Awareness and utilization of mother and child protection (MCP) card among mothers attending immunization OPD: An urban health centre-based cross-sectional study.

Background: The MCP card is used as a tool for pregnant women, young mothers and family members to learn about various types of services which they should assess and utilize. The study was undertaken to see the awareness about MCP card and its components among beneficiaries in urban slum area. Methodology: This is a cross-sectional observational study done in urban slum immunization OPD with a sample size of 226. Convenient sampling method was used to select the samples. Mothers consenting and willing to participate in the study were enrolled. Results: Observed that the MCP card was issued to majority participants at the time of baby immunization (44.15%), followed by at time of delivery (31.4%) and least number received it at the time of pregnancy registration (24.34%). It is also observed that only 53.54%(121) women had read the card while the remaining didn't. Majority thought the primary use of MCP card was vaccination record (91.5%), followed by information tool (52.%). It is observed that knowledge regarding pregnancy care and its related complications leads to better utilization of ANC services. Conclusion: As observed in the present study a sizeable proportion of populations doesn't even read the card, and among those who read it the level of knowledge isn't satisfactory, many use the card as a vaccination record but still the awareness about various vaccines among the beneficiaries remains low.

CD8α-CI-M6PR Particle Motility Assay to Study the Retrograde Motion of CI-M6PR Receptors in Cultured Living Cells.

The cation-independent mannose 6-phosphate receptors (CI-M6PR) bind newly synthesized mannose 6-phosphate (Man-6-P)-tagged enzymes in the Golgi and transport them to late endosomes/lysosomes, providing them with degradative functions. Following the cargo delivery, empty receptors are recycled via early/recycling endosomes back to the trans-Golgi network (TGN) retrogradely in a dynein-dependent motion. One of the most widely used methods for studying the retrograde trafficking of CI-M6PR involves employing the CD8α-CI-M6PR chimera. This chimera, comprising a CD8 ectodomain fused with the cytoplasmic tail of the CI-M6PR receptor, allows for labeling at the plasma membrane, followed by trafficking only in a retrograde direction. Previous studies utilizing the CD8α-CI-M6PR chimera have focused mainly on colocalization studies with various endocytic markers under steady-state conditions. This protocol extends the application of the CD8α-CI-M6PR chimera to live cell imaging, followed by a quantitative analysis of its motion towards the Golgi. Additionally, we present an approach to quantify parameters such as speed and track lengths associated with the motility of CD8α-CI-M6PR endosomes using the Fiji plugin TrackMate. Key features • This assay is adapted from the methodology by Prof. Matthew Seaman for studying the retrograde trafficking of CI-M6PR by expressing CD8α-CI-M6PR chimera in HeLa cells. • The experiments include live-cell imaging of surface-labeled CD8α-CI-M6PR molecules, followed by a chase in cells. • Allows the monitoring of real-time motion of CD8α-CI-M6PR endosomes and facilitates calculation of kinetic parameters associated with endosome trajectories, e.g., speed and distance (run lengths).

An epidemiological study of the determinants and patterns of complementary feeding practices among children of 6-24 months of age group.

Background: The introduction of complementary food is the most important factor determining the nutritional status of the children in the first 2 years of life. This study aimed to find out the determinants and patterns of complementary feeding practices and their impact on the growth and development of children of 6-24 months of age group. Materials and Methods: A descriptive cross-sectional study was done on immunization out patient department (OPD) in the field practice area of the Department of Community Medicine. The sample size taken was 250 using a systematic random sampling method. Results: One hundred and seven (42.8%) were given the optimum amount of complementary food for their age. One hundred and three (41.2%) were fed with an adequate frequency for their age. One hundred and ninety-five (78.0%) were given food that was appropriate in consistency for their age. Among 183 (73.2%) children who were not fed appropriately during and after their illness episodes, 119 (65.0%) were malnourished. On using logistic regression it was seen that the variables which had statistically significant association with the complementary feeding patterns (P<0.05) were maternal education, father's age, total members in the family, advice on complementary feeding from health care workers and use of bottle for feeding. Father's education, availability of ration card, antenatal counselling on childcare, birth order and history of repeated illness in the past did not show statistically significant association with complementary feeding practices (P>0.05). Conclusion: There was no statistically significant difference between the feeding patterns of normal and malnourished children. The association of complementary feeding practices and the anthropometric status of study children was not found statistically significant in the present study. Advice on complementary feeding from healthcare workers is seen to be having a positive impact on complementary feeding practices (P < 0.01).

Bone marrow metastasis in nonhematological malignancies: A study from tertiary care center.

Introduction: Metastatic cancer presents a treatment challenge to clinicians, particularly for patients with bone marrow infiltration. For tumor staging, therapy selection, and prognosis risk stratification, the status of the bone marrow should be known for the presence or absence of metastasis. The study aimed to evaluate the hematological findings and comprehensive analysis of bone marrow in cases of nonhematological malignancies with bone marrow metastasis. Materials and Methods: This retrospective study comprised a record retrieval of the departmental archives for the past 6 years. A total of 331 patients with nonhematological malignancies were found, of whom 31.42% (104/331) showed bone marrow metastasis. An integrated clinical approach with bone marrow examination findings and immunohistochemistry whenever necessary was used to achieve a definitive diagnosis of bone marrow metastasis. Results: Among the study population, 31.42% (104/331) of patients had nonhematological malignancies that metastasized to the bone marrow. Most of the patients with bone marrow metastasis had anemia, which was found in 77.88% (81/104) of the cases. Leukoerythroblastic reaction was noted in 31.73% (33/104) of the cases, and thrombocytopenia was found in 25% (26/104) of the cases. The most common malignancy with bone marrow metastasis in adults was prostatic adenocarcinoma (28.1%) (9/32) and in pediatric cases, neuroblastoma (53.9%) (52/98). Conclusions: It is essential to diagnose nonhematological malignancies that have metastasized to the bone marrow since this necessitates tumor staging, therapy selection, and prognosis risk stratification. To conclude, not a single hematological parameter is predictive of bone marrow metastasis; however, unexplained anemia, a leukoerythroblastic blood picture, and thrombocytopenia in peripheral blood should raise suspicion for bone marrow metastasis in cases of nonhematological malignancies.

Résumé Introduction: Le cancer métastatique présente un défi de traitement pour les cliniciens, en particulier pour les patients présentant une infiltration de moelle osseuse. Pour la stadification tumorale, la sélection du traitement et la stratification du risque de pronostic, l'état de la moelle osseuse doit être connu pour la présence ou l'absence de métastases. L'étude visait à évaluer les résultats hématologiques et l'analyse complète de la moelle osseuse dans les cas de tumeurs malignes non hématologiques avec métastases de la moelle osseuse. Matériel et méthodes: Cette étude rétrospective comprenait une récupération des archives ministérielles des 6 dernières années. Un total de patients atteints de tumeurs malignes non hématologiques ont été trouvés, dont 31,42% (104/331) présentaient des osmétastases médullaires. Une approche clinique intégrée avec les résultats de l'examen de la moelle osseuse et l'immunohistochimie chaque fois que nécessairea été utilisé pour établir un diagnostic définitif de métastases médullaires. Résultats: Dans la population étudiée, 31,42 % (104/331) des patients présentaient des tumeurs malignes non hématologiques qui se métastasaient à la moelle osseuse. La plupart des patients atteints de métastases de la moelle osseuse présentaient une anémie, qui a été trouvée dans 77,88% (81/104) des cas. Une réaction leucoérythroblastique a été observée dans 31,73 % (33/104) des cas, et une thrombocytopénie a été observée dans 25 % (26/104) des cas. La tumeur maligne la plus fréquente associée aux métastases de la moelle osseuse chez l'adulte était l'adénocarcinome de la prostate (28,1 %) (9/32) et, chez les enfants, le neuroblastome (53,9 %) (52/98). Conclusions: Il est essentiel de diagnostiquer les tumeurs malignes non hématologiques qui ontmétastasé à la moelle osseuse car cela nécessite une stadification tumorale, une sélection thérapeutique et une stratification du risque de pronostic. Pour conclure, pas un seul paramètre hématologique n'est prédictif des métastases de la moelle osseuse; Cependant, une anémie inexpliquée, une image sanguine leucoérythroblastique et une thrombocytopénie dans le sang périphérique devraient faire suspecter des métastases de la moelle osseuse en cas de tumeurs malignes non hématologiques. Mots-clés: Aspiration de moelle osseuse, biopsie de la moelle osseuse, métastases de la moelle osseuse, résultats hématologiques, immunohistochimie, tumeurs malignes non hématologiques, frottis sanguin périphérique.

Solitary superficial angiomyxoma of the ear pinna: a diagnostic dilemma with a review of literature.

Superficial angiomyxoma is an extremely rare subcutaneously placed myxoid soft tissue neoplasm. There are few case reports with fine needle aspiration cytological and histopathological findings available for this tumor because of its rarity. Here, we describe a case of superficial angiomyxoma in a 24-year-old girl who had a solitary left ear pinna mass without a Carney's complex at the time of presentation or at the end of two years of follow-up next to the surgical removal of the tumor. The clinical, cytomorphological, and histological findings, together with the immunohistochemical markers, in a case of superficial angiomyxoma are described in this rare case report for the first time in the English literature.

Clinicopathological Parameters of Haemophilia Patients at a Tertiary Care Centre in Northern India.

INTRODUCTION: Haemophilia affects a large number of people all over the world, yet very little is known about the clinical manifestations and diagnostic protocols of the condition in areas with limited access to resources in developing countries. Understanding the clinical spectrum and diagnostic approach will help with the design of measures to address the situation in these places. The primary objective of this study was to examine the clinicopathological parameters of haemophiliac patients. MATERIALS AND METHODS: From the departmental archive, a thorough history of each patient was retrieved, including values of bleeding time, prothrombin time, activated partial prothrombin time, and percentage of specific factor activity. RESULTS: Out of a total of 385 cases over the period of six years, 86.75% were classified as haemophilia A and 13.25% of cases were diagnosed as haemophilia B. In terms of the severity of the disease, 44.93% were classified as severe, 42.08% as moderate, and 12.99% as mild. Joint bleeding was the first and most typical clinical manifestation of the disease, accounting for 34.80% of cases, followed by ecchymosis (23.12%), post-traumatic bleeding (12.73%), epistaxis (12.20%), and gum bleeding (8.05%). 1.56% of patients had a positive screening test for the hepatitis C virus, followed by 1.30% for HIV and 0.78% for hepatitis B surface antigen. CONCLUSION: In the presence of joint bleeding, ecchymosis, and post-traumatic bleeding in an otherwise healthy individual, a clinician should be alerted to the possibility that the patient has haemophilia and should request a work-up for the bleeding disorder.

Study of Hemato-morphological Features in Neuroblastoma Infiltrating Marrow.

Objective Neuroblastoma typically affects children within the first 5 years of life and accounts for 10% of all pediatric malignancies. Neuroblastoma at onset may manifest as a localized or metastatic illness. The aim of this study was to identify hematomorphological features in neuroblastoma infiltrating marrow as well as to ascertain the prevalence of bone marrow infiltration in neuroblastoma. Materials and Methods This retrospective study included newly diagnosed 79 cases of neuroblastoma, which were referred for bone marrow examination for the staging of the disease. Medical records were retrieved to acquire hematomorphological findings of peripheral blood and bone marrow smears. Statistical Package for Social Sciences, IBM Inc., USA, version 21.0 was used to analyze the data. Results The interquartile age range of neuroblastoma cases was 24.0 to 72.0 months (median = 48 months) with a male to female ratio of 2.7:1. Also, 55.6% (44/79) of cases in the study population showed evidence of marrow infiltration. The bone marrow infiltration was significantly linked to thrombocytopenia ( p = 0.043) and nucleated red blood cells ( p = 0.003) in peripheral blood. The bone marrow smears of cases with infiltration showed a significant shift to the left in the myeloid series ( p = 0.001) and an increased number of erythroid cells ( p = 0.001). Conclusion For neuroblastoma patients, a diligent, exhaustive search for infiltrating cells in bone marrow is advised if thrombocytopenia or nucleated red blood cells are identified on a peripheral blood smear and bone marrow smears showed myeloid left shift with an increased number of erythroid cells.

A study of sexually transmitted infections and reproductive tract infections among the bar girls in Mumbai, India.

Introduction: There is a continuous and increasing trend in sexually transmitted infections (STIs) worldwide. There are severe consequences of STI especially among women practicing high-risk behavior. Control of STI among women practicing high-risk behavior is an important strategy to reduce HIV transmission. In the present study, STIs and reproductive tract infections (RTI) were assessed among bar girls in an urban metro city. Methods: The cross-sectional study was conducted among bar girls residing in an urban settlement from May 2018 to December 2018. 195 bar girls randomly selected from among the registered bar girls for HIV prevention services with a local NGO and willing to participate were enrolled after obtaining informed consent. They were interviewed in person and clinical examination was conducted for assessing symptoms and signs of STI and RTI. Results: The median age of women was 26 years. 45% women reported sexual activity 3-6 times/week. 49.7% women reported symptom of vaginal discharge in the preceding 3 months, 52.3% women reported pain in lower abdomen, 10.2% women complained of genital ulcer disease, 67.2% women reported itching in the genital area, and 36.4% women had complaint of dyspareunia. 90.2% women in the present study had at least one symptom of STI/RTI. Conclusion: High-risk sexual behavior of bar girls with their regular clients puts them at a higher risk of acquiring HIV/AIDS. Focused efforts need to be put in to encourage reporting of symptoms for early diagnosis and management of STI/RTIs.

Lower lip cysticercosis: An unusual case report.

Cysticercosis is a disease that occurs when humans are infected with Taenia solium larvae. The parasitic illness cysticercosis, which is common in impoverished nations, hardly ever affects the mouth. Oral cysticercosis is rare that might be challenging to diagnose clinically. This rare case report documents an oral cysticercosis case in a 38-year-old male patient who had an asymptomatic lesion in the buccal mucosa of his lower lip. A T. solium larva was identified on histopathological examination in a cystic cavity after an excisional biopsy.

Primary Pure Intrarenal Yolk Sac Tumor in 1.5-Year-Old Boy-A Rare Case Report.

Germ cell tumors primarily arise in gonads and extragonadal germ cell tumors, an uncommon entity, originates usually along the midline. Here, we report the fifth example of intrarenal pure yolk sac tumor in a 1.5-year-old boy who presented with abdominal pain and underwent excision of the mass for suspected Wilms tumor. On histopathology and immunohistochemistry, a diagnosis of a yolk sac tumor was rendered. Postoperative serum alpha-fetoprotein levels were 21 000 ng/dl. The purpose of this report is to emphasize the importance of suspecting a germ cell tumor as one of the differential diagnoses of a suspected case of Wilms tumor and the significance of evaluating serum alpha-fetoprotein levels preoperatively.

RUFY1 binds Arl8b and mediates endosome-to-TGN CI-M6PR retrieval for cargo sorting to lysosomes.

Arl8b, an Arf-like GTP-binding protein, regulates cargo trafficking and positioning of lysosomes. However, it is unknown whether Arl8b regulates lysosomal cargo sorting. Here, we report that Arl8b binds to the Rab4 and Rab14 interaction partner, RUN and FYVE domain-containing protein (RUFY) 1, a known regulator of cargo sorting from recycling endosomes. Arl8b determines RUFY1 endosomal localization through regulating its interaction with Rab14. RUFY1 depletion led to a delay in CI-M6PR retrieval from endosomes to the TGN, resulting in impaired delivery of newly synthesized hydrolases to lysosomes. We identified the dynein-dynactin complex as an RUFY1 interaction partner, and similar to a subset of activating dynein adaptors, the coiled-coil region of RUFY1 was required for interaction with dynein and the ability to mediate dynein-dependent organelle clustering. Our findings suggest that Arl8b and RUFY1 play a novel role on recycling endosomes, from where this machinery regulates endosomes to TGN retrieval of CI-M6PR and, consequently, lysosomal cargo sorting.

Prostate Tuberculosis Masquerading as Prostate Carcinoma: A Rare Case Report.

Genitourinary tuberculosis (GUTB), the second most frequent type of extrapulmonary tuberculosis (TB) in endemic regions, was initially described by Wildbolz in 1973. The prostate and epididymis are the first sites of male genital tuberculosis, followed by the seminal vesicles and the testicles. Here, we describe a case of a 65-year-old male who presented with obstructive lower urinary tract symptoms (LUTS) for the previous six weeks. The digital rectal examination revealed prostatic enlargement with a firm and nodular surface. A high prostate-specific antigen level (88 ng/ml) was found in serum analysis. There was a suspicion of prostate cancer on the basis of clinical, radiological, and serological examination. In view of the suspicion of carcinoma, a prostate biopsy was performed, which revealed the proliferation of prostatic glandular and stromal elements with interspersed granulomas, necrosis, and aggregates of mature lymphoid cells. The histopathology findings were indicative of benign prostatic hyperplasia with granulomatous prostatitis. Ziehl-Neelsen (ZN) stain was negative for acid-fast bacilli. The cartridge-based nucleic acid amplification test (CBNAAT) for Mycobacterium tuberculosis was ordered on the prostate biopsy tissue bits, which showed positive results. On the basis of histopathology and nucleic acid amplification test, the diagnosis of prostate tuberculosis was considered. There are no specific clinical and radiological findings related to prostate tuberculosis; hence, the diagnosis can be established only after histopathological examination and tissue-based cartridge-based nucleic acid amplification test. Clinicians should have a high index of suspicion for tuberculosis, especially in patients from endemic countries who present with symptoms of the lower urinary tract, especially if there is granulomatous inflammation coupled with necrosis.

Histological Spectrum of Post Covid Debridement Tissues: Salient Histomorphological Features With Respect to Identification Fungal Elements.

Background: Secondary bacterial and fungal infections in COVID patients have been documented during current pandemic. The present study provides detailed account of histomorphology of debridement tissue received for suspected fungal infections. The primary objective was to determine the morphological characteristics that must be recognized for the identification of fungal hyphae. Methods: The detailed histological examination of debridement tissue was performed. Demographic and clinical findings with treatment provided was recorded. Presence or absence of necrosis and lecocytoclasis was noted. Results: A total of 110 cases of debrided tissues were included in the study. Eosinophilic granular necrosis with lecocytoclasis was observed in 103cases; fungal elements were identified in 89.3% (92/103) of these. Eleven cases where necrosis was observed, strong suspicion of fungus was reported, 6 of them displayed fungus on KOH preparation, 3 on repeat biopsy. However, in 2 of these cases, neither KOH nor repeat biopsies identified the fungus. Mucor with aspergillus was observed in 7 cases and actinomyces in 3. In all these 10 cases dense fungal colonies were evident. In 7 cases careful observation revealed fruiting bodies of aspergillus. Cotton ball appearance of actinomyces was evident. Mucor infection in current disease was so rampant that aseptate ribbon like branching mucor hyphae were evident on H&E sections. Diabetes was significantly associated with fungal infection (97.2%; 70/72; P < .005). 90% [19/21] of the patients who were on room air and diagnosed with fungal infection were diabetic. Conclusions: Eosinophilic granular necrosis with the presence of neutrophilic debris in a case of suspected fungal disease suggests the presence of fungal elements. This warrants processing of the entire tissue deposited for examination, careful observation, application of fungal stains, and repeat biopsy if clinical suspicion is strong. Moreover, uncontrolled diabetes is more frequently associated with secondary fungal infection in COVID patients as compared to oxygen therapy.

Gender determination and gender gap: A cross sectional comparative study of mothers attending under five immunisation clinics in urban and rural areas.

BACKGROUND: Sex ratio is an important sociodemographic characteristic of the country reflecting the status of its women and underlying socioeconomic and cultural patterns. PC-PNDT law is in place since so many years still sex determination is prevalent. Here not only doctors but the parents are also equally responsible for propagating this social evil as most of them are unaware about the Act and its legal implications and consequences of the declining sex ratio. METHODS: Study was conducted over a period of 24 months from December 2018 to November 2018 in Immunisation OPD of a tertiary health care centre and a primary health centre with a sample size of 117 in both areas. Simple Random sampling method was used and analysis was done using SPSS software. RESULTS: Out of 234 mothers approximately 70% were aware that pre-natal sex determination can be done. About 40% were aware that it is illegal, 30% said that ultrasonography is used for doing it, 20% said that both doctor and parents are punished under this act. Only 5% were aware about the correct punishment under this Act. Awareness regarding the place, method, legality and punishment was more among mothers of urban area as compared to rural area. Education and socioeconomic status was associated with awareness. CONCLUSION: Creating awareness in the general public and specifically mothers regarding the Act and consequences of its violation. Comprehensive behavioural change communication activities can be done through mass media for educating the people regarding the effect of declining sex ratio.

Epidemiological factors influencing gender preference among mothers attending under-five immunization clinic: A cross-sectional comparative study.

BACKGROUND: Sex ratio is an important social indicator measuring the status and equality of female in society. The falling sex ratio of our country is a demographic disaster that is waiting to happen and is a matter of grave concern. Perception of gender by mothers or families has long-term implications on how children are nurtured during their lives. This study was done to understand mother's preference for the gender of the child and their concerns about the same. MATERIALS AND METHODS: An observational cross-sectional study was carried out using a semi-structured questionnaire. Two hundred and thirty-four mothers were interviewed. Frequencies and percentages were calculated. Pearson's Chi-square test was used to check the significance of the association. RESULTS: Study results depict that 26.47% of the mothers who were already having a male child still preferred son. Preference for son was 24.52% and 48.61% among earning mothers and nonearning mothers, respectively. Out of 206 mothers said that they would prefer male child. Reasons cited were as follows: sons carry family name forward (30.6%), having daughters leads to increased expenditure (20.9%), daughters are subjected to different problem in their lifetime mainly violence (11.7%), and sons supported their parents in old age (10.7%). CONCLUSION: Preference for male child was found to be equally prevalent in both urban and rural areas. Mothers should be educated about the effect of declining sex ratio along with financial capacity building of women and providing social security to senior citizens which was the main reason for son preference. The impact of gender imbalance on individuals, families, and on society has to be emphasized at every possible point of contact with health-care delivery system.

"Silent sufferers: A study of domestic violence among pregnant women attending the ANC OPD at a Primary Health Care Centre".

INTRODUCTION: Domestic violence against women is one of the most pervasive abuses of human rights in the world. Violence during pregnancy leads to both acute injuries and profound long-term challenges to health and wellbeing. Pregnancy provides a good opportunity for healthcare personal to screen women for domestic violence. AIM: To identify the pattern of domestic violence amongst pregnant women and to plan appropriate interventions. SETTINGS AND DESIGN: This cross-sectional study was carried out at Primary Health Care Centre. METHODS AND MATERIAL: 90 pregnant women attending the ANC OPD and fulfilling the inclusion criteria were interviewed using a semi-structured questionnaire. Data were compiled and analyzed using SPSS version 24. Percentages were calculated and Chi-square test was used wherever applicable. RESULTS: Violence was mostly seen in the women who were married for five years (47.36%) and many among them experienced it within one year of marriage (34.28%). The most common violence faced by the women was verbal violence (44.73%), followed by financial violence (27.63%). Physical violence was experienced by 22.36% women. The Perceived risk factor for violence was mostly addiction of spouse in 26.31% of women and insufficient dowry and demand for male child in 19.73%. CONCLUSIONS: As occurrence of violence was found to be significantly associated with duration of marriage, educational status, and earning status of women asking about intimate partner violence should be a part of routine antenatal care for early detection and identification of cases, their counseling, and appropriate interventions.

Heterogeneity in pneumolysin expression governs the fate of Streptococcus pneumoniae during blood-brain barrier trafficking.

Outcome of host-pathogen encounter is determined by the complex interplay between protective bacterial and host defense strategies. This complexity further amplifies with the existence of cell-to-cell phenotypic heterogeneity in pathogens which remains largely unexplored. In this study, we illustrated that heterogeneous expression of pneumolysin (Ply), a pore-forming toxin of the meningeal pathogen, S. pneumoniae (SPN) gives rise to stochastically different bacterial subpopulations with variable fate during passage across blood-brain barrier (BBB). We demonstrate that Ply mediated damage to pneumococcus containing vacuolar (PCV) membrane leads to recruitment of cytosolic "eat-me" signals, galectin-8 and ubiquitin, targeting SPN for autophagic clearance. However, a majority of high Ply producing subset extensively damages autophagosomes leading to pneumococcal escape into cytosol and efficient clearance by host ubiquitination machinery. Interestingly, a low Ply producing subset halts autophagosomal maturation and evades all intracellular defense mechanisms, promoting its prolonged survival and successful transcytosis across BBB, both in vitro and in vivo. Ply therefore acts as both, sword and shield implying that its smart regulation ensures optimal disease manifestation. Our elucidation of heterogeneity in Ply expression leading to disparate infection outcomes attempts to resolve the dubious role of Ply in pneumococcal pathogenesis.