Idiopathic Normal Pressure Hydrocephalus: An Overview of Pathophysiology, Clinical Features, Diagnosis and Treatment

Normal pressure hydrocephalus is characterised by the triad of gait disturbance, dementia and urinary incontinence. Although our understanding of the condition has considerably improved since it was initially described over 50 years ago, its pathophysiology is still a matter of debate. We provide an overview of the current concepts in pathophysiology and discuss the clinical features, diagnosis and treatment of this cause of dementia

S-duality, triangle groups and modular anomalies in N=2 SQCD

We study N=2 superconformal theories with gauge group SU(N ) and 2N fundamental flavours in a locus of the Coulomb branch with a Z_N symmetry. In this special vacuum, we calculate the prepotential, the dual periods and the period matrix using equivariant localization. When the flavors are massless, we find that the period matrix is completely specified by [N/2] effective couplings. On each of these, we show that the S-duality group acts as a generalized triangle group and that its hauptmodul can be used to write a non-perturbatively exact relation between each effective coupling and the bare one. For N = 2, 3, 4 and 6, the generalized triangle group is an arithmetic Hecke group which contains a subgroup that is also a congruence subgroup of the modular group PSL(2,\u2124). For these cases, we introduce mass deformations that respect the symmetries of the special vacuum and show that the constraints arising from S-duality make it possible to resum the instanton contributions to the period matrix in terms of meromorphic modular forms which solve modular anomaly equations

Modular anomaly equations and S-duality in N=2 conformal SQCD

We use localization techniques to study the non-perturbative properties of an N = 2 $$\mathcal{N}=2$$ superconformal gauge theory with gauge group SU(3) and six fundamental flavours. The instanton corrections to the prepotential, the dual periods and the period matrix are calculated in a locus of special vacua possessing a ℤ 3 symmetry. In a semiclassical expansion, we show that these observables are constrained by S-duality via a modular anomaly equation which takes the form of a recursion relation. The solutions of the recursion relation are quasi-modular functions of Γ 1 (3), which is a subgroup of the S -duality group and is also a congruence subgroup of SL(2 , ℤ )

Haemoglobinopathies- thalassaemias and abnormal haemoglobins in Eastern Uttar Pradesh and adjoining districts of neighbouring states

The haemoglobinopathies- thalassaemias and abnormal haemoglobins- constitute a major burden of genetic diseases in India. Our study, based on index cases from 120 families detected between May 1999 and May 2003, highlights the ethnic distribution of haemoglobinopathies in regions in and around Varanasi comprising 8-10 districts of eastern Uttar Pradesh and adjoining districts of Bihar, Jharkhand, Chhattisgarh and Madhya Pradesh. Homozygous and heterozygous β-thalassaemia was the most common (66.9%), with thalassaemic haemoglobinopathies HbE-β-thalassaemia (15.9%) and HbS-β-thalasseamia (7.8%) contributing to almost a quarter of the cases. Along with HbSS disease (4.3%), the results indicate a confluence of β-thalassaemia, HbS and HbE in this region. IVS1-5 nt was the most common mutation in the few carriers analysed for mutation detection. The significance of the study lies in the demonstration of wide prevalence of β-thalassaemia across all castes and communities of this region, with migrant population groups of Sindhis and Punjabis comprising only 5.8% of the index cases. Also, HbE seems to have a much higher presence in this region than so far believed and HbS has a significant presence in general castes as well

An NGO-Implemented Community-Clinic Health Worker Approach to Providing Long-Term Care for Hypertension in a Remote Region of Southern India.

Poor blood pressure control results in tremendous morbidity and mortality in India where the leading cause of death among adults is from coronary heart disease. Despite having little formal education, community health workers (CHWs) are integral to successful public health interventions in India and other low- and middle-income countries that have a shortage of trained health professionals. Training CHWs to screen for and manage chronic hypertension, with support from trained clinicians, offers an excellent opportunity for effecting systemwide change in hypertension-related burden of disease. In this article, we describe the development of a program that trained CHWs between 2014 and 2015 in the tribal region of the Sittilingi Valley in southern India, to identify hypertensive patients in the community, refer them for diagnosis and initial management in a physician-staffed clinic, and provide them with sustained lifestyle interventions and medications over multiple visits. We found that after 2 years, the CHWs had screened 7,176 people over age 18 for hypertension, 1,184 (16.5%) of whom were screened as hypertensive. Of the 1,184 patients screened as hypertensive, 898 (75.8%) had achieved blood pressure control, defined as a systolic blood pressure less than 140 and a diastolic blood pressure less than 90 sustained over 3 consecutive visits. While all of the 24 trained CHWs reported confidence in checking blood pressure with a manual blood pressure cuff, 4 of the 24 CHWs reported occasional difficulty documenting blood pressure values because they were unable to write numbers properly. They compensated by asking other CHWs or members of their community to help with documentation. Our experience and findings suggest that a CHW blood pressure screening system linked to a central clinic can be a promising avenue for improving hypertension control rates in low- and middle-income countries