Immunization status of children in the age group 0-5 years in urban slum area of Pratiksha nagar, Sion, Mumbai

Background: In India, immunization services are being provided through existing healthcare delivery system. In spite of services being available, it is observed that many children are not immunized till date. This study was carried out with the aim to find the immunisation status of the children in the urban slum areas of Pratiksha nagar, Sion which is the field practice area of Department of Community Medicine, K. J. Somaiya Medical College and Reasearch Centre. Objectives of the study was to assess the proportion of children fully immunized, to assess the proportion of children partially immunized, to assess the proportion of children not at all immunized and to explore the reasons for partial immunization.Methods: It is a cross-sectional study. This study was carried out in  urban slum areas of  Pratiksha nagar, in Sion  namely Almeda compound, Shastrinagar B wing, Panchsheel nagar which are  the field practice areas of Department of  Community Medicine located in F north ward of Mumbai city.Results: 148 (76.29%) children were fully immunized and 46 (23.71%) were partially immunized. Out of the 46 children who were partially immunized, 23.91% respondents reported that child was ill when immunisation was due, so they did not take the child to health care facility for immunisation, followed by the other common reason that family was out of town (17.39%).Conclusions: The study highlights the need for educating parents that minor illnesses are not a contraindication for immunisation and that the child may receive the vaccine due in any health centre when they are out of town so as to avoid delay between the doses therein not interrupting the immunisation schedule.

Accuracy of Orthodontic Soft Tissue Prediction Software between Different Ethnicities

Objective: The objective of this study was to assess the accuracy of the soft tissue prediction module of Dolphin Imaging Software (DIS) in patients requiring extractions as part of the orthodontic treatment plan and compare its accuracy between different ethnicities. Materials and Methods: Initial and final records of 57 patients from three ethnic groups (African Americans, Caucasians, and Hispanics) who completed orthodontic treatment were included for assessment. The identified cases were managed non-surgically with dental extractions. A predictive profile was generated using DIS and compared to post-treatment lateral photographs. Actual and predictive profile photographs were compared using five designated parameters. The assessment parameters were evaluated using a manual protractor. ANOVA was used to compare differences between actual and predicted parameters between the specified groups and ICC was used to assess correlations between the data. Results: Neither ethnicity nor gender had a significant effect on the difference between predicted and final values. No significant difference was noted between the predicted and final images for the nasolabial angle. Significant differences were observed for the mentolabial fold, upper lip to E-line, and lower lip to E-line between predicted and actual images. Additionally, soft tissue convexity was significantly different (p=0.019). Additionally, a clinically significant difference was found for the mentolabial fold. Conclusion: Ethnicity and gender had no impact on the accuracy of predicted and actual image parameters. Overall, DIS demonstrated acceptable accuracy when simulating soft tissue changes after extraction therapy. Additional research on the accuracy of the software is warranted

GDF15 mediates the effects of metformin on body weight and energy balance.

Metformin, the world's most prescribed anti-diabetic drug, is also effective in preventing type 2 diabetes in people at high risk1,2. More than 60% of this effect is attributable to the ability of metformin to lower body weight in a sustained manner3. The molecular mechanisms by which metformin lowers body weight are unknown. Here we show-in two independent randomized controlled clinical trials-that metformin increases circulating levels of the peptide hormone growth/differentiation factor 15 (GDF15), which has been shown to reduce food intake and lower body weight through a brain-stem-restricted receptor. In wild-type mice, oral metformin increased circulating GDF15, with GDF15 expression increasing predominantly in the distal intestine and the kidney. Metformin prevented weight gain in response to a high-fat diet in wild-type mice but not in mice lacking GDF15 or its receptor GDNF family receptor α-like (GFRAL). In obese mice on a high-fat diet, the effects of metformin to reduce body weight were reversed by a GFRAL-antagonist antibody. Metformin had effects on both energy intake and energy expenditure that were dependent on GDF15, but retained its ability to lower circulating glucose levels in the absence of GDF15 activity. In summary, metformin elevates circulating levels of GDF15, which is necessary to obtain its beneficial effects on energy balance and body weight, major contributors to its action as a chemopreventive agent

Avoiding false discovery in biomarker research

Abstract Background Human tyrosine-protein phosphatase non-receptor type substrate 1α (SIRPA) is a surface marker identified in cardiomyocytes differentiated from human embryonic stem cells. Our objective was to determine if circulating SIRPA levels can serve as a biomarker of cardiac injury in children undergoing open heart surgery. Results Paired pre- and post-operative serum samples from 48 pediatric patients undergoing open heart surgery and from 6 pediatric patients undergoing non-cardiac surgery (controls) were tested for SIRPA protein levels using commercially available SIRPA ELISA kits from two manufacturers. Post-operative SIRPA concentrations were significantly higher in patients after cardiac surgery compared to non-cardiac surgery when tested using SIRPA ELISA kits from both manufacturers. To verify the identity of the protein detected, recombinant human SIRPA protein (rhSIRPA) was tested on both ELISA kits. The calibrator from both ELISA kits was analyzed by Western blot as well as by Mass Spectrometry (MS). Western blot analysis of calibrators from both kits did not identity SIRPA. MS analysis of calibrators from both ELISA kits identified several inflammatory markers and albumin but no SIRPA was detected. Conclusions We conclude that commercially available ELISA kits for SIRPA give false-positive results. Verifying protein identity using robust protein characterization is critical to avoid false biomarker discovery when using commercial ELISA kits

CORRELATION OF ANKLE DORSIFLEXION RANGE OF MOTION WITH DYNAMIC BALANCE IN YOUNG NORMAL INDIVIDUALS

This study was to examine correlation of ankle dorsiflexion range of motion with dynamic balance in young normal individuals. A cross sectional study has been done on 60 females by convenient sampling. The study was to examine dorsiflexion ROM by using star excursion balance test. It was performed in all directions for three trials. Distance was recorded with measure tape. Ankle ROM was performed by weight bearing lunge. Individuals who demonstrate impairments in dorsiflexion ROM may also demonstrate difficulty with portions of the SEBT. There is significant positive correlation in between dorsiflexion range of motion and star excursion balance test in anterior and postero lateral direction

The rationale and design of Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT): a prospective cohort study of childhood nephrotic syndrome

Abstract Background Nephrotic syndrome is one of the most commonly diagnosed kidney diseases in childhood and its progressive forms can lead to chronic kidney disease (CKD) and/or end-stage renal disease (ESRD). There have been few longitudinal studies among a multi-ethnic cohort to determine potential risk factors influencing disease susceptibility, treatment response, and progression of nephrotic syndrome. Temporal relationships cannot be studied through cross-sectional study design. Understanding the interaction between various factors is critical to developing new strategies for treating children with kidney disease. We present the rationale and the study design of a longitudinal cohort study of children with nephrotic syndrome, the Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT) study. The specific aims are to determine: 1) socio-demographic, environmental, and genetic factors that influence disease susceptibility; 2) rates of steroid treatment resistance and steroid treatment dependence, and identify factors that may modify treatment response; 3) clinical and genetic factors that influence disease susceptibility and progression to CKD and ESRD; and 4) the interaction between the course of illness and socio-demographic, environmental, and clinical risk factors. Methods/design INSIGHT is a disease-based observational longitudinal cohort study of children with nephrotic syndrome. At baseline, participants complete questionnaires and provide biological specimen samples (blood, urine, and toenail clippings). Follow-up questionnaires and repeat biological specimen collections are performed annually for up to five years. Discussion The proposed cohort will provide the structure to test various risk factors predicting or influencing disease susceptibility, treatment response, and progression to CKD among children with nephrotic syndrome. Trial registration ClinicalTrials.gov Identifier NCT01605266

GDF15 mediates the effects of metformin on body weight and energy balance.

Metformin, the world's most prescribed anti-diabetic drug, is also effective in preventing type 2 diabetes in people at high risk1,2. More than 60% of this effect is attributable to the ability of metformin to lower body weight in a sustained manner3. The molecular mechanisms by which metformin lowers body weight are unknown. Here we show-in two independent randomized controlled clinical trials-that metformin increases circulating levels of the peptide hormone growth/differentiation factor 15 (GDF15), which has been shown to reduce food intake and lower body weight through a brain-stem-restricted receptor. In wild-type mice, oral metformin increased circulating GDF15, with GDF15 expression increasing predominantly in the distal intestine and the kidney. Metformin prevented weight gain in response to a high-fat diet in wild-type mice but not in mice lacking GDF15 or its receptor GDNF family receptor α-like (GFRAL). In obese mice on a high-fat diet, the effects of metformin to reduce body weight were reversed by a GFRAL-antagonist antibody. Metformin had effects on both energy intake and energy expenditure that were dependent on GDF15, but retained its ability to lower circulating glucose levels in the absence of GDF15 activity. In summary, metformin elevates circulating levels of GDF15, which is necessary to obtain its beneficial effects on energy balance and body weight, major contributors to its action as a chemopreventive agent