EFFECTIVENESS OF SIMULATION BASED TEACHING PROGRAM ON KNOWLEDGE AND SKILL REGARDING BASIC NEONATAL RESUSCITATION PROCEDURES AMONG FEMALE HEALTH WORKERS OF SELECTED AREAS: A STUDY PROTOCOL

Background Of The Study: Worldwide, 136 million babies are born annually. 10 million require some stimulation at birth to breathe, while 6 million require basic resuscitation with a bag and mask. Evidence shows that 1 million neonatal deaths occur yearly on the day of birth. Near about 2 million babies die in the rst week of life and 4 million die in the neonatal period, which accounts for 46% of under-ve mortality. This mortality is estimated to increase to 52% in 2030 unless strategic interventions are implemented. To assess the effect of a simulation-based teaching Objective: program on knowledge and skill regarding basic neonatal resuscitation procedures among female health workers of selected areas. Pre-experimental one group pre-test post-test research design will be used. The duration of the study will Methodology: be one month. 60 female health workers from selected primary health centres and sub-health centres of Nagpur district will be selected as a sample through the simple random sampling technique. The structured questionnaire and standardized observational checklist will be used to assess the knowledge and skill respectively. Validity and reliability of the tool will be determined with appropriate standardized methods. Enhance knowledge and skill after simulation-based Expected Result: teaching program. Female health workers working in primary health centres and sub-health centres of Nagpur Limitation: district will be included in this study. The study ndings will reect the need for simulation based education to Conclusion: enhance the knowledge and skill of female health workers to identify birth asphyxia and its potential complications leading to neonatal mortality during the rst few hours after birth.

Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodefciency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and ofered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodefciencies (ESID) criteria (working defnition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody defciencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classifcation. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and eforts to provide optimal care for children with possible IEI in this center.

Hair tourniquet syndrome of labia minora in 14 year teen: a rare case report

Hair tourniquet syndrome (HTS) is rare clinical phenomenon in which body appendage is circumferentially entangled by string of hair leading to ischemia and necrosis or even autoamputation of the appendage. HTS commonly affects toes, finger or genitalia. Early diagnosis and prompt intervention lead to good outcome.  This article presents a case of hair tourniquet syndrome of labia minora, a rare presentation in 14 year child.

Markers of Inflammation in Rheumatoid Arthritis and Osteoarthritis

Introduction: Rheumatoid arthritis is characterized by local and systemic effects of inflammation while osteoarthritis is aninflammatory degenerative disorder of joints. A wide range of inflammatory markers are implicated in pathogenesis of rheumatoidarthritis and osteoarthritis as a consequence of persistent imbalance between pro- and anti-inflammatory immune mechanisms,leading to chronic inflammation. Hence the present study is an attempt to estimate the levels of serum ceruloplasmin , C-reactiveprotein (CRP) and rheumatoid factor (RF) factor as inflammatory markers in serum of rheumatoid arthritis and osteoarthritispatients and compare them with normal healthy controls. Materials and Methods: Serum ceruloplasmin was estimated byspectrophotometric method while serum C-reactive protein and RA factor were detected using agglutination test in thirty patientsof rheumatoid arthritis ,osteoarthritis and age and sex matched healthy controls each were included in the study. Results:Significant increase in ceruloplasmin was observed (p<0.0001) in rheumatoid arthritis and osteoarthritis as compared to healthycontrols and in that especially ceruloplasmin was more elevated in rheumatoid arthritis than osteoarthritis. C-reactive proteinwas found to be positive in rheumatoid arthritis and osteoarthritis and none of the controls. RF factor was found positive inrheumatoid arthritis and none of the osteoarthritis and controls. Conclusion: There was increased level of serum ceruloplasmin inthe patients with rheumatoid arthritis and osteoarthritis. C-reactive protein and RF factor was found to be positive in rheumatoidarthritis while C-reactive protein was found to be positive in rheumatoid arthritis and osteoarthritis. These findings suggest apossible role of these inflammatory markers in the pathogenesis of rheumatoid arthritis.

A Review of Behavioral Tests to Evaluate Different Types of Anxiety and Anti-anxiety Effects

Behavioral tests are very useful to understand the Neuro-psychotic disease and also helpful in finding the treatment of the particular disease. Nowadays various tests are available to evaluate the anxiolytics effect of a new entity or even for comparative studies with the standard drug. As per the ethics, a new compound or drug believes to have possible pharmacological effects should be tested on animals before tested on humans which have similar physiology than humans. First, rats were used for behavioral test for evaluation of anti-anxiety drug but later on the various strain of mice were added for evaluation of anxiolytics because of better genetic possibilities than rats. In this review article, we have discussed the most commonly used behavioral tests used to evaluate the anti-anxiety effect. Anxiolytics are the agent which are used to elevate anxiety effect produced due to any cause. The various parameter will be undertaken for the better and precise evaluation of anxiolytics.

Assessment of the learning curve: total laparoscopic hysterectomy versus total abdominal hysterectomy

Background: Abdominal hysterectomy is the most frequented way of hysterectomy in the world; today we have a lot of techniques for hysterectomy. Total Laparoscopic Hysterectomy (TLH) versus Total Abdominal Hysterectomy (TAH) needs experience an assessment of the learning curve. Objective of the study was to determine the feasibility and safety of TLH and TAH.Methods: Total 100 women were taken for study. Operating time, estimated blood loss, operating complication and length of stay in hospital were noted for each patient. The success rates of TLH were more compared to TAH. The operating time estimated blood loss, conversion to laparotomy was directly proportional to size of uterus.Results: There were no statistically significant differences between the two groups regarding age, body mass index (BMI), specimen weight, pre-operative hemoglobin (Hb) value and rates of the complications. The mean post-operative Hb value was significantly higher in group TLH than group TAH (11.3±0.7 gr/dl versus 10.6±1.6, p = 0.03). The mean time of operation was significantly longer in TLH than group TAH (105.4±22.9 minutes versus 74±18, p<0.001). The mean duration of hospital stay was statistically shorter in TLH compared to the TAH (2.47±0.5 days versus 4.86±1.1, p<0.001).Conclusions: Advantage of TLH over TAH are less blood loss, fewer wound infection and fever, smaller incisions, with less pain, shorter hospitalization time, speedier recovery.

Role of angiogenesis in oral submucous fibrosis using vascular endothelial growth factor and CD34: An immunohistochemical study

Background: Oral submucous fibrosis (OSF) is an insidious, chronic, disabling disease, in which there is lack of perfusion due to reduced level of the vasculature and this is said to be responsible for the epithelial atrophy seen in OSF. The degree of vasculature of the affected mucosa and its effects on the epithelial thickness remains controversial till date. Aims: This study attempts to analyze the role of angiogenesis in OSF and its progression using vascular endothelial growth factor (VEGF) and CD34 markers. Materials and Methods: The study samples for the present study comprised of 10 cases each of early OSF, moderately advanced, advanced OSF, and 10 cases of normal oral mucosa were used as controls. All the cases were subjected to immunohistochemical staining with VEGF and CD34 markers. Results: Among the different grades of OSF, we did not find any noticeable difference in VEGF expression although we found a upregulation in microvessel density (CD34) in early and moderately advanced OSF followed by a downregulation in advanced OSF. Conclusions: As the disease progresses, there is an increased production of the extracellular matrix component (collagen I and II and fibronectin) and results in fibrosis. Subsequently, it leads to the reduction in the level of corium vascularity and results in hypoxia which ultimately causes reduction and constriction of the vascular channels. This sequence of events alerts us to the relevance of early disease diagnosis and management in an irreversible pathology such as OSF.

One Year Comparative Prospective Study on MIPH Versus Milligan –Morgan open Haemorrhoidectomy in a Tertiary Care Hospital

Haemorrhoids are dilated veins which descend down to the anus present as pain during defaecation, bleeding and a protruding mass outside the anus. The aim of the study is to evaluate the effectiveness of open haemorrhoidectomy with minimal invasive procedure for haemorrhoids (MIPH). Methods: 60 cases were selected for this study .30 patients each were divided into two groups.Open surgery ( Milligan-morgan haemorrhoidectomy ) was done in one group and MIPH for the other group .The follow up period was one year .The duration of post. operative pain, complications, level of satisfaction was documented . The relative merits and demerits of the procedures were assessed and the results documented. Results: MIPH is a safe and effective procedure in patients presenting with haemorrhoids .Duration of hospital stay is less and hence return to work is earlier. Conclusion: MIPH can be considered as a procedure of choice in patients presenting with grade II, grade III and grade-IV haemorrhoids.

A Prospective Study on Single Layer versus Double Layer Anastomosis in Emergency Colonic Surgery in a Tertiary Care Hospital

Colonic anastomosis is mostly due to to primary colonic diseases like volvulus, carcinoma, strangulation, injuries and stricture .As a result intestinal ischaemia and gangrene develops and finally the affected bowel is resected and end to end anastomosis is done .The aim of the study is to evaluate the effectiveness and outcome of colonic anastomosis by single layer or double layer. Methods: 134 cases were selected for this study.69 patients were taken up for single layer and 65 for double layer anastomosis. Single layer anastomosis has a better outcome in terms of healing, less time consuming and minimal complications. Results: Single layer takes less time, post. Operative complications are minimal, duration of hospital stay is less and mortality and morbidity is reduced. Conclusion: Single layer anastomosis should be a preferred technique and a procedure of choice for colonic anastomosis.

Incidence of Incidental Gall Bladder Carcinoma in Cases of Routine Cholecystectomy – A One Year Prospective Study in a Tertiary Care Hospital

Gall stones,gall bladder polyps,porcelain gall bladder leads to carcinoma.Malignancy is detected with a history of gall stone disease and patient presents with non-specific symptoms such as abdominal discomfort,right upper quadrant pain,nausea,vomitting,weight loss,anorexia and jaundice at a later stage .The aim of the study is to find the incidence of gall bladder carcinoma in cases of routine cholecystectomy. Methods: 100 cases were selected for this study. Open cholecystectomy / laparoscopy were done as routine cases and sent for histo-pathological study .The patients were clinically examined.clinica; symptoms, USG findings were corroborated. The follow up period was one year .The age of presentation,clinical examination,USG findings,was documented. Results: Gall bladder carcinoma is arare disease and 7 times more common in patients with gall stones. Conclusion: Predisposing conditions like gall bladder polyps more than 2 cms,porcelain gall bladder may tend to develop malignancy.Morbidity and mortality is associated with this disease due to early spread to liver,lymph node spread and jaundice.

Cervical cancer: perception of peripheral health workers in Lucknow: a cross-sectional study

Background: Cervical cancer is one of the most prevalent cancers among Indian women. Cervical cancer incidence reduces dramatically when effective screening programs linked with access to treatment are in place and are readily accessible. Peripheral health workers (PHWs) being frontline workers have a major influence on raising awareness among community about acceptability of available screening programmes. This study was thus conducted to assess the awareness of PHWs regarding risk factors, signs and symptoms, early detection and prevention for cervical cancer.Methods: A questionnaire-based study was conducted among 450 PHWs (ASHAs and BHWs). Information was collected regarding their bio-social characteristics, awareness about female cancers, risk factors, signs/symptoms, early detection methods and services available for screening and prevention of cervical cancer.Results: Awareness of different aspects of cervical cancer was found to be very low. Only eight per cent of the PHWs had good awareness score. BHWs obtained statistically significant better mean scores as compared to ASHAs. Few (7.6%) PHWs had received training for any type of female cancers. Only 17 per cent of the PHWs were aware of HPV vaccine availability and only 29 per cent from them could name the vaccine.Conclusions: Majority of the PHWs had poor awareness about cervical cancer and available screening facility in our health system. They had almost no idea of availability of free HPV vaccination at the Sampoorna clinics. This low level of awareness calls for regular training of PHWs on cervical cancer which would ultimately trickle down to the community.

Morphological And Morphometric Study Of Mitral Valve With Reference To Anatomical Variability In South Indian Subjects

Background:The mitral valve (MV) is a complex structure that is altered in various disease status. Mitral valveclosure prevents systolic backflow of blood from the left ventricle into atrium, which depends on the co-ordinatedaction of left atrium, mitral valve leaflets, annulus, chordae, papillary muscles and the left ventricular wall.Alteration in the structure and function of any of these elements lead to mitral valve incompetence.Purpose of the study: The aim of the study was to determine the morphological and the morphometric variationsof mitral valve. The present study has classified mitral valve based on the number of mitral valve leaflets/cuspsand also measured the size and area of mitral orifice and mitral annulus circumference.Methods:Present study included 50 human hearts from the cadavers in the department of Anatomy at PondicherryInstitute of Medical Sciences. Circumference, annular diameter, area of the valve, height of the anterior leafletand height of the posterior leaflet was measured.Results:In this study annular circumference ranged between 6.8 to11.5 cm and 64% of the circumference rangedbetween 8.1 to 10 cm. Annular diameter ranged between 2 to 3.6 cm and 58% of diameter ranged between 2.6 to3 cm.Height of the anterior leaflet ranged between 1 to 2.5 cm and 54% ranged between 1.6 to 2 cm. Height of theposterior leaflet ranged between 0.5 to 1.5 cm and 70% ranged between0.5to 1cm.Conclusion:Although the most commonly described mitral valve is bicuspid, in the present study 3 cusps werefound in 4% of the specimens. Improper cusp approximation may cause cardio vascular problems. Morphometricmeasurements of the mitral valve will help in finding the correct size of the prosthesis for the valve replacementwhich will accurately fix in the valve orifice.

Screening of antiproliferative activity mediated through apoptosis pathway in human non-small lung cancer A-549 cells by active compounds present in medicinal plants

Objective: To explore the antiproliferative activity and apoptosis in cells caused by active compounds present in plants using different techniques. Methods: We investigated the antiproliferative effects of methanolic extracts from different parts of seven plants on A-549 (lung cancer) cells and primary cell culture (chick embryo fibroblast cells, as normal cells) using MTT assay and the potent plant was fractioned further. All these fractions were screened again for anti-proliferative activity. DNA fragmentation and DAPI staining were used to study apoptosis. Quantitative real-time was used to investigate the expression of apoptotic-related genes. LC-MS and

Screening of antiproliferative activity mediated through apoptosis pathway in human non-small lung cancer A-549 cells by active compounds present in medicinal plants

Objective:To explore the antiproliferative activity and apoptosis in cells caused by active compounds present in plants using different techniques.Methods:We investigated the antiproliferative effects of methanolic extracts from different parts of seven plants on A-549 (lung cancer) cells and primary cell culture (chick embryo fibroblast cells, as normal cells) using MTT assay and the potent plant was fractioned further. All these fractions were screened again for anti-proliferative activity. DNA fragmentation and DAPI staining were used to study apoptosis. Quantitative real-time was used to investigate the expression of apoptotic-related genes. LC-MS andResults:Methanolic extract of Vitex negundo (V. negundo) was selected as a potent fraction. Among all fractions screened, ethylacetate fraction of V. negundo was selected as the most potent antiproliferative fraction and phytochemical analysis of the extract revealed the presence of secondary metabolites. Ethaylacetate fraction of V. negundo was found to cause characteristic apoptotic morphological changes and generation of ROS in A-549 cells. Ethaylacetate fraction of V. negundo also induced apoptosis in A-549 which was supported by DNA fragmentation and DAPI staining. To investigate the molecular mechanism behind the cytotoxic effect of ethaylacetate fraction of V. negundo, quantitative real-time PCR was used to measure expression levels of p53, bax, bcl2, casp-3 and casp-9. Using LC-MS andConclusions:It is concluded from the present study that V. negundo is capable of triggering growth-inhibitive and apoptosis effects in A-549 cells, signifying that V. negundo may possesses anti-lung cancer activity.

Comparative study on morpho-anatomy of leaf, stem and root of Boerhaavia diffusa L. (Nyctaginaceae) and its adulterant plants

ABSTRACT Punarnava (Boerhaavia diffusa L.- Nyctaginaceae) is a promising drug to rejuvenate new cells in the body. It is well known in Ayurvedic medicine and locally called Tambadivasu. Superficially it is similar to other species of Boerhaavia and species of Trianthema and Sesuvium. Due to the minute morphological differences, the above plants are erroneously used in medicine as Punarnava, and at times on purpose as an adulterant. Therefore, it is necessary to highlight the anatomical features of Punarnava for proper identification of the medicinal plant species for local people and for scientific research. Due to the ambiguity in local names and similar apparent appearance, market samples of Punarnava are often adulterated with various species of Trianthema and Sesuvium. These adulterated samples contain neither the Punarnavine alkaloid, nor does it possess anisocytic stomata but possess paracytic stomata. Comparative study of stem anatomy showed two main characteristic differences. First, plenty of starch grains can be seen in both the ground parenchymatous tissues present in between successive cambia and xylem parenchyma of Punarnava which is not observed in species of Trianthema, and second, the phloem around the xylem of Punarnava root has semi-circular or eccentric patches, while that of Trianthema only has narrow strips. This study is focused on comparative SEM study of leaf morphologies and anatomy of leaf, stem, and root of Boerhaavia diffusa L., Trianthema portulacastrum L. and Sesuvium portulacastrum L.

Oviposition Deterrents in Herbivorous Insects and their potential use in Integrated Pest Management.

In the life cycle of insects, oviposition is an important phenomenon, and it is influenced by many intrinsic and extrinsic factors, especially in relation to suitable hosts for completion of their life-cycle. Oviposition deterrents which deter an insect from laying eggs are important in the management of insect pests. Proper understanding of these deterrents shall provide necessary insight into new vistas for Insect Pest Management. Chemicals from plants and insects play an important role in attracting phytophagous insects for selecting host for oviposition. Considerable research has been done on oviposition deterrents and their mode of actions. In the present review, we have consolidated the updated information on this important aspect of insect behavior.

Papilloma of lip associated with human papilloma viruses‑32 infection in a child.

Squamous papilloma is the most common benign oral epithelial lesion, and it is well known to be associated with human papilloma virus 6 and 11. Here, we report a case of squamous papilloma associated with human papilloma viruses (HPV)‑32 in a 4‑year‑old boy who presented with a verrucous lesion on the lower lip. HPV‑32 is often associated with a rare benign condition focal epithelial hyperplasia (FEH). A limited number of lesions and the absence of characteristic histology ruled out FEH in our patient. To the best of our knowledge, the association of oral squamous papilloma with HPV‑32 is hitherto unreported.

Significant ACE Gene Haplotype Stipulates Development of Type 2 Diabetes in Women with Gestational Diabetes Mellitus.

Introduction: Angiotensin-converting enzyme (ACE) plays a key role in glucose and insulin regulation, and in the onset of diabetes. ACE gene polymorphisms A240T, C1237T, G2350A and I/D located in the promoter, coding and non-coding regions have been studied in both type-2 diabetes and gestational diabetes mellitus (GDM). However, their impact on the development of type-2 diabetes post GDM remains unknown, especially in under-represented population. Aim: We examined possible associations and networking between ACE gene polymorphism susceptibility / protection towards/against progression of type-2 diabetes post GDM in North Indian women. Methods: Two hundred and twenty four women (n = 224) were recruited in this study and genotyped for four ACE gene polymorphisms using polymerase chain reaction (PCR), followed by digestion through restriction endonuclease enzymes. Results: Study results suggest a significant association of ACE genes SNPs A240T, C1237T, G2350A and I/D haplotype with GDM cases progressing to type-2 diabetes later in life (P =.02). Individuals possessing haplotype “CAAI” derived from these SNPs had a 3.65 fold increased risk of type-2 diabetes development in GDM cases later in life relative to other haplotypes. Conclusion: Due to its pivotal role in the pathogenesis of both diseases, the current finding might be of future therapeutic value. Larger-scale studies are required to confirm this novel finding in multi-ethnic populations.

Malaria transmission in Tripura: disease distribution & determinants.

Background & objectives: Malaria is a major public health problem in Tripura and focal disease outbreaks are of frequent occurrence. The State is co-endemic for both Plasmodium falciparum and P. vivax and transmission is perennial and persistent. The present study was aimed to review data on disease distribution to prioritize high-risk districts, and to study seasonal prevalence of disease vectors and their bionomical characteristics to help formulate vector species-specific interventions for malaria control. Methods: Data on malaria morbidity in the State were reviewed retrospectively (2008-2012) for understanding disease distribution and transmission dynamics. Cross-sectional mass blood surveys were conducted in malaria endemic villages of South Tripura district to ascertain the prevalence of malaria and proportions of parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT. Results: The study showed that malaria was widely prevalent and P. falciparum was the predominant infection (>90%), the remaining were P. vivax cases. The disease distribution, however, was uneven with large concentration of cases in districts of South Tripura and Dhalai coinciding with vast forest cover and tribal populations. Both Anopheles minimus s.s. and An. baimaii were recorded to be prevalent and observed to be highly anthropophagic and susceptible to DDT. Of these, An. minimus was incriminated (sporozoite infection rate 4.92%), and its bionomical characteristics revealed this species to be largely indoor resting and endophagic. Interpretation & conclusions: For effective control of malaria in the State, it is recommended that diseases surveillance should be robust, and vector control interventions including DDT spray coverage, mass distribution of insecticide-treated nets/ long-lasting insecticidal nets should be intensified prioritizing population groups most at risk to avert impending disease outbreaks and spread of drug-resistant malaria.

Four Heads of Sternocleidomastoid: A Case Report.

During the routine cadaveric dissection, the presence of accessory heads of Sternocleidomastoid was observed on right side. i.e., additional bellies from sternal and clavicle were observed on the right side. These additional slips were innervated by the spinal accessory nerve. These additional slips could have been formed due to unusual splitting in the mesoderm of post-sixth branchial arch during organogenesis. The awareness of variations of sternocleidomastoid muscle is important for Anaesthetists, Plastic surgeons, Orthopaedicians and Dental surgeons while taking muscle flap in reconstructive surgeries and is also important for radiologists while interpreting MR images of this region.