Prevalence of thyroid dysfunction in women with abnormal uterine bleeding in reproductive age

Background: Abnormal uterine bleeding (AUB) is one of the commonest presentations encountered in gynecological outpatient department. Menstruation is also regulated by many mechanisms, including thyroid hormone. So, for definitive management of AUB, it becomes imperative to assess thyroid status in those with abnormal uterine bleeding.Methods: Cross sectional study was conducted on all woman attending to OPD at Sri Siddhartha Medical College, Tumukuru, with complaints of abnormal uterine bleeding (AUB). Thyroid test was done for those who were eligible under inclusion criteria. Incidence of thyroid disorders among AUB and type of abnormal menstrual pattern associated with specific type of thyroid dysfunction were noted in this study.Results: Total of 522 presented with AUB. AUB was most common among woman age >40 years at 49.23% (257 of total 522 cases). AUB was more common in Multipara at 61.49% (321 of 522 cases). Menorrhagia was commonest pattern in AUB accounting for 51.34% (268 of 522cases). Thyroid dysfunction was present in 12.27% (64 of 522) of cases with AUB. Among them hypothyroid was most common accounting for 8.81% (46 of 522 cases). Hyperthyroidism was present in 3.44% (18 of 522 cases). Menorrhagia was most common pattern in Hypothyroidism at 65.21% (30 of 46 cases, followed by polymenorrhea at 17.39% (8 of 46 cases). Oligomenorrhea was most common in hyperthyroid group at 55.54% (10 of 18 cases) closely followed by hypomenorrhea at 44.44% (8 of 18 cases).Conclusions: Abnormal uterine bleeding (AUB) is one of the commonest gynecological complaint at gynecological OPD.  Thyroid dysfunction is noted consistently in cases of AUB. So, evaluation of thyroid profile should be part of evaluation of AUB, especially during perimenopause.

Study of clinical and laboratory profile in alcoholic liver disease with emphasis on renal function.

Background: Alcoholic liver disease is a major health care problem in India and accounts for increased economic burden. Chronic liver disease is most commonly complicated with renal dysfunction and this combination leads to significant morbidity and mortality. The aim was to study the clinical and laboratory profile and evaluation of renal function in alcoholic liver disease. Methods: Sixty consecutive patients presenting to a tertiary care hospital in central India with alcoholic liver disease were studied and their clinical and laboratory investigation noted and analysed. Results: The mean age at presentation was 45.18years. Fifty nine of them were male. Abdominal distension and jaundice were the most common presenting complaint. Fourteen (23%) patients presented with complications. Twenty six (43%) had severe anemia, 16 (27%) had thrombocytopenia and 23 (38.3%) had coagulopathy. The mean AST, ALT, bilirubin, ALP and albumin were 113.51 U/l, 62.16 U/l, 5.78 mg/dl, 211 U/l and 3.12 gm/dl respectively. On abdominal sonography fatty changes was seen in 20 (33%), Hepatomegaly in 20 (33%), Splenomegaly in 25 (41%) and PVD ≥13 mm in 11 (21%). The prevalence of renal dysfunction on the basis of reduced GFR was 30% which included all forms of renal failure in chronic liver disease. Serum creatinine level was increased in 20% of the patients. Blood urea was raised in 37%. Conclusion: The results of this study established most of the known facts about alcoholic liver disease in this part of the world. Not only liver function tests, patients with alcoholic liver disease have abnormal haematological and renal function too. Renal dysfunction was seen in significant number of patients.

Prevalence and Sociodemographic Correlates of Primary Headache Disorders: Results of a Population-based Survey from Bangalore, India.

Background: Headache disorders are common and burdensome throughout the world, placing high demand on health care services. Good information on their prevalence and distribution through sectors of the population are a prerequisite for planning interventions and organizing services, but unavailable for India. Objectives: To fi nd out the prevalence of headache disorders in Karnataka State and establish important sociodemographic associations. Materials and Methods: Using a door to door survey technique, amongst 2997 households, 2329 individuals were interviewed with a validated structured questionnaire by randomly sampling one adult member (aged 18-65 years) from eligible households in urban (n = 1226) and rural (n = 1103) areas of Bangalore, during the period April 2009 and January 2010. Statistical Analysis Used: Chi-square, odds ratio (OR), and logistic regression. Results: The 1-year prevalence of headache was 63.9% (62.0% when adjusted for age, gender and habitation) and 1-day prevalence (headache on the day prior to the survey) was 5.9%. Prevalence was higher in the age groups of 18-45 years, among females (OR = 2.3; 95% confi dence interval: 1.9-2.7) and those in rural areas. Prevalence was higher in rural (71.2 [68.4-73.8]) than in urban areas (57.3 [54.5-60.1]) even after adjusting for gender. The proportion of days lost to headache from paid work was 1.1%, while overall productivity loss (from both paid and household work) was 2.8%. Conclusions: Headache disorders are a major health problem in India with signifi cant burden. It requires systematic efforts to organize effective services to be able to reach a large number of people in urban and rural India. Education of physicians and other health-care workers, and the public should be a pillar of such efforts.

Carboplatin loaded polymethylmethacrylate nano-particles in an adjunctive role in retinoblastoma: An animal trial.

Purpose: The purpose of the study is to compare the intra-vitreal concentrations of carboplatin, post peri-ocular injections of commercially available carboplatin (CAC) and a novel carboplatin loaded polymethylmethacrylate nanoparticulate carboplatin (NPC), in either eye, as a model system for treatment of advanced intra-ocular retinoblastoma (RB). Design: Experimental, comparative, animal study. Materials and Methods: Polymethylmethacrylate nanoparticles were prepared by free radical emulsion polymerization of methyl methacrylate in aqueous solution of carboplatin in the presence of surfactant sodium dodecyl sulfate and thermal initiator ammonium persulfate. 21 Sprague-Dawley rats, aged between 6 weeks and 3 months were enrolled. The right eye of each rat was injected peri-ocularly with CAC formulation (1 ml of 10 mg/ml) and the left eye with NPC (1 ml of 10 mg/ml), post-anesthesia, by an ophthalmologist trained in ocular oncology. Three rats each were euthanized on days 1, 3, 5, 7, 14, 28 and 42, post-injection and both eyes were carefully enucleated. Intra-vitreal concentrations of CAC and NPC were determined with Inductively Coupled Plasma Atomic Emission Spectroscopy. Analysis of data was done with paired t-test. Results: The intra-vitreal concentration of carboplatin with NPC was ~3-4 times higher than with CAC in all animals, on all the days (P < 0.05). Conclusion: A higher trans-scleral permeability gradient is obtained with the novel nanoparticles than with the commercial drug, leading to sustained higher levels of carboplatin in the vitreous. Peri-ocular injection of NPC could thus have an adjuvant effi cacy in the treatment for advanced clinical RB, specifi cally those with vitreous seeds.

cross-sectional study of correlation of body image anxiety with social phobia and their association with depression in the adolescents from a rural area of Sangli district in India

Prevailing socio-cultural influences lead females to desire a thin body and males a muscular body, especially in adolescents. This results in body image anxiety which may lead to social phobia. Together they can develop depression. The aim was to study the correlation of body image anxiety with social phobia and their association with depression, among adolescents. This was a cross-sectional study conducted in randomly selected colleges from a rural area of Sangli district Maharashtra, India. Stratified random sampling technique used with sample size 805. Pretested self-administered questionnaire used. Percentage, Chi-square test, binary logistic regression model was used to estimate odds ratio [OR] and its 95% confidence intervals. Of 997 study subjects body image anxiety, social phobia and depression were observed in 232 [23.3%], 193 [19.4%] and 326 [32.7%] participants, respectively. Binary logistic regression showed that body image anxiety [OR = 1.849 [1.22, 2.804]; P = 0.004] and social phobia [OR = 4.575 [2.952-7.09]; P < 0.001] were significant predictors for depression. Body image anxiety and social phobia are linked with the development of depression. This impresses the need for timely counseling and education among adolescents

study of stress among students of professional colleges from an urban area in India

Various studies across the globe have emphasised that students undertaking professional courses, such as medical and dental studies, are subjected to higher stress. Excessive stress could lead to psychological problems like depression and anxiety. The objective of the current study was to assess stress among students of various professional colleges and its association with various academic, social and health-related factors. This cross-sectional study was conducted from September 2011 to February 2012 among students of medical, dental and engineering colleges from the urban area of Sangli district, Maharashtra, India, using a convenience sampling technique. The calculated total sample size was 1,200. A pretested self-administered questionnaire was used for the data collection. Analysis was done using percentage, the chi-square test, binary logistic regression and multinomial logistic regression. Out of the 1,224 respondents, 299 [24.4%] experienced stress. Among them 115 [38.5%], 102 [34.1%] and 82 [27.4%] were dental, medical and engineering students, respectively. There was a statistically significant association between stress and the field of education. Stress was observed in 187 [27.7%] females and 112 [20.4%] males; the association with gender was statistically significant. By applying binary logistic regression, medical studies, health and lifestyle factors, and academic factors were the significant predictors for stress. Students from all the three fields studied were exposed to stress. Academic factors were one of the most important stressors. The introduction of stress management education into the curriculum could prove useful in combatting this problem

Effects of micronutrient status on oxidative stress and exocrine pancreatic function in patients with chronic pancreatitis.

Micronutrient deficiency and oxidative stress in relation to pancreatic exocrine insufficiency among chronic pancreatitis (CP) patients needs closer scrutiny. In this study, we examined the role of micronutrients (Zn and Cu) on oxidative stress related parameters and stool elastase-1 in tropical chronic pancreatitis (TCP) and alcoholic chronic pancreatitis (ACP) patients. We also compared oxidative stress parameters in CP patients with low and normal pancreatic stool elastase-1, estimation of which is the best available test for detecting pancreatic exocrine insufficiency. Ninety-one (56 male and 35 female) TCP cases, 84 ACP cases and 113 (60 male and 24 female) healthy controls were studied. Levels of reduced glutathione (GSH), ascorbic acid and zinc and activities of glutathione peroxidase (GPx), superoxide dismutase (SOD) reduced significantly, while thiobarbituric acid reactive substance (TBARS) and copper level increased significantly in erythrocytes of both ACP and TCP patients in comparison to healthy controls. However, we did not find differences in these parameters between diabetic and non-diabetic TCP patients or between diabetic and non-diabetic ACP patients. The study suggested an association between pancreatic exocrine insufficiency and oxidative parameters, while zinc deficiency was found to be correlated with SOD and pancreatic exocrine insufficiency in CP, irrespective of its etiology.

Coronary angiogram and intervention through transulnar approach.

BACKGROUND: This study was conducted to assess the safety and feasibility of a transulnar approach in performing diagnostic and interventional percutaneous coronary procedures. METHODS AND RESULTS: In the year 2004, a total of 100 patients underwent diagnostic angiography (n=64) and percutaneous coronary interventions (n=36) through transulnar approach. The patients' age ranged from 40 to 70 years and male to female ratio was 7.3:1. The cases of percutaneous coronary interventions were mostly elective procedures and emergency intervention was done in only 2 patients. The procedure was successful in 95 (95%) patients and unsuccessful in 5 (4 diagnostic and 1 percutaneous coronary intervention). The procedure was done through right ulnar artery in all except one patient in whom it was done through left ulnar artery. The total procedure time ranged between 25-45 min. Among the cases of percutaneous coronary interventions, single vessel angioplasty was performed in 23 (65.7%) patients, double vessel in 11 (31.4%) patients and triple vessel in 1 (3%) patient. All percutaneous coronary intervention patients received aspirin, clopidogrel and intravenous enoxaparin. Glycoprotein IIb/IIIa inhibitors were used in 7 patients. Complications such as local hematoma, ulnar artery perforation and reversible parasthesia occurred in one patient each. CONCLUSIONS: Tansulnar approach is a safe and easy alternative technique to perform diagnostic and therapeutic coronary interventions.