A community-based study to evaluate the prevalence and risk factors for osteoporosis among menopausal and pre-menopausal women

Background: To determine the prevalence of osteoporosis among pre and post menopausal women using quantitative ultrasound of calcaneal bone and to identify the risk factors associated with osteoporosis.Methods: This prospective community based epidemiological study was conducted during 2019 in a suburban area attached to Sri Muthu Kumaran Medical College Hospital and Research Institute, Chennai. 305 subjects met the inclusion and exclusion criteria. Using a structured questionnaire, demographic details, obstetric, gynaecological and medical history were collected. Quantitative ultrasound of the calcaneal bone was used to calculate the bone mineral density. Using statistical methods, risk factors for osteoporosis were analysed.Results: The mean age of the participants was 52.67±9.41 years, 62.2% were post menopausal and 37.38% were premenopausal. The BMD ‘T’ score was normal in 29.8%, osteopenia was diagnosed in 38.4% and osteoporosis in 31.8% of participants. 14% of premenopausal women and 42.4% of postmenopausal women were osteoporotic. Age, menopausal status, duration of menopause, and previous history of fractures emerged as significant risk factors for osteoporosis.Conclusions: The prevalence of osteoporosis is high among both pre-menopausal and menopausal women, but the awareness is limited. This study highlights the need for screening all women after the age of 40 years which is feasible using portable and easily available technology such as quantitative ultrasound of peripheral bones

ANTI-DIABETIC ACTIVITY OF TRADITIONAL POLYHERBAL FORMULATION: DEVELOPMENT AND EVALUATION

Herbal therapy has emerged as a prominent therapeutic approach for a wide range of ailments. In tandem with a nutritious diet and lifestyle, these interventions aim to address certain health objectives by supplying each cell with the most suitable and advantageous nourishment. There exists a botanical alternative for each synthetic medicine now available. Material and Methods: The herbs utilized in the formulation were obtained from reputable vendors and subsequently verified by Department of Life Sciences, Garden City University, Bengaluru, Karnataka, India. For the purpose of standardizing raw materials, shade-dried powdered plant parts from the plants Berberis aristata (dried stem), Terminalia chebula (pericarp of matured fruit), Emblica officinalis (pericarp of dried mature fruit), Terminalalia belerica (pericarp of dried ripe fruit), and Cyperus rotundus (dried rhizome) are used. Results: Blood glucose and lipid profiles were taken first thing in the morning. The formulation had a significant impact when compared to the typical range before diabetes was introduced. Total cholesterol, bad LDL cholesterol, and bad triglyceride levels were all reduced while HDL levels were increased. The phytochemical investigation backed up the claim that flavonoids were present. This may explain why it has such a dramatic impact on treating diabetes. It is recommended that future clinical trials be conducted in Human Volunteers, and that stability studies be conducted on the manufactured polyherbal capsules. Conclusion: The oldest type of therapy, herbal remedies are used to identify and treat illnesses. An animal model was used to assess the antidiabetic potency of five raw materials that were chosen for formulation into polyherbal capsules. The capsules significantly improved the lipid profile and fasting blood glucose indices, as well as their anti-diabetic efficacy. Future use is advised to pursue additional stability research and clinical trials

Knowledge and awareness of cervical cancer prevention and HPV vaccination among medical and nursing students in a tertiary care hospital

Background: This study was done to assess the level of knowledge and awareness about cervical cancer and its prevention among medical and nursing students. Methods: This descriptive cross-sectional study was conducted during 2022 in a tertiary care hospital in Chennai. The study included 407 subjects; 224 medical students, and 183 nursing students and consent was obtained from each participant prior to the study. A questionnaire survey was used to assess their knowledge on cervical cancer and its prevention. Results: Out of the 407 participants, 95.5% of the medical students and 30.6% of the nursing students knew that HPV virus causes cervical cancer. Medical students had more knowledge on risk factors. 84.38% of medical students and 43.72% of nursing students were aware that vaccine is available for the prevention of cervical cancer. Overall nursing students had limited knowledge on cervical cancer and its prevention. 51.79% of the medical students and 27.87% of the nursing students acquired their knowledge about HPV vaccine through social media. The uptake of HPV vaccine was very low among both medical and nursing students. Conclusions: The results of our study demonstrate that there is a need for creating more awareness about cervical cancer and its prevention among medical and nursing students

Regional specialization and fate specification of bone stromal cells in skeletal development

Bone stroma contributes to the regulation of osteogenesis and hematopoiesis but also to fracture healing and disease processes. Mesenchymal stromal cells from bone (BMSCs) represent a heterogenous mixture of different subpopulations with distinct molecular and functional properties. The lineage relationship between BMSC subsets and their regulation by intrinsic and extrinsic factors are not well understood. Here, we show with mouse genetics, ex vivo cell differentiation assays, and transcriptional profiling that BMSCs from metaphysis (mpMSCs) and diaphysis (dpMSCs) are fundamentally distinct. Fate-tracking experiments and single-cell RNA sequencing indicate that bone-forming osteoblast lineage cells and dpMSCs, including leptin receptor-positive (LepR(+)) reticular cells in bone marrow, emerge from mpMSCs in the postnatal metaphysis. Finally, we show that BMSC fate is controlled by platelet-derived growth factor receptor β (PDGFRβ) signaling and the transcription factor Jun-B. The sum of our findings improves our understanding of BMSC development, lineage relationships, and differentiation

Patterning in Birthweight in India: Analysis of Maternal Recall and Health Card Data

National data on birthweight from birth certificates or medical records are not available in India. The third Indian National Family Health Survey included data on birthweight of children obtained from health cards and maternal recall. This study aims to describe the population that these data represent and compares the birthweight obtained from health cards with maternal recall data in terms of its socioeconomic patterning and as a risk factor for childhood growth failure.The analytic sample consisted of children aged 0 to 59 months with birthweight data obtained from health cards (n = 3227) and maternal recall (n = 16,787). The difference between the card sample and the maternal recall sample in the distribution across household wealth, parental education, caste, religion, gender, and urban residence was compared using multilevel models. We also assessed the ability of birthweight to predict growth failure in infancy and childhood in the two groups. The survey contains birthweight data from a majority of household wealth categories (>5% in every category for recall), both genders, all age groups, all caste groups, all religion groups, and urban and rural dwellers. However, children from the lowest quintile of household wealth were under-represented (4.73% in card and 8.62% in recall samples). Comparison of data across health cards and maternal recall revealed similar social patterning of low birthweight and ability of birthweight to predict growth failure later in life. Children were less likely to be born with low birthweight if they had mothers with over 12 years of education compared to 1-5 years of education with relative risk (RR) of 0.79 (95% confidence interval [CI]: 0.52, 1.2) in the card sample and 0.70 (95% CI: 0.59, 0.84) in the recall sample. A 100 gram difference in a child's birthweight was associated with a decreased likelihood of underweight in both the card (RR: 0.95; 95% CI: 0.94, 0.96) and recall (RR: 0.96; 95% CI: 0.96, 0.97) samples.Our results suggest that in the absence of other sources, the data on birthweight in the third Indian National Family Health Survey is valuable for epidemiologic research

Factors Associated With Small Size at Birth in Nepal: Further Analysis of Nepal Demographic and Health Survey 2011

Background: The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children. Methods: Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.Results: A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams). The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males. Conclusion: One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal

Role of antenatal care and iron supplementation during pregnancy in preventing low birth weight in Nepal: Comparison of national surveys 2006 and 2011

Background: Low birth weight (LBW) is a major cause of neonatal deaths in developing countries including Nepal. Its social determinants in Nepal have rarely been identified. This study aimed to identify the factors associated with low birth weight among under-five children comparing data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011. Methods: Pooled data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011 were analysed initially and the two survey data were then compared separately. The association between LBW and socio-demographic and health related factors were analysed using multiple logistic regression analysis with a stepwise backward elimination procedure. Complex Sample Analysis method was used to account for study design and sampling.Results: A total of 2845 children, 923 children in 2006 and 1922 children in 2011, had their birth weight recorded. The mean birth weight was 3024 (SD = 654.5) grams. A total of 12.1% (95% Confidence interval (CI); 10.6%-13.7%) children had low birth weight (<2500 grams) at the time of birth. Attending antenatal care was found to be consistently associated with low birth weight for the pooled survey data, and both 2006 and 2011 survey data, respectively. Not attending antenatal care increased the odds of having a LBW infant by more than two times [OR 2.301; 95% CI (1.526-3.471)]. Iron supplementation, which is an integral part of antenatal care in Nepal, was also significantly associated with birth weight for combined and individual surveys. Mothers not consuming iron supplementation during their pregnancy were more likely to have LBW infants [OR 1.839; 95% CI (1.282-2.363)]. Residing in the Far-western and Eastern region were also significant risk factors for LBW in the pooled dataset and in 2011 survey. Conclusions: The current study indicated there was no significant decrease in the LBW prevalence and there is a need of targeted interventions aimed at decreasing the high rate of LBW through increasing antenatal care and consumption of iron supplementation during pregnancy

Gender Based Within-Household Inequality in Childhood Immunization in India: Changes over Time and across Regions

Background and Objectives: Despite India’s substantial economic growth in the past two decades, girls in India are discriminated against in access to preventive healthcare including immunizations. Surprisingly, no study has assessed the contribution of gender based within-household discrimination to the overall inequality in immunization status of Indian children. This study therefore has two objectives: to estimate the gender based within-household inequality (GWHI) in immunization status of Indian children and to examine the inter-regional and inter-temporal variations in the GWHI. Data and Methods: The present study used households with a pair of male-female siblings (aged 1–5 years) from two rounds of National Family Health Survey (NFHS, 1992–93 and 2005–06). The overall inequality in the immunization status (after controlling for age and birth order) of children was decomposed into within-households and between-households components using Mean log deviation to obtain the GWHI component. The analysis was conducted at the all-India level as well as for six specified geographical regions and at two time points (1992–93 and 2005–06). Household fixed-effects models for immunization status of children were also estimated. Results and Conclusions: Findings from household fixed effects analysis indicated that the immunization scores of girls were significantly lower than that of boys. The inequality decompositions revealed that, at the all-India level, the absolute level of GWHI in immunization status decreased from 0.035 in 1992–93 to 0.023 in 2005–06. However, as a percentage o

New Directions in the Development of Population Estimates in the United States?

The advent of a continuously updated Master Area File (MAF) following the 2000 census represents an information resource that can be tapped for purposes of developing timely, cost-effective, and precise population estimates for even the smallest of geographical units (e.g., census blocks). We argue that the MAF can be enhanced (EMAF) for these purposes. In support of our argument we describe a set of activities needed to develop EMAF, each of which is well within the current capabilities of the U.S. Census Bureau and discuss various costs and benefits of each. We also describe how EMAF would provide population estimates containing a wide range of demographic (e.g., age, race, and sex) and socio-economic characteristics (e.g., educational attainment, income, and employment). As such, it could largely negate and eliminate the need for many of the traditional demographic methods of population estimation and possibly reduce the number of sample surveys. We identify important challenges that must be surmounted in order to realize EMAF and make suggestions for doing so. We conclude by noting that the idea of the EMAF could be of interest to other countries with MAF files and strong administrative records systems that, like the United States, are facing the challenge of producing good population information in the face of increasing census costs

Selective deployment of transcription factor paralogs with submaximal strength facilitates gene regulation in the immune system

In multicellular organisms, duplicated genes can diverge through tissue-specific gene expression patterns, as exemplified by highly regulated expression of Runx transcription factor paralogs with apparent functional redundancy. Here we asked what cell type-specific biologies might be supported by the selective expression of Runx paralogs during Langerhans cell and inducible regulatory T cell differentiation. We uncovered functional non-equivalence between Runx paralogs. Selective expression of native paralogs allowed integration of transcription factor activity with extrinsic signals, while non-native paralogs enforced differentiation even in the absence of exogenous inducers. DNA-binding affinity was controlled by divergent amino acids within the otherwise highly conserved RUNT domain, and evolutionary reconstruction suggested convergence of RUNT domain residues towards sub-maximal strength. Hence, the selective expression of gene duplicates in specialized cell types can synergize with the acquisition of functional differences to enable appropriate gene expression, lineage choice and differentiation in the mammalian immune system