Incidence, risk factors and complications of dysphagia in stroke patients admitted to medical wards at a tertiary hospital in South India

OBJECTIVES: 1.To determine the incidence of swallowing dysfunction in stroke. 2. To study the factors associated with swallowing dysfunction in stroke. 3. To determine the incidence of aspiration pneumonia in stroke. 4. To determine factors associated with development of aspiration pneumonia in dysphagia. METHODS: This is a prospective cohort study. We recruited 100 patients with acute stroke from medical wards and swallowing assessment was done by principal investigator using Mann’s assessment of swallowing, by speech therapist and by Fibreoptic endoscopic evaluation of swallowing. The patients were followed up for a period of 3 months. The main outcomes were improvement in dysphagia and pneumonia. The secondary outcomes were death and duration of hospitalization. The relation between various factors and outcomes was also assessed. RESULTS: Dysphagia was seen in 77 patients. The dysphagia improved with time and at the end of 3 months, 18 patients had dysphagia. Dysphagia was significantly associated with mortality (28% vs 4.5%; p=0.04). Pneumonia was seen in 28 patients. Pneumonia was associated with a significantly high mortality rate (59.3% vs 8.6%; p=0.001) and prolonged duration of hospitalization (8.86 vs 6.33; p=0.001). Weak gag reflex was found to be associated with dysphagia. No independent factors predicting pneumonia were found. CONCLUSION : There is a high incidence of dysphagia and pneumonia in acute stroke. Pneumonia is associated with significant mortality and prolonged duration of hospitalization

The Impact of Job Stress on Turnover Intention: A Study of Reputed Apparel Firm in Sri Lanka

This study attempts to identify the impact of job stress on turnover intention among machine operators in reputed apparel firm in Sri Lanka. Due to high level of turnover among machine operators, Presently Sri Lankan apparel industry faces a greater difficulties and it is noted that little attempt has been taken by the researchers to integrate the job stress with turnover intention in Sri Lankan literature. Hence problem of this study is to investigate ‘How the job stress causes an impact on turnover intention among machine operators in reputed apparel firm in Sri Lanka’. This study is conducted under the mixed research method and data were collected through a self-administered questionnaire consisting of 23 questions with five point Likert scale ranging from “strongly agree” to “strongly disagree”. In addition to that, data were collected through structured interviews with ten resigned employees. Under the universal sampling method, data were collected from 90 machine operators currently employed in the selected apparel firms. Data thus collected were analyzed using SPPS computer package having the univariate and bivariate analyses. Findings of the research revealed that there is a positive impact of job stress on turnover intention among machine operators in reputed apparel firms in Sri Lanka. It was concluded that there is a positive impact of job stress on turnover intention which means that majority of machine operators have a high degree of job stress. Further, this study also supported the view that the managers of apparel firms should get strategic steps to reduce job stress and turnover intention among the employees.Keywords: Apparel Firm, Job Stress, Machine Operators, Turnover Intentio

Topical Hpmc/s-nitrosoglutathione Solution Decreases Inflammation And Bone Resorption In Experimental Periodontal Disease In Rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)S-nitrosoglutathione (GSNO) is a nitric oxide (NO) donor, which exerts antioxidant, anti-inflammatory, and microbicidal actions. Intragingival application of GSNO was already shown to decrease alveolar bone loss, inflammation and oxidative stress in an experimental periodontal disease (EPD) model. In the present study, we evaluated the potential therapeutic effect of topical applications of hydroxypropylmethylcellulose (HPMC)/GSNO solutions on EPD in Wistar rats. EPD was induced by placing a sterilized nylon (3.0) thread ligature around the cervix of the second left upper molar of the animals, which received topical applications of a HPMC solutions containing GSNO 2 or 10 mM or vehicle (HPMC solution), 1 h prior to the placement of the ligature and then twice daily until sacrifice on day 11. Treatment with HPMC/ GSNO 10 mM solution significantly reduced alveolar bone loss, oxidative stress and TNF-alpha e IL-1 beta levels in the surrounding gingival tissue, and led to a decreased transcription of RANK and TNF-alpha genes and elevated bone alkaline phosphatase, compared to the HPMC group. In conclusion, topical application of HPMC/GSNO solution is a potential treatment to reduce inflammation and bone loss in periodontal disease.11National Council for Scientific and Technological Development - CNPq [478380/2011-9, 309390/2011-7]Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Historical perspectives on pastoralism and land tenure transformation in Ngamiland, Botswana: What are the policy and institutional lessons?

Pastoral societies in dryland Africa continue to face changes to their pastoral systems. These systems are influenced by a range of historical factors but little use is made of this information to design policies that suit pastoralists’ landscapes. This article provides a synthesis of historical perspectives on pastoral land use and tenure transformations in Ngamiland, south of the Okavango Delta, Botswana. Little documentation of herders’ historical perspectives exists and less is known about how past experiences can be applied to sustainable pastoralism policies. In this article, current land use pressing issues are examined and analysed within the context of past experiences. We use a series of oral histories with key informants, focus group discussions, expert interviews and rangelands field observations. Ngamiland historical perspectives depict a pastoral landscape that has been shaped by a variety of factors; livestock diseases, Human-wildlife-conflicts, droughts, land tenure transformations associated with rangeland policies and the pastoral identity of the Ovaherero/Ovambanderu ethnic groups. Pastoralists have followed unique trajectories, specific to their rangeland conditions and socio-cultural context. Resilience to climate shocks and diseases has been weakened by inequitable patterns of control over rangeland resources. We recommend institutional diversity such that from experiences of the past, lessons can be drawn of the sort of processes and institutions required for pastoralism policies including targeted pastoralists’ adaptations. Using pastoralists to provide information, especially in the area of indigenous knowledge, strategies can be developed to link conservation of wildlife and rangelands with pastoral production by developing ecologically-sensitive low-volume tourism that pastoral communities can tap in to diversify their livelihoods

CRISPR Inhibition of Prophage Acquisition in Streptococcus pyogenes

Streptococcus pyogenes, one of the major human pathogens, is a unique species since it has acquired diverse strain-specific virulence properties mainly through the acquisition of streptococcal prophages. In addition, S. pyogenes possesses clustered regularly interspaced short palindromic repeats (CRISPR)/Cas systems that can restrict horizontal gene transfer (HGT) including phage insertion. Therefore, it was of interest to examine the relationship between CRISPR and acquisition of prophages in S. pyogenes. Although two distinct CRISPR loci were found in S. pyogenes, some strains lacked CRISPR and these strains possess significantly more prophages than CRISPR harboring strains. We also found that the number of spacers of S. pyogenes CRISPR was less than for other streptococci. The demonstrated spacer contents, however, suggested that the CRISPR appear to limit phage insertions. In addition, we found a significant inverse correlation between the number of spacers and prophages in S. pyogenes. It was therefore suggested that S. pyogenes CRISPR have permitted phage insertion by lacking its own spacers. Interestingly, in two closely related S. pyogenes strains (SSI-1 and MGAS315), CRISPR activity appeared to be impaired following the insertion of phage genomes into the repeat sequences. Detailed analysis of this prophage insertion site suggested that MGAS315 is the ancestral strain of SSI-1. As a result of analysis of 35 additional streptococcal genomes, it was suggested that the influences of the CRISPR on the phage insertion vary among species even within the same genus. Our results suggested that limitations in CRISPR content could explain the characteristic acquisition of prophages and might contribute to strain-specific pathogenesis in S. pyogenes

Modeling rare gene variation to gain insight into the oldest biomarker in autism: construction of the serotonin transporter Gly56Ala knock-in mouse

Alterations in peripheral and central indices of serotonin (5-hydroxytryptamine, 5-HT) production, storage and signaling have long been associated with autism. The 5-HT transporter gene (HTT, SERT, SLC6A4) has received considerable attention as a potential risk locus for autism-spectrum disorders, as well as disorders with overlapping symptoms, including obsessive-compulsive disorder (OCD). Here, we review our efforts to characterize rare, nonsynonymous polymorphisms in SERT derived from multiplex pedigrees carrying diagnoses of autism and OCD and present the initial stages of our effort to model one of these variants, Gly56Ala, in vivo. We generated a targeting vector to produce the Gly56Ala substitution in the Slc6a4 locus by homologous recombination. Following removal of a neomycin resistance selection cassette, animals exhibiting germline transmission of the Ala56 variant were bred to establish a breeding colony on a 129S6 background, suitable for initial evaluation of biochemical, physiological and behavioral alterations relative to SERT Gly56 (wildtype) animals. SERT Ala56 mice were achieved and exhibit a normal pattern of transmission. The initial growth and gross morphology of these animals is comparable to wildtype littermate controls. The SERT Ala56 variant can be propagated in 129S6 mice without apparent disruption of fertility and growth. We discuss both the opportunities and challenges that await the physiological/behavioral analysis of Gly56Ala transgenic mice, with particular reference to modeling autism-associated traits