A comparative study of clinical profile, severity and outcome of acute coronary syndrome in women and men admitted to a tertiary hospital

Background: Coronary artery disease (CAD) has emerged as a major health burden in developing countries. Many recent reports concluded that women with CAD have a worse prognosis than men and also with regards to invasive interventions when compared to men. In this study, author determined the comparative outcomes of ACS in women when compared with men.Methods: This study was conducted in a tertiary care hospital from November 2016 to March 2018. History taking, ECG, cardiac enzymes, 2D-Echo and angiogram were done to diagnose ACS and the appropriate treatment was given. The severity was assessed and compared the outcomes along with complications.Results: The total of 112 patients were treated for ACS, in which, 55 were females and the remaining 57 were males. Majority of the patients in both genders was between the ages of 51-60. In males, STEMI noted 50.8%, NSTEMI in 36.8%, UA in 12.2%. In females, STEMI is noted in 62%, unstable angina in 32.7%, NSTEMI in 27.2%. Six patients (11%) had mortality in the women group and one (1.8%) had died among men.Conclusions: Atypical presentation of ACS was more common in females. Women with ACS had higher complications and higher mortality than men.

Immediate effect of dynamic oscillatory stretching vs. neurodynamic sliding technique on stretch tolerance, popliteal angle range and hamstring flexibility in apparently healthy individuals with hamstring tightness: a pre-post clinical trail

Background: The hamstrings being postural muscles are prone to tightness which leads to muscular imbalances and inefficiency of daily living activities. Hence, the present study aims to compare two competent techniques Dynamic Oscillatory Stretching (DOS)vs. neurodynamic sliding (NDS) technique.Methods: A Total of 60 subjects were recruited (31 males, 29 females). passive 90-90 knee extension test, modified v sit to reach test and NPRS scale were used to evaluate the range, flexibility and stretch tolerance in participants pre intervention and were allotted into Group A (DOS) and Groups B. The subjects were then re-assessed immediately post intervention.Results: The results were obtained using the independent and dependent t-tests. Post intervention results were suggestive of a significant within group result with a p=0.0001 under all the parameters. Subjects in Group a showed a greater increase in the ROM while, Group B showed a better result in flexibility and stretch tolerance.Conclusions: Both the techniques are efficient and can be incorporated in sports rehabilitation to prevent on site injury thereby improving athlete’s performance.

Thymoma: First large Indian experience.

BACKGROUND: Thymoma is the most common tumor of the anterior mediastinum. Surgery is mainstay of treatment, with adjuvant radiation recommended for invasive thymoma. Because of rarity, prospective randomized trials may not be feasible even in multicentric settings hence the best possible evidence can be large series. Till date Thymoma has not been studied in Indian settings. MATERIALS AND METHODS: All patients presenting to Thoracic disease management group at our Centre during 2006‑2011 were screened. Sixty two patients’ with histo‑pathological confirmation of thymoma medical records could be retrieved and are presented in this study. Mosaoka staging and WHO classification was used. The clinical, therapeutic factors and follow up parameters were recorded and survival was calculated. Effects of prognostic factors were compared. RESULTS: Sixty two patients were identified (36M, 26F; age 22‑84, median 51.5 years) and majorities (57%) of thymoma were stage I‑II. WHO pathological subtype B was most common 30 (49%). Mean tumor size was smaller in patients with myasthenia (5.3cm) than the entire group (7.6cm). Neoadjuvant therapy was offered to five unresectable stages III or IV a patient’s with 40% resectability rates. Median overall survival was 60 months (Inter quartile‑range 3‑44 months) with overall survival rate (OS) at three year being 90%. Resectable tumors had better outcomes (94%) than non resectable (81%) at three years. Mosaoka Stage was the only significant (P = 0.03) prognostic factor on multivariate analysis. CONCLUSION: This is first thymoma series from India with large number of patients where staging is an important prognostic factor and surgery is the mainstay of therapy. In Indian context aggressive multimodality treatment should be offered to advanced stage patients and which yields good survival rates and comparable.

Scanning the macula for detecting glaucoma.

Background: With the advent of spectral domain optical coherence tomography (SDOCT), there has been a renewed interest in macular region for detection of glaucoma. However, most macular SDOCT parameters currently are thickness parameters which evaluate thinning of the macular layers but do not quantify the extent of area over which the thinning has occurred. We therefore calculated a new macular parameter, “ganglion cell complex surface abnormality ratio (GCC SAR)” that represented the surface area over which the macular thickness was decreased. Purpose: To evaluate the ability of SAR in detecting perimetric and preperimetric glaucoma. Design: Retrospective image analysis. Materials and Methods: 68 eyes with perimetric glaucoma, 62 eyes with preperimetric glaucoma and 165 control eyes underwent GCC imaging with SDOCT. SAR was calculated as the ratio of the abnormal to total area on the GCC signifi cance map. Statistical Analysis: Diagnostic ability of SAR in glaucoma was compared against that of the standard parameters generated by the SDOCT soft ware using area under receiver operating characteristic curves (AUC) and sensitivities at fi xed specifi cities. Results: AUC of SAR (0.91) was statistically signifi cantly bett er than that of GCC average thickness (0.86, P = 0.001) and GCC global loss volume (GLV; 0.88, P = 0.01) in diff erentiating perimetric glaucoma from control eyes. In diff erentiating preperimetric glaucoma from control eyes, AUC of SAR (0.72) was comparable to that of GCC average thickness (0.70, P > 0.05) and GLV (0.72, P > 0.05). Sensitivities at specifi cities of 80% and 95% of SAR were comparable (P > 0.05 for all comparisons) to that of GCC average thickness and GLV in diagnosing perimetric and preperimetric glaucoma. Conclusion: GCC SAR had a bett er ability to diagnose perimetric glaucoma compared to the SDOCT soft ware provided global GCC parameters. However, in diagnosing preperimetric glaucoma, the ability of SAR was similar to that of soft ware provided global GCC parameters.

eyeglass frame retained nasal prosthesis after partial rhinectomy: a clinical report

Surgical defects often have adverse effects on patient perception of esthetics and self-esteem. Facial defects resulting from neoplasms, congenital malformations or trauma can be restored with facial prosthesis using different materials and retention methods to achieve a lifelike look and function. For the successful result consideration should be given to harmony, texture, color matching and blending of tissue-prosthesis interface. This clinical report describes a psychosocial rehabilitation of the patient with nasal resection which includes part of the nasal septum, the entire cartilage, and the ala. An interim nasal prosthesis was fabricated for this patient after three weeks of surgery, to provide early rehabilitation treatment using the frame of spectacle glasses that retained the prosthetic nose

Extraction and estimation of theobromine in marketed tea by HPTLC and UV method.

A rapid, simple and sensitive chromatographic method (RP-HPTLC) has been developed for the extraction and quantitative estimation of Theobromine in different extract tea samples (Camellia sinensis). Separation was performed on Silica gel 60 f254 HPTLC plates with ethyl acetate: methanol (27:3 v/v), as mobile phase. The determination was carried out in the UV region, using densitometric absorbance at 274 nm. The maximum concentration of Theobromine in tea samples was found to be 2.313 %. The theobromine response was found to be linear over range 3-15 μg per zone. Limit of detection and quantitation were found to be 30 and 140 ng/ spot respectively. The HPTLC method was validated in terms of precision, accuracy, sensitivity and robustness. The proposed method provided precise and accurate analysis for extraction and estimation of theobromine by HPTLC-UV.

Awareness of health personnel about lymphatic filariasis and mass drug administration in Kerala State.

The mass drug administration programme to eliminate lymphatic filariasis with DEC in Kerala was started in 1997, extended to all the 11 endemic districts by 2005. Since the beginning of Mass drug Administration, the drug consumption rate was found to be not satisfactory. The reasons for noncompliance indicated that the community is not fully convinced about the programme. The knowledge of the medical and para medical workers is certainly a factor in the success of implementation of the programme and is vital. To ascertain the knowledge, a study was undertaken and found not satisfactory. Hence intensive training on all aspects of lymphatic filariasis and the Mass drug Administration programme to achieve the requisite drug consumption rate to meet the goal is needed.

Estimation of survival rates of breast cancer patients--a hospital-based study from Mumbai.

PURPOSE: To estimate the survival rates of breast cancer patients with reference to various factors like age, literacy status, residential status, T-stage and treatment. This is because there are very few studies reported from Indian subcontinent. METHODS: Survival rates were obtained by using the actuarial method and loss-adjusted survival rate method (LAR) for the above factors and the rates were compared. The present study carried out at the Tata Memorial Hospital (TMH), includes newly diagnosed (who were not treated elsewhere before attending TMH) primary breast cancer patients and having completed the initial treatment. RESULTS: The survival rates, actuarial survival and rates corrected for losses to follow-up (LAR) are presented. It showed that younger patients (<or=50 yrs) had a better 5-year survival ( 81%) than the older patients (> 50 years), with statistical significance ( p=0.024). There was no variation in survival with regard to the residential status but literate patients had a better ( non-significant) survival (77%) than their illiterate counterparts. T3-stage patients had the worst prognosis showing a 5-year survival of 60% (p=0.0002). Survival for those treated with surgery as the only modality and also in combination with other modalities did not show any remarkable differences except for the group that were treated with 'surgery in combination with chemotherapy'. The 5-year survival for those treated with surgery as the only modality was 83%. This study yielded useful information on breast cancer survival, especially in a situation with incomplete follow-up. The method applied (LAR) also clearly demonstrates the bias in estimates obtained by direct application of the standard actuarial method.

Mass drug administration against lymphatic filariasis: experiences from Kozhikode district of Kerala State.

The mass DEC drug administration to eliminate lymphatic filariasis in Kozhikode district was monitored from 2001 to 2003 to assess the drug distribution coverage, compliance, reasons for non-compliance, side reactions, mf prevalence and intensity, infection and infectivity rates in the vector. The drug distribution coverage and compliance were much below the required level. "No disease so not necessary" (42.5%) and "fear of side reactions" (25.2%) were the two major reasons for non-compliance. The adverse reactions were minimal. No appreciable changes were found in the mf prevalence and intensity. For the successful implementation of the MDA programme, proper planning, intense and timely efforts to motivate the community and innovative drug delivery strategies are required.

Estimate of cancer incidence in India in 1991.

Cancer incidence and eighteen site-specific age standardised rates in India were estimated for the year 1991. With the establishment of National Cancer Registry Programme, incidence rates per 100,000 are available from six metropolitan registries and one rural registry. Using population census data for India in 1991, about 609,000 new cancer cases were estimated to have been diagnosed in the country in 1991. The estimated age standardised rates per 100,000 were 96.4 for males and 88.2 for females. The five most common cancers were lung (10.6%) pharynx (9.1%), oesophagus (6.7%), tongue (6.6%) and stomach (5.7%) among males and cervix (23.5%), breast (19.3%), ovary (5.5%) oesophagus (4.4%), and mouth (3.9%) among females. A comparison of estimated ASRs for two two largest countries in Asia (China and India) showed differences in the pattern of cancer.

Epidemiological observations on cancer of the oesophagus--a review of Indian studies.

This is an epidemiological review on cancer of the oesophagus. In this attempt, all aspects of epidemiological factors based on national and international studies on oesophageal cancer have been brought out. The problem of this cancer in Indian context has been documented. The association of tobacco and alcohol habits with oesophageal cancer has been confirmed from the studies conducted in India. There is an urgent need to educate the common people about the harmful effect of these two habits and governments and voluntary organisation should take effective steps for its prevention.