An Autopsy Case of ß-Thalassemia Major Illuminating the Pathological Spectrum of the Disease.

Despite declining rates worldwide, autopsy studies remain invaluable tools to expand existing knowledge on the pathophysiology of diseases, especially those with multisystem involvement. ß-thalassemia major (ß-TM) is a relatively common hemoglobinopathy in India and is characterized by a regular requirement for life-sustaining transfusions and chelation. The iron overload is an invariable side effect. This secondary hemosiderosis leads to several complications, primarily in the heart, liver, pancreas, and endocrine organs. Despite adequate transfusion and chelation, untransplanted patients may show early mortality for several reasons. We report a 10-year-old boy with ß-TM who died with clinical possibilities of iron overload-related cardiac failure and pulmonary arterial hypertension. His autopsy revealed certain unique disease pathologies in the form of minimal cardiac fibrosis in the presence of significant cardiac siderosis and widespread endocrine damage due to iron-overload. A null-cell pituitary microadenoma, previously undescribed in thalassemia syndromes, was found. This report highlights the importance of the diminishing art of autopsy, without which these histopathological insights would not have emerged.

Practices and knowledge regarding dengue infection among the rural community of Haryana.

BACKGROUND: The dengue infection has become a major global public health problem and 40% of the world's population living in an area at risk for dengue and causing nearly 400 million infections every year. There is no specific treatment for dengue, but if there is proper case management then case fatality rates can be below 1%. AIM AND OBJECTIVES: To study the knowledge and practice about dengue fever in a rural community of Haryana. METHODOLOGY: The study recruited 400 adults (15-60 years) and all subjects were selected randomly from survey registers of eight anganwadi centres and data was collected by visiting house to house. RESULTS: The association between demographic variables and knowledge about dengue fever and found out that only caste wise and socio-economic wise were found to be statistically significant rest associations were found to be statistically non-significant. CONCLUSION AND RECOMMENDATIONS: There is a need of hour to make rural people aware of symptoms of DF and different preventive methods through mass media like television, newspapers, internet, social media etc or audio visual aids or through primary care physician.

Relationship of physical activity with body image, self esteem sedentary lifestyle, body mass index and eating attitude in adolescents: A cross-sectional observational study.

AIM: To Study Relationship of physical activity (PA) with body image, self-esteem, body mass index (BMI), sedentary lifestyle and eating attitude in adolescents. METHODS: An observational cross-sectional study done at the Centre for Adolescent Health, Kalawati Saran Children Hospital, Lady Hardinge Medical College, New Delhi, India. Volunteering adolescents between the age group of 13 and 18 years were included and assessed using PA questionnaire for adolescents Score, Body Shape Questionnaire-34 Score, Rosenberg self esteem Score, adolescent sedentary activity questionnaire score, eating attitude test (EAT-26) and BMI Z-score. Relationship of these scales to various parameters was assessed using correlation and regression. RESULTS: A total of 191 boys and girls were included in the study; 25% had underweight, 75% were normal (only 1 child had overweight and none had obesity). Three fourth (77%) of the children had low PA. The girls were relatively more inactive (83.9% girls vs. 72.1%boys). Most (90.05%) subjects did not have any concerns related to body image. Almost all the subjects had normal or high self esteem. Nearly one quarter of the subjects (23.56%) had disordered eating behaviours. Multiple regression found the PA is positively dependent on EAT 26 score and adolescent sedentary activity questionnaire (ASAQ) score (sedentary score) in girls, whereas in males ASAQ (sedentary score) score was only variable related to physical activity questionnaire for adolescents score (PAQ-A). CONCLUSION: Normal weight and underweight adolescents had minimal PA and despite this, almost all had normal self-esteem and body image. PA was significantly related to eating and sedentary behaviours.

Complementary and Alternative Medicine: A Cross-Sectional Observational Study in Pediatric Inpatients.

The aim was to study the prevalence of complementary and alternative medicine use in acutely sick hospitalized children and factors associated with it. This is a cross-sectional, hospital-based study in a tertiary care center of Delhi, India. Children admitted to a pediatric unit during the study period were assessed using a specially designed questionnaire. Out of the total 887 admitted children, 161 (18.1%) were using complementary and alternate medicine in one form or another. Of these, 113 (70.2%) were using complementary and alternate medicine for the current illness directly leading to admission and the remaining 48 (29.8%) had used complementary and alternate medicine in past. The common complementary and alternate medicine use observed in our study was combined ayurveda and spiritual approach (25.5%), ayurveda (24.8%), spiritual (21.7%), homeopathic (13%), and 47.2% of children were using spiritual approach in form of Jhada (tying piece of cloth on arm or leg or keeping a knife by the side of child). The significant factors associated with complementary and alternate medicine use were younger age, female gender, and father being employed. Complementary and alternate medicine is commonly used even in acutely sick children.

Community perception about swine flu in an urban slum of Haryana: A cross-sectional study.

BACKGROUND: Swine flu caused by influenza virus and it's a respiratory disease of pigs. The people like farmers and pork processors working in close proximity with pigs are at higher risk of getting swine flu. In India, a total of 117 deaths and 1,154 cases have been reported in the first two months of year 2018. OBJECTIVES: To assess the community perception about Swine flu among adults in an urban slum of District Rohtak. METHODOLOGY: The study was a community based epidemiological study with cross-sectional design and carried out by visiting house to house. The study recruited 500 adults of age 18-60 years. RESULTS: The study found that there was no significant difference between gender and age with heard of swine flu while education wise (p= 0.002) and caste wise (p=0.011) awareness of swine flu was found to be statistically significant. CONCLUSION AND RECOMMENDATION: The study concluded that the majority of subjects heard about swine flu and majority of subjects said that swine flu spread after coughing or sneezing. The study recommends that health care functionaries should spread awareness about signs and symptoms of swine flu.

Pediatrician's cough and cold medication prescription for hypothetical cases - A cross-sectional multi-centric study.

BACKGROUND: Concerns over inappropriate use of cough and cold medication (CCM) in children have been raised. In addition to being ineffective, these are now considered toxic for young children. Despite this fact studies from some regions have shown high use of these medications by physicians. However data on pediatricians and from India are negligible. AIM: To study the burden and patterns of cough and cold medications use by pediatricians for hypothetical cases. METHODS: In this cross-sectional study; 172 pediatricians of various hospitals of Delhi and Haryana were enrolled from February 15 to March 15, 2012. They were contacted personally by authors and asked to write their prescriptions for two hypothetical case scenarios [having cough and cold] of two different age groups; (1) less than 2 years and (2) 2-5 years. We made two categories as recommendations exist for children less than 2 years while recommendations for the second category are underway. RESULTS were summarized as percentages, counts and; presented in tables and figures. Chi square test was used to establish association between categorical variables of subgroups. RESULTS: Response rate was 93%. The most used CCM was antihistaminics (82%) and systemic sympathomimetics (48%). The use of CCM was significantly less in teaching hospitals as compared to non-teaching (77% vs. 95%; p-value - 0.025). However there was no statistical difference in the practice of post graduates and more senior pediatricians (p value-0.895). No difference in CCM use in two age groups {(82% (less than 2 years) vs. 85% (2-5 years); p-value - 0.531} was observed. CONCLUSION: Overall use of CCM is still high irrespective of patient age, pediatrician's seniority or hospital setting. Efforts should be made to create awareness among the pediatricians regarding cautious use of these medications.

Vaccination during pregnancy: Today's need in India.

Immunization during pregnancy is a simple and effective way to protect the mother and child from certain infections. The immunological changes occur during pregnancy which may be responsible for the susceptibility of certain infectious diseases that increases the risk of more serious outcomes. Vaccination of pregnant women can protect to mother against vaccine-preventable infections, and in so doing potentially protect the fetus. Immunization during pregnancy can also directly protect the fetus and infant via transferred of antibodies from the mother to the fetus. This is why vaccinations during pregnancy are so important. Vaccination during pregnancy is a cost-effective strategy to improve pregnancy outcomes in India. Globally, no scientific study exist which shows the risk of fetus after vaccination of pregnant women with inactivated vaccines or bacterial vaccines or toxoids. Even live vaccines causing risk to fetus is theoretical. Vaccination with inactivated virus, bacterial or toxoid in pregnancy is risk to a developing fetus during pregnancy is theoretical. But definitely the live vaccine poses a theoretical risk to a developing fetus. Therefore, all live vaccines should be avoided during pregnancy. The developing country like India where the people can't afford these vaccines, the government should be included these vaccines in routine immunization program.

HIV vaccine: Can it be developed in the 21st century?

HIV infection is a major public health problem especially in the developing countries. Once a person infects with HIV, it remained infected for lifelong. The advanced stage developed after 10-15 y of HIV infection that stage is called acquired immunodeficiency syndrome (AIDS). From 1990 to 2000 the number of people living with HIV rose from 8 million to 27 million; since the beginning of the HIV/AIDS epidemic, AIDS has claimed almost 39million lives so far. Till now, there is no cure for HIV infection; however, after the introduction of effective treatment with antiretroviral (ARV) drugs the HIV individual can enjoy healthy and productive lives. Vaccine is safe and cost-effective to prevent illness, impairment, disability and death. Like other vaccines, a preventive HIV vaccine could help save millions of lives. All vaccines work the same way i.e. the antigen stimulate the immune system and develop antibodies. The ultimate goal is to develop a safe and effective vaccine that protects people worldwide from getting infected with HIV. However, some school of thought that vaccine may protects only some HIV people, it could have a major impact on the rates of transmission of HIV and this will help in control of epidemic, especially in populations where high rate of HIV transmission. In the past, some scientist doubted on the development of an effective polio vaccine, but now we are near to eradicate the polio from the world this is possible because of successful vaccination programmes. HIV vaccine research is aided by the not-for-profit International AIDS/HIV vaccine Initiative (IAVI), which helps to support and coordinate vaccine research, development, policy and advocacy around the world. Although the challenges for scientist are intimidating but scientists remain hopeful that they can develop safe and effective HIV vaccines for patients in future.