TENSE MARKERS IN 6-8 YEARS OLD TYPICAL CHILDREN SPEAKING HINDI

Language acquisition entails the acquisition of several crucial linguistic components like phonology, morphology, syntax and semantics. Individual elements merge seamlessly with each other giving birth to insightful communication whenever needed. Among these varied but fundamental aspects necessary for any competent communicator, is adding on the vital aspect of tense marking appropriately into conversations or text rendering accurately when an event occurred or will occur. We must appreciate this pivotal role played by acquiring fiuency in using verb tenses by young children seeking effective communication alongside understanding its importance a bit more in the language development process. The study attempts to investigate the acquisition of tense markers in typical children speaking Hindi with the goal of assessing data from children in the age range of 6-8 years. Results suggested that tense markers increased with age. Almost half of the tense markers were not fully acquired by the age of 8 years. The research also analysed various studies that uphold the findings.

Comparison of Hemodynamic Consequences of Hand Ventilation Versus Machine Ventilation for Transportation of Post?Operative Pediatric Cardiac Patients

Learning Objective: Hemodynamic monitoring during in?hospital transport of intubated patients is vital; however, no prospective randomized trials have evaluated the hemodynamic consequences of hand versus machine ventilation during transport among pediatric patients� post?cardiac surgery. The authors hypothesized that manual ventilation after pediatric cardiac surgery would alter hemodynamic and arterial blood gas (ABG) parameters during transport compared to mechanical ventilation. Design: A prospective randomized trial. Setting: Tertiary cardiac care hospital. Participants: Pediatric cardiac surgery patients. Materials and Methods: One hundred intubated pediatric patients were randomized to hand or machine ventilation immediately post?cardiac surgery during transport from the operating room to the pediatric post?operative intensive care unit (PICU). Hemodynamic variables, including end?tidal CO2 (ETCO2 ), oxygen saturation, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), peak airway pressure (Ppeak), and mean airway pressure (Pmean), were measured at origin, during transport, and at the destination. ABG was measured before and upon arrival in the PICU, and adverse events were recorded. The Chi?square test and independent t?test were used for comparison of categorical and continuous parameters, respectively. Results and Discussion: The mean transport time was comparable between hand?ventilated (5.77 � 1.46 min) and machine?ventilated (5.96 � 1.19 min) groups (P = 0.47). ETCO2 consistently dropped during transport and after shifting in the hand?ventilated group, with significantly higher ETCO2 excursion than in machine?ventilated patients (P < 0.05). SBP and DBP significantly decreased during transport (at 5 and 6 min intervals) and after shifting in hand?ventilated patients than in the other group (P < 0.05). Additionally, after shifting, a significant increase in Ppeak (P < 0.001), Pmean (P < 0.001), and pH (P < 0.001), and a decrease in pCO2 (P = 0.0072) was observed in hand?ventilated patients than machine?ventilated patients. No adverse event was noted during either mode of ventilation. Conclusion: Hand ventilation leads to more significant variation in ABG and hemodynamic parameters than machine ventilation in pediatric patients during transport post?cardiac surgery. Therefore, using a mechanical ventilator is the preferred method for transporting post?operative pediatric cardiac patients

Measures to Improve In?Hospital Outcomes of Patients Undergoing Surgical Repair for Anomalous Origin of Left Coronary Artery from Pulmonary Artery

Background:Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly leading to progressive left ventricular dysfunction and mitral regurgitation. We conducted this study to investigate various measures to optimize the outcomes of surgical correction for ALCAPA. Materials And Methods: This was a single?centre, retrospective, observational study including consecutive patients operated for ALCAPA. The main outcomes evaluated were in?hospital mortality, duration of mechanical ventilation, and duration of intensive care unit (ICU) stay. Independent sample t? test and Fisher’s exact test were used for the analysis of continuous and categorical variables respectively. Results: 31 patients underwent surgical correction for ALCAPA during the study duration. The median age was 7.3 months with a range of 21 days to 25 months. All patients underwent coronary re?implantation with the coronary button transfer technique. There was no in?hospital mortality, the mean duration of mechanical ventilation and ICU stay was 117.6 hours and 10.7 days respectively. Age at admission, development of acute kidney injury after surgery, lactate levels at 12? and 24?hours post?surgery, and heart rate at ICU admission and 12?hours post?surgery were significantly associated with mechanical ventilation duration longer than 48 hours. Use of a combination of levosimendan and milrinone and elective intermittent nasal continuous positive airway pressure ventilation after extubation in all patients with severe left ventricular dysfunction were helpful in preventing low cardiac output and need for reintubation post?surgery respectively. Conclusion: Surgical correction for ALCAPA by coronary re?implantation has an excellent short?term outcome. Optimal postoperative management is of utmost importance for achieving the best results.

Current Status Of Immunoglobulin M And Immunoglobulin G Seroprevalence Of Torch Infections In Pregnant Women With Bad Obstetric History At A Tertiary Care Hospital

Introduction: TORCH stands for Toxoplasma gondii, Rubella virus, Cytomegalo virus (CMV) and Herpes simplex virus- 2 (HSV-2). These infections are transmitted to the foetus through transplacental route at any time during gestation or sometimes at the time of delivery. The infection may be asymptomatic or mild in mother but associated with inadvertent outcomes for the foetus. One of the causes of BOH is maternal infection. TORCH infection is asymptomatic in pregnant women and on clinical basis it is difficult to diagnose. To study the TORCH infection (IgM and IgG antibodies)Aim: prevalence in pregnant women with Bad Obstetric History. A hospital based cross-sectionalMaterials And Methods: study conducted in Department of Microbiology in collaboration with Department of Obstetrics and Gynecology, SHKM GMC, Nalhar, Nuh, Haryana over a period of one year (February 2020 - January 2021). A total of 90 samples were included in the study including control group. The IgM seroprevalence of TORCH in participants with bad obstetricResults: history was found to be 11.11%. In cases with Bad obstetric history prevalence of IgM Toxoplasma, Rubella, Cytomegalovirus & Herpes Simplex Virus was found as 4.44%, 0%, 2.22% & 4.44% respectively and prevalence of IgG Toxoplasma, Rubella, Cytomegalovirus, & Herpes Simplex Virus was found as 53.33%, 91.11%, 88.89% & 66.67% respectively. This study concluded that a previous history of pregnancy wastage and the serologicalConclusion: screening for TORCH infections during current pregnancy must be considered while managing BOH cases to reduce the adverse fetal outcome

Isolation and characterization of native Rhizobium from root nodules of raikia french bean growing area of Odisha-Supplementary Data

Injudicious application of nitrogenous fertilizers leads to soil quality deterioration which results into yield loss. The application of biofertilizer containing native efficient rhizobia enhances the nodular properties, N-fixation and soil quality. Therefore, fifty strains of Rhizobium were isolated from root nodule of Raikia french bean and among them only two isolates viz., RBHR-15 and RBHR-21 were confirmed as Rhizobium. The isolates were unable to grow under anaerobic conditions and failed to produce ketolactase enzyme, showed a negative response for gelatin liquefaction and Simmon’s citrate agar test, responded positively towards the indole test, MR-VP, TSI test and could produce NH4+ from peptone in the growth medium. The isolate RBHR-15, could reduce H2S and nitrate whereas, RBHR-21 could not. The growth of both isolates was luxuriant in the nutrient broth containing 1% NaCl and decreased with an increase in the concentration of NaCl and grew profusely in the pH range of 6-8. The generation time of RBHR-15 and RBHR-21 were 16.4and 10.6 h, respectively. The 16s rRNA of both isolates was sequenced and submitted to the National Center for Biotechnology Information (NCBI). The isolates RBHR-15, and RBHR-21 were assigned accession numbers MN480514 and MN480516.

Isolation and characterization of native Rhizobium from root nodules of raikia french bean growing area of Odisha

Injudicious application of nitrogenous fertilizers leads to soil quality deterioration which results into yield loss. The application of biofertilizer containing native efficient rhizobia enhances the nodular properties, N-fixation and soil quality. Therefore, fifty strains of Rhizobium were isolated from root nodule of Raikia french bean and among them only two isolates viz., RBHR-15 and RBHR-21 were confirmed as Rhizobium. The isolates were unable to grow under anaerobic conditions and failed to produce ketolactase enzyme, showed a negative response for gelatin liquefaction and Simmon’s citrate agar test, responded positively towards the indole test, MR-VP, TSI test and could produce NH4+ from peptone in the growth medium. The isolate RBHR-15, could reduce H2S and nitrate whereas, RBHR-21 could not. The growth of both isolates was luxuriant in the nutrient broth containing 1% NaCl and decreased with an increase in the concentration of NaCl and grew profusely in the pH range of 6-8. The generation time of RBHR-15 and RBHR-21 were 16.4and 10.6 h, respectively. The 16s rRNA of both isolates was sequenced and submitted to the National Center for Biotechnology Information (NCBI). The isolates RBHR-15, and RBHR-21 were assigned accession numbers MN480514 and MN480516.

A Prospective Study to Assess the Knowledge Regarding Maternal and Child Health Services available among Antenatal Women Visiting Antenatal OPD, Government Medical College and Hospital in Chandigarh.

The objective of the study was to assess the knowledge regarding maternal & child health services available to antenatal mothers and to fi nd out association between knowledge score and selected socio demographic variables. A prospective, observational research design was used. Convenient sampling technique was used to select 120 subjects visiting antenatal OPD, Government Medical College & Hospital (GMCH), Chandigarh. Data was obtained from study subjects by proformas developed by the researchers consisting of Part A- having socio-demographic data and Part B- covering knowledge regarding maternal & child health services available. Approval was taken from research and ethical committee of the institution as well as from incharge of academics GMCH. Data analysis was done by calculating mean, standard deviation, percentage and correlation coeffi cient by using descriptive and inferential statistics; p-value below 0.05 was considered statistically signifi cance. Majority of the antenatal women had average knowledge regarding maternal & child health services available. There was no association between knowledge score and demographic variables. The fi ndings show that out of total subjects 24.2 percent had good knowledge, 62.5 percent had average knowledge and 13.3 percent had poor knowledge regarding maternal & child health services.

First report on the detection of Japanese encephalitis virus in fruit bats from India

Japanese encephalitis (JE) is a mosquito borne viral zoonotic disease and JE virus (JEV) is responsible for causing several children deaths every year in India. Since 1978, cases of JE have been reported from Gorakhpur district of Uttar Pradesh state annually. The knowledge on the role played by wildlife reservoirs in the sylvatic transmission and maintenance of JE virus remains limited. Bats are reservoir hosts for several emerging and re-emerging viral pathogens but their role in zoonotic cycle of JEV has not been elucidated yet. In Gorakhpur district of Uttar Pradesh, 52 fruit bats were found dead on 26 May 2020. The post-mortem report of the bat samples conducted at the Indian Veterinary Research Institute stated that the bats died due to brain hemorrhage, caused by excessive heat. The brain tissue samples of the bats were subjected to investigation using molecular techniques to determine the presence of JEV. The present work reports for the first time the detection of JEV in brain samples of bats from India. The viral load ranging from 8 to 18 copies/reaction was detected in brain samples by TaqMan real Time RT-PCR. The low viral load might be the reason for the absence of apparent clinical signs in bats and suggests the probable role of fruit bats in maintaining the JEV in nature.

Histomorphological Spectrum of Ovarian Lesions in a Tertiary Care Institute in Gujarat with Special Emphasis on Ovarian Tumors

Introduction: Ovarian cancer is the third most common cancer among women of India. Microscopic examination is the goldstandard for diagnosing ovarian tumors and plays an important role in determining prognosis.Purpose: The aim of the study is to assess the frequency of non-neoplastic and neoplastic lesions in ovarian specimens andbiopsies and to study the histomorphological spectrum, gross features, and age distribution of the ovarian tumors.Materials and Methods: The present study was an observational retrospective study conducted over a period of 1 year(February 2019–January 2020) in the Department of Pathology in a Tertiary Care Hospital in South Gujarat. A total of cases (8ovarian biopsies and 82 ovarian specimens) were analyzed. Tumors were classified according to the WHO classification 2014.Results: Of 90 cases, eight were of non-neoplastic lesions, 13 were tumor-like lesions, and nine neoplastic lesions. Amongneoplastic lesions, 43 cases (62.3%) were benign, 3 (4.4%) were borderline, while 23 (33.3%) cases were malignant.Histopathologically, surface epithelial tumors (76.7%) were the most common subtype followed by germ cell tumors (13.3%)and then sex cord tumors (10%). Malignant surface epithelial tumors constitute 78.2% of the total malignant ovarian tumors. Themost common neoplastic lesion was serous cystadenoma. 30–39 years age group was the most common age group overall inovarian tumors. Benign tumors were most common in the 30–39 years age group, while malignant tumors were most commonin the 60–69 years age group. Bilaterality was seen in 10 (16.4%) of 61 gross specimens of ovarian tumors.Conclusion: The frequency of malignant ovarian tumors was higher in our institute. Accurate histopathological diagnosis isessential for management and determining prognosis

Study of histomorphological spectrum of lesions in nephrectomy specimen in a tertiary care hospital in South Gujarat

Background: Nephrectomy is a standard surgical procedure in urology indicated in patients with organ confined renal malignancies and irreversible kidney damage resulting from chronic infection, trauma, obstruction and congenital malformation. This study aims to study the histomorphological features of lesions in nephrectomy specimens in a tertiary care hospital, to analyse the neoplastic and non-neoplastic lesions of kidney according to age, gender and site and observe any variation from the conventional pattern.Methods: The present study was conducted in department of pathology, Tertiary care hospital over a period of 5 years and 7 months (1 Jan 2013 to July 31, 2018). This included 4 years retrospective and 1 year 7 months prospective.  A total of 73 cases of were studied.Results: Males constituted 65.73% and females constituted 35.27%  of all nephrectomy cases. Right kidney was more commonly affected. Highest percentage of patients belonged to 41-50 years age group. 45 cases were of non-neoplastic lesions and 28 cases were of neoplastic lesions. Among neoplastic lesions, one case was benign while remaining 27 cases were malignant. Chronic Pyelonephritis was the most common indication overall and also amongst non-neoplastic lesions with stone identified in 55% cases. Most common neoplastic lesion in nephrectomy specimen was Renal Cell carcinoma (71.4.1%) followed by Wilms tumour (14%).Conclusions: This study gives a fair insight of the current state of incidence of neoplastic and non-neoplastic lesions of kidney requiring surgical intervention.

Computer Game-Based Rehabilitation For Poststroke Upper Limb Deficits- Systematic Review And Meta-Analysis

Background: The need for intense rehabilitation protocols with easy applicability to improve for patient adherence and harness the potential neuroplasticity leading to improvement in the quality of life (QOL) in post-stroke patients. Several studies have described the benefits of virtual reality and video games in rehabilitation. Aims: To explore and determine if Computer game-based rehabilitation for post-stroke upper limb deficits after stroke is superior to conventional therapy in terms of (1) ICIDH based outcomes (2) Intervention duration (3) acceptability and adherence to the intervention. Methods: This systematic review and meta-analysis followed PRISMA guidelines. Several electronic databases were searched using specific keywords, to measure the effects of computer-game-based therapy in post-stroke patients compared to conventional therapy. Results: 14 studies were included after a systematic review, out of which 11 were included for analysis. Studies recording Wolf motor function test and box and block test have shown improvements with Computer-game-based therapy in addition to conventional therapy. No improvements were recorded in impairments and patient participation/Quality of life. CGBT was acceptable and reported no adverse effects. Conclusions: Computer-game-based therapy or non-immersive virtual rehabilitation is effective and acceptable for upper limb rehabilitation after stroke. With significant improvement in ‘activity-limitation,’ this mode of rehabilitation can be adapted for patient-specific needs. Its effects on impairment and quality of life need further exploration.

The effects of coronavirus disease 2019 pandemic on the South African health system: A call to maintain essential health services

South Africa had its first coronavirus disease 2019 (COVID-19) case on 06 March 2020 in an individual who travelled overseas. Since then, cases have constantly increased and the pandemic has taken a toll on the health system. This requires extra mobilisation of resources to curb the disease and overcome financial loses whilst providing social protection to the poor. Assessing the effects of COVID-19 on South African health system is critical to identify challenges and act timely to strike a balance between managing the emergency and maintaining essential health services. We applied the World Health Organization (WHO) health systems framework to assess the effects of COVID-19 on South African health system, and proposed solutions to address the gaps, with a focus on human immunodeficiency virus (HIV) and expanded programme on immunisation (EPI) programmes. The emergence of COVID-19 pandemic has direct impact on the health system, negatively affecting its functionality, as depletion of resources to curb the emergency is eminent. Diversion of health workforce, suspension of services, reduced health-seeking behaviour, unavailability of supplies, deterioration in data monitoring and funding crunches are some of the noted challenges. In such emergencies, the ability to deliver essential services is dependent on baseline capacity of health system. Our approach advocates for close collaboration between essential services and COVID-19 teams to identify priorities, restructure essential services to accommodate physical distancing, promote task shifting at primary level, optimise the use of mobile/web-based technologies for service delivery/training/monitoring and involve private sector and non-health departments to increase management capacity. Strategic responses thus planned can assist in mitigating the adverse effects of the pandemic whilst preventing morbidity and mortality from preventable diseases in the population

Knowledge, attitude and practice of fever and febrile illness among parents of under five children

Background: Fever in children is the commonest cause for outpatient and inpatient admissions in the health care setup. Though most fever episodes are benign with self-limiting course, it is often a reason for anxiety and concerning for parents. The aim of the study was to assess the parental knowledge, attitude and practice regarding fever in children under five years of age.Methods: A cross-sectional question based survey, conducted in the pediatric department of a peripheral hospital in Pune, Maharashtra from parents of under five children, presenting for any consultation from July 2018 to December 2018.Results: There were 636 respondents who completed the study. 38.1% were males. Mean age of responders was 26.85 years (SD 5.12 Range 18 to 37 years). Most of the population were educated lot. 55.5% responders defined fever correctly. There was a huge gap in the parent's knowledge attitude and practice in fever and it's management. Lack of information and fear of any untoward incident occurring due to fever were the reason for parental anxiety, frequent medication & combination antipyretic use, and pressure on part of health professionals to increase antibiotic prescriptions.Conclusions: Lack of parental knowledge of fever and fever management in younger children is of concern in the community in spite of improvement in the educational level of parents. There is a utmost need to spread awareness in the community about the benign and the self-limiting nature of most febrile illnesses.

Knowledge, attitude and practice of acute diarrheal disease and use of oral rehydration therapy among mothers of under five children

Background: Acute diarrhea in children is among the commonest causes of outpatient and inpatient attendance in medical setup. Though enough has been done in imparting knowledge about diarrhea and its management, there is a gap between knowledge and practice in the population. Aim of the study is to assess the mother's knowledge, attitude and practice about diarrhea in children.Methods: Cross-sectional survey, conducted in the pediatric department of a peripheral hospital in Pune, Maharashtra.Results: Of the 305 mothers surveyed, their knowledge about diarrhea was good with 77.1% knowing correct definition, and most mothers knowing correctly about its mode of transmission, the positive role of good hygiene & sanitation, breast feeding and oral rehydration therapy (ORT) in prevention and management of acute diarrhea. However, their attitude and practice were found lacking, with higher rate of bottle feeding (59.3%) and lesser use of standard (46.3%) as well as home based (69.9%) ORT measures.Conclusions: There is discrepancy between the knowledge and practice. Hence, there is the need of sustained efforts in imparting both knowledge and practice among the population.

Comparative Evaluation of the Effects of Two Different Local Drug Delivery Systems Incorporating Green Tea and Turmeric Extracts in the Treatment of Chronic Periodontitis: A 2-month Clinical Trial

Aim: This randomized, triple-blinded parallel study was aimed to evaluate the effects of two different local drug delivery (LDD)systems incorporating green tea and turmeric extracts as an adjunct to scaling and root planing (SRP) in the treatment ofchronic periodontitis (CP).Materials and Methods: Thirty-four subjects randomized to receive either Gel A or Gel B containing green tea or turmericextract were included in the study. Following SRP, probing pocket depth (PPD), relative attachment level, gingival marginposition (GMP), bleeding on probing, gingival index, and periodontal inflammatory surface area were recorded at baseline and8 weeks after treatment with Gel A or Gel B.Results: Mean PPD reduction from baseline to 8 weeks was −24.57% for Gel A while for Gel B, it was −22.99%. On comparisonof GMP values for Gel A and Gel B at baseline (3.03±1.10 and 2.80±1.06) and at the end of 8 weeks (3.27±1.41 and 3.27±1.14),a statistically significant difference was noted. However, the percentage change was positive (7.69% and 16.67%) in both groups.Conclusion: Both LDD gel systems were equally beneficial and showed a noteworthy reduction in the clinical parametersrecorded when used as an adjunct to SRP in the treatment of CP.

A study of fetomaternal outcome of hepatic disorders in pregnancy

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyses the causes and fetomaternal outcome in pregnancies with jaundice and suggests measures to reduce morbidity and mortality.Methods: This is a one-year prospective study in a tertiary care institute during which 7165 deliveries are conducted. Total 55 cases of Jaundice with pregnancy are identified and studied for clinical, biochemical profile, etiology and maternal and fetal outcome. 8 maternal deaths are reported amongst this study group.Results: In this study 55 cases of hepatic disorders in pregnancy are studied. The age group reported is 21-29 years. Majority 72% cases belong to rural areas and 85% in lower socioeconomic class. 96.3% patients were in the third trimester of pregnancy. Most common etiology of hepatic disorders in pregnancy is acute viral hepatitis followed by intrahepatic cholestasis of  pregnancy and preeclampsia and HELLP syndrome. In acute viral hepatitis 81% patients were hepatitis E positive. Most common complication are DIC followed by hemorrhagic shock and subsequently AKI and septicemia. 77.7% babies were born alive and 30.9% NICU admission due to severe birth asphyxia and prematurity. Of these 16.6% died in neonatal period. Maternal mortality in 14.5% patients due to viral hepatits, HELLP and septicemia.Conclusions: Jaundice in pregnancy is a rare medical disorder and deadly combination affecting maternal and fetal outcome. Earl detection and timely intervention with multidisciplinary approach including obstetrician, neonatologist, intensivist and skilled nursing care can help to reduce maternal mortality and morbidity.

A Compartive Study Of Usg And Ct Scan Evaulation Of Patient Of Acute And Chronic Pancreatitis

Background: Pancreatitis is a condition of inflammation of pancreas with high rate of morbidity and mortality. USG is useful in the initial radiological assessment of the pancreas, extent of involvement and to evaluate other abdominal organs affected by it. CT scan provides a cross-sectional anatomy of the organ, its internal structure, focal or diffuse involvement and involvement of adjacent structures. This study is done to evaluate the role of USG and CT scan in patients of pancreatitis admitted to L.G. hospital,AMC MET medical college,ahmedabad, Gujarat, India. Aim was to understand the role of CT and USG in determination of diagnosis of pancreatitis and to highlight and evaluate the cases in which USG failed to diagnose the cases which were helped through by CT. Methods: This study was done in department of radio diagnosis at L.G hospital, AMC MET medical college, Ahmedabad, Gujarat, India, over a period from may 2018 to september 2018. Each patient was studied taking into consideration relevant clinical and laboratory reports. USG of patients was done using LOQIC P5 machine. CT scan was done using PHILIPS 16 Slice CT scan machine. Results: Advantages ofUltrasound are non-invasiveness, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However,limitations of USG are fails imaging in conditions with excess of bowel gas or fatty patient. Detailed characterization of the inflammatory process and peroper extent of necrosis of the gland is not properly evaluated by USG.. CT is superior to ultrasound for precise detection of size, parenchymal involement, main pancreatic duct, calcification, pseudocyst, ascites, pleural effusion, necrosis and peri pancreatic region and hence helps to determine exact extent of inflammation of the organ, multi-system involvement and prognosis. Conclusions: Ultrasound by non-invasiveness, easy availability, cost parameters, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However, ultrasonography lacks in detailed characterization of the extent of involvement of the organ and adjacent structures. CT is superior to ultrasound for precise detection and extension of the pancreatitis and it has better sensitivity and specificity than ultrasonography.

​Fine-Needle Aspiration Cytology In Palpable As Well As In Non-Palpable Breast Lesions: A Study Of 430 Cases

Background: Fine-needle aspiration cytology (FNAC) is an established, highly accurate, and cost-effective method for diagnosinglesions in different organs including the breast. The method is minimally invasive without unwanted side effects. At present,accurate diagnosis of breast lesions depends on a triple assessment approach that is combined clinical, radiological, andpathological diagnosis. FNAC is widely adopted for pathological diagnosis of different types of the breast lesions. In developingcountries, like India, malignant causes as well as non-malignant causes are the most common causes of breast lump. FNACproves to be a valuable tool in diagnosing these cases.Aims: This study intended to look the frequencies and various cytomorphological presentations of different lesions on FNACof breast lump.Materials and Methods: In a study period of January 2015–December 2017, in the Pathology Department, GMERS MedicalCollege, Ahmedabad, 430 patients of breast lesions for FNAC came. Those were subjected to cytological evaluation withhematoxylin and eosin, Giemsa, Papanicolaou, and Ziehl–Neelsen stained smears. We assessed the age of the patients, lesionsize, site, type of lesion, and axillary lymph node metastasis in case of malignancies. In addition, the ultrasonography/mammographyof these patients with the clinical presentation was also studied.Results: Age ranges from 13 to 100 years with a mean age of 38 years. Among the lesions, 31.86% fibroadenoma, 23.02%malignant lesions, 11.81% fibrocystic changes, and 20.23% inflammatory lesions were identified. Mean lesion size was3.37 ± 2.08 cm. 12 (12.12%) of malignant lesion cases showed metastasis in axillary lymph nodes.Conclusion: FNAC serves as a safe, rapid, economical, requiring minimal instrumentation, and highly sensitive tool forthe diagnosis of different kind of the breast lesions and ductal carcinoma. The cytomorphological examination of theselesions before operation or treatment serves as an important diagnostic modality. The sensitivity can be further increased bycomplementing with radiological and clinical findings.

Knowledge, attitude and practice of informed consent process in biomedical research among postgraduate medical students

Background: Research is integral part of post graduate studies. Informed consent is a vital ethical and regulatory requirement for the conduct of biomedical research.Methods: Mixed methods study was carried out from July to August 2017. Cross sectional part constitute quantitative component and forced field analysis (FFA) forms qualitative part. Approval from the institutional ethical committee was obtained. Pre-designed, validated, structured questionnaire was used to gather information from 114 participants about knowledge, attitude and practice (KAP) regarding informed consent process. FFA was employed to understand driving and restrictive forces in obtaining informed consent from the research participants.Results: Out of the 114 study participants majority participants were males i.e. 69.3% and pursuing post-graduation in clinical subjects. There is significant association between knowledge (p=0.008), attitude (p=0.032) among postgraduates from clinical and nonclinical departments. Among clinical 51.7% and 48.3% among non-clinical have good knowledge and 67.7% among clinical and 32.3% among non-clinical have good practice. Main driving forces for informed consent process identified during FFP were ICMR guideline for biomedical research, feeling morally right to inform the participants about what the research. Main restrictive force was fear of losing the participant due to signing on informed consent.Conclusions: There is good knowledge among postgraduates about informed consent process however there is scope of improvement in attitude and practice. Ethics training should address how to build trust with research participants and how to overcome the fear of losing the study subject

Prevalence and risk factors of Helicobacter pylori infections in the patients suffering from acid-peptic disease at tertiary care center, Gujarat, India

Background: Helicobacter pylori (H. pylori) infection is a medical encumber especially in the developing countries, ranging from acute inflammation to malignancy. The study is intended to explore the prevalence of H. pylori infection and also to compute its associated risk factors.Methods: Sixty two (n=62) symptomatic patients attending the tertiary care hospital, were included in the study. Two antral biopsies collected from each patient were subjected to rapid urease test and Gram staining. IgG antibodies were detected by rapid test based on the principle of Immunochromatography. To evaluate the risk factors, various determinants were asked to each patient in the form of questionnaire. Statistical analysis was done using Fisher exact test. P value < 0.05 was considered significant.Results: Prevalence rate of H. pylori infection was 24.19 % (15/62). More than half (53%) of the infected patients had complained of persistent burning abdominal pain. Prevalence rate was found highest in the patients suffering from peptic ulcer disease (66.6%, P=0.0237). Consumption of unfiltered water (P=0.007, Odd Ratio (OR)-1.06), eating spicy food, meat, fish and chili pepper (P=0.052, OR-1.01) was found the major risk factors. Addictive habits of either smoking/alcohol/tobacco (P=0.904) were not associated with infection.Conclusions: Prevalence of H. pylori infection was found low comparatively and was mainly associated with symptom of persistent burning abdominal pain and peptic ulcer. Use of unfiltered water, spicy food, chili pepper and meat undoubtedly increase the risk of acquiring H. pylori infection. Addictive habits were not significantly associated with infection.