PROSPECTIVE COMPARATIVE STUDY OF CONSERVATIVE VERSUS OPERATIVE MANAGEMENT AMONG PATIENT WITH CELLULITIS

INTRODUCTION: Cellulitis is a bacterial infection of the skin and subcutaneous tissuethat is more generalized than erysipelas and associated with broken skin and pre-existingulceration. Mild cases of cellulitis are generally treated with oral antibiotics, GlycerinMgSO4 dressing & affected part elevation and severe cases required admission & higherantibiotics, skin & blood culture & sensitivity & in case of systemic symptoms & abscessoperative management is required.AIMS AND OBJECTIVES:• To observe the outcome of conservative and operative patients in view ofcomorbidity and after treatment complications.• Following factors are accounting before conclusive outcome.• To understand the patients characteristics, comorbidity and mode of presentation.• To study spectrum of organism isolated from patient undergoing conservative oroperative management.• To compare treatment modality and outcome in management of cellulitis.MATERIAL & METHODS: Data consists of primary data collected by the principalinvestigator directly from the patients who were admitted from OPD in the GCS medicalcollege and hospital. It was observational study for a period of six months from April2022 to September 2022 under sample size was 50 cases.CONCLUSION: We recommended Operative management over Conservativemanagement in cellulitis because single operative incision can release toxic fluid fromaffected part and can promote faster healing and better recovery and less hospital stay.Patient has less mental trauma, less pain and more economical benefits in Operativemanagement therefore study concludes Operative management is superior Compared toConservative management. However, conservative management is preferable in earlystages of cellulitis.

A PROSPECTIVE COMPARATIVE STUDY OF CONSERVATIVE AND SURGICAL MANAGEMENT OF VARICOSE VEINS

Introduction : Varicose Veins are Defined as “ Permanently Elongated, Dilated vein/veins withtortuous path causing pathological circulation”.Varicose veins can develop anywhere in the bodybut are most commonly seen in the lower limbs. A detailed knowledge of the mechanism ofhemodynamic failure and the underlying anatomy is important in deciding treatment of the patientwith chronic venous disease.Methodology : The aim of this study was to determine the correlation between differentcomplications of varicose veins and Recurrence rate of Complications with the treatmentundergone by the patient. Total 30 patients were randomly assigned to Conservative management(i.e. Limb End Elevation, Elastic Stockings Application & Intermittent Bed rest to avoid prolongedStanding) or Surgical management (i.e. Trendelenburg Operation with Great Saphenous VeinStripping).Special focus was given to the follow-up visit of the patients who were asked to be present forreview every week, till two months so as to be vigilant regarding the occurrence of complications.Results : Out of 30 patients, 15 were treated surgically while 15 were treated conservatively. Eleven(11) patients in total developed some complications in post treatment part. The commonestcomplication observed in post surgical patients was haematoma. Recurrence of Varicosity wasseen in 4 patients who were previously managed conservatively. A single case of wound infectionand ulcer formation were observed in each respectively. Out of the 11 patients who had developedsome complications, 5 patients had undergone surgical management, while 6 patients hadundergone conservative management.Conclusion : Surgical Intervention is better than conservative management in Varicose veins. Therate of complications / recurrence over a 2 months period was less in the surgical group than in thegroup managed by conservative therapy.

ALTERATIONS IN UNITS OF CENTRAL DOGMA UNDER ARSENIC EXPOSURE DURING PREPARATORY PHASE OF TESTICULAR CYCLE OF Mystus (M.) vittatus (Bl.)

Central dogma units comprise of DNA, RNA and synthesis of protein. Reproductive cycle in ?shes is always dynamic and the units of central dogma are always changing in different phases of testicular and ovarian cycle which constitute reproductive cycle in ?shes. The adult specimens of Mystus (M.) vittatus, a tropical siluroid, when exposed for 30 days to sublethal concentration of trivalent arsenic (11.24 mg/l) revealed signi?cant decline in DNA, RNA and consequently protein in the ovary of Mystus (M.) vittatus during its preparatory phase of Testicular cycle. However, 15 days exposure revealed less signi?cant alterations. Causes for declining in various units of central dogma and consequently protein synthesis is discussed in this paper

Laparohysterotomy for Managing Dystocia due to Uterine Inertia in a Sow: A Case Report

A nondescript sow with the history of delivering eight piglets and one remain in uterus since three days but unable to deliver was reported. The case was diagnosed as dystocia due to uterine inertia and laparohysterotomy was performed under general anesthesia, one male dead piglet was recovered successfully. The animal showed uneventful recovery.

Correlation of vitreous chamber depth with ocular biometry in high axial myopia

Purpose: The proportion of axial length (AL) occupied by vitreous chamber depth (VCD), or VCD:AL, consistently correlates to ocular biometry in the general population. Relation of VCD:AL to ocular biometry in high myopia is not known. The purpose of this study is to evaluate the relation of VCD and VCD:AL to ocular biometry of highly myopic eyes. Methods: This was a cross?sectional retrospective study of records of 214 myopic eyes (<?1 D SE, aged 20–40 years) attending the refractive surgery services. High axial myopia was defined as AL >26.5 mm. Eyes with posterior staphyloma and myopic maculopathy were excluded. Records were assessed for measurements of AL, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white to white diameter (WTW), and vitreous chamber depth (VCD). Groups were formed based on increasing AL, while the sum of CCT, ACD, and LT was recorded as anterior segment depth (AS). The main outcome measure was the correlation of VCD and VCD:AL to ocular biometry. A comparison was also performed based on of degree of axial myopia. Results: Mean age of the patients was 27.0 ± 5.2 years. VCD showed a very strong correlation with AL (R = 0.98, P < 0.001) but did not correlate to any anterior parameter. VCD:AL showed moderate negative relation with AS (R = ?0.43, P < 0.001) and ACD (R = ?0.3, P < 0.001), while it had a weakly negative relation with LT (R = ?0.18, P = 0.006). VCD:AL showed strong negative relation (R > ~0.7) with AS in all individual groups of AL. Among anterior parameters, WTW showed the most consistent relation with ocular biometry. Conclusion: VCD:AL is a better correlate of ocular biometry in high myopia as compared to VCD. However, the correlation is weaker than that noted by previous studies done on the general population. Longitudinal studies of VCD:AL in the younger age group is recommended

ARSENIC INDUCED ALTERATIONS IN GLYCOGEN AND LIPID DURING TESTICULAR CYCLE OF A FRESHWATER SILUROID, MYSTUS (M.) VITTATUS (BL.)

The increasing order in the glycogen and lipid content was observed during preparatory and spawning phase but decrease in these biochemical parameters was during post-spawning phase of testicular cycle in Mystus (M.) vittatus, a freshwater siluroid. Less signi?cant alteration in glycogen and lipid was noticed after 15 days of exposure but highly signi?cant decrease was observed after 30 days of exposure in SLC (Sublethal concentration) of trivalent arsenic as AsCl3. causes for decline in these biochemical parameters have been discussed.

A Randomized Double-Blind Comparative Study of Efficacy and Safety Between Low-Dose Etoricoxib and Ibuprofen Coadministered with Low-Dose Paracetamol for Dental Pain

Objective: To study the safety and efficacy of low-dose etoricoxib and low-dose paracetamol versus ibuprofen and low-dose paracetamol treatments in patients who experienced acute pain after tooth extraction. Methods: A total of 80 patients were recruited and randomized to two study groups, i.e., EP and IP. Group EP received etoricoxib 30 mg once a day and add-on paracetamol 325 mg eight-hourly, and Group IP received ibuprofen 400 mg and paracetamol 325 mg eight-hourly for three days. The analgesic efficacy was assessed by a visual analog scale, pain relief score, and global evaluation score. Patients were assessed at 0, 6, 24, 48, and 72 h. Safety was assessed by the patient’s estimation of the severity of adverse drug reactions using a 3-point scale and the type of adverse drug reactions reported by the patients after 72 h. Results: Mean pain intensity reduction, mean pain relief score, and global evaluation score all showed better analgesic efficacy results in Group EP as compared to Group IP but were not significant (P > 0.05) at 6, 24, 48, and 72 h, respectively. No patient had reported any serious adverse drug reaction in both the groups. Mild to moderate adverse reactions were reported in 20% cases in the IP group and 10% cases in the EP group; however, the incidence of GIT intolerance was seen in 17.5% of the cases in the IP group and none in the EP group. Conclusion: Low-dose etoricoxib with low-dose paracetamol has comparable analgesic efficacy with better safety than therapeutic dose ibuprofen and low-dose paracetamol.

Correlation of Red Blood Cell Indices and RBC Histogram with Peripheral Blood Smear Findings in Anemia

The advent of automation has made diagnosis of Anemia and to some extent its underlying cause easy. The objective of our study is to correlate RBC indices and RBC Histogram findings with peripheral smear to provide a better approach in accurate diagnosis of Anemia and to analyze their limitations. All cases of Anemia as per WHO reference range of Hemoglobin levels were included in our study. Patients who have received medical treatment for Anemia in past three months, patients having recent history of blood transfusion, patients having Leukemia or Leukemoid reactions were excluded from the study. Venous blood samples collected from these patients were run in SYSMEX automated hematology analyzer and complete blood count, Red Blood Cell (RBC) indices ie, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW) and RBC Histogram were obtained and peripheral smears were examined. Anemia typing was done based on RBC indices and position, shape and skewing of RBC histograms, followed by peripheral smear examination for morphological typing of Anemia. The diagnoses made by peripheral smear versus RBC histogram and indices were compared and analysed

Inheritance pattern of okra enation leaf curl disease among cultivated species and its relationship with biochemical parameters

Okra production in eastern India at present is severely threatened by whitefly-mediated okra enation leaf curl disease(OELCuD). Identification of resistant genotype and understanding the genetic control and biochemical relationship of OELCuD resistanceare prerequisite for developing an effective breeding strategy. This study was conducted employing six populations (P1, P2, F1, F2, BC1 andBC2) of two selected (resistant 9 susceptible (R9S)) crosses. Associationship between severity of OELCuD and biochemical parametersof parents and hybrids at preflowering and flowering stages was studied. Segregation pattern of the genotypes in F2 generation showingOELCuD reaction of two crosses suggested that two duplicate recessive genes was operative for resistance to OELCuD. Generation meananalysis revealed involvement of both additive and nonadditive effects in the inheritance of disease resistance. Hence, postponement ofselection in later generations or intermating among the selected segregates followed by one or two generations of selfing to break theundesirable linkage and allow the accumulation of favourable alleles could be suggested for the development of stable resistant genotypeagainst this disease. Higher peroxidase activity and total phenol content in leaf emerged as reliable biochemical markers for early selectionof genotype resistant to OELCuD.

Prevalence of asymptomatic and symptomatic bacterial vaginosis in pregnant women attending antenatal clinic in a tertiary care rural hospital

Background: Bacterial vaginosis (BV) is one of the most common lower genital tract conditions, occurring in 35% of women attending sexually transmitted infection (STI) clinics, 15% to 20% of pregnant women, and 5% to 15% of women attending gynaecology clinic. It has been associated with serious pregnancy complications, including premature rupture of the membranes, preterm delivery and postpartum endometritis. The diagnosis of BV is usually based on clinical criteria including homogeneous vaginal discharge, an elevated vaginal pH, the presence of clue cells, and an amine odour. Objective of this study was to study the prevalence of asymptomatic and symptomatic BV in pregnant women attending antenatal clinic in a tertiary care rural teaching hospital.Methods: Sample size of 301 patients over 6 months study duration in an observational cross sectioned prospective type of study. An unfixed vaginal smear was collected from pregnant women and sent to microbiology for staining and fixing and diagnosis was established.Results: The age range in pregnant women enrolled was 18 to 42 with mean age 26.10 years. As per the Nugent score criteria, 68 (23%) women tested positive for BV (Nugent score 7-10) and 77 (25%) had an intermediate score (Nugent score 4-6). While in 156 (52%) pregnant women’s Nugent score was in between 0-3 indicating no BV but 10% cases amongst these were showing presence of fungal elements mainly budding yeast cells with or without hyphae. In only 53% of cases of BV characteristic clue cells were present. In this study 69% cases of BV were observed in multigravida while 31% were present in primigravida.Conclusions: Screening of asymptomatic pregnant women’s by taking vaginal swab and evaluating gram smear using Nugent score system will play vital role early diagnosis of reproductive tract infections.

Blood heavy metal levels in children with attention deficit hyperactivity disorder: an unsolved enigma

Background: The role of heavy metals in the etio-pathogenesis of attention deficit hyperactivity disorder (ADHD) is a burning enigma. The available studies with discordant results are from different geographical localities with different monitoring, regulations and sociocultural backgrounds. The differential association of heavy metals with ADHD severity and phenotypes has not been adequately examined. Also, there are concerns about laboratory quality control. Therefore, the present case control study was formulated.Methods: Thirty children with ADHD diagnosed by DSM IV criteria and thirty group age matched controls were enrolled. Detailed perinatal, past, developmental and possible exposure history to various heavy metals was taken. Severity of ADHD was assessed using ConnersTM Parent reporting questionnaire. Blood level of metals was estimated by inductively coupled plasma- atomic emission spectroscopy (ICP-AES).Results: The mean blood lead, mercury, cadmium, arsenic, zinc were comparable in children with ADHD and group age matched controls. The mean blood lead, mercury and cadmium levels in study population was higher than found in studies from developed countries. Elevated arsenic, mercury and cadmium were found in both cases and controls. Blood zinc correlated significantly with inattention T score and blood mercury with hyperactivity-impulsitivity T score of Conners parent rating scale. Blood cadmium was present in greater proportion of predominant hyperactive-impulsive type patients.Conclusions: Zinc deficiency correlates with inattention; cadmium and mercury toxicity correlate with hyperactivity. Mean blood levels of heavy metals is elevated in a substantial proportion of study population. So, there is an urgent need for sensitization and environmental control.

A Comparative Study between Elebute and Stoner Grading and Mannheim Peritonitis Index in Prognostic Evaluation of Intraperitoneal Sepsis Due to Perforation Peritonitis in Suburban Teaching Hospital

Background: Peritonitis is one of the most common surgicalemergencies with significant morbidity and mortality. Multiplescoring systems have been proposed and assessed inpredicting the outcome in patients with peritonitis. A scoringsystem should be able to assess the need, type, and quality ofthe care required for a particular patient. Realizing the need fora simple and accurate scoring system in these conditions, thepresent study was undertaken to evaluate the Prognosticevaluation of intraperitoneal sepsis in perforation peritonitis byevaluating the efficacy of Elebute and Stoner grading andMannheim peritonitis index (MPI) in predicting the overall riskof morbidity and mortality in patients with peritonitis. This studywas conducted to identify the predicting ability of both thesescores and to compare MPI with Elebute and Stoner grading(ESG) system.Aim: To predict outcome of patients with peritonitis using theElebute and Stonjej grading of sepsis and Mannheim peritonitisindex in these patients and to predict the possible clinicaloutcome and to compare the results of both the scoringsystems.Patients & Methods: The present work is based on theobservations made in 48 patients of perforation peritonitisadmitted in surgical ward of Rama Medical College Hapur,Uttar Pradesh, India from March 2017 to March 2018. Thediagnosis of perforation peritonitis was made on the basis ofdetailed history, physical examination, investigations andoperative findings. A detailed record was maintained carefullyfor every patient and evaluation of Elebute and Stoner gradingof sepsis and Mannheim peritonitis index were made and thenresults of both the scoring systems are compared.Results: Comparison of both the scoring systems showed thatsensitivity was almost equal in both the scoring systems (80%).But specificity and accuracy were slightly improved withElebute and Stoner grading of sepsis (89.42% and 87.36% Vs84.16% and 83.22%) respectively. This may be because ofmore organ systems incorporated in Elebute and Stonergrading of sepsis like hepatobiliary system, temperature,bleeding diathesis, central nervous system which had not beenincorporated in Mannheim Peritonitis index.Conclusion: In the univariate analysis both scoring systemsstudied, were relatively accurate for identifying patients athigher risk for dying from peritonitis. It was found thatprediction among the dead was better than survived in both thescoring systems.

Efectos del tratamiento homeopático individualizado en la hipertensión esencial de estadio I: ensayo aleatorizado, simple ciego, controlado con placebo / Effects of Homeopathic Treatment Individualized in Hypertension Stage I Essential: Randomized Trial, Single Blind, Placebo controlled

Fundamentos: la hipertensión arterial es el cuarto principal factor de riesgo de muerte e incapacidad, así como el responsable de más de 1.6 millones de fallecimientos en la India. Los informes de casos clínicos, los estudios observacionales y los ECA evidencian los efectos de los medicamentos homeopáticos en la hipertensión. Objetivos: los resultados de este estudio se añaden a la evidencia de la eficacia del uso de los medicamentos homeopáticos individualizados en la hipertensión de estadio I. Materiales y métodos: Se ha realizado un ensayo aleatorizado, simple ciego y controlado por placebo entre octubre de 2013 y marzo de 2018. El parámetro primario fue evaluar los cambios en la presión sistólica (PS) y la presión diastólica (PD) mensualmente durante tres meses. 217 pacientes de los 2,127 pacientes examinados cumplieron los criterios de selección y fueron aleatorizados para recibir un medicamento en potencias Q (o potencias LM) más indicaciones para la modificación del estilo de vida (MEV) (116 pacientes) o bien placebo + MEV (101 pacientes). La modificación del estilo de vida incluyó actividad física y dieta como parte de la pauta terapéutica. El análisis fue de intención de tratamiento. Resultados: Las mediciones ANOVA repetidas entre los grupos mostraron una diferencia estadística significativa (Lambda de Wilks 0.85, F=12.12, dF=213, P=0.0001) tanto en la PS como en la PD a favor de la Homeopatía individualizada. La prueba t independiente post hoc mostró una reducción media significativa de la PS [diferencia media 7.12 mmHg, IC del 95%; CI 4.72 a 9.53, P=0.0001] y un descenso medio de la PD [diferencia media 5.76 mmHg, IC del 95%: 4.18 a 7.23, P=0.0001] a favor del grupo con Homeopatía más MEV. Los medicamentos más utilizados fueron: Sulphur (n=24), Natrium muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) y Phosphorus (n=10). Conclusiones: Se ha constatado que la Homeopatía individualizada junto con la MEV fue más eficaz que el placebo junto con la MEV en los pacientes que sufren hipertensión en estadio I. Se precisan más ensayos en un marco estricto. (AU)

Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebocontrolled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2,127 patients screened, 217 patients who fitted the inclusion criteria were randomised to receive either homoeopathic Q potencies (or LM potencies) plus lifestyle modification (LSM)=116 or placebo + LSM=101. LSM included physical activity and diet as part of the treatment regimen. Analysis was by intention to treat. Results: Repeated-measure ANOVA between the groups showed statistically significant difference (Wilk lambda 0.85, F=12.12, df=213, P=0.0001), in both SBP and DBP favouring Individualised Homoeopathy (IH) along with LSM. Post hoc independent t-test showed a significant mean reduction in SBP (mean difference 7.12 mmHg, 95% confidence interval [CI] 4.72-9.53, P=0.0001) and DBP (mean difference 5.76 mmHg, 95% CI: 4.18-7.23, P=0.0001) favouring Homoeopathy plus LSM group. Sulphur (n=24), Natrum muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) and Phosphorus (n=10) were the most useful medicines. Conclusion: IH in LM potency along with LSM was found effective over placebo along with LSM in the patients suffering from Stage I HTN. Further trials in rigorous setting are warranted. (AU)

Prevalence of Intestinal parasites at a Tertiary Care Centre at the Foothills of Himalayas, Srinagar, Uttarakhand, India: A six-year Observational Study

Intestinal parasitic infections is a serious public health problem in most of the regions of the world, especially in developing countries, and represents a major cause of morbidity and mortality in children and among high-risk groups. Aims: To find out the prevalence of intestinal parasitic infections in Garhwal region of Uttarakhand and compare and correlate it with gender, age group and area (rural or urban). Methods: The collected stool samples were subjected to routine stool investigations during the study, i.e. Macroscopic examination was carried out for the presence adult worms or their body segments and microscopic examination such as stool wet mounts (both saline and iodine mounts); modified acid-fast staining for Cryptosporidium and Isospora and ELISA for Cryptosporidium were done. Results: Out of total 3614 patients, 197 (5.45%) (excluding Cryptosporidium ) and 338(9.35%) (Including Cryptosporidium), while 141(3.90%)(only Cryptosporidium )had parasitic infection. Maximum numbers (average) of patients were enrolled in month of May (102, 16.94%) and June (87, 14.45%). Maximum number of patients were in the age group of 1-10yrs (949, 26.26%) whereas out of these110 patients were found positive (11.6%). On the other hand, out of 343 patients in 11-20yrs age group, 46 (13.4%) were found positive and least number of patients were from <1year age group. Mostly male patients were affected by parasitic infections (60.06%). Parasite most commonly isolated was Cryptosporidium 141(41.72%), followed by Giardia lamblia 74(21.89%) and hookworm 40(11.83%). One cases each of trematodes, Fasciola hepatica (both ova and adult) and Clonorchis (ova) whereas two cases of Isospora belli were also seen. Conclusion: Prevalence of intestinal parasites (9.35%) is low in Garhwal region of Uttarakhand.

How conscious are adolescent boys about their body image?

Background: Perceived body image is an important determinant of nutritional status of adolescent boys. Body image misconception during adolescence is mostly unexplored field in Indian boys. The objective of this study is to assess the perceived body image and degree of dissatisfaction about it, among adolescent boys of different socioeconomic class.Methods: This multistage observational study was conducted on 200 adolescent boys of Gwalior in two different schools. Anthropometric measurements were taken. Information about socioeconomic status and perceived body image, desired body size and actual body size was collected with predesigned questionnaire.Results: Out of 200 study subjects 155 had normal BMI and 36 had high BMI, remaining were thin. Majority of adolescents (90%) desires to be neither thin nor fat and 10% (20) studied adolescent boys desires thin body. Lesser number of study subjects (63, 31.5%) adolescent boys were satisfied with their perceived body image. Satisfaction was more (34.65%) in middle adolescent age group as compared to late adolescent (28.28%). Almost two third (137, 68.6%) adolescent boys were dissatisfied with their perceived body image. Majority of adolescent boys (160, 80%) correctly estimated their body image, only 03% adolescent boys overestimated their body image whereas 17% adolescent boys underestimated their body image.Conclusions: Majority of adolescent boys are dissatisfied with their body image and almost all of them desire to have perfect body size.

Intralesional Verapamil for the Treatment of Peyronie’s Disease: A Prospective Study

Background: Peyronie’s disease is an inflammatory, fibroticpenile disorder affecting men in age range of 19-83 years. Itoccurs as an acute or chronic phase and rarely cases resolveon their own. Several treatment options are available includingoral, intralesional and surgery. Although several clinical trialshave been performed, they lack significant and corroboratedresults hence there is a need to attempt prospective researchto elucidate the most effective therapies. The aim of this studyis to determine the efficacy of intralesional injection ofverapamil over normal saline.Methods: This was a randomized parallel group studyconducted between March 2013 and February 2017 whichrandomized patients with Peyronie’s disease into two groups toreceive verapamil or normal saline intralesional injections, withinclusion criteria of penile curvature with or without plaque.After 6 biweekly injections, all above parameters andsatisfaction score was reexamined. Patients were evaluated byhistory, physical examination, questionnaire, ultrasonographyand color Doppler study of the penis.Results: A total of 53 patients were enrolled (verapamil, n=28;control, n=25). Overall, among verapamil group attenuatedcurvature, erectile dysfunction and reduced plaque size werefound in 82%, 64.2%, 67.8% of and 60.7of patientsrespectively. Pain decreased in both groups considerable to97% and 91%. Overall satisfaction level was higher inverapamil group that is82% to control group of 40%.Conclusion: Intralesional verapamil is a good treatmentchoice with absence of invasive procedures and overall goodsuccess rate and patient acceptability.

Biofilm Formation among Various Candida Species and its Role in Antifungal Resistance at Tertiary Care Centre, Jhalawar

Introduction: Serious fungal infections particularly Candidainfection have increased in recent years.It is as a consequenceof increased immunosuppression associated with HIVinfection, organ and tissue transplant and aggressive treatmentfor neoplastic and autoimmune diseases. Study aimed toinvestigate biofilm formation among candida species isolatedfrom various clinical samples and its role in antifungalresistance.Material and methods: A retrospective observational studywas conducted from October 2017 to January 2019 in theDepartment of Microbiology, Jhalawar Medical College,Jhalawar. A total of 630 samples with suspected Candidainfections were collected and processed. A total of 313Candida isolates from various clinical samples were taken upfor the study. Samples were processed by Gram staining, KOHmount and culture on SDA and BHI agar. Isolated yeasts wereidentified and speciated by germ tube test, chlamydosporesformation on corn meal agar, color production on CHROMagar, sugar fermentation test and sugar assimilation test.Biofilm production was tested by Tube method and Tissueculture plate method. Antifungal susceptibility testing ofisolates was performed as per CLSI guidelines.Results: A total of 313 samples out 630 samples were positivefor candida infections. Out of 313 isolates, 157 (50.16%) werefound to be biofilm producers. Candida tropicalis (52.86%)was most common Candida species to be isolated as biofilmproducer followed by C. Parapsilosis (10.19%), C. glabrata(10.19%) and C. krusei (4.45%) while C. albicans was 35/157(22.29%). Antifungal resistant was found to be more in biofilmproducer and tissue culture plate method was found to be moresensitive than tube method for biofilm detection.Conclusion: There is increasing trend of antifungal resistanceamong candida isolates particularly in Non Albicans Candidaspecies. So, it is necessary to identify all yeast isolates up tospecies level and their potential for biofilm formation as it isone of the major virulence factors responsible for antifungalresistance. This will be helpful for efficient treatment,prevention of development of antifungal resistance and finally,the reduction of the treatment costs.

Transvesical Prostatectomy Versus Transurethral Resection ofProstate For Treatment of Benign Prostatic Hyperplasia More Than 100 Gms: A Randomized Control Trial

Purpose: To compare the functional effects and complicationsof transvesical prostatectomy (TVP) and bipolar transurethralresection of prostate (TURP) in patients with benign prostatichyperplasia (BPH) more than 100 gms.Method: Hundred and five patients participated at the SPMCMedical College, Bikaner, India with complaints of BPH withprostate size of 100-150 gm over study duration from June2015 to May 2018. Patients were grouped according to theireligibility for the two surgical procedures namely TVP (n=56)and bipolar TURP (n=49).Results: Of the total 105 patients, 56 (53.33%) patients weresurgically treated with TVP while the remaining 49 (46.67%)were managed with TURP. We did not observe any statisticallysignificant difference between the two groups with regards theIPSS, Qmax, residual urine volume. The numbers of postoperative complications were higher in TURP group (n=9) ascompared to TVP (n=3). Even the late complications such asstricture formation, need for redoing the surgery were higher inTURP group compared to TVP group.Conclusion: Open prostatectomy is a safer and more effectivesurgical treatment option for patients with BPH more than 100gms as compared to bipolar TURP. Even the reports of postoperative complications were higher in TURP group.

Towards an Understanding of Physiological and Biochemical Mechanisms of Drought Tolerance in Plant

Drought stress is one of the major abiotic stress that can causes huge loss to the world food production. It remains a major contributor to severe food shortage and famine. With a consistent increase in world population, pressure will continue to mount on the existing yet limited water resources. The situation is respected to further aggravate due to the predicted increase in temperature and decrease in precipitation consequent upon global warming. Water scarcity has already become a severe constraint in plant survival and productivity of crops in arid and semi-arid regions. The active response of plants to drought stress through various biochemical and physiological modifications improves the metabolism and can further the mobilize various defense mechanisms in order to enhance survival of the plants under conditions of drought. In this review, various physiological and biochemical responses in plants towards enhancement of drought tolerance are discussed.

Syndromic approach to identify cases of vaginal discharge: a cross-sectional study among females of Shaheed Nagar, Bhopal, Madhya Pradesh

Background: Management of Sexually Transmitted Infections (STIs) is important in controlling STIs and to break the chain of infection and transmission.Syndromic case management is a standardized evidence-based approach which utilizes clinical management algorithms and flowcharts that are handy and can be consistently used across health care providers. The objectives of the study were to identify cases of vaginal discharge in Shaheed Nagar, Bhopal and to provide them treatment following syndromic approach.Methods: Prospective cross-sectional study carried out over a period of three months among reproductive age group females (15-45 years) in Shaheed Nagar, Bhopal. Purposive sampling by conducting door- to- door survey until 150 women fulfilling study criteria was interviewed. A pre-designed questionnaire used for data collection. Educational intervention given to all participants. 37 participants identified with vaginal discharge syndrome and were assisted by study team to gynecological OPD for obtaining treatment based on syndromic approach. Data entered in MS Excel 2007 and statistical analysis carried out using epi-info 7.2. Proportions and percentages were calculated. Chi-square was used to find out association between prevalence of vaginal discharge and qualitative variables. P value <0.05 considered statistically significant.Results: Prevalence of vaginal discharge was 24.67%. The most common presenting complaint was general weakness (52%). The most common diagnosis was cervicitis (8.67%) followed by vaginitis (4.67%). Statistically significant correlation was found between presence of disease (STI) and use of intra- uterine device (IUD), non-use of sanitary pads, marital status, occupation and socio- economic class.Conclusions: Abnormal vaginal discharge can both be the cause as well as the effect of pelvic inflammatory disease.