Deafness is genetically very heterogeneous and forms part of several syndromes. So far, delayed rectifier potassium channels have been linked to human deafness associated with prolongation of the QT interval on electrocardiograms and ventricular arrhythmia in Jervell and Lange-Nielsen syndrome. Ca(v)1.3 voltage-gated L-type calcium channels (LTCCs) translate sound-induced depolarization into neurotransmitter release in auditory hair cells and control diastolic depolarization in the mouse sinoatrial node (SAN). Human deafness has not previously been linked to defects in LTCCs. We used positional cloning to identify a mutation in CACNA1D, which encodes the pore-forming α1 subunit of Ca(v)1.3 LTCCs, in two consanguineous families with deafness. All deaf subjects showed pronounced SAN dysfunction at rest. The insertion of a glycine residue in a highly conserved, alternatively spliced region near the channel pore resulted in nonconducting calcium channels that had abnormal voltage-dependent gating. We describe a human channelopathy (termed SANDD syndrome, sinoatrial node dysfunction and deafness) with a cardiac and auditory phenotype that closely resembles that of Cacna1d(-/-) mice.

The manufacture of garments is the main industry in Bangladesh and employs 1·6 million female workers. Due to the indoor lifestyle and low dietary intake of calcium, we hypothesised that they are at risk of low vitamin D and bone mineral status. Two hundred female garment workers (aged 18-36 years) were randomly selected. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), serum calcium (S-Ca), serum phosphate (S-P) concentration and serum alkaline phosphatase activity (S-ALP) were measured from fasting samples. Bone indexes of hip and spine were measured by dual-energy X-ray absorptiometry. The mean S-25OHD (36·7 nmol/l) was low compared to that recommended for vitamin D sufficiency. About 16 % of the subjects were found to be vitamin D-deficient (S-25OHD , 25 nmol/l). We observed a high prevalence (88·5 %) of vitamin D insufficiency (S-25OHD , 50 nmol/l) as well as a significant inverse relationship between S-25OHD and S-iPTH (r 20·25, P# 0·001). A decrease in S-25OHD (,38 nmol/l) and an increase in S-iPTH (. 21 ng/l) was associated with progressive reduction in bone mineral density at the femoral neck and lumbar spine. According to the WHO criteria, the mean T-score of the femoral neck and lumbar spine of the subjects were within osteopenic range. We observed that subjects with a bone mineral density T-score , 22·5 had a trend of lower values of BMI, waist -hip circumference, mid-upper-arm circumference, S-25OHD and higher S-iPTH and S-ALP. The high prevalence of hypovitaminosis D and low bone mineral density among these subjects are indicative of higher risk for osteomalacia or osteoporosis and fracture. Osteoporosis is a disease in which the density of bone is decreased with a consequent increase in bone fragility and susceptibility to fracture risk. Women are four times more likely than men to develop this disease. Osteoporosis has profound implications for an individual and for the economics of society. Although the exact mechanisms that lead to osteoporosis are not fully understood, two major determinants are known: peak bone mass during childhood and adolescence, and the rate of bone loss during ageing (1)

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Due to little outdoor activity and low dietary intake of vitamin D (VD), Bangladeshi low-income women are at risk for osteoporosis at an early age. The present study assessed the effect of VD, Ca and multiple micronutrient supplementation on VD and bone status in Bangladeshi young female garment factory workers. This placebo-controlled 1-year intervention randomly assigned 200 apparently healthy subjects (aged 16 -36 years) to four groups: VD group, daily 10 mg VD; VD and Ca (VD-Ca) group, daily 10 mg VD þ 600 mg Ca; multiple micronutrient and Ca (MMN-Ca) group, 10 mg VD and other micronutrients þ 600 mg Ca; a placebo group. Serum 25-hydroxyvitamin D (S-25OHD), intact parathyroid hormone (S-iPTH), Ca, phosphate and alkaline phosphatase were measured. Bone mineral density and bone mineral content were measured by dual-energy X-ray absorptiometry. All measurements were made at baseline and at 12 months. Significantly (P, 0·001) higher S-25OHD concentrations were observed in the supplemented groups than in the placebo group after the intervention. Supplementation had an effect (P,0·001) on S-iPTH in the VD-Ca and MMN-Ca groups compared with the placebo group. Bone mineral augmentation increased at the femur in the supplemented groups. Supplementation with VD-Ca should be recommended as a strategic option to reduce the risk of osteomalacia and osteoporosis in these subjects. MMN-Ca may have analogous positive health implications with additional non-skeletal benefits. Calcium and vitamin D interventions: Bone mineral accretion: Female garment workers: BangladeshOsteoporosis is a growing concern in both developed and developing countries. This situation is to some extent related to the increased longevity of the population. In the developing world, the growth of the general population as well as the life expectancy of the elderly is increasing dramatically. Women are four times more vulnerable to developing osteoporosis, as it is one of the serious physiological consequences of menopause. A decrease in the production of oestrogens during menopause triggers an accelerated rate of bone loss in women. Osteoporosis is a significant public health problem associated with increased mortality and morbidity. Recent studies indicate the growing prevalence of osteoporosis and osteoporotic fractures in developing countries and suggest that the situation be taken into account by improved health care planning (1)

This is the largest reported series with the longest follow-up showing the SilverHawk device as an effective endovascular therapy for patients with claudication and CLI with a low mortality, low complications rate, low amputation rate, and rare need for conversion to surgical bypass. The majority of reintervention was performed with endovascular techniques.

Objective:To study the level of job satisfaction among doctors serving in a tertiary care hospital in Lahore and ascertain its co-relation with multiple demographic variables which had a profound impact.Methods:This cross sectional study with non-probability purposive sampling was conducted at Combined Military Hospital, Lahore, from February 2014 to November 2014. Subjects were doctors serving in that hospital for minimum six months duration. Pre-formed questionnaires were distributed to volunteers (average filling time was 3 ½ to 7 minutes). Multiple demographic features were independent variables. Outcome variable was job satisfaction. Statistical analysis was done via descriptive statistics (SPSS 20), data expressed as mean ± standard deviation (SD).Results:Out of 263 doctors serving in hospital, 203 (77.91%) volunteered to participate; response rate by depositing the filled forms was 47.78% (97 doctors). Amongst the respondents, 10 (10.3%) doctors had below average job satisfaction, 32(33.0%), 21(21.6%), 21(21.6%) and 13(13.3%) had average, above average, well above average and outstanding job satisfaction respectively. There was significant relation between job satisfaction and age group of the doctors (p 0.025), education (p 0.015), service years (p 0.013) income per month (p<0.001). There was no significant impact of gender (p 0.540), marital status (p 0.087), number of children (p 0.153), current employment (p 0.71), nature of job (p 0.204), working hours (p 0.089), additional duties p 0.421) and socioeconomic class (p 0.104) on outcome variable.Conclusion:A significant number of doctors was found discontented with their job, which may consequently impact their yield/performance. The job satisfaction can be substantially improved if these contributory factors are aptly addressed at all tiers.

Despite previous concerns over adverse outcomes in women undergoing carotid endarterectomy, from our data, carotid stenting appears to be a safe modality in women with equivalent outcomes when compared to men.

Security is one of the most critical aspects of software quality. Software security refers to the process of creating and developing software that assures the integrity, confidentiality, and availability of its code, data, and services. Software development organizations treat security as an afterthought issue, and as a result, they continue to face security threats. Incorporating security at any level of the Software Development Life Cycle (SDLC) has become an urgent requirement. Several methodologies, strategies, and models have been proposed and developed to address software security, but only a few of them give reliable evidence for creating secure software applications. Software security issues, on the other hand, have not been adequately addressed, and integrating security procedures into the SDLC remains a challenge. The major purpose of this paper is to learn about software security risks and practices so that secure software development methods can be better designed. A systematic literature review (SLR) was performed to classify important studies to achieve this goal. Based on the inclusion, exclusion, and quality assessment criteria, a total of 121 studies were chosen. This study identified 154 security risks and 424 best practices that help software development organizations to manage the security in each phase of the SDLC. To pursue secure SDLC, this study prescribed different security activities, which should be followed in each phase of the SDLC. Successful integration of these activities minimizing effort, time, and budget while delivering secure software applications. The findings of this study assist software development organizations in improving the security level of their software products and also enhancing their security efficiency. This will raise the developer's awareness of secure development practices as well.