Ayurvedic Management of Primary Infertility Associated with PCOS - A Case Report

Poly cystic ovarian syndrome is a condition characterised by a wide range of signs and symptoms including menstrual irregularities, obesity, acne, hirsutism and is causing adverse effects on metabolic and endocrinal system. Exact etiology and pathophysiology is still unclear but it’s having a strong familial predisposition. This is a case report on an anovulatory infertility caused by PCOS. A 27-year-old female patient presented to the Streeroga OPD at ITRA On December 29, 2020, complaining of infertility, irregular and delayed menstruation, and weight gain over the past three years. She has been taking allopathic medicine for the same for the last two years. During her initial opd visit, she received a thorough medical history as well as all relevant clinical, physical, and laboratory tests. Bulky ovaries with polycystic morphology were discovered on sonography. Anovulatory factor infertility owing to PCOS was determined based on clinical symptoms and sonography. Pathadi choorna and Arogyavardhini rasa were chosen as medications and Samana oushadha was chosen as the line of management. The patient was counselled on lifestyle changes, the need of exercise, and correction of food habits. Patient was under medication for a period of 5 months. Patient got conceived after that and on 8th February 2022 she gave birth to a healthy male baby per vaginally with a baby weight of 3.2 kg.

Role Of Ultrasound In Ectopic Pregnancy

Introduction: Ectopic pregnancy (EP)is an implantation occurring outside the uterine cavity. Before introduction of diagnostic role of USG in ectopic pregnancy (EP) it was used to be mediate the time of surgery. Currently ultrasonography is regarded as the gold standard method for diagnosing ectopic pregnancy (EP).It may identify masses as small as 10 mm in diameter in the adnexa and details about character of the mass. It also evaluates the content of endometrial cavity and assess presence of free peritoneal fluid. Color flow Doppler technology may even further improve the accuracy of diagnosis. In present study we analysed diagnostic accuracy of trans abdominal USG in patients presented to tertiary care hospital with suspected ectopic pregnancy (EP). To evaluateAims And Objectives: transabdominal USG features in ectopic pregnancy and correlate them with surgical findings. Material And Method: Amongst the patients referred to radiology department of our hospital from January 2022 to September 2022 for first trimester ultrasound, those with the suspected ectopic pregnancy and who underwent surgical treatment for ectopic pregnancies were enrolled. Transabdominal USG was performed preoperatively in all cases by Philips affinity 30 machine. On transabdominal USG adnexal mass with pelvic fluid was found in 19 (66 %), Pelvic fluid withoutResult: adnexal mass in 7 (24 %), mild hemoperitoneum in 9 (31 %), moderate hemoperitoneum in 9 (31 %), severe hemoperitoneum in 5 (17 %) and thickened endometrium in 2 (7 %) cases. Out of total Salpingostomy was performed in 2 (7 %), Salpingectomy was performed in 24 (83 %) and Salpingectomy with oophorectomy in 3 (10 %). USG Sensitivity was found 100 %,Specificity as 66.67 %, Positive Predictive value as 96.30 % and negative predictive value as 100 %. Conclusion: A high level of suspicion, early diagnosis, and treatment enhance the chance for future reproduction. Early diagnosis is made possible by ultrasound. Therefore, ultrasounds should be performed to determine the viability and location of all early pregnancies.

Severe primary hypothyroidism presenting as polymorphic ventricular tachycardia / Hipotiroidismo primario grave que se presenta como taquicardia ventricular polimórfica

Abstract Introduction: Hypothyroidism may have various cardiovascular manifestations due to morphological, functional and electrical alterations in the heart. The usual electrocardiographic findings being sinus bradycardia, low voltage complexes, and slowed intraventricular conduction. Hypothyroidism manifesting as polymorphic ventricular tachycardia has only been reported in a few case reports. Clinical case. A 60-year-old lady presented to us in the emergency department in an unresponsive and unconscious state and electrocardiogram showed a polymorphic ventricular tachycardia. After initial resuscitation with direct current cardioversion and supportive care, she found to have severe hypothyroidism and responded well to thyroid replacement therapy. Conclusion. Polymorphic ventricular tachycardia is a life threatening emergency that can have various etiologies. Polymorphic ventricular tachycardia secondary to primary hypothyroidism is a rare presentation but it is treatable and reversible with thyroid replacement therapy. In patients presenting with QT interval prolongation and ventricular tachycardia, hypothyroidism should be one of the differential diagnosis.

Resumen Introducción: El hipotiroidismo puede presentar diferentes manifestaciones cardiovasculares dadas por alteraciones morfológicas, funcionales y eléctricas en el corazón, siendo los hallazgos electrocardiográficos usuales son la bradicardia sinusal, los complejos de bajo voltaje y la conducción intraventricular lenta. El hipotiroidismo manifestado como taquicardia ventricular polimórfica solo se ha descrito en unos pocos reportes de caso. Caso clínico: Se trata de una mujer de 60 años que acudió que acurdió al servicio de urgencias en un estado inconsciente y sin respuesta a estímulos, y el electrocardiograma reveló taquicardia ventricular polimórfica. Luego de la reanimación inicial con cardioversión con corriente directa y tratamiento sintomático se le encontró un hipotiroidismo grave, el cual se trató con terapia de reemplazo con hormona tiroidea. y se obtuvo una buena respuesta Conclusión. La taquicardia ventricular polimórfica es una emergencia vital que puede tener varias etiologías. La taquicardia ventricular polimórfica secundaria a un hipotiroidismo primario es una presentación poco común, pero es tratable y reversible con la terapia de reemplazo con hormona tiroidea. En los pacientes que presentan una prolongación del intervalo QT y taquicardia ventricular, es pertinente incluir el hipotiroidismo en el diagnóstico diferencial.

Gender differences in genotypic distribution of endothelin-1 gene and endothelin receptor A gene in pulmonary hypertension associated with rheumatic mitral valve disease

Introduction: The female gender is a risk factor for idiopathic pulmonary arterial hypertension. However, it is unknown whether females with rheumatic mitral valve disease are more predisposed to develop pulmonary hypertension compared to males. Aim: We aimed to investigate whether there was a difference in genotypic distribution of endothelin-1 (ET-1) and endothelin receptor A (ETA) genes between female and male patients of pulmonary hypertension associated with rheumatic mitral valve disease (PH-MVD). Methods: We compared prevalence of ET-1 gene (Lys198Asn) and ETA gene (His323His) polymorphisms according to gender in 123 PH-MVD subjects and 123 healthy controls. Results: The presence of mutant Asn/Asn and either mutant Asn/Asn or heterozygous Lys/Asn genotypes of Lys198Asn polymorphism when compared to Lys/Lys in females showed significant association with higher risk (odds ratio [OR] 4.5; p ¼0.007 and OR 2.39; p ¼0.02, respectively). The presence of heterozygous C/T and either mutant T/T or heterozygous C/T genotypes of His323His polymorphism when compared to wild C/C genotype in females showed a significant association with higher risk (OR 1.96; p ¼0.047 and OR 2.26; p ¼0.01, respectively). No significant difference was seen in genotypic frequencies in males between PH-MVD subjects and controls. Logistic regression analysis showed that mutant genotype Asn/Asn (p ¼0.007) and heterozygous genotype Lys/Asn of Lys198Asn polymorphism (p ¼0.018) were independent predictors of development of PH in females.

Trametes versicolor (L.) Lloyd as a source of thermostable serine protease: production and characterization

Proteases are ubiquitously present and are among the largest groups of commercially important enzymes. Here, we investigated a wood-rot basidiomycete Trametes versicolor (L.) Lloyd [Syn. Coriolus versicolor (L.) Quél.; Polyporus versicolor (L.) Fr.] as a source of the enzyme serine protease, its production, and optimized to obtain a higher yield of the enzyme.. The significant variables with optimized values for maximum production of the enzyme were temperature (30?C), incubation time (120 h) and wheat bran (10 g). The yield increased by 30.76% by statistically optimizing the media. The optimized temperature and pH for the maximum protease activity was 50?C and pH 7.0, respectively. The enzyme was purified through ion exchange (using DEAE cellulose 52 resin) and gel filtration chromatography (using Superdex 200 column). The purified enzyme had a retention time of 7 min in RP-HPLC. The enzyme was stable at a broad range of temperature (30-60?C) and pH (5.0-8.0) with a half-life of 58.72 min, Vmax of 37.17 ?M min/mL and Km of 0.657 mg/mL. Its activity was enhanced by Na+, Ca2+, Mg2+ ions and SDS surfactant. These properties make this enzyme a valuable candidate for industrial applications

Long-term Persistence of Immunogenicity After Primary Vaccination and Response to Booster Vaccination With Typhoid Conjugate Vaccine: Results of a Phase IV Extension Study

Objective: To evaluate the persistence of antibodies three years after primary vaccination with typhoid conjugate vaccine (TCV) of either Cadila Healthcare Ltd. (Cadila-TCV) or Bharat Biotech International Ltd. (Bharat-TCV) administered in a previous phase II/III study, and to study the booster dose response to Cadila-TCV. Methods: This was an open-label, phase IV extension study conducted in tertiary care and multispecialty hospitals in India. 112 subjects (Cadila-TCV-57, Bharat-TCV-55) who had participated in previous study were enrolled. Of these, eligible subjects received a single-dose of Cadila-TCV and were followed-up for 28 days post-booster. Primary outcome was persistence of antibodies 3 years after primary vaccination and seroconversion (?4-fold rise in antibody titre from baseline) 28 days postbooster. Safety was based on reported adverse events (AEs) post-booster. Results: The baseline GMT reported in the current study was significantly higher than pre-vaccination GMT reported in the previous study. 89/112 (79.5%) subjects had antibody titer ?10 IU/mL at baseline; eligible subjects (n=17) who had baseline antibody titre <10 IU/mL were administered booster dose. All the vaccinated subjects showed seroconversion post-booster. The GMTs reported at 10 days and 28 days post-booster were significantly higher as compared to GMTs reported after primary vaccination in previous study. 4 (23.5%) vaccinated subjects reported 9 AEs; all were solicited and of mild/moderate intensity. Conclusion: There was a significant persistence of immunogenicity after primary vaccination with both the TCVs, and robust immune response after booster vaccination with Cadila-TCV.

Pterion: Morphometry and Surgical Significance

Introduction: Pterion is a H-Shaped formation of sutures and cranio-metric point on the lateral side of skull. It is marked by the junction of frontal, parietal, greater wing of sphenoid & squamous temporal bone. Objective: The study is aimed to determine prevalence of types of pterions, presence of epipteric bone. We also tried to find pterion’s relationship with anterior branch of middle meningeal artery Materials and methods: Study was done in department of Anatomy, GMCH-32, Chandigarh on 40 adult dried skulls without calvaria, of unknown age, gender and race. The skulls with broken lateral wall were excluded. Skulls were examined for 1. A. prevalence of pterion shape B. Prevalence of bilaterality of similar shape of pterion. C. Prevalence of unilateral variation of pterion on two sides of skull. 2. Epipteric bone A. Presence of epipteric bone B. relation to the suture on both sides. 3. Distance of pterion center point to frontozygomatic suture and upper border of zygomatic arch. 4. relationship of pterion on external and internal surface of skull and on inner side its relationship with anterior branch of Middle meningeal artery. Observations: In the present study 3 types of pterions i.e., Sphenoparietal, stellate, frontotemporal were observed. Sphenoparietal was found to be present bilaterally 40% on both sides. Frontotemporal & stellate were 2.5%. Sphenoparietal type of pterion was 55% on right side & 67.5% on left side. frontotemporal type of pterion was 5% on right side & 2.5% on left side, stellate type was 7.5% on right side & 2.5% on left side. epipteric bone were present in pterion on right side in 32.5% & on left side 27.5%. Pterion was lying approximately 3.5 cm above the zygomatic arch and 2.83 cm behind the posterior margin of frontozygomatic suture. Conclusion: in our study the commonest type of pterion shape was Sphenoparietal. This type was most common to be present bilaterally. Epipteric bone was found in Sphenoparietal type both unilaterally & bilaterally. The anterior branch of MMA was closest and farthest in stellate type.

Association of level of IL-6, IL-10, IL-18, tumour necrosis factor-?with rheumatic mitral stenosis and subsequent pulmonary hypertension

Background:Objective of the study was to provide insight on the immune response in patients of rheumatic heart disease, mitral stenosis and evaluation of various cytokines in pulmonary hypertension secondary to rheumatic heart disease.Methods:Total 163 subjects, more than 18 year of age, were enrolled in this study. 84 subjects with rheumatic mitral stenosis (group A) diagnosed on two-dimensional echocardiography (2D echo)and 79 normal healthy volunteers(group B). Patients with mitral stenosis were further divided into subgroups based on severity of mitral stenosis [mitral valve area (MVA >1 cm2 and MVA <1 cm2)(subgroup Aa and Ab)]and presence or absence of pulmonary hypertension [pulmonary arterial systolic pressure (PASP >36 mm Hg)(subgroup Ac and Ad)]. Interleukins IL-6, IL-10, IL-18, tumour necrosis factor alpha (TNF-?)andhigh-sensitivity C-reactive protein (hs-CRP)levels were assessed in both groups.Results:Mean IL-6, IL-10, IL-18, TNF-? and hs-CRP in group A and group B was 6.57�53 and 2.73�p?0.001), 8.185�8 and 3.51�86(p?0.001), 136.31�.0 and 47.96�76(p?0.001), 21.26�.59 and 5.36�57(p?0.001), 4.69�3 and 2.63�22(p?0.008) respectively. On subgroup analysis mean TNF-? in subgroup Aa was 20.71�.84, while in subgroup Ab was 7.56�93 (p?0.001). Mean IL-10 in subgroup Ac and Ad was 8.74�29 and 7.47�82, respectively. Differences in levels of other cytokines in these subgroups were not found statistically significant.Conclusions:This study finds increased IL-6, IL-10, IL-18, TNF-? and hs-CRP levels in subjects with rheumatic mitral stenosis. Subjects with severe mitral stenosis had increased TNF-? levels. Subjects of mitral stenosis having pulmonary hypertension had increased IL-10 levels.

Left atrial function by two-dimensional speckle tracking echocardiography in patients with severe rheumatic mitral stenosis and pulmonary hypertension

We studied left atrial (LA) function in severe rheumatic mitral stenosis (MS) patients using twodimensional speckle tracking echocardiography (STE). Eighty patients with isolated severe MS in sinus rhythm and 40 controls underwent comprehensive echocardiography including STE derived LA strain [reservoir strain (LASr), conduit strain (LAScd) and contractile strain (LASct)]. The mean MVA was 0.93 ± 0.21 cm2 . The mean values of LASr (14.73 ± 8.59%), LAScd (±7.61 ± 4.47%) and LASct (±7.16 ± 5.15%) in patients were significantly lower (p < 0.001) vs. controls 44.11 ± 10.44%, ±32.45 ± 7.63%, -11.85 ± 6.77% respectively and showed decreasing trend with increasing MS severity and higher NYHA class. In conclusion, LA dysfunction is prevalent in severe MS irrespective of NYHA functional class.

Role of ACE and ACE-2 in abrogated cardioprotective effect of ischemic preconditioning in ovariectomized rat heart

Abstract Ischemic heart disease is the leading cause of death in postmenopausal women. The activity of heart ACE increases whereas the activity of ACE-2 decreases after menopause. The present study was designed to investigate the role of ACE and ACE-2 in the abrogated cardioprotective effect of IPC in OVX rat heart. The heart was isolated from OVX rat and mounted on Langendorff's apparatus for giving intermittent cycles of IPC. The infarct size was estimated using TTC stain, and coronary effluent was analyzed for LDH, CK-MB, and nitrite release. IPC induced cardioprotection was significantly attenuated in the ovariectomized rat heart as compared to the normal rat heart. However, this attenuated cardioprotection was significantly restored by perfusion of DIZE, an ACE-2 activator, and captopril, an ACE inhibitor, alone or in combination noted in terms of decrease in myocardial infarct size, the release of LDH and CK-MB, and also increase in the release of NO as compared to untreated OVX rat heart. Thus, it is suggested that DIZE and captopril, alone or in combination restore the attenuated cardioprotective effect of IPC in OVX rat heart which is due to an increase in ACE-2 activity and decrease in ACE activity after treatment.

Retrospective review of case records of snakebite presenting to a single tertiary care centre over a 5-year period

BACKGROUND Snakebite is a disease of the poor, and hospitals catering to these individuals are often resource-constrained. Lack of electronic medical records in these resource-limited settings makes the capture of data even harder. METHODS Before establishing a snakebite registry in the region, we did a retrospective case record review of all snakebite victims (n=3229) over 5 years who presented to a single tertiary care centre, catering to one of the largest number of snakebite victims in the country. RESULTS Of the 451 cases, 262 (58.1%) presented to the emergency department within 2 hours of the bite. In 170 instances, the snake was brought along and the species of the snake was recorded. Russell’s viper was the most common (130; 76.5%). Blood products were used in 237 (52.5%) patients. Acute kidney injury occurred in 165 (36.6%) patients, of whom 37 (8.2%) required dialysis. The mean (SD) duration of hospital admission was 10.5 (7.4) days. There was a significant correlation between number of snakebites with rainfall and humidity. One hundred and seven cases (3.3%) of snakebite resulted in mortality. A majority of mortality records were not available (88%; 94/107), rendering us incapable of doing reliable mortality data correlations or interpretation. CONCLUSION Viperidae bites predominate in the region, with renal injury being the most common cause for morbidity. Region-specific, prospective snakebite mapping could be a cost-effective strategy that might help in vulnerability analysis of the region. A multi-centric region-specific snakebite registry encompassing not just the clinico-epidemiological characteristics of snakebite victims, but also the demographic data, the pre-hospital care and local remedial practices, geospatial distribution, anti-snake venom and blood product usage, will help in developing better healthcare strategies for snakebite victims in India.

Impact of the novel coronavirus disease and lockdown on the packed red blood cells inventory management: An experience from a tertiary care oncology center in Western India

ABSTRACT Introduction The novel coronavirus disease has disrupted blood transfusion services worldwide. Despite blood transfusion services taking several precautionary measures to minimize the risks of COVID-19 during blood donations, donors became anxious regarding the risk of the COVID-19 infection during the donation and the blood transfusion services was facing the inevitable hazard of blood shortage. Methods The study was conducted at a tertiary care oncology hospital-based blood transfusion services and included analysis of blood donations, packed red blood cell units requirements, and packed red blood cell inventory in the pre lockdown and lockdown phase. New COVID-19 standard operating procedures with enhanced safety guidelines and donor confidence-building measures were implemented at the blood transfusion services. Results The total number of average monthly blood donations decreased in lockdown but the decrease was not statistically significant (238.5 vs. 197.8, P = 0.391). The requisitions for the packed red blood cell cross-matches (722.5 vs. 329.0, P = 0.001) and the packed red blood cell utilization (176.5 vs. 103.3, P = 0.028) for the hospital patients also decreased significantly due to the lockdown. In the lockdown phase, an expressive number of packed red blood cell units were outdated due to the unprecedented fall in the number of patients. In the post-lockdown phase, the packed red blood cell inventory was optimized with decreased outdating via a comprehensive approach. A special emphasis was given to the in-house donations. A second partial lockdown also decreased the blood donations. Conclusion Confidence-building in blood donors and the resolution of logistical issues were crucial for the efficient packed red blood cell inventory management in the lockdown. Implementation of COVID-19 preventive measures helped in the blood donor and blood transfusion services staff safety.

Antiviral activity of ethanolic extract of Nilavembu Kudineer against dengue and chikungunya virus through in vitro evaluation

BackgroundCurrently, no vaccines or modern drugs are available for dengue and chikungunya and only symptomatic relief is provided to the patients. Siddha medicine, a traditional form of indigenous medical system uses specific polyherbal formulations for the treatment of such infections with considerable success. One such polyherbal formulation for the treatment of chikungunya and dengue is Nilavembu kudineer (NVK). The mechanistic details of this drug as an antiviral for chikungunya virus (CHIKV) and dengue virus (DENV) is poorly understood.ObjectivesThe current study was undertaken to study the efficacy of NVK as an antiviral formulation against CHIKV and DENV.Materials and methodsCytotoxicity assays (MTT) were performed to determine the role of NVK as an antiviral during chikungunya and dengue infections in the following conditions-i). post infection, ii). during active infections and iii) protective, not allowing virus infection.ResultsIt was observed that NVK provides protection against CHIKV and DENV-2 during active infection as well can help to prevent virus infection in the cells and it mainly depends on the cellular availability of drugs for maximum protection against both the infections.ConclusionOur study establishes that extraction protocols are important to ensure maximum efficacy of NVK along with the time of addition of the drug during CHIKV and DENV infections in the cells. This study provides insights to the possible mode of action of NVK in in vitro condition during CHIKV and DENV infection.

Correlation of serum uric acid with severity of airflow limitation in the patients of chronic obstructive pulmonary disease

Background: Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA in COPD patients and to evaluate whether sUA level can be used as predictors of exacerbation risk and disease severity.Methods: This cross-sectional study included COPD patients and healthy controls. The sUA levels in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk were reported.Results: The study included 106 COPD patients and 110 healthy controls. The mean sUA levels were significantly higher in patients with COPD compared to healthy controls (p<0.05). Mean sUA levels were compared with different stages of COPD according to GOLD criteria. Stage 4 COPD subjects had highest sUA levels compared to other stages. Statistically significant trend was observed for GOLD staging of disease (p<0.05). Surprisingly non-smokers were having higher uric acid level than smokers (p<0.05). The ROC analyses indicated that sUA levels can be useful in predicting exacerbation risk (AUC, 0.412) especially at higher cut-off values, but with low specificity.Conclusions: Study suggested that sUA levels increased in patients with COPD compared to healthy controls. At higher cut-off values sUA levels might be useful in predicting COPD exacerbation risk and disease severity. However, more prospective cohort studies with large number of participants are needed to further analyse the possible different prognostic roles of hyperuricemia.

Changing trend in prevalence of refractive errors: a hospital-based study

Background: Refractive errors are the second most common reason of blindness in India after cataract. It accounts for 33.3% of cases of childhood blindness. The purpose of this study was to estimate the prevalence of refractive error and related visual impairment in children visiting a tertiary care eye center in Southern India.Methods: This was hospital-based descriptive study. Children <15 years of age with significant refractive error were included in the study. They were examined for visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment and fundus. Significant refractive error was defined as myopia ≥-0.75D, hypermetropia >+2D and astigmatism >0.75D. Descriptive statistics with frequency, mean±Standard deviation were computed for better and the worse eye. Statistical tests were applied between the worse and better eye using Chi square test.Results: A total of 946 children were screened. The mean age was 10.5±6.2 years (3-15 years) with 503 (53.2%) males and 443 (46.8%) females. With respect to vision in the worse eye; 54.01% (n=511) had moderately subnormal vision. One hundred and twenty- two children (23.4%) of <10 years, and 351 (67.4%) of ≥10 years group had myopia, with statistically significant difference (p<0.001). The reverse pattern was seen with respect to hypermetropia and astigmatism. Prevalence of amblyopia was found to be 8.6%.Conclusions: Though myopia is more prevalent among general population, prevalence of astigmatism is higher among children attending an eye hospital and uncorrected astigmatism is the most significant amblyogenic factor in refractive amblyopia.

Serological Evaluation of Clinically Suspected Leptospirosis Cases in a Tertiary Care Hospital

Leptospirosis is a zoonotic infection caused by the spirochaete Leptospira, which has worldwide distribution. Laboratory diagnosis is routinely performed by serological tests like dipstick assay, lateral flow assay and latex agglutination which are rapid tests recommended for screening the disease. Microscopic Agglutination Test (MAT) is the standard test for serological diagnosis of leptospiral infection which is not included in the test panel in most of the peripheral laboratories as the procedure is laborious and it requires to maintain live leptospira. Therefore, one of the rapid tests is routinely employed for demonstration of leptospiral antibodies. Our objective was to screen the acute cases of leptospirosis by Leptochek WB IgM and PanBio IgM Elisa and compare the findings with the MAT and correlate the clinical findings with the serological tests.METHODSThis study was conducted in a tertiary care hospital in Mangalore from August 2010 to September 2013. A total of 314 cases of clinically suspected leptospirosis were included based on the Faine’s criteria. Patients’ serum was screened for leptospiral antibodies by Leptochek WB IgM, PanBio IgM ELISA and Microscopic Agglutination Test (MAT).RESULTSOut of 314 clinically suspected cases screened, seropositivity for leptospirosis by Leptochek WB-IgM, PanBio IgM ELISA and MAT was found to be 49 (15.6%), 65 (20.7%) and 78 (24.8%) respectively. Thus, an overall prevalence rate of leptospirosis was 24.8% (78/314) based on the MAT test. Sensitivity, specificity, positive predictive value and negative predictive value of Leptocheck WB IgM was 53.8%, 97%, 85.7 and 86.4% with MAT while the comparative values of PanBio-ELISA IgM with respect to MAT test was 74.5%, 97 %, 89.2% and 92% respectively. Common clinical features among MAT positive cases were fever, chills and rigors, oliguria, vomiting, jaundice and headache.CONCLUSIONSMAT is a standard serological test for Leptospirosis. This test is not always available for peripheral health centres, as the test is time consuming and cumbersome. Thus, screening tests are now being employed for screening the patients. Rapid tests like Leptocheck -WB can be supplemented with an ELISA test for screening of clinically suspected cases of Leptospirosis and later confirmed with the MAT at reference centres.

A Retrospective Study of Seroprevalence of Chikungunya in Patients Attending Microbiology Department of MGM Medical College, Jamshedpur: A Tertiary care Hospital of Kolhan Region of Jharkhand

Background: Chikungunya virus, an alphavirus belonging tothe Togaviridae family, caused large scale outbreaks in severalparts of southern, western and eastern India in 2006. Wereport Chikungunya outbreak in Jamshedpur region in 2011.Objective: To know the seroprevalence and seasonal trendsof Chikungunya infection among the patients of the diseasewho attended to MGM Medical College, Jamshedpur, A tertiarycare hospital during 2011 to 2014.Materials & Methods: Present retrospective observationalstudies were conducted in the Microbiology Department ofMahatma Gandhi Medical College, Jamshedpur from August2011 to December 2014.Result: Serum samples of 323 patients presenting with fever,arthralgia, rash etc. were tested for anti-Chikungunya IgMantibody using MAC ELISA. 148/324 (47.9%) samples werepositive for anti Chikungunya IgM antibody. More males wereaffected compared to females. The most common age groupaffected was 29-49 year. Characteristically, pediatrics agegroup was least affected. The number of cases increased withincreasing age group.Conclusion: Screening for Chikungunya infection in theendemic areas, especially in monsoon season would improvethe quality of arboviral surveillance and potentially aid in clinicalmanagement of the disease.

Prevalence of Cervical Cancer in Childbearing, Premenopausal and Postmenopausal Women in Kolhan Region, Jharkhand

Background: Cancer of uterine cervix is one of the commoncarcinoma among females. The global incidence of cervicalcancer varies (5 lakhs new cases/year), highest in developingcountries with >50% dying. In India, cervical cancer contributesto approximately 6–29% of all cancers in women. Prevention ofcervical cancer, whether primary or secondary requires activeparticipation of the community. This study is to assess thePrevalence, Pap screening, knowledge, attitude practice andprevention regarding cervical cancer. Identification of riskfactors is necessary to curb the disease.Methods: A cross-sectional study was conducted in differentCHC, PHC and MGM Medical college Jamshedpur area ofKolhan region of Jharkhand. A sample of 499 women aged 15-70 years was taken from January 2017- August 2019 and wasselected and subjected to Pap smear test of cervix andabnormal smears, Histopathological report of HSIL/invasivecarcinoma, Factors like menarche, coitarche, age at marriage,parity, contraception, smoking habit and socio-economic statuswere noted.Results: In our study, HSIL was 0.2% and invasive cancer was2.8%. Out of the 499 respondents most of them belonged tothe 15-39 years age group. About 81.96% were Hindu, morethan all the other religion respondents 79.75% of the womenwere educated in primary level. Around 85.17% of therespondents were housewives by occupation. Majority of thembelonged to the lower socio-economic strata. The awarenessabout Pap smear where p>0.05 not significant.Conclusions: Early menarche, early coitarche, early marriage,high parity, use of contraception other than barrier, lowsocioeconomic status, poor habitat and HPV infection, carrieda high risk of developing cervical cancer. HPV infection wasthe most important risk factor. Improvement of socioeconomicstatus, education and cervical cancer screening of the high-riskgroup can reduce cervical cancer mortality and morbiditysignificantly.

Hypertension prevalence and associated risk factors among bank employees working in an urban area of Marathwada region, Maharashtra, India

Background: Epidemiologic transition of diseases is occurring in recent times throughout the world. The morbidity, disability and mortality burden is now more because of non-communicable diseases. Cardiovascular diseases are number one killer throughout the world. Hypertension has been found to be an independent and consistent risk factor for cardiovascular diseases. Bank employee’s job being sedentary in nature and involving cash management related stress makes bank employees a potential occupational group to develop hypertension. So, this study was planned to assess the prevalence of hypertension in bank employees in the urban area of Latur district, Maharashtra.Methods: A cross-sectional observational study was carried out between January 2016 to December 2016 among all the bank employees working in urban area of Latur, Maharashtra. Approval from institutional ethics committee was obtained beforehand.Results: Total 577 bank employees were surveyed for this study. 32.4% of subjects were found to be hypertensive. Association of higher age group and managerial cadre of employment were found to be statistically significant.Conclusions: Bank employees have a higher prevalence of hypertension as compared to general population. Bank employees are an occupational risk group to develop hypertension.