Hepatitis B virus and hepatitis C virus co-infection among outdoor patients and indoor patients of tertiary care institute, Bathinda, Punjab, India

Background: Hepatitis virus infections have many serious consequences like chronic hepatitis, fulminant hepatitis, liver cirrhosis, hepatocellular carcinoma and liver cancer. Serological test is thus necessary to identify hepatitis virus in the body. An observational study was conducted with an objective to detect hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (HCV) antibodies by rapid card tests and to find the prevalence of co-infection with hepatitis B and hepatitis C viruses from January 2019 to June 2019.Methods: Blood samples were received from patients irrespective of age and sex, constituted the material for the present study. All samples were tested on hepacard and tri-dot card for the detection of hepatitis B virus and hepatitis C virus and results were interpreted as per Clinical Laboratory Standards Institute guidelines.Results: Out of 3488 samples, 254 samples were positive for hepatitis virus infection. Out of these 254 samples positive for hepatitis viruses, 22 (0.6%) patients were positive for hepatitis B virus and 232 (6.6%) patients were positive for hepatitis C virus. Only 2 (0.7%) of these patients showed co-infection with both viruses.Conclusions: Male patients showed more positivity of hepatitis virus as compared to females. Patients were more from outpatient department (OPD) as compared to inpatient department (IPD). Hepatitis virus infection was found to be highest in the age group 21-40 and lowest in the age group above 80 years. Both the co-infected patients were males and from IPD.

Comparative Evaluation of Ornigreat Gel and Placebo (Hexigel 0.25%) as a Local Drug Delivery System in Association with Scaling and Root Planing in Patients with Chronic Periodontitis – An In vivo Study

Aim: The aim of the study was to evaluate the comparative effect of Ornigreat gel and Hexigel as a local drug delivery system in association with scaling and root planing (SRP) in patients with chronic periodontitis. Materials and Methods: A double-blind trial was conducted to test the comparative efficacy of the two commercially available Ornigreat gel and Hexigel at Indira Gandhi Govt. Dental College and Hospital, Jammu. These indices were recorded at baseline (“0 day”), 15th day, 30th day, 60th day, and 90th day in 40 sites, >4 mm pockets in 11 patients among which 20 sites received Ornigreat gel and other 20 sites receive Hexigel following SRP were compared. Results: The results of the study showed that the combination of SRP and Ornigreat gel therapy was more effective in reducing the mean values of gingival index and sulcus bleeding index though not statistically significant, but the values of plaque index showed statistical significance on the 60th day and 90th day, and the probing pocket depths showed statistically significant difference from the 15th day to the 90th day at P < 0.05 in comparison with Hexigel. Conclusion: The Ornigreat gel could be an efficient local drug delivery system when used in adjunct to SRP in comparison with Hexigel.

Clinical Profile of Chronic Kidney Disease Patients in Rural Population of Haryana: A Single-center Experience

Background: CKD is a major health problem associated with high morbidity and mortality. Chronic kidney disease is end result of long standing cases of diabetes mellitus and hypertension. There is paucity of data, regarding spectrum of CKD. CKD is generally asymptomatic in early stages. Early interventions delay the progression to ESRD, thus reducing morbidity and mortality. Objectives: To study the Clinical profile, Biochemical profile and determine the Aetiology of chronic kidney disease among Rural population. Methods: In this study, we retrospectively analysed data of 161 patients admitted in hospital over a period of six months. Data was collected based on clinical assessment, laboratory analysis and Radiological investigations to determine aetiology of chronic kidney disease. Results: 161 patients of chronic kidney disease were included in the study. The mean age of all patients studied was 47.20±16.16 years. The most common aetiology was hypertensive nephropathy. Most of the patients presented with, pedal oedema (59.6%) followed by Oliguria (52.2%), facial edema (46.9%). Conclusion: The major causes of CKD in descending order were hypertension, Type 2 diabetes mellitus, chronic glomerulonephritis and obstructive uropathy. So if we are able to detect and treat these conditions in early phase, we can prevent further progression and damage to the kidney.

Retrograde Intubation An Alternative Way For Endotracheal Intubation Using Epidural Catheter As A Guide – A Case Report

Patients having restricted mouth opening and limited movement of tempro-mandibular joint present as difficult airway scenario. Fibre-optic assistance is a gold standard technique for anticipated difficult intubation, but it’s availability and expertise still is a challenge at most of places worldwide especially in developing countries.The retrograde intubation technique can be an alternative and less invasive than other emergency surgical airway options for such cases. We present a case of difficult intubation, successfully managed with the help of retrograde intubation.

Spina Bifida - A Retrospective Study

Background: The occurrence of congenital anomalies is increasing in the present era. The incidence is estimatedto be 3-7% of the congenital disorders.Aim: The present study is focused on the spina bifida and to know the incidence of spinal defects in north Indianpopulation. This study will be helpful for providing baseline data from the north Indian population.Methodology: The present study was done on 1400 fetuses which were sent by gynecology and obstetricsdepartment of GMCH Sec. 32, Chandigarh to anatomy department for autopsy purpose during period of 2008 to2017. In every case, location and morphology of spinal defects were observed.Results: The present study showed 11.7% cases with spinal defects, out of these, 1.2% spina bifida closed(occulta) and 10.5% spina bifida open defects were noted which included 1.2% ventral spinal defects, 31.7%with meningocele, 24.3% myelomeningocele, 28.6% myelocele and 12.8% with rachischisis.Conclusions: It is important to note the detection of congenital anomalies in early stage of gestation. It isadvantageous for the obstetrician in planning the line of management whether to continue the pregnancy or not.

Histopathological Findings in Spleen on Autopsy—A Study of 100 Cases

Background: Autopsies are carried out to establish the identity, cause of death, time of death, and antemortem orpostmortem nature of death. These help in establishing the cause of death and ascertain the disease process which led to death. It provides the opportunity to discover new diseases, to evaluate toxic effects of drugs and therapies. The spleen is the site of direct and indirect toxicity, a target for some carcinogens, and also a site for metastatic neoplasia. Many systemic or generalized diseases have splenic involvement. Methods: The present study was conducted on 100 specimens of spleen on routine autopsies received in the department of pathology, Government Medical College, Patiala, Punjab to find out the frequency of various lesions in spleen on autopsy. All the histological sections were stained in H & E stain, mounted ,examined microscopically & findings were recorded and tabulated. Results: 80 of the 100 autopsies were males, while 20 were females. In 81 (81%) cases, the microscopic findings were congestion, hemorrhage in 8 cases(8%) ,7 cases (7%) had autolytic changes,1 case(1%) had necrosis, granulomatous pathology were seen in 2 cases (2%) and 1 case (1%) had leukemic infiltration. Conclusion: Despite recent advances in diagnostic technology, there is large number of cases of preventable diseases for which the autopsy has remained an important complementary tool for identifying.

Role of Dynamic Contrast Enhanced MRI in Evaluation of Focal Hepatic Lesions

Background: CMost of the focal hepatic lesions in day to day practice can be diagnosed by cross sectional contrast enhanced studies. The present study evaluates the role of dynamic contrast enhanced MRI for detection & characterization of these lesions commonly found in our area. Methods: It’s a perspective study of 50 patients with all age groups who were suspected clinically to have focal hepatic lesions or diagnosed so by ultrasonography or computed tomography. The patients underwent MRI including dynamic contrast enhanced sequences, which included i.v. administration of the contrast material (Gadopentate dimeglumine). The results of the MRI were confirmed by various confirmatory methods depending upon the lesion in question. Results & Conclusions: Overall sensitivity of MRI in detection of focal hepatic lesions was 100% while its specificity was 98%. Comprehensive MR imaging examination yields characteristic enhancement patterns that can be used to diagnose or at least narrow the differential diagnosis for most of these lesions

Port Site Chronic Sinuses – A Wisdom of 5 Years and 50 Cases.

Background: Laparoscopic surgery has now become an accepted method of minimal invasion of human anatomy but the dreaded problem of port site complications especially the chronic sinuses has rejuvenated the proponents of open techniques. The scope of laparoscopy widened from diagnostic purposes to resecting large tumors in almost all the systems of the body. As the time progressed, the problems associated with use of long instruments and dexterity of movements started creeping in. The vision, which was analogue, to start with, became 3D digital and with the introduction of robotic arm, the problem of dexterity was addressed to some extent. One thing that persisted right through so much of technical development was the problem of infection and sinuses and the enormity of this issue can be gauged by its evergrowing number. Methods: Although minimal invasive surgery is here to stay for all intent and purposes, we have decided to study 50 cases of chronic port site sinuses treated and followed up for 5 years in various wards of department of surgery in Guru Nanak Dev Hospital, Amritsar. In this study the authors present their experience and rationale regarding various factors like age and sex distribution, site of infection, results of microscopy and culture/sensitivity, treatment given (both surgical and non surgical), response time and prognosis. Results: In the cases where there was discharge culture of the pus yielded skin and soft tissue infections like staphylococcus, streptococcus, pseudomonas, E. coli and klebsiella. Out of 50, 20 cases were treated by appropriate antibiotics after culture sensitivity and quinolones.Conclusion: From the above discussion and flow chart, it can be safely concluded that atypical mycobacteria and some of the anaerobes remain the main offending agents.

Prevalence of methylenetetrahydrofolate reductase 677 C-T polymorphism among mothers of Down syndrome children.

INTRODUCTION: The relationship between chromosomal non‑disjunction leading to aneuploidy and folate metabolism has drawn attention in the recent years. In this study, we examined the polymorphism in the gene encoding the folate metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR), namely, 677 C‑T in women having Down syndrome (DS) children. MATERIALS AND METHODS: The prevalence of these variant genotypes (MTHFR 677 C‑T polymorphism) in women having DS children (case mothers) (n = 110) was compared with controls (n = 111) from Punjab. Genotyping was done using the polymerase chain reaction method followed by restriction fragment length polymorphism. RESULTS: In the present study, 1.8% of case mothers had TT genotype while none of the control mothers showed this genotype. T allele frequency among cases was 0.13 and 0.11 in controls. The Chi‑square value showed a non‑significant difference between cases and controls. CONCLUSION: No association has been observed between 677 C‑T polymorphism and risk of non‑disjunction in case mothers. Detection of polymorphisms in more genes of folate pathway is required to find out the exact cause of non‑disjunction.

Probiotic potential of lactic acid bacteria isolated from food samples: an in vitro study.

Probiotics are the health promoting viable microorganisms that exhibit a beneficial effect on the health of human being by improving the intestinal microbial balance. Probiotic bacteria may produce various compounds, which are inhibitory to the growth of pathogen, which include organic acids (lactic and acetic acids), bacteriocins, and reuterin. In the present study a total of 17 food samples were collected for isolation of lactic acid bacteria. A total of 26 isolates of lactic acid bacteria were purified and screened for their antimicrobial activity against seven human pathogenic MTCC strains counting three test fungal strains such as Aspergillus fumigatus, Aspergillus sp. and Candida albicans and four test bacterial strains (two Gram-negative namely Escherichia coli, Salmonella enterica ser. typhi and two Gram-positive Staphylococcus epidermidis and Bacillus amyloliquifaciens). Out of 26, eight isolates were considered for further analysis of probiotic potential whose antimicrobial activity was found to be good against maximum number of tested strains. The selected lactic acid bacteria exhibited excellent probiotic characteristics and thus can be used as a potential source of probiotic. Study affirms their use in the development of new pharmaceutical preparations and functional foods belonging to vegetables and fruits (as origin) as probiotics for the betterment of public health.

Controlled Drug Delivery Approaches for Rheumatoid Arthritis.

A cure for rheumatoid arthritis is yet to be discovered. Although vast resources have been expended in the search for an immunological key to switch off the rheumatoid process, the most significant advances in the treatment of rheumatoid arthritis in recent times had come from gaining better understanding and skill in the safe use of existing disease modifying antirheumatic drugs (DMARDs). If prescribed appropriately and combined with adequate patient education and monitoring, Disease modifying anti-rheumatic drugs are safe and effective tools in the treatment of rheumatoid arthritis. The step down approach has been proposed for the treatment of patients with recent onset rheumatoid arthritis who have clinical features predictive of an adverse prognosis. More efficient ‘targeting’ of drugs at the site of desired action should help to minimize the adverse effects of therapy. Ultimately the most efficient way of relieving pain and stiffness will be to prevent or suppress the inflammatory disorders which give rise to the symptoms. Unfortunately this is a goal at present.

Pharmacological actions of opuntia ficus indica: A review.

Cactus (Opuntia ficus-indica) belongs to the family Cactaceae. Family Cactaceae is reported to contain about 130 genera and nearly 1500 species. This plant is native of Mexico and it is widely distributed in Mexico and in all American hemispheres as well as in Africa and in the Mediterranean basin. It has been used in traditional folk medicine because of its role in treating a number of diseases and conditions, including anti-inflammatory effects hypoglycemic effects inhibition of stomach ulceration, neuroprotective effects Through antioxidant actions and also used for treating diabetes, burns, bronchial, asthma and indigestion in many countries over the world. It is also used in Pharma industry as a pharmaceutical agent. The fruit, as well as cactus stem are used to prepare value-added products, such as jam, squash, wine, pickle, body lotions, shampoo, creams, etc. It also has several medicinal and industrial uses. Its seeds can be used as flavouring agents. Due to the remarkable biological activity of Opuntia and its constituents, it will be appropriate to develop them as a medicine.

Synthesis and antimicrobial activity of some newer biphenyl imidazo [2,1-b] [1,3,4] thiadiazole derivatives.

In the present study, we have reported the synthesis of some novel heterocyclic derivatives comprising imidazole and 1,3,4-thiadiazole containing moiety. Imidazothiadiazoles are of interest because of their diverse biological activities and clinical applications. Reactions of biphenyl carboxylic acid with thiosemicarbazide in the presence of phosphorous oxychloride resulted in biphenyl containing 2-amino-1,3,4-thiadiazole which is then further subjected to condensation with α-bromoarylketone under reflux in dry ethanol. The structures of the newly synthesised compounds were characterized by various spectral techniques and screened for antibacterial activity against strains of Escherichia coli, Pseudomonas aeruginosa and Bacillus subtilis, and antifungal activity against Candida albicans, Saccharomyces cerevisiae and Aspergillus niger. The compounds exhibited moderate to good activity when compared with standards.

Review on Ethanomedicinal and Pharmacological Properties of Ficus religiosa.

Ficus religiosa (Bo tree) is the most popular member of the genus Ficus, commonly named as Peepal. Various parts of the plant, like bark, fruit, leaves and seeds are widely used in indigenous system of medicine. F. religiosa showed a wide spectrum of pharmacological activities like, anticonvulsant, anthelmintic, anti-amnesic, anti-anxiety, anti-asthmatic, antibacterial, antioxidant, anti-inflammatory and antiulcer. The present review is an attempt to provide a detailed survey of the literature on traditional uses and pharmacological properties of the plant.

A simplified approach to fabrication of an ocular prosthesis: A case series.

The eye is a vital organ and an important component of facial expression. Loss of an eye has a crippling effect on the psychology of the patient. Enucleation of the eye is therefore normally followed by fabrication of an ocular prosthesis to improve esthetics. A less complex technique for fabrication of an ocular prosthesis is described in this report of two different cases.

Antileishmanial phenylpropanoids from Alpinia galanga (Linn.) Willd.

Hexane, chloroform and ethyl acetate extracts (100 µg/ml) of Alpinia galanga rhizomes exhibited significant activity in vitro against promastigotes of L. donovani. Twelve compounds namely, methyleugenol (1), p-coumaryl diacetate (2), 1'-acetoxychavicol acetate (3), 1'-acetoxyeugenol acetate (4), trans-p-acetoxycinnamyl alcohol (5), trans-3,4-dimethoxycinnamyl alcohol (6), p-hydroxybenzaldehyde (7), p-hydroxycinnamaldehyde (8), trans-p-coumaryl alcohol (9), galangin (10), trans-p-coumaric acid (11) and galanganol B (12) were isolated from these extracts. Of these, compounds 2, 3, 4 and 5 were found most active in vitro against promastigotes of L. donovani with IC50 values of 39.3, 32.9, 18.9 and 79.9 µM respectively. This is the first report of antileishmanial activity of the extracts and isolated constituents of A. galanga.

Early intervention in developmental delay.

OBJECTIVES: To establish the socio-demographic and clinical profile of children attending Early Intervention Program (EIP). METHODS: Retrospective analysis of case records of 100 consecutive children examined from July 2002 to June 2004. Data regarding socio-demographic variables, clinical profile, locomotor, speech and audiology functions were recorded. Data is described in terms of frequency and mean (with SD). RESULTS: Mean age of these children was 4.0 +/- 1.4 years. 70% were male and a similar percentage hailed from urban areas. 88% were mentally retarded with mean IQ of 50 +/- 24.3. Cerebral Palsy was seen in 50% of the children, learning disorder in 24%, Attention Deficit Hyperactivity Disorder (ADHD) in 12% and autism in 4%. 25% of children suffered from epilepsy and 66% were unable to communicate verbally. 21% of children had strong evidence of genetic disorders. An etiological diagnosis could not be made in 31% of children. CONCLUSIONS: Awareness of developmental delay as well as of possible interventions is low in India. Speech delay is the only delay which is considered important by parents. Active involvement and early referrals from pediatricians, obstetricians and other specialists is suggested.