Hearing Loss in HIV-Infected Children in Lilongwe, Malawi.

INTRODUCTION: With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. METHODS: This was a cross-sectional survey of 380 HIV-infected children aged 4-14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. RESULTS: Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2-13.0) and ear drainage (OR 6.4, 3.6-11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2-4.5) or Stage 4 (OR 6.4, 2.7-15.2) and history of malnutrition (OR 2.1, 1.3-3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child's hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). CONCLUSIONS: There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to frequent ear infections, and many children with hearing loss qualified for hearing aids. Screening strategies need to be developed and tested since caregivers were not reliable at identifying hearing loss, and often mis-identified children with normal hearing as having hearing loss. Children with frequent ear infections, ear drainage, TB, severe HIV disease, or low BMI should receive more frequent ear assessments and hearing evaluations

Smart Irrigation Using RF Technology and Solar Metering System

This paper is based on model of AVR atmega microcontroller based irrigation system. We are using solar energy as the source of power to regulate the overall system .In the field the sensors are placed  so that these sensors are   sense the water level continuously  and it gives indication to the farmer informing the level of water. There is no need to visit the fields; farmers can get the updated about the water level without wasting their time. According to the water level, a farmer can regulate the motor by sending a message from his cellular phone even from a remote place. As the water level reaches to the peak level; the motor will automatically run there is no need of farmer to assure the proper water level in the field

The effects of HIV on the sensitivity of a whole blood IFN-gamma release assay in Zambian adults with active tuberculosis.

BACKGROUND: Interferon gamma release assays (IGRA) are replacing the tuberculin skin test (TST) as a diagnostic tool for Mycobacterium tuberculosis infection. However research into the test's performance in the high HIV-TB burden setting is scarce. This study aimed to define the sensitivity of an IGRA, QuantiFERON-TB Gold In-Tube (QGIT), in adult Zambian patients with active smear-positive tuberculosis. Secondary outcomes focussed on the effect of HIV on the test's performance. PRINCIPAL FINDINGS: Patients attending government health clinics were recruited within 1 month of starting treatment for TB. Subjects were tested with QGIT and TST. T lymphocyte counts were estimated (CD3(+), CD4(+), CD8(+)). QGIT was performed for 112 subjects. 83/112 were QGIT positive giving an overall sensitivity of 74% [95%CI: 66,82]. A marked decrease in sensitivity was observed in HIV positive patients with 37/59 (63%) being QGIT positive compared to 31/37 (84%) HIV negative patients [chi(2) p = 0.033]. Low CD4(+) count was associated with increases in both indeterminate and false-negative results. Low CD4(+) count in combination with high/normal CD8(+) count was associated with false-negative results. TST was recorded for 92 patients, 62/92 were positive, giving a sensitivity of 67% [95%CI: 58,77]. Although there was little difference in the overall sensitivities, agreement between TST and QGIT was poor. CONCLUSIONS: QGIT was technically feasible with results in HIV negative subjects comparable to those achieved elsewhere. However, where under-treated HIV is prevalent, an increased proportion of both indeterminate and false-negative QGIT results can be expected in patients with active TB. The implications of this for the diagnosis of LTBI by QGIT is unclear. The diagnostic and prognostic relevance of IGRAs in high burden settings needs to be better characterised

HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

BACKGROUND: As paediatric antiretroviral therapy (ART) is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV) infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. STUDY OBJECTIVES: 1) Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2) Examine types of disability and associated clinical and socio-demographic factors. 3) Identify needs, opportunities and barriers for rehabilitation in Malawi. METHODS: A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases) and their uninfected siblings (controls) was conducted. Disability was assessed using the WHO Ten Question Screen (TQS). Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. RESULTS: Of 296 case and control pairs recruited, 33% (98) versus 7% (20) screened positive for a disability (OR 8.4, 4.4-15.7) respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2), to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8) and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6) than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. CONCLUSION: This study reveals the magnitude of disability among HIV-infected children and the large unmet need for rehabilitation services. This expanding issue demands further investigation to provide an evidence base for holistic care for disabled children living with HIV

E-Krishi Vikas - Multilingual App

Abstract: The Indian agriculture sector has many growing concerns. As the Indian economy has diversified and grown, agriculture’s contribution to GDP has steadily declined from 1951 to 2019. Agriculture in India has achieved grain selfsufficiency but the production is resource-intensive, cereal centric, and regionally biased. The resource-intensive ways of Indian agriculture have raised serious sustainability issues too. Farmers in India face the unavailability of resources or lack of ways to access the available resources. In the majority of cases, plenty of facilities are available for the farmers to succeed in their job, but there is a huge information gap between the farmers and those available schemes. In these kinds of cases also, there is another problem that makes those services insufficient, and that problem is the communication problem. India has a huge diversity in terms of languages, culture, region, and rich history behind that diversity. There is a huge probability that farmers speaking and understanding their own regional language do not understand the National and International languages to gain full advantage of the available services for them. In this paper, we propose an android-based app, E-krishi Vikas, intended to address this issue. Further, it will act as a complete farmers’ friend, by helping them to get information about the weather, help them in finding the equipment of their needs, and much more in their preferred language. The unique features of E-krishi Vikas are its simple and user-friendly interface. Keywords: Krishi, Agriculture, Multi-lingual, Android, Marketplace, Community</jats:p

Gold nanoparticles-reduced graphene oxide based electrochemical immunosensor for the cardiac biomarker myoglobin

A composite consisting of gold nanoparticles and reduced graphene oxide (AuNPs@rGO) was electrochemically prepared in-situ on a screen printed electrode (SPE) which then was used as an immunosensor for the cardiac biomarker myoglobin. The nanocomposite was characterized by transmission electron microscopy (TEM, scanning electron microscopy (SEM), atomic force microscopy, FTIR and electrochemical impedance spectroscopy. For FTIR, TEM and SEM, the deposition was done on indium tin oxide coated glass plates. The immunosensor was obtained by immobilization of in-house generated antibody against cardiac myoglobin on the electrode surface. The immunosensing response was monitored using differential pulse voltammetry, which showed a reduction peak at ~ −0.5 V (vs. Ag/AgCl). The reduction peak arises from the reduction of iron moiety present in the heme group of myoglobin. The immunosensor exhibited dynamic linearity range from 1 ng.mL−1 to 1400 ng.mL−1 with the detection limit of ~0.67 ng.mL−1 for cardiac myoglobin. The obtained result was almost eight times better (in terms of detection limit) than that obtained with ELISA tests (with detection limit of ~4 ng.mL−1) using the same antibodies. The immunosensor was applied to analyze spiked serum samples also

A green polyol approach for the synthesis of Cu₂O NPs adhered on graphene oxide: a robust and efficient catalyst for 1,2,4-triazole and imidazo[1,2-<i>a</i>]pyridine synthesis

Cu2O NPs immobilized on graphene oxide are used as a heterogeneous catalyst for the synthesis of a series of 1,2,4-triazoles and imidazo[1,2-a]pyridines under solvent-free conditions.</jats:p

Phase, microstructure, and wear behavior of Al₂O₃-reinforced Fe–Si alloy-based metal matrix nanocomposites

In the present work, phase, microstructure, and wear properties of Al2O3-reinforced Fe–Si alloy-based metal matrix nanocomposites have been studied. Composites using 2 wt.% and 5 wt.% of Si and rest Fe powder mix were synthesized via powder metallurgy and sintered at different temperature schedules. Iron–silicon alloy specimens were found to have high hardness and high wear resistance in comparison to pure iron specimens. Addition of 5 wt.% and 10 wt.% alumina reinforcement in Fe–Si alloy composition helped in developing iron aluminate (FeAl2O4) phase in composites which further improved the mechanical properties i.e. high hardness and wear resistance. Formation of iron aluminate phase occurs due to reactive sintering between Fe and Al2O3 particles. It is expected that the improved behavior of prepared nanocomposites as compared to conventional metals will be helpful in finding their use for wide industrial applications. </jats:p

Impact Artificial Intelligence in the Pharmaceutical Industry on Working Culture: A Review

The pharmaceutical and healthcare industries have benefited greatly from artificial  intelligence in recent years. A wide range of pharmaceutical fields, such as this novel  approach, showed potential in drug discovery, continuous manufacturing (CM),  dosage form design, and quality control. This article focuses on the use of artificial  intelligence in the pharmaceutical sector. Before all else, the film sheds light on how  AI will be implemented into health care, as well as its potential benefits. To  conclude, there are several hurdles to overcome in the project implementation. At  present, it's no secret that artificial intelligence (AI) and genetic algorithms (ANNs)  are becoming increasingly popular in the pharmaceutical industry. In the  pharmaceutical industry, artificial intelligence (AI) has shown promise, and it can be  used in combination with robotics. Physical robots could revolutionize the  healthcare industry. To keep their minds sharp and alert, it's used as a social  interaction guide with elderly patients. In the pharmaceutical industry, artificial  intelligence (AI) will help reduce costs and time. </jats:p