Socio demographic determinants of violence among school-going adolescent girls in a rural area of North India: A cross-sectional study.

Background: The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life".[1] Violence can take many forms, including physical, sexual or emotional and varies in its severity. Gender discrimination, norms and practices mean that adolescent girls are likely to experience certain forms of violence, such as sexual violence, at much higher rates than boys. Methods: This cross-sectional study was conducted in a rural block of North India. A total of 500 adolescent girls in the age group of 13-19 years studying in class VIII to class XII in 10 government and private senior secondary schools of the Lakhanmajra block were included in the study. A pre-designed pre-tested semi-structured interview schedule was used. Results: In this study, we found the prevalence of physical, sexual and emotional violence among adolescent girls as 6.6, 5.4 and 5.2%, respectively. The most frequent perpetrator of physical violence was the parent and of sexual violence was the neighbour followed by friends or relatives. Higher emotional violence was experienced by adolescent girls from middle-class families (P < 0.05). The prevalence of physical violence among adolescent girls was maximum in the younger age group 13-14 years (10.2%), followed by 15-17 years (4.0%). This association was found statistically significant (P < 0.05). Conclusions: There are several restrictions on free communication about violence-related topics in our highly conservative society. Blaming the victim is the rule rather than the exception and sexual abuse is usually linked to a loss of virginity and family honour in our patriarchal society. Hence, girls may be more reluctant to disclose their experience of violence.

Studying the result of underlay myringoplasty using platelet-rich plasma.

OBJECTIVE: Perforations of the tympanic membrane are treated with various surgical techniques and materials. This study aimed to determine the efficacy of platelet-rich plasma during underlay myringoplasty. METHODS: The study included 40 patients. Autologous platelet-rich plasma was applied in-between temporalis fascia graft and tympanic membrane remnant during underlay myringoplasty in group 1 (n = 20). The outcome was evaluated after three months and compared with group 2 (n = 20), a control group that underwent routine underlay tympanoplasty. RESULTS: After three months' follow up, graft uptake was 95 per cent in group 1 and 85 per cent in group 2 (p < 0.03). Mean hearing threshold gain was 18.62 dB in group 1 and 13.15 dB in group 2. This difference was statistically significant (p < 0.01). CONCLUSION: Platelet-rich plasma, with its ease of preparation technique, availability, low cost, autologous nature and good graft uptake rate, justifies its use in tympanoplasty type I procedures.

Interim estimates of the effectiveness of influenza vaccination against influenza-associated hospitalization in children in Hong Kong, 2015-16.

From 1 September 2015 through 31 January 2016, we enrolled 2068 children 6 months to 17 years of age admitted to hospital with a febrile acute respiratory infection in our test-negative study. Information on receipt of 2015-16 northern hemisphere inactivated influenza vaccination was elicited from parents or legal guardians. Using conditional logistic regression adjusting for age and matching on calendar time, we estimated influenza vaccine effectiveness against hospitalization with influenza A or B to be 79.2% (95% confidence interval: 42.0%-92.4%). Annual influenza vaccination should be more widely used in children in Hong Kong.

The Dynamic Relationship Between Clinical Symptomatology and Viral Shedding in Naturally Acquired Seasonal and Pandemic Influenza Virus Infections.

BACKGROUND: Although the pattern of viral shedding over time has been documented in volunteer challenge studies, understanding of the relationship between clinical symptomatology and viral shedding in naturally acquired influenza infections in humans remains limited. METHODS: In a community-based study in Hong Kong from 2008 to 2014, we followed up initially healthy individuals and identified 224 secondary cases of natural influenza virus infection in the household setting. We examined the dynamic relationship between patterns of clinical symptomatology and viral shedding as quantified using reverse transcription polymerase chain reaction and viral culture in 127 cases with a clinical picture of acute respiratory infection. RESULTS: Viral shedding in influenza A virus infections peaked on the first 1-2 days of clinical illness, and decreased gradually to undetectable levels by day 6-7, matching closely with the dynamics of clinical illness. Viral shedding in influenza B virus infections rose up to 2 days prior to symptom onset and persisted for 6-7 days after onset with a bimodal pattern. CONCLUSIONS: Our results suggest that while clinical illness profiles may serve as a proxy for clinical infectiousness in influenza A virus infections, patients may potentially be infectious even before symptom onset or after clinical improvement in influenza B virus infections.

Reproductive risk factors associated with breast carcinoma in a tertiary care hospital of north India: A case-control study.

Context: Worldwide, breast cancer is the most common cancer among women. In India and other developing countries, breast carcinoma ranks second only to cervical carcinoma among women. But the incidence of breast cancer is on the rise and may become number one cancer in females in near future. Aims: (1) To find out the magnitude of reproductive risk factors of carcinoma breast among the study subjects; and (2) to find out the association of reproductive risk factors with breast carcinoma. Materials and Methods: The study was done in the wards of General Surgery and Oncosurgery from August 2009-July 2010 in a tertiary care institute. A total of 128 histopathologically confirmed cases of breast cancer those came in this duration were considered. Equal controls were selected by simple random sampling by lottery method. The controls were matched for age with a range of ± 2 years. The subjects were interviewed using a pre-tested questionnaire. Written informed consent was taken from study subjects before starting the interview. Statistical Analysis Used: Chi-square test, odds ratio with 95% confidence interval, and t test. Results: The age group of the cases was 25-78 years, whereas that of the controls was 24-79 years. The difference among cases and controls regarding age at marriage, age at menarche, age at menopause, age at first pregnancy, and number of children was statistically significant. Continuous variables of the study population were analyzed by independent t tests, in which age at menarche and age at first pregnancy were found statistically significant. Conclusions: Information, education, and communication activities regarding risk factors and breast self-examination should be imparted to the women to create awareness about this fatal disease.

Adenovirus respiratory infection in hospitalized children in Hong Kong: serotype-clinical syndrome association and risk factors for lower respiratory tract infection.

Lower respiratory tract infections (LRTI) caused by adenovirus can be severe with resultant chronic pulmonary sequelae. More than 50 serotypes have been recognized; however, the exact association of serotype with clinical phenotype is still unclear. There have been no reports on the adenovirus serotype pattern in Hong Kong, and their relationships with disease manifestations and complications are not known. Clinical and epidemiological data on 287 children (<6 years old) admitted with adenovirus respiratory infections from 2001 to 2004 were reviewed. Common presenting symptoms included fever (97.9 %) and cough and rhinitis (74 %). Extra-pulmonary manifestations were present in 37.3 %. The clinical picture mimicked bacterial infection for its prolonged high fever and neutrophilic blood picture. Forty-two patients (14.6 %) had LRTI, either pneumonia or acute bronchiolitis, but none had severe acute respiratory compromise. Children aged 1 to 2 years old were most at risk for adenovirus LRTI (adjusted p = 0.0165). Serotypes 1 to 7 could be identified in 93.7 % of the nasopharyngeal specimens, with serotypes 2 and 3 being the most prevalent. Different serotypes showed predilection for different age groups and with different respiratory illness association. The majority of acute bronchiolitis (71.4 %) were associated with serotype 2 infection, and this association was statistically significant (p < 0.0001). Serotype 3 infection accounted for over half of the pneumonia cases (57-75 %) in those aged 3-5 years old. Only one patient developed mild bronchiectasis after serotype 7 pneumonia. Children aged 1 to 2 years old were the at-risk group for adenovirus LRTI, but respiratory morbidity was relatively mild in our locality. There was an apparent serotype-respiratory illness association.

Systems-level comparison of host responses induced by pandemic and seasonal influenza A H1N1 viruses in primary human type I-like alveolar epithelial cells in vitro.

BACKGROUND: Pandemic influenza H1N1 (pdmH1N1) virus causes mild disease in humans but occasionally leads to severe complications and even death, especially in those who are pregnant or have underlying disease. Cytokine responses induced by pdmH1N1 viruses in vitro are comparable to other seasonal influenza viruses suggesting the cytokine dysregulation as seen in H5N1 infection is not a feature of the pdmH1N1 virus. However a comprehensive gene expression profile of pdmH1N1 in relevant primary human cells in vitro has not been reported. Type I alveolar epithelial cells are a key target cell in pdmH1N1 pneumonia. METHODS: We carried out a comprehensive gene expression profiling using the Affymetrix microarray platform to compare the transcriptomes of primary human alveolar type I-like alveolar epithelial cells infected with pdmH1N1 or seasonal H1N1 virus. RESULTS: Overall, we found that most of the genes that induced by the pdmH1N1 were similarly regulated in response to seasonal H1N1 infection with respect to both trend and extent of gene expression. These commonly responsive genes were largely related to the interferon (IFN) response. Expression of the type III IFN IL29 was more prominent than the type I IFN IFNß and a similar pattern of expression of both IFN genes was seen in pdmH1N1 and seasonal H1N1 infection. Genes that were significantly down-regulated in response to seasonal H1N1 but not in response to pdmH1N1 included the zinc finger proteins and small nucleolar RNAs. Gene Ontology (GO) and pathway over-representation analysis suggested that these genes were associated with DNA binding and transcription/translation related functions. CONCLUSIONS: Both seasonal H1N1 and pdmH1N1 trigger similar host responses including IFN-based antiviral responses and cytokine responses. Unlike the avian H5N1 virus, pdmH1N1 virus does not have an intrinsic capacity for cytokine dysregulation. The differences between pdmH1N1 and seasonal H1N1 viruses lay in the ability of seasonal H1N1 virus to down regulate zinc finger proteins and small nucleolar RNAs, which are possible viral transcriptional suppressors and eukaryotic translation initiation factors respectively. These differences may be biologically relevant and may represent better adaptation of seasonal H1N1 influenza virus to the host.

Rhinovirus infection in hospitalized children in Hong Kong: a prospective study.

OBJECTIVES: To analyze the clinical features and estimate the hospitalization disease burden of rhinovirus infection in children in Hong Kong. METHODS: In this prospective study, nasopharyngeal aspirates were taken from children aged <18 years with symptoms of acute respiratory infection admitted to Queen Mary Hospital on one fixed day of the week during August 2001-July 2002 for detection of common respiratory viruses by immunofluorescence, viral culture, and for rhinovirus, human metapneumovirus, and coronaviruses by reverse transcription polymerase chain reaction. The clinical features of rhinovirus infections were analyzed and hospitalization disease burden was estimated. RESULTS: Altogether 239 of the 426 nasopharyngeal aspirates (56.1%) were positive for respiratory viruses, including 151 patients with rhinovirus (35.4%). The median age was 2.34 years. Upper respiratory infection, asthma exacerbation, pneumonia, and acute bronchiolitis were diagnosed in 44.4%, 19.9%, 11.3%, and 7.9%, respectively. The most common symptoms were cough (81.5%), runny nose (76.8%), and fever (68.9%). Shortness of breath, wheezes, and crepitation were present in 25.8%, 29.1%, and 18.5%, respectively. Fifty-five of 99 patients (55.6%) had chest radiographic abnormalities, most commonly perihilar streakiness. Children with chronic diseases were more likely to have lower respiratory tract infection and these children required longer hospitalization (mean 0.6 days longer). Coinfection with other respiratory pathogens was common (33.1%). CONCLUSION: Rhinovirus is frequently associated with asthmatic exacerbations and lower respiratory tract infection, especially in children with chronic diseases and is potentially an important contributor to hospitalization in children in Hong Kong.

Risk for infection with highly pathogenic influenza A virus (H5N1) in chickens, Hong Kong, 2002.

We used epidemiologic evaluation, molecular epidemiology, and a case-control study to identify possible risk factors for the spread of highly pathogenic avian influenza A virus (subtype H5N1) in chicken farms during the first quarter of 2002 in Hong Kong. Farm profiles, including stock sources, farm management, and biosecurity measures, were collected from 16 case and 46 control chicken farms by using a pretested questionnaire and personal interviews. The risk for influenza A (H5N1) infection was assessed by using adjusted odds ratios based on multivariate logistic regression analysis. Retail marketing of live poultry was implicated as the main source of exposure to infection on chicken farms in Hong Kong during this period. Infection control measures should be reviewed and upgraded as necessary to reduce the spread of influenza A (H5N1) related to live poultry markets, which are commonplace across Asia.

Study of STD pattern and its associated risk factors--a hospital study.

This study was conducted to know the STD prevalence and its associated risk factors among patients attending STD clinic of Govt using cross sectional hospital based data collected on 255 patients visited STD clinic during Jan. 2005- Dec.2005. Results suggested that highest prevalence found was of Herpes genitalis (31.8%), followed by Venereal warts (25.1%), Gonorrhoea (11.0%), Syphilis (10.6%). The most commonly associated risk factor found to be multiple sexual partners followed by factor as visit to prostitutes. Since most diseases are of social nature, IEC activities to improve the awareness in the community about STDs and about risk factors associated with them should bring behaviour related risk taking among people spreading STDs in the community.

Infants born to mothers with severe acute respiratory syndrome.

Severe acute respiratory syndrome (SARS) is a newly discovered infectious disease caused by a novel coronavirus. During the community outbreak in Hong Kong, 5 liveborn infants were born to pregnant women with SARS. A systematic search for perinatal transmission of the SARS-associated coronavirus, including serial reverse transcriptase-polymerase chain reaction assays, viral cultures, and paired serologic titers, failed to detect the virus in any of the infants. In addition, none of the infants developed clinical, radiologic, hematologic, or biochemical evidence suggestive of SARS. One preterm infant developed jejunal perforation and another developed necrotizing enterocolitis with ileal perforation shortly after birth. This case series is the first report to describe the clinical course of the first cohort of liveborn infants born to pregnant women with SARS.

Health education at PHC level -- status and strategies.

PIP: The Government of India's National Health Policy emphasizes the importance of health education programs to primary health care. Implementation of this strategy was evaluated through both quantitative and qualitative methods among 32 multipurpose health workers, 5 health supervisors, 60 anganwadi workers, 32 adult education instructors, 73 school teachers, and 10 women's groups in Haryana, India. Despite the official emphasis on health education, this function is not included in the job descriptions of health workers, training is not provided, and locally relevant IEC materials are not available or distributed. Home visits focus mainly on family planning, deliveries, and malaria and rarely include a health education component. Management of health education is the responsibility of the Block Extension Educator, who failed to distribute many IEC materials or conduct training activities. 62.5% of health workers indicated they used IEC materials only once a month. Moreover, monitoring of health education activities was sporadic and incomplete. Work plans emphasize physical targets (i.e., number of meetings) rather than the quality of educational interventions. No operations research studies were conducted. Overall, these findings suggest a need for integration of health care delivery and communication activities, training of health workers in health education techniques, field evaluation of IEC materials, establishment of a system to provide field workers with feedback on their work, and greater use of mothers' groups and school-based programs for interpersonal communication.^ieng

Empowering young girls for health and development.

Yuvati Vikas Kendra (YVK) model of empowering young girls in the age bracket of 7-19 years could raise the level of awareness and generate self-esteem and self-confidence in over 50% of young girls over a period of six months of operation. The YVK model was utilised by 37-55% of enrolled girls in different age brackets; thus these centres functioned well below their installed capacity. Functional inter-sectoral linkages have to be developed for better impact and better coverage. Data based information from other models of empowerment such as schools, non-formal system of education and Integrated Child Development Services Scheme, is called for to choose different alternatives for our country, as no uniform system can succeed in this vast country. Diversified modes and approaches for empowerment of young girls are needed.