Prevention of vertical transmission of HIV in India through service integration: lessons from Mysore District, Karnataka.

Meeting the needs of HIV‑positive pregnant women and their offspring is critical to India’s political and financial commitment to achieving universal access to HIV prevention, treatment, care and support. This review of the strategy to prevent vertical transmission of HIV in Mysore district, Karnataka, highlights the need to integrate prevention of parent‑to‑child transmission (PPTCT) and reproductive and child health (RCH) services. All key officials who were involved in the integration of services at the state and district levels were interviewed by use of semistructured protocols. Policy documents and guidelines issued by the Department of Health and Family Welfare and Karnataka State AIDS Prevention Society were reviewed, as were records and official orders issued by the office of District Health and Family Welfare Officer and District HIV/AIDS Programme Office, Mysore. Routine data were also collected from all health facilities. This review found that 4.5 years of PPTCT‑RCH integration resulted not only in a rise in antenatal registrations but also in almost all pregnant women counselled during antenatal care undergoing HIV tests. Based on the findings, we propose recommendations for successful replication of this strategy. Integration of PPTCT services with RCH should take place at all levels − policy, administration, facility and community. The increased demand for HIV counselling and testing resulting from service integration must be met by skilled human resources, sufficient facilities and adequate funds at the facility level.

PTTH--a potential growth activator in silkworm, Bombyx mori L. for enhancing silk production.

In silkworm, prothoracicotropic hormone (PTTH), directly or indirectly controls silk production and spinning activity along with juvenile hormone (JH). An effort was made to exploit the potential of PTTH by indirectly activating silk gland for increasing silk productivity using short chain synthetic analogues of PTTH. The analogy in action was also established using PTTH extracted from the silkmoth. Different doses of 42 synthetic PTTH analogues, viz., 2.5, 5, 10 and 20ppm and 3.3 mg/ml of PTTH extracted from silkmoth heads were administered orally to V instar silkworm larvae (Race:KAxNB4D2 and PMxNB4D2) at 0-144 hr at an interval of 24 hr. The analysed data showed an improvement of about 14 - 23% in KA x NB4D2 and about 10-14% in PMxNB4D2 in respect of cocoon shell weight on administration of some of the synthetic PTTH analogues. The PTTH extracted from the adult brain also showed similar effect. The structural analogy of synthetic PTTHs (which improved the shell weight) with original PTTH and its probable mode of action in silkworm are discussed.

Prevalence of dental fluorosis and associated risk factors in Alappuzha district, Kerala.

BACKGROUND: Fluorosis is considered endemic in 15 states of India. Dental fluorosis is the most convenient biomarker of exposure to fluoride. In Kerala, although the condition is reported to be endemic in the districts of Alappuzha and Palakkad, there are no systematic epidemiological studies evaluating dental fluorosis. We studied the prevalence of dental fluorosis among school children in Ambalappuzha taluk, Alappuzha district, Kerala and evaluated the contribution of potential risk factors. METHODS: We conducted a community-based, cross-sectional survey of 1142 school children (630 girls, 512 boys) in the age group of 10-17 years, using a multistage random cluster sampling technique. A pre-tested structured questionnaire was used to assess exposure to various sources of fluoride. A dental specialist examined all the children to determine the presence or absence of dental fluorosis and graded the degree of dental fluorosis using Dean's Index. The water fluoride content in the study area was obtained from the district water authority department. Bivariate associations were examined using the Chi-square and Chi-square trend tests, while multiple logistic regression was used to evaluate the association of select risk factors with the presence or absence of dental fluorosis. RESULTS: The overall prevalence of dental fluorosis in our study sample was 35.6% and the community fluorosis index was 0.69. The prevalence of dental fluorosis was higher in the urban compared to the rural areas (55.3% v. 16.8%; p < 0.001), and in girls compared to boys (39.2% v. 31.3%; p < 0.01). The prevalence of dental fluorosis was higher among children who consumed pipe water as compared to children who consumed well water (44.8% v. 12.7%; p < 0.001). We noted a step-wise increase in the prevalence of dental fluorosis with a corresponding increase in water fluoride content in different panchayats (p = 0.024). The principal factor associated with the presence of dental fluorosis was a high fluoride content of drinking water (OR 1.85, 95% Cl: 1.17-2.92). We did not observe any significant association between dental fluorosis and the intake of brick-tea, consumption of fish or the use of toothpaste. CONCLUSION: Dental fluorosis is a public health problem in the Ambalappuzha taluk. Active steps must be taken to partially defluoridate the water before distribution to reduce the morbidity associated with dental fluorosis in this area. Similar surveys are required in other parts of India to identify areas with high water fluoride content and determine the extent and manner in which defluoridation can be carried out.