Search

Antibiotic resistance is a worldwide public health concern due to improper usage, increases morbidity, prolongs hospital stay duration and risk of mortality. Antibiotics are magic bullets against many microbial and bacterial infections. Doctors are using antibiotics in almost all treatments starting from the common cold to serious open-heart surgery. This study was done to assess the knowledge, attitude and practice on antibiotic usage and its resistance against microbial infections. About 169 medical undergraduates were briefed about the KAP questionnaire (detailed assessment of 4 parameters for knowledge, 5 parameters for attitude and 4 parameters for practice) and distributed to third year and final year medical students. Descriptive statistics was used to analyse the various parameters. About 83.72% of the participants were aware that excessive and inappropriate use of antibiotics causes ineffective therapy. About 53.84% were aware about the adverse effect profile of the antibiotic. 65.22% of the participants felt the emerging issue of antibiotic resistance due to inappropriate drug usage. They were conscious that antibiotics are advantageous for bacterial infection. The students had a good attitude, a majority had moderate knowledge and practice towards antibiotics use. The medical professionals are to be well trained about the rational prescribing pattern of antibiotics, adverse effects of drugs and antibiotic resistance.

BACKGROUND Mini-cholecystectomy (MC), with its varied incision length, has long been considered feasible with comparable results to laparoscopic cholecystectomy (LC) 1-6,7 We undertook this study, driven by resource-constraints, by well-experienced surgeons, using 3 - 5 cm incision length, in our patients with low BMI. The aim of this study is to compare the results and outcomes between MC and LC. METHODS In this retrospective study of a prospectively maintained database, first 50 patients each were selected for MC and LC respectively. Operative time, pain-score, SSI (Surgical Site Infection), hospital stay, return to normal activity and complications were compared. RESULTS Both groups were matched for age, sex, BMI (Body Mass Index) and American Society of Anesthesiologists (ASA) grading. The mean operating time for MC was 43 minutes and for LC, 64 minutes. Hospital stay for MC was 1.9 days and for LC was 1.8 days, which was statistically not significant. Return to normal activity was 8 days for MC and 6.6 days for LC. In a subset analysis of eight lean and thin patients using 3 - 3.5 cm length incision with rectus muscle splitting, the return to normal activity was 6.9 days which is comparable to LC patients. CONCLUSIONS Mini-cholecystectomy and laparoscopic cholecystectomy produce comparable patient outcomes. In lean and thin patient, MC may be slightly more advantageous than LC in terms of less operating time. KEYWORDS Mini-Cholecystectomy, Laparoscopic Cholecystectomy, Outcome, Lean and Thin Patient

Background: Yoga is scientifically validated health promotion intervention developed thousands of years ago in India. It is helpful in improving attention, memory and learning efficacy of students along with reduced incidence of depression and anxiety. Introducing yoga in medical curriculum will not only improve the health of students, it will also make them advocates of the same for their patients in future. Objectives: 1. To identify the students who are practicing yoga in medical and nursing college and assess the perceived benefits of yoga practice; 2. To use yoga practicing students to create a ripple effect in the institution for yoga awareness and practice; 3. To incorporate yoga module in the Competency Based Medical Education curriculum(CBME). Materials and Methods: Interventional study among all medical and nursing students. Started with a pre tested questionnaire. Descriptive statistics is used for analysis of data with Epi-Info7software.Yoga practicing students were motivated to influence the freshers to adopt yoga(Ripple effect). Results: Among 200 students 83 yoga practicing students were selected as study subjects. Among them 38% of them are practicing for more than 1 year and 25% of them for less than 1 month. 78% of students favorably perceived the health benefits of yoga. Sensitization program had influenced the students positively. Conclusion: Students were aware of the importance of Yoga and all of them perceived some benefits by Yoga practice. Using yoga practicing student volunteers to create ripple effect is a novel method to spread awareness and practice. Keywords: Medical and nursing students, Ripple effect, Yoga.

Obesity and its associated risks are a leading public health concern. Sleep deprivation is speculated to boost appetite. Medical students are prone to sleep deprivation.a): To study Sleep duration & pattern of study population using the Pittsburgh Sleep Quality Index (PSQI). b): To correlate between Body Mass Index (BMI) and Sleep duration & pattern among study population. Medicals students (n=247; males=133 & females=114) of age group 18-23years were properly examined to exclude those suffering from any major diseases, psychiatric problems, alcoholics or sleep medication. Height & weight were examined to calculate BMI and it was graded according to ICMR guidelines. Sleep quality & duration was assessed by a self-report questionnaire, PSQI. Pearson’s correlation was used to find the association among parameters. 41.3%(102) had overweight BMI of ≥23; 38.1%(94) had poor sleep quality with PSQI score >5 and 43.3%(107) are sleep deprived with sleep duration 5-6 hours. Analysis showed highly significant negative correlation bet ween BMI & sleep duration with ‘p’ value It was found that with increase in BMI there is decrease in sleep duration as well as reduction in sleep quality which again leads to obesity as a vicious cycle. Hence proper education about sleep and life style modification is needed to medical students to prevent obesity and its associated comorbidities among them.

The fact that pancreatic cancer has a low life expectancy, that is only 9% of people survive five years, makes a diagnosis catastrophic. The majority of patients are diagnosed late in life, where care choices are minimal. Early diagnosis of pancreatic cancer will greatly increase a person’s chances of survival. Accurate PC staging will help doctors have the right treatment plan for PC patients at different stages, as well as the diagnostic measures needed for a quicker cancer recovery. In this proposed project, ultrasound images will be analyzed. The noise in the image is minimised using the Median Filter. In the next step, Gray Level Co-occurrence Matrix (GLCM) and Discrete Wavelet Transform (DWT)are used to extract related features. Following this extraction step, the refined characteristics are fed into a Probabilistic Neural Network (PNN) neural network classifier, which determines whether or not cancer is present. Metrics such as sensitivity, precision, and specificity are used in experimental computation.

Glaucoma which is known as the “thief of sight”, is an irreversible eye disease It is mainly caused by increased intraocular pressure (IOP), or loss of blood supply to the optic nerve. Glaucoma detection and diagnosis is very important. By analyzing the optic disc and its surroundings, This paper introduces a method for providing automated glaucoma screening services based on a framework that proposes a retinal image synthesizer for glaucoma assessment by analyzing the optic disc and its surroundings. The Cup to Disc Ratio (CDR) is critical for the system, and it is calculated using 2-D retinal fundus images. The synthetic images produced by our system are compared quantitatively. The structural properties of synthetic and real images are analyzed, and the quality of colour is calculated by extracting the 2-D histogram. The system allows patients to receive low-cost remote diagnostics from a distance, preventing blindness and vision loss by early detection and management.

Due to the picture similar region of interest, local area, and the effect of respiration, separating a lung tumor from neighboring tissue from a collection of magnetic resonance images (MRI) faces a number of challenges. However, precise tumor segmentation is needed when preparing radiation therapy in order to prevent excessive radiation exposure to healthy tissues. Delineation of the whole MRI pattern by hand is boring, time-consuming, and costly. Using neural networks, this research studies the automated tracking of tumor borders during radiation therapy. To improve the accuracy of lung tests, we proposed using neural network architecture with fuzzy clustering.

Objective: The present study was aimed to evaluate the antidiabetic activity of ethanolic extract of the whole aerial plant of Portulaca grandiflora Hook on streptozotocin (STZ)-induced diabetic rats. Methods: Experimental diabetes was induced by a single dose of intraperitoneal injection of STZ (150 mg/kg). Adult male Wister albino rats were divided into five groups; normal control, diabetic control, diabetic glibenclamide (5 mg/kg), diabetic P. grandiflora H. extract (200 mg/kg), and diabetic P. grandiflora H. extract (400 mg/kg) for 21 days and analyzed for body weight (BW) and blood glucose. Results: The STZ-treated diabetic control rats showed a significant increase in blood glucose with a concomitant decrease in BW. Oral administration of P. grandiflora H. extract (200 and 400 mg/kg) and glibenclamide (5 mg/kg) for 21 days showed a significant reduction in blood glucose levels and elevation in the bodyweight studies as compared to control and glibenclamide-treated rats. Conclusion: The results of the present study showed that a potent antidiabetic activity was present in the aerial part of plant P. grandiflora H. extract.

Objective: COVID19 pandemic out of all odds has created an opportunity to offer treatment in an integrative manner. This study measures the Length of stay (LS) of patients in an integrative way, as done earlier in China and Vietnam. Length of stay, Clinical presentations, and Comorbidities were analyzed among COVID19 patients in ESI Hospital, Coimbatore, Tamil Nadu, India. Method: Retrospective cross-sectional data on 251 Positive COVID19 patients of both sexes irrespective of age admitted from 27 March 2020 and 26 April 2020 cases were included in the study. The final discharge date is taken as 5th May 2020. Kaplan Meier survival analysis was adopted. Results: Male, female ratio were 141(56.2%): 83(33.1%), 12 (4.8%) Male Child and 15 (6.0%) were Female child. 5.2% of the patients were in the age group greater than 60, 75.3% were in the age group 20-60, and the remaining 19.5% were 0- 20 age group. 84.9% of patients were Asymptomatic, while fever and cough were the main symptoms recorded in the remaining cases. CT scan was done for 7 patients. No mortality and no serious adverse events were reported. Comorbidity is 15% and does not influence hospital length of stay. The overall median length of stay is 12 days for those who were under ZVcKK (Median ST CI- 11.59-12.41). Conclusion: This study recorded a median of 12 days in the Length of stay and 13.5 days in the Length of stay average. Comparing earlier studies, patients taking ZVcKK have savings of 7 days. i.e., the relief speed is higher while using ZVcKK.

ObjectivesThe 2019 pandemic of coronavirus disease (COVID-19) has prompted several efforts to find safe and effective drugs, but little is understood as to where early efforts were centered. Several clinical trials, both Allopathy and AYUSH medicines have been registered in the Clinical Trial Registry of India (CTRI). We aimed to characterize and extract relevant data registered under CTRI for COVID-19.Materials and MethodsA cross-sectional analysis was performed of clinical trials for the treatment of COVID-19 that were registered in the Clinical Trial Registry of India (CTRI) from 1st March 2020 to 22nd June 2020. Relevant trial records were downloaded, deduplicated, and independently analyzed by three reviewers.Main outcomesTrial intervention, design, sponsorship, phase of the trial, and indicated outcomes.Results233 COVID-19 clinical trials, was registered from India in CTRI. Out of these, 146 were Interventional trials, 84 Observational trials, and three Post-marketing surveillance. Questionnaire and survey-based intervention occupy a significant portion. Randomized control trials are large in number 37.8% than non-randomized. 20% of the trials were recruiting patients, and the Research institution (34%) sponsored more than half of the trials. Global trials are minimal, occupying 3% of total trials and Indian trials were 97%. In most of the trials, the interventional agent is either multiple drug combinations or compound drug formulations compared to single drug administration. Among the trials, 46 Allopathic interventions, 41 Ayurveda interventions, 14 Homeopathy interventions, one in Unani, and 2 in yoga and Naturopathy.ConclusionThis study will provide a background of COVID-19 clinical trials registered in CTRI and provide specific issues observed related to clinical trial designs, which offer information to perform clinical trials on COVID-19

The skin cell which grows abnormally is known as skin cancer and it is caused due to sun rays in the uncovered skin. It spreads within a week, so the early diagnosis of skin cancer is required. Skin Cancer Classification (SCC) based on ranklet transform, co-occurrence features and random forest classifier is presented in this paper. Dermoscopic image in the PH2 database is used in this study for performance evaluation. Initially, the dermoscopic images of three categories normal benign and malignant images are preprocessed to smooth the images. Then the images are given to ranklet transform for decomposition. It produces subband coefficients. The Ranklet Features based Co-occurrence Matrix (RFCM) is used to extract the features and stored in database. The classification is made by Random Forest Classifier (RFC). The result shows better classification accuracy of 93.5% sensitivity is 92% and specificity is 95% is obtained by RFCM and RFC.

Models of a variety of neurons share the same form as the Hodgkin-Huxley (HH) neuron and evidence suggests that single-compartment models can capture the key properties of in vivo and in vitro neurons. In this paper we are going to discuss about how the conductance of the excitatory and inhibitory synapse vary when the pre synaptic action potential arrived at the synapse and how this synaptic conductance affects the information transfer in the single neuron. In our model the injected current is replaced with the synaptic current in the HH model. In order to validate the impact of excitatory and inhibitory synapse in the generation of action potential, the extended HH model is examined with various synaptic inputs.

Chronic hyperglycemia in type 2 diabetes mellitus increases oxidative stress and inflammation which contributes to long-term diabetic kidney disease. Tocotrienol-rich vitamin E, as Tocovid, has been shown to reduce oxidative stress and inflammation to ameliorate diabetes in rat models and human subjects. In this prospective, multicenter, double-blinded, placebo-controlled clinical trial, 54 patients (duration = 18.4 years, HbA1c = 8.8%) with diabetic nephropathy were randomized to receive Tocovid 200 mg or placebo for 12 weeks. Fasting blood samples were taken to measure HbA1c, serum creatinine, estimate glomerular filtration rate (eGFR), urine albumin:creatinine ratio, malondialdehyde, tumor necrosis factor receptor-1, vascular cell adhesion molecule-1 (VCAM-1), and thromboxane-B2. Patients were reassessed 6–9 months post-washout. After 12 weeks of supplementation, Tocovid significantly decreased serum creatinine levels (mean difference: –3.3 ± 12.6 versus 5.4 ± 14.2, p = 0.027) and significantly increase eGFR (mean difference: 1.5 ± 7.6 versus –2.9 ± 8.0, p = 0.045) compared with placebo. There were no significant changes in HbA1c, blood pressure, and other parameters. Subgroup analysis revealed that in patients with low serum vitamin E concentrations at baseline, Tocovid reduced serum creatinine, eGFR, and VCAM-1 significantly. After 6–9 months of washout, persistent difference in serum creatinine remained between groups (mean difference: 0.82 ± 8.33 versus 11.26 ± 15.47, p = 0.031), but not eGFR. Tocovid at 400 mg/day significantly improved renal function in 12 weeks of supplementation, as assessed by serum creatinine and eGFR, which remained significant 6–9 months post-washout.

BACKGROUND Diabetes Mellitus (DM) is one of the most common metabolic disorders causing damage in multiple organs. The normal role of polymorphonuclear leukocytes, leukocyte adherence, chemotaxis, and the processes of phagocytosis may all be compromised and associated with an increased incidence or severity of common upper or lower respiratory tract infections. The impact that these disturbances have on the development and outcomes of infectious diseases has been poorly studied. The objectives of this study were to evaluate the aetiological, demographic profile, clinical presentation and risk factors of lower respiratory tract infections and the severity of illness and outcome in patients with Diabetes Mellitus. MATERIALS AND METHODS This study includes 50 patients with Diabetes Mellitus admitted in ICU and Medical wards of Sri Venkateswara Ramnarain Ruia Government General Hospital, Tirupati, with lower respiratory tract infection. RESULTS In the current study, 45 patients got discharged without any complications and 5 patients expired. The cause of death is Tuberculosis in three patients and staphylococcal pneumonia and streptococcal pneumonia one each. CONCLUSION Increased incidence of respiratory infections is seen in males with poor glycaemic control. Streptococcus pneumoniae is the most common pathogen with unilobar involvement. Mortality is due to advanced age, increased duration of diabetes, prolonged duration of illness, poor drug compliance and increased severity of illness.

Castleman disease is a rare hyperplastic disorder that can affect any group of lymph nodes. Clinically and radiologically, it can mimic a malignancy and can only be diagnosed by histopathological examination. Castleman disease should be considered as one of the differential diagnosis for a patient presenting with a retroperitoneal mass. Complete surgical excision is usually curative; a preoperative diagnosis by biopsy can avoid extensive surgery for this condition. In this case report, we present a 40 year old female with a retroperitoneal mass, which was clinically suspected to be a malignancy. Complete surgical excision was done and histopathological examination of the mass revealed a unicentric Hyaline vascular type of Castleman disease. Keywords: Castleman disease, Hyaline vascular type, Giant lymph node hyperplasia, Plasma cell type, retroperitoneal mass, Unicentric.

Aim and objective: To evaluate the analgesic effect of baclofen in albino rats in comparison with diclofenac. Materials and Methods: Eighteen inbred male albino rats weighing about 150-200 gms were selected from central animal house. They were divided into three groups, with six rats in each. Group I served as control received normal feed and water. Group II served as standard received T. Diclofenac – 10 mg/kg (oral). Group III served as test group received T. Baclofen -- 8mg/kg (oral). The analgesic effect of baclofen was evaluated using Eddy’s hot plate method and tail-flick method and compared with diclofenac. The values obtained are expressed as mean ± SEM. Statistical analysis of differences between groups was carried out using one-way analysis of variance (ANOVA). Probability (P) value of

BACKGROUND Traditional lecture is the most common type of teaching learning method used in professional colleges of India. Interactive lecture seems to be an important and feasible teaching learning method to increase the effect of learning in medical education. MATERIALS & METHODS The study was performed from July 2015 to October 2015 among first year medical students in Government Medical College, Idukki. All fifty first year MBBS students of 2014 batch were divided into group A and group B by simple random method. Two topics of translation were taken to both groups by two different lecture methods. The first topic was taught by interactive lecture to group A and traditional lecture to group B on the first day. Pre-test and post-test were done to assess gain in knowledge by two lecture methods. Second topic was taken to both groups on the second day by exchanging lecture methods. Their increase in knowledge was assessed by pre-test and post-test. On the second day, their feedback regarding perceptions and preferences were taken. STATISTICAL ANALYSIS Mean scores of pre and post-test were analysed by paired t test. Level of knowledge gained among two lecture methods was compared by independent t test and qualitative data on feedback was analysed using Chi square test. RESULTS The level of knowledge gained by interactive lectures was significantly higher than traditional lectures. Students agreed that interactive lectures motivated them for self-learning and increased their confidence regarding study materials. It also helped them in the recollection of lecture content and clearing doubt than traditional lectures. CONCLUSIONS Interactive lectures were accepted and considered to be more useful than traditional lectures for teaching biochemistry at Government Medical College, Idukki.

Background Varicose vein is a common surgical problems in India. This study was done to assess the clinico-epidemiological profile, risk factors and management practices in varicose veins. Materials and methods Medical records of 170 varicose vein cases admitted in tertiary care hospitals in Mangalore between May 2011 to April 2014 were reviewed retrospectively. Results Majority of cases 53(31.2%) were of the age group 41–50 years. Majority were males 127(74.7%) and majority were unskilled workers 101(59.4%). Superficial veins were involved in 123(72.4%) cases. Perforator followed by great saphenous vein were most frequently involved. Veins on the left side were more involved than on the right. Common symptoms at the time of presentation was ulceration 98(57.6%) followed by pain in the legs 96(56.5%). Ulceration was seen significantly more among females (p = 0.027) and among house wives (p = 0.004). Complications like eczema 46(27.1%), non-healing ulcers 21(12.3%) and deep vein thrombosis 10(5.9%) were reported among cases. Eczema was present significantly more among elderly patients aged above 60 years (p = 0.019). Risk factors like prolonged standing was observed in 86(50.6%) cases. This history was significantly seen among males (p = 0.001) and among those involved in unskilled occupations (p, Highlights • Perforator veins were most commonly involved indicating risk of future complications. • Most common symptom at the time of presentation of varicose veins was ulceration. • Recurrence of varicose vein was reported in 13.5% cases. • High risk groups for common risk factors, symptoms and complications in varicose veins were identified. • Saphenous vein stripping was the most common surgical procedure performed.

During female mammal reproductive tract development, epithelial cells of the lower Müllerian duct are committed to become stratified squamous epithelium of vagina and ectocervix, when the expression of ΔNp63 transcription factor is induced by mesenchymal cells. The absence of ΔNp63 expression leads to adenosis, the putative precursor of vaginal adenocarcinoma. Our previous studies with genetically engineered mouse models have established that fibroblast growth factor (FGF)/mitogen-activated protein kinase (MAPK), bone morphogenetic protein (BMP)/SMAD, and activin A/runt related transcription factor 1 (RUNX1) signaling pathways are independently required for ΔNp63 expression in Müllerian duct epithelium (MDE). Here we report that sine oculis homeobox homolog 1 (SIX1) plays a critical role in the activation of ΔNp63 locus in MDE as a downstream transcription factor of mesenchymal signals. In mouse developing reproductive tract, SIX1 expression was restricted to MDE of the future cervix and vagina. SIX1 expression was totally absent in SMAD4 null MDE and was reduced in RUNX1 null and FGFR2 null MDE, indicating that SIX1 is under the control of vaginal mesenchymal factors, BMP4, activin A and FGF7/10. Furthermore, Six1, Runx1 and Smad4 gene-dose-dependently activated ΔNp63 expression in MDE within vaginal fornix. Using a mouse model of diethylstilbestrol (DES)-associated vaginal adenosis, we found DES action through epithelial estrogen receptor α (ESR1) down-regulates SIX1 and RUNX1 in MDE within the vaginal fornix. This study establishes that the vaginal/ectocervical cell fate of MDE is regulated by a collaboration of multiple transcription factors including SMAD4, SIX1 and RUNX1, and the down-regulation of these key transcription factors leads to vaginal adenosis.Author SummaryIn embryogenesis, differentiation fate of cells is specified through constant communication between neighboring cells. In this study, we investigated the molecular mechanism of epithelial cell fate commitment in the lower female reproductive organs utilizing mouse genetic models. The cell fate of epithelial cells in the uterus, cervix and vagina is directed by signaling from mesenchymal cells. We demonstrated that within the epithelial cells of the developing vagina, signals from mesenchymal cells are integrated into activities of transcription factors including SMAD4, RUNX1 and SIX1, which dose-dependently co-operate in the determination of vaginal epithelial cell fate. Disruption of these processes alters the cell fate from vaginal to uterine epithelium, resulting in a condition called vaginal adenosis, a putative precursor of vaginal adenocarcinoma. Women exposed to diethylstilbestrol (DES) in the womb have about 40 times the risk of developing vaginal adenocarcinoma. We determined that developmental exposure to DES induces vaginal adenosis by repressing SIX1 and RUNX1 through ESR1 in the epithelial cells. This discovery enhances the understanding of how early-life events, such as exposure to endocrine disruptors, causes vaginal adenosis, and thus may contribute to the prevention and therapeutic treatment of idiopathic vaginal adenocarcinoma.

Platinum-based chemotherapies can result in ovarian insufficiency by reducing the ovarian reserve, a reduction believed to result from apoptosis of immature oocytes via activation/phosphorylation of TAp63α by multiple kinases including CHEK2, CK1, and ABL1. Here we demonstrate that cisplatin (CDDP) induces oocyte apoptosis through a novel pathway and that temporary repression of this pathway fully preserves ovarian function in vivo. Although ABL kinase inhibitors effectively block CDDP-induced apoptosis of oocytes, oocytic ABL1, and ABL2 are dispensable for damage-induced apoptosis. Instead, CDDP activates TAp63α through the ATR > CHEK1 pathway independent of TAp63α hyper-phosphorylation, whereas X-irradiation activates the ATM > CHEK2 > TAp63α-hyper-phosphorylation pathway. Furthermore, oocyte-specific deletion of Trp73 partially protects oocytes from CDDP but not from X-ray, highlighting the fundamental differences of two pathways. Nevertheless, temporary repression of DNA damage response by a kinase inhibitor that attenuates phosphorylation of ATM, ATR, CHEK1, and CHEK2 fully preserves fertility in female mice against CDDP as well as X-ray. Our current study establishes the molecular basis and feasibility of adjuvant therapies to protect ovarian function against two distinctive gonadotoxic therapeutics, CDDP, and ionizing radiation.

BACKGROUND: At present Diabetes Mellitus is a global phenomenon with the disease topping the list, comprising of about 32 million cases, India is in the forefront with 30% of the cases. The disease affects multiple organs and is a leading cause of much morbidity and mortality. Since it is a multi-factorial disease a major step would be to identify different associated factors, for an early diagnosis and prompt treatment. The ABO blood groups are often associated with several diseases, with one blood group more often seen with the patients of a particular disease. Our study will help to determine the frequency and distribution of blood groups in correlation with Diabetes Mellitus. MATERIAL & METHODS: This study was conducted in the Gandhi Medical College, Secunderabad, during a two year period. A random study involving every third diabetic patient was chosen and their blood group was determined. A total of 300 patients were selected with 150 male and 150 female patients. Another 300 volunteers who were not diabetics were chosen as controls and their blood groups were also determined. A pro-forma was given to both diabetics and controls which included the following variables: 1. Demographic data 2. Blood grouping 3. Fasting and post prandial blood sugar. Following this, blood groups of both cohorts and controls were determined by antigen antibody agglutination method. Data analysis was done after data was entered into excel sheet and double checked for errors using SPSS Software RESULTS: Our analysis showed that O group was significantly more among diabetic patients when all patients were compared to control.2 there was a preponderance of blood group O among female diabetics and B among male diabetics. CONCLUSION: ABO blood groups have been determined in 300 diabetic patients and compared with the controls comprising of a series of 300 voluntary blood donors. When the results were analysed on the basis of sex, there was preponderance of group O in female diabetics. It can be observed that no uniform association has been found between blood groups and diabetes although the preponderance of one or the other blood group has been reported from time to time.. The results have been so variable and often inconclusive that the possible role of ethnic and social factors cannot be ignored.

“KALLADAIPPU” (Urolithiasis) “KALPIRAMIYAM”(Urolithiasis) are the synonyms in Siddha and the term equated to renal calculi in allopathic system of medicines. An increasing affluence and adaptation of Western diet habits in many developing countries seem likely to contribute to the changes for the development of renal calculi. Siddha medicine describes certain formulations as Lithotriptic and diuretic which is used in the treatment of renal calculi successfully. This case reported again is an example that proves the efficacy of Siddha medicines for expulsion of renal stones. The synergistic action enhanced resulting in disintegration and elimination of urinary stones from urinary tract.

OBJECTIVE: Identify the prevalence and type of specific learning disabilities in students with poor scholastic performance. Screen the students with specific learning disabilities for anemia. DESIGN: Simple Random Sampling method. SETTING: Government and semi-aided schools in the city of Mysore. DURATION OF STUDY: 4 months from August 2010 to November 2010. PARTICIPANTS: Students who satisfy the criteria for poor scholastic performance, which is, scoring less than 45% marks or equivalent grades for the past 2years or more aged between 812 yrs. METHODS: Students were administered NIMHANS Index for Specific Learning Disability (SpLD). RESULTS: On physical examination to check signs of anemia it was found that pallor was present in 33 out of 41 subjects (80.5%) and the percentage of girls and boys having pallor is almost the same. On assessing learning parameters it is found that in performance of the normal subjects, number of mistakes, omissions and correct cancellations increased as the standard of the subject increased. In reading, out of all the subjects only 2 had learning disability and 4 had learning difficulty. 24 subjects had learning difficulty in mathematics and 2 students had learning disability in mathematics. All subjects except 2 had adequate auditory memory. Most subjects have a learning difficulty in mathematics. 22 subjects were having a specific learning difficulty and 2 subjects specific learning disability. Subjects were having moderate anemia. CONCLUSION: Specific learning disability and micronutrient deficiency screening should be done in children with poor scholastic performance. Timely treatment and support mechanisms should be provided for these children.

OBJECTIVES: To get an insight into: 1. Perceived health needs and demands of positive mothers. 2. Constraints and barriers in accessing health services. 3. Impact of positive status on social and economic entitlements.4. Role of positive network in educating and empowering mothers. METHODOLOGY: Type of study; Qualitative research using focus group discussions (FGD). Study Setting; “AnandaJoythi Network of People Living with HIV/AIDS®”A positive network at Mysore. Period of study; SeptemberOctober, 2008. Study participants: positive mothers from in and around Mysore city attending AnandaJoythi Network of People Living with HIV/AIDS. Inclusion Criteria; Mother of at least one child irrespective of: Her age. Duration of the positive status/ stage of disease. Age of the child-live/dead. On ART or not. And were willing to participate in the study. EXCLUSION CRITERIA: Those not willing to participate in the study. RESULTS: Health Needs and Demands: The positive women felt the need for regular screening tests for side effects of ART free of cost, nutrition supplementation programmes, more health centres and health education. Barriers to treatment: Poverty is the main barrier to accessing treatment. This is the amount of money required by clients for the government health services before being put on the ART programme and individuals have to pay for a CD4 count, a full hemogram and a liver function test. Poverty also means that people experience difficulty in paying for transport to get to services, especially when travelling from rural areas where distances to the nearest clinic or hospital are further and infrastructure poorer. Social and economic impact of positive status: It becomes difficult to look after their children when they are thrown out of their house. Even though they are mentally harassed by their family members they find it difficult to come out of their house because of their children are too young and need a family support. They face discrimination in getting admission to schools for their children because of their positive status (especially when thrown out of the school).They find it difficult to get their daughters married as the bride groom may reject her after coming to know that her parents are HIV positives, even though she is negative. Positive network and mothers: The positive women find this network as a source of confidence, information and education regarding their rights, duties and the disease itself. By becoming members of this network they have rediscovered themselves and have developed a positive outlook towards life.

The relationship between diabetes and root caries has not received much attention in the literature; therefore the objectives of the present study were to assess the root surface caries among type 2 diabetic patients and the factors affecting root surface caries. A hospital based cross-sectional study was done among type 2 diabetics visiting a medical hospital in Bangalore. Those who had been diagnosed from at least past 5 years and were above 35 years of age were included. Among the 400 study subjects, root caries were present among 42% of the subjects. There was a statistically significant association for the presence of root caries and age (p = 0.00023), presence of periodontal pockets (p = 0.0004) and presence of loss of attachment of more than 3 mm (p < 0.0001). These findings indicate that there is a need for implementation of caries preventive measures with increasing age, and among those with compromised periodontal status among those suffering from type 2 diabetes mellitus.

BACKGROUND Adjuvant chemotherapy for T3N0 colon cancer is controversial. National guidelines recommend its use in patients with stage II with high-risk features, including lymph node harvest of less than 12, yet this treatment is underused. OBJECTIVE The purpose of this study was to demonstrate that the use of adjuvant chemotherapy in patients with T3N0 adenocarcinoma with inadequate lymph node harvest is beneficial. DESIGN This was a retrospective population-based study of patients with resected T3N0 adenocarcinoma of the colon. SETTINGS The National Cancer Database was queried from 2003 to 2012. PATIENTS A total of 134,567 patients with T3N0 colon cancer were included in this analysis. MAIN OUTCOME MEASURES The use of chemotherapy, short-term outcomes, and overall survival was evaluated. Clinicopathologic factors associated with omission of chemotherapy were also analyzed. RESULTS Inadequate lymph node harvest was observed in 23.3% of patients, and this rate decreased over the study period from 46.8% in 2003 to 12.5% in 2012 (p < 0.0001). Overall 5-year survival for patients with T3N0 cancer was 66.8%. Inadequate lymph node harvest among these patients was associated with lower overall 5-year survival (58.7% vs 69.8%; p < 0.001). The use of adjuvant chemotherapy among patients with T3N0 cancer after inadequate lymph node harvest was only 16.7%. In a multivariable analysis, factors associated with failure to receive chemotherapy included advanced age (OR = 0.44 (95% CI, 0.43-0.45)), increased comorbidities (OR = 0.7 (95% CI, 0.66-0.76)), and postoperative readmission (OR = 0.78 (95% CI, 0.67-0.91)). Patients with inadequate lymph node harvest who received adjuvant chemotherapy had improved 5-year survival (chemotherapy, 78.4% vs no chemotherapy, 54.7%; p < 0.001). Even when controlling for all of the significant variables, the administration of chemotherapy remained a predictor of decreased mortality (HR = 0.57 (95% CI, 0.54-0.60); p < 0.001). LIMITATIONS This study was limited by its retrospective, population-based design. CONCLUSIONS Patients with T3N0 colon cancer with inadequate lymph node harvest who receive adjuvant chemotherapy have increased overall survival. Despite this survival benefit, a fraction of these patients receive adjuvant chemotherapy. Barriers to chemotherapy are multifactorial.

Background. Breast lumps have varied pathology, and there are different techniques to prove the diagnosis. The aim of the present study is to analyze the role of fine needle aspiration cytology (FNAC) of the breast lesions at our center. Methods. We had retrospectively analysed 854 patients who underwent FNAC for primary breast lumps and 190 patients who underwent FNAC for an axillary lymph node in the year 2010. Results. Of 854 patients, histological correlation was available in 723 patients. The analysis was done for 812 patients as medical records were not available for 42 patients. FNAC was false negative in seven cases; 2 cases of phyllodes were reported as fibroadenoma, and 5 cases of carcinoma were diagnosed as atypical hyperplasia. The sensitivity, specificity, and false negative value of FNAC in diagnosing breast lumps were 99% (715/723), 100%, and 1%, respectively. Of 190 patients for whom FNAC was performed for axilla, 170 had proven to have axillary lymph node metastases, and the rest had reactive hyperplasia or inflammatory cells. Conclusions. FNAC is rapid, accurate, outpatient based, and less complicated procedure and helps in diagnosis of breast cancer, benign diseases, and axillary involvement in experienced hands with less chance of false results.

Patients with platelet-mediated disorders often present clinical manifestations of bruising and bleeding. Although these changes are detected most frequently on the skin, the oral cavity also may exhibit signs of bleeding. In this report, we describe a patient who presented isolated oral features of hemorrhagic bullae with bleeding, indicative of a bleeding disorder. Results of laboratory tests revealed severe thrombocytopenia and a careful history disclosed dengue fever as the cause. The importance of recognizing the oral manifestations of thrombocytopenia is highlighted here, since the oral cavity is a frequent site of hemorrhage and could be the only manifestation of the disease.

Objective: To evaluate the effect of pentoxifylline as a single regimen therapy for thin endometrial lining in infertility. Method: A cross-sectional retrospective research was held in Yasmin Clinic - Kencana, Dr. Cipto Mangunkusumo Hospital from 2010 until 2011. Our respondents were women with infertility problem. Result: There was significant improvement of endometrial lining in respondents who received pentoxifylline in the first month (p

BACKGROUND: Bone marrow examination is a commonly used diagnostic modality in the evaluation of hemato-oncological disorders and in patients with malignancies of visceral organs to detect metastasis. This study reviews clinical, hematological and pathological data of interesting cases with bone marrow involvement. Out of 490 bone marrow aspirations performed during a period of 4 years, 5 cases show metastatic carcinomatous deposits which included adenocarcinomas(3), squamous cell carcinoma(1) and neuroendocrine tumour(1), Non-Hodgkins lymphomas(2), storage disorder(2), granulomatous lesions(1), gelatinous transformation(1). Fever, generalized weakness, loss of appetite and loss of weight were the main symptoms. Anemia and pancytopenia were the main hematological findings. Dry tap was a significant finding in bone marrow aspiration in cases of metastatic cancers.

Many hepatoprotective herbal preparations have been recommended in alternative system of medicine for the treatment of hepatic disorders. There are few or no systemic studies have been done on protective efficacy of Ziziphus rotundifolia (Rhamnaceae) to treat liver diseases. In this study, hepatoprotective and antioxidant activity of ethanolic extracts was evaluated against CCl4-induced liver damage in rats. Liver damage was evidenced by elevated levels of biochemical parameters such as serum glutamate oxaloacetic acid transaminase, glutamate pyruvic transaminase and serum alkaline phosphatase. Treatment with ethanolic extracts of Z. rotundifolia (300 mg/kg, p.o.) produced a significant reversal in the above biochemical parameters, and reducing power, superoxide anion scavenging activity and reduced histopathological scores. These findings suggest that the extracts of Zizphus rotundifolia possess significant hepatoprotective and antioxidant properties.

Objectives: The objective of this study is to assess the safety and efficacy of formoterol and tiotropium combination compared to formoterol and tiotropium with roflumilast combination in treatment of moderate-to-severe chronic obstructive pulmonary disease (COPD) patients on inhaled combination therapy. Methods: A comparative prospective interventional study was carried out in 61 COPD patients who were visiting the pulmonary medicine ward during 6 months (October 2016 to March 2017). The patients were randomized into two groups. Group A patients received a combination of formoterol and tiotropium, whereas Group B patients received roflumilast along with formoterol and tiotropium combination. Spirometry tests were done to both the study population. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were noted at the initial visit and after the treatment. All the statistical analyses such as mean and p values were calculated using SPSS 14.0 version software. Results: The average age group of the study population was 57.63±8.3 years. Comorbid condition such as diabetes mellitus was higher in the study groups. Comparison of spirometry reports before and after drug administration in both groups was done. FEV1 and FVC were found to be statistically significant between the study group (0.001, p

Aim: This study was carried out to assess the outcome of the intracytoplasmic morphologically selected sperm injection (IMSI) technique compared with the previous failed intracytoplasmic sperm injection (ICSI) attempts in oligoasthenoteratozoospermia (OAT)/severe OAT (SOAT)/teratozoospermia patients. Setting: Institution-based, in vitro fertilization center. Study Design: It was a nonrandomized prospective study including 57 couples who had previous one or two ICSI failures (failure due to no implantation as embryos were transferred in these cycles and had no pregnancy) due to male factor. There was no case of total fertilization failure. IMSI was carried out in these couples and the results were compared with their previously failed ICSI attempts. Materials and Methods: Real-time selection of sperms was done using IMSI as it allows the assessment of fine nuclear morphology and vacuoles in the sperm head at a high magnification (>6000×) with differential interference contrast optics. Therefore, IMSI was applied in couples having OAT, SOAT or teratozoospermia as male factor and the results were compared with their previous failed ICSI attempts. Statistical analysis was carried out using GraphPad Prism. Results and Conclusion: Data analysis demonstrated significant difference in the fertilization rate between IMSI and previous ICSI attempts of these patients (30.0% vs. 52.0%; P < 0.05). The embryo quality, implantation and pregnancy rates with IMSI were also significantly higher than those of their previous ICSI cycles (32% vs. 56.4%; 30.2% vs. 68.5%; 0.0% vs. 62.4%; P < 0.05). Our conclusion is that the IMSI procedure improved embryo development and the clinical outcomes in the same infertile couples with male infertility and poor embryo development over their previous ICSI attempts and can be taken up as the treatment of choice in cases of severe male factor infertility.

Endothelial cell dysfunction is the hallmark of every cardiovascular disease/condition, including atherosclerosis and ischemia/reperfusion injury. Fluid shear stress acting on the vascular endothelium is known to regulate cell homeostasis. Altered hemodynamics is thought to play a causative role in endothelial dysfunction. The dysfunction is associated with/preceded by mitochondrial oxidative stress. Studies by our group and others have shown that the form and/or function of the mitochondrial network are affected when endothelial cells are exposed to shear stress in the absence or presence of additional physicochemical stimuli. The present review will summarize the current knowledge on the interconnections among intracellular Ca2+ - nitric oxide - mitochondrial reactive oxygen species, mitochondrial fusion/fission, autophagy/mitophagy, and cell apoptosis vs. survival. More specifically, it will list the evidence on potential regulation of the above intracellular species and processes by the fluid shear stress acting on the endothelium under either physiological flow conditions or during reperfusion (following a period of ischemia). Understanding how the local hemodynamics affects mitochondrial physiology and the cell redox state may lead to development of novel therapeutic strategies for prevention or treatment of the endothelial dysfunction and, hence, of cardiovascular disease.