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Background: Anemia is a very important preventable nutritional disorder affecting pregnant ladies which may have some adverse effects on the neonatal survival and development. Birth weight was correlated with changes in maternal hemoglobin concentration in various trimesters as it is important for determining child survival and development. Aims and Objectives: The aim of the study was to assess the correlation between maternal hemoglobin levels in various trimesters and neonatal birth weight. Materials and Methods: The study enrolled all pregnant women within age group 15–35 years who gave birth at Agartala Government Medical College and GBP Hospital from June 15, 2017 to August 15, 2017. Pregnant women were included into the study following delivery by simple random sampling into cases (Pregnant women who delivered low birth weight babies <2500 g) and control group (Pregnant women who delivered normal birth weight babies ?2500 g). Antenatal data were collected from hospital case sheet and labor room register. Data were analyzed using descriptive statistics and presented as Mean + SD. P < 0.05 (P < 0.05) was considered statistically significant. Results: Mean hemoglobin concentration was normal (?11 g/dl) in all three trimesters among the controls but it is found to be <11 g/dl in second and third trimesters of the case group. The mean birth weight of the babies was 2.151(± 0.2386) kg in case group and 3.047(± 0.3666) kg in control group. Conclusions: It was found that maternal hemoglobin concentration has a positive correlation (r > 0) with neonatal birth weight in all three trimesters in both cases and controls which is statistically significant (P < 0.05).
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India’s health‑care delivery is challenged with different inequalities and the dual burden of communicable and noncommunicable diseases. Lockdown posed negative effects on the growth and economy of the country; simultaneously, some positive effects, like increased health consciousness and adoption of hygienic practices, were also there. Health‑care delivery system faced tremendous challenges in diagnostics, therapeutics, infrastructure for inpatient care, and protection of health‑care manpower. During this period, people chose to self medicate which in turn increased the threat of emergence of antimicrobial resistance. Due to shifting priority to COVID from other diseases, resources were shifted to COVID, affecting the management of other acute and chronic diseases. The launching of COVID‑19 vaccination campaign showed some hope. However, despite the vaccination drive, strengthening infrastructure, and surveillance system, the devastating second wave could not be avoided due to the conglomeration of the crowd for pilgrimage, election campaign, and tourism in an unrestricted manner. It may be concluded that the fourth wave may be short lasting due to increased herd immunity.
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Background: Caregivers face a lot of adversities while supporting their near ones undergoing haemodialysis, and their burden is often ignored by health professionals. The paucity of research in the Indian context has kept their needs out of sight. Aim: To explore the level of burden in the caregivers of patients with chronic kidney disease (CKD) undergoing haemodialysis and to assess whether patient related variable affects the burden. Methods: Fifty-one patients and their caregivers from two dialysis units in Sikkim, India, were assessed cross-sectionally. The Zarit Caregiver Burden Scale (ZCBS) was administered to measure the caregiver burden. The Patient Health Questionnaire-9 (PHQ-9) and the Charlson’s Comorbidity Index (CCI) assessed the patient’s depression and medical comorbidities, respectively. Descriptive analysis was done for the sociodemographic and clinical variables. Chi-square test was used to find the association between the categorical data. Kruskal-Wallis tested the association between categorical and quantitative variables. Results: Mean age of patient was 46.13 (±13.15) years and that of the caregiver was 44.78 (±12.14) years. 68.6% of caregivers had mild to severe levels of caregiver burden. Caregivers who were unemployed and educated till secondary school were more likely to report caregiver burden. Female gender, older caregivers, and caregivers attending patients with a longer history of haemodialysis reported a more severe burden. Conclusion: The level of burden in caregivers of CKD patients is significant and is affected by various factors, which, in turn, also affects patient’s wellbeing. Further research in this area is needed in our country for better management of patients and policymaking.
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Cherry tomatoes are usually cultivated under greenhouse which is out of the reach of the marginal farmers. Due to unavailability of microclimatic and biochemical data in cherry tomato, meagre yield is obtained at open field conditions. Since the microclimatic factors and growing environment have immense influence on yield and quality attributes of any crop, this experiment was aimed to study the correlation of microclimate with the yield and quality contributing traits of eighteen genetically diverse genotypes of cherry tomato at open field trained on trellis and under naturally ventilated polyhouse conditions. In the given study, under open conditions, mean canopy temperature in morning at 7 a.m. (15.3-19.4°C) showed highly significant positive correlation with total yield, whereas total yield possessed highly significant negative association with the mean mid-day (12 noon) canopy temperature and mean mid-day soil temperature above 25°C. In poly house condition, total yield reflected significant negative correlation with morning mean canopy temperature (24.6°C) and mid-day mean canopy temperature (25.8-26°C), whereas total yield was negatively correlated with morning and mid-day mean soil temperature when the temperature was above 20.7°C. Among biochemical parameters, lycopene and beta-carotene content increased with mean canopy temperature at 19.5°C and further decreased above 21.5°C, however TSS increased with increase in mean canopy temperature from 15 to 25°C and decreased beyond 30°C temperature.
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Background: In adults most common intracranial malignant lesion is brain metastasis, far outnumbering primary brain tumor. The most common primary site is lung cancer (18–64%), followed by breast (25–21%), malignant melanoma (4–16%), and colorectal cancer (2–12%). It is hypothesized that the incidence of brain metastasis might be increasing, as a result of increasing survival from recent advance in cancer treatment, more frequent brain screening for specific primary malignancy that known to have a higher prediction for brain metastasis and greater availability and use of magnetic resonance imaging (MRI) of brain. In clinical oncology, understanding brain metastasis is important, because it has profound effect on length of survival, quality of life, and in one-third to one-half of affected patients, they represent the direct cause of death despite current improvement in therapeutic approach. Epidemiological data of brain metastasis are lacking in India. Objectives: Aims of our retrospective analysis are to study epidemiology and pattern of care of brain metastasis over last one decade in Nil Ratan Sircar Medical College and Hospital, Kolkata. Materials and Methods: Between 2006 and December 2017, a total of 710 patients of brain metastasis treated in our department with palliative intent were analyzed retrospectively. New-onset neurological symptoms in a known case of cancer we always presumed that, symptoms were due to brain metastasis until proven otherwise. Hence, all patients presenting with acute neurological signs and symptoms underwent through clinical examination, contrast-enhanced (CE) computed tomography brain, and/or CEMRI of brain. Epidemiology, pattern of care, and outcome in the form of overall survival (OS) and disease-free survival were determined. Results: Fifty-seven percent patients were male. The median age was 62 years at the time of diagnosis. Lung carcinoma was most common primary site seen in 52% patients, followed by carcinoma breast second most common primary site, seen in 32% patients. Headache (73%) and motor weakness were most common presenting symptoms. Supratentorial location most common site, out of which parietal region is most common. The only small number of patients was offered best supportive care alone whereas majority of the patients were considered fit for palliative therapy. Treatment consisted of metastasectomy when possible and palliative whole-brain radiotherapy (WBRT) alone or followed by systemic therapy. Optimal supportive care in addition to chemotherapy or radiotherapy is given to all patients. A total of 254 patients were given blood product, erythropoietin, granulocyte-colony-stimulating factor following chemotherapy. Hospitalization required in 71% patients and tumor-related problem was most common cause (46%). Remaining patients were hospitalized for delivery WBRT or CCT. The median OS is 9 months. Patients with younger age and breast primary associated with better prognosis than lung primary. Conclusions: We can conclude that carcinoma lung in male and carcinoma breast in females was most common cause of brain metastasis. Because advance in palliative therapy, outcome of patients with brain metastasis has improved, and patients with brain metastasis benefit from palliative radiotherapy and chemotherapy and this treatment could be delivered easily on outpatients basis.
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Background: Worldwide, an estimated 572,034 esophageal cancer cases and 508,585 deaths occurred in 2018 and it accounts for approximately 3.2% of all malignancy. Because esophagus has no serosal covering with extensive, longitudinal connecting system of lymphatic plexus, direct invasion to contiguous structures and lymph node metastasis occurs early. Unresectable or metastatic disease at the time of diagnosis is seen in approximately 80% of patients, with cure rate <15% and thus making carcinoma of esophagus is one of the most dreaded malignancies. As most of the patients are diagnosed in locally advanced or metastatic stage, so curative surgical resection is not an option. Hence, in these groups of patients, other treatment modalities including concurrent chemoradiation have been tried. However, many of these patients are in a poor general condition so that radical concurrent chemoradiation as an alternative surgical resection could not be offered. In this group of patients, only radiotherapy (RT) is an option in intention to improve quality of life and to increase disease-free survival (DFS) if possible. As there is more chance local failure when patients treated with only external beam RT (EBRT), increasing dose to tumor may improve local control. Intraluminal brachytherapy (ILBT) is an important treatment option for dose escalation along with EBRT in the treatment of locally advanced and inoperable carcinoma esophagus. ILBT provides focal dose escalation, rapid reduction tumor, rapid restoration of swallowing function with sparing of surrounding normal tissue, and potentially improving therapeutic ratio. Hence, based on these facts, following EBRT, ILBT is an effective adjuvant modality to delivered high tumoricidal dose which can facilitate good local control, DFS with acceptable toxicity. We have used ILBT alone as palliative RT and combined modality with EBRT as radical treatment approach. Objectives: The aim of our study is to evaluate efficacy and safety of external beam radiation plus ILBT in locally advanced, inoperable carcinoma of esophagus in terms of improving local control, DFS, toxicity, and quality of life. Materials and Methods: A total of 58 carcinoma esophagus patients treated with EBRT plus ILBT in our RT department from 2012 to 2015 analyzed retrospectively. EBRT, total dose of 40 Gy/20 fractions, delivered in 4 weeks, using anteroposterior posteroanterior portal in cobalt-60 machine. Two–three weeks after completion of EBRT, ILBT was done using esophageal budgie. The total dose of brachytherapy was 10 Gy in two fractions, 1 week apart, 5 Gy in each fraction. EBRT and ILBT treatment completed in 8–9 weeks. Response assessed by clinical assessment, upper gastrointestinal endoscopy, and contrast-enhanced computed tomography chest and abdomen initially at 3 months and then at 6 months. Results: Local disease control seen in 65% of patients. With a median follow-up of 15 months, the median DFS was 8 months and median overall survival was 14 months. Regional nodal failure and distant metastasis were seen in 35% and 46% of patients, respectively. The incidence of acute mucositis was seen in 75% of patients and late toxicity is seen in 25% of cases. Swallowing function preserved in >87% of patients. Conclusion: In patients with locally advanced carcinoma of esophagus and poor performance status who are unable to tolerate radical concurrent chemoradiation, combination of EBRT plus ILBT produces good local control, DFS, and durable relief of dysphagia with acceptable toxicity.
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Background: In India, the majority of the head and neck squamous cell carcinoma (SCC) of head and neck (60–80%) presented in locally or locoregionally advanced stage but non-metastatic disease as compared to 40% in developed nations. Uncontrolled local and/or locoregional disease causes most fatalities and predominant failure pattern is local and/or locoregional. Concurrent chemoradiation (CRT) is now standard of care. However, regarding either the optimal scheduling of chemotherapy regimen or radiotherapy (RT) dose fractionation scheme, no consensus exists. Paclitaxel is also active agents against squamous cell carcinoma of head and neck. Weekly paclitaxel appeared to be equivalent to weekly cisplatin with concurrent radiation in the treatment of locally advanced SCC of head and neck cancer (HNC). Concurrent chemoradiotherapy with paclitaxel in locally advanced head and neck malignancy is recommended in NCCN Guideline. Objectives: The aim of our study is feasibility and efficacy of CRT with paclitaxel for the treatment locally advanced HNC in our institute, Nil Ratan Sircar Medical College and Hospital, Kolkata. Material and Methods: Between January 2014 and December 2018 ninety eight (98) previously untreated patients with locally advanced histologically confirmed carcinoma oral cavity, oropharynx, and hypopharynx treated with CRT. Chemotherapy consisted of paclitaxel at a dose 40 mg/m2 over 1 h given once weekly from 1st week of RT, up to 4–6 cycles. RT consisted of 66 Gy/33#/61/2 weeks, 2 Gy/fraction, delivered by two parallel opposed lateral face and neck and low anterior neck portal, in cobalt 60 machines. Toxicity was graded using Common Terminology Criteria for Adverse Events v3. To assess response to therapy contrast-enhanced computed tomography (CECT) head and neck and/or magnetic resonance imaging head and neck; CECT chest or whole-body fluorodeoxyglucose and positron emission tomography computed tomography scan were done. Results: Overall complete response (CR) rate seen in 68% and partial response seen in 32% patients. Two-year disease-free survival, progression free survival, and overall survival were 59%, 72% and 85%, respectively. Grade II acute skin reaction seen in 45% patients and Grade III acute skin reaction seen in 55% patients. Similarly, Grades II and III mucosal reaction is seen in 48% and 52% patients. All patients experience Grade II dysphagia and managed conservatively. Conclusions: CRT with paclitaxel in locally advanced HNC is safe and confers high CR rate with acceptable toxicity. However, more randomized study with large number of patients is needed to come to conclusions regarding its efficacy.
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Background: Worldwide, leading cause of cancer mortality is lung cancer. Approximately 63,000/year new lung cancer cases reported in India. Around 80–85% of patients of lung cancer is non-small cell histology (non-small cell lung cancer) and over >90% of patients presented locally advanced and metastatic disease. Hence, in these patients, population curative treatment approach with radiotherapy (RT) and chemotherapy in most of the time is non-viable option yielding short survival and relatively poor prognosis. In majority of such cases, the only aim of treatment remains palliative, the main aim is to improve quality of life. Although there are other medical management of symptoms palliation, radiation therapy is the cheapest option, quite effective, time efficient, and well tolerated in providing relief from symptoms. The rate of palliation of symptoms is quite high for chest pain and hemoptysis at 60–80%, whereas cough and dyspnea are improved in only 50–70%. For intrathoracic disease with obstructive symptoms, 30 Gy/10# over 2 weeks are generally recommended. Patients with poor performance status, advanced age, and associated comorbidity at the time of diagnosis, for which daily RT over 2–3 weeks is logistically difficult, 1–2 fractions have been utilized with good results. There are multiple randomized trials showed that both short and long RT course were equally effective for symptoms control. Aims and Objectives: The aims of our study are to compare the outcome, symptom control and assess toxicity profile in locally advanced lung cancer patient with 17 Gy/2 fractions (8.5 Gy/fraction, × 2 fractions) only on Saturdays over 2 weeks versus 30 Gy/10 fractions (3 Gy/fraction) over 2 weeks and to compare quality of life. Materials and Methods: This study was a single-institutional, prospective, open-labeled, randomized controlled study. Eligible patients were age ≥18 years with histopathologically proven lung carcinoma which was inoperable Stage III or IV disease and too locally advanced to curative concurrent chemoradiation, pulmonary symptoms attributable to the primary tumor, Eastern Cooperative Oncology Group (ECOG) performance status ≤3, and adequate hematologic (hemoglobin >10 g/dl; absolute neutrophil count >1500; platelet count >100,000/ml; and hepatic and renal function calculated creatinine >60 ml/min). Patients with bleeding diathesis, emphysematous bullae, poor respiratory function or reserve, pregnancy, and ECOG performance status >3 were excluded from the study. Results: Age, stage, histopathology, and pre-treatment symptoms score between two groups were comparable and statistically not significant. Pain in chest due to lung cancer was decreased in both arms due to treatment (at treatment completion Arm A = 47.62 and Arm B = 38.09). However, at the 2nd follow-up, difference between two arms was statistically significant where Arm A = 27.78 and Arm B = 15.00; P = 0.005. Global health status of patients in this study was improved in both arms due to treatment. Physical functioning emotional functioning, role functioning, global health status, cognitive functioning, and social functioning were improved in both arms due to treatment and kept improving during follow-up, but difference between two arms was not significance. Conclusions: Although overall symptom palliation, toxicity profile, and quality of life parameters are almost equal in both arms, patients with short expected survival, 8.5 Gy × 2 fractions would be preferable, limiting the number of hospital visit to a minimum. On the other hand, 3 Gy × 10 fractions schedule can be chosen for those patients with longer expected survival and better ECOG status, due to prolong duration of palliative response.
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A field experiment was conducted at research farm, Bihar Agricultural University, Sabour, India during 2017 and 2018 to gain insight crop phonology mediated greenhouse gas emission under different tillage and nitrogen management practices in direct seeded rice (DSR). The experiment was conducted in split plot design with two tillage viz. zero tillage (ZT) and conventional tillage (CT) as main plot and four nitrogen management practices viz. 100% nitrogen through neem coated urea (S1), SPAD based nitrogen management (S2), 75% through neem coated urea + 25% nitrogen through vermicompost, (S3) and ¼ nitrogen as basal and rest in equal three splits at 20, 40, 60 DAS (S4) as sub plot, in three replication. The highest yield (4.69 t ha-1), net return (Rs 46440 ha-1) and B:C ratio (1.44) were recorded from zero tilled DSR. Further, highest yield (4.82 t ha-1), net return (Rs 44880 ha-1) and B:C ratio (1.36) was obtained under split application of nitrogenous fertilizers among other subplot treatments. The range of methane (0.57- 1.47 mg m-2 hr-1) carbon dioxide (0.32- 0.61 mg m-2 hr-1) and nitrous oxide (19.58- 38.79 µg m-2 hr-1) emission was recorded lowest in zero tilled plots and split application of nitrogenous fertilizer also emitted lowest values of 1.59 mg m-2 hr-1 methane, 0.86 mg m-2 hr-1 carbon dioxide and 46.76 µg m-2 hr-1 nitrous oxide at maximum tillering stage of crop growth. Moreover, methane and nitrous oxide emission was gradually decreased from maximum tillering to harvesting stage. Zero tilled DSR with split nitrogen fertilizer application ascribed lowest greenhouse gas intensity among the other crop establishment and nitrogen management options. Thus, zero tilled method of crop establishment with split application of nitrogenous fertilizer could be a remunerative and environmentally stable method for direct seeded rice cultivation.
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Background: Lung cancer is the most common cancer and leading cause cancer-related death in worldwide and also in India. Around 42% of these patients have adenocarcinoma. Most of these patients presented in locally advanced stage or metastatic disease. There is no significant difference in effectiveness among different chemotherapy regimens with median survival of 8 months only. Hence, additional treatment option including newer monoclonal antibodies is needed to improve tumor control and survival. Vascular endothelial growth factor (VEGF) is critical determinant of tumor angiogenesis, a process that is necessary component of tumor growth, invasion, and metastasis. Bevacizumab (Bev), a humanized monoclonal antibody (IgG1) targeting VEGF, effective in colorectal cancer, renal cell carcinoma, glioblastoma multiforme, and non-small cell lung cancer and approved for clinical use since 2004. Objectives: The aim of our study is feasibility of the combination of Bev with paclitaxel and carboplatin in locally advanced (Stage IIIB) metastatic adenocarcinoma of lung in our institute, N.R.S. Medical College and Hospital, Kolkata. Materials and Methods: Between February 2015 and December 2018, ninety-eight previously untreated patients with locally advanced metastatic (Stages IIIB and IV) adenocarcinoma of lung treated with Bev with paclitaxel and carboplatin. Paclitaxel at a dose of 175 mg/m2, carboplatin at an AUC 6 mg/ml/min, and Bev at a dose of 15 mg/kg given on the 1st day of chemotherapy. Chemotherapy administered every 3 weeks up to 6 cycles with maintenance Bev until disease progression or unacceptable toxicity whichever is earlier. Patients ECOG 2 or more, brain metastasis, squamous cell histology, and hemoptysis were not included in the study. Results: The Median overall survival (OS), progression free survival (PFS) were 9.4 and 5.2 months, respectively. Anemia (19%) and neutropenia (16 %) are most common toxicity. Conclusion: Bev with paclitaxel and carboplatin in selected patients with adenocarcinoma of lung is safe and confers survival benefit with acceptable toxicity.
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Background: The primary goal of treatment in oncology is cure but efforts should be made to preserve quality of life. The gold standard for treatment of muscle-invasive bladder cancer is radical cystectomy. However, radical cystectomy cannot be performed without risk of complications and often the outcome for the patient is a mediocre quality of life as the patient has to live with an artificial bladder or ileal conduit. Even after radical cystectomy, 40–50% of patients will succumb to distant metastases within 5 years. As in the case of several other malignancies, increasing efforts have been made over the last few decades to adopt organ sparing treatment. Bladder-sparing monotherapies lead to disappointing results, local disease control may be maximized using a trimodal approach based on complete transurethral tumor resection of bladder (TURB), followed by concurrent chemoradiotherapy and cisplatin-based systemic chemotherapy. Objectives: The aim of our study is feasibility of concurrent cisplatin with radiation in bladder preservation in our hospital. Materials and Methods: Thirty-two previously untreated patients of histologically proven transitional cell carcinoma of urinary bladder received concurrent chemoradiation (60 Gy) with cisplatin. All patients received concurrent chemotherapy with cisplatin infusion in a dose of 20 mg/m2/day on consecutive 5 days from Day 1 to Day 5 in 1st and 5th week of radiotherapy. Detailed clinical examination along with cystoscopy, TURB along with biopsy, and computed tomography scan of abdomen pelvis were done before treatment and to assess response toxicity, and disease-free survival (DFS) during follow-up period. Results: Median follows up period was 36 months. Local disease control was seen in 71% patients. Five years DFS is 58%. Five years overall survival is 64%. Conclusions: Concurrent chemoradiation in carcinoma of urinary bladder is feasible in our hospital and results in good local control, survival with acceptable toxicity.
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Purpose: Helicobacter pylori causes various gastro-intestinal diseases. Antibiotic resistance to commonly used antibiotics for the treatment of H. pylori infection is the major cause for treatment failure. The aim of this study is to determine the antimicrobial susceptibility pattern for clarithromycin and levofloxacin and find the evolutionary relationship of the partial sequence of 23S rRNA and gyraseA gene of H. pylori by phylogenetic analysis. Materials and Methods: A total of 46 H. pylori strains were tested for clarithromycin and levofloxacin susceptibility pattern and phylogenetic tree were reconstructed by PhyML software. Results: In this study, we observed that only 6.5% of North-East Indian H. pylori strains were resistant for clarithromycin showing mutation at A2143G and T2182C positions of 23S rRNA gene. Resistance for levofloxacin was observed in 89.1% of the H. pylori strains showing mutations at asparagine to lysine at 87 and aspartic acid to glycine/tyrosine/asparagine at 91 positions of gyraseA gene. The phylogenetic tree of the partial sequence of 23S rRNA and gyraseA gene depicts that the North-East Indian strains falls in different cluster when compared to other countries. Conclusions: Resistance for clarithromycin was less in North-East Indian strains but high for levofloxacin indicating that first-line therapy may be best and effective for eradication of H. pylori in this region. This study is the first report that showed antibiotic susceptibility pattern for clarithromycin and levofloxacin by mutation analysis. By partial sequencing of 23s rRNA and gyraseA gene, we found that North-East Indian strains are geographically distinct.
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Background & objectives: Dengue virus infection is endemic in India with all the four serotypes of dengue virus in circulation. This study was aimed to determine the geographic distribution of the primary and secondary dengue cases in India. Methods: A multicentre cross-sectional study was conducted at Department of Health Research / Indian Council of Medical Research (DHR)/(ICMR) viral research and diagnostic laboratories (VRDLs) and selected ICMR institutes located in India. Only laboratory-confirmed dengue cases with date of onset of illness less than or equal to seven days were included between September and October 2017. Dengue NS1 antigen ELISA and anti-dengue IgM capture ELISA were used to diagnose dengue cases while anti-dengue IgG capture ELISA was used for identifying the secondary dengue cases. Results: Of the 1372 dengue cases, 897 (65%) were classified as primary dengue and 475 (35%) as secondary dengue cases. However, the proportion varied widely geographically, with Theni, Tamil Nadu; Tirupati, Andhra Pradesh and Udupi-Manipal, Karnataka reporting more than 65 per cent secondary dengue cases while Srinagar, Jammu and Kashmir reporting as low as 10 per cent of the same. The median age of primary dengue cases was 25 yr [interquartile range (IQR 17-35] while that of secondary dengue cases was 23 yr (IQR 13.5-34). Secondary dengue was around 50 per cent among the children belonging to the age group 6-10 yr while it ranged between 20-43 per cent among other age groups. Interpretation & conclusions: Our findings showed a wide geographical variation in the distribution of primary and secondary dengue cases in India. It would prove beneficial to include primary and secondary dengue differentiation protocol in the national dengue surveillance programme.
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Background: Malaria has long been known to human populations from across the world. Malaria remains the most important parasitic disease worldwide. Malaria is a potential medical emergency and should be treated accordingly. Routinely malaria is diagnosed using a combination of clinical observations, case history, and diagnostic tests, principally microscopic examination of stained slides. The objective of this study is to detect the flagging of malaria parasite in sysmex with correlation in peripheral smear and kit so that early detection of Malaria can be done with the most accurate result in lesser duration and cost. Objectives:-To detect the flagging of malaria parasite in hematology analyser & to correlate the flagging findings on peripheral smear and rapid diagnostic kit. Methods: the study was conducted in Department of Pathology in collaboration, Teerthankar Mahaveer Medical College and Research Centre (TMMC&RC), Moradabad, Uttar Pradesh. TMMC&RC .A total of 11o cases were enrolled with Patients presenting with fever suggestive of clinical features of malaria (high grade fever with chills) and found serologically positive by blood smear, Sysmex flagging or RDT. Results: On the basis of observations made in the present study, Sysmex flagging was positive in 92 (83.6%) cases, 94 (85.5%) were positive by RDT& PBS positivity was seen in 99 (90%) cases. Among 99 positive cases, 85 were positive for P. vivax, 9 were positive for P. falciparum and 6 were positive for mixed infection. As compared to RDT, Sysmex flagging had 90.4% sensitivity; 56.3% specificity; 92.4% positive predictive value; 50.0% negative predictive value and 84.5% accuracy for detection of malarial parasite. Whereas when compared to PBS, Sysmex flagging had 90.9% sensitivity; 81.8% specificity; 97.8% positive predictive value; 50.0% negative predictive value and 90% accuracy for detection of malarial parasite. Sysmex flagging had moderate and significant agreement with both RDT and PBS assessments. Flagging had a detection rate of 66.7%, 94.1% and 80% respectively for P. falciparum, P. vivax and mixed infections. Conclusion: The findings of present study showed that Sysmex flagging is a cost-effective highly efficacious tool for screening of malaria parasite and it showed a high level of agreement with conventionally used laboratory tests as well as peripheral blood smear.
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Objective: To study the changes in composition of preterm milk till 6 months of age. Methods: Milk samples from 33, 19, 7 and 12 lactating mothers (delivered <34 weeks) were analyzed on days 7, 28, 90 and 180, respectively. Results: Triglyceride and sodium concentrations increased significantly with time and protein concentration decreased significantly over 180 days. Sodium (P=0.02) and triglyceride concentrations (P=0.06) were higher in milk samples of mothers who had introduced mixed feeding by 6 months post natal age (n=6) compared to exclusively breast-feeding mothers (n=6); but lactose and protein content was not significantly different. Conclusions: Milk of preterm mothers has higher amount of triglycerides and sodium during introduction of mixed feeding.
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Globus hystericus is a functional esophageal disorder, contributes a significant portion of ENT referral. Severe incapacitating symptoms of globus invariably compromise their quality of life which is further hampered by associated psychiatric co-morbidities. But in literature, conflicting results were reported regarding the pattern of psychiatric co-morbidities. Method: In an observational cross sectional study 53 consecutive consenting patients (N=53) of globus diagnose by criteria of R E Clouse, attending to the Department of ENT of tertiary care hospital of Eastern part of India were referred to Psychiatry OPD and screened for psychiatric comorbidities using Mini International Neuropsychiatric Interview (MINI) English Version 5.0.0 and confirmed by Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR). Result: 79.25 % (n=42) of globus patients had psychiatric co-morbidities which was significantly higher (p<0.05, odds ratio 14.02) than their relatives attending with the patients. Among the patients of globus, 32.01% (n=17) had multiple diagnoses. Major depressive disorder was found in 43.04% (n=23), obsessive compulsive personality disorder in 16.98% (n=9), undifferentiated somatoform disorder in 13.21% (n=7), generalized anxiety disorder and panic disorder with agoraphobia each in 9.43% (n=5), borderline personality disorder in 7.55% (n=4), obsessive compulsive disorder and dysthymia each in 3.77% (n=2) and hypochondriasis in 1.89% (n=1). No association was found between presence of psychiatric morbidity and socio-demographic variables of the globus patients. Conclusion: Burden of psychiatric co-morbidities among the patients of globus is quiet high. So, they should be regularly screened for psychiatric illness and an integrated treatment approach can be taken for them to get the opportunity of effective psychopharmacological and behavioral approaches.