The recovery of semen from bathwater using the Evidence Recovery System (ERS)

Sexual offences are under-reported and ascertaining accurate offence numbers is difficult. Any methods which could increase the ability to obtain biological evidence or reduce the additional distress associated with reporting a sexual offence may result in an increase in reporting this crime type. The Evidence Recovery System (ERS) is designed to collect trace evidence, including hairs, fibres and biological evidence, from bath or shower water in a non-invasive manner. Initially, samples of semen were placed in baths filled with water, and washing was simulated using a range of body wash products. The water was then drained through the ERS before its filters were subjected to acid phosphatase testing and haematoxylin and eosin staining of spermatozoa. Recovered spermatozoa were then graded accordingly. Following this, the experiment was repeated with the addition of dirt/dust particulates during the washing stage, to simulate recovery of biological evidence in a more realistic environment. The results showed that spermatozoa considered 'easy to find' could regularly be obtained from bathwater using the ERS. It appeared that this recovery was not affected by the presence of different body wash products. When dust/dirt particles were added, the number of spermatozoa recovered increased at two of the evidence collection stages. The difference in recovery was considered to be statistically significant. This study provides evidence to suggest the feasibility of use of the ERS as a method to collect semen evidence from individuals subjected to sexual offences. The recovery of spermatozoa does not appear to be affected by the presence of a body wash, but does appear to be improved when skin cells, hair and other debris are transferred into the water, as would be likely during a bath/shower. Further to this, the possibility of obtaining spermatozoa from the home bath or shower of a victim following a post-offence bathing experience is implied.

Sexual risk behaviour and HAART: a comparative study of HIV-infected persons on HAART and on preventive therapy in Kenya

Unprotected sex (UPS) among persons receiving highly active antiretroviral therapy (HAART) remains a concern because of the risk of HIV-transmission. A cross-sectional study comparing the sexual risk behaviour of 179 people living with HIV/AIDS (PLHA) receiving HAART with that of 143 PLHA receiving preventive therapy (PT) with cotrimoxazole/isoniazid was conducted in Mombasa, Kenya. Forty-five percent of all participants were sexually active in the last six months. Participants receiving PT were more likely to report > or =2 partners (13% vs.1%; P = 0.006). Participants receiving PT reported more UPS with regular partners (odds ratio [OR]: 3.9; 95% confidence interval [CI]: 1.8-8.4) and also more sexually transmitted infections (STI) symptoms (OR: 1.7; 95% CI: 1.0-2.8; P = 0.059). More than 40% of all participants did not know the HIV-status of regular partners. Therefore, HAART was not associated with increased sexual risk behaviours though considerable risk of HIV-transmission remains. HIV-care services need to emphasize partner testing and consistent condom use with all partners.

Adherence to antiretroviral therapy & its determinants amongst HIV patients in India

BACKGROUND & OBJECTIVE

Very high levels of adherence are required for ART to be effective. There is limited information available from India on adherence to ART and its predictors. We carried out this study to examine adherence levels and to explore the factors associated with adherence among PLHA receiving ART in India.

METHODS

Using a cross-sectional study design 310 HIV+ patients receiving ART (252 paying out-of-pocket; 58 free via employee-insurance programme) were interviewed from Pune and Delhi health facilities, using a semi-structural questionnaire.

RESULTS

The median age for patients was 36 yr. The median time from diagnosis of HIV-infection was 34.5 months, median time on ART was 16 months and median CD4 cell count at start of ART was 110 cells/microl. 98 per cent of the respondents were using a non protease inhibitor (PI) treatment regimen. Mean 4-day adherence was 93 per cent. Adherence was lower over longer periods of recall: 20 per cent reported missed does over the past 7 days; 33 per cent reported ever missing a full day's medications and 16 per cent had a treatment interruption of more than 7-days at least once. On univariate analysis less than university education, being unemployed, obtaining free treatment, severe depression, baseline CD4 count>200/microl, hospitalization >2 times, having moderate to severe side-effects and taking 4 or more medicines were associated with lower adherence (<90%). However, only obtaining free treatment (adjusted OR, 4.05, 95% CI 1.42-11.54, P=0.009) and severe depression (adjusted OR 4.48, 95% CI 1.64-12.27, P=0.003) were associated with lower adherence in multivariate analysis.

INTERPRETATION & CONCLUSION

Although the overall adherence was high, lower levels of adherence were documented among patients receiving free ART. Provision of free treatment without adequate patient preparation and adherence support may compromise the success of ART scale up programmes. Early diagnosis and management of depression need special focus.

Effect of aging, position, and temperature on the threshold volume triggering pharyngeal swallows

BACKGROUND/AIMS

Swallows triggered by direct stimulation of pharyngeal structures may help to prevent aspiration by emptying the pharynx. The aims of this study were to compare the biomechanical events of the pharyngeal and primary swallow, determine the threshold volume of liquid required to trigger the pharyngeal swallows, and determine the effect of aging, position, and temperature on this threshold volume.

METHODS

Concurrent manometry, video fluoroscopy, and video endoscopy were used to study young and elderly healthy volunteers.

RESULTS

During pharyngeal swallows, in contrast to primary swallows, the free portion of the tongue did not make contact with the hard palate. In addition, pharyngeal swallows did not result in oral bolus clearance. All other biomechanical events, including deglutitive glottal function, were similar in both types of swallows. The threshold volume for pharyngeal swallows in young volunteers was significantly smaller than in the elderly (P < 0.01). Temperature and position did not have significant effects on threshold volume.

CONCLUSIONS

Swallowing is readily induced by water stimulation of the pharynx. Pharyngeal swallows do not induce lingual peristalsis or clearance of oral content. The threshold volume of the pharyngeal swallow is significantly higher in the elderly than in the young, but it is not affected by body position or bolus temperature.

Prevalence of dental caries and associated teeth cleaning habits among children in four primary schools

A study was conducted in four primary schools of Mehrauli block of rural Delhi. Four hundred and fifty eight primary school children of both sexes in the age group of 5-14+ were medically examined in daylight using a mouth mirror and probe. The children came from low socioeconomic backgrounds. Presence of clinical caries was recorded by naked eye examination. Dental caries prevalence was 33.19% and DMF index was 0.52. Teeth cleaning habits of the school children in terms of regularity and associated caries prevalence was also noted. The 'Regular' teeth cleaning group showed significantly less caries prevalence while 'Not Regular' and 'Never Cleaning' groups had higher caries prevalence. Since childhood is such an impressionable age all students were made aware of the need for proper oral hygiene to minimize the incidence of caries among them.