Trust Black Women: Using Photovoice to Amplify the Voices of Black Women to Identify and Address Barriers to Breastfeeding in Southeast Georgia.

Barriers to breastfeeding for Black mothers are well documented in the literature. Local context is crucial for understanding and addressing barriers. Our research used the photovoice method to amplify the voices of Black mothers in Chatham County, Georgia. Guided by the sociol-ecological model, this photovoice project explored and identified the social, cultural, and physical barriers to breastfeeding that the mothers experienced. Two additional themes emerged through data analysis: personal comfort with public breastfeeding and the women's recommendations for breastfeeding support and normalization. Lack of physical spaces, lack of peer and family support, the need to overcome the stigma associated with breastfeeding, and advocating for more lactation spaces were commonly stated by the participants. These results led to the creation of a policy toolkit, a breastfeeding policy template, a proclamation to make the City of Savannah a Breastfeeding Family Friendly Community, an online photobook to share the experiences of the mothers, and additional paths of dialogue to increase inclusivity and expand health equity within Chatham County.

The effect of gender inequality on HIV incidence in Sub-Saharan Africa.

OBJECTIVE: We aimed to quantify the extent to which country-level trends in HIV incidence in Sub-Saharan Africa (SSA) were influenced by gender inequalities, measured by gender gaps in educational attainment, income, and a Gender Inequality Index (GII). STUDY DESIGN: We examined the relation between gender inequality and HIV incidence using country-level panel data from 24 SSA countries for the period between 2000 and 2016. METHODS: Our goal was to estimate the relation between within-country changes in gender inequality and HIV incidence. We compared results from fixed effects and random effects models for estimating the effect of gender inequalities on changes in HIV incidence. Based on the results of the Hausman test, the fixed effects model was selected as the preferred approach. RESULTS: HIV incidence decreased by nearly one-half over the period from 2000 to 2016. We estimated that a one percent increase in the GII was associated with a 1.6 percent increase in HIV incidence (95% confidence interval = [0.21%; 3.00%]), after adjusting by country-level socio-economic and governance variables. CONCLUSIONS: Our study suggests that addressing gender inequalities is a potential strategy to reduce HIV incidence in the SSA region. To control HIV infection, policymakers and public health practitioners should support relevant interventions for promoting gender equality. Further work is needed to identify specific interventions to improve gender inequality and to examine their impacts on changes in HIV incidence.

Black College Women and the Health of Black College Men.

The purpose of this study was to understand the influence Black college women have on the health behaviors of Black men. Using the Health Belief Model and the socioecological model as guides, focus groups and interviews were conducted with Black college men (n = 35) and Black college females (n = 25) at a Historically Black College and University in the Southern United States. Participants provided responses to questions on what impacts their health behaviors and whose health they influence. Results indicate that Black college men believed Black peer women influence decisions they make regarding their diet, physical activity, and general health behaviors. However, Black college women believe they only influenced physical activity and sexual health in Black college men. While they understood they had some influence on their health, the women were unsure if they had long-term influence. These findings highlight the need for programming that informs young Black women on the important role they play in the health of men in their lives, particularly young Black men. These findings also highlight the need for peer health educator training to cross-train educators on health issues of all gender groups.

Sexual Lifestyle, Risk Factors and Socioeconomic Status of the STD Patients in Bangladesh.

Sexually transmitted diseases (STDs) are increasing alarmingly with time among the young-adults in Bangladesh. The objective of the study was to investigate Sexual lifestyle, Risk Factors and Socioeconomic Status of the STD Patients. A total of 205 STD patients were selected following convenient method of sampling consistent with defined selection criteria from outpatient department of Skin and Venereal Disease of Mymensingh Medical College Hospital, Mymensingh. Period of data collection was from July 2014 to June 2015. The research instrument was an interviewer questionnaire and laboratory investigation reports. Results showed that the mean age of the respondents was 27±5.9 years of which 104(50.7%) unmarried and 95(46.3%) married. Level of education, 168(82.0%) of the STD patients were literate. Occupation of the STD patients, 201(98.0%) had specific occupation of which 74(36.1%) were businessmen, 48(23.4%) student, 24(11.7%) technical jobs, 20(9.8%) day labourer, 15(7.3%) household workers, 14(6.8%) service holders and 6(2.9%) were transport workers. Their average monthly income was Tk. 7892±6763. Majority of the STD patients 115((56.1%) expressed that they enjoyed extra-marital sex or illegal sex out of curiosity, 32(15.6%) habitual, 24(11.7%) to test sexual performance, 18(8.8%) inadequate response of the legal sex partners, 8(3.9%) hyper-sexuality and 8(3.9%) family disharmony. Most of the patients 200(97.6%) were heterosexual of which 165(80.5%) visited 1-10 sex partners, 18(8.8%) 11-20 sex partners and 22(10.7%) visited 21-100 sex partners in lifetime. In category of sex partners, 60(29.3%) were hotel-based sex partners, 111(54.1%) brothel-based, 20(9.8%) friends sex partners, 10(4.9%) street sex sellers and 4(2.0%) were residential sex partners respectively. Of them, 132(64.4%) did not use condom during sex, 65(31.7%) use it occasionally and only 8(3.9%) use condom regularly. Most of them 170((82.8%) had been suffering from gonococcal urethritis, 19(9.3%) non-gonococcal urethritis, 12(5.9%) genital herpes, and rest other specific infections. STDs were significantly (p<0.05) associated with category of sex partners and use of condom. Altering sexual lifestyle is still the only applicable way to stop this human catastrophe.

Optimized weak measurements of Goos-Hänchen and Imbert-Fedorov shifts in partial reflection.

The spatial and the angular variants of the Imbert-Federov (IF) beam shifts and the angular Goos-Hänchen (GH) shift contribute in a complex interrelated way to the resultant beam shift in partial reflection at planar dielectric interfaces. Here, we show that the two variants of the IF effects can be decoupled and separately observed by weak value amplification and subsequent conversion of spatial ↔angular nature of the beam shifts using appropriate pre and post selection of polarization states. Such optimized weak measurement schemes also enable one to nullify one effect (either the GH or the IF) and exclusively observe the other. We experimentally demonstrate this and illustrate various other intriguing manifestations of optimized weak measurements in elliptical and / or linear polarization basis. We also present a Poincare sphere based analysis on conversion / retention of the angular or spatial nature of the shifts with pre and post selection of states in weak measurement. The demonstrated ability to amplify, controllably decouple or combine the beam shifts via weak measurements may prove to be valuable for understanding the different physical contributions of the effects and for their applications in sensing and precision metrology.

Effectiveness of Topical Corticosteroid, Topical Calcineurin Inhibitors and Combination of Them in the Treatment of Vitiligo.

Vitiligo is an acquired pigmentary skin disorder which is disfiguring and difficult to treat. Cure and response rates for vitiligo are significantly lower. This study was conducted to evaluate the effectiveness of topical corticosteroid, topical calcineurin inhibitors (tacrolimus) and combination of them in the treatment of vitilligo in two tertiary care Hospital, in the Department of Dermatology and Venereology OPD (out patient department) in Mymensingh Medical College Hospital and Jahurul Islam Medical College Hospital, Bajitpur, Kishoregonj from January 2015 to December 2015. Newly diagnosed 112 vitiligo patients, aged more than 1 year to 70 years were assigned for therapy and to observe the response. This study indicates that, in case of vitiligo treatment topical tacrolimus was the most effective drug. Topical tacrolimus, topical corticosteroid and combination of them are to be effective in the treatment of vitiligo with reduction in the number of vitiliginous spots by increased repigmentation. But topical tacrolimus was the most effective drug, as it caused highest percentage of repigmentation of vitiliginous spot.

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture.

BACKGROUND: Public health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA. METHODS: An online survey of key informants in Georgia's districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting. RESULTS: Increases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments. CONCLUSIONS: Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of organizational culture and demonstrated the potential of PBRNs to support agency QI activities.

Hepatitis-B Infections among the Injection Drug Abusers: An Emerging Risk in Public Health, Bangladesh.

The objective of the study was to determine the incidence of Hepatitis-B (HBV) infection among the injection drugs abusers (IDUs). The research work was a cross-sectional study. A total of 400 IDUs were selected from July 2012 to June 2013 at the Outpatient Department of the Central Drug Addiction Treatment Center, Tejgaon, Dhaka, Bangladesh. They were selected consecutively following the purposive sampling method on the basis of defined selection criteria. Research instruments were a pre-tested interviewer questionnaire and blood specimen. Results showed that 79.70%(315) of the IDUs were found literate and 20.3%(85) illiterate. In present occupation, majority of them 60.5%(242) had no work and 39.5%(158) specific occupation. The mean age of them was 27.9±6.4 years. In marital status, 46.5%(186) were unmarried, 20.7%(83) married after addiction and 30.3%(121) married before addiction. Majority of the IDUs 75.2%(289) started their addiction with cannabis. In addition to injection drugs use, all of them were multiple drug abusers. In response to the sharing of needle, 35.7%(143) of the IDUs shared needle uncommonly and 64.3%(257) did not shared it at all. Ninety-three percent (372) of them were heterosexual and polygamous having extramarital sex with multiple partners. The quality of sex-partners was wife, friends, brothel & hotel based sex sellers and street sex sellers. Majority of IDUs {82.0%(328)} did not use condom at all and 15.5(62) sold blood several times in their lifetime. Seven percent {7.0%(28)} injection drug abusers had been suffering from hepatitis-B virus (HBV) infection. HBV infection was found to be significantly (p≥0.05) associated with the quality of sex partners and number of sex partners, and age and marital status. There is no significant association with sharing of needle particularly occasional sharing of needle. Altering the behaviors of IDUs, especially their sexual lifestyles, drug habit, using of disposable syringe without sharing of needle, and also alternative preventive measures against injection drugs are still the applicable way to control spread of the HBV among the IDUs in Bangladesh.

Topical Tacrolimus versus Hydrocortisone on Atopic Dermatitis in Paediatric Patients: A Randomized Controlled Trial.

Atopic dermatitis (AD) is a chronic, inflammatory skin disease in early childhood. Atopic dermatitis is familial disease, often coexists with other atopic diseases with multiple risk factors associated with atopic eczema. The disease is more frequent in urban areas compared with rural areas. Changes in nutrition and a decrease in infant breast-feeding and respiratory allergies are contributory factors for the condition. A Randomized Controlled Trial (RCT) was carried to compare the efficacy and safety of Tacrolimus ointment with a topical corticosteroid reference therapy. A total 60 patients aged between 2 to 10 years, having atopic dermatitis for at least one year and comply Hanifin-Rajka criteria were selected using random number table and allocated into study and control groups through randomization. Study group was treated with topical Tacrolimus 0.03% twice daily for three weeks, while the control group was treated with 1% Hydrocortisone acetate for the same period. Both groups had a washed out phase for 2 weeks with a follow up period of 6 weeks. Eczema Area and Severity lndex (EASI) was assessed at baseline and three weeks after treatment. Efficacy was evaluated at each visit by six clinical signs of atopic dermatitis through measurement of the affected surface area and the EASI score in each of four body regions. Before intervention, in study group mean EASI score was 11.29 with a SD of 2.14, while in control group it was 11.05 with a SD of 2.46. Difference was statistically insignificant (p>0.05). At the end of the treatment, in study group mean EASI score was 4.86 with a SD of 1.01, while in control group it was 7.97 with a SD of 1.80. Statistically high significant difference was observed between EASI scores of two groups before and after the treatment (p<0.001). After getting treatment with Tacrolimus, median reduction of EASI score was 56.07 in study group, while getting treatment with Hydrocortisone, median reduction of EASI score was 27.16. Difference was highly significant (p<0.001). It is evidenced that Tacrolimus ointment (0.03%) acts as an effective as well as safe non-steroidal topical therapy for the treatment of dermatitis in paediatric patients.

Simultaneous weak value amplification of angular Goos-Hänchen and Imbert-Fedorov shifts in partial reflection.

The optical analogue of quantum weak measurements has shown considerable promise for the amplification and observation of tiny optical beam shifts, namely Goos-Hänchen (GH) and Imbert-Fedorov (IF) shifts. Here, we demonstrate simultaneous weak value amplification of both the angular GH and the IF shifts in partial reflection of a fundamental Gaussian beam at planar dielectric interfaces. We employ pre and postselection schemes with appropriate linear polarization basis states for simultaneous weak measurements and amplification of both of these shifts. The experimentally observed enhancement of the beam shifts and their dependence on the angle of incidence are analyzed/interpreted via theoretical treatment of weak measurements.

Acupuncture in IVF: A review of current literature.

Women's choice to delay fertility due to various reasons is making subfertility a growing problem and increased use of IVF as a last resort. Despite advances in the technology, IVF success remains low, especially in older women. Hence, many of these women need to undergo several cycles of IVF and are faced with unprecedented anxiety and frustration. In desperation, they resort to anything that might increase the success of their IVF treatment. Acupuncture has gained popularity among the various complementary medicines available and many go privately to have acupuncture while undergoing IVF. Since 1999, in spite of multiple trials and systematic reviews, the beneficial effect of acupuncture in improving the success of IVF remains unproven and debatable. As clinicians, we face the dilemma of what to suggest to our patients when asked about having acupuncture during IVF, given that different meta-analyses have come to different conclusions. Hence, this review is conducted with the aim to summarise the available literature and provide a better insight into this complex and controversial topic.

Cutaneous anthrax in a school teacher.

Cutaneous anthrax is an infection of the skin caused by Bacillus anthracis. This is a report of a case of cutaneous anthrax attending outpatients of Mymensingh Medical College Hospital in October, 2010. The infected person was a retired school teacher with a very good body build. He reported to handle cow flesh about 4-5 days ago, developed few painless papules over shin of right leg, which gradually became large bullae and blackish eschar developed over the lesion. Smears from the lesions were investigated which confirmed the causative agent B. anthracis. The patient was treated with oral Ciprofloxacin (500mg) twice daily for seven days which cured the infection as observed on his subsequent follow up visits on 7 and 14 days later. Oral Ciprofloxacin is found effective as recommended by the World Health Organization.

Parental Knowledge and Perceptions on Prevention of Sudden Unexpected Infant Death and Infant Care.

(1) Background: The study's purpose was to explore the knowledge, perceptions, and confidence of mothers about infant care to reduce the risk of sudden unexpected infant death. (2) Methods: A purposeful sampling method was used to recruit 15 first-time mothers from Georgia with infants under 1 year of age. The researchers utilized the Socio-ecological model to report the results. Participants also provided recommendations on how to improve infant care and reduce the risk of SUID. (3) Results: The confidence level of infant care among most participants was low but increased over time. Mothers' knowledge level about the prevention of SUID was high, but poor emotional health could hurt their parental abilities. Most participants recognized medical providers as the main source of reliable information. However, a lack of emotional and physical support was reported by mothers. (4) Conclusions: Results suggested that a more holistic approach to infant care is needed. The healthcare system and communities should provide more physical, social, and mental support to first-time mothers, a consolidated approach to care before and after birth, and easy access to services at all stages of the process to reduce the risk of SUID.

Home foreclosure and risk of psychiatric morbidity during the recent financial crisis.

BACKGROUND: A defining feature of the US economic downturn of 2008-2010 was the alarming rate of home foreclosure. Although a substantial number of US households have experienced foreclosure since 2008, the effects of foreclosure on mental health are unknown. We examined the effects of foreclosure on psychiatric symptomatology in a prospective, population-based community survey. METHOD: Data were drawn from the Detroit Neighborhoods and Health Study (DNHS), waves 1 and 2 (2008-2010). A probability sample of predominantly African-American adults in Detroit, Michigan participated (n=1547). We examined the association between home foreclosure between waves 1 and 2 and increases in symptoms of DSM-IV major depression and generalized anxiety disorder (GAD). RESULTS: The most common reasons for foreclosure were an increase in monthly payments, an increase in non-medical expenses and a reduction in family income. Exposure to foreclosure between waves 1 and 2 predicted symptoms of major depression and GAD at wave 2, controlling for symptoms at wave 1. Even after adjusting for wave 1 symptoms, sociodemographics, lifetime history of psychiatric disorder at wave 1 and exposure to other financial stressors between waves 1 and 2, foreclosure was associated with an increased rate of symptoms of major depression [incidence density ratio (IDR) 2.4, 95% confidence interval (CI) 1.6-3.6] and GAD (IDR 1.9, 95% CI 1.4-2.6). CONCLUSIONS: We provide the first prospective evidence linking foreclosure to the onset of mental health problems. These results, combined with the high rate of home foreclosure since 2008, suggest that the foreclosure crisis may have adverse effects on the mental health of the US population.

Pattern of mental illness on substance abusers.

The aim of this study was to investigate mental illnesses among the substance abuse dependent populations. A total of 1076 substance abusers were recruited from the Outpatient Department of the Central Drug Addiction Treatment Center, Tejgaon, Dhaka from July 2008 to June 2009. They sought detoxification therapy voluntarily at this centre. The research participants were selected consecutively following the defined selection criteria. Research instruments were interviewer-administered questionnaire and standard mental state examination scales. Of the 1076 substance abusers, 82.6% had been using heroin currently and rest of them used phensedyl followed by injection drugs and cannabis with a period ranged 2-30 years. Results showed that 91.3% of the substance abusers had been suffering from insomnia and 75.0% had altered food habit. About 49.0% showed disturbed behaviors and 45.2% had been suffering from sexual dysfunctions. Around 32.0% of the substance abusers had been suffering from nonspecific generalized anxieties and 72.7% were found in abnormal mood/affects. A striking finding was that 7.3% of the substance abusers had been suffering from perceptual and/or thought disturbances. In conclusion, 7.3%-92.5% of the substance abusers had been suffering from mental illnesses. Insomnias, decreased intake of food and taste preference, irritable mood/affects, loss of interest in sex and non-specific anxieties were highly prevalent among them. Medical management and altering lifestyle are still the only applicable way to control this human catastrophe.

Instability of human rotavirus G genotypes circulating in a rural area of Bangladesh.

A total of 280 fecal specimens from patients with acute gastroenteritis attending one rural hospital (Dharmapasha health complex, Sunamgonj) in Bangladesh from August 2004 to May 2006 were tested for rotavirus by Polyacrylamide Gel Electrophoresis (PAGE). The diversity of rotavirus was investigated using electropherotyping and reverse transcription-PCR amplification of the VP7 and VP4 genes. The electrophoretic patterns of dsRNA of rotavirus showed 9 different migrations (6 long and 3 short) by PAGE. In the year 2004-2006, group A rotavirus was detected in 112 out of 280(40.0%) specimens. G and P genotyping was performed among the 46 representative positive specimens, 20(43.5%) were emerging strain G9P[8], which were associated with VP6 genotype II (subgroup II), and NSP4 genotype B, followed by 16(34.8%) G2P[4], 8(17.4%) G1P[8] and 2(4.4%) G4P[8] strains. G9P[8] was found to be the most predominant strain in 2004, but the prevalence rate abruptly decreased during the period 2005-2006. In addition G2P[4] was the most prevalent strain in 2005 and 2006. G1P[8] was less prevalent in the study period then the previous years. Nucleotide Sequence identity of VP7 gene of G9 rotaviruses were higher than 99.4% with each other and all the G9 rotavirus strains in this study clustered in a single branch of the phylogenetic tree. Nucleotide sequence identity of complete VP4 gene of P[8] rotaviruses were more than 99.7% with each other and all the P[8] rotavirus strains in this study grouped in a single cluster suggesting recent emergence from a common ancestor. An important finding of this study is that the genetic profile of rotavirus is changing within very short period in Bangladesh and continued surveillance of the circulating strains is necessary to detect new strains or new variants which can escape immune protection induced by available vaccines.

Systemic Therapy of Dermtophytosis with Voriconaole: A Clinical Observational Study of 250 Bangladeshi Patients.

Superficial fungal infection or dermatophytosis is one of the most common dermatological problems in a tropical country like Bangladesh. For last 4-5 years this skin problem is on rise with increase in cases of recalcitrant, recurrent and chronic dermatophytosis. In place of an easy task to treat dermatophytosis recently it has evolved into difficult to treat by traditional antifungal agents. Meanwhile, voriconazole, primarily appeared as an agent for deep fungal infections, has come out as a new promising systemic antifungal drug for dermatophytosis also. In Bangladesh recently an endeavor has been made to treat superficial fungal infection with voriconazole. Two hundred and ninety four patients suffering from recalcitrant, recurrent, resistant and chronic dermatophytosis between 12 and 70 years of age and both sexes were selected for the study between August 2018 and November 2018 from different parts of the country. Two categories of therapy were designed: Group A - 200mg 12 hourly for 14 days and Group B - 200mg 12 hourly for 28 days. Patients showing full response in 2 weeks were declared apparently cured and were kept under follow up. Those who did not show significant response (less than 50% improvement) in 2 weeks were considered failed. Unresponsive cases after 28 days were considered failed. Both groups were followed up for 4 weeks. Cases not showing any activity of the disease and negative microscopy on two occasions at 2 weeks interval were considered cured. Two hundred and fifty patients completed the study. Incidence of cure rate was more in Group B (93.04%) which is statistically significant (p<0.005). Relapse rate was observed more in Group A (22.83%). Visual side effects were 4.4% while vertigo and headache were observed in 12.0% and 10.8% respectably. Voriconazole is a promising treatment option for recurrent, recalcitrant and chronic dermatophytosis in dosage of 200mg twice daily for at least 4 weeks with negligible side effects. More diversified studies with longer follow up period is required for further opinion to establish an authenticated dosage schedule for treatment of superficial fungal infection.

Altered electrochemical properties of iron oxide nanoparticles by carbon enhance molecular biocompatibility through discrepant atomic interaction.

Recent advancement in nanotechnology seeks exploration of new techniques for improvement in the molecular, chemical, and biological properties of nanoparticles. In this study, carbon modification of octahedral-shaped magnetic nanoparticles (MNPs) was done using two-step chemical processes with sucrose as a carbon source for improvement in their electrochemical application and higher molecular biocompatibility. X-ray diffraction analysis and electron microscopy confirmed the alteration in single-phase octahedral morphology and carbon attachment in Fe3O4 structure. The magnetization saturation and BET surface area for Fe3O4, Fe3O4/C, and α-Fe2O3/C were measured as 90, 86, and 27 emu/g and 16, 56, and 89 m2/g with an average pore size less than 7 nm. Cyclic voltammogram and galvanostatic charge/discharge studies showed the highest specific capacitance of carbon-modified Fe3O4 and α-Fe2O3 as 213 F/g and 192 F/g. The in vivo biological effect of altered physicochemical properties of Fe3O4 and α-Fe2O3 was assessed at the cellular and molecular level with embryonic zebrafish. Mechanistic in vivo toxicity analysis showed a reduction in oxidative stress in carbon-modified α-Fe2O3 exposed zebrafish embryos compared to Fe3O4 due to despaired influential atomic interaction with sod1 protein along with significant less morphological abnormalities and apoptosis. The study provided insight into improving the characteristic of MNPs for electrochemical application and higher biological biocompatibility.

Interleukin 15 induces endothelial hyaluronan expression in vitro and promotes activated T cell extravasation through a CD44-dependent pathway in vivo.

T cell recruitment to extralymphoid tissues is fundamental to the initiation and perpetuation of the inflammatory state during immune and autoimmune responses. Interleukin (IL)-15 is a proinflammatory cytokine whose described functions largely overlap with those of IL-2. The latter is attributable in large part to its binding of the heterotrimeric receptor that contains the beta and gamma chains of the IL-2R in combination with an unique IL-15R alpha chain. However, unlike IL-2, IL-15 and its receptor have a wide tissue and cell type distribution, including endothelial cells. Here, we examine the effect of IL-15 on hyaluronan expression by endothelial cells, and investigate its role in vivo in promoting the extravasation of antigen-activated T cells through a CD44-dependent pathway. The expression of hyaluronan on primary endothelial cells and microvascular endothelial cell lines is induced by IL-15, whereas IL-2 has no such activity. Moreover, intraperitoneal administration of IL-15 or TNF-alpha in the absence of other exogenous proinflammatory stimuli allows the extravasation of superantigen-stimulated T cells into this site in vivo in a CD44-dependent manner. T cell recruitment induced by IL-15 requires expression of an intact IL-2R beta chain, indicating that IL-15 operates in this context through the traditional IL-15R. The results suggest that IL-15 can regulate endothelial cell function and thereby enables a CD44-initiated adhesion pathway that facilitates entry of activated T lymphocytes into inflammatory sites. They further demonstrate a novel role for IL-15 (distinct from any of IL-2) in regulating microvascular endothelial cell adhesive function help to understand the role of IL-15R expression on endothelium, and further support a central position for this cytokine in orchestrating multiple sequential aspects of T cell effector function and therefore chronic inflammatory processes.

Efficacy of Fexofenadine in the Treatment of Chronic Idiopathic Urticaria.

Urticaria is a common clinical condition that gives a major concern for physicians and patients alike. Urticaria is referred to as chronic when wheals occur daily or almost daily for a period of at least six weeks. The primary purpose of this study is to find out the efficacy of fexofenadine in the treatment of chronic idiopathic urticaria patients among the Bangladeshi population. This quasi-experimental study was performed in the Department of Dermatology & Venereology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from July 2013 to December 2013. Total 100 patients of chronic idiopathic urticaria aged 18 years and above with exclusion and inclusion criteria were selected. Then they were given fexofenadine 120mg twice daily for the treatment of chronic idiopathic urticaria for four weeks. A semi quantitative rating scales were used for the assessment of therapeutic efficacy before and after treatment. Data were collected in a pre-designed questionnaire by face-to-face interview and analyzed by the help of SPSS. Among the 100 respondents after one week of treatment, 8.0% had complete disappearance of symptoms, 10.0% had marked improvement, 40.0% had moderate improvement and 42.0% had slight improvement. After two weeks of treatment 35.0% had complete disappearance of symptoms, 13.0% had marked improvement, 12.0% had moderate improvement and 40.0% had slight improvement. After three weeks of treatment 40.0% had complete disappearance of symptoms, 13.0% had marked improvement, 35.0% had moderate improvement and 12.0% had slight improvement. After four weeks of treatment 42.0% had complete disappearance of symptoms, 24.0% had marked improvement, 26.0% had moderate improvement and 8.0% had slight improvement. The study concluded that fexofenadine is very effective in the treatment of chronic idiopathic urtecaria.