Impact assessment of school-based sex education program amongst adolescents

This was a cross-sectional, interview-based study to assess the impact of sex education on the students and the feasibility of such a program. Study sample consisted of 189 students from two secondary schools of Surat city. Impact was assessed by “before and after” administration of questionnaires. Statistical analysis was done by Z tests for difference of means and proportions. Sex education influenced the need perception and the knowledge of the students. After the training, the preferred mean age to start sex education in the two sexes converged to be 15–16 years. Doctors remained the first choice to impart the sex education, followed by school teachers. Knowledge about the STDs and the method(s) of prevention improved significantly (more in boys). Optimum days for conception became known to more students after the training and the gain was more in girls. Increased awareness about the contraceptives (condoms) use was evident in boys and (oral pills and condoms) in girls. The training improved the participation of girls in the post-evaluation program. A positive attitudinal change was observed after the training, towards extra-marital sex. It also removed the myths associated with masturbation. All students were satisfied with the programme, however, two-third of boys considered the duration insufficient.     

A computer model study of the ventricular fibrillation vulnerable window: Sensitivity to regional conduction depressions

The cardiac vulnerable window is typically defined to be that portion of the cardiac cycle during which ectopic stimuli can induce ventricular fibrillation (VF). We have used cardiac electrophysiological computer modeling to investigate how the size and shape of the cardiac vulnerable window is affected by regional conduction velocity depressions (RCVDs), as might be found in ischemia. Computer simulations were performed on a three-dimensional finite-state, discrete-element model of the ventricles of a dog heart, with simulated RCVDs of 0% (normal) to 100% (infarcted) isolated to the apical region of this heart. Using a programmed electrical stimulation protocol, vulnerability was quantified as the number of ectopic stimuli necessary to induce VF. We observed a nonlinear and nonmonotonic relation between increases in RCVD and the vulnerability of the heart to ectopic stimuli. The size and shape of the vulnerable able window remained stable through RCVDs of 30%, expanded rapidly thereafter through RCVDs of 90%, and then contracted significantly at the RCVD of 100%. These increases in vulnerability were manifest as both a lowering of the overall stimulus thresholds necessary for fibrillation (window “deepening”), and an increase in the fraction of the cardiac cycle susceptible to these ectopic stimuli (window “widening”). In all cases of induced VF, the mechanism of induction was through reentry facilitated by temporary functional block. Moreover, the ability to form such a block—and thus the likelihood of subsequent VF—was enhanced as the RCVD increased. Taken together, these results demonstrate the complex relation between vulnerability and RCVD and, at the very least, suggest that the entire shape of the vulnerable window, rather than just its minimum threshold, is important when determining a heart's electrical stability. These conclusions are supported by results obtained from an experimental study—which utilized a similar programmed stimulation protocol—of normal and ischemic canine hearts.     

Design and evaluation of QRS and noise detectors for ambulatory e.c.g. monitors

In ambulatory e.c.g. monitoring, a high level of noise results in false QRS detection. We present a compact low-powered QRS detector design. We present a noise detector circuit that identifies most false QRS detections so that it can disable alarms. We present a standardised exercise protocol for testing the QRS detector. Data collected from subjects bending forward (for baseline drift), lifting a weight (for e.m.g.), and jogging (for motion artefact) present a realistic test set for an ambulatory QRS detector. We observe error rates of the order of 1%, the noise detector identifies more than half of these. These techniques should reduce false alarms in arrhythmia monitoring systems.     

Vulnerability of the thalamic somatosensory pathway after prolonged global hypoxic-ischemic injury

The aim of this study was to test the hypothesis that under prolonged global ischemic injury, the somatosensory thalamus and the cortex would manifest differential susceptibility leading to varying degrees of thalamo-cortical dissociation. The thalamic electrical responses displayed increasing suppression with longer durations of ischemia leading to a significant thalamo-cortical electrical dissociation. The data also point to a selective vulnerability of the network oscillations involving the thalamic relay and reticular thalamic neurons.An adult rat model of asphyxial cardiac arrest involving three cohorts with 3 min (G1, n=5), 5 min (G2, n=5) and 7 min (G3, n=5) of asphyxia respectively was used. The cortical evoked response, as quantified by the peak amplitude at 20 ms in the cortical evoked potential, recovers to more than 60% of baseline in all the cases. The multi-unit responses to the somatosensory stimuli recorded from the thalamic ventral posterior lateral (VPL) nuclei consists typically of three components: (1). the ON response (<30 ms after stimulus), (2). the OFF response (period of inhibition, from 30 ms to 100 ms after stimulus) and (3). rhythmic spindles (beyond 100 ms after stimulus). Asphyxia has a significant effect on the VPL ON response at 30 min (P<0.025), 60 min (P<0.05) and 90 min (P<0.05) after asphyxia. Only animals in G3 show a significant suppression (P<0.05) of the VPL ON response when compared to the sham group at 30 min, 60 min and 90 min after asphyxia. There was no significant reduction in somatosensory cortical N20 (negative peak in the cortical response at 20 ms after stimulus) amplitude in any of the three groups with asphyxia indicating a thalamo-cortical dissociation in G3. Further, rhythmic spindle oscillations in the thalamic VPL nuclei that normally accompany the ON response recover either slowly after the recovery of ON response (in the case of G1 and G2) or do not recover at all (in the case of G3).We conclude that there is strong evidence for selective vulnerability of thalamic relay neurons and its network interactions with the inhibitory interneurons in the somatosensory pathway leading to a thalamo-cortical dissociation after prolonged durations of global ischemia.     

Success rate versus defibrillation energy: temporal profile and the most efficient defibrillation threshold

To determine the temporal profile of the energy requirement for defibrillation, shocks were delivered to canine hearts after 5, 10, or 20 seconds from the onset of fibrillation with a combination of patch and catheter electrodes. A total of 956 fibrillation-defibrillation sequences were performed at one of four energy levels appropriately selected for each period of fibrillation in 10 anesthetized dogs. The energy values related to 50% (E50) and 80% (E80) of the predicted success were calculated from a logistic regression curve. The E50 and E80 values at 10 seconds after the onset of fibrillation were less than those at 20 seconds after the onset by 7.1% +/- 18.3% and 9.7% +/- 21.4%, respectively; differences were not significant. At 5 seconds after the onset, the differences were 15.3% +/- 14.2% (p less than 0.02) and 16.4% +/- 12.7% (p less than 0.01), respectively. The defibrillation energy efficiency was assessed by dividing the success rate (SR) of fibrillation by the applied energy (E). The maximal SR/E at 5, 10, and 20 seconds of fibrillation was achieved at the energy corresponding to the SRs of 88.8% +/- 4.5%, 90.4% +/- 3.9%, and 88.1% +/- 4.6%, respectively. We conclude that the energy requirement for defibrillation increases with the duration of fibrillation, even shortly after the onset of fibrillation, and the maximal energy efficiency is attained at the energy associated with the SR of approximately 90%.     

Alpha globin gene number: population and restriction endonuclease studies

Restriction endonuclease analysis was used to test a proposed genetic model using alpha-globin gene number to account for the observed distributions of the proportions of hemoglobin (Hb) S in sickle cell trait. In a subsample of specimens collected during a population survey in India, these studies confirmed that the postulated genotype was present in 22 of the 23 individuals examined. In the study population, the number of alpha-globin genes explains about 90% of the variance in the proportion of HbS in sickle cell trait (r2 = 0.895, p less than 10(- 10)).     

Treatment of children with neurogenic bladder dysfunctions using dynamic nero-electrostimulation(DENS) and M-Cholinolytic therapy

【Objective】 To investigate effects of combined usage of dynamic neuro-electric stimulation(DNES) and M-cholynolytic therapy(oxybutynin) upon manifestations of neurogenic bladder dysfunctions(NBD) in children.【Method】 Urodynamics examination included registration of extemporaneous urinary excretion,urofluometry,and retrograde cytometry in horizontal and vertical position by example of urodynamic system(UDS) ACS 180 Plus(MENFIS BioMed.,USA).In accordance to severity of clinician manifestations,three groups of patients have been defined(27-highest one,49-middle and 51 low levels).Dynamic neuro-electrostimulation(DNES) procedures were conducted using the"DiaDNES-PKM"device(Russian Federation).The children were exposed to juxtaspinal stimulation on S1-S3 level-altogether 10 sessions have been performed.Oxybutynin(driptan) was used in dosage of 2.5 mg per diem.【Result】It was established that combined usage of DNES and oxybutynin in the group with highest severity caused the reduction of manifestations by 3.1 times while separately given DNES and basic therapy were followed by 34.1% and 28.0% reduction correspondently.Meanwhile,DNES and oxybutynin reduced severity in patients with pronounced disturbances by 7.5 times.Combined usage of oxybutynin and DNES in severely manifested NBD increased the effective volume of bladder by 2.3 times.Also significant reduction of both intrabladder pressure(by 48.0%) and compliance of the bladder(by 4.8 times) were detected under condition of combined usage of DNES and oxybutynin.All mentioned indices were modified to less extent in case of separate usage of DNES or oxybutynin when compared with the one registered after the combined their usage(P <0.05).【Conclusion】Combined usage of DENS and oxybutinin(driptan) is effective in most severe cases in children suffered from neurogenic overactive bladder.