Clinic In India Research Articles

Bridge of Life–DaVita Medical Missions Opens New Clinic in India

Bridge of Life–DaVita Medical Missions Opens New Clinic in India

Perception of HIV testing among attendees at an STD clinic in India

This study reports perception of STD clinic attendees of Government General hospital, Chennai, India towards free HIV testing. All STD clinic attendees who were eligible for the study (511), from January to April 2001 formed the study subjects. In all, 362 (71%) subjects responded to the question on perception of risk in getting HIV/AIDS. Among them 36% perceived that they were at risk of getting infected with HIV. There was a significant difference (P=0.01) between the genders, as more males perceived risk of getting HIV than females and, with the increase in number of sexual partners in a lifetime there was an increasing trend (p<0.0001) in the perception of risk. There were 244 (55%) subjects willing for HIV testing. A significant difference between the genders (p<0.0001) was observed, as more females were willing to accept free HIV testing than males. When adjusting the effect of co-variates such as gender, age, marital status and perception of risk in getting HIV, persons having two or more sexual partners in their life time were four times more willing to be HIV tested than persons with one sexual partner (OR=4; p=0.001). The findings in this study will help optimize HIV testing in at risk patient populations in India.

Biomedical markers and psychiatric morbidity of neurasthenia spectrum disorders in four outpatient clinics in India

Context:Disorders of unexplained fatigue are researched globally and debated prominently concerning their biomedical and psychiatric comorbidity. Such studies are needed in India.Aims:To identify biomedical markers and psychiatric morbidity of disorders of severe unexplained fatigue or weakness with disability, designated neurasthenia spectrum disorders (NSDs). To compare biomedical markers of patients with controls. To study correlation between biomedical markers and psychiatric morbidity.Settings:Four specialty outpatient clinics of Psychiatry, Medicine, Dermatology, and Ayurved of an urban general hospital.Design:Case-control study for biomedical markers. Diagnostic interviews for assessment of psychiatric morbidity.Materials and Methods:Patients (N = 352) were recruited using screening criteria and Structured Clinical Interview for DSM-IV screening module. They were compared with controls (N = 38) for relevant biomedical markers. Psychiatric morbidity was assessed with SCID-I interviews, Hamilton scales, and Symptom Check List-90 (SCL-90). Correlations between a nutritional index and axis I morbidity were studied.Statistical Analyses:Frequencies and means of biomedical markers and psychiatric diagnoses were compared and associations assessed with regression analysis.Results:Corrected arm muscle area (CAMA) was significantly lower among patients (P < 0.001), but not anemia. Anxiety (73.0%) and somatoform (61.4%) disorders, especially nonspecific diagnoses, were more frequent than depressive disorders (55.4%). Generally, Hamilton and SCL scores were lowest in Ayurved clinic, and highest in Psychiatry clinic. Presence of Generalized Anxiety Disorder (GAD) and adjustment disorders correlated with low nutritional index.Conclusions:Malnutrition or de-conditioning that may explain weakness need to be considered in the management of NSDs in India, particularly with comorbid GAD or adjustment disorders. Weakness and anxiety, rather than fatigue and depression, are distinct features of Indian patients. SCL may be more useful than categorical diagnoses in NSDs. NSDs are an independent entity with nonspecific psychiatric comorbidity. Cross clinic differences among patients with similar complaints highlight need for idiographic studies.

Factors affecting dental anxiety and beliefs in an Indian population

The purpose of this study was to describe the possible factors that may affect dental anxiety and beliefs and to validate and test the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and a Modified Dental Beliefs Scale (MDBS) among the patients attending a university dental clinic in India. A cross-sectional study design was used. A total of 482 general dental patients attending a university dental clinic returned completed forms of the Indian translations of the MDAS and MDBS. General information about the age, sex, occupation and educational qualifications of the respondents as well as information about past dental experiences was also collected. All the statistical analysis was carried out by the spss (version 10) statistical software package. The Indian translations of the MDAS and the MDBS were found to be internally reliable with a Cronbach's alpha of 0.78 and 0.85, respectively. Validity was demonstrated by a statistically significant correlation between the MDAS and the MDBS scores with the correlation coefficient of 0.47. Age was also inversely related to dental anxiety. Anxiety scores were higher among the less educated patients. Those who had a prior unpleasant dental experience showed higher dental anxiety and more negative dental beliefs. The data obtained in this study provided strong evidence for the psychometric properties of the Indian version of the MDAS and the MDBS.

Evaluation of socio-economic factors causing discontinuation of epilepsy treatment resulting in seizure recurrence: A study in an urban epilepsy clinic in India

The prevalence rate of epilepsy in India ranges between 4.15 and 7.03 per 1000 population. In the developing countries, the major problems of epilepsy are lying in the treatment gap and discontinuation of treatment due to various adverse socio-economic factors. The objective of this study was to evaluate the rate of discontinuation of epilepsy treatment and its related socio-economic factors responsible for discontinuation. Among 1450 patients with epilepsy who were recurrently followed up at an intervals of 2 months from 05 January to 06 January; 620 patients discontinued their treatment. Among them 88.7% patient had breakthrough seizures for more than in two occasions. Socio-economic factors in respect to the treatment were evaluated during the follow-up period vis-a-vis income and expenditure, unemployment status, negative attitude towards medical treatment, non-availability of drugs locally, co-morbid psychiatric and other illnesses, polytherapy and socialillusional thoughts about epilepsy. Discontinuation of epilepsy treatment was detected in 42.75% (n = 620) of total patients resulting in recurrence of seizures. Reasons for discontinuation were multiple in most of the cases. The discontinued group had an average annual cost of treatment and income of Rs. 5500 ($110) and Rs. 12,800 ($256), respectively, amounting to 40% of their total income being expended for the cost of the treatment, while in continued group annual cost of treatment and income were Rs. 4500 ($ = 90) and Rs. 24,400 ($ = 580) respectively amounting to only 18% of the total income (p < 0.001) for the cost of treatment. Among the discontinued group, 90% of the patients reported the cost factors, 29.09% due to the unemployment, 20% from the frustration and despair, 20.09% due to non-availability of medicines locally, 17.27% spiritual illusional thoughts about epilepsy, 10% for marital disharmony were the causes for discontinuation of treatment. In the discontinued group, 10% got polytherapy against 9.03% in the continued group (p > 0.01), co-morbid psychiatric illnesses were observed in 4.54% against 3.25% in the continued group (p > 0.10). The study showed a significant number of patients (42.75%) discontinued epilepsy treatment within 1 year due to poor knowledge regarding the problem of discontinuation, cost and income disparity, unemployment, spiritual illusional thoughts about epilepsy, frustration and mental impairment, lack of uniform availability of drugs in local market. To tide these shortcomings, uniform availability of cheaper antiepileptic drugs with adequate information and communication regarding the disease and upliftment of socio-economic status are to be ensured.

Adherence to Antiretroviral Therapy and Virologic Suppression among HIV-Infected Persons Receiving Care in Private Clinics in Mumbai, India

Adherence to antiretroviral therapy (ART) and correlates of adherence and virologic suppression among human immunodeficiency virus (HIV)-infected persons receiving ART in private, outpatient clinics in India is unknown. Between December 2004 and April 2005, persons receiving ART at 3 private clinics in Mumbai, India, were interviewed regarding HIV care and adherence to ART. Physicians also completed a survey for each participant. Quantitative HIV-1 RNA level was determined for 200 participants. Of 279 participants, 73% reported > or = 95% adherence to ART. Adherence was positively associated with age > or = 50 years (adjusted odds ratio [aOR], 3.90), presence of comorbid conditions (aOR, 1.92), medication self-efficacy (aOR, 4.01), absence of pain in the past month (aOR, 2.14), and support from family and friends (aOR, 2.57). Lack of reminders from family members to take medication (aOR, 0.27) was negatively associated with adherence. Of 200 participants, 127 (63.5%) had virologic suppression (RNA level, < 400 copies/mL). Independent correlates of suppression were a regimen containing > or = 3 ART drugs (aOR, 5.52), first ART regimen (aOR, 3.28), adherence to therapy > or = 95% (aOR, 5.70), female sex (aOR, 3.19), and a physical component score > or = 50 (aOR, 1.07). Self-reported adherence to ART in a sample of patients attending Mumbai's private clinics was relatively high. However, the fact that a detectable viral level was found in nearly 40% of patients suggests that second-line ART regimens, as well as an emphasis on adherence and appropriate ART regimens in India, is needed.

Knowledge, Attitudes, And Practices of Antiretroviral Therapy among HIV-Infected Adults Attending Private And Public Clinics in India

India has approximately 5.2 million persons infected with HIV. Although antiretroviral therapy (ART) is being widely introduced in public clinics, many HIV-infected persons still seek care via the private sector. A cross-sectional survey was conducted in 2004 at six public and private sites to characterize the knowledge, attitudes, and practices (KAP) of ART among patients with HIV receiving care in India. Of 1667 persons surveyed, 609 (36%) had heard of ART and 19% of these persons reported that ART could cure HIV. Twenty-four percent reported that they were currently taking ART, with 18% of these patients not actually on ART according to their provider. Major barriers to taking ART were cost (33%), lack of knowledge of ART (41%), and deferral by physician (30%). More than half of all public and private patients had not heard of CD4 (57%) or viral load testing (80%), and even fewer had received these tests (32% and 11%, respectively). Private clinic attendees were almost 4 times more likely to be on ART (35% versus 9%, p < 0.0001), more likely to be male, have a higher education, be partnered, have a higher income, and have had a CD4 or viral load (p < 0.0001). Overall, low levels of ART knowledge and access were observed among HIV infected patients, with access to ART being particularly low among patients attending public clinics. In order to make widespread dissemination of ART effective in India, further educational and programmatic efforts are likely needed to optimize access, treatment awareness, and compliance among patients with HIV.

Same-Sex Behavior and High Rates of HIV Among Men Attending Sexually Transmitted Infection Clinics in Pune, India (1993-2002)

To determine HIV/sexually transmitted infection (STI) prevalence, trends, and risk behaviors of men who have sex with men (MSM) and compare these with those of non-MSM attending STI clinics in Pune, India over a 10-year period. Cross-sectional. From 1993 through 2002, men attending 3 STI clinics in Pune underwent HIV/STI screening. Demographic, risk behavior, clinical, and laboratory data were collected using standardized questionnaires and laboratory procedures. Of 10,785 men screened, 708 (6.6%) were MSM. Among these 708 MSM, 189 (31.7%) had 10 or more lifetime partners, 253 (35.7%) were married, 163 (23.1%) had sex with a hijra (eunuch), and 87 (13.3%) had exchanged money for sex. A total of 134 (18.9%) were HIV-positive, 149 (21.5%) had genital ulcer disease (GUD), 37 (5.8%) had syphilis, and 29 (4.3%) had gonorrhea (GC). Over the decade, neither HIV nor GC prevalence changed among MSM (P = 0.7), but syphilis and GUD decreased significantly (P < 0.0001). Compared with non-MSM, MSM were more likely to initiate sexual activity at age <16 years, to have >10 lifetime partners, to have sex with a hijra, and to use condoms regularly, but they did not differ significantly in HIV prevalence and had a lower prevalence of GC, GUD, and syphilis. Independent factors associated with HIV among MSM were employment (adjusted odds ratio [AOR] = 3.08; P = 0.02), history of GUD (AOR = 1.86; P = 0.003), and syphilis (AOR = 2.09; P = 0.05). Same-sex and high-risk sexual behaviors are prevalent among men attending STI clinics in India. Although syphilis and GUD rates decreased, HIV prevalence remained high during the decade, highlighting the importance of additional targeted efforts to reduce HIV risk among all men, including MSM, in India.

Can Homeopathic Treatment Slow Prostate Cancer Growth?

Homeopathy is a complementary medicine widely used around the world. Despite extensive use of homeopathy for cancer and other serious conditions with reported success, clinical and laboratory research has been equivocal, and no rigorous research has been done on cancer. In 1999, the US National Cancer Institute evaluated the effects of homeopathic treatment of cancer from a clinic in India and has released a request for protocols to conduct further research into this treatment. Therefore, the authors conducted a series of carefully controlled laboratory studies evaluating the effects of commonly used homeopathic remedies in cell and animal models of prostate cancer. One hundred male Copenhagen rats were randomly assigned to either treatment or control groups after inoculation with prostate tumor cells. Prostate tumor cells DU-145, LNCaP, and MAT-LyLu were exposed to 5 homeopathic remedies. Male Copenhagen rats were injected with MAT-LyLu cells and exposed to the same homeopathic remedies for 5 weeks. In vitro outcomes included tumor cell viability and apoptosis gene expression. In vivo outcomes included tumor incidence, volume, weight, total mortality, proliferating cell nuclear antigen (PCNA) expression, apoptotic cell death (terminal deoxynucleotidyl transferase mediated d-uridine triphosphate nick end labeling), and gene expression (rAPO-multiprobe). There were no effects on cell viability or gene expression in 3 prostate cell lines with any remedies at any exposure time. There was a 23% reduction in tumor incidence (P < .0001), and for animals with tumors, there was a 38% reduction in tumor volume in homeopathy-treated animals versus controls (P < .02). At time of killing, experimental animals with tumors had a 13% lower average tumor weight (P < .05). Tumors in these treated animals showed a 19% increase in apoptotic cell death (P < .05) and reduced PCNA-positive cells. The findings indicate that selected homeopathic remedies for the present study have no direct cellular anticancer effects but appear to significantly slow the progression of cancer and reduce cancer incidence and mortality in Copenhagen rats injected with MAT-LyLu prostate cancer cells.

Received social support, self-efficacy, and finding benefits in disease as predictors of physical functioning and adherence to antiretroviral therapy

Objective The study investigated whether received social support, self-efficacy, and finding benefits in disease are related to physical functioning and adherence to antiretroviral medication among men and women infected with HIV. Methods Data were collected among 104 patients of three HIV clinics in India. The measures included general self-efficacy scale, Berlin social support scales, questionnaire on taking antiretroviral medication, and SF-20 (physical functioning). Results The results of path analysis and mediation analysis revealed that finding benefits and self-efficacy were directly related to both adherence and physical functioning. Additionally, finding benefits mediated the relation between patients’ self-efficacy and adherence as well as physical functioning. Although received support was unrelated to adherence directly, effects of received support on adherence were mediated by self-efficacy. Conclusions Besides personal and social resources, benefit finding was related to better adherence to antiretroviral medication. Practice implications Identifying patients receiving low social support, with weak general self-efficacy and finding no benefits in being diagnosed with HIV may help to elicit those people who are at risk for poorer adherence and physical functioning.

High HIV Prevalence Among a High-Risk Subgroup of Women Attending Sexually Transmitted Infection Clinics in Pune, India

To investigate changes over a decade in prevalence and correlates of HIV among high-risk women attending sexually transmitted infection (STI) clinics in Pune, India, who deny a history of commercial sex work (CSW). Cross-sectional. From 1993 to 2002, 2376 women attending 3 STI clinics in Pune were offered HIV screening. Women who denied CSW were included (n = 1020). Of 1020 women, 21% were HIV infected. The annual HIV prevalence increased from 14% in 1993 to 29% in 2001-2002 (P < 0.001). The change in HIV prevalence over time was paralleled by changes in clinic visitor characteristics; in later periods, women were older, more often employed, less likely to be currently married, and more likely to report condom use. In multivariate analysis, factors independently associated with HIV were calendar period (adjusted odds ratio [AOR], 1.9 for 1997-1999 vs. 1993-1996; 95% CI, 1.2-3.0; AOR, 2.3 for 2000-2002 vs. 1993-1996; 95% CI, 1.5-3.6), lack of formal education (AOR, 2.0; 95% CI, 1.4-2.9), having been widowed (AOR, 3.1; 95% CI, 1.6-6.1), current employment (AOR, 1.8; 95% CI, 1.2-2.6), and genital ulcer disease on examination (AOR, 1.8; 95% CI, 1.2-2.7). Women attending STI clinics in India who deny a history of CSW represent a small, hidden subgroup, likely put at risk for HIV because of high-risk behavior of their male partners, generally their husbands. Educational and awareness efforts that have targeted other subgroups in India (men and CSWs) should also focus on these hard-to-reach women. Risk reduction in this subgroup of Indian women would also be expected to reduce perinatal infections in India.

Organization and Running of the First Comprehensive Hereditary Cancer Clinic in India

Hereditary cancers are thought to account for around 5% of cancers, particularly breast/ovarian and colorectal cancers. In India there is a paucity of data on hereditary cancers and the mutations in some of the common genes linked to hereditary cancers, such as BRCA1, BRCA2, hMSH2 and hMLH1. The country's first comprehensive hereditary cancer clinic was established in February 2002. The article describes the organization and running of the Clinic. It also discusses some of the social issues relevant to the given population in running the Hereditary Cancer Clinic.

Quality of Life in Indian Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a multisystem disease with various extra-articular manifestations (EAMs). Health-related quality of life (HRQOL) issues are assuming increasing importance in chronic rheumatic diseases like RA. No data on QOL in RA is available from the Indian subcontinent. There is also a paucity of literature on the impact of EAMs on HRQOL in RA. The objective of this study was to address these lacunae. The study group comprised 81 patients with RA from a rheumatology clinic in India. Quality of life was estimated by the generic HRQOL measure: World Health Organization quality of life instrument (WHOQOL-Bref). Disease activity in RA was measured by calculating Disease Activity Score-28 (DAS28). The mean HRQOL scores of the patients were 12.0+/-2.8, 13.2+/-2.7, 14.4+/-2.9 and 13.3+/-2.6 in the physical, psychological, social, and environmental domains of the WHOQOL-Bref respectively. Age, gender, disease duration, educational status, constitutional symptoms, rheumatoid factor positivity, erosions and deformities did not influence HRQOL. Disease activity had a negative influence on the physical and psychological domains. Patients with EAMs had significantly higher DAS28 scores compared to patients without EAMs. Even after adjustment for disease activity, patients with EAMs had lower HRQOL scores than patients without these features (statistically significant for physical domain). The physical domain of HRQOL is most affected in Indian patients with RA. Increasing disease activity and presence of EAMs worsens the quality of life.

Economic evaluation of HIV screening in pregnant women attending antenatal clinics in India

Objective With prevalence of HIV rising in pregnant women in India, pediatric HIV/AIDS is emerging as a public health problem. We evaluated the additional costs to the health care system and the additional health outcomes of introducing a voluntary primary care HIV screening program for pregnant women in India. Methods The analysis was conducted from the government perspective. We analyzed two scenarios: a programme of universal screening nation-wide and a programme of screening restricted to high prevalence states. Health benefits were measured by the number of perinatal HIV cases prevented and the reduction in the potential years of life lost (PYLL). Findings Nation-wide screening would cost the government Rs. 254.78 million and would prevent 9880 cases of perinatal HIV resulting in savings of 131,700 life years (average cost per HIV case prevented Rs. 25,787; per year reduction in PYLLs Rs. 1935). Implementing the program in only the high prevalence states would achieve 45% of these reductions in cases and life years lost at only 20% of this cost, at an average of Rs. 12,091 per HIV case prevented or Rs. 907 per year reduction in PYLLs (44 Indian rupees = US$ 1). In sensitivity analysis, the cost of the program was influenced mainly by antenatal coverage, the cost of the HIV test, the lifetime costs of treatment of a HIV infected child and the overhead costs. Conclusions We provide an estimate of the additional costs and health effects of two approaches to introducing HIV screening among pregnant women in India. Decision-makers would have to demonstrate that the resources used for its implementation would result in more health benefits than from the alternative uses of those resources.

Male circumcision and risk of HIV-1 and other sexually transmitted infections in India

Circumcised men have a lower risk of HIV-1 infection than uncircumcised men. Laboratory findings suggest that the foreskin is enriched with HIV-1 target cells. However, some data suggest that circumcision could simply be a marker for low-risk behaviours. In a prospective study of 2298 HIV-uninfected men attending sexually transmitted infection clinics in India, we noted that circumcision was strongly protective against HIV-1 infection (adjusted relative risk 0.15; 95% CI 0.04-0.62; p=0.0089); however, we noted no protective effect against herpes simplex virus type 2, syphilis, or gonorrhoea. The specificity of this relation suggests a biological rather than behavioural explanation for the protective effect of male circumcision against HIV-1.

Surviving childhood cancer: what next? Issues under consideration at the After Completion of Therapy (ACT) clinic in India.

Medical and Pediatric OncologyVolume 41, Issue 6 p. 588-589 International Note Surviving childhood cancer: What next? Issues under consideration at The After Completion of Therapy (ACT) clinic in India P.A. Kurkure MD, DCH, Corresponding Author P.A. Kurkure MD, DCH kurkure@vsnl.com Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaAdditional Professor/Incharge of Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai 400012, India.Search for more papers by this authorS. Achrekar MBBS, DCH, S. Achrekar MBBS, DCH Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorU. Uparkar MD, U. Uparkar MD Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorN. Dalvi MA, N. Dalvi MA Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorS. Goswami MA, S. Goswami MA Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this author P.A. Kurkure MD, DCH, Corresponding Author P.A. Kurkure MD, DCH kurkure@vsnl.com Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaAdditional Professor/Incharge of Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai 400012, India.Search for more papers by this authorS. Achrekar MBBS, DCH, S. Achrekar MBBS, DCH Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorU. Uparkar MD, U. Uparkar MD Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorN. Dalvi MA, N. Dalvi MA Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorS. Goswami MA, S. Goswami MA Pediatric Oncology and ACT Clinic, Department of Medical and Pediatric Oncology, Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this author First published: 24 October 2003 https://doi.org/10.1002/mpo.10323Citations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume41, Issue6December 2003Pages 588-589 RelatedInformation

Age at Onset Typology in Opioid‐dependent Men: An Exploratory Study from India

This study attempted to apply age at onset typology in ICD-10-diagnosed opioid dependence. The sample is comprised of eighty men seeking treatment at an addiction clinic in India. The measures included a sociodemographic and clinical profile, Severity of Opioid Dependence Questionnaire, Sensation Seeking Scale, Multiphasic Personality Questionnaire (MPQ), and Family History Assessment Module. Application of k-means cluster analysis led to the emergence of two cluster types: early onset (mean age at onset 21 years) and late onset (mean age at onset 27 years). The early onset group was characterized by a significantly younger current age, more urban and unemployed subjects, younger ages at the onset of opioid use and dependence, a higher severity of opioid use, a higher lifetime use of sedatives and tobacco, younger ages at the onset of dependence on alcohol and cannabis, higher sensation seeking, and higher global psychopathology in terms of MPQ. Other less differentiating features were higher family history of psychiatric illness (including substance abuse), longer duration of opioid use and dependence, and higher lifetime use of cannabis. These results show the age at onset typology in opioid dependence to be feasible and to have some similarities to age at onset typology in alcoholism.

Accreditation, supervision, and regulation of ART clinics in India--a distant dream?

Accreditation, supervision, and regulation of ART clinics in India--a distant dream?

α6β1 Integrin is a potential clinical marker for evaluating sperm quality in men

Objective To determine the clinical significance of α6β1 integrin in human spermatozoa. Design Prospective case-controlled study. Setting Hospital infertility clinic in India. Patient(s) Sixty-two men undergoing evaluation for infertility and 20 healthy, proven-fertile controls were selected. Intervention(s) Role of α6β1integrin in sperm quality evaluation was determined using semen analysis, cell ELISA, flow cytometry, and in vitro sperm–egg binding. Main outcome measure(s) Determination of sperm-associated α6β1 integrin may help in assessing the quality of the human spermatozoa. Result(s) Expression of α6β1 integrin was significantly low in the spermatozoa obtained from subfertile men. Only 35%–40% of spermatozoa from fertile men showed a positive reaction to α6β1 antibody. The samples with high rate of acrosomal reaction showed a good expression of α6β1 and maximum binding to oocyte in an in vitro binding assay. Conclusion(s) α6β1 Integrin may be used as a clinical marker to evaluate sperm quality.

Age at Onset Typology in Opioid-dependent Men: An Exploratory Study from India

This study attempted to apply age at onset typology in ICD-10-diagnosed opioid dependence. The sample is comprised of eighty men seeking treatment at an addiction clinic in India. The measures included a sociodemographic and clinical profile, Severity of Opioid Dependence Questionnaire, Sensation Seeking Scale, Multiphasic Personality Questionnaire (MPQ), and Family History Assessment Module. Application of k-means cluster analysis led to the emergence of two cluster types: early onset (mean age at onset 21 years) and late onset (mean age at onset 27 years). The early onset group was characterized by a significantly younger current age, more urban and unemployed subjects, younger ages at the onset of opioid use and dependence, a higher severity of opioid use, a higher lifetime use of sedatives and tobacco, younger ages at the onset of dependence on alcohol and cannabis, higher sensation seeking, and higher global psychopathology in terms of MPQ. Other less differentiating features were higher family history of psychiatric illness (including substance abuse), longer duration of opioid use and dependence, and higher lifetime use of cannabis. These results show the age at onset typology in opioid dependence to be feasible and to have some similarities to age at onset typology in alcoholism.