Morbidity profile of under-5 slum dwellers of Amritsar city: A descriptive cross-sectional study.

CONTEXT: Children living in slums are deprived from basic necessities. Unhygienic environment and deficient nutrition hinder their growth and make them more prone to infectious diseases. AIMS: To study morbidity profile of under-5 children and determine social epidemiological factors associated with it. SETTINGS AND DESIGN: A descriptive cross-sectional study in urban slums of district Amritsar. METHODS AND MATERIAL: In total, 400 households each from four slums (1600 in total) were randomly selected. One to one interview with mother of each under 5 was conducted and information was recorded on pretested performa. Height and weight with haemoglobin estimation was done for each child. STATISTICAL ANALYSIS USED: Descriptive statistics (frequencies and proportions) and univariate logistic regression was applied to determine factors associated with under nutrition. RESULTS: Out of 1136 under-5, 50, 45 and 8% were stunted, underweight and wasted. Severe malnutrition was seen among 23%. In total, 79% had anaemia. About 69% suffered from one or more infectious disease in last 3 months. Anaemia, birth order >2, lower socio-economic status and suffering from any infectious disease in last 3 months were associated with malnutrition. CONCLUSIONS: Severe malnutrition and anaemia was high among under-5 of urban slums and 69% suffered from infectious disease in last 3 months emphasizing on addressal of health needs of under-5 residing in urban slums.

Experimental measurement of effective atomic numbers and albedo factors for some alloys using the backscattering technique.

Alloys of the type Pb60Sn20ZnxCd(20-x) where x = 0, 5, 10, 15 or 20 were prepared by a conventional melt quench technique. The intensity distribution of backscattered photons from the radioactive isotopes 22Na and 137Cs (with photon energies of 511 keV and 662 keV, respectively) were recorded for different thicknesses of alloy samples and some metallic samples (Al, Zn, Sn and Pb) with use of a GAMMA-RAD5 spectrometer (76 mm × 76 mm NaI(Tl) scintillation detector). Backscattered photon intensities were plotted as a function of both the atomic number and the target thickness. A best fit curve was drawn between backscattered photon counts and the atomic number of the metallic samples, from which the effective atomic numbers (Zeff) of the alloys were obtained at a particular photon energy as well as thickness. The experimentally obtained Zeff values are in good agreement with the theoretical ones (based on mass attenuation coefficients from the WinXCom database). The plot of intensity versus thickness shows that the intensity of backscattered photons increases with sample thickness. The albedo factors (energy albedo, number albedo and dose albedo) were also determined experimentally at these photon energies for the alloys and metallic samples. In the Compton scattering dominant region, the albedo factors decrease with an increase in atomic number as well as with an increase in photon energy.

Gamma radiation shielding properties of some Bi-Sn-Zn alloys.

We investigate the gamma radiation shielding properties of some Bi-Sn-Zn alloys. For this study, we synthesised five bismuth-based lead-free alloy samples using the melt quench technique with the composition Bi50Sn[Formula: see text]Zn[Formula: see text] where [Formula: see text] Apart from physical parameters such as the weight, density, and thickness of the alloy samples, we estimated their optimum thickness range at photon energies of 122, 511, 662, and 1250 keV. The mass attenuation coefficients and effective atomic number, measured experimentally, were found to be in close agreement with values computed using WinXCom software, within a ± 4% error. From the transmitted photon spectra, the radiation protection efficiency (RPE) was determined and analysed for different alloy compositions. A correlation between RPE and effective atomic number was established at different photon energies. The Bi50Sn50 binary alloy composition is reported to exhibit maximum shielding efficiency.

Factors Associated with Physical and Psychosocial Problems among Indian Stroke Survivors.

BACKGROUND: Rehabilitative services in India are inadequate in dealing with the physical and psychosocial problems faced by stroke survivors. The present study assessed these problems and the associated sociodemographic factors. METHODS: Discharged stroke patients were interviewed at home. Logistic regression analysis assessed associations between patient variables and their problems. RESULTS: We interviewed 127 stroke patients. Patients with modified Rankin Scale score higher than 3 were more likely to have complaints of pain (odds ratio [OR] = 2.21, 95% confidence interval [CI] = 1.03-4.33), sleeping difficulties (OR = 2.78, 95% CI = 1.34-5.78), and feelings of hopelessness (OR = 2.92, 95% CI = 1.23-6.93). Patients aged 60 years or above were more likely to have feelings of helplessness (OR = 3.64, 95% CI = 1.23-10.75) and hopelessness (OR = 3.28, 95% CI = 1.02-10.54). Male patients were more likely to have feelings of hopelessness (OR = 2.88, 95% CI = 1.06-7.80). Patients residing in rural areas had higher odds of having thoughts of death (OR = 17.18, 95% CI = 1.98-153.93). Married patients were more likely to face difficulty in asking for help (OR = 4.39, 95% CI = 1.19-16.15) and preferred home-based care (OR = 3.95, 95% CI = 1.11-14.05). Patients educated above 2nd grade were more likely to have feelings of hopelessness (OR = 6.31, 95% CI = 2.17-17.29) and anger (OR = 3.35, 95% CI = 1.39-8.07). Employed patients were more likely to have feelings of helplessness (OR = 1.13, 95% CI = 1.03-8.54). CONCLUSIONS: Sociodemographic variables of stroke patients can predict their physical and psychosocial problems, which can help the health-care professionals optimize rehabilitation strategies. There is an urgent need of expert rehabilitative and palliative services in India.

Enhanced moisture sensing properties of a nanostructured ZnO coated capacitive sensor.

This work reports the enhancement in sensitivity of a simple and low-cost capacitive moisture sensor using a thin film of zinc oxide (ZnO) nanoparticles on electrodes. The ZnO nanoparticles are systematically characterized using X-ray diffraction, atomic force microscopy, transmission electron microscopy, BET surface area analysis, Fourier transform infrared spectroscopy, and UV-visible and photoluminescence (PL) spectroscopy. The average crystallite size of the ZnO nanoparticles is ∼16 nm with a surface roughness of ∼3 nm. Blue emission in the PL spectrum confirms the presence of oxygen vacancy dipoles, which are responsible for enhancing the dielectric properties of the ZnO nanoparticles. The effect of the ZnO nanoparticles on the sensitivity of a moisture sensor cell has been studied using wheat grains with a moisture content from 7% to 25%. An enhancement in sensitivity of 36.4% at 1 MHz and 97.4% at 500 Hz has been observed. A detailed sensing mechanism is proposed and the enhancement in sensing has been explained based on the interaction of ZnO with water vapor and the dielectric behavior of the nanostructured ZnO. The present results establish ZnO as a sensing material for improving the utility of moisture sensors.

Unilobar Versus Bilobar Biliary Drainage: Effect on Quality of Life and Bilirubin Level Reduction.

BACKGROUND: Percutaneous biliary drainage is an accepted palliative treatment for malignant biliary obstruction. PURPOSE: To assess the effect on quality of life (QOL) and bilirubin level reduction in patients with inoperable malignant biliary obstruction treated by unilobar or bilobar percutaneous transhepatic biliary drainage (PTBD). MATERIALS AND METHODS: Over a period of 2 years, 49 patients (age range, 22-75 years) of inoperable malignant biliary obstruction were treated by PTBD. Technical and clinical success rates, QOL, patency rates, survival rates, and complications were recorded. Clinical success rates, QOL, and bilirubin reduction were compared in patients treated with complete (n = 21) versus partial (n = 28) liver parenchyma drainage. QOL before and 1 month after biliary drainage were analyzed retrospectively between these two groups. RESULTS: Biliary drainage was successful in all 49 patients, with an overall significant reduction of the postintervention bilirubin levels (P < 0.001) resulting in overall clinical success rate of 89.97%. Clinical success rates were similar in patients treated with whole-liver drainage versus partial-liver drainage. Mean serum bilirubin level before PTBD was 19.85 mg/dl and after the procedure at 1 month was 6.02 mg/dl. The mean baseline functional score was 39.35, symptom scale score was 59.55, and global health score was 27.45. At 1 month, mean functional score was 61.25, symptom scale score was 36.0 4, and global health score was 56.33, with overall significant improvement in QOL (<0.001). There was a statistically significant difference in the improvement of the QOL scores (P = 0.002), among patients who achieved clinical success, compared with those patients who did not achieve clinical success at 1 month. We did not find any significant difference in the QOL scores in patients according to the amount of liver drained (unilateral or bilateral drainage), the type of internalization used (ring biliary or stent). Overall, minor and major complications rates were 14.3% and 8.1%, respectively. CONCLUSION: Percutaneous biliary drainage provides good palliation of malignant obstructive jaundice. Partial-liver drainage achieved results as good as those after complete liver drainage with significant improvements in QOL and reduction of the bilirubin level.

Impact of Health Education on The Knowledge, Attitude and Practices of Teachers Regarding Reproductive Health of Adolescents of Amritsar, Punjab.

CONTEXT: Teachers play an important role in guiding the adolescents. Adolescents are ill equipped to deal with the impending changes in their body which makes them vulnerable to STDs, HIV/AIDS and premarital sex. This study attempts to study the impact of reproductive health education on the knowledge, attitude and practices of teachers, about which only a few studies are available. AIMS: To study the impact of health education on the knowledge, attitude and practices of teachers regarding reproductive health of adolescents. SETTINGS: Senior Secondary schools of Amritsar and Department of Community Medicine, Government Medical College, Amritsar, Punjab, India. STUDY PARTICIPANTS: Male teachers of senior secondary schools of Amritsar teaching class 9th-12th. STUDY DESIGN: Educational intervention study. SAMPLING METHOD: Purposive sampling. MATERIALS AND METHODS: The study was started with 155 teachers (teaching class 9th -12th) who willingly participated from 50 senior secondary schools of Amritsar district. It was carried out in three phases. In first phase, after taking informed consent, the teachers filled a pretested questionnaire which was followed by an interactive session on reproductive health in second phase. In third phase, to study the impact of the interactive session and the sustainability of knowledge gained, they were again administered the same questionnaire after a period of 3 months. STATISTICAL ANALYSIS: Microsoft Excel, SPSS, Chi-square test. RESULTS: Maximum 74 (47.7%) teachers were aware of the psychosocial problems of adolescents. Majority 110 (71%) of the teachers had only partial knowledge about pubertal changes. 117 (75.5%) teachers were unaware about genital hygiene. Only 33 (21.3%) teachers had adequate knowledge about different STDs. 91 (58.7%) and 54 (34.8%) of teachers had adequate knowledge about routes of transmission and prevention of AIDS respectively. Only 37 (23.9%) teachers were imparting sex education to students. After intervention significant favorable changes were seen in their knowledge, attitude and practices regarding most of above mentioned topics. CONCLUSION: Although the baseline knowledge of teachers in most aspects of reproductive health of adolescents was found to be low, significant favourable changes were observed after health education.

Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21.

Indians undergoing socioeconomic and lifestyle transitions will be maximally affected by epidemic of type 2 diabetes (T2D). We conducted a two-stage genome-wide association study of T2D in 12,535 Indians, a less explored but high-risk group. We identified a new type 2 diabetes-associated locus at 2q21, with the lead signal being rs6723108 (odds ratio 1.31; P = 3.32 × 10⁻9). Imputation analysis refined the signal to rs998451 (odds ratio 1.56; P = 6.3 × 10⁻¹²) within TMEM163 that encodes a probable vesicular transporter in nerve terminals. TMEM163 variants also showed association with decreased fasting plasma insulin and homeostatic model assessment of insulin resistance, indicating a plausible effect through impaired insulin secretion. The 2q21 region also harbors RAB3GAP1 and ACMSD; those are involved in neurologic disorders. Forty-nine of 56 previously reported signals showed consistency in direction with similar effect sizes in Indians and previous studies, and 25 of them were also associated (P < 0.05). Known loci and the newly identified 2q21 locus altogether explained 7.65% variance in the risk of T2D in Indians. Our study suggests that common susceptibility variants for T2D are largely the same across populations, but also reveals a population-specific locus and provides further insights into genetic architecture and etiology of T2D.

Comparative studies of different concretes on the basis of some photon interaction parameters.

Different photon interaction parameters viz. linear attenuation coefficient, mass attenuation coefficient, penetration depth, equivalent atomic number, exposure buildup factor have been computed for seven different concretes (ordinary, hematite-serpentine, ilmenite-limonite, basalt-magnetite, ilmenite, steel-scrap and steel magnetite) in the energy region of 0.015-15.0MeV. The computed parameters were studied as a function of incident photon energy, chemical composition and penetration depth of the selected concretes. It has been observed that among the selected concretes, steel magnetite offers maximum value for linear attenuation coefficient, mass attenuation coefficient, equivalent atomic number and least values in terms of penetration depth equivalent to mean free path and exposure buildup factors. Hence, it is concluded that it offers better shielding among the selected concretes. It is expected that in case of any nuclear accident, the presented buildup factor data may be helpful in estimating the effective dose given to people living in buildings constructed from one of the selected concretes.

Task-oriented circuit class training program with motor imagery for gait rehabilitation in poststroke patients: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: The ability to walk is impaired in more than 80% of poststroke patients. The objective of the present study was to evaluate the effectiveness of the task-oriented circuit class training (TOCCT) with motor imagery (MI) on the gait during the subacute phase after a stroke. METHOD: This was a randomized, controlled, assessor-blinded trial in a neurology department of a university hospital. A convenience sample of 30 people, 4 to 12 weeks (mean, 6.3 weeks) after the stroke was randomized into 2 groups (the TOCCT with MI and standard training group) of 15 people each. Twenty-nine participants completed the 6-week follow-up. Participants were assigned to receive either the TOCCT with MI or dose-matched standard training program based on the Bobath's neurodevelopmental technique, 7 days a week for 2 weeks, as outpatients or inpatients. Outcome measures were the Functional Ambulation Classification (FAC), the Rivermead Visual Gait Assessment (RVGA), step length asymmetry, walking speed, and 6-minute walk test (6MWT). RESULTS: The TOCCT with MI group showed a positive improvement in the mean/median scores on most of the outcome measures at post and follow-up assessments in comparison to the control group. However, statistically significant differences were observed in changes between the groups at post and follow-up assessment for FAC, RVGA, walking speed, and 6MWT (ANOVA, P = .001 to .049; Mann-Whitney U test, P = .001). CONCLUSION: Among the patients who had a stroke within the previous 4 to 12 weeks, the TOCCT with MI produced statistically significant and clinically relevant improvements in the gait and the gait-related activities.

A new and simplified functional tendon transfer for a dropped hallux.

A case of fracture of the right tibia proximal 1/3rd extending up to diaphysis after a road traffic accident along with a dropped hallux is being reported. The extensor digitorum longus (EDL) was intact. Patient was taken up for surgery for the fracture tibia with conservative management for his dropped hallux for initial six weeks. After six weeks when no improvement was seen surgical intervention was planned for the dropped hallux. The subsequent management of this patient is being described.

Breastfeeding knowledge and practices among rural women of punjab, India: a community-based study.

OBJECTIVES: Irrespective of the fact that breastfeeding in India is almost universal, psychosocial and cultural barriers still exists to early breastfeeding. The exact reasons for this delay are not clearly known. Hence we conducted this study to assess breastfeeding knowledge and practices and the factors influencing them among women in rural Punjab, India. METHODOLOGY: We interviewed 1,000 women in a community-based analytical cross-sectional study that was carried out in 20 villages of the District of Amritsar, Punjab, India, in 2005-2006 by standard cluster sampling. Time at initiation of breastfeeding and variables like understanding about the importance of colostrum, nutrition during lactation, and motivation by health workers were assessed. Statistical analysis was done by percentages compared with the χ² test. RESULTS: Two hundred twenty-five respondents (23.8%) started breastfeeding their babies on the first day of birth, but in terms of early breastfeeding only 128 (13.5%) respondents put their babies on the breast within 4 hours of birth. Of the 1,000 respondents, 356 (35.6%) of the respondents were unaware of the importance of colostrum, 733 (77.6%) were not given advice on benefits of breastfeeding/weaning, and 306 (33.5%) of respondents had not increased their diet during lactation. CONCLUSIONS: Early breastfeeding knowledge and practices were suboptimal among the mothers in rural Punjab. Health education on breastfeeding and nutrition remains the dark area. Research and public health efforts like one-to-one "breastfeeding counseling and health education on nutrition" to the mother by health workers should be promoted.

A study of photon interaction parameters in some commonly used solvents.

Various parameters of dosimetric interest such as mass attenuation coefficients, effective atomic numbers and electron densities of some commonly used solvents such as acetonitrile (C(4)H(3)N), butanol (C(4)H(9)OH), chlorobenzene (C(6)H(5)Cl), diethylether (C(4)H(10)O), ethanol (C(2)H(5)OH), methanol (CH(3)OH), propanol (C(3)H(7)OH) and water (H(2)O) were computed in the wide energy range of 10 keV-100 GeV. A comparative study of two different methods used to compute effective atomic numbers has been done. It is observed that in the intermediate energy region (0.1-5 MeV), the mass attenuation coefficient values becomes almost the same for all the solvents, and the effective atomic number and electron density show almost constant values, whereas significant variation is observed in both lower (10-100 keV) and higher (5 MeV-100 GeV) energy regions for all the solvents, which may be due to the dominance of different partial interaction processes in different energy regions.

Intensity of transmitted photon spectra as a function of transverse and longitudinal dimensions of soil medium using 137Cs.

Transmitted photon spectra (pulse-height distribution) of (137)Cs gamma rays are measured through longitudinal and transverse dimensions of the soil medium. The intensity (photon fluence rate) of the multiple-scattered peak, appearing in the lower energy part of the spectrum, has been studied as a function of longitudinal as well as transverse thickness of the soil medium. The intensity of multiple-scatter peak decreases exponentially with the increase in longitudinal thickness of the soil medium, whereas a reverse trend of multiple-scatter peak intensity with transverse thickness occurs as the longitudinal dimension increases. The soil medium as a whole takes part in multiple scattering affecting the intensities of transmitted photons.