Evidence of a Hardening in the Cosmic Ray Proton Spectrum at around 166 TeV Observed by the GRAPES-3 Experiment

We present the measurement of the cosmic ray proton spectrum from 50 TeV to 1.3 PeV using 7.81×10^{6} extensive air shower events recorded by the ground-based GRAPES-3 experiment between 1 January 2014 and 26 October 2015 with a live time of 460 day. Our measurements provide an overlap with direct observations by satellite and balloon-based experiments. The electromagnetic and muon components in the shower were measured by a dense array of plastic scintillator detectors and a tracking muon telescope, respectively. The relative composition of the proton primary from the air shower data containing all primary particles was extracted using the multiplicity distribution of muons which is a sensitive observable for mass composition. The observed proton spectrum suggests a spectral hardening at ∼166  TeV and disfavors a single power law description of the spectrum up to the Knee energy (∼3  PeV).

Lupus-like nephritis in an HIV-positive patient: report of a case and review of the literature

The most common manifestation of HIV/AIDS in the kidney is the collapsing variant of focal segmental glomerular sclerosis, HIV-associated nephropathy (HIVAN). Other forms of renal disease in HIV-infected patients include mesangial proliferative glomerulonephritis (GN), membranoproliferative GN, IgA nephropathy, minimal change disease and proliferative immune-complex GN. We present the case of a 42-year-old Caucasian male with HIV infection, treatment associated peripheral neuropathy, nephrotic syndrome and progressive renal failure. The initial and subsequent kidney biopsies showed diffuse proliferative glomerulonephritis resembling diffuse proliferative (WHO class IV) lupus nephritis. There was no clinical or serological evidence of systemic lupus erythematosus (SLE). Proteinuria improved with ACE-inhibitors, and renal function remained relatively stable while receiving highly active antiretroviral therapy (HAART). A precipitous decline in renal function to end-stage renal disease followed a brief period of withdrawal from potent antiretroviral therapy during which the viral load rebounded. Considering previously reported cases, it appears that lupus-like nephritis is a rare but well-defined pattern of immune-complex-induced renal injury seen in HIV-infected patients. It appears to be markedly responsive to HAART.

Knowledge and attitudes of rural adolescent girls regarding reproductive health issues

BACKGROUND

Adolescent girls (10-19 years old) comprise about 22% of women in India. They are the mothers of tomorrow and the burden of planned reproduction rests on them. Yet very little is known about their knowledge and attitudes towards reproductive health issues--a crucial aspect if India is to achieve the net reproduction rate of 1 by AD 2016. This study aimed to gather information on areas required for the planning of family life education strategies.

METHODS

This cross-sectional study was conducted in the government schools and anganwadi premises of three villages of the primary health centre, Chhainsa, under the Comprehensive Rural Health Services Project Area (CRHSP), Ballabgarh, Haryana. The participants were 254 girls aged 13 to 17 years, who had attained menarche. A pre-tested interview schedule was administered to each girl after taking permission from the principals and parents and with the consent of the participants. The knowledge and attitudes regarding age at marriage, concept of small family norm, family size and preference for a son were assessed.

RESULTS

All the girls were aware that there is a law regarding legal age of marriage but only 165 (65%) of them knew the correct legal age. Early marriage was preferred by 19 (7.6%). Though 214 (84.3%) girls were aware of the small family norm, only 19 (8.8%) knew the exact norm. A preferred family size of two or less was reported by 151 (59.2%). Preference for a son was reported by 233 (91.7%).

CONCLUSION

All the girls were aware of the small family norm, but few could correctly define it. Though most girls preferred a two-child family, almost all of them had a preference for at least one son. This preference for a son could dominate their future decision-making. As attitude development is a long-term process, there is indeed a long way to go.

Screening for chronic impairments using medical interns in rural Haryana, India

BACKGROUND

With the increase in life expectancy, prevalence of impairments and disabilities are expected to increase in India. However, there have been very few studies to estimate the magnitude of the problem in rural India. This is essential, if appropriate rehabilitation services are to be planned in the country.

METHODS

The study was done in the rural field practice area of the All India Institute of Medical Sciences at Ballabgarh, Haryana. The survey was conducted by successive batches of interns posted at Ballabgarh as a part of their compulsory rotating internship programme. The diagnostic criteria were based on history and simple clinical examination done at the domiciliary level.

RESULTS

A total population of 25,509 in twelve villages were screened. The total impairment rate was 5.4% with no significant men/women difference. The prevalence of physical impairment was 4.7 per 1000 population. The prevalence of corneal opacity in children below 15 years of age was 4.7 per 1000. Prevalence of cataract was almost 35% in the population over 60 years of age and 15% in the population between 45 to 60 years. Auditory impairment was 19.6 per 1000 as ascertained by history. Three-fourths of this was conductive deafness and was found mainly in people above 60 years of age.

CONCLUSION

Utilizing the rural field practice areas of medical colleges for collection of data on issues of national health importance would not only strengthen the health system in the country but also improve medical education. There is a need for a comprehensive preventive, promotive, curative and rehabilitative approach to disabilities in India.