Assessment of knowledge regarding anaemia and its preventive measures among lactating mothers of North Gujarat region, India

Background: Anaemia in pregnancy and lactation period has detrimental effects on maternal and child health. Objective of this study was to assess knowledge of lactating mothers regarding anaemia and its preventive measures before and after educational intervention.Methods: The interventional study conducted in purposively selected lactating mothers attending the outpatient department of obstetrics and gynecology. Hospital ethical committee permission was obtained. After taking informed consent 100 lactating mothers were selected by systemic random sampling methods. Knowledge of lactating mothers regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Health education for 30 minutes was given to selected lactating mothers. Knowledge of pregnant women for the same was assessed after health education. Thus, collected data was analyzed using Epi info 7.Results: Awareness among lactating mothers regarding causes, signs and symptoms of anemia and dietary sources of iron was 41%, 26% and 5% respectively which was significantly increased to 73%, 56% and 42% respectively after health education. Awareness among lactating mothers regarding factors which inhibit and increase iron absorption was 31% and 22% respectively which was significantly increased to 80% and 65% respectively after health education. Out of 100 lactating mothers only 24% were aware regarding treatment of anemia.Conclusions: Lack of awareness among lactating mothers regarding anemia and its preventive measure should be addressed by health education during hospital visits

NASYA-MOST VITAL THERAPEUTIC INTERVENTION OF PANCHAKARMA-A REVIEW

Ayurveda is a Science and art of appropriate living which helps to achieve longevity. Panchakarma present a unique approach of Ayurveda to therapy with specially designed five procedures of internal purification of the body. One of the Panchakarma, the Nasyakarma is considered the best and the most specific procedure for disease of Urdhvajatrugatarogas like Pratishyay, Shirahshoola etc. It is also useful in other systemic diseases like Ardita, Kampavata. According to Ayurveda, the nose is the gate way to Shirah. So, systemically performed Nasyakarma cures almost all the diseases of Urdhvajatrugata rogas. Other procedures of Panchakarma are also very effective in numerous diseases according to condition but Nasya Karma is very easy to perform and there are no many strict regimens to follow during Nasya Karma but it will give effectual results in loads of diseases due to direct contact with nerve terminals by the nasal mucosa. So, it is demand of time to know about Nasyakarma and its importance. In this direction, to evaluate the actual efficacy of different Ayurveda treatment modalities; few works on Nasya Karma are compiled here. In current attempt, it has been planned to review as such works done on Nasyakarma. By this Present study it can be stated that in various diseases Nasya Karma is found to be significantly effective. It proved to be a better therapy as compared to only oral drug because it provides affect for longer duration than oral drug

Young at risk-people in Maputo City, Mozambique, present a high willingness to participate in HIV trials: Results from an HIV vaccine preparedness cohort study

Introduction: Vaccine efficacy testing requires engagement of willing volunteers with high disease incidence. We evaluated factors associated with willingness to participate in potential future HIV vaccine trials in Maputo, Mozambique. Methods: Adults aged 18–35 years without HIV and who reported at least two sexual partners in the 3 months prior to screening were enrolled into a 24-month observational study. They were asked at screening and exit if they would be willing to participate in a theoretical HIV vaccine study. Bivariate and multivariate logistic regression analyses were done between willingness to participate, demographic, sexual behavior, and motivational factors for screening visit data. Logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors potentially associated with willingness to participate for data from both visits. Results: A total of 577 participants without HIV were eligible, including 275 (48%) women. The mean age was 22.2 (SD ± 3.9) years. At screening 529 (92%) expressed willingness to participate and the proportion remained stable at 378 (88%) of the 430 participants retained through the exit visit (p = 0.209). Helping the country (n = 556) and fear of needles (n = 26) were the top motive and barrier for willingness to participate, respectively. Results from the GEE binary logistic regression (screening visit and exit visit) showed that wanting to learn how to avoid risk behaviors (aOR 3.33, 95% CI: 1.61–6.86) and feeling protected against HIV infection (aOR 2.24, 95% CI: 1.07–4.7) were associated with willingness to participate in HIV vaccine studies. Conclusion: The majority of our study population in Mozambique expressed willingness to participate in a theoretical HIV vaccine trial. Participation in a HIV vaccine trial was seen as a way to contribute to the fight against HIV but was associated with some unrealistic expectations such as protection against HIV. This reinforces the need for continuous mobilization and awareness of potential participants to HIV vaccine trial

Genetic Characterization of Human T-Cell Lymphotropic Virus Type 1 in Mozambique: Transcontinental Lineages Drive the HTLV-1 Endemic

Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent of Adult T-Cell Leukemia/Lymphoma (ATL), the Tropical Spastic Paraparesis/HTLV-1-associated Myelopathy (TSP/HAM) and other inflammatory diseases, including dermatitis, uveitis, and myositis. It is estimated that 2–8% of the infected persons will develop a HTLV-1-associated disease during their lifetimes, frequently TSP/HAM. Thus far, there is not a specific treatment to this progressive and chronic disease. HTLV-1 has means of three transmission: (i) from mother to child during prolonged breastfeeding, (ii) between sexual partners and (iii) through blood transfusion. HTLV-1 has been characterized in 7 subtypes and the geographical distribution and the clinical impact of this infection is not well known, mainly in African population. HTLV-1 is endemic in sub-Saharan Africa. Mozambique is a country of southeastern Africa where TSP/HAM cases were reported. Recently, our group estimated the HTLV prevalence among Mozambican blood donors as 0.9%. In this work we performed a genetic analysis of HTLV-1 in blood donors and HIV/HTLV co-infected patients from Maputo, Mozambique. Our results showed the presence of three HTLV-1 clusters within the Cosmopolitan/Transcontinental subtype/subgroup. The differential rates of HIV-1/HTLV-1 co-infection in the three HTLV-1 clusters demonstrated the dynamic of the two viruses and the need for implementation of control measures focusing on both retroviruses

Co-infection by human immunodeficiency virus type 1 (HIV-1) and human T cell leukemia virus type 1 (HTLV-1): does immune activation lead to a faster progression to AIDS?

<p>Abstract</p> <p>Background</p> <p>Recent data have shown that HTLV-1 is prevalent among HIV positive patients in Mozambique, although the impact of HTLV-1 infection on HIV disease progression remains controversial. Our aim was to determine the phenotypic profile of T lymphocytes subsets among Mozambican patients co-infected by HIV and HTLV-1.</p> <p>Methods</p> <p>We enrolled 29 patients co-infected by HTLV-1 and HIV (co-infected), 59 patients mono-infected by HIV (HIV) and 16 healthy controls (HC), respectively.</p> <p>For phenotypic analysis, cells were stained with the following fluorochrome-labeled anti-human monoclonal antibodies CD4-APC, CD8-PerCP, CD25-PE, CD62L-FITC, CD45RA-FITC. CD45RO-PE, CD38-PE; being analysed by four-colour flow cytometry.</p> <p>Results</p> <p>We initially found that CD4⁺T cell counts were significantly higher in co-infected, as compared to HIV groups. Moreover, CD4⁺T Lymphocytes from co-infected patients presented significantly higher levels of CD45RO and CD25, but lower levels of CD45RA and CD62L, strongly indicating that CD4⁺T cells are more activated under HTLV-1 plus HIV co-infection.</p> <p>Conclusion</p> <p>Our data indicate that HTLV-1/HIV co-infected patients progress with higher CD4⁺T cell counts and higher levels of activation markers. In this context, it is conceivable that in co-infected individuals, these higher levels of activation may account for a faster progression to AIDS.</p

Loci influencing blood pressure identified using a cardiovascular gene-centric array

Blood pressure (BP) is a heritable determinant of risk for cardiovascular disease (CVD). To investigate genetic associations with systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP), we genotyped 50 000 single-nucleotide polymorphisms (SNPs) that capture variation in 2100 candidate genes for cardiovascular phenotypes in 61 619 individuals of European ancestry from cohort studies in the USA and Europe. We identified novel associations between rs347591 and SBP (chromosome 3p25.3, in an intron of HRH1) and between rs2169137 and DBP (chromosome1q32.1 in an intron of MDM4) and between rs2014408 and SBP (chromosome 11p15 in an intron of SOX6), previously reported to be associated with MAP. We also confirmed 10 previously known loci associated with SBP, DBP, MAP or PP (ADRB1, ATP2B1, SH2B3/ATXN2, CSK, CYP17A1, FURIN, HFE, LSP1, MTHFR, SOX6) at array-wide significance (P 2.4 10(6)). We then replicated these associations in an independent set of 65 886 individuals of European ancestry. The findings from expression QTL (eQTL) analysis showed associations of SNPs in the MDM4 region with MDM4 expression. We did not find any evidence of association of the two novel SNPs in MDM4 and HRH1 with sequelae of high BP including coronary artery disease (CAD), left ventricular hypertrophy (LVH) or stroke. In summary, we identified two novel loci associated with BP and confirmed multiple previously reported associations. Our findings extend our understanding of genes involved in BP regulation, some of which may eventually provide new targets for therapeutic intervention.</p

Large-Scale Gene-Centric Meta-Analysis across 39 Studies Identifies Type 2 Diabetes Loci

To identify genetic factors contributing to type 2 diabetes (T2D), we performed large-scale meta-analyses by using a custom similar to 50,000 SNP genotyping array (the ITMAT-Broad-CARe array) with similar to 2000 candidate genes in 39 multiethnic population-based studies, case-control studies, and clinical trials totaling 17,418 cases and 70,298 controls. First, meta-analysis of 25 studies comprising 14,073 cases and 57,489 controls of European descent confirmed eight established T2D loci at genome-wide significance. In silico follow-up analysis of putative association signals found in independent genome-wide association studies (including 8,130 cases and 38,987 controls) performed by the DIAGRAM consortium identified a T2D locus at genome-wide significance (GATAD2A/CILP2/PBX4; p = 5.7 x 10(-9)) and two loci exceeding study-wide significance (SREBF1, and TH/INS; p <2.4 x 10(-6)). Second, meta-analyses of 1,986 cases and 7,695 controls from eight African-American studies identified study-wide-significant (p = 2.4 x 10(-7)) variants in HMGA2 and replicated variants in TCF7L2 (p = 5.1 x 10(-15)). Third, conditional analysis revealed multiple known and novel independent signals within five T2D-associated genes in samples of European ancestry and within HMGA2 in African-American samples. Fourth, a multiethnic meta-analysis of all 39 studies identified T2D-associated variants in BCL2 (p = 2.1 x 10(-8)). Finally, a composite genetic score of SNPs from new and established T2D signals was significantly associated with increased risk of diabetes in African-American, Hispanic, and Asian populations. In summary, large-scale meta-analysis involving a dense gene-centric approach has uncovered additional loci and variants that contribute to T2D risk and suggests substantial overlap of T2D association signals across multiple ethnic groups

Coastal geomorphology and tsunami hazard scenario along the Kachchh coast, western India

549-556Geomorphology and coastal configuration plays a vital role during tsunami events as different coastal geomorphic units respond differently to a tsunami hazard. The study of ability of different coastal landforms to respond tsunami surge is very much important for vulnerability mapping of coast. The Kachchh coast that runs for about more than 450 km has conspicuous presence of both, wave as well as tide influenced landforms. Following the classification suggested by Ramasamy et al.1, the geomorphic features for possible response of tsunami event can be classified as facilitators, conveyors, accommodators, absorbers and barriers. Depending upon its action as facilitator, conveyor or accommodator, the geomorphic units like estuary, creek, mudflats and backwater increase the possibility of tsunami run ups and inundation. The beach ridges and wide sandy beaches on the other hand absorb tsunami energy and act as barriers. In view of these six distinct segments have been identified along the Kachchh coast and are described for their possible response to tsunami event. Accordingly, the segment between Jakhau and Suthari has barrier kind of geomorphic set up with presence of backswamps that has higher preservation potential of tsunami deposits. The segment from Suthari to Kanthada has steep beaches and dune ridges that can reduce the intensity of tsunami hazard. The Kanthada - Rawal Pir segment has Rukmavati River mouth that can convey the effect of tsunami to a considerable landward area whereas, the Rawal Pir - Mundra and Mundra – Tuna segments have dominant accommodator type of geomorphic assemblage that also has a higher preservation potential for tsunami sediments. The segment between Tuna and Kandla has relatively much wider mudflats and mangrove swamps which accommodates as well as reduces tsunami energy. However, the configuration suggests much intensified tsunami surge that can devastate the large scale developments in this part. Response mechanism of the coastal geomorphic assemblages will not only help in the disaster risk reduction activities but will also be useful in better understanding of palaeo and historical tsunamis

Incidence of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and impact on patient outcome.

We used data from a randomized trial of HIV-tuberculosis co-infected patients in Mozambique to determine the incidence and predictors of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome (IRIS) occurring within 12 weeks of starting antiretroviral therapy, and to evaluate its association with patient outcome at 48 weeks.HIV-tuberculosis co-infected and antiretroviral therapy-naïve adults with less than 250 CD4/mm3 were randomized to a nevirapine or efavirenz-based antiretroviral therapy initiated 4 to 6 weeks after starting tuberculosis treatment, and were then followed for 48 weeks. Tuberculosis cases were diagnosed using WHO guidelines, and tuberculosis-IRIS by case definitions of the International Network for the Study of HIV-associated IRIS.The 573 HIV-tuberculosis co-infected patients who initiated antiretroviral therapy had a median CD4 count of 92 cells/mm(3) and HIV-1 RNA of 5.6 log10 copies/mL. Mortality at week 48 was 6.1% (35/573). Fifty-three (9.2%) patients presented a tuberculosis-IRIS within 12 weeks of starting antiretroviral therapy. Being female and having a low CD4 count, high HIV-1 RNA load, low body mass index and smear-positive pulmonary tuberculosis were independently associated with tuberculosis-IRIS. After adjustment for baseline body mass index, CD4 count and hemoglobin, occurrence of tuberculosis-IRIS was independently associated with 48-week mortality (aOR 2.72 95%CI 1.14-6.54). Immunological and HIV-1 virological responses and tuberculosis treatment outcomes were not different between patients with and without tuberculosis-IRIS.In this large prospective cohort, tuberculosis-IRIS occurrence within 12 weeks of starting antiretroviral therapy was independently associated with the mortality of HIV-tuberculosis co-infected patients at 48 weeks post antiretroviral therapy initiation