The effectiveness of home-based physical therapy on glycemic control and quality of life in adults with prediabetes

Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.

Study Of Pyoderma In Its Acute Dimensions With Respect To Causation, Pathogenesis And Miasmatic Co-Relation In The Paediatric Age Group

Background:Hahnemann was always at great pains to emphasis the importance of causative factors in the environment-both physical & emotional which could be held responsible for development of illness. According to homoeopathy, mind, body and soul are trinity of life. So along with exciting and maintaining causes, there is need of studying the psycho -somatic correlations. As in many clinical cases, the state of mother during pregnancy leading to skin condition in child is noted. Aim and Objective: To study the various clinical presentations of Pyoderma. To examine time of occurrence & observe whether it is in antecedence with the onset of pyoderma i.e. .to establishes the precipitating factors of pyoderma. To observe the socio-economical scenario of the patient’s life to establish the maintaining causes of pyoderma. To understand the susceptibility and to establish the role of miasms. Material And Methods:Detailed case study to understand patient as a person & the focus will be on the life space of the child, the parents’ mental state before conception, mother’s state during pregnancy, his interactions with people around him both inside & outside family; possible causative events and classifyingthem into precipitating, exciting & maintaining causes.Result:In all the 30 cases no psychological cause has been found. So we can postulate that pyoderma is predominantly a physical disease where the predisposing maintaining and precipitating causes play a vital role.Conclusion:As prescription was based mainly on the symptoms exhibited, recurrence and understanding of susceptibility, the most frequently used potency, were moderate, in frequent repetition (80%).

To Study The Relationship Of Classification Of Depressive Disorders With The Hahnemannian Concept Of Mental Illness

Background: Hahnemann (1996) has classified mental illnesses in a rather different way. Heunderstood the mental illness not very different in kind from the physical illness. He classified theillnesses on the principles of cause and effect and the dynamic shift of the illness from the body tomind or vice versa. Aim & Object: To classify patients suffering form Depressive Disorder as per DSM IVcriteria. To determine the relationship of this classification with that enunciated in the 215,216, 221 and225 aphorisms of Organon of Medicine. To evolve the totality of patients on the basis of the aboveevolved Hahnemannian classification of Depressive Disorders. To project a therapeutic plan based onthe finding in 1, 2 and 3 above. Material And Methods: Detailed interview focusing mainly uponsymptomatology for arriving at acomprehensive clinical diagnosis according to DSM IV. Studying theevolutionary pattern of the selected cases to understand them according to the Hahnemannianclassification. Correlating the therapeutic outcome with the principles used and thus discovering anycorrelation between the two approaches. Result and Conclusion: The conclusions range from theconceptual clarity of the applicability of the two systems of classification together to the specificunderstanding of the requirement of appropriate remedy in the appropriate potency and repetitionbased upon a collective understanding of the predisposing and maintaining causes and thesusceptibility. The importance of understanding of the susceptibility came out as the most importantaspect in the combination of the two systems of classification.

A morphologic and morphometric study of articular facets of Patella

Background: The patella plays a major role in flexion and extension of the knee. The patella morphology can be a predisposing factor in patella instability. The congruency between the patella and femur affects the kinematics of the patellofemoral joint, contact mechanics of the patellar cartilage, and strain in the underlying bone, whereby higher stresses and strains potentially contribute to cartilage wear and anterior knee pain. Aim and Objective: The present study was conducted to assess the morphology of facets of patella. Materials and Methods: The present study was conducted to assess the morphology of facets of patella. Ninety-six patella of unknown sex from bone store of Department of Anatomy were included in the study. The patellar morphology and morphometry were investigated. Statistical analysis was performed using the SPSS (v 12.01) software package (SPSS Inc., Chicago, Illinois). Statistical significance was set at P < 0.05. Results: In the present study; 96 patella of unknown sex from bone store of Department of Anatomy were included in the study. The mean size of the right lateral facet was 23.34 mm and left lateral facet patella was 23.06. P value was non-significant. The shape of lateral facet was concave in 93.9% in the left patella and 100% in the right patella. The shape of lateral facet was flat in 6.1% in the left patella and 0% in the right patella. The mean size of the right medial facet was 17.68 mm and left medial facet patella was 17.39 mm. P value was nonsignificant. The shape of medial facet was concave in 2% in the left patella and 10.6% in the right patella. The shape of medial facet was convex in 69.4% in the left patella and 61.7% in the right patella. The shape of medial facet was flat in 28.6% in the left patella and 27.6% in the right patella. P value was non-significant. Conclusion: The present study concluded that the mean size of the right lateral facet was more left lateral facet patella. The shape of lateral facet was concave in 93.9% in the left patella and 100% in the right patella. The shape of lateral facet was flat in 6.1% in the left patella and 0% in the right patella. The mean size of right medial facet was more than left medial facet patella. The shape of medial facet was concave in 2% in the left patella and 10.6% in the right patella. The shape of medial facet was convex in 69.4% in the left patella and 61.7% in the right patella. The shape of medial facet was flat in 28.6% in the left patella and 27.6% in the right patella.

Exploring Factors of Absenteeism Among Students Attending Community Medicine Department

Background: Frequent absence from classes may lead to improper learning and poor academic performance. Absenteeism can make teaching - learning environment unwelcoming and impacting those also who attend classes regularly. Aims & Objectives: To explore factors responsible for absenteeism among second professional students attending Community Medicine Department and to formulate recommendations to deal with absenteeism. Material and Methods: A Cross sectional study was conducted among 132 second professional medical undergraduate students attending Community Medicine Department in a teaching hospital. A self-designed pre validated questionnaire comprising of various sections related to teaching –learning factors was used to explore factors responsible for student absenteeism. Faculty perception regarding student absenteeism and recommendations formulated to deal with it were recorded separately. Data analysis: Data was entered in MS Excel and Chi Square test was used for analysis. Results: Among 132 study participants, majority of the participants (62.1%) were females who were residing in hostels. Highest percentage of absenteeism (40.1%) was during examination time. Extracurricular activities like sports/gym, browsing net and parties were significantly (p<0.001) associated with absenteeism. Conclusions: Absenteeism can adversely affect academic performance and low attendance can demotivate teachers also to teach with keen interest.

Vaccine Significantly Reduces the Severity of Covid 19 Infection: Evidence from a Community Based Study

Background: Coronavirus disease is an infectious disease caused by newly discovered coronavirus (SARS-CoV-2), which spread rapidly throughout the world. Vaccines will provide a lasting solution by enhancing immunity and containing disease spread. This study was conducted to find out vaccination status among Covid-19 positive patients and correlate severity of infections with vaccination status. Methodology: This cross sectional study was carried out among 1218 Covid-19 positive patients that were positive after the launch of Covid-19 vaccine, selected by purposive sampling method. Data was collected using pretested semi structured proforma. Results: Covid-19 vaccination coverage was very low (10.03%) in Covid-19 positive patients, for single dose it was 8.38% and for two doses it was 1.65%. Asymptomatic and mild cases were more in vaccinated compared to unvaccinated, it was statistically significant. Though hospitalization in vaccinated was less it was not significant. There was no death among vaccinated cases. Conclusion: Vaccination coverage were very low, this needs to improve. Vaccine was significantly reduces the severity of infection. It is recommended to vaccinate all eligible population as early as possible which will help in reducing severe and hospitalized cases and ultimately reducing the impact of Covid-19 pandemic.

Development And Characterization Of Liposomal Formulation For Ophthalmic Delivery Of Prednisolone Acetate

Liposomal vesicular drug carriers for ocular delivery have earned a wide potential nowadays. Prednisolone Acetate liposome as ocular drug carriers have been demonstrated to be a useful mode to ameliorate bioavailability and patient abidance. Liposome was prepared by lipid extruder method. Liposome were characterized for entrapment efficiency (EE %), vesicle size, surface morphology and in vitro drug release. An ex vivo corneal permeation study was performed to determine the level of drug in the external eye tissue of goat and an ocular irritation assessment was done by Hen’s Egg Test - Chorioallantoic Membrane (HET-CAM) method. The optimized formulation of liposome had shown acceptable viscosity (1.21 ± 0.03 cps), refractive index (1.47±0.001), osmolarity (303 ± 3 mOsm) and pH measurement (7.12 ± 0.09). Liposome as drug delivery carriers were evidenced to be a anticipating impendent to enhance corneal contact and penetration as well as retention time in the eye ensuing in a prolonged action and enhanced bioavailability. The results of stability study exhibited stable profile of developed liposomes.

Vitamin A Deficiency among School Going Adolescents in Rural Areas of Bareilly.

Objective: 1. To find out the prevalence of Vitamin A deficiency (VAD) on the basis of presence of bitot’s spot and conjunctival xerosis among rural school going adolescents of District Bareilly, Uttar Pradesh, India. 2. To identify the associated factors and to suggest the suitable measures to prevent VAD among them. Study Design: Cross sectional study. Place and Duration of Study: Field practices areas Department of Community Medicine RMC&H Bareilly, Uttar Pradesh India, between Jan 2012 to Dec 2012. Participants: 900 school going adolescents. Sampling: Multistage sampling method. A structured schedule was used to collect the information. Statistical Analysis: Data were analyzed with SPSS 17. Significant difference was determined using Chi- square test. Results: The overall prevalence of VAD was found to be 42.22%. It was higher in 15-19 years of age group adolescents (48.77%) as compare to 10-14 years (41.6%). The prevalence of VAD was slightly higher among boys (p value=0.666). Out of total 398 (42.22%) VAD adolescents 300 adolescents were from socioeconomic class V. Conclusion: Nutrition education regarding regular intake of foods rich in vitamin A rich is needed to prevent the deficiency.

New Spectrophotometric Methods for Simultaneous Determination of Amlodipine besylate and Lisinopril in Tablet Dosage Forms.

Two simple, accurate, precise, reproducible, requiring no prior separation and economical procedures for simultaneous estimation of Amlodipine besylate (AML) and Lisinopril (LIS) in tablet dosage form have been developed. First method is simultaneous equation method; in this method 360.0 nm and 248.0 nm were selected to measure the absorbance of drugs at both wavelengths. The second method is Q-value analysis based on measurement of absorptivity at 300.0 nm (as an iso-absorptive point) and 360.0 nm. AMD and LIS at maximum wavelength of AML, 360.0 nm and at isoabsorptive point 300.0 nm shows linearity in a concentration range of 5- 40 μg/mL. Recovery studies range from >99.82% for AMD and >98.09% for LIS in case of simultaneous equation method and >100% for AMD and >98.45% for LIS in case of Q-analysis method confirming the accuracy of the proposed method. The proposed methods are recommended for routine analysis since it is rapid, simple, accurate and also sensitive and specific (no heating and no organic solvent extraction is required).

Study of antibiotic sensitivity pattern in urinary tract infection at a tertiary hospital.

This study was conducted in a tertiary hospital at Bareilly, Uttar Pradesh between Aug 2009 and July 2010 to check the changing pattern of antibiotic sensitivity among uropathogens causing urinary tract infections (UTI). A total of 170 urine culture sensitivity reports were analyzed. The predominant growth of single bacteria was seen in 143 (84.12%) samples. The most common organisms isolated were Escherichia coli, klebsiella, pseudomonas, and Staphylococcus aureus. (These represented 64.33%, 92; 20.3%, 29; 9.1%, 13 and 6.30%, 9 of isolates respectively). More than 80% of the isolates were sensitive to amikacin and nitrofurantoin, while more than 70% were sensitive to norfloxacin, ciprofloxacin and levofloxacin. Very high rate of resistance was seen against cotrimoxazole (81.82%), amoxicillin (77.42%) and amoxi-clav (64.34%). E. coli showed high sensitivity to Amikacin 98.91% (91), Nitrofurantoin 93.48% (86). 75% of E. coli isolates were sensitive to minocycline, showing a good utility of this drug for the treatment of outdoor patients with urinary tract infections.

The sex determination by posterior border of adult human hip bone.

The sex determination of individual is greatly useful in Anatomy, Archeology & Forensic departments. The hip bone is most reliable bone to determine the sex of individual. A biometrical study of posterior border of 100 adult human hip bones has been done. With the use of osteometric board & triflanged stainless steel caliper, various parameters were measure. Various variables of posterior border of hip bone were calculated by using range, mean, S.D. & P value. In all parameter the arch PB (arch of posterior border), the total angle of greater sciatic notch & the posterior angle of greater sciatic notch gives statistically significant differences between the means related to sex. Above three parameters were highly significant to determine the sex by posterior border of hip bone. The mean value of the arch PB of male was high than female. The mean value of posterior angle of greater sciatic notch was 2.5 times higher in female. We had also measure demarking point (DP) for above three variables. The demarking point gives 99.75% accurate data which were measure by adding & subtracting 3xS.D.from the means. In present study the demarking point for arch PB was >143mm in male & <126mm in female, total angle of greater sciatic notch was <460 in male & >860 in female & posterior angle of greater sciatic notch <110 in male & >250 in female. In medicolegal cases where 100% accuracy is required, the use of demarking point is preferable. This study is useful for carrying out medico legal examination of bones, cephalopelvic proportions in obstetric cases, for academic studies in Anatomy & for anthropological examination of skeleton, radiological study of pelvis & for archaeological examination of skeleton.

Prevalence of intestinal parasites among school going children in Bareilly District.

This study was conducted to find out the burden of intestinal parasitic infection among school going children in Bareilly District Uttar Pradesh India. A total of 320 stool samples were collected and screened from 4 schools. The stool sample was examined by direct wet mount examination. The prevalence of intestinal parasite was 22.81%. Ascaris lumbricoides (9.68%), Giardia lamblia (6.25%), Entamoeba histolytica (2.50%) were the commonest parasite isolated. Lack of pure drinking water and lack of proper sanitary disposal, and improper health education is supposed to be the root cause of these parasitic infections. This also advocates the regular and periodic health check up & deworming schedule for the students attending the school.

Determinants of nutritional status of school children - A cross sectional study in the western region of Nepal.

Under-nutrition continues to be a primary cause of ill health and mortality among children in developing countries. Besides poverty, there are other factors that directly or indirectly affect the nutritional status of children. In the present study, an attempt was made to find the prevalence of under-nutrition among school children in 4 – 14 year age group and the role of socio-demographic characteristics of mother on child nutrition. Methods: Descriptive, cross-sectional study was conducted in schools of Kaski district of Western Nepal from January 2007 to June 2007. A total of 786 students were randomly selected from six schools in the study area and nutritional status of the children was assessed by anthropometric measurements. Results: Among 786 students, 26% of the students were found to be undernourished and 13% stunted, 12% wasted and only 1% both stunted and wasted. The present study shows highly significant association (p<0.005) of maternal factors like literacy, occupation, diet knowledge and monthly per-capita income respectively with child nutrition. Conclusion: Maternal education status, socio-economic status, occupation and dietary knowledge are important determinants of nutritional status of school children.

Evaluation of primary immunization coverage in an urban area of Bareilly city using cluster sampling technique.

Infectious diseases are major cause of morbidity and mortality in children. One of the most cost effective and easy methods for the child survival is immunization. Objective of present study was to find out the various reasons for partial or non immunization of child and to assess the factors associated with immunization. The present cross sectional study was carried out in urban slums of Bareilly city from April 2010 to Aug. 2010 using 30 by 7 cluster sampling technique. A total of seven children aged 12-23 months were interviewed from each cluster on pre tested, predesigned schedule, thus giving us the sample size of 210.Chi square test was applied for statistical analysis. Two third children (61.9%) were found to be fully immunized. Immunization coverage was high for BCG (92.86%) and lowest for measles (62.38%). Most common reason (50%) for partial and non immunization of children was found to be ignorance on the part of parents. Religion, education of both mother and father was found to be significantly associated with immunization status. The need of the hour is to make routine immunization a “felt need” of the community. Increasing the knowledge and understanding of the caretakers of the young children about the essentiality and benefits of routine immunization would be a strong step forward in achieving the goals.

Risk factors for low birth weight (LBW) babies and its medico-legal significance.

Birth weight is the most important factor that affects infant and child mortality. This one year study was conducted in a cohort of pregnant women to study the proportion of low birth weight babies and to find out the socio-economic and maternal risk factors affecting the birth weight of newborns and its medico-legal significance. Information regarding socio-economic status, obstetric history and present pregnancy was collected. These women were followed up till their delivery and birth weight was recorded with 24 hours of delivery. Birth weight was available for 256 births. The overall prevalence of low birth weight was 34.37%. Overall mean birth weight was found to be 2.64±0.444 with 95% confidence interval of 2.59-2.69. Primigravida mothers showed the highest prevalence of low birth weight (30.86%, p< 0.001). The main factors which were significantly associated with LBW were maternal education, stature, age at delivery; short inter pregnancy interval, inadequate antenatal care, and per capita income of family.

Infant feeding practices of mothers in an urban area in Nepal.

BACKGROUND: Child health in developing countries including Nepal is a matter of serious concern as the prevalence of malnutrition among children continues to be high with 48.6% of children under five in Nepal being underweight. Since infant feeding practices adopted by mothers play a major role in influencing health of these children, there is a need to study the infant feeding practices prevalent in different areas in order to have pragmatic approaches to solve this problem. MATERIALS AND METHODS: A cross sectional study was conducted among mothers who attended the immunization clinics of 18 wards of Pokhara municipality area. They were interviewed with a semi-structured questionnaire on various aspects of infant feeding. RESULT: A total of 168 mothers were interviewed and prevalence of breastfeeding was 99.4% (167). Only 43.5% of the mothers initiated breastfeeding within one hour of birth and 60.5% were practicing exclusive breastfeeding at 5 months. Almost 40% of the mothers started complementary feeding before the recommended age of 6 months and 22.5 % delayed introduction of complementary feeding beyond the recommended age. CONCLUSION: Breast feeding practices adopted by mothers of Pokhara urban area are still lacking in terms of late initiation of and early starting of complementary feeding. There is a need to educate the mothers regarding proper infant feeding practices.

Monoclonal antibody based ELISA : an effective diagnostic tool for the diagnosis of falciparum malaria.

An enzyme-linked immunosorbent assay (ELISA) system based on the monoclonal antibodies (F2W22C1) originated from Thai strains of P.falciparum in mice models and polyclonal antibodies raised against Nepali strains of P.falciparum in rabbit models was developed for the detection of local Nepali strain of P.falciparum antigens in red cell lysates. The monoclonal-polyclonal antibody based indirect ELISA developed for the detection of P.falciparum antigens was specific since it was positive only with P.falciparum infected erythrocytes and negative when blood from forty healthy individuals collected from the malaria non-endemic areas and forty P.vivax infected erythrocytes were tested. When the test was applied to microscopically confirmed 154 falciparum infected blood samples collected from Dhanusha district, Nepal; the assay detected only 138 out of 154 P.falciparum samples indicating the sensitivity of the test to be 89.6%. When the assay was used to detect forty samples from the patients of unknown origin of fever other than the malaria collected from the malaria endemic areas, all forty samples were negative with the assay system. A significant correlation was observed (r = 0.872; p = 0.013) in between the parasitemia and the O.D. values obtained from the MAb-PAb based indirect ELISA. The test developed using monoclonal antibodies raised against Thai P. falciparum isolates and the polyclonal antibodies raised against native Nepali strains of P.falciparum offered high degrees of sensitivity and specificity. However, the test requires further evaluation with higher number of samples; requires further improvement in sensitivity; before commercial use of the test in patient care.

Hyperhomocysteinemia masquerading as pulmonary embolism.

We describe a 30-year-old male who presented with acute onset of breathlessness, tachycardia, and palpitations associated with distension of jugular vein and clear lungs on physical examination. The chest X-ray was normal and ECG was showing S1Q3T3 and right ventricular strain pattern. His 2-D echocardiography was showing dilated right atrium, right ventricular dilatation and moderate pulmonary arterial hypertension. He was found to have thrombosis involving left side of deep venous system with normal superficial venous system (Doppler proved). All routine blood investigations for etiology of recurrent DVT were normal except serum homocyteine level, which was significantly raised. Megaloblastic anemia on peripheral smear and hyperhomocysteinemia prompted us to search for its cause, which was subsequently found to be vitamin B12 deficiency. Such an association of megaloblastic anemia due to vitamin B12 deficiency leading to hyperhomocysteinemia and subsequent thrombosis in left venous system presenting as acute pulmonary embolism has not been described earlier in the medical literature.

In vitro immunity of rat peritoneal macrophages to Candida albicans.

Phagocytic, germ tube inducing and candidacidal activities were investigated in monolayers of peritoneal macrophages of rats. The phagocytic activities observed in macrophages of the healthy rats in the presence of normal serum, those in the presence of immune serum and of immunized rats in the presence of normal serum were 40%, 45.3% and 44.8% respectively. The percent of macrophages in which intracellular Candida formed germ tubes in the above three situations were 10, 9.59 and 10.19, respectively and the percent of intracellular Candida that formed germ tubes were 6.6, 3.7 and 4.1, respectively. The candidacidal activity observed in the above three sets of macrophages were 5.33%, 22.66% and 19.88%, respectively. Induction of germ tube in C. albicans in supplemented tissue culture medium containing normal serum was 15 per cent. These observations indicate that immunisation/sensitisation of individuals with C. albicans organisms does provide some degree of cell mediated immunity by activating macrophages. This may partly be due to the appearance of specific antibodies. It is likely that this type of immunity can be produced by subclinical infections during invasion by the commensal organism thus preventing further invasion establishment of infection and keeping the organism (C. albicans) in a state of commensalism. However, the degree of immunity so produced is so low that predisposing factors suppress it and allow establishment of infection.