Showing papers in "International Journal of Research in Medical Sciences in 2014"

Dermatoglyphics: in health and disease - a review -

Abstract: Dermatoglyphics is the study of finger print patterns and the term was coined by Harold Cummins in 1926. Finger prints are imprints of epidermal ridges, which are formed in early embryonic life, during 10 th to 16 th week of intrauterine life and remain permanent during whole life. Dermatoglyphic patterns have polygenic inheritance and are affected by environmental factors in the uterus. Finger print patterns are mainly of three types: arches whorls and loops; though there are more than 100 ridge characteristics, called Galton’s details, in a single rolled finger print. Dermatoglyphics is not only used in the identification of an individual but also serves as a mirror of one’s potential and talent. In this review, we will be discussing Dermatoglyphics and its important role in the diagnosis of chromosomal disorders and other diseases which have some genetic bases.

Morphometric analysis of sella turcica in North Indian population: a radiological study

Abstract: Background: The purpose of this study was to describe the morphology and measure the size of the sella turcica in North Indian population. Methods: Lateral cephalometric radiographs of 180 individuals (90 males and 90 females) with an age range of 12 - 65 years were taken. Morphology of sella turcica was studied and various measurements were taken to determine the shape of the sella. Statistical analysis was done to calculate differences in dimensions and to establish if any, relationship exists between age, sex and the morphometry of sella turcica. Results: The study found that sella turcica presented with a normal morphology in only 28 per cent of the subjects. A significant difference in linear dimensions between genders was found in sella height and width. When age was evaluated, some dimensions showed negative correlation with the age. Sella size of the older age group was as a rule larger than the younger age. Conclusion: Pathological enlargement of the pituitary fossa can be detected by this technique and may also be helpful in providing data in the assessment of racial, gender, age specific variation in the skull.

Work related musculoskeletal disorders among medical laboratory professionals: a narrative review

Abstract: Work related musculoskeletal disorders are common health problem and increasing cause of disability. Laboratory professionals are unique group of healthcare professionals who play an essential part in diagnosis and therapy planning and often their work is associated with potential health hazards. Objective of current study was to review literature on prevalence of work-related musculoskeletal disorders among medical laboratory professionals. Electronic databases and bibliographies were searched and identified papers evaluated against inclusion criteria. The searching strategy uncovered 13 reports. Total 7 studies were included for the review. A high degree of heterogeneity among studies was observed. The overall prevalence’s ranges from 40-60%. With neck being more prevalent 18-78%. However additional high quality studies are required in this area.

A study of complications of scrub typhus in a tertiary health care institute of Uttarakhand, India

Abstract: Background : Scrub typhus or tsutsugamushi disease is a febrile illness caused by Orientia tsutsugamushi. Uttarakhand State in the northern region of India has been witnessing increased incidence of this fever. There is paucity of data on this topic from this region. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from scrub typhus in a tertiary health care institute of Uttarakhand, India. Methods: The study was performed at SGRR Institute of Medical & Health Sciences, Dehradun, which is a tertiary health care institute Uttrakhand. The study period was of 1year from December 2012 to November 2013. Patients of 12 years of age or above it who were IgM antibody positive by ELISA technique were included in the study. All such patients underwent detailed clinical examination and investigation. Results: 47 patients were found to be suffering from scrub typhus. The common symptoms noted fever, myalgias, headache, vomiting, diarrhoea, breathlessness, petechiae and jaundice. Common complications noticed were hepatitis (78.7%) acute respiratory distress syndrome (19.2%), thrombocytopenia (46.8%) and acute renal failure (31.9%), Mortality was seen in 3 (6.4%) patients. Conclusions: Scrub typhus is an important cause of mortality and morbidity in Uttarakhand. High index of suspicion, early diagnosis, monitoring of the clinical and laboratory parameters and prompt intervention may help in reducing the mortality.

Histopathological study of endometrium in cases of abnormal uterine bleeding

Abstract: Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB) also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%). The most common menstrual disorder was menorrhagia (46.86%). In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8%) followed by endometrial hyperplasia (19.40%), atrophic endometrium (7.16%), secretory endometrium (5.97%), irregular shedding [1.80%], irregular ripening (1.20%) and anovulatory endometrium (0.59%). Organic lesions encountered in AUB cases were leiomyoma (17.92%), endometrial polyp (1.79%), endometrial carcinoma (1.50%), endometriosis (0.59%) and choriocarcinoma (0.29%). Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications.

Prevalence and risk factors of nocturnal enuresis among school age children in rural areas

Abstract: Background: The word enuresis is derived from a Greek word ( enourein ) that means “to void urine.” It can occur either during the day or at night (though some restrict the term to bedwetting that occurs at night). Enuresis can be divided into primary and secondary forms. Aim of current study was to find out the prevalence and underlying its risk factors of nocturnal enuresis in age groups 5 to 12 years in the rural areas of the district. Methods: The study was done during the year 2011-12 among 1258 school children residing in rural areas of Ahmadabad district of Gujarat state by the help of health personnel staff with the cooperation of the teaching staff and all the parents of the children. Results: There were 869 males and 389 females. We found the prevalence of nocturnal enuresis in 11.13% of total subjects. Nocturnal enuresis was more common in males than in females, 91/140 in males and 49/140 in female children. Conclusions: Our findings suggest that nocturnal enuresis is a common problem among school children especially with low income, lower age, family history of enuresis and history of urinary tract infection. Enuresis is a pediatric public health problem and efforts at all levels should be made such as preventive, etiological and curative. The ratio of males to females in this study was 1.86 that is comparable to other data of the same study.

An overview of hospital acquired infections and the role of the microbiology laboratory

Abstract: Every year, many lives are lost because of the spread of infections in hospitals These nosocomial infections, also called hospital acquired infections (HAI) are infections that patients acquire during the course of receiving healthcare treatment for other conditions HAIs are a cause of significant morbidity and mortality in patients receiving healthcare, and the costs direct and indirect of these infections deplete the already limited financial resources allocated to healthcare delivery

Increasing incidence of multidrug resistant Pseudomonas aeruginosa in inpatients of a tertiary care hospital

Abstract: Background: Pseudomonas aeruginosa is an important pathogen isolated from various clinical infections. The occurrence of multidrug-resistant (MDR) Pseudomonas aeruginosa strains is increasing worldwide and limiting our therapeutic options resulting in high mortality. We aim to study the incidence of multidrug resistant Pseudomonas aeruginosa in inpatients from various departments along with rate of nosocomial infections. Methods: A cross sectional study from January 1, 2013 to December 31, 2013. A total of 167 Pseudomonas aeruginosa were isolated from 764 clinical specimens. The isolates were identified by standard microbiological techniques. The antibiotic susceptibility was done by Kirby Bauer method. Results: The highest number of isolates were from pulmonary samples n=90 (53.89%) followed by pus n=48 (28.74%). Overall, 39 (23.36%) isolates were nosocomial. The nosocomial isolates were mainly isolated from department of surgery, orthopaedics, obstetrics & gynaecology followed by others. Among 167 isolates screened, 53 (31.73%) were found to be MDR (resistant to ≥3 classes of antipseudomonal agents). The resistance was most against cephalosporins [Cefepime (65.26%), cefotaxime (60.47%)], fluoroquinolones [Ciprofloxacin (46.1%), levofloxacin (31.87%)] aminoglycosides [Amikacin (37.72%), gentamicin (31.13%)] followed by ureidopenicillins and carbepenems. About 56.75% isolates were suspected Metallo β lactamases producers. Conclusion: The study suggests that the incidence of nosocomial infection by multidrug resistant Pseudomonas aeruginosa is increasing globally especially the Metallo Beta lactamases producing strains. So there is a continuous need of conduction of surveillance programmes to formulate rational treatment strategies to combat this emerging challenge.

Prospective study of histopathological patterns of ovarian tumours in a tertiary care centre

Abstract: Background: Ovarian tumours account for 3% of all cancers amongst women, being the second most common cancer of the female genital tract. The ovarian tumours are highly heterogenous with a wide range of histological patterns. Aim of current study was to study the histological patterns and the age incidence of the ovarian tumours in our institute. Methods: The present study is a prospective study conducted in the department of pathology, Andhra Medical College, from August 2011 to July 2013. Results: We received a total of 267 specimens of ovarian tumours during this period, out of which, 263 were primary and 4 were secondary tumours. Benign tumours were 209 (78.3%), borderline were 10 (3.7%) and malignant were 48 (18%) in numbers. Overall surface epithelial tumours constituted the majority of tumours accounting for 214 (80.2%) cases, followed by germ cell tumours 38 (14.2%) and sexcord stromal tumours 11 (4.1%). The single most common tumour diagnosed was serous cystadenoma. The most common malignant tumour was serous cystadenocarcinoma. The age groups affected ranged from 11-70 years. The peak age incidences for different histological types were as follows: surface epithelial tumours: 21-50 years, germ cell tumours: 21-30 years, sexcord stromal tumours: 51-60years. Benign tumours were more common in 21-40 years of age, borderline in 31-50 years and malignant tumours in 41-50 years age group. Conclusion: The results from our study were comparable with those reported in literature; however malignant serous and mucinous tumours showed a lower peak age incidence in our study. Krukenberg tumours also occurred in younger age group in our study.

Hypertension and associated risk factors in some selected rural areas of Bangladesh

Abstract: Background: Although, Bangladesh has the ninth highest rate of age-standardized rates of deaths due to chronic diseases, mostly due to cardiovascular diseases and diabetes. There is scanty literature on the estimated burden, and the determinants of hypertension in the rural areas of Bangladesh. Methods: This facility based cross-sectional survey was conducted at sub-urban field research clinic from four unions of Araihazar upazilla of Narayangong district, Bangladesh. The analyses were based on 212 male and female respondents of more than 30 years of age. The prevalence of hypertension was the main outcome of interest. Results: The study found that the prevalence of systolic hypertension among the respondents is 15.6% and that of diastolic pressure is 12.3%. Systolic pressure was found in an increasing manner with the increase of age and BMI. Tendency of increase systolic pressure was observed among those who took extra salt. Significant association was also found between increasing systolic pressure with the heart disease. No significant association was found between increasing systolic pressure with smoking habit, physical activity and vegetable intake and with the development of systemic diseases namely cardiovascular disease (CVD), diabetes mellitus and coronary obstetrics pulmonary disease. Conclusion: Suggestion on regular periodical health check-up especially including blood pressure monitoring and restriction of taking extra salt to all the people of age more than 30 years is recommended.

Histopathological study of neoplastic lesions of large intestine in Kashmir Valley, India

Abstract: Background: Aim of current study was to study the histopathological spectrum of neoplastic lesions of large intestine and histopathological pattern of colorectal carcinoma in young adults. Methods: We took a combined retrospective & prospective study in the department of pathology. The specimens were collected from subjects diagnosed as colorectal carcinomas in histopathology department and clinical details were sought from the medical records. Variables like age, sex, dietary habit, relevant history, tumor size, location, type of lesion, histological pattern of patients were checked. Results: In the series of 446 patients of colorectal neoplasm, maximum number of patients presented in 4 th to 6 th decade of life (47.30%), while as (15.46%) were between 20-40 years. The youngest patient with an adenocarcinoma was 18 years (male) of age and the oldest one was 80 years (male) of age. Average age of patients was 50.50 years. The male to female ratio was 1.3:1. The study revealed that the carcinoma of ascending colon was much more prevalent, constituting 107 (40.07%) cases. The proportion of well differentiated carcinoma was highest in left side colon and rectum. The incidence of moderately differentiated and poorly differentiated carcinoma was greater on right side colon. Conclusion: Adenocarcinoma is the most common histological variant of colon carcinomas.

Bacteriological study of discharging ear in patients attending a tertiary care hospital

Abstract: Ear infections occur in all age groups. Chronic Suppurative Otitis Media ( CSOM) is the most common illness in ENT practice. It may even cause hearing impairment especially sensory – neural deafness if not treated properly and with caution. The study was undertaken to know the aerobic microbiological/bacteriological profile of ear discharge and variations in sensitivity pattern to treat the patients efficiently. A total of 71 patients who had discharging ear infection were included in this study. The most common microorganisms isolated were Pseudomonas aeruginosa and Staphylococcus aureus followed by Coagulase-Negative Staphylococci ( CoNS), Klebsiella spp, Proteus spp and Escherichia coli. Among the commonly used topical antibiotics, Ciprofloxacin appear to be first line antibiotic (91.52% sensitive) to treat CSOM followed by Gentamycin (89.6% sensitive). However, the action of Chloramphenicol was low (59.53% sensitive). Ofloxacin can be used to treat CSOM due to Staphylococcus aureus other than Ciprofloxacin and Gentamycin.

Aerobic bacteriology of chronic suppurative otitis media: a hospital based study

Abstract: Background: Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups both in developing and industrialized countries. It involves considerable morbidity and can cause extra- and intra-cranial complications. The aim of this study was to determine the microbial diversity and the antibiogram of aerobic bacterial isolates among patients suffering from CSOM who attended the ENT Department of SMHS hospital, a tertiary care centre located in the heart of the Kashmir valley. Methods : A total of 154 patients clinically diagnosed with CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and cultured for microbial flora. Drug susceptibility testing for aerobic isolates was conducted using Kirby-Bauer disc diffusion method. Results : Out of total 154 ear swabs processed, microbial growth was seen in 138 (89.61%) while 16 (10.38%) samples showed no growth. In 102 (66.23%) samples mono-microbial growth was seen whereas 26 (16.88%) samples showed poly-microbial growth. The most frequent organism isolated was Pseudomonas aeroginsa followed by Staphylococcus aureus and Proteus sp. The most effective antibiotic against Pseudomonas aeroginsa was amikacin followed by imipenem and piperacillin plus tazobactam, while as Staphylococcus aureus showed maximum sensitivity to vancomycin. Conclusion: Otitis media linked with high levels of multiple antibiotic resistant bacteria is a major health concern in all age groups of the study population. An appropriate knowledge of the etiology and antibacterial susceptibility of microorganisms would contribute to a rational antibiotic use and the success of treatment for chronic supportive otitis media.

A study of superficial surgical site infections in a tertiary care hospital at Bangalore

Abstract: Background: All postoperative surgical infections occurring in an operative site are termed surgical site infections (SSI). Superficial incisional surgical site infection occurs within 30 days after the operation and infection involves only skin or subcutaneous tissue of the incision and represents a substantial burden of disease for patients and health services. The study was conducted to know the incidence of surgical site infection in our hospital, risk factors associated with it and the antibiotic susceptibility pattern of the pathogens. Methods: This prospective study was carried out in the Department of Microbiology at Dr B R AMC for a period of 1 year from Jan 2013to Jan 2014. Samples of SSI received in the Microbiology laboratory were processed and Data collected. Results: The overall surgical site infection rate in our hospital during the study period is 4.3%. Staphylococcus aureus (S. aureus) was the most common isolate obtained followed by Escherichia coli (E. coli) and Coagulase negative Staphylococcus (CONS). Other organisms isolated were Pseudomonas aeruginosa, Enterococcus, Klebsiella pneumoniae and Proteus mirabilis. Among them, 88.8% of S. aureus and 50% of CONS isolates were methicillin-resistant strains. 80% of E. coli and 100% of Klebsiella species were ESBL producers. 50% of Enterococci were Vancomycin resistant. Risk factors like diabetes mellitus and duration plays a significant role in causing surgical site infection. Conclusion: Implementation of an effective infection control programme and judicious use of antibiotic prophylaxis reduces the incidence of SSI in the hospital.

Predictors of diabetes distress in patients with type 2 diabetes mellitus

Abstract: Background: Diabetes distress is a condition distinct from depression that is related to diabetes outcomes.This study intends to identify the predicting risk factors of diabetes distress in Bangladeshi type 2 diabetes mellitus patients. Methods: A cross sectional study was conducted from January to June, 2012 in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. Data were collected through interview and reviewing documents. Results: Among 165 respondents, the proportion of diabetes distress was 48.5% (n=80) which include 22.4% (n=37) high distress and 26.1% (n=43) moderate distress. Glycemic status measured by HbA 1c was the best predictor of diabetes distress [Adjusted odds ratio (AOR) 1.56; 95% Confidence Interval (CI) 1.16 to 2.10]. Insulin users were five times more likely to develop distress [Adjusted odds ratio (AOR) 5.05; 95% Confidence Interval (CI) 1.20 to 21.19] than users of oral anti-diabetic agents. Other predictors of diabetes distress were duration of DM [Adjusted odds ratio (AOR) 1.27; 95% Confidence Interval (CI) 1.06 to 1.52], Diabetic complications [Adjusted odds ratio (AOR) 3.92; 95% Confidence Interval (CI) 1.09 to 14.19], Average monthly family income [Adjusted odds ratio (AOR) 1.00; 95% Confidence Interval (CI) 1.00 to 1.00]. Conclusion: HbA 1c , treatment modalities, duration of DM, diabetic complications and average monthly family income appeared to be significant predicting factors of diabetes distress among the type 2 diabetes mellitus patients. This should be taken into consideration for effective management of patient.

The relationship between pelvic alignment and trunk control in stroke subjects: a cross-sectional study

Abstract: Background: Following stroke static as well as dynamic components of postural control were affected. Ability to maintain postural alignment is also a vital component of the postural control system. Pelvic asymmetry is commonly observed in stroke subjects which can influence trunk control. However, there is a paucity of literature that determines the relationship between pelvic alignment and trunk control in subjects with stroke. Aim: To analyze the relationship between pelvic alignments using PALM and trunk control as measured by the Trunk Impairment Scale (TIS). Setting: Inpatient rehabilitation unit, Tertiary Care Hospitals, Mangalore. Design: A cross-sectional study. Subjects: 38 supra-tentorial stroke subjects with more than 3 weeks duration and who can be able to sit independently were recruited. Methods: The medio-lateral pelvic alignment of the stroke subjects was measured in sitting using the PALM™. The deviation in the pelvic tilt on the paretic side in comparison to the non-paretic side was measured in degrees. Following which the trunk control was evaluated using the Trunk Impairment Scale. Results: The correlation between the pelvic tilt and the trunk control in the stroke subjects showed a negative correlation which indicates that a change in the pelvic alignment which affects the trunk control. Pelvic tilt values negatively correlated with all the sub-items of trunk impairment scores (p < 0.00). The pelvic tilt and the items of TIS scores. Brunnstrom’s stage of lower extremity Motor Recovery demonstrated a significant association (p < 0.05), except for the coordination sub score of the TIS. Conclusion: Pelvic alignment influences the trunk control and is also available to be associated significantly with the acute phase of stroke (3 weeks to 3 months). Brunnstrom’s Stage of lower extremity motor recovery is also associated significantly with the static and dynamic sub scores of the TIS, hence trunk control may influence extremity motor recovery.

Oncogenic human papilloma virus infection among women attending the cytology clinic of a tertiary hospital in Lagos, South-West Nigeria

Abstract: Background: Cervical cancer is the most common gynaecological cancer and a leading cause of cancer death in women in Nigeria. Persistence infection with high risk or oncogenic Human Papillomavirus (HPV) types is now known to be a necessary cause of cervical cancer. Methods: This study is a descriptive cross-sectional study carried out to determine the prevalence and distribution of oncogenic HPV infection among women seen at the cytology clinic of a tertiary hospital in Lagos South-west Nigeria and then identify the likely predisposing factors to this infection. Eligible women were selected by consecutive sampling method for the study. Pap smear and endocervical swab samples were collected from each participant. The endocervical swab samples were screened for HPV types 16, 16A, 31, 33 and 35 by the multiplex Polymerase Chain Reaction (PCR) using the specific primers for the HPV types. Results: Twenty-four (30.4%) of the 79 tested swab samples were positive for viral DNA of high risk HPV 16. There was a statistically significant difference in the mean ages of participants with positive cervical HPV and those without the infection respectively (34.8 ± 9.9 vs. 46.2 ± 10.1 years; P = 0.028). However, there were no significant differences found between the women with HPV positivity and those without with respect to marital status (P = 0.074), tribe (P = 1.009), religion (P = 0.681) and educational status (P = 0.552). Other identified risk factors that showed statistically significant differences for oncogenic HPV infection were age at sexual debut (P = 0.009), parity (P = 0.003), number of lifetime sexual partner(s) (P = 0.000), use of combined oral contraceptives (P = 0.044), HIV seropositivity (P = 0.000) and smoking (P = 0.033). Conclusion: Cumulative high risk HPV infection is high in Lagos, Nigeria. This thus support the need for routine and early screening of all identified high risk sexually active women for HPV infection in Nigeria, as well as emphasising further the importance of sex education for the girl child in schools and increased awareness for parents towards HPV vaccination for their generally healthy adolescent girls.

In vivo antioxidant and hepatoprotective potential of Glycyrrhiza glabra extract on carbon tetra chloride (CCl4) induced oxidative-stress mediated hepatotoxicity

Abstract: Objective: This study aimed to evaluate the antioxidant and hepatoprotective potential of Glycyrrhiza glabra hydromethanolic root extract against carbon tetra chloride (CCl 4 ) induced oxidative-stress mediated hepatotoxicity in liver tissue of Swiss albino mice. Background: Medicinal plants play a vital role for the development of new drugs. Glycyrrhiza glabra is a widely used medicinal plant. It has many phyto-constituents and active components, which can be used for many diseases. Methods: For the antioxidant and hepatoprotective study, measurement of GSH, CAT, LPO bio-markers in Liver tissue of Swiss albino mice were taken. The animals were divided in six different groups each having 4 mice. The requisite dose of CCl 4 was dissolved in appropriate solvent (1.5ml/kg body wt) and administrated as single i.p. dose per mice after 6 hr of last treatment of extract to the animals in each group. Mice were received orally administration of extract up to 7 days. Positive Control group received single i.p. injection of 1.5ml/kg body wt CCl 4 in 0.9% saline. Results: The results suggest that, the crude extract of root of G. glabra at the doses of 300 and 600mg/kg body wt. expressed significant hepatoprotective potential against CCl 4 induced oxidative stress mediated hepatotoxicity in student ‘t’ test (p<0.05) at dose dependent manner in the Liver tissue of Swiss albino mice. G. glabra root extract alone has not induced hepatotoxicity. Conclusion: Based on this study, It may be concluded that Glycyrrhiza glabra root extract possess hepatoprotective potential in Swiss albino mice.

A study on asymptomatic bacteriuria in pregnancy: prevalence, etiology and comparison of screening methods

Abstract: Background: Asymptomatic bacteriuria is common in women with prevalence of 4-7% in pregnancy. The traditional reference test for bacteriuria is quantitative culture of urine which is relatively expensive time consuming and laborious. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify pathogens and their antibiotic susceptibility patterns and to device a single or combined rapid screening method as an acceptable alternative to urine culture. Methods: Clean catch mid-stream urine were collected from 250 pregnant women aged between 18-45 years attending antenatal clinic, for a period of one year (November 2008-2009). Screening tests such as gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test were done. Identification of organisms and antibiotic sensitivity tests were performed as per standard methods. Results: Out of the 250 pregnant women, 21 (8.4%) had significant bacteriuria. High percentage of asymptomatic bacteriuria was seen in 2 nd trimester (42.86%) and in primigravidas (52.38%). E. coli (57.14%) was the most common organism. Among screening tests gram staining of uncentrifuged urine had a sensitivity of 85.71%. Nitrite and leukocyte esterase tests alone showed sensitivity of 71.42%. However, the combination of these two tests, either tests positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively. Conclusion: Asymptomatic bacteriuria in pregnancy can be identified by simple and combined rapid screening methods and urine culture along with antibiogram so that early treatment can be started thereby preventing complications.

Comparison of serum levels of calcium and magnesium among preeclamptic and normotensive pregnant women at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria -

Abstract: Background: Despite numerous studies, the exact aetiology of pre-eclampsia remains unknown. Some studies have shown that supplementation of calcium and magnesium could ameliorate the effects of pre-eclampsia. The objective of this study was to compare the calcium and magnesium levels in the serum of Nigerian women with or without pre-eclampsia. Methods: In this study, serum calcium and magnesium levels were determined using atomic absorption spectrometry in 54 patients and 48 healthy normotensive pregnant women. The mean, standard deviation, Student’s‘t’ test and Pearson correlation were employed. Results: Serum calcium was significantly lower in patients than controls (9.17 ± 0.6 vs. 7.22 ± 0.5 mg/dl. P <0.001) (t test). Plasma Magnesium was significantly lower in patients than controls 13.19 ± 1.1 vs. 9.81 ± 0.7 mg/dl. P <0.001). The systolic and diastolic blood pressure showed significant inverse correlation with both calcium and magnesium (P<0.01). Conclusion: There was significant reduction in the levels of calcium and magnesium in patients with pre-eclampsia. Dietary supplementation of these trace elements may help to prevent pre-eclampsia.

Prevalence of osteoporosis and factors associated with osteoporosis in women above 40 years in the Northern Part of Saudi Arabia

Abstract: Background: Women have lower bone density than men and they lose bone mass more quickly as they advance in age, which leads to osteoporosis. The Saudi Diabetes and Endocrine Association in the Eastern Province revealed that 30 to 50% of Saudi women above 40 years of age develop osteoporosis. Factors related to the development of osteoporosis include poor diet, low calcium intake, vitamin D deficiency, sedentary lifestyle and smoking. Previous studies have shown that there is a high prevalence of vitamin D deficiency in Saudi women. Methods: The present study was done in 100 Saudi women above 40 years of age who were outpatients in Arar Central Hospital during a period of four months. After taking an informed consent, data was collected relating to the risk factors, vitamin D levels were assessed and the patients underwent a Dual Energy X-ray Absorptiometry (DEXA) scan. Results: The results showed that 82% of Saudi women patients had vitamin D deficiency. Only 21% of women were exposed to sunlight. 58% of the women had low BMD (18% with osteoporosis and 40% with osteopenia). Only 5% of patients took Vitamin D and Calcium rich diet and 7% were in the habit of doing exercise. There was a significant association between bone mass density and exercise when Fisher's exact test was used (P value < 0.05) Conclusion: Prevalence of osteopenia is higher than osteoporosis in the Saudi women above 40 years in the Northern part of Saudi Arabia. The major cause of low BMD is lack of exercise even though there is a high prevalence of Vitamin D deficiency.

Effect of cyclophosphamide on the microanatomy of liver of albino rats

Abstract: Background: Cyclophosphamide is widely used in the treatment of various neoplastic diseases and diseases associated with altered immunity. Higher doses used for longer duration effects many organs like urinary bladder, lungs, liver, heart and male reproductive organs. Methods: To study the effect of cyclophosphamide on the micro anatomy of liver, sixty eight Albino rats were taken and divided into three groups, group A (control group) of 20 animals, were fed with routine diet, group B (low dose group) of 24 animals, were given cyclophosphamide at the dose of 0.5 mg/100 gms in addition to the routine diet and group C (high dose group) of 24 animals, were given high dose of cyclophosphamide at the dose of 0.7 mg/100 gms of weight of animal in addition to the routine diet. The animals were sacrificed at intervals of 3, 6, 9 and 12 weeks, 5 microns sections of the tissue were prepared and stained with Haematoxylin and Eosin stain. Results: Microscopic changes in liver were apparent in the drug treated animals. In group B the changes appeared after 6 weeks while in group C they started appearing after 3 weeks of drug treatment. The changes were in the form of fatty changes, hemorrhages and central vein congestion. Conclusion: Cyclophosphamide induces histological changes like fatty infiltration and central vein congestion in the liver. These changes are with low doses given for longer durations and manifest earlier when larger doses are used. Thus it is advised that patients receiving cyclophosphamide should be periodically evaluated for liver dysfunction.

Current treatment of visceral leishmaniasis (Kala-azar): an overview

Abstract: Visceral Leishmaniasis (VL) is also popularly known as kala-azar which was first reported in early forties and since then it continues to affect millions of people. The ranges of common drugs available for the treatment of visceral leishmaniasis are limited. It mainly includes pentavalent antimonials e.g. stibogluconate (SbV), amphotericin B deoxycholate (AB), lipid formulations of amphotericin B (L-AB), miltefosine (MF) and paromomycin (PM) - all of which have limitations in terms of toxicity, variable efficacy, price and inconvenient treatment schedules. Most are parenteral except MF which is administered orally. Due to the parasite’s drug resistance, the most widely used (SbV) of these drugs is now of little use in northern Bihar, India, which alone accounts for 50% of the world's burden of visceral leishmaniasis. In areas of resistance to SbV, AB is highly effective. The formulation of AB in liposomes (L-AB) has been a major advancement in the treatment of visceral leishmaniasis. However, despite a significant reduction in price, this treatment remains very expensive for endemic countries like India. Combination short course therapy has been reported by many researchers who found that it is equally effective as conventional monotherapy with added benefits of less side effects, better compliance and less resistance. The aim of this article is to review the current aspects of the treatment for leishmaniasis, giving an overview of current agents clinically used to new agents & modalities of treatment under development.

Assessment of nutritional status among adolescents: a hospital based cross sectional study -

Abstract: Background: Adolescence, a period of transition between childhood and adulthood, occupies a crucial position in the life of human beings. The primary causes of under nutrition in India are its large population, socio-economic differences and inadequate access to health facilities. Nutritional assessments among adolescents are important as they are the future parents and constitute a potentially susceptible group. Studies on the assessment of nutritional status of adolescents are less in number and a National database has not yet been developed. Methods: The present hospital based cross sectional study was conducted in year 2013 among 344 rural adolescents of 10-19 years age (166 boys and 178 girls) attending the outpatient department at rural health training centre (RHTC) Dhaura Tanda, district Bareilly, Uttar Pradesh, belonging to the Muslim and Hindu caste communities. The nutritional status was assessed in terms of under nutrition (weight-for-age below 3rd percentile), stunting (Height-for-age below 3rd percentile) and thinness (BMI-for-age below 5 th percentile). Diseases were accepted as such as diagnosed by pediatrician, skin specialist and medical officer. Results: The prevalence of underweight, stunting and thinness were found to be 32.8%, 19.5% and 26.7% respectively. The maximum prevalence of malnutrition was observed among early adolescents (28%-47%) and the most common morbidities were URTI (38.6%), diarrhea (16.8%), carbuncle / furuncle (16%) and scabies (9.30%). Conclusion: The study concluded that the most common morbidities among adolescents were related to nutrition and personal hygiene. Regular health programmes should focus to educate and promote health among adolescent.

The relationship between emotional intelligence and academic achievement in medical undergraduate

Abstract: Background: In today’s era of technology, intelligence and success are not viewed the same way they were before. New theories of intelligence have been introduced and are gradually replacing the traditional theory. Academic achievement is based on creativity, emotions, and interpersonal skills. Methods: The aim of this study was to see whether there is a relationship between emotional intelligence and academic success. Study was done on 1 st MBBS students of Govt. Medical College, Bhavnagar. The sample size was 75 students (boys and girls). The emotional intelligence questionnaire from Institute for Health and Human Potential was given to the students, Depending on the EQ score we divided the students in to five groups and compared with their academic performance. Results: Study showed inverse relationship between emotional intelligence and academic achievement. Conclusion: There is a negative relation among emotional intelligence and academic achievement of the participants.

A study to assess awareness on eye donation and willingness to pledge eyes for donation in adult population in Gwalior district (M.P.), India

Abstract: Background: Purpose of current study was to determine the awareness of eye donation and willingness to pledge eyes for donation in the government colonies (Central and state govt. colonies) of district Gwalior (M.P.). Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. Although Strategies to prevent corneal blindness are likely to be more cost effective, visual rehabilitation by Corneal Transplantation remains the major treatment for restoring sight in those who already have corneal blindness. Methods: The present study was undertaken from July 2012 to Dec. 2012 with a total population 2192 was surveyed of people residing in central and state govt. Colonies of district Gwalior in which total of 500 houses were taken. The total population aged 30 years and above were interrogated by a predesigned questionnaire regarding awareness of eye donation, any eye related problem and willingness to pledge eyes for donation. Results: The total respondents were 947 in which 481 (50.79%) were Males and 466 (49.21%) were females. The awareness of eye donation was present in 590 (62.30%) while 357 (37.70%) were not aware. Conclusion: The awareness regarding eye donation should be increased so that the public’s attitude would be more favorable to facilitate an increase in the number of corneas available for transplantation.

Molecular and hormonal regulation of angiogenesis in proliferative endometrium

Abstract: Angiogenesis is a hallmark of wound healing, the menstrual cycle, cancer, and various ischemic and inflammatory diseases. A rich variety of pro and anti-angiogenic molecules have already been identified. Vascular endothelial growth factor (VEGF) is an interesting inducer of angiogenesis and lymphangiogenesis, because it is a highly specific mitogen for endothelial cells. Signal transduction involves binding to tyrosine kinase receptors and results in endothelial cell proliferation, migration, and new vessel formation. In this article, the role of VEGF and other growth factors in the pathology of dysfunctional uterine bleeding is reviewed. We also discuss the role of VEGF expression and interaction with extracellular matrix that lead to possible inhibition or stimulation of Angiogenic factor on endometrium of dysfunctional uterine bleeding patients.

Causal inference at the population level

Abstract: Three elements are needed to formalize a causal quantity at the population level: response, treatment, and the causal element, which are introduced here by notation. Inclusion of two essential causal assumptions, the monitoring and illumination assumptions, in a function distinguishes causal from association analyses. The discussion provides insight into causal inference.

Association between functional polymorphisms of Foxp3 and Interleukin-21 genes with the occurrence of recurrent pregnancy loss in Gaza strip-Palestine

Abstract: Background: This study was conducted in order to investigate the association between IL-21 (rs2055979 G/T and rs13143866 A/G) and Foxp3 (rs2232365 A/G and rs3761548 A/C) gene polymorphisms and recurrent pregnancy loss (RPL) in a group of Palestinian women residing in Gaza strip. Methods: A retrospective case-control study was carried out during the period (January to June, 2014). A total of 200 females, 100 RPL patients and 100 controls women without previous history of RPL, aged 20–35 years were included in the study . IL-21 rs13143866 A/G and Foxp3 rs2232365 A/G polymorphisms were analyzed by allele-specific PCR whereas, IL-21 rs2055979 G/T and Foxp3 rs3761548 A/C polymorphisms were investigated by PCR-RFLP. Results: No statistically significant difference existed between RPL cases and controls in terms of the allelic and genotypic distribution of IL-21 rs2055979 or rs13143866. On the other hand, the two Foxp3 gene polymorphisms showed statistically significant association with RPL: the rs2232365 A/G allele G and its homozygous genotype G/G and the rs3761548 A/C allele A and its A/A genotype were significantly higher in RPL group. Conclusions: Foxp3 rs2232365 A/G and rs3761548 A/C polymorphisms represent risk factors for RPL in Gaza strip women. IL-21 polymorphisms rs2055979 G/T and rs13143866 A/G however, do not pose tangible risk for RPL in our population. Study results should be confirmed on a larger sample.

Study of association of non alcoholic fatty liver disease (NAFLD) with micro and macrovascular complications of type 2 diabetes mellitus (T2DM)

Abstract: Background: Non Alcoholic Fatty Liver Disease (NAFLD) is a common liver disorder that is strongly associated with insulin resistance and Type 2 Diabetes Mellitus (T2DM). This study was designed to determine the prevalence of NAFLD among T2DM patients and to evaluate whether there is an association between NAFLD and diabetic micro-and macro vascular complications. Methods: In a cross-sectional design study, 120 type 2 diabetic patients were submitted to a complete clinical and laboratory evaluation and abdominal ultrasonography for NAFLD detection and grading. They were divided into fatty liver group and non-fatty liver group and various laboratory and clinical variables were compared in these two groups. Statistical analysis included bivariate tests, chi square test, univariate and multivariate logistic regression. Results: Out of 120 type 2 diabetic patients, 68 (56.66%) had fatty liver on ultrasonography. An increase in the waist circumference, BMI, systolic blood pressure, diastolic blood pressure and levels of HBA 1c , AST, ALT, Total Cholesterol, Triglycerides and a decrease in HDL was observed in the fatty liver group as compared to non-fatty liver group. NAFLD group had higher prevalence of retinopathy (67.67% vs. 17.30%, P <0.001), neuropathy (52.94% vs. 19.23%, P = 0.0002), nephropathy (83.82% vs.53.84%, P = 0.0003). The prevalence of CAD (70.58% vs. 21.11%, P <0.0001) and POVD (10.25% vs. 0%, P <0.05) was higher in NAFLD patients. All patients with severe fibrosis had raised BMI, HbA 1c and hypertension. The results of multiple logistic regression analysis showed that NAFLD was associated with BMI, HbA1c, Triglyceride and CAD. Univariate analysis showed significant association between retinopathy, neuropathy, CAD, POVD and NAFLD. Conclusion: Cognitive. The prevalence of NAFLD is higher in type 2 diabetic patients. Obesity, dysglycemia, dyslipidemia, elevated liver enzymes and coronary artery disease are seen to be significantly associated with fatty liver than non-fatty liver type 2 diabetic patients.