Most studies of migration that ask why and how people migrate examine economic rationales and the network connections of migrants. In this article, I explore one understudied aspect of the migration process, the 'culture of migration', using data gathered from field research in Hyderabad, India. Hyderabad is a city with substantial capital investment, especially from IT companies, and is an excellent site to examine how the desire to migrate remains salient in spite of the immigration of capital to the migrants' home setting, resulting in increased job opportunities at home, at least for professionals. Additionally, greater restrictions have been placed by Persian Gulf states on migrant labourers, resulting in decreased opportunities abroad. I argue that it is the culture of migration among Hyderabadi Muslim professionals and labourers that promotes migration to the US and Saudi Arabia, even though opportunities at home are greater for some, and opportunities abroad are more restricted for others. I further argue that this culture of migration helps to shape the effects of remittances on status relations and marriage patterns among Muslims in Hyderabad, which further promotes migration abroad.

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Introduction:Congenital heart defects (CHDs) are an important cause of mortality and morbidity in children representing a major global health burden. It is thus important to determine their prevalence and spectrum and identify risk factors associated with the development of heart defects.Materials and Methods:A case-control study was carried out in the Department of Pediatrics and Center of Cardiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from February 2014 to August 2015. All patients referred with complaints or clinical examination suggestive of CHDs were further evaluated with echocardiography. On Echocardiography, patients having CHDs were included as cases and those having a normal echocardiographic study were included as controls. Healthy controls were also included. 400 cases and 400 controls were thus identified; preterms having patent ductus arteriosus and patent foramen ovale and those with acquired heart defects were excluded. Risk factors among cases and controls were further studied.Results:Acyanotic heart defects were 290 (72.50%) of the total heart defects, whereas the contribution of cyanotic heart defects was 110 (27.50%). Out of all CHDs, ventricular septal defect was the most common lesion with contribution of 152 (38%) cases, whereas among the cyanotic heart defects, Tetralogy of Fallot was the most common lesion (18% of total cases). Out of the total 400 cases, 261 were males (65.25%). On univariate analysis, paternal age (odds ratio, OR, 2.01), bad obstetric history (OR, 2.65), antenatal febrile illness (OR, 4.12), and advanced maternal age (OR, 3.28) were found to increase the risk of CHD whereas intake of multivitamin (OR, 3.02) was found to be protective. The risk factors were further analyzed with multivariate logistic regression analysis and all the above factors were found to be significantly associated.Conclusion:We noted that the profile of CHD in our population was similar to the published literature although many were missed during infancy and detected later in life. Several antenatal factors were found to be associated with the incidence of congenital heart disease emphasizing the need to prioritize antenatal care and counseling to pregnant mothers along with good maternal nutrition and folic acid supplementation.

Carbapenem-resistance among enterobacteriaceae has become a global health concern. The objective of this study was to understand NDM producing enterobacteriaceae and their genetic basis of resistance, spreading in neonatal intensive care unit. Carbapenem resistant NDM producing enterobacteriaceae isolates were recovered from rectal swab and blood sample of infants admitted in NICU. These were determined by using Carba-NP test. All isolates were identified using BD PhoenixTM−100 and MICs were determined by broth microdilution method. The blaNDM and associated resistant markers were checked by PCR followed by sequencing. Moreover, ERIC-PCR and genetic environment of blaNDM gene were also performed for the analysis of clonal relationship and genetic surrounding of the strains. We characterized 44 isolates with blaNDM variants in Escherichia coli (45.5%), Klebsiella pneumoniae (40.9%), Citrobacter freundii (4.5%), Citrobacter braakii (2.3%), Klebsiella oxytoca (2.3%), Enterobacter cloacae (2.3%), Enterobacter aerogenes (2.2%) from NICU, showing resistance against all antibiotics except colistin and polymixin B. ISAba125 and bleomycin gene were found surrounding all blaNDM variants, besides class I integron on plasmid. (ERIC)-PCR data revealed non-clonal relatedness among most of the isolates. The transfer of resistant markers was confirmed by conjugation experiment. The PCR-based replicon typing was carried out using DNA of transconjugants. These isolates carried NDM-1 (20.45%), NDM-4 (36.36%), NDM-5 (38.64%), NDM-7 (4.55%), along with OXA, CMY, and SHV variants on conjugative plasmid of IncFIA, IncFIC, IncF, IncK, IncFIB, IncB/O, IncHI1, IncP, IncY, IncFIIA, IncI1, and IncN types. An increased number of carbapenem-resistant NDM producing enterobacteriaceae isolates recovered from NICU which is alarming signal for health workers and policy makers. Hence, it is utmost important to think about infection control measures.

Objectives. To compare the efficacy and safety of intravaginal misoprostol with transcervical Foley catheter for labour induction. Material and Methods. One hundred and four women with term gestation, with Bishop score < 4, and with various indications for labour induction were randomly divided into two groups. In Group I, 25 μg of misoprostol tablet was placed intravaginally, 4 hourly up to maximum 6 doses. In Group II, Foley catheter 16F was placed through the internal os of the cervix under aseptic condition and then inflated with 50 cc of sterile saline. Statistical analysis was done using SPSS software. Results. The induction to delivery interval was 14.03 ± 7.61 hours versus 18.40 ± 8.02 hours (p < 0.01). The rate of vaginal delivery was 76.7% versus 56.8% in misoprostol and transcervical Foley catheter group, respectively. Uterine hyperstimulation was more common with misoprostol. Neonatal outcome was similar in both the groups. Conclusion. Intravaginal misoprostol is associated with a shorter induction to delivery interval as compared to Foley's catheter and it increases the rate of vaginal delivery in cases of unripe cervix at term. Transcervical Foley catheter is associated with a lower incidence of uterine hyperstimulation during labour.

Acquisition of extended-spectrum b-lactamase producing Escherichia coli strains in male and female infants admitted to a neonatal intensive care unit: molecular epidemiology and analysis of risk factors Extended-spectrum b-lactamases (ESBLs) are bacterial enzymes that confer resistance to advanced generation cephalosporins and can lead to therapeutic failures. There has been no analysis of factors associated with the risk of acquisition of ESBLs in neonates in an intensive care unit from northern India. The CTX-M ESBL enzymes impart resistance against advanced generation cephalosporins (e.g. cefotaxime) and CTX-M variants have become the most prevalent ESBLs worldwide. The CTX-M-15 enzyme in particular is increasingly being reported from Escherichia coli isolates from northern India together with TEM-1. Moreover, E. coli is the most common cause of neonatal sepsis. Accordingly, this study aimed to: (i) characterize the mode of transmission of bla CTX-M and bla TEM among ESBL-producing E. coli strains isolated from patients admitted to a neonatal intensive care unit (NICU), and (ii) identify factors associated with the acquisition of the said strains in male and female neonates. A total of 97 ESBL-producers was identified among 266 E. coli strains isolated from 238 neonates. The isolates were screened for bla CTX-M , bla TEM , armA, rmtA and rmtB, the last three genes being responsible for aminoglycoside resistance. PCR amplified bla CTX-M genes were cloned and sequenced. Five bla CTX-M-15 , two rmtB, two bla TEM-1 and thirteen class1 integrons were detected. All the bla CTX-M-15 positive isolates, except one, were clonally related. Both univariate and multivariate analyses of factors for the acquisition of the said strains were performed with respect to the sex of the neonates. 'Length of stay in the NICU' was found to be the single independent factor associated with ESBL acquisition. In conclusion, our data suggest that male neonates who are colonized or infected by ESBL-producing E. coli have a longer stay in the NICU compared to their female counterparts. This prolonged stay may be due to male neonates becoming colonized/infected earlier than their female counterparts. Plasmid-mediated-conjugal transfer was found to be the mechanism of transfer of the bla CTX-M-15 resistance marker in the described setting. INTRODUCTIONThe prevalence of multidrug-resistant bacteria in hospital environments has become a matter of due concern (Shakil et al., 2008). Extended-spectrum b-lactamases (ESBLs) are bacterial enzymes that confer resistance to advanced generation cephalosporins and can lead to the therapeutic failure of these agents. ESBLs are often plasmid associated and there can be cross-species dissemination of these plasmids. Moreover, these plasmids often carry genes encoding co-resistance to other antibiotics such as aminoglycosides, fluoroquinolones, tetracyclines, chloramphenicol and sulfamethoxazole-trimethoprim, to name a few. Concomitant b-lactam and aminoglycoside resistance involving armA and rmtB genes is ...

This hospital based prospective study was conducted from September 2009 to September 2011.All the patients irrespective of age and sex, who reported with history of snake bite were included in the study. A total 169 snake bite patients, consisting of 116 (68.7%) male and 53 (31.3%) female [mean (SD) age 32±12 years] were admitted to the hospital during the study period, the ratio being 2.2:1. The majority of victims belonged to rural areas (67.5%) and most vulnerable occupation group was the people involved in agricultural activities (48.5%). The study population was predominately bitten outdoors (62.7%). Most of the time people could not identify the snake (52.1%) and among identified poisonous snakes Elapidae and Viperidae type were 15.4% and 13.0% respectively. The maximum cases of snakebite were recorded in the 3rd quarter of the year (67.4%) and peak incidence of snake bite was recorded in the time between 6:00 PM to 12:00 midnight (30.2%). In 69.2% of cases, the site of snake bite was lower limbs. The commonest manifestation was fright (85.2%) followed by pain at local site (57.9%). Majority of the victims were treated with ASV (81.1%) and most of them survived (92%).

Thrombocytopenia is one of the common hematological problems encountered in the neonatal period particularly in the sick newborns, premature babies and neonates admitted in neonatal intensive care units and usually indicate an underlying pathologic process. Thrombocytopenia is reported in neonates with bacterial, fungal, rickettsial, protozoal and viral infection. Some patients with bacterial septicemia may develop coagulopathy associated with DIC. The presence of thrombocytopenia is seen frequently in early sepsis with or without laboratory evidence of overt DIC. This study was conducted on 85 neonates admitted in NICU with clinical diagnosis of septicemia and 50 age and weight matched neonates served as control. Thrombocytopenia was seen in 83.5% cases where as bacterial culture was positive in only 41.1% cases. Further it was noted that, in gram negative (Gm -ve) septicemia, thrombocytopenia was more severe as compared to gram positive (Gm ?ve) septicemia. It is concluded that thrombocytopenia is early predictor of septicemia but other causes of neonatal thrombocytopenia should also be ruled out.