Effect of body mass index on VO2 max among apparently healthy male young adults: A cross-sectional study

Background: Factors determine the change in aerobic capacity (VO2 max). This study discovered an association between body mass index (BMI) with aerobic capacity (VO2 max) in apparently healthy male young adults. Aims and Objectives: The study aimed to determine the effect of obesity on cardiopulmonary health of apparently healthy male young adults with following objectives: (i) To compare the VO2 max in different BMI groups and (ii) to study the correlation of BMI with VO2 max. Materials and Methods: A study was conducted among 100 male subjects of 18–30 years assessing BMI (height/weight2) and VO2 max by CPET Ergo-bike machine. Statistical analysis was done with unpaired t-test. Results: In correlation between four BMI groups and their respective VO2 max, we found that VO2 max in the underweight group (BMI <18.5) is positively correlated and statistically significant. In the normal group (BMI 18.5–24.9), it is negatively correlated and insignificant. In the overweight group (BMI 24.9–29.9), it is negatively correlated and significant and in the obese group (BMI ?30), it is negatively correlated and not significant. Conclusion: VO2 max is gradually increasing with BMI toward the normal range and decreasing away from the normal range significantly in both underweight and overweight groups. Whereas, this change of VO2 max is not so significant in both normal and obese groups as per. As BMI is inversely related to cardiopulmonary function, persons having high BMI can be motivated toward a healthy lifestyle.

Kaposiform hemangioendothelioma in an unusual site: A report of two cases in children

Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor usually seen in children. It is frequently associated with Kasabach-Merritt phenomenon. Here we report two cases of KHE: the first case being an 11-month-old boy who came with massive swelling on the face and violaceous discoloration. The second case was a 7-year-old boy who presented with respiratory distress and bleeding manifestations. CT scan chest showed a large mass involving the anterior mediastinum. Histologic examination of resected masses from both these cases showed features of KHE involving subcutaneous tissue and thymus, respectively. Although cutaneous and subcutaneous location is common, thymic involvement is unusual. It is important to distinguish KHE from infantile haemangioma, tufted angioma, spindle-cell haemangioma, verrucous malformation and Kaposi sarcoma. Histologic features, supportive immunohistochemistry and the clinical profile together are helpful to differentiate KHE from other vascular lesions.

Salivary microbial dysbiosis may predict lung adenocarcinoma: A pilot study

Background: Adenocarcinoma is a more common type of Non-small cell lung cancer (NSCLC). Lung cancer showed a statistically significant increment in the Kamrup Urban district of Assam, Tripura, Sikkim, and Manipur of India. The goal of our pilot study is to identify non-invasive microbial biomarkers to detect lung adenocarcinoma (LAC). Material and Methods: DNA extraction from saliva samples of five LAC patients and five healthy controls was performed by Qiagen DNeasy blood and tissue kit using Lysozyme (3mg/ml) treatment. 16S rRNA genes of distinct regions (V3-V4) were amplified from saliva DNA by PCR. Paired-end sequencing targeting the V3-V4 region of the 16S rRNA gene has been performed on the Illumina MiSeq platform. Raw sequences were analyzed using the QIIME(Quantitative Insights Into Microbial Ecology) software package. Results: Our preliminary results showed that Rothia mucilaginosa, Veillonella dispar, Prevotella melaninogenica, Prevotella pallens, Prevotella copri, Haemophilus parainfluenzae, Neisseria bacilliformis and Aggregatibacter segnis were significantly elevated in saliva of LAC which may serve as potential non-invasive biomarkers for LAC detection. Functional prediction analysis showed that bacterial genes involved in glycosyltransferase, peptidases, amino sugar, and nucleotide sugar metabolism, starch and sucrose metabolism were significantly enriched in LAC. Conclusion: These salivary bacteria may contribute to the development of LAC by increasing expression of glycosyltransferase and peptidases. However to understand their role in pathobiology, studies are required to perform in large cohort.

Determination of the antimicrobial property of oregano (Plectranthus amboinicus (Lour.) Spreng.) crude aqueous leaf extract against throat pathogens using broth and checkerboard dilution methods

@#<p style="text-align: justify;"><strong>Objective:</strong> This study aimed to determine the antimicrobial property of oregano (Plectranthus amboinicus) crude leaf extract against pathogens that infect the throat, specifically Streptococcus pyogenes and Candida albicans using the broth and checkerboard dilution methods.</p><p style="text-align: justify;"><strong>Methods:</strong> This study employed an experimental study design using broth dilution method for the determination of the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) against Streptococcus pyogenes ATCC 19615, and minimum fungicidal concentration (MFC) against Candida albicans ATCC 14053 of P. amboinicus crude extract (PA extract). Checkerboard dilution method was then used for determination of the synergy between PA extract and the standard antimicrobials.</p><p style="text-align: justify;"><strong>Results:</strong> In vitro growth inhibition of S. pyogenes (MIC 0.13 g/mL) and C. albicans (MIC 0.03 g/mL) was exhibited by the PA extract. The highest concentration of PA extract used in this study was not sufficient to demonstrate bactericidal and fungicidal activity (MBC >0.25 g/mL, MFC >0.25 g/mL). Results of checkerboard dilution method revealed that PA extract when combined with either penicillin (for S. pyogenes) or nystatin (for C. albicans) demonstrated indifference.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The crude extract of Plectranthus amboinicus has the capability to inhibit the growth of both S. pyogenes and C. albicans. This demonstrates its potential use in the treatment of throat infections caused by these organisms.</p><p style="text-align: justify;"><strong>Key Words:</strong> Plectranthus amboinicus, oregano, antimicrobial, throat infections, herbal medicine</p>

Tunica vaginalis flap – is it a better surgical choice for urethro-cutaneous fistula following circumcision?

Objective: To study the effectiveness of tunica vaginalis flap in repair of post circumcision urethro- cutaneous fistula. Materials and Methods: The current study reviewed all patients having surgical repair of post-circumcision urethrocutaneous fistula from December 2014 to April 2019 at our institution. Results: Ten cases presenting at age 5 to 22 years were operated. Most [60%] of the circumcisions were performed by a doctor at peripheral hospitals and others were done by traditional circumcisers. All cases had a single fistula and the size was more than 5mm in all cases. Three-layered fistula closure was done in all cases using the tunica vaginalis flap as the second layer for closure. There was no recurrence in any case. Conclusion: Use of Tunica vaginalis flap for repair of post circumcision urethro-cutaneous fistula is a highly effective technique regardless of size and site of the fistula. It is a simple procedure without any postoperative complications and without any recurrence

Sexual functioning in females with depression in remission receiving escitalopram

Background & objectives: Sexual functioning is a strong determinant of quality of life. Sexual dysfunction has been widely reported due to depressive disorder as well as selective serotonin reuptake inhibitors. Thus, treatment with antidepressants can culminate in a double-edged sword, leading to drug discontinuation and symptom relapse. The objective of this study was to assess the sexual functioning of sexually active females with depression, currently in remission, receiving escitalopram and to compare with healthy controls. Methods: Fifty female patients with depression, currently in remission, with self-reported normal pre-morbid sexual function and receiving escitalopram for at least three months, were assessed on female sexual function index (FSFI) questionnaire and compared with healthy controls. Results: Half of the patients (n=25, 50%) in group A were found to have sexual dysfunction (FSFI score <26.55), while, 90 per cent (n=45) had decreased desire, 86 per cent (n=43) had decreased arousal, 54 per cent (n=27) had decreased lubrication, 68 per cent (n=34) had decreased orgasm, 62 per cent (n=31) had decreased satisfaction and 32 per cent (n=16) had pain during sexual activity. Patients receiving escitalopram had significantly higher sexual dysfunction as compared to healthy controls in mean total FSFI score (P < 0.001) and all mean domain scores of FSFI except pain. Interpretation & conclusions: A significant proportion of sexually active females with depression currently in remission, receiving escitalopram, reported dysfunction in all domains of sexual function; thus, routine screening for sexual dysfunction during follow up is advisable for early identification and prompt treatment.

Prevalence estimation of microsatellite instability in colorectal cancers using tissue microarray based methods – A tertiary care center experience

Aim: Microsatellite instability (MSI) pathway is known to be implicated in carcinogenesis of 15% colorectal carcinomas (CRC), including 2%–3% of cases of Lynch syndrome, as per western literature. MSI status has important prognostic and therapeutic implications. The prevalence of MSI in Indian CRC patients is unknown. We aimed to determine the prevalence by studying 231 consecutive unselected cases of CRC. Methods: Tissue microarrays using duplicate cores per case for 141 cases, and whole tissue sections for 90 cases, were used. Immunohistochemistry with four mismatch repair (MMR) markers – MLH1, MSH2, MSH6, and PMS2 was performed. Molecular analysis for MSI status was performed in 18 randomly selected cases. Correlation with various clinical and histopathological features was done using univariate and multivariate analysis. Results: Loss of MMR immunohistochemical (IHC) was seen in 53/231 cases, i.e. 22.94% (95% confidence interval 17.52%–28.36%). MLH1-PMS2 dual loss comprised 13.9%, MSH2-MSH6 7.4%, and isolated PMS2 loss in 1.73% of cases. Univariate analysis showed significant association with age (<60 years), right-sided tumor location, histologic type, high grade, the presence of severe intratumoral lymphocytic (ITL) and peri-tumoral lymphocytic response, and N0 nodal stage. On multivariate analysis, independent variables were age < 60 years, right-sided location, and severe ITL. Molecular testing for MSI corroborated with the IHC results. Conclusion: The study results show a slightly higher prevalence of MSI-H phenotype, compared to Western literature, stressing the need for more widespread testing for better clinical management and identification of possible hereditary colon cancer syndrome.

A study on gender‑related differences in laboratory characteristics of dengue fever.

Studies have reported significant gender‑related differences in serological tests for detection of NS1 antigen and IgM antibody used for diagnosing dengue fever. However, no such study has been undertaken in India though dengue fever is endemic in this country. Therefore, this study was planned to study the association of serological findings with gender in 700 patients suspected to be suffering from dengue fever in the Indian setting. Haematological parameters of seropositive patients were also studied. Seropositivity and haemorrhagic findings were significantly associated with the female gender. Positive NS1 antigen and IgM antibody results were significantly associated with females and males, respectively.

Pregnancy Following Surgery Of Multiple Pelvic Hydatid Cysts.

Abstracts: Background: Hydatid cyst in pelvic region is very rare. A patient was admitted in Gynaec ward with complaints of , lump and pain in lower abdomen and, constipation since, five months. General examination was normal. Abdominal and gynaecological examination lead to diagnoses as ovarian cyst ? Multiple uterine subserous fibroids? Ultra sonography diagnosis was Hydatid cysts abdomen / Mucininious cystadenoma ovaries . CT Scan abdomen and pelvis confirmed USG findings of Hydatid cysts. On Laprotomy multiple hydatid removed from pelvic region , omentum , ileocaecal junction and liver . Patient put on chemotherapy and follow up was satisfactory.

Ovarian Pregnancy.

Primary ovarian pregnancy is a rare type of extra-uterine pregnancy, and occurs in 1:7000 to 1: 40,000 deliveries. This is a case that occurred in a 26 years old multiparous woman. She had presented with pain abdomen and bleeding per vaginum and was hemodynamically stable, negative pregnancy test, but vaginal examination showed painful cervical movements, slight bleeding through external os, uterus just bulky, tender mass felt in right adnexa. Ultrasonography revealed—Right tubo-ovarian mass with fluid in peritoneal cavity. Laparotomy showed Right Ovarian Pregnancy. Managed by Right Ovariectomy.

An Unusual Presentation of Choriocarcinoma.

Gestational choriocarcinoma is a highly malignant tumor of trophoblastic cells with a propensity to metastasize to various sites including lungs, vagina, brain, liver, kidney, and gastrointestinal tract, in descending order of frequency. Usually it is treated by chemotherapy but rarely hysterectomy is indicated if bleeding is heavy, or if tumor is resistant to chemotherapy A 45-year-old woman presented to the hospital as an emergency with heavy bleeding per vagina since 4 days preceded by abdominal pain. H/O spontaneous abortion of 5months pregnancy 2 yrs back and was asymptomatic since 2years. Investigations showed severe anemia and high level of β-hCG. She underwent Total abdominal Hysterectomy for heavy bleeding and Histopathology revealed it to be a case of gestational choriocarcinoma. Chemotherapy was given pre and postoperatively and resulted in complete cure.

Validity of Clinical Signs and Symptoms in Diagnosis of Ovarian Mass.

Objective: The main aim for undertaking this study was to find out what was the appropriateness of clinical diagnosis of benign ovarian tumor and compare the results after Histopathological study. Material And Methods: Retrospective files study of 240 cases was carried out to analyze the clinical signs and symptoms and evaluation done of clinical findings, tumour marker study, ultrasonography, and the plan of treatment. Results: Laparotomy was done in 200 cases, clinically ovarian masses were diagnosed as benign in 75%, by Tumor marker i.e. CA125 in 80%, by sonography in 70% and by histopathology in 83%. The study was statistically analyzed. The values in diagnosis of ovarian mass clinically and comparing with other parameters was significant p value<0.05. Conclusion: Clinical signs and symptoms are still important predictors in reaching the diagnosis of benign Ovarian Mass.

Comparative Evaluation of Hystero-Salpingography and Laparoscopy For Determination of Tubal Patency.

Objective: To find out whether Hysterosalpigography (HSG), can be used as initial method for assessing tubal factor of infertility, instead of more invasive method like diagnostic laparoscopy. Methods: Retrospective analysis of 75 cases, who had attended infertility Clinic at Medical College, Ujjain, and underwent HSG as initial test followed by Laparoscopy from November 2005 to December 2010. Results: Primary infertility was the major cause of tubal factor of infertility (75%) and majority of women were between 20-25 years (60%). In comparison to laparoscopy, HSG has 80.8% sensitivity & 100% specificity for determination of tubal patency. HSG also has a high sensitivity (100%) for determination of unilateral or bilateral blockage with specificity of 100% & 85.3% respectively. HSG can detect only endo-tubal and intrauterine pathology, whereas laparoscopy can detect pelvic pathology. Conclusion: HSG should be used as initial test to assess tubal patency whereas laparoscopy should be limited to selected cases.

Twin to twin transfusion endangering the mother.

There was a case of Twin to twin transfusion syndrome (T.T.T.S.) with one dead monster baby and other alive low birth weight baby, leading to early Disseminated Intravascular Coagulation(D.I.C) in mother, in Obstetric ward of C.R. Gardi Hospital Ujjain, (M.P) India.

Study of primary caesarean section in multiparous women.

Background: This prospective study was carried out to assess, indication, maternal & fetal outcome of primary caesarian in multiparous women. Materials & Methods: 50 women with primary CS (caesarean section) studied in multiparous women studied and analysed. Results: Most of women belonged to >25yrs age group, rural, & low socio-economic group, Malpresentation, Low AFI (amniotic fuid index), Fetal Distress were most common indications. Post operative uneventful in majority of cases. Conclusion: Antenatal care in multigravida, USG (ultra-sonography) Analysis Close monitoring can reduce CS(caesarean section) in multipara.

Primary internal iliac artery ligation – an effective technique for surgical hemostasis in wertheim’s hysterectomy.

Objective: Lessening intra-operative blood loss by the technique of bilateral internal iliac artery ligation as 1st step in Wertheim’s Hysterectomy. Methods: 20 cases of early Stage Cancer Cervix, who underwent Wertheim’s hysterectomy over period June 09 to Dec 12 in CRG Hospital, Ujjain and Base Hospital Delhi Cantonment, were studied. The demographic data, hemoglobin before and after surgery, and requirement of intra-operative blood transfusion, were studied. Results : 80% patients had less than 200ml intra-operative blood loss. Conclusion : Alleviating troublesome bleeding during dissection of lymph nodes and ureteric tunnel by primary ligation of internal iliac artery is a statistically proven optimum technique of Wertheim’s Hysterectomy.

Investigation of Antioxidant and Antimicrobial Potential of Chloroform and Petroleum Ether Extracts of Selected Medicinal Plants of Bangladesh.

Aim: To investigate the antioxidant and antimicrobial potential of Chloroform and Pet ether extracts of Manilkara zapota (MZCE, MZPE), Polyalthia longifolia (PLCE, PLPE), Abroma augusta (AACE, AAPE) Ficus hispida (FHCE, FHPE), Vitex negundo (VNCE, VNPE) plants. Study Design: In vitro antioxidant and antimicrobial study. Place and Duration of Study: Department of Pharmacy, School of Science & Engineering, Southeast University, Banani, Dhaka between June 2011 and March 2012. Methodology: In vitro antioxidant activity was performed using DPPH radical scavenging, nitric oxide (NO) scavenging, reducing power, total antioxidant capacity, total phenol and total flavonoid content determination assays. The antimicrobial assay was performed by disc diffusion method using kanamycin and Nystatin as the standard. Results: The most prominent antioxidant activity was observed with PLPE in DPPH radical scavenging test (IC50 =191.308 ± 28.450 μg/ml) as opposed to that of standard ascorbic acid (IC50= 43.129 ± 1.181μg/ml). In total antioxidant capacity method, FHCE showed the highest activity (837.558 ± 110.835 mg ascorbic acid/g). The total phenolic and flavonoids content were determined by Folin–Ciocalteu Reagent and aluminum chloride colorimetric method respectively. The highest total phenols & total flavonoids content were found in VNPE (180.434 ± 142.19 mg Gallic acid/g & 1265.255 ± 165.593 mg quercetin/g, respectively). The ferric reducing capacity of the extracts was strong and dose dependent manner. PLPE displayed the highest antimicrobial actions against Bacillus megaterium (40 mm). Conclusion: Comparison of different plant extracts used in the present study in various tested models showed wide variations in phenolic content and varying degrees of radical scavenging & reducing capacity. The obtained results indicate that investigated plants could be potential sources of natural antioxidants & antimicrobial agents and can be used for infectious diseases.

Vanishing twin, natures choice.

A surprising finding at emergency Caesarean Section of an empty sac, along with fetus & placenta , was observed. Retrospectively, when USG reports were reviewed it was a case of Vanishing Twin after 20 wks of gestation. This syndrome is diagnosed more frequently since the use of USG has become a common investigation. Probably the twin which vanishes may be chromosomally abnormal. Prognosis of the surviving twin is generally excellent but depends on the etiology of the death of the dead twin.