RESUMO
Non-Transfusion Dependent Thalassemia (NTDT) is a term used to label patients who do not require lifelong transfusions for survival. The common conditions traditionally described as NTDT are beta thalassemia intermedia, haemoglobin H disease and haemoglobin E beta thalassemia. The major problem with NTDT patients remains that, as they do not require regular transfusions, so they often do not seek medical attention until they develop serious complications such as anaemia due to ineffective erythropoiesis, iron overload, hypercoagulability and hormonal imbalances like hypogonadism, hypoparathyroidism, renal dysfunction etc.METHODSOur study was conducted in the Thalassemia Out Patient Department, Institute of Haematology & Transfusion Medicine at Medical College, Kolkata, over a span of 1 year 6 months. It was a cross sectional observational study of 30 patients of Non-Transfusion Dependant Thalassemia (NTDT) selected randomly as per the inclusion criteria. Thorough history taking and clinical examination were performed. Blood samples were tested for haemoglobin levels, RBC indices, fasting glucose, serum calcium, serum phosphate, SGPT, serum creatinine, TSH, FT4, FSH and LH (3 pooled samples at 30-minute-intervals), serum testosterone (in males) and serum ferritin. Ultrasonography and echocardiography were done. The data was analysed by standard statistical methods, using MedCalc (version 3.0) software. The correlation of different complications of NTDT with serum ferritin levels was done using Mann-Whitney U test. An alpha level of 5% has been taken i.e. any p value < 0.05 has been taken as significantRESULTSSerum ferritin levels were found to be quite high in the NTDT patients, with a range of 335.1 (min.) - 1300 (max.) ng/mL, with a mean serum ferritin level of 568.78 ng/mL and SD of 224.9, despite the fact that nearly 87% (26 out of 30) of the patients had received less than 10 transfusions in their lifetime. Our study showed that, delayed puberty, renal dysfunction, liver dysfunction and pulmonary hypertension were found to be significantly related to the serum ferritin levels (serving as a marker of liver iron concentration).CONCLUSIONSThus, we conclude that despite requiring much fewer transfusions than transfusion dependant thalassemia patients, the NTDT patients do develop iron overload as well as different complications, some of which are significantly related to the liver iron overload. Knowledge of such complications could help to initiate chelation therapy at the appropriate time for NTDT patients, thereby reducing morbidity and improving their quality of life.
RESUMO
Background : The propaganda for the use of condoms remains one of the mainstay for prevention of human immunodeficiency virus (HIV) transmission. In spite of the proven efficacy of condom, some moral, social and psychological obstacles are still prevalent, hindering the use of condoms. Aims : The study tried to construct a short condom-attitude scale for use among the migrant workers, a major bridge population in India. Settings and Design : The study was conducted among the male migrant workers who were 18-49 years old, sexually active and had heard about condoms and were engaged in nonformal jobs. We recruited 234 and 280 candidates for Phase 1 and Phase 2 respectively. Materials and Methods : Ten items from the original 40-item Brown's ATC (attitude towards condom) scale were selected in Phase 1. After analysis of Phase 1 results, using principal component analysis six items were found appropriate for measuring attitude towards condom use. These six items were then administered in another group in Phase 2. Utilizing Pearson's correlations, scale items were examined in terms of their mean response scores and the correlation matrix between items. Cornbach's alpha and construct validity were also assessed for the entire sample. Results : Study subjects were categorized as condom users and nonusers. The scale structure was explored by analyzing response scores with respect to the items, using principal component analysis followed by varimax rotation analysis. Principal component analysis revealed that the first factor accounted for 71% of the variance, with eigenvalue greater than one. Eigenvalues of the second factor was less than one. Application of screen test suggests only one factor was dominant. Mean score of six items among condom users was 20.45 and that among nonusers was 16.67, which was statistically significant ( P Conclusion : This tailor-made attitude-toward-condom-use scale, targeted for most vulnerable people in India, can be included in any rapid survey for assessing the existing beliefs and attitudes toward condoms and also for evaluating efficacy of an intervention program.