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Objectives: Diabetic dyslipidaemia (DD) is characterised by hypertriglyceridaemia and elevated or normal levels of low-density lipoprotein cholesterol and decreased levels of high-density lipoprotein cholesterol with Type 2 diabetes mellitus. Statins and anti-diabetic medication are coprescribed for optimal control. Materials and Methods: The objective of the study was to compare the safety and efficacy of Saroglitazar 4-mg and Fenofibrate 200 mg in combination with low dose Atorvastatin (10 mg) in patients with DD. Run-in period of 4 weeks for life-style and diet modification followed by 12 weeks of treatment with saroglitazar or fenofibrate and low dose of atorvastatin was followed. Primary outcome of this study was an absolute change in serum triglyceride level at baseline and end of treatment period (12 weeks). Secondary outcome was changed from baseline lipid profile, fasting blood glucose and glycosylated haemoglobin (HbA1c) at the end of treatment period. Safety assessment was also done during the duration of study. Results: Forty patients of DD were randomly divided into two groups. One group received Saroglitazar 4 mg along with Atorvastatin 10 mg. Patients in second group received Fenofibrate 200 mg along with Atorvastatin 10 mg. Improvement in deranged lipid levels in both the groups was observed and this difference in improvement statistically was not found to be significant. We also observed that Saroglitazar significantly improves glycaemic profile by decreasing fasting blood sugar levels and HbA1c (P = 0.01, P < 0.01). Adverse events reported during this study were mild and none of the patients reported serious adverse events. Conclusion: Saroglitazar could be a potential drug to control both hyperglycaemia and dyslipidaemia in patients with DD.
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Objectives: The objectives of this study were to evaluate and compare the success rate of local application of iodoform-based obturating material (Pulpotec – [Produits Dentaires S.A., Switzerland]) and clindamycinmodified triple antibiotic paste (ClinM-TAP) in pulp chamber using minimally invasive endodontic treatment of carious primary molars indicated for pulpectomy, for 12 months, using clinical and radiographic parameters. Materials and Methods: A randomised clinical trial was conducted in 60 children in the age group of 3–8 years reporting carious primary molars with symptoms of irreversible pulpitis and pulpal involvement clinically, allocated into Group 1 (30) and Group 2 (30). In Group 1, Lesion sterilisation and tissue repair (LSTR) was done using Pulpotec (Produits Dentaires S.A., Switzerland) as medicament and in Group 2, ClinM-TAP (Clindamycinmodified triple antibiotic paste) was used as medicament. Clinical follow-up was done at 3, 6 and 12 months; radiographic follow-up was done at 6 and 12 months. Clinical parameters compared were tenderness on percussion, spontaneous pain, intraoral swelling and sinus/fistula. Radiographic comparison was done based on furcation radiolucency, root resorption and bone regeneration. Both intergroup and intragroup statistical analysis was done using Chi-square test or Fisher exact test, Cochran’s Q Test and Mann–Whitney U-Test for the test of significance. All the statistical tests were performed at 5% significance level. Results: The mean age of patients in the study was 5.25 ± 1.3years with 45% males and 55% females. Both groups showed significant improvement in terms of clinical symptoms from baseline to 12 months. On intergroup comparison clinical parameters, TOP was present in 11.2% and 44% of cases at the end of 12 months in Groups 1 and 2, respectively (P < 0 0.05). On intergroup comparison of radiographic parameters, at the end of 12 months, furcation radiolucency was seen in 32% and 73% (P < 0.05) and root resorption was seen in 16% and 30% cases in Group 1 and 2, respectively (P > 0.05). Overall clinical success rate of Group 1 and Group 2 was 88% and 50%, respectively (P < 0.05) and radiographic success rate was 60% and 27%, respectively (P < 0.05). Conclusion: LSTR using Pulpotec as a medicament has shown promising results in the present study. It could be a better alternative to conventional endodontic treatment in primary teeth. In the present study, ClinM-TAP has shown poor radiographic success; hence, it should be used with caution.
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Background: Visual evoked potentials (VEPs) are electrical potential differences recorded from the occipital lobe in response to different visual stimulus. In myopic individuals, there is blurring of the stimuli, causing defocusing which tends to affect the VEP parameters. Aim and Objective: The study was designed and done to evaluate the effect of various degrees of myopia on VEP in medical students of age 18–24 years. Materials and Methods: A total of 120 subjects were included in this study, consist of 60 individuals without having any refractive disorders and 60 individuals having various degree of myopia, that is, 22 subjects with mild myopia of <?3D, 26 subjects with moderate myopia of ?3 to ?6D, and 12 subjects with severe myopia of > ?6D. The study was approved by Ethical and Research Committee, Govt. Medical College, Patiala. Results: In the present study, mean values for P100 latency were significantly high in myopic group as than in control group. Furthermore, mean values for N75 latency were significantly high in the myopic group as compared to the control group and mean values for N145 latency were significantly high in the myopic group as compared to the control group for both the right and left eyes. Mean values for amplitude (N75-P100) was significantly lower for the myopic group as compared to the control group for both the left and right eyes. There is prolongation of latencies in myopic individuals as compared to the control and latencies increase with the increase in degree of myopia. Furthermore, there is decrease in the amplitude in myopic individuals and it decreases with the increase in degree of myopia. Conclusion: The mean values for latencies were found to be comparable and the mean values of latencies were found to be increasing with increase of degree of myopia. Probably, the reason behind this result may be the optical blurring of the stimulus which lead to defocusing, therefore causes the prolongation of latency. The mean values for amplitude were found to be comparable and the mean values of amplitude were found to be decreasing with increase of degree of myopia. Probably, the reason for our finding is that in a pattern reversal VEP, the amplitude relies on the visual system’s ability to determine the pattern and on the degree of retinal image focus.
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In last three decades, more than 30 new infectious agents have been detected worldwide and out of which more than 60% have been found to be zoonotic in origin. Monkeypox disease is an infectious zoonotic disease caused by the monkeypox virus belonging to the Orthopoxvirus genus of the Poxviridae family. Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in a 9month-old boy in a region where smallpox had been eliminated in 1968. First outbreak of human monkeypox outside Central and Western African region was detected in 2003 in United States of America which was linked to contact with the infected pet prairie dog. The latest Monkeypox outbreak in non-endemic countries started from May 2022 and have been reported from 89 member states across all six WHO regions. India reported first case of Monkeypox on 14 th July 2022.
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Background: The price of medicine in India has always been a point of discussion in public domain. The price range of the same drug is very large with more than 100% difference between various brands available in different settings. Aims and Objectives: To assess the price of different drugs at Jan Aushasdhi (JA), AMRIT and Private Chemist and to compare the prices of these three outlets so that the issues. Material and Methods: This institution-based cross-sectional study was carried out from May 2019 to June 2019. A pretested proforma was prepared to compare the prices of 284 different medicines in Jan Aushadhi, AMRIT and private chemist shops. The collected data were entered in an Excel spreadsheet and presented in Proportions, percentages, and mean. Results: The price of 284 medicines were compared from JA (Median(IQR)- 15.18(18.75) INR) and Private chemist shop (Median(IQR)-88(111.5) INR) while 249 medicine from AMRIT (Median(IQR)-61.05(78.33) INR). Although the majority of the AMRIT drugs are cheaper than the chemist shop except for 31% of Antipsychotic drugs, 26.6% of antihypertensives, 25% of respiratory drugs, 25% of steroids, 21.9% of antibiotics. Conclusion: We concluded that JA is providing drugs cheaper than AMRIT and Private chemist . The prices of medicines offered at AMRIT are lower than market pricing but they are costlier when compared to JA prices.
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Background: To decrease morbidity in patients undergoing hysterectomy for benign lesions, oophorectomy should not be done. Aims and Objectives: This study aims to compare the effects of surgical and natural menopause on menopausal symptoms and musculoskeletal complaints in menopausal women. Materials and Methods: This study was conducted in gynecology outpatient department from June 2019 to June 2020. A total of 200 postmenopausal women were selected between the age group of 40 and 55 years and then divided into two main groups – Group A (100), that is, natural menopause and Group B (100), that is, surgical menopause. Interviews were conducted about menopausal symptoms, using a standard questionnaire and were modified for yes or no response. The women were asked about symptoms such as hot flashes, sweating, vaginal dryness, dryness of skin, decreased libido, poor memory, depression, and musculoskeletal pain. Results: The study showed that menopausal symptoms and musculoskeletal pain were more common in women with surgical menopause as compared to women with natural menopause. The rate of hot flashes and sweating was more in surgical menopause group, that is, 81% and 82%, respectively, as compared to 52% and 50%, respectively, in natural menopause group. The musculoskeletal pain was more significant in Group B as compared to Group A, especially low back and upper back which were present in 55% and 42%, respectively, in Group B as compared to 43% and 41%, respectively, in Group A. Conclusion: As the menopausal symptoms and musculoskeletal pain are more common in patients with surgical menopause thereby increasing the morbidity, so oophorectomy should not be done in patients who are undergoing hysterectomy for benign lesions. Therefore, treatment of osteoporosis and hormone replacement therapy is recommended after surgery to decrease the menopausal and musculoskeletal symptoms within the 1st year of menopause.
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Background:Chronic kidney disease (CKD) is a term that encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure. CKD is now a public health problem affecting an estimated 10-13% of the world population. The Kidney disease: Improving global outcomes (KDIGO) define CKD as either structural or functional kidney damage or a decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least 3 months. CKD-mineral and bone disorder (CKD-MBD) is a broader, newly defined term to define the mineral, bone, hormonal, and calcific cardiovascular abnormalities occurring in CKD. Ours study aims to evaluate the prevalence CKD-MBD in CKD stages 3, 4 and 5. Material And Methods:Ours is a retrospective observational study involving Patients >18 years known cases of CKD as per KDIGO guidelines with a minimum follow up duration of 3 or more months. Result:Our study population had a mean age of 52.8 years with male preponderance (72%). All of the patients had some form of MBD present. Conclusion:Our study was able to demonstrate a very high prevalence of CKD-MBD in patients of CKD indicating a need for better understanding the factors behind MBD in Indian patients and the need to emphasize on preventing and treating MBD in patients.
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@#Introduction: To evaluate the trends of C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) in the first three weeks after uncomplicated total hip (THR) and total knee (TKR) arthroplasty/replacement in the Indian population and to compare it with available literature. Material and methods: A total of 90 patients were enrolled for this prospective study, of which 30 were unilateral THR, 30 were unilateral TKR (U/L TKR) and 30 were simultaneous bilateral TKR (B/L TKR). Serum CRP and ESR were measured on the day before surgery and postoperatively on day 1st, 2nd, 3rd, 7th, 12th, and at the end of 3rd week. Results: CRP showed a peak at day 2nd with normalisation to pre-operative value by the end of 3rd week. While ESR showed a peak on day 3rd and continued to remain elevated even at end of 3rd week post-operatively. Both mean CRP and ESR values were higher in THR patients followed by in B/L TKR and then in U/L TKR patients. Conclusion: CRP persists to be the best acute phase reactant in the early post-operative phase with a relatively typical pattern as compared to ESR. CRP values peak at postoperative day 2nd and then show a gradual decline. However, its normalisation to pre-operative baseline values may vary among different groups of population.
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Complete postexposure prophylaxis with 4 doses of anti-rabies vaccine (ARV) in a previously vaccinated (nonna飗e) individual results in administration of two extra ARV doses resulting in wastages of precious resources comprising vaccine logistics, human resources, physician, and patient time. This cross-sectional study conducted in a secondary care hospital in Delhi among 175 incident animal bite cases observed 39 (22.3%) had an animal-bite history within the previous 5 years. A total of 19 (10.8%) cases reported a history of complete ARV vaccination during a previous animal-bite exposure. However, in the absence of supportive patient medical documentation, all the animal bite cases without exception were prescribed a full course of ARV irrespective of their previous exposure status. Rabies immunoglobulins (anti rabies serum) were also re-administered in 13 (81.2%) cases. National guidelines for rabies prophylaxis should, therefore, consider the inclusion of an explicit decision-making algorithmic mechanism when the health-care provider is confronted with this situation carrying the potential for hidden vaccine wastage.
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Background: The frequent surgical interventions of thoracic spine are more common due to a wide array oftraumatic, degenerative and neoplastic diseases. For successful surgical management of these conditions, adetailed anatomical knowledge of the thoracic vertebrae is required.Aim: The aim of this study was to present a morphometric reference database for Pedicle morphometry of typicalthoracic vertebrae in Indian population.Material and methods: The study was conducted on 120 dry human typical (T2-T8) thoracic vertebrae selectedfrom the bone bank of the Department of Anatomy, SGT Medical College Hospital and research institute, Gurugram.Linear measurements of the vertebrae were taken with the help of digital Vernier caliper .Statistical Analysis:Mean and standard deviation of the morphometric parameters taken into account were analyzed. The comparisonof morphometric dimensions of the right and left sides was performed using Student’s t-test and p-value wascalculated.Results: The morphometric analysis of the thoracic vertebrae demonstrated that the Pedicle height (PH) was10.35 ± 1.22 mm and Pedicle Width (PW) was 5.65±2.06mm.Conclusion: The results provide a comprehensive database for more accurate modelling and design of vertebralbody implants and instrumentations for Indian population.
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Background: Immunization is safe, powerful and proven tool for elimination and controlling various highly infectious diseases and in spite of every possible effort put by the Government still there is a big gap between reported and evaluated coverage. Aims & Objectives: To find out the immunization coverage and its determinants among children in the age group 12 – 23 months in urban and rural area of district Ambala. Material and Methods: It was a cross sectional study carried out by WHO recommended 30 by 7 cluster survey technique. Results: It was observed that overall 83.1% children were fully immunized, 14% were partially immunized and 2.9% were unimmunized. In present study Educational status of mothers, Occupation of mothers, Religion, Sex, Monthly Family Income and Caste were found to be significantly associated with immunization coverage. “Fear of side effects” of vaccination was found to be the main reason for failure to fully immunize the child. Conclusion: To conclude, immunization coverage was found to be reasonably but still there is a lot of scope for improvement.
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Introduction: The present study was conducted to note the osteological evidence of a synovial joint between clavicle and first rib in Indians. Material and Methods: The present study was conducted on 310 pairs of adult clavicles and first ribs, out of which 210 pairs were males and 100 pairs were females obtained from the Anatomy department of Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak. The articular facets were studied and measured with the help of a sliding Vernier caliper (Micropole). Results: Among 210 pairs (420 no.) of male clavicles examined, 6 clavicles (2.86%) had a circumscribed smooth articular facet with well-defined margins. Out of these 6 clavicles, 3 (1.43%) were of right side and 3(1.43%) were of left side. A corresponding facet was present on the first ribs of the same skeletons. The facets were found to be present unilaterally and that too in males only. The measurements of the articular facets on the rhomboid area of the clavicles and ribs were-the average length, width and elevation was 7mm, 5.4mm and 2.2mm respectively. Conclusion: These articular facets on the rhomboid area of clavicles and first ribs are osteological evidence of a synovial articulation between clavicle and first rib.
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Introduction: The present study was conducted to note the osteological evidence of a synovial joint between clavicle and first rib in Indians. Material and Methods: The present study was conducted on 310 pairs of adult clavicles and first ribs, out of which 210 pairs were males and 100 pairs were females obtained from the Anatomy department of Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak. The articular facets were studied and measured with the help of a sliding Vernier caliper (Micropole). Results: Among 210 pairs (420 no.) of male clavicles examined, 6 clavicles (2.86%) had a circumscribed smooth articular facet with well-defined margins. Out of these 6 clavicles, 3 (1.43%) were of right side and 3(1.43%) were of left side. A corresponding facet was present on the first ribs of the same skeletons. The facets were found to be present unilaterally and that too in males only. The measurements of the articular facets on the rhomboid area of the clavicles and ribs were-the average length, width and elevation was 7mm, 5.4mm and 2.2mm respectively. Conclusion: These articular facets on the rhomboid area of clavicles and first ribs are osteological evidence of a synovial articulation between clavicle and first rib.
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In the era of the sustainable development goals, India is committed to reduce its maternal mortality ratio to less than 70 per one lakh live births by 2030. An important strategy that was adopted in the Reproductive and Child Health Programme in 2010 was maternal death review. Analysis of the progress so far has brought to light certain gaps which have prompted the paradigm shift toward Maternal Death Surveillance and Response (MDSR), which focuses on taking action on information obtained from every maternal death so as to prevent further maternal deaths. The new guidelines on MDSR were released by the Ministry of Health and Family Welfare in 2017.
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Background: One's house is believed to be the safest and the healthiest place to live in. Indoor air pollution (IAP) means the presence of unwanted substances in the indoor air at concentration toxic to health. Objective: The objective of this study is to study the presence of IAP, its associated factors and impact on health of women residing in an urban slum of Kolkata, West Bengal, India. Methods: It was a cross-sectional study done from January 2017 to March 2017 among 120 households of a slum. Data were collected using a pre-designed pre-tested schedule from the homemaker of the households. All analyses were conducted with R: A Language and Environment for Statistical Computing. Results: About 60% households used kerosene as cooking fuel predominantly. Smoke from the neighbouring houses troubled 57.5% respondents. More than 60% houses were overcrowded and more than 70% houses were poorly ventilated. IAP-related symptoms such as irritation in the eye, suffocation, dry cough significantly correlated with the presence of IAP sources and its contributory factors. Of 120, 78 (65%) perceived the presence of IAP in their houses. Lower per capita income (PCI), ground floor, and joint family were found to have higher odds of sources of IAP. Younger age, lower PCI, and ground floor were found to be strongly associated with higher contributory factors of IAP. Conclusion: The present study found that the majority of the households were exposed to IAP due to kerosene, neighborhood smoke while overcrowding and ill-ventilation accentuated it. Effective intervention with intersectoral coordination is the need of the hour.
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Background: Vitamin D deficiency/Vitamin D Insufficiency (VDI) is now recognized as a pandemic. Cutaneous exposure to ultraviolet-B causes photolysis of epidermal 7-dehydrocholesterol, converting it to pre-Vitamin D3 (precholecalciferol), which then undergoes isomerization to form the stable hormone Vitamin D3. Objectives: The objectives of the study is to determine the status of Vitamin D level among the adults residing in a rural area of West Bengal and to find out the optimal cutoff of the sun exposure for Vitamin D sufficiency. Methods: This study was a rural community based cross-sectional study. It was done from May 2016 to April 2017 among 197 adults residing in a rural block of West Bengal. Data were collected by interviewing the respondents with the help of a structured pre-tested pre-designed schedule. After interviewing, every individual was examined for height and weight and blood was collected for serum Vitamin 25-(OH) D. Receiver Operating Characteristic (ROC) curves were utilized to find out optimum cut-off for sun exposure using Youden's index. Binary logistic regression was performed to find out the associates of high sun exposure. All analysis was done using R. Results: Overall VDI was found in 133 (67.5%). Among them, 102 (51.8%) were female. On ROC curve for veritable sun exposure for Vitamin D sufficiency, area under curve was 0.7841 which signifies veritable sun exposure as a good screening tool. Conclusion: Proper information, education, and communication material regarding various aspects of sun exposure and Vitamin D should be prepared with due consultation of field experts and disseminated to increase awareness among the community.
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The realization of Universal Health Coverage requires adequate healthcare financing and human resources to provide financial protection to the economically disadvantaged population by covering their medicine, diagnostics, and service costs. Conventionally, inadequate public healthcare financing and the lack of skilled human resources are considered as the major barriers towards achieving UHC in India. To strengthen the Indian healthcare system, there has been significant increase budgetary allocation towards healthcare, a national health protection scheme targeting low-income households, upgrading of primary health-care and expansion of the health work-force. Nevertheless, an evolving paradigm for improving holistic health, sanitation, nutrition, gender equity, drug accessibility and affordability, innovative initiatives in national health programs for reduction of maternal deaths, tuberculosis and HIV burden and the utilization of information technology in healthcare provision of the underserved and the marginalized is gaining rapid acceleration. These represent a genuine innovation towards fulfillment of UHC goals for India.
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Background: Oral cancer being one of the most common malignancies in the low-income group in India. It usually presents in an advanced stage limiting treatment options. The mainstays of treatment being surgery and radiotherapy both being lifestyle changing procedures. Aims and objectives: The purpose of this study is to evaluate the quality of life for oral cancer survivors after surgery in comparison with radiotherapy using ICF questionnaire Materials and methods: Oral cancer patients who underwent surgery (25 patients) and Radiotherapy (25 patients) in Stanley medical college for stage 1 and stage 2 lesions of oral carcinoma for past 3 Years (2013-2015) were enrolled. Results: The study showed that surgery as primary therapy provided a better quality of life than radiotherapy alone in the treatment of oral cancer patients. Conclusion: After comparing the results primary surgery for oral malignancy seems to be the treatment of choice as long as the tumor is amenable to surgical resection. Radiotherapy though resulting in a lower quality of life is very efficacious for unresectable tumors.
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Dengue fever is generally not characterized by neurological manifestations, especially in infants. Here we present an 11 month old male child residing in Jalandhar, Punjab, who presented with status epilepticus and later, on investigation, was found to be Dengue encephalitis. To our knowledge, this is the first reported case from this region.