Title: Ebola Virus as a Potential Bio-Weapon: A Fantasy or a Possibility?
Authors: Adnan Bashir Bhatti, Shah Faisal Ahmad Tarfarosh, Maham Abbasi
In addition to the devastations created by the Ebola epidemic of 2014, the rumors about the misuse of Ebola virus as a potential bio weapon have already put fear among the common masses. The aim of this review was to find the evidences, from the medical literature, against and in support of the potential of Ebola virus to be used as a bio weapon. The factors which oppose this possibility were seen to be: lack of epidemiological evidence of aerosol infectivity of Ebola, slow spread, availability of rapid diagnostic methods, and difficulty of access to nonhuman hosts and bio safety laboratories as well as environmental instability of Ebola virus. On the other hand, increased morbidity and mortality of Ebola virus disease, its spread by interpersonal contact, evidence of aerosol spread in Non-human Primates and possibility of the same in humans by harmful mutation of any Ebola strain, and lack of effective vaccines/drugs raise this possibility. We have also suggested some public health measures to be taken beforehand in order to deal with such a global emergency if it ever occurs.
Keywords: Ebola, Biowarfare, Bioweapon, Bioterrorism, Ebola Bomb, Ebola Virus Disease
Title: Breast Schwannoma: A Rare Entity
Authors: Dr. Sapna Shrivastava, Prof. Dr. Chandra Mathur, Dr. Sandhya Bordia
Though benign breast lesions are common, but schwannoma which develops out of nerve sheath cells usually arises in extremities, trunk &head region is a rare presentation in breast. This is a case of 43 yr female presenting as lump breast for 6 months which was diagnosed as schwannoma. Grossly, it was a well defined, oval shaped, firm mass measuring 4x3x1.5 cm with a rim of fatty tissue. External surface was grey white and smooth. It was well circumscribed. Cut surface of the tumor was grey white in colour. Microscopic examination revealed closely packed bundles of woven spindle cells with pallisading of the nuclei.
Keywords: schwannoma, varocay bodies
Title: Development and Validation of Simultaneous RP-HPLC Method for Estimation of DROTAVERINE HCl and MEFENAMIC Acid in bulk and Pharmaceutical Formulations
Authors: Pallavi A. Patil, A. R.Umarkar, M.M.Bari, S.D.Barhate
A simple, specific, accurate and precise RP HPLC method has been developed for the simultaneous determination of Drotaverine HCl and Mefenamic Acid from combined dosage form by reverse phase C18 column (Younglin (S.K) Gradient System UV (250mm x 4.6mm) 5μ). The sample was analysed using Methanol : Water in the ratio of 80:20( 0.1% triethylamine at pH 3 ) as a mobile phase at a flow rate of 1.0ml/min and detection at 250nm. The retention time for Drotaverine HCl and Mefenamic Acid was found to be 5.500 min and 9.550 min respectively. The stability assay was performed for this combination and was validated for accuracy, precision, linearity, specificity and sensitivity in accordance with ICH guidelines. Validation revealed the method is specific, rapid, accurate, precise, reliable, and reproducible. Calibration plots were linear over the2-10 μg/mL for Drotaverine Hcl and 6-30 μg/mL for Mefenamic Acid, respectively, and recoveries from combined dosage form were between 98 and 102%. The method can be used for estimation of combination of these drugs in combined dosage form.
Keywords: Drotaverine Hydrochloride , Mefenamic Acid , RP-HPLC.
Title; Comparative Evaluation of Various Methods for Detection of Malaria with Special Reference to Modified Buffy Coat Preparation
Authors: Sonal Bhati, Gunja Dwivedi, Sunita Bhargava, Narendra Mogra
The present study was aimed to do comparative evaluation of various methods for detection of Malaria with special reference to Modified buffy coat preparation and thus to establish a more sensitive method of detection. Blood samples collected from 200 suspected malaria patients were subjected to all the four tests. The results obtained from Modified buffy coat preparation were compared with the conventional PBF, QBC and antigen detection test. Sensitivity of PBF, antigen detection test and modified buffy coat preparation method was 84.90%, 86.79%, 94.33% respectively and specificity was 100%, 95.74% and 97.87%, respectively. It was seen that by addition of centrifugation to the PBF, sensitivity improved from 84.90% to 94.33 %.
Keywords: PBF- Peripheral blood film, QBC- Quantitative buffy coat
Title: Seroprevalence of Hepatitis A and E Virus IgM in Children Suffering from Acute Hepatitis
Authors: Sumit Kumar Rawat, Dr Ashish Jain
Objective: Acute viral hepatitis (AVH) in children is a major health problem, among which feco-orally transmitted hepatitis A and hepatitis E are major public health problem in developing countries like India. Their incidence, severity and outcome in small children in central India is not well known
Methods: Prospective cross sectional study in which children with acute viral hepatitis were analysed for hepatitis A and hepatitis E IgM by ELISA.
Results: A total of 70 patients were included in the study, out of which 11 (15.7%) patients were positive for hepatitis A, whereas 7(10%) patients were positive for hepatitis E and 2 (2.8%) patients were positive for recent infection of both hepatitis A and hepatitis E. Male preponderance was noted.
Acute liver failure (ALF) was seen more often in HAV infection.
Conclusion: AVH is a significant problem in central India. Co-infection of hepatitis viruses is not infrequent and detected in many cases.
Keywords: Seroprevalence, Viral, Acute Hepatitis, children
Title: A Comparison between Intravenous Fentanyl Alone and Intravenous Fentanyl plus Intravenous Ketorolac for Late Intraoperative and Immediate Postoperative Analgesia during Laparoscopic Cholecystectomy
Authors: S A Mannan, Rabiaarifa, Sajad Hamid
Objective: Our study compared the effect of fentanyl alone with fentanyl plus intravenous ketorolac for analgesic efficacy, opioid sparing effects, and opioid-related side effects after laparoscopic cholecystectomy.
Materials and Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomized into two groups. Both groups received fentanyl during induction. First group of patients received IV placebo before the end of surgery while second group received 0.5mg of I.V. ketorolac just before the end of surgery. The postoperative pain relief was evaluated by a visual analog scale (VAS) using a 100-mm visual analog scale adverse effects, as well as vital signs were recorded every 15 min for 150 min or until discharge from the postanesthesia care unit.
Results: The mean VAS score in first and second hour after surgery was less in the group receiving I.V. ketorolac (3.4 0.2 vs5.4±0.5./ 3.3±0.4 vs4.7 ±0.2.); the rescue analgesia consumption over first 24 h was also less in the group receiving I.V. ketorolac (40±25.9 vs. 102±20.7). The time requirement of first dose of rescue analgesic in the postoperative period was also significantly prolonged in the group receiving I.V. ketorolac (240±24.9 vs. 55±12.3). There was no difference in the sedation scores and in the incidence of PONV in the two groups.
Conclusion: The study demonstrates the usefulness of intravenous ketorolac as supplementary analgesic in the treatment of postoperative pain after laparoscopic cholecystectomy.
Keywords: Intravenous ketorolac, pain after laparoscopic cholecystectomy, postoperative analgesia
Title: Induction Characteristics of Propofol and Thiopentone: A Comparative Clinical Study in short day Care Cases
Authors: Ashok Kulasekhar, Chitra Ashok, Sivanesan S
In This Randomized Study, an attempt was made to evaluate clinically and compare Propofol and Thiopentone when used alone in unpremedicated patients undergoing minor surgical and orthopedic procedures like fracture reductions and manipulation for dislocations. The study was conducted to know the side effects and drawbacks of the drug. Premedication was avoided to study the drug as a sole inducing agent and also to avoid the effect of premedication on various parameters. All the parameters studied with Propofol were compared with that of Thiopentone.
Keywords- Propofol, Thiopentone, induction
Plot no 4080, Ramar Koil street, Ram nagar north,
Madipakkam, Chennai - 600091, TamilNadu, India
Title: Effect of Mechanical Ventilation on Serum Electrolytes in Preterm Neonates with Respiratory Distress Syndrome
Authors: Tahaseen Banu Shaikh, S. C. Hiremath, K. F. Kammar
This study was done to evaluate serum electrolytes values of preterm neonates with respiratory distress syndrome who were treated with mechanical ventilation. Serum electrolyte values of sodium, potassium and chloride were analysed. The values were found to be within the normal range when compared with the known standard normal values.
Key words: preterm; mechanical ventilation; respiratory distress syndrome; serum electrolytes
Title: Non traumatic Massive Subcutaneous Emphysema in a Baby
Authors: Dr. Nirmal Bhaskar, Dr. K.Sudha Bhanu, Dr. Nandakumaran.T.K
Subcutaneous emphysema is a condition in which air is trapped in the layer under the skin. A 1½ year old boy presented in our casualty with history of violent cough followed by bloating up of baby. The whole baby was covered by massive subcutaneous emphysema from scalp to foot. No respiratory distress. X ray/ Babygram showed massive subcutaneous emphysema extending from scalp to foot. But no pnuemothorax or pneumomediastinum. Baby was managed conservatively with oxygen inhalation without ICD tube. Extensive subcutaneous emphysema can be managed conservatively without intercostal drainage tube, if there is no respiratory distress. Administering oxygen may help the body to absorb the subcutaneous air more quickly.
Keywords-Subcutaneous Emphysema, Pneumothorax, intercostal drainage, respiratory distress, breathing oxygen.
Title: Changes of Serum Transaminases in Chronic Alcoholics Undergoing Deaddiction Treatment
Authors: Archana.A.Dharwadkar, B.Vikram, Shruti.Mohanty
Alcoholism is a major health issue with socioeconomic consequences. Clinicians can use cost effective and easily available biochemical measurements to objectively assess patients’ current or past alcohol use. Commonly known as the liver enzymes, the serum aminotransferases include: aspartate aminotransferase (AST), alanine aminotransferase (ALT) which reflect liver injury due to excessive alcohol consumption.
The aim of this case control study was to estimate the transaminases (AST and ALT) and compare their levels in chronic alcoholics undergoing deaddiction treatment with apparently healthy age matched controls.
30 cases between 25-60 years of age, selected for the study in the inpatient unit of Dept.of de-addiction centre at Kamineni Institute of Medical Sciences, Narketpally. AST and ALT estimated by modified IFCC UV-Kinetic method by life chem Kit.
ALT, and AST in the serum were significantly higher in alcoholics before de-addiction which decreased significantly after one month and two months of alcohol withdrawal regimen. But the values did not reach normal control levels .Thus these changes of serum transaminases observed in chronic alcoholics offer use not only as diagnostic markers but also as prognostic markers and are helpful in management of chronic alcoholics.
Associate Professor, Department of Biochemistry
Kamineni Institute of Medical Sciences
Title: Early Laparoscopic Appendicectomy in Complicated Appendicitis – A Retrospective Analysis of Our Experience
Authors: Habeeb Mohammed.S, Loganathan. M, Karunanithi R, Natarajan R, Balakrishnan. V
Background: Laparoscopic approach for complicated appendicitis including appendicular mass remains controversial. Outcomes of laparoscopic approach for higher grades of appendicitis are reviewed.
Methods: Over a period of four years 152 patients undergo appendectomy in our General Surgical Unit. Among them 59 patients had complicated appendicitis. As was our practise based on our experience, all these 59 patients were taken up for Laparoscopic Appendicectomy within 24 hours of admission. About 3% (2 cases) of cases had to be converted to open because of various reasons (dense caecal or ileal adhesions). The other 57 patients were successfully operated upon by the minimally invasive procedure. All patients were uniformly treated with parenteral broad spectrum antibiotic for a minimum of 48 hours starting from the time of admission. Age of patients was ranging from 11 to 54. Various parameters analysed are length of hospital stay, return to full activity, and complication rates.
Results: Results of early laparoscopic appendicectomy for complicated appendicitis in our hospital were reviewed. The mean operating time for these 57 patients was 55 minutes. The average hospital stay was 3.5 days. Most of the patient returned to complete activity by day 5. There was no immediate postoperative complication in any of these cases. One patient had stump appendicitis with abscess after 9 months, who underwent open abscess drainage, and appendicular stump excision. One patient had port site hernia after 2 years. Follow up data was available on all these patients for a minimum period of 6 months.
Conclusion: From our collective experience on such cases of complicated appendicitis we conclude that, in spite of slightly increased operating time than uncomplicated cases, all patients with complicated appendicitis should be consideredfor the minimally invasive procedure on the same admission, as the benefits of early laparoscopic procedure definitely outweigh the demerits of open procedure or interval appendicectomy.
Title: Genexpert® MTB/RIF for Rapid Identification of Clinically Suspected MDR-TB Cases
Authors: Shevade Smita Uday, Dange Shubhangi Chnadrashekar, Khadse Ravindra Kashinath, Dravid Mrudulla Nandkumar
Introduction: An alarming increase in global incidence of drug-resistant Mycobacterium tuberculosis infection has created a critical need for methods that can rapidly detect it. Multidrug-resistant tuberculosis is defined as tuberculosis caused by M. tuberculosis that are resistant to at least isoniazid and rifampicin (RIF). The process to detect M. tuberculosis is time consuming. GeneXpert® MTB/RIF detects it within two hours.
Aim and Objectives: The study was undertaken to detect M. tuberculosis and simultaneously RIF resistance in clinically suspected MDR cases of pulmonary TB by using GeneXpert® MTB/RIF. Compare MTB detection with sputum smear status and geographical mapping of clinically suspected MDR-TB cases and confirmed by GeneXpert® MTB/RIF.
Material & Methods: Sputum samples from 100 clinically suspected MDR-TB cases were subjected to sputum smear microscopy followed by to GeneXpert® MTB/RIF.
Results: Amongst 100 clinically suspected MDR-TB cases, 81 (81%) were smear-positive and 19 (19%) smear-negative. M. tuberculosis was detected amongst 69 (85.19%) smear-positive and 6 (35.29%) smear-negative cases. Amongst 75 MTB detected cases, 58 (77.33%) were RIF sensitive, 12 (16%) resistant and 5 (6.67%) indeterminate.
Discussion: In100 clinically suspected MDR-TB cases, only 12 (16%) showed RIF resistance. The MDR-TB appears to be low in our area against clinically suspected MDR cases. This may be due to irregular, inadequate and intermittent treatment leading to clinical failure of primary line anti-TB drugs. Emphasis on proper counselling is needed while starting primary line anti-TB drugs. Conclusion: GeneXpert®MTB/RIF assay may prove to be useful in rapid diagnosis and initial management of clinically suspected MDR-TB cases.
Key words: M. tuberculosis, geneXpert, multidrug resistance (MDR)
Title: Detection of ESBL Producers in Gram Negative Clinical Isolates
Authors: Jyoti Kohli (MD), Ajay Puri (MD), T.Sarda (MD)
ESBL is a matter of great concern in hospitalized patients and a global challenge. The high incidence of beta-lactamase production due to multiple mechanism in clinical isolates is alarming and screening of ESBL strains is done in routine by their antibiotic susceptibility-testing which is to be done prior to the institution of therapy.
Keywords: Extended spectrum beta lactamases (ESBL), Antibiotic susceptibility-testing, Ceftazidime-clavulanic acid, Piperacillin-tazobactam, Escherichia coli, Klebsiella species.
Title: Uncommon Presentation of Snake Bite
Authors: Paliwal H.P, Jain Ashish, Agarwal C.M
A 26 years male patient was presented to us two days after snakebite on forehead. Few hours subsequently to bite he developed neuromuscular weakness with difficulty in breathing requiring mechanical ventilatory support. He had bilateral total areflexia, bilateral mute planters reflex with hypotonia of all extremities and ptosis without any sensory involvement. His biochemical, Hematological and Electrophysiolological features are suggestive of Gullain Barre syndrome following snakebite. This is a very unusual complication following snakebite and has therapeutic and prognostic significance.
Key words- Gullain- Barre syndrome, Snakebite, Neuropathy.
Title: Analysis of Hormonal Responses to Aerobic and Anaerobic Zone Training
Authors: Sarika Chaudhary, Shweta Shenoy
The purpose of the present study was to examine and compare hGH, cortisol, plasma testosterone ,epinephrine and nor epinephrine levels following an Aerobic and Anaerobic zone training.39 male football players of age(18.08±1.09) ,height(172.15±4.76) and weight(61.52±7.06) were randomly distributed into three groups, aerobic zone group (n=13),anaerobic zone group(n=13) and control group(n=13). The subjects reported to the laboratory between 8-9a.m. after an overnight fast. They were instructed to avoid caffeine and alcohol consumption for 24h and not to perform any physical activity for 48h before the experimental sessions. After reporting to lab the subjects were asked to take 20 minutes rest and the resting heart rate was observed with the help of heart rate monitor (S410) tied on the chest. With the help of HRmax(220-age) and resting heart rate the training zone was calculated by using Karvonen method. In aerobic zone group the subjects performed treadmill running at 75% of HRmax and in anaerobic zone group at 85% of HRmax till exhaustion. Blood samples were obtained before and immediately after the end of exercise from the anticubital vein. All the subjects performed exercise at the same time of day to avoid diurnal variation. In the control session, the subjects did not perform any exercise but they were sitting quietly for 45 minutes while blood samples were drawn at same time points. Data analysis amongst various groups was compared by one way ANOVA. Significant differences between means were located with the Tuckey HSD procedures. Aerobic and anaerobic zone training seems to be sufficient stimulus for an acute increase in hGH, cortisol, plasma testosterone ,epinephrine and nor epinephrine concentrations where hGH and cortisol showed greater responses to high intensity exercise and plasma testosterone and epinephrine to long duration and moderate intensity exercise. These hormonal responses may create an optimal environment for the metabolic processes and improved cardiovascular functions.
Key words: cortisol, plasma testosterone, epinephrine, nor epinephrine
Title: Prevalence of Aspirin Resistance in Patients with Ischemic Stroke at a Tertiary Care Center in North India
Authors: Singh S Laxmi⃰⃰, Atam Virendra, Verma Rajesh, Kumar Ashutosh, Singh Jyotsana, Atam Isha
Background: Ischemic strokes are one of the leading causes of morbidity and mortality now days. Problem increases further if stroke is recurrent. Therefore alongside of acute stroke management, secondary prophylaxis is veryimportant. As for as drugs are concerned aspirin is the most common drug used for the secondary prophylaxis. Despite of these various measures there are recurrences in many patients. Many factors have been held responsiblefor causing such recurrences and aspirin resistance is one of them.
Aim: The aim of this study was to assess the prevalence of aspirin resistance in patients with ischemic stroke.
Material and method: This study was conducted in the ischemic stroke patients admitted to the Department of Medicine, King George’s Medical University, Lucknow over a period of One year. The study comprised of 76 consecutive patients of ischemic stroke admitted in our wards. All patients with ischemic stroke (acute/recurrent) received standard treatment with non-enteric coated Aspirin 150 mg per day (supervised) at least for 7 days after which study for platelet function to assess aspirin resistance was performed.
Result:Prevalence of Aspirin resistance in our study was found to be 23.7% and this was more prevalent among elderly patients.
Conclusion: Based on results of this study we concluded that aspirin resistance does exist. However in absence of any standard definition and gold standard tests exact prevalence and its role in stroke recurrence is still a matter of research.
Title: Toxic and Histopathological Changes of harmful Effect of Diclofenac Sodium on Some Loose Organs in Albino Rats for Twelve Weeks
Author: Hasan Mohammed, A.A.
The present investigation demonstrated the side effect of (I.M.) injection (75 mg/3 ml/ rat/ week)of diclofenac sodium for 12 week on the histological structure of some loose organs of adult rats. During the study no clinical sings were seen and none of the treated animals died during the experiment. This indicate tolerance of the rat to toxicity of the diclofenac sodium. Only histopathological changes were seen after termination and those were in the liver, kidney, heart, pancreas and stomach. These were as follows, vacuolation and degeneration of liver cells, dilated cortical tubules in kidney, degeneration and vacuolation of islet of pancreas, vacuolation of myocardial muscle cells in the heart and erosion and ulceration of the glandular stomach.
Keywords- Albino Rat, Histopathological, Toxic, vacuolation & Diclofenac Sodium.
HASAN MOHAMMED, A.A.
School of Veterinary Medicine (Pathology Department), Basrah University, Basrah, Iraq.
OR: School of Veterinary Medicine (Pathology and Microbiology Department), UPM University,
43400 UPM Serdang, Selangor, Malaysia
Title: Polymers in Clinical Practice: A Beginning of a Revolution
Authors: Parth Vagholkar, Dr. Ketan Vagholkar
The science of polymer engineering has led to the development of a wide range of compounds which offer an extensive spectrum of physical and chemical properties rendering these compounds therapeutically useful. These compounds are now widely used in a variety of surgical settings thus providing superior surgical results without significant side effects. The paper reviews the basics of polymer compounds relevant to clinical practice.
Key words: polymers, biodegradable, clinical applications.
Title: Radical Resection and Reconstruction for Malignant Posterior Compartment Tumors of calf
Authors: Mir.Ruquaya, Singh.Vikram P, Tandon.Havind
Wide resection with reconstruction remains a challenge in management of soft tissue sarcoma of posterior compartment of leg. Obtaining adequate surgical margins can result in extensive loss of muscle units resulting in poor function and disability. This technical note illustrates the use of easily available vascular graft material for the reconstruction of large posterior compartment defects of leg.
Title: Study on Effect of Transanastomotic Jejunostomy Tube in the Surgery of Jejunoileal Atresia in Neonates
Authors: Dr. Nirmal Bhaskar, Dr. K.Sudha Bhanu, Dr. Nandakumaran.T.K
Introduction: Jejunoileal atresia is one of the major causes of neonatal intestinal obstruction.
Objective: To study the effect of transanastomotic jejunostomy tube in the surgery of neonatal jejunoieal atresia.
Materials and Methods: Retrospective study was conducted over the statistical data available in the hospital for the period of 3 years. All cases had resection of the atretic segment and end to end anastomosis, with cheetle’s cut to the distal bowel. From the post operative data available from records, patients were categorised into two groups. Those with transanastomotic jejunostomy tube inserted and not inserted. Total 22 cases were included in the study. 14 cases underwent resection anastomosis with transanastomotic jejunostomy tube. 8 cases underwent resection anastomosis without transanastomotic jejunostomy tube. Post operative clinical course evaluation includes, duration of hospital stay, incidence of complications like anastomotic leak, anastomotic stricture/intestinal obstruction, incidence of relaparotomy, incidence of mortality are evaluated and compared.
Result: In the group with transanastomotic tube, 2 cases had post operative complications; whereas the other group 4 cases had post operative complications
Conclusion: Our study also shows that resection and end to end anastomosis in jejunoileal atresia , with insitu transanastomotic jejunostomy tube is better than, those without transanastomotic jejunostomy tube.
Jejunoileal atresia, trananastomotic jejunostomy tube, anastomotic leak, anastomotic stricture
Title: Quality of Life among Patients after Vaginal Hysterectomy and Pelvic Floor Repair Operation
Authors: S Lovereen, F A Suchi, M A Khanum, U.N Zahan
Objective: To find out the complications affecting the quality of life after vaginal hysterectomy and pelvic floor repair operation.
Methods and Materials: This is a prospective cross sectional study enrolled from Obstetrics and Gynaecology Department of Shaheed Suhrawardy Medical College and Hospital, Dhaka done with 50 randomly selected cases in the period between July 2009 to 31st December 2009.
Results- In this study 100% patients had history of something coming down per vagina. Many patients(40%) had varying degree of urinary problem, stress incontinence was present in a significant number of cases(12%). 20% had some vaginal discharge. The commonest type of prolapse was second degree (76%). In present series no major surgical complication or unexpected haemorrhage occurs postoperatively. There was no mortality in this series, febrile reaction was the commonest minor complication experienced by the postoperative patients. In present series the percentage of urinary tract infection was 16%, most of the patients had to stay in the hospital for about 7days only 24% had to stay for more than 1 week for infection. 4% had stress incontinence & 8% experienced dyspareunia.
Conclusion: Most of the patients had average peroperative bleeding (72%) and 50% patients had blood stained pervaginal discharge, 32% had febrile reaction, 16% experienced urinary tract infection in the postoperative period. There was no mortality in this study and average postoperative hospital stay was 7 days. Then follow up of the patient and found only 8% had experienced dyspareunia, 4% had urinary incontinence and no one had vault prolapse within six months postoperatively.
Keywords: Quality of life, vaginal hysterectomy & pelvic floor repair operation, dyspareunia, urinary incontinence, vault prolapse.
Title: Rhinoscleroma Presenting As Nasal Mass – A Case Report
Authors: Venkata Vydehi Bheemaraju, Vissa Shanthi, Bhavana Grandhi, Swathi Sreesailam
Rhinoscleroma is a human specific chronic granulomatous disease caused by Gram negative bacilli, Klebsiella rhinoscleromatis (1). The specific histologic feature is accumulation of foamy macrophages called Mikulicz cells. We report a case of 35 years old female who presented to the ENT department with firm, non-tender swelling over the dorsum of the nose. Excision was done and specimen was sent for histopathlogical examination which confirmed the diagnosis of rhinoscleroma.
Key words: Rhinoscleroma; Klebsiella; Mikulicz cells.
Title: Quality of Life in Patients with Chronic Schizophrenia
Authors: Ranjit Kumar Pindikura, Ananda Reddy Endreddy, Prasanth Ampalam, Shaik Ekramulla
Background: The concept of Quality of life (QOL) is perhaps more important in those disorders which run a chronic and debilitating course and where the treatment is incomplete swith pharmacotherapy alone and requires varied psychotherapeutic interventions.
Aims: To assess Quality Of Life in patients with chronic schizophrenia on maintenance treatment.
Material and Methods: Sixty patients of schizophrenia diagnosed as per ICD - 10 with minimum duration of illness being two years and attending outpatient department were recruited in to the study. A written consent of the patient and caregiver for participation in the study was obtained. The interview was semi-structured and all information was recorded in a pre-designed structured proforma. Following this, the patients were administered with WHO QOL scale BREF version, and PANSS scale.
Results: Mean QOL scores of the patients in various domains of WHOQOL-BREF version scale were physical:20.33, psychological:20.25, social:5.17, environmental:24.60 and total 70.35.Significant positive association was found between patients that were employed and social and total QOL, and also them with total monthly income and social relationships domain. The patients with prominent positive symptoms had poor QOL in psychological and social domains and total QOL. The patients with prominent negative symptoms had poor QOL in psychological and social domains and total QOL. The patients with high scores in general psychopathology had poor QOL in all domains of QOL and Total QOL. The patients with high total PANSS scores had poor QOL in all domains of QOL and Total QOL.
Conclusion: Patients were having lowest QOL in social relationships domain of WHO QOL - BREF scale. Employed patients and those patients earning relatively better monthly incomes enjoyed a comparatively better QOL. Schizophrenic patients, especially those with prominent symptoms in the general psychopathology subset had a poorer overall Qol.
Keywords: Quality of Life, Schizophrenia, WHO QOL – BREF, PANSS Scale.
Title: Study on Comparison of Outcome of Orchiopexy with and without Ligation of Hernial sac.
Authors: Dr. Nirmal Bhaskar, Dr. K.Sudha Bhanu, Dr. Nandakumaran.T.K
Aim: Traditionally, ligation of hernial sac during orchiopexy is considered mandatory to prevent postoperative development of hernia. Our study is to compare the results of orchiopexy, with or without ligation of hernial sac.
Materials and Methods: This is a retrospective study on the basis of statistical data available. Duration of the study was 2 years. Data of the patients who already had surgery with and without ligation of hernia were collected. All patients were below 3 years. In all cases testis was palpable in inguinal canal. No patient had evidence of inguinal hernia clinically. Total 66 patients were included in the study. Traditional orchiopexy, with ligation of sac was done in 40 patients, and they were grouped into group A. Rest 26 patients, had orchiopexy without ligation of sac were grouped into group B. In both group, standard orchiopexy was then performed by making subdartos pouch. Incidence of post operative hernia was compared in both groups. Patients were followed up for 3 years.
Results: 100% cases of both groups were devoid of the complication of post operative inguinal hernia.
Discussion: There is no risk of post operative inguinal hernia, in case of orchiopexy, even if we ligate the hernial sac or not. Provided there is no preoperative inguinal hernia.
Keywords- Orchiopexy, Hernial sac, Inguinal hernia, Undescended testis.
Title: The Influences of Women’s Empowerment on Reproductive Health outcomes: A comparative study of Nigeria and Uttar Pradesh State (India).
Authors: Mrs Asabe Ibrahim, Prof. Sushama Tripathi, Dr Alok Kumar, Dr Chander Shekhar
A large body of research has attempted to explore the relationships between women’s empowerment and their reproductive health practices in some developing countries. The objective of this study was to investigate whether women’s empowerment in Nigeria and Uttar Pradesh (India) is related with women’s reproductive health practices. The study used the Nigerian Demographic Health Survey (NDHS 2008) and Indian National Family Health Survey (NFHS-3). Two dimensions of empowerment were considered in the study. These include household decision making and attitudes towards domestic violence. The study determined if the dimensions of women’s empowerment considered had different effects on reproductive health outcomes in the two populations. The study revealed that women’s empowerment had a direct and significant influence study on the reproductive health practices of women in the two study populations. The study also showed that lack of participation in household decisions compromise women’s health in both populations studied.
Keywords: Reproductive Health; Family Planning; Women’s empowerment; Comparative study; Institutional delivery.
Research Scholar, Department of Statistics,
Banaras Hindu University, Varanasi –221005 India
Title: Maternal Risk Factors for Low Birth Weight Infants: A Hospital based study in Lucknow
Authors: Megha Sharma, Prof. Sunita Mishra
Low Birth Weight is a serious public health problem and is a major issue of concern in maternal and child health. About 50 % of all neonatal deaths occur only due to Low Birth weight and survivors may also have to suffer greater risk of malnutrition, infection, neuro- developmental disorders and chronic health problems in adult life. Low Birth Weight is the single most important predictor of infant’s mortality, morbidity and disability in early life as well as important indicator of reproductive and general health status of population. The incidences of low birth weight and mortality rates can be reduced if the factors identified and managed as early as possible. So it is necessary to identify and correct the responsible factors to reduce the burden of low birth weight.
Objectives: The objectives of the study were to find out the prevalence of low birth weight in study area and to determine the risk factors responsible for low birth weight in infants.
Methodology: A study on maternal biosocial determinants and mean actual birth weight was conducted on 310 mother-infants pairs in the maternity wards of two hospitals. Respondents were interviewed and information thus collected was entered in SPSS. Chi square test was applied to determine the association of various factors with birth weight of infants.
Results: Among the 310 respondent studied a total of 61.3% (190) new born were low birth weight, and rest 38.7 % were normal. 48.1 %( 149) of low birth weight was due to preterm birth and only 19.7 % were due to IUGR. The Mean birth weight found in the study was about 2.350 gms. A large percentages of respondents were found undernourished (67.4%) and are unaware of the nutritional information regarding health and pregnancy due to lack of proper education (65.8%).Birth weight was found significantly associated with birth interval, previous history of prematurity, pre-pregnancy weight, hemorrhage, stress and depression, chronic illness of mother, hemoglobin status and pre-pregnancy BMI of mother.
Conclusion: We concluded that the prevalence of low birth weight in the study area was 61.3 % . Results indicated that a large proportion of respondents was under nourished and even they were unaware of the role of nutrition in keeping themselves healthy We recommended that improvement in nutritional status, knowledge and life style by increasing access and utilization of policies and programs provided by the government may contributes on a great level in reducing the problems occurred due to prematurity and low birth weight.
Keywords: Survivors, Bio-Social, Policies, Mortality, Morbidity, Disability, Birth weight.
Department of Human Development & Family Studies, School for Home Science,
Babasaheb Bhimrao Ambedkar University (A Central University) Lucknow, India
Title: Morphometric Study of Supra-Scapular Notch in Eastern UP
Authors: Dr. Sajjad Jafer, Dr. Bindu Singh, Dr. M.K. Pandey, Dr. R.K. Dixit
Introduction- Scapula is also known as the shoulder blade. The scapula is flat triangular bone that lies on the posterolateral aspect of the thorax. The superior border is thin and shortest and extends from the superior angle to the root of coracoid process. The supra-scapular notch is converted into Suprascapular foramen by supra-scapular ligament. The Supra-scapular foramen transmits Suprascapular nerve and Suprascapular vessels passes above the foramen.
Aim and Objective- The study was determining the Variation of the Shape of Supra-scapular notch of dry human scapula in Eastern UP (Purvanchal) region of India.
Results– In our study 150 dry human scapula on the basis of anatomical variations of supra-scapular notch is classified into four groups:-
1. V Shaped notch
2. U Shaped (shallow)notch
3. U Shaped (deep)notch
4. J Shaped Notch
5. Complete absence of Notch.
Conclusion:-The results of present study showed anatomical variation of supra-scapular notch is essential for clinicians, for understanding of location and source of the entrapment of the suprascapular nerve.
Keywords:- Dry scapula, Anatomical variations of supra-scapular notch.
Authors: Neha Sharma, Rajkumari Rathore, Dr. Purnima Dey Sarkar, Dr. Anil Bidwai
Cardiometabolic diseases like metabolic syndrome (Mets), cardiovascular disease (CVD) and type 2 diabetes mellitus have several risk factors in common. Several biochemical markers are in current use as laboratory diagnostic aids for these disorders. Many more such markers will emerge in the future as a result of current research. Serum uric acid (SUA) has emerged as a common candidate involved in these three cardiometabolic disorders.The purpose of the present study was to investigate the prevalence of hyperuricemia and the association between uric acid levels and the various cardiometabolic risk factors. This study included 150 cardiometabolic subjects aged 25 to 80 years. The body mass index (BMI), waist circumference, total and HDL cholesterol, serum triglycerides and serum uric acid were measured. Data were analyzed using student t-test, pearson’scoefficient and linear regression model.The prevalence of a serum uric acid level >0.42mmol/L in men was 18.32% and the prevalence of a serum uric acid level >0.36 mmol/L was 15.9% in women. Serum uric acid was strongly related to serum triglycerides in men as well as in women (r = 0.255 in men and r = 0.254 in women, p < 0.001). Uric acid levels were also significantly associated but to a lesser degree with age, BMI and waist circumference. This study shows that serum uric acid is markedly associated with parameters of the metabolic syndrome, in particular serum triglycerides. Considering the growing incidence of obesity and metabolic syndrome worldwide and the potential link between hyperuricemia and cardiovascular complications, more emphasis should be put on the evolving prevalence of hyperuricemia.
Key words: Cardiometabolic disease, Hyperuricemia, Metabolic syndrome
Title; Evaluation of the Role of Alpha-Fetoprotein (AFP) Levels in Chronic Viral Hepatitis C Patients, Without Hepatocellular Carcinoma (HCC)
Authors: Hisham Khalil Dabbous, Runia Fouad El-Folly, Adham Mohamed Hamdan EL-Nakeeb, Amir Helmy, Shereen A.Saleh
Background: elevated serum AFP is not uncommonly seen in patients with CHC, but not HCC.
Aim of the Study:is to evaluate the clinical significance of Alpha- Fetoprotein (AFP) levels in chronic hepatitis C patients without hepatocellular carcinoma (HCC).
Patients and Methods: We operated our study on selected 70 patients of chronic hepatitis C virus infection diagnosed by history taking, clinical manifestations and positive laboratory investigations for chronic HCV infection. The following investigations were done for all cases; liver function tests, complete blood picture and viral markers (HCV-Ab, HBs-Ag and quantitative PCR for HCV-RNA). Abdominal ultrasound and histopathological examination of ultrasound guided liver biopsy were done for all cases.
Results: The study reveals that AFP levels were very much higher in HCV cases compared to controls. There was a positive highly significant correlation. It was found that higher serum AFP levels were associated with more advanced stage of fibrosis especially F3 & F4. Regarding the mean AFP levels in different grades of liver pathology, there was no statistical significant relation. Also, there was no statistical significant relation between the mean AFP levels and the presence of Steatosis. By using a ROC curve, the level of AFP can be used as a screening for chronic HCV infection (sensitivity=75.4%, specificity=85.7%), as well as for advanced fibrosis in chronic HCV infection (sensitivity=69.7%, specificity=83.8%).
Conclusion: Serum AFP levels increase with advanced stages of liver fibrosis in chronic hepatitis C infection, even without hepatocellular carcinoma. Serum AFP levels may be used as a marker for prediction of chronic liver affection and staging of fibrosis.
Key words:Hepatitis C virus: HCV; Alphafetoprotein: AFP.
Title: Effect of Surgical Treatment of Sinonasal Pathology on the Outcome of Active Mucosal Chronic Otitis Media
Authors: Dr. B.V.Chandre Gowda, Dr. K.G.Somashekara, Dr. Smitha.S.G, Dr. Amrita Suzanne Mathew
Objectives: To determine the role of sinonasal pathology in the disease process of active mucosal chronic otitis media and to evaluate the effect of surgical treatment of sinonasal abnormalities on the outcome of active mucosal chronic otitis media
Materials and methods: 100 consenting adults aged 20-60 years, with chronic rhinosinusitis and uncomplicated active mucosal chronic otitis media (persisting otorrhoea for 12 or more weeks following culture directed antibiotics) were included. Evaluation including diagnostic nasal endoscopy, otomicroscopy, computerised tomogram of the paranasal sinuses and brain, and culture and sensitivity were conducted. Functional endoscopic sinus surgery, with concomitant correction of nasal abnormalities, was performed and postoperative (otomicroscopy) follow up at 1week, 1, 3, 6months was carried out.
Results: Mean age of the patients (58males and 42 females) was 29.6±2.73years.Majority (61%) were in the lower income group. Chronic otitis media was present bilaterally in 62% and unilaterally in 38%, coinciding with laterality of detectable disease in the nose/paranasal sinuses. Cultures isolated 56% Gram negative and 54% Gram positive organisms; Pseudomonas was the commonest pathogen in the ear and Coagulase positive staphylococcus in the nose/paranasal sinuses. Postoperatively, 85% had dry ears at the end of 6 months.
Conclusion: Infection/inflammation of nose/paranasal sinuses is associated with inadequate resolution of active mucosal chronic otitis media. Surgical correction of anatomical abnormality(s) of the nose with functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis reduces inflammation/discharge of the middle ear. Surgical treatment of sinonasal pathology is thus indicated before undertaking ear surgery.
Keywords: Otitis Media,Suppurative; Otitis Media/microbiology; Sinusitis/surgery
Title: Non Specific Vaginitis with Special Reference to Gardenerella Vaginalis and Its Antibiotic Susceptibility Pattern
Authors: P. Vasundhara Devi, P. Sreenivasulu Reddy, Maria Sindhura John, G. Avinash
Background: Vaginal discharge, the major sign of vaginitis is the common reason for which women consult a Gynecologist. About 9 out of 10 patients with this problem suffer from infections of vagina. A symbiotic relationship between Gardnerella vaginalis and anaerobic bacterial flora, which changes vaginal ph is responsible for nonspecific vaginitis.
Objective: The present study was undertaken to study the Non specific vaginitis with special reference to Gardenerella vaginalis.
Materials and methods: 200 women attending to Gynaecology op with the complaint of vaginal discharge of one week duration or more were selected as the study group along with a control group of 50 women attending the same op with complaints other than leucorrhoea. Sterile swabs were collected and transported in Amie’s transport medium. Swabs were inoculated on to Columbia blood agar and incubated upto 48 hours in candle jar.
Results: G.vaginalis was isolated in 68(34%) of cases. The incidence was maximum in the age group of 21-30 years and women with greyish white discharge was 66.25%. Majority of isolates were sensitive to Ampicillin (51%) followed by metronidazole (50 µg) (36%).
Conclusion: our study findings are contrary to the belief. Therefore it is recommended that large sample based studies may be taken up in which may throw better light.
Key words: Gardenerella vaginalis, Vaginitis, Vaginal ph, Amies transport medium
Title: Ocular Manifestations in Chronic Renal Failure Patients
Authors: Dr.G. Narendranath Reddy, Dr.M. Satyanarayana Reddy, Dr.M. Premanandam, Dr.M. Laalasa
The study was done during a period of two years from november 2011 to September 2013 on 200 consecutive patients who were admitted to the nephrology ward, Kurnool medical college, Kurnool and met the inclusion and exclusion criteria. Inclusion criteria: All cases diagnosed as chronic renal failure. Exclusion criteria: Cases of reversible renal failure, Patients on peritonial dialysis.
Chronic kidney disease (CKD) is a worldwide public health problem, both for the number of patients and cost of treatment involved. Globally, CKD is the 12th cause of death and the 17th cause of disability, respectively. The chronic diseases account for 60% of all deaths worldwide. 80% of chronic disease deaths worldwide occur in low and middle socio economic countries 1. In India the projected number of deaths due to chronic disease was around 5.21 million in 2008 and is expected to raise to 7.63 million in 2020 ( 66.7% of all deaths)2.
As a part of multi organ involvement, eye is not an exception. The common Ocular manifestations include some anterior segment manifestations like lid puffiness, conjuctival pallor, conjuctival &corneal calcification, posterior segment manifestations like hypertensive retinopathy, diabetic retinopathy, CSME, maculopathy, retinal detachment.
Chronic renal failure is irreversible and progressive process that results in end stage renal disease where patient has to be dependent on renal replacement therapy for survival 5.
The most common cause of CRF is diabetic nephropathy followed by hypertensive nephro angiosclerosis and various primary and secondary glomerulo nephropathies.
This study is an attempt to access the ocular status/complications associated with CRF.
To analyse the ocular status/complications in the patients with chronic renal failure.To screen patients for any potential visual threat so that necessary treatment and or advice can be given before they become irreversibly visually impaired.
Admissions due to CRF ( Chronic renal failure ) the patients were 1308 (69.5%) the common age affected being 40 to 80 years ( 65%) male dominant 143 patients ( 71.5%), CRF with DM 55 patients ( 27.5%), CRF with HTN 45 patients (22.5%), patients with diminished vision 124 patients(62%) patients with DM,Maculopathy 39 patients (9.75%), patients with PDR 24 patients (5.8%), Conjunctival Pallor 152 patients ( 75.60%), Lid Oedema 126 patients(63%) Diabatic retinopathy 64 patients (88.8%), Hypertensive retinopathy 31 patients (47%).
These above results are observed by us in our study.
we aimed to prospectively analyze the ocular manifestations among CRF patients .
A detailed history, detailed ophthalmic examination was done for all the cases and recorded.
When CRF patients were evaluated the patients in the age group of 40-80 years were commonly affected . There was a definite male preponderance among the cases. The most common aetiological factor leading to CRF in these patients is diabetes mellitus followed by hypertension and some are due to glomerulonephritis and Autosomal dominant polycystic kidney disease.
Diminished vision was the most common symptom seen with CRF patients and it was commonly attributed to maculopathy followed by cataract and PDR.lid puffiness and conjuctival pallor were the most common signs observed in CRF patients. These findings are statistically significant and can be regarded as consistent finding in CRF.
Among the posterior segment signs hypertensive retinopathy findings are most common followed by diabetic retinopathy.
Ocular manifestations are common in CRF patients. The most frequently encountered manifestations in CRF is conjuctival pallor and lid edema. The most common cause of CRF in our study is diabetes mellitus. Regular screening for diabetic retinopathy in cases of CRF can help patients with early intervention with laser photocoagulation and alert physician for more aggressive management of diabetes. Ocular condition is an indicator of the metabolic control of the disease process.
Title: Schwannoma of the Suprascapular Nerve Presenting With Atypical Neuralgia
Authors: Dr. Buchupalli Bharath Reddy, Dr. P.Chandrasekhar
The suprascapular nerve, being a mixed peripheral, supplies the supraspinatus and the infraspinatus muscles and posterior aspect of the capsule of the shoulder joint. Impairment of this nerve, therefore presents as weakness and atrophy of these muscles and a poorly defined aching pain along the posterior aspect of the shoulder joint and the adjacent scapula.Amongst the various non-traumatic suprascapular nerve lesions, entrapment neuropathy at the suprascapular notch is far more common than tumorous lesions. When considering the latter, ganglion cysts occurring in relation to the suprascapular nerve are more frequently seen. Whereas lipoma, other soft tissue and peripheral nerve sheath tumours [PNST] are rare. This is a case report of 24 year male presented with complaint of a poorly defined aching pain along the posterior aspect of the right shoulder joint and adjacent scapula, and difficulty in carrying out over head activities since 4 months. On examination weakness and atrophy of supraspinatus and infraspinatus noted. Tenderness elicited in the posterior aspect of the shoulder joint. Rest of the neurological examination including sensation over the shoulder and scapular regions was normal.
Antero-posterior radiograph and Scapular V-Y view of the right shoulder no obvious abnormality noted. MR imaging on T1weighted image showed an isointense mass in the substance of infraspinatus, normal labrum and articular cartilage. MRI on STIR image showed hyper intense signal due to cystic degeneration in the mass at the spinoglenoid notch with no communication of the lesion to the gleno-humeral joint. MR Coronal image showed a more peripheral location of the mass than usual at the spinoglenoid notch. ENMG showed delayed conduction velocities distal to suprascapular notch secondary to suprascapular nerve compression with denervation potentials in the supra- and infra-spinatus muscles. Managed with diagnostic shoulder arthroscopy and open surgical excision of the benign tumour. Histopathological examination revealed Spindle cells with elongated nuclei arranged in alternating hyper cellular palisading regions and hypo cellular loosely meshed regions. Immunohistochemical staining Positive for S 100 classical of Schwannoma. Post-operatively the pain subsided over a period of 5 months and the weakness recovered considerably. Three years following surgery the patient was symptom free and there is no recurrence of swelling.
Key words: suprascapular nerve, Schwannomas, atypical neuralgia, Atrophy of the supra and infra-spinatus muscles, MRI, Nerve conduction study.
Dr. Buchupalli Bharath Reddy
MS Orthopaedics (NIMS), Fellow In Arthroscopy, Department of Orthopaedics
S.V.R.R.G.H (Sri Venkateswara Rammnarain Ruia Govt. Hospital), Tirupathi
Title: Eagle Syndrome: A Rare Case Report
Authors: Gaurav Dubey MDS, Gourishankar Patnaik MS (Orth) FAOI (USA) Ph.D
An abnormally long styloid process stylohyoid chain ossification producing cluster of symptoms give rise to Eagles Syndrome (E.S) stylohyoid syndrome. It was Eagle in 1937 that first defined stylalgia as an autonomous entity related to abnormal length of styloid process or mineralization of the stylohyoid ligament complex. The stylohyoid complex is made of styloid process, stylohyoid ligament and the small cornus of the hyoid bone. All these Struthers are derivate from Reicherts cartilage of the second branchial arch. The normal length of styloid process varies from 0.8 to 2.5 cm 3. 4% of the population are believed to have elongated styloid process while only a small percentage (between 4- 10.3%) of these patients are symptomatic.
Key Words: Eagle Syndrome; Stylo-hyoid syndrome; Styloid Process; Oral surgeon
Title: Speciation of Enterococci to Predict Antibiotic Resistance Pattern: A Study from Teritiary Care Hospital
Authors: P. Sreenivasulu Reddy, Maria Sindhura John, P. Vasundhara Devi, G. Avinash
Background: Enterococci has recently emerged as a medically important pathogen causing hospital as well as community acquired infections. Detection of multi drug resistance is major health concern among the enterococci species in the hospitalized patients.However at present prevalence of E.faecium is more common than E.faecalis in hospital acquired infections. So exact speciation may help to predict the antibiotics to be used.
Objective: To isolate and speciate Enterococci from the clinical specimens and to detect their antibiotic susceptibility pattern.
Materials and methods: This study was conducted over a period of 2 years from January 2013 to January 2015.Clinical samples were received from various departments of Narayana Super speciality Hospital in the form of pus, urine, blood and peritoneal, synovial, ascetic fluids ect. Antibiotic sensitivity patterns were determined by Kirby-Bauer’s disc diffusion method after isolation and speciation of enterococci. The work is carried out at Department of Microbiology, Narayana Medical College.
Results: During this period total of 150 clinical samples were processed for the presence of Enterococci and its speciation and antibiotic sensitivity test. Among the 150 samples processed 83% were E.faecalis and 67% were E.faecium. In our study more number of Enterococci were isolated from Pus followed by urine and blood. Among antibiotic resistance of Enterococci species, E.faecium showed more resistance than E.faecalis.
Conclusion: Our study findings are contrary to the belief. So correct speciation can help to predict antibiotic resistant pattern and treatment. Though the study has not been included the prevalence of fecal carriage of enterococci and vancomycin resistant enterococci (VRE),microbiologists and clinicians should know the threat of these specie. Surveillance for screening tests to detect fecal VRE carriage among the hospitalized and general population must be carried out for effective therapy and infection control measure to implement.
Key words: Enterococci, Community acquired infection, Speciation, Antibiotic resistance,VRE
Title: A Clinical Study of Management and Outcome in Empyema Thoracis in a South Indian Teaching Hospital
Authors: Seshagiri Rao Damaraju, Raghavendra Rao Manukonda
Empyema thoracis is a pyogenic or suppurative infecton of the pleural space. Empyema is the most common exudative type of pleural effusion. Empyema is never a primary disease, often it is difficult to arrive at primary focus of infection, Empyema thoracis is the one of the commonest suppurative lung disease commonly seen in this country in chronic ally ill debilitated patients suffering with diabetes mellitus, immunecomprimised state, alcoholism and tuberculosis. Medical management is limited to culture specific antibiotics. but the role of intercostals tube drainage and appropriate surgical procedures like de-cortication are important for the appropriate timing. In this background we submit this study of incidence and management of Empyema Thoracis in a tertiary care hospital.
Key-Words: CT-thorax, Culture sensitivity, Decortication, Empyema thorax, Immuno-compromised Patient, ICTD with underwater seal, Morbidity ,Serial Chest-Xrays, ,Thoraco-centesis, Thoracoscopy.
Title: A Rare Case of Fracture Intracapsular Neck Femur with Distal Femur Nail in Situ
Authors: Dr. Rohan Khavte, Dr. Yash Shah
A 64 year old male patient was previously operated 8 years ago for a fracture of right thigh came with a history of trivial trauma.
The patient was further investigated with X-ray of the right hip joint with the proximal half of the femur and X-ray of the right knee with the distal half of the femur both done in the antero-posterior view.
The X-ray suggested that the patient was previously operated for a distal femur fracture with an interlocking distal femur nail. The X-ray also showed an intra-capsular fracture of the neck of femur.
“PRE-OP TEMPLATING” -this was the biggest challenge confronting us. The Austin Moore Prosthesis normally ranges from a length of 11cm to 15cm. With the distal femoral nail in situ, the ordeal was to fit an AMP of an appropriate length so as not to give rise to a stress fracture at the junction between the two implants.
We were faced with the dilemma of whether to remove the previous implant in the well united distal femur fracture and put a long stem bipolar prosthesis or to keep the distal femoral nail in situ and do a hemiarthroplasty.
After considering the pros and cons of both the procedures, we decided to go with the latter.
Results: The patient had a good result and could do weight bearing satisfactorily.
Dr. Rohan Khavte
Khavte Accident and Orthopaedics Hospital, Taluka Daund, Dist. Pune Pin 413801
Title: A Clinical Study of Evaluation and Management of Paediatric Ocular Trauma
Authors: Dr.M. Premanandam, Dr. M. Satyanarayana Reddy, Dr.G.Narendranath Reddy
Between june 2003 to June 2005 in Regional Eye Hospital, Kurnool, Kurnool Medical College, Kurnool, we taken a sample size 95 paediatric ocular trauma cases of
0 – 14 years were selected to identify the causes, demographic clinical profile and evaluation final visual outcome of ocular injuries.
In paediatric age 0 – 14 years group the ocular trauma was very common. The trauma to the Eye may be penetrating, blunt, thermal, chemical, IOFB, and others. The causes for these trauma were stick, stone, crackers, ball, needle, toy, thron, fall, chemicals, and glass etc.
Due to mention above causes the adenexia and ocular structures may be injured, like lid laceration, conjunctival tear sclero corneal tear, corneal erosions or abrations, Hyphema, secondary glaucoma, vitrious, haemorrhage, retinal detachment, retained IOFB, optic nerve injury, lense dislocation or sub luxation.
Among 95 paediatric ocular, patients, some patients were admitted and some patients were treated as OPD cases, for these patients we given medical treatment and medical and surgical treatment where ever necessary.
The results and observations were noticed as follows. The commonest type of ocular injury was penetrating injury 55% (n-51), blunt trauma 40% (n-38) and other types noticed. Most of the injuries were occurred at home 43% (n-41), 0-4 year age group affected 71% at home. Male children had ocular trauma 75% (n-71), Female 25%(n-24), 83% (n-73) between the age group 6-14 years.
In this study commonest cause were stick 22%, stone 23% fire crackers, 9% and other modes, among 95 paediatric ocular trauma cases were noticed.
Laterality concerned 51% (n-41) right eye underwent ocular trauma. Ocular trauma wise in these 95 cases the involvement of conjunctiva 12.23% (n-17), cornea 36% (n-50), sclera 5% (n-7), Hyphema, 7%(n-10), traumatic cataract 13%(n-18), posterior segment damage 5%(n-8), 1%(n-2), orbital injury were affected respectively. The followup period we taken as 3 months for all paediatric Ocular injury cases.
Regarding visual outcome in these cases the blunt ocular trauma had better visual outcome than the penetrating trauma 53% cases (n-50) had >6/12 vision, 7%(n-7) blind, 34 cases shown 6/18 to 6/60 vision.
The commonest sequelae noted were corneal opacities 45 cases noticed. To conclude home was common place for ocular trauma in paediatric age group 6-14 years, the common cause were stick or stone, penetrating type of injury have been the commonest type, right eye shown predominant involvement good prognosis of vision noticed in blunt ocular trauma.
To prevent these ocular injuries awareness, health education, better care of children and avoiding domestic hazards were necessary.
Title: The Experience of Household Food Insecurity among Elderly
Authors: Hadeel Fadhil Farhood
Background: Food insecurity has been associated with a wide array of negative health outcomes bothamong the young and old.
Objective: to compare food insecurity status as measured by the Household Food Insecurity Access Scale (HFIAS) amongst older adults living in rural & urban areas.
Patients and methods: A cross-sectional comparative study. This study include a sample of 240 elderly persons (aged 60 years and above) at selected rural and urban households residing in Babylon governorate, urban (n=125) and rural (n=155) was recruited. Household Food Insecurity Access Scale (HFIAS) was used to assess food insecurity.
Results: From all participants 42% reported history of food security compared to 58% reported food insecurity , 40% of total participant had mild food insecurity, 15% moderate food insecurity and 3% sever food insecurity by HFIAS ,significant difference in food insecurity between urban and rural areasregarding gender, occupational status , educational level, housing size , housing turners and per-capita monthly expenditure.
Conclusion: Household elderly food insecurity was higher among urban area than in rural area. . Many risk factors attributed to food insecurity, age 60-74, male gender in urban area and female gender in rural area, un-employment, low educational level , large housing size ,ranting houses and low per capita monthly expenditure.
Key words: Household, food insecurity, elderly
Title: Effect of Qurs-e-Rewand (A Hepatoprotective Unani Formulation) on Pentobarbitone induced Sleeping in Mice
Authors: Shamshad Alam, Naeem A. Khan
Background: The present study was planned to investigate the effect of Qurse Rewand commonly used compound hepatoprotective drug on sleep duration in sodium pentobarbital (PB)-induced sleeping in mice.
Methodology:The animals were divided into five groups of 6 animals each and they were fasted overnight. The animals of group I and II were left untreated, whereas the animals kept in group III, IV and V were administered, Silymarin (100 mg/kg b. w.) Extract of Qurse Rewand (50mg/kg b. w.) and (100 mg/kg b. w.) respectively as single and double dose orally for 7 days. On the 8th day the animals in group II, III, IV and V were given CCl4 in dose of 2 ml/kg b. w. intraperitonial route. Two hours later the animals in all the five groups were administered 30 mg/ kg b. w. of sodium pentobarbitone I.P. The sleeping time was recorded by observing the CNS activity as pinna, sound and righting reflex in each animal at every five minutes.
Results:The findings obtained, indicated the significant reduction (P ≤ 0.05-0.001) in the onset and duration of pentobarbitone-induced sleep in mice treated with the test drug of both the doses and it was found significant against CCl4+Pentobarbitone induced animals. The results suggest that Qurse Rewand shortened the pentobarbital hypnosis without major toxic effect and the result exhibited by the double dose of QR was more potent than single dose and shortening of duration is almost equal to the standard drug.
Conclusion: On the basis of reduction in sleeping time it can be concluded that the test drug is quite safe and has wide therapeutic index and therefore can be safely used in high doses also.
Key words: Hepatoprotective drug, Sodium pentobarbitone, sleeping time, CCl4, Silymarin
Title: Effectiveness of Misoprostol for the Prevention of Postpartum Haemorrhage: A Review
Authors: Joy Chidinma Agom, David A. Agom, Chidiebere V. Ekuma, Jude N. Ominyi, Simon N.Onwe
Postpartum haemorrhage (PPH) is the major cause of maternal morbidity and mortality globally. Prevention of PPH will reduce the number of maternal deaths in rural communities of developing countries. This study aim to access evidence on the effectiveness of misoprostol compared to oxytocin or placebo, and to explore the optimal dose and the best route of administration for the prevention of PPH. The MEDLINE, CINAHL, Science Direct, Intermid and the Cochrane Library were systematically searched. Studies that compared misoprostol and oxytocin or placebo for the prevention of PPH were selected following inclusion and exclusion criteria. Also, hand-searches of 7 Journals and citations tracking were employed. A total of 16 articles that met the inclusion criteria were selected and used for this review. Among the 16 studies included in the review, misoprostol was found to be as effective as oxytocin in the prevention of PPH in developing countries. Misoprostol at the dose of 600 µg to 1000 µg was associated with higher percentages of side-effects, while sublingual route at the dose of 400 µg seems to be better in minimizing the adverse side-effects.
Title: Reasons for Introducing Solid Foods to Infants Younger than Six Months of Age
Authors: Sijal Fadhil Farhood Makki, Hadeel Fadhil Farhood
Background: The introduction of solid foods to infants younger than (six months) of age differs from one country to another and from one society to another. In fact cultural issues in Babylon Province influence early introduction of solid foods because the older generations ,who are now grandparents; grew up at a time when it was a norm to give solid foods as early as 40 days of age on the belief that the infant will get used to eating better.
Aim of the Study: This study was conducted to determine the maternal and infantile socio-demographic and medical characteristics that influence the decision to introduce solid foods to young infants before six months of age in Hillah city Babylon Iraq.
Patients and method: A cross sectional study was conducted in Al-Hilla city, Babylon Governorate, Iraq. ,It was carried on infants younger than six months attending primary health care centers for vaccination, during the period from 1st of March 2014 to 31st October 2014.
The sample included 200 infants younger than 6 months who had history of early introduction of solid foods.
Results: The study found out that a number of maternal and infantile demographic and medical characteristics interact and impact the decision to introduce solid foods earlier than 6 months of age. Most mothers were low income (64%) married (79%) urban (66.5%) housewives (73%) younger than 18 years old (39.5%).(50.5% )of these mothers live in extended families with varying degrees of educations.(20%) were illiterate.
Two thirds of infants were artificially fed, male (75%) preterm babies (59%) with low birth weight (70.5%). Self-reported decisions and advice from an older person accounted for (64%) of reasons for early introduction of solid foods. Some factors had a relatively weak effect for example the presence of infantile colic and maternal age with the type of food introduced, while maternal education had a significant impact on the choice of solid food introduced. Our study concludes that a number of maternal and infantile demographic and medical characteristics interact and impact the decision to introduce solid foods earlier than 6 months of age. Most mothers were low income married urban housewives younger than 18 years old. Half of these mothers live in extended families. There was an uneven distribution among educated and illiterate mothers.
Key Word: solid food, infant, weaning food.
Title: Assessment of Janani Suraksha Yojana (JSY) Component Under NRHM In Selected Districts of Kashmir Valley: A Descriptive Study
Authors: Yangchen Dolma, Syed Gazala Nazki, Dr Iftikhar Hussain Munshi, Rinchen Angmo
National Rural Health Mission launched a safe motherhood intervention named Janani Suraksha Yojna in 2005 to reduce maternal and infant mortality by promoting institutional deliveries. The objective of the study was to assess the social profile, knowledge and utilization pattern of JSY beneficiaries. It was a community based Cross sectional study. Multi-stage Random sampling was adopted. The study was conducted in three district of Kashmir valley for a period of three months from April 2012 to June 2012. A total of 349 beneficiaries were interviewed using pre tested semi-structured questionnaire. Results were expressed in proportion. Mean age of the women was 29.2 yrs. Majority of the women were illiterate (75 %). 95.5% had heard about JSY. Most of them had correct knowledge about the main objective of the scheme. Majority of women (86.5%) got themselves registered in 1st trimester of pregnancy. 90.2% had undergone more than four antenatal check up. Injection Tetanus Toxoid was received as per the schedule.86% consumed recommended Iron Folic acid tablets. Majority of the delivery (57.3%) took place at tertiary care hospital. Only 4 % was paid incentive at the time of discharge. ASHA accompanied women in 41.3% women at the time of delivery. Postnatal care was the most neglected component.
Keywords: Cross sectional study, Institutional delivery, Postnatal care
Title: Intravenous Dexmedetomidine in Attenuating Intubation Response in Awake Fibreoptic Nasal Intubation
Authors: Dr. Jyoti V. Kulkarni, Dr. Kasturi Mulmule, Dr. Tushar Patil, Dr. Suhas Jewalikar
Introduction: Fibreoptic intubation is a is an effective, safe and reliable technique for difficult airway management. Optimal intubating conditions and patient comfort are paramount while preparing the patient for fibreoptic intubation. Challenge associated with this procedure is to provide adequate sedation while maintaining a patent airway and ensuring ventilation. This procedure is accompanied with several pressor responses like tachycardia, hypertension and even arrhythmias. An ideal sedation regimen would provide patient comfort, blunting of airway reflexes, patient cooperation, haemodynamic stability, amnesia and the maintenance of a patent airway with spontaneous ventilation. Dexmedetomidine is a α-2 adreno receptor agonist is ideal for the management of patients with difficult airways. Dexmedetomidine infusion provides conscious sedation in which patient is co-operative and communicative. So we want to study efficacy of intravenous Dexmeditomidinein a attenuation of pressor response after Fibreoptic intubation.
Material And Method: We included 60 patients in the age group of 20-55 years of either sex belonging to ASA grade I and II scheduled for elective surgical procedures under general anesthesia with anticipated difficult intubation in this study. Local anesthesia of upper airway was given by Lignocaine with adrenaline 2% topical solution applied to the more patent nostril, oral viscous Lignocaine gargles and intratracheal instillation of 2 ml of 4 % Lignocaine done by cricothyroid puncture. Patient received a loading dose of Dexmedetomidine 1 micrograms/ kg infused over 10 minutes. Pulse rate, blood pressure, respiratory rate, oxygen saturation and sedation score were recorded prior to infusion , 10 minutes after infusion. Sedation score was assessed with Ramsay Sedation Scale. Above parameters were again recorded once the tube enters glottis, 1 minute, 3 minutes and 5 minutes after securing the endotracheal tube. Any event of breath-holding or laryngospasm were also noted. All parameters were compared to the baseline values.
Observations: The decrease in mean pulse rate was observed throughout the procedure with maximum decrease 3 minutes after securing the endotracheal tube. There was decline in mean systolic blood pressure from basal value at all stages with maximum fall 5 minutes after securing the endotracheal tube. There was decline in mean diastolic blood pressure from basal value at all stages of the procedure with maximum fall 5 minutes after securing the endotracheal tube. SpO2 was maintained close to basal value at all stages of intubation with minimum value 97 and maximum 100. The mean respiratory rate at various stages of intubation was close to basal value with minimum value 12 and maximum value 14. Following Dexmedetomidine infusion all patients showed sedation score of 4 at further steps of the procedure as assessed by Ramsay Sedation Scale.
Conclusion: We conclude that good local anesthesia of upper airway with 1 micrograms/kg infusion of Dexmedetomidine given over 10 minutes provides good intubating conditions, sedation, patients co-operation with attenuation of intubation response.
Title: A Study of Clinical Presentation and Outcome in Community Acquired Pneumonia in Hospitalised Adults
Authors: Dr Seshagiri Rao Damaraju, Dr Raghavendra Rao Manukonda, Dr.M.Hussain
Community-acquired pneumonia (CAP) is one of the most common infectious diseases addressed by clinicians. CAP is an important cause of mortality and morbidity worldwide.It is usually polymicrobial.
CAP is usually acquired via inhalation or aspiration of pulmonary pathogenic organisms into a lung segment or lobe. CAP morbidity and mortality are highest in elderly patients and in immunocompromised hosts. Patients who require hospital treatment for CAP are typically elderly persons; persons with underlying chronic obstructive pulmonary disease (COPD), such aschronic bronchitis (not emphysema); and individuals with severe CAP related to underlying cardiopulmonary function, immune status, or pathogen virulence.
Ambulatory CAP is most common among young adults and is usually due to atypical CAP pathogens (eg, Mycoplasma pneumoniae). Negative prognostic factors in community-acquired pneumonia (CAP) include preexisting lung disease, underlying cardiac disease, poor splenic function, advanced age, multilobar involvement, and delayed initiation of appropriate antimicrobial therapy
We conducted a prospective study in the hospitalised cases of community acquired pneumonia patients with regards to severity, clinical presentation, bacteriological study and response to culture specific antibiotics, course and outcome of the Community Acquired Pneumonia patients.
Keywords: Clinical Outcome. Etiology, Radiology, Specific Investigations And Treatment.
Title: Prevalence of Obesity Among Females Above 18 Years of Block Hazratbal, Srinagar: A Cross Sectional Study
Authors: Dr Syed Ghazala Nazki, Dr Yangchen Dolma, Dr Junaid Kousar
The study was done with the objective to determine the magnitude of obesity in the women above 18 years in block Hazratbal. It was a community based cross sectional descriptive study done over a period of one year from July 2010 – June 2011.10% of the villages were selected randomly from four zones .All the house hold of selected villages were surveyed .Further, all the non pregnant females older than 18 years were subjected to height and weight measurements after taking informed consent .The sample size came out to be 2267 females. The BMI (Body Mass Index) was calculated as per “WHO” classification. A comprehensive questionnaire was used to record demographic characteristics. Categorical data was summarized in the form of percentages and continuous data in the form of mean and standard deviation. Chi square test was used for evaluating statistical significance and p value <0.05 was considered significant. The overall prevalence of obesity was 9.4%.Maximum prevalence of obesity was observed in 51-60 years of age group.It was more in urban(11.3 %) area. Maximum percentage was found among widows (13.3%).Retired group among occupation had preponderant obesity (25%).Females in joint families were significantly obese(11.2%).Obesity was more in females belonging to socioeconomic class1(15.2%) and class 2(12.0%).
Keywords: Obesity, Body Mass Index,Cross Sectional study.
Title: Throbocytopenia an Indicator of Malaria in Febrile Patients- A Retrospective Study
Authors: Vissa Shanthi MD, Swathi Sreesailam M.D, Nandam Mohan Rao MD, Shyam Sundara Rao M.D, Bhavana Grandhi M.D
Back ground: Malaria is a major health problem in India. It is mosquitoe born protozoal disease caused by parasite of the genus Plasmodium. Various hematological consequences are produced in patients with this infection, out of which thrombocytopenia is the most common.
Objective: To analyze thrombocytopenia and its severity in patients infected with malarial parasite.
Methods: The prospective study was conducted during the period of November 2013 to December 2014 on 204 patients who were malaria infected. The diagnosis of malaria was done by peripheral smear examination. Platelet count were performed using automated cell counter. Thrombocytopenia was categorized into mild (1,00,000 – 1,50,000/μl), moderate (1,00,000 – 50,000/μl) and severe (less than 50,000/μl). Presence and severity of thrombocytopenia was compared in different types of malaria.
Results: In the study group of 204 malaria infected patients, males were 148 (72.55%) and females were 56 (27.45%). In these patients vivax infection was predominant (76.47%) when compared to falciparum (19.61%) infection and mixed infections (3.92%). The analysis of thrombocytopenias in these patients showed that both the vivax and falciparum infected patients had moderate thrombocytopenia in majority cases. Patients with mixed infection showed moderate and severe thrombocytopenia and no case with mixed infection had normal platelet count in these patients.
Conclusion: Presence of thrombocytopenia in patients with fever and chills acts as an indicator of malaria infection, though the severity of the thrombocytopenia is not useful for distinguishing the types of malaria.
Key words: Plasmodium, Peripheral smear, Thrombocytopenia
Title: Autogenous Fibula Grafting of a Radial Defect Complicating Acute Hematogenous Osteomyelitis in An Infant
Authors: Kumar Anshuman MBBS, DNB (Orth), Gourishankar Patnaik MBBS,MS (Orth) FAOI (USA) Ph.D
Introduction: Osteomyelitis is an inflammation of bone caused by a pyogenic organism. Historically, osteomyelitis has been categorized as acute, subacute or chronic, with the presentation of each type based on the time of disease onset (i.e., occurrence of infection or injury).
Clinical Description: Acute hematogenous osteomyelitis occurs predominantly in children, with the metaphysis of long bones the most common location. Patients usually present within several days to one week after the onset of symptoms. In addition to local signs of inflammation and infection, patients have signs of systemic illness, including fever, irritability and lethargy.
Case Report: 19 months old female child R.P. sustained injury to right forearm 1 and half years ago and was treated by quack with local herbs and plaster. She developed developed infection of her right forearm 2 months later. She was referred to a higher centre and was treated for acute osteomyletis with rest, antibiotics and other supportive treatment.
Discussion: The emphasis of this case report is on the management of a radial defect after diaphysectomy complicating acute hematogenous osteomyelitis in a 19-month-old girl. An autogenous fibular graft was used to replace the defect of the radius.
Keywords: osteomyelitis, autologus, fibula,antibiotics, JESS fixator
Title: Reduction in Maximum Voluntary Ventilation of lungs of Sand Stone Quarry Workers: A Case study
Authors: Dr. Suresh Kumar Singh, Dr. D. Patel, Dr. Gopal Purohit
This study was designed to assess the impact of high particulate concentration on Maximum Voluntary Ventilation of lungs of sand stone quarry workers. The workers were engaged in different types of activities such as drilling, loading and dressing. These different working conditions had different concentrations of RSPM, leading to different exposure levels in workers. It was found that exposure duration and exposure concentrations were the main factors responsible for damage to the respiratory tracts of the workers. The particles were deposited at various areas of the respiratory system and affect the Maximum Voluntary Ventilation of lungs . It was also revealed from the study that most of the workers suffered from silicosis if the exposure duration was more than 20 years.
Keywords: Maximum voluntary ventilation (MVV), respirable suspended particulate matter (RSPM), silicosis, respiratory tract
Title: Platelet-Rich Fibrin – A Review of Its Impact in Endodontics
Authors: Dr. Priya R, Dr. Sapna C. M. , Dr. Rakesh R. Rajan
As with every aspect of science, Endodontics is in a perpetual quest for the best outcome. In Endodontic surgery, this entails a faster and predictable healing, of both soft tissue and hard tissue. One of the recently reported adjuncts that has the potential to achieve this objective is platelet-rich fibrin (PRF). PRF is one among a group of compounds derived from blood platelets, with a positive influence on wound healing, by virtue of their content of growth factors. This paper is aimed at a detailed description of the preparation, effects and endodontic applications of PRF.
Key words: Platelet derivatives; Platelet-rich fibrin; Endodontics; Surgery; Regeneration
Title: Chaning Trends in the Incidence of Carcinoma Thyroid –A Clinico Pathological Correlation
Authors: Dr. K. Sailaja DNB, Dr. R. Mahalakshmi MS, Dr. D.M. Sasank
Background: Thyroid tumours are the most common endocrine neoplasms. (1) 5-10% of all clinically presenting thyroid nodules are carcinomas. Thyroid malignancies are divided into-Well-differentiated Carcinomas of which papillary carcinomas (80%), follicular carcinomas (10%), modularly thyroid carcinomas (5-10%) are the most common types , and Undifferentiated anaplastic carcinomas are less (1-2%).Primary thyroid lymphomas and primary thyroid sarcomas are rare. The recent rise in incidence of thyroid swellings is also recorded in India (2) and may be traced to the increased patient awareness and also due to increased specificity of the investigations(8).The availability of trained pathologist in the interpretation of the cytology picture has contributed to a sensitivity of the diagnosis especially for malignancies of thyroid gland(11).
Methods:A prospective study was conducted at Government General Hospital, Kakinada. The study period is from August 2011 to August 2014.The Study sample constituted 112 patients.
Inclusion criteria – all patients admitted and diagnosed to be carcinoma thyroid by HPE irrespective of co - morbidities. Exclusion criteria - patients who had positive cytology for carcinoma but HPE proved no carcinoma i.e, false positives, (30 cases).and Patients who absconded from treatment and follow – up.
Results: There is an increase in the incidence of Carcinoma thyroid cases by about 0.6%.
There is a shift in Age distribution to a younger age in our study to 37yrs. Malignant neck node presentation has been observed in 5.35% of patients.
Key Words: Age and sex incidence, FNAC picture, Management strategies and follow-up, Radio-iodine treatment, Thyroglobulin assay, Well-differentiated Thyroid carcinoma.
Title: Aggression and Violence in Perspective of Hypoglycaemia: A Review Analysis
Authors: Dr Munawwar Husain, Dr Mohd Asrarul Haque, Dr Mohammad Mojahid Anwar, Dr Faiz Ahmad, Dr Jawed A. Usmani, Farha Azmi
Violence is instinctive to human nature. The human mind is slow to react to peaceful mechanism to conflict resolution but instantly jump to quick redress using violence and aggression as the vehicle. Additionally, there are some inborn errors in genetic, hormonal and nutritional component that may compel the individual to resort to violent means, sometimes provocatively and at other times without adequate stimulus.In the current paper nutritional element emphasizing on hypoglycaemia is reviewed. This particular component is selected because it has medico legal connotation and the trial court have given conflicting opinion on occasions ignoring biochemical basis and preferring on circumstantial ones. Automatism leads to hypoglycaemia which leads to violence which itself is triable and perhaps a mitigator to sentencing.
Key words: hostility, aggression, violence, hypoglycaemia, tyrosine, under nutrition
Title: Fruits and vegetables consumption pattern as a risk factor for NCDs in a rural population of India
Authors: Dr. Sanjay Chaudhary, Dr. Neeraj Gour. Dr. R C Chaudhary, Dr.Vishal Gupta¸ Dr. Abhay Mudey, Dr. Vasant V Wagh
Introduction:Globally Non-communicable diseases (NCDs) kill more than 36 million people each year. Nearly 80% of NCD deaths - 29 million - occur in low- and middle-income countries. WHO recommends consumption of five or more servings of fruit and/or vegetable per day in a typical week as adequate for reducing risk of NCD. With this background the present study was undertaken to know fruit and vegetables consumption in rural population of district Wardha (MH.).
Material and Methods: Community based cross- sectional study with participants’ age between 15 to 64 years taking a sample size of 3500. Multistage sampling technique was adopted to collect the needed sample size.
Results:There were 1920(54.86%) male and 1580 (45.14%) female. Overall mean consumption days for fruits per week were 1.63.Overall mean number of days in the study population was 6.53, more in males (6.56) than that in females (6.48).servings of fruit per day in a typical week for study subjects was 1.25, it being 1.27 in male and 1.23 in female. mean number of days of vegetable consumption in the study population was 6.53, more in males (6.56) than that in females (6.48).
Conclusion:In our study it was observed that number of days per week of consumption of fruit and vegetable was very less. Nutrition education, price control, local production and governmental policies can alter the scenario.
Key words: fruits & vegetables; pattern; NCD; risk factor.
Title: Spirometry in Treated Cases of Pulmonary Tuberculosis
Authors: Doye George, Sethu Babu, P Sukumaran, Anu Sam Mathew, Salini M R
1. Fifty four male patients who were cured of sputum direct smear positive pulmonary tuberculosis and were working full time were selected for the study of lung function.
2. Spirometry was done in all patients.
3. About 10% of the patients showed evidence of slight to moderate degree of restrictive ventilatory defect as judged from values of FVC and FEV1/FVC %
4. About 37% showed evidence of airway obstruction mostly mild to moderate degree, except 10% who were severely obstructed.
5. About 24% of the patients had cough with expectoration and/or dyspnoea. These symptoms were associated with reduced FEV1/FVC%.
6. It was observed that in smokers greater extent of residual lesion was associated with more severe airflow obstruction which was statistically significant.
7. Early detection and prompt treatment of pulmonary tuberculosis so that residual lesions will be minimal, and cessation of smoking will prevent or reduce the extent of airway obstruction, after completion of treatment.
Title: Antihyperlipidemic Activity of Gardenia Gummifera
Authors: Mr. Chandrashekhar R. Pal, Mrs. Vaibhavi N. Garge, Dr. Vilasrao J. Kadam
Ethanolic extract of twigs and gums of Gardenia gummifera (EEGG) was investigated for antihyperlipidemic activity. It was evaluated via in vivo model i.e. Poloxamer-407 induced hyperlipidemia and suspension of Cholesterol + cholic acid induced hyperlipidemia. Poloxamer-407 is an acute model used for determination of preventive antihyperlipidemic properties of EEGG and determination of most efficacious dose i.e. EEGG (250mg/kg), which further used as treatment dose for chronic model (cholesterol +cholic suspension induced hyperlipidemia model). In Poloxamer-407 induced hyperlipidemia models, blood samples were withdrawn at 48th hrs and serum lipid levels and atherogenic index were analyzed. EEGG exhibited significant inhibition of serum TC and LDL levels while as atherogenic coefficient decreased significantly. Effective dose obtained from Poloxamer-407 induced hyperlipidemia model also demonstrated significant inhibition in serum lipid levels (TC and LDL) and atherogenic index (AI,CRR and CR). EEGG also significantly increased serum HDL levels when blood samples were analyzed at 28th day. Liver enzyme assays and Histopathological showed enough evidence to prove its hypolipidemic properties.
Title: Management of Congenitally Missing Lateral Incisors with Orthodontics and Single-Tooth Implants (A Case Report: After One Year Clinical Follow-Up)
Authors: Abu-Hussein Muhamad, Abdulgani Azzaldeen, Watted Nezar,Zahalka Mohammed
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants.
Careful treatment planning, space management, augmentation of bone and attention to the details of implant surgical and pros-thetic techniques are important factors when treating anterior maxilla, especially in the replacement of missing teeth. This case report addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.
Key words: Dental implant, lateral incisor, case report.
Title: Correlation of Insulin Resistance and Serum Leptin in Metabolic Syndrome
Authors: Rajkumari Rathore, Neha Sharma, Purnima Dey Sarkar, Anil Bidwai
The metabolic syndrome mostly represented by obesity, hypertriglyceridemia and reduced level of HDL-C. Obesity and hyperinsulinemia connected with insulin resistance, present the main mechanism in the pathogenesis of CVD. The present study was designed to compare the fasting leptin level with the insulin and insulin resistance between metabolic syndrome patients and healthy subjects. The present study included 140 metabolic syndrome cases (81 men and 59 women) and 100 healthy controls. Metabolic syndrome cases were diagnosed by (NCEP ATP III) criteria. Serum leptin , insulin, glucose and lipid profile measured and insulin resistance and BMI were calculated. All the parameters were significantly (P<0.0001) high in metabolic cases excepts HDL-C which was significantly (P<0.0001) low. Serum leptin level was significantly (P<0.0001) high in metabolic women compare to metabolic men. The correlation of leptin with insulin, and BMI were strong in both sexes. Increased leptin level shows positive correlation with regards to the metabolic component except the HDL which was decreased. The present study concluded that increased leptin level observed in metabolic cases, more in women compare to men and level increased with the obesity increases. So leptin can be sign of hyperinsulinemia, insulin resistance and disturbance in lipid metabolism that are associated with CVD and type 2 DM.
Key Words: Metabolic Syndrome, Insulin resistance, Type 2 diabetes Mellitus, Cardio Vascular Disease, Leptin, Hypertriglyceridemia
Title: Socio-Cultural Aspects of Menstruation among Unmarried Girls in Chandigarh
Authors: Dr.Dinesh Kumar, Dr.N.K.Goel, Dr.Sonia Puri, Dr.Nancy Gupta
Menstruation is linked with several misconceptions, ignorance and practices among young girls. Adolescent girls often lack knowledge about menstruation because of social and cultural barriers which sometimes results into adverse reproductive health outcomes. With the objectives of finding misconceptions and socio-cultural aspects of menstruation among unmarried girls, A community based cross-sectional study was conducted during April 08 to March 09 in Rural, Urban and Slum strata of UT Chandigarh. A total of 744 unmarried girls who have attained menarche were surveyed using Stratified Multistage Random Sampling Design with probability proportional to size (PPS).Data was collected using a pre –tested questionnaire. Maximum proportions of respondents 50% preferred comedy literature /films followed by romantic ones. Mother was found to be the preferred discussant by majority of respondents 405(54.4%) followed by Girl friends. Majority of respondents 264 (35.5%) got scared at initiation of menarche. About 75% respondents considered it is a normal phenomenon while 174 (23.4%) respondents considered it as a sign of impurity Problems related with menstruation are quite frequent and girls should be imparted health education for clearing up their misconceptions and be offered them possible treatment options.
Key Words: Stratified Multistage Random Sampling, Menarche.
Title: A Comparative Study to Evaluate the Effect of 0.2% Ropivacaine With Fentanyl Compared to 0.125% Bupivacaine With Fentanyl for Labor Analgesia - A Prospective, Randomised, Double Blinded and Controlled Study
Authors: Dr.B.Vishnu Mahesh Babu, Dr.S.Sai Baba, Dr.T.Prem Sagar, Dr.A.S.Kameswara Rao
Background:Pain less labor, a complete freedom from labor pains, is a dream to every parturient woman Lumbar epidural analgesia offers a safe and effective method of pain relief during labor.The benefits include effective pain relief without appreciable motor block, reduction in maternal catecholamines, and a means to rapidly achieve surgical anesthesia. Bupiacaine is commonly used but Ropivacane is considered as good alternative.1
Material and Methods: This study was undertaken from April to September2012.The aimof this study was to evaluate the effect of 0.2% Ropivacaine with 25 mcg Fentanyl compared to 0.125% Bupivacaine with 25 mcg Fentanyl for labor analgesia. 50 pregnant woman of American Society of Anesthesiologists grading I&II, nulliparous, singleton pregnancy, vertex presentation were taken up for the study. They were randomly divided into two groups (each comprising of 25), Group R(Ropivacaine group) and Group B(Bupivacaine group). The results were statistically analysed by student’s t- test. The demographic data were comparable in both groups.
Results: There was no significant difference among two groups in the total duration and second stage of labor, the volume of local anesthetic, onset and duration of analgesia, neonatal outcome as far as Apgar scores at 1 and 5 minutes. But the incidence of spontaneous vaginal delivery are more and Cesarean delivery & Forceps delivery are less in Ropivacaine group compared to bupivacaine group.
Conclusion: We conclude that 0.2% Ropivacainewith 25 mcg Fentanyl is preferred to 0.125% Bupivacaine with 25mcg Fentanyl for labor analgesia as it is associated with less number of instrumentation and caesarean sections, while maintaining same degree of sensory blockade.
Keywords :Bupivacaine, labor analgesia, Ropivacaine.
The JMSCR is accepting manuscripts for its coming issues to be Publish January 2018 the JMSCR invites authors to submit manuscripts Reporting original medical research, original article, research article, case report, systematic reviews, or educational Innovations for publication for the coming issues that will be released in January 2018. Types of manuscripts suitable for JMSCR include: Medical research, Clinical research Educational Innovation, Brief Report, Reviews on Teaching In keeping with high quality scholarship, Read More.....