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Volume 02 Issue 04 April 2014

Title: Knowledge About Tuberculosis  and DOTS Centre Among Newly Registered Pulmonary TB Patients Under DOTS Centre’s  Located in a Municipal Ward of Metropolitan City, Maharashtra.

Authors: Dr Amol R Patil, Dr Jyoti M.Bawa, Dr Mukesh S.Bawa and Dr P.B.Sawant

Tuberculosis (TB) is a serious public health problem in India as ranks first among 22 high burden countries, causing immense morbidity, mortality. Several factors have been identified including the individual’s perception of disease, socioeconomic level, extent of awareness about the disease and dots centre. The present study was aimed to analyze the knowledge of TB and DOTS centers among the newly registered pulmonary TB patients. This was an observational cross sectional interviewed based study conducted with newly registered pulmonary TB patients at DOTS centres. Frequency distributions showing number and percentages were generated for each identified outcome variables. The results show 36 % reported germ as a cause of TB. 30% reported inhalation is route of transmission.71% reported that TB is curable while 65 % cases told that TB can be prevented. 24(50%) has responded that they have got the TB from someone who had TB. only 105(42.0%) study subjects were aware about the TB related health facility in their area, 132(52.8%) were aware about the free availability of drugs. Regarding the DOTS centre facilities like timing, location and service provider were not suitable for, 94(37.6%), 19(07.6%), & 8(3.2%) respondents respectively. The study concludes that not only chemotherapy but the knowledge about TB among the pulmonary TB patients needs to be enhanced so as to prevent and control of TB. The general population should make aware about DOTS centre’s located in community.  Health education at the time of initiation of chemotherapy among pulmonary TB patients could be useful strategy to spread the knowledge about TB among the general population.

Key words: Knowledge, Tuberculosis, DOTS Centre, PTB Patients.

Dr Amol R.Patil

Department of Preventive & Social Medicine

SBH Government Medical College, Dhule (Maharashtra)

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Title: Physical Therapy for Neck of Femur Fracture and Its Functional Out Come

Authors: P.Karthikeyan ,Dr V.K. Mohandoss kurup

Background; Acute care rehabilitation and intensive physical therapy after hemiarthroplasty in neck of femur fracture was need to be studied in Asian population

Objective; to compare the effectiveness of intensive physical therapy and regular physical therapy in acute post operative rehabilitation of NOF# treated with hemiarthroplasty.

Methodology; Fresh cases of neck of femur fracture admitted between March 2009to march2012 were included in this study.50 patients were recruited from the wards of RMMC&H based on the selection criteria. Patients were randomly divided in to experimental and control groups. Intensive physical therapy group [experimental] treated twice a day in each 30 minutes of physical therapy. Control group treated with regular physical therapy 30minutes per day. Harris hip score, KATZ ADL, gait speed and TUG Test are used as outcome measures patients in both groups were assessed 3rd post operative day, at discharge and at four months. On analysis p-value for HHS was 0.238, tug- test was 0.824 and gait speed was 0.672.In conclusion physical therapy for both experimental and control groups were significantly effective in all scores but comparatively there is no significant difference on both groups

P.Karthikeyan

MPT

36,Murugan Street, Chidambaram

Cuddalore,Tamilnadu

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Title: Tramadol: Is It Still Relevant As A Labour Analgesic

Authors: Meenakshi Lallar, Anam  Ul  Haq, Rajesh Nandal

A prospective randomized single blinded controlled study conducted in 200 primigravidae in active labor, distributed in two groups of 100 women each with one receiving 100mg intramuscular tramadol and the other receiving intramuscular 2 ml distilled water as control. Pain intensity was recorded by McGills scale before, one and three hours after drug administration and perinatal outcome recorded. No difference in pain intensity seen before drug administration. After 1 hour, of drug administration, in tramadol group 4% women had horrible pain and 29% had distressing pain while in control group, 30% women had horrible pain and 60% had distressing pain.  After 3 hours, of drug administration, in tramadol group 26% had distressing pain while in control group, 51% women had horrible pain and 35% had distressing pain. Labor duration in tramadol and control group was 4.3 and 5.9 hours respectively.  In control group, nausea seen in 2.2%, vomiting in 1.1% while in tramadol group nausea seen in 6.4% and vomiting in 4.3%. Neonatal outcome was favourable in both the groups. Intramuscular tramadol is an effective labor analgesic with few maternal adverse effects, shortens labor and has no adverse neonatal outcome.

Keywords – Intramuscular Tramadol, labor , intrapartum, analgesia

Meenakshi Lallar

Senior resident,Room no. 21, PG girls’ hostel

SHKM Medical College,Mewat, Haryana

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Title: Huge Liposarcoma of Face and Scalp- An Uncommon Presentation

Authors:Dr. Arunima Mukhopadhyay,Dr. Sukla Naskar, 

Dr. Ujjwal Bhattacharya, Dr. Keya Basu,Dr. Ramprasad Dey

Liposarcomas , situated in the head and neck region are uncommon.We report a case of a huge liposarcoma of the face and scalp which presented with severe compressive effects.

Keywords- Liposarcoma, Well differentiated  liposarcoma

Dr. Arunima Mukhopadhyay

836 BLOCK –P , NEW ALIPORE , KOLKATA -700053.

Mobile No- 09830166404, Phone No- 03324003998.

E mail- ram_ arunima @ yahoo.co.in

Title: Effect of Hemodialysis on Oxidative Stress on Diabetogenic Patient of Chronic Renal Failure

Authors: Ashish Shukla, Akash Gupta, Naved Ahmad    

Free radicals are highly reactive molecules generated by biochemical redox reactions that occur as a part of normal cell metabolism. Advance glycations end products in diabetes also give rise to free radicals, which shift the balance in favour of prooxidant resulting in oxidative stress which is present in diabetogenic chronic renal failure patients undergoing hemodialysis. Hemodialysis can control uremia, reduce hypotensive episode, resolves acute renal failure rapidly and lowers the mortality significantly. The objective of the study was to estimate and compare markers of oxidative stress (Malondialdehyde, Glutathione peroxidise and Vitamin C) in pre and post hemodialysis patients. Fifty diabetic patients diagnosed as per criteria of American Diabetic Association, under going hemodialysis, were selected for the study after obtaining the ethical clearance from the institute. Levels of MDA, GPx and Vitamin C were estimated before and after hemodialysis. We observed that MDA levels were significantly raised in post hemodialysis as compared to pre hemodialysis (p < 0.001) while glutathione peroxidise and vitamin C levels were significantly lower in post hemodialysis as compared to pre hemodialysis. As their is consumption of antioxidants by over production of free radicals/ reactive oxygen species in hemodialysis, levels of malondialdehyde, glutathione peroxidise and vitamin C can lead us more close to new approaches for improvement in hemodialysis membranes and its techniques and also exogenous supplementation of antioxidant for removal of free radicals.

Key words – Free radicals, MDA, GPx, Vitamin C, Hemodialysis

Dr Akash Gupta

Department of Biochemistry,

Rama Medical College

Pilakhua -245304, Hapur, U.P. India

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Title: Evaluation of Causes of Thrombocytopenia in Pregnancy among Kashmiri Women

Authors: Imteyaz Ganai,Shazia Jeelani,Tazeen Jeelani Samoon,

Rifat Gull

Objective: Finding causes of thrombocytopenia in pregnancy in hospitalized patients.

Methods: The study was conducted in the department of obstetrics and gynecology, Sher-e-kashmir institute of medical sciences, Kashmir from Oct. 2011 to Nov. 2013. Total of 100 pregnant women with thrombocytopenia were studied among the women admitted in wards and labour room.

Results: Among 100 thrombocytopenic pregnant women; Sixty five patients were diagnosed with gestational thrombocytopenia (65%); thirteen patients were diagnosed with Idiopathic thrombocytopenia purpura (13%), fifteen patients with pre-eclampsia (15%), six patients with HELLP syndrome (6%) and one patient with HIV (1%).

Conclusion: The gestational thrombocytopenia is most common cause of thrombocytopenia in pregnancy while Pre-eclampsia, Idiopathic thrombocytopenic purpura and HELLP syndrome are less common causes.

Key words: Pregnancy, Gestational thrombocytopenia, ITP and platelet count. 

Imteyaz Ganai (MD)  

Department of Gynecology and Obstetrics                      

Sher-E-Kashmir Institute of Medical Sciences, Kashmir

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Title: A Study of Anemic Status of Women of Child Bearing Age from Rajkot Western India

Authors: Gira P. Mankad,Veena S. Samani

Anemia is the most common disorder of the blood. It is a pathophysiological condition where production, morphology and functionality of red blood cells (RBC) are adversely affected.Up to 10% or more of adolescent and adult women in USA under age 49 years are iron deficient. It is in the range of 50-90% or even more in developing countries like India. In the present study a survey of was carried out of 1,000 women from semi-urban area in child bearing age, i.e. 15-49 years to check hemoglobin level and to correlate it with some of the contributing factors like age, educational qualification and dietary habit. A very high prevalence (80.4%) of anemia along with very poor awareness was observed. Correlation between age of the respondents as well as educational qualification with hemoglobin level was found to be statistically significant at more than 1% level of significance. Respondents with non-vegetarian food habits were found to be having high hemoglobin level compare to their counterparts. Thus, awareness regarding dietary modifications, supplementations etc.is highly recommended to overcome huge burden of anemia in this very important segment of society.

Gira P. Mankad 

M.V.M.Sc. & HSc. College, Rajkot, India

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Title: Cerebellar Medulloblastoma in a 60 Years old Male- A Case Report

Authors: Dr. Meena Mittal MD, Prof. Dr. C.V. Kulkarni MD,

Dr. Roma Singh MD

Medulloblastoma is a tumour of neuroepithelial origin Although Medulloblastoma is the most common central nervous system malignancy in children, cases are much less common in adults. Moreover, in adulthood 80 % of the Medulloblastoma arise in the 21-40 age groups. During intraoperative consultation, the pathologist should consider Medulloblastoma in the differential diagnosis of a cerebellar mass in the elderly because cytological features may overlap with metastatic small cell carcinoma or lymphoma. We present a case of Medulloblastoma in a 60-year-old man and review the literature on the subject   

Case report:  Here is a case of 60 years old man who presented to our hospital with complains of pain over the scalp, occasional vomiting, giddiness, headache and weakness over a period of four months .Magnetic resonance imaging findings revealed a lesion measuring 4.2 X 3.6 X 2.5 cm in the right cerebellar region in the posterior paramedian region resulting in effacement of the underlying 4th ventricle. Features were suggestive of a high grade lesion/ glioma/ metastatic lesion. Oncologic staging for systemic tumours were negative.

Conclusion:  Medulloblastoma is a rare cerebellar malignancy in elderly and tend to occur more so in a lateral position. One should always consider systemic tumours  in the differential diagnosis in a cerebellar lesion.

Dr. Roma Singh  MD

Chief Resident Department of Pathology

M.Y. Hospital, Indore (MP) 452001 India Mob: +91-7566702709

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Title: Comparative Study of Sevoflurane and Sodium Thiopentone in Electroconvulsive Therapy

Authors: Chetna Jadeja,Rashida Jadliwala,Deepak Mangal, Dharmendra M. Gohil,V.A.Chhaya

Sodium thiopentone is most commonly used agent for electroconvulsive therapy (ECT) in India, but have side effects like prolonged awakening time, arrhythmias and laryngeal spasm. Therefore keeping into view the requirements of ideal and safe induction agent for anaesthesia in ECT, new modality of induction agent like sevoflurane have been tried.

This is a randomised prospective crossover study to compare recovery profile and hemodynamics of Sevoflurane and Thiopentone sodium. 100 patients who underwent ECT were divided into two groups Group-T & Group S.

Group-T patients were induced with Inj. sodium thiopentone and inj.succinyl choline. In group-S, induction was done with Sevoflurane 8%. After loss of eye lash reflex inspired sevoflurane concentration was reduced to 2% and inj. succinyl choline 0.5 mg/kg was administered intravenously. Onset of action, seizure duration, recovery time, hemodynamic effects and side effects were noted.

Power of study was 80% and p-value <0.05 was considered significant. All data were represented as mean ± SD.  The seizure duration was shorter in group S compared to Group T. The rise in heart rate

(HR) was significantly more in group T as compared with group S. The rise in mean blood pressure (MBP) after delivering ECT was more in group S as compared with group T. The mean time of eye opening and response to verbal command was shorter in group S (p=0.0129, p=0.0356 respectively) than group T.

Conclusions: Sevoflurane induction was well tolerated by our patients, and its induction was associated with faster recovery. Sevoflurane does not compromise seizure induction and may offer a stable heart rate

Key-words: sevoflurane, sodium thiopentone, electroconvulsive therapy, recovery, convulsions

Dr Chetna Jadeja

Address: 31, University Karmachaari Society, Behind FSL, University Road,

Rajkot (Guj) India- 360005. Mobile No. 9974968442,

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Title: Changes in the Electrolyte Profile of Patient having Hypothyroidism

Authors: Jaskiran Kaur,Naved Ahmad,Akash Gupta

Hypothyroidism is one of the most common forms of thyroid dysfunction. Its effect on electrolytes and certain minerals like calcium, phosphorus, magnesium is not yet clear and the underlying mechanisms for their derangement are not well understood. The objective was to find out the effect of hypothyroidism on certain electrolytes and mineral levels. A total of 110 known cases of hypothyroidism and 110 age and sex match controls were selected. Blood samples were collected from them and T3, T4 and TSH levels were measured. Also calcium, phosphorus, sodium, potassium levels in blood was measured. It was found that magnesium and phosphorus levels were significantly elevated in hypothyroidism cases then the controls. The levels of calcium, sodium and potassium were significantly decreased in cases then controls. It was also found that there was a significant positive correlation between serum TSH values, magnesium and phosphorus levels. At the same time, there was a significant negative correlation between serum TSH values and serum sodium, potassium and calcium levels. Higher the TSH levels, higher will be magnesium and phosphorus levels in blood and lower will be the values of serum calcium, sodium and potassium levels.

Keywords – Electrolytes, Hypothyroidism, T3, T4, TSH 

Dr Akash Gupta

Assistant Professor

Deprtment of Biochemistry, Rama Medical College

Pilakhua, Hapur, U.P.

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Title: Evaluation of Risk Factor of Cardiovascular Disease on Hypertensive Post-Menopausal Women and Aged-Matched Hypertensive Males

Authors: UK Amah1, VE Obianyia2,  SC Meludu3, CE Onah*, JA Onuegbu4, JM Olisakodiaka5 JE Okwara6, AK Amah7, EC Okwara8, AO Oluboyo9.

Background: This study compared plasma lipids and glucose levels in hypertensive post-menopausal women with age-matched hypertensive men. Methods: This is a cross sectional study that involves 100 subjects attending out-patient department of Nnamdi Azikiwe University Teaching hospital hypertensive clinics and control subjects. 25 hypertensive post-menopausal women and 25 hypertensive male subjects both within the same age range of 50-60 years. Also 25 hypertensive pre-menopausal women and 25 non-hypertensive controls both within the age range of 30-40 years. The lipid profile parameters (Total Cholesterol (TC), Triglyceride (TG), Low density Lipoprotein (LDL-C), and High Density Lipoprotein (HDL-C)) and fasting plasma glucose were determined using standard methods. The study also assessed the anthropometric indices such as BMI, SBP and DBP in each group. Results: The mean levels of TC and TG were significantly lower in post-menopausal hypertensive females when compared with the hypertensive males (p<0.05). However, the mean plasma HDL-C and LDL-C did not show any significant difference between the two groups. The comparison of the mean levels of all the parameters in hypertensive males with the non-hypertensive controls showed a significant difference (P < 0.05). The mean levels of TC and LDL-C were significantly higher in hypertensive post-menopausal women when compared with hypertensive pre-menopausal females (P<0.05). Conclusion: This study showed that menopause had altered the plasma lipids of the hypertensive post-menopausal women, but not to the extent of putting them at the same atherosclerosis scale as their male counterpart.

Key words: Hypertension, Menopause, Total cholesterol, Triglycerides.

Onah, Christian Ejike

Department of Chemical Pathology

Nnamdi Azikiwe University Teaching Hospital, Nnewi

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Title: The Prevalence of Thyroid Dysfunction and Thyroid Autoantibodies Among  Type 2 Diabetic Patients in Nnewi, South Eastern Nigeria.

Authors: Hope I. Nwokolo1, Samuel C. Meludu2;3, Chudi E. Dioka3

Christian E. Onah* Florence O. Ikemefuna4, Obiageli B. Onyema-Ilo5

Background: This study was carried out to determine the prevalence of anti-thyroid antibodies and Thyroid dysfunction (TD) among Type 2 Diabetic (T2DM) patients in our environment. Methods: The study comprises one hundred (100) known type 2 diabetic subjects attending out-patients diabetic clinics of Nnamdi Azikiwe University Teaching Hospital, Nnewi and one hundred (100) control subjects. Anti-thyroid peroxidase antibody (Anti-TPO Ab), Anti-thyroglobulin antibody (Anti-Tg Ab), Thyroid stimulating hormone (TSH), Total thyroxine (T4), Total triiodothyronine (T3), Free thyroxine (FT4), Free triiodothyronine (FT3), and Fasting plasma glucose (FPG) were assayed using standard methods. Anthropometric data such as age and body mass index (BMI) were determined.

Key words: Anti-thyroid antibodies, Prevalence, Thyroid dysfunction, Type 2 diabetes mellitus, Anti thyroglobulin antibody, Anti-thyroid peroxidase antibody.

Onah, Christian Ejike

Department of Chemical Pathology

Nnamdi Azikiwe University Teaching Hospital, Nnewi

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Title: A New Horizon for Better Dental Implants-A Nanotechnological Approch

Authors: Dr. Laxmi Chhuchar, Dr. Hiroj Bagde, Dr. Nitin Lokhande, Dr. Abhishek Bezalwar

Current trend in dental implants include use of endosseous dental implant surfaces embellished with nanoscale topographies. The goal of this review is to consider the role of nanoscale topographic modification of titanium substrates for the purpose of improving osseointegration. There is a strong belief that nanoscale materials will produce a new generation of implant materials with high efficiency, low cost, and high volume. The nanoscale in materials processing is truly a new frontier. Metallic dental implants have been successfully used for decades but they have serious shortcomings related to their osseointegration and the fact that their mechanical properties do not match those of bone. Nanoscale modification of titanium endosseous implant surfaces can alter cellular and tissue responses that may benefit osseointegration and dental implant therapy. This paper reviews recent advances in the fabrication of novel coatings and nanopatterning of dental implants.  Important distinctions between nanoscale and micron-scale modification of the implant surface are presently considered.  It also provides a general summary of the state of the art in dental implant science and describes possible advantages of nanotechnology for further improvements.

Keywords-Implants, Nanoscale, osseointegration, Nanotechnology, implant surface

Dr Hiroj Bagde

ACPM Dental College, Sakri road

Dhule,Maharashtra,India

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Title: Effect of Specific Yogasanas on Volunteers Having Cardiovascular Hyper-Reactivity to Cold Pressor Test 

Authors: Jitendra Mahour, Sanjeev K. Shrivastava, Chanda Rajak, Asha Shrivastava

According to the World Health Organization, stress is a significant problem of our times and affects both physical as well as the mental health of people. Stress coping methods are the cognitive, behavioral and psychological efforts to deal with stress. The Yoga helps the person to control stress and hypertension. It offers gentle asanas, relaxation, pranayama and meditation which helps to calm your mind, teaching us to relax at will and giving a mental vacation. Numerous scientific studies have reported that yoga is beneficial both physiologically and psychologically. Stress reduction via Yoga has been shown to lower blood pressure levels and reduce cardiovascular risk in adults and adolescents.The aim of present study was to investigate whether practice of Yogasanas can reduce the prevalence of hyper-reactivity measured by cold-pressor test.The study group comprises 55 healthy medical students of 18-27 years age group. Initially there were 22 hyper-reactors to cold pressor test which reduce to 10 after practicing yogasanas for three months. The remaining subjects also reduce their reactivity to cold stress. Practice of “yogasanascauses significant reduction in the cardiovascular hyper-reactivity. There was significant change in basal BP, BP after one minute of cold stress, rise in BP due tocold stress, heart rate and respiratory rate after performing yogasanas. The statisticalanalysis werecarried out using student‘t’ test. We concluded that regular practice of Yogasanas for three months reduces the cardiovascular hyper-reactivity to cold pressor test in subjects who were hyper-reactive to cold stress, possibly by inducing parasympathetic predominance and cortico-hypothalamo-medullary inhibition.

Keywords:Stress;Cold pressor test; Hyper-reactive subjects;Blood Pressure; Heart rate; Respiratory rate

Jitendra Mahour

Department of Physiology

GMC, Bhopal, M.P, India

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Title: Schizencephaly: An Incredibly A Rare Disease

Authors: Dr. Inder Maurya, Dr. Ketan Vagholkar, Dr. Kanika Jhamb

Schizencephaly is  an extremely rare cortical malformation that manifest as a grey matter lined cleft extending from ependymal to the piamater .It is also known as split brain disease. It usually presents itself in childhood and in rare cases in adults. The most common mode of presentation is hemiparesis and recurrent seizure.

We present to you a case of 21 year old male who came to our Emergency department with recurrent seizure and the CT scan imaging showed Type 2 schizencephaly. This case highlights the importance of how uncommon diseases may have a common mode of presentation.

Keywords: Open lip schizencephaly, seizure, premature death, CT scan

Dr. Inder Maurya

MD

Junior Resident

Department of Emergency Medicine,Padmashree. Dr. DY Patil Medical College

Nerul , Navi Mumbai 400706,Maharashtra(India),Mob: :+ 91- 9833828161

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Title: A Clinical Study of Programmed Labour and Its Maternal and Fetal Outcome

Authors: G. Sravani*, Kudupudi Subba Rao

Programmed labor aims at reducing the duration of labor, labor pain and incidence of cesarean section with improved maternal and neonatal outcome. The aim of the present study was to evaluate the efficacy of providing obstetric analgesia by a regime, and to evaluate its effects on the mother, on the progress of labour, fetal outcome. The present study was a prospective evaluation conducted at our hospital from November 2007 to April 2009. Fifty uncomplicated primigravide at term (between 37-42 weeks) were included in the study and compared with 50 uncomplicated control group. 66% of patients had mild relief of pain, 24% of patients had moderate relief while 10% had no relief. In this study group maximum patients had mild to moderate relief of pain. In conclusion; Programmed labor significantly reduced duration of labor with good pain relief without compromising maternal and fetal/neonatal safety.

KeyWords: Programmed labor, obstetric analgesia, Pain relief, maternal outcome.

Title: Incidence of Amebiasis Amoung Blody Diarrhea and Malnutrition Patients With Relation to Gamma Interferon Bellow Five Years of Age in Babylon Province in Iraq

Authors: Dr. Ahmed Shemran Al-Wataify

Abstract :-

Background

Malnutrition is an underlying factor in many diseases in both children and adults, it increases the incidence of infection including bloody diarrhea(parasite infection mostly Entamoeba histolytica) and potentiates the severity of the disease. Increased levels of  gamma interferon  from stimulated peripheral blood mononuclear cells and a mucosal IgA antilectin antibody response have been associated with protection from Entamoeba histolytica infection.

Aim of Study

To study the  incidence of amebiasis among patients with bloody diarrhea and malnutrition below 5 years of age and its correlation to serum level of gamma interferon .

Patients and Methods

A case-controlled study was conducted on 150 patients(81 males and 69 females) with malnutrition and bloody diarrhea , attending the Babylo maternity and children hospital in the period from April 2012 to end of June 2013, with age  below 5 years, in comparison to 100 patients ( 47 males and 53 females )with bloody diarrhea and well nourished as control group.

Fresh general stool examination, ,blood aspirate for gamma interferon  were sending for all patients and control group.

Results and Conclusion :

The incidence of amebiasis in malnourished patients were increased among bloody diarrhea patients in 58%, associated with reduction in ga interferon to 8.5ρg/ml ,in comparison to control group 30% with the level of gamma interferon 250pg/ml. The rate of its occurrence was increased with decreased level of nutritional state and the education level but had no relation with the age , sex and address.

*Key word : malnutrition , bloody diarrhea , amebiasis ,gamma interferon, Babylon governorate 

Dr: Ahmed Shemran Al-wataify

CABP, F.I.C.M.S

Assistant professor, Department of Pediatric ,Faculty of Medicine,

Babylon University, Babylon Maternity and Pediatric hospital, Iraq.

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Title: Clinical Profile and Treatment Response of Primary Focal Segmental Glomerulosclerosis (FSGS) in Eastern Indian Children

Authors: Subal Ku. Pradhan, Pawan Mutalik, Pravakar Mishra, J. Bikrant Ku Prusty, Anil Ku. Mohanty

Currently, there is very little information about the spectrum of clinical profile and treatment response of children presenting with primary Focal Segmental Glomerulosclerosis in India and other South East Asian countries. This entity is an important component of childhood nephrotic syndrome because of its high chance of progression to Chronic Kidney Disease and End Stage Renal Disease. This retrospective study was conducted from June 2009-February 2014 to determine the spectrum and treatment response of primary Focal Segmental Glomerulosclerosis in children at a tertiary level hospital. All children aged between 6 months-14 years with biopsy proven Focal Segmental Glomerulosclerosis were included in the study. Their demographical, clinical and histopathological data were studied from case files. Treatment was given as per Indian Society of Paediatric Nephrology guidelines and responses that occurred were documented. Statistical analysis was done using Microsoft Excel software. We found that 31 (22.14%) children in our study had primary Focal Segmental Glomerulosclerosis with 64.51% being males. The mean age was 5.51 ± 3.82 years. Most of these cases had presented clinically with Steroid Resistant Nephrotic Syndrome (64.51%). Majority went into remission (90.3%) with immunosuppressive medications. Our results indicated that response to Cyclosporine-A is better compared to oral Cyclophosphamide (p= 0.00098). Hence, it maybe advocated in a paediatric patient with SRNS after renal histopathology primary Focal Segmental Glomerulosclerosis.

Keywords: Children, Cyclosporine A, Focal Segmental Glomerulosclerosis, Renal biopsy, Steroid Resistance

Pawan Mutalik

Department of Pediatrics

Sardar Vallabh Bhai Patel Post Graduate Institute of Pediatrics (SVPPGIP) and SCB Medical College, Cuttack, Odisha, India

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Title: The Correlation of Physician to Population Ratio and Life Expectancy in Asian Countries

Authors: Anil Shetty, Shraddha Shetty

Life expectancy is influenced by a number of factors. There is a significant degree of variation in life expectancy among nations, particularly in the Asian region. The Physician to population ratio in the region is also not uniform. This study aims to assess the influence of physician population ratio on the life expectancy. Data on the number of doctors per 10,000 people and the life expectancy for Asian countries was obtained from the World Health Organization databases. The data obtained was evaluated under 4 sub- regional groupings and matched to assess the effect of doctors per capita on average life span. The population to physician ratio had a positive correlation with life expectancy.

Key Words: Life Expectancy, Physician Population Ratio, Mortality Rate.

Anil Shetty

Associate Professor, Department of Pediatrics

Father Muller Medical College

Kankanady,  Mangalore-575002.

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Title: Fracture Neck of Femur Treated with Hemiarthroplasty and Its Functional Out Come

Authors: P. Karthikeyan

Objective; To document the functional outcome of fracture neck of femur treated with hemiarthroplasty using HHS,KATZ-ADL,TUG-Test and Gait speed. Methodology; Patients with neck of femur fracture admitted in the RMMC&H between 2010 to 2012  for surgical management [hemiarthroplasty] were included in this study. Patient who had elective hemiarthroplasty and admitted for post operative management were included in this study. Based on the selection criteria 58 Patients were recruited from the wards of orthopaedics.50 Patients completed the evaluation [HHS, KATZ-ADL, TUG-Test and Gait speed]. Results; while comparing the findings on third post operative day, at the time of discharge and at four months statistical analysis showed that there was significant improvement in all 4 outcome measures. Conclusion; Based on the results we concluded that hemiarthroplasty is a effective procedure in improving functional outcome in treating for the fracture neck of femur.

P.Karthikeyan

MPT

36,murugan street chidambaram

Cuddalore,tamilnadu 608001

India

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Title: A Bacteriological Study of EAR Discharge

Authors: Dr. G V S S D Deepak Chakravarthy, Dr. G. Prabhakar 

Discharge from the ear is one of the commonest symptoms of infections of the ear.With a view to study the major strains of bacteria encountered in ear discharges, this study was conducted in our ent department, The aim of the study was to identify the organisms commonly found in Ear discharge and their sensitivity to Antibiotic. Every day around 60 patients were treated in department of ENT, in our hospital; out of which 30-40 patients had chief complaints of ear discharge.  34,800 patients were attended ENT outpatient department of which 5800 belong to ear diseases.  Out of 5800 patients, 100 patients were selected by random basis from October 2007 to October 2009. Patients who have taken antibiotic therapy, local or systemic within 2 weeks before presenting to the department were excluded from this study. Out of 100 cases, Pseudomonas aeruginosa is isolated in 42 cases (42.86%), Staphylococcus aureus in 38 cases (38.77%), Proteus species in 8 cases (8.16%), Escherichia coli in 6 cases (6.12%), Klebsiella in 5 cases (5.1%), Enterobacter, Pneumococci & Atypical coliforms in 1 case each.

Key Words : ear discharge, pseudomonas, sensitivity

Dr. G V S S D. Deepak Chakravarthy

Assistant Professor in Department of ENT

Alluri Sitarama Raju Academy of Medical Sciences

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Title: Gastric Outlet Obstruction Due to Isolate Pyloric Stenosis Following Corrosive Acid Ingestion: A Case Report

Authors: Dr. Shubhankar Mishra, Dr. Bhagabat Swain 

Corrosive poisoning is a common thing in children .But isolated gastric outlet obstruction after one month of asymptomatic ingestion of some unknown liquid is a rare phenomenon and rarely reported. We report a case in which isolated gastric outlet obstruction is seen after one month of drinking some liquid from a battery. At the time of poisoning she was asymptomatic, but subsequently she had intractable vomiting with abnormal bowel movements.UGI endoscopy confirmed diagnosis of acquired pyloric stenosis. Early surgical management showed a satisfactory recovery.

Key Words:  Gastric outlet obstruction, intractable vomiting , corrosive poisoning

Dr. Shubhankar Mishra

Room No 96, Pg Hostel 2

M.K.C.G Medical College,

Berhampur, Odisha,760004

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Title: Quinacrine Sterilization Induced Cryptomenorrhoea: A Rare Complication

Authors: Brig Kumar Praveen MD (Gynae), Gp. Capt JC Sharma MD (Gynae), Dr. Rupa Talukdar MD (Gynae)

Quinacrine  was used as a non-surgical technique for permanent sterilization was been under study several  years back .  It was used and propagated by several resource poor countries to control population . It was relatively inexpensive and had mass acceptability due to similarity in procedure of IUCD insertion.. The side effects of this sterilization process have been reported to be low as compared to surgical methods. Menstrual abnormalities in the form of menorrhagia and ammenorrhoea have been reported but  cryptomenorrhea was very uncommon complication. Here we present  a case of quinacrin induced  crypyomenorrhoea in  a  young women.

Keywords: quinacrine, cryptomenorrhoea, trans cervical sterilization, heamatometra

Gp Capt JC Sharma  MD (Gynae)

Associate Prof ( Obs & Gyn) Army College of Medical Sciences Delhi Cantt.

New Delhi. Pin: 110010.

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Title: Embryo protective effect of leaf extract of Vitex negundo Linn. in Adriamycin induced toxicity

Authors: Hitesh U. Shingadia & Vinayak Dalvie

Herbal drugs are known to prevent toxicity in general & side effects of certain molecules in particular. Further, they are also being evaluated for their character of protecting embryo against such toxins & molecules. Administration of anticancer drugs such as Adriamycin during embryonic development in animals has been shown to cause foetal malformations. Since there are very few antioxidants and synthetic agents to prevent the toxicity in embryo, present investigation was carried out, in which herbal leaf extract of Vitex negundo Linn. was proved to have effect of protecting chick embryo from Adriamycin (ADR). The results of present study clearly reveal the toxicity of drug on the developing chick embryos. A significant decrease in weight of ADR-treated group was due to decreased energy supply as evidenced by the altered properties of macromolecules of yolk-sac & reduction in extra-embryonic vascular network which, in turn, reduced the nutrient transport, hence detrimental to the embryonic growth & damage to vital tissue like kidney when compared with the control. A momentous decrease in the volume of amniotic fluid is believed to be caused due to decrease in the amount of albumin entering the amniotic fluid via sero-amniotic connection that constricts the perforation of sero-amniotic plate.

Key Words: Adriamycin; Amniotic fluid; Chick embryo; Kidney; Vitex negundo Linn.

Hitesh U. Shingadia

Dept. of Zoology, SVKM’s Mithibai College of Arts,

Chauhan Institute of Science & Amrutben Jivanlal College of Commerce & Economics

Vile Parle - West Mumbai 400 056 Maharashtra India 

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Title: A Rare Case of Duodenal  Somatostatinoma

Authors: Dr Jitendra T. Sankpal, Dr Spoorthy Shetty, Dr Vivek Tilwani, Dr. Manjiri J. Sankpal, Dr Prashanth Turkar

Somatostatinomas are the rarest of pancreatic tumours and can arise in pancreas  andduodenum.Duodenalsomatostatinomas are less common and are distinguished from their pancreatic counterparts by a frequent association with type I neurofibromatosis, the presence of psammomabodies,the less frequent presence of metastatic disease and absence of somatostatinoma syndrome.

We present a case of somatostatinoma in a 70 year old woman who presented with vague epigastric pain and nausea. In view of CT and MRCP finding suggestive of malignant lesion in periampullaryregion, patient was posted for exploratory laparotomy and Whipple’s procedure was done.Histopathology report revealed a somatostinoma. Postoperative course was uneventful and patient was discharged after 15 days. After 2 years of follow up patient was disease free.

Dr. Spoorthy Shetty

Dept of Surgery

JJ Group of hospitals

Maharashtra, India

Tel:- +91-8097088535

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Title: Efficacy and Tolerability of Oral Triple Drug Combination (Voglibose, Glimepiride and Metformin) in the Management Type 2 Diabetes Mellitus 

Authors: Hari K., Arif A. Faruqui

The prevalence of diabetes is rapidly rising across the globe at an alarming rate. Despite the introduction of new agents efforts for better management of diabetes are disappointing and the control of blood glucose levels remains unsatisfactory. Material and method: The study was a post marketing surveillance (PMS) non-randomized, open, non-comparative, mono centric study. The triple drug fixed dose combination of Voglibose, Glimepiride and Metformin was administered to 20 Type 2 diabetic patients once daily for 4 months. Observation: Baseline value was recorded for glycated haemoglobin (HbA1c), fasting blood glucose and post prandial blood glucose level. There was a significant decrease in glycated haemoglobin value (9.07 ±0.346 to 6.51±0.129, p < 0.0001), fasting (181±10.2 mg/dl to 116±2.97 mg/ml P < 0.0001) and post prandial blood glucose level (239±11.2 mg/dl to 140±4.42 mg/dl P < 0.0004) after 4 months of treatment from the baseline. The combination was found to be effective in controlling both fasting and post prandial glucose level and was well tolerated. Conclusion: Fixed dose triple drug combination of voglibose plus metformin plus glimepiride significantly reduces the HbA1c value, fasting and post prandial blood glucose level with an excellent tolerability.

Keywords-HbA1c; Fasting blood glucose; Post Prandial Blood Glucose;Fixed Dose Triple drug

Arif A.Faruqui

Associate P, (Pharmacology)

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Title: A Rare Case of Carcinoma Oesophagus in 16 Year Old  Male Patient Nutritional Deficiency

Authors: Dr Jitendra T. Sankpal, Dr Spoorthy Shetty, Dr Vivek Tilwani,Dr. Manjiri J. Sankpal, Dr Prashanth Turkar

Esophageal carcinoma is commonly seen in elderly. Most common etiological factors are environment related with constant long term exposure of carcinogens. Hence, it is rarely seen in younger age groups (<18 years).Till date only few cases have been reported in world literature. In our case report we present squamous cell carcinoma esophagus in young male (16 yr old) with no predisposing factors except for past history suggestive of scurvy and combined iron and vitamin b12 deficiency anemia. Patient was taken up for surgery after building up his hemoglobin by blood transfusion and multivitamin infusions. Ivor lewis oesophagectomy was performed with transthoracic anastomosiS. Post operatively patient recovered well from surgery and patient was given chemoradiation. .In Indian scenario which is a developing country with majority of population having nutritional deficiency randomized control study linking vitamin deficiencies with malignancy of oesophagus is lacking. This case report can be an impetus for carrying out randomized control trials in developing countries to study association of vitamin deficiency with carcinoma esophagus. Further studies need to be undertaken to prove whether supplementation of micronutrients can prevent carcinogenesis.

Dr. Spoorthy Shetty

Dept of Surgery

JJ Group of hospitals

Maharashtra, India

Tel:- +91-8097088535

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Title: The Effects of Thermally Oxidized Palm Oil on the Kidney of Adult Wistar Rats

Authors: *Boniface MN, Ejimofor OC , Ezissi AI

This study was aimed at the histological changes that might occur following the ingestion of thermally oxidized palm oil. The study was prompted by rising reports of toxicity of thermoxidized palm oil to body tissues and organs following ingestion, and palm oil happens to be the most widely consumed oil especially in Nigeria as it is a core ingredient of many Nigerian diets. Sixteen wistar rats of an average weight of 180g were used for this study and were divided into four groups of four rats in each group. Group A served as the control, receiving normal feed (grower mash), group B received a diet containing 20% fresh palm oil and 80% of normal feed. Group C received a diet containing 15% thermoxidized palm oil and 85% normal feed. Group D received a diet containing 20% thermoxidized palm oil and 80% normal feed. The animals were sacrificed after 28days (1month) of administration. The results showed that consumption of thermally oxidized palm oil had a negative effect on the histological appearance of the kidney ranging from vacuolation and degeneration of renal corpuscle, tubular necrosis, patches/diffused denudation of the renal tubular cells with loss of brush border; to accumulation of homogenous substances with eosinophilic debris, suggesting acute renal failure. Excessive ingestion of fresh palm oil was also seen to be unsafe as it induced vacuolation of renal corpuscles and tubular necrosis. From the result of this study, I recommend that ingestion of thermoxidized palm oil should be avoided and also, there should be a controlled ingestion of fresh palm oil in adequate quantity.

Keywords: Thermally Oxidized Oil, Palm Oil, Kidney, Body Weight.

Boniface MN

Department of Anatomy

College of Health sciences, Nnamdi Azikiwe University

Nnewi Campus, Anambra State, Nigeria.

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Phone number: +2347066739416

Title: Brain Death: Diagnosis and Clinical Application 

Authors: Asra al Fauzi, Joni Wahyuhadi

Brain death has a story of nearly one full century. In most cases brain death occurs as a sequelae toincreased intracranial pressure. Nearly every neurosurgeon has experienced it. In addition, neurologist,emergency care physicians and intensivists may also experienced brain death state. However it is unlikelythat all clinicians will encounter this condition. The fact is that there are a large number of medicalprofessional lacking on criteria of drain death. A particular aim of this article is to give every neurosurgeonand intensivist sufficient theoretical knowledge to feel confident in diagnosing brain death.

Key words : Brain death. diagnosis. clinical application.

ASRA AL FAUZI, MD

(NeuroSurgeon)

Department of Neurosurgery,Airlangga University School of Medicine

Dr.Soetomo General Hospital,Jl.Karangmenjangan 12,Surabaya - Indonesia

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Title: Pregnancy in Head Injury: Friend or For? A Proposed Guideline for the Management of Head Injury in Pregnancy 

Authors: Asra al Fauzi

Even mild, head injury during pregnancy can threaten either the maternal or the fetal life. The risk is associated with systemic and cerebral consequences of rapid expanding mass lesion, high intracranial pressure, hypotension, anoxia or anemia. But recent studies also show that hormonal status contribute to better outcome after traumatic brain injury, and progesterone is a potent neuroprotector. This phenomena leads to different and specific management than usual case. 

Key Words  :  Pregnancy, head injury, specific management, outcome

ASRA AL FAUZI, MD

(NeuroSurgeon)

Department of Neurosurgery,Airlangga University School of Medicine

Dr.Soetomo General Hospital,Jl.Karangmenjangan 12,Surabaya - Indonesia

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Title: Correlation of Histopathological Osteoarthritis Finding With the Clinical Severity in Osteoarthritic Patients  

Authors: Dr. Prof. C.V. Kulkarni, Dr. Garima Malpani, Dr. Meena Mittal 

Objective: To determine Osteoarthritis Cartilage Histopathology (OACH) assessment system applied to the characterisation of the osteoarthritic human knee and hip and correlate it with clinical severity.

Method: Osteoarthritic knees of 23 patients and osteoarthritic hip of 2 patients were assessed. Oxford knee scoring was done for osteoarthritic knee patients, hip scoring for OA hip patients and scores were given to assess them clinically.

Result: The OACH grading system correlated with the clinical oxford knee/ hip score.

Conclusion: The grading system implemented provided useful measures in the characterisation of knee and hip osteoarthritis and correlated with the radiological findings

Keywords- Osteoarthritis, OACH grading, oxford score.

Dr. Garima Malpani , MD

Chief Resident

Department of Pathology

M.Y. Hospital , Indore (M. P.) 452001

India

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Title: A Rare Collision Tumor of Ovary 

Authors: Dr. Kudupudi Subba Rao, Dr. Siva Ranjan D

Collision tumors represent a coexistence of two adjacent tumors but histologically distinct tumors without admixture in the same tissue or organ. Collision tumors in ovary are a rare entity and combination of mucinous cystadenoma and adult granulosa cell tumor is very rare. Here we present a case in 47 year old women who presented out patient department of obstetrics and gynecology with complaints of lower abdomen pain and dysfunctional uterine bleeding. Patient underwent hysterectomy with salphingo oophorectomy and microscopically it was diagnosed as Adult granulosa cell tumor with mucinous cystadenoma.

Keywords: Adult granulosa cell tumor,  mucinous cystadenoma, ovary, collision tumors.

Dr. Siva Ranjan D

Assistant Professor in Pathology

Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram

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Title: Serum Endothilin- 1 Level, Pulse Oximetry and Echocardiography for Diagnosis of Hepatopulmonary Syndrome 

Authors: Mohamed Youssef El Hasafy, Tarek El Zawawy, Perihan El Sayed Salem, Dalia Abdelmoety I brahim, El Shaimaa Sobhy Aboshady

Liver cirrhosis is a condition in which there is development of regenerative nodules surrounded by fibrous bands in response to chronic liver injury that leads to portal hypertension and end stage liver disease. Hepatopulmonary syndrome (HPS) is a triad of portal hypertension, intrapulmonary vascular dilatation or shunting, and hypoxemia. The prevalence of HPS in patients with liver cirrhosis varies from 4%- 47% with adverse out come and increase mortality in comparison to those without HPS especially when sever hypoxemia is present. The aim of the present work was to study the significance of serum endothelin-1 level, digital pulse oximetry, arterial blood gases analysis and contrast enhanced transthoracic echocardiography in diagnosis of HPS among Egyptian patients with liver cirrhosis.

Keywords:Hepatopulmonary syndrome (HPS), serum endothilin-1 level, pulse oximetry, arterial blood gases analysis, echocardiography

Perihan El Sayed Salem

Hepatobiliary Unit, Internal Medicine Department

Alexandria University

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Title: Leiomyoma of Jejunum - A Rare Cause of Acute Abdomen

Authors: Dr. Sheela Chaudhari, Dr. Pawan Bhat, Dr. Sachan Bhat 

Leiomyomas are benign smooth muscle neoplasm. Commonest site for leiomyomas is uterus. Small intestinal leiomyomas are rare. Only 3%-6% of gastrointestinal tumors arise from small bowel. Leiomyomas of small bowel are mostly asymptomatic and found incidentally at surgery or autopsy. We report a case of benign jejunal leiomyoma presented as acute abdomen surgical emergency.

Key words- small intestine, benign tumor, acute abdomen.

Dr Sheela Chaudhari

Associate Professor

Department of Pathology

V.C.S.G. Government Medical Sciences and Research Institute

Uttarakhand, 246174 Srinagar, India

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Title: Supernumerary Axillary Breasts : A Case Study 

Authors: Dr. Achala Sahai, Dr. Jyoti Bindal

Polymastia the presence of supernumerary breast tissue is rare and may be found in 2-6% of woman. Axillary breast tissue is a common variant of supernumerary breast tissue and is commonly bilateral and often associated with a distinct areola and nipple. This tissue tends to become symptomatic and noticeable during pregnancy due to hormonal stimulation. Here we report a case of axillary breast tissue, that became symptomatic in a post caesarian case due to engorgement and responded well to conservative treatment.

Keywords: supernumerary breast tissue, axillary ectopic breast tissue.

Dr. Achala Sahai

M.S., M.I.C.O.G.

Assistant Professor

Dept. Of Obst. & Gyn., G.R.Medical College

Kamla Raja Hospital Gwalior, 474001 (M.P.)

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Title: Polyherbal Extract of Ocimum Gratissimum and Gongronema Latifolium on Reproductive Function in Alloxan Induced Diabetic Male Rats   

Authors: Agbai Emmanuel Onuka,Mounmbegna Pouonkoussou Phillpe, Prof. Nwafor Arthur

Background: Reproductive functions are impaired in diabetes mellitus. Polyherbal extracts from ocimum gratissimum and gongronema latifolium extracts on reproductive hormones and sperm parameters were studied in alloxan induced diabetic rats.

Materials and Methods:  Twenty five adult male albino rats were used in the study. Twenty rats were made diabetic using 100 mg/kg body weight of alloxan monohydrate (intraperitoneal injection). The rats were divided into five groups I (control), II (diabetic control), III, IV and V. The rats were treated with 200mg/kg of ocimum gratissimum (group III), 200mg/kg of gongronema latifolium (group IV), and 200mg/kg per extract of ocimum gratissimum and gongronema latifolium (group V) for 21 days.

Results: The rats treated with polyherbal extracts showed significantly reduced levels of FSH, LH, testosterone, sperm count, sperm motility, sperm morphology and viability. The same results was obtained in rats treated with gongronema latifolium (200mg/kg) except in rats treated ocimum gratissimum extract (200mg/kg) that showed elevated testosterone levels. 

Conclusion: These findings showed that polyherbal treatment from ocimum gratissimum and gongronema latifolium do not restore reproductive functions in alloxan induced diabetic rats.

Keywords: gongronema latifolium. ocimum gratissimum. testosterone. follicle stimulating hormone. luteinizing hormone. sperm parameters 

AGBAI EMMANUEL ONUKA

Lecturer

Department of Human Physiology

Faculty of Basic MEdical Sciences, Madonna

University  Elele. PMB 48 Elele, Rivers State Nigeri

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Crossref - DOI Prefix: 10.18535/jmscr

 

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