Prevalence and risk factors for falls among the community dwelling older adults of Thrissur: A pilot study.

Background: According to World Health Organization (WHO) statistics, every year 28-35% of people over 65 years and 32-42% of people over 70 years experience falls. Given that many falls are preventable, can occur in any population, and can result in significant morbidity and mortality, falls are receiving more attention as a major global issue. Objective: The objectives of this study were as follows: 1. To measure the prevalence of falls among the elderly living in the Thrissur Taluk Health Centre. 2. To identify the risk factors associated with falls in the elderly using the Centre for Disease Control and Prevention, Stopping Elderly Accidents, Deaths and Injuries (CDCs STEADI) 2019 scale and the Timed Up and Go (TUG) scale. 3. To find the association between the risk factors and the prevalence of fall among older people. Materials and Methods: A cross-sectional study was conducted to find the prevalence of fall among the elderly in Thrissur Taluk Health Centers. CDCs STEADI 2019 fall risk assessment tool was used to assess the risk factors associated with the elderly. TUG test was used to determine gait, balance, strength, and posture. Results: In our study, we discovered a prevalence of 41 percent of falls among the community-dwelling older adults of Thrissur. This study has shown that the risk of fall was higher among the female elderly population. 88% are found to be at high risk of fall, and 65% of the population were worried about fall. Conclusion: This study found out a high prevalence of falls among community dwelling older adults.A future study with a larger sample size would be more helpful to confirm the impact of different variables in relation to the risk of fall among the elderly.

Comparison of the effectiveness of lifestyle interventions and multi-interventional therapy on biochemical parameters of metabolic syndrome among women.

BACKGROUND: Metabolic syndrome is one of the emerging health issues in developing countries. It includes diabetes, high blood pressure, obesity, and elevated blood cholesterol. This study aimed to compare the effects of two different types of interventions: multi-interventional therapy (MIT) and lifestyle interventions (LIs) on high-density lipoprotein (HDL), triglycerides, and fasting blood sugar (FBS) among women with metabolic syndrome. MATERIALS AND METHODS: The study used a quasi-experimental nonequivalent control group design with two experimental groups and one control group. This study was conducted among self-help group women from nine area development societies (ADS) in a selected area in South India from March 1, 2019, to February 28, 2020. Women (aged between 35 and 55 years) with metabolic syndrome were recruited by multistage sampling (N = 220) and randomly assigned into three groups: (a) control, (b) MIT (intervention 1), and (c) LIs (intervention 2). Reflexology foot massage, dietary modification, moderate-intensity exercise, and structured education were given to the MIT group and dietary modification, moderate-intensity exercise, and structured education were given to the LI group for 12 weeks. The control group received routine care. A demographic and clinical data sheet is used to collect the basic information. Biochemical variables (HDL, triglycerides, and FBS) were assessed before and after the intervention. The data obtained from the study were computed using a frequency distribution to describe the demographic characteristics, and a Chi-square (x2) test was conducted to find the homogeneity. Both parametric and nonparametric tests were conducted for the comparison of the effectiveness of different methods of interventions on biochemical parameters of metabolic syndrome. RESULTS: Women who received MIT and LI had significantly lower values of HDL, triglycerides, and FBS after the treatment from baseline and compared with the control group. The study found a significant improvement in the biochemical parameters in the MIT group as compared to the control group and the LI group (<0.001). CONCLUSION: Paired t-test shows significant improvement in HDL, triglycerides, and FBS (P < 0.001) in both the LI and MIT groups. In case of triglycerides, MIT was found to be more effective (P < 0.001). Both MIT and LIs can be considered interventions for reducing triglycerides and FBS and increasing HDL.

Development and Field-Testing of Proposed Food-Based Dietary Guideline Messages and Images amongst Consumers in Tanzania.

In this paper we report on the development and field-testing of proposed food-based dietary guideline (FBDG) messages among Tanzanian consumers. The messages were tested for cultural appropriateness, consumer understanding, acceptability, and feasibility. In addition, comprehension of the messages was assessed using culturally representative images for low literacy audiences. Focus group discussions were used as method for data collection. Results indicate that the core meaning of the proposed FBDG messages and images were understood and acceptable to the general population. However, participants felt that nutrition education would be required for improved comprehension. Feasibility was affected by some cultural differences, lack of nutrition knowledge, time constraints, and poverty. Suggestions were made for some rewording of certain messages and editing of certain images. It is recommended that the field-tested messages and images, incorporating the suggested changes, should be adopted. Once adopted, the FBDGs can be used to inform and engage various stakeholders, including parents, caregivers, healthcare providers and educators on appropriate nutritional practices for children and adults. They can also be used to guide implementation of relevant policies and programmes to contribute towards the achievement of sustainable healthy diets and healthy dietary patterns.

The Role of Age of Onset in Problematic Alcohol Consumption: Artefact or Cohort Effect? / El papel de la edad de inicio en el consumo problemático de alcohol: ¿artefacto o efecto de cohorte?

Age of onset has been reported as a crucial predictor for alcohol consumption in adolescence. However, several authors have warned against it as an unreliable artefact accounted by the tendency to delay age of onset as respondents’ age increases (forward telescoping). This study aims to test whether age of onset is either a proxy for age or a predictor of alcohol consumption of its own. A hierarchical regression model and Process Macro for SPSS were used to test the effect of age of onset (controlling for age) on alcohol consumption and the mediating/moderator role of age of onset, parental control, and sex on alcohol consumption, respectively. Results support the role of age of onset as a significant predictor of alcohol consumption in Ecuadorian adolescents, rather than an artefact. Furthermore, age of onset completely mediated the effect of age on alcohol consumption, often moderated by sex. Practical implications are further discussed.

La edad de inicio se ha señalado como un predictor crucial del consumo de alcohol en la adolescencia. Sin embargo, varios autores han advertido que se trata de un artefacto poco fiable que se explica por la tendencia a retrasar la edad de inicio a medida que aumenta la edad de los encuestados (forward telescoping o sesgo de memoria). Este estudio pretende comprobar si la edad de inicio es una medida aproximativa de la edad o un predictor del consumo de alcohol por sí mismo. Se utilizó un modelo de regresión jerárquica y la Macro Process para SPSS para probar el efecto de la edad de inicio (controlando la edad) en el consumo de alcohol y el papel mediador/moderador de la edad de inicio, el control parental y el sexo en el consumo de alcohol, respectivamente. Los resultados confirman el papel de la edad de inicio como predictor significativo del consumo de alcohol en los adolescentes ecuatorianos en lugar de artefacto. Además, la edad de inicio medió completamente el efecto de la edad en el consumo de alcohol, con frecuencia moderado por el sexo. Se discuten posteriormente las implicaciones prácticas.

Awareness, Prevalence and Factors Associated with Respiratory Morbidities Among Selected Petrol Pump Workers in Bengaluru City?

INTRODUCTION: Petrol pump workers are exposed to fumes emanated during petrol filling and vehicular exhaust thus falling prey to several respiratory diseases. OBJECTIVES: To assess the awareness and prevalence of respiratory morbidities among petrol pump workers of selected petrol pumps in Bangalore. METHODOLOGY: This cross-sectional study was conducted among 158 petrol pump workers from 11 selected pumps in Bengaluru. Following IEC approval, the baseline socio-demographic data, knowledge regarding respiratory morbidities and current morbidity pattern were ascertained. Medical examination and Peak Expiratory Flow rate (PEFR) was estimated. RESULTS: The 158 workers were all male, mostly between 18-27 years (65.19%) and high school educated (49.37%). Knowledge regarding respiratory morbidities was 56%, while prevalence of respiratory morbidity was 61%. Those workers who had completed their higher education (>10th standard), earning monthly income (>Rs. 5000) had better knowledge regarding respiratory morbidities. RECOMMENDATION: Pre-employment and regular medical examination including lung function tests and promotion of use of PPEs to be implemented.

Prevalence and correlates of burnout in health professionals in Ecuador.

BACKGROUND: Although burnout is a widespread phenomenon among healthcare professionals, there are no studies about its prevalence in Ecuador. This study assesses the prevalence of burnout syndrome among Ecuadorian healthcare professionals and examine the relationship with their personal and organizational characteristics. METHODS: A total of 2404 healthcare professionals (average age 40.0years; 68.4% women) from the capitals of all 24 provinces in Ecuador participated in this study. Trained psychologists assessed the presence of burnout by applying the Maslach Burnout Inventory. Sociodemographic variables, emotional distress, social support and coping styles as well as organizational variables were also collected. RESULTS: Of all healthcare professionals surveyed, 2.6% presented burnout syndrome. By dimensions, 17.2% of the participants presented a high level of emotional exhaustion, 13.5% of depersonalization, and 18.2% had reduced personal accomplishment. Being non-mestizo, being classified as a probable case of mental disorder and using more passive coping were associated with a greater probability of presenting burnout; having >10years of experience was associated with a lower probability of burnout. CONCLUSIONS: A significant number of active health professionals suffer from burnout. It is necessary to develop effective psychotherapeutic interventions for those who have the syndrome and to evaluate potential prevention strategies in those who have not yet developed it.

Art of publication and selection of journal.

Publication is both an art and a science. For the beginner, not knowing the intricacies of publication, choice of subject and the appropriate journal to get their work published are major obstacles. In this article, the authors share their experience on how to go about getting an article published and selecting the most suitable journal for publication. They hope this article stimulates medical writing.

Stimulation of serotonin 2A receptors facilitates consolidation and extinction of fear memory in C57BL/6J mice.

Excessive fear is a hallmark of several emotional and mental disorders such as phobias and panic disorders. Considerable attention is focused on defining the neurobiological mechanisms of the extinction of conditioned fear memory in an effort to identify mechanisms that may hold clinical significance for remediating aberrant fear memory. Serotonin modulates the acquisition and retention of conditioned emotional memory, and the serotonin 2A receptor (5HT2AR) may be one of the postsynaptic targets mediating such effects. Here we tested the hypothesis that the 5HT2AR regulates the consolidation and extinction of fear memory in male C57BL/6J mice. The influence of 5HT2ARs on memory consolidation was further confirmed with a novel object recognition task. With a trace fear conditioning paradigm, administration of the 5HT2AR agonist TCB-2 (1.0 mg/kg, i.p.) before the extinction test facilitated the acquisition of extinction of fear memory as compared to vehicle treatment. In contrast, administration of the 5HT2AR antagonist MDL 11,939 (0.5 mg/kg, i.p.) delayed the acquisition of extinction of fear memory. Further, the post-conditioning administration of TCB-2 enhanced contextual and cued fear memory, possibly by facilitating the consolidation of fear memory. Administration of TCB-2 also facilitated the acquisition of extinction of fear memory in delay fear conditioned mice. Stimulation or blockade of 5HT2ARs did not affect the encoding or retrieval of conditioned fear memory. Finally, administration of TCB-2 right after training in an object recognition task enhanced the consolidation of object memory. These results suggest that stimulation of 5HT2ARs facilitates the consolidation and extinction of trace and delay cued fear memory and the consolidation of object memory. Blocking the 5HT2AR impairs the acquisition of fear memory extinction. The results support the view that serotonergic activation of the 5HT2AR provides an important modulatory influence on circuits engaged during extinction learning. Taken together these results suggest that the 5HT2AR may be a potential therapeutic target for enhancing hippocampal and amygdala-dependent memory. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

Comparative testing of six antigen-based malaria vaccine candidates directed toward merozoite-stage Plasmodium falciparum.

Immunogenicity testing of Plasmodium falciparum antigens being considered as malaria vaccine candidates was undertaken in rabbits. The antigens compared were recombinant baculovirus MSP-1(19) and five Pichia pastoris candidates, including two versions of MSP-1(19), AMA-1 (domains I and II), AMA-1+MSP-1(19), and fused AMA-1/MSP-1(19)). Animals were immunized with equimolar amounts of each antigen, formulated in Montanide ISA720. The specificities and titers of antibodies were compared using immunofluorescence assays and enzyme-linked immunosorbent assay (ELISA). The antiparasite activity of immunoglobulin G (IgG) in in vitro cultures was determined by growth inhibition assay, flow cytometry, lactate dehydrogenase assay, and microscopy. Baculovirus MSP-1(19) immunizations produced the highest parasite-specific antibody titers in immunofluorescence assays. In ELISAs, baculovirus-produced MSP-1(19) induced more antibodies than any other single MSP-1(19) immunogen and three times more MSP-1(19) specific antibodies than the AMA-1/MSP-1(19) fusion. Antibodies induced by baculovirus MSP-1(19) gave the highest levels of growth inhibition in HB3 and 3D7 parasite cultures, followed by AMA-1+MSP-1(19) and the AMA-1/MSP-1(19) fusion. With the FCR3 isolate (homologous to the AMA-1 construct), antibodies to the three AMA-1-containing candidates gave the highest levels of growth inhibition at high IgG concentrations, but antibodies to baculovirus MSP-1(19) inhibited as well or better at lower IgG concentrations. The two P. pastoris-produced MSP-1(19)-induced IgGs conferred the lowest growth inhibition. Comparative analysis of immunogenicity of vaccine antigens can be used to prioritize candidates before moving to expensive GMP production and clinical testing. The assays used have given discriminating readouts but it is not known whether any of them accurately reflect clinical protection.

Acquired Blaschkoid dermatitis.

Acquired Blaschkoid dermatitis characterised by unilateral relapsing inflammatory disease along the lines of Blaschko. A 40-year-old Indian male presented with unilateral erythematous, itchy grouped papules on the left side of the chest, abdomen, back and left arm of 15 days duration. The eruption stopped abruptly at the midline of the torso, completely sparing the right side of the body. The lesions were arranged in whorls and streaks corresponding to the lines of Blaschko. Skin biopsy showed hyperkeratosis and features suggestive of sub-acute spongiotic dermatitis with lymphocytic infiltrate around the blood vessels in the dermis. Patient was diagnosed as a case of Blaschkoid dermatitis. To the best of our knowledge, this is the first case of this condition being reported from India.

Ehlers Danlos syndrome in two siblings.

Two cases of Ehlers-Danlos syndrome affecting two real brothers are being reported. Both of them presented with features of atrophy and hyperextensibility of skin, hypermobility of joints and scarring at the sites of trauma. The elder brother also had kyphoscoliosis and hypogonadism with testicular failure.

Purification and characterization of N-glycolyneuraminic-acid-specific lectin from Scylla serrata.

A sialic-acid-binding lectin with specificity for N-glycolylneuraminic acid (NeuGc) was purified from the hemolymph of the marine crab Scylla serrata by affinity chromatography using thyroglobulin-coupled agarose. The binding specificity of Scylla lectin distinguishes it from other known sialic-acid-specific lectins found in Limulus polyphemus and Limax flavus, which show a broader range of specificity for sialic acids. The molecular mass of the purified lectin is about 55 kDa. Under reducing conditions (SDS/PAGE), it resolved into two subunits of 30 kDa and 25 kDa. NeuGc inhibited hemagglutination activity of the purified lectin at a concentration as low as 0.6 mM, whereas N-acetylneuraminic acid (NeuAc) even at a concentration of 100 mM, failed to inhibit hemagglutination. This finding was supported by potent inhibition of hemagglutination by bovine and porcine thyroglobulins, which contain a NeuGc alpha 2-6Gal as terminal component of oligosaccharide residues. Neither glycoproteins (glycophorin NN; porcine submaxillary mucin), which contain NeuAc alpha 2-3Gal/GalNAc and NeuAc alpha 2-6GalNAc, nor human acid glycoprotein, which contains NeuAc alpha 2-3/alpha 2-6 Gal, or colominic acid, a sialopolymer with NeuAc alpha 2-8NeuAc, inhibited the lectin activity. The specificity of the lectin for NeuGc appears to account for the fact that it agglutinates rabbit and mice erythrocytes, but not human A, O, AB, rat or chicken erythrocytes, which contain NeuAc. The inability of the lectin to agglutinate erythrocytes (horse) that prominently express NeuGc could be due to O-acetylation of NeuGc. In support of this, bovine submaxillary mucin, which contains O-acetylated NeuGc inhibited the hemagglutination of the lectin better after removal of O-acetyl groups by base treatment. The unique specificity of Scylla lectin is of diagnostic potential for human cancer tissues expressing NeuGc, since NeuGc is not found in normal human tissues.

An agglutinin with unique specificity for N-glycolyl sialic acid residues of thyroglobulin in the hemolymph of a marine crab Scylla serrata (Forskal).

A novel agglutinin with specificity for sialic acid sequence of sugars in thyroglobulin is identified in the hemolymph of Scylla serrata. The physico-chemical characteristics of its binding affinity, such as pH and temperature optima, and cationic requirements are defined. N-glycolyl neuraminic acid (NeuGc) (at 0.6 mM), in contrast to N-acetyl neuraminic acid (NeuAc) (at greater than 5.0 mM), is the potent inhibitor of hemagglutination. Bovine and porcine thyroglobulins containing NeuGc, inhibited the agglutination. NeuGc-acid glycoprotein fraction (bovine) but not NeuAc-acid glycoprotein fraction (human) inhibited the hemagglutination. The inability of other NeuGc-glycoproteins (bovine submaxillary mucin) to inhibit the agglutination suggests that the agglutinin may also recognize glycosidic linkage associated with NeuGc. The potential of the agglutinin in identifying NeuGc containing human tumor associated antigens is discussed.