Factors associated with adolescent pregnancy among Chepang women and their health-seeking behavior in Ichchhakamana rural municipality of Chitwan district.

Adolescent pregnancy is a critical public health issue, particularly in developing regions like Nepal, where it poses significant risks to maternal and child health and perpetuates the cycle of poverty. This study focused on the marginalized Chepang community, which is endangered and faces unique challenges. The study aimed to explore the factors associated with adolescent pregnancy among Chepang women in Ichchhakamana Rural Municipality, Chitwan, Nepal, and also assessed their reproductive health-seeking behavior. A cross-sectional analytical study was conducted with 217 Chepang women aged 15-20 years, and data was collected through face-to-face interviews using a semi-structured questionnaire. The collected data was entered and analyzed using IBM SPSS version 20. Descriptive statistical tools like frequency, and percentage were used to express the results. Pearson chi-square test, Fisher exact test were used for bivariate analysis to determine the presence of association between the dependent and independent variables. Binary logistic regression was used for further analysis. The prevalence of current adolescent pregnancy was 8.3%(18), while one-fourth had experienced prior pregnancies during their adolescence. Factors significantly associated with adolescent pregnancy included lack of education among the women and their mothers, as well as living in joint families. Additionally, number of antenatal visits and consumption of iron tablets seemed to be lower among Chepang women in comparison to the national data. Chepang women had high adolescent pregnancy rates, with low education level and joint family structure being important risk factors for it. They also had inadequate reproductive health seeking behavior. Addressing these problems requires strategies that prioritize education and raise awareness about reproductive health.

Intra familial phenotypical variations in adrenoleukodystrophy.

Adrenoleukodystrophy (ALD) is an X-linked recessively inherited peroxisomal disorder, characterized by progressive white-matter demyelination of the central nervous system and adrenocortical insufficiency. It has a wide phenotypical variability ranging from symptomatic childhood cerebral form to the asymptomatic with biochemical defects only; sometimes within the same family. We report a family of three siblings diagnosed with ALD confirmed with the mutations in ABCD1 gene having phenotypical variability ranging from pure adrenal insufficiency to progressive neurodegeneration in the same family. The mother was identified as the carrier and maternal uncle was diagnosed with Adrenomyeloneuropathy. We discuss the variable presentation in our family and the possible causes of phenotypical variability.

Relation of echocardiographic wall motion score index and response to dobutamine stress to defibrillation threshold at the time of implantation of a cardiac defibrillator.

Predictors of defibrillation threshold (DFT) at implantation remain poorly defined. It was hypothesized that a greater wall motion score index (WMSI) at rest on echocardiography and an ischemic or biphasic response on dobutamine stress echocardiography (DSE) would predict a greater DFT. Consecutive patients who underwent implantable cardiac-defibrillator implantation underwent echocardiography and DSE. DFT at implantation was assessed using the step-down method. Thirteen men aged 68 +/- 10 years with left ventricular ejection fractions of 28 +/- 10% participated in the study. DFTs ranged from 5 to 25 J (mean 14 +/- 8). A WMSI at rest of > or = 2.5 had a 71% positive predictive value and an 83% negative predictive value for a DFT > or = 15 J. An ischemic or biphasic response during DSE did not predict a greater DFT at implantation.

A phase II study of weekly paclitaxel and carboplatin in previously untreated patients with advanced non-small-cell lung cancer.

PURPOSE: Both paclitaxel (P) and carboplatin (C) have a significant activity in non-small cell lung cancer (NSCLC). Weekly administration of P is active, is dose intense, and has a favorable toxicity profile. To evaluate the efficacy and toxicity of weekly P and C in advanced-stage NSCLC, we initiated this phase II study in patients with advanced NSCLC (III B with pleural effusion and stage IV). PATIENTS AND METHODS: Eligible patients were treated with paclitaxel 100 mg/m2 intravenously (iv) over 1 h followed by carboplatin AUC 2 iv over 30 min. This treatment was administered weekly for 3 of every 4 wk until disease progression or intolerable toxicities. RESULTS: Of the 30 patients enrolled in the study, one patient did not meet the eligibility criteria. Of the remaining 29 patients, 6 did not complete at least two cycles of treatment and hence were not assessable for response. The overall response rate was 43.5% (10/23) (all partial responses). An additional 43.5% had stable disease. The median time to progression was 162 d and the median duration of response was 169 d. Overall survival at 1 yr on intent-to-treat analyses was 44% and median survival was 10.8 mo. We observed the following grade 3/4 toxicities: hypersensitivity to paclitaxel (13%), hypersensitivity to carboplatin (3%), neutropenia (31%), thrombocytopenia (7%); 31% experienced grade 1 neuropathy and 17% experienced grade 2 neuropathy. CONCLUSIONS: We conclude that weekly paclitaxel and carboplatin is active and very well tolerated in patients with advanced NSCLC.