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Objective: To assess proportion and predictors of lesion calcification in children aged 2-12 years with neurocysticercosis at six months follow up. Method: Children aged between 2 and 12 years with Neurocysticercosis diagnosed on MRI brain were initially included and followed up for 6 months. Repeat CECT brain at 6 months was done to find if the lesion persisted/calcified/ resolved. Results: 16 out of 30 patients (53.3%) had calcification at six months follow up. Perilesional edema at the initial stage of the presentation was significantly associated with calcification at 6 months (P=0.042). Conclusion: Perilesional edema at the time of presentation was significantly associated with calcification in children with neurocysticercosis, six months after diagnosis.
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Background@#Knowledge of anatomy and morphometry of the patella and patellar tendon is crucial for the selection of bonepatellar tendon-bone (BTB) graft for anterior cruciate ligament reconstruction. Graft tunnel mismatch in BTB graft especially in patients with patella alta or baja can result in compromised fixation for the bone-to-bone healing. This complication can be avoided by proper templating of graft using parameters measured from magnetic resonance imaging (MRI). The study aimed to derive morphometric data from MRI and predict the suitability of BTB graft preoperatively. @*Methods@#MRI of 1,002 knees was chosen from database after applying the eligibility criteria, which included individuals in the age group of 18–50 years (both sexes) with the intact patella and patellar tendon. Individuals with pathologies of the knee joint and associated structures such as patellar fracture/dislocations, fractures of the distal femur and proximal tibia, and avulsion of the quadriceps tendon or patellar tendon were excluded. For analysis, 1.5 Tesla, proton density, and fat-suppressed sequences of sagittal and axial sections of T2-weighted MRI images were used. @*Results@#Mean age of the 1,002 patients was 35.45 years and there were 290 women and 712 men. Respective measurements were as follows: patella length, width, and thickness, 40.3 mm, 40.2 mm, and 18.6 mm, respectively; patellar tendon length, width, and insertional thickness, 45.2 mm, 27.2 mm, and 5.7 mm, respectively; Insall-Salvati ratio, 1.13; overall graft length, 90.2 mm; and effective tendon length, 26.1 mm. @*Conclusions@#A simple MRI analysis can give us valuable inputs on BTB graft morphometry. The values can also help us with the near-perfect graft harvest. The intraoperative complication of graft tunnel mismatch can be avoided by predicting the overall graft length, effective tendon length, tibial tunnel length, and patellar position using the measured parameters on MRI.
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Introduction: A person spends one third life in sleep, so the quality and quantity of sleep is of utmost importance. Health Care Professionals (HCPs) are more prone to inconsistency in sleep both in quality and quantity, which leads to deflection from health and well-being of themselves and care of others. This study aims to assess the various factors influencing sleep quality and daytime sleepiness among medical and nursing healthcare professionals. Methodology: A cross sectional study was conducted using a structured questionnaire to collect socio-demographic and work-related information, co-morbidity and quality of Sleep using ESS (Epworth Sleepiness Scale) and PSQI (Pittsburgh Sleep Quality Index) scale. Results: Among the 150 HCPs, 64.7% were medical and 35.3% were nursing professionals. 53.6% of medical and 66% of nursing professionals reported poor sleep quality. Increased coffee consumption influences sleep quality and it was found to be statistically significant. Nursing professionals had more excessive daytime sleepiness (58.5%) with significant p-value (p=0.01). Conclusion: According to our study results, sleep quality was poor among nursing professionals which highlights the need for measures to improve their quality of sleep.
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Colorectal cancer is a one of the leading causes of death globally and its clinical management of cancer involves chemotherapy. Increase in the development of resistance to the drugs used in the cancer treatment and serious side effects associated with chemotherapeutic drugs are the major limitations in cancer therapy. Hence, there exists a huge need to develop safer natural therapeutic products for cancer therapy. In this study, ethanolic extract of Stoechospermum marginatum was evaluated for its anticancer activity. The cytotoxicity of S. marginatum extract was evaluated on HT-29 cells by MTT assay. Trypan blue cell viability was also carried out to evaluate cytotoxicity and antiproliferative effect. The apoptosis-inducing potential of the extract was analyzed by acridine orange and ethidium bromide dual staining method, mitochondrial membrane potential assay and FITC Annexin V-Propidium iodide staining method. The ethanolic extract of S. marginatum showed significant dose-dependent cytotoxicity in HT-29 cells Treatment with S. marginatum extract increased number of apoptotic cells in HT-29 cells and caused damage to mitochondrial membrane potential. The findings of the present study confirmed in vitro anticancer activity of ethanolic extract S. Marginatum
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In today's world stress is playing a vital role in all days' life. Especially stress among students has been increasing beyond their capability. Today's student population is the entire world's population tomorrow.We could find students' life is going into trouble because of uncontrollable stress factors. In recent times we could see students attempting suicide; this would be because students are not capable enough to control their stress. There would be various factors for students' stress which Create negative impacts on the peace of future generations. In this study, such major factors of stress and its impacts have been analyzed taking the Coping strategy as a moderate factor. The major factor analyzed in this study is academic fear due to online classes and relationships with teachers. The impacts of the stress are stress and depression. Student counseling is taken as a part of a coping strategy. The method of the study is descriptive. Simple Random Sampling was conducted among 120 undergraduates from Gobi Arts & Science College. In this study, Chi-square was used to analyze the significance level of Academic Stress in regard to Gender and Family size and Correlation was used to analyze the relationship between the behavior of teachers and academic stress of students.
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Humans have evolved and adapted as a social being and it has ensured the survival of all. The novel corona virus, COVID 19 has impacted the psychosocial functioning of billions of people around the world. The various impacts it might have on different categories of people over a period of time is one of the main concerns of the World Health Organisation. College students are vulnerable and are more prone to psychological problems due to the prolonged stress experienced by them during this period of uncertainty and social isolation. We wanted to analyse the level of perceived stress among college students in India and the impact of this sudden break in studies and social distancing has on them. We also wanted to study the number of mental setbacks the college students experience because of their financial situation and their future job prospects during this lockdown. METHODSAn online survey was conducted among the college students in India. A total of 775 responses were analysed for the level of perceived stress using the perceived stress scale. The psychological impact caused by the lockdown was analysed through statements regarding the amount of worry they felt across various aspects of their life such as economic stability, missing friends during lockdown, use of mobile phone for connecting with people, continuation of education and impact of Covid 19 on future job prospects. RESULTSCollege students were experiencing significant amount of stress as measured by the perceived stress (PS) scale with 11.5 % experiencing high stress and 81.2 % students experiencing moderate amount of stress. The perceived stress was found to be significantly associated with worry regarding education, job prospects being affected by the Covid 19 situation and the reduction of time spent with their peers. CONCLUSIONSCollege students are experiencing moderate to high level of stress in the context of the pandemic situation and preventive and protective measures have to be taken by the college administration to address these issues. More targeted assessments needs to be done in colleges to assess the mental health of its student population and protective measures like counselling services should be made to vulnerable students as they try to handle the stress associated with the current pandemic situation.
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Background: The objective of the study was to evaluate anti-nociceptive effect of methanolic extract of Murraya koenigii leaves on thermal and mechanical pain in swiss albino mice.Methods: Thirty adult male swiss albino mice weighing 25-30 grams were selected and allocated in to five groups. Each group consists of six animals. The control group received vehicle (10 ml/kg), standard group received morphine (10 mg/kg) and test groups received dried methanolic extract of Murraya koenigii leaves (100 mg/kg, 200 mg/kg, 400 mg/kg per oral respectively) 1 hour before placing the animal over the hot plate at temperature of 55?C . A cut off period of 10 sec was observed to avoid damage of the paw. The response in the form of withdrawal of paws or licking of the paws. The delay in the reaction time denotes analgesic activity. The latency was recorded before and after 15, 30, 60, 120 minutes administration of drug. After washout period of 1 month the same group of animals were utilized to evaluate the analgesic effect by tail clip method for better comparison.Results: All the doses of Murraya koenigii leaves significantly delayed reaction time in hot plate method and tail clip method. The results were comparable to that produced by standard drug morphine.Conclusions: Murraya koenigii leaves has analgesic activity which was comparable to morphine.
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Background: Many Studies and Research Articles in our medical field focuses on Verbal Communication component. The Non-Verbal Component has been neglected in many circumstances. But Medical science endorses that Non-Verbal component plays a major role in the communication process in all set ups whether it is in the classrooms, Examination Hall, Outpatient Room or Wards or Intensive Care Units. The objective of this study is to access the knowledge and Awareness of NVC Component among Doctors of Non-Clinical and Para Clinical Departments of GVMCH - Vellore, Tamil Nadu, India.Methods: This Cross-Sectional Study was conducted among 45 Doctors across 7 Departments of Government Medical College Vellore. Mean, Median, Mode and Standard Deviation were used for quantitative Data and Pearson Chi Square Test and Logistic regression was used for qualitative Data using Trial Version of SPSS 22.Results: The mean Score was 7.2±2.8 with Mean scoring percentile of 28.8 ±11.5. There was Pearson’s Chi Square significance for Variables like External Resources related to NVC, Books related to NVC, UG and PG pursued at, Exposure to Workshops or CME s related to NVC, and age Group < 35. But on running Logistic Regression we got statistical significance for variables like External resources related to NVC, UG studied at same state, Age Group >35 years.Conclusions: Variables like External resources, UG studied at same state, Age Group >35 years Showed Statistical significance in knowledge on Non-Verbal communication in this Study set up.
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Introduction: The increasing prevalence of ureteric stone is a matter of concern in this era and it may be linked to improvedquality of life. Medical expulsive therapy, including alpha-blockers, steroids, and calcium channel blockers, has been extensivelystudied for improving the rate of stone passage in patients who do not require immediate urologic intervention.Aim: The aim of this study is to compare the efficacy of tamsulosin and tadalafil in expulsive treatment for distal ureteralstones.Materials and Methods: This was a prospective comparative study included 120 adult patients (>18 years of age) presentingwith distal ureteric stones were randomized into 60 patients with tamsulosin 0.4 mg once daily (Group A) or 60 patients withtadalafil 10 mg once daily (Group B) treatment. Therapy was given for a maximum of 4 weeks.Results: About 85% of study patients had a size between 5 mm and 7 mm and 18 patients had size between 8 mm and 10 mm.There was no statistical difference noted in the pain duration and analgesic usage of both groups. In Group A, 67% of patientshad expulsion of stones; in Group B, 63% of patients had expulsion of stones. About 90% of patients in 40 cases of expelledstones are in <5 days in Group A and 89% of patients 38 cases of expelled stones are in <5 days in Group B. There was nostatistical difference noted between both groups.Conclusion: Tamsulosin and tadalafil have shown similar expulsion rate. Both of them simultaneously provides better paincontrol and significantly lower the needs for analgesia.
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Aims: To estimate the impact, connection and association among the biometric attributes, pulping qualities and anatomical characters in Bambusa balcooa. Place and Duration of Study: The study was conducted across the agro climatic regions viz., North Eastern Zone, Northern Zone, Western Zone, Cauvery Delta Zone and Southern Zone of Tamil Nadu, India during 2017-2018. Methodology: The Principal Components Analysis (PCA) was examined to establish the numbers of clusters using Statistical Package for Social Studies (SPSS) version 16.0.1 software in order to identify the patterns of variation (PCA). The principal component analysis was computed using the equation PCA = Σa jXj. Results: The PCA separated into three cluster principal components among the nineteen parameters studied. Out of nineteen principal components generated, twelve principal components had contributed positively on pulp yield. Among these twelve traits, maximum contribution to the pulp yield was observed by the traits viz., numbers of culms, hollocellulose, kappa number, tear index, burst index, fibre wall thickness and vessel diameter with respect to Bambusa balcooa. Conclusion: The results showed some relationships between the biometric attributes, pulping qualities and anatomical characters in Bambusa balcooa. PCA was shown to be a useful tool for assessing the impact and connection for further research.
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Background: Stroke a global health problem is the second commonest cause of death and fourth leading cause of disability. Bed mobility the most important requisite for all activities in impaired in stroke. Retraining of bed mobility skills is very important to gain better outcome in the later phases of rehabilitation. Based on the concepts of motor learning there are numerous practice methods to retrain motor skills. Since sufficient literatures are not available in comparing the effect of massed practice and distributed practice on bed mobility skills among post stroke patients, there is a need for incorporating it in this study. Objectives: To compare the effect of massed practice and distributed on basic mobility skills among post stroke patients. Materials and Methods: Study was conducted as a quasi experimental design – pretest and posttest designs with two comparison treatments at the Department of Physical Medicine and Rehabilitation ,KMCH Hospitals, Coimbatore, Tamil Nadu, India. A total of 20 stroke patients in the age group of 45 to 60 years participated in the study. The participants who satisfied the selection criteria were selected by convenience sampling and randomly assigned into two groups. Group A received bed mobility training using massed practice method and group B received bed mobility training using distributed practice method for 7 days. Outcomes were measured with bed mobility item of Stroke Rehabilitation Assessment of Movement (STREAM) scale. Results: All participants in group A and group B showed significant improvement in bed mobility item of STREAM scale with a mean difference of 11.2 and 15.9 respectively. The calculated ‘t’ value using the paired test for group A and B were 27.03 and 51.36 (P<0.005) respectively. When comparing between the groups using independent ‘t’ test, the bed mobility item of STREAM scores showed mean difference of 4.9 and ‘t’ value of 9.7 (P<0.005). Conclusion: This study revealed that there was significant improvement in bed mobility skills following distributed practice method than massed practice method among post stroke patients.
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Infections still remain a major cause of therapy-associated morbidity and mortality in pediatric cases with acute myeloid leukemia (AML). Down syndrome (DS) children have an approximately 10-20 fold higher incidence of acute leukemia and approximately 150 fold increased risk of developing myeloid leukemia of DS (ML-DS).' Multi-drug resistant (MDR-GNB) Gram-negative bacterial septicaemia is an emerging global challenge. Authors are reporting a 4 and half year old boy with diagnosis Acute Megakaryocytic Leukemia (AMKL) who developed septicaemia and diaper rash. MDR E. coli was isolated and he was treated with fosfomycin followed by colistin. The boy developed cardiac arrest with chest compression and expired.
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INTRODUCTION: Approximately 40% of patients receiving first-line chemotherapy (CT1) for advanced pancreatic adenocarcinomas (PDACs) receive second-line chemotherapy (CT2). The most appropriate regimen to be used has not been identified, and data regarding CT2 in advanced PDAC from India are scarce. MATERIALS AND METHODS: A retrospective analysis of advanced PDAC patients who were evaluated during the period of August 2013 to August 2016 in the Department of GI medical Oncology, at Tata Memorial Hospital was conducted. Patients with histologically proven PDAC and started on CT2 postprogression or recurrence after CT1 were included for analysis. RESULTS: A total of 237 patients received CT1 in the period of study, of which 76 patients (39.66%) received CT2. The median age of patients was 59.5 years (range: 38–82), majority were male (69.7%), and 14 patients (18.4%) had undergone curative pancreatic resection at baseline. The common regimens used as CT2 were modified 5 fluorouracil/leucovorin/irinotecan (mFOLFIRI) (35.5%), gemcitabine-nab paclitaxel (18.4%), and gemcitabine-erlotinib (11.8%). Common grade 3/4 toxicities noted were fatigue (10.3%), anemia (10.3%), neutropenia (7.4%), and vomiting (7.4%). Dose reductions were required in 32.9% of patients. RR, DCR, median event free survival, and median overall survival were 21.1%, 48.7%, and 5.94 months (95% confidence intervals [CI]: 4.68–7.20) and 8.08 months (95% CI: 7.11–9.07) respectively. CONCLUSIONS: CT2 in advanced PDAC appears feasible in the Indian setting if the patients are appropriately selected and they can be treated with acceptable toxicities and reasonable outcomes.
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Twenty-nine years old male, a case of Crohn's disease diagnosed by histopathology 5 years back, when he developed a perforative peritonitis. Resection and anastomosis was done, and he was started on Mesalamine therapy. Patient stopped the drug 8 months back and presented with cough for 1-month duration. HRCT chest showed IVC thrombosis. CECT abdomen showed intrahepatic extension of thrombus with active colitis and absent left testicle in scrotum with no intra-abdominal testicle. Coagulation parameters were normal. Colonoscopy and biopsy was done showing features of active Crohn's disease. Patient was restarted on Mesalamine and anticoagulation. Follow up imaging showed features of resolution of thrombus.
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Background: Stroke is a major health problem in India. Stroke burden has been rising in India as compared to the developed countries. Recent studies have shown that high serum cholesterol is associated with clinically less severe ischaemic strokes and better outcome. Aim: The primary objective of the study was to compare the outcome of patients with ischaemic stroke to their cholesterol levels and to correlate the cholesterol levels to the stroke outcome. Materials and methods: This hospital based prospective follow-up study was conducted in 140 patients admitted with ischaemic stroke in the medical wards of Medical College hospital, Trivandrum. Patients were divided into 2 groups based on cholesterol levels as <160 mg/dl and >160 mg/dl. Their clinical severity at presentation was calculated by Scandinavian stroke scale (0=worst, 58=best) and outcome of these patients at the end of 1 year was measured by Modified Rankin scale (0=best, 6=worst).Serum cholesterol was measured using enzymatic method. Results: Mean age of 140 patients of at presentation was 63.4±11.9 years of which 53.5% (n=75) males, the mean Scandinavian stroke scale (SSS) being 28.3±12.5. The mean SSS score of high cholesterol group was 39.6 whereas 17 in the low cholesterol group (p<0.001). Similarly, the size of infarct in CT brain, outcome variables of modified Rankin scale and mortality were statistically significant between these groups (p<0.001). Bivariate correlation analysis showed that increased serum cholesterol level is associated with increased SSS score (positive correlation) with high statistical significance (p<0.001). Logistic regression adjustedwith other risk factors showed high cholesterol levels are associated with better outcome and decreased mortality, which is supported by Kaplan-Meier survival analysis. Sreenath S, Santhosh Kumar T.S., Parthiban, Jasen Joseph, Ratheesh Kumar V.R. Study of cholesterol levels in patients with ischaemic stroke and their outcome. IAIM, 2017; 4(10): 194-202. Page 195 Conclusion: Hypercholesterolemia is associated with clinically minor strokes and better outcome, whereas major strokes are commonly seen in patients in the low cholesterol group. Hence post stroke outcome is inversely related to serum cholesterol levels in ischaemic stroke patients.
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Abstract Medicinal plants are treating and preventing various diseases. There is urgency in recording such data. This is first ethno botanical study in which statistical calculations about plants are done by Informant Consensus Factor method in the study area. The aim of the present study is to identify plants collected for medicinal purposes by the traditional healers of Kudavasal taluk located in Thiruvarur district of Tamil Nadu, India and to document prepare and use the traditional names of these plants. Field study was carried out for a period of one year in (tk), located in Thiruvarur district of Tamil Nadu. The ethnoveterinary information's were collected through interviews among traditional healers. The collected data were analyzed through RFC, UV, CI, FI, RI and ICF. A total of 54 species of plants distributed in 51 genera belonging to 33 families were identified as commonly used ethno medicinal plants by traditional healers in Kudavasal (tk) for the treatment of 12 ailment categories based on the animal body systems treated. Leaves are the most frequently used plant parts and most of the medicines are prepared in the form of paste, administrated orally and inhalation. The most important species according to their use value are Oryza sativa (0.977). In these studies some of the plant species are first position in relative importance Datura metel (2.00) followed by Azadirachta indica (1.80). ICF values of the present study indicate that a urological ailment is the highest use report. In this study, documenting the medicinal plants and associated indigenous knowledge can be used for conservation and sustainable use of medicinal plants in the area and for validation of these plant preparations for veterinary treatment. The study has various socioeconomic dimensions associated with the local communities.
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Leptospirosis is a bacterial disease caused by bacteria of the genus Leptospira affecting humans and animals. Untreated leptospirosis may result in severe kidney damage, meningitis, liver failure, respiratory distress, and even death. Virulent leptospirosis can rapidly enter kidney fibroblasts and induce a programmed cell death. Thus, it is a challenge for immunologists to develop an effective and safe leptospirosis vaccine.Here, we compared the commercial canine leptospira vaccine and recombinant proteins (OmpL1 and LipL41) with and without adjuvant in terms of immune response and challenge studies in hamsters and immune response studies alone in experimental dogs. The outer membrane proteins viz., lipL41 and OmpL1 of leptospira interrogans serovars icterohaemorrhagiae were amplified. The primers were designed in such a way that amplified products of OmpL1 and lipL41 were ligated and cloned simultaneously into a single vector. The cloned products were expressed in E.coli BL21 cells. The immunoprotection studies were conducted for both recombinant proteins and commercial vaccine. The challenge experiment studies revealed that combination of both rLip41 and rOmpL1 and commercial vaccine gave 83% and 87% protection, respectively. Histopathological investigation revealed mild sub lethal changes were noticed in liver and kidney in commercially vaccinated group alone. The immune responses against recombinant leptospiral proteins were also demonstrated in dogs.
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Dengue vaccine development has been one of the strategies to reduce dengue incidence in the world alongside with other horizontal interventions such as vector control and the transgenic mosquito programmes. The objective of this paper is to evaluate the safety, reactogenicity and immunogenicity of dengue vaccine clinical trials for the last ten years systematically through a descriptive review. This paper discusses safety issues like adverse events, systemic adverse reactions, injection site reactions, viraemia, morbidity and mortality as well as immunogenicity which measures effectiveness through mean geometric titre and seropositive rates. Adverse events were seen to range from 0% to 28.3%. Immunogenicity was noted to increase post 1st and 2nd dose and decrease post 3rd dose. The seropositivity at baseline ranged between 53.1% and 97.8% at post 3rd dose, and it was 88.5% for at least four serotypes. The dengue vaccine studies that were reviewed were shown to be relatively safe with low reactogenicity, however the immunogenicity was unequal and waning. The immunogenicity waned post 3rd dose showing a decrease in all serotypes of varying degrees although the seropositivity, on average, at post 3rd dose was 97.8%. It can be concluded that dengue vaccine development would require further studies on its unequal and waning immunogenicity, which could result in a more severe form of dengue following wild infection, during re-immunisation, especially if there is variation in the circulating virus.
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Dengue Vaccines , DengueABSTRACT
Haemophilia is the most common inherited coagulation disorders, with X linked recessive inheritance, affecting the males while females are the carriers of the disease. Haemophilia A and Haemophilia B are the commonest form of Haemophilia encountered and they result from defect in Factor VIII and Factor IX gene respectively. A clinico hematological study with suspected coagulation disorder was conducted over a period of two years, from June 2008 to July 2010. Of the 76 patients visited OPD, based on clinical presentation and family history, 50 cases were categorized as Hemophilia A or B after laboratory investigations. Majority (41) of the cases were categorized as Hemophilia A & only 7 cases were Hemophilia B. The mean age group of the patients was 2.87 years with an age of onset ranged between 3rd day to 5.6 years. All the cases were males and only a very rare case of female Hemophilia patient was noted. Thirty five (52.23%) patients had positive family history of bleeding. In 12 families (18.75%) there had been consanguineous marriage. Spontaneous bleeding was the predominant presenting symptom followed by Hemarthrosis and prolonged post traumatic bleeding. The knee joint was most commonly involved. Coagulation screening tests showed that 60% patients had prolonged activated partial thromboplastin time (APTT) with an average of 88 seconds. Mixing and substitution studies were very useful in distinguishing between Hemophilia A & B. Factor assays in both Hemophilia A & B showed 66% of cases with severe factor deficiency, 26% moderate and 8% with mild deficiency. In the present study an effort is made to explore, elucidate and document the clinico haematological correlation of Hemophilia in this part of Karnataka.