A Peer Outreach Initiative to Increase the Registration of Minorities as Organ Donors

Background Black, Asian and minority ethnic (BAME) communities are disproportionately affected by inequalities in transplant services in the UK. There are some indications from pilot programmes that appeals for BAME organ donors may be more effectively communicated by employing grassroots, community-networking approaches, but such initiatives have not been adequately described or evaluated. Methods Lay individuals from BAME communities were trained as peer outreach workers. They attended a series of public events to promote knowledge of organ donation and transplantation among the public. Information was gathered from 806 evaluation forms completed by event attendees at 34 separate events. From these, 54 follow-up interviews were conducted with event attendees who completed evaluation forms, indicated that they intended to sign up to the NHS Organ Donor Register (ODR) within the next month and consented to follow-up. Results Peer outreach initiatives of the type evaluated are associated with increased numbers of BAME people registering as organ donors. A total of 8.8% of event attendees signed up to the NHS ODR. The programme was most effective with people who had previously considered becoming organ donors but who did not know how to go about it. It was less effective with people who had not previously considered it, or who were scared about signing up, or who feared family or religious disapproval. Conclusions Peer outreach programmes with BAME communities can be an effective way of reducing inequalities by increasing the number of people on the NHS ODR and encouraging people to think about the issue

Who waits longest for a kidney? : Inequalities in access to kidney transplantation among Black and Asian Minority Ethnic (BAME) groups in the UK

This version deposited with the permission of the publisher 6/15Black and Asian Minority Ethnic (BAME) groups are over-represented on active kidney transplantation waiting lists and have relatively long waiting times. This inequality arises from a particularly high need for kidney transplantation combined with a low rate of deceased donation among BAME groups which limits the availability of a well-matched graft. This paper outlines the major barriers to both registration as a potential donor and family consent to donation. It then describes initiatives to increase donation and transplantation in terms of system changes, organisational changes and community interventions, and considers requirements for effective strategies.Peer reviewedFinal Published versio

A Case Report on Mutrakricchra with Special Reference to the Chronic Cystitis with Bladder Atony

In Ayurvedic texts, various Mutra-rogas and their management has been described. Mainly eight types of Mutrakricchra has been elaborated. Krichchhrata (difficulty in voiding / pain full voiding), is the main feature but sometimes some feature of obstructions (mutravibhandhata) is also present. In Mutraghat, obstruction is a major feature. According to Acharya Sushrut, Mutrakricchra is a tridoshaj vyadhi, physiological action of urination and defecation is predominantly under the control of Apan vayu, seat of which is Pakwashaya and if this vayu gets vitiated, it causes various genitourinary and anorectal diseases (S. Ni. 1/19), (C. SU. 20/15, C. Si. 1/32-34, A. H. Su. 1/25).On the basis of symptomatology, Cystitis can be assumed as one of the Mutraroga. Chronic cystitis may result in bladder atony in which there is a declination in the normal bladder tone, may causes increase frequency of micturition, incomplete bladder evacuation, abnormal sensation of micturition etc

Role of saline infusion sonography in evaluation of abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is one of the most common reasons for women seeking gynaecological advice. The objective of this study was to determine the accuracy of Transvaginal sonography (TVS) and Saline Infusion Sonography (SIS) in evaluation of Abnormal Uterine Bleeding (AUB) and to compare the diagnostic accuracy after hysterectomy.Methods: Prospective, comparative study of TVS and SIS in evaluation of AUB in patients who are being subjected to hysterectomy with uterus of less than 12 weeks.Results: 100 patients were included in the study. 98% were of 30-50 years. Heavy menstrual bleeding was the commonest symptom (52%) and most common finding was fibroid, and Polyp followed by abnormal endometrium. The overall sensitivity and specificity when correlated with operative and HPE were 66% and 88% respectively for TVS and 82% and 95% for SIS respectively. The false positive and false negative rates were more in TVS compared to SIS. Commonest histopathology was intramural fibroid in 42% followed by sub mucus myoma in 21%, polyp 18% and endometrial hyperplasia 10%.Conclusions: SIS is a simple highly sensitive and specific technique to detect intra uterine pathology in the evaluation of AUB when TVS findings are inconclusive

Acute intermittent porphyria and pregnancy: an obstetric challenge

Acute intermittent porphyria is a rare autosomal dominant disease caused by a mutation in the gene coding for the porphobillinogen deaminase enzymes in heam biosynthesis. The disease manifests as acute attacks of neuropsychiatric dysfunction and neurovisceral manifestations presenting as acute abdomen. In pregnancy, 54% patient has exacerbation of attacks in the form of seizures and acute abdomen occurs due to hormonal changes. Prevalence of acute intermittent porphyria is 1-2/200000 in general. Here we report a case of 36 year old women, G4P1L2A2 presenting at 10+4 weeks of gestation requesting pregnancy termination. Patient was diagnosed as case of acute intermittent porphyria with porphyic polyneuropathy 6 months back. At that time her main symptoms were acute pain abdomen with numbness and weakness in all four limbs. Her urinary porphobillinogen and 5 ALA raised. Her CECT of brain and nerve conduction studies were normal. Since then she is on Tablet Gabapentin 300 mg H.S. She underwent successful pregnancy termination by suction and evacuation under spinal anesthesia and she refused for copper-T insertion. Only safe drugs were used for procedure and she was discharged with advice of barrier contraception

Study the Frequency of Colorectal Carcinoma in Anorectal OPD of Department of Shalya Tantra S. S. Hospital, BHU : An Overview

Colorectal cancer starts in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on the site of its origin. Colon cancer and rectal cancer are often grouped together because they have many common features. Most common malignancy in the gastrointestinal tract is the colorectal cancer. Usually in early stage colorectal cancer is asymptomatic. Clinical symptoms are limited and develop slowly over time. There are, however, a few symptoms or signs that most frequently lead to diagnostic evaluation. These symptoms include lower gastrointestinal bleeding or occult bleeding with resultant microcytic / iron deficiency anemia, changes in bowel habits and abdominal pain, painful defecation, stool mix with blood and mucous, increase frequency of defecation, morning spurious diarrhea, mass present at anal verge, anal canal or rectum which may or may not bleed on touch. Sometimes most of patients having Complains of bleeding per rectum, painful defecation, something coming out during defecation are treated as simple anorectal diseases without digital rectal examination by general practitioner and surgeon inspite being the cases of Colorectal Carcinoma. Colorectal cancer may also progress and present as large bowel obstruction or even as perforation, either at the site of the tumors or proximally. Up to 20 – 25% of colon cancer cases present as emergencies; in contrast to this only a small number of rectal cancer cases present as emergencies

Role of sustainomics and external climate forcing mechanism in biodiversity extinction : An overview

Over millions of years, physiology and anatomy of the living organisms has been changed due to internal climate forcing mechanism. This has influenced the world wide distribution of species. External climate forcing mechanism has caused rapid rise in earth’s temperature and it is expected to rise by 2-4 °C by the end of the century. It has now been recognised as the most complex problem of present scenario and being concerned in almost every field of science. Climate change is the most sensitive issue which is a challenge not only for the government and society but also for each individual. In the present communication impact of external climate forcing mechanism on biodiversity and its extinction is being analysed and role of sustainomics for the same is overviewed. Studies reveal that the rate of speciation of flora and fauna is not in the accordance with the rate of externally enforced climate change. Thus, the increased rate of climate change has caused catastrophic mass extinction threat for plants, animals and insects in the anthrapocene era. The pattern of extinction and threatened species are not yet known. Various solutions for the problem have been suggested by the multidisciplinary researches, rooted by the sustainomics. These suggestions include to diverge from fossil fuel, to use renewables, to make and apply rules for 3Rs etc. Only cooperative involvement of social, scientific and industrial bodies may resolve the problem

Effect of antenatal exercises on pulmonary functions and labour outcome in uncomplicated primigravida women: a randomized controlled study

Background: Physical fitness could influence pulmonary functions, labour and neonatal outcomes in pregnancy. The present study was undertaken to evaluate the effect of antenatal exercises on pulmonary functions and labour outcomes.Methods: Study included 122 uncomplicated primigravida in age group of 18-35 years at 24th - 28th week of gestation were randomly allocated into study and control groups. Antenatal exercises were performed by study group for a minimum of 3 days a week for 20 minute duration till their delivery. Pulmonary function tests (PFTs) were done for all subjects at 24th week of gestation and after 36th week of gestation.Results: A significant improvement in FEV1, FVC, FEF25-75%, MEF50%, MIF50% and MVV between 24 & 36 weeks was observed in the study group after exercises. In study group 85.24% patients had spontaneous onset of labour, 14.8% patients had induction of labour as compared to 75.4% and 24.6% respectively in control group, however statistically insignificant. In the study group 41.67% patients did not require augmentation compared to 22.95% in the control group. In study group 13.11% patients had meconium stained liquor which was significantly less in comparison to 41% patients in the control group. Mean duration of first, second and third stage of labour was shorter in study group than control group. In study group 96.72% had normal and none had instrumental vaginal delivery compared to 88.52% and 6.6% from control group respectively. Caesarean section rate was 3.3% in study group and 4.9% in control group. APGAR score was normal in all the neonates. Fetal weight gain, birth weight, birth length and head circumference was significantly higher and NICU stay was significantly lesser in study group compared to control group.Conclusions: Antenatal exercises lead to improvement of pulmonary functions and hence labour and neonatal outcomes

An integrated transcriptomics-guided genome-wide promoter analysis and next-generation proteomics approach to mine factor(s) regulating cellular differentiation

Differential next-generation-omics approaches aid in the visualization of biological processes and pave the way for divulging important events and/or interactions leading to a functional output at cellular or systems level. To this end, we undertook an integrated Nextgen transcriptomics and proteomics approach to divulge differential gene expression of infant and pubertal rat Sertoli cells (Sc).Unlike, pubertal Sc, infant Sc are immature and fail to support spermatogenesis. We found exclusive association of 14 and 19 transcription factor binding sites to infantile and pubertal states of Sc, respectively, using differential transcriptomics-guided genome-wide computational analysis of relevant promoters employing 220 Positional Weight Matrices from the TRANSFAC database. Proteomic SWATH-MS analysis provided extensive quantification of nuclear and cytoplasmic protein fractions revealing 1,670 proteins differentially located between the nucleus and cytoplasm of infant Sc and 890 proteins differentially located within those of pubertal Sc. Based on our multi-omics approach, the transcription factor YY1 was identified as one of the lead candidates regulating differentiation of Sc.YY1 was found to have abundant binding sites on promoters of genes upregulated during puberty. To determine its significance, we generated transgenic rats with Sc specific knockdown of YY1 that led to compromised spermatogenesis

An integrated transcriptomics-guided genome-wide promoter analysis and next-generation proteomics approach to mine factor(s) regulating cellular differentiation.

Differential next-generation-omics approaches aid in the visualization of biological processes and pave the way for divulging important events and/or interactions leading to a functional output at cellular or systems level. To this end, we undertook an integrated Nextgen transcriptomics and proteomics approach to divulge differential gene expression of infant and pubertal rat Sertoli cells (Sc).Unlike, pubertal Sc, infant Sc are immature and fail to support spermatogenesis. We found exclusive association of 14 and 19 transcription factor binding sites to infantile and pubertal states of Sc, respectively, using differential transcriptomics-guided genome-wide computational analysis of relevant promoters employing 220 Positional Weight Matrices from the TRANSFAC database. Proteomic SWATH-MS analysis provided extensive quantification of nuclear and cytoplasmic protein fractions revealing 1,670 proteins differentially located between the nucleus and cytoplasm of infant Sc and 890 proteins differentially located within those of pubertal Sc. Based on our multi-omics approach, the transcription factor YY1 was identified as one of the lead candidates regulating differentiation of Sc.YY1 was found to have abundant binding sites on promoters of genes upregulated during puberty. To determine its significance, we generated transgenic rats with Sc specific knockdown of YY1 that led to compromised spermatogenesis