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@#Introduction: Studies have shown that staying at home for prolonged periods of crisis can pose a significant challenge to individuals and affect their mental health. Hence, this study was conducted to identify the susceptible subgroups among Malaysian citizens that are prone to mental health problems during the lockdown period of the COVID-19 pandemic and its association with sociodemographic factors. Methods: The mental health status was assessed using the Depression, Anxiety, and Stress Scale -21 (DASS-21) questionnaire. The survey link was distributed online between October and December 2020. Results: Of 637 respondents, one-third experienced mild to extremely severe depression and anxiety (31.1% and 35.1%, respectively). Female respondents (odds ratio = 1.516, 95% confidence interval (CI) 1.057-2.172) were 1.5 times more likely to experience mild to severe depression than male respondents. Unmarried and divorced respondents were 2.1 times more prone to experience mild to severe depression than married respondents. A significant association was also found between employment status and age with depression symptoms among the respondents. For anxiety, a significant association was observed between the age group with mild to severe anxiety symptoms. Marital status, age, and employment status were socio-demographic factors significantly impacting stress levels. Conclusion: According to our findings, females, individuals aged 18-30 years old, students, unmarried and divorced respondents were more susceptible to mental health problems, suggesting that mental health support shall also be provided for these vulnerable groups during the COVID-19 crisis.
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Objective: To describe the characteristics of gonadotropin-dependent precocious puberty (GDPP) in Indian children. Methods: Clinical profiles of GDPP (n=78, 61 females) and premature thelarche (n=12) from a single center in Western India were retrospectively studied. Results: Pubertal onset was earlier in boys than girls (29 vs 75 months, respectively; P=0.008). The basal luteinizing hormone (LH) was ?0.3 mIU/mL, except 18% of GDPP girls. At 60 minutes after GnRHa-stimulation, all patients (except one girl) had LH ?5 mIU/mL. The GnRHa-stimulated LH/FSH ratio was ?0.34 at 60 minutes in girls with GDPP unlike premature thelarche. Only one girl had an allergic reaction to long-acting GnRH agonist. Among GnRH agonist-treated girls (n=24), the predicted final adult height was -1.67±1.5 SDS, whereas the attained final height was -0.25±1.48 SDS. Conclusion: We establish the safety and efficacy of long acting GnRH agonist therapy in Indian children with GDPP. The 60-minute stimulated serum LH/FSH of ?0.34 differentiated GDPP from premature thelarche.
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Basidiobolus ranarum is known to cause subcutaneous mycoses; however, rare cases of hepatic and gastrointestinal involvement by basidiobolomycosis have been reported. Hepatic basidiobolomycosis may be confused with a carcinoma on imaging, and histological examination and fungal culture can help distinguish between these two. We report a rare case of basidiobolomycosis in a 16-year-old male with liver and gastrointestinal involvement.
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An undifferentiated carcinoma (UC) of the gall bladder behaves aggressively and has a grave prognosis. Small cell type undifferentiated carcinoma of the gall bladder is a rare variant. This paper reports a case of UC of gall bladder with PAS-positive diastase-resistant eosinophilic hyaline globules present as liver mass (on imaging) in a male patient. The microscopic findings of the liver and gall bladder after a right tri-segmentectomy showed an un-differentiated malignant neoplasm composed of cells with round to oval nuclei, prominent nucleoli, and scanty neoplasm. No definite cell pattern was identified with these neoplastic cells. A section from the gall bladder revealed a tumor arising from the lining epithelium and infiltrating through the muscularis. This tumor was infiltrating the adherent liver tissue directly and forming a mass of undifferentiated malignant cells. The focal area within the tumor mass showed the presence of PAS-positive, diastase-resistant, eosinophilic hyaline globules within the neoplastic cells. The immunohistochemistry test was diffusely positive for perinuclear anti-neutrophil cytoplasmic antibodies and negative for chromogranin, vimentin, Desmin, alpha-fetoprotein, leukocyte common antigen, CD34, and bcl2. When the clinical and radiological data are inconclusive, careful analysis of the histological and immunophenotypic features is needed to make the final diagnosis of UC of the gall bladder. The biological behavior and prognosis of this tumor remain unclear because of its rarity. Further studies will be needed to understand the characteristics of this deadly tumor and to establish an effective therapy for it.
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Objectives@#This study provides insights on the impact of a targeted intervention (TI) programme on behaviour change among injecting drug users (IDUs) in India. @*Methods@#This paper examined the data from the Integrated Biological and Behavioural Surveillance 2014-2015 for IDUs in India. Logistic regression was performed to understand the factors (TI programme services) that affected injecting risk behaviours by adjusting for covariates. Propensity score matching was conducted to understand the impact of the TI programme on using new needles/syringes and sharing needles/syringes in the most recent injecting episode by accounting for the covariates that predicted receiving the intervention. @*Results@#Participants who received new needles and syringes from peer educators or outreach workers were 1.3 times (adjusted odds ratio, 1.29; 95% confidence interval [CI], 1.09 to 1.53) more likely to use new needles/syringes during most recent injecting episode than participants who did not receive needles/syringes. The matched-samples estimate (i.e., average treatment effect on treated) of using new needles in the most recent injecting episode showed a 2.8% (95% CI, 0.0 to 5.6) increase in the use of new needles and a 6.5% (95% CI, -9.7 to -3.3) decrease in needle sharing in the most recent injecting episode in participants who received new needles/syringes. There was a 2.2% (95% CI, -3.8 to -0.6) decrease in needle sharing in the most recent injecting episode among participants who were referred to other services (integrated counselling and testing centre, detox centres, etc.). @*Conclusions@#The TI programme proved to be effective for behaviour change among IDUs, as substantiated by the use of new needles/syringes and sharing of needles/syringes.
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Objective@#Approximately 30% of preeclamptic pregnancies exhibit abnormal liver function tests. We assessed liver injury-associated enzyme levels and circulating transforming growth factor beta (TGF-β) levels in an arginine vasopressin (AVP)-induced pregnant Sprague-Dawley rat model. @*Methods@#Pregnant and non-pregnant Sprague-Dawley rats (n=24) received AVP (150 ng/hr) subcutaneously via mini-osmotic pumps for 18 days. Blood pressure was measured, urine samples were collected, and all animals were euthanized via isoflurane. Blood was collected to measure circulating levels of TGF-β1-3 isomers and liver injury enzymes in pregnant AVP (PAVP), pregnant saline (PS), non-pregnant AVP (NAVP), and non-pregnant saline (NS) rats. @*Results@#The PAVP group showed significantly higher systolic and diastolic blood pressure than both saline-treated groups. The weight per pup was significantly lower in the AVP-treated group than in the saline group (p<0.05). Circulating TGF-β1-3 isomer levels were significantly higher in the PAVP rats than in the NS rats. However, similar TGF-1 and TGF-3 levels were noted in the PS and PAVP rats, while TGF-2 levels were significantly higher in the PAVP rats. Circulating liver-type arginase-1 and 5'-nucleotidase levels were higher in the PAVP rats than in the saline group. @*Conclusion@#This is the first study to demonstrate higher levels of TGF-β2, arginase, and 5'-nucleotidase activity in PAVP than in PS rats. AVP may cause vasoconstriction and increase peripheral resistance and blood pressure, thereby elevating TGF-β and inducing the preeclampsia-associated inflammatory response. Future studies should explore the mechanisms through which AVP dysregulates liver injury enzymes and TGF-β in pregnant rats.
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Primary signet ring neuroendocrine tumors of the liver are extremely rare tumors. Morphologically, they mimic signet ring cell adenocarcinomas; however, the absence of mucin by special stains and the expression of neuroendocrine markers help to diagnose these tumors. We herein report a case of a 47-year-old female who presented with multiple solid and cystic lesions in both liver lobes, which were initially suggested to be biliary cystadenocarcinoma on imaging. Liver biopsy of the lesion revealed the presence of a signet ring neoplasm with diffuse expression of synaptophysin and pan-cytokeratin. The case was subsequently diagnosed as a primary hepatic signet ring neuroendocrine tumor. The patient was offered 3 cycles of chemotherapy and is well preserved after 14 months of diagnosis. Although this is an extremely rare entity, its possibility should be considered in the differential diagnosis of neoplasms characterized by signet ring cell morphology.
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Background@#and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. @*Methods@#A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. @*Results@#Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). @*Conclusions@#This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.
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Objective@#Approximately 30% of preeclamptic pregnancies exhibit abnormal liver function tests. We assessed liver injury-associated enzyme levels and circulating transforming growth factor beta (TGF-β) levels in an arginine vasopressin (AVP)-induced pregnant Sprague-Dawley rat model. @*Methods@#Pregnant and non-pregnant Sprague-Dawley rats (n=24) received AVP (150 ng/hr) subcutaneously via mini-osmotic pumps for 18 days. Blood pressure was measured, urine samples were collected, and all animals were euthanized via isoflurane. Blood was collected to measure circulating levels of TGF-β1-3 isomers and liver injury enzymes in pregnant AVP (PAVP), pregnant saline (PS), non-pregnant AVP (NAVP), and non-pregnant saline (NS) rats. @*Results@#The PAVP group showed significantly higher systolic and diastolic blood pressure than both saline-treated groups. The weight per pup was significantly lower in the AVP-treated group than in the saline group (p<0.05). Circulating TGF-β1-3 isomer levels were significantly higher in the PAVP rats than in the NS rats. However, similar TGF-1 and TGF-3 levels were noted in the PS and PAVP rats, while TGF-2 levels were significantly higher in the PAVP rats. Circulating liver-type arginase-1 and 5'-nucleotidase levels were higher in the PAVP rats than in the saline group. @*Conclusion@#This is the first study to demonstrate higher levels of TGF-β2, arginase, and 5'-nucleotidase activity in PAVP than in PS rats. AVP may cause vasoconstriction and increase peripheral resistance and blood pressure, thereby elevating TGF-β and inducing the preeclampsia-associated inflammatory response. Future studies should explore the mechanisms through which AVP dysregulates liver injury enzymes and TGF-β in pregnant rats.
ABSTRACT
Primary signet ring neuroendocrine tumors of the liver are extremely rare tumors. Morphologically, they mimic signet ring cell adenocarcinomas; however, the absence of mucin by special stains and the expression of neuroendocrine markers help to diagnose these tumors. We herein report a case of a 47-year-old female who presented with multiple solid and cystic lesions in both liver lobes, which were initially suggested to be biliary cystadenocarcinoma on imaging. Liver biopsy of the lesion revealed the presence of a signet ring neoplasm with diffuse expression of synaptophysin and pan-cytokeratin. The case was subsequently diagnosed as a primary hepatic signet ring neuroendocrine tumor. The patient was offered 3 cycles of chemotherapy and is well preserved after 14 months of diagnosis. Although this is an extremely rare entity, its possibility should be considered in the differential diagnosis of neoplasms characterized by signet ring cell morphology.
ABSTRACT
Background@#and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. @*Methods@#A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. @*Results@#Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). @*Conclusions@#This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.
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Obstructive Sleep Apnoea (OSA) is the most common sleep-related breathing disorder and is associated with significant morbidity. A simple but accurate tool to screen patients for OSA is needed. We wanted to compare STOP-BANG Questionnaire & Epworth Sleepiness Scale to predict the probability of OSA. MethodsA prospective observational study of 46 eligible patients was undertaken. They were assessed using SBQ & ESS & stratified as per the risk of OSA. The Apnoea Hypopnea Index (AHI) was calculated & patients were stratified into mild, moderate & severe OSA. The SBQ scores, ESS scores & AHI was then studied along with the predictive probabilities of both questionnaires in diagnosing OSA. ResultsOf the 46 patients, 89.13 % & 45.65 % were classified as high risk on the SBQ & ESS respectively. 78.26 % were diagnosed OSA on the sleep study according to AHI. SBQ had a high sensitivity to predict OSA (97.22 %) & low specificity (40 %). ESS had low sensitivity & high specificity to predict OSA being 52.78 % & 80 % respectively. ConclusionsBoth Stop-Bang questionnaire & ESS help in determining the risk of OSA. STOP-BANG is a better screening parameter due to its high sensitivity & negative predictive value.
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Interstitial Lung Diseases (ILDs) also known as diffuse parenchymal lung disease, include a group of diffuse parenchymal infiltrative lung diseases. A restrictive defect is the most frequent pulmonary abnormality in patients with pulmonary fibrosis which is the usual consequence of many ILDs. Connective tissue disorders are usually rare, but are potentially life threatening conditions. The spectrum of ILD varies from mucocutaneous symptoms, arthralgia / arthritis to impairment of pulmonary and renal function. Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc), Sjogren’s Syndrome (SS), inflammatory muscle diseases and overlap-syndromes are grouped together as connective-tissue disorders. Involvement of lung and its function is the most common form of interstitial lung disease, leading to high morbidity and mortality among the group of connective tissue disorders. We wanted to correlate the 6-Min Walk Distance (6MWTD) with the Pulmonary Function Test values such as % FEV1, % FVC and FEV1 / FVC, among patients with connective tissue disorder associated Interstitial Lung Disease in SRM Medical College Hospital, a tertiary care hospital in Tamilnadu, South India. MethodsThis study was done as a cross sectional analytical study among 31 patients in the Department of Respiratory Medicine, Rheumatology and General Medicine in SRM medical college and hospital. Each patient was explained the purpose of the study and the need for complete co-operation. Those who satisfied the inclusion and exclusion criteria were included. Data was collected using a structured proforma. 6-minute walk test and pulmonary function tests were performed and correlated. ResultsThere appears to be a significant correlation between 6-minute walk test, % desaturation, 6 Minute Walk Test Distance, 6 Minute Walk Test Pre BDI and 6 Minute Walk Test Post BDI with spirometry values especially with the Spirometry FEV 1 %, Spirometry FVC % and % predicted DLCO. Conclusions6MWT can be used as a useful surrogate for pulmonary function tests especially among the population where spirometry is not possible. 6MWT has good reproducibility, is simple to perform and can be used as a screening tool for Interstitial Lung Disease in connective tissue disorder patients.
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Resumo Introdução A goiaba é um fruto amplamente utilizado como alimento e é considerada planta medicinal em países tropicais e subtropicais. Pesquisas têm mostrado que o fruto contém constituintes químicos com abrangente uso clínico. Além disso, a maior parte das substâncias utilizadas no tratamento contra câncer foi isolada a partir de produtos naturais. Objetivo Avaliar o potencial citotóxico, mutagênico, antimutagênico e quimioprotetor da fruta liofilizada de Psidium guajava, a goiaba, in vivo. Método A citotoxicidade, a mutagenicidade e a antimutagenicidade foram avaliadas em três diferentes dosagens (0,625, 1,25 e 2,50 g/kg) de goiaba. Resultados Os resultados mostraram que a goiaba não apresentou atividade citotóxica e mutagênica no ensaio de micronúcleo em sangue periférico e que não houve alterações nos valores de ALT e AST, indicando ausência de toxicidade hepática. Nos animais tratados com a goiaba, a dose de 0,625 mg/kg significativamente reduziu os danos induzidos pela doxorrubicina. Conclusão Esses resultados mostraram que o consumo de goiaba é seguro e capaz de proteger o material genético de alterações genômicas.
Abstract Background Guava is a fruit widely used as food and is considered a medicinal plant in the tropical and subtropical countries. Scientific research has shown that the fruit contains chemical constituents with comprehensive clinical use. In addition, most of the substances used in cancer treatment have been isolated from natural products. Objective To evaluate the cytotoxic, mutagenic, antimutagenic, and chemoprotective potential of the freeze-dried fruit of Psidium guajava, guava, in vivo. Method Cytotoxicity, mutagenicity, and antimutagenicity were evaluated in three different dosages (0.625, 1.25, 2.50 g/kg) of guava. Results The results show that guava does not present cytotoxic 2 and mutagenic activity in the micronucleus assay in peripheral blood and there were no alterations in ALT and AST values showing the absence of hepatic toxicity. In animals treated with guava, the dose of 0.625 mg/kg significantly reduced the damage induced by doxorubicin. Conclusion These results show that guava consumption is safe as it is also capable of protecting the genetic material from changes.
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Background: The objective of this present study was to assess the efficacy of condom uterine balloon tamponade (C-UBT) in averting the obstetric hysterectomy (OH) in cases of major postpartum haemorrhage (PPH) over a period of 10 years.Methods: A retrospective cohort study from January 2010 to December 2019. A historical cohort was drawn from a group of women who had OH for major PPH between Jan 2010 to December 2014 (Group 1) whereas those from January 2015 to December 2019 were designated as Group 2. Total 305 C-UBT were used in the later period. Women who had OH at <28 weeks were excluded from the study. Primary outcome was to determine the efficacy of C-UBT in averting the risk of OH. Secondary objective was to determine the success rate of C-UBT after five years of useResults: Total 37463 births occurred from January 2010 to December 2014 and 38808 during January 2015 to December 2019. Cases of OH were 33 in the first five years period (Group 1) and 20 in the later (Group 2), p=<05, odds ratio=0.58 with 95% CI 0.335-1.019 favoring C-UBT. After exclusion of rupture uterus and placenta accreta syndrome, OH for uterine atony alone were 22 (66.6%) for Group 1 and 08 (40%) for Group 2, P=0.01 odds ratio=0.350 (95% CI 0.156-0.788). No OH was done in group 2 for placenta previa. Efficacy of C-UBT was 96%.Conclusions: C-UBT is very safe, cheap and effective option for averting OH and associated physical, emotional and psychosocial morbidity.
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Background: Hearing impairment is a factor that directly compromises the individual’s language which can affect emotional and academic defects by delayed development of communicative ability. This can vary according to the type and degree of hearing loss. Speech therapy intervention is important, along with the use of sound amplification devices, so that the child may have a chance to develop speech, consequently learning and re-habilitation to the society. Aims of the present study was performed to assess the effectiveness of early intervention of speech and language therapy after use of hearing aids to hearing impaired children on their syntactic and lexical development.Methods: This quasi-experimental study conducted on 100 children having different degree of hearing loss at department of Neurology and department of ENT, King George’s Medical University, Lucknow, Uttar Pradesh. After collecting socio-demographic data of subjects by observation, completion of questionnaires, and speech recording by audiologist; Speech and language therapy provide by audiologist for six month after providing hearing aids and improvement in their syntactic and lexical development recorded.Results: There is significant improvement in verbal response from 14% before therapy to 81% after therapy and non-verbal response before therapy was 86% and after therapy was 19%. Before giving speech and language therapy to subjects pointing score was 24%, sign language was 10% and words response was 0% which increases after therapy were 1%, 2% and 39% respectively. Early identified/intervened hearing-impaired children had a notable positive difference in all assessed lingual gains.Conclusions: This is study results definitely point to positive effects of intensive and continuous application of speech and language therapy to syntactic and lexical development of hearing impaired children.
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Background: Sleep is an important process of our body and a good sleep will lead to a healthy lifestyle. In medical field, students have sleep patterns changing due to heavy academic workload. This may have ill effects on their health. Though most factors that affect sleep are modifiable and treatment for them exists still there are can be many factors that affect sleep which should be explored. The thermal model of human body is a theoretical model that accounts for thermal effects of electromagnetic waves on a given point in human body. This could be easily affect brain as it has highest electrical activity in body and may lead to sleep related disorders.Methods: This study is conducted on medical and dental students to analyse the amount of electromagnetic field they get exposed to and any changes in sleep patterns associated with it. The findings of medical and dental students are compared to see if changes in sleep patterns are due to professional course pursued. Any other confounding factors affecting this study are screened by self-rated Pacific Sleep Questionnaire.Results: There were significant changes seen in the time taken to fall asleep and total sleep period but the time taken to wake up from sleep remained unaffected. The sleeping habits of medical and dental students showed no significant changes.Conclusions: Static electromagnetic fields have significant impact on sleep onset and sleep duration. This is regardless of academic background.
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Introduction: It has been hypothesized that there existssome correlation between myopia and ABO blood group.Current study aimed to study the distribution of ABO bloodgroup among first year medical students and also to assess theassociation of myopia among different blood groups.Material amd method: A cross sectional study conducted byDepartment of Physiology on first year medical students ina medical college in Bangalore.Blood group of the subjectswas determined by slide method and microscopy and detailsregarding myopia and family history of myopia were collectedvia questionnaire from participants who confirmed usage ofspectacles or contact lenses for vision correction.Results: Of the total 142 subjects, 77(54.2%)were males and65 (46%) were females. Most common ABO blood group inthis population was found to be B positive (33%) followedby O positive (30%). Out of 142 participants, 46(32.39%)were Myopics, i.e 24(16.9%) females and 22 (15.49%) males.B blood group showed higher prevalence of myopia whencompared to other ABO blood groups. Odds ratio done tocompare risk of Myopia between B and Non B blood groupsrevealed that B blood group showed higher risk (Odd’s ratio1.70) of myopia but this was not statistically significant.Relative risk of myopia was higher in Rh positive group(1.09) in comparison to Rh negative blood group and it wasnot statistically significant.Conclusions: B blood group participants showed slightlyhigher prevalence of myopia as compared to other bloodgroups but it was not statistically significant.
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Background: Chronic wounds are responsible for increase in burden to healthcare systems. The evidence concerning effectiveness of antibiotic therapy or optimal regimens is insufficient. Patients with chronic wounds receive significantly more systemic and topical antibiotics. Current guidelines for antibiotic prescribing for such wounds are often based on expert opinion rather than scientific fact. As there is increasing prevalence of antibiotic resistance, the relationships between antibiotic resistance and rationales for antibiotic therapy have to be determined. Current practice of antibiotic usage for chronic wounds and postoperative wounds in a tertiary care setting should be studied.Methods: Retrospective study was conducted from February 2017 to February 2018 using medical records of patients with wound admitted in surgical departments in HIMS, Hassan, Karnataka. The inpatient records were analysed, which includes duration of stay in the hospital, number of drugs/products per person, percentage of antibiotics prescribed, percentage of antibiotic injection prescribed, and other modalities used to treat wounds.Results: In present study, amongst 100 antimicrobial prescriptions, 26 females and 74 males. The most commonly prescribed parenteral antibiotic was ceftriaxone (58%), followed by metronidazole (56%). The average number of antibiotics per prescription was 2.8. The mean duration parenteral antibiotics given was 4.26 days during their hospital stay oral antibiotics were 5.18 days after the discharge from the hospital.Conclusions: The information generated shall be used to decide the policies to govern the prescription of antibiotics in the management of chronic wounds and post-operative wounds.
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Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.