Assessment of Perception about Immunization Among the Mothers of Under-Five Children at Urban Slum Area of Vijayapura City

Introduction: Immunization is one of the most cost-effective health investments worldwide. The World Health Organization (WHO) launched the expanded programme on immunization (EPI) in 1974 with the aim of immunizing children throughout the world. Objective: Assessment of perception about immunization among the mothers of under-five children at urban slum area of Vijayapura city. Methods: Cross-sectional study was conducted in Urban Field practice area of Community Medicine department among the mothers of under-five children residing permanently in the area and were interviewed regarding the perception about immunization to their children by using pre-structured proforma. Results: level of knowledge & perception was found average (around 50%). Nearly 40 to 60% of the participants agreed to the statements which signifies the immunization is very important to the child’s growth and development and should not be avoided. Conclusions: Providing mothers of under-five children with information about vaccination effectively increases the immunization coverage and was highly cost-effective also

Prevalence of anaemia in pregnant and lactating women in rural Vijayapur

Background: Nutritional anaemia is defined as a condition in which the haemoglobin content of the blood is lower than normal as a result of deficiency of one or more essential nutrients. Anaemia is the late manifestation of deficiency of nutrient(s) needed for haemoglobin synthesis. The prevalence of anaemia in developing countries is estimated to be 43% and that of developed countries is 9%. Anaemia is estimated to contribute to more than 115000 maternal deaths and 591000 prenatal deaths globally per year. The objectives of the present study were to determine the prevalence of anaemia among the pregnant women and lactating mothers and to explore the associated factors with anaemia.Methods: A cross sectional study was conducted among pregnant and lactating women in Ukkali a rural field practice area Shri B. M. Patil Medical College, Vijayapur. Criteria for inclusion were pregnant women- current pregnancy of more than 6 months and lactating mother with child aged up to 6 months of age. Estimation of haemoglobin was carried by standard Sahlis pipette method. Anaemia was classified according to WHO grading criteria.Results: The maximum number of pregnant women (85.71%) in the age group of 35-49 years was anaemic followed by those who were in the age group of 20-34 years (61.54%). Prevalence of anaemia was 72 % in women of less than 20 years, whereas it was as high as 80% among lactating women of 35-49 years age group.Conclusions: Anaemia continues to be a problem with the existing health care resources. Socio-economic status, literacy of women and awareness related to health concerns are the major determinants that contribute to the problem of anaemia.

An Investigator Initiated Prospective, Single Arm Observational Study to Evaluate the Safety and Efficacy of Saroglitazar 4 mg in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)/Non- Alcoholic Steatohepatitis (NASH)

Introduction: Saroglitazar is known to safely and effectivelyimprove dyslipidemia by reducing triglyceride (TG), lowdensity lipoprotein (LDL) cholesterol, very low-densitylipoprotein (VLDL) cholesterol, non-high-density lipoprotein(non-HDL) cholesterol and increasing high densitylipoprotein (HDL) cholesterol. In addition, saroglitazar canimprove glycemic indices in diabetic patients by reducingfasting plasma glucose (FPG) and glycosylated haemoglobin(HbA1c). Aim of the study was to evaluate the hospital basedclinic-pathological profile, diagnosis, treatment and followup of Indian patients with Non-alcoholic fatty liver diseaseand to evaluate the safety and efficacy of Saroglitazar 4 mg inpatients with Non-alcoholic fatty liver disease /Non-alcoholicSteatohepatitis in real life setting.Material and methods: This was an ongoing observationalstudy with the sample size of 52 patients having Nonalcoholic fatty liver disease and dyslipidaemia with or withoutType 2 Diabetes Mellitus and treatment follow up for a periodof 1 year in the Department Of Gastroenterology. The datawas collected from eligible patients who have been prescribedSaroglitazar 4 mg once daily in routine clinical practice.Primary endpoints were to see liver stiffness. Secondaryendpoints were to measure serum alanine aminotransferase,aspartate aminotransferase level and Serum triglycerideslevel.Results: There was a significant decrease in Serum alanineaminotransferase (p <0.001), aspartate aminotransferase (pvalue < 0.001), triglycerides (p value <0.001) and triglycerides(p value 0.01), levels after the treatment as compared to thebaseline.Conclusion: Saroglitazar treatment is effective and there isa significant difference in Serum alanine aminotransferaseand aspartate aminotransferase, triglycerides and LiverStiffness Measurement levels after treatment. The drug can besuccessfully administered for the treatment of Non-alcoholicfatty liver disease.

Molar Refraction and Polarizability of Antiemetic drug 4-amino-5-chloro-N-(2-(diethylamino)ethyl)-2 methoxybenzamide hydrochloride monohydrate in {Aqueous-Sodium or Lithium Chloride} Solutions at 30oC.

The 4-amino-5-chloro-N-(2-(diethylamino)ethyl)-2 methoxybenzamide hydrochloride monohydrate exhibits antiemetic and parasympathomimetic activity. Density () and refractive index (nD) measurements were carried out as a function of drug concentration (c=0.01-0.11 mol·L-1) in aqueous NaCl/LiCl (c=0.05, 0.10 and 0.15 mol·L-1) solutions at 30oC. Linear relation of concentration dependence of density and refractive index were studied. Molar refractivity (RM) of solution was calculated from density and refractive index data and polarizability () was calculated from molar refractivity data. Stronger polarizability effects have been observed with increase in drug concentration.

Investigation of Volumetric and Optical Properties of Anti-Emetic Metoclopramide Hydrochloride Drug in Aqueous-Dimethylsulfoxide (DMSO) Solutions At 303.15.

In view of pharmaceutical applications, the density (ρ) and refractive index (nD) of antiemetic metoclopramide hydrochloride monohydrate (MHM) drug in aqueous, aqueous-DMSO and DMSO solutions were measured at 303.15 K in the wide range of concentration of drug. Apparent molar volumes (φv) were calculated from density data and fitted to the Masson relation to determine partial molar volume (φ °v) of drug. Overall, strong drugsolvent interactions with significant structural changes in pure and mixed solvents have been confirmed.

Transungual drug delivery: An overview.

The body normally hosts a variety of microorganisms, including bacteria and fungi. Some of these are useful to the body and others may cause infections. Fungi can live on the dead tissues of the hairs, nails. Continuous exposal of nail to warm, moist environments usually develops nail infection. Nail plate is main route for penetration of drug. Varity of conventional formulation like gel, cream and also oral antifungal are available for treatment of nail infection. The nail lacquer is a new drug delivery system in treatment of nail infections. The major hurdle associated with developing nail lacquers treatment for nail disorders is to deliver the active (antifungal) therapeutically effective concentrations to the site of infection, which is often under nail. However possible means to enhance nail penetration must be explored in greater depth before effective local treatments for fungal nail infections are developed. Lack of proper in vitro methods to measure the extent of drug permeation across the nail plate is the major difficulty in the development of transungual delivery. Penetration of topical antifungal through the nail plate requires a vehicle that is specifically formulated for transungual delivery. Recent focus is emphasizing on development of a promising antifungal treatment in form of nail lacquer owing to its beneficial advantages.

Narrow band imaging cholangioscopy in hilar cholangiocarcinoma.

Per oral cholangioscopy has been developed as a diagnostic modality for evaluation of bile duct lesions. Per oral cholangioscope with narrow band imaging (NBI) system can provide good quality images of bile duct lesions. There is limited data on per oral cholangioscopy using NBI in biliary tract diseases. We report our experience of NBI cholangioscopy in hilar strictures.

Endoscopic ultrasound-guided biliary stent placement using Soehendra stent retriever.

Symptomatic bilary obstruction with duodenal nar-rowing requires either surgical or percutaneous biliary drainage procedure. We report a 54-year-old woman suffering from carcinoma of the head of pancreas, who had combined duodenal and bilary obstruction and underwent successful endoscopic ultrasound-guided transduodenal biliary stent placement.

Safety of therapeutic ERCP in pregnancy - an Indian experience.

INTRODUCTION: Only limited data are available regarding the safety of therapeutic ERCP in pregnancy. We report our experience with therapeutic ERCP in pregnant women. METHODS: Medical records of 18 pregnant women (first trimester 4, second 6, third 8) who underwent ERCP between July 1994 and December 2004 were reviewed. Patients and their families were contacted to assess the well being of mother and baby. RESULTS: All the women underwent therapeutic ERCP and biliary sphincterotomy for common bile duct (CBD) stones. In 4 patients, 10-Fr CBD stents were inserted; three of these four cases required mechanical lithotripsy after delivery. Median procedure time was 17 min and median fluoroscopy time was 8 seconds. One patient each developed mild post ERCP pancreatitis and post sphincterotomy bleed. One woman had a preterm delivery. At follow up after a median of 6 years, all the babies were healthy. CONCLUSION: Therapeutic ERCP can be performed safely in all the trimesters of pregnancy provided appropriate precautions are taken.

Spectrum of intracranial subdural empyemas in a series of 45 patients: current surgical options and outcome.

BACKGROUND: The subject of subdural empyema (SDE) is reviewed on the basis of experience with 45 cases. METHODS: Records of 45 patients with SDE were analyzed. There were 35 males and 10 females in the series. The majority of the patients were either infants (22.2%) or in their second and third decade of life (37.8%). For supratentorial SDE, craniotomy was done in 5 cases (11.1%). In six cases (13.3%) two burr-holes and in the rest of the cases multiple burrholes were done to evacuate the empyema. Craniectomy was done in three cases (6.7%), of which two had posterior fossa SDE. All patients received appropriate preoperative and postoperative broad-spectrum antibiotics. RESULTS: There was good recovery in 35 (77.8%) patients, six patients (13.3%) had moderate disability, two patients (4.4%) had severe disability, and two (4.4%) died. Three patients who developed recollection at operation site required evacuation of residual SDE. Median follow-up was 3(1/2) years (range 4 months to 3(1/2) years). CONCLUSION: Emergent evacuation of SDE using multiple burr-holes and irrigation of the subdural cavity with saline for 24 hours results in a satisfactory outcome in cases with SDE.

Delayed traumatic interacranial haematoma in postoperative patients: a case for serial computerised tomography

Delayed traumatic intracranial haematoma [DTIH] is an uncommon entity and an epiphenomenon of head injury. Its time of evolution and location is unpredictable. We report two cases of DTIH. First patient was a road traffic accident victim who had left fronto-temporal acute subdural haemoatoma [SDH] with brainstem haemorrhage. Following evacuation of acute SDH, his intracranial pressure [ICP] remained high and repeat computerised tomography [CT] scan of the head done 36 hours later, revealed a large right parieto-temporal acute extradural haematoma [EDH]. The second patient had a minor head injury, 2 weeks prior to admission and CT scan of the head revealed an isodense right fronto-parietal chronic SDH. Eleven days following evacuation of chronic SDH, he developed headache and altered sensorium and repeat CT scan of the head showed right medial temporal intracerebral haematoma [ICH]. Evolution of second intracranial haematoma changes the total clinical scenario. Their clinical manifestation, especially in a postoperative patient is delayed and the prognosis adversely affected by the delay in treatment. Early detection of such haematoma is crucial. Combination of close clinical surveillance, ICP monitoring and radiological evaluation is suggested, however there are limitations and inherent fallacies. Mechanism of evolution and strategies for early detection of DTIH in a postoperative situation is discussed

Unusual case of cystic cerebellar metastasis from breast cancer

Cerebellar metastasis in a 70-year-old female is reported. She was admitted with a 1-month history of vertigo and unsteadiness of gait. There was no history suggestive of raised intracranial pressure. Except for cerebellar signs on right side, she had no other neurological deficit. Systemic examination revealed no abnormality except for a 3cm mobile lump under the nipple that was present for last 10 years without increasing in size. Computed tomography and magnetic resonance imaging of the head revealed a cystic tumour 3 x 3 cm diameter in right cerebellar hemisphere with a possible diagnosis of haemangioblastoma. The lesion was excised and she had an uneventful recovery. Histopathology revealed a metastatic carcinoma of the breast. After two months she underwent modified radical mastectomy. She received deep x-ray therapy for the brain and the breast. Follow-up 6 months later showed no neurological deficits or local recurrence

Multiple central nervous system tumors and combined treatment modalities - an illustrative case

Multiple space occupying lesions in the craniospinal axis pose special type of challenges in their management. Surgeries for decompression or total excision of the symptomatic tumors at various sites and at different times are needed. Radiosurgery and administration of chemotherapeutic agents are other modalities for the treatment of such lesions caused by benign or malignant conditions and acute or chronic infections. We report a case of a young woman with central neurofibromatosis harbouring bilateral acoustic neurinomas multiple meningiomas and other cranial and spinal neurofibromas. she underwent radiosurgery for the right vestibular schwannoma [VS] and surgery for the left sphenoidal wing meningioma and a large right C5 nerve root neurofibroma. There was no evidence of tumor necrosis or shrinkage 4 years after the radiosurgery. Brain stem compression increased over 4 years period. she is likely to need futher intervention for symptomatic lesions

Spontaneous appearing and disappearing acute traumatic intracranial haematomas - an interesting clinical entity case reports and review of literature

Two cases of appearing and disappearing traumatic intracranial haematomas have been described. In the first case, with an initiol normal CT brain scan, a delayed intracerebral haematomas appeared ten hours after injury, while in the second case, an acute subdural haematoma, seen immediately after traumatic brain injury [TBI], disappeared ten hours later. The importance of a delayed CT brain scan in cases of TBIs has been emphasised

Ossification of posterior longitudinal ligament in ankylosing hyperostosis as a cause of myelo-radiculopathy

Development of hypertrophic ossification in the region of posterior longitudinal ligament [OPLL] in patients with ankylosing hyperostosis [AH] may result in significant spinal stenosis and progressive myelopathy and/or radiculopathy. Severe neurological manifestations in such cases are indicators of long term poor prognosis.Therefore it is important to recognise these cases early enough to offer effective therapy when working up myeloradiculopathy. A clinico-radiological analysis of seven patients of OPLL in AH with myelopathy and radiculopathy is presented. Surgically treated patients [4 cases]had remarkably good outcome on long term basis

Post-traumatic occlusion in vertebro-basilar system: report of two cases

OccIusions of the vertebral and basilar arteries following trauma are uncommon occurrences. Most patients present with brain stem or cerebellar dysfunction and although four vessel angiography is essential for localising the anatomic diagnosis, computed tomography of the head [CT head] is helpful in showing associated changes such as infarction, haemorrhage or hydrocephalus. Two cases form the basis of the present report. One patient developed occlusion of the cervical vertebral artery following a gun shot injury and presented with Brown Sequard syndrome and the other patient, who was treated initially for a left frontal extradural haematoma, later developed acute coma eight weeks following the injury. Angiography showed vertebro-basilar dissection, occlusion and posterior inferior cerebellar artery [PICA] pseudo-aneurysm, and computer tomography showed subarachnoid and intraventricular haemorrhage and left cerebellar infarction