Female sexual dysfunction amongst rural postmenopausal woman

Background: Female Sexual dysfunction is a common neglected symptom of postmenopausal women in rural India. Prevalence of sexual dysfunction increases with age and sexual response is dynamic process influenced by socio-cultural, physiological, psychological and socio-economical factors. The objective of the study was to analyse the prevalence of female sexual dysfunctions in postmenopausal women from rural area and to analyze prevalence of sexual activity among them.Methods: A cross-sectional study was conducted from June 2015 to January 2016 in Obstetrics and Gynecology outpatient department of Indian Institute of Medical Science and Research, Badnapur, Jalna, Maharashtra which is a tertiary care centre. All postmenopausal women who have attained menopause naturally were questioned about sexual symptoms with the help of pre-tested questionnaires and then analyzed with appropriate tests.Results: Mean age of menopause was 47.59±3.98 yrs and 51.9% were sexually active. Mean age among sexual active and sexual inactive women was 54.42±5.23 and 62.13±6.39 respectively. Prevalence of dyspareunia, vaginal dryness and decreased libido were 10.7%, 10.7% and 55.36% respectively in sexually active postmenopausal women. Sexual activity decreased from 54.4% to 5.6% as the duration of menopause increased from 5 years or less to 11 or more years. Sexual dysfunction increased as the duration of menopause increased.Conclusions: Sexual dysfunction is common in postmenopausal women and increases with increasing duration of menopause. Awareness of health care facility among rural menopausal women should be increased to improve their quality of life

Study of biosocial factors affecting laparoscopic tubal ligation in rural Maharashtra, India

Background: As compared to vasectomy, Indian women prefer female sterilization as the best mode sterilization. Many socio-demographic factors and gender of living children affects women in deciding laparoscopic tubal ligation.Objective of the study was to assess the biosocial factors affecting of laparoscopic tubal ligation patients in rural area and also to asses average family size and preference for male child before laparoscopic tubal ligation.Methods: A cross-sectional study was done during January to June 2016 in Indian Institute of Medical Science and Research medical College, Badnapur, Jalna, Maharashtra. A total of 549 patients from rural area, underwent laparoscopic tubal ligation were enrolled for the study. Data was analyzed by using percentage and proportion whenever necessary.Results: In this study, mean age of patients undergoing tubal ligation was 26.37±3.82 year. Maximum patients were from 25-29 years age group and among them 45.54% were illiterates. Average family size was 2.61±0.66. In 51.73% cases, couple themselves motivated for their sterilization. Education of both participant and their husband was significantly related to the total no. of living children. Only 9 patients under went tubal ligation with only 1 male child, while all other couples had at least one male child in the family.Conclusions: The study reveals that all couple had at least one male child. Education of both participant and their husband was an important factor in deciding the size of family.

Multiresponsive Dielectric Metasurfaces Based on Dual Light‐ and Temperature‐Responsive Copolymers

Abstract Tunability is essential for unlocking a range of practical applications of high‐efficiency metasurface‐based nanophotonic devices and systems. Increased research efforts in this area during recent years led to significant progress regarding tuning mechanisms, speed, and diverse active functionalities. However, so far almost all the demonstrated works are based on a single type of physical stimulus, thereby excluding important opportunities to enhance the modulation range of the metadevices, the available design options, as well as interaction channels between the metadevices and their environment. In this article, it is experimentally demonstrated that multi‐responsive metasurfaces can be realized by combining asymmetric, highly resonant metasurfaces with multi‐responsive polymeric materials. The respective copolymers combine light‐ and temperature‐responsive comonomers in an optimized ratio. This work demonstrates clearly reversible light‐responsive, temperature‐responsive, and co‐responsive tuning of the metasurface optical resonance positions at near‐infrared wavelengths, featuring maximum spectral resonance shifts of nearly twice the full‐width‐at‐half‐maximum and accompanied by more than 60% absolute modulation in transmittance. This work provides new design freedom for multifunctional metadevices and can potentially be expanded to other types of copolymers as well. Furthermore, the studied hybrid multiresponsive systems are promising candidates for multi‐dimensional sensing applications.Light and temperature‐responsive polymers are integrated with asymmetric silicon metasurfaces for dual‐responsive tuning of their transmittance. Reversible resonance shifts induced by light exposure, temperature changes or a combination of both stimuli are experimentally demonstrated. This work paves the way for multiresponsive metasurface components and is promising for multi‐dimensional interactive smart optical devices. imag

Psychiatric morbidity and poor follow-up underlie suboptimal functional and survival outcomes in Huntington’s disease

Background: Huntington’s disease (HD), an inherited, often late-onset, neurodegenerative disorder, is considered to be a rare, orphan disease. Research into its genetic correlates and services for those affected are inadequate in most low-middle income countries, including India. The apparent ‘incurability’ often deters symptomatic and rehabilitative care, resulting in poor quality of life and sub-optimal outcomes. There are no studies assessing disease burden and outcomes from India. Methods: We attempted to evaluate individuals diagnosed to have HD at our tertiary-care center between 2013 and 2016 for clinical symptoms, functionality, mortality, follow up status through a structured interview, clinical data from medical records and UHDRS-TFC scoring. Results: Of the 144 patients, 25% were untraceable, and another 17 (11.8%) had already died. Mean age at death and duration of illness at the time of death, were 53 years and 7 years respectively, perhaps due to suicides and other comorbidities at an early age. The patients who could be contacted (n = 81) were assessed for morbidity and total functional capacity (TFC). Mean CAG repeat length and TFC score were 44.2 and 7.5 respectively. Most individuals (66%) were in TFC stage I and II and could perhaps benefit from several interventions. The TFC score correlated inversely with duration of illness (p < 0.0001). The majority were being taken care of at home, irrespective of the physical and mental disability. There was a high prevalence of psychiatric morbidity (91%) including suicidal tendency (22%). Three of the 17 who died had committed suicide, and several other families reported suicidal history in other family members. Only about half the patients (57%) maintained a regular clinical follow-up. Conclusions: This study demonstrates the poor follow-up rates, significant suicidality and other psychiatric symptoms, sub-optimal survival durations and functional outcomes highlighting the need for holistic care for the majority who appear to be amenable to interventions

Consortium on Vulnerability to Externalizing Disorders and Addictions (cVEDA):A developmental cohort study protocol

Background: Low and middle-income countries like India with a large youth population experience a different environment from that of high-income countries. The Consortium on Vulnerability to Externalizing Disorders and Addictions (cVEDA), based in India, aims to examine environmental influences on genomic variations, neurodevelopmental trajectories and vulnerability to psychopathology, with a focus on externalizing disorders. Methods: cVEDA is a longitudinal cohort study, with planned missingness design for yearly follow-up. Participants have been recruited from multi-site tertiary care mental health settings, local communities, schools and colleges. 10,000 individuals between 6 and 23 years of age, of all genders, representing five geographically, ethnically, and socio-culturally distinct regions in India, and exposures to variations in early life adversity (psychosocial, nutritional, toxic exposures, slum-habitats, socio-political conflicts, urban/rural living, mental illness in the family) have been assessed using age-appropriate instruments to capture socio-demographic information, temperament, environmental exposures, parenting, psychiatric morbidity, and neuropsychological functioning. Blood/saliva and urine samples have been collected for genetic, epigenetic and toxicological (heavy metals, volatile organic compounds) studies. Structural (T1, T2, DTI) and functional (resting state fMRI) MRI brain scans have been performed on approximately 15% of the individuals. All data and biological samples are maintained in a databank and biobank, respectively. Discussion: The cVEDA has established the largest neurodevelopmental database in India, comparable to global datasets, with detailed environmental characterization. This should permit identification of environmental and genetic vulnerabilities to psychopathology within a developmental framework. Neuroimaging and neuropsychological data from this study are already yielding insights on brain growth and maturation patterns.</p

Nef Alleles from All Major HIV-1 Clades Activate Src-Family Kinases and Enhance HIV-1 Replication in an Inhibitor-Sensitive Manner

The HIV-1 accessory factor Nef is essential for high-titer viral replication and AIDS progression. Nef function requires interaction with many host cell proteins, including specific members of the Src kinase family. Here we explored whether Src-family kinase activation is a conserved property of Nef alleles from a wide range of primary HIV-1 isolates and their sensitivity to selective pharmacological inhibitors. Representative Nef proteins from the major HIV-1 subtypes A1, A2, B, C, F1, F2, G, H, J and K strongly activated Hck and Lyn as well as c-Src to a lesser extent, demonstrating for the first time that Src-family kinase activation is a highly conserved property of primary M-group HIV-1 Nef isolates. Recently, we identified 4-amino substituted diphenylfuropyrimidines (DFPs) that selectively inhibit Nef-dependent activation of Src-family kinases as well as HIV replication. To determine whether DFP compounds exhibit broad-spectrum Nef-dependent antiretroviral activity against HIV-1, we first constructed chimeric forms of the HIV-1 strain NL4-3 expressing each of the primary Nef alleles. The infectivity and replication of these Nef chimeras was indistinguishable from that of wild-type virus in two distinct cell lines (U87MG astroglial cells and CEM-T4 lymphoblasts). Importantly, the 4-aminopropanol and 4-aminobutanol derivatives of DFP potently inhibited the replication of all chimeric forms of HIV-1 in both U87MG and CEM-T4 cells in a Nef-dependent manner. The antiretroviral effects of these compounds correlated with inhibition of Nef-dependent activation of endogenous Src-family kinases in the HIV-infected cells. Our results demonstrate that the activation of Hck, Lyn and c-Src by Nef is highly conserved among all major clades of HIV-1 and that selective targeting of this pathway uniformly inhibits HIV-1 replication

Apoptosis of CD4+CD25high T Cells in Type 1 Diabetes May Be Partially Mediated by IL-2 Deprivation

from T1D subjects. in T1D may be caught up in a relatively deficient cytokine milieu. function in subjects predisposed to T1D

Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort

Background: Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse. The study aims to determine the prevalence of ACEs and its association with substance misuse. Methods: Data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used (n = 9010). ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure. Results: 1 in 2 participants reported child maltreatment ACEs and family level ACEs. Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. 12.7%). In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5–11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4–31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1–3.5). Conclusion: ACEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. The results suggest enhancing current ACE resilience programmes and ‘trauma-informed’ approaches to tackling longer-term impact of ACEs in India. Funding: Newton Bhabha Grant jointly funded by the Medical Research Council, UK (MR/N000390/1) and the Indian Council of Medical Research (ICMR/MRC-UK/3/M/2015-NCD-I)