Cathelicidin LL-37 level in presence and absence of vitamin D in cultured macrophages isolated from elderly women

@#Introduction: Vitamin D deficiency and frequent infections are the two common worldwide phenomenon among elderly. Recent studies have demonstrated that vitamin D regulates the expression of specific endogenous antimicrobial peptides like cathelicidin LL-37 of macrophages and neutrophils, which is active against a broad spectrum of infectious agents. Therefore, the objective of the present study was to determine the level of cathelicidin LL-37 in macrophages of elderly women (classified according to serum 25(OH)D level) after exposure to Vibrio cholera infection and to find out the effect of 1,25(OH)2D added in vitro. Methods: This study was conducted among 40 randomly selected rural elderly women aged between 60 to 70 years of age. Their vitamin D status was assessed by the estimation of serum 25(OH)D and classified into three groups viz. sufficient (14 members), insufficient (13 members), and deficient (13 members). Later, their peripheral blood mononuclear cells (PBMC) were isolated and cultured from fresh blood. 1,25(OH)2D supplementation was given selectively at a dose of 10 ×10-8 M for 72 hours in the culture media; then exposed to infection and screened according to the objectives of this study. Results: Macrophages in all groups, except vitamin D deficient group, responded significantly in terms of LL-37 release during exposure to Vibrio cholera infection. Considering in vitro 1,25(OH)2D, supplementation responded significantly (p<0.05) in all three groups. Conclusion: Vitamin D can be used as a prophylaxis to enhance cathelicidin LL-37 release for all three groups as in the present study.

Adherence to highly active antiretroviral therapy in a tertiary care hospital in West Bengal, India

<p><b>INTRODUCTION</b>The introduction of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has led to the reduction of mortality and the improvement of the quality of life of people living with HIV/AIDS (PLWHA). The present study was conducted to determine the pattern of adherence to HAART among PLWHA, and to assess the factor(s) affecting nonadherence, if any.</p><p><b>METHODS</b>This study was a hospital-based analytical, cross-sectional epidemiological study conducted between July and October 2011. A total of 370 adult HIV-positive patients registered in the Antiretroviral Therapy Centre of Burdwan Medical College and Hospital, West Bengal, India, were included. Nonadherence was defined as missing at least a single dose of medicine within the last four days. Data was analysed using the Statistical Package for the Social Sciences version 19.0 (IBM Corp, Armonk, NY, USA).</p><p><b>RESULTS</b>A total of 87.6% of patients were found to be adherent to HAART. Principal causes of nonadherence were forgetting to take medicine (70.2%), being away from home (65.2%), and busyness with other things (64.7%). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with a positive family history of HIV/AIDS (odds ratio [OR] 16; 95% confidence interval [CI] 2.2-114.3; p = 0.01), occurrence of side effects with HAART (OR 9.81; 95% CI 1.9-51.7; p = 0.01) and employment (OR 5.93; 95% CI 1.5-23.2; p = 0.01).</p><p><b>CONCLUSION</b>Although overall adherence was high, the factors that affect nonadherence can be addressed with proper counselling and motivation of patients and their family members. Adherence to HAART could delay the progression of this lethal disease and minimise the risk of developing drug resistance.</p>

The Status of Birth Preparedness and Complication Readiness among Rural Indian Mothers

A cross-sectional study was conducted with the aim to explore the present status of birth preparedness and complication readiness in rural area of West Bengal and determine the possible factor(s) influencing their knowledge and practice regarding this concern. Thirty villages with homogenous characteristics were identified by cluster sampling methods from a rural block (Bhatar, Burdwan district, West Bengal) of India on April 2013 to November 2013. From every cluster 7 mothers who had delivered baby within the last year and were available first, interviewed consecutively using a guided questionnaire adapted from JHPIEGO Maternal and Neonatal Health Programme survey tools. Multivariate logistic regression was applied in analysis to predict how much the independent variables influenced the birth preparedness of mothers. 62.4% mothers were found to be well prepared. Trained birth attendants and health facilities were identified before delivery in 81.9% and 78.1% cases respectively. Mode of transportation for complication management or delivery was pre-decided by about 60% of family. Only 35.7% family saved money for the same purpose. Logistic regression revealed that well preparedness increased 11 times with every new pregnancy, but it did not depend on caste and education status of the mothers. The overall birth preparedness status of the rural mothers is poor and they acquire more knowledge regarding birth preparedness from their self experience rather than from existing health system. ​

Wilson's Disease Can Present As Paranoid Schizophrenia And Mania: Two Cases Reports

Objective: This case report highlights Wilson's disease, a rare genetic disorder involving the liver and brain presenting clinically with psychiatric symptoms as the first manifestation. Method: We present two cases of Wilson’s disease who had the typical symptoms of Schizophrenia and Bipolar mood disorder (mania) respectively. Results: Wilson disease first presentation of psychiatric diagnosis may obscure the diagnosis who later on turned out to be suffering from Wilson’s disease. Conclusion: Although such patients are more commonly seen in neurological and hepatological settings, mental health professionals must keep in mind a high level of suspicion, once first presentations may be of psychiatric nature.

Morbidity pattern of low-birth-weight infants in an urban slum of Kolkata, India

Low birth weight [birth weight < 2500 g] is one of the major determinants of neonatal morbidity as well as mortality and these are known to be significantly higher in these infants. To study the morbidity pattern of low-birth-weight [LBW] infants in an urban slum in Kolkata, India. A follow-up community-based study was undertaken in 2004-2005 in an urban slum of Chetla [Kolkata, West Bengal, India], among 126 singleton live-born babies, who were followed up for 9 months at 15 +/- 5 days interval by home visits. Incidence of LBW was 28.6%. Morbidity episodes and hospitalization rate were more in LBW than in normal-birth-weight infants. Overall, gastrointestinal infection and acute respiratory infection were predominant in both LBW and normal-birth-weight babies. Although morbidity episodes as well as hospitalization rate were lower compared with other studied slums of India, there is still room for further improvement of health status of these babies. Adequate care, exclusive breast-feeding, and proper nutrition of the LBW infants must be ensured to have healthy lifestyle free from morbidity