Umbilical hernia in pediatric patients attending outpatient department in tertiary care centre

Background: Umbilical hernias are estimated to affect 15% of children. Age, race, gestational age, and coexisting disorders are some of the variables that affect it. In comparison to the general population, there are greater incidences of connective tissue illnesses in children, premature delivery, low birth weight, syndromic newborns, black children, and children with pathologies that raise intraabdominal pressure. To determine the prevalence and to assess the risk factors of umbilical hernia in pediatric patients attending outpatient department (OPD) in tertiary care centre.Methods: The present observational study was conducted in paediatric OPD, of a tertiary care centre over a period of one year. A total of 100 study subjects were enrolled with suspected umbilical hernia. The data was collected with the help of a structured clinical proforma and analysed with SPSS version 20.0.Results: In our study the most prevalent age group involved being 0-1 years (6%) followed by 8-10 years (3%) and 2-4 years (2%). Umbilical hernia was seen more in males (64%) than females. Low birth weight (81%), premature delivery (54.54%), and undernutrition (90.9%) were the risk factors that were observed to be associated with the development of umbilical hernia.Conclusions: The study concluded that the overall prevalence of umbilical hernia was 11% and the associated risk factors were premature delivery, low birth weight and poor nutrition.

A Novel Method of Treatment of Small Osteolabral Avulsions Associated with Posterior Fracture dislocation of the Hip / Um novo método de tratamento de pequenas avulsões osteolabrais associadas a fratura-luxação posterior do quadril

Abstract Small osteolabral avulsions of the hip can be easily missed, and postreduction stress testing and computed tomography (CT) scans of the hip should be performed to look for these injuries. The usual modality of treatment of these unstable osteolabral avulsions is suture anchors, Herbert screws or spring plates. But when the bony avulsion is small, the use of these implants becomes a tedious job. We present a novel technique to fix small osteochondral avulsion fractures not amenable to fixation using screws or spring plates. We performed a retrospective analysis of 57 cases of patients who underwent open reduction and internal fixation for posterior fracture dislocation of the acetabulum, and we identified 6 cases of small posterior labral osteochondral fragments leading to instability. These injuries were fixed using a novel method. The mean Harris Hip Score at the final follow-up was of 92.5. Fixation of osteochondral avulsions associated with posterior hip fracture dislocation can be a difficult task if the bony fragment is small. Our technique is a simple, cost-effective and reliable way of fixing such avulsions with satisfactory outcomes.

Resumo Pequenas avulsões osteolabrais do quadril podem passar despercebidas, e testes de estresse pós-redução e tomografia computadorizada do quadril devem ser realizados para sua detecção. O tratamento dessas avulsões osteolabrais instáveis geralmente é feito com âncoras de sutura, parafusos de Herbert ou placas-molas. Em avulsões ósseas pequenas, porém, o uso desses implantes é um trabalho tedioso. Apresentamos uma nova técnica de fixação de pequenas fraturas com avulsões osteocondrais não passíveis de fixação com parafusos ou placas-molas. Realizamos uma análise retrospectiva de 57 casos de pacientes submetidos à redução aberta e fixação interna de fratura-luxação posterior do acetábulo, e identificamos 6 casos em que um pequeno fragmento osteocondral labral posterior causava instabilidade. Essas lesões foram corrigidas com um novo método. A pontuação média no Harris Hip Score no último acompanhamento foi de 92,5. A fixação de avulsões osteocondrais associadas a fratura-luxação posterior do quadril pode ser difícil se o fragmento ósseo for pequeno. Nossa técnica é uma maneira simples, econômica e confiável de corrigir tais avulsões com resultados satisfatórios.

Foeto-maternal outcome in pregnancy with and without heart disease: a comparative cross-sectional study in a tertiary care hospital

Background: Pregnant women with underlying heart disease are at increased risk for adverse maternal, obstetric, and neonatal outcomes. One can successfully treat the majority of these incidents if detected early by accurate individual risk assessment and careful follow-up. The aim and objectives of this study were to compare the foeto-maternal outcome in pregnancy with and without heart diseases with period of gestation >32 weeks.Methods: This study was carried out in a tertiary care teaching hospital of Imphal, the capital city of Manipur, using a standard-questionnaires among patients admitted. Data was analysed using SPSS 21.0 with statistical significance set at p<0.05.Results: Study was conducted on 112 pregnant women. The prevalence of heart disease was higher (71.4%) among the primiparous women. Highest occurrence of heart disease (66.1%) was seen in the housewife group. There was increased incidence of pre-term deliveries among pregnant women with heart disease (26.8%). Caesarean section (62.5%) and maternal complications (42.9%) were found to be higher among the pregnant women with heart disease. The incidence of NICU admission of babies was higher among mothers with heart disease (17.9%) compare to 5.4% in mothers without heart disease.Conclusions: Early detection by accurate individual risk assessment and careful follow-up are key to improving outcomes.

Undifferentiated Pleomorphic Sarcoma Mimicking Breast Implant-Associated Anaplastic Large Cell Lymphoma / 한국유방암학회지

Breast implant augmentation is a low-risk procedure with few life-threatening complications, most commonly rupture or leakage and contraction of the capsule. Breast implant-associated (BIA) malignancies are rare. Anaplastic large cell lymphoma (ALCL) is the most well-known neoplastic condition associated with breast augmentation. Carcinomas arising in association with implants have been reported but are rarer than ALCL. BIA-mesenchymal tumors are extremely rare and most are locally aggressive fibromatosis. To date, only eight cases of BIA sarcomas have been reported. Herein, we describe a case of silicone BIA-undifferentiated pleomorphic sarcoma (UPS) that was initially mistaken for ALCL because of a significant clinical and radiological overlap in presentation and imaging. Here, we present the morphological and molecular features of this rare neoplasm. We reviewed the existing literature related to BIA sarcomas to highlight the importance of considering this diagnosis in cases of recurrent ALCL-negative BIA effusions.

Effect of Integrated Nutrient Management on Physical Characteristics of Guava (Psidium guajava) cv. Allahabad Safeda under Meadow Orcharding

The present study was carried out in the years 2022, at Central Research Farm, Department of Horticulture, Sam Higginbottom Institute of Agriculture & Sciences, Prayagraj (U.P.). Twenty treatments made up the experiment with : (T0) Control, (T1) 100% NPK (650:325:375g plant-1), (T2) 100% NPK (650:325:375g plant-1)+FYM 13.2kg plant-1+VC 9.9kg plant-1+PM 3.3 kg plant-1, (T3) 60% NPK (390:195:225g plant-1)+ FYM 16 kg plant-1, (T4) 60% NPK (390:195:225g plant-1)+ VC 12 kg plant-1, (T5) 60% NPK (390:195:225g plant-1)+ PM 4 kg plant-1, (T6) 40% NPK (260:130:150g plant-1)+ FYM 12 kg plant-1+VC 9 kg plant-1, (T7) 40% NPK (260:130:150g plant-1)+ FYM 12 kg plant-1+PM 4 kg plant-1, (T8) 40% NPK (260:130:150g plant-1)+ PM 3 kg plant-1+VC 9 kg plant-1, (T9) 25% NPK (162.5:81.25:93.75)+FYM 10 kg plant-1+PM 2.5kg plant-1+VC 7.5 kg plant-1, (T10) Aztobacter 250g plant-1, (T11) Aztobacter 250g plant-1 +100% NPK (650:325:375g plant-1), (T12) Aztobacter 250g plant-1+100% NPK (650:325:375g plant-1)+FYM 13.2kg plant-1+VC 9.9kg plant-1+PM 3.3 kg plant-1, (T13) Aztobacter 250g plant-1 +60% NPK (390:195:225g plant-1)+ FYM 16 kg plant-1, (T14) Aztobacter 250g plant-1 +60% NPK (390:195:225g plant-1)+ VC 12 kg plant-1, (T15) Aztobacter 250g plant-1+60% NPK (390:195:225g plant-1)+ PM 4 kg plant-1, (T16) Aztobacter 250g plant-1 +40% NPK (260:130:150g plant-1)+ FYM 12 kg plant-1+VC 9 kg plant-1, (T17) Aztobacter 250g plant-1 +40% NPK (260:130:150g plant-1)+ FYM 12 kg plant-1+PM 4 kg plant-1, (T18) Aztobacter 250g plant-1 +40% NPK (260:130:150g plant-1)+ PM 3 kg plant-1+VC 9 kg plant-1, (T19) Aztobacter 250g plant-1+25% NPK (162.5:81.25:93.75)+FYM 10 kg plant-1+PM 2.5kg plant-1+VC 7.5 kg plant-1. These treatments were evaluated in Randomized Blocked Design with three replications. The results showed that a combination of different nutrients had a significant impact on the guava plant's growth and yield parameters, including minimum days required for flowering (24.16), from flower to fruit set (19.31), from fruit set to maturity (99.15), and fruits per plant (246.14), fruit weight (g) (144.74), fruit setting (%) (96.01), pulp weight (g) (136.03), total soluble solid (0Brix) (9.52), Ascorbic acid (mg / 100 g) (206.88), minimum acidity (0.41)were all found to be best under the treatment (T14) Aztobacter 250g plant-1 +60% NPK (390:195:225g plant-1)+ VC 12 kg plant-1, whereas acidity (0.80%) was at its highest in T0 Control.

EVALUATION OF FUNCTIONAL OUTCOME OF DUAL MOBILITY CUPS IN TOTAL HIP ARTHROPLASTY IN ARTHRITIS HIP AND FEMORAL NECK FRACTURES

Background- Osteoarthritis hip and femoral neck fractures in old age can be treated by total hip arthroplasty using dual mobility cup designs. The posterior approach (Kocher-Langenbeck) was used earlier however, lateral (Harding) and anterior approach (Smith-Petersen) are more often used. Evaluation of functional outcomes of total h Aim- ip arthroplasty using dual mobility cups in patients with osteoarthritis hip and femur neck fractures in terms of time of surgery, re-operation rate and mortality in 1 year, length of hospital stay and post-operative complications, using Harris Hip Score (HHS). Study Design- Hospital based prospective cohort study. Material and Methods- 40 cases were include in the study of which, 20 cases are of osteoarthritis hip and 20 cases are of femur neck fracture managed by dual mobility total hip arthroplasty. Clinical and functional outcome was graded using HHS. Anatomical reduction was assessed at 8 weeks, 3months, 6 months and 9 months. The mean HHS at 8 weeks, 3months, 6 months and 9 mont Result- hs in osteoarthritis hip was 56.40, 69.80, 80.90 and 91.50 and in femur neck fractures was 51.10, 63.50, 74.60 and 84.50, achieved. Better result was found in osteoarthritis hip. Conclusion- We concluded that using dual mobility total hip arthroplasty in osteoarthritis hip is far better than femur neck fractures due to better clinical and functional outcome, better anatomical reduction.

Charcot’s osteoarthropathy – Lest we forget

Charcot’ osteoarthropathy (COA) is a rare, often misdiagnosed inflammatory debilitating complication of conditions most common being diabetes that needs to be discussed further to prevent associated morbidity. The natural history of the disease sees four stages and requires prompt diagnosis and treatment to ensure the desired outcome. We describe a case series of two cases of diabetes-associated osteoarthropathy and their management. A 72-year-old male with the early COA was managed with a total contact cast for both lower limbs and an 80-year-old male with the early COA with bone marrow edema in the tibia and talus, as well as, subtalar effusion, managed conservatively. The follow-up review documented clinical recovery in the form of a marked reduction in swelling of the lower limbs with the resolution of the functional status of lower limbs. It is the responsibility of every physician to ensure the goals of management which includes immediate offloading and good glycemic control.

Effects of glenohumeral corticosteroid injection on stiffness following arthroscopic rotator cuff repair: a prospective, multicentric, case-control study with 18-month follow-up

Background@#This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). @*Methods@#In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. @*Results@#A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. @*Conclusions@#Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI.

Role of concomitant percutaneous pie crusting and local corticosteroid injection in lateral epicondylitis: a prospective, case control study

Background@#Lateral epicondylitis is an increasingly debilitating condition in working population. Evidence for conservative treatment modalities has been inconclusive. Percutaneous pie crusting of the common extensor origin at the lateral epicondyle at the time of local corticosteroid injection (CSI) has been proposed sparsely. The objective of this study was to analyze if concomitant CSI and pie-crusting of the common extensor origin provides better outcome than CSI alone in lateral epicondylitis. @*Methods@#This case-control study on 236 patients was conducted at a single center between January 1, 2020, and May 31, 2022. Patients were divided into two groups (n=118 each) based on their preference. Group A underwent CSI alone and group B underwent pie crusting along with CSI. The clinical and functional outcomes of all patients were evaluated at 2,4,6, and 12-week post-procedure using the visual analog scale (VAS) and Nirschl score. The mean time for return to daily activities was also compared. @*Results@#Both groups showed significant improvement in post-procedure outcome at successive follow-ups on intragroup longitudinal analysis (VAS: F=558.384 vs. 1,529.618, Nirschl: F=791.468 vs. 1,284.951). On intergroup analysis, VAS of group B was superior to that of group A; however, it was statistically significant (P<0.05) only from the 6-week follow-up onwards. Nirschl score of group B was significantly better throughout the period of follow-up (P<0.05). Group B returned to daily activities faster than Group A (6.2±0.44 weeks vs. 7.18±0.76 weeks). @*Conclusions@#Concomitant pie crusting with CSI is recommended for lateral epicondylitis as it provides significantly better results than CSI alone.

Long-Term Outcome of Valgus Osteotomy and Fixation with Double Angled Dynamic Hip Screw for Nonunion Fracture of the Neck of the Femur in Young Adults / Desfecho a longo prazo da osteotomia valgizante e fixação com parafuso dinâmico de quadril de ângulo duplo de fratura não consolidada do colo femoral em adultos jovens

Abstract Objective To evaluate the long-term results of valgus intertrochanteric osteotomy fixed with double angled dynamic hip screw for nonunion fracture of the neck of the femur in young adults. This implant allows more freedom of fixation in the sagittal plane. Very few studies have evaluated the long-term outcome for treatment of nonunion in fractures of the neck of the femur. Methods This is a prospective interventional study that included 20 patients with nonunion of the fracture of the neck of the femur aged < 60 years old without avascular necrosis of the head and significant resorption of the neck of the femur. A lateral closing wedge osteotomy was performed just above the lesser trochanter after inserting the Richard screw across the nonunion site, and it was fixed with a double-angle 120° barrel plate. The outcome was evaluated using union rate and the Harris Hip Score for functional outcome. Results The average postoperative decrease in the Pauwels angle was of 28.9°. A total of 80% of the cases progressed to union within a mean duration of 7.53 months. The mean Harris Hip Score at the final follow-up was 86.45. Conclusion Valgus intertrochanteric osteotomy and fixation with a double angled dynamic hip screw is a reliable and effective method for preservation of head and promoting union in an ununited fractured neck of the femur in young patients.

Resumo Objetivo Avaliar os resultados a longo prazo da osteotomia intertrocantérica valgizante, fixada com parafuso dinâmico de quadril (DHS, na sigla em inglês) de ângulo duplo, em fraturas não consolidadas do colo femoral em adultos jovens. Este implante permite uma liberdade maior de fixação no plano sagital. Muito poucos estudos avaliaram o desfecho do tratamento a longo prazo da fratura não consolidada do colo femoral. Métodos Trata-se de um estudo prospectivo de intervenção que incluiu 20 pacientes com fratura não consolidada do colo femoral com idade < 60 anos, sem necrose avascular da cabeça femoral e significativa reabsorção do colo femoral. Foi realizada uma osteotomia em cunha de fechamento lateral logo acima do trocânter menor após a inserção do parafuso tipo Richard no sítio do retardo da consolidação óssea, sendo fixada com uma placa cilíndrica de ângulo duplo de 120°. O resultado foi avaliado com o uso da taxa de consolidação e da escala Harris Hip Score quanto ao desfecho funcional. Resultados Foi obtida uma redução pós-operatória média de 28,9° do ângulo de Pauwels. Os casos que evoluíram para a consolidação alcançaram 80%, em um período médio de 7,53 meses. A média da escala Harris Hip Score foi de 86,45 no acompanhamento final. Conclusão A osteotomia intertrocantérica valgizante e a fixação com DHS de ângulo duplo é um método confiável e eficaz para a preservação da cabeça do fêmur, promovendo a consolidação de uma fratura não consolidada do colo femoral em pacientes jovens.

Evaluation of simple cost-effective immuno-haematological markers to predict outcome in hospitalized COVID-19 patients during second wave

Background:COVID-19 pandemic has strained the health infrastructure globally, hence the importance of cost-effective biomarkers. We aimed to identify simple haematological prognostic markers in hospitalized COVID-19 patients to differentiate between milder and severe cases, thus predicting outcome.Methods:A retrospective study of COVID-19 patients admitted at MallaReddy institute of medical sciences was conducted from April to June 2021. Total leukocyte count (TLC), neutrophil-to-lymphocyte ratio (NLR), derived NLR ratio (dNLR) and platelet-to-lymphocyte ratio (PLR) were calculated and correlated with outcome. These parameters were compared with other inflammatory markers using ROC(receiver operator curve)analysis.Results:303 patients of 397 fulfilled the inclusion criteria (male-198, female-105). There was a significant higher mean of NLR in patients with death (14.46�84) compared to patients recovered (8.43�33), similarly the dNLR was higher in death (8.06�34) compared to recovered (4.97�49). A significant positive strength of association between the NLR and dNLR with the ESR, CRP, CORADS score and CT severity score in the patients. The ROC analysis showed the NLR (AUC=0.777) and dNLR (0.799) a better marker to predict the outcome.Conclusions:In COVID-19, immuno-haematological markers like NLR, dNLR, PLR found to be a simple and cost-effective tool to prognosticate the clinical outcome among hospitalized patients and were in concordance with the other inflammatory markers. Hence, these markers serve as better indicators in risk stratification and better management.

STUDY ON RELATIONSHIP BETWEEN OBESITY & LIPID PROFILE IN NORMAL POPULATION OF CENTRAL UTTAR PRADESH

INTRODUCTION: Obesity is generally considered to play a key role in the metabolic syndrome, including hypertension. Metabolic syndrome is defined as a cluster of as a combination of obesity, insulin resistance, hyperinsulinemia, dyslipidaemia and hypertension. Other measures of obesity apart from Body Mass Index (BMI) are Waist Circumference (WC) and Height Weight Ratio (HWtR) and are efficient risk factors for prediction of CVD in children. BMI is calculated as person's weight (kg) 2 divided by height in meters (m ). Correlation between BMI and lipid profile were studi MATERIAL & METHODS: ed in a sample of 270 people (154 males & 116 females). In our study, we found that Mean total cholest RESULT: erol of Group I and Group II patients was 163.88±50.17 mg/dl and 184.02±36.31 mg/dl respectively. Total mean total cholesterol of the patients was 173.95±44.86 mg/dl. Triglycerides in Group I and Group II patients was 152.84±58.82 mg/dl and 157.28±73.29 mg/dl respectively. Total mean total cholesterol of the patients was 155.06±66.37 mg/dl. HDL in Group I and Group II patients was 48.55±16.76 and 47.03±9.06 respectively. Total mean total cholesterol of the patients was 47.79±13.47 mg/dl. The mean LDL of Group I and Group II patients was 85.04±36.13 mg/dl and 113.1926±24.35 mg/dl respectively. Total mean LDL of the patients was 99.11±33.83 mg/dl. Total Chol CONCLUSION: esterol and LDL of the studied patients have shown significant correlation in both groups (p<0.05). Triglycerides and HDL of the studied patients have shown non-significant correlation in both groups. (p>0.05)

Congenital Rubella Syndrome as a possible cause for persistent thrombocytopenia in early infancy: The Forgotten Culprit

Abstract We present a case of a late preterm intrauterine growth-restricted neonate with isolated and persistent severe thrombocytopenia. At birth, the neonate did not have a complete clinical spectrum of congenital rubella syndrome (CRS) but later developed peculiar findings that helped clinch the diagnosis. The neonate also had interstitial pneumonia and died secondary to superimposed acute viral infection leading to acute respiratory distress syndrome. The serology was positive for IgM antibodies against the rubella virus. The constellation of clinical manifestations of congenital rubella in the presence of positive IgM antibody against rubella and consistent histopathology confirmed the diagnosis of CRS.

Transcranial lateral perforating gunshot injury through skull base presenting without residual damage: A fortunate survivor / 中华创伤杂志(英文版)

We reported a case of a 32 years old male presenting with a perforating gunshot injury in craniocerebral region 3 h after the assault. The bullet entered above the right zygomatic arch, travelling through the coronal plane, and exited from the left zygomatic arch. The patient was fully conscious at presentation and developed facial nerve palsy during his hospital stay. Non-contrast CT scan of the head revealed fractures of the right orbit, bilateral maxilla, bilateral pterygoid plates, ethmoid air cells, vomer and left zygoma, and without any cerebral damage. He was treated conservatively and the facial palsy was resolved. The patient survived without any complications. Such case has not been described in the available literature till date.

Role of PANC-3 score to predict severe acute pancreatitis

Background: Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera. Prediction of severity is an essential step in the management of acute pancreatitis. 50% of mortality can be reduced to 8% by its early recognition. PANC-3 score is widely available test that can be performed quickly, easy to measure with high accuracy in predicting acute pancreatitis.Methods: This cross-sectional study was conducted in the department of general surgery, VMMC and Safdarjung Hospital over 50 patients admitted with acute pancreatitis. After making the clinical diagnosis, PANC -3 score, modified ATLANTA score, APACHE II were done. CRP and CTSI (computed tomography sensitivity index) were calculated and correlated.Results: Mean age was 44.74 years and most common cause was biliary tract pathology. Mortality observed in 5 patients, 11 patients had severe disease. Sensitivity of PANC- 3 was 81.82%, specificity -92.31% with 75% PPV and 94.7% NPV.Conclusions: PANC-3 can be used to predict the severity of pancreatitis as efficiently as Modified ATLANTA classification/APACHE II. It uses only three criteria which are easily done, and available in the basic health care setup. Its interpretation does not need expertise and can be applied at the time of admission which is an advantage when compared to classical scoring systems.

A study to determine socio demographic corelates of reproductive tract infection amongst women of reproductive age group

Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.

Esophageal varices presenting as lower GI bleed in an infant: a rare presentation

GI Bleeding is a common problem encountered in the emergency department and in the primary care settings. Lower GI Bleeding is relatively rare as compared to upper GI bleeding. Common causes of lower GI Bleeding are Polyp (32.5%), chronic nonspecific colitis (20.7%), lymphoid nodular hyperplasia (20%), Proctitis (18.2%), Solitary rectal ulcer (10%), Inflammatory bowel disease (6.5%).Among the various causes of lower GI Bleeding, esophageal varices is a rare cause. One such case presented to us with lower GI bleeding, on further evaluation was found to having esophageal varices due to portal hypertension. Child improved after conservative and definitive management.

Incidental benefits after fecal microbiota transplant for ulcerative colitis

Gut dysbiosis can result in several diseases, including infections (Clostridium difficile infection and infectious gastroenteritis), autoimmune diseases (inflammatory bowel disease, diabetes, and allergic disorders), behavioral disorders and other conditions like metabolic syndrome and functional gastrointestinal disorders. Amongst various therapies targeting gut microbiome, fecal microbiota transplantation (FMT) is becoming a focus in the public media and peer reviewed literature. We have been using FMT for induction of remission in patients with moderate to severe active ulcerative colitis (UC) and also for subsequent maintenance of remission. Four cases reported incidental benefits while being treated with FMT for UC. These included weight loss (n=1), improvement in hair loss (n=1), amelioration of axial arthritis (n=1) and improvement in allergic rhinitis (n=1), thereby suggesting potential clinical applications of FMT in treating extraintestinal diseases associated with gut dysbiosis.

Assessment of infrastructure of first referral unit facilities in Surguja division: a responsibility of providing emergency obstetric care

Background: Availability of emergency obstetric care (EmOC) is one of interventions to reduce maternal and newborn deaths. The health system fails when effective and affordable health interventions do not reach the population, when Poor infrastructure, drugs and equipment are lacking, and qualified human resources are scarce. The objective of the present study was to assess the availability of EmOC infrastructure in first referral units (FRUs) of Surguja division, Chhattisgarh.Methods: A cross sectional study was designated with 13 FRUs of Surguja division. A semi structured, closed-ended questionnaires was observed on the basis of check list, reviewing record, and interview by available staff.Results: FRUs of Surguja division for physical infrastructure scored 68.5%, for essential medicine 69.2%, for equipments 50.7%, for instruments 45.3% and for availability of blood 34.6%, for health man power category of specialist score was 25.7% but for supportive staff 65.4%.Conclusions: Our study revealed three existing bottlenecks in the healthcare delivery system as inadequate civil infrastructure, short fall of specialists as well as inadequate supplies of drugs and equipment, hampering the function of facility.

Molecular Docking Study to Identify Potent Inhibitors of Alpha-synuclein Aggregation of Parkinson’s Disease

Introduction: Parkinson’s disease (PD) is the widespreadneurodegenerative disorder ranked second in this categoriesand PD is also the most common movement disorder. PDdisorder affects more than 0.1% of the total population olderthan 40 years of age. Contemporary, therapies of PD arerestricted to only symptomatic relief without dealing withthe basic disease etiology such as aggregation of αSyn, thusthe progression of the disease continues with the currenttherapies. The major objective of this study was to find outputative inhibitors of human alfa-synuclein to search possibletherapeutics of Parkinson’s disease.Material and Methods: Our study included Moleculardocking study of 3D-Structure of alfa- synuclein of humanretrieved from PDB with their chemical ligands. The proteinligands docking were performed using AutoDock4.2.5.1.Further, Molecular Dynamic Simulation for protein-ligandcomplex of best dock complex was carried out usingGromacs16.10.Result: Total nineteen molecules was selected for dockingstudy out of which Amento flavones molecule shows bestbinding. The molecular docking simulation results indicatethat the protein complexes were stable throughout MDsimulations and thus proteins possess the ability to stability.Conclusion: This study provides an insight of in-silico drugdesigning approach towards alfa- synuclein modulators as apromising therapeutics of Parkinson’s’s disease.