Utilization pattern of child health care services in the rural area of Surendranagar district: a community based cross sectional study

Background: Infant and child mortality continues to be a major public health problem all over the country. Despite the existence of national programmes for improving child health in India, child mortality and morbidity continue to be high. Utilization of child health care services is poor in the rural areas, causing significant impact on the health causing increased morbidity and mortality.Methods: It was a Community based Cross-sectional study carried out in the rural area of Surendranagar district through oral questionnaire method which was pre-designed and pretested. Data on demography, history of colostrum, initiation of breastfeeding, prelacteal feeds, exclusive breastfeeding, introduction of complementary feeding, immunization, respiratory infections etc. were collected, compiled and analyzed by applying appropriate tests using SPSS.Results: Out of 154 participants, 43.51% were offered breastfeeding within one hour of birth. Association was observed between initiation of breastfeeding, exclusive breastfeeding, time of introduction of complementary foods and duration of breastfeeding and utilization of health education services. Educational level of mothers and immunization status of the children had a significant statistical association. The overall prevalence of ARI was 31.82% & of Diarrhoea was 39.61%.Conclusions: A positive association was observed between nutritional status and utilization of nutritional services. Significant impact of health education services given during the antenatal period was observed on initiation of breastfeeding as well as exclusive breastfeeding. Although child services in India have been created, strengthened and expanded over the years, their performance in terms of utilization particularly in rural area is still limited

Violence against women: a study on nature, prevalence and extent

Background: To study the nature, prevalence and extent of domestic violence against women in the study area.Methods: The cross-sectional study was carried out in the urban and rural area of Surendranagar district of Gujarat. Total 600 ever married women of 15-49 years of age were selected for the study purpose. The self-administered questionnaire was used to gather all the information. Steps were taken up to maintain confidentiality.Results: Out of total 600 women, 231 (38.5%) were victims of domestic violence in one form or the other. The analysis based on each form of violence discloses that about 83% were victims of psychological violence, about 54% of the victims had experienced physical violence, about 32% were victims of economical violence and about 24% were victims of sexual violence.Conclusions: Husband was the frequent instigator of domestic violence. Psychological violence is the commonest form of violence experienced by the victims

Optimizations for a Current-Controlled Memristor-based Neuromorphic Synapse Design

The synapse is a key element of neuromorphic computing in terms of efficiency and accuracy. In this paper, an optimized current-controlled memristive synapse circuit is proposed. Our proposed synapse demonstrates reliability in the face of process variation and the inherent stochastic behavior of memristors. Up to an 82% energy optimization can be seen during the SET operation over prior work. In addition, the READ process shows up to 54% energy savings. Our current-controlled approach also provides more reliable programming over traditional programming methods. This design is demonstrated with a 4-bit memory precision configuration. Using a spiking neural network (SNN), a neuromorphic application analysis was performed with this precision configuration. Our optimized design showed up to 82% improvement in control applications and a 2.7x improvement in classification applications compared with other design cases

Experience with NESTROFT for screening for thalassemia trait/ minor: evaluation against CBC and HPLC in a high prevalence region in Saurashtra, Gujarat, India

Background: Hemoglobinopathies pose a significant health burden in India. Prevention programmes can significantly reduce this burden. Although sophisticated methods of screening for β thalassemia trait are available, a cheap and simple method is beneficial for population screening. Although the Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) has been evaluated in many studies, sample sizes were small in some and many earlier studies have not done complete blood count (CBC) and High-Performance Liquid Chromatography (HPLC) in all the cases. We evaluate the suitability of NESTROFT for detection of β-thalassemia trait in a high prevalence region in Saurashtra, Gujarat.Methods: Here, 1000 unrelated individuals were studied. NESTROFT, CBC and estimation of HbA2 and HbF or other hemoglobin variants were done by HPLC.Results: Prevalence of β thalassemia trait was 7.8% in this population. NESTROFT showed an overall sensitivity and specificity of 94.87 and 85.38 respectively for the detection of β thalassaemia trait. Using red cell indices (MCH <27 pg and MCV <80 fl), One β thalassemia trait with normal indices would have been missed. Among twelve individuals with other hemoglobinopathies (HbS, HbD, HbE, δβ thalassemia trait or HPFH), seven had a positive NESTROFT while three had normal MCV & MCH values.Conclusions: NESTROFT is a cost-effective sensitive test which does not require any equipment and can be done in remote areas. It remains a useful first line screening test when large populations have to be screened.

TNFAIP3 Maintains Intestinal Barrier Function and Supports Epithelial Cell Tight Junctions

Tight junctions between intestinal epithelial cells mediate the permeability of the intestinal barrier, and loss of intestinal barrier function mediated by TNF signaling is associated with the inflammatory pathophysiology observed in Crohn's disease and celiac disease. Thus, factors that modulate intestinal epithelial cell response to TNF may be critical for the maintenance of barrier function. TNF alpha-induced protein 3 (TNFAIP3) is a cytosolic protein that acts in a negative feedback loop to regulate cell signaling induced by Toll-like receptor ligands and TNF, suggesting that TNFAIP3 may play a role in regulating the intestinal barrier. To investigate the specific role of TNFAIP3 in intestinal barrier function we assessed barrier permeability in TNFAIP3−/− mice and LPS-treated villin-TNFAIP3 transgenic mice. TNFAIP3−/− mice had greater intestinal permeability compared to wild-type littermates, while villin-TNFAIP3 transgenic mice were protected from increases in permeability seen within LPS-treated wild-type littermates, indicating that barrier permeability is controlled by TNFAIP3. In cultured human intestinal epithelial cell lines, TNFAIP3 expression regulated both TNF-induced and myosin light chain kinase-regulated tight junction dynamics but did not affect myosin light chain kinase activity. Immunohistochemistry of mouse intestine revealed that TNFAIP3 expression inhibits LPS-induced loss of the tight junction protein occludin from the apical border of the intestinal epithelium. We also found that TNFAIP3 deubiquitinates polyubiquitinated occludin. These in vivo and in vitro studies support the role of TNFAIP3 in promoting intestinal epithelial barrier integrity and demonstrate its novel ability to maintain intestinal homeostasis through tight junction protein regulation.</p

A typhoid fever outbreak in a slum of South Dumdum municipality, West Bengal, India, 2007: Evidence for foodborne and waterborne transmission

<p>Abstract</p> <p>Background</p> <p>In April 2007, a slum of South Dumdum municipality, West Bengal reported an increase in fever cases. We investigated to identify the agent, the source and to propose recommendations.</p> <p>Methods</p> <p>We defined a suspected case of typhoid fever as occurrence of fever for ≥ one week among residents of ward 1 of South Dumdum during February – May 2007. We searched for suspected cases in health care facilities and collected blood specimens. We described the outbreak by time, place and person. We compared probable cases (Widal positive >= 1:80) with neighbourhood-matched controls. We assessed the environment and collected water specimens.</p> <p>Results</p> <p>We identified 103 suspected cases (Attack rate: 74/10,000, highest among 5–14 years old group, no deaths). Salmonella (enterica) Typhi was isolated from one of four blood specimens and 65 of 103 sera were >= 1:80 Widal positive. The outbreak started on 13 February, peaked twice during the last week of March and second week of April and lasted till 27 April. Suspected cases clustered around three public taps. Among 65 probable cases and 65 controls, eating milk products from a sweet shop (Matched odds ratio [MOR]: 6.2, 95% confidence interval [CI]: 2.4–16, population attributable fraction [PAF]: 53%) and drinking piped water (MOR: 7.3, 95% CI: 2.5–21, PAF-52%) were associated with illness. The sweet shop food handler suffered from typhoid in January. The pipelines of intermittent non-chlorinated water supply ran next to an open drain connected with sewerage system and water specimens showed faecal contamination.</p> <p>Conclusion</p> <p>The investigation suggested that an initial foodborne outbreak of typhoid led to the contamination of the water supply resulting in a secondary, waterborne wave. We educated the food handler, repaired the pipelines and ensured chlorination of the water.</p

Screening for Posttraumatic Stress Disorder among Somali ex-combatants: A validation study

In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD), that impairs their ability to re-integrate into civilian life. This study reports on development and validation of a screening tool for PTSD in Somali language with a sample of ex-combatants.Waxaa Soomaaliya ka jira tiro badan oo askartii hore ah oo dhimirka wax ka gaaray, sida cudurka la yiraahdo "Posttraumatic Stress Disorder (PTSD)", kaaso isbeddel ku sameeyo qofka dad ladhaqankiisa. Darasaadkanina wuxuu horumarinayaa qalabka baaritaanka caafimaadka cudurka DPTS oo loo adeegsanayo Af-soomaaliga.In Somalia, un gran numero di soldati o ex-soldati sono affetti da problemi psicologici come il Disturbo Post-Traumatico da Stress (DPTS), che altera la capacità di re-integrarsi nella vita civile. Questo studio riporta sullo sviluppo di uno strumento di screening per il DPTS in lingua somala

Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse

Background: Posttraumatic Stress Disorder (PTSD) related to childhood sexual abuse (CSA) is often associated with a wide range of trauma-related aversive emotions such as fear, disgust, sadness, shame, guilt, and anger. Intense experience of aversive emotions in particular has been linked to higher psychopathology in trauma survivors. Most established psychosocial treatments aim to reduce avoidance of trauma-related memories and associated emotions. Interventions based on Dialectical Behavior Therapy (DBT) also foster radical acceptance of the traumatic event. Methods: This study compares individual ratings of trauma-related emotions and radical acceptance between the start and the end of DBT for PTSD (DBT-PTSD) related to CSA. We expected a decrease in trauma-related emotions and an increase in acceptance. In addition, we tested whether therapy response according to the Clinician Administered PTSD-Scale (CAPS) for the DSM-IV was associated with changes in trauma-related emotions and acceptance. The data was collected within a randomized controlled trial testing the efficacy of DBT-PTSD, and a subsample of 23 women was included in this secondary data analysis. Results: In a multilevel model, shame, guilt, disgust, distress, and fear decreased significantly from the start to the end of the therapy whereas radical acceptance increased. Therapy response measured with the CAPS was associated with change in trauma-related emotions. Conclusions: Trauma-related emotions and radical acceptance showed significant changes from the start to the end of DBT-PTSD. Future studies with larger sample sizes and control group designs are needed to test whether these changes are due to the treatment. Trial registration: ClinicalTrials.gov, number NCT0048100

TNFAIP3 Maintains Intestinal Barrier Function and Supports Epithelial Cell Tight Junctions

Tight junctions between intestinal epithelial cells mediate the permeability of the intestinal barrier, and loss of intestinal barrier function mediated by TNF signaling is associated with the inflammatory pathophysiology observed in Crohn's disease and celiac disease. Thus, factors that modulate intestinal epithelial cell response to TNF may be critical for the maintenance of barrier function. TNF alpha-induced protein 3 (TNFAIP3) is a cytosolic protein that acts in a negative feedback loop to regulate cell signaling induced by Toll-like receptor ligands and TNF, suggesting that TNFAIP3 may play a role in regulating the intestinal barrier. To investigate the specific role of TNFAIP3 in intestinal barrier function we assessed barrier permeability in TNFAIP3−/− mice and LPS-treated villin-TNFAIP3 transgenic mice. TNFAIP3−/− mice had greater intestinal permeability compared to wild-type littermates, while villin-TNFAIP3 transgenic mice were protected from increases in permeability seen within LPS-treated wild-type littermates, indicating that barrier permeability is controlled by TNFAIP3. In cultured human intestinal epithelial cell lines, TNFAIP3 expression regulated both TNF-induced and myosin light chain kinase-regulated tight junction dynamics but did not affect myosin light chain kinase activity. Immunohistochemistry of mouse intestine revealed that TNFAIP3 expression inhibits LPS-induced loss of the tight junction protein occludin from the apical border of the intestinal epithelium. We also found that TNFAIP3 deubiquitinates polyubiquitinated occludin. These in vivo and in vitro studies support the role of TNFAIP3 in promoting intestinal epithelial barrier integrity and demonstrate its novel ability to maintain intestinal homeostasis through tight junction protein regulation