Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital.

Context: In India, where the heavy burden of visual impairment exists, low vision services are scarce and under‑utilized. Aims: Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India. Subjects and Methods: The low vision quality of life (LVQOL) questionnaire measures vision‑related quality of life through 25 questions on a Likert scale of 0–5 that pertain to (1) mobility, distance vision, and lighting; (2) psychological adjustment; (3) reading and fine work; and (4) activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs) were prescribed at the discretion of the low vision specialist. 1‑month later, the same questionnaire was administered over the phone. Results: About 44 of 55 low vision patients completed baseline and follow‑up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points). After the low vision clinic visit, the low vision group demonstrated a 4.55‑point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001). Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24) experienced an even larger increase than those who did not (n = 20) (8.89 points, P < 0.001). Conclusion: Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

IgG - Indirect fluorescent antibody technique to detect seroprevalence of Toxoplasma gondii in immunocompetent and immunodeficient patients in southern districts of Tamil Nadu.

Purpose: The purpose of the study was to determine the prevalence of Toxoplasma antibodies in selected immunocompetent and immunodeficient patients in and around Tirunelveli District of Tamil Nadu. Materials and Methods: This study was carried out from May 2006 to October 2007 in 175 immunodeficient and 175 immunocompetent patients. Serum samples were subjected into in-house IgG assay using indirect fluorescent antibody test (IFAT). Results: Out of 350 patients tested by IgG IFAT, 41 (11.71%) had antibodies for Toxoplasma gondii with a mean IFA titre of 43.42 ± 58.7 and the titre ranging from 1 : 16 to 1 : 256. Among the immunocompetent and immunodeficient groups, 19 patients (10.86%) and 22 patients (12.57%), respectively, had antibodies to T. gondii. Various risk factors associated within the study group was analysed and results were interpreted. Conclusions: The study has highlighted an overall seroprevalence of 11.71% with 12.57% in immunocompromised and 10.86% in immunocompetent patients respectively in a southern district, Tamil Nadu, which underlines the importance of screening of this parasite especially in the immunocompromised patients.

Civil Society, Health, and Social Exclusion in Bangladesh.

Civil society has the potential to have a positive impact on social exclusion and health equity through active monitoring and increased accountability. This paper examines the role of civil society in Bangladesh to understand why this potential has not been realized. Looking at two models of civil society action— participation in decentralized public-sector service provision and academic think-tank data analysis—this analysis examines the barriers to positive civil society input into public policy decision-making. The role of non-governmental organizations, political, cultural and economic factors, and the influence of foreign bilateral and multilateral donors are considered. The paper concludes that, with a few exceptions, civil society in Bangladesh replicates the structural inequalities of society at large.

The Group-lending Model and Social Closure: Microcredit, Exclusion, and Health in Bangladesh.

According to social exclusion theory, health risks are positively associated with involuntary social, economic, political and cultural exclusion from society. In this paper, a social exclusion framework has been used, and available literature on microcredit in Bangladesh has been reviewed to explore the available evidence on associations among microcredit, exclusion, and health outcomes. The paper addresses the question of whether participation in group-lending reduces health inequities through promoting social inclusion. The group-lending model of microcredit is a development intervention in which small-scale credit for income-generation activities is provided to groups of individuals who do not have material collateral. The paper outlines four pathways through which microcredit can affect health status: financing care in the event of health emergencies; financing health inputs such as improved nutrition; as a platform for health education; and by increasing social capital through group meetings and mutual support. For many participants, the group-lending model of microcredit can mitigate exclusionary processes and lead to improvements in health for some; for others, it can worsen exclusionary processes which contribute to health disadvantage.

Review of the Bangladesh Female Secondary School Stipend Project Using a Social Exclusion Framework.

The Female Secondary School Stipend Project in Bangladesh was established to increase the enrollment of girls in secondary schools, thereby delaying marriage and childbearing. This analysis examined the existing data using the social exclusion framework to clarify the primary exclusionary factors that have kept girls from education: harassment, poverty, and the primacy of marriage and childbirth and explored the extent to which the project has diminished such barriers. While causality is difficult to establish, data suggest that the stipend programme has contributed to the rise in enrollment of girls in secondary schools. Questions remain as to the impact of the stipend programme on delaying marriage, empowerment of girls and women, and enhancing employment opportunities. A thorough assessment of the impact is required. The case study suggests that, if the programme design had focused on the quality and content of education and the broader economic and social context, more opportunities would have been created for social and economic participation of girls.

Effects of repeated extracorporeal shock wave on kidney apoptosis of normal and diabetic rat

OBJECTIVE: To assess the effect of repeated extracorporeal shock waves (ESW) on the apoptosis of renal parenchyma in normal and diabetic rats by the caspase-3 expression. MATERIALS AND METHODS: 80 rats were assigned for ESW (Direx Tripter X1® - 14 KVA) to one of three groups with 50 percent rats with diabetes (A) and 50 percent normal (B) in each: G1 (n = 40): no ESW; G2 (n = 20): one ESW; G3 (n = 20): two ESWin an interval of 14 days. The animals were sacrificed 3 days after the ESW and samples of the renal parenchyma were histologically prepared, stained by the caspase-3 cleavage immunohistochemical method, and the apoptotic index (ApIn) was calculated by computer program Image Pro-Plus V 4,5,1 Media Cybernetics® ( ApIn = number of apoptotic cells in the microscopic section / total cells in the microscopic section). RESULTS: There was no statistical difference in ApIn of normal rats with one ESW (8.4 + 0.2) or two ESW (9.1 + 0.3) and both were similar to the control group with no ESW (7.9 + 0.2). The ApIn of diabetic rats with one ESW (7.4 + 0.3) was similar to the normal rats with one or two ESW. On the other hand, the ApIn was statistically higher in diabetic rats with two ESW (11.9 + 0.4) than in diabetic rats with one ESW (7.4 + 0.3). CONCLUSIONS: The ApIn of normal rats with a single (2,000 SW) or repeated ESW (4,000 SW) was similar to the control animals without any ESW. In diabetic rats, the repeated ESW (4,000 SW) may result in an additional risk of tissue damage expressed by the higher ApIn.

Alterações orofaciais em doenças alérgicas de vias aéreas: [revisão] / Orofacial alterations in allergic diseases of the airways: [review]

OBJETIVO: Apontar as possíveis alterações orofaciais decorrentes do sintoma "obstrução nasal" em pacientes portadores de doenças alérgicas de vias aéreas superiores, por meio de revisão de literatura. FONTES DE DADOS: Levantamento bibliográfico utilizando bancos de dados eletrônicos, como Medline, Ovid, SciELO e Lilacs, com as palavras-chave "asthma", "rhinitis" e "mouth breathing", abrangendo os 30 últimos anos. Foram incluídos artigos de revisão, estudos observacionais e ensaios clínicos. SÍNTESE DOS DADOS: A obstrução nasal é encontrada freqüentemente em doenças alérgicas de vias aéreas, como rinite e asma. A respiração bucal decorrente da obstrução nasal pode interferir de maneira direta no desenvolvimento infantil, com alterações no crescimento do crânio e orofacial, na fala, na alimentação, na postura corporal, na qualidade do sono e no desempenho escolar. CONCLUSÕES: Devido à variedade de alterações orofaciais encontradas na criança respiradora bucal decorrente de obstrução nasal por doenças alérgicas de vias aéreas, é necessário realizar diagnóstico e tratamento precoces por uma equipe multidisciplinar, composta por médico, ortodontista e fonoaudiólogo, contemplando a visão de uma via respiratória única, que traz conseqüências ao crescimento e desenvolvimento do sistema motor oral.

OBJECTIVE: To study possible orofacial alterations originated from nasal obstruction symptoms in patients with allergic diseases of the superior airways, through search of scientific literature about the theme. DATA SOURCES: Bibliographic survey of the last 30 years using electronic data such as Medline, Ovid, SciELO and Lilacs, and the keywords "asthma", "rhinitis" and "mouth breathing". Revision articles, observational and clinical studies were included. DATA SYNTHESIS: Nasal obstruction is often found in patients with allergic diseases of airways, such as rhinitis and asthma. The mouth breathing originated from nasal obstruction can interfere directly in the child development with alterations in the craniofacial growth, body posture, sleep quality and performance at school. CONCLUSIONS: Due to the variety of orofacial alterations found in children who have nasal obstruction because of allergic diseases of airways and, therefore, are mouth breathers, it is necessary to start the treatment as soon as possible by a multidisciplinary team, formed by doctors, orthodontists and speech therapists, considering a unique airway that brings consequences to growth and development of the oral motor system of these children.

Evaluacion de la producion de interleuquina 1 por celulas adherentes en pacientes con diabetes tipo II / Production of interleukin 1 by adherent cells in patients with Diabetes Mellitus type II

Se evaluó la actividad comitogénica de la interleuquina 1 producida en cultivos de células adherentes mononucleares de pacientes con diabetes mellitus (DM) tipo II o insulino no dependente. Dicha actividad fue medida por la incorporación de timidina en cultivos de timocitos de ratones (C3H/Hej, en presencia de fitohemaglutinina (PHA). Se observó que los sobrenadantes de los cultivos de células adherentes de los pacientes con DM tipo II no produjeron efecto sinergista con la PHA, obteniéndose niveles de linfoproliferación semejantes a los obtenidos en ausencia de dicha lectina. Esta falta de efecto comitogénico (p < 0,001) con respecto a la respuesta obtenida con la interleuquina 1 de sujetos normales más PHA, podría deberse a la liberación de algún/os factor/es solubles que podieron interferir con los receptores glicosilados para mitógenos o con los procesos de activación celular