OUTCOME OF USE OF PLASTIBELL DEVICE FOR CIRCUMCISION IN PAEDIATRIC PATIENTS

Introduction – Circumcision is one of the oldestsurgical procedure practiced to remove shaft skinand inner foreskin to uncover the glans.Among various techniques for the circumcision, wehave described Plastibell method which has becomepopular and more preferable for its advantages suchas minimal tissue trauma and better cosmesis.Aim - This article aims to analyse the safety, efficacyand outcome of plastibell circumcision in paediatricpatients.Material & Methods – This study includes 30inpatient cases who satisfied the inclusion criteriaand underwent circumcision using plastibell device atsheth L.G. hospital, AMC MET Medical college,Ahmedabad. Data on operative time, intra op andpost op complications, post operative hospital stay,cosmetic outcome and parent satisfaction wasobtained and analysed.Results – Total of 30 patients were circumcised withplastibell device with average operative time of 9±3mins. Most common post-operative complication waspain which was observed in 8 patients (26.67%).Post-op bleeding was seen in 1 patient (3.33%) dueto detachment of ring. 28 out of 30 parents weresatisfied with the cosmetic outcome.Conclusion – Based on our study, plastibellcircumcision is effective technique for circumcisionoffering lesser operating time, post-operative pain,

Recent HIV Infection among men who have sex with men and transgender women in Tijuana

ABSTRACT OBJECTIVE To characterize recent HIV infections among newly diagnosed men who have sex with men and transgender women in Tijuana. METHODS Limiting Antigen (LAg)-Avidity testing was performed to detect recent HIV infection within a cohort of newly-diagnosed men who have sex with men and transgender women in Tijuana. Logistic regression was used to determine characteristics associated with recent infection. A partial transmission network was inferred using HIV-1 pol sequences. Tamura-Nei 93 genetic distances were measured between all pairs of sequences, and the network was constructed by inferring putative transmission links (genetic distances ≤ 1.5%). We assessed whether recent infection was associated with clustering within the inferred network. RESULTS Recent infection was detected in 11% (22/194) of newly-diagnosed participants. Out of the participants with sequence data, 60% (9/15) with recent infection clustered compared with 31% (43/139) with chronic infection. Two recent infections belonged to the same cluster. In adjusted analyses, recent infection was associated with years of residence in Tijuana (OR = 1.5; 95%CI 1.01-1.09), cocaine use (past month) (OR = 8.50; 95%CI 1.99-28.17), and ever experiencing sexual abuse (OR = 2.85; 95%CI 1.03-7.85). DISCUSSION A total of 11% of men newly diagnosed with HIV who have sex with men and transgender women in Tijuana were recently infected. The general lack of clustering between participants with recent infection suggests continued onward HIV transmission rather than an outbreak within a particular cluster.

Potential of herbal constituents as new natural leads against helminthiasis: A neglected tropical disease

The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas; nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.

Umbilical Cord Length With Relation To Birth Weight

Background: The Umbilical cord is the fetal lifeline and it is a structure that connects the foetus to the placenta.Placenta and umbilical cord acts as a mirror which reflects intrauterine status of foetus. The length of theumbilical cord varies from achordia to 300 cm. This study aims to identify the relationship between the umbilicalcord length and birth weight and other parameter such as maternal age, gestational age and gender. More recentresearch suggests that the length of the cord at birth is influenced by intrauterine fetal activity & thereforecorrelate with fetal well being.Materials and Methods: This cross sectional study was conducted in Anatomy department in collaboration withgynecology department of our hospital on 100 freshly delivered samples of placenta with cord which are obtainedfrom labour room of our Government Hospital.Conclusion: The range of cord length was 28- 106 cm .However maximum were between 40cm to 60 cm in length.The mean length was 53.18 cm. Cord length varies with birth weight and conclude that as cord length showspositive correlation with birth weight (r=0.40).

A Study On Variations Of Nutrient Foramen Of Ulna In Saurashtra Region With Its Clinical Relevance

Background: Nutrient foramen is an opening into shaft of Ulna which gives passage to the blood vessels ofmedullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting andmore recently in microsurgical vascularized bone transplantation.Objective: To determine the number, location and direction of nutrient foramen and whether the nutrient foramensobey the rule of ossification, that is directed away from the growing end of the bone or not.Method: The present study consisted of 150 (75 right and 75 left) dried ulna bones excluding any fracture orpathological abnormalities Number and direction of nutrient foramen was observed in each ulna. Location ofnutrient foramen in relation with surfaces and zones of ulna was determined.Result: It has been observed that 96.67% of the ulna had a single nutrient foramen, 1.33% double foramen and 2%had no nutrient foramen. It was concluded that 90% of the nutrient foramina were present on the anteriorsurface, 5.33% on anterior border and 4.67% on interosseous border It was also concluded that most (62.67%)of the foramina present in the zone II followed by zone I (23.33%) then by zone III (14%). All foramina weredirected toward the upper end of ulna.Conclusion: By knowing the number and location of the nutrient foramina in ulna would be useful in preventingintra-operative injury of nutrient artery during orthopedic, plastic and reconstructive surgery and will also berelevant in medico legal practice.

Cancer treatment associated cardiac toxicities

Cardiovascular disease remains the leading cause of mortality and morbidity in men and women both in the US and worldwide. With increased access to healthcare, it is predicted that life expectancies in developed countries will continue to rise and thus, lead to an increase in both cardiovascular disease and cancer. Similarly, improved survival rates in cancer patients have led to an increased awareness of the presence and potential worsening of cardiovascular disease in these patients. Cardiovascular complications due to side effects from cancer therapy or from cancer progression can be a common occurrence. Although recent advances in cancer therapeutics have led to improved survival rates and quality of life, the increase in life expectancy may be counteracted by the increased morbidity and mortality from progressive cardiac pathology. Examples of such complications include local invasion or distant metastatic spread, which can lead to superior vena cava syndrome, cardiac tamponade, or hyperviscosity syndromes. In addition, many chemo and radiation therapies can be directly toxic to the cardiovascular system. This review aims to discuss the potential cardiac toxicities of the most commonly used chemotherapeutics along with some strategies to manage these complex patients.

Barriers for early detection of cancer amongst urban Indian women: a cross sectional study

Background: Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis

Objectives: This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities

Materials and Methods: This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22

Results: Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents

Conclusions: Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme

Long PFN in unstable subtrochantric fracture with absent lateral wall support in proximal fragment with delayed augmentation with encircalage wire and bone grafting.

In 1949 Boyd and Griffin Subtrochanteric fracture femur as a variant of peritrochanteric fracture with higher incidence of unsatisfactory result both in the elderly and young. Most of this fracture is with higher incidence of unsatisfactory result after operative treatment This single case study shows one of the unpredicted iotrogenic complications. Material and method: Patient is 78yr female patient with multiple co-morbid conditions with subtrochanetric fracture. Surgery was done with long PFN nail inserted with good purchase in head, reduction check under C-arm with in antero-posterior & lateral view shows little malreduction and nail is out of medulary cavity in proximal fragment. Revision in same sitting not possible due to some medical reasons. Revision surgery done after fitness and reduction held with encieclage wire and bone grafting done. Conclusion: Even without lateral wall support if there is good purchase of screws in head and shaft, there will be good union and good functional outcome.

cross-sectional study of correlation of body image anxiety with social phobia and their association with depression in the adolescents from a rural area of Sangli district in India

Prevailing socio-cultural influences lead females to desire a thin body and males a muscular body, especially in adolescents. This results in body image anxiety which may lead to social phobia. Together they can develop depression. The aim was to study the correlation of body image anxiety with social phobia and their association with depression, among adolescents. This was a cross-sectional study conducted in randomly selected colleges from a rural area of Sangli district Maharashtra, India. Stratified random sampling technique used with sample size 805. Pretested self-administered questionnaire used. Percentage, Chi-square test, binary logistic regression model was used to estimate odds ratio [OR] and its 95% confidence intervals. Of 997 study subjects body image anxiety, social phobia and depression were observed in 232 [23.3%], 193 [19.4%] and 326 [32.7%] participants, respectively. Binary logistic regression showed that body image anxiety [OR = 1.849 [1.22, 2.804]; P = 0.004] and social phobia [OR = 4.575 [2.952-7.09]; P < 0.001] were significant predictors for depression. Body image anxiety and social phobia are linked with the development of depression. This impresses the need for timely counseling and education among adolescents

Simple Spectrophotometric Method for Estimation of Raltegravir Potassium in Bulk and Pharmaceutical Formulations.

A simple, rapid, precise, and economical spectrophotometric method has been developed for quantitative analysis of Raltegravir Potassium (RALP) in tablet formulations. The stock solution of RALP was prepared in water. The standard solution of RALP in water showed absorption maxima at 331.6 nm. The drug obeyed Beer–Lambert’s law in the concentration range of 1–100 μg/mL with coefficient of correlation (R2) was 0.9999. It showed coefficient of variation below 2 % in intra-run and inter-run precision. The recovery was obtained with values close to the 100 % of theoretical at three different concentrations. The results of analysis have been validated as per ICH guidelines. The method can be adopted in routine analysis of RALP in bulk and tablet dosage form and it involves water as a solvent and no complex extraction techniques.

Farnesol Sensitivity of Serum Induced Yeast to Hyphae Morphogenesis: A Study on Fifty Clinical Isolates of Candida albicans.

Aim: Objective of this study was to examine farnesol sensitivity of yeast to hyphae dimorphism in clinical isolates of Candida albicans. Study Design: Variations in virulence attributes contribute to variations in pathogenicity of C. albicans. Ability to switch from yeast to hyphae morphology is an important virulence factor. Farnesol, a quorum sensing molecule is known to play an important role in the regulation of C. albicans morphogenesis. Analysis of farnesol susceptibility of yeast to hyphae conversion may reveal a factor responsible for variation in pathogenicity among clinical isolates of C. albicans. Place and Duration of Study: SCG Medical College & SGGS Memorial Hospital, and School of Life Sciences, SRTM University, Nanded, India. Duration of this study was, December 2008 to December 2010. Methodology: Fifty clinical isolates of C. albicans were recovered from body fluids (such as, sputum, blood, urine, vaginal swab, tracheal swab, throat swab, feces, pus and cerebrospinal fluid, etc.) of patients with different clinical manifestations, in the tertiary care center hospital. Presumptive identification of C. albicans was done on HiCHROM agar- Candida, while confirmation was done by Germ tube formation assay, Carbohydrate assimilation and Corn meal agar test. Serum induced yeast to hyphae morphogenesis in C. albicans was performed in 96 well plates. Recent methodology of micro broth dilution was used for farnesol susceptibility testing in fifty clinical isolates. Results: Farnesol prevented hyphae formation in a concentration dependent manner, in the range 25 to 400 μM. Inhibition of ≥ 50% hyphae was considered as significant reduction in morphogenesis. MIC70 for farnesol mediated inhibition of morphogenesis in C. albicans was at 200 μM. Mean values for percentage inhibition of morphogenesis in fifty strains was compared by analysis of variance (ANOVA). P = 0.05 was considered significant. Conclusion: Susceptibility of yeast to hyphae morphogenesis to the quorum sensing molecule farnesol, varied significantly among clinical isolates of C. albicans. We hypothesize that variation in farnesol sensitivity may be a factor responsible for variable dissemination and infection ability of C. albicans.

Pathophysiology & genetics of obstructive sleep apnoea.

Obstructive sleep apnoea (OSA) is a highly prevalent condition with proven neurocognitive and cardiovascular consequences. OSA patients experience repetitive narrowing or collapse of the pharyngeal airway during sleep. Multiple factors likely underlie the pathophysiology of this condition with considerable inter-individual variation. Important risk factors for OSA include obesity, male gender, and ageing. However, the mechanisms underlying these major risk factors are not well understood. We briefly review the state-of-the-art knowledge regarding OSA pathogenesis in adults and highlight the potential role of genetics in influencing key OSA pathophysiological traits.

Immunization status in children.

OBJECTIVE: Recent studies and surveys are observing a declining trend of routine immunization coverage and fully immunized children in India are reported to be 38%. A rapid assessment technique was used on National Immunization Day (PPI) to assess the immunization status among children in the age group of 12-23 months covering urban, rural and slum areas in UT, Chandigarh. METHODS: The study covered 796 children in proportion of their distribution in urban, rural and slum areas. RESULTS: Evaluation recorded fully immunized children as 72.23%, partially immunized as 22.99% and unimmunized as 4.64%. Only 58.66% children in urban slums were fully immunized. The overall coverage for various vaccines was BCG: 93.09%, DPT1/OPV1: 93.97%, DPT2/OPV2: 90.57%, DPT3/OPV3: 85.92% and measles: 76%. No sex-wise difference was noticed in the study. CONCLUSION: Efforts must be made to strengthen routine immunization programme especially in the underprivileged groups and areas such as slum in cities so that target of universal coverage can be achieved as envisaged at national level.

Comparison of colour duplex ultrasound and ankle-brachial pressure index measurements in peripheral vascular disease in type 2 diabetic patients with foot infections.

BACKGROUND AND OBJECTIVES: Peripheral vascular disease (PVD) is a common cause of morbidity and mortality and is reported to be more common among diabetic subjects compared to non-diabetic subjects. The aim of the study was to compare the specificity and sensitivity of ankle-brachial index (ABI) measured by peripheral doppler with the colour duplex ultrasound (CDU) for diagnosis of PVD. METHODS: One hundred type 2 diabetic patients admitted to our diabetic centre with foot lesions underwent both colour duplex ultrasound and ankle-brachial index measurements. PVD was diagnosed if the individual had haemodynamically significant obstruction on CDU, or if the ABI was < 0.9. The sensitivity and specificity of ABI was determined using the CDU as 'gold standard'. RESULTS: The mean age of the study group was 59.5 +/- 10.1 years and the mean duration of diabetes was 11.7 +/- 8.1 years. Of the total 100 subjects, six subjects had calcification of peripheral vessels and they were not included while calculating for sensitivity and specificity of ABI. Twenty (21.3%) subjects diagnosed as PVD by the CDU were not classified as PVD by the ABI measurements. Conversely, only three subjects (3.2%) classified as PVD by ABI had normal arteries based on CDU scanning. Overall, ABI had low sensitivity (70.6%) but a high specificity (88.5%). The overall agreement between CDU and ABI was poor (k = 0.20). CONCLUSION: ABI is a good initial screening tool but some patients with significant stenosis in lower extremities would be missed, if ABI measurement alone is used for diagnosis of PVD.