A Study On Awareness Of Pradhan Mandri Jandhan Yojana In Erode District

Financial inclusion is an important factor for a country's development. Government is continuously taking some measures for financial inclusion, one among such measure is introduction of Pradhan Mandri Jan Dhan Yojan with so many useful features. Even though the Government is taking initiatives, the awareness of public on this scheme questionable. This study is an attempt to study the awareness of PMJDY in Erode District. The researcher has collected 110 samples using convenient sampling technique. The findings stated that, all the socio-economic variables are associated with awareness. Further certain segments are more aware of PMJDY than of others.When it comes to source of awareness, visual media is found to be more influential than others.

Evaluation and correlation of clinicopathological and radiological findings of axillary node positivity in clinically node negative carcinoma breast

Background: In 2015, there will be an estimated 155,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. By the time a breast lump becomes palpable for clinical detection, it is usually advanced. We conducted a study to compare the status of axillary lymph node between the radiologicaland histopathological finding with the clinically negative lymph mode in carcinoma breast in order to limit the axillary lymph node dissection.Methods:This prospective study 50 female patients of carcinoma breast freshly detected and those with non-palpable axillary lymph admitted in S.C.B M.C.H, Cuttack, were included in the study.Results:The mean age of the patients was 51.26 years with standard deviation of 12.26 years with a range of 20 to 80 years. All 50 cases included in the study was done mammography of both breast and among them BIRADS IV 18 cases, BIRADS V 19 cases, BIRADS VI 5 cases and 08 cases were benign. 44 (88%) patients had Karnofsky performance score of 90-100 and 6 (12%) patients had score of 80-90. None (0.00%) of the patients had <80 performance score. Out of the 50 cases enrolled in the study, 04 were underwent wide local excision, 09 were breast conservation surgery and 37 were modified radical mastectomy along with axillary clearance.Conclusions: Higher sensitivity due to axillary ultrasound helps to reduce surgery time as patients with positive axillary lymph nodes directly get an Axillary Lymph Node Dissection (ALND) without preceding Sentinel lymph node biopsy (SLNB).

A clinical study of management of wounds using vacuum assisted dressings

Background: The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. Vacuum assisted closure (VAC) has proved its efficacy for wound dressing leading to faster wound healing and shorter hospital stay. The aim of the study was to determinethe advantage of vacuum assisted closure over conventional dressing in SCBMCH hospital.Methods:The study was conducted at general surgery wards of SCB Medical College hospital. After debridement of the wound vacuum assisted dressing was applied. Control group was given conventional dressing.Results:In the study sample 10% patients were less than 40 years,76% belonged to 41-60 age group and 7% were more than 61 years of age, 60% male and 40% female. Wounds were located in the foot 27 (54%), leg 19 (38%), sole 2 (4%) and forearm 2 (4%). Patients with sterile pre (VAC), culture and sensitivity was not turning non sterile after VAC, but 90% non-sterile turns sterile after vacuum assisted dressing. In 5 days 25% of granulation tissue formed in VAC dressing whereas only 10% in case control. Similarly, in 10 days it was 40% for VAC and 25% in case of control. Finally, in 15 days it was 70% in case of VAC and 40% in case of control.Conclusions:VAC results in better healing, with few serious complications, and a promising alternative for the management of various wounds.

In Vitro Antioxidant Potentiality Of Purified Anthocyanin From Floral Petals Of Wild Balsam Species

Phenolics are the largest group of phytochemicals ubiquitous in plant species with considerable interest economically. Recently, search of novel polyphenols increasingly becomes an area of intensive pharmacological research due to their multiple bioactive features such as antioxidant, antimicrobial, anti-carcinogenic, anti-viral and anti-inflammatory potentialities. Anthocyanins are flavonoid group of polyphenols, a group predominant in flowers, fruits and vegetables. The flavonoids, perhaps the unique single group of phenolics in foods, comprise a group of over 4200 C15 aromatic molecules with multiple structural patterns. The functions of anthocyanins as medicinal have been well-accepted in folk medicine throughout the world. In fact, these molecules are connected to an amazingly broad-based range of health benefits. In this juncture, the aim of this work was to evaluate the antioxidant activities of purified anthocyanin from wild balsam species. Initially, anthocyanin was extracted from floral leaves of wild balsam species and purified by chromatographic techniques. Subsequently, it was subjected to NMR and LC MS analysis. The major fractions identified were hesperidin, dimethoxy antirrhinin and trimethoxy antirrhinin. Further, the anthocyanin extracts were subjected to in vitro protocols like 2,2’-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS) radical cation, DPPH scavenging assay, ferric reducing antioxidant power (FRAP), beta carotene bleaching assay, metal chelating and H2O2 scavenging power. Interestingly, ABTS, FRAP analyzes yielded significant results as compared to others. The data were comparable with that of synthetic antioxidants like ascorbate and catechin. Meanwhile, beta carotene and H2O2 scavenging assay showed moderate results. DPPH and metal chelating protocols displayed the values 71% and 64% respectively at 25 µg/ml concentration. This study provides model systems for the evaluation of natural antioxidants like anthocyanin. Future in vivo clinical studies are warranted to confirm the obtained data.

Antibiotic regimens utilization in treating community acquired pneumonia of a government practice setting: a prospective observational study in medical inpatients

Background: Pneumonia is a lower respiratory tract infection characterized by inflammation of lung tissue accompanied by infiltration of alveoli and bronchioles. Most common type is community acquired pneumonia (CAP). Initial therapy is usually empirical that is designed to treat various pathogens. In CAP cases, antibiotic therapy should begin at the earliest. The objectives of the study include to identify most common causative micro-organisms, to assess risk of developing CAP in patients having co-morbidities, to identify most commonly prescribed antibiotic regimen.Methods: A prospective observational study was conducted for period of 6 months at RIMS, Kadapa. 120 patients were recruited based on inclusion criteria. Treatment was given according to Infectious Diseases Society of America and American Thoracic Society guidelines.Results: In a total of 120 patients, 77 were males and 43 were females. 69 patients belong to 46-55 & above age groups. 84 patients had social habits and 36 patients are without social habits. Patients with single lobe infiltrations are 105 and patients with multiple lobe infiltrations are 15. In our study, streptococcus pneumoniae and pseudomonas aeruginosa were the most common isolated organisms. Monotherapy was given for 7 patients, dual therapy for 97 patients and triple therapy for 16 patients. 33 patients received ceftriaxone (CEF) and augmentin (AUG), 29 patients received CEF and azithromycin (AZI), 7 patients received levofloxacin (LEV), 25 patients received CEF and LEV, 10 patients received CEF and ciprofloxacin (CIP) and 16 patients received CEF, AUG and AZI. 100 patients had less than 8 days of hospital stay.Conclusions: Research study concluded that ? lactum antibiotics were the most commonly prescribed class. CEF and AUG was highly recommended drug regimen.

Near full thickness macular hole with an intact overlying internal limiting membrane following resolution of fulminant acquired toxoplasma retinitis -A unique finding

A 43-year-old immunocompetent male presented with focal macular retinitis with overlying vitritis in the right eye. His BCVA was counting fingers close to face. OCT showed increased intraretinal thickness at the area of retinitis with adjacent hypo reflectivity of the choroid. Serology was positive for IgM and IgG antibodies for toxoplasma. He received oral clindamycin 300 mg 4 times/day for 8 weeks. At 6 weeks, his BCVA was CF 2 metres. Fundus showed complete resolution of retinitis with formation of near, full thickness macular hole with intact overlying ILM. A small hyper reflective scar was seen at the base of the macular hole.

Seroprevalence of Lymes disease in the Nagarahole and Bandipur forest areas of South India

Purpose: The aim of this study was to determine the seroprevalence of Lymes disease in a population at risk in south India. Methods: Prospective ongoing study and included screening of forest workers and staff of Nagarahole and Bandipur forest ranges in South India for Lymes disease. Screening included a detailed questionnaire for Lymes disease, complete ocular and systemic examination by an ophthalmologist and infectious disease specialist and blood collection. ELISA for IgM and IgG antibodies for Borrelia burgdorferi were performed on the collected sera samples. Western blot confirmation was done on the seropositive samples. Ticks were also collected from these forest areas for future studies to detect if they harbor B. burgdorferi. Results: Seroprevalence of 19.9% was noted by ELISA. Western blot confirmation was seen in 15.6% of the seropositive samples. There was significant correlation between seropositivity and exposure to tick bites (P = 0.023). Conclusion: There is a high seroprevalence of infection with B. burgdorferi in the forest areas of Nagarahole and Bandipur ranges in south India.

Delayed Spontaneous Thrombosis of Neglected Direct Carotid-Cavernous Fistula: A Case Report / 신경중재치료의학

Direct carotid-cavernous fistula (CCF) refers to direct communication between the cavernous portion of the internal carotid artery (ICA) and the cavernous sinus due to rent in the ICA, most commonly secondary to trauma. These are generally high-flow fistula and rarely resolve spontaneously. We report a case of a young male who developed features of direct CCF after trauma, was denied any treatment for 4 years, and then presented with spontaneous thrombosis of the fistula and a residual large pseudoaneurysm of the cavernous segment of the right ICA, which was subsequently managed with parent vessel occlusion.

Pediatric viral orbital cellulites secondary to H1N1 infection: A case report

A 10-year-old boy admitted for high-grade fever and pneumonia developed left preseptal and early orbital cellulitis, unresponsive to higher intravenous antibiotics. He received oseltamivir, on testing positive for H1N1 virus on the nasopharyngeal and throat swabs. There was dramatic improvement with resolution of orbital cellulitis within 24 h of starting oseltamivir. We report a very rare presentation of pediatric orbital cellulitis secondary to systemic H1N1 infection. Prompt investigations and timely treatment with oseltamivir aided in complete resolution, avoiding vision and life-threatening complications.

Intravenous tocilizumab in idiopathic pediatric uveitis with refractory cystoid macular edema – A case report

A 13-year-old boy with a 4-year history of idiopathic pediatric uveitis and recurrent uveitic macular edema had failed conventional immunomodulatory therapy and presented to us with a vision of 6/24 [right eye (OD)] and 6/9 [left eye (OS)]. Fluorescein angiography showed diffuse vascular leakage along with cystoid macular edema (CME). Intravenous tocilizumab (10 mg/kg body) was given as 14 injections over 12 months. Repeat fluorescein angiography every 3 months showed a dramatic improvement in the vascular leakage and resolution of CME. At 13 months OF follow-up, vision had improved to 6/9p (OD) and 6/6(OS) with no recurrence of inflammation or CME.

Breast Diseases - Clinicopathological Correlation: A Three Years Study

Introduction: To establish the early definite diagnosis in the cases of breast diseases, it is evaluated the relationship between clinical diagnosis, cytological, and histopathological findings. A definite diagnosis of breast disease at the proper time will lead to the correct and successful management. Breasts are the characteristic features of the mammalian family of the animal kingdom. Breasts are present in pairs in all animals. In human beings, mammary glands are present one on each right and the left side of the chest cage in both females and males. The diseases of the breast are more common in females. The common diseases are benign and malignant neoplasm’s, infections such as mastitis and breast abscess. The usual clinical presentation is with a breast lump, breast pain, and breast enlargement. Benign breast diseases are not life-threatening, but malignancyis dangerous for life. The most common cause of death in females, all over the world is breast cancer. Therefore, early detection of the malignant condition is essential for successful treatment and better results which increases survival rate. Materials and Methods: A total of 110 female and seven male patients who attended General Surgery Outpatient Department (OPD) of Maheshwara Medical College and Hospital, Chitkul of Telangana State with various types of clinical breast complaints are included in the present study. The data were collected from the outpatient register, operation theater, cytology, and histopathology register. All the patients who received treatment at this hospital from January 2016 to December 2018 are included in this study, after obtaining the Institutional Ethical Committee Clearance. The clinical provisional diagnosis was confirmed by investigations such as local ultrasound and fine-needle aspiration cytology before the definite line of management was planned. The patients who require surgical intervention were treated accordingly, and surgery under the necessary anesthesia was done. The excised specimen was sent for histopathological examination. The correlation between clinical diagnosis and histopathological findings was compared to evaluate accuracy. Results and Discussion: A total of 110 female patients and seven male patients were studied. The age range was from 13 years to 80 years. The youngest girl of 13 years of age was presented with a lump in the left breast and oldest patient was of 80 years female presented with a mass in the right breast. The maximum number of patients presented clinically with a lump in the breast and the second symptom was a pain in the breast. The common breast diseases were benign and malignant neoplasms. In the benign conditions, most common was fibroadenoma (69 patients 62.72%) in young females. In older age >40 years, the breast cancer is common. All the seven male patients with breast enlargement clinically, diagnosed as gynecomastia and histopathologically confirmed. Conclusion: In this series about 110 female and seven male patients who attended general surgery OPD in 3 years were studied. The provisional clinical diagnosis was compared with cytological and histopathological findings, which was found to be accurate in 86.3% of cases. The common clinical presentation with breast lump was histopathologically found to be fibroadenoma. The older females after menopause or above 50 years of age usually presented with a mass in the breast clinically diagnosed as cancer breast histopathologically proved in all cases 100%

Synchronous primary cancers: Renal cell carcinoma and rectal cancer

Although cancers of rectum and kidney are common malignancies, the occurrence of primary synchronous neoplasms of these organs has been reported rarely. Very few case reports are available in literature till date. The relationship between these two events remains unclear, probably because of the rarity of the association. In this report, we describe incidentally detected renal cell carcinoma in an elderly man, during staging workup of rectal adenocarcinoma and both malignancies were surgically managed simultaneously with curative intent.

Progressive, subretinal fibrosis mimicking retinal necrosis with poor visual prognosis in sympathetic ophthalmia: A rare finding

We report a rare finding of progressive subretinal fibrosis mimicking retinal necrosis in 2 cases of sympathetic ophthalmia. Histopathology of the inciting eye and vitreous biopsy of the sympathizing eye ruled out infections and masquerades. Progression of inflammation and rapid deterioration of vision inspite of maximum immunosuppression are key findings in this variant of sympathetic ophthalmia.

A Case Series Of Sarcomatoid Transitional Cell Carcinoma Of Renal Pelvis And Collecting Duct Carcinoma Of Kidney

Sarcomatoid transitional cell carcinoma (TCC) of the renal pelvis and collecting duct carcinoma (CDC) of the kidney are rare types of malignant renal tumors with aggressive behavior. Here, we report a case series of these tumors, in males of age 65 years and 72 years, respectively. In both the cases, the left kidney was affected and they underwent the left-sided radical nephroureterectomy. Histologically, sarcomatoid TCC showed two components with invasive TCC and areas with spindle cells and osteoclastic type of giant cells. The immunohistochemistry showed diffuse positivity for CK7 and negativity for CK20 and p63 in both the components. CDC showed tubule-papillary patterns with marked desmoplasia. The patients were disease free after a follow-up of 12 months and 2½ years, respectively, without any adjuvant therapy

Induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma in adults: Results from a nonendemic region

BACKGROUND: Recently published prospective clinical trials and two meta-analyses have shown that addition of induction chemotherapy (IC) to concurrent chemoradiation (CRT) could potentially improve outcomes in comparison to CRT alone, in locoregionally advanced nasopharyngeal carcinoma (LANPC). Although it remains unclear which is the best IC regimen to be offered and for how many cycles. Unfortunately, till date, there are no published data from India regarding the outcomes of various commonly used IC regimens before CRT, in LANPC. MATERIALS AND METHODS: Patients diagnosed with LANPC from January 2012 to December 2017, who received three cycles of IC before definitive CRT were reviewed retrospectively. Patients' profile, toxicity of IC, response rates, failure-free survival, and overall survival (OS) were evaluated. RESULTS: A total 34 patients with LANPC who received IC were reviewed. The median age at diagnosis was 36 years, and the majority were males (67.6%, n = 23). Nineteen patients received IC with paclitaxel plus cisplatin regimen (TP) and the remaining 15 patients received IC with docetaxel/paclitaxel plus cisplatin plus 5-FU regimen (TPF). The overall response rates after three cycles of TP and TPF IC were 68.4% and 80%, respectively, and the corresponding rates were 84.2%and 93.3%, respectively, 2 months after completion of CRT. At a median follow-up of 24 months, 2-year failure-free survival and OS for TP arm were 78.9% and 89.5%, and the corresponding rates for TPF arm were 86.7% and 93.3%, respectively. All Grade III–IV toxicities were numerically higher with triplet IC regimen in comparison to doublet regimen. CONCLUSION: In this retrospective analysis, there was no significant difference between taxane-based doublet and triplet IC regimens, in terms of survival outcomes, although Grade III–IV toxicities were numerically higher with triplet IC regimen. Clearly, these hypothesis-generating findings should be tested in a prospective randomized setting.

Primary cutaneous B-cell lymphoma: A single-center 5-year experience

BACKGROUND: Skin is the second most common site for extranodal non-Hodgkin's lymphoma (NHL). Most primary cutaneous NHLs are of T-cell origin (70%). Primary cutaneous B-cell lymphoma (PCBCL) is a rare entity. MATERIALS AND METHODS: Patients diagnosed with PCBCL between January 2012 and July 2017 at our center were retrospectively analyzed. RESULTS: Eight patients of PCBCL were diagnosed. Three patients (37.5%) were males while 5 patients (62.5%) were females. The median age at diagnosis was 45 years (range, 18–60 years). Scalp was the most common site of involvement (50% of the patients). Diffuse large B-cell lymphoma (DLBCL) was the most common histology (63%), with leg-type DLBCL diagnosed in 1 patient. Two patients had primary cutaneous follicle center lymphoma, whereas the remaining 1 patient had precursor B-lymphoblastic lymphoma. All 5 DLBCL cases were treated with CHOP chemotherapy, and rituximab was given to 3 patients. Of the primary cutaneous follicle center lymphomas, 1 patient with stage II disease was treated with CHOP and is alive without recurrence for the past 5 years, whereas the other patient is on observation alone. The patient with precursor B-lymphoblastic lymphoma was started on MCP-841 protocol; however, the patient did not complete the treatment and died after 11 months. CONCLUSIONS: PCBCL is a heterogeneous group of diseases and dividing them into subtypes, based on morphology and immunophenotype, has therapeutic implications.

Bilateral arterial occlusions masking retinitis in a HIV-positive male

We report an interesting case of 36-year-old HIV-positive male with uveitis, cilioretinal artery occlusion in OD, and superotemporal branch retinal artery occlusion in OS. Hypercoagulability, cardiovascular, and rheumatologic workups were unremarkable. Aqueous taps were negative for toxoplasma, viruses, and MTb by multiplex polymerase chain reaction. Patches of retinitis were seen on clearing of retinal edema. Serology was positive for toxoplasma and rickettsia. Management included doxycycline, azithromycin, bactrim DS, and oral steroids. Vision improvement to 6/60 and 6/24 in OD and OS refer to the right eye and left eye, respectively, were noted at 4-month follow-up. Infections should be considered in arterial occlusions associated with inflammation in HIV-positive individuals.

Healicoll: An Alternate to Flap Cover for Bare Bones and Tendons.

Background: Wounds with bare bone, joint and tendons in the extremities have been a formidable challenge to plastic surgeons. Although several skin substitutes are used in West, as both dermal and epidermal analogue, they are expensive and most of them are unavailable in India. It is in this scenario that Healicoll – a type 1 pure collagen as a possible dermal substitute is being investigated. The material ‘Healicoll’ is a type-1 native collagen derived from the bovine source and is bioengineered, biocompatible and biodegradable skin substitute. The advantages of Healicoll have led us to an increase in its use for complex wounds. Medical literature on Healicoll, thus far has only reported its use for superficial burns and ulcers. Materials & Methods: The purpose of this study was to evaluate the advantages of using an inexpensive, easily available, bioengineered skin substitute ‘Healicoll’ for the closure of bare bone, joints and tendon. Results: Healicoll was used in three patients with two patients having undergone surgery involving use of Healicoll for bare bones, joints and tendons after release of contracture following burns and trauma, and one patient was treated with Healicoll as an outpatient procedure for bare bones following electrical burns. The mean hospital stay was 15 days. In all the three cases, a clear neodermis had covered the bones and joints in 5 days time and was ready to support the take of skin graft. Conclusions: Based on our initial experience, Healicoll skin substitute offers an excellent alternative for rapid reconstruction obviating the need for flap cover for wounds that have been difficult to reconstruct.