Tuberculosis and gender: exploring the patterns in a case control study in Malawi.

BACKGROUND: In many populations there is an excess of tuberculosis in young women and older men. We explored possible explanations for these patterns, concentrating on human immunodeficiency virus (HIV) status, pregnancy, smoking, cooking smoke exposure, contact with tuberculosis cases within the household or outside, and gender differences in health service usage and diagnostic delay. DESIGN: Case control study in Karonga District, Malawi. METHODS: Cases were new tuberculosis patients with bacteriological or histological evidence of tuberculosis. Controls were selected in the community using field-based random sampling. RESULTS: The study included 598 tuberculosis cases and 992 controls, with an excess of tuberculosis in young females and older males. This was more marked in HIV-positive individuals. HIV infection was a similarly strong risk factor for tuberculosis in both men and women. Tuberculosis was associated with having a family or household contact with tuberculosis for both men and women. For women, but not men, contacts outside the close family and household were also a risk factor for tuberculosis. Tuberculosis was not associated with current or recent pregnancy, or with smoking or smoke exposure. There were no differences between men and women in health service usage or delay. CONCLUSIONS: In this population, HIV infection and contacts with known tuberculosis patients are important determinants of the gender distribution of cases

The impact of academic performance on self-esteem among the female students studying in different colleges under Royal University of Bhutan

The current study was carried out among the female students of The Royal University of Bhutan to evaluate the relationship between academic performance and self-esteem, and the factors affecting self-esteem.  The study adopted concurrent triangulation design of mixed methodology to collect and analyse the data. A total of 491 female students participated in the survey and of which 34 of them participated in focus-group interview.  The result of the quantitative analysis showed that there is a positive relationship between academic performance and self-esteem (rho=.170, p<.05), which attests to the similar earlier findings. Qualitative analysis explored Ackerman’s nine factors influencing self-esteem. Of the nine factors influencing self-esteem, parental influence was shown to have the most effect on the participants’ self-esteem. Based on the findings, the current study made a number of recommendations

Lipotransfer provides effective soft tissue replacement for acquired partial lipodystrophy

We present a 48-year-old female patient who presented with features consistent with acquired partial lipodystrophy (APL) also known as 'Barraquer-Simons syndrome'. It is a rare disease characterised by a gradual and progressive onset of lipoatrophy limited to the face, neck, upper limbs, thorax and abdomen and sparing the lower extremities. The resultant physical appearance can have significant psychosocial sequelae, further compounded by misdiagnosis and delay in recognition and management. Treatment is aimed at surgical correction of soft tissue destruction. Autologous fat transfer is an established plastic and reconstructive procedure that is safe and minimally invasive and can be used to reconstruct a variety of soft tissue defects and has shown to be an effective treatment modality in patients with APL

Comparison of drug advertisements published in Indian and foreign journals

Background: Drug advertisements form one of the major sources for updating drug information by the medical professionals. It has been observed that Indian drug advertisements provide incomplete and poor quality of essential information. However, existing information on comparison of drug advertisements in Indian and foreign journals is limited. Hence, this study was planned to compare the drug advertisements published in Indian and foreign journals.Methods: A total of 200 drug advertisements, 100 each from Indian and foreign journals, were randomly selected excluding those of medical devices, surgical appliances, nutritional supplements and ayurvedic drugs. The drug advertisements from two sources were compared for drug groups, compliance to ‘Ethical criteria for medicinal drug promotion’ of World Health Organization (WHO), retrievability of cited reference(s) and mention of any additional information.Results: Drug groups advertised frequently in the Indian journals were those used for chronic diseases whereas chemotherapeutic agents topped the list in foreign journals. Brand names were mentioned in 100% advertisements in both categories of journals whereas information on other ingredients known to cause problems was not mentioned in any of the studied advertisements. Overall, compliance to WHO guidelines by advertisements was 54.6% in Indian journals and 68.2% in foreign journals. The two categories of journals didn’t differ significantly in retrievability of cited reference(s) and additional information except for information on drug storage which was significantly more mentioned in Indian journals.Conclusions: Drug advertisements in both Indian and foreign journals were incomplete for updating drug information by medical professionals.

Quantum chemical study of tautomerization in select pharmaceuticals

Prototropička tautomerizacija je ravnotežna reakcija pomaka protona s kiselog centra molekule na bazični, uz istovremeni pomak π-elektrona u suprotnom smjeru. Molekule koje posjeduju -CH-C(=O)-NH- fragment postoje u tri tautomerna oblika: keto, enol i iminol. Među takvim molekulama nalazi se značajan broj lijekova. Tautomeri se međusobno razlikuju po fizikalno-kemijskim osobinama, stoga je karakterizacija tautomerne smjese važna za razumijevanje farmakokinetike i farmakodinamike lijekova, kao i za postupke proizvodnje i oblikovanja. Udio svakog tautomera u ravnotežnoj smjesi ovisi o njihovim relativnim stabilnostima. Gibbsova energija molekule može se odrediti in silico, koristeći računalne programe bazirane na zakonima kvantne mehanike. U ovom radu ispitane su stabilnosti tautomera 15 molekula farmaceutika. Keto oblik najstabilniji je u svim slučajevima. Iminolni oblik većine molekula dovoljno je stabilan kako bi se smatrao značajnim dijelom ravnotežne smjese, za razliku od enola čiji se udio zbog nestabilnosti može zanemariti. Supstituenti na amidnom dušiku i α-ugljiku utječu na energije tautomera: najjači su stabilizatori elektron-akceptorske skupine, aromatski sustavi i strukture koje omogućuju uspostavu produžene konjugacije. Stabilnost se može povećati i uspostavom intramolekulske vodikove veze. Ispitivani lijekovi koriste se u terapiji velikog broja pacijenata širom svijeta. Karakterizacija tautomera pomoći će u produbljivanju razumijevanja njihovih fizikalno-kemijskih osobina te u izgradnji srodnih lijekova poboljšanih svojstava.Prototropic tautomerization is an equilibrium reaction that includes a proton shift from the acidic centre of a molecule to the basic centre, with the simultaneous shift of π-electrons in the opposite direction. Molecules possessing the -CH-C(=O)-NH- fragment exist in three tautomeric forms: keto, enol and iminol. Among such molecules is a large number of pharmaceuticals. Tautomers differ in physico-chemical properties. The characterisation of the tautomeric equilibrium is thus important for the understanding of pharmacokinetics and pharmacodynamics of drugs, as well as for their manufacturing and formulation. The percentage of each tautomer in the equilibrium depends on their relative stabilities. The Gibbs energy of a molecule can be determined in silico, using computer programs based on the laws of quantum mechanics. In this thesis the stabilities of tautomers of 15 molecules were examined. Keto form is the most stable in all cases. Iminolic form of most molecules is stable enough to be considered a significant part of the tautomeric mix, while the enolic form is very unstable, so its presence can be deemed negligible. Substituents on the amidic nitrogen and the α-carbon affect the energies of tautomers: electron-accepting groups, aromatic structures and conjugated systems possess the strongest stabilizing effect. Stability of tautomers can also be increased by the formation of an intramolecular hydrogen bond. The analyzed pharmaceuticals are widely used for treatment of patients all over the world. Characterization of their tautomers will help increase the understanding of their physico-chemical properties and aid in design of related drugs with improved features

Vektorima prenosive bolesti

Bolesti koje prenose vektori su skupina zaraznih bolesti čiji se uzročnici (virusi, bakterije, rikecije, protoz i dr.) prenose na čovjeka posredno putem vektora. Globalne klimatske promjene i intenziviranje međunarodnog prometa, trgovine i turizma znatno utječu na promjene u distribuciji i osobitostima, kao i na pojavu novih obrazaca širenja vektorskih bolesti. Ove bolesti se obično nalaze u tropskim i sub-tropskim područjima i čine 17% svih zaraznih bolesti u svijetu. Prema procjenama Svjetske zdravstvene organizacije (SZO) više je od polovine svjetskog stanovništva izloženo riziku obolijevanja od bolesti kao što su denge, malarija, lišmanijaza, žuta groznica i druge. Prema procjenama Europskog centra za prevenciju i nadzor nad zaraznim bolestima (European Center for Disease Prevention and Control, ECDC) vektorske bolesti čine 29% udjela u svim zaraznim bolestima tijekom posljednjih 10 godina u Europi. Među navedenim postotkom dominiraju bolesti koje prenose komarci. Bolesti koje prenose krpelji također su od velike javnozdravstvene važnosti u Europi. Među zabilježenim vektorskim bolestima u Hrvatskoj, najveći je broj prijava oboljelih od Lyme borelioze i krpeljnog meningncefalitisa, koje prenose krpelji. U rujnu 2010. godine prvi puta u Hrvatskoj zabilježeni su oboljeli od autohtone dengue. Krajem ljeta 2012. godine prvi puta su zabilježeni slučajevi West Nile meningncefalitisa u istočnim dijelovima Hrvatske, dok su 2013. godine u 3 oboljelih prvi puta dijagnosticirani neuroinvazivni oblici bolesti uzrokovani Usutu virusom u Hrvatskoj

Optimising the decellularization of human elastic cartilage with trypsin for future use in ear reconstruction

Decellularized scaffolds can induce chondrogenic differentiation of stem cells. This study compares different methods to optimise the decellularization of auricular cartilage. The process consisted of an initial 12 hour dry freeze thaw which froze the cartilage specimens in an empty tube at −20 °C. Samples were allowed to thaw at room temperature followed by submersion in phosphate buffer solution in which they were frozen at −20 °C for a 12 hour period. They were then allowed to thaw at room temperature as before. Protocol A subsequently involved subjecting specimens to both deoxyribonuclease and sodium deoxycholate. Protocol B and C were adaptations of this using 0.25% trypsin (7 cycles) and a 0.5 molar solution of ethylenediaminetetraacetic acid (3 hours for each cycle) respectively as additional steps. Trypsin accelerated the decellularization process with a reduction in DNA content from 55.4 ng/μL (native) to 17.3 ng/μL (P-value < 0.05) after 14 days. Protocol B showed a faster reduction in DNA content when compared with protocol A. In comparison to protocol C after 14 days, trypsin also showed greater decellularization with a mean difference of 11.7 ng/μL (P-value < 0.05). Histological analysis with H&E and DAPI confirmed depletion of cells at 14 days with trypsin