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Summary Background Coronavirus disease-2019 (COVID-19) is a global pandemic. Studies reported dyslipidemia in patients with COVID-19. Herein, we conducted a systematic review and meta-analysis of published articles to evaluate the association of the lipid profile with the severity and mortality in COVID-19 patients. Methods PubMed/Medline, Europe PMC, and Google Scholar were searched for studies published between January 1, 2020 and January 13, 2021. Random or Fixed effects models were used to calculate the mean difference (MD) and 95% confidence intervals (CIs). Statistical heterogeneity was assessed using Cochran's Q test and I2 statistics. Results This meta-analysis included 19 studies. Of which, 12 studies were categorized by severity, 04 studies by mortality, and 03 studies by both severity and mortality. Our findings revealed significantly decreased levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the severe group when compared with the non-severe group in a random effect model. Similarly, random effect model results demonstrated significantly lower levels of HDL-C and LDL-C in the non-survivor group when compared with the survivor group. The level of TC was also found to be decreased in the non-survivor group when compared to the survivor group in a fixed-effect model. Conclusion In conclusion, the lipid profile is associated with both the severity and mortality in COVID-19 patients. Hence, the lipid profile may be used for assessing the severity and prognosis of COVID-19. Prospero registration number CRD42021216316 .

Periodontitis has been associated with many systemic diseases and conditions, including metabolic syndrome. Metabolic syndrome is a cluster of conditions that occur concomitantly and together they increase the risk of cardiovascular disease and double the risk of type 2 diabetes. In this review, we focus on the association between metabolic syndrome and periodontitis; however, we also include information on diabetes mellitus and cardiovascular disease, since these two conditions are significantly intertwined with metabolic syndrome. With regard to periodontitis and metabolic syndrome, to date, the vast majority of studies point to an association between these two conditions and also demonstrate that periodontitis can contribute to the development of, or can worsen, metabolic syndrome. Evaluating the effect of metabolic syndrome on the salivary microbiome, data presented herein support the hypothesis that the salivary bacterial profile is altered in metabolic syndrome patients compared with healthy patients. Considering periodontitis and these three conditions, the vast majority of human and animal studies point to an association between periodontitis and metabolic syndrome, diabetes, and cardiovascular disease. Moreover, there is evidence to suggest that metabolic syndrome and diabetes can alter the oral microbiome. However, more studies are needed to fully understand the influence these conditions have on each other.

Aim and objective To reduce the incidence of infiltration and phlebitis by 50% over 2 months among children admitted to the emergency room (ER) of a tertiary care hospital. Materials and methods The study was conducted in the pediatric ER of a tertiary care hospital in North India. All children aged >28 days, receiving intravenous (IV) medication and/or fluids, were enrolled between June (2017) and September (2017). Existing practices of IV line insertion and maintenance were observed and recorded. The visual infusion phlebitis score and infiltration assessment scale were to grade the extent of two. The intervention classified as “IV line insertion and maintenance bundle” included the introduction of low-cost mobile sterile compartment trays, audit and feedback, organizational change, introduction of infection control nurse and quality improvement (QI) team formations were implement in different Plan-Do-Study-Act (PDSA) cycles. Reduction in the “incidence of phlebitis and infiltration” was outcome measures while “scores on checklist of IV line insertion and IV line maintenance and administration of drugs” were process measures. Result The process measures, for IV line insertion, maintenance and administration of drugs through IV line, revealed an increase in scores on the checklist. There was a significant decrease in the incidence of infiltration and phlebitis from 82.9 and 96.1% to 45 and 55%, respectively, postimplementation of all PDSA cycles. Conclusion Multifaceted QI IV line insertion and maintenance bundle reduced the incidence of infiltration and phlebitis. These interventions when integrated into daily work bundles along with continuous education and motivation help in sustaining the goal and attaining long-term success. How to cite this article Singh N, Kalyan G, Kaur S, Jayashree M, Ghai S. Quality Improvement Initiative to Reduce Intravenous Line-related Infiltration and Phlebitis Incidence in Pediatric Emergency Room. Indian J Crit Care Med 2021;25(5):557–565.

The numerical simulation of lead-free all-perovskite tandem solar cell using solar capacitance one dimensional tool (SCAPS 1D) has been performed. The combination of methyl ammonium germanium halide (CH3NH3GeI3) as wide band-gap (1.9 eV) perovskite layer and FA0.75MA0.25Sn0.25 Ge0.5I3 (FAMASnGeI3) as a low band-gap (1.4 eV) perovskite layer is considered for the first time which shows the optimal device efficiency of 26.72%. The present work studies the effect of the different electron transport layer, perovskite absorber thickness and its defect density on photovoltaic performance. Further, the effect of front electrode work function on the device photovoltaic performance is also studied. It has been observed that the device open circuit voltage (VoC) is significantly affected by the built-in voltage (Vbi) across the perovskite layer. In addition, the effect of thickness of the perovskite absorber layers is also investigated. Moreover, the effect of defect density of the absorber layer is also explored, and it has been found that for better device performance the defect density needs to be as low as possible. Furthermore, it has been observed that the work function of the front contact plays a significant role and for the proposed device its value should not be more than 4.4 eV. The proposed all–perovskite tandem solar cell shows the remarkable photovoltaic parameters i.e., open circuit voltage (VOC) = 1.07 Volts, short circuit current density (JSC) = 28.36 mA/cm2, fill factor (FF) = 84.39% and efficiency (η) = 26.72%.

Prediabetes is a condition which appears prior to the development of diabetes in which blood glucose is abnormally high but do not reach the diagnostic threshold of type 2 diabetes mellitus. It is characterized by a cluster of metabolic abnormalities viz. dysglycemia, dyslipidemia, hypertension, physical inactivity, obesity, insulin resistance, procoagulant state, endothelial dysfunction, oxidative stress and inflammation, placing prediabetic subjects to an increased risk for diabetes and its complications. Recent studies demonstrate that complications of diabetes i.e. microvascular and macrovascular complications may manifest in some prediabetic subjects. This article reviews prediabetes-related risk factors and health issues. In addition, this article also highlights the interventions to prevent the development of diabetes in prediabetic subjects.

Introduction Prediabetes is a chronic low-grade inflammatory disease and considered as a risk factor for the development of diabetes mellitus and cardiovascular disease. Myeloperoxidase (MPO) is a leukocyte-derived enzyme, linked to both oxidative stress and inflammation and has been proposed as a possible mediator of atherosclerosis, the major cause of cardiovascular disease. The objective of the present study was to evaluate the level of MPO in prediabetic subjects and correlate it with other cardiovascular disease risk factors. Materials and methods In this cross-sectional study, a total of 400 subjects were recruited. Of them, 200 were prediabetic subjects and 200 were age and gender-matched controls. For each subject, blood pressure, weight, height, waist circumference, hip circumference and lipid parameters were measured. In addition, MPO was determined. Results MPO was significantly increased in prediabetic subjects as compared to controls. In correlation analysis, MPO was found to be significantly and positively correlated with all the cardiovascular disease risk factors i.e. age, body mass index (BMI), waist-to-hip ratio (WHR), blood pressure [both systolic blood pressure (SBP) and diastolic blood pressure (DBP)], lipid parameters except high density lipoprotein (HDL) to which it was negatively correlated. Conclusion In conclusion, MPO is well correlated with cardiovascular disease risk factors in prediabetes. Hence, MPO could be used to detect cardiovascular risk among prediabetic subjects and also can be used as an early biomarker of oxidative stress and inflammation in prediabetes.

Aim: Nowadays the ‘‘sunshine’’ vitamin attracts full attention toward its anti-inflammatory role that is much beyond its classical role in bone metabolism. Vitamin D deficiency is a major health issue that affects people of all ages, especially elderly women. With increasing age, women are at high risk of several metabolic diseases. This study aims to determine the levels of serum vitamin D and inflammatory markers in premenopausal and postmenopausal women. Methods: A total of 500 female subjects were included in the study, with 400 pre- & postmenopausal women were considered as cases while 100 subjects were considered as control healthy women. Serum Vitamin D was estimated by chemiluminescent microparticle immunoassay method. Inflammatory markers, Interleukin-6 (IL-6), and highly sensitive C-reactive protein (hs-CRP) were assayed in serum by using standard immunoassay method. Serum Estradiol (E2) was estimated by the competitive immunoassay method in all studied female subjects. Data were analyzed by using SPSS software, version 22.0. Result: Serum Vitamin D levels were significantly decreased while inflammatory markers were significantly increased (p

This paper simulates the lead-free or non-toxic PSC (perovskite solar cell) based on cesium tin germanium halide (CsSnGeI3). The effect of different electron transport layers is understood by mutually related the built-in potential (Vbi) with the open circuit voltage (VOC). The simulation study reveals that electron transport layer (ETL) shows a crucial effect on the photovoltaic performance (PV performance) of solar cell. It is obtained from simulation, that ZnOS (Zincoxysulfide) as an ETL shows better device efficiency. Further, the PV performance is optimized based on the defect density (DD) of perovskite absorber layer. The proposed work depicts that at the optimum defect density of 1 × 1014 cm−3 a remarkable device efficiency is achieved i.e., ~ 25.43%.

Introduction Vaginal discharge is the most frequent complaint during pregnancy, leading to numerous complications in both the mother and fetus. Aim The goal of this study was to determine the prevalence of vaginal discharge, investigate its common infectious causes and associated symptoms during pregnancy. Methods This hospital-based cross-sectional study performed over one year evaluated 200 expectant mothers with vaginal discharge at any trimester in the Department of Obstetrics and Gynecology, in cooperation with the Microbiology section, of Indira Gandhi Institute of Medical Science, Patna. Results The mean age of the mothers was 26.84±5.51 years (range 19-42 years). Most of the patients (47.5%) were in the age group of 26-35 years, belonged to the lower socioeconomic class (67.5%), gravida 3 or more (43.5%), and presented in the third trimester. The prevalence of pathological discharge in pregnancy was 148/308 (48.05%). A positive culture was obtained in 105 (52.5%), and negative culture was obtained in 95 (47.5%). Vaginal candidiasis was diagnosed in most cases (37.5%), followed by aerobic vaginitis (15%), trichomoniasis (13.0%), and bacterial vaginosis (8.5%). The non-pathological discharge was diagnosed in 26.0%. Dysuria was the most common symptom (32.5%), followed by itching (27.5%) and urinary tract infection (UTI; 10.0%). The following variables were significantly associated (P

The presence of lead material in lead halide perovskite absorber is always remains a major obstacle due to its toxic nature. The emergence of tin halide perovskite absorber will overcome this toxicity issue and due to its extraordinary properties such as direct band gap and compatible visible spectrum of solar cells attracts a wide attention to researchers to focus on the development of lead free perovskite solar cells. This paper comprises of the device simulation of lead-free perovskite material. In addition, effect of various hole transport layers, and the effect of absorber band gap have been studied. It has been observed from the results that along with the proper band alignment of HTM layer with perovskite layer, the mobility of HTM layer plays an important role to achieve better device performance. Furthermore, it has been concluded that Cu2O layer as a hole transport material exhibits better device performance as compare to the other HTM layer used in this paper.

The numerical simulation of inorganic halide based perovskite solar cell has been performed. This paper demonstrates the use of CsPbI2Br as a perovskite layer in the device simulation based on SCAPS 1D for the first time. The magnesium doped zinc oxide (ZnMgO) as an electron transport layer (ETL) of varying band gap has been used and correspondingly the photovoltaic performance has been measured. The values of the band gap of ZnMgO layer has been directly taken from the literature where the variation in band gap has been performed by changing the magnesium concentration in the ETL layer. It has been elucidated from the simulation results that with the increase in band gap of ZnMgO layer, the photovoltaic performance decreases. This is mainly because the ZnMgO layer with wider band gap has higher carrier recombination. Moreover, the increase in recombination also degrades the other parameters such as VOC, JSC, and FF of the simulated device.

Background: Objectives of the current study were to evaluate the risks factors, clinical presentations, the management and maternal and fetal outcome of common obstetric emergencies encountered at Government general hospital Nizamabad, Telangana, from April 2019 to November 2019.Methods: It is an Observational, hospital-based study done department of obstetrics and gynaecology in 160 cases of obstetric emergencies managed in 8 months study period were reviewed.Results: Out of 3000 deliveries there were 160 cases of obstetric emergencies giving a percentage of 5.33%. About 84% had antenatal care and 16% had not taken ANC with perinatal mortality of 91.9% in booked cases. Out of 160 cases of obstetric emergencies, obstetric haemorrhage constituted 94 (58.75%) cases and among those cases, 23 cases (24.5%) were PPH including both atonic and traumatic, abruptio placenta constituted 35 cases (37.3%). Out of 160 cases of obstetric emergencies, obstructed labour constituted 29 cases (18.1%) being a frequent indication for emergency caesarean section, 1 case of septic abortion and 30 cases eclampsia. 29 perinatal deaths giving the perinatal mortality rate as 181 per 1000 live births. One maternal mortality due to rupture uterus. Maternal morbidity was in the form of wound infections which was found in 6 cases (3.75%), wound gaping in 2 cases (1.25%) PPH in 19 cases (11.81%), septicaemia in 17 cases (10.6%), puerperal pyrexia 6 cases (3.7%), vaginal or cervical injury 6 cases (3.7%), ICU admissions in 9 cases (5.6%). This morbidity increased the number of days of hospital stay to the patients.Conclusions: In majority of cases, the complications are preventable and treatable with proper antenatal and intranatal care. Identification of high risks cases, education of people about the importance of supervised pregnancy, delivery and emergency obstetric care will reduce the maternal mortality and morbidity and perinatal mortality and morbidity significantly.

Background: Caesarean section is associated with risks of postoperative adhesions, incisional hernias (which may require surgical correction) and wound infections. The risk of the surgery may be increased due to a number of factors. The aim of the study was to study the effects of repeated caesarean sections and intra surgical difficulties.Methods: A cross sectional, observational, hospital-based study was done for all patients with repeat caesarean section for a period of 8 months. 190 women who have undergone one or more caesarean section of term gestation with a live foetus irrespective of amniotic fluid colour and amount with cephalic, breech, or transverse presentation elective and emergency caesarean sections and singleton or multiple pregnancies were selected for study.Results: In the present study the highest prevalence of previous C-section was seen in age group 20-29 years, which accounted for (88.5%). Complications are present in 42.1% patients in which adhesions was the most found complication. Adhesion between Parietal peritoneum and anterior surface of uterus is present in 26.3% patients, omentum and uterus is present in 25.8% patients, adhesiolysis was done in 28.9% patients. 80% complications were present in patients with one previous CS. The association was found to be statistically significant.Conclusions: Women undergoing repeated cesarean sections have a risk of increased morbidity due to increased intraoperative complications. To avoid this one should keep the cesarean section rate at reasonable limit with appropriate surgical techniques and to limit primary cesarean section rate.

This article presents the numerical simulation of lead–free (Pb-free) double–perovskite (Cs2AgBi0.75Sb0.25Br6, i.e., mixed antimony bismuth halide double-perovskite) solar cell (DPSC) using solar cell capacitance one dimensional simulator (SCAPS-1D). In this contribution, the hole transport layers (HTLs) and electron transport layers (ETLs) are optimized. The optimization is performed by correlating the open circuit voltage (VOC) with the built-in potential (Vbi). It is disclosed from the simulation results, that higher Vbi resulted higher VOC. Furthermore, it is also found that, for the proper selection of HTL, the EV_HTL (Valence band maximum of HTL) and φBC (Work function of back contact) should not be much deeper than the EV_PVK (Valence band maximum of double–perovskite layer) to avoid Vbi loss. Correspondingly, for proper selection of ETL, EC_ETL (Conduction band minimum of electron transport layer) and ΦFC (Work function of front contact), should not be much higher than EC_PVK to prevent Vbi loss. The optimized HTL and ETL are found to be Cu2O (copper(I) oxide) and ZnOS (Zinc oxysulfide) respectively. Moreover, the device photovoltaic performance is further improved by optimizing the double-perovskite layer thickness which is found to be 400 nm. Under optimized condition, the device photovoltaic power conversion efficiency (η) improves to 18.18%. The optimized device photovoltaic performance are found to be, open –circuit voltage (Voc) = 1.39 V, short-circuit current density (JSC) = 16.04 mA/cm2, and fill factor (FF) = 78.34% which indicates that double–perovskite absorber layer (Cs2AgBi0.75Sb0.25Br6) is a suitable candidate for the development of highly efficient Pb-free DPSC.

The numerical simulation of lead-free perovskite cesium tin germanium halide (CsSnGeI3) and methyl ammonium germanium halide (CH3NH3GeI3) solar cells have been performed. It has been elucidated from the numerical simulation that as compare to the CH3NH3GeI3 based structure, CsSnGeI3 based structure depicts better photovoltaic performance under constant illumination condition. To enhance the device photovoltaic performance, the effects of different hole transport layer (HTL), defect density of the absorber layer, metal work function and the effect of temperature has been studied. In the present investigation, the effect of hole transport layers are analyzed by correlating the built-in voltage (Vbi) with the open circuit voltage (VOC). It has been obtained from the simulation results, that Vbi has a significant impact on VOC as the higher Vbi corresponds to the highest VOC. Moreover, the effect of defect density and metal work function is also studied. It is obtained from the simulation results, that the optimum defect density is found to be 1 × 1014 cm−3 and metal work function should be greater than or equal to 5 eV for both lead-free CH3NH3GeI3 and CsSnGeI3 based perovskite layer. Furthermore, to suggest possible lead-free alternatives for all-perovskite two-terminal multi-junction solar cell, an attempt is made to match the current of bottom perovskite layer i.e., CsSnGeI3 based perovskite layer to the top perovskite layer i.e., CH3NH3GeI3 based perovskite layer. To attain the current matching for bottom perovskite layer (CsSnGeI3 based perovskite layer) to top perovskite layer (CH3NH3GeI3 based perovskite layer), the bottom perovskite sub cell is fed with the filtered spectrum which is obtained by transmission from top electrode. After, the realization of current matching the short circuit current density of CsSnGeI3 based perovskite layer drops from 25.75 mA/cm2 to 15.32 mA/cm2 which is similar to CH3NH3GeI3 based perovskite absorber layer. In addition, it has been obtained from literature, that both the perovskite layers can be fabricated using solution–processing low-temperature technology. Hence, the numerical study suggests the possible alternatives for wide and narrow bandgap perovskite layers for the application to obtain highly efficient lead-free all-perovskite multi-junction solar cells.

Background: The prevalence of obesity is alarmingly high, affecting both developed and developing countries of all socio-economic groups, irrespective of age, sex or ethnicity. As the prevalence of obesity increases so does the burden of its associated co-morbidities. The purpose of this study was to evaluate the prevalences of overweight and obesity in our region, study the association between family history of diabetes (FHD) and body mass index (BMI) and to assess the relationship between family history of obesity and body mass index (BMI). Methods: A cross sectional population based study of 1017 randomly selected individuals was conducted. Pregnant patients and those with hypothyroidism, severe disability or severe psychiatric disturbance were excluded. Study included school going children, college going students, employees of medical college GRMC Gwalior and attendants of indoor and outdoor patients. Weight and height were measured and body mass index calculated. Patients with BMI > 23 kg/m2 were defined as overweight and those with BMI 27.5 kg/m 2 and above were labelled as obese as per the WHO recommendation for Asian population. Results: A total of 1017 patients were included in this study. There were 573 (56.34%) males and 444(43.66 %) females. Overall prevalence of overweight was 251(24.6%) and prevalence of obesity was (25) 2.4%. 93 (33.69%) of those with BMI >23 had family history of obesity while the figure was 81 (10.93%) in those with BMI 23 had family history of diabetes and 40 (5.39%) with BMI 23 consumed alcohol compared to 11 (7.5%) cases with BMI

Background: Inflammation has important role in the pathophysiology of atherosclerosis and acute myocardial infraction and hs-CRP is an inflammatory marker. GPBB is a marker of myocardial necrosis or myocardial ischmia i.e. the initial phase of AMI. The aim of this study was to know the levels of GPB and the relation between hs-CRP and GPBB in AMI patients. Materials & methods: This study was conducted in the Cardiology of J.A. Hospital and Department of biochemistry, G.R. Medical College, Gwalior. Patients were admitted with severe chest pain out of which 100 were included in this study. 50 normal healthy individuals were also selected. Blood samples were collected at the admission time for the analysis of hs-CRP and GPBB. All patients underwent thorough clinical examination and investigations. Estimation of GPBB and hs-CRP were done by ELISA method and other routine parameters done by enzymatic method. Results: The mean level of GPBB in patients was 46.92ng/mL while in controls it was 13.88ng/mL. The mean level of hs-CRP in patients was 4.38mg/L while in controls it was 1.34mg/L. There was highly significant difference of GPBB and hs-CRP in control group and AMI group. The finding of results showed that hs-CRP and GPBB was positively correlated. The levels of FBG, Triglyceride, Cholesterol, LDL, and VLDL were significantly increased and HDL was decreased in AMI group when compare controls. Conclusion: Our results demonstrate that there was positive correlation of hs-CRP and GPBB in AMI patients. So along with GPBB, hs-CRP is also additional marker of myocardial ischemia and AMI.

Background: India accounts for world's 17.5 percent population and is the second most populous country in the world next only to China (19.4%). Birth control pills, condoms, sterilization, IUD (intrauterine device) etc. are most commonly practiced family planning methods in India. The latest NFHS shows that 77% of sterilized women did not use a family planning method. Despite of family welfare program having a target free approach, the program has not been successful in educating people about the concept and advantages of contraceptive methods for spacing births.Methods: This randomized controlled trial was carried out in the department of obstetrics and gynecology of Pondicherry Institute of Medical Sciences (PIMS), Puducherry. All antenatal mothers >28 weeks of gestational age were enrolled and given a semi-structured questionnaire. After randomization intervention was done in the form of counselling and distribution of pamphlets for future use. The women were followed in the postnatal period and 6 weeks later.Results: A total of 280 subjects were enrolled in this study. Socio-demographic characteristics were similar in both the study groups. Majority of women in both the comparison and intervention group were in the age group 20-25 years (43.6%). Very few participants (20.0%) had used some form of contraception to delay pregnancy. However, the postpartum follow-up of the study participants revealed significant increase in the knowledge on the various contraceptive methods in the intervention group compared with the comparison group.Conclusions: The implementation of behaviour change communication strategy to communicate the benefits of uptake of postpartum contraception to antenatal mothers, is vital in improving the acceptability of family planning programs in India.

Prediabetes is the precursor stage of diabetes mellitus and is also considered to be a risk factor for the development of cardiovascular disease. Atherogenic indices have been used for assessment of risk for cardiovascular disease development. To date, there is no data on evaluating the relationship between atherogenic indices (cardiac risk ratio (CRR), atherogenic coefficient (AC), and atherogenic index of plasma (AIP)) and carotid intima-media thickness (CIMT) in prediabetes. Hence, we aimed to determine atherogenic indices (CRR, AC, and AIP) and CIMT in prediabetic subjects and then sought to evaluate the relationship between them. A total of 400 human subjects were included in the present study, out of which 200 were prediabetic subjects and 200 were normal healthy control subjects. For each subject, CRR, AC, and AIP were calculated from routine lipid parameters and carotid intima-media thickness was measured as well. Atherogenic indices, that is, CRR, AC, and AIP, were significantly increased in prediabetic subjects as compared to the controls (5.87 &plusmn, 0.87 vs. 4.23 &plusmn, 0.50, p &lt, 0.001, 4.87 &plusmn, 0.87 vs. 3.23 &plusmn, and 0.29 &plusmn, 0.07 vs. 0.09 &plusmn, 0.09, p &lt, 0.001, respectively). Moreover, a significant and positive correlation was observed between CIMT and AIP (r = 0.529, p &lt, 0.01), CRR (r = 0.495, p &lt, 0.01), and AC (r = 0.495, p &lt, 0.01). Prediabetic subjects present abnormalities in atherogenic indices and CIMT, which indicate a greater propensity of prediabetes for the development of cardiovascular disease. Hence, atherogenic indices can be used in addition to routine lipid parameters for the better assessment of subclinical atherosclerosis in prediabetic subjects.

Mature cystic teratoma (MCT) is the commonest germ cell neoplasm of the ovary but malignant transformation is a rare occurrence (1-2%). Of these malignancies documented in literature the commonest are squamous cell carcinoma and adenocarcinoma. Urothelial carcinomas arising in an MCT are a rare occurrence and only 7 cases have been reported in literature. We report a case of an MCT which was complicated by the presence of urothelial carcinoma confirmed on histopathological examination.

With the rapid growth of population and technology, security problems become a major issue due to abnormal human behaviors. Recently researches have been motivated towards automatic human face detection from still image or from moving image. Present human face detection system leads computation inaccuracies i.e. higher degree of false negative rate. In this paper, a multilevel hybrid model has been proposed for face detection. In the proposed work, we initially use C4.5 classifier so that foreground and background images can be differentiated, as a result of which search space can be reduced. After that skin color model has been applied to detect the skin region which is followed by canny edge detection to detect the edges of skin region. In the last step, we use the Modified Hausdorff Distance Method which matches the pixel values and detects the faces with lower false negative rate.

Background: Sex selective abortions have become a significant social phenomenon in contemporary India. In order to curb sex selective abortions, the Pre-Natal Diagnostic Techniques (PNDT) Act was passed in the year 1994. Methods: A cross-sectional study was conducted by the Department of Obstetrics and Gynecology in Puducherry among 75 medical under-graduate students. A semi-structured, pre-designed questionnaire was used to collect the information on their knowledge, attitude and perception regarding gender discrimination and prenatal sex determination act. Results: Only 34 (45.3%) students were correctly aware of the prevailing sex ratio in India. Most common source of information for awareness was internet (44.1%), followed by newspaper (41.1%), and family/friends (14.7%). Majority (74.7%) of the students were aware of the PCPNDT Act. Awareness about PCPNDT Act among female students (85.4%) was higher as compared to male students (61.8%). Only half of the students (56.0%) correctly reported about the punishment for sex determination and implication of feticide (fine and imprisonment both). Conclusions: Awareness regarding the altered sex ratio and the PCPNDT Act was poor among medical undergraduates. In order to combat the poor awareness regular workshops and continuing medical education sessions (CMEs) should be conducted.

Background: Maternal mortality is an important indicator of women’s health and social well-being. According to the WHO report,each year, an estimated 190 women for every 100,000 live births die due to maternal causes. In India, unsafe abortion and related complications accounts for 9% of all maternal deaths. Abortion was made legal in India by the Medical Termination of Pregnancy (MTP) act, which was enacted by Indian Parliament in the year 1971. But the number of unsafe abortions has not declined. Methods: A present study was conducted by the Department of Obstetrics and Gynaecology of Pondicherry Institute of Medical Sciences, in Puducherry, India. All undergraduate students of VII th semester MBBS participated in the study. A pre-designed semi-structured questionnaire was used to collect information regarding the awareness and perceptions on abortion care and Medical Termination of Pregnancy Act in India. Data were entered in Microsoft Excel 2007 . Averages were calculated and chi square test was applied to find the significant difference. Results: Among a total of 75 participants, 41(54.7%) were female and 34 (45.3%) were male students. Majority of the students ( 97.3%) were aware of the fact that unsafe abortions are a serious health problem in India and all of the students ( 100.0%), were aware of the MTP Act of India. But only 36.0% students were aware of the fact, that consent from husband was not required to undergo abortion. To reduce the number of unsafe abortions in India majority of the medical students ( 45.3%) were of the opinion that easy access to MTP services in the community is an effective measure. Conclusions: Legalization of abortions through the MTP Act in India resulted in a considerable decrease in maternal mortality through the decline in abortions but it has failed to ensure effective implementation and access to medically safe abortion services. Training in basic contraceptive counseling and abortion care should be incorporated in basic medical education in India.

Background: The caesarean section (CS) delivery rate is steadily increasing worldwide, including India. Identifying the proportion of women in various categories as per Robson's ten group classification system and CS rate among them is important to bring down the increasing CS rate. Methods: This retrospective study was conducted at Pondicherry Institute of Medical Sciences (PIMS), a tertiary care teaching hospital in Puducherry, South India. The data was collected for the women delivered by CS during January 2011 to December 2011 and proportions in various groups as per Robson’s ten-group classification system were calculated. Results: Among a total of 1123 women delivered during study period, 367 (32.6%) delivered by CS. The CS rates among various groups varied from 100% among women with breach presentation (group 6 and group 7) and abnormal lies (group 9) to 5.9% among multiparous women with spontaneous labour having single cephalic pregnancy (group 3). Among women with precious section, CS rate was very high (89.6%). Women with previous CS (group 5) contributed maximum (40.1%) to the total number of CS. Conclusions: In the present study, all women with breech presentation and abnormal lies delivered by CS and repeat CS was the highest contributor to all CS deliveries.

Background In the past, cardiac surgical procedures during pregnancy have been associated with a high risk of adverse maternal and fetal outcomes. Therefore, this meta-analysis of more recent studies was done to assess the fetomaternal risk after cardiac operations during pregnancy using cardiopulmonary bypass. Methods The MEDLINE, Embase, and Cochrane library were searched to find studies from January 1, 1990, to July 31, 2016, without language restriction. We selected studies that included at least 4 women to report fetomaternal outcomes after a cardiac operation using cardiopulmonary bypass during pregnancy. Two authors independently extracted data from the selected studies. The studies were assessed for methodological qualities using the Newcastle-Ottawa Scale. The primary outcomes included maternal death and any pregnancy loss. The secondary outcomes were maternal complications and neonatal complications. Primary analysis calculated absolute risks and 95% confidence intervals (CIs) for pregnancy outcomes using the DerSimonian-Laird random effects model. Heterogeneity was assessed by I2 statistic and visual plot. Results Ten studies, including 154 women, were eligible for inclusion in this study. The patients underwent cardiac operations during pregnancy involving cardiopulmonary bypass. As calculated per 100 pregnancies, the pooled unadjusted estimate of maternal mortality was 11.2 (95% CI, 6.8 to 17.8), pregnancy loss was 33.1 (95% CI, 25.1 to 41.2), maternal complications were 8.8 (95% CI, 2.8 to 24.2), and neonatal complications were 10.8 (95% CI, 4.2 to 25.2). The risks of preterm labor and cesarean delivery were 28 per 100 pregnancies (95% CI, 15.6 to 45) and 33.8 per 100 pregnancies (95% CI, 19.1 to 52.4), respectively. Conclusions The fetomaternal mortality and morbidity after a cardiac operation during pregnancy are higher than that reported in the earlier literature (PROSPERO No. CRD42016047093).

Background Type II diabetes mellitus is a complex heterogeneous group of metabolic conditions characterized by an increased level of blood glucose, due to impairment in insulin action and/or insulin secretion. Hyperglycemia is a major factor in the pathogenesis of atherosclerosis in diabetes. Oxidative modification of low density lipoprotein (LDL) is recognized as one of the major processes involved in the early stages of atherosclerosis in type II diabetes. LDL contains different antioxidants, which increase LDL resistance against oxidative modification, this is known as its antioxidant potential (AOP). Objectives The present study has been carried out to investigate the sensitivity of LDL to oxidation, AOP of LDL and to assess whether hyperglycemia in diabetes mellitus is associated with increased LDL oxidizability, and whether these relationships are related to diabetic complications. Patients and Methods This study was carried out on 100 diabetic subjects, divided into two groups according to their glycosylated hemoglobin (HbA1c) values, either regulated ( < 0.50 M hexose/ M Hb) or unregulated ( > 0.50 M hexose/ M Hb.) A further 50 healthy subjects were included to determine the sensitivity of LDL oxidation and measurement of LDL AOP. LDL from the serum sample was precipitated by the heparin-citrate precipitation method. The LDL fractions were exposed to oxidation with copper sulphate and their sensitivity to oxidation was evaluated. AOP was measured by taking measurements from 30 subjects in each group. Results The sensitivity of LDL oxidation was significantly higher in both diabetic groups compared to the control group. AOP was significantly decreased in all diabetic groups compared to the control group. Conclusions In type II diabetes, the increased susceptibility of LDL to oxidation is related to hyperglycemia and low AOP.

Background : IV line insertion and maintenance is very crucial to prevent nosocomial infection in pediatric patients visiting pediatric emergency.PGIMER is a tertiary care hospital that cater to the needs of pediatric clients by providing 24 hours services in Advance Pediatric Center (APC).Pediatric emergency department is located on the ground floor in APC and has capacity of 22 beds and 24 incubators. Daily admission of patient in pediatric emergency is approximately 30-40 children in a day, whereas as early transfer of patients to other units is not feasible. This leads to overcrowding and HCPs have to manage two to three children on single bed. Though in each shift 10-12 nursing officers and 12-14 residents are posted on duty and they strive hard to provide quality care, still there are many barriersrelated to IV line insertion and maintenance.If such barriers are identified and managed time to time the infection rates can be reduced. Keeping this fact in view we conducted this study to find out the barriers and facilitators related to IV line insertion and maintenance.A total of 8 focused group discussion were conducted with the health care personnel of pediatric emergency, out of which 5 were conducted with nursing officers and 3 were conducted with physicians (junior and senior residents). In each FGD 4 to 5 members were included. Discussions were recorded and field notes were taken. Focused group discussion guide was used to know the barriers and facilitators, it included questions aboutHCPs view about current status of infection associated with IV line, possible cause of infection that is phlebitis and infiltration, measures taken by HCPs to prevent IV line related infections, causes of not being able to adhere to infection control measures, suggestive measures to reduce incidence of infection. After conducting discussion interviews were transcribed, read and reread and themes were generated. Physician mentioned about high rates of infection in the unit. According to them themes relatedto the barriers of IV line insertionwere lack of supply of articles, difficult to manage the time, over- crowding of patient, less co-ordination between health care workers, low socioeconomic status of patients. The facilitators identified were availability of tourniquets, available and arranged articles and parental help to restrain the child. The suggested remedial measures were to improve the practices related infection prevention such as to increase hand washing/ hand rubbing and ensure liberal supply of: hand rubs, gloves, additional packs and trays. They also emphasized on the need of assistance form nursing personal to hold the child and fix the cannula. They also highlighted the routine checking of the cannula sites, its fixation and removal of blood from 100cm extensions by nurses. Related to maintenance of iv line they mentioned that HCPs should perform hand hygienebefore touching cannula hub and administering drugs as lack of handhygiene is a source of infection.

In diabetic patients, persistence of hyperglycemia has been reported as a cause of increased production of oxy- gen free radicals. Hyperglycemia could induce oxidative stress and become the main factor for predisposing the complica- tions in diabetes. The study is being aimed to find out the status of lipid peroxidation product i.e. malondialdehyde (MDA) and antioxidant enzymes (AOEs) such as glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT), superoxide dismutase (SOD) and reduced glutathione (GSH) which might be helpful in risk assessment of various complications of diabetes mellitus. The study included 300 subjects (50-70yrs) out of which 150 patients were non insulin dependent diabetes mellitus (NIDDM) with micro vascular complications and 150 age matched healthy controls. The status of fasting blood sugar (FBS), reduced glutathione (GSH), GPx, GR, CAT, SOD and MDA were determined. Our results showed significant increase (p< 0.001) in FBS, CAT and MDA while GSH, GPx, GR and SOD were found decreased significantly (p< 0.001). The data suggest that alteration in antioxidant status and MDA may help to predict the risk of various micro vascular complications of diabetes mellitus.

The burden of disease in patients with congestive heart failure is high. The future of BNP looks promising as it may be a better diagnostic tool for the diagnosis of CHF in developing countries in new millennium. Natriuretic peptide hormones, a family of vasoactive peptides with many favourable physiological properties, have emerged as important contenders for development of diagnostic tools and therapeutic agents in cardiovascular disease. Measurement of B-type natriuretic peptide has become as an easy-to-perform bedside test. The clinical and diagnostic significance of the measurement of plasma Nt-proBNP in the diseases of the cardiovascular system with particular emphasis on the assessment of patients with heart failure and their effects on predicting survival rate. The plasma levels of Nt-proBrain Natriuretic peptide responds more vigorously after myocardial infarction than those of other natriuretic peptides. This article is an attempt to give a short overview on the utility of BNP-blood levels for the diagnosis and treatment of heart failure.

Background The blood–brain barrier is compromised in stroke patients. The release of neuro-biochemical protein markers, such as Neuron Specific Enolase (NSE) into the circulation may allow the pathophysiology and prognosis of patients with cerebrovascular diseases to be evaluated further. Method Present study aimed to investigate the predictive value of NSE and Interleukin-10 (IL-10) with respect to early neurobehavioral outcome which evaluated by National Institute of Health Stroke Scale (NIHSS). We investigated 100 patients of ischemic stroke and blood samples were taken within first 72 h of stroke onset. NSE and IL-10 were analyzed by commercially available ELISA kits. The neurological status was evaluated by a standardized NIHSS at the time of admission. Results NSE was significantly increased (17.95 ± 4.54 vs 7.48 ± 1.51 {ng/ml} p ≤ 0.05) and IL-10 significantly decreased (11.79 ± 2.77 vs 15.72 ± 2.69 {pg/ml} p ≤ 0.05) in patients when compared with controls. NSE also significantly (r = 0.8, p ≤ 0.001) correlated with degree of neurological deficit but IL-10 level in serum did not show any significant correlation with NIHSS score at the time of admission. Conclusions Serum concentrations of NSE and IL-10 have a high predictive value for early neurobehavioral outcome after acute stroke.

Background: Anemia is an increasingly recognized entity in patients with diabetes mellitus. Reduced hemoglobin levels identify diabetic patients with an increased risk of microvascular complications.Methods: A hospital based observational prospective study was conducted in Department of medicine, J.A. Group of Hospitals, Gwalior from June 2014 to October 2015. Adults with diabetes mellitus both type 1 and type 2 were selected as subjects are included and anemia due to blood loss and anemia due to chronic kidney diseases were excluded from the study. Estimation of hemoglobin was done by using capillary method by calorimetric hemoglobinometer. Anemia was defined as hemoglobin 10 years duration respectively. HbA1c levels were 10 in 3 (3%) patients. Overall 67 (67%) diabetics had anemia. Out of 53 males 30 (56.6%) had anemia and amongst females, out of 47 cases 37 (78.72%) had anemia P value 0.009. Anemia was more common in patients less than 50 years 36 (70.59%) compared to31 (63.2%) with anemia in patients more than 50 years. 65 (65%) patients had diabetic retinopathy (DR). 30 (46.1%) males and 35 (53.8%) females had diabetic retinopathy. All patients with diabetic retinopathy had anemia. Among 35 (35%) patients without DR only 2 (5.71%) had anemia. P value

Background: Diabetic nephropathy is one of the most severe diabetic microangiopathies. The aim of this study was to evaluate the lipid abnormalities associated with different stages of proteinuria in type 2 diabetic patients.Methods: In this study 100 type 2 diabetic patients were subjected to detailed history, clinical examination, Serum lipid profile, urine albumin creatinine ratio and routine biochemical investigations.Results: Out of 100 patients were included in study, 41 patients were normoabluminuric, 37 patients were microalbuminuric and 22 patients were overt proteinuric. Most common dyslipidemia found in study is increased triglyceride (43%) followed by increased LDL (28). On comparing normoalbuminuric to overt proteinuric, a positive correlation found in increased triglyceride (P value < 0.001) and increases LDL (P value

Background: Hypertensive disease of pregnancy is one of the major causes of maternal mortality in India. 7.1% of maternal deaths are attributed to hypertension disorder of pregnancy. Early identification of modifiable and non-modifiable risk factors of hypertensive disorders of pregnancy is essential for effective management of hypertensive disease of pregnancy. The study assesses the knowledge of primigravida women regarding home care management of pregnancy induced hypertension before and after administering structured teaching programme.Methods: It is a pilot study with pre-experimental study design. 30 study participants were recruited with non-probability purposive sampling of primigravida women attending antenatal clinic of maternity hospital of Petlaburj, Hyderabad. A pretested and standardized survey instrument was used for collecting socio-demographic characteristics and knowledge, attitude and practices regarding home care management of pregnancy after obtaining informed consent before and after structured teaching intervention programme with audio-visual aids for home management of pregnancy induced hypertension.Results: 43.3% of primigravida women were 21-24 years old and 43.3% of primigravida women were 20-24 years of gestation. Mean pre-test and post-test knowledge assessment score increased by 155.2% from 13.4 to 34.2 after administration of structured teaching programme and paired-t test was carried out to test difference of means. The test reports t-test statistic of -20.7 with p-value of

Background: Variation exists in utilization of antenatal and postnatal care services in public health facilities of developing countries. Provision of antenatal and postnatal care services is the major function of public health delivery system of India to improve maternal health outcomes. The objective of this study is to estimate the determinants of utilization of antenatal and postnatal care services stratified by geographical region in Telangana.Methods: It is a cross-sectional study of District Level Health and Facility Survey-4 of the state of Telangana. Multistage, stratified, probability proportional to size sample with replacement was used. 3065 women, who delivered after the year 2008, were considered for analysis. Descriptive analysis of components of antenatal and postnatal care services stratified by geographical region was carried out. Binomial logistic regression was carried out to determine association of demographic, system level variables with adequate antenatal care.Results: Study reveals variation exists across four regions of Telangana in utilization of maternal health services. Reception of adequate antenatal care is low in South region (20.6%) and high in East region (31.5%). Pregnant women with secondary education were 66% more likely to receive adequate antenatal care services compared to illiterate.Conclusions: Short term and long-term goals to be adopted and implemented by government to address the demand-supply imbalance such as public health infrastructure and quality of services in underperforming districts of Telangana to increase utilization of maternal health services by training health staff and engaging local communities to seek health care services.

Background: Tobacco smoking is widely prevalent all over the world and it continues to rise in developing countries. Smoking has a deleterious effect on pulmonary functions. Smoking is the single most significant risk factor contributing to the development of Chronic obstructive airway diseases (COPD). Spirometry by a trained health professional gives an indication of lung health by measuring airway abnormality. Objectives were to study pulmonary function test (PFT) in smokers and non-smokers between 30-50 years and to study the correlation of PFT with pack years.Methods: Apparently healthy subjects, 50 smokers and 50 non-smokers between 30-50 years without any symptoms were included as subjects. Patients with uncontrolled hypertension, recent myocardial infarction and pulmonary TB were excluded. Ex-smokers were excluded from the study. Patients with acute respiratory illness, severe systemic illness, chest trauma and dementia were also excluded. After proper history taking and clinical examination, measuring height and weight (vitals, pulse rate, respiratory rate, blood pressure) the selected individual was subjected to spirometry using ATS criteria (American Thoracic Society criteria). Spirometry was performed using UNI-EM spirometer. Collected data was analyzed using Statistical Package for the Social Service (SPSS) software version 17.Results: In this study 94 males and 6 females were enrolled as subjects. Maximum number of the patient 49 cases (49%) presented in the age group of 30-35 years, followed by 23 cases (23%) in 36-40 years age group. Of these 49 cases,15 were smokers while the rest 34 were non-smokers (P=0.0007). In 100 cases studied, 39% showed normal PFT and 61% shows abnormal PFT. Among smokers (out of total 50 cases) pulmonary function test (PFT) was abnormal in 36 cases (72%) while in non-smokers, 25 (50%) had abnormal PFT (P-value-0.024). This data indicates that smoking is highly associated with an abnormal PFT pattern. Out of 100 cases both smokers and non-smokers, 11 (73.33%) underweight cases with (BMI15 (P-value 0.383).Conclusions: Smoking is common in males between 30-35 years age group. Smoking is highly associated with an abnormal PFT. Cessation of smoking should be encouraged and PFTs from time to time in asymptomatic adults both smokers and non-smokers will be useful for early identification of abnormalities.

Background: Knee osteoarthritis is the most common form of joint disorder and a leading cause of pain and functional disability among elderly female population. Type 2-diabetes is frequently reported comorbidity in elderly female patients with knee osteoarthritis. VCAM-1 is emerging as a strong and independent predictor for severe osteoarthritis. VCAM-1 is an inducible cell surface sialo glycoprotein and mediates heterotypic cellular aggregation. Therefore, the aim of this study is to assess the role of soluble vascular cell adhesion molecule-1 at the onset of knee osteoarthritis among type 2 diabetic postmenopausal women.Methods: The present study includes 100 type 2-diabetic female subjects of age above 50 years as cases and 100 normal healthy female age matched individuals as controls. Osteoarthritis of knee was ascertained using the American college of rheumatology classification criteria. Serum soluble VCAM-1 concentration was measured by ELISA method in all 200 subjects. Biochemical parameters-Fasting blood sugar and lipid profile were measured using Mind ray BS-400 and HbA1c was measured by turbidimetric immunoassay method. Statistical analysis was made by student independent sample t-test. Correlation was determined by using spearman’s rank correlation coefficient.Results: Serum level of soluble VCAM-1 was found statistically highly significant (p

Background: Acute myocardial infarction (AMI) is a significant cause of morbidity and mortality worldwide, which results from occlusion of coronary artery. Dyslipidemia is a major risk factor of AMI. C-reactive protein (CRP) is an acute phase protein, synthesized by hepatocytes in response to cytokines released into circulation by activated leukocytes and has been found to increase after AMI. The objective of the present study is to investigate lipid profile in AMI patients and correlate it with inflammatory marker i.e. CRP.Methods: The present study includes 150 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum lipid profile and inflammatory marker were measured by diagnostic kits supplied by ERBA.Results: The levels of lipid profile and inflammatory marker were significantly altered in the AMI cases compared to controls. We found significantly higher levels of total cholesterol, TG, LDL, VLDL, CRP and lower level of HDL in AMI compared to that of control subjects. We also found strong positive correlation of CRP with total cholesterol, triglyceride, LDL-C and VLDL-C and significant negative correlation with HDL-C in AMI patients.Conclusions: We found alterations in the lipid profile and inflammatory marker in AMI cases; hence, all the people should undergo regular check up including lipid profile evaluation and inflammatory marker such as CRP to decrease the incidence, morbidity and mortality from the disease.

Background: Breast cancer is one of the most common malignancies found among women in India. Haematological parameters have been shown to predict severity, mortality and treatment follow-up in breast cancer patients. The aim of the study was to compare haematological parameters along with effect of chemotherapy and radiotherapy in different stages of breast cancer patients.Methods: Total 235 human subjects were taken in the study. Out of which 100 normal ages matched healthy subjects were considered as controls and 135 breast cancer patients subjects as cases which were further divided into their respective stages according to TNM classification.Results: Estimation of haematological parameters was done by Sysmex Automated Hematology Analyzer Kx-21. The statistical differences between cases and control were determined by using student independent sample t-test.Conclusions: We found hemoglobin level, polymorphs, lymphocytes, monocytes and RBC count were statistically reduce (p

 We report a rare case of primary postpartum haemorrhage due to a traumatic cause following spontaneous vaginal delivery in which surgical intervention failed. It was successfully treated by transcatheter embolisation of the uterine artery. This technique, although well known, is still underused in such conditions.

To determine age-specific prevalence of hypertension and blood pressure (BP) levels in relation to diet and lifestyle factors in North Indians.Cross-sectional survey in 20 randomly selected streets in Moradabad, North India.A total of 1806 subjects from North India (904 males and 902 females) age range 25-64 years. The survey methods were as follows: dietary diaries for 7 days food intake record; BP measurements; physician administered questionnaire and anthropometric measurements. Diagnosis of hypertension was based on new World Health Organization/International Society of Hypertension (WHO/ISH) criteria. Risk factors were assessed based on WHO guidelines.The prevalence of hypertension according to WHO/ISH criteria was 23.7% and by old WHO criteria 13.3%. In the WHO/ISH hypertensive group, isolated diastolic hypertension was present in 47.3% males and 40.6% females. Males have a slightly higher prevalence than females in the young age group, however, the prevalence rates are comparable in the older age groups. In both sexes, the prevalence rates and BP level increased with older age. Multivariate analysis revealed that age, higher body mass index, central obesity and higher socioeconomic status were independently and strongly associated with hypertension in both sexes. Higher dietary fat and salt intake and lower physical activity were weakly but significantly associated with hypertension.Association of higher socioeconmic status, higher body mass index and central obesity in North Indian adults with higher fat intake, lower physical activity and higher prevalence and level of hypertension indicate that these populations may benefit by decreasing the dietary fat intake and increasing physical activity, with an aim to decrease central obesity for decreasing hypertension in North Indians.

Background: In diabetic patients, persistent hyperglycemia and poor glycemic control cause disturbances of lipid profiles, especially an increased production of oxygen free radicals. Lipid peroxidation has been considered to be a pathogenic factor of diabetic complications in Type-1 Diabetes mellitus. Aims: The aim of the present study was to investigate the effect of glycemic control on blood viscosity, lipid profile, and lipid peroxidation in Type-1 Diabetic subjects. Materials and Methods: The study included three groups; Group-I (age-matched healthy control subjects, n = 50), Group-II (Type-1 Diabetics with good glycemic control, n = 10), and Group-III (Type-1 Diabetics with poor glycemic control, n = 15). The Type 1 diabetic patients with duration of diabetes for more than 5 years were taken. Blood samples of all subjects were analyzed for all biochemical, hematological, and oxidative stress parameters. Results: The Erythrocyte malondialdehyde level was non-significantly changed (P = NS) in group-II patients but significantly increased (P > 0.001) in group-III patients, and no significant changes were found (P = NS) in Blood viscosity of both the groups (group-II and group-III), as compared to healthy control subjects (group-I). Conclusions: Our findings suggest that the monitoring of Oxidative stress and Blood Viscosity in poorly controlled Type-1 diabetic patients may be very useful marker of diabetic complications.

Background: Oxidative stress has been considered to be a pathogenic factor of diabetic complications including nephropathy. There are many controversies and limited studies regarding the antioxidant enzymes in diabetic nephropathy. Aim: This study was to evaluate the levels of antioxidant enzymes and lipid peroxidation in Type-2 Diabetes Mellitus (DM) patients with and without nephropathy. Materials and Methods: The study included 90 age and sex matched subjects. Blood samples of all subjects were analyzed for all biochemical and oxidative stress parameters. Results: The malondialdehyde (MDA) levels and catalase (CAT) activity were significantly increased and reduced glutathione (GSH) levels and activities of glutathione peroxidase (GPx) and glutathione reductase (GR) were significantly decreased in Type-2 DM with and without nephropathy as compared to controls and also in Type-2 DM with nephropathy as compared to Type-2 DM without nephropathy. There were an excellent positive correlation of glycohemoglobin (HbA1c) with MDA and a good negative correlation of GPx with GSH in controls. There were positive correlations of GR, CAT, and superoxide dismutase (SOD) with MDA in Type-2 diabetes patients with nephropathy. Conclusions: Intensity of oxidative stress in Type-2 diabetic patients with nephropathy is greater when compared with Type-2 diabetic patients without nephropathy as compared to the controls.

The objective of this study was to investigate the lipid profile and high sensitive C-reactive protein (hs-CRP) levels in rheumatoid arthritis (RA) patients, and compare them with healthy controls, and also compare the different patterns of these parameters during active RA between male and female patients.We studied 60 RA patients and 65 controls matched by age and sex. All cases were selected from the Rheumatology Department of a tertiary care hospital, Delhi, India and fulfilled the 1987 American College of Rheumatology revised criteria for RA.We found that male RA patients had significantly higher levels of hs-CRP (p0.001), low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) (p0.001), total cholesterol (TC)/HDL-C (p0.05), and lower level of HDL-C (p0.01), than male controls. The mean levels of HDL-C and TC were high (p0.05), and LDL-C, LDL-C/HDL-C (p0.01), and hs-CRP (p0.001) were low in healthy females as compared to female RA patients. Between RA patients, females had significantly high level of HDL-C (p0.001), and low levels of TC/HDL-C and LDL-C/HDL-C (p0.001) as compared to RA males. Mean levels of TC and HDL-C were higher in healthy females (p0.05) and triglyceride (TG) was lower (p0.05) than in healthy males.Results demonstrate that the RA patients have high levels of inflammatory marker hs-CRP and altered lipid profile, and these are affected by the gender of the RA patients. Lipid levels should be monitored and managed in patients with RA to minimize the long-term risk of cardiovascular disease.