A study of adult rubella outbreak and its implications on increasing number of women in uniform.

Background: Rubella, although a fairly innocuous disease, is a known cause of severe birth defects in newborn. With number of women in uniform on the rise and they being assigned instructional and medical care duties, adult rubella outbreak in a training centre as in this study poses grave threat to them; besides, having disruption potential for their training. Methods: This study was conducted at an Airmen Training Centre of the Indian Air Force having more than 2500 recruits, in five squadrons. All cases of fever with rash and/or lymphadenopathy were included in the study. The demographic, epidemiological and clinical data of all the cases were analyzed and medical records reviewed. Results: A total of 31 male recruits reported over 5 days. Among those, 21 cases were from a single squadron to which the index belonged. Twelve women officers were doing instructional duties at the time of outbreak though none became infected. Fever with a rash (90.32%) was the commonest presentation, and lymphadenopathy (64.51%) was the most common sign. Attack rate (AR) with-in the squadron most affected was 4.18%, with an overall AR of 1.23%. The case fatality rate of the disease was nil. Conclusion: Till the fully immunized cohort of young recruits start getting enrolled, it will be prudent to introduce rubella vaccine to limit the loss of vital training man-hours and prevent the possibility of congenital rubella syndrome in the women instructors and medical caregivers, working in the line of their duty.

A study on quality of life among lower limb amputees at a tertiary prosthetic rehabilitation center.

BACKGROUND: Limb loss is one of the most physically and psychologically devastating events causing major disfigurement, rendering people less mobile, and at risk for loss of independence. This research aims to study the quality of life (QoL) among lower limb amputees (LLAs) at a tertiary prosthetic rehabilitation center. METHODS: The present study is based on the self-perceived QoL of new LLAs reporting to a tertiary prosthetic rehabilitation center for prosthesis using World Health Organization Quality of Life-BREF scale. RESULTS: 35% of this study population were currently serving personnel of Indian Armed Forces, while 17.3% were dependents. 17.3% of the study participants were retired Indian Armed Forces personnel. 51.5% of study participants had undergone a lower limb amputation following trauma; 22.7% of the traumatic amputations had resulted from road traffic accidents, 16.7% from trauma sustained following railway accidents, and combat-related injuries accounted for 11.4% of traumatic lower limb amputations. Diabetic foot/gangrene was responsible for 32% of lower limb amputations in the current study. Overall QoL score of 78.76 (standard deviation [SD] = 15.03) was seen revealing highest mean score in environmental domain 26.59 (SD = 5.38), followed by physical domain, psychological domain, and lowest score being in social domain. CONCLUSION: When judging the success or failure of lower limb amputation, the assessment of QoL outcome is paramount. A number of factors need to be taken into consideration to ensure holistic reintegration of the amputees back into the society.

'Jago Grahak Jago': A cross-sectional study to assess awareness about food adulteration in an urban slum.

BACKGROUND: Food adulteration includes various forms of practices, including mixing, substituting, concealing the quality of food, etc. One of the main causes for rampant adulteration is ignorance of consumer regarding their right and responsibilities resulting in faulty buying practices. Hence, the present study was done to assess the knowledge about adulteration among consumers in an urban slum. METHODS: A community-based cross-sectional study was done among residents of an urban slum over a period of 2 months. Adults responsible for purchasing groceries for the household were included. A sample size of 100 was taken and pilot-tested questionnaire was administered. All of them were made aware about adulteration. RESULTS: The mean age of the study subjects was 40.2 ± 11.7 years. Only 7% of the study subjects were illiterate. Good practices like checking of Food Safety and Standards Authority of India (FSSAI) logo (90%), Agmark logo (76%) and nutrition label (65%) are lacking among the majority. The most prominent source of knowledge about adulteration is mass media especially television (65%). Almost 40% of the study subjects are unaware about the consumer empowering initiative 'Jago Grahak Jago'. Factors which had a strong positive relationship with good practices like checking of nutrition label, FSSAI logo, Agmark logo, seal and expiry date are age, education status and socio-economic status (p value ≤ 0.05). CONCLUSION: Majority of study subjects are unaware about adulteration. 'Jago Grahak Jago' initiative which empowers the consumers has to be instilled in the minds of consumers. Awareness and motivation will lead to empowerment and end the menace of food adulteration.

Risk Factors Associated with Head Lice Infestation in Rural Pediatric Patients.

INTRODUCTION: Head louse infestation is a common parasitic disease in pediatric age group. It is common in collective centers such as schools, garrisons, campuses and old age homes. It is worldwide in distribution with no strict limitation with respect to age, gender and race. AIMS: Present study was conducted to investigate the socio-economic and lifestyle risk factors for head louse infestation in pediatric patients. MATERIALS AND METHODS: An observational descriptive study at a tertiary care hospital in rural Uttar Pradesh over a period of 1 year wherein measurement of disease/risk factors associated with head louse infestation was performed. It was carried out in all children between 5 and 15 years of age using a pre-validated questionnaire. The method of convenience sampling was used and multiple logistic regression was run to account for potential confounding variables using SPSS software. RESULTS: A total of 165 (71.1%) females and 67 (28.8%) males were infested. Most common age group affected was between 5 and 7 years where 97 (41.8%) children were infected. Ninety-five (40.9%) children were in fourth to seventh standards. Parents of 137 (59%) children were not formally educated. Eighty-one (34.9%) children had six members in the family while per capita income was between 5000 and 2500 in families of 139 (59.9%) children. Eighty-seven (37.5%) children had hair length up to shoulders. One twenty-eight (55.1%) children had no family member affected. Seventy-six (32.7%) children took bath twice a week only. CONCLUSION: Social and economic factors as well as lifestyle and education level of patients play a significant role in epidemiology of head lice.

Impact of Psychosocial Profile on Alopecia Areata in Pediatric Patients: A Case Control Study from A Tertiary Care Hospital in Eastern Uttar Pradesh.

BACKGROUND: Alopecia areata (AA) is a common form of nonscarring alopecia characterized by patchy loss of hair from the scalp and body. It is a complex outcome of factors such as autoimmunity, genetic factors, infectious diseases, as well as psychological factors, such as stress, personality type, familial conditions. Around 20% of patients are in the pediatric age group, and 60% of the patients develop AA before the age of 20 years. AIM: The present study looked into the impact of psychosocial factors in AA. MATERIALS AND METHODS: This was a case-control study conducted over a period of 1 year. One hundred and two patients and age and gender-matched control group between the ages of 2 and 14 years were included. A questionnaire was administered to identify the stress arising due to personal or familial conditions, school-related issues, psychotrauma or illness, and accidents prior to developing AA. Age and gender-matched patients with other dermatoses with low psychosomatic component to it and unlikely to be influenced by stress were selected as control. RESULT: Fifty-three patients (52 %) were male and 49 were female (48 %). Fifty-five (53.9%) patients were in the age group of 10 to 14 years. Forty (39.2%) children had multiple patches. Onset was <5 months in 30 patients (29.4%). Forty-nine (48%) children reported stress due to school-related issues compared to 13 (12.7%) in the control group. Eighteen (17.6%) children had familial issues compared to 6 (0.05%) in the control group. Nineteen children (18.6%) had multiple stressors. Sixty-nine (67.6%) patients related their disease to a stress component compared to 33 (32.3%) who could not relate to any stress. A significant association was noted between examination pressure and academic performance with onset of AA compared to control (P < 0.05%), which was stronger among female compared to male. CONCLUSION: The psychological profile and comorbidities have a significant impact on the onset or recidivism of AA. Impact of a stressful personal or family life, parental pressure to perform better in school, and psychological vulnerability can significantly contribute to the onset or exacerbation of AA.

Corneal dysfunction precedes the onset of hyperglycemia in a mouse model of diet-induced obesity.

PURPOSE: The purpose of this study was to use a mouse model of diet-induced obesity to determine if corneal dysfunction begins prior to the onset of sustained hyperglycemia and if the dysfunction is ameliorated by diet reversal. METHODS: Six-week-old male C57BL/6 mice were fed a high fat diet (HFD) or a normal diet (ND) for 5-15 weeks. Diet reversal (DiR) mice were fed a HFD for 5 weeks, followed by a ND for 5 or 10 weeks. Corneal sensitivity was determined using aesthesiometry. Corneal cytokine expression was analyzed using a 32-plex Luminex assay. Excised corneas were prepared for immunofluorescence microscopy to evaluate diet-induced changes and wound healing. For wounding studies, mice were fed a HFD or a ND for 10 days prior to receiving a central 2mm corneal abrasion. RESULTS: After 10 days of HFD consumption, corneal sensitivity declined. By 10 weeks, expression of corneal inflammatory mediators increased and nerve density declined. While diet reversal restored nerve density and sensitivity, the corneas remained in a heightened inflammatory state. After 10 days on the HFD, corneal circadian rhythms (limbal neutrophil accumulation, epithelial cell division and Rev-erbα expression) were blunted. Similarly, leukocyte recruitment after wounding was dysregulated and accompanied by delays in wound closure and nerve recovery. CONCLUSION: In the mouse, obesogenic diet consumption results in corneal dysfunction that precedes the onset of sustained hyperglycemia. Diet reversal only partially ameliorated this dysfunction, suggesting a HFD diet may have a lasting negative impact on corneal health that is resistant to dietary therapeutic intervention.

A cross-sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra.

INTRODUCTION: Reproductive health of adolescent girls is crucial as it determines the health of future generations. School girls when experiencing menarche find themselves in a setting without water, toilets or a supportive female teacher to explain the changes happening in their body. An important concern for adolescent girls is to have adequate, correct knowledge along with facilities and the cultural environment to manage menstruation hygienically and with dignity. Hence, the present study was done to assess knowledge and practices about menstruation in adolescent school girls of an urban slum. METHODOLOGY: This was a descriptive cross-sectional study conducted among girls of a Government School located in an urban slum of western Maharashtra. A total of 250 girls participated. Data collection was through a pilot-tested questionnaire. The data thus collected were entered into Microsoft Excel and analyzed using the SPSS 20 software. All girls were educated about menstrual hygiene after the study. RESULTS: The mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97 (95% CI: 11.94-11.99). It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. Out of these in a large proportion, the knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). There was no significant association between educational status of mother and awareness in respondent about menstruation. Regarding the organ of menstrual blood flow, half (50.7%) knew the correct answer (i.e. uterus); whereas the rest believed that it was stomach/kidney, etc. Most of the school girls (90.5%) used sanitary pads. Almost 90% of the young women faced physical complaints or health problems during menstruation. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises. CONCLUSION: Correct knowledge in adolescent young girls regarding menstruation is lacking. Lack of awareness is a roadblock in adopting safe and hygienic menstrual practices. It also hinders them from overcoming traditional beliefs, misconceptions and restrictions regarding menstruation. This will empower them as they transition into womanhood.