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Background: Pulmonary hypertension (PH) is a recently recognized complication of chronic kidney disease (CKD), especially in end-stage renal disease. Cardiovascular disease is the most important cause of morbidity and mortality in CKD. This study was done to assess the prevalence of Pulmonary Hypertension in CKD patients and to assess the severity of Pulmonary Hypertension in different stages of CKD. The study Materials And Methods: was performed on 140 patients. At M. L. N. medical college prayagraj. All patients were evaluated by clinical, laboratory and imaging. All patients were subjected to echocardiography for assessment of Pulmonary arterial Hypertension. A total Results: of 140 patients were included. Mean age of statics was 55.61±11.65 years. Male: Female was 2.33:1. Out of 140 study subjects, PH was found in 45 patients (32.1%.). Amongst which 26 had mild PH, 13 moderate and 6 had severe PH. Prevalence of Severe PH was signi?cantly higher in stage 5 CKD subjects (23.5%) compared to stage 3(1.3%) & 4(2.3%). As CKD progresses Conclusion: the prevalence and severity of PH increases
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Aims: To study the prevalence of infertility in obese or overweight females and its association with Dyslipidemia and Diabetes mellitus. Materials And Methods: The study was performed on 160 infertile women between age 18-45 years who attended Obstetrics and Gynaecology OPD and Medicine OPD in Swaroop Rani Hospital, Prayagraj.The duration of study was from December 2019 to March 2021.Patients were divided into lean/normal weight females and obese/overweight females based on BMI. Results: Out of total 200 patients 40 were excluded and remaining 160 were divided in two groups, Group 1: lean or normal weight infertile women(N1 =63) and Group 2: obese /overweight infertile women(N2= 97) Mean age of controls and cases were found to be comparable(31.54±2.82 vs 31.22±2.97 years) with p =0.50. Mean BMI of control group was found to be 20.23±1.39 kg/m2 as compared to cases with mean BMI 27.77±2.86 kg/m2 which was signi?cantly higher with p=<.001. Mean W:H ratio in cases and controls was found to be 0.83±0.05 and o.74±0.04 respectively with p-value= <0.001. Mean A1C levels in cases was signi?cantly higher than in the control group (5.91±0.91% vs 4.61±0.58%) with p=<.001. Mean S, Triglycerides levels in cases was signi?cantly higher than in the control group. (160.4±96.9 vs 110.2±15.8) with p=<.001. Mean S.Cholesterol levels in cases was signi?cantly higher than in the control group. (165.1±41.06 vs 100±22.1) with p=<.001. Mean S.VLDL levels in cases was signi?cantly higher than in the control group (43.9±18.94 vs 54.9±14.07) with p=<.001.Mean S.LDL levels in cases was signi?cantly higher than in the control group (64.16±22.4 vs 54.33±16.17) with p=<.002. Mean S.HDL levels in control was higher than in the case group. (78.65±6.86 vs 40.77±12.83) with p=<.001. Conclusion: The prevalence of obesity in infertile females at a tertiary care centre was 60.62 %. Positive association of obesity was found with dyslipidemia and diabetes mellitus(A1C -5.91±0.91% vs 4.61±0.58% with p=<.001)in obese females. Most of the females were in the range of impaired glucose tolerance phase which could be reversed by dietary modi?cation and early intervention.
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Background@# Status epilepticus, when continued despite the administration of two antiepileptic drugs, is called refractory status epilepticus (RSE). The seizure-like phenomenon due to propofol is widely reported in the literature. However, RSE caused by propofol is rare and is a diagnostic dilemma. Case: A 44-year-old male patient presented with RSE during the intraoperative period and was under general anesthesia on propofol infusion. The seizure was resistant to benzodiazepines and phenytoin. Thereafter, the seizure subsided after the discontinuation of propofol infusion, and the patient was shifted to fentanyl and dexmedetomidine infusion for the maintenance of anesthesia. The postoperative follow-up was uneventful. @*Conclusions@# This article focuses on the management of intractable intraoperative seizure and highlights the need for the exploration of seizure characteristics caused by propofol.
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The competency based assessment (CBA) is an integral part of competency based medical education (CBME). It is important to discern the similarities and differences between CBME and traditional curriculum for developing effective implementation schedules and to identify opportunities for best use of the CBA in pharmacology training. CBA relies on assessment of core competencies and attitudes. The viva marks, to be decided at university level, are excluded from theory marks. An advantage of CBA is early entry of failed students into next phase of study. The areas of concern are, viva marks are included in practical marks further reducing ratio of practical to theory marks despite increase in total marks, and non-contribution of internal assessment marks to university marks for rank or grades. Multiple assessments using multiple tools in limited duration of 11 months would pose logistic problems and would require concerted efforts of faculty members for accomplishment.
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Mosquito-borne diseases such as malaria, filariasis, dengue, chikungunya, Japanese encephalitis, yellow fever and Zika contribute significantly to health problems of developing as well as developed nations. Vector control is central to control of vector borne diseases. In the last four-five decades, biological control methods have been inducted in the integrated vector management strategy, advocated nationally as well as globally by the World Health Organization. Currently, biological control of vectors is globally acknowledged as the best available strategy in the wake of growing concerns about vector resistance as well as adverse effects of insecticides on the environment and non-target fauna co-inhabiting the same ecological niches as vectors. In India and elsewhere, efforts are ongoing to screen newer isolates to bring forth new biolarvicidal products of public health importance. In this review, by carrying out extensive literature survey, we discuss advances thus far and the prospects of bacilli-based control of vectors and vector borne diseases.
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The Medical Council of India (MCI) has formulated a new Competency Based Medical Education (CBME) Curriculum for the Indian Medical Graduates with an objective of making medical education outcome based. A one month long Foundation Course (FC) is a hallmark of this CBME which is implemented during the first month of first professional MBBS studies. The objective is to acquaint, allay apprehension and prepare freshers for further studies using andragogical and heutagogical approaches. The MCI also released the guidelines for the medical colleges for uniform conduct of FC across the country. The FC was divided into six modules, i.e. Orientation Module, Skills Module, Community orientation module, Professional Development and Ethics Module (P and E), Enhancement of Language and Computer Skills Module, and Sports and extracurricular activities. A total of 175 hours were allotted to these modules. Like every institute, our institute also developed the implementation program and time-table of FC using MCI guidelines and taking into account the available resources. The FC at our institute was conducted from 1st August 2019 to 31st August 2019 and was meticulously planned and implemented. The effective implementation required committed efforts of 30 faculty members (12 Professors, 11 Associate Professors and 7 Assistant Professors), two language and one fine arts teacher, and 4 non-teaching members (Librarian, IT-personnel, Coach for sports and motivational Guru). The students were trained to write reflections daily in their log - books which are being analysed further.
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Present study was conducted on twelve apparently healthy goats free from cardiothoracic diseases. The animals were divided into two groups each containing 6 animals to evaluate various the cardiothoracic parameters. Mean ± SE values of body weight and age were measured 11.83 ± 0.70 (range 10 - 15) kg, 3.75 ± 0.31 (range 3 - 5) month and 25.67 ± 1.73 (range 16-30) kg, 8.58 ± 0.95 (range 6.5 - 12) month in animals of the group-I and II, respectively. In thoracic radiographic examination, routinely used in cases which cardiac evaluation is indicated, quantitative assessment of the heart is a useful role to be used in combination with subjective analysis. The purpose of this study was to establish the standard values (range) for radiographic parameters of the heart and thorax. Cardiophrenic contact (cm), Cardiac inclination angle (degree), Tracheal angle (degree), Tracheal diameter (cm), Cardiac height/thoracic height, Cardiac width/thoracic height, Cardiac width / T3-T5, Cardiac height / R3-R5, Cardiac width / R3-R5, Cardiophrenic contact /cardiac height, Cardiac height + cardiac width/R3-R5, cardiac height + cardiac width /thoracic height and Tracheal diameter/T4, except cardiosternal contact (No. of sternabae), cardiac height/T3-T5, and cardiac height + cardiac width /T3-T5, were found to be non-significantly different between animals of the group-I and group-II. The standardized values of cardiothoracic parameters and their correlation with age and weight would be helpful to diagnose various cardio-thoracic illnesses in goats
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Background: Microalbuminuria is a sign of glomerular dysfunction in general and sign of tubulointerstitial disease to a lesser extent. Hypoxia induces endothelial cell to release a number of different vasoactive agents including endotheline-1, platelet derived growth factor (PDGF), nitric oxide; that causes endothelial injury and lead to microalbuminuria. This study was aimed to assess the prevalence of microalbuminuria in COPD patients and assess the Relationship of microalbuminuria with the disease severity in the forms of FEV1, PaO2, PaCO2, and BODE INDEX in COPD patients.Methods: Total 130 COPD patients were included in our cross sectional study. Total patients were divided into two groups, 1st group was COPD with microalbuminuria while 2nd group was COPD without microalbuminuria. Lung function test, 6 min walk distance, arterial blood pressure (BP), BODE index, arterial blood gases, fasting and post prandial plasma glucose and kidney function tests were measured. Screening for microalbuminuria was done by measuring urinary microalbumin in a random spot urine collection.Results: The prevalence of microalbuminuria was 29.23% in patients of COPD. As compared with COPD without microalbuminuria group, COPD with microalbuminuria group were more hypoxic (12% vs 74%, P=0.0001 ), more hypercapnic (22% vs 84%, p=0.00001) and most of the patients with grade III (16% vs 34%, p=0.00001) or grade IV (19% vs 47%, p=0.00001) severity (according to GOLD criteria).Conclusions: Patients with severe COPD with hypoxemia or hypercapnia were significantly associated with microalbuminuria.
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After a gap of nearly two decades, Medical Council of India (MCI) has revised, rather revamped, the Undergraduate (UG) medical curriculum, making it competency based (CBME) and learner centric.
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Metaphors are increasingly used for learning in medical education.1,2 Learning can be facilitated by giving homologous/analogous examples and story-telling.3-5 The undergraduate students are involved, and learning becomes enjoyable and stress-free. Here is a conversation between two NSAIDs while travelling in anthropomorphic forms (human beings) and discussing the detailed pharmacology and therapeutics of NSAIDs.
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Background: Excessive use of mobile phones, including smart phones, is found to result in various health related, social and psychological problems. Nomophobia expands to ‘No Mobile Phobia’, i.e., fear of being out of mobile phone contact. Previous studies on nomophobia have focused on the student populations, since the younger generation is more technology savvy. This questionnaire-based study aimed to know the prevalence and factors leading to nomophobia in general population.Methods: This study was conducted in western Gujarat from September 2018 to October 2018. A prevalidated questionnaire, containing three parts, the demographic details, details about the characteristics of mobile phone use and the Nomophobia Questionnaire (NMP-Q), was sent through emails and WhatsApp to 1000 individuals. The responses were tabulated and analyzed.Results: Out of 331 respondents 192 (58%) were males and 139 (42%) females. There was no significant difference in average NMP scores with respect to gender (p = 0.401), age brackets (p = 0.135), marital status (p = 0.123) and profession (p = 0.055). However, NMP scores were significantly more in individuals who spent more time on mobile phones per day (p = 0.000), checked their mobile phones more frequently (p<0.000) and in whom phantom ringing syndrome was also present (p<0.000). 241 respondents (72.80%) felt that their mobile phone use was consuming time and affecting their other daily activities.Conclusions: Nomophobia is an emerging health related adverse effect of prolonged mobile phone use. Interventions are required to promote judicious use of mobile phones.
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ABSTRACT The present study was aimed to evaluate the in vitro antileishmanial activity of four different concentrations of natamycin and nystatin by using MTT 3-(4.5-dimethylthiazol-2-yl)-2.5-diphenyl tetrazolium bromide reduction assay. In vitro antileishmanial activity revealed that the IC50 of natamycin (80.49 μg/ml) and nystatin (105.7 μg/ml) was less than that of sodium stibogluconate (127.9 μg/ml), and more than amphotericin B (18.91 μg/ml).
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Objective: The aim of our study was to compare the presence of hypertension in people consuming hard water or fresh water and level of hardness, in individual water resources in Haji Samoa village near Keti Bundar, Sindh, Pakistan. Methods: A cross sectional study was conducted in Keti Bundar in September 2014. There are two sources of water supply in the area; rain water / hard water. 340 people were included. People > 18 years of age, living in Keti Bundar for > 5 years were included. People having chronic kidney disease, diabetes, or taking anti-hypertensive drugs/oral calcium supplements were excluded. Demographic features, Body Mass Index [BMI] and blood pressure were recorded. Water sample was checked for hardness. Hardness of > 180 ppm was considered to be very hard. Hypertension was compared between people consuming hard or fresh water. p<0.05 was considered statistically significant. Result: Out of 340 people, 80 [23.5%] had hypertension; in people consuming hard water 38 [20%] were hypertensive while 42 [28%] people consuming fresh water were hypertensive. This difference was not found to be statistically significant. While testing the hardness of water resources, the level of hardness was found to be very high, 3 out of 4 reservoirs; which were not suitable for human consumption. Conclusion: We conclude that hypertension is no more common in people taking fresh water than hard water; but the underground well water in area of Keti Bundar has high levels of hardness
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Objective: To determine the gender differences in risk factors and patterns contributing towards deliberate self-poisoning. Methods: A descriptive study of patients admitted in National Poisoning Control Center Ward-5, Jinnah Post Graduate Medical Center Karachi, was conducted for six months from 1st July 2013 to 1st January 2014. The information was gathered using a questionnaire generated from World Health Organization, International Programme on Chemical Safety's INTOX [WHO IPCS INTOX] recording format for toxic exposure the data was analyzed on package SPSS version 14.0. The results were obtained in numbers and percentages. The Chi-square test was used for statistical differences of risk factors for deliberate self-poisoning in relation to gender. p-values of <0.05 were considered significant. Results: Out of the 374 patients analyzed during this period the age group most frequent was within the range of 15-74 years, with 61.5% of the subjects being male. No significant age difference was observed between male and female subjects. Single male subjects represented the largest population which attempted deliberate self-poisoning. History of psychiatric illness and drug abuse was more common in male subjects. There was no significant difference in educational status, agent used for Deliberate Self-Poisoning [DSP], number of agents used or route of exposure in the two genders. The agent most commonly used was organophosphate insecticide. Conclusion: Young single males belonging to low socioeconomic group and having history of psychiatric illness or drug abuse are at greater risk of Deliberate Self-Poisoning [DSP]. Preventive strategies need to be directed at this population
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Objective: The primary aim of our study was to determine the frequency of headache in medical students exposed to secondhand smoking, as well as observing response of non-smoker medical students for passive smoking
Methods: A cross-sectional study was conducted at three private colleges of Karachi in June 2014, sample size was 300. The inclusion criteria were medical students between 18-25 years of age who were non-smokers, exposed daily once or more to secondhand smoking. Students were inquired about age, gender, duration, location and frequency of exposure to passive smoking and presence or absence of secondhand smoking related headache and response and behavior of smokers observed by non-smoker students to counselling
Results: Out of 290 students 186 [64.1%] complained of headache related to passive smoking, 172 [59%] were exposed in medical colleges. Of 127 [43%] had been exposed to passive smoking more than two times a day. Although 255 [88%] out of 290 students favoured prohibition of smoking at public place, but only 90 [31%] did practical attempt to advise smokers to stop smoking at public place. Response of smokers was good, 73% students believed that smokers gave positive response to their advice
Conclusion: There appears to be a high frequency of headache related to secondhand smoking. Hence, students should be provided special training skills to council the smokers to avoid smoking at public place; moreover we also need practical implementation of laws against smoking at public place
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Objective: To describe and quantify, co-existence of Allergic Rhinitis [along with the serum levels of IgE and Eosinophils] in patients with Asthma and specifically to describe common allergens found in patients with Asthma and Allergic Rhinitis in Al Ain, UAE
Methods: A descriptive study was conducted from June 2014 to July 2015 at Al Ain Hospital, UAE, a Tertiary care health facility in the private sector. Patients [>12 years] diagnosed as having Asthma and or Allergic Rhinitis [as per clinical evaluation based on Global Initiative for Asthma [GINA] and Allergic Rhinitis and its Impact on Asthma [ARIA] Guidelines were subjected to skin allergy test, serum IgE levels and Eosinophils count were obtained after informed consent
Results: Seventy one percent patients were found to have co existing Asthma and Allergic Rhinitis. Serum IgE levels were significantly associated with a positive skin allergy test while serum Eosinophil counts were not. Dust mite, Cat fur, Cockroach, Russian thistle, Bermuda grass and Date palm were the commonest allergens detected
Conclusion: These results suggest high prevalence of co-existing Asthma and Allergic Rhinitis in Al Ain, UAE. Since the main fraction of local population lives in this region of UAE, this data may represent UAE overall. Patient education about prevention from causal allergens may play an important role in management
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Despite availability of a number of oral antidiabetics, a sizeable population of diabetics remains uncontrolled. Thus there is growing need of new group of drugs for diabetic control. Understanding renal conservation of glucose by efficient reabsorption through sodium glucose cotransporter-2 (SGLT-2) has paved way for development of an entirely new group of drugs, the SGLT-2 inhibitors. These glucosuric antidiabetic agents have shown promise in early clinical studies. Canagliflozin is recently approved for use in diabetes alone or along with other antidiabetics. Other highly selective inhibitors undergoing various stages of clinical developments are dapagliflozin, sergliflozin, remogliflozin, ipragliflozin, empagliflozin, luseogliflozin, tofogliflozin and desoxyrhaponticin. KGA-2727 (pyrazole-O-glucoside) is the first selective SGLT-1 inhibitor undergoing intense preclinical testing. There are safety issues associated with this group like urogenital infections (fungal), weight loss, initial osmotic diuresis and increased incidence of cardiovascular events. The long term safety remains to be established. Despite these limitations, SGLT-2 inhibition offers a unique target for achieving adequate control of diabetes in adults.
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Vertigo is a sense of whirling and rotation and is frequently associated with nausea and vomiting. Vertigo is a cardinal manifestation of vestibular disorders. Pharmacotherapy is required for symptomatic treatment of vertigo and motion sickness irrespective of the aetiology. Drugs like cinnarizine, betahistine and scopolamine are time honoured drugs. Antihistaminics and phenothiazines are also useful agents. Surprisingly, very few newer agents have shown undisputed efficacy against vertigo. This review describes the neurotransmitters involved in the genesis of vertigo and current status and evolution of appropriate pharmacological options for the treatment.
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To assess the association of Diabetic Retinopathy [DR] with type and duration of Diabetes Mellitus, mode of treatment and glycaemic control. An observational study was carried out. Patients with the diagnosis of either Type1, insulin dependent diabetes mellitus [IDDM] or Type 2, non-insulin dependent diabetes mellitus [NIDDM] were enrolled into the study through non-probability, convenient sampling method from Jinnah Medical College Hospital Karachi from July 2012 to March 2013. Thorough history and physical examination was done on each patient. Glycaemic control was assessed by glycosylated Hb level [HbAIc]. All information so collected was entered into a proforma. Data was analyzed using SPSS version 20. A total of 108 patients were examined. Out of these, 33 [30.6%] had Type 1 and 75 [69.4%] had Type 2 diabetes. In Type 1 group, 18 [54.5%] were female while in Type 2 group, 37 patients [49.3%] were female. In Type 1 group, 60.6% [n=20] had DR compared to 37.3% [n=28] in Type 2 group [p <0.005]. DR. was seen less frequently in subjects with less than five years duration in both the groups i.e. 12.6% in Type 1, and 15.7% in the Type 2 group. This increased to 100% [p<0.001] in Type 1, and 77.7% [p<0.02] in the Type 2 group with a duration of over 20 years of diabetes. In patients on insulin therapy, 60.6% in Type 1 group and 53.1% subjects in Type 2 had DR. In Type 2 group, 25.6% subjects on oral hypoglycaemics and/or diet therapy had DR. None of the subjects in both groups with HbA1c <7% had any evidence of DR. The frequency of DR. is higher in patients with Type 1, than those with Type 2, in patients receiving insulin therapy and with long duration of diabetes. Higher levels of HbA1c have clear relationship with development of DR