Birth Preparedness and Complication Readiness among Pregnant Women in Rural Area of District Sonipat, Haryana, India: A Cross Sectional Community Based Study

Introduction: Birth Preparedness and Complication Readiness (BPCR) is an important intervention included by WHO as essential elements of antenatal care package. It is often delivered to pregnant women through their active participation by health care provider during antenatal care or initiated/followed up through visits to the homes of pregnant women by community health workers. Objectives: To determine the knowledge and practice regarding BPCR and to identify factors associated with it among rural pregnant women. Method: Cross-sectional study was conducted in rural field practice area of Community Medicine Department of a medical teaching institutes. A total of 210 pregnant women who were in the second and third trimesters of pregnancy were selected by simple random sampling and interviewed for data collection. Results: Mean age of study subjects was 24.14 + 3.88 years.The highest number of women was in the age group of 20-29 years (84.8%). More than half (57.6%) mothers had observed at least two or more components of BPCR. Maximum number of females had identified facility for delivery (63.8%) followed by transportation (60.9%). Identification of potential blood donor by mothers was low (14.3%). Bleeding was most commonly identified danger symptom in all three phases of child bearing. Knowledge regarding danger signs was significantly associated with birth preparedness. Conclusion: In the present study, practice of all components of BPCR by mothers was very low. Bleeding was the most commonly identified danger symptom during all three phases i.e., pregnancy, child birth and after birth.Knowledge regarding other danger signs was highly inadequate.

PATTERNS OF SEROPREVALENCE FOR TRANSFUSION-TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS IN A BLOOD CENTRE OF NORTHEAST INDIA

PATTERNS OF SEROPREVALENCE FOR TRANSFUSION-TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS IN A BLOOD CENTRE OF NORTHEAST INDIA Original Research Paper Okram Geet- chandra Singh* Associate Professor, Blood Centre, JNIMS, Imphal *Corresponding Author Introduction: Transfusion– Transmissible Infections (TTIs) are the infections resulting from the introduction of a pathogen into a person through blood transfusion. In an attempt to mitigate the inherent risk of TTIs, the demographic information of blood donors including knowledge on local prevalence of infections and its pattern in the donor population is important for formulating recruitment strategies and planning other precautionary measures. Materials & Methods: This cross-sectional study was conducted in the Blood Centre, Jawaharlal Nehru Institute of Medical Sciences, Imphal between January 2019 and December 2022. All donated blood units were tested for the mandatory TTI markers for HIV 1 & 2, Hepatitis B, Hepatitis C, Syphilis and Malarial parasite. The prevalence and patterns of seropositivity for TTIs were studied based on the donor demographic characteristics such as donation type, gender and age group. The Results: overall seroprevalence among blood donors (n=31,563) was 1.79%. The seroprevalence was lower among voluntary donors (1.08%) than the replacement donors (2.10%). Seropositivities among female and male donors were 0.79% and 1.93% respectively. The lowest TTI seropositivity was seen among female voluntary donors (0.59%) and highest among male replacement donors (2.24%). The seroprevalence for speci?c TTI markers among the blood donors were 0.15% for HIV; 0.57% for HBV; 0.93% for HCV; 0.14% for Syphilis and no donor was found positive for Malaria. The frequency of TTI seropositivity was increased with increase in the age groups of donors in both sexes. There were 9 (0.029%) donors who had co-infection of TTIs. The patterns of TTI markers for co-infections were HCV+HIV=3; HCV+HBV=3; HCV+Syphilis=2 and HIV+ Syphilis=1. Conclusion: The measures to provide safe blood may include collection of blood from the targeted low risk donor population, using more sensitive testing methods, implementing pathogen reduction technologies and other public health measures

Comparative, observational study of the use of artesunate injections along with standard-of-care treatment versus only standard-of-care treatment in moderate and severe acute respiratory distress syndrome cases of COVID-19-positive infections

Introduction: COVID-19 is a type of coronavirus disease belonging to the family Coronaviridae. In late December 2019, this virus emerged from Wuhan, Hubei province, China, and resulted in an outbreak in China and expanded globally. In India, the mortality rate today was 521,691 till the date-time of writing this article. Several therapeutic agents have been evaluated for the treatment of COVID-19. Materials and Methods: This was a hospital-based comparative, observational study of the use of artesunate injections with standard-of-care (SOC) treatment (group A) versus only SOC (group B) treatment in moderate- to-severe cases of COVID-19 acute respiratory distress syndrome (ARDS) patients, on a total of 130 patients (comparative group of 65 patients each). The study was done on hospitalized COVID-19-positive moderate and severe cases of ARDS from October 2020 to June 2021 at MGM Hospital and Research Centre, CBD Belapur, Navi Mumbai, Maharashtra, India. Results: One hundred and thirty patients were divided into two groups of 65 each; group A was compared with group B; group A received SOC with artesunate injections and group B received only SOC treatment. The mean age of patients in group A was 57.3 ± 12.5 years (standard deviation [SD]: 54.2–60.3) and in group B was 55.8 ± 12.5 years (SD: 52.8–58.9). Diabetes mellitus was the most comorbid condition. The inflammatory markers, respiratory rate, and SpO2 improved in group A as compared to group B. The proportion of patients progressing to noninvasive and invasive ventilation was more in group B as compared to group A (P < 0.05). About 93.8% of patients (61 patients) recovered in group A compared with 72.3% of patients (47 patients) who recovered in group B. The overall death in group A was 6.2% (four patients) and 27.7% (18 patients) in group B (P < 0.05), indicating the proportion of dead patients is significantly more where only SOC treatment was given. Conclusions: Artesunate injection administration accelerated recovery in our patients with moderate and severe COVID-19 disease by controlling hyperimmune response. The clinical improvement was seen by decreased levels of inflammatory markers, reduced respiratory rate, and improved oxygen saturation and showed significant survival in group A compared with group B. Artesunate injections were given 2 mg/kg body weight diluted in 1 mL 5% sodium bicarbonate solution as a bolus followed by 1 mg/kg body weight after 6 h and 2 mg/kg body weight with 1 mL sodium bicarbonate solution for next 2 days at an interval of 24 h. Patients tolerated the injections well and recovery improved, so artesunate can be considered a therapeutic option in moderate and severe cases of COVID-19 ARDS.

Characteristics & outcomes of cancer patients with COVID-19: A multicentre retrospective study from India

Background & objectives: High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome. Methods: Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality. Results: Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil–lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome. Interpretation & conclusions: Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected

Determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending a rural tertiary care hospital of Haryana

Introduction : Rabies is a fatal but vaccine-preventable viral disease. Animal bite victims who report in primary and secondary level health care lack some measures which can help in protecting and preventing deaths due to rabies. The most important factor for prevention of death due to rabies is the timely administration of post-exposure prophylaxis (PEP) among animal bite victims. Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delay in PEP initiation. Objective: To determine the determinants of delay in initiation of post exposure prophylaxis for rabies prevention among animal bite cases attending anti-rabies clinic of a ruraltertiary care hospital in Sonepat, Haryana. Method: This cross-sectional study was conducted at an Immunization-cum-antirabies clinic of Bhagat Phool Singh Government Medical Collegefor Women, Khanpur Kalan, Sonepat, Haryana. A pre tested, structured questionnaire was used to collect information among 410 participants after taking consent. The Institutional Ethics Committee of institute approved the study. The groups were compared with Chi-square test for categorical data. Results: Delay was present among 27.3% of participants. Significant factors of delay were no local wound treatment, any treatment taken prior to anti-rabies vaccine administration, rabies clinic closed on holidays, unawareness about PEP, non-availability of accompaniment, transportation issues and money problem for transportation. Knowledge also played significant role as delay was significantly more among the participants not having knowledge regarding source of infection, mode of transmission and incubation period of rabies. Conclusions: Delay ininitiation of PEP was common and were significantly associated with lack of knowledge and unawareness, closure of rabies clinic on Sundays/holidays, non-availability of accompaniment and money problem during transportation

A COMPARATIVE STUDY ON BODY SHAPE CONCERNS BETWEEN RURAL AND URBAN COLLEGE GIRLS

The purpose of this study was to make comparison of body shape concerns between rural and urbalcollege girls. For this purpose to total 1000 (500 Urban and 500 Rural) college girls were randomly selectedfrom different colleges of rural and urban areas of Delhi and Uttar Pradesh. For assessing the body shape concerns the BodyShape Questionnaire (BSQ) developed by Chris Evans in (1993 ) was used. To compare mean difference of body shape concernsbetween rural and urban college girls, descriptive statistics and Z – test was applied, ?ndings of the study revealed that the meanbody shape of Urban College girls is signi?cantly greater (16.1874%), than the mean body shape of Rural College Girls.

Methylene blue treatment for moderate-to-severe cases of acute respiratory syndrome due to COVID-19 infection: clinical outcomes—a prospective study

Background: We studied the real-life experience with Methylene blue administration among the moderate and severe cases of acute respiratory distress syndrome due to Covid-19 infection with the standard of care. Materials and Methods: This study is a prospective, single-center study including 103 hospitalized patients conducted in a tertiary healthcare center from June 2020 to July 2021. The route of administration of Methylene blue was through nebulization (0.5 mL 0.5% solution of Methylene blue + 2.5 mL of distilled water) three times a day as long as the patient was admitted. An ampoule of 10 mL of Methylene blue with 90 mL of potable water through oxygen port was administered as long as they needed oxygen. About 2 mg/kg body weight of Methylene blue in 300 mL of N.S. over 3 h was given once a day for 5 days. Results: Approximately 103 patients were seen with a mean age of 56.49 years. The most prevalent comorbid condition was diabetes. The SpO2 improved by 7.827%. On post-Methylene blue administration, the serum ferritin, C-reactive protein, lactate dehydrogenase, and D-dimer were reduced in comparison to pre-Methylene blue administration. Also, the average total length of stay was 14 ± 4.20, 13 ± 5.66, and 14 ± 3.50 days in 26.78% of patients in intensive care unit, 17.51% of patients in high dependency unit, and 58.71% of patients in Covid general ward, respectively. About 86.4% of the patients recovered and got discharged post-Methylene blue administration. The all-cause mortality was 13.59%, which could be due to underlying comorbidities and complications of Covid-19 infections. Conclusion: Methylene blue administration accelerated recovery in our patients with moderate and severe Covid-19 disease by controlling the hyperimmune response. The clinical improvement was seen by decreased levels of inflammatory markers, improved oxygen saturation, reduced length of hospital stay, and clinical improvements. Methylene blue administered in nebulization form, through oxygen port, and through intravenous infusion in the dose of 2 mg/kg body weight for 5 days and improved patients’ recovery, so it can be considered as a therapeutic option in moderate and severe Covid-19 disease.

Addition of 2 mg dexamethasone to improve the anesthetic efficacy of 2% lidocaine with 1:80,000 epinephrine administered for inferior alveolar nerve block to patients with symptomatic irreversible pulpitis in the mandibular molars: a randomized double-blind clinical trial

Methods@#In a double-blinded setup, 124 patients randomly received either of the following injections: 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, or plain 2% lidocaine mixed with 2 mg dexamethasone, which were injected as a primary IANB. Ten minutes after injection, patients with profound lip numbness underwent electric and thermal pulp sensibility tests. Patients who responded positively to the tests were categorized as “failed” anesthesia and received supplemental anesthesia. The remaining patients underwent endodontic treatment using a rubber dam. Anesthetic success was defined as “no pain or faint/weak/mild pain” during endodontic access preparation and instrumentation (HP visual analog scale score < 55 mm). The effect of the anesthetic solutions on the maximum change in heart rate was also evaluated. The Pearson chi-square test at 5% and 1% significance was used to analyze anesthetic success rates. @*Results@#The 2% lidocaine with 1:80,000 epinephrine, 2% lidocaine with 1:80,000 epinephrine mixed with 2 mg dexamethasone, and plain 2% lidocaine mixed with 2 mg dexamethasone groups had anesthetic success rates of 34%, 59%, and 29%, respectively. The addition of dexamethasone resulted in significantly better results (P < 0.001, χ 2 = 9.07, df = 2). @*Conclusions@#The addition of dexamethasone to 2% lidocaine with epinephrine, administered as an IANB, can improve the anesthetic success rates during the endodontic management of symptomatic mandibular molars with irreversible pulpitis.

Comparison of ultrasound guided pulsed radiofrequency of genicular nerve with local anesthetic and steroid block for management of osteoarthritis knee pain

Background@#To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. @*Methods@#Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group).Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. @*Results@#VNRS scores decreased significantly (P 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. @*Conclusions@#Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

Winged nance palatal arch An adjunct to tooth movement

Anchorage control during the correction of severely crowded dentitions has always been a source of concern during orthodontic therapy. The Nance palatal arch (NPA) has, in the past, been widely used for reinforcing anchorage in such cases. Modifications of the NPA have been reported for use as a fixed functional appliance or for molar distalization. Herein, a simple, effective modification of the conventional NPA is introduced incorporating two power arms, which can be used for unravelling of anterior crowding at the same time effectively augmenting molar anchorage.

Association of vitamin D deficiency and bone mass with liver and heart iron overload in transfusion dependent thalassemia

Background: Transfusion dependent thalassemia patients are reported to have Vitamin D insufficiency/deficiency in many countries. Vitamin D hydroxylation occurs in the liver; whether liver iron overload interferes with this step has not been addressed till date. This study helps to establish an association between liver iron concentration (LIC) and heart iron concentration (MIC) with vitamin D levels and Bone Mass Density in these patients.Methods: A cross sectional study was done by including transfusion dependent Thalassemia patients (TM) if they had an assessment of Liver and cardiac iron done by T2*MRI and bone mineral density by DEXA. Clinical data regarding age, gender, type of iron chelation therapy and laboratory data of S. ferritin and Vitamin D was collected. Data was assessed using appropriate statistical methods.Results: Among 40 TM patients were taken and mean age was 17.6 years. Vitamin D deficiency was identified in 26(65%). 20 out of them had an LIC>7mg/g DW and 6 had MIC>1.65mg/g DW. There was a significant association between LIC>7mg/g and vitamin D level<20 ng/ml and a significant inverse correlation between LIC and vitamin D, suggesting that liver iron overload may indeed affect vitamin D metabolism. Osteopenia was present in 32.5% and osteoporosis was present in 27.5 % of all TM patients. Reduced Bone Mass Density was also found to be linked with iron over load.Conclusions: Regular monitoring of vitamin D levels and supplementation is required in patients with severe liver and heart iron load. More studies are needed to confirm these results.

Comparison of Decellularized Bubaline Diaphragmatic Scaffold with Synthetic Polygalactin and Polypropylene Composite Mesh for Perineal Hernioplasty in Dogs

Present study was planned to compare xenogenic decellularized bubaline diaphragmatic scaffold with synthetic polygalactin and polypropylene composite mesh for repair of perineal hernia in dogs. Twelve dogs suffering with perineal hernia were randomly divided in to two equal groups. In group I perineal hernioplasty was done with Synthetic polygalactin and polypropylene composite mesh while in group II, with decellularized bubaline diaphragmatic scaffold (dBDS). Mean surgical time was 59.17 ± 14.04 and 57.50 ± 6.15 minute in group I and II respectively. Swelling, redness and warmth increased significantly (p<0.05) on day 3 in both the groups. In group II initially significantly (p<0.05) increased exudation was observed on day 3 which reduced gradually. Degree of pain after surgery was significantly (P<0.05) decrease on day 3 in both the groups. Neutrophil count was significantly (p<0.05) increased and correspondingly lymphocyte count significantly (p<0.05) decreased on day 7 in group I while in group II no significant difference within the group was observed. Colour Doppler ultrasonographic examination revealed no vascularization on 0 day in both the groups. Neovascularization was observed on day 30 in group I and day 14 in group II on Colour Doppler ultrasonographic examination. It was increased on day 90 in both the groups. The complication encountered in the present study includes local seroma, suture dehiscence due to self mutilation, constipation and fistula formation. Decellularized bubaline diaphragmatic scaffold was well accepted by all the animals and showed less complication than synthetic mesh

Alcohol and drug intake pattern among truckers of Haryana, India

Background: Newborn period is culturally and traditionally sensitive in every society. Different communities have different traditional practices when it comes to taking care of newborn. Head-shaving in newborn period is one such unique traditional practice existent among rural population of West Bengal. This study was conducted to explore the traditional practice of head-shaving and to highlight its related morbidities among newborns following head-shaving.Methods: This was a descriptive, cross-sectional study conducted at triage of special newborn care unit of Malda Medical College and Hospital among 650 mothers who presented to us with their sick newborns following head-shaving. After obtaining informed consent, mothers were interviewed. The data were collected using pre-designed questionnaires. Statistical analyses of the data were done using SPSS version 21.Results: In the present study, majority (52.62%) of the mothers were within the age group of 18-21 years and 94.15% belonged to Muslim community. Neonatal head-shaving was usually done on 4th day of life (48.15%) and on 10th day of life (28.77%). Baby bath following head-shaving was given in 49.54% newborns using pond water and 77.70 % mothers used crude mustard oil for massaging following baby bath. Following head-shaving, 37.69% of newborns presented with poor feeding, 33.23% with abdominal distension and 61.23% presented with respiratory distress.Conclusions: Findings of present study highlights the harmful aspects of traditional practice of head-shaving among newborns in rural Bengal. This practice can be avoided by proper health education and counselling of the mothers and her associates involved in newborn care.

Extraperitoneal versus transperitoneal cesarean section: a retrospective analysis

Background: Cesarean section is becoming a more common delivery type worldwide. The objective of this study was to compare surgical morbidity in extraperitoneal versus transperitoneal techniques of cesarean section.Methods: A total of 60 patients was included in this study out of which 30 underwent extraperitoneal cesarean section(ECS) and 30 patients underwent transperitoneal cesarean section (TCS) and compared both the techniques with respect to nausea or vomiting intra-operatively, pain score (as measured by visual analogue scale) post operatively, return of bowel function and blood loss.Results: Intra-operative nausea and vomiting was noted in 33.34% of patients in TCS group while none of the patients in ECS group had any such complaints. No difference was noted in average blood loss between the 2 groups. Post-operative pain in ECS was 4.13 as compared to 6.86 in TCS. Return of bowel sounds in ECS group was much earlier (5.46 hours) as compared to TCS group (11.33 hours).Conclusions: We conclude that extraperitoneal technique is advantageous over transperitoneal approach. Decreased nausea and vomiting, early return of bowel function in the post-operative period, decreased post-operative pain allowing early feeding and mobilization are definite benefits of this technique. This further helps in making a relatively smoother post-operative recovery.

Successful management of a patient with sudden loss of vision and eclampsia complicated by posterior reversible encephalopathy syndrome

Reversible visual disturbances in patients with eclampsia may be due to either retinal detachment or retinal arteriolar vasospasm or thrombosis of the central retinal arteries or PRES (posterior reversible encephalopathy syndrome). Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness may occur in 1% to 15% of patients with eclampsia. Reporting herewith a case of reversible cortical blindness in the setting of severe preeclampsia complicated with eclampsia.

Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study / Efetividade do plasma rico em plaquetas no tratamento da dor em osteoartrite de joelho: estudo comparativo randômico e duplo-cego

Abstract Background: Intra-articular injections of platelet-rich plasma to treat symptoms of knee osteoarthritis have been successfully used in young patients. However in most of these studies the control and test knees were present in different patients thus incorporating a large amount of bias in the results. Therefore, the present study was designed in which patients with bilateral osteoarthritis knee were included and platelet-rich plasma was administered in one knee and normal saline in another knee of same patient. Methods: 20 patients aged 30-65 years with bilateral osteoarthritis knees (ASA class I and II) of either gender were included in the study. Patients were randomized to receive platelet-rich plasma and normal saline in one of the two knees. The primary outcome was VAS and WOMAC score at 6 months after procedure. The secondary outcome included changes in joint stiffness, physical function, any adverse effects noted during the course of study. Results: The baseline VAS score in platelet-rich plasma knee was 8.4 ± 0.88 which improved significantly to 4.85 ± 2.48 (p < 0.001) at 6 months as compared to normal saline knee (p = 0.017). The WOMAC pain score also improved from baseline (14.5 ± 1.3) to over 6 month 7.00 ± 4.24 (p < 0.001) in platelet-rich plasma knee while in the normal saline knee, no significant change occurred from baseline to six months (10.2 ± 1.2 to 10.05 ± 1.23). There was also significant decrease in stiffness and improvement of physical activity in the platelet-rich plasma knee as compared to normal saline knee. Conclusion: The present study showed significant decrease in pain and stiffness and improvement of physical functions of knee joint with intra-articular platelet-rich plasma injection as compared to normal saline.

Resumo Justificativa e objetivos: Injeções intra-articulares de plasma rico em plaquetas têm sido usadas com sucesso para tratar os sintomas da osteoartrite de joelho em pacientes jovens. Porém, na maioria desses estudos, os joelhos de controle e teste estavam presentes em diferentes pacientes, o que incorporou uma grande quantidade de viés aos resultados. Portanto, o projeto do presente estudo incluiu pacientes com osteoartrite em ambos os joelhos, com a administração de plasma rico em plaquetas em um dos joelhos e de solução salina normal no outro joelho do mesmo paciente. Métodos: 20 pacientes, de ambos os sexos, com idades entre 30-65 anos e portadores de osteoartrite bilateral de joelho (classificação ASA I e II) foram incluídos no estudo. Os pacientes foram randomizados para receber plasma rico em plaquetas e solução salina normal em um dos dois joelhos. O desfecho primário foram os escores VAS e WOMAC seis meses após o procedimento. O desfecho secundário incluiu alterações na rigidez articular, função física e qualquere feito adverso observado durante o curso do estudo. Resultados: O escore VAS basal para o joelho que recebeu plasma rico em plaquetas foi 8,4 ± 0,88 e melhorou significativamente para 4,85 ± 2,48 (p < 0,001) após seis meses, comparado ao joelho que recebeu solução salina normal (p = 0,017). A intensidade da dor avaliada com o WOMAC também melhorou de 14,5 ± 1,3 na fase basal para 7,00 ± 4,24 após seis meses (p < 0,001) nos joelhos que receberam plasma rico em plaquetas, enquanto nenhuma mudança significativa ocorreu nos joelhos que receberam solução salina normal entre a fase basal e após seis meses (10,2 ± 1,2 a 10,05 ± 1,23). Além disso, houve uma diminuição significativa da rigidez e melhora da atividade física nos joelhos que receberam plasma rico em plaquetas, comparados aos joelhos que receberam salina normal. Conclusão: O presente estudo identificou uma diminuição significativa da dor e da rigidez e uma melhora das funções físicas da articulação do joelho com a injeção intra-articular de plasma rico em plaquetas, comparada à solução salina normal.

Water Quality and Nutrient Dynamics of Biofloc with Different C/N Ratios in Inland Saline Water

A study evaluating water quality and nutrient dynamics in inland saline water was carried out using biofloc technology with different C/N ratios employed to raise Litopenaeus vannamei juveniles. The study was carried out for 60 days in FRP with no water exchange. Salinity, temperature, Dissolved oxygen, pH, nutrients, Biofloc Volume and Total Suspended Solids were monitored. All biofloc units indicated reduction in alkalinity at 40th day except the treatment with highest (25:1) C/N ratio, pH and alkalinity was not significant different among various treatments. Dissolved Oxygen was found to be significantly decreasing with increasing C/N ratios. The least Dissolved Oxygen was recorded at higher C/N ratios of 20:1 and 25:1 at the end of experiment. The Total Ammonical Nitrogen (TAN) and NO2–Nin C/N ratios 15:1 and 20:1 were found to have a significantly decreasing in trend after 20th and 18th day respectively. The NO3–N, PO43-–P, BVF and TSS in biofloc were shown an increasing trend in all the experiments. The present study elucidates the suitability of optimum C/N ratios in biofloc for maintaining the water quality to raise L. vannamei in inland ground saline water. The finding could help in reducing the environmental concern saline waste water discharge from the shrimp pond to the land.

Correlation between CD4 Count and HIV-1 Viral Load among ART Naive Patients Attending ICTC, SMS Medical College, Jaipur

Objectives: To study the correlation between CD4 count &HIV-1 viral load among ART Naive patients attending ICTCSMS Medical College, Jaipur.Material and Methods: This study was conducted on 250 HIVserologically confirmed, ART Naive cases from ICTC, SMSJaipur. RNA extraction was done from plasma samples byQiagen Viral RNA Mini Kit then HIV-1 Viral load wasdetermined by Qiagen HIV-1 viral load kit on ABI 7500 Fast dxReal Time PCR, while CD4 count was done on FACSCALIBUR flowcytometer (BD Biosciences). SPSS ver. 21.0was used to determine correlation between CD4 count & HIV-1viral load.Results: Out of 250, 216 (86.4%) cases were found in whichviral RNA was detected. These samples were correlated withtheir CD4 Count. The mean of viral load was 194746.2791 ±550442.61805 IU/ml while CD4 count was 282.7674 ±217.56456 cells/ul. Females were having Avg. Viral load228506.7273 & CD4 count 337.21 and males were found tohave Avg. Viral load 179791.9866 & CD4 count 258.65Conclusion: This study concluded a negativecorrelation between HIV-1 RNA viral load and CD4 count inHIV-seropositive ART naïve patients of this part of the country.Our study confirmed that HIV-1 RNA viral load levels aresignificantly higher in women than in men, but no suchsignificant gender difference in the CD4 count was found.

Titanium Allergy In Implant Dentistry : Literature Review

Titanium use for making implants to replace the teeth and associated structures is now in common Dental practice. Owing to its high resistance to corrosion in a physiological environment and the excellent biocompatibility that gives it a passive, stable oxide film, titanium is considered the material of choice for intraosseous use. There are certain studies which show titanium as an allergen but the resources to diagnose titanium sensitivity are very limited. The allergic response to titanium is reported in very few cases. The purpose of this article is to create awareness among the people handling and using titanium in dentistry so that better strategies can be developed to manage the allergic response to it

Role of antenatal care in reducing incidence of eclampsia in eastern Uttar Pradesh, India

Background: Eclampsia is characterized by sudden onset of generalized tonic-clonic convulsions or coma in pregnancy or postpartum. It is a major cause of maternal and perinatal morbidity and mortality in developing countries. This study was conducted to determine the incidence of eclampsia and role of antenatal care in reducing the incidence.Methods: This was a prospective study (July 2015-June 2016) conducted in labour room of department of obstetrics and Gynecology, BRD Medical college, Gorakhpur, Uttar Pradesh, India. A total no. of 141 women presenting with eclampsia were included in the study. Risk factors like antenatal care and sociodemographic status were studied for their role in increased incidence of eclampsia.Results: There were 141 eclampsia cases out of 3536 deliveries, during the study period. The incidence of eclampsia was found to be 4%. Out of 141 eclampsia cases 35.5% did not receive any antenatal care. 56.7% received substandard care in less than 4 antenatal visits. Out of those who received antenatal care (91/141), 67% received irregular, substandard care in primary health centre of their locality. Majority of eclampsia cases were between 16-25 years of age (85.1%) and were primigravida (62.4%). Majority of eclampsia cases were uneducated (89.4%), of lower socioeconomic status (71.4%) and belonged to rural area (67.4%).Conclusions: High incidence of eclampsia in B.R.D. Medical College reflects the status of eclampsia in eastern Uttar Pradesh, India. To prevent eclampsia our health care centres should be strengthened by well trained medical officers, other health care workers and adequate antenatal care facilities.