The siltation rate in the Wular Lake shows abnormality in space and time, as evidenced from preliminary geological survey of its catchment. The Panjal traps, limestones (with scanty intercalations of black shales) and Karewas form the major provenance for the silt which drains into the lake. The lineament fabric suggests a strong structural control over the formation of the lake. The Tertiary uplift, as well as, the pulses of seismicity have been instrumental in modifying regional geomorphological relief and the resultant changes in the rate of siltation. The climatic changes have also influenced the varied rate of erosion and subsequent siltation. The topographic relief appears to have fluctuated in the recent geological past, as is evidenced from the silt deposits in and around the lake. The environmental significance lies in the fact that such a rate of siltation would result in shallowing of the lake floor and may prove disastrous during higher degrees of runoff (either due to excess precipitation or melting of ice). The present state of human interference, in the form of settlements around the lake and farming practices on the reclaimed and / or acquired land of the lake, are beyond permissible limits of the environmentally safety zones.
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Kuttner’s tumour, also known as chronic sclerosing sialadenitis predominantly involves the submandibular gland. Though described more than a century ago, the entity remains under diagnosed and is commonly mistaken for carcinoma. The diagnosis is done by histopathological examination of excised salivary gland which reveals dense lympho-plasmacytic infiltration with acinar atrophy and periductal fibrosis. We present a case of Kuttner’s tumour in a 50 year old male patient to highlight its histopathological features and to increase the awareness about this under diagnosed entity.
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Sixty groundwater samples were collected in different seasons from the study area. The water soluble products of congruent weathering reactions such as Na, K, Ca, Mg, HCO3, and SiO2 have been probed. Apart from these, anthropogenic parameters such as Cl, NO3, PO4, and SO4 have also been analyzed. The mathematical and graphical tools are used to assess the groundwater quality for drinking and irrigation purpose. The study reveals that the concentration of major ions is controlled by the water-rock interactions. The water is not at all suitable for drinking purpose. As per pH, TDS, SAR, chloride and sulphate concentration water is suitable for irrigation purpose. Critical verification of hardness, EC, RSC, salinity hazard compels to assign water quality doubtful for irrigation purpose. Such doubtful zones need special care and suggested to adopt alternative salt tolerance cropping pattern. Also it is advised to avoid excessive use of artificial fertilizer and excessive irrigation.
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Anomalous muscle bellies in the flexor compartment of forearm - a case report
Introduction: The muscular variations of upper limb are common. Their importance becomes apparent with regard to surgical approaches for various clinical conditions involving the upper limb. During routine dissection classes to undergraduate medical students, we came across two additional muscle bellies in the flexor compartment of the left forearm of a male cadaver arising from the under surface of flexor digitorum superficialis (FDS) and were found to be inserted into flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) separately. The above two accessory muscle bellies are also called Gantzer's muscles. In another male cadaver, an accessory muscle belly arising from the flexor digitorum superficialis of the right forearm was found to be inserted into the flexor digitorum profundus (FDP). Muscle anomalies of the upper extremity are recognized causes of peripheral nerve disorder. Awareness of these variations is necessary to avoid complications during radio-diagnostic procedures or surgeries in the upper limb.
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Effect on sexual dysfunction in depressed females after treatment with SSRI antidepressants
Introduction: Depression is associated with sexual dysfunction. As the depression improves sexual dysfunction also improves. There are not many studies on female sexuality. Aims and Objectives: To find out the changes in sexual functioning in depressed females after treatment with anti-depressant drugs. Method: 41 female patients diagnosed to have depression were included in study. Becks Depression Inventory, Arizona Sexual Experience Scale and Female Sexual Functioning Index scales were applied at the beginning and after 6 weeks to assess the improvement in sexual dysfunction and depression. Results: When scores were compared after 6 weeks of antidepressant treatment then a highly significant difference was seen on all the scores of BDI ( p< 0.000***), ASEX ( p< 0.027***)and FSFI. (p< 0.01**). On the various domains of FSFI a highly significant difference was seen on the domains of Arousal (p< 0.03**), Lubrication (p< 0.051**), Orgasm (p< 0.028**) and Satisfaction (p< 0.06**). Desire and pain domains did not show any significant changes. Conclusions: This study showed significant improvement in sexual dysfunction and different aspects of sexual dysfunctions after treatment with antidepressants for 6 weeks.
Introduction: Schizencephaly is an extremely rare developmental disorder of the brain. Its prevalence in Indian data is 1.5: 1,00,000 population. It is a triad of hemiplegia, seizure disorder and mental retardation. Hence we are reposting a case of 28 yrs. old female who presented with intractable seizures and altered sensorium for 2 days. She is a known case of epilepsy since the age of two months. She also had left sided hemiparesis since the same duration. She had delayed developmental milestones and mental retardation. Her, CT brain was done. It showed large fluid filled cavity occupying right frontal, temporo- parietal region lined by grey matter communicated with right ventricle. These findings are constistent with right sided unilateral open-lip schizencephaly.
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Comparative study of glycosylated hemoglobin and lipid profile in gestational diabetic women and normal pregnant women
B. J. Pradeep Kumar, Sudhir Modala, Parimala P., Manisha Baghel
Aim: Lipid profile and glycosylated hemoglobin level changes in gestational diabetes. The extent to which this alteration takes place is still not clearly documented. Materials and Methods: To add a clear answer to this question, lipid profile parameters, and glycosylated hemoglobin status were determined in patients with gestational diabetes mellitus and compared to healthy pregnant women (controls). Results: Fasting plasma glucose levels, plasma glucose levels 1 hour, and plasma glucose levels 2 hours after 75 gm oral glucose administration (oral glucose tolerance test) were significantly higher in patients with gestational diabetes as compared to controls. Glycosylated hemoglobin was significantly higher in gestational diabetes than in controls. It was observed that there was a significant increase in serum cholesterol and serum triglyceride level in cases with gestational diabetes when compared to healthy pregnant women. Conclusion: The results of our study suggest that abnormal glucose levels, glycosylated hemoglobin, serum cholesterol, and serum triglycerides play an important role in pathophysiology of gestational diabetes, and therefore, extensive studies are required. Early diagnosis of gestational diabetes will decrease adverse neonatal and maternal outcomes
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Inducible clindamycin resistance in Staphylococcus aureus isolatedfrom clinical samples
Purpose: Clindamycin is commonly used in the treatment of erythromycin resistant Staphylococcus aureus causing skin and soft tissue infections. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on routine basis. Materials and Method: 100 Staphylococcus aureus isolates from various clinical samples subjected to routine antibiotic susceptibility testing by Kirby Bauer disc diffusion method. Inducible clindamycin resistance was detected by D test, as per CLSI guidelines on erythromycin resistant isolates. Results: 42 (42%) isolates showed inducible clindamycin resistance, 13 (13%) showed constitutive resistance while 10(10%) showed MS phenotype. Inducible resistance was found to be higher in Methicillin resistance Staphylococcus aureus (MRSA) as compared to Methicillin sensitive Staphylococcus aureus (MSSA) (56.6%, 13.2% and 25.53%, 12.7% respectively) Conclusion: Study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance.
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Background: Hearing is the means by which the newborn comes into contact with the world of sound and with language. The first three years of life are the most important period for speech and language acquisition. Reduced hearing acuity of any severity in infancy or early childhood may prevent the child from receiving adequate auditory, linguistic and social stimulation required for speech and language development. Hearing loss is one of the most common abnormalities present since birth. The prevalence of hearing loss is reported to be 1.5 to 6 per 1000 newborn in the well baby nursery population. Several risk factors associated with hearing loss during early infancy have been described by Joint Committee on Infant Hearing which includes hereditary cause, inutero infection, prematurity, asphyxia, hyperbili-rubinemia and ototoxic medications. Objectives: To assess the degree of hearing impairment in high risk infants by using BERA and to analyse and compare BERA responses in high risk infants with age matched controls. Methods: 100 high risk infants having one or more risk factors attending Pediatric OPD of Bapuji hospital and Chigateri General Hospital and 30 age matched controls satisfying the inclusion criteria were randomly selected from immunization centre were subjected to BERA. Parameters such as absolute latencies of waves I, III, and V, Interpeak latencies I-III, I-V and III-V were assessed and analysed by using unpaired t-test. Results: The high risk infants had increased wave V threshold when compared to the control group. Absolute latencies of wave III, V, interpeak latencies of I-III and I-V were prolonged in the cases. The incidence of hearing impairment was 64.9% in the high risk infants.
1. Biswas. A Brainstem evoked response audiometry. In: clinical Audiovestibulometry. 3rd ed. Mumbai: Bhalani; 2002. p. 68 – 88.
2. World Health Organization. State of hearing and ear care in the South East Asia Region. WHO Regional office for Sout East Asia. WHO – SEARO. Available at http://www.searo.who.int/link Files/Publications - HEARING - and - EAR – CARE.pdf.
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6. Bilgen H, Akman I, Ozek E, Kulekei S, Ors R, Carman K et al. Auditory brain stem response screening for hearing loss in high risk neonates. Turk J Med Sci. 2000; 30: 479 – 82.
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10. Fakhraee SH, Kazemian M, Hamidieh A. hearing assessment of high risk neonates admitted to Mofid hospital for children during 2001 – 2002 using auditory brainstem response. Arch Inanian Med. 2004; 71: 44 – 46.
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12. John M, Balraj A, Kurien M. Neonatal screening for hearing loss: pilot study from a tertiary care centre. Indian J Otolaryngol Head Neck surgery. 2009; 61: 23 – 26.
13. Murphy OA, van Straaten HL, Ens-Dokkum MH, Beer KMA. Neonatal hearing screening. Ned Tijdschr Geneedsk. 2000; 144:594-98.
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Study to find the efficiency of multi-detector computed tomography in evaluation of renal masses
Introduction: Detection of malignant renal masses and their differentiation from their benign counterparts is extremely important, especially when these masses are small. Although the effectiveness of conventional axial renal CT is well established, a variety of problems can be encountered. The major advantages of the multiple detector-row computed tomography (MDCT) technology over conventional CT is that it allows for acquisition of different image thicknesses from the same acquisition data set. Thus the present study was undertaken to study the efficiency of MDCT in diagnosing renal masses. Aims and Objective: To find out the efficiency of Multi-detector Computed Tomography in the evaluation of renal masses. Materials and Method: The study was conducted over a period of two years on 50 patients with clinically suspected Renal mass or patients who were diagnosed to have renal mass on ultrasound and were referred to CT for further characterization. Results: Overall there were 33 (66%) males and 17 (34%) females; the male to female ratio was 1.9:1.thus renal neoplasm was seen more commonly in males. MDCT was able to differentiate a benign from malignant lesion with Sensitivity of 100, Specificity of 71 %, and Accuracy of 96 %. When the images were assessed in unenhanced, corticomedullary and nephrographic phases. Conclusion: Multi-detector Computed Tomography can be used as an efficient tool with high degree of accuracy in diagnosing renal masses.
1. Multi-detector row CT of the kidneys Atadan Tunaci, Ensar Yekeler European Journal of Radiology - October 2004 (Vol. 52, Issue 1, Pages 56-66
2. Curry NS AJR Am J Roentgenol. 1995 Feb;164(2):355-62.Small renal masses (lesions smaller than 3 cm): imaging evaluation and management
3. Effect of incidental detection for survival of patients with renal cell carcinoma: Results of population-based study of 701 patients Urology, Volume 66, Issue 6, Pages 1186-1191 T. Gudbjartsson, A. Thoroddsen, V. Petursdottir, S. Hardarson, J. Magnusson, G. Einarsson
4. K. Tsui, O. Shvarts, R. Smith, R. Figlin, J. De kernion, A. Belldegrun Renal cell carcinoma: prognostic significance of incidentally detected tumors the journal of urology, volume 163, issue 2, pages 426-430
5. RPS Bajwa, P Sandhu, BS Aulakh, JS Sandhu, K Saggar, Helical CT Evaluation of Renal Mass Lesions: A Prospective Study A Ahluwalia Journal, Indian Academy of Clinical Medicine Vol. 8, No. 3 July-September, 2007
6. Ronald J. Zagoria, MD, Tyler Gasser, BA, John R. Leyendecker, MD, Robert E. Bechtold, MD,and Raymond B. Dyer, MD . Differentiation of Renal Neoplasms From High-Density Cysts: Use of Attenuation Changes Between the Corticomedullary and Nephrographic Phases of Computed Tomography. J Comput Assist Tomogr 2007;31:37-41
7. Kopka L, Fischer U, Zoeller G, Schmidt C, Ringert RH, Grabbe E (1997) Dual-phase helical CT of the kidney: value of corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinomas. Am J Roentgenol 169:1573–1578
8. Garant M, Bonaldi VM, Taourel P, Pinsky MF, Bret PM (1998) Enhancement patterns of renal masses during multiphase helical CT acquisitions. Abdom Imaging 23:431–436.
Prescription pattern of antihypertensive drugs and life style practices of hypertensive patients in an urban locality of Mysore
Kalabharathi H L, Mohammed Sibgatullah, Pushpa V H, Satish A M, Suresha R N
Objective: To determine the prescription pattern of antihypertensive drugs in Narsimharajamohalla of Mysore. To determine the lifestyle practices of hypertensives. Materials and Methods: Around 165 patients were enrolled in the survey after obtaining their consent. Prescription pattern of antihypertensive drugs was noted. Lifestyle practices such as exercise habits, dietary salt intake; compliance to medication was enquired through a questionnaire. Results: majority of patients are on combination therapy. Diuretics were the commonly prescribed antihypertensives. Reduction in salt intake and exercise habits were poor among majority of the patients. Few patients were noncompliant to the prescribed medication. Conclusion: With the obtained data showing a large amount of patients on combination therapy with poor life style practices, there should be an emphasis on health education. The prescribing doctor, paramedics, media, government should do their best in educating the masses.
1. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertension 2003; 21: 1983-92.
2. Chockalingam A. "Impact of World Hypertension Day". Canadian Journal of Cardiology 2007; 23(7): 517–9. PMID 17534457
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Issue details
Environmental hazards due to rate of siltation in the Wular Lake (Jammu and Kashmir), India
Kulkarni U.D., Khan Asiya
The siltation rate in the Wular Lake shows abnormality in space and time, as evidenced from preliminary geological survey of its catchment. The Panjal traps, limestones (with scanty intercalations of black shales) and Karewas form the major provenance for the silt which drains into the lake. The lineament fabric suggests a strong structural control over the formation of the lake. The Tertiary uplift, as well as, the pulses of seismicity have been instrumental in modifying regional geomorphological relief and the resultant changes in the rate of siltation. The climatic changes have also influenced the varied rate of erosion and subsequent siltation. The topographic relief appears to have fluctuated in the recent geological past, as is evidenced from the silt deposits in and around the lake. The environmental significance lies in the fact that such a rate of siltation would result in shallowing of the lake floor and may prove disastrous during higher degrees of runoff (either due to excess precipitation or melting of ice). The present state of human interference, in the form of settlements around the lake and farming practices on the reclaimed and / or acquired land of the lake, are beyond permissible limits of the environmentally safety zones.
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Kuttner’s tumour: a rare case report
Nanda Patil, Alok Kumar Yadav, Shrutika D. Dhawan
Kuttner’s tumour, also known as chronic sclerosing sialadenitis predominantly involves the submandibular gland. Though described more than a century ago, the entity remains under diagnosed and is commonly mistaken for carcinoma. The diagnosis is done by histopathological examination of excised salivary gland which reveals dense lympho-plasmacytic infiltration with acinar atrophy and periductal fibrosis. We present a case of Kuttner’s tumour in a 50 year old male patient to highlight its histopathological features and to increase the awareness about this under diagnosed entity.
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Contributory geochemical factors for variation in groundwater quality along confluence of Mula-Mutha and Bhima River, Dist. Ahmednagar, Maharashtra
U. D. Kulkarni, Y. M. Nandurkar, R. R. Sangpal
Sixty groundwater samples were collected in different seasons from the study area. The water soluble products of congruent weathering reactions such as Na, K, Ca, Mg, HCO3, and SiO2 have been probed. Apart from these, anthropogenic parameters such as Cl, NO3, PO4, and SO4 have also been analyzed. The mathematical and graphical tools are used to assess the groundwater quality for drinking and irrigation purpose. The study reveals that the concentration of major ions is controlled by the water-rock interactions. The water is not at all suitable for drinking purpose. As per pH, TDS, SAR, chloride and sulphate concentration water is suitable for irrigation purpose. Critical verification of hardness, EC, RSC, salinity hazard compels to assign water quality doubtful for irrigation purpose. Such doubtful zones need special care and suggested to adopt alternative salt tolerance cropping pattern. Also it is advised to avoid excessive use of artificial fertilizer and excessive irrigation.
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Anomalous muscle bellies in the flexor compartment of forearm - a case report
Sunita U Sawant, Sunil M Kolekar
Introduction: The muscular variations of upper limb are common. Their importance becomes apparent with regard to surgical approaches for various clinical conditions involving the upper limb. During routine dissection classes to undergraduate medical students, we came across two additional muscle bellies in the flexor compartment of the left forearm of a male cadaver arising from the under surface of flexor digitorum superficialis (FDS) and were found to be inserted into flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) separately. The above two accessory muscle bellies are also called Gantzer's muscles. In another male cadaver, an accessory muscle belly arising from the flexor digitorum superficialis of the right forearm was found to be inserted into the flexor digitorum profundus (FDP). Muscle anomalies of the upper extremity are recognized causes of peripheral nerve disorder. Awareness of these variations is necessary to avoid complications during radio-diagnostic procedures or surgeries in the upper limb.
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3. Takkallapalli Anita1, Sanjay Kalbande, Krishnamurthy Asha, Dattatray Dombe and Neelee Jayasree A Unique Variation of Flexor Digitorum Superficialis Muscle and Its Clinical Significance J Life Sci 2012; 4, 1, 39-43.
4. Vasavi Rakesh G, Bhagath Kumar Potu, Raghu Jetti, Venkata Ramana Vollala, Thejodhar P Rare Origin of Two Accessory Bellies from the Undersurface of the Flexor Digitorum Superficialis Muscle. Eur J Gen Med 2009; 6, 1, 57-59.
5. Pai MM, Nayak SR, Krishnamurthy A, Vadgaonkar R, Prabhu LV, Ranade AV. The accessory heads of flexor pollicis longus and flexor digitorum profundus: Incidence and morphology. Clin Anat 2008; 21, 252–58.
6. Soubhagya R. Nayak, Suranjali Sharma, Hasi Dasgupta and Kalyan Bhattacharya. Presence of triple gantzer's muscle - a rare anatomical variation. NUJHS Vol. 3, No.1, March 2013, ISSN 2249-7110
7. Jones M, Abrahams PH, San˜udo JR, Campillo M. Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer's muscles). J Anat 1997; 191, 451–55.
8. Potu BK, Gorantla VR, Pulakunta T, Rao MS, Mamatha T, Vollala VR, Nayak SR. Accessory head of flexor pollicis longus muscle and its significance in anterior interosseous nerve syndrome: case report and review. Int J Morphol. 2007; 25, 911–914.
9. Vishal KUMAR, Naveen NS, Murlimanju BV, Prima S. D’SOUZA. A rare muscular variation in the flexor compartment of the forearm International Journal of Anatomical Variations 2011; 4,115–116.
10. Binod Kumar Tamang, Pranoti Sinha, Rohit Kumar Sarda, Poonam Shilal, Murlimanju BV. Incidence and morphology of accessory head of flexor pollicis longus muscle – an anatomical studyâ€. Journal of Evolution of Medical and Dental Sciences 2013; 2, 36, 6800-6806.
Effect on sexual dysfunction in depressed females after treatment with SSRI antidepressants
Abhivant Niteen N., Sawant Neena S.
Introduction: Depression is associated with sexual dysfunction. As the depression improves sexual dysfunction also improves. There are not many studies on female sexuality. Aims and Objectives: To find out the changes in sexual functioning in depressed females after treatment with anti-depressant drugs. Method: 41 female patients diagnosed to have depression were included in study. Becks Depression Inventory, Arizona Sexual Experience Scale and Female Sexual Functioning Index scales were applied at the beginning and after 6 weeks to assess the improvement in sexual dysfunction and depression. Results: When scores were compared after 6 weeks of antidepressant treatment then a highly significant difference was seen on all the scores of BDI ( p< 0.000***), ASEX ( p< 0.027***)and FSFI. (p< 0.01**). On the various domains of FSFI a highly significant difference was seen on the domains of Arousal (p< 0.03**), Lubrication (p< 0.051**), Orgasm (p< 0.028**) and Satisfaction (p< 0.06**). Desire and pain domains did not show any significant changes. Conclusions: This study showed significant improvement in sexual dysfunction and different aspects of sexual dysfunctions after treatment with antidepressants for 6 weeks.
1. Laumann EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281:537–544 2. Mathew RJ, Weinman ML: Sexual dysfunctions in depression. Arch Sexual Behav 1982; 11:323–328 3. Verma KK, Khaitan BK, Singh OP: The frequency of sexual dysfunctions in patients attending a sex therapy clinic in north India, Arch sex behav; 1998;27: 309-314 4. Kulhara P, Avasthi A. Sexual dysfunction on the Indian subcontinent. Int Rev Psychiatry 1995; 7:231-9. 5. Avasthi A, Kaur R, Prakash O, Banerjee A, Kumar L, Kulhara P. Sexual behavior of married young women: A preliminary stud0y from north India. Indian J Community Med 2008; 33:163-7. 6. Grover S, Shah R, Dutt A, Avasthi A. Prevalence and pattern of sexual dysfunction in married females receiving antidepressants: An exploratory study. J Pharmacol Pharmacother 2012; 3:259-65. 7. Angst J. Sexual problems in healthy and depressed patients. Int Clin Psychopharmacol 1998; 13 (Suppl 6): S1–3 8. Montejo A, Llorca G, Izquierdo J, et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. J Clin Psychiatry. 2001; 62:10Y21. 9. Taylor D, Paton C, Kerwin R, editors. Antidepressants and sexual dysfunction. The Maudsley. 9th ed. London: Informa Healthcare; 2007. p. 231-4. 10. Montgomery SA, Baldwin DS, Riley A. Antidepressant medications: A review of the evidence for drug-induced sexual dysfunction. J Affect Disord 2002; 69:119-40 11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Text revision, Washington, DC: American Psychiatric Association, 2000 12. Beck A T et al: “Psychometric properties of Beck Depression Inventory: Twenty five years of evaluationâ€. Clin Psychol Rev, 1988, 8:77-100 13. McGahuey CA, Gelenberg AJ, Laukes CA, et al. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther. 2000; 26:25- 40. 14. Meston CM. Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder. J Sex Marital Ther 2003; 29:39-46. 15. Wiegel M, Meston C, Rosen R. The Female Sexual Function Index (FSFI): Cross-validation and Development of Clinical Cutoff Scores. J Sex Marital Ther 2005; 31:1-20. 16. Female Sexual Function Index [homepage on the Internet]. Bayer AG, Zonagen, Inc. and Target Health Inc.; © 2000 Available from: http://www. fsfiquestionnaire.com/. [Last cited on 2009 Mar 23]. 17. Hayes RD, Dennerstein L, Bennett CM, Fairley CK What is the true prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sex Med. 2008; 5:777-787. 18. Mathew R, Weinman M. Sexual dysfunctions in depression. Arch Sex Behav. 1982; 11:323-328. 19. Clayton A, Pradko J, Croft H, Montano CB, Leadbetter RA, Bolden-Watson C et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychiatry. 2002;63:357-366 20. Gregorian R, Golden K, Bahce A, Goodman C, Kwong WJ, Khan ZM. Antidepressant-induced sexual dysfunction. Ann Pharmacother. 2002; 36:1577-1589. 21. van Geffen EC, van der Wal SW, van Hulten R, de Groot MC, Egberts AC and Heerdink ER. Evaluationof patients’ experiences with antidepressants reported by means of a medicine reporting system. Eur J Clin Pharmacol. 2007;63:1193-1199 22. Keltner NL, McAfee KM, Taylor CL. Mechanisms and treatments of SSRI-induced sexual dysfunction. Perspect Psychiatr Care. 2002; 38:111-116. 23. Chen KC, Yang YK, Lee IH, Yeh TL, Lu RB, Chen PS Sexual dysfunction and physicians’ perception in medicated patients with major depression in Taiwan. Depress Anxiety. 2008; 25:E56-E62. 24. Williams VS, Baldwin DS, Hogue SL, Fehnel SE, Hollis KA, Edin, H.M. Estimating the prevalence and impact of antidepressant-induced sexual dysfunction in 2 European countries: a cross-sectional patient survey. J Clin Psychiatry. 2006; 67:204-210. 25. Werneke U, Northey S, Bhugra D. Antidepressants and sexual dysfunction. Acta Psychiatr Scand. 2006; 114:384-397. 26. Lahon K, Shetty HM, Paramel A, Sharma G. Sexual dysfunction with the use of antidepressants in a tertiary care mental health setting - a retrospective case series. J Pharmacol Pharmacother 2011;2:128-31 27. Kennedy SH,Rizvi S.Sexual Dysfunction, Depression, and the Impact of Antidepressants. Journal of Clinical Psychopharmacology 2009;29 (2): 157-164
Schizencephaly: a case report of a rare developmental disorder of brain
Kapil S. More, Vijaykumar R. Kapse, Sonali Kagne, Deepak Kubde
Introduction: Schizencephaly is an extremely rare developmental disorder of the brain. Its prevalence in Indian data is 1.5: 1,00,000 population. It is a triad of hemiplegia, seizure disorder and mental retardation. Hence we are reposting a case of 28 yrs. old female who presented with intractable seizures and altered sensorium for 2 days. She is a known case of epilepsy since the age of two months. She also had left sided hemiparesis since the same duration. She had delayed developmental milestones and mental retardation. Her, CT brain was done. It showed large fluid filled cavity occupying right frontal, temporo- parietal region lined by grey matter communicated with right ventricle. These findings are constistent with right sided unilateral open-lip schizencephaly.
1. Denis D, Chateil JF, Brun M, Brissaud O, Lacombe D, Fontan D, Flurin V, Pedespan J. Schizencephaly: Clinical imaging features in 30 infantile cases. Brain Dev 2000 Dec; 22(8)475-83 2. Iannetti P, Nigro G, Spalice A, Faiella A, Boncinelli E. Cytomegalovirus infection and schizencephaly: case report Ana Neuronal 1998 Jan; 43(1); 123-7 3. Pati S, Helmbrecht GD. Congenital schizencephaly associated with utero warfarin exposure Reprod Toxicol 1994 Mar- Apr 8(2): 115-20 4. Capra-V; De-Marco-P; Moroni-A; Faiella- A; Brunelli-S; Tortori-Donati-P; Andreussi- I; Boncinelli-E; Cama-A Schizencephaly: Surgical features and new molecular genetic results. Emr J Pediatr Surg 1996 Dec; suppl 1:27-9 5. Al-Qudah-AA Clinical patterns of neuronal migration disorder and parental consanguinity. J T Prop Pediatr.1998 Dec; 44(6): 351-4 6. Gasparetto EL, Warszawiak D, de Carvalho Neto A, Benites Filho PR, Bruck I, Antoniuk S. Septo optic dysplasia plus a case report. Arq Neuropsiquitar 2003 Sep; 671-6 7. Hayashi N, Tsutsumi Y, Barkovich AJ. Morphological features and associated anomalies of schizencephaly in the clinical population: detailed analysis of MR images. Neuroradiology 2002 May; 44(5): 418-27
Comparative study of glycosylated hemoglobin and lipid profile in gestational diabetic women and normal pregnant women
B. J. Pradeep Kumar, Sudhir Modala, Parimala P., Manisha Baghel
Aim: Lipid profile and glycosylated hemoglobin level changes in gestational diabetes. The extent to which this alteration takes place is still not clearly documented. Materials and Methods: To add a clear answer to this question, lipid profile parameters, and glycosylated hemoglobin status were determined in patients with gestational diabetes mellitus and compared to healthy pregnant women (controls). Results: Fasting plasma glucose levels, plasma glucose levels 1 hour, and plasma glucose levels 2 hours after 75 gm oral glucose administration (oral glucose tolerance test) were significantly higher in patients with gestational diabetes as compared to controls. Glycosylated hemoglobin was significantly higher in gestational diabetes than in controls. It was observed that there was a significant increase in serum cholesterol and serum triglyceride level in cases with gestational diabetes when compared to healthy pregnant women. Conclusion: The results of our study suggest that abnormal glucose levels, glycosylated hemoglobin, serum cholesterol, and serum triglycerides play an important role in pathophysiology of gestational diabetes, and therefore, extensive studies are required. Early diagnosis of gestational diabetes will decrease adverse neonatal and maternal outcomes
1. Kalliopi I. pappai,2, Nicholas P. Anagnou3, Emmanuel Salamalekis2 et.al; Gestational Diabetes Exhibits Lack of Carnitine Deficiency Despite relatively Low Carnitine Levels and Alterations in Ketogenisis; Journal of Maternal-Fetal and Neonatal Medicine (2005). 2. Louise K Pirc, Julie A Owens, Caroline A Crowter, Kristyn Willson Miles J De Blasio et.al; Mild Gestational diabetes in pregnancy and the adipoinsular axis in babies born to mother in the ACHOIS randomized controlled trial; BMC pediatrics. 2007; 7:18. 3. Landon, M, Catalono, and P.M and Gabbe, S.G (2001) Diabetes mellitus In: Obstetrics: Normal and problem pregnancies (Gabbe S.G., Niebyl, J.R and Simpson, J.L., cds), pp 1081-1116. 4th Edition Churchill Livingstone, New York. 4. Jimenez-Moleon JJ, Luna-del-Castillo J, Garcia-Martin M, Lardelli-Claret P, Calvez-Vargas R. Prevalence of gestational diabetes mellitus: Variation related to screening strategy used. Eur J Endocrinol 2002;146:831-37 5. Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational Diabetes mellitus and its association with Type 2 Diabetes. Diabet Med 2004; 21:103-13. 6. Dooley SL, Metzger BE, Cho NH. Gestational diabetes mellitus: Influence of race on disease prevalence and perinatal outcome in a U.S. population. Diabetes 1991;40:25-29 7. Coustan DR, Nelson C, Carpenter MW, Carr SR, Widness JA. Maternal age and screening for gestational diabetes: A population based study. Obstet Gynecol 1989;73:557-61 8. ACOG Committee on Practice Bulletins - Obstetrics. ACOG practice bulletin. Management of preterm labor. Int J Gynaecol Obstet 2003;82:27-135 9. Sokol R, Blackwell S. American College of Obstetricians and Gynecologists Committee on Practice Bulletins. ACOG practice bulletin: Shoulder dystocia. Int J Gynaecol Obstet 2003;801:87-92 10. Kjos SL, Buchanan TA, Montoro M, Coulson A, Mestman JH. Serum lipids within 36 month of delivery in women with recent gestational diabetes. Diabetes 1991;40:142-6 11. Alexander CM, Landsman PB, Teutsch SM. Diabetes mellitus, impaired fasting glucose, atherosclerotic risk factors, and prevalence of coronary heart disease. Am J Cardiol 2000;l86:897-902 12. Masding MG, Stears AJ, Burdge GC, Wootton SA, Sandeman DD. Premenopausal advantage in postprandial lipid metabolism are lost in women with type 2 diabetes. Diabetes Care 2003;26:3243-9 13. Ho JE, Paultre F, Mosca L. Is diabetes a cardiovascular disease risk equivalent for fatal stroke in women? Data from the Women's Pooling Project. Stroke 2003;34:2812-6 14. Natarajan S, Liao Y, Cao G, Lipsitz SR, McGee DL. Sex differences in risk of coronary heart disease mortality associated with diabetes and established coronary heart disease. Arch Intern Med 2003; 163:1735-40. 15. Kanaya AM, Grady D, Barrett-Connor E. Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: A meta-analysis. Arch Intern Med 2002; 162:1737-45. 16. Chen L, Hu FB, Yeung E, Willett W, Zhang C. A prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care 2009;32:2236-41 17. Varley H. Glucose tolerance tests and tests for investigating hypoglycemia. In: Practical Clinical Biochemistry. 4th ed. New Delhi: CBS Publishers and Distributors; 2005. p. 97-102. 18. Trinder P. Determination of blood glucose using an oxidase - peroxidase system with a noncarcinogenic chromogen. Journal of clinical pathology 1969; 22:158-61. 19. Little RR, England JD, Weidmeyer HM, Goldstein DE. Glycosylated hemoglobin measured by affinity chromatography: Microsample collection and room-temperature storage. Clin Chem 1983; 29:1080-2. 20. Alian CC, Poon LS, Chan CSG. Enzymatic determination of total serum cholesterol. Clinical Chemistry 1974; 20:470-5. 21. Bucolo G, David H. Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 1973;19:476-82 22. Burstein M, Scholnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyamines. J Lipid Res 1970;2:583-95 23. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without the use of preparatory centrifuge. Clin Chem 1972;18:499-503 24. Sobki SH, Al-Senaidy AM, Al-Shammari TA, Inam SS, Al-Gwiser AA, Bukhari SA.Impact of gestational diabetes on lipid profiling and indices of oxidative stress in maternal and cord plasma. Saudi Med J. 2004 Jul;257:876-80 25. Taricco E, Radaelli T, Rossi G, Nobile de Santis MS, Bulfamante GP, Avagliano L, Cetin I. Effects of gestational diabetes on fetal oxygen and glucose levels in vivo. BJOG. 2009 Dec; 11613:1729-35. Epub 2009 Oct 13 26. Baxi L, Barad D, Reece EA, Farber R. Use of glycosylated hemoglobin as a screen for macrosomia in gestational diabetes. Obstet Gynecol 1984;6:347-50 27. Bacigalupo G, Langner K, Saling E. Glycosylated hemoglobin (HbA1c), glucose tolerance and neonatal outcome in gestational diabetic and nondiabetic mothers. J Perinat Med 1984; 12:137- 45.
Inducible clindamycin resistance in Staphylococcus aureus isolatedfrom clinical samples
K. Vidyasagar, R. Ravikumar
Purpose: Clindamycin is commonly used in the treatment of erythromycin resistant Staphylococcus aureus causing skin and soft tissue infections. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on routine basis. Materials and Method: 100 Staphylococcus aureus isolates from various clinical samples subjected to routine antibiotic susceptibility testing by Kirby Bauer disc diffusion method. Inducible clindamycin resistance was detected by D test, as per CLSI guidelines on erythromycin resistant isolates. Results: 42 (42%) isolates showed inducible clindamycin resistance, 13 (13%) showed constitutive resistance while 10(10%) showed MS phenotype. Inducible resistance was found to be higher in Methicillin resistance Staphylococcus aureus (MRSA) as compared to Methicillin sensitive Staphylococcus aureus (MSSA) (56.6%, 13.2% and 25.53%, 12.7% respectively) Conclusion: Study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance.
1. Feigin RD, Pickering LK, Anderson D, et al .Clindamycin treatment of osteomyelitis and septic arthritis in children. Pediatrics. 1975; 55:213–223. 2. Martinez-Aguilar G, Hammerman W, Mason E Jr, et al. Clindamycin treatment of invasive infections caused by community-acquired, methicillin resistant and methicillin-susceptible Staphylococcusaureus in children. Pediatr Infect Dis J. 2003; 22:593–598. 3. Frank AL, Marcinak J, Mangat P, et al. Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children. PediatrInfect Dis J. 2002; 21:530 –534. 4. Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Practical disc diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase negative Staphylococci. J Clin Microbiol 2003; 41:4740-4. 5. Gadepalli R, Dhawan B, Mohanty S, Kapil A, Das BK, Chaudhry R. Inducible clindamycin resistance in clinical isolates of Staphylococcus aureus. Indian J Med Res 2006; 123:571-3. 6. Steward CD, Raney PM, Morrell AK, Williams PP, McDougal LK, Jevitt L, et al. testing for induction of clindamycin resistance in erythromycin resistant isolates of Staphylococcus aureus. J Clin Microbiol 2005;43:1716-21 7. Kloos WE, Banerman TL. Staphylococcus and Micrococcus, Chapter 22. In: Manual of clinical microbiology. 7 th ed. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, editors. Washington DC: ASM Press; 1999. p. 264-82. 8. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing; Seventeenth informational supplement. Vol. 27. No.1 Clinical Laboratory Standards Institute; 2007. 9. Yilmaz G, Aydin K, Iskender S, Caylan R, Koksal I. Detection and prevalence of inducible clindamycin resistance in staphylococci. J Med Microbiol 2007;56:342-5 10. Rahabar M, Hajia M. Inducible clindamycin resistance in Staphylococcus aureus: A cross sectional report. Pak J BiolSci 2007; 10:189-92. 11. Ajantha GS, Kulkarni RD, Shetty J, Shubhada C, Jain P. Phenotypic detection of inducible clindamycin resistance amongst Staphylococcus aureus isolates by using lower limit of recommended inter-disk distance. Indian J Pathol Microbiol 2008; 51:376-8. 12. Rao GG. Should clindamycin be used in treatment of patients with infections caused by erythromycin-resistant staphylococci? J AntimicrobChemother 2000; 45:715.
Evoked response audiometry in high risk infants
Lakshmi T., Zaheera Sultana S., S. V. Brid
Background: Hearing is the means by which the newborn comes into contact with the world of sound and with language. The first three years of life are the most important period for speech and language acquisition. Reduced hearing acuity of any severity in infancy or early childhood may prevent the child from receiving adequate auditory, linguistic and social stimulation required for speech and language development. Hearing loss is one of the most common abnormalities present since birth. The prevalence of hearing loss is reported to be 1.5 to 6 per 1000 newborn in the well baby nursery population. Several risk factors associated with hearing loss during early infancy have been described by Joint Committee on Infant Hearing which includes hereditary cause, inutero infection, prematurity, asphyxia, hyperbili-rubinemia and ototoxic medications. Objectives: To assess the degree of hearing impairment in high risk infants by using BERA and to analyse and compare BERA responses in high risk infants with age matched controls. Methods: 100 high risk infants having one or more risk factors attending Pediatric OPD of Bapuji hospital and Chigateri General Hospital and 30 age matched controls satisfying the inclusion criteria were randomly selected from immunization centre were subjected to BERA. Parameters such as absolute latencies of waves I, III, and V, Interpeak latencies I-III, I-V and III-V were assessed and analysed by using unpaired t-test. Results: The high risk infants had increased wave V threshold when compared to the control group. Absolute latencies of wave III, V, interpeak latencies of I-III and I-V were prolonged in the cases. The incidence of hearing impairment was 64.9% in the high risk infants.
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Study to find the efficiency of multi-detector computed tomography in evaluation of renal masses
Shailender Singh N, Satishchandra H
Introduction: Detection of malignant renal masses and their differentiation from their benign counterparts is extremely important, especially when these masses are small. Although the effectiveness of conventional axial renal CT is well established, a variety of problems can be encountered. The major advantages of the multiple detector-row computed tomography (MDCT) technology over conventional CT is that it allows for acquisition of different image thicknesses from the same acquisition data set. Thus the present study was undertaken to study the efficiency of MDCT in diagnosing renal masses. Aims and Objective: To find out the efficiency of Multi-detector Computed Tomography in the evaluation of renal masses. Materials and Method: The study was conducted over a period of two years on 50 patients with clinically suspected Renal mass or patients who were diagnosed to have renal mass on ultrasound and were referred to CT for further characterization. Results: Overall there were 33 (66%) males and 17 (34%) females; the male to female ratio was 1.9:1.thus renal neoplasm was seen more commonly in males. MDCT was able to differentiate a benign from malignant lesion with Sensitivity of 100, Specificity of 71 %, and Accuracy of 96 %. When the images were assessed in unenhanced, corticomedullary and nephrographic phases. Conclusion: Multi-detector Computed Tomography can be used as an efficient tool with high degree of accuracy in diagnosing renal masses.
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Prescription pattern of antihypertensive drugs and life style practices of hypertensive patients in an urban locality of Mysore
Kalabharathi H L, Mohammed Sibgatullah, Pushpa V H, Satish A M, Suresha R N
Objective: To determine the prescription pattern of antihypertensive drugs in Narsimharajamohalla of Mysore. To determine the lifestyle practices of hypertensives. Materials and Methods: Around 165 patients were enrolled in the survey after obtaining their consent. Prescription pattern of antihypertensive drugs was noted. Lifestyle practices such as exercise habits, dietary salt intake; compliance to medication was enquired through a questionnaire. Results: majority of patients are on combination therapy. Diuretics were the commonly prescribed antihypertensives. Reduction in salt intake and exercise habits were poor among majority of the patients. Few patients were noncompliant to the prescribed medication. Conclusion: With the obtained data showing a large amount of patients on combination therapy with poor life style practices, there should be an emphasis on health education. The prescribing doctor, paramedics, media, government should do their best in educating the masses.
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