Context:Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable.Aim:This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes.Settings and Design:A cross-sectional survey of 213 doctors working at a tertiary care hospital was conducted to determine their attitudes toward euthanasia.Materials and Methods:A self-administered questionnaire was used to assess attitudes and personal perceptions about euthanasia.Statistical Analysis Used:The Chi square test was used to assess factors influencing attitudes toward euthanasia.Results:A majority of the respondents (69.3%) supported the concept of euthanasia. Relief from unbearable pain and suffering was the most commonly (80.3%) cited reason for being willing to consider the option of euthanasia. Majority of those who were against euthanasia (66.2%) felt that the freedom to perform euthanasia could easily be misused. Disapproval of euthanasia was associated with religious affiliation (P<0.001) and speciality (P<0.001).Conclusions:A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

Dengue viral (DENV) infection has a broad clinical spectrum ranging from classical febrile illness to life-threatening disease. Literature suggests that spectrum of illness could be due to differences in innate immune-responses; however, the knowledge is still at infancy. Amongst the various cells involved in innate immune responses, NK cells play a central role, particularly in anti-viral immunity. Thus in this study we have evaluated the role of NK-cells during acute-DENV infection and its influence on severity of disease, by analyzing activation, cytotoxic receptors, cytolytic granule contents and degranulation markers on NK-cells during different stages of infection. Based on the clinical manifestations and severity of the disease, DENV patients were classified into patients with dengue without warning signs (DF), dengue with warning signs (DFWS) and severe dengue (SD) patients. During acute-DENV infection, though there was no alteration in frequency of NK-cells, significant increase in frequency of CD56 bright subset in DF patients (p < 0.05) was observed, while it remained unaltered in SD patients. We also found that, CD56 dim NK-cell subset of DF patients had elevated CD69 expression, granzyme B and intracellular IFN-γ levels compared to SD patients (p < 0.05). Amongst the NK-cell cytotoxicity receptor (NCR), NKp30 receptor was significantly elevated in DF patients (p < 0.05), however in SD patients it was comparable to healthy controls. This receptor is essential for dendritic cells-NK-cells crosstalk for initiating adaptive immune response. IL-15 is known to induce NKp30 expression, which was also seen to be elevated in DF patients (p < 0.05) but unaltered in SD patients. In SD patients, even post-6 days of infection i.e. during recovery phase, CD69 and NKp30 expression did not raise, suggesting impaired NK-cell response in these patients. To summarize, our study reports, that efficient NK cell response during acute phase of DENV infection is crucial for preventing severity of the disease. This study helps in understanding the dynamics of NK cell response in immunopathogenesis of DENV infection; which is crucial for development of efficacious therapeutics as well as vaccine.

Background: There is limited Indian data available regarding inherited thrombophilias. This study was to determine the prevalence of inherited thrombophilias in young Indian patients presenting with thrombotic events.Methods: This study was done at a tertiary hospital in Western India over a period of 20 months. Epidemiological, clinical and laboratory data was recorded of all consecutive patients aged 16 to 45 admitted with arterial and venous thrombotic vascular events. Blood samples for the thrombophilia profile were sent. Data was tabulated and analyzed using microsoft excel and graph pad software.Results: 49 patients aged 15 to 45 years, admitted with thrombotic vascular events a period of 20 months were included. 26 (53.1%) were male. The mean age was 22.2±7 years. 20 (40.8%) patients; 10 (38.5%) males and 10 (43.5%) females had at least one thrombophilia. The commonest thrombophilia in both arterial and venous thrombotic events was hyperhomocysteinemia.Conclusions: Young patients with thrombotic vascular events should be tested for thrombophilias since they are an important risk factor in this subset of patients.