Doppler Indices of the Fetal Middle Cerebral and the Umbilical Arteries in Pregnancies at High Risk Followed Up for Suspected Fetal Growth Restriction

Background: Fetal growth restriction is related to compromised perinatal outcomes. The screening and prevention tools for fetal growth restriction like Doppler indices in high-risk groups compared with general antenatal populations. An evaluation of the correlation between Doppler indices and placental weight and birth weight of the neonate at term pregnancy in high-risk pregnancies is essential. For the early detection of fetal growth limitations in high-risk pregnancies, sensitive screening techniques are few. Objectives: To determine the most accurate indicator for predicting a poor perinatal outcome or intrauterine growth restriction by comparing and correlating the modifications in Doppler ultrasound studies of fetal circulation in general pregnant women with those of high-risk patients both with and without intrauterine growth retardation. Study design: A cross-sectional research including 81 healthy pregnancies and 19 high-risk patients at 31–40 weeks of gestation was conducted. The pulsatility index (PI) of the middle cerebral artery (MCA), the umbilical artery (UA), and the MCA PI to UA PI ratio were all analyzed. We compared the Doppler indices’ mean values. Then these values were correlated with placental weight and birth weight of the offspring. Results: A significantly low birth weight and less fetoplacental ratio and placental coefficient ratio were found in high-risk cases than in normal pregnant women (P <0.05). A strong positive relationship was observed between the middle cerebral artery pulsatility index and placental weight, while negative relationship between the pulsatility index of the middle cerebral artery and the Feto-placental ratio (P < 0.05). In addition, a positive association was found between the pulsatility index of the middle cerebral artery and placental coefficient, whereas a negative correlation was observed between the Cerebro-placental ratio and Feto-placental ratio in high-risk cases (P <0.05). Conclusion: Low birth weight can be predicted using Doppler indices since there is a definite correlation between it and unfavorable perinatal outcomes.

Correlation of glycated hemoglobin and diastolic dysfunction in type 2 diabetes mellitus patients in a tertiary care centre

Background: There is a substantial increase in the coincidence of diabetes mellitus and cardiomyopathy. The cardiomyopathy may occur in patients who have no evidence of large vessel disease or abnormalities. The early and commonest hemodynamic derangement of diabetic cardiomyopathy is left ventricular diastolic dysfunction. So, the present study was undertaken to assess the prevalence of diastolic dysfunction in patients with type 2 diabetes and to assess the correlation of diastolic dysfunction and HbA1c% levels. Materials and methods: A total of 100 diabetic patients with minimum 5 years duration of diabetes were selected from Malla Reddy Hospital, Suraram from August 2020 to June 2022. Patients with minimum history of 5 years of type 2 diabetes were scrutinized for Doppler echo cardiography and HbA1c levels. Results: Diastolic dysfunction of left ventricle was observed in 58 patients out of 100, of which 54 (93.1%) patients had HbA1c% of > 6.4. 2 (3.4%) patients belong to HbA1c% group of 5.7-6.4. and 2(3.4%) patients belong to HbA1c% of < 5. Conclusion: Our findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function. Diabetic cardiomyopathy is characterized by an early diastolic dysfunction and a later systolic dysfunction. Impaired diastolic function was not affected by sex or type of diabetes. Even young patients with diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a marker of a diabetic cardiomyopathy. Diastolic seems not to correlate with disease duration. HbA1c% can be a very good indicator of long term prognosis. Strong corelation exists between diastolic dysfunction and HbA1c.

Impact of an Alcohol-based hand sanitizer usage during COVID-19 pandemic on disulfiram treatment: A South Indian psychiatrist's practice experiences

Background: Alcohol-based hand sanitizer (ABHS) usage has become one of the COVID-19 pandemic-related adapted responses. Some disulfiram-ethanol reactions are reported in people who use alcohol-based hand rub/sanitizer and take Disulfiram as a treatment for their alcohol use disorders. Aim & Objective: To determine the practice experiences of psychiatrists on disulfiram prescription to alcohol use disorder victims. Methodology: A cross-sectional study on the psychiatrists to find the experiences of disulfiram prescription to their clients with alcohol use disorders during the COVID-19 pandemic. Results: Nearly 84 (51%) were reverted with a completed questionnaire. Among the respondents, 28 (33.3%) of the respondents decreased to prescribe Disulfiram, 48 (57.1%) reported that their patients stopped using ABHS due to fear of Disulfiram-Ethanol Reaction (DER), and 20 (23.8%) responders notified that their patients were expressed their worry on DER with Disulfiram and ABHS. Conclusion: Disulfiram prescribed for alcohol use disorders; treatment got peculiar experiences with the incidences of DER reported with Alcohol-based hand sanitizer. Many practitioners were scared to prescribe disulfiram due to DER with ABHS. The prevailing evidence that there is no possibility of cutaneous application of ABHS producing enough significant DER. Hence using ABHS is not a contraindication for disulfiram prescription.

A case of superior vena cava syndrome

Superior Vena Cava Syndrome is the clinical manifestation of the Superior Vena Cava obstruction, with severe reduction in venous return from the head, neck and upper extremities. More than 80% cases of SVCS is nearly attributable to advanced malignancy, most commonly lung cancer. SVC syndrome is characterized by congestion and swelling of the face and upper thorax, with distended superficial chest veins. The most severe complications of SVC syndrome include Glottic edema and venous thrombosis in the central nervous system. We represent a case SVC syndrome due to Small Cell Cancer of the lung.

Clinical perspectives on the management of common psychiatric disorders in India

Psychiatric disorders are common health problems in patients of all age groups, under-diagnosis and under-treatment of these disorders can result in disability and serious complications. With an objective of creating a comprehensive evidence-based consensus on common mental health disorders and their management in the Indian setting, 10 expert groups meetings involving 98 psychiatrists across India were conducted in the month of May 2020. Clinical insights related to burden, signs and symptoms, diagnosis and management were summarized based on the discussions during these meetings. Experts agreed that depressive disorders and anxiety disorders represent two important psychiatric disorders in India. Selective serotonin reuptake inhibitors (SSRIs) are commonlyused for the treatment of depression. Benzodiazepines are effective for the treatment of comorbid anxiety in patients with depression, but their long-term use causes adverse events such as dependence and withdrawal reaction. Obsessive compulsive disorder (OCD), bipolar disorder, substance use especially alcohol withdrawal syndrome, and sleep disorders are other common psychiatric disorders found among Indian patients. Lithium and valproate represent the commonly used and effective pharmacological treatments for bipolar disorder. SSRIs are preferred drugs in the treatment of OCD,whereas benzodiazepines such as chlordiazepoxide and diazepam represent important pharmacological treatment optionsfor alcohol withdrawal. Early identification and timely and effective treatment of psychiatric disorders is important for prevention of complications. Treatment should be individualized based on efficacy, tolerability profile of the medicine, risk of drug interactions, and cost. This consensus may be useful to psychiatrists and general practitioners treating common psychiatric conditions in Indian patients.

A case of subclavian steal syndrome

Subclavian steal syndrome is a relatively rare condition that results from occlusion of the subclavian artery proximal to the origin of the vertebral artery. This causes a reversal in the direction of the blood flow in the vertebral artery, leading to symptoms of vertebrobasilar insufficiency. In this article, we report a case of subclavian steal syndrome in a 55 year old male, who presented with giddiness, and variation in blood pressures in both upper limbs, was investigated with doppler and MR angiography. This article emphasises physical examination with discrepancy in pulse and blood pressure should bring attention to diagnosis of this syndrome.

A review on risk assessment of formulation development and technology transfer of COVID-19 vaccines / Una revisión sobre la evaluación de riesgos del desarrollo de formulaciones y la transferencia de tecnología de las vacunas COVID-19

Background: COVID-19 pandemic situation made the pharmaceutical companies develop the vaccine with different formulations in a short period. Objectives: The main objective of the review is to focus on different types of vaccine formulations available globally and the importance of technology transfer in vaccine development associated with potential risks. Results: Research on vaccine development led to various types of vaccines, such as Inactivated vaccines, Live Attenuated vaccines, Ribonucleic acid (RNA) and Deoxyribonucleic acid (DNA) vaccines, viral vector vaccines, and Protein Subunit Vaccines for COVID-19. But the process of vaccine development and technology transfer is lined with various risks and challenges. Through risk assessment, we found some major potential risks involved in product development; this leads to a smoother and more efficient method to develop safe vaccines available for public health. Conclusions: This review will explain the significance of technology collaboration for the faster development of various formulations of vaccines globally

Antecedentes: La situación de pandemia de COVID-19 hizo que las empresas farmacéuticas desarrollaran la vacuna con diferentes formulaciones en un corto período. Objetivos: El objetivo principal de la revisión es centrarse en los diferentes tipos de formulaciones de vacunas disponibles a nivel mundial y la importancia de la transferencia de tecnología en el desarrollo de vacunas asociado con los riesgos potenciales. Resultados: La investigación sobre el desarrollo de vacunas condujo al desarrollo de varios tipos de vacunas, como vacunas inactivadas, vacunas vivas atenuadas, vacunas de ácido ribonucleico (ARN) y ácido desoxirribonucleico (ADN), vacunas de vectores virales y vacunas de subunidades de proteínas para COVID-19. Pero el proceso de desarrollo de vacunas y transferencia de tecnología está lleno de varios riesgos y desafíos. A través de la evaluación de riesgos, encontramos algunos riesgos potenciales importantes involucrados en el desarrollo de productos, lo que conduce a un método más fluido y eficiente para desarrollar vacunas seguras disponibles para la salud pública. Conclusiones: Esta revisión dará una idea de la importancia de la colaboración tecnológica para el desarrollo más rápido de varias formulaciones de vacunas a nivel mundial

Comparison of split skin thickness graft survival in diabetic and non-diabetic ulcer

Background: Split skin grafting is widely used surgical procedure for the treatment of ulcers. Graft survival depends on number of factors like vascularity, wound infection etc, diabetes is associated with endothelial dysfunction, neuropathy, wound infection which collectively affect the graft survival. Objective of this study was to compare the amount of graft uptake, the post-operative complications and survival of split thickness skin graft in diabetic and non-diabetic ulcer.Methods: In our prospective comparative study total 112 patients with ulcer were included of which 56 were diabetic and 56 were non-diabetic. All of them underwent split skin grafting as part of their wound management. Comparison was made between two groups in terms of amount of graft uptake, post-operative wound infection, revisional surgery, donor site infection.Results: Compared with non-diabetics, diabetics have significantly less graft uptake (p<0.001). out of 56 patients in diabetic group 4 (66.7%) underwent revisional surgery, out of 56 patients in non-diabetic group 2 (33.3) patients underwent revisional surgery (p value is <0.68) which is statistically insignificant. 3 (60%) out of 56 in diabetic group developed post-operative graft infection, 2 (40%) out of 56 in non-diabetic group developed graft infection (p=1, not significant). One patient in the study developed donor site infection. Among 112 cases, only 1 case had donor site infection with diabetic.Conclusions: Diabetes is associated with poor graft uptake and post-operative complication rates in patients undergoing split skin grafting.

A Study of Thyroid Dysfunction in Type 2 Diabetes Mellitus in Tertiary Care Center

Introduction: Type 2 diabetes mellitus and thyroid disordersare the most common endocrine disorders and growingproblem in our country. We have observed that many diabetesmellitus patients are associated with thyroid dysfunction.However, the prevalence of thyroid dysfunction in thesepatients has not been investigated. We conducted this study tostudy the proportion of Thyroid dysfunction in patients withtype 2 Diabetes.Materials and methods: The current study was a prospective,cross-sectional study. All the type-2 Diabetic patients andnormal subjects with no diabetes attended to the outpatientclinic and admitted in the General Medicine departmentat Kasturba hospital, Manipal was considered as the studypopulation. After obtaining informed written consent, astructured questionnaire was used to analyse the patient’s chiefcomplaints, General and local examination was performedby measuring BMI, waist circumference. Lab investigationswere recorded. Analysis based on patient’s lab values for FBS,PPBS, HbA1C AND TSH, LIPID PROFILE.Results: The mean age of subjects in cases was 55.98 ±11.19 years and it was 54.54 ± 10.08 years in controls. Thedifference in the proportion of gender between study groupswas statistically not significant, the difference in weight andBMI between the two groups was statistically significant.There was no statistically significant difference in cholesterol,triglyceride, LDL between two groups. The difference in theproportion of thyroid dysfunction between the two groups wasstatistically significant.Conclusion: The present study showed a high prevalence ofthyroid dysfunctions in patients of type 2 DM.

Prevalence of fecal incontinence among women in a rural community in Southern India

Background: The prevalence of fecal incontinence (FI) in the community is usually grossly underreported. There are very few studies done in the Asian population to assess FI. Objective: Our study aimed to assess the prevalence and the factors associated with FI in adult females aged 30–60 years in a rural community in south India. Materials and Methods: We conducted a community-based cross-sectional study among 200 people in three villages (Allivaram, Thoppanthangal, and Veppampet) in Kaniyambadi block, Vellore district, Tamil Nadu. Participants were recruited into the study after informed consent. Information about demographic details, comorbidities, and risk factors for FI was collected using a structured pilot-tested questionnaire. Revised FI Scale (RFIS) was used for evaluation and grading of FI. Results: Our study reports the community prevalence of 1.5% (3/200) with 95% confidence interval (0.05, 2.95) for FI using the RFIS scale. The women who were identified to have FI were referred to the secondary hospital for further evaluation and management. All the women who reported FI had a history suggestive of local anal conditions/surgery. Only “passing blood in stool” was statistically significant with FI in logistic regression. Multiple vaginal deliveries or associated obstetrical injuries did not show any association with FI. Conclusions: Large-scale multicenter studies are required to assess the prevalence and social burden caused by this disabling condition.

Efficacy of pregabalin premedication prior to surgery in attenuating the adverse hemodynamic response to laryngoscopy and tracheal intubation

Background: In general pregabalin is used in patients with normal blood pressure undergoing operation for controlling the response of the pressor in nature. There are few studies which have been carried out to study efficacy of pregabalin in controlling responses to instrumentation of the airway in patients with controlled hypertension. Objective was to study efficacy of pregabalin premedication 90min prior to surgery in attenuating the adverse hemodynamic response to laryngoscopy and tracheal intubation.Methods: Hospital based randomized comparative trial was conducted. 100 patients of ASA I and II physical status aged 18-60 yrs scheduled to undergo elective surgery like orthopaedic, spine, otorhinolaryngeal, gynaecological and general surgical procedures. Patients were randomly divided into 2 groups of 50 each. Randomization was done by computer generated table. Group "P" received- 150mg pregabalin. Group "C" received-200µg clonidine.Results: The patients in clonidine group documented the heart rate as more compared to the patients in the pregabalin group at various time intervals. The patients in clonidine group documented the mean systolic blood pressure as more compared to the patients in the pregabalin group at various time intervals. The patients in clonidine group documented the mean diastolic blood pressure as more compared to the patients in the pregabalin group at various time intervals.Conclusions: We concluded that use of pregabalin is more effective in comparison to use of clonidine in terms of controlling the hemodynamic parameters. But it has been found that bradycardia may not be properly attenuated with the use of pregabalin.

The Evaluation Of Pulp Score (PEPTIC Ulcer Perforation Score) As A Predictor Of Mortality Following Peptic Ulcer Perforation.

Introduction: Mortality and morbidity following perforated peptic ulcer (PPU) remains high, and mortality proportions of 25–30% have been reported in population–based studies.The aim of this study was to evaluate the efficacy of PULP SCORE in predicting 30 day mortality. Patients and methods: A series of 52 patients were enrolled in the study.Patients who underwent surgical treatment for perforated peptic ulcer were allotted points according to the PULP scoring system and stratified into high and low risk groups. All the data was prospectively analyzed. Observations and results:46 patients were in low risk and 6 patients were in high risk category. 5 patients were deceased in high risk group but none in low risk group. The PULP SCORE had a sensitivity of 83.33% and specificity of 97.83% in predicting mortality. In the ROC curve the AUC was 91.8%. 4 variables out of 8 variables in the score were found to be most important in predicting mortality. They were : 1. Treatment delay >24 hrs, 2. Shock on admission, 3. High ASA score, 4. Age >65 years. Conclusion:The prognostic predictors included in the PULP score can be readily identified prior to surgery, easy to use and feasible in emergency. The PULP score can assist in accurate and early identification of high–risk patients, and thus assist in risk stratification and triage of patients.

Study Of Wormian Bones In Adult Dry Skulls Of Human Cadaver

Introduction: Wormian bones are islands of small bones found at the sutures and fontanelles of the skull.Commonly appears in the lambdoid suture. This study reporting the incidence, location and morphology ofWormian bones as it may give the false impression as fractures and lead to confusion to the radiologists,surgeons and traumatologists to deal during surgeries.Materials and Methods: The study comprises the 100 human adult skulls. Measuring tape, Sliding calipers,sutural thread and scale were used for measuring the length of the suture, incidence, types, morphology andtopography of sutural bones were observed and compared with the studies done by previous authors. The boneswere obtained from the Department of Anatomy, sri venkata sai medical college Mahbubnagar, Telangana, India.Results: Wormian bones were found in Lambdoid suture (28%), Lambda (12%), Parietomastoid suture (0%),Coronal Suture (0%), Asterion (8%), Sagittal suture (12%), Occipitomastoid suture (0%), Parietosquamous (0%)and Pterion (8%). Three different shapes of WBs was witnessed; Quadrangular (4%), Irregular (36%), Triangular(8%).Discussion: the knowledge of wormian bones is important to radiologists, orthopedicians and traumatologistsas it can imitate fractures and lead to confusion and eventually differential diagnosis.

The impact of intrapartum amniotic fluid index on perinatal outcome

Background: Fetal distress in labour is a common occurrence and is of great concern. Evaluation in early labor which could predict the risk of fetal distress could aid in the management of labour. Aim: The purpose of the study was to determine the value of routine intrapartum amniotic fluid assessment on perinatal outcome. Materials and methods: Study was done on 240 admitted patients in labou. They had an intrapartum AFI determined by four-quadrant technique subsequently these patients delivered during the same hospitalization. AFI determined was graded as Oligohydramnios was defined as AFI ≤ 5 cm (n = 48), Borderline as AFI 5.1- 8 cm (n = 50), Normal as AFI 8.1-24 cm (n = 142) and Women with AFI > 24 cm were not included in the study. The three groups were compared with regard to intrapartum and postpartum variables. Results: In present study, 20% of women were in oligohydramnios group, 21% in borderline group and 59% in normal group. Hence, the cesarean section rate for fetal distress was 54% in oligohydramnios and 28% in borderline group. The incidence of instrumental delivery for fetal distress was 12% in oligohydramnios and 14% in borderline. The incidence of APGAR score < 7 at 1 min and 5 min in oligohydramnios and borderline group were respectively 54%, 35%; and 30%, 14%. The incidence of birth weight <2500 gms in oligohydramnios group was 37% and borderline was 24%. NICU admissions in oligohydramnios group were 40% and 8% in borderline group. The percentage of neonatal deaths among oligohydramnios group was 4.2% and nil in borderline. The efficacy of intrapartum determination of oligohydramnios predicting cesarean delivery for fetal distress gave a sensitivity of 64%, specificity of 89%, positive predictive value of 53% and negative predictive value of 93%. Conclusion: Intrapartum detection of oligohydramnios is a valuable screening test for subsequent fetal distress requiring cesarean delivery

The promotion of oral health within Health Promoting Schools in KwaZulu-Natal

Background. Oral health promotion is a cost-effective strategy that can be implemented at schools for the prevention of oral diseases. The importance and value of school-based interventions in children has been identified in South Africa (SA). Although oral health strategies include integrated school-based interventions, there is a lack of published evidence on whether these strategies have been translated into practice and whether these programmes have been evaluated.Objective. To assess the efficiency and sustainability of the toothbrushing programme implemented at health-promoting schools in KwaZulu-Natal Province, SA.Methods. A mixed-methods approach was used for this study, conducted at 23 health-promoting schools in KwaZulu-Natal using focus group discussions. Triangulation was used for evaluation.Results. The intervention implemented had created awareness of oral health for learners, educators and parents. Findings in this study indicate that although there were benefits obtained from this school-based intervention, many challenges, such as time constraints, large classes and a lack of adequate resources and funding, affected the sustainability of the programme.Conclusion.The school setting has the potential to deliver integrated preventive and promotive programmes provided they are supportedby adequate funding and resources

Comparative study of glyceryl trinitrate ointment versus surgical management of chronic anal fissure

Background: Fissures are common, but are often confused with other anal conditions, such as haemorrhoids. Fissures are usually caused by trauma to the inner lining of the anus from a bowel movement or other stretching of the anal canal. Aim: This study evaluated the efficacy of 0.2% glyceryl trinitrate versus lateral internal sphincterectomy in treatment of chronic anal fissure. Materials and Methods: This was a study which included 80 patients between November 2014 to September 2017. In this study, based on computer generated randomization, the patients were divided into two groups. Group A consisted of 40 patients with chronic anal fissure who were treated with 0.2% glyceryl trinitrate ointment, which was applied twice daily for 5 weeks. Group B included 40 patients who were treated by lateral internal sphincterotomy. Results: The mean duration of symptoms was 15.35±10.87 weeks in group A, it was 15.02±11.7 weeks in group B. Mean pain score during defecation was 7.89±1.58 in group A, it was 7.52±2.41 in group B. Bleeding during defecation was observed in 82% of patients in group A, 75% of patients in group B. Constipation was present in 27 patients i.e. 67% in group A and it was present in 31 patients i.e. 77% in group B. In Group A, 36 (90%) patients had posterior midline fissure, 4 (10%) had anterior midline fissure, In group B, 40 (100%) had posterior midline fissure. In group A, 24 (60%) had anal tag, in group B, 22 (56%) had anal tag. The VAS score in both the groups decreased gradually but the decrease was more in group B compared to group A at the end of 7th week which was statistically significant (p<0.05). Hence, the number of patients who had pain relief after surgical treatment was statistically significant as compared to patients who were treated with 0.2% glyceryl trinitrate ointment Awais Ghori, Bhooma Reddy M, Rajendra Prasad. Comparative study of glyceryl trinitrate ointment versus surgical management of chronic anal fissure. IAIM, 2017; 4(12): 188-194. Page 189 application. At the end of the 1st week, none of the patients were healed completely. But at the end of the 4th , in group A, only 14 patients were completely healed, 38 patients were completely healed in group B. At the end of the 7th week, all patients in group B were healed i.e. 100% were healed and in group A, 32 patients were healed completely. Conclusion: Chemical treatment by applying glyceryl trinitrate is also advantageous in that it doesn’t cause any complications. Surgical treatment by lateral sphincterotomy is most effective when patients fail to respond to chemical treatment.

A study of changes in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients

Background: Recent evidence incidence that low level of lead exposure, previously thought to be safe, have adverse effects on neurobehavioural and cognitive development of the child. Aim: This study was a clinical study composed of children who were likely to be at higher risk for lead exposure. To correlate Blood lead levels with the clinical profile, developmental and behavioral profile and bio-chemical parameters of these children. Materials and methods: Patients attending Niloufer hospital, Hyderabad were evaluated for pica were considered to be at risk for inorganic lead poisoning and Children who working at petrol bunks were at risk of Organic Lead poisoning Results: Children of lower socio-economic state of classes of 3 and 4 and those living poor housing conditions are associated with high blood lead levels than children of higher and those in good housing conditions. Pica children had significantly higher blood levels, more behaviour problems and lower hemoglobin levels than controls. Pica particularly for multiple (mud, plaster, coal) and duration of habit for more than 6 months are associated with high blood lead levels. Children working in petrol bunks for more than 1 year showed a high Blood Pb levels and low hemoglobin levels than those working for less than 1 year and controls. Children of petrol bunk group, showed more behavioural problem and significant organic impairment and low intelligence than controls. Children of petrol bunk group, similar to pica group showed a high Blood Lead levels. Conclusion: Present study suggests that oral ingestion in an important route of inorganic poisoning in children with pica, where inhalation through respiratory passages and absorption through intact skin is an important route of organic lead poisoning in children working in petrol bunks or automobile garages-by virtue of their occupation.

Synthesis, spectral aspects and biological activities of 5-hydroxy-2-nitrobenzaldehydethiosemicarbazone and their Mn(II), Co(II) and Ni(II) complexes.

The ligation behavior of 5-hydroxy-2-nitrobenzaldehydethiosemicarbazone (L) and its Mn(II), Co(II) and Ni(II) complexes has been synthesized and characterized by Elemental analysis, Electronic, FT-IR, Raman, EPR spectral techniques and Cyclic voltammetric study. The ligand (L) belongs to triclinic system with P1 space group. The IR spectral data of ligand indicate the taking part of sulphur and azomethine nitrogen in coordination to the central metal ion. The electronic, FT-IR and EPR spectral studies reveals all the complexes are distorted octahedral geometry. The synthesized ligand and its metal(II) complexes were tested for their antioxidant activity by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) method and antibacterial activity against E.coli, Staphylococcus aureus, Bacillus subtilis, Salmonella typhi and Klebsiella pneumonia. The antibacterial and antioxidant activities of the ligand and its metal complexes had shown moderate to good activity, among all the compounds Ni(II) complex had shown more activity.

Poorly Differentiated Synovial Sarcoma over Tendo Achilles: A Rare Case.

Synovial sarcomas of Tendo Achilles are rare tumors. The name “synovial sarcoma” is a misnomer, as it does not arise from synovial membrane. These tumors occur usually in the upper and lower limbs, more often in lower limbs in the distal parts. Distal extremities are more commonly associated with this tumor. It is seen to affect mostly tendon sheath, bursa, and joint capsule; knee being the commonly affected large joint. The common age group is 15-40 years. In our case, the initial pathology report came as hemanioma to us, but the immunohistochemistry report revealed it to be poorly differentiated synovial sarcoma.

Clinco-hematological Profile of Patients with Falciparum Malaria.

Background: Malaria is one of the major public health problems of the country. Worldwide prevalence of malaria is about 300- 500 million per annum. It is present in more than 100 countries around the world. Most of these are developing countries or under developed countries. So it has a great impact on their economy. The aim is to study the clinicohematological profile of patients with falciparum malaria. Methods: The present study was conducted at MNR Medical College and Hospital, Sanga Reddy, Andhra Pradesh. The study was carried out in 100 patients out of 121 cases of Falciparum malaria, admitted during the period of 2010 November to 2012 October in this hospital. Results: The numbers of males (72%) affected in our study were more compared to females (28%). The male to female ratio was 2.5:1. In this study the predominantly affected age group was between 20-40 years. The most common presenting symptom was fever i.e. in 100% of cases. Pallor was noted in 81 % of the total cases. It was found that 37% of patients had normocytic normochromic picture on peripheral smear. Conclusion: Incidence of falciparum malaria was more compared to other plasmodium. Fever was the chief presenting complaint in almost all the cases. Thrombocytopenia is very common in malaria, but spontaneous bleeding is rare.