The rational use of drugs requires the patient to receive medicines appropriate to their needs in doses that meet their individual requirement for adequate period of time and at lowest cost. Rational use of drugs forms the corner stone of successful implementation of rational use of medicines(1). Medically inappropriate, ineffective, non-economical use of pharmaceutical product is commonly observed in health care system throughout the world and especially so in developing countries (2). Inappropriate prescription not only increases the cost of medical treatment but also increases the morbidity and mortality. Third world population spends 30-40% of their total health budget on drugs many of which are prescribed irrationally. These countries double their expenditure on drugs every 4 years while GNP double every of 16 years. (3). Thus there is an urgent need to ensure that the patients are always given evidence based cost effective & rational treatment. Children constitute 40% of Indian population. Infant and children are the most vulnerable group of population suffers from frequent but usually non serious illness. Most of these are self limiting (4) and treated not only inappropriately but also reporting to polypharmacy (5). Compared to adult medicines drug use in paediatrics is not extensively researched and range of licensed drug in appropriate dose form is limited (6). One significant study has shown that potentially harmful medication error can be three times more common in paediatric population than in adults (7). Prescriber and consumer are flooded with vast array of pharmaceutical preparation with innumerable trade names, available often at unaffordable prices. Considering these facts, the present study was planned to understand the prescription pattern of paediatric patient in Yavatmal, Central India.
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9. Janaki R. Torvi ,Suman Dambal.Drug prescription pattern in pediatric outpatient clinic in a tertiary hospital. Curr Pediatr Res 2011; 15(2):77-80.
10. Gajjar BM, Desai S, Srivastava S. Evaluation and comparison of prescribing pattern of ohysician from “The Institute†and “The Private†sectors for rational drug therapy. Vallabh Vidyanagar,S.P University,1999.
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Comparative Analysis of Prescription Writing by Teaching and Non-Teaching Clinicians in and around Guntur
Aim: To study the prescribing patterns of clinicians working in two different settings. i.e. a) Teaching clinicians (clinicians working in teaching hospital) and b) Non-teaching clinicians (clinicians involved in private practice). Materials and methods: Comparative cross sectional study was carried out for a period of 6 months in 2 different settings. The study is confined to a) Qualified medical practitioners in Katuri medical college and hospital (Teaching clinicians) b) Qualified medical practitioners in Private health sector(PMPs) or (Non-teaching clinicians).450 prescriptions were collected from clinicians belonging to various departments of KMC &H and 450 prescriptions from private practitioners of Guntur city. Data were coded and entered with the help of a statistician to minimize data entry errors. Data were analysed on EPINFO version 3.5.4 and MS EXCEL. Results: It was found that non-teaching clinicians prescribed in average number of drugs for prescription (3.28) more than teaching clinicians (2.82).Teaching clinicians prescribed 73 drugs (5.75%) by generic name, whereas non-teaching clinicians prescribed 62 drugs (4.18%). Number of drugs prescribed from essential drug list was compared in both the settings. Teaching clinicians prescribed 860 drugs (67.76%) from the essential medicines list, whereas non-teaching clinicians prescribed only 574 drugs (38.78%) from the essential medicines list. Number of injectables prescribed by both categories of clinicians is compared. Non-teaching clinicians prescribed 130 drugs (8.78%) compared to 52 drugs (4.09%) by teaching clinicians. Teaching clinicians prescribed 283(28.30%) drug combinations compared to 462(31.21%) drug combinations prescribed by non-teaching clinicians. Among the total drugs prescribed in different categories by teaching clinicians more than 46% (46.48%) were from two major groups, antimicrobials 24.11% and NSAIDs 22.37%. Non-teaching clinicians prescribed about 54% (54.04%) Antimicrobials 29.52% and NSAIDs 24.52%. Conclusion: The results indicate a considerable scope for improving the prescribing patterns of drugs in both the settings.
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8. Hanumantha Rao Potharaju and S.G. Kabra Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra, Indian J Pharmacol. 2011 April; 43(2): 150–156.
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10. T.M. Vijayakumar, D. Sathyavati, T. Subhashini, S. Grandhi and M.D. Dhanaraju, Assessment of prescribing trends and rationality of drug prescribing. International Journal of Pharmacology, 2011 7: 140-143.
11. S Sharif, M Al-Shaqra, H Hajjar, A Shamout, and L Wess, Patterns Of drug prescribing in a hospital in Dubai, United Arab Emirates; Libyan J Med. 2008; 3(1): 10–12.
12. Phalke VD, Phalke DB, Syed MMA, Mishra A, Sikchi S, Kalakoti P. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India. AMJ 2011, 4, 1, 4-8.
13. S.Siddiqui, S.Hamid, G.Rafique, S.A. Chaudhry, N. Ali, S. Shahab, R.Sauerborn Prescription practises of public and private health care providers in Attock district of Pakistan; Int J Health Plann Mgnt 2002: 17: 23-40.
14. Manju Toppo, Nirmal Verma, Teeku Sinha, Subhra Agrawal Prescription analysis report in Chhattisgarh SHRC Indian J Pharmacol 2004; 31:151-3.
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A Clinicomicrobiological Study of Enterococcus Species with Special Reference to Its Virulence Factors
Abstract: Clinical samples were screened for enterococcus species. 215 enterococcal isolates were biochemically characterized. Seven species of enterococcus could be identified. The isolates were further screened for the presence of virulent factors such as hemolysin, gelatinase, enterococcal surface protein (esp) and aggregation substance (Agg) both phenotypically and genotypically. Virulent factors are known to cause an increase in the severity of the infection in animal models. The isolates produced 54 (25%), 77 (36%), 122 (57%) and 2(1%) of hemolysin, gelatinase, enterococcal surface proteins and aggregation substance respectively. The hemolysin (cylA) and gelatinase (gelE) genes did not correlate with their respective phenotypic expression indicating the presence of silent genes. The urine isolates had the maximum number of virulence factors.
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6. Jayanthi S, Anantha subramanian N, Appalaraju B. Assessment of pheromone response in biofilm forming clinical isolates of high level gentamycin resistant Enterococcus faecalis. Indian J Med Microbiol 2008; 23:248-51.
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12. Jones RN, Marshall SA, Pfaller MA, Wilke WW, Hollis RJ, Erwin ME, Edmond MB, Wenzel RP. Nosocomial enterococcal blood stream infections in the SCOPE Program: antimicrobial resistance, species occurrence, molecular testing results and laboratory testing accuracy. SCOPE Hospital Study Group DiagnMicrobiol Infect Dis 1997; 29: 95-102.
13. Gordon S, Swenson JM, Hill BC, Pigott NE. Facklam RR, Cooksey RC, et al. Antimicrobial susceptibility patterns of common and unusual species ofenterococci causing infections in the United States. Enterococcal Study Group.JClinMicrobiol 1992; 30: 2373-8.
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15. Devi PS, Rao PS, Shivananda PG. Characterization, antibiotic susceptibilitypattern and detection of beta-lactamases in Enterococci. Indian J PatholMicrobiol 2002; 45: 79-82.
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18. Carvalho MG, Teixeira LM, Facklam RR. Use of tests for acidification of methyl-alpha-D-glucopyranoside and susceptibility to efrotomycin for differentiation of strains of Enterucoccusand some related genera. J ClinMicrobiol 1998; 36: 1584-7.
19. Desai PJ, Pandit D, Mathur M, Gogate A. Prevalence, identification and distribution of various species of enterococci isolated from clinical specimens with special reference to urinary tract infection in catheterized patients Indian Journal of Medical Microbiology 2001; 19: 132-7.
20. Shankar V. Baghdayan AS, Huycke MM, Lindahl G, Gilmore MS. Infection derived Enterococcus faecalis strains are enriched in esp, a gene encoding anovel surface protein. Infect Immun 1999; 67: 193-200.
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Role of Neonatal Foot Length as Alternative Predictor of Low Birth Weight
Introduction: LBW is the major public health problem in India. The perinatal mortality in LBW babies is 8 times higher than that in infants weighing more than 2500gms. 74% of India’s population lives in rural areas. Most of the deliveries in rural areas conducted at home by untrained relatives and dais where weight recording is a problem. Aim and objective: To overcome the logistic problems associated with weighing the newborns in the field, a study was undertaken to assess the usefulness of neonatal foot length (FL) as an alternative to birth weight in identifying low birth weight babies specially below 2000 gms. Methods: nine hundred and thirty four live born neonates having weight below 2500 gms were studied at Sassoon general hospital, block no 20, the postnatal wing where the neonates are kept with their mothers. Birth weight and FL were recorded within 24 – 48 hrs of birth by standard procedures. Results: results showed significant correlation between birth weight and FL (r=0.70). The correlation was significant in preterm neonates (r=0.54). Mean weight of LBW babies was 2183.88 ± 255.04 gms. the mean birth weight of preterm newborn was 1856.8 ±249.4 gms. The mean FL was 6.67 ± 0.47 cm. the mean FL of preterm newborns was 6.21 ± 0.28 cm. sensitivity and specificity of FL at cut off point of < 6.75 cm for identifying low birth weight babies specially below 2000 gms was 92.8% and 65% respectively. Conclusion: Measurement of FL being simple alternate,low cost, reliable, and practicable method for identification of LBW babies specially below 2000 gms can be used by a person with little training in community.
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Comprehensive Eye Care with Community Development in Rural Area
Abstract: Dang is the smallest, poorest and backward tribal District of Gujarat state in India.It is one of the underdeveloped district of the country. The goal was to develop comprehensive eye care with community development in 73 villages with active community participation. The objective of the programme was explained with various community groups. To identify the urgent needs, it was decided to do the community assessment. Problems faced by community were tackled. Training imparted to various Health workers. The programme was implemented from year 2001 and yearly monitoring and evaluation was done. The reviewing of results showed satisfactory results. Comprehensive eye care programme with active community participation leading to improvement in general health, control of avoidable blindness, development of referral system, networking and linkages with Govt. and NGO’s has helped in achieving Millennium Development Goals and sustainable eye care programme along with community development is develop in tribal area.
1. Rao GN, Khanna RC, Athota CM, Integrated model of Primary and Secondary Eye care for underserved rural areas , The LV Prasad Eye Institute experience, Indian Journal of Ophthalmology, 2012; 60:396:400.
2. T/B of Preventive and Social Medicine, K Park, 21st edition, Bhanot Publishers, 828-830.
3. Kovai V, Krishnaih S, Shamanna BR, Barriers to accessing eye care services among visually impaired population in Rural Andhra Pradesh, South India, Journal of Ophthalmology, 2007, 55:365-71.
Detection of Mediastinal Masses in Adult Patients Using Spiral Computerised Tomography
Introduction: Since, its advent, Computerised Tomography (CT) has emerged as the main technique to evaluate mediastinum. CT has become the imaging method of choice in the evaluation of mediastinal widening or suspected mediastinal abnormalities. CT has the ability to distinguish density differences as well as provide a 3 dimensional cross sectional view of anatomic relations. A variety of imaging modalities are available for investigating the mediastinum, but CT and Magnetic Resonance Imaging (MRI) are undoubtedly the most versatile radiological investigation for evaluating an abnormality demonstrated on high kv chest radiograph.
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Synthesis And Characterization Of Lanthanum Doped Mg-Zn Ferrite Nanoparticles Prepared by SOL-GEL Method
R. U. Mullai, P. Priyadharsini Pradeep, G. Chandrasekaran
Abstract: The Ferrite compositions of La substituted Mg0.5Zn0.5LaxFe2-xO4 (x=0.0, 0.025, 0.05, 0.075, 0.1) are prepared using sol-gel citrate-nitrate. The as prepared powders are annealed at 600Ëš c to improve structural and magnetic properties. The thermal behavior of ferrite from its gel is studied by using DSC and the structural and morphological studies of the ferrites have been investigated by using XRD, SEM-EDAX and FAR-IR respectively. The magnetic properties of the samples are studied using VSM at room temperatures. The samples are found to exhibit saturation magnetization. Lanthanum doped Mg-Zn ferrites are found to exhibit large relaxation which make them useful for microwave applications.
Introduction: Migration is an important demographic event and needs to be studied by Public Health Experts. As migration is a facet of population growth & development assessing patterns helps understand the dynamics of society.In this study, the pattern of interstate & international migration in different zones is compared and various socioeconomic factors influencing migration are assessed along with their reasons for migration.Materials and Methods: The study is based on the secondary data of 1991, 2001 Census of India. Zone wise comparison was studied for patterns & reasons for migration among interstate&international migrant (based on last place of residence, for all duration).The official census data was analyzed using SPSS version 17.Results:The study findings show that, North Zone of India has highest interstate migrants, amounting to 11 % of the total population as per Census 2001 data. The work & business have been found as main causes for interstate migration in Western zone while education as the major cause for interstate migration in southern zone of India, excluding marriage and other reasons for migration. Looking at data from 1971 to 2001, there is significant correlation (Pearson Correlation 0.752) between Gross National Income per capita and Internal Migration (P < 0.01).On Further analysis of Census 2001 data it was noted that there is significant correlation (Pearson Correlation 0.388) between literacy rate of states receiving in-migrants and education as a reason for migration (P < 0.05) among interstate migrants. Similarly ‘work’ as the reason for migration among International migrants was observed to be more in states with higher GDP (Pearson’s Correlation 0.411) Conclusion: Higher the literacy rates, GDP, urbanization, all favors migration. More research is required to know the educational levels of migrants who mention education as reason for migration.
1. International Institute of Population Studies. Master of Population Studies- Block 2, Migration: concepts, Measures, determinants and Consequences:7
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3. World Bank national accounts data: 1971 – 2001.
4. Bhagat, R.B. Internal migration in India: Are the Under Privileged Migrating More. Asia Pacific Migration Journal, vol.25, no.1: Positive association between per capita income with total migrants at state level.
5. D.P. Singh. Migration and Occupation in Mumbai: Issues and Implication. Paper presented on 35th International Conference of International Conference of International Union for study of population (France) July 18 -23, 2005.
6. R.Lusome & R. B. Bhagat. Trends and patterns of internal Migration in India, 1971 -2001 – Paper presented at annual Conference of Indian Association for study of population (IASP) during 7 – 9 June, 2006, Thrivananthapurm.
7. Ronald Skeldon. Interlinkages between Internal & International Migration and development in the Asian region. Population, Space, & Place, 12, 2006:15-30.
8. Amitabh K.(2012) Migration & Exclusionary Urbanization in India. Economic & Political Weekly: Vol XLVII Nos 26 & 26. Pg 219 – 227: Migration less common among poor socio economy strata as seen with decreased migration in search of employment & increase in business & study related mobility in India
Giant Retroperitoneal Lipoma: a Case Report and Review
Abstract: Retroperitoneal lipomas have remained the essentially rare tumors seen in clinical practice. There are very few reported cases in surgical literature worldwide.Case: The authors report a case of giant retroperitoneal lipoma in a 35-year-old female, with a history of pain and abdominal distension. Abdominal ultrasonography and CT scan of abdomen showed a large mass located in the retroperitoneal space. Laparotomy showed a large encapsulated tumor measuring 40 x 30 x 10 cm and weighing 8kg. The histological study revealed a benign neoplasm of fatty cells. The patient had a good postoperative performance status. Conclusion: Lipomas should be considered in the differential diagnosis of a solid tumor in the retroperitoneal space and treatment of retroperitoneal lipomas is eminently surgical.
Abstract: The aim of the present study was to evaluate the association between plasma Osteopontin (OPN) levels and ischemic Heart disease (IHD).OPN is a bone related protein present within the atherosclerotic plaque. OPN is 44kDa glycoprotein which is implicated in the regulation of biological phenomenon including atherosclerosis. Plasma OPN level was measured from 115 patients (age36 to 66 years) who underwent coronary angiography OPN level of patients with IHD is not significantly different than that of non IHD patients. Hence plasma OPN cannot be considered as an independent risk factor for development of IHD.
1. Michael H Crawford, Current Diagnosis and Treatment in Cardiology, Second edition Chapter 3: Chronic ischemic heart disease. Mc Graw-Hill’s Access Medicine, 2007.
2. Susan Amanda Lund,Cecill a m Giachelli. The role of Osteopontin in inflammatory processes, J Cell Commun. Signal 2009; 3:311-22.
3. Gul Gursoy ,Yasur Acar, Selma Alagz . Osteopontin: A multifunctional molecule. Journal of medicine and medical science. 2010; Vol. 1(3) pp 055-060.
4. Cecilia M.Giachelli,Susan steitz ,Osteopontin :a versatile regulator of inflammation and biomineralization.Matrix Biology 19 2000; 615-22.
5. L.A.Fitzpatrick A, Severson, W.D.Edwards and R.T. Ingram, Diffuse calcification in Human Coronary Arteries Association of Osteopontin with Atherosclerosis. The Journal of Clinical Investigation Inc. 1994; Vol. 94:1597-1604.
6. Reiko Ohmori,Yukihiko Momiyama ,Hiroaki Taniguchi ,Rie Takahashi,Masatoshi Kusuhara et al.Plasma Osteopontin levels are associated with the presence and extent of coronary artery diseas. Atherosclerosis, 2003; 170:333-37.
7. Wendelin saarenhovi, Mervi Oikonen,Britt-Marie Loo.Markus Juonala ,Milka Kahonen ,Jorma S.A.,Virari and Oll T.Raitakari.[abstract]. Plasma Osteopontin is not associated with vascular markers of subclinical atherosclerosis in a population of young adults without symptoms of cardiovascular disease. The cardiovascular Risk in Young Finns Study, Scandinavian Journal of Clinical and Laboratory Investigation. 2011; vol .71, 683-89.
Clinical Profile, Etiological Factors and Outcome of Acute Renal Failure in Children: A Clinical Study
Sk Mohammed Ajaz, Minhaj S Pathan, Khaled Mohsin Badaam
Abstract: Acute Renal failure is a syndrome characterised by acute decline in glomerular filtration rate leading to retention of nitrogenous wastes such as urea and creatinine. 56 Acute Renal Failure patients were included in the study who attended our hospital during the study period. Out of the total 56 patients included for the study analysis, 34 patients were males and 22 were females’ indicating that frequency of acute renal failure was more in males as compared to females with a male: female ratio of 1.54:1. Children in the age group of 5-8 years were most commonly affected followed by children between 9-12 years, 1-4 years and less than one year in decreasing order. Oliguria was the most common presenting complaint in the patients. Vomiting, haematuria, fever were other common complaints. Intrinsic renal pathology was the commonest cause of acute renal failure in enrolled patients, followed by pre-renal and post-renal causes. Acute glomerulonephritis was the commonest etiology of intrinsic renal failure. Age less than one year, female sex, Acute Tubular Necrosis, Obstructive Uropathy, Haemlytic Uremic syndrome, presence of CNS complications and prolonged oligoanuria were associated with poor prognosis. The mortality rate was 25% in the present study.
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5. Kandoth PW, Agarwal GJ, Dharnidharka VR: Acute renal failure in children requiring dialysis therapy. Indian Paediatr., March 1994, 31(3): 305-09
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A Prevalence Study of Risk Factors for Chronic Diseases among Police Personnel in a Metropolitan Area
Nikhil N. Tambe, Vivek Singh, Kiran Narang, Vikrant Tambe, Rajesh B. Goel
Abstract: Police are backbone for maintaining law and order within the limits of city. Their motto is ‘to protect the good and punish the evil’; but they are themselves punished by the evil- CHRONIC LIFESTYLE DISEASES. They suffer from stress related to their work-uncertain duty hours, transferable jobs, inadequate sleep, addiction to alcohol and tobacco. Hypertension, diabetes, acute coronary syndromes, obesity and even cancer are some of the major chronic health diseases commonly observed due to their hectic and stressful lifestyle. This study was carried out to assess the risk factors among police personnel, contributing to chronic diseases like obesity, hypertension, diabetes and creating awareness of the same. It emerged that almost 49% of police personnel in study population of 443 were overweight, alcohol and tobacco consumption accounted to 28%, 20% were hypertensive, 11% diabetics and smoking observed in 8%. This study provided us with data about the health status in police community and will help us in devising new strategies to bring about a healthy change in their life style. Such study if carried out periodically will help reduce the rampant problem of chronic health diseases in police community at primordial level.
1. WHO global report: Preventing chronic diseases: a vital investment. Available from URL: http://www.who.int/chp/chronic_disease_report/contents/en/index.html
2. K. Park; Park’s Textbook of Preventive and Social Medicine 20th ed. , Banarsidas Bhanot Publisher, India : 2009.
Protein-Protein Interaction-Yeast two Hybrid System
Abstract: Many proteins recognize and bind to other proteins. The total of all protein-protein interactions is sometimes referred to as the protein interactome by those enthusiastic about “omics†terminology. Mass screening of such interactions has proved possible by means of the “Two hybrid†system. It is assumed that the binding of a novel protein to one that is well characterized may provide some hint as the function. Two hybrid analyses depend on the modular structure of transcriptional activator proteins. Many of these proteins contain two factor domains -DNA Binding Domain (DBD) and Activation Domain (AD). The DBD recognizes a specific sequence in the DNA upstream of a promoter and the AD stimulates transcription by binding to RNA polymerase. Provided that the two domains interact, they will activate transcription. The whole experiment is based on this principle of Yeast two Hybrid system.
1. Diversity in Genetic In Vivo Methods for Protein-Protein Interaction Studies: from the Yeast Two-Hybrid System to the Mammalian Split-Luciferase System Microbiol. Mol. Biol. Rev., 76 (2) 331-382, 2012.
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3. A yeast two -hybrid system reconstituting substrate recognition of the von Hippel-Lindau tumor suppressor protein Nucleic Acids Res., 35 (21) e142, 2007.
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Anatomy Post Graduation as Career Option: A Situational Analysis
Abstract: Medical graduates often have confusion after PG entrance while selecting Branch for Post graduation. Large numbers of medical colleges facing difficulty in getting anatomy faculty. Situational Analysis is one method to understand situation in simpler manner. Research Question: What is the present scope of Anatomy Post-graduation as career option? Aims & Objectives: 1. To carry out situational Analysis of Anatomy PG Seat in Medical colleges, 2.To Suggest suitable recommendation based on study findings. Methodology: Present situational analysis based on data of official web page of Medical Council of India (On March 2012) www.mciindia.org. in which we use PG college database and faculty database, All these data were entered in Microsoft excel sheet and analyzed by using statistical software SPSS version 16.Situational Analysis: Total number of Medical colleges in India 335(till March 2012) of which only 198(59.1%) colleges having PG seat in Anatomy Discipline. Annual Anatomy PG seat intake in all colleges was found to be 610.Total MBBS seat intake Yearly 40525, the ratio of MBBS to Anatomy PG seat is 100: 1.5. Karnataka is having highest number of anatomy PG seat annually 92(15.1%), followed by Maharashtra 91 (14.9%), Andhra Pradesh 70 (11.5%). These three state namely Maharashtra, Karnataka, A.P is contributing about 42.7% PG seat in India. In Last Five year 42.8% colleges are in process of increasing PG seat. Till now 21% college PG seat intake permitted in 10(A) section of MCI. Total numbers of Anatomy faculty in India are 3774.
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Abstract: The variation in the anterior part of the circle of willis is quiet rare and finding multiple variation in single case is still rare. During routine dissection we noted multiple anomalies in form of hypoplasticity, duplication and persistence of embryonic pattern in the form of azygous artery in the right anterior cerebral artery. Any variation in the vessels of circle of Willis influences the change in the haemodynamics of blood supply to the brain. such variations also play a great role in the decision of line of management of the patient. The awareness of this rare anatomical variant is important considering today advanced imaging modalities and give consideration to its potential serious complications with fellow clinicians.
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Effect of Pranayama Training on Cardiovascular Parameters
S.P. Surwase, D.N. Deore, U.S. Zingade, P.R. Deshmukh, A.K. Zombade, Shazia
Objectives- To study the effect of pranayama training on cardiovascular parameters. Design- Longitudinal study. Settings/Location- Government Dental College, Aurangabad. Subjects- 60 Normal healthy females and males volunteers in the age group of 30 to 50 years ready to give consent. Subjects were divided randomly into two groups of 30 individuals act as subjects and control. Trial was registered under WHO and CTRI trial registry systems. CTRI registration no. is CTRI/2012/03/002512 and WHO registry no. is UTN- U1111-1129-2155. Interventions- Pranayama training camp will be conducted 45 minutes daily for 1 month. The exercises include slow and fast breathing exercises like ‘nadishuddhi’, ‘mukh-bhastrika’, ‘pranav’ and ‘savitripranayama’. Outcome Measures- Cardiovascular efficiency will be tested by using parameters like
1. Systolic blood pressure
2. Diastolic blood pressure
3. Heart rate and Systolic time intervals involving pre-ejection period (PEP), left ventricular ejection time (LVET), total mechanical systole (QS2) & PEP/LVET ratio.
Results- Pranayama training for 1 month resulted in significant decrease in systolic blood pressure (<0.0001) & LVET (<0.0001) whereas QS2 (<0.0001) and PEP (<0.0001) were increased significantly.PEP/LVET ratio which is a sensitive index of cardiac performance was significantly increased after the training. Conclusion- Our study shows that pranayama training improves ventricular performance by increasing parasympathetic activity.
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Allopurinol in Inflammatory Arthritis (probably Gout): Indian Perspective in Light of EULAR Recommendations
Amit R Burande, Amit Kale, Meeta A Burande, Nitin Deshpande
Introduction-Hyperuricemia (solubility point of Mono Sodium Urate Crystal i.e. 7.1 mg/dl) is associated with gout and present in 0.2 to 2% of Indian popultion. EULAR has published the guidelines for the diagnosis of gout based on evidences. In this study, we tried to evaluate clinical correlation of arthralgia with serum uric acid level in Indian patients and benefit from Allopurinol treatment. Material and Methods-Study design - Prospective, open labeled single arm Study carried out in Hospital attached to Medical University. Exclusion Criteria were Patients having definitive diagnosis for the etiology of arthralgia or Definitive Gout by clinical diagnosis as per EULAR recommendation. Inclusion criteria were Patients having the history of use of analgesic with persistent symptoms, having less than 4 EULAR criteria for gout and willing to be enrolled in the study. Intervention - Allopurinol 100 mg twice a day was given to patients and clinically assessed on day 1, day 10 and at 4 week
Sample size: 28 patients were included in the study and follow up.
Results – In elderly age group incidence is same in both sexes. Purine rich diet increases the risk five times with more risk of precipitation of symptoms at lower level of uric acid. Most common site of presentation was knee pain i.e. 50%. Serum Uric acid at enrollment was 6.76+0.99 that reduced to 3.74+0.63 at four week with dissolving of symptoms. Conclusion–There is a subset of Gout in elderly Indians, which is more prone to precipitation of symptoms at lower level of serum Uric acid and equal gender distribution. Hyperuricemia in patients may be defined on 5.0 mg% and target level should be kept less than 4.0 mg in Indians.
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Influence of Certain Factors on Overweight and Obesity among Undergraduate Medical Students at Vizianagaram
Introduction: In recent years, developing countries like India have been experiencing a nutritional transition in food choices from typically starchy (mainly carbohydrate diets) to fast food pattern and as a result, the dietary habits of young adults like medical students have been affected. Obesity is associated with a large number of debilitating and life-threatening disorders, such as increase in associated cardiovascular, metabolic and other non-communicable diseases. Aim and Objectives: To determine the influence of certain dietary habits and life style on body weight of medical students. Materials and Methods: Descriptive cross sectional study was conducted in 263 MBBS students. The study questionnaire covered demographic details, eating habits, types of food, exercise and lifestyle. The Body mass index (BMI) was calculated from weight (kg) & square of height (m). Various factors influencing overweight and obesity were analyzed. Results: Overweight and obesity was detected in a total of 41 students. Significant difference was observed between mean BMI of normal weight(21.23±1.71kg/m2) and overweight-obese (27.08±2.51kg/m2) students. Factors such as irregular diet (OR=2.79), restaurant visits (OR=2.96), family history of diabetes (OR=1.99) and obesity (OR=3.48) were associated with significantly higher risk of overweight and obesity. Conclusions: Obesity per se was detected as an uncommon occurrence as compared to overweight or pre-obesity which may turn to obesity in future life. Prevalence of overweight and obesity in young adults similar to national figures is alarming and warrants the need for regular risk factor screening and young adult-based approaches such as changes in life style and health education.
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Unilateral Merging of Musculocutaneous Nerve with Variant Branching of Median Nerve
Abstract: Variations of brachial plexus in different ways are very often detected in upper limb. During our study, in a 75 years old cadaver we found the musculocutaneous nerve communicating with median nerve in the left arm. The musculocutaneous nerve gave a branch to coracobrachialis then the nerve merged with the lateral root of median nerve. Later the area of innervations of musculocutaneous nerve was replaced by Median nerve. The Median nerve originated normally from the union of medial and lateral root but gave two muscular branches in the arm, to Biceps brachii, Brachialis & a sensory branch which continued as lateral cutaneous nerve of forearm. The course of Median nerve in the forearm was normal. The Musculocutaneous nerve of right side was present with normal course & routine branches.
Objectives: 1) To assess the awareness about Cancers in an Urban Slum population of Mumbai. 2) To assess the impact of health intervention on awareness of slum population about various Cancers. Materials and Methodology: A community based descriptive epidemiological interventional study was conducted at Cheetah Camp urban slum which is a field practice area of Department of Preventive and Social Medicine, of TN Medical College Mumbai during January 2008 to October 2009. Population above 40 years of age were included in this study. Sample was selected using cluster sampling method. The information was gathered by personal interview using semi-structured questionnaires. Results: Out of 525 study participants Out of 525 study participants, males were 50.48%. 169 (32.2%) participants thought that cancer is a disease; whereas 109 (20.6%) participants were not able to describe cancer. Regarding general initial symptoms of cancer, 272 (51.8%) don’t knew any symptom. Commonest risk factor known to participants (450, 85.7%) was tobacco consumption. Awareness of participants about prognostic factors, screening facilities, screening centres of cancers, treatment centres of cancer was very poor. After health intervention improvement in the knowledge of study participants about various cancers was seen. Conclusion: Awareness of study participants about cancers was very poor. There is a need for awareness generation programs to educate population about various common cancers. Propagation of correct messages and promotion of early detection of cancers should be stressed.
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Effect of Specific Stabilization Exercise versus Conventional Back Extension in Management of Chronic Herniated Pulposus
Sucheta Golhar, Amit V. Nagrale, Tanpreet kaur Bagga
Background: Local stabilizing musculature activation occurs automatically in a preparatory manner prior to movement. Failure of this preparatory stabilizing mechanism is identified as primary cause of persistence low back pain. The aim of this study was to investigate whether specific stabilization exercises or conventional back extension exercises are effective in people with Chronic Herniated Pulposus (HNP). Materials and Methods: 20 patients with Chronic Herniated Pulposus (HNP) were randomized into two groups. 10 patients in Group A received Specific stabilization exercise while 10 patients in Group B received conventional back extension exercise. Pain perception was measured using the Visual Analogue Scale (VAS). Disability was measured using the Ronald – Morris Disability Questionnaire (RMDQ). Both the intervention periods were delivered at 5 times/week for 4 weeks. Results: Training of the specific stabilization exercise in group A showed a significant improvement in decreasing pain and in improving functional ability when compared to strengthening exercise in group B at p <0.05 (t-test). Conclusion: There was decrease in the pain intensity and improvement in functional level in patients who were given conventional back extension exercise but there was a more marked relief in patients who were given Specific stabilization exercises after a treatment protocol of four weeks.
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Why and How Aerobic Mesophilic Composting is Effective? A Comprehensive Study on Aerobic and Anaerobic Composting of Green Waste under Mesophilic and Thermophilic Conditions
Abstract:The relative advantage of aerobic-mesophilic(ARM) condition forgreen waste composting over other conditions such as aerobic-thermophilic(ART), anaerobic-mesophilic (ANM) and anaerobic-thermophilic (ANT) is evaluated in the present investigation. A perusal of results indicated that ARM is the most favorable condition for green waste composting as it facilitates the growth and development of cellulolytic microbesand increasing their cellulose activity required for lignocellulosic degradation. Although, aerobic thermophilic condition (ART)was found to increase the rate of cellulose degradation, it was not mediated through cellulase activity. The effect of thermophilic phase on lignocelluloses wasmere physical in nature. The quality assessment studies on finished compost also confirmed ARM as the most favorable condition for composting.
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Maternal Risk Factors Determining Birth Weight of Newborns: A Tertiary Care Hospital Based Study
P. S. Thomre, A. L. Borle, J. D. Naik, S. S. Rajderkar
Introduction: Globally, more than 20 million infants are born with low birth weight. The number of low birth weight babies is concentrated in two regions of the developing world: Asia and Africa. 72% of low birth weight infants in developing countries are born in Asia where most births also take place, and 22% are born in Africa. India alone accounts for 40% of low birth weight births in Asia. . The reduction of low birth weight also forms an important contribution to the Millennium Development Goal (MDG) for reducing child mortality. The factors associated with intrauterine growth retardation are multiple and interrelated to mother, placenta and foetus. Objectives: 1) To study the ‘Birth weight’ pattern among study group. 2) To identify the maternal factors associated with low birth weight of newborns. Material and Methods: The present cross sectional study was carried out in Government Medical College & Hospital, Miraj amongst all the mothers and newborns delivered at institution during the period of one calendar year from January 2007 to December 2007. The data was collected with the help of interview technique using predesigned and pretested questionnaires followed by the thorough clinical examination and anthropometric measurements of mother and newborn. Interview was followed by thorough clinical examination and necessary investigations. Results & Conclusion: Low birth weight was found to be present in 92 (18.1%) newborns. The internal comparison was made among the study subjects with normal birth weight babies and those with low birth weight babies using the bivariate analysis and multiple logistic regressions. The factor found significantly associated were gestational age at delivery, number of antenatal visits, anemia, gestational age at 1st ANC visit, bad obstetric history, mothers weight, socio-economic status, birth interval, type of work, iron and folic acid supplementation, religion, sex of new born and gravida.
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Congenital Dyserythropoitic Anemia Type I Presenting as Congestive Cardiac Failure in Neonatal Life
Anilkumar M. Khamkar, Manish M. Tiwari, Pallavi P. Saple, Amol Suryawanshi, P.M.Zadke, Manisha Surwade
Abstract: Congenital Dyserythropoietic Anemias (CDAs) constitute a heterogeneous group of rare inherited disorders, characterized by moderate to severe anemia due to a markedly ineffective erythropoiesis with an erythroblastic bone-marrow and specific erythroid morphological anomalies. Three major types of CDA and a number of variants have been described. The diagnosis and categorization of these disorders are facilitated by microscopic examination of the blood and bone marrow and by serologic testing. The severity of Anemia varies considerably within and between families. We report a case of CDA type I in a neonate who presented as congestive cardiac failure secondary to severe Anemia who also had PPHN due to LVF. Baby succumbed to death on day 1 of life itself. Clinical profile and laboratory investigations were consistent with CDA type I.
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Issue details
Drug Prescription Practices among Paediatric Patients in Yavatmal, Central India
Ajapuje P., Dhengre P., Giri V.C., Khakse G.M
The rational use of drugs requires the patient to receive medicines appropriate to their needs in doses that meet their individual requirement for adequate period of time and at lowest cost. Rational use of drugs forms the corner stone of successful implementation of rational use of medicines(1). Medically inappropriate, ineffective, non-economical use of pharmaceutical product is commonly observed in health care system throughout the world and especially so in developing countries (2). Inappropriate prescription not only increases the cost of medical treatment but also increases the morbidity and mortality. Third world population spends 30-40% of their total health budget on drugs many of which are prescribed irrationally. These countries double their expenditure on drugs every 4 years while GNP double every of 16 years. (3). Thus there is an urgent need to ensure that the patients are always given evidence based cost effective & rational treatment. Children constitute 40% of Indian population. Infant and children are the most vulnerable group of population suffers from frequent but usually non serious illness. Most of these are self limiting (4) and treated not only inappropriately but also reporting to polypharmacy (5). Compared to adult medicines drug use in paediatrics is not extensively researched and range of licensed drug in appropriate dose form is limited (6). One significant study has shown that potentially harmful medication error can be three times more common in paediatric population than in adults (7). Prescriber and consumer are flooded with vast array of pharmaceutical preparation with innumerable trade names, available often at unaffordable prices. Considering these facts, the present study was planned to understand the prescription pattern of paediatric patient in Yavatmal, Central India.
1. Ansari KU, Singh S, Pandey RC. Evaluation of prescribing pattern of doctors for rational drug therapy. Indian J Pharmacol. 1998; 30:43-46. 2. Melrose D. Double deprivation public and private drug distribution from the perspective of the third world’s poor .World Dev .1983; 11:181-6. 3. Mohanty BK, Ashwini M, Hasamnis AA, Patil SS,Murty KSN,Jena SK. Prescription pattern the department of a tertiary care hospital in Rajamundry, India. Journal of Clinical & Diagnostic Research 010 Feb ;(4): 2047-51. 4. Strand J,Rockstad K,Heggedal U. Drug prescribing for children in general practice: A report from the more and Romsdal prescription study ,Acta pediatrica 1988,87:218-24. 5. Ghai OP,Paul VK Rational Drug Therapy In Pediatric Practice, Indian Pediatric 1988;25:1905-1909. 6. Roager Walker, Clinical Pharmacy and Therapeutics,4th edition Published by Elsevier Churchill Livingston 7. Kaushal R, Bates DW, Landrigan C,McKenna KJ,Clapp MD,Federico F,et al. Medication errors and adverse drug events in pediatric inpatient. J Am Med Assoc. 2001; 285:2114-20. 8. Sanz EJ, Boada JN. Drug utilization by children in Tenerif Island,Spain. Eur J Clin Pharmacol.1998; 34:495-99. 9. Janaki R. Torvi ,Suman Dambal.Drug prescription pattern in pediatric outpatient clinic in a tertiary hospital. Curr Pediatr Res 2011; 15(2):77-80. 10. Gajjar BM, Desai S, Srivastava S. Evaluation and comparison of prescribing pattern of ohysician from “The Institute†and “The Private†sectors for rational drug therapy. Vallabh Vidyanagar,S.P University,1999. 11. Prakash O, Mathur GP, Singh YD, Kushwalia KP. Prescription audit of under six children living in periurban areas.Indian Pediatr.1989; 26:900-04. 12. Nazima Y. Mirza,Sagun Desai ,Barna Ganguly. Prescribing pattern in a pediatric out-patient department in Gujarat. Bangladesh J pharmacol 2009; 4:39-42. 13. WHO Model list of essential medicines 16th edition,2011 14. McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 995; 273:214-219.
Comparative Analysis of Prescription Writing by Teaching and Non-Teaching Clinicians in and around Guntur
G. B. Simpson, G. Naveen Choudary
Aim: To study the prescribing patterns of clinicians working in two different settings. i.e. a) Teaching clinicians (clinicians working in teaching hospital) and b) Non-teaching clinicians (clinicians involved in private practice). Materials and methods: Comparative cross sectional study was carried out for a period of 6 months in 2 different settings. The study is confined to a) Qualified medical practitioners in Katuri medical college and hospital (Teaching clinicians) b) Qualified medical practitioners in Private health sector(PMPs) or (Non-teaching clinicians).450 prescriptions were collected from clinicians belonging to various departments of KMC &H and 450 prescriptions from private practitioners of Guntur city. Data were coded and entered with the help of a statistician to minimize data entry errors. Data were analysed on EPINFO version 3.5.4 and MS EXCEL. Results: It was found that non-teaching clinicians prescribed in average number of drugs for prescription (3.28) more than teaching clinicians (2.82).Teaching clinicians prescribed 73 drugs (5.75%) by generic name, whereas non-teaching clinicians prescribed 62 drugs (4.18%). Number of drugs prescribed from essential drug list was compared in both the settings. Teaching clinicians prescribed 860 drugs (67.76%) from the essential medicines list, whereas non-teaching clinicians prescribed only 574 drugs (38.78%) from the essential medicines list. Number of injectables prescribed by both categories of clinicians is compared. Non-teaching clinicians prescribed 130 drugs (8.78%) compared to 52 drugs (4.09%) by teaching clinicians. Teaching clinicians prescribed 283(28.30%) drug combinations compared to 462(31.21%) drug combinations prescribed by non-teaching clinicians. Among the total drugs prescribed in different categories by teaching clinicians more than 46% (46.48%) were from two major groups, antimicrobials 24.11% and NSAIDs 22.37%. Non-teaching clinicians prescribed about 54% (54.04%) Antimicrobials 29.52% and NSAIDs 24.52%. Conclusion: The results indicate a considerable scope for improving the prescribing patterns of drugs in both the settings.
1. W.H.O Geneva. How to investigate drug use in health facilities EMD Research series No.7, 1993;3-27. 2. Choudhury RR, Sharma S, Research on rational drug use in India: A Gimpse 2003;1-29. 3. Trostle J, Inappropriate distribution of medicines by professionals in developing countries. Soc Sci Med,1996 42:1117-1120. 4. Saurabh MK.,Jaykaran, Prescription audit and rational use of drugs J of pharmacy research 2010,3(3),474-477. 5. Health Action International Asia-Pacific, Colombo. Position paper on rational drug use 2004: 1-3. 6. W.H.O Geneva. Model list of essential drugs, 2010. 7. Simpson GB, Das DG, Indian hospital drug use study shows need to improve prescribing. W.H.O Essential Drugs Monitor, 2003; 32:23. http://www.who.int/medicines/mon/32_13pdf 8. Hanumantha Rao Potharaju and S.G. Kabra Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra, Indian J Pharmacol. 2011 April; 43(2): 150–156. 9. Tarun Bhatnagar, C.P.Mishra, R.N. Mishra ‘Drug prescription practices: A household study in rural Varanasi’ Indian J. Prev.Soc.Med.2003 Vol. 34 No. 1&2. 10. T.M. Vijayakumar, D. Sathyavati, T. Subhashini, S. Grandhi and M.D. Dhanaraju, Assessment of prescribing trends and rationality of drug prescribing. International Journal of Pharmacology, 2011 7: 140-143. 11. S Sharif, M Al-Shaqra, H Hajjar, A Shamout, and L Wess, Patterns Of drug prescribing in a hospital in Dubai, United Arab Emirates; Libyan J Med. 2008; 3(1): 10–12. 12. Phalke VD, Phalke DB, Syed MMA, Mishra A, Sikchi S, Kalakoti P. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India. AMJ 2011, 4, 1, 4-8. 13. S.Siddiqui, S.Hamid, G.Rafique, S.A. Chaudhry, N. Ali, S. Shahab, R.Sauerborn Prescription practises of public and private health care providers in Attock district of Pakistan; Int J Health Plann Mgnt 2002: 17: 23-40. 14. Manju Toppo, Nirmal Verma, Teeku Sinha, Subhra Agrawal Prescription analysis report in Chhattisgarh SHRC Indian J Pharmacol 2004; 31:151-3. 15. Manoj kumar et al, Comparative study of prescribing behaviors of government doctors of teaching hospital and private practitioners in Jhalawar City (Rajasthan) J. Pharm. Sci. & Res. Vol.2(4), 2010, 208-215.
A Clinicomicrobiological Study of Enterococcus Species with Special Reference to Its Virulence Factors
Sharma Revati, Pai (Bhat) Chitra, Urhekar A.D
Abstract: Clinical samples were screened for enterococcus species. 215 enterococcal isolates were biochemically characterized. Seven species of enterococcus could be identified. The isolates were further screened for the presence of virulent factors such as hemolysin, gelatinase, enterococcal surface protein (esp) and aggregation substance (Agg) both phenotypically and genotypically. Virulent factors are known to cause an increase in the severity of the infection in animal models. The isolates produced 54 (25%), 77 (36%), 122 (57%) and 2(1%) of hemolysin, gelatinase, enterococcal surface proteins and aggregation substance respectively. The hemolysin (cylA) and gelatinase (gelE) genes did not correlate with their respective phenotypic expression indicating the presence of silent genes. The urine isolates had the maximum number of virulence factors.
1. Giridhara Upadhyaya PM, Umapathy BL, Ravikumar KL. Comparative study for the presence of enterococcal virulence factors gelatinase, hemolysin and biofilm among clinical and commensal isolates of Enterococcus faecalis. J Lab Physicians 2010;2:100-4 2. Malani PN, Kauffman CA, Zervos MJ. 2002. Enterococcal disease, epidemiology, and treatment, p 385–408. In Gilmore MS, The enterococci: pathogenesis, molecular biology, and antibiotic resistance. ASM Press, Washington, DC. 3. Facklam RR, Collins MD. Identification of enterococcus species isolated from human infection by a conventional test scheme. J ClinMicrobiol 1989; 27:731-734. 4. Creti R, Imperi M, Bertuccini L, Fabretti F, Orefici G, Di Rosa R. Survey for virulence determinants among Enterococcus faecalis isolated from different sources. J Med Microbiol 2004; 53:13-20. 5. Whaley DN, Dowell DR Jr, Wanderlinder LM, Lombard GL. Gelatin agar medium for detecting gelatinase production by anaerobic bacteria.J Clin Microbiol 1982 Aug;16(2) : 224-9 6. Jayanthi S, Anantha subramanian N, Appalaraju B. Assessment of pheromone response in biofilm forming clinical isolates of high level gentamycin resistant Enterococcus faecalis. Indian J Med Microbiol 2008; 23:248-51. 7. Eaton, T. J. & Gasson, M. J. Molecular screening of Enterococcus virulence determinants and potential for genetic exchange between food and medical isolates. Appl Environ Microbiol 2001; 67, 1628–1635. 8. Brtkova A, Filipova M, Drahovska H, Bujdakova H. Characterization of enterococci of animaland environmental origin using phenotypicmethods and comparison with PCR based methods. Veterinarni Medicina; 55, 2010 (3): 97–105. 9. Murray BE. The life and times of the Entcrococcus. ClinMicrobiol Rev 1990;3: 46-65. 10. Murray BE. Diversity among multidrug-resistant enterococci Emerg Infect Dis 1998; 4: 37 -47 11. Moellering RC Jr. Emergence of Ettterococcusas a significant pathogen. ClinInfect Dis 1992; 14: 1 173-6. 12. Jones RN, Marshall SA, Pfaller MA, Wilke WW, Hollis RJ, Erwin ME, Edmond MB, Wenzel RP. Nosocomial enterococcal blood stream infections in the SCOPE Program: antimicrobial resistance, species occurrence, molecular testing results and laboratory testing accuracy. SCOPE Hospital Study Group DiagnMicrobiol Infect Dis 1997; 29: 95-102. 13. Gordon S, Swenson JM, Hill BC, Pigott NE. Facklam RR, Cooksey RC, et al. Antimicrobial susceptibility patterns of common and unusual species ofenterococci causing infections in the United States. Enterococcal Study Group.JClinMicrobiol 1992; 30: 2373-8. 14. Jones RN, Sader HS, Erwin ME, Anderson SC. Emerging multiply resistant enterococci among clinical isolates. I. Prevalence data from 97 medical centersurveillance study in the United States. Enterococcus Study Group. DiagnMicrobiol Infect Dis 1995; 21: 85-93. 15. Devi PS, Rao PS, Shivananda PG. Characterization, antibiotic susceptibilitypattern and detection of beta-lactamases in Enterococci. Indian J PatholMicrobiol 2002; 45: 79-82. 16. Nischal M; Macaden R. Biochemical speciation and haemolytic activity in enterococci. lndian Journal of Medical Microbiology 1996; 14: 205-8. 17. Gulati V, Agganval A, Khanna S, Narang VK. Biochemical speciation ofenterococci causing human infections. Indian J Med Sci 1997; 5 1 : 3 10-2. 18. Carvalho MG, Teixeira LM, Facklam RR. Use of tests for acidification of methyl-alpha-D-glucopyranoside and susceptibility to efrotomycin for differentiation of strains of Enterucoccusand some related genera. J ClinMicrobiol 1998; 36: 1584-7. 19. Desai PJ, Pandit D, Mathur M, Gogate A. Prevalence, identification and distribution of various species of enterococci isolated from clinical specimens with special reference to urinary tract infection in catheterized patients Indian Journal of Medical Microbiology 2001; 19: 132-7. 20. Shankar V. Baghdayan AS, Huycke MM, Lindahl G, Gilmore MS. Infection derived Enterococcus faecalis strains are enriched in esp, a gene encoding anovel surface protein. Infect Immun 1999; 67: 193-200. 21. Willems RJ, Homan W, Top J, van Santen-Verheuvel M, Tribe D, Manzioros X, et al. Variant esp gene as a marker of a distinct genetic lineage of vancomycin-resistant Enterococcus faecium spreading in hospitals. Lancet2001; 357: 853-5. 22. Dupre 1, Zanetti S, Schito AM, Fadda G. Sechi LA. Incidence of virulence determinants in clinical Enterococcus faeciumand Enterococcus faecalis isolates collected in Sardinia (Italy). J Med Microbiol2003; 52: 491-8. 23. Kühnen E, Richter F, Richter K, Andries L. Establishment of a typing system for group D streptococci. Zentbl Bakteriol Hyg A. 1988;267:322–330.
Role of Neonatal Foot Length as Alternative Predictor of Low Birth Weight
Holambe V. M., Kakrani V. A. , Godale L. B.
Introduction: LBW is the major public health problem in India. The perinatal mortality in LBW babies is 8 times higher than that in infants weighing more than 2500gms. 74% of India’s population lives in rural areas. Most of the deliveries in rural areas conducted at home by untrained relatives and dais where weight recording is a problem. Aim and objective: To overcome the logistic problems associated with weighing the newborns in the field, a study was undertaken to assess the usefulness of neonatal foot length (FL) as an alternative to birth weight in identifying low birth weight babies specially below 2000 gms. Methods: nine hundred and thirty four live born neonates having weight below 2500 gms were studied at Sassoon general hospital, block no 20, the postnatal wing where the neonates are kept with their mothers. Birth weight and FL were recorded within 24 – 48 hrs of birth by standard procedures. Results: results showed significant correlation between birth weight and FL (r=0.70). The correlation was significant in preterm neonates (r=0.54). Mean weight of LBW babies was 2183.88 ± 255.04 gms. the mean birth weight of preterm newborn was 1856.8 ±249.4 gms. The mean FL was 6.67 ± 0.47 cm. the mean FL of preterm newborns was 6.21 ± 0.28 cm. sensitivity and specificity of FL at cut off point of < 6.75 cm for identifying low birth weight babies specially below 2000 gms was 92.8% and 65% respectively. Conclusion: Measurement of FL being simple alternate,low cost, reliable, and practicable method for identification of LBW babies specially below 2000 gms can be used by a person with little training in community.
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Comprehensive Eye Care with Community Development in Rural Area
Pradeep Sawardekar, Sunita Thorat, Gopa Kothari
Abstract: Dang is the smallest, poorest and backward tribal District of Gujarat state in India.It is one of the underdeveloped district of the country. The goal was to develop comprehensive eye care with community development in 73 villages with active community participation. The objective of the programme was explained with various community groups. To identify the urgent needs, it was decided to do the community assessment. Problems faced by community were tackled. Training imparted to various Health workers. The programme was implemented from year 2001 and yearly monitoring and evaluation was done. The reviewing of results showed satisfactory results. Comprehensive eye care programme with active community participation leading to improvement in general health, control of avoidable blindness, development of referral system, networking and linkages with Govt. and NGO’s has helped in achieving Millennium Development Goals and sustainable eye care programme along with community development is develop in tribal area.
1. Rao GN, Khanna RC, Athota CM, Integrated model of Primary and Secondary Eye care for underserved rural areas , The LV Prasad Eye Institute experience, Indian Journal of Ophthalmology, 2012; 60:396:400. 2. T/B of Preventive and Social Medicine, K Park, 21st edition, Bhanot Publishers, 828-830. 3. Kovai V, Krishnaih S, Shamanna BR, Barriers to accessing eye care services among visually impaired population in Rural Andhra Pradesh, South India, Journal of Ophthalmology, 2007, 55:365-71.
Detection of Mediastinal Masses in Adult Patients Using Spiral Computerised Tomography
Sartaj S Pathan, Minhaj S Pathan
Introduction: Since, its advent, Computerised Tomography (CT) has emerged as the main technique to evaluate mediastinum. CT has become the imaging method of choice in the evaluation of mediastinal widening or suspected mediastinal abnormalities. CT has the ability to distinguish density differences as well as provide a 3 dimensional cross sectional view of anatomic relations. A variety of imaging modalities are available for investigating the mediastinum, but CT and Magnetic Resonance Imaging (MRI) are undoubtedly the most versatile radiological investigation for evaluating an abnormality demonstrated on high kv chest radiograph.
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Synthesis And Characterization Of Lanthanum Doped Mg-Zn Ferrite Nanoparticles Prepared by SOL-GEL Method
R. U. Mullai, P. Priyadharsini Pradeep, G. Chandrasekaran
Abstract: The Ferrite compositions of La substituted Mg0.5Zn0.5LaxFe2-xO4 (x=0.0, 0.025, 0.05, 0.075, 0.1) are prepared using sol-gel citrate-nitrate. The as prepared powders are annealed at 600Ëš c to improve structural and magnetic properties. The thermal behavior of ferrite from its gel is studied by using DSC and the structural and morphological studies of the ferrites have been investigated by using XRD, SEM-EDAX and FAR-IR respectively. The magnetic properties of the samples are studied using VSM at room temperatures. The samples are found to exhibit saturation magnetization. Lanthanum doped Mg-Zn ferrites are found to exhibit large relaxation which make them useful for microwave applications.
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A Study to Assess Pattern of Migration across India Based on Census Data
Radha Taralekar, Prasad Waingankar, Pandurang Thatkar
Introduction: Migration is an important demographic event and needs to be studied by Public Health Experts. As migration is a facet of population growth & development assessing patterns helps understand the dynamics of society.In this study, the pattern of interstate & international migration in different zones is compared and various socioeconomic factors influencing migration are assessed along with their reasons for migration.Materials and Methods: The study is based on the secondary data of 1991, 2001 Census of India. Zone wise comparison was studied for patterns & reasons for migration among interstate&international migrant (based on last place of residence, for all duration).The official census data was analyzed using SPSS version 17.Results:The study findings show that, North Zone of India has highest interstate migrants, amounting to 11 % of the total population as per Census 2001 data. The work & business have been found as main causes for interstate migration in Western zone while education as the major cause for interstate migration in southern zone of India, excluding marriage and other reasons for migration. Looking at data from 1971 to 2001, there is significant correlation (Pearson Correlation 0.752) between Gross National Income per capita and Internal Migration (P < 0.01).On Further analysis of Census 2001 data it was noted that there is significant correlation (Pearson Correlation 0.388) between literacy rate of states receiving in-migrants and education as a reason for migration (P < 0.05) among interstate migrants. Similarly ‘work’ as the reason for migration among International migrants was observed to be more in states with higher GDP (Pearson’s Correlation 0.411) Conclusion: Higher the literacy rates, GDP, urbanization, all favors migration. More research is required to know the educational levels of migrants who mention education as reason for migration.
1. International Institute of Population Studies. Master of Population Studies- Block 2, Migration: concepts, Measures, determinants and Consequences:7 2. Census of India. Series 1, soft copy, India D series Migration tables. Registrar General & census Commissioner India. 2001. 3. World Bank national accounts data: 1971 – 2001. 4. Bhagat, R.B. Internal migration in India: Are the Under Privileged Migrating More. Asia Pacific Migration Journal, vol.25, no.1: Positive association between per capita income with total migrants at state level. 5. D.P. Singh. Migration and Occupation in Mumbai: Issues and Implication. Paper presented on 35th International Conference of International Conference of International Union for study of population (France) July 18 -23, 2005. 6. R.Lusome & R. B. Bhagat. Trends and patterns of internal Migration in India, 1971 -2001 – Paper presented at annual Conference of Indian Association for study of population (IASP) during 7 – 9 June, 2006, Thrivananthapurm. 7. Ronald Skeldon. Interlinkages between Internal & International Migration and development in the Asian region. Population, Space, & Place, 12, 2006:15-30. 8. Amitabh K.(2012) Migration & Exclusionary Urbanization in India. Economic & Political Weekly: Vol XLVII Nos 26 & 26. Pg 219 – 227: Migration less common among poor socio economy strata as seen with decreased migration in search of employment & increase in business & study related mobility in India
Giant Retroperitoneal Lipoma: a Case Report and Review
Jaykar R.D., Kasabe P., Bhushan C., Kamble P.H
Abstract: Retroperitoneal lipomas have remained the essentially rare tumors seen in clinical practice. There are very few reported cases in surgical literature worldwide.Case: The authors report a case of giant retroperitoneal lipoma in a 35-year-old female, with a history of pain and abdominal distension. Abdominal ultrasonography and CT scan of abdomen showed a large mass located in the retroperitoneal space. Laparotomy showed a large encapsulated tumor measuring 40 x 30 x 10 cm and weighing 8kg. The histological study revealed a benign neoplasm of fatty cells. The patient had a good postoperative performance status. Conclusion: Lipomas should be considered in the differential diagnosis of a solid tumor in the retroperitoneal space and treatment of retroperitoneal lipomas is eminently surgical.
1. Weiss SW, Goldblum JR. Enzinger and Weiss’s soft tissue tumors. 5th ed. St Louis, Mo: Mosby, 2007. 2. Montbrun E, Pereio R, Barbeito J, Nastasi A, Montbrun M, Gómez J, Gonçalves I, Bãez L. Tumores malignos retroperitoneales primários. Arch Hosp Vargas. 1990; 32: 101-6. 3. Montesinos MR, Falco JE, Sinagra DL, Mazzadri NA, Curutchet P. Sarcomas retroperitoneales. Rev Argent Cir. 2000; 78:1-5. 4. Bengmark S, Hafstrom L, Jonsson PE, Karp W, Nordgren H. Retroperitoneal sarcomas treated by surgery. J Surg Oncol 1980 ; 14:307-14. 5. Jensen BenÃtez C, Vergara Bahamondes JI, Aparicio R, Ibarra A, Chomali T. Tumores primaries retroperitoneales de origemmesenquimático. Rev Hosp Clin Univ Chile 1994; 5:58-64. 6. Usandivaras JR, DÃaz San Román AH. Resección de tumors retroperitoneales. Rev Med Tucuman 2001; 7:23-32. 7. Lopes-Filho GJ, Carvalho SMT, Scalabrini M, Ricca AB, Sato NY. Liposarcomas abdominais. Rev Assoc Med Bras 1995;41:219-26. 8. Marshall MT, Rosem P, Berlin R, Gresson N. Appendicitis masquerading as tumor: a case of two diagnoses. J Emerg Med 2001; 21:397-9. 9. Shouzhu Z, Xinhua Y, Xumin L, Shulian L, Xianzhi W. Giant retroperitoneal pleomorphic lipoma. Am J SurgPathol 1987;11:557-62. 10. Zhang SZ, Yue XH, Liu XM, Lo SL, Wang XZ. Giant retroperitoneal pleomorphic lipoma. Am J SurgPathol 1987; 11:557-62. 11. Cavazza A, Giunta A, Pedrazzoli C, Putrino I, Serra L, De Marco L, Gardini G. Extrarenal retroperitoneal angiomyolipoma: description of a case and review of the literature. Pathologica 2001; 91:44-9. 12. Eresué J, Philippe JC, Casenave P, Laurent F, Grenier N, Simon JM, Drouillard J, Tavernier J. La tomodensitométrie des lipomes et liposarcomes abdominaux de l'adulte. A propos de 9 cas. J Radiol 1984; 65:145-9. 13. Susini T, Taddei G, Massi D, Massi G. Giant pelvic retroperitoneal liposarcoma. ObstetGynecol 2000; 95:1002-4.
Plasma Osteopontin Level in Ischemic Heart Disease
Sudhir P. Sase, Jayshree V. Ganu, Ashok N. Bhupali, Pramod Shinde
Abstract: The aim of the present study was to evaluate the association between plasma Osteopontin (OPN) levels and ischemic Heart disease (IHD).OPN is a bone related protein present within the atherosclerotic plaque. OPN is 44kDa glycoprotein which is implicated in the regulation of biological phenomenon including atherosclerosis. Plasma OPN level was measured from 115 patients (age36 to 66 years) who underwent coronary angiography OPN level of patients with IHD is not significantly different than that of non IHD patients. Hence plasma OPN cannot be considered as an independent risk factor for development of IHD.
1. Michael H Crawford, Current Diagnosis and Treatment in Cardiology, Second edition Chapter 3: Chronic ischemic heart disease. Mc Graw-Hill’s Access Medicine, 2007. 2. Susan Amanda Lund,Cecill a m Giachelli. The role of Osteopontin in inflammatory processes, J Cell Commun. Signal 2009; 3:311-22. 3. Gul Gursoy ,Yasur Acar, Selma Alagz . Osteopontin: A multifunctional molecule. Journal of medicine and medical science. 2010; Vol. 1(3) pp 055-060. 4. Cecilia M.Giachelli,Susan steitz ,Osteopontin :a versatile regulator of inflammation and biomineralization.Matrix Biology 19 2000; 615-22. 5. L.A.Fitzpatrick A, Severson, W.D.Edwards and R.T. Ingram, Diffuse calcification in Human Coronary Arteries Association of Osteopontin with Atherosclerosis. The Journal of Clinical Investigation Inc. 1994; Vol. 94:1597-1604. 6. Reiko Ohmori,Yukihiko Momiyama ,Hiroaki Taniguchi ,Rie Takahashi,Masatoshi Kusuhara et al.Plasma Osteopontin levels are associated with the presence and extent of coronary artery diseas. Atherosclerosis, 2003; 170:333-37. 7. Wendelin saarenhovi, Mervi Oikonen,Britt-Marie Loo.Markus Juonala ,Milka Kahonen ,Jorma S.A.,Virari and Oll T.Raitakari.[abstract]. Plasma Osteopontin is not associated with vascular markers of subclinical atherosclerosis in a population of young adults without symptoms of cardiovascular disease. The cardiovascular Risk in Young Finns Study, Scandinavian Journal of Clinical and Laboratory Investigation. 2011; vol .71, 683-89.
Clinical Profile, Etiological Factors and Outcome of Acute Renal Failure in Children: A Clinical Study
Sk Mohammed Ajaz, Minhaj S Pathan, Khaled Mohsin Badaam
Abstract: Acute Renal failure is a syndrome characterised by acute decline in glomerular filtration rate leading to retention of nitrogenous wastes such as urea and creatinine. 56 Acute Renal Failure patients were included in the study who attended our hospital during the study period. Out of the total 56 patients included for the study analysis, 34 patients were males and 22 were females’ indicating that frequency of acute renal failure was more in males as compared to females with a male: female ratio of 1.54:1. Children in the age group of 5-8 years were most commonly affected followed by children between 9-12 years, 1-4 years and less than one year in decreasing order. Oliguria was the most common presenting complaint in the patients. Vomiting, haematuria, fever were other common complaints. Intrinsic renal pathology was the commonest cause of acute renal failure in enrolled patients, followed by pre-renal and post-renal causes. Acute glomerulonephritis was the commonest etiology of intrinsic renal failure. Age less than one year, female sex, Acute Tubular Necrosis, Obstructive Uropathy, Haemlytic Uremic syndrome, presence of CNS complications and prolonged oligoanuria were associated with poor prognosis. The mortality rate was 25% in the present study.
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A Prevalence Study of Risk Factors for Chronic Diseases among Police Personnel in a Metropolitan Area
Nikhil N. Tambe, Vivek Singh, Kiran Narang, Vikrant Tambe, Rajesh B. Goel
Abstract: Police are backbone for maintaining law and order within the limits of city. Their motto is ‘to protect the good and punish the evil’; but they are themselves punished by the evil- CHRONIC LIFESTYLE DISEASES. They suffer from stress related to their work-uncertain duty hours, transferable jobs, inadequate sleep, addiction to alcohol and tobacco. Hypertension, diabetes, acute coronary syndromes, obesity and even cancer are some of the major chronic health diseases commonly observed due to their hectic and stressful lifestyle. This study was carried out to assess the risk factors among police personnel, contributing to chronic diseases like obesity, hypertension, diabetes and creating awareness of the same. It emerged that almost 49% of police personnel in study population of 443 were overweight, alcohol and tobacco consumption accounted to 28%, 20% were hypertensive, 11% diabetics and smoking observed in 8%. This study provided us with data about the health status in police community and will help us in devising new strategies to bring about a healthy change in their life style. Such study if carried out periodically will help reduce the rampant problem of chronic health diseases in police community at primordial level.
1. WHO global report: Preventing chronic diseases: a vital investment. Available from URL: http://www.who.int/chp/chronic_disease_report/contents/en/index.html 2. K. Park; Park’s Textbook of Preventive and Social Medicine 20th ed. , Banarsidas Bhanot Publisher, India : 2009.
Protein-Protein Interaction-Yeast two Hybrid System
Ajay K Srivastava, Preety Prasad
Abstract: Many proteins recognize and bind to other proteins. The total of all protein-protein interactions is sometimes referred to as the protein interactome by those enthusiastic about “omics†terminology. Mass screening of such interactions has proved possible by means of the “Two hybrid†system. It is assumed that the binding of a novel protein to one that is well characterized may provide some hint as the function. Two hybrid analyses depend on the modular structure of transcriptional activator proteins. Many of these proteins contain two factor domains -DNA Binding Domain (DBD) and Activation Domain (AD). The DBD recognizes a specific sequence in the DNA upstream of a promoter and the AD stimulates transcription by binding to RNA polymerase. Provided that the two domains interact, they will activate transcription. The whole experiment is based on this principle of Yeast two Hybrid system.
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Anatomy Post Graduation as Career Option: A Situational Analysis
Sunita Bharati, Praful Nikam, Ujwal Gajbe, Vivekanand Giri
Abstract: Medical graduates often have confusion after PG entrance while selecting Branch for Post graduation. Large numbers of medical colleges facing difficulty in getting anatomy faculty. Situational Analysis is one method to understand situation in simpler manner. Research Question: What is the present scope of Anatomy Post-graduation as career option? Aims & Objectives: 1. To carry out situational Analysis of Anatomy PG Seat in Medical colleges, 2.To Suggest suitable recommendation based on study findings. Methodology: Present situational analysis based on data of official web page of Medical Council of India (On March 2012) www.mciindia.org. in which we use PG college database and faculty database, All these data were entered in Microsoft excel sheet and analyzed by using statistical software SPSS version 16.Situational Analysis: Total number of Medical colleges in India 335(till March 2012) of which only 198(59.1%) colleges having PG seat in Anatomy Discipline. Annual Anatomy PG seat intake in all colleges was found to be 610.Total MBBS seat intake Yearly 40525, the ratio of MBBS to Anatomy PG seat is 100: 1.5. Karnataka is having highest number of anatomy PG seat annually 92(15.1%), followed by Maharashtra 91 (14.9%), Andhra Pradesh 70 (11.5%). These three state namely Maharashtra, Karnataka, A.P is contributing about 42.7% PG seat in India. In Last Five year 42.8% colleges are in process of increasing PG seat. Till now 21% college PG seat intake permitted in 10(A) section of MCI. Total numbers of Anatomy faculty in India are 3774.
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Anomalous Anterior Cerebral Artery
Kardile Poorwa Baburao, Ughade Jaideo Manohar, Ughade Manohar Namdeo, Sudhir Vishnupant Pandit
Abstract: The variation in the anterior part of the circle of willis is quiet rare and finding multiple variation in single case is still rare. During routine dissection we noted multiple anomalies in form of hypoplasticity, duplication and persistence of embryonic pattern in the form of azygous artery in the right anterior cerebral artery. Any variation in the vessels of circle of Willis influences the change in the haemodynamics of blood supply to the brain. such variations also play a great role in the decision of line of management of the patient. The awareness of this rare anatomical variant is important considering today advanced imaging modalities and give consideration to its potential serious complications with fellow clinicians.
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Effect of Pranayama Training on Cardiovascular Parameters
S.P. Surwase, D.N. Deore, U.S. Zingade, P.R. Deshmukh, A.K. Zombade, Shazia
Objectives- To study the effect of pranayama training on cardiovascular parameters. Design- Longitudinal study. Settings/Location- Government Dental College, Aurangabad. Subjects- 60 Normal healthy females and males volunteers in the age group of 30 to 50 years ready to give consent. Subjects were divided randomly into two groups of 30 individuals act as subjects and control. Trial was registered under WHO and CTRI trial registry systems. CTRI registration no. is CTRI/2012/03/002512 and WHO registry no. is UTN- U1111-1129-2155. Interventions- Pranayama training camp will be conducted 45 minutes daily for 1 month. The exercises include slow and fast breathing exercises like ‘nadishuddhi’, ‘mukh-bhastrika’, ‘pranav’ and ‘savitripranayama’. Outcome Measures- Cardiovascular efficiency will be tested by using parameters like 1. Systolic blood pressure 2. Diastolic blood pressure 3. Heart rate and Systolic time intervals involving pre-ejection period (PEP), left ventricular ejection time (LVET), total mechanical systole (QS2) & PEP/LVET ratio. Results- Pranayama training for 1 month resulted in significant decrease in systolic blood pressure (<0.0001) & LVET (<0.0001) whereas QS2 (<0.0001) and PEP (<0.0001) were increased significantly.PEP/LVET ratio which is a sensitive index of cardiac performance was significantly increased after the training. Conclusion- Our study shows that pranayama training improves ventricular performance by increasing parasympathetic activity.
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Allopurinol in Inflammatory Arthritis (probably Gout): Indian Perspective in Light of EULAR Recommendations
Amit R Burande, Amit Kale, Meeta A Burande, Nitin Deshpande
Introduction-Hyperuricemia (solubility point of Mono Sodium Urate Crystal i.e. 7.1 mg/dl) is associated with gout and present in 0.2 to 2% of Indian popultion. EULAR has published the guidelines for the diagnosis of gout based on evidences. In this study, we tried to evaluate clinical correlation of arthralgia with serum uric acid level in Indian patients and benefit from Allopurinol treatment. Material and Methods-Study design - Prospective, open labeled single arm Study carried out in Hospital attached to Medical University. Exclusion Criteria were Patients having definitive diagnosis for the etiology of arthralgia or Definitive Gout by clinical diagnosis as per EULAR recommendation. Inclusion criteria were Patients having the history of use of analgesic with persistent symptoms, having less than 4 EULAR criteria for gout and willing to be enrolled in the study. Intervention - Allopurinol 100 mg twice a day was given to patients and clinically assessed on day 1, day 10 and at 4 week Sample size: 28 patients were included in the study and follow up. Results – In elderly age group incidence is same in both sexes. Purine rich diet increases the risk five times with more risk of precipitation of symptoms at lower level of uric acid. Most common site of presentation was knee pain i.e. 50%. Serum Uric acid at enrollment was 6.76+0.99 that reduced to 3.74+0.63 at four week with dissolving of symptoms. Conclusion–There is a subset of Gout in elderly Indians, which is more prone to precipitation of symptoms at lower level of serum Uric acid and equal gender distribution. Hyperuricemia in patients may be defined on 5.0 mg% and target level should be kept less than 4.0 mg in Indians.
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Serum uric acid and hypertension: the Olivetti heart study. J Hum Hypertens. 1994; 8:677-681. 23. Selbly IV, FriedhmanGD, Quesenberry CP et al. Precursors of es¬sential hypertension: pulmonary function heart rate uric acid, serum cholesterol, and other serum chemistries. Am J Epidemiol. 1990; 131:1017-1027. 24. Rathmann W, Funfhouser E, Dyer AR, Roseman JM. Relation of the hyperuricemia with various components of insulin resistant syndrome in young black and white adults. Ann Epidemiol. 1998; 8: 250-261. 25. Ficchini F, Chen YDI, Hollenback CB, et al. Relation between the resistant to insulin mediated glucose uptake, urinary uric acid clearance and plasma uric acid concentration. J Am Med Assoc. 1991; 266: 3008¬3009. 26. Cappucio FD, Strazullo P, Farinaro E. Uric acid metabolism and tubular sodium handling: results from population based study. J Am Med Assoc. 1993; 270: 354-59 27. Lee J, Sparrow D, Vokanos PS et al. Uric acid and coronary heart disease risk: evidence for a role of uric acid in obesity insulin resistant sysdrome. Am J Epidem. 1995; 142:288-294. 28. Kerntz AL. Insulin resistace. Br Med J. 1996; 313: 1385-89. Mohan M, Halkin H, Karasik A, Lusky A. Elevated serum uric acid a facet of huperinsulinimia. Diabetologia. 1987; 30: 713-718 29. Solomma VV, Tuomilehto J, et al. Hypertriglycerimia in different de¬gree of glucose intolerance in finish population: based study.Diabetes Care. 1992; 15:657-65. 30. Loebl WY, Scott JT: Withdrawal of allopurinol in patients with gout. Ann Rheum Dis 1974; 33: 304–7. 31. Li-Yu J, Clayburne G, Sieck M et al.: Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout? J Rheumatol 2001; 28: 577–80. 32. Shoji A, Yamanaka H, Kamatani N: A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Arthritis Rheum 2004; 51: 321–5. 33. Srivastava DC, Gaur SC. Evaluation and assessment of the symptomatic uricaemia in vegetarian population. Indian J Orthop 2005;39:117-20 34. Perez-Ruiz F, Calabozo M, Fernandez-Lopez MJ, Herrero-Beites A, Ruiz-Lucea E, Garcia-Erauskin G, et al. Treatment of chronic gout in patients with renal function impairment: an open, randomized, actively controlled study. J Clin Rheumatol 1999;5:49–55. 35. Becker MA, Schumacher HR Jr, Wortmann RL, MacDonald PA, Eustace D, Palo WA, et al. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005; 353:2450–61. 36. Perez-Ruiz F, Calabozo M, Herrero-Beites AM, Garcia-Erauskin G, Pijoan JI. Improvement of renal function in patients with chronic gout after proper control of hyperuricemia and gouty bouts. Nephron 2000; 86:287–91. 37. Perez-Ruiz F, Calabozo M, Pijoan JI, Herrero-Beites AM, Ruibal A. Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout. Arthritis Rheum 2002; 47:356–60. 38. McCarthy GM, Barthelemy CR, Veum JA, Wortmann RL. Influence of antihyperuricemic therapy on the clinical and radiographic progression of gout. Arthritis Rheum 1991; 34: 1489–94. 39. Schumacher HR. Crystal-induced arthritis: an overview. Am J Med 1996; 100:46S–52S. 40. FERNANDO PEREZ-RUIZ1 AND FRE´DE´RIC LIOTE.´ Optimal Target for Improving Clinical Outcomes in Gout? Arthritis & Rheumatism (Arthritis Care & Research) 57; 7:2007:1324–1328.
Influence of Certain Factors on Overweight and Obesity among Undergraduate Medical Students at Vizianagaram
Dantu Padmasree, Ukey Ujwala U
Introduction: In recent years, developing countries like India have been experiencing a nutritional transition in food choices from typically starchy (mainly carbohydrate diets) to fast food pattern and as a result, the dietary habits of young adults like medical students have been affected. Obesity is associated with a large number of debilitating and life-threatening disorders, such as increase in associated cardiovascular, metabolic and other non-communicable diseases. Aim and Objectives: To determine the influence of certain dietary habits and life style on body weight of medical students. Materials and Methods: Descriptive cross sectional study was conducted in 263 MBBS students. The study questionnaire covered demographic details, eating habits, types of food, exercise and lifestyle. The Body mass index (BMI) was calculated from weight (kg) & square of height (m). Various factors influencing overweight and obesity were analyzed. Results: Overweight and obesity was detected in a total of 41 students. Significant difference was observed between mean BMI of normal weight(21.23±1.71kg/m2) and overweight-obese (27.08±2.51kg/m2) students. Factors such as irregular diet (OR=2.79), restaurant visits (OR=2.96), family history of diabetes (OR=1.99) and obesity (OR=3.48) were associated with significantly higher risk of overweight and obesity. Conclusions: Obesity per se was detected as an uncommon occurrence as compared to overweight or pre-obesity which may turn to obesity in future life. Prevalence of overweight and obesity in young adults similar to national figures is alarming and warrants the need for regular risk factor screening and young adult-based approaches such as changes in life style and health education.
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Unilateral Merging of Musculocutaneous Nerve with Variant Branching of Median Nerve
Kardile Poorwa Baburao, Ughade Jaideo Manohar, Joshi Rajani A, Herekar Narsimh G, Jadhav Asmita S, Katti Anupama S, Ughade Manohar Namdeo
Abstract: Variations of brachial plexus in different ways are very often detected in upper limb. During our study, in a 75 years old cadaver we found the musculocutaneous nerve communicating with median nerve in the left arm. The musculocutaneous nerve gave a branch to coracobrachialis then the nerve merged with the lateral root of median nerve. Later the area of innervations of musculocutaneous nerve was replaced by Median nerve. The Median nerve originated normally from the union of medial and lateral root but gave two muscular branches in the arm, to Biceps brachii, Brachialis & a sensory branch which continued as lateral cutaneous nerve of forearm. The course of Median nerve in the forearm was normal. The Musculocutaneous nerve of right side was present with normal course & routine branches.
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Impact of Health Intervention on Cancer Awareness of Mumbai Urban Slum Population
Sarang Pedgaonkar, GD Velhal, Hemant Mahajan, Bhuwan Sharma
Objectives: 1) To assess the awareness about Cancers in an Urban Slum population of Mumbai. 2) To assess the impact of health intervention on awareness of slum population about various Cancers. Materials and Methodology: A community based descriptive epidemiological interventional study was conducted at Cheetah Camp urban slum which is a field practice area of Department of Preventive and Social Medicine, of TN Medical College Mumbai during January 2008 to October 2009. Population above 40 years of age were included in this study. Sample was selected using cluster sampling method. The information was gathered by personal interview using semi-structured questionnaires. Results: Out of 525 study participants Out of 525 study participants, males were 50.48%. 169 (32.2%) participants thought that cancer is a disease; whereas 109 (20.6%) participants were not able to describe cancer. Regarding general initial symptoms of cancer, 272 (51.8%) don’t knew any symptom. Commonest risk factor known to participants (450, 85.7%) was tobacco consumption. Awareness of participants about prognostic factors, screening facilities, screening centres of cancers, treatment centres of cancer was very poor. After health intervention improvement in the knowledge of study participants about various cancers was seen. Conclusion: Awareness of study participants about cancers was very poor. There is a need for awareness generation programs to educate population about various common cancers. Propagation of correct messages and promotion of early detection of cancers should be stressed.
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Effect of Specific Stabilization Exercise versus Conventional Back Extension in Management of Chronic Herniated Pulposus
Sucheta Golhar, Amit V. Nagrale, Tanpreet kaur Bagga
Background: Local stabilizing musculature activation occurs automatically in a preparatory manner prior to movement. Failure of this preparatory stabilizing mechanism is identified as primary cause of persistence low back pain. The aim of this study was to investigate whether specific stabilization exercises or conventional back extension exercises are effective in people with Chronic Herniated Pulposus (HNP). Materials and Methods: 20 patients with Chronic Herniated Pulposus (HNP) were randomized into two groups. 10 patients in Group A received Specific stabilization exercise while 10 patients in Group B received conventional back extension exercise. Pain perception was measured using the Visual Analogue Scale (VAS). Disability was measured using the Ronald – Morris Disability Questionnaire (RMDQ). Both the intervention periods were delivered at 5 times/week for 4 weeks. Results: Training of the specific stabilization exercise in group A showed a significant improvement in decreasing pain and in improving functional ability when compared to strengthening exercise in group B at p <0.05 (t-test). Conclusion: There was decrease in the pain intensity and improvement in functional level in patients who were given conventional back extension exercise but there was a more marked relief in patients who were given Specific stabilization exercises after a treatment protocol of four weeks.
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Why and How Aerobic Mesophilic Composting is Effective? A Comprehensive Study on Aerobic and Anaerobic Composting of Green Waste under Mesophilic and Thermophilic Conditions
D.Anand, V.Veerakumar, JagdishGabhane, SPM Prince William, V.P.Bhange, A.N.Vaidya, M.P.Patil, J.K.Bhattacharyya, S.R.Wate
Abstract:The relative advantage of aerobic-mesophilic(ARM) condition forgreen waste composting over other conditions such as aerobic-thermophilic(ART), anaerobic-mesophilic (ANM) and anaerobic-thermophilic (ANT) is evaluated in the present investigation. A perusal of results indicated that ARM is the most favorable condition for green waste composting as it facilitates the growth and development of cellulolytic microbesand increasing their cellulose activity required for lignocellulosic degradation. Although, aerobic thermophilic condition (ART)was found to increase the rate of cellulose degradation, it was not mediated through cellulase activity. The effect of thermophilic phase on lignocelluloses wasmere physical in nature. The quality assessment studies on finished compost also confirmed ARM as the most favorable condition for composting.
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Edelmann, W., Engeli, H. Combined digestion and composting of organic industrial and municipal wastes in Switzerland. Water Science and Technology, 27 (2), 169– 182,1993. 8. Cromell, C. Composting for duminis. National gardening association, 2010. 9. Nakasaki, K., Ohtaki, A., Takemoto, M., Fujiwara, S. Production of well-matured compost from night-soil sludge by an extremely short period of thermophilic composting. BioresourceTechnology ,100 , 676–682, 2009. 10. Sundberg, C., Jonsson, H. Higher pH and faster decomposition in biowaste composting by increased aeration. Waste Management,28, 518–526, 2008. 11. Lopes, W.S., Leite, V.D., Prasad, S. Influence of inoculum on performance of anaerobic reactors for treating municipal solid waste. Bioresoure Technology, 94,261–266, 2004. 12. Mohaibes, M., Heinonen-Tanski, H. Aerobic thermophilic treatment of farm slurry and food wastes. Bioresoure Technology, 95, 245–254,2004. 13. Wagner, A.O., Malin, C., Gstraunthaler, G., Illmer, P. Survival of selected pathogens in diluted sludge of a thermophilic waste treatment plant and in NaCl-solution under aerobic and anaerobic conditions. Waste Management,29, 425–429, 2009. 14. Bolzonella, D., Innocenti, L., Pavan, P., Traverso, P., Cecchi, F. Semi-dry thermophilic anaerobic digestion of the organic fraction of municipal solid waste: focusing on the start-up phase. Bioresource Technology, 86, 123–129, 2003. 15. Hassen, A., Belguith, K., Jedidi, N., Cherif, A., Cherif, M., Boudabous, A. Microbial characterization during composting of municipal solid waste.Bioresoure Technology,8, 217–225,2001. 16. Narihiro, T., Abe, T., Yamanaka, Y., Hiraishi, A. Microbial population dynamicsduringfed-batch operation of commercially available garbage composters.Applied Microbiology Biotechnology,65, 488–495, 2004. 17. Schloss, P.D., Hay, A.G., Wilson, D.B., Walker, L.P. Tracking temporal changes of bacterial community fingerprints during the initial stages ofcomposting.FEMSMicrobiology Ecology, 46, 1–9,2003. 18. MacGregor, S.T., Miller, F.C., Psarianos, K.M., Finstein, M.S. Composting process-control based on interaction between microbial heat output and temperature. Applied Environmental Microbiology, 41, 1321–1330,1981. 19. Rao, N., Grethlein, H.E., Reddy, C.A. Effect of temperatureon composting of atrazine-amendedlignocellulosicsubstrates. Compost Science Utilization, 4, 83–88,1996. 20. Vikman, M., Karjomaa, S., Kapanen, A., Wallenius, K., Itavaara, M. The influence of lignin content and temperature on the biodegradation of lignocellulose in composting conditions.Applied Environmental Microbiology, 59, 591–598, 2002. 21. Elorriota, M.A., Suarez-Estrella, F., Lopez, M.J., Vargas-Garcia, M. C., Moreno, J. Survival of phytopathogenic bacteria during waste composting. Agricultural EcosystemEnvironment,96,141–146,2003. 22. 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Optimization for the Production of Cellulase Enzyme from Municipal Solid Waste Residue by Two Novel Cellulolytic Fungi. Biotechnology Research International, 10.4061/2011/810425, 2010. 32. Russell, J.B., Wilson, D.B. Why are ruminal cellulolytic bacteria unable to digest cellulose at low pH?.Journal of Dairy Science, 79, 8, 1503-1509, 1996. 33. aut,M.P., Prince William,S.P.M., Bhattacharyya,J.K., Chakrabarti,T., Devotta,S. Micobial dynamics and enzyme activities during rapid composting of municipal solid waste-A compost maturity analysis perspective. Bioresource Technology, 99, 6512–6519,2008.
Maternal Risk Factors Determining Birth Weight of Newborns: A Tertiary Care Hospital Based Study
P. S. Thomre, A. L. Borle, J. D. Naik, S. S. Rajderkar
Introduction: Globally, more than 20 million infants are born with low birth weight. The number of low birth weight babies is concentrated in two regions of the developing world: Asia and Africa. 72% of low birth weight infants in developing countries are born in Asia where most births also take place, and 22% are born in Africa. India alone accounts for 40% of low birth weight births in Asia. . The reduction of low birth weight also forms an important contribution to the Millennium Development Goal (MDG) for reducing child mortality. The factors associated with intrauterine growth retardation are multiple and interrelated to mother, placenta and foetus. Objectives: 1) To study the ‘Birth weight’ pattern among study group. 2) To identify the maternal factors associated with low birth weight of newborns. Material and Methods: The present cross sectional study was carried out in Government Medical College & Hospital, Miraj amongst all the mothers and newborns delivered at institution during the period of one calendar year from January 2007 to December 2007. The data was collected with the help of interview technique using predesigned and pretested questionnaires followed by the thorough clinical examination and anthropometric measurements of mother and newborn. Interview was followed by thorough clinical examination and necessary investigations. Results & Conclusion: Low birth weight was found to be present in 92 (18.1%) newborns. The internal comparison was made among the study subjects with normal birth weight babies and those with low birth weight babies using the bivariate analysis and multiple logistic regressions. The factor found significantly associated were gestational age at delivery, number of antenatal visits, anemia, gestational age at 1st ANC visit, bad obstetric history, mothers weight, socio-economic status, birth interval, type of work, iron and folic acid supplementation, religion, sex of new born and gravida.
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Congenital Dyserythropoitic Anemia Type I Presenting as Congestive Cardiac Failure in Neonatal Life
Anilkumar M. Khamkar, Manish M. Tiwari, Pallavi P. Saple, Amol Suryawanshi, P.M.Zadke, Manisha Surwade
Abstract: Congenital Dyserythropoietic Anemias (CDAs) constitute a heterogeneous group of rare inherited disorders, characterized by moderate to severe anemia due to a markedly ineffective erythropoiesis with an erythroblastic bone-marrow and specific erythroid morphological anomalies. Three major types of CDA and a number of variants have been described. The diagnosis and categorization of these disorders are facilitated by microscopic examination of the blood and bone marrow and by serologic testing. The severity of Anemia varies considerably within and between families. We report a case of CDA type I in a neonate who presented as congestive cardiac failure secondary to severe Anemia who also had PPHN due to LVF. Baby succumbed to death on day 1 of life itself. Clinical profile and laboratory investigations were consistent with CDA type I.
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