Cathelicidin LL-37 level in presence and absence of vitamin D in cultured macrophages isolated from elderly women

@#Introduction: Vitamin D deficiency and frequent infections are the two common worldwide phenomenon among elderly. Recent studies have demonstrated that vitamin D regulates the expression of specific endogenous antimicrobial peptides like cathelicidin LL-37 of macrophages and neutrophils, which is active against a broad spectrum of infectious agents. Therefore, the objective of the present study was to determine the level of cathelicidin LL-37 in macrophages of elderly women (classified according to serum 25(OH)D level) after exposure to Vibrio cholera infection and to find out the effect of 1,25(OH)2D added in vitro. Methods: This study was conducted among 40 randomly selected rural elderly women aged between 60 to 70 years of age. Their vitamin D status was assessed by the estimation of serum 25(OH)D and classified into three groups viz. sufficient (14 members), insufficient (13 members), and deficient (13 members). Later, their peripheral blood mononuclear cells (PBMC) were isolated and cultured from fresh blood. 1,25(OH)2D supplementation was given selectively at a dose of 10 ×10-8 M for 72 hours in the culture media; then exposed to infection and screened according to the objectives of this study. Results: Macrophages in all groups, except vitamin D deficient group, responded significantly in terms of LL-37 release during exposure to Vibrio cholera infection. Considering in vitro 1,25(OH)2D, supplementation responded significantly (p<0.05) in all three groups. Conclusion: Vitamin D can be used as a prophylaxis to enhance cathelicidin LL-37 release for all three groups as in the present study.

Universal Nucleation Behavior of Sheared Systems.

Using molecular simulations and a modified classical nucleation theory, we study the nucleation, under flow, of a variety of liquids: different water models, Lennard-Jones, and hard sphere colloids. Our approach enables us to analyze a wide range of shear rates inaccessible to brute-force simulations. Our results reveal that the variation of the nucleation rate with shear is universal. A simplified version of the theory successfully captures the nonmonotonic temperature dependence of the nucleation behavior, which is shown to originate from the violation of the Stokes-Einstein relation.

Seeding method for ice nucleation under shear.

Hydrodynamic flow can have complex and far-reaching consequences on the rate of homogeneous nucleation. We present a general formalism for calculating the nucleation rates of simply sheared systems. We have derived an extension to the conventional Classical Nucleation Theory, explicitly embodying the shear rate. Seeded molecular dynamics simulations form the backbone of our approach. The framework can be used for moderate supercooling, at which temperatures brute-force methods are practically infeasible. The competing energetic and kinetic effects of shear arise naturally from the equations. We show how the theory can be used to identify shear regimes of ice nucleation behavior for the mW water model, unifying disparate trends reported in the literature. At each temperature, we define a crossover shear rate in the limit of 1000 s-1-10 000 s-1, beyond which the nucleation rate increases steadily up to a maximum, at the optimal shear rate. For 235 K, 240 K, 255 K, and 260 K, the optimal shear rates are in the range of ≈106 s-1-107 s-1. For very high shear rates beyond 108 s-1, nucleation is strongly inhibited. Our results indicate that the optimal shear rates have a non-monotonic dependence on temperature.

Nursing personnel planning for rural hospitals in Burdwan District, West Bengal, India, using workload indicators of staffing needs.

Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO-Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel.

The Status of Birth Preparedness and Complication Readiness among Rural Indian Mothers

A cross-sectional study was conducted with the aim to explore the present status of birth preparedness and complication readiness in rural area of West Bengal and determine the possible factor(s) influencing their knowledge and practice regarding this concern. Thirty villages with homogenous characteristics were identified by cluster sampling methods from a rural block (Bhatar, Burdwan district, West Bengal) of India on April 2013 to November 2013. From every cluster 7 mothers who had delivered baby within the last year and were available first, interviewed consecutively using a guided questionnaire adapted from JHPIEGO Maternal and Neonatal Health Programme survey tools. Multivariate logistic regression was applied in analysis to predict how much the independent variables influenced the birth preparedness of mothers. 62.4% mothers were found to be well prepared. Trained birth attendants and health facilities were identified before delivery in 81.9% and 78.1% cases respectively. Mode of transportation for complication management or delivery was pre-decided by about 60% of family. Only 35.7% family saved money for the same purpose. Logistic regression revealed that well preparedness increased 11 times with every new pregnancy, but it did not depend on caste and education status of the mothers. The overall birth preparedness status of the rural mothers is poor and they acquire more knowledge regarding birth preparedness from their self experience rather than from existing health system. ​

Adherence to highly active antiretroviral therapy in a tertiary care hospital in West Bengal, India

<p><b>INTRODUCTION</b>The introduction of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has led to the reduction of mortality and the improvement of the quality of life of people living with HIV/AIDS (PLWHA). The present study was conducted to determine the pattern of adherence to HAART among PLWHA, and to assess the factor(s) affecting nonadherence, if any.</p><p><b>METHODS</b>This study was a hospital-based analytical, cross-sectional epidemiological study conducted between July and October 2011. A total of 370 adult HIV-positive patients registered in the Antiretroviral Therapy Centre of Burdwan Medical College and Hospital, West Bengal, India, were included. Nonadherence was defined as missing at least a single dose of medicine within the last four days. Data was analysed using the Statistical Package for the Social Sciences version 19.0 (IBM Corp, Armonk, NY, USA).</p><p><b>RESULTS</b>A total of 87.6% of patients were found to be adherent to HAART. Principal causes of nonadherence were forgetting to take medicine (70.2%), being away from home (65.2%), and busyness with other things (64.7%). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with a positive family history of HIV/AIDS (odds ratio [OR] 16; 95% confidence interval [CI] 2.2-114.3; p = 0.01), occurrence of side effects with HAART (OR 9.81; 95% CI 1.9-51.7; p = 0.01) and employment (OR 5.93; 95% CI 1.5-23.2; p = 0.01).</p><p><b>CONCLUSION</b>Although overall adherence was high, the factors that affect nonadherence can be addressed with proper counselling and motivation of patients and their family members. Adherence to HAART could delay the progression of this lethal disease and minimise the risk of developing drug resistance.</p>

Wilson's Disease Can Present As Paranoid Schizophrenia And Mania: Two Cases Reports

Objective: This case report highlights Wilson's disease, a rare genetic disorder involving the liver and brain presenting clinically with psychiatric symptoms as the first manifestation. Method: We present two cases of Wilson’s disease who had the typical symptoms of Schizophrenia and Bipolar mood disorder (mania) respectively. Results: Wilson disease first presentation of psychiatric diagnosis may obscure the diagnosis who later on turned out to be suffering from Wilson’s disease. Conclusion: Although such patients are more commonly seen in neurological and hepatological settings, mental health professionals must keep in mind a high level of suspicion, once first presentations may be of psychiatric nature.