Cellphone and media usage among adolescent girls of Bhopal city, Madhya Pradesh, India

Background: Several researchers have reported that mobile phone uses are increasing among adolescents. Better understanding of cellphone and media usage by adolescents would help health care providers in guiding more responsible use of cellphone by teenagers. Aim of the study was to study the level and pattern of mobile phone usages among adolescent girls of Bhopal city, Madhya Pradesh.Methods: This cross-sectional study was conducted among adolescent girls between 14 to 19 years of age studying in schools of Bhopal city. Data was collected using a self-administered questionnaire. The questionnaire contains items related to demographic variables, cellular phone usage and patterns.Results: All the study subjects were using smart phones. Facebook was the most commonly surfed website. Maximum adolescent girls were using smartphones for 2-4 hours in a day. Seventy-eight (69.03%) study subjects preferred text messaging service for awareness about reproductive and sexual health.Conclusions: The cellphone usage can also be exploited to promote awareness about reproductive health among adolescents

Distracted Driving and Driving Patterns in Older Drivers With Glaucoma.

Limited research exists examining self-perceived vision and driving ability among individuals with glaucoma, and this study assessed the relationship between glaucoma, visual field, and visual acuity with driving capability. 137 individuals with glaucoma and 75 healthy controls were asked to evaluate self-rated vision, self-perceived driving ability, and self-perceived distracted driving. Visual acuity and visual field measurements were also obtained. Multivariable linear regressions were run to test each visual measure with driving outcomes. The average age was 72.2 years, 57.3% were male, and 72.5% were White. There were significant associations for a one-point increase in visual field and quality of corrected vision (RR = 1.06; 95% CI = 1.03-1.10), day vision (RR = 1.05; 95% CI = 1.03-1.08), night vision (RR = 1.08; 95% CI = 1.05-1.13), visual acuity score and higher quality of corrected of vision (RR = .41; 95% CI = .22-.77), day vision (RR = .39; 95% CI=.22-.71), and night vision (RR = .41; 95% CI = .18-.94); visual acuity score and ability to drive safely compared to other drivers your age (RR = .53; 95% CI = .29-.96). Individuals with poorer visual acuity and visual fields rate their vision and ability to drive lower than those with better vision, and this information will allow clinicians to understand where to target interventions to enhance safe driving practices

Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy

Contains fulltext : 169804.pdf (publisher's version ) (Open Access)BACKGROUND: Patients with atrial fibrillation who undergo intracoronary stenting traditionally are treated with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT), yet this treatment leads to high risks of bleeding. We hypothesized that a regimen of rivaroxaban plus a P2Y12 inhibitor monotherapy or rivaroxaban plus DAPT could reduce bleeding and thereby have a favorable impact on all-cause mortality and the need for rehospitalization. METHODS: Stented subjects with nonvalvular atrial fibrillation (n=2124) were randomized 1:1:1 to administration of reduced-dose rivaroxaban 15 mg daily plus a P2Y12 inhibitor for 12 months (group 1); rivaroxaban 2.5 mg twice daily with stratification to a prespecified duration of DAPT of 1, 6, or 12 months (group 2); or the reference arm of dose-adjusted VKA daily with a similar DAPT stratification (group 3). The present post hoc analysis assessed the end point of all-cause mortality or recurrent hospitalization for an adverse event, which was further classified as the result of bleeding, a cardiovascular cause, or another cause blinded to treatment assignment. RESULTS: The risk of all-cause mortality or recurrent hospitalization was 34.9% in group 1 (hazard ratio=0.79; 95% confidence interval, 0.66-0.94; P=0.008 versus group 3; number needed to treat=15), 31.9% in group 2 (hazard ratio=0.75; 95% confidence interval, 0.62-0.90; P=0.002 versus group 3; number needed to treat=10), and 41.9% in group 3 (VKA+DAPT). Both all-cause death plus hospitalization potentially resulting from bleeding (group 1=8.6% [P=0.032 versus group 3], group 2=8.0% [P=0.012 versus group 3], and group 3=12.4%) and all-cause death plus rehospitalization potentially resulting from a cardiovascular cause (group 1=21.4% [P=0.001 versus group 3], group 2=21.7% [P=0.011 versus group 3], and group 3=29.3%) were reduced in the rivaroxaban arms compared with the VKA arm, but other forms of rehospitalization were not. CONCLUSIONS: Among patients with atrial fibrillation undergoing intracoronary stenting, administration of either rivaroxaban 15 mg daily plus P2Y12 inhibitor monotherapy or 2.5 mg rivaroxaban twice daily plus DAPT was associated with a reduced risk of all-cause mortality or recurrent hospitalization for adverse events compared with standard-of-care VKA plus DAPT. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01830543

The Relationship of DNA methylation with Healthy Longevity

In the United States, the number of individuals who are 90 and older is expected to quadruple from 1.9 million in 2010 to 7.6 million individuals in 2050. Aging into the later years is often accompanied by time spent with mobility and cognitive impairments, multiple morbidity and disability in activities of daily living. Impairments in either the physical or mental domains contribute to declines in one’s intrinsic capacity to maintain high functioning and wellbeing.The pace of biological aging differs across older adults of the same chronological age. Faster biological aging is linked to greater accumulation of multiple morbidities, lower physical and cognitive functioning, and earlier death. Epigenetic age, a biomarker of aging, is a composite measure of DNA methylation across specific cytosine-guanine dinucleotide sites (CpG sites) associated with chronologic or phenotypic age. Epigenetic age acceleration, as measured by epigenetic clocks, is postulated to identify whether individuals are aging faster or slower when compared to their chronologic age. There have been no prospective studies that have examined the relationships between genome wide DNA methylation or epigenetic age acceleration with multiple morbidity at a specified older age or survival to 90 years of age with intact mobility and cognitive functioning. The first chapter of this dissertation reviews the epidemiological evidence on DNA methylation and epigenetic clocks and their relationships with longevity, mobility, cognitive functioning and multiple morbidity. The second chapter assesses the associations between four DNA methylation clocks that measure epigenetic age acceleration and exceptional longevity, defined as survival to age 90 with intact mobility and cognitive function. The third chapter utilizes an epigenome wide association study to identify specific CpG sites and regions that are associated with exceptional longevity. The fourth chapter evaluates associations between the four DNA methylation clocks and multiple morbidity among women when they reach 90 years of age. The final chapter summarizes and integrates the key findings from this dissertation and highlights future directions for research on the potential of DNA methylation and epigenetic clocks to expand knowledge of the etiology of healthy longevity and to identify targets for intervention to improve healthy aging

Intrusion Effects on Maxillary Anteriors using Mini Implant Anchorage and K-Sir Loop in Subjects with Deep Overbite- A Cohort Study

Introduction: Various options to treat deep bites nonsurgically involve extrusion of posterior teeth or intrusion of anterior teeth. Intrusion of anterior teeth is required in patients with excessive incisal display and to correct deep bite in adult patients when extrusion of posterior teeth is not desirable. Aim: To compare the rate of intrusion and dento-alveolar effects on maxillary anterior teeth by Kalra-Simultaneous Intrusion and Retraction loop (K-SIR loop) and Mini implant anchorage in subjects with deep overbite. Materials and Methods: This prospective cohort study included 12 patients with Class I or Class II Div 1 malocclusion having an overbite and overjet of >4 mm treated with therapeutic extractions of upper first premolars. Group A included six subjects treated using orthodontic Mini implants, while Group B had six subjects treated with K-SIR loop. Lateral cephalograms were taken before intrusion and retraction (T1) and at the end of six months (T2) into intrusion and retraction. Independent t-test and paired t-test was done for intergroup and intragroup comparison respectively. Results: The rate of intrusion was 0.38 mm/month and 0.31 mm/ month for Group A and Group B, respectively. The amount of intrusion was significantly more in Temporary Anchorage Devices (TAD) group (p-value <0.01). Conclusion: In the TAD group, rate and amount of intrusion was significantly higher. There is no difference in vertical control between the two modalities statistically significant amount of molar extrusion was seen with the K-SIR loop group

Recent Strategies for Cardiac Rehabilitation in Post-Myocardial Infarction Patients: A Narrative Review

Myocardial Infarction (MI) is a severe cardiac crisis that can result in significant morbidity and death. ST segment Elevated Myocardial Infarction (STEMI) is irreparable myocardial damage caused by persistent ischaemia, and while the adage “time is muscle” remains true, rapid and prompt detection of MI continues to be a key concern. Cardiac Rehabilitation (CR) is the most significant evidencebased intervention for secondary prevention following STEMI. However, only a small proportion of patients have access to a cardiovascular recovery programme. Recent research implies that exercise-based CR provides significant benefits to patients with cardiovascular disease, including a lower risk of MI, a likely slight decline in all causes of mortality, a massive reduction in all-cause hospitalisation, along with associated medical costs, and enhanced Health-Related Quality of Life (HRQoL) upto a year of followup. Adapting rehabilitation programmes to existing abilities based on experience in the field of activity is becoming a major solution in the current CR training programme selection. The effectiveness of both centre-based and home-based therapy is proven. Telerehabilitation and home-based rehabilitation strategies have gained much importance during the Coronavirus Disease-2019 (COVID-19) pandemic. Further research is needed to standardise the treatment quality for patients with home-based CR

Antibiotic susceptibilities, streptococcal pyrogenic exotoxin gene profiles among clinical isolates of group C or G Streptococcus dysgalactiae subsp. equisimilis & of group G S. anginosus group at a tertiary care centre

Background & objectives: Group C and group G streptococci (together GCGS) are often regarded as commensal bacteria and their role in streptococcal disease burden is under-recognized. While reports of recovery of GCGS from normally sterile body sites are increasing, their resistance to macrolides, fluoroquinolone further warrants all invasive β haemolytic streptococci to be identified to the species level and accurately tested for antimicrobial susceptibility. This study was aimed to determine the prevalence, clinical profile, antimicrobial susceptibility and streptococcal pyrogenic exotoxin gene profile (speA, speB, speC, speF, smeZ, speI, speM, speG, speH and ssa) of GCGS obtained over a period of two years at a tertiary care centre from north India. Methods: The clinical samples were processed as per standard microbiological techniques. β-haemolytic streptococci (BHS) were characterized and grouped. Antimicrobial susceptibility of GCGS was performed using disk diffusion method. All GCGS were characterized for the presence of streptococcal pyrogenic exotoxins (spe) and spe genes were amplified by PCR method. Results: GCGS (23 GGS, 2GCS) comprised 16 per cent of β haemolytic streptococci (25/142 βHS, 16%) isolated over the study period. Of the 25 GCGS, 22 (88%) were recovered from pus, two (8%) from respiratory tract, whereas one isolate was recovered from blood of a fatal case of septicaemia. Of the total 23 GGS isolates, 18 (78%) were identified as Streptococcus dysgalactiae subsp equisimilis (SDSE, large-colony phenotype), five (21%) were Streptococcus anginosus group (SAG, small-colony phenotype). The two GCS were identified as SDSE. All GCGS isolates were susceptible to penicillin, vancomycin, and linezolid. Tetracycline resistance was noted in 50 per cent of SDSE isolates. The rates of macrolide and fluoroquinolone resistance in SDSE were low. Twelve of the 20 SDSE isolates were positive for one or more spe genes, with five of the SDSE isolates simultaneously carrying speA+ speB+ smeZ+ speF or speB+ smeZ+speF, speI+speM+speG+speH or, speI+spe M+speH or speA+ speB+ speC+ smeZ+ speF. One notable finding was the presence of spe B in four of the five isolates of the Streptococcus anginosus group. No isolate was positive for ssa. Interpretation & conclusions: Our study showed no association between GCGS isolates harbouring streptococcal pyrogenic exotoxins and disease severity. This might be attributed to the small sample size of spe-positive isolates