Assessment of stigma associated with tuberculosis in Mexico

BACKGROUND

Stigma is a major barrier to health care access and impacts the quality of life for individuals affected by tuberculosis (TB). Assessing TB stigma is essential to addressing health disparities. However, no such instrument was available in Mexico at the time of our study. This study examined the adaptability of the TB and human immunodeficiency virus (HIV) stigma scales previously used in Thailand.

METHODS

The original scale, developed in English, was linguistically adapted to Spanish and administered to 217 individuals affected by TB in five states in Mexico. The TB-HIV stigma subscales were designed to assess individual and community perspectives. Additional data collected included general information and socio-demographics. Assessment of psychometric properties included basic statistical tests, evaluation of Cronbach's alpha and factor analysis.

RESULTS

We found no significant statistical differences associated with higher stigma scores by location, age, marital status, education and stigma scores. Factor analysis did not create any new factors. Internal consistency reliability coefficients were satisfactory (Cronbach α = 0.876-0.912).

CONCLUSION

The use of the stigma scales has implications for 1) health improvements, 2) research on stigma and health disparities, and 3) TB and HIV stigma interventions. Further research is needed to examine transferability among larger and randomly selected Spanish-speaking populations.

A novel nested reverse-transcriptase polymerase chain reaction method for rapid hepatitis C virus detection and genotyping

PURPOSE

Rapid and specific detection of viral nucleic acid is increasingly important in the diagnosis of infectious diseases. The objective was to develop a rapid, efficient process of nucleic acid based detection of hepatitis C virus (HCV) infection for its diagnosis and treatment follow-up.

MATERIALS AND METHODS

A two-step nested reverse-transcriptase polymerase chain reaction (RT-PCR) has been standardised on a sample set of 125 individuals from different liver clinics in Kolkata. The method utilises a novel fast nested RT-PCR for HCV detection and genotyping from HCV infected patient plasma with high processivity.

RESULTS

The overall time required from ribonucleic acid (RNA) isolation to nested PCR amplified product detection is reduced to 42% when compared with conventional nested RT-PCR amplification. The method is sensitive as conventional PCR and detected all HCV RNA positive samples. Sequencing, phylogenetic analysis of the PCR amplified product by this method showed concordant genotypes with conventional PCR.

CONCLUSION

Though being a two-step process, this method is fast, cost-efficient, reliable and feasible for regular HCV RNA screening and apt even in resource limited settings. This method could be translated to regular nucleic acid screening for other infectious diseases as regular PCR regimen.

Design and development of an in-line sputtering system and process development of thin film multilayer neutron supermirrors

Neutron supermirrors and supermirror polarizers are thin film multilayer based devices which are used for reflecting and polarizing neutrons in various neutron based experiments. In the present communication, the in-house development of a 9 m long in-line dc sputtering system has been described which is suitable for deposition of neutron supermirrors on large size (1500 mm × 150 mm) substrates and in large numbers. The optimisation process of deposition of Co and Ti thin film, Co/Ti periodic multilayers, and a-periodic supermirrors have also been described. The system has been used to deposit thin film multilayer supermirror polarizers which show high reflectivity up to a reasonably large critical wavevector transfer of ∼0.06 Å(-1) (corresponding to m = 2.5, i.e., 2.5 times critical wavevector transfer of natural Ni). The computer code for designing these supermirrors has also been developed in-house.

Cause of and contributing factors to maternal deaths; a cross-sectional study using verbal autopsy in four districts in Bangladesh

Verbal autopsy used at community level is an accepted method to identify cause of death and factors contributing to death. Maternal deaths occurring in four districts in Bangladesh over a period of 24 months were identified and community health workers were trained to conduct a verbal autopsy. Of 571 maternal deaths identified almost half (273, 47.8%) occurred at facility level, 97 (17.0%) died en route to a healthcare facility and 201 (35.2%) maternal deaths occurred at home. The majority of maternal deaths occurred in the postpartum period (78.8%) in the first 6 hours after giving birth (41.6% of all postpartum deaths). Women who had accessed care at a healthcare facility were less likely to die in the first 6 hours when compared with women who died at home (relative risk 0.70; 95% confidence interval 0.56-0.88) 70.4% (402) of deaths were classified as direct maternal deaths, 12.4% (71) as indirect and 13.8% (79) as unspecified. The most common cause of death was haemorrhage (38%), followed by eclampsia (20%) and sepsis (8.1%). Almost three out of four women who died had sought care for complications during the index pregnancy. Most mothers who died in Bangladesh had accessed care. It is now crucial that the quality of care received at health facility level is improved. This includes a refocus on strengthening healthcare providers' knowledge and skills to recognise and manage complications and provide emergency obstetric care. The enabling environment must be in place as well as ensuring a fully functional referral pathway between healthcare facilities.

The many faces of Pulmonary Langerhans Cell Histiocytosis

Langerhans Cell Histiocytosis is a rare disease with variable presentation and prognosis in adults and in children. Histiocytosis of the ocular choroidal tissue has never been reported before in adults. We present two cases, one with choroidal involvement with asymptomatic nodulo-cystic changes in the lungs and another case with advanced single organ pulmonary involvement. We discuss the various treatment modalities and highlight the lack of adequate guidelines to treat adults. Most of the current guidelines are based on evidence derived from pediatric literature. We would also like to draw attention to the asymptomatic nature of the lung involvement and suggest that imaging of the lung be obtained in all cases of Langerhans Cell Histiocytosis.

Service satisfaction in E_Electricity service in Odisha (a state of India) by structural equation modeling

Purpose

– The purpose of this paper is to develop a new model, namely service quality measurement for E_Electricity utility service in Odisha a state of India for the measurement of service quality.

Design/methodology/approach

– Service quality regulation is an important and timely issue in many industries. The question of governance of power sector is an important question before researchers, policy makers and administrators for the obvious reason of its being an important input for socio-economic development of a nation. Power sector involves complex activities like generation, transmission, distribution and final delivery of service to end-users, i.e. consumers. Initially, private sector was the main player in the power sector when the electricity came to be used in India during the pre-independence period. The trajectory of power industry, from its inception to the present, has been complex rather than being simplistic for the reason that the pendulum of industry's ownership and regulation swings between privatization and nationalization. The consumers are main sufferer in this type of situation, and the satisfaction level decreases day by day. So government has changed it's strategies by implementing e-governance to electricity sector for achieving maximum consumer satisfaction. The first step to e-governance is change management within the government, enhancing citizens' access to information and improving government-to-citizen (G2C) interactions. This work seeks to propose a theoretical scale to measure e-government service quality and validate the measured instrument for electricity utility service by structural equation modeling.

Findings

– The results indicate that basically the E_electricity service has a positive and direct influence on dimensions (web site design, fulfillment, privatisation and information).

Research limitations/implications

– Only Odisha state is considered for measuring online service quality in electricity utility service.

Originality/value

– As the electricity utility industry is doing monopoly business in India and all states basically in Odisha due to that the customer dissatisfaction is the most important obstacle. So the policy makers must concentrate on the dimensions and the sub-dimension before regulating new policies.

A preliminary report on the genetic variation in pointed gourd (Trichosanthes dioica Roxb.) as assessed by random amplified polymorphic DNA

Pointed gourd (Trichosanthes dioica Roxb.) is an economically important cucurbit and is extensively propagated through vegetative means, viz vine and root cuttings. As the accessions are poorly characterized it is important at the beginning of a breeding programme to discriminate among available genotypes to establish the level of genetic diversity. The genetic diversity of 10 pointed gourd races, referred to as accessions was evaluated. DNA profiling was generated using 10 sequence independent RAPD markers. A total of 58 scorable loci were observed out of which 18 (31.03%) loci were considered polymorphic. Genetic diversity parameters [average and effective number of alleles, Shannon's index, percent polymorphism, Nei's gene diversity, polymorphic information content (PIC)] for RAPD along with UPGMA clustering based on Jaccard's coefficient were estimated. The UPGMA dendogram constructed based on RAPD analysis in 10 pointed gourd accessions were found to be grouped in a single cluster and may represent members of one heterotic group. RAPD analysis showed promise as an effective tool in estimating genetic polymorphism in different accessions of pointed gourd.

Coagulation factor XIII deficiency. Diagnosis, prevalence and management of inherited and acquired forms

The plasma circulating zymogenic coagulation factor XIII (FXIII) is a protransglutaminase, which upon activation by thrombin and calcium cross-links preformed fibrin clots/fibrinolytic inhibitors making them mechanically stable and less susceptible to fibrinolysis. The zymogenic plasma FXIII molecule is a heterotetramer composed of two catalytic FXIII-A and two protective FXIII-B subunits. Factor XIII deficiency resulting from inherited or acquired causes can result in pathological bleeding episodes. A diverse spectrum of mutations have been reported in the F13A1 and F13B genes which cause inherited severe FXIII deficiency. The inherited severe FXIII deficiency, which is a rare coagulation disorder with a prevalence of 1 in 4 million has been the prime focus of clinical and genetic investigations owing to the severity of the bleeding phenotype associated with it. Recently however, with a growing understanding into the pleiotropic roles of FXIII, the fairly frequent milder form of FXIII deficiency caused by heterozygous mutations has become one of the subjects of investigative research. The acquired form of FXIII deficiency is usually caused by generation of autoantibodies or hyperconsumption in other disease states such as disseminated intravascular coagulation. Here, we update the knowledge about the pathophysiology of factor XIII deficiency and its therapeutic options.

Ascites, anemia and (intestinal) atresia

We report a neonate who presented antenatally with fetal ascites and fetal anemia. The cause of this remained uncertain until 2 weeks later when bowel dilatation was noted on antenatal ultrasound. Clinical signs of intestinal obstruction became evident after delivery, and ileal atresia was found at laparotomy, which was resected with primary anastomosis. Recent reports in the literature have suggested a possible connection between fetal ascites, anemia and dilated bowel with neonatal intestinal obstruction. In these cases and ours, the likely sequence of events was that of in utero midgut volvulus with bleeding into ischemic bowel, hemorrhagic ascites resulting in fetal anemia and progressive bowel dilatation occurring as a consequence of intestinal atresia. Early treatment in our patient with intrauterine blood transfusion may have altered the natural history of her condition, allowing pregnancy to progress to term with a subsequent improved outcome.

Observational assessment and correlates to blood pressure of future physicians of Bengal

INTRODUCTION

Hypertension is a modern day epidemic and growing public health problem. A sizable proportion of world populations suffer from prehypertension or hypertension.

OBJECTIVES

The present study was carried out to detect the prevalence of undiagnosed hypertension among undergraduate medical students and to identify the associated risk factors.

MATERIALS AND METHODS

The study was observational in nature and was done in medical colleges of Bengal. Study tool was a predesigned, pretested, validated, and semi-structured questionnaire containing both open-ended and close-ended questions. Data were collected through self-administration, clinical, and anthropometric examination. The data were then tabulated, analyzed and interpretation was done by using percentage and Chi-square test.

RESULTS

Most of the students (63%) were young adults, predominantly males (67%) and day scholars (71%). Almost one-third of them either suffered from hypertension or at risk of hypertension. Hypertension was found higher among male students. Family history of hypertension or diabetes mellitus was not associated with hypertension. Vegetarian or nonvegetarian diet or extra-salt consumption was also not associated with hypertension. Smoking was shown positively associated with hypertension but alcohol consumption was not. Higher per capita monthly income and overweight or obesity were shown positively associated with hypertension.

CONCLUSION

The overall prevalence of hypertension in this study was 13% and there were positive association of hypertension with multiple socio-demographic factors like age, sex, type of family, per capita monthly income, residence, BMI, smoking, etc.