Socio-economic Correlates of Body Mass Index, Blood Pressure and Contraceptive Use by Reproductive age-group Females

Background: Oral Contraceptive use, BP and BMI are strongly associated variables in terms of socio economic conditions. Oral Contraceptives are an important and widely accepted contraceptive modality used throughout the world. Aim & Objective: This study aims to examine the effects of socio-economic factors on Body Mass Index (BMI), Blood pressure (BP) and contraceptive use by reproductive age-group females of Uttarakhand. Settings and Design: This study utilizes nationwide data from the Fourth National Family Health Survey (NFHS-IV). Methods and Material: Information was collected from Indian Institute of Population Sciences (IIPS) Mumbai and 17,300 women of Uttarakhand were considered for this study. Statistical analysis used: For inter age-group comparisons of blood pressure, BMI and socio-demographic indicators, analysis of variance (ANOVA) technique has been used. Results: The variation in mean age at menarche was found to be significant (p< 0.01, ANOVA). The numbers of live births over the women's total lifetime were lower in the younger age groups (p<0.01, ANOVA). Conclusions: The important findings of present study were that the use of contraceptive tended to have increased BMI and elevated blood pressure, even though the magnitude of these was little (equal to 4% and 40% respectively).

The functional outcomes of scaphoid nonunion with deformity treated with anterior wedge bone grafting: A case series

INTRODUCTION@#Scaphoid nonunion is one of the most difficult fractures to treat. Restoration of carpal alignment and fracture stability can provide good outcomes in the management of scaphoid nonunion.@*OBJECTIVE@#The purpose of this study was to determine the functional outcomes of scaphoid nonunion associated with humpback deformity treated with anterior wedge bone grafting and internal fixation.@*METHODS@#A retrospective review of all patients with scaphoid nonunion treated with anterior wedge bone grafting from January 1, 2014 to December 31, 2019 was done. Outcome measurements were time to union, pre- and postoperative FIL-DASH scores, grip, pinch, and scapholunate angle improvement. The other outcome measures were pain and complications.@*RESULTS@#A total of 12 patients were included in the study. All were males with an average age of 27.4 years (SD, 9.6). The average delay to surgery was 9.5 months (SD, 10). All fractures were at the waist, except for three proximal pole fractures, none had established avascular necrosis. Eleven out of 12 scaphoids healed at an average of 11.5 weeks (SD, 3.2). There was a significant improvement in the FIL-DASH score and scapholunate angle after surgical reconstruction. Grip strength averaged 83% of the contralateral side. All returned to previous normal activities. One patient with persistent proximal pole nonunion was managed with a 4-corner arthrodesis.@*CONCLUSION@#Anterior wedge bone grafting for scaphoid nonunion restored the scapholunate angle and was able to establish union in 11 of 12 scaphoid nonunions with good outcomes.

articleIndicators of maternal ‘near miss’ morbidity at different levels of health care in North India: A pilot study.

Introduction: Maternal morbidity and mortality in India continues to remain high despite concerted efforts during the past decades. Objective of this study was to determine the prevalence and indicator of Potentially Life Threatening Conditions (PLTC) and ‘near miss’ obstetric cases at different tiers of health care. Material and Methods: A cross-sectional epidemiological study was carried out over a period of 12 months as per the WHO criteria for ‘near miss’. Probability sampling was done to systematically and randomly select health facilities i.e. two primary health centers (PHC), one community health centre (CHC) and a tertiary hospital all from Doiwala block of Dehradun, Uttarakhand, India. The study included all the women attending health-care facilities, who were pregnant, in labour, or who had delivered or aborted up to 42 days ago arriving at the facility. A convenient sampling was done (a hundred percent enumeration of eligible study subjects) for the audit. Result: A total of 937 pregnant women who accessed health care had 688 live births and 231 women had one or more of the Potentially Life Threatening Conditions (PLTC). Among them, 61 women had Severe Maternal Outcome (SMO) - 51 with maternal ‘near-miss’ and 10 maternal deaths. The Severe Maternal Outcome Ratio (per 1000 live births) was 88.66. The Maternal ‘near miss’ Mortality Ratio (MNM-MR) and Mortality Index (MI) were 5.1 and 16.39% respectively. Conclusion: The WHO ‘near miss’ approach has been found to be an effective measure to assess quality of care in maternal health across countries including India.

Possibilities of Developing New Formulations for Better Skin Protection from a Traditional Medicinal Plant Having Potent Practical Usage.

Aims: Natural products obtained from different types of plants have made an important impact since ancient times throughout Asia. Since wood of Hesperethusa crenulata (Roxb.) Roem has been used traditionally by women in Southeast Asia for protection against sunlight and other harmful environmental factors, present study was aimed to determine antioxidant and antimicrobial properties of water extract of H. crenulata wood. Methodology: Wood was powdered, soaked in water, macerated, extracted fluid was lyophilized and tested for antioxidant and antimicrobial properties following standard techniques. The IC50 values were calculated from regression equations prepared from concentrations of extract and inhibition percent of free radical formation. The extract was screened for antimicrobial action following international guidelines against 44 organisms. Results: In DPPH assay system IC50 value was 344.74 μg/ml, the same for superoxide scavenging assay was 326.13μg/ml, while in hydroxyl radical scavenging system it was 999.85 μg/ml. Among 32 strains of staphylococci 10 strains were inhibited at 25 -50 μg /ml level of the extract, 6 strains at 100 μg /ml, 4 at 200 μg /ml and the remaining 12 strains were resistant. Strains of Bacillus spp and Vibrio vulnificus were rather sensitive to the extract, while E. coli and Pseudomonas aeruginosa were resistant. Thus the extract was inhibitory for bacteria known to invade human skin. Conclusions: The distinctly beneficial properties of the wood of H. crenulata indicate its usefulness as a highly active agent for the protection of skin against invasion by microorganisms and free radicals including those that may come from the sunlight.

Diagnóstico de hepatozoon spp. en perros (Canis familiaris) y sus vectores en áreas rurales de los Estados Lara y Yaracuy-Venezuela / Diagnosis of hepatozoon spp. in dogs (Canis familiaris) and its vectors from rural areas of Lara and Yaracuy States, Venezuela

El objetivo de este trabajo fue diagnosticar Hepatozoon spp. en perros de áreas rurales en algunos municipios de los estados Lara y Yaracuy, así como su relación con los potenciales artrópodos vectores involucrados en su transmisión. Babesia canis vogeli, Ehrlichia canis y en menor frecuencia Hepatozoon canis son los agentes parasitarios más importantes en caninos teniendo todos ellos como vector a Rhipicephalus sanguineus. Estos hemotrópicos infectan frecuentemente a los animales sin causarles sintomatología clínica y en otros casos les causan enfermedad de gravedad variable. La asociación de estos agentes es muy común, lo que favorece la gravedad de los síntomas clínicos. Además de R. sanguineus, otros géneros de garrapatas pueden ser encontradas parasitando perros, como Amblyomma e Ixodes. Durante el estudio se realizaron frotis sanguíneos de sangre periférica de la oreja de 300 perros y se colectaron 604 garrapatas por medio de extracción manual. Estos ixódidos fueron identificados taxonómicamente en el Laboratorio de Parasitología con la ayuda de claves dicotómicas y luego fueron sometidas a disección en busca de fases evolutivas de Hepatozoon spp. Los resultados fueron analizados a través de estadísticas no paramétricas indicando la presencia o ausencia de Hepatozoon spp. y la identificación de los vectores involucrados. Se observó Hepatozoon spp. en las muestras de sangre periférica de 11 de los perros estudiados, correspondiendo a tres perros del estado Lara y ocho al estado Yaracuy. En relación a los vectores, se identificaron en el estado Lara, 557 Rhipicephalus sanguineus, 11 Amblyomma ovale y 10 Ixodes spp. y en el estado Yaracuy solamente se diagnosticaron 26 especímenes de Amblyomma ovale. Es importante destacar la presencia de Hepatozoon spp. en áreas rurales donde no se identificó R. sanguineus.

The purpose of this research was to diagnose Hepatozoon spp. in dogs from rural areas in some municipalities of the States of Lara and Yaracuy, Venezuela, and its relationship with potential arthropods vectors involved in its transmission. Babesia canis vogeli, Ehrlichia canis, and less frequently, Hepatozoon canis, are the most important hemoparasites of dogs, all having as a common vector Rhipicephalus sanguineus. These hemoparasites frequently infest both domestic and rural animals without overt clinical symptoms; in other cases, they cause diseases of varied severity. Coinfections by hemoparasites are very common, which favors the severity of clinical symptoms. Besides R. sanguineus, other tick genera like Amblyomma and Ixodes, can be found infesting dogs. To carry out this study, thin blood smears from peripheral ear veins of 300 dogs were performed; and 604 ticks were collected by manual extraction. These ixodids were taxonomically identified at the Parasitology Laboratory, with the help of dichotomous taxonomic keys. Then, they were subjected to dissections looking for evolutionary stages of Hepatozoon spp. Results obtained were analyzed through non-parametric statistics, showing the presence or absence of Hepatozoon spp. and the identification of the involved vectors. Hepatozoon spp. was found in samples of peripheral blood in 11 of the dogs studied, three from the State of Lara and eight from the State of Yaracuy. Regarding vectors, 557 Rhipicephalus sanguineus, 11 Amblyomma ovale and 10 Ixodes spp. were identified in Lara, whereas only 26 specimens of Amblyomma ovale were identified in Yaracuy. It is important to underscore the presence of Hepatozoon spp. in rural areas where R. sanguineus was not identified.

Altered DNA repair, oxidative stress and antioxidant status in coronary artery disease.

Coronary artery disease (CAD) is a multifactorial disease caused by the interplay of environmental risk factors with multiple predisposing genes. The present study was undertaken to evaluate the role of DNA repair efficiency and oxidative stress and antioxidant status in CAD patients. Malonaldehyde (MDA), which is an indicator of oxidative stress, and mean break per cell (b/c) values, which is an indicator of decreased DNA repair efficiency, were found to be significantly increased in patients compared to normal controls (P<0.05) whereas ascorbic acid and GSH were found to be lower among patients than the control group. It has been found that elevated oxidative stress decreased antioxidant level and decreased DNA repair efficiency can contribute to the development of CAD. This study also showed that high MDA, low ascorbic acid and GSH were significantly associated with high b/c value.

Multiple Idiopathic Cervical Resorption: A Case Report.

Multiple idiopathic cervical resorption (MICR) is a disease of the tooth in which there is progressive cervical resorption of multiple teeth leading to exfoliation of crown. The etiological factors for such a resorption are various but the lack of definitive single etiological factor/disease process makes management of such processes extremely difficult. A flap surgery followed by restoration with glass ionomer cement was carried out for the cessation of resorption process, finally a cast partial denture was delivered for prosthetic rehabilitation.

Especies de Amblyomma (acari: ixodidae) parasitando perros (canis familiaris) en áreas rurales de los estados Lara, Yaracuy, Carabobo y Falcón Venezuela / Species of Amblyomma (acari: ixodidae) parasitizing dogs (canis familiaris) from rural areas of Lara, Yaracuy, Carabobo y Falcón Venezuela

Un total de 50 caninos de áreas rurales de los estados Lara, Yaracuy, Carabobo y Falcón, Venezuela, fueron examinados visualmente y mediante palpación cutánea con el fin de detectar la presencia de garrapatas. Ninguno de los animales se encontró parasitado por Rhipicephalus sanguineus, la garrapata común del perro. Se colectaron 139 especimenes adultos del género Amblyomma Koch, 1844: 72 hembras y 65 machos de la especie Amblyomma ovale Koch, 1844, y dos hembras de la especie Amblyomma triste Koch, 1844. La identificación de los especimenes se realizó mediante observación en lupa estereoscópica y con la ayuda de claves taxonómicas. Los Estados donde se colectó el mayor número de ixódidos fueron Falcón con 52 especimenes y Lara con 49, representando 38 y 36%, respectivamente. A. ovale ha sido reportada como vector natural de Hepatozoon canis en áreas rurales. La especie A. triste fue colectada sólo en un canino del estado Yaracuy. Esta especie ha sido incriminada como el vector biológico de varios agentes rickettsiales patógenos, tanto para humanos como para animales domésticos y salvajes, por lo que se resalta la importancia del género Amblyomma en la transmisión de enfermedades zoonóticas.

Fifty dogs from the rural areas of Lara, Yaracuy, Carabobo and Falcón States of Venezuela were sampled through the visual and touch techniques in search of the presence of ticks. All the dogs were free of the brown dog tick Rhipicephalus sanguineus. A total of 139 adult ticks of the genus Amblyomma Koch, 1844 were collected: of them, 65 males and 72 females were identified as Amblyomma ovale Koch, 1844, whereas two females belonged to the species Amblyomma triste Koch, 1844. The observation through stereomicroscope, as well as the use of taxonomic keys, were employed in the identification of the collected specimens. Most of the ticks were collected in Falcón and Lara States, totalling 52 (38%) and 49 (36%), respectively. The species A. ovale has been reported as a natural vector of the protozoan Hepatozoon canis in rural areas. A. triste was collected only in one dog in Yaracuy State. This species has been incriminated as a biological vector of several rickettsial agents to the men and animals. The actual role of the genus Amblyomma as vector of zoonotic disease agents is highlighted.

Seroprevalencia de la tripanosomosis y anaplasmosis bovina en el municipio Juan José Mora del Estado Carabobo Venezuela: mediante la técnica de Elisa / Seroprevalence of bovine trypanosomosis and anaplasmosis: bye Elisa at Juan José Mora municipality Carabobo state Venezuela

En el Municipio Juan José Mora, estado Carabobo, Venezuela, se han registrado frecuentemente casos clínicos causados por hemoparásitos en rebaños bovinos. Este Municipio y los circunvecinos están siendo considerados por el sector oficial como potenciales productores de ganado de carne con fines de exportación hacia el mercado internacional, por ello se decidió iniciar en esta zona un estudio de soprevalencia para Trypanosoma vivax y Anaplasma marginale. De los rebaños seleccionados se escogieron al azar 400 bovinos; de cada uno se obtuvo muestras de sangre para separar el suero. La muestra fue seleccionada por el método estratificado tomando en cuenta: a) diversos sectores del Municipio e estudio, b) tipo de ganadería y c) la edad de los animales. Se utilizó la técnica del ensayo inmunoenzimático o ELISA para la detección de anticuerpos contra T. vivax y A. marginale. Los resultados obtenidos indican una seropositividad total del 39,5 y 31,8 por ciento, respectivamente, para estos hemoparásitos. La seropositividad para T. vivax fue mayor en fincas dedicadas a la ceba y la cría 43,3 y 50,0 por ciento, respectivamente, al compararlas con fincas dedicadas a producir leche o de ganado docle propósito, 29,4 y 37,5 por ciento, respectivamente, al compararlas con fincas dedicadas a producir leche o de ganado doble propósito, 29,4 y 37,5 por ciento, respectivamente. Además, la seropositividad a T. vivax según el grupo etáreo fue mayor en novillas, novillos y mautes, 61,5; 48,4 y 46,3 por ciento, respectivamente, al compararla con los valores obtenidos para toros, vacas y belares a los de T. vivax fueron obtenidos para A. marginale, para el tipo de ganadería y para el factor grupo etáreo. Los valores de seropositividad total indican que la zona se encuentra en condiciones de inestabilidad endozoótica y además, hay una seroprevalencia de asociación entre ambas hemoparasitosis de un 18,3 por ciento...

At the Juan José Mora County, Carabobo State, Venezuela, clinical cases caused by these hemoparasites are often reported in cattle herds, consequently, an epidemiological and seroprevalence study was carried out for Trypanosoma vivax y Anaplasma marginale. Recently, this County and its neighboring ones are officially considered as a potential zone for cattle meat production with the future aim of exportation of meat to the international market, consequently, a study on bovine seroprevalence of Trypanosoma vivax and Anaplasma marginale was undertaken. Four hundreds (400) bovines were randomly chosen from the selected cattle herds, and from each one a sample of whole blood was drawn for serum separation. Bovine samples were selected using the stratified method and on the following bases: a) the sector in the studied County, b) type of cattle husbandry, and c) the age factor. The Enzyme-linked Immunosorbent Assay (ELISA) was used to detect anti-T. vivax and anti-A. marginale antibodies, respectively. Results showed a total seropositivity of 39.5 and 31.8% for T. vivax and A. marginale respectively. Seropositivity for T. vivax was greater in meat farms, 43.3 and 50.0%, respectively, when it was compared with that of farms dedicated to dairy production or dual purpose cattle, 29.4 and 37.5%, respectively. In addition, T. vivax seropositivity was greater in heifers, steers and yearlings, 61.5, 48.4 and 46.3%, respectively, when compared with that of bulls, cows and calves, 25.0, 22.1 and 23.3%, respectively. Similar results to these of T. vivax seropositvity were found for A. marginale, both for the type of cattle husbandry as for the age factor. These results showed that the studied zone is on a condition of enzootic inestability for these hemoparasites. In addition, it was observed a seroprevalence association of 18.3% for both hemoparasitosis. With these results it can be suggested a) that similar epidemiological conditions should also be present for these...

Electricity and the heart.

Understanding of cardiac rhythm requires application of physical principles governing electricity. Over a period of more than 100 years, application of the knowledge of electric current led to the gradual evolution of electrocardiogram, pacemaker, defibrillator, and ultimately electrophysiology. The discovery of electrocardiogram (ECG) by Einthoven in 1902 and that of pacing by Zoll in 1952 were two landmarks in this field.

Prospective evaluation of modified Alvarado score for diagnosis of acute appendicitis.

Modified Alvarado scoring system was evaluated regarding its usefulness in the early diagnosis of acute appendicitis and in reduction of the incidence of negative appendicectomies. One hundred and ten patients with a provisional diagnosis of acute appendicitis were studied prospectively at R G Kar Medical College and Hospital, Calcutta over a period of 10 months. High score was found to be a dependable aid both in the pre-operative diagnosis of acute appendicitis and in the reduction of negative appendicectomies in men and children but the same was not true for women who had a high false positive rate for acute appendicitis.

Long-term performance of single-pass physiological pacing.

BACKGROUND: Single-pass physiological pacing has several advantages over dual-lead physiological pacing. The present study evaluated the long-term performance of single-pass pacing using the overlapping biphasic impulse stimulation technique. METHODS AND RESULTS: A total of 30 patients with single-pass VDD pacing and 8 patients with single-pass DDDC pacing were followed up for 1 year by basal and magnet electrocardiograms and real-time telemetry. All the patients showed satisfactory atrial sensing and pacing capture threshold. The atrial sensing thresholds at implant and at 1 month, 3 months, 6 months and 12 months of follow-up were 2.5+/-0.67 mV, 1.6+/-0.6 mV, 1.1+/-0.5 mV, 1.0+/-0.5 mV and 1.0+/-0.04 mV, respectively. The corresponding values for atrial pacing threshold at a pulse wave of 0.5 ms were 2.5+/-1.0 V, 4.4+/-0.9 V, 3.8+/-1.2 V, 3.6+/-1.4 V and 3.8+/-1.4 V. Of the patients with DDDC pacing, 88% showed stable pacing capture in the supine position, 75% in the upright position and 62% in both positions. Diaphragmatic contraction was seen in 25% of cases with DDDC pacing. No such event was seen in patients with VDD pacing. CONCLUSIONS: Single-pass pacing is safe, technically easy and cheap as compared to dual-lead systems. However, it would be prudent to recommend DDDC pacing in patients who require predominantly VDD pacing and only occasionally atrial pacing, as the latter showed a low percentage of stable atrial pacing capture in both upright and supine positions as well as a significant percentage of diaphragmatic contraction.

Fibrothorax--problem, profile and prevention.

Fibrothorax is a common clinical condition found in everyday clinical practice. The clinical horizon of fibrothorax can be differentiated into pleural and lung parenchymal fibrosis. The two groups can be differentiated clinically and also by investigations. A thorough understanding of the process gives one better knowledge as to their different aetiologies, presentations and prognoses. The nature of prevention of this meance varies in these types. Patient's drug compliance status is important in preventing primary lung parenchymal fibrosis whereas physician's adequate care for pleural drainage is important in the prevention of pleural fibrosis. In this prospective study, observations were made on (1) the clinical presentation of 100 cases of fibrothorax and its relation to the primary disease, (2) aetiological distribution of the cases of fibrothorax and (3) scope of prevention, if any.

Risk factors and angiographic profile of coronary artery disease in young.

A total of 124 patients of ischaemic heart disease under 40 years of age (96 with myocardial infarction and 28 with angina) were studied for risk factors of coronary artery disease. Electrocardiogram, treadmill test, lipid profile and coronary arteriography were done in all cases. Smoking (56.4%) and hyperlipidaemia (30.6%) emerged as the major risk factors. Further stratification of lipid profile revealed that predictive value of hypercholesterolaemia could be enhanced by considering the different ratios of lipoproteins and indices of atherogenicity. Coronary arteriography revealed a preponderance of single vessel disease (48.4%)-left anterior descending being most commonly involved (71.8%). Increase in low density lipoprotein fraction was related to multivessel involvement.