Nutritional Status and Morbidity among School going Adolescents in Wardha, a Peri-Urban area

Objectives: To assess the nutritional status and morbidity among the school going adolescents in peri urban area Wardha. Materials and Methods: The present study was conducted in the year 2008. 116 children in the age group of 10 to 19 years studying in high school of peri urban area Wardha were examined. Nutritional status of the adolescents was assessed through weight for age (wasting) and height for age (stunting) according to WHO criteria. Data was entered and analyzed by using Epi Info 6.04 software package. Chi- square value was used for testing statistical significance. Results: Mean age of the adolescents was 13.16+ 1.99. 48.3% of the adolescents were found to be normal and 51.7% were underweight. Early adolescents were at highest risk of underweight significantly more 73.3% ( p < 0.05 ) as compared to late adolescents 26.7%. Overall 34.5% of the adolescents were stunted with boys suffering more 72.5% as compared to girls 27.5%. 28.45% of the school going adolescents had anaemia with girls suffering significantly more 38.89% (p < 0.05) as compared to boys 23.75%. 35.34% adolescents had dental caries. 13.79% adolescents were found to be suffering from refractive error. 7.76% adolescents had worm infestation. 6.9% adolescents had skin problems. 2.59% adolescents had tonsillitis and 2.59% had wax in the ear. Conclusion: The study shows the poor health and nutritional status among the adolescents. A periodical and regular health check-up with concerted efforts towards their nutrition along with focused health education will improve the health and nutritional status of these school going adolescents in peri urban area Wardha

Efficacy and Safety of Prucalopride in Patients with Chronic Noncancer Pain Suffering from Opioid-Induced Constipation

Opioid-induced constipation (OIC) has negative effects on quality of life (QOL). Prucalopride is a new, selective 5-HT4 agonist and enterokinetic with strong clinical data in chronic constipation. This study investigated the efficacy, safety, and tolerability of prucalopride in patients with noncancer pain and OIC. A phase II, double-blind, placebo-controlled study of 196 patients randomized to placebo (n = 66), prucalopride 2 mg (n = 66) or 4 mg (n = 64), for 4 weeks, was carried out. The primary endpoint was the proportion of patients with increase from baseline of a parts per thousand yen1 spontaneous complete bowel movement (SCBM)/week. Secondary endpoints [proportion of patients with a parts per thousand yen3 SCBM/week, weekly frequency of (SC)BM, severity of constipation, and efficacy of treatment], adverse events (AEs), and safety parameters were also monitored. More patients had an increase from baseline of a parts per thousand yen1 SCBM per week (weeks 1-4) in the prucalopride groups [35.9% (2 mg) and 40.3% (4 mg)] versus placebo (23.4%), reaching statistical significance in week 1. Over weeks 1-4, more patients in the prucalopride groups achieved an average of a parts per thousand yen3 SBM per week versus placebo (60.7% and 69.0% versus 43.3%), reaching significance at week 1. Prucalopride 4 mg significantly improved patient-rated severity of constipation and effectiveness of treatment versus placebo. Patient Assessment of Constipation-Symptom (PAC-SYM) total scores and Patient Assessment of Constipation-Quality of Life (PAC-QOL) total and satisfaction subscale scores were improved. The most common AEs were abdominal pain and nausea. There were no clinically relevant differences between groups in vital signs, laboratory measures or electrocardiogram parameters. In this population with OIC, prucalopride improved bowel function and was safe and well tolerated

In Search of the Optimal Surgical Treatment for Velopharyngeal Dysfunction in 22q11.2 Deletion Syndrome: A Systematic Review

<div><h3>Background</h3><p>Patients with the 22q11.2 deletion syndrome (22qDS) and velopharyngeal dysfunction (VPD) tend to have residual VPD following surgery. This systematic review seeks to determine whether a particular surgical procedure results in superior speech outcome or less morbidity.</p> <h3>Methodology/ Principal Findings</h3><p>A combined computerized and hand-search yielded 70 studies, of which 27 were deemed relevant for this review, reporting on a total of 525 patients with 22qDS and VPD undergoing surgery for VPD. All studies were levels 2c or 4 evidence. The methodological quality of these studies was assessed using criteria based on the Cochrane Collaboration's tool for assessing risk of bias. Heterogeneous groups of patients were reported on in the studies. The surgical procedure was often tailored to findings on preoperative imaging. Overall, 50% of patients attained normal resonance, 48% attained normal nasal emissions scores, and 83% had understandable speech postoperatively. However, 5% became hyponasal, 1% had obstructive sleep apnea (OSA), and 17% required further surgery. There were no significant differences in speech outcome between patients who underwent a fat injection, Furlow or intravelar veloplasty, pharyngeal flap pharyngoplasty, Honig pharyngoplasty, or sphincter pharyngoplasty or Hynes procedures. There was a trend that a lower percentage of patients attained normal resonance after a fat injection or palatoplasty than after the more obstructive pharyngoplasties (11–18% versus 44–62%, p = 0.08). Only patients who underwent pharyngeal flaps or sphincter pharyngoplasties incurred OSA, yet this was not statistically significantly more often than after other procedures (p = 0.25). More patients who underwent a palatoplasty needed further surgery than those who underwent a pharyngoplasty (50% versus 7–13%, p = 0.03).</p> <h3>Conclusions/ Significance</h3><p>In the heterogeneous group of patients with 22qDS and VPD, a grade C recommendation can be made to minimize the morbidity of further surgery by choosing to perform a pharyngoplasty directly instead of only a palatoplasty.</p> </div

Effect of duration of cough (≥3 weeks Vs ≥2 weeks) on yield of sputum positive tuberculosis cases and laboratory load

Background & objective: Early detection and prompt treatment is the basis of tuberculosis control through reducing the reservoir of infection. The objective of the present study was to study the effect of reducing the screening criteria of chest symptomatics from existing ≥ 3 weeks to ≥ 2 weeks on case detection of smear positive tuberculosis and laboratory load. Methods: The present cross-sectional study was carried out at General Out-Patient Department (GOPD) of Kasturba Hospital, Sewagram. All the chest symptomatics with cough of two weeks or more than two weeks duration attending in GOPD were screened for pulmonary tuberculosis by examining the three sputum smears in designated microscopy center as per RNTCP guidelines. The data was entered and analyzed using epi_info 6.04d. Results: Number of sputum positive cases detected using RNTCP guideline (cough ≥ 3 weeks) for screening the chest symptomatic for AFB was 104. When, the screening guideline was modified from cough ≥ 3 weeks duration to cough ≥ 2 weeks duration, it yielded 138 cases. The yield of sputum positive cases of tuberculosis was increased by 32.7%. This also increased the laboratory load by 54.8%. Conclusion: The modifications of existing screening criteria from cough ≥ 3 weeks to cough ≥ 2 weeks increased the yield of sputum positive cases by 1.3 times and the laboratory (microscopy center) load by 1.5 times

Heterosexual Anal Sex among Female Sex Workers in High HIV Prevalence States of India: Need for Comprehensive Intervention

INTRODUCTION: Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. METHODS: Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA) from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. RESULTS: Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%–12.6%). Typology (AOR 2.20, 95% CI 1.64–2.95) and literacy (AOR 1.28, 95% CI 1.10–1.49) were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44–1.99), entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47–2.15), alcohol consumption (AOR 1.21, 95% CI 1.03–1.42) and inability to negotiate condom use (AOR 1.53, 95% CI 1.28–1.83) were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25–1.71) did not impede HAS. Although symptoms of sexually transmitted infections (STIs) in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13–1.72) there was no significant association between laboratory confirmed HIV and other STIs with HAS. CONCLUSION: Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed