A study of sociodemographic determinants, reasons and decision maker of medical termination of pregnancy in urban slums of Jamnagar, India

Background: Medical termination of pregnancy is defined as “willful termination of pregnancy before the age of viability of the foetus. The objective was to study the socio-demographic & obstetric profile and the reasons for procuring an abortion & choice of health care provider.Methods: A Cross-sectional study was done in urban slum in Jamnagar municipal corporation area by using 30 clusters sampling technique. Every women in the reproductive age group (15-49 years) was included in the study till the sample size of 15 was completed in each cluster and thus total 450 women were interviewed. 48 women out of the total of 450 ever married women in the reproductive age group who had ever undergone induced abortion were studied in detailResults: In the present study out of 450 eligible women, 48 (10.67%) had undergone an induced abortion and once only. 72.91% (35/48) of the women belonged to the age group 25-34 years and 89.59% (43/48) of the women were Hindus. Almost half of the total women (45.83%) had primary education, higher proportion of women were housewife 77.09% (37/48). According to Modified Prasad’s classification, 54.17 % of women belonged to lower social class (IV and V). One third (33.33%) of the women who underwent MTP had 1 living child. Majority 79.16% of the women preferred government hospital and in 45.83% cases both husband and wife acted as decision maker for MTP. Most common reason given for terminating the pregnancy was “birth spacing”. (52.09%) Other reasons given were, “family completed” (22.91%), “medical” (14.58%) & social (4.17%). Majority of the women (70.83%) accepted post abortion contraception.Conclusion: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth and it is not free from risk. They should be motivated for various methods of contraception.

A Comparative Evaluation of Mono-, Di- and Triglyceride of Medium Chain Fatty Acids by Lipid/Surfactant/Water Phase Diagram, Solubility Determination and Dispersion Testing for Application in Pharmaceutical Dosage Form Development

Purpose To compare physiochemical properties of mono-, diand triglycerides of medium chain fatty acids for development of oral pharmaceutical dosage forms of poorly water-soluble drugs using phase diagrams, drug solubility, and drug dispersion experiments. Methods Phase diagrams were prepared using a monoglyceride (glycerol monocaprylocaprate: Capmul MCM ® EP), a diglyceride (glycerol dicaprylate) and two triglycerides (glycerol tricaprylate

Evaluation of efficacy of whatsapp messenger application in medical research education

Background: There is lack of knowledge regarding research amongst medical students as it is not included in the present curriculum of MBBS. Hence authors have selected ‘Medical Research’ as a topic to evaluate the efficacy of WhatsApp messenger application as a teaching-learning tool. There is very limited research on impact of technological modalities like WhatsApp on education. Authors undertook this study to evaluate its efficacy as a tool to supplement medical research education and assess the perception of students about e-learning via WhatsApp messenger application.Methods: A prospective analytical interventional study was conducted after obtaining ethical approval from the Institutional Ethics Committee. A self-designed comprehensive questionnaire was used to test the knowledge of medical students. A series of modules were sent and discussed on the WhatsApp study groups followed by assessment in change of the level of knowledge amongst the participants post intervention.Results: Applying the paired t-test, the scores of the study participants showed a statistically significant increase in the post- intervention evaluation (Mean=10.13, Median=10, Range=0-21) as compared to the baseline knowledge regarding medical research as reflected in the pre intervention evaluation (Mean=6.76, Median=7, Range=0-16). Conclusions: Growing availability of economical and user friendly smart phones in every generation has promoted use of WhatsApp by teachers as well as students. WhatsApp has the potential to supplement academic learning and become a natural educational modality. Necessary precautions could be taken to minimize the drawbacks expressed by the students to make it a more enjoyable and acceptable tool for teaching and learning

Lateral Connectivity in the Olfactory Bulb is Sparse and Segregated

Lateral connections in the olfactory bulb were previously thought to be organized for center–surround inhibition. However, recent anatomical and physiological studies showed sparse and distributed interactions of inhibitory granule cells (GCs) which tended to be organized in columnar clusters. Little is known about how these distributed clusters are interconnected. In this study, we use transsynaptic tracing viruses bearing green or red fluorescent proteins to further elucidate mitral- and tufted-to-GC connectivity. Separate sites in the glomerular layer were injected with each virus. Columns with labeling from both viruses after transsynaptic spread show sparse red or green GCs which tended to be segregated. However, there was a higher incidence of co-labeled cells than chance would predict. Similar segregation of labeling is observed from dual injections into olfactory cortex. Collectively, these results suggest that neighboring mitral and tufted cells receive inhibitory inputs from segregated subsets of GCs, enabling inhibition of a center by specific and discontinuous lateral elements

Recent Patterns in Population-Based HIV Prevalence in Swaziland

Background: The 2011 Swaziland HIV Incidence Measurement Survey (SHIMS) was conducted as part of a national study to evaluate the scale up of key HIV prevention programs. Methods: From a randomly selected sample of all Swazi households, all women and men aged 18-49 were considered eligible, and all consenting adults were enrolled and received HIV testing and counseling. In this analysis, population-based measures of HIV prevalence were produced and compared against similarly measured HIV prevalence estimates from the 2006-7 Swaziland Demographic and Health. Also, measures of HIV service utilization in both HIV infected and uninfected populations were documented and discussed. Results: HIV prevalence among adults aged 18-49 has remained unchanged between 2006-2011 at 31-32%, with substantial differences in current prevalence between women (39%) and men (24%). In both men and women, between since 2006-7 and 2011, prevalence has fallen in the young age groups and risen in the older age groups. Over a third (38%) of the HIV-infected population was unaware of their infection status, and this differed markedly between men (50%) and women (31%). Of those aware of their HIV-positive status, a higher percentage of men (63%) than women (49%) reported ART use. Conclusions: While overall HIV prevalence remains roughly constant, age-specific changes strongly suggest both improved survival of the HIV-infected and a reduction in new HIV infections. Awareness of HIV status and entry into ART services has improved in recent years but remains too low. This study identifies opportunities to improve both HIV preventive and care services in Swaziland

A new type of superelastic and shape memory materials: ThCr2Si2- structured novel intermetallic compounds at small length scales

Crystalline, superelastic materials typically exhibit large recoverable strains due to the ability of the material to undergo a reversible phase transition between martensite and austenite phases. Applicable to various alloys, ceramics and intermetallic compounds, this reversible transition serves as a general mechanism for superelasticity and shape memory effect. Recently, we noticed that ThCr2Si2-structured intermetallic compounds exhibit a reversible phase transition between a tetragonal (or orthorhombic) phase to a collapsed tetragonal phase under compression along c-axis of the unit cell by making and breaking Si-Si type bonds. This process has nothing to do with martensitic transformation. This unique reversible phase transformation process motivated us to investigate their potential as a superelastic and shape memory material. Please click Additional Files below to see the full abstract

Prevalence of and factors associated with late diagnosis of HIV in Malawi, Zambia, and Zimbabwe: Results from population-based nationally representative surveys

Introduction Late diagnosis of HIV (LD) increases the risk of morbidity, mortality, and HIV transmission. We used nationally representative data from population-based HIV impact assessment (PHIA) surveys in Malawi, Zambia, and Zimbabwe (2015–2016) to characterize adults at risk of LD and to examine associations between LD and presumed HIV transmission to cohabiting sexual partners. Methods We estimated the prevalence of LD, defined as CD4 count <350 cells/μL, among adults newly diagnosed with HIV during the surveys and odds ratios for associated factors. We linked newly diagnosed adults (index cases) to their household sexual partners and calculated adjusted odds ratios for associations between LD of the index case, viral load of the index case, and duration of HIV exposure in the relationship, and the HIV status of the household sexual partner. Results Of 1,804 adults who were newly diagnosed with HIV in the surveys, 49% (882) were diagnosed late. LD was associated with male sex, older age, and almost five times the odds of having an HIV-positive household sexual partner (adjusted odds ratio [aOR], 4.65 [95% confidence interval: 2.56–8.45]). Longer duration of HIV exposure in a relationship and higher viral load of the index case were both independently associated with higher odds of having HIV-positive household sexual partners. Individuals with HIV exposure of more than 5 years had more than three times (aOR 3.42 [95% CI: 1.63–7.18]) higher odds of being HIV positive than those with less than 2 years HIV exposure. The odds of being HIV positive were increased in individuals who were in a relationship with an index case with a viral load of 400–3499 copies/mL (aOR 4.06 [95% CI 0.45–36.46]), 3,500–9,999 copies/mL (aOR 11.32 [95% CI: 4.08–31.39]), 10,000–49,999 copies/mL (aOR 17.07 [95% CI: 9.18–31.72]), and ≥50,000 copies/mL (aOR 28.41 [95% CI: 12.18–66.28]) compared to individuals who were in a relationship with an index case with a viral load of <400 copies/mL. Conclusions LD remains a challenge in Southern Africa and is strongly associated with presumed HIV transmission to household sexual partners. Our study underscores the need for earlier HIV diagnosis, particularly among men and older adults, and the importance of index testing

Clinical, radiologic, pathologic, and molecular characteristics of long-term survivors of diffuse intrinsic pontine glioma (DIPG): a collaborative report from the International and European Society for Pediatric Oncology DIPG registries

Purpose Diffuse intrinsic pontine glioma (DIPG) is a brainstem malignancy with a median survival of &lt; 1 year. The International and European Society for Pediatric Oncology DIPG Registries collaborated to compare clinical, radiologic, and histomolecular characteristics between short-term survivors (STSs) and long-term survivors (LTSs). Materials and Methods Data abstracted from registry databases included patients from North America, Australia, Germany, Austria, Switzerland, the Netherlands, Italy, France, the United Kingdom, and Croatia. Results Among 1,130 pediatric and young adults with radiographically confirmed DIPG, 122 (11%) were excluded. Of the 1,008 remaining patients, 101 (10%) were LTSs (survival ≥ 2 years). Median survival time was 11 months (interquartile range, 7.5 to 16 months), and 1-, 2-, 3-, 4-, and 5-year survival rates were 42.3% (95% CI, 38.1% to 44.1%), 9.6% (95% CI, 7.8% to 11.3%), 4.3% (95% CI, 3.2% to 5.8%), 3.2% (95% CI, 2.4% to 4.6%), and 2.2% (95% CI, 1.4% to 3.4%), respectively. LTSs, compared with STSs, more commonly presented at age &lt; 3 or &gt; 10 years (11% v 3% and 33% v 23%, respectively; P &lt; .001) and with longer symptom duration ( P &lt; .001). STSs, compared with LTSs, more commonly presented with cranial nerve palsy (83% v 73%, respectively; P = .008), ring enhancement (38% v 23%, respectively; P = .007), necrosis (42% v 26%, respectively; P = .009), and extrapontine extension (92% v 86%, respectively; P = .04). LTSs more commonly received systemic therapy at diagnosis (88% v 75% for STSs; P = .005). Biopsies and autopsies were performed in 299 patients (30%) and 77 patients (10%), respectively; 181 tumors (48%) were molecularly characterized. LTSs were more likely to harbor a HIST1H3B mutation (odds ratio, 1.28; 95% CI, 1.1 to 1.5; P = .002). Conclusion We report clinical, radiologic, and molecular factors that correlate with survival in children and young adults with DIPG, which are important for risk stratification in future clinical trials