Magnetic resonance imaging of temporomandibular joint in juvenile idiopathic arthritis

Background: Juvenile Idiopathic Arthritis (JIA) is the most common autoimmune inflammatory synovial arthritis causing wide range of disability in children. The involvement of temporo-mandibular joint (TMJ) in JIA varies ranging from 17% to 87%. Unlike other synovial joints, the TM joint is particularly vulnerable to inflammatory damage as the mandibular growth plate is superficial. JIA is a clinical diagnosis and is characterized by synovial hyperplasia and inflammation leading to joint effusion. TMJ involvement is clinically difficult to assess and often goes untreated. Children with TMJ arthritis have mastication dysfunction and pain. Delayed detection and treatment leads to abnormalities like micrognathia, jaw deformity, facial dysmorphism and chewing problems. MRI is the most sensitive modality to diagnose synovitis and involvement of TMJ in children of JIA.Methods: A cross-sectional observational study was undertaken in 30 children diagnosed as JIA as per ILAE criteria. They were evaluated clinically followed by contrast enhanced MRI for evidence of TMJ arthritis.Results: Of the 60 joints evaluated, clinical involvement was found in 18 joints (10 patients). 12(66.7%) out of them had MRI changes. 3(7.1%) joints out of 42 asymptomatic joints had MRI changes. 13 joints had synovial hypertrophy, 8 joints showed bone erosions. Bone marrow edema was seen in 2 joints, with no evidence of cartilage involvement in any joint. The sensitivity, specificity, PPV and NPV of clinical examination to diagnose TMJ arthritis as compared to MRI was 80.0%, 86.7%, 66.7% and 92.7% respectively.Conclusions: With paucity of clinical signs and symptoms, early involvement of TMJ arthritis in children of JIA can be detected by MRI to prevent long term disability in patients

Day time variations in noise levels at major crossings of Jammu city, India

The present study has been carried to assess Equivalent noise level (Leq), Noise climate (NC), Traffic noise index (TNI) and Day Time Average Noise level from7.00 A.M. to 9.00 P.M (Ld) at eleven major crossings of Jammu City. The Leq and Ld values at all the sites were observed to be above permissible limits prescribed by CPCB. The calculated values of Ld at all the sites were observed to be statistically significant at 0.05 (5%) level of significance (p=0.000-0.004)

FORMULATION AND CHARACTERIZATION OF HPMC AND HPMCAS BASED SOLID DISPERSIONS OF FENOFIBRATE: A COMPARATIVE STUDY

Objective: The aim of the present study was to investigate the effect of novel polymeric carriers and to develop solid dispersion formulation that could improve in vitro profile of Fenofibrate (FB). Methods: Spray drying technique was used to fabricate solid dispersions with hydrophilic carriers, mainly hydroxypropyl methylcellulose (HPMC) and hydroxypropyl methylcellulose acetate succinate (HPMCAS). Solid dispersions in the form of spray-dried powder were characterized with respect to the pure drug and the corresponding physical mixtures by optical microscopy, x-ray diffraction (XRD), fourier transform infrared (FT-IR) spectroscopy and differential scanning calorimetry (DSC). Size and morphology of optimized solid dispersion were performed by scanning electron microscopy (SEM). Furthermore, in vitro dissolution comparisons were carried out between the optimized solid dispersion against the pure drug and the physical mixtures. Results: Solubility studies demonstrated that the solubility of FB was not affected by pH change. The transformation of crystalline FB into an amorphous solid dispersion powder has been clearly demonstrated by optical microscopy. The molecular dispersion of drug in the dispersion matrix prepared by spray drying was confirmed in XRD and DSC studies. IR spectroscopy was observed with negligible incompatibility of the drug with polymers. Spherical morphology was observed in SEM with no evidence of FB crystals. The prepared solid dispersions exhibited dissolution improvement as compared to the pure drug and spray dried FB in 0.05 M SLS, with HPMCAS as the superior carrier over HPMC. Conclusion: The present study vouches better in vitro profile of FB from spray-dried HPMCAS based solid dispersions

The risk associated with iron deficiency anemia for simple febrile seizures in children: A case–control study

Background: Studies have postulated iron deficiency state to be a risk factor for febrile convulsions as it changes the threshold of neurons excitation which may lower the threshold for seizures in children. However, many other studies have reported a protective role for febrile convulsions by increasing the neuronal threshold. Objective: The objective of the study was to evaluate the association of iron deficiency anemia (IDA) as a risk factor for the occurrence of simple febrile seizures (FS) in children. Material and Methods: A case-control study was conducted in a tertiary teaching hospital from September 2015 to February 2017. A total of 240 cases with fever and simple FS were enrolled according to the inclusion and exclusion criteria. Another 100 cases of children without seizure but with short duration of fever were enrolled as controls. Blood samples were then taken for assessing the hematological indices of these patients. The results were statistically analyzed. Results: Incidence of IDA was found to be more in children with simple FS than controls but was not statistically significant (p=0.35). Furthermore, no association was found with other hematological indices with FS occurrence. Conclusion: We could not find any association of IDA as a risk factor for a simple FS

Provision of adolescent reproductive and sexual health services in India: Provider perspectives

The recently launched Rashtriya Kishor Swasthya Karyakram (RKSK) program seeks to enable all adolescents and youth to realize their full potential by making informed decisions concerning their health and well-being and by accessing the services and support they need to implement their decisions. To realize this vision, the RKSK framework acknowledges the strengthening of Adolescent Friendly Health Clinics (AFHCs) and providing correct knowledge and information through counseling services as two of its seven critical components. As the government makes an effort to roll out the RKSK program at scale across the country, reviewing the experiences of the AFHCs established under the National Adolescent Reproductive and Sexual Health Strategy, the predecessor of RKSK, can provide useful lessons. With this in view, at the request of the Ministry of Health and Family Welfare, the Population Council conducted an assessment of AFHCs from the perspectives of adolescents and youth and of health care providers in three states in India. This report presents the findings of the study conducted among health care providers

Execution and challenges of using focus group discussions as a research tool for secondary school students

Introduction: Focus group discussions (FGD) are a valuable method to obtain information and explore attitudes, feelings and views on a subject of research, especially when existing knowledge of the subject is inadequate. We used FGD as a tool to develop a cardiovascular disease (CVD) behavioural intervention programme for secondary school students. In this paper, we describe the planning and execution of the FGD and the various challenges faced. We believe that FGD will lead to development of a suitable and relevant intervention programme for our target group. Methods: Four out of nine districts in Selangor state were selected at random using the table of random numbers. In each of the selected districts, three schools were selected at random from the total list of schools. Participants to the FGD included students, teachers, parents and canteen operators who were then selected from the schools based on a voluntary basis of participation. Twenty-one facilitators and 20 scribes were trained to conduct the FGD. Questions for the FGD were semi-structured around six themes: CVD and its risk factors; diet; physical activity; self-image; smoking; and miscellaneous. Training for facilitators was provided using a Facilitator's Guide. Results: A total of 33 focus group discussions were conducted involving 297 participants from 11 schools. Discussions were scribed, audio taped and transcribed. Incentives for transport, certificates of participation and favourable venue were important motivating factors for participation. Conclusion: Detailed planning is important for the successful implementation of a FGD. An adequately planned and well-managed FGD can serve as an important tool to explore views of a research target population and develop a CVD behavioural intervention programme

Executive Summary: Understanding the lives of adolescents and young adults (UDAYA) in Uttar Pradesh, India (2015–16)

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have acquired a set of assets that can help them make a healthy, safe, and successful transition from adolescence to young adulthood in the states of Bihar and Uttar Pradesh; 2) to describe the extent to which the situation of adolescents has changed over time; and 3) to assess factors that determine the accumulation or loss of assets and the quality of transitions from adolescence to young adulthood. This report presents findings from Uttar Pradesh

Understanding the lives of adolescents and young adults (UDAYA) in Uttar Pradesh, India (2015–16)

The goal of the program of research titled “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can be measured. This report focuses on the findings from the first round of cross-sectional surveys of adolescents conducted in Uttar Pradesh, which confirm that adolescents are a heterogeneous group with correspondingly diverse needs. The findings of UDAYA show that adolescents face numerous challenges in making the transition to adulthood. The report identifies and discusses several programmatic areas for action to improve the situation of adolescents

Understanding the lives of adolescents and young adults (UDAYA) in Bihar, India

The goal of the “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” program is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can be measured. This report focuses on the findings from the first round of cross-sectional surveys of adolescents conducted during January–July 2016 in Bihar, which confirm that adolescents are a heterogeneous group with correspondingly diverse needs. While large proportions of adolescents are healthy and have been to school, our findings confirm that they face numerous challenges in making the transition to adulthood. The report identifies and discusses several programmatic areas for action to improve the situation of adolescents

Executive Summary—Understanding the lives of adolescents and young adults (UDAYA) in Bihar, India

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have acquired a set of assets that can help them make a healthy, safe, and successful transition from adolescence to young adulthood in the states of Bihar and Uttar Pradesh; 2) to describe the extent to which the situation of adolescents has changed over time; and 3) to assess factors that determine the accumulation or loss of assets and the quality of transitions from adolescence to young adulthood. This report presents findings from Bihar