Factores psicosociales y adherencia al tratamiento antirretroviral en niños con infección perinatal por VIH-1 / Psychosocial factors and adherence to antiretroviral therapy in children with perinatal HIV-1 infection

Introducción: Con la incorporación de los tratamientos antirretrovirales de alta eficacia (HAART) el pronóstico de los niños con infección perinatal por VIH-1 ha mejorado sustancialmente. A fin de evaluar los factores psicosociales que podrían asociarse con la adherencia, hemos analizado entre otros la presencia de depresión y sucesos de vida. Métodos: Estudio prospectivo. Se incluyeron niños entre 7 y 12 años con infección perinatal por VIH-1 con tratamiento antirretroviral, en seguimiento en el Hospital Garrahan. Resultados: se incorporaron 79 niños, 51% eran mujeres, 94% vivían con sus familias de origen y 6% vivían con familia adoptiva; 60% tenían uno o ambos padres fallecidos. El inventario de depresión infantil (CDI) arrojó que un 39% presentaron síntomas depresivos. La población estudiada presentó un alto porcentaje de sucesos de vida estresantes. El 80% experimentó entre uno y ocho sucesos de vida no deseados. El suceso de vida que se observó con mayor frecuencia estaba relacionado con el estado de salud de sus padres. La adherencia resultó muy buena en el 43%. En la variable “tipo de familia” se observó una tendencia de asociación con adherencia: el 69% de los niños de familias ensambladas tenían muy buena adherencia vs. 23% de aquellos que vivían con familia ampliada (p=0,051). La autoeficacia de los padres en el manejo de la medicación del niño estuvo asociada con menores dificultades con los regímenes de tratamiento (p=0,008), mientras que con el conocimiento del diagnóstico se observó sólo una tendencia (p= 0,08). No hubo asociación entre depresión y sucesos de vida y la con adherencia. Conclusiones: El estudio revela que aproximadamente el 40% de los niños presenta puntajes indicativos de depresión y un elevado número de eventos estresantes de vida. Se remarca la necesidad de evaluar y brindar apoyo al entorno familiar para optimizar la adherencia de los niños infectados por VIH.

Microalbuminuria as a Predictor of Short-Term Mortality in Acute Ischemic Stroke.

Stroke is one of the major causes of morbidity and mortality all over the world. Microalbuminuria is one of the predictors of mortality. Available published data has suggested that microalbuminuria is a potential new risk factor for ischemic stroke. This study was carried out in the Department of Biochemistry, Dhaka Medical College during the period from July 2009 to June 2010. In this study, we enrolled 120 patients of ischemic stroke. 60 of them were with microalbuminuria (MA) and 60 were without MA. Among the MA +ve group, 38 (63.3%) were males and 22 (36.7%) were females. On the other hand those belonging to MA -ve groups 52 (36.7%) were males and 8 (13.3%) were females. Age range of the subjects in MA +ve group was 45-70 years and in MA-ve group was 50-70 years. In patients with microalbuminuria mortality was 26.7% and in patients without MA mortality was 11.7% (p<0.05). The study showed significantly higher mortality in patients with microalbuminuria than that of the patients without microalbuminuria.

Effects of substance P on spontaneous contraction in the flexure region of the guinea pig colon.

Effects of Substance P on spontaneous contractions of the circular muscle of the flexure region of guinea pig colon were studied by mechanical tension recording. Substance P (3 nM-10 nM) produced tonic contraction associated with phasic activities but the contraction was found stronger at higher concentration. Verapamil (3 microM), a voltage dependent L-type Ca(2+) channel blocker completely blocked the spontaneous activities and also Substance P induced contraction. These results suggest that Substance P produce contraction by Ca(2+) influx and the Ca(2+) influx occurs by activating verapamil sensitive Ca(2+) channel.

Clinical profile and predisposing factors of cerebral palsy.

This was an analysis of one hundred ten children with cerebral palsy (CP) attending at the Child Development & Neurology Care Center of Dhaka Medical College Hospital during January 2002 to December 2003. These children were observed to study their clinical profile, etiological factors and associated problems. The mean age of these children was 2.9 +/- 2.9 years, mostly being males (n=79, 71.8%). Most of the families of these children belonged to poorer socioeconomic strata. Spastic diplegia constituted the predominant group (34.5 per cent), followed by spastic quadriplegia (25.5 per cent). Dyskinetic CP was present in 15.5 percent of the cases. Hypotonic CP constituted a significant proportion of cases. Delayed Motor Function was observed in all 110 cases, delayed speech was complained in 67.3% cases and impaired hearing was identified in 26.8% CP children. Mothers of 43.6% CP cases reported that they had prolonged labour during delivery and almost one third (29.1%) had suffered from pre-eclampsia or eclampsia. Majority (53.6%) of the CP cases were reported to have had perinatal asphyxia. Comprehensive assessment and early management of these problems are emphasized, which can minimize the extent of disabilities. By proper perinatal care, CP can be prevented.

Efficient protocol for in vitro direct plant regeneration in chickpea Cicer arietinum L.

An efficient plant regeneration system was developed for two important Indian chickpea cultivars, C-235 and HC-1. Immature cotyledons (7-8 mm) directly formed shoots without an intervening callus phase on MS medium containing B5 vitamins, BAP (2.0 mg/l), IBA (0.125 mg/l), AgNO3 (1.69 mg/l) and phytagel (2.5 g/l). The regenerated shoots had normal morphology and were successfully rooted in half strength MS medium under partial dark conditions. Regenerated plants were transferred to potted soil. However, the survival rate of pot house transferred plants was 17.6 per cent.

Interspecific hybridization in Brassica juncea and Brassica tournefortii through embryo rescue and their evaluation for biotic and abiotic stress tolerance.

Interspecific hybrids were obtained in an otherwise incompatible cross Brassica juncea x Brassica tournefortii through in vitro culture of hybrid embryos. The best response was observed from culture of embryos excised 20 days after pollination on MS medium supplemented with kinetin, alpha-naphthylacetic acid, gibberellic acid, glutamine and casein hydrolysate. One hybrid plant had many distinct or intermediate characters. It was tolerant to aphid attack, exhibited irregularities in meiotic events and was partially fertile. The F2 open pollinated and BC1 progenies showed a large diversity in their morphological traits and some promising plants with less aphid infection, drought tolerance and high yield were selected.

Cervical cytology screening in Calcutta and adjoining areas with special reference to carcinoma of the uterine cervix.

A total of 1232 female subjects including 100 prostitutes from Calcutta and adjoining areas in the age group of 21-70 years were screened for cervical pathology according to the method of Papanicolaou. Of 1232 examined, 815 were found to have smears with normal cellular cytology (66.15%). The others were grouped into dysplasia (18.4%) and inflammatory (15.4%) according to the cytomorphological characteristics of the exfoliated cells. The findings though revealed more cases of cervical dysplasia in women with early marriage, early childbirth, high parity and multiple sexual partners, it failed to support the smegma theory of cervical carcinoma. This study also showed a number of inflammatory cervical smears in women coming from low socio-economic group.