Background
Congenital cytomegalovirus infection (cCMV) is a leading non-genetic cause of permanent congenital or early-onset hearing loss (PCEHL). Although cCMV rates are high despite near-universal seroimmunity, the contribution of cCMV to PCEHL in the developing world is unclear.
Methods
Neonates at a rural north Indian hospital were screened for cCMV by saliva PCR and hearing by distortion product otoacoustic emission (DPOAE) testing. CMV positive infants and those not passing newborn hearing screening (NHS) were evaluated by auditory brainstem response to confirm PCEHL. Infants with cCMV and those with PCEHL were tested for mutations within the GJB2 gene.
Results
Of the 1720 infants screened, 40 (2.3%) did not pass NHS and 20 (1.2%) were CMV positive. ABR testing confirmed unilateral or bilateral PCEHL in 11 (0.64%) children who either did not pass NHS or CMV positive. PCEHL was 20-fold higher in neonates with cCMV (2/20, 10%) than those without (9/1700, 0.5%; p<0.01). None of 11 infants with PCEHL had connexin 26 mutations.
Conclusion
PCEHL incidence is high in India, with cCMV contributing significantly despite near universal seroimmunity. Our findings also demonstrate the feasibility and the utility of simultaneous newborn screening for both cCMV and hearing loss in a resource-limited setting.
Results of a study on commuter exposure to carbon monoxide (CO) and PM10 during transit in the several commonly popular modes of transport in Mumbai, India and Newcastle, UK are presented in this paper. In Mumbai, real-time exposure concentrations were measured whilst commuting along a route by bus, train, air conditioned taxi and a non-air-conditioned private car. In Newcastle, real-time exposure concentrations were measured whilst travelling by electric vehicle, public bus and bicycle along a route. Average heart rate whilst commuting was monitored and subsequently simulated in a submaximal exercise test to give minute ventilation (VE) associated with each transport mode. The study in Mumbai has indicated that commuters travelling on buses and private non-air-conditioned cars are exposed to very high levels of air pollution compared with the train commuters. In Newcastle, electric vehicle and bicycle displayed lowest exposure concentrations relative to buses. Higher exposure concentrations were observed for all travel modes in Mumbai as compared to Newcastle. When inhaled amount and the lung deposition of pollutants are considered, cyclists are exposed to higher amount of exposure dose in Newcastle due to the considerable increase in VE induced by the physical exertion of cycling. Thus, inhaled quantity and pollutant dosage give a better indication of the possible health risks and should be considered in future studies and in designing the cycle routes in cities.
course of ulcerative colitis (UC) in up to 25% of cases with a third of these episodes being the presentation of UC. 1,2 Intravenous (IV) steroids remain first-line therapy for ASUC, but only 60% patients respond to IV steroids, with the rest requiring rescue in the form of advanced immunosuppression (infliximab or ciclosporin) or surgery. 3 It is clinically highly relevant to predict steroid nonresponse in order to identify patients who need a change in treatment strategy to improve outcomes, both in the short and medium term. Baseline endoscopic severity, stool frequency, C-reactive protein (CRP) at
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