A Study on Sexually Transmitted Infections Using Syndromic Approach among Patients Attending Suraksha Clinic at a Tertiary Care Hospital of West Bengal

Introduction : A proper understanding of different aspects of Sexually Transmitted Infections (STIs) in different regions of a country like India is very essential for STI control. Objectives : To assess pattern of STIs using Syndromic approach among patients attending at Suraksha Clinic and to find out treatment seeking behaviour among them. Material and Method : A cross-sectional study was conducted at a Tertiary Care Hospital of West Bengal. This retrospective study was done selecting all patients who attended the Clinic for first time from 1st May, 2020 to 30th April, 2021. Relevant records were reviewed. Descriptive statistics and chi-square test were used. Observations : In present study Suraksha Clinic attendees were mainly comprised of female (95.8%); while 65.8% and 64.2% of patients were suffering from Lower abdominal pain and Cervicovaginal discharge respectively. Nearly one-third of them (37.9%) were suffering from more than one disease. About one-fourth of patients (28.2%) accessed the STI/RTI/Suraksha Clinic directly. The treatment seeking behaviour was significantly associated with gender and education of patients. Conclusions : This Tertiary Care Hospital based study highlighted higher prevalence of certain STIs among attendees to Suraksha Clinic as well as lower proportion of male and directly walk-in patient

Correlation Between Blood Pressure Measurement by Non-invasive and Invasive Methods in Critically-ill Children

Objective: To determine the correlation of non-invasive blood pressure obtained byauscultatory and oscillometric methods, with invasive blood pressure in critically ill children.Methods: We compared invasive with auscultatory and oscillometric blood pressures usingpaired t-test, Pearson’s correlation coefficient and Bland-Altman plot in 50 children (age 1-12y) admitted in Pediatric intensive care unit. Results: Systolic, diastolic, and mean arterialpressures of invasive methods significantly correlated with auscultatory and oscillometricmethods (P<0.001). Auscultatory and oscillometric measurements under-estimated systolicarterial pressures [mean (SD) difference 5.4 (12.2) mmHg and 6.3 (14.0) mmHg,respectively; P<0.001] and overestimated diastolic arterial pressures [-4.1 (5.8) mmHg and-3.6 (7.2) mmHg; P<0.001] compared to invasive blood pressure. Conclusion: Mean arterialpressure obtained by NIBP measurement is more closer than systolic or diastolic pressures,when compared with invasive blood pressure measurement.

Clitoral Length and Anogenital Ratio in Indian Newborn Girls.

Objective: To generate normative data on clitoris length, anogenital distance and anogenital ratio in Indian newborns. Design: Cross-sectional study. Setting: Neonatal unit of a tertiary care teaching hospital in Kolkata. Participants: 378 female neonates, who were hemo-dynamically stable without critical illness or chromosomal anomaly, and without any vulval hematoma or genital abnormalities. Interventions: Measurements were recorded using a digital vernier caliper between 24-72 hours. Infant was held in position by an assistant, while the investigator measured clitoral length by gently retracting the labia majora. Anogenital distance (centre of the anus to posterior convergence of the fourchette) and anogenital ratio (anogenital distance divided by the distance from centre of the anus to base of the clitoris) was also measured. Main outcome measures: Gestational age- and birthweight-wise normative values of clitoral length, anogenital distance and anogenital ratios. Results: Mean clitoral length was 3.1 (1.54) mm for the whole cohort while anogenital distance and anogenital ratio were 10.2 (2.78) mm and 0.34 (0.07) mm, respectively. The gestation age-wise percentile charts of clitoral length, anogenital distance and anogenital ratio have been generated. There was no correlation between clitoral length and gestational age, body length, head circumference and birth weight. Correlations were also weak for anogenital distance. Conclusions: The normative values generated can serve as reference standard in the assessment of clitoromegaly, ambiguous genitalia, virilizing effects and suspected in utero androgen exposure.

Biology of the HIV Nef protein.

The accessory Nef protein is expressed by all primate lentiviruses--HIV-1,HIV-2 and simian immune deficiency virus (SIV). Its expression in the early stages of the viral life cycle ensures two basic attributes of HIV infection. These are T-cell activation and the establishment of a persistent state of infection. Nef has a positive effect on viral infection and replication by promoting the survival of infected cells. Its role in HIV persistence is based largely on the ability of Nef to downmodulate the surface levels of important molecules at the immune synapse. These include major histocompatibility complex-I (MHC I) and (MHC II) present on antigen-presenting cells (APCs) and target cells, and CD4 and CD28 present on helper T cells. In this review we present these biological properties of Nef from a mechanistic point of view, and relate them to the structural attributes and interactions of the Nef protein. A brief outline of the limited studies on Nef from Indian subtype C HIV-1 isolates is also presented.