The expression of chemokine MCP-1 in colorectal carcinoma and its relationship to the infiltration of macrophage

Objective: To study the expression of MCP-1 in colorectal carcinoma and its relationship to the infiltration of the macrophage and to the biological behaviour of infiltration and metastasis of colorectal carcinoma. Methods: The expression of the MCP-1 mRNA was assessed in colorectal carcinoma collected freshly from surgical specimen by RT-PCR and the expres- sion of the MCP-1 protein was assessed in colorectal carcinoma collected from surgical specimen by immunohistochemistry. The tumor infiltrating cell and macrophage were also investigated by immunohistochemistry. Results: All the 12 specimens of colorectal carcinoma detected by RT-PCR expressed the MCP-1 mRNA; MCP-1 protein was detected in 90℅ (36/40) cases of the tumor; The expression of the MCP-1 protein in colorectal carcinoma correlated negatively with its state of metastasis and the Dukes’ stage. But a postive correlation was found between the expression of MCP-1 and the infiltrated macrophage. The stron- ger expression of MCP-1, the more number of the infiltrated macrophage. Conclusion: The expression of chemokine MCP-1 in colorectal carcinoma may influence its biological behaviour of infiltration and metastasis, and can attract the immuno-cell to the local of the tumor, such as Macrophage.

Clinical Audit on the Provision of Diabetes Care in the Primary Care Setting by United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)

OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under difficult circumstances in Gaza, West Bank, Jordan, Lebanon and Syria. A total of 114,911 people with diabetes were registered with UNRWA health centres in 2011. The aim of this cross-sectional observational study was to assess the quality of diabetes care in the UNRWA primary health care centres. METHOD: The study population consisted of 1600 people with diabetes attending the 32 largest UNRWA health centres and treated there for at least one year. Between April and Sept. 2012 data from medical records, including results of clinical examinations and laboratory tests performed during the last one year, current management including self-care education and evidence of diabetes complications were collected and recorded in a previously validated data collection form (DCF). Patients were interviewed and clinically examined on the day of the audit and blood collected for HbA1c testing which was done at a central lab using High-performance liquid chromatography (HPLC) method (HLC&reg-723G8 Tosoh Corporation, Japan). Data was transferred from paper records into a computer and analysed with Epi-info 2000. RESULTS: Type 1 diabetes was present in 4.3% and type 2 diabetes in 95.7%. Co-morbid hypertension was present in 68.5%;90.3% were either obese (64.0%) or overweight (26.3%). Clinical management of diabetes was largely in line with UNRWA’s technical instructions (TI) for diabetes. Records for 2 hour postprandial glucose (2 h PPG), serum cholesterol, serum creatinine, and urine protein analysis were available in 94.7%, 96.4%, 91.4% and 87.5%, cases, respectively. Records of annual fundoscopic eye examination were available in 47.3% cases but foot examinations were less well documented. Most patients (95.6%) were on anti-diabetic drugs—68.2% oral anti diabetic drugs (OAD) only, 14.4% combination of OAD and insulin, and 12.9% insulin only. While 44.8% patients had 2 h PPG ≤ 180 mg/dl, only 28.2% had HbA1c ≤ 7%;55.5% and 28.2% had BP ≤ 140/90 and ≤130/80 mm of Hg respectively. Serum cholesterol ≥ 200 mg/dl, serum creatinine ≥ 1.2 mg/dl and macro albuminuria were noted in 39.8%, 6.4% and 10.3% cases respectively. Peripheral neuropathy (52.6%), foot infections (17%), diabetic retinopathy (11%) and myocardial infarction (9.6%) were the most common long term complications. One or more episodes of hypoglycaemia were reported by 25% cases in total and in 48% of those using insulin. 17.7% and 22.6% cases received no or ≥4 self-care education sessions respectively. CONCLUSION: The study confirmed that UNRWA doctors and nurses follow TI for diabetes and hypertension fairly well. Financial constraints and the consequent effects on UNRWA TI and policies related to diabetes care were important constraints. Key challenges identified were: reliance on 2 h PPG to measure control;non-availability of routine HbA1c testing, self-monitoring of blood glucose (SMBG) and statins within the UNRWA system;and high levels of obesity in the community. Addressing these will further strengthen UNRWA health system’s efforts of providing services for diabetes and hypertension at the primary care level. Given that most developing countries either have no or only rudimentary services for diabetes and hypertension at the primary care level, UNRWA’s efforts can serve as an inspiration to others.

Drug-Induced Hypothyroidism during Anti-Tuberculosis Treatment of Multidrug-Resistant Tuberculosis: Notes from the Field

We followed 188 euthyroidic persons undergoing treatment for multidrug resistant tuberculosis (MDR-TB) in the state of Karnataka, India to determine the incidence of hypothyroidism during anti-tuberculosis treatment. Overall, among MDR-TB patients with valid thyroid stimulating hormone (TSH) values, about 23% developed hypothyroidism (TSH value ≥10 mIU/ml) during anti-tuberculosis treatment;the majority (74%) occurring after 3 months of treatment. Among 133 patients who received a regimen that contained ethionamide, 42 (32%) developed hypothyroidism. Among 17 patients that received a regimen that contained para-aminosalicylate sodium, 6 (35%) developed hypothyroidism. Among 9 HIV positive patients on antiretroviral treatment, 4 (44%) developed hypothyroidism. These results differ from previously reported 4% incidence of hypothyroidism amongst patients who passively reported thyroidal symptoms during treatment, suggesting routine serologic monitoring of TSH throughout the course of treatment for MDR-TB is warranted.

Threefold Increase in the Number of Drug Resistant TB Cases after Introduction of Universal Drug Susceptibility Testing: Experiences from Two South India Districts

Background: In India, tuberculosis (TB) is a major public health problem, and the advent of drug resistance TB (DR-TB) has worsened the situation. The Revised National TB Control Programme (RNTCP) has introduced universal drug susceptibility testing (UDST) for all diagnosed TB cases in 2018. We conducted this study to know the advantage of implementing UDST when compared to selective testing existent in 2017 on key diagnostic cascade parameters and to identify the challenges in the implementation of UDST. Methods: The study was conducted in two districts of Karnataka, India during January 2017-December 2018. The quantitative part consisted of before-and-after design and the qualitative part consisted of descriptive design. Results: In 2017 (during selective testing/“before” period) out of the 2440 TB patients, 80 (3%) were diagnosed with Isoniazid and Rifampicin resistance patients;in contrast in 2018 (during UDST/“after” period) of the 5129 TB patients 258 (5%) were diagnosed with Isoniazid and Rifampicin resistance. However, the proportion of eligible patients tested for rifampicin resistance during the “after” period was 60% when compared to 100% during the “before” period and median turnaround time for testing was also longer during the “after” period when compared to the “before” period (32.5 days vs 27.5 days). Major reasons for these two gaps were found to be difficulties in collecting sputum specimens and transportation. Conclusion: The rollout of UDST has led to a three-fold increase in a number of DR-TB cases detected in the region. There is a need for the programme to increase the proportion tested for DST by increasing the laboratory capacity and address the challenges in sputum collection and transportation.

Asymptomatic Screening of Clients on Opioid Substitution Therapy for Tuberculosis: An Experience from India

Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpert MTB/Rif. Among 472 who underwent CXR, 0.1% had CXR suggestive of TB. The number needed to screen was 118 clients for one CXR suggestive of TB. All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. The TB patient was asymptomatic and could have been missed through the passive approach. We recommend further studies to explore ACF among OST clients.

Comparative Study on Results of Euler,Improved Euler and Run­ge-Kutta Methods for Solving the Engineering Unknown Problems

The paper presents the comparative study on numerical methods of Euler method,Improved Euler method and fourth-order Runge-Kutta method for solving the engineering problems and applications.The three proposed methods are quite efficient and practically well suited for solving the unknown engineering problems.This paper aims to enhance the teaching and learning quality of teachers and students for various levels.At each point of the interval,the value of y is calculated and compared with its exact value at that point.The next interesting point is the observation of error from those methods.Error in the value of y is the difference between calculated and exact value.A mathematical equation which relates various functions with its derivatives is known as a differential equation.It is a popular field of mathematics because of its application to real-world problems.To calculate the exact values,the approximate values and the errors,the numerical tool such as MATLAB is appropriate for observing the results.This paper mainly concentrates on identifying the method which provides more accurate results.Then the analytical results and calculates their corresponding error were compared in details.The minimum error directly reflected to realize the best method from different numerical methods.According to the analyses from those three approaches,we observed that only the error is nominal for the fourth-order Runge-Kutta method.

Construction of the recombinant expression vector for CD80-IgG fusion gene and its expression in Chinese hamster ovary cells

To construct the recombinant expression vector for CD80-IgG fusion gene and to express it functionally in Chinese hamster ovary cells in order to be used as an effective method to eliminate the immune escape of leukemic cells, the cDNA encoding the signal and extracellular domains of murine CD80 was generated by PCR amplification from plasmid pcDNA/B7 containing the full length cDNA of murine CD80 and those of murine IgG1, in which the Fc fragment was obtained through RT-PCR amplification from murine spleen cells. These two cDNAs were then cloned in tandem into eukaryotic expression vector pcDNA3.0 and the resultant recombinant plasmid pcDNA/CD80-IgG was then transfected to Chinese hamster ovary cells with liposome transfection reagent. The cell clones constitutively expressing CD80-IgG fusion protein were obtained by G418 screening. Western blotting and dot ELISA assay were used to detect the expression of the fusion protein in the supernatants of these cells. Meanwhile, the fusion protein expressed was then purified with affinity chromatography, and its biological activity was demonstrated by flow cytometry, MTT colorimetry and ELISA assay. The experimental results showed that these two inserts were successfully cloned into plasmid pcDNA3.0, and the highly purified fusion protein was obtained. This fusion protein was proved to be able to upregulate the density of CD80 on leukemic cells, deliberately promote the proliferative reactions of mouse allogenic lymphocytes and increase the killing activity against WEHI-3 cells from 49.7% up to 84.6%. In addition, this fusion protein could also enhance the IL-2 secretion from allogenic lymphocytes activated by tumor-specific antigens. It is concluded that the recombinant vector constructed can be functionally expressed in the mammalian cells, thus providing a solid foundation for the further investigation on the mechanism to eliminate the immune escape of leukemic cells in vivo.

Interleukin-18 Suppresses Angiogenesis and Lymphangiogenesis in Implanted Lewis Lung Cancer

Objective： To investigate the effects of interleukin-18 （IL-18） on implanted Lewis lung cancer in suppressing angiogenesis and lymphangiogenesis. Methods： One week after hypodermic inoculation of Lewis cells, sixteen tumor-bearing syngeneic mice were randomly divided into two groups. The mice in the treatment group （group A） were intraperitoneally injected with the IL-18 and in the control group （group B） were intraperitoneally injected with normal saline for 7 days. The mice were killed on day 19. The morphology of the tumors was studied, the growth curve was described and the tumor inhibition rate was calculated. The numbers of metastasized pulmonary colonies were calculated using hematoxylin-eosin （HE） staining. The vascular endothelial growth factor A （VEGF-A）, vascular endothelial growth factor C （VEGF-C）, microvessel density （MVD） and lymphatic microvessel density （LMVD） in tumor mass were measured by immunohistochemistry staining （IHCS）. Results： In the group A, the tumor volume, tumor weigh, lung metastatic nodules, expression of VEGF-A and VEGF-C, MVD were all decreased significantly （P0.01 or P0.05）. The tumor inhibition rate was 75% and the inhibition rate of lung metastatic nodules was 61%. The LMVD in group A was also lower than group B, but without significant difference （P0.05）. Conclusion： IL-18 could suppress the tumor growth and metastasis of implanted Lewis lung cancer by way of down-regulating VEGF-A and VEGF-C expression, suppressing angiogenesis and lymphangiogenesis.

白细胞介素-18抑制Lewis肺癌小鼠移植瘤生长与诱导移植瘤细胞凋亡的研究(英文)

Objective:The aim of our study was to investigate the effects of interleukin-18(IL-18) on implanted Lewis lung cancer in suppressing tumor growth and inducing tumor cells apoptosis.Methods:One week after hypodermic inoculation of Lewis cells, sixteen tumor-bearing syngeneic mice were randomly divided into two groups.The mice in the treatment group were intraperitoneal injected with the IL-18, in the control group were intraperitoneal injected with normal saline.The health conditions of the mice were measured, the morphology of the tumors was studied and the apoptosis of implanted lung cancer cells was detected by TUNEL to evaluated the effects of IL-18.Results:IL-18 had no significant effects on the health conditions of the mice, but it could suppress the implanted tumor growth(inhibition rate was 75%) and induce tumor cells apoptosis.Conclusion:IL-18 can suppress the implanted Lewis lung cancer cells by way of inducing tumor cells apoptosis.It could be used as a new strategy for lung cancer.

Five High-risk Factors for Inpatient Suicide

Objective： The aim of this study was to identify the risk factors for inpatient suicide in a general hospital. Methods： Thirty suicide victims were drawn from the adverse event reports of suicidal acts during hospitalization in a general hospital from 2008 to 2014. Data were gathered from a focus group interview of 6 medical staff who had experienced inpatient suicide. Interpretative phenomenological analysis was used to analyze the data. Results： Five main themes regarding high-risk factors for inpatient suicide emerged from this study： mental disorders, diseases, the source of money to meet medical expenses, social support, and the hospital environment. Patients with mental disorders were at a high risk of suicide. Having a serious disease, paying high medical expenses alone, the loss of social support and unsafe hospital environments were also associated with an increased risk of suicide. Conclusions： This study puts forward different perspectives on the reasons that inpatients commit suicide and corresponding preventive measures based on these 5 main themes that could be implemented to avoid or reduce suicidal acts among inpatients during hospitalization.

Demonstration of caring by males in clinical practice:A literature review

Gender stereotyping on the role of male nurses in the use of intimate care,especially the application of touch,was explored.The barriers for men to provide care were determined.Strategies adopted by male nurses to overcome these barriers were discussed.The review of literature showed that role stereotyping is still prevalent within nursing.Public media should recognize the diversity of caring and apply positive materials to shape a new image of nursing.The nursing faculty should develop an atmosphere of acceptance and empower male nursing students in the nursing school and clinic.Male nurses themselves should deeply believe that nursing is a profession suitable for both genders.

Pediatric allergic conjunctivitis and allergic rhinitis

Objective： To assess the relationship between allergic conjunctivitis（AC） and allergic rhinitis（AR） in pediatric ophthalmology and E.N.T outpatient clinic. Methods：Eight hundred and ninety two patients were enrolled in survey during Mar. 2005-Jan. 2007, 407 allergic conjunctivitis cases were placed in the ophthalmology clinic group and 485 allergic rhinitis cases were from the E.N.T clinic. The comorbid disorders, histories, symptoms, signs of patients were recorded. Type 1 allergy was tested in 479 cases by a specific IgE antibody blood test. Eosinophils were detected in superficial conjunctival scrapings of the superior tarsal conjunctiva and mucosa surface scrapings of middle nasal meatus in 88 cases with both diseases. Results：302（74%）, 374（92%）, 116（29%） in 407 cases with allergic conjunctivitis had concomitant eczema, rhinitis and asthma, respectively; 334（69%）, 430（89%）, 145（30%） in 485 cases with allergic rhinitis had concomitant eczema, allergic conjunctivitis and asthma, respectively. The prevalence of allergic conjunctivitis concomitant allergic rhinitis and allergic rhinitis concomitant allergic conjunctivitis had no significant difference（x2=2,6, P 〉 0.05）. The prevalence of allergic conjunctivitis and allergic rhinitis concomitant eczema and asthma also had no significant difference （x2=3.08; x2=0.21, P 〉 0.05）. The degree of severity of two kinds of disease symptoms is not parallel, in the patients with seasonal allergic conjuctivitis（SAC） and perennial allergic conjunctivitis（PAC）, the clinical signs of AR were always severer（x2=258.2, P 〈 0.05） than those of AC. However, the results coincided with the cases with vernal keratoconjuctivitis（VKC）（x2=66.5, P 〈 0.05）; Eosinophils were revealed in 50（57%） conjunctival scrapings and nasal mucosa scrapings（x2=1.5, P〉 0.05）, 47（53%） cases had positive results in both scrapings. The main aeroallergens were house dust mites, house dust and fungi, and the main food-allergens were fish, crab and shrimp. Conclusion：The two disorders were shown to share more similarities than differences, as suggested that allergic conjunctivitis should be considered in future guidelines on preventing the development of rhinitis and asthma in children.

Characteristics of and management strategies for 54 suicidal inpatients in a general hospital

Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.

Treatment Initiation among Patients with Multidrug Resistant Tuberculosis in Bhopal District, India

Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to follow-up (non-initiation of treatment by programme within 6 months of diagnosis) and time from diagnosis to treatment initiation in Bhopal district, central India (2014). Pre-treatment loss to follow-up was 13% (0.95 CI: 7%, 23%), not significantly different from the national estimates (18%) and median time to initiate treatment was seven days, lower than that reported elsewhere in the country. Bhopal was performing well with reference to time to treatment initiation in programmatic settings.

Effects of tetrandrine on phenotypic modulation of vascular smooth muscle cells and expression of p38 MAPK as well as MKP-1 after intimal injury of rabbit carotid arteries

Objective： To study the effects of tetrandrine （Tet） on phenotypic modulation of vascular smooth muscle cells （VSMCs） and expression of p38 mitogen-activated protein kinase （p38MAPK） as well as mitogen-activated protein kinase phosphatase-1 （MKP-1） after vascular intimal injury. Methods： HE staining was used to analyze vascular morphology of sham-injured group, injured group and Tet-treated group at day 28. lmmunohistochemistry, Western blot and RT-PCR were respectively used to detect the expression change of smooth muscle a-actin （SMa-actin）, proliferation cell nuclear antigen （PCNA）, p38MAPK and MKP-1 of injured group and Tet group at days 7, 14 and 28 after balloon injury. Results： ① All layers of vascular wall in sham-injured group were intact at day 28. The neointimal area was significantly increased and the lumen area notably decreased in injured group at day 28. The neointimal proliferation in Tet treated group was less than that in injured group, and the lumen area of Tet group was significantly increased than that of injured group at day 28. ②Compared with the injured group, the expression of SMa-actin, PCNA, p38MAPK and MKP-1 of vascular wall in Tet group was no difference, and the neointimal proliferation condition was also basically as same as injured group at day 7 after injury. The expression of PCNA and p38MAKP in Tet group was obviously lower than that in injured group, and the expression of MKP-1 in Tet group was obviously higher than that in injured group at days 14 and 28 after injury. The expression of SMa-actin in Tet group was slightly higher than that in injured group at days 14 and 28 after injury. Conclusions： Tet could reduce neointimal proliferation by inhibiting VSMCs phenotypic modulation and p38MAPK signaling transduction pathway as well as its down regulation.

Quantitative monitoring and mutations of ctDNA before and after non-small cell lung cancer radical surgery

Objective The aim of this study was to study the quantitative expression of circulating tumour DNA(ctDNA) in patients with non-small cell lung cancer(NSCLC) before and after radical operation and to explore the correlation between gene mutations in non-small cell lung cancer tissues and those in ctDNA.Methods We randomly assigned 5 NSCLC patients from the Department of Thoracic Surgery of Fujian Medical University Union Hospital. All the patients had undergone radical surgery. Venous blood samples were collected from the 5 NSCLC patients at two time points(before the operation and 21–37 days after the operation) for monitoring ctDNA levels. This was done by isolating plasma from venous blood using high velocity centrifugation, extracting DNA from the plasma using the QIAamp Circulating Nucleic Acid kit, and then quantifying the ctDNA levels. The results were analyzed using the Wilcoxon Rank Sum Test. Moreover, the ctDNA levels were compared with those of carcinoembryonic antigen(CEA), which was detected simultaneously with the ctDNA. Then, DNA samples from the tumor tissues and peripheral blood cells and ctDNA were sequenced using the Hiseq2000 sequencing platform(Illumina) and the mutant genes were screened out. Mutations that occurred within the tumor tissues were used as positive control, whereas those found in the pre-operative blood cells were used as a negative control. Based on the mutational analysis of ctDNA genes, a total of 508 cancer-related genes were screened. Results The median values of the pre-and post-operative ctDNA levels in the 5 patients with NSCLC were 0.612(0.518–0.876) and 0.430(0.372–0.612) ng/μL, respectively. There was a significant difference between the two groups(P < 0.05). The pre-operative CEA level was slightly higher than the post-operative level(P > 0.05). In one of the cases, LC tissues showed multiple mutations, consistent with pre-operative ctDNA. Moreover, isogenic mutations of the same type were not detected in post-operative ctDNA or peripheral blood cells. Conclusion Mutations found in the lung cancer(LC) ctDNA gene were consistent with the mutation type of LC tissue. Hence, the quantitative and qualitative analysis of ctDNA is a promising novel molecular biomarker for the evaluation of tumor burden changes in NSCLC.

Dual Burden of Malnutrition among Primary School Children in Myanmar

Background: The distribution of childhood nutritional diseases is shifting from a predominance of under nutrition to a dual burden of under-and over nutrition in low and middle income countries. Rapid economic development and urbanization lead to an increase in overweight and obesity and diet-related chronic diseases. The co-existence of under-and over nutrition is double burden and this is a public health challenge for community. Objective: To find out the nutritional status of primary school children. Method: The study was school based descriptive study and conducted during November 2014 to February 2015 in basic primary schools, basic middle schools and basic high schools in urban and rural area of Yangon, Mandalay, Taungyi and Mawlamyaing. A total of (2937) Grade IV and Grade V students were measured for weight, height and 592 students were measured for haemoglobin by standard equipment and standard procedure. Results: The overall prevalences of stunting, wasting, overweight, obesity and anaemia were 8.8%, 15%, 4.6% and 3.1% and 36.1% respectively. The prevalences of stunting, over weight and obesity were more prevalent in boys and wasting and anaemia were more prevalent in girls. The result showed that the stunting was more prevalent in rural than in urban (7.5% in urban and 12.0% in rural). The prevalences of overweight and obesity were higher in urban than rural area (overweight 5.3% in urban and 2.8% in rural, obesity 3.8% in urban and 0.9% in rural). Children residing in urban area had higher anthropometric parameter than rural children. Conclusion: The present study observed the coexistence of obesity, overweight and undernourishment (wasting and stunting) among Myanmar School children.The findings highlighted the need for continued health promotion efforts to improve nutritional status of primary school children.

Salt Consumption Patterns and Iodine Nutrition Status of Pregnant Women in Coastal Region

Background: Maternal Iodine Deficiency Disorder can result in inevitable cretinism as well as miscarriages, stillbirth and low birth-weight babies. Objective: There is a need to find out contributing factors towards urinary iodine concentrations of pregnant women. Methods: Therefore, the cross-sectional, descriptive study was conducted to assess the patterns of salt utilization and iodine status of pregnant women living in coastal areas of Mon State in January and May, 2013. Result: A total of 144 pregnant women from Pa-Nga village and Kalokepi village in Thanbyuzayat township were asked by using structured questionnaires including age, parity, socioeconomic status and patterns of salt and iodine-rich foods (seaweed, fish, prawn) consumption. Casual urine samples were collected from each pregnant woman and urinary iodine concentrations were measured. Three samples each of the iodized salt and non-iodized salt from local markets were collected for determination of iodine content by the iodometric titration method. Only 83.3% of the study population consumed iodized salt and the remaining (16.7%) consumed non-iodized salt. The median urinary iodine concentration of the study population was 105 μg/L. The mean urinary iodine level of pregnant women who consumed iodized salt and that of pregnant women who consumed non-iodizes salt were 110.47 ± 67.34 μg/L and 95.83 ± 70.13 μg/L (P = 0.336). Iodine content of the iodized salt and non-iodized salt was 20.6 ± 9.2 ppm and 5.1 ± 1.2 ppm respectively. In conclusion, the median iodine level of pregnant women was lower than that of the optimal iodine nutrition for pregnant women, i.e., 150 - 250 μg/L and the mean iodine content of salt samples was lower than the permissible level of iodine in iodized salt, i.e., 30 - 40 ppm. Conclusion: Our findings indicate that iodine nutritional status of pregnant women in this area is insufficient and salt iodization needs to be monitored for the optimal iodine content in iodized salt.

When Does Drug Resistant TB Strike HIV/TB Patients?—A South India Experience

Background: India is a high TB (tuberculosis) burden country. The advent of HIV (Human immunodeficiency virus) and DR-TB (drug resistant TB) has worsened the ongoing TB control efforts. A study was conducted to (a) to determine the duration for developing drug resistant TB after diagnosis of HIV (b) to ascertain the patients status after one year of DR-TB treatment in Karnataka, India. Methods: It is a retrospective cross-sectional study involving review of records and reports at ART (Anti-retroviral treatment) centres and DR-TB centres in Karnataka during the period 2013-2014. Results: The median time from being known as HIV positive to being diagnosed as DR-TB was 1168 days (IQR: 571 - 1955). At the end of 14 months, nearly 39% of patients had died and 49% of patients were on treatment. Conclusion: The National Health programmes should prioritize monitoring of the HIV/TB patients and develop appropriate novel strategies for community involvement.