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Background: Prediabetes is the preceding stage of diabetes which puts an individual to induce complications same as that of diabetes; hence, it should be treated to prevent its progression to diabetes and other consequences. However, there is very less literature about impact of home-based physical therapy on glycemic control and quality of life in Indian prediabetic population. Aims and Objectives: The aims of this study were to evaluate whether the home-based physical therapy shows effect on glycemic control and individual’s quality of life after a 3-month intervention. Materials and Methods: The study was conducted on 55 individuals who were diagnosed with prediabetes (36 males and 19 females) on basis of HbA1c level ranging from 5.7% to 6.4%. A 12-week exercise protocol was made which includes warm up exercises, main exercise program (aerobic and strengthening training), and cool down exercises along with dietary changes. SF-36 and HbA1c level is taken at baseline and at the end of 12 weeks for quality of life and glycemic control measures in participants, respectively. Results: The difference in HbA1c levels before and after treatment was found to be statistically significant. The HbA1c levels after the 3-month intervention showed significant reduction (P < 0.008) along with significant difference in all domain of SF-36 except in domain 3 (role limitation due to emotional problem) and domain 6 (social functioning). Conclusion: The home-based physical therapy program is effective in glycemic control and quality of life in adults with prediabetes.
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Background: Breast cancer is one of the most frequently diagnosed cancer and the leading cause of death worldwide. The risk factors for breast cancer can be genetic mutation, age, and family history, reproductive risk factors such as early age at menarche and late age at menopause, older age at first full-term birth, number of children, nulliparity, and duration of breastfeeding. Aim and Objectives: The aim of the present study was to investigate the epidemiological characteristics of the patients with breast cancer attending tertiary care hospital in Southern Rajasthan. Materials and Methods: This was a retrospective record-based study that was conducted in a tertiary health care hospital in Southern Rajasthan. Data were collected from the case files/records of the patients suffering from breast cancer. Information regarding the demographic details of patients (age at time of diagnosis, religion, place of residence, and education level), reproductive (age at menarche, age at menopause, age at first child birth, duration of breast feeding, and number of children) and life style related data were collected from case files for analysis. Results: The majority of the patients at the time of diagnosis were between 35 and 45 year age group followed by 46–55 year age group in the present study. The majority of the patients, 72.01% were from urban areas. The most of the patients at the time of diagnosis were in clinical Stage II and III. In the present study, 16% of the patients were <13 years of age at menarche, 12.23% had attained late menopause at >51 years, 7.99% patients had the first child birth at the age of >30 years, and 12.98% patients had the family history of breast cancer. Conclusion: Breast cancer develops earlier in Indian women compared to Western population and is one of the leading cause of mortality. Early detection and awareness about breast cancer through implementation of public health programs can help in reducing mortality.
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Introduction: In developed countries, about 50% of all Low-Birth-Weight new born are preterm. Low birth weight is also a leading cause of neonatal death and major risk factor for infant and under-five morbidity and mortality. Objectives: To find out prevalence of low birth weight& to determine the association of socio-demographic variables, maternal medical and obstetric risk factors with low birth weight. Methodology: Across sectional community-based study was conducted in a rural field practice area of a medical college. A total of 600 participants (mothers who delivered within 3 months) were included in the study. Results: The prevalence of LBW was found to be 17% in the current study. Statistically significant asso-ciation was obtained between age, education, occupation, socio-economic class of participants and birth weight of the child. The prevalence of LBW was found to be significantly high (51.7%) amongst children of those participants who consumed/used tobacco in any form. Conclusion: The prevalence of the LBW was found to be 17%. Extremes of reproductive age group, illit-eracy, occupation of labourer, SEC class IV, grand-multiparity, inadequate IFA consumption, short stat-ure, weight of mother and use of tobacco were found to be significantly affecting the birth weight and as-sociated with low birth weight.
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Background: Era’s one of the utmost scourges is air pollution, owing to not only its impact on climate change but also its impact on public and individual’s health due to combined morbidity and mortality. Objectives: The current study was intended to monitor the air quality data from two districts of Chhattisgarh, namely Raipur and Korba, so that policymakers will be able to take corrective measures to control individual’s health‑related issues associated with polluted air. Methods: All air samples were collected from around Raipur and Korba city of Chhattisgarh and submitted to the Chester LabNet, a laboratory based in 3 Oregon, USA, for analysis. Particulate matter (PM2.5) was determined by using the gravimetry technique and used the X‑ray fluorescence 4 technique to detect the presence of heavy metals. Results: PM2.5 levels in all samples in Raipur and Korba ranged from 131.4–653.8 µg/m3 to 150.3–1699.2 µg/m3 which is 2.18–10.88 and 2.5–28.3 times higher than standards prescribed by the Ministry of Environment, Forest and Climate Change (MoEFCC) of 60 µg/m3 . Heavy metals such as silica (Si), lead (Pb), nickel (Ni), and manganese (Mn) levels were recorded higher than the standard level reported by the National Ambient Air Quality Standards in locations of Raipur and Korba, Chhattisgarh. Conclusion: Although Chhattisgarh, a state in Central India covered with 45% forest, but it is suffering from low air quality due to developing township and industrial area, which is causing a lot of commotion in the local community. At this time, the government should approach to take immediate action and measures to control air pollution and to reduce the terrible impact on the health of local citizens.
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Background: In India, cataract is the foremost cause of blindness, leading to the mild-to-severe morbidity. Objective: The objective of the study was to find out the epidemiologic profile and risk factors of posterior polar cataract/posterior subcapsular cataract. Materials and Methods: A prospective non-comparative observational study involving 50 patients having posterior polar cataracts attending our outpatient department was selected and was questioned about their locality, systemic diseases, ocular disease, and use of steroid in any form which were included in the study. Results: Of the 50 patients, 30 were male and 20 females, most patients were in the age group of 61–70 years. About 66% of the patient belongs to the rural locality. Most of the females were homemaker, 24% were farmer, 8% were shopkeeper, and 6% retired persons while 2% each of electrician, computer programmer, and bus driver. About 48% had bilateral cataracts, 42% (21) were pseudophakic in one eye, and 1% (5) unilateral cataract. About 24% of patients had hypertension, 18% of patients had of asthma/chronic obstructive pulmonary disease, 16% of patients had diabetes mellitus, 2% of patients had h/o arthritis, 8% had skin disease, 6% had h/o injudicious use of over-the-counter topical drops while 4% of patients of thyroid disease were noted and 34% of patients had h/o steroid use. The most common type of cataract seen Grade I (52%, 26 patients), followed by Grade II (36%, 18 patients), Grade III (8%, 4 patients), and Grade IV (4%, 2 patients). Conclusion: With increasing injudicious use of steroid can result in formation of posterior polar/posterior subcapsular cataract in young age and professional office class workers who are seeking medical help at early stage. An ultrasound should be done to rule out posterior capsular defect if suspected and the patient should be counseled well about the complication prior taking into surgery.
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We report a case of combined brilliant blue G and endoilluminator retinal toxicity in a patient who has undergone macular hole surgery. The patient developed extensive degeneration of the retinal pigment epithelium as early as 1 week following surgery that eventually lead to poor visual outcome. We look into the pathogenesis of BBG and endoilluminator causing retinal toxicity and also suggest measures to avoid this irreversible retinal damage.
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We report the retinal and choroidal manifestations using multimodal imaging in a patient with Neurofibromatosis type 1 (NF-1). In this report, we describe the occurrence of a new retinal finding which we label as retinal caf�-au-lait macules. Also, we describe the superiority of multicolour imaging in comparison to colour fundus photography for identifying the retinal manifestations in NF-1.
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Quality assurance (QA) is the maintenance of a desired level of quality in a service, by means of attention to every stage of process of delivery. Correct image acquisition along with accurate and reproducible quantification of ophthalmic imaging is crucial for evaluating disease progression/stabilization, response to therapy, and planning proper management of these cases. QA includes development of standard operating procedures for the collection of data for ophthalmic imaging, proper functioning of the ophthalmic imaging equipment, and intensive training of technicians/doctors for the same. QA can be obtained during ophthalmic imaging by not only calibration and setting up of the instrument as per the manufacturer's specifications but also giving proper instructions to the patients in a language which they understand and by acquisition of good quality images. This review article will highlight on how to achieve QA in imaging which is commonly being used in ophthalmic practice.
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Background: Increasing antisocial and violent behaviors in adolescents and young adults present serious challenges for public health. Children with persistent high levels of aggressiveness are often associated with developing conduct disorders later in life. Early detection of highly aggressive children and sociodemographic risk-modifying factors are important for developing effective preventive strategies. Objectives: The present study was undertaken to assess levels of aggressiveness for detecting highly aggressive children in sample populations of primary school children in an urban setting and determine significant biosociocultural risk-modifying factors in this scenario. Methods: The study was conducted during August朣eptember, 2015 in 5 primary schools of South Delhi Municipal Corporation. Sociodemographic data on 2080 students were collected. Overall aggressiveness scores (OA-Scores) were estimated using a self-report questionnaire in Hindi. Results: Categorizing students according to their OA-Scores, the data revealed that highly aggressive children constituted 4.3% of the study population. Analysis showed significant influence of (a) gender: boys displayed higher levels of aggressiveness compared to girls; (b) dietary pattern: omnivores showed higher aggressiveness than vegetarians; and (c) school environment: boys in mixed-sex (coeducational) schools displayed lower aggressiveness than from single-sex schools. Statistically significant influences of religion (Hindu/Muslim) and family type (joint/nuclear) on aggressiveness profiles were not noticeable. Conclusions: Vegetarian diets and mixed-sex education act as protective factors in the development of aggressiveness in children, especially among boys. Extending investigations to populations differing in geography and cultural backgrounds are warranted to verify present results.
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Introduction: This study was aimed to assess the hearing outcome after type I tympanoplasty using temporalis fascia graft, to assess the factors which influence the outcome and to evaluate the result of our study and to compare our data with similarly published study. Materials and methods: The study was conducted at NSCB Medical College and Hospital, Jabalpur in the Department of Otorhinolaryngology after obtaining approval from the institutional ethics committee, from October 2014 till October 2015. Patients, aged 15 to 45 years, presenting with perforated tympanic membrane were consented. Audiological evaluation was done preoperatively, 1 month and 3 month after tympanoplasty. Results: During the study period 45 type I Tympanoplasty were performed using temporalis fascia as graft, 24 males. 21 cases below the age of 26 years showed graft take up of 84% and the mean hearing gain of 11.37 dB. 77% of those belonging to low socioeconomic group showed graft take up of 76.9% with mean hearing gain of 12.03 dB and 88% of those belonging to high socio economic group showed graft take up of 87.5% with mean hearing gain of 11.14 dB. Out of 21 cases which had perforation size <50% 20 showed graft take up of 95.23% with mean hearing gain of 11.77 dB. Conclusions: Graft uptake is independent of gender, age of the patient. Pre operative dry ear status is directly related to the outcome of surgery. Graft take up is better in perforation size less that 50% but hearing gain will be more in perforation size of more than 50%.
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Introduction: This study aimed to clinically correlate adenoid facies with various clinical features related to ear, nose and throat and to broadly study the various sequelae of adenoid hypertrophy on the physical, mental as well as the social conditioning of children. Materials and methods: After taking approval of the institutional ethics committee the study was carried out in the department of Otorhinolaryngology and Head and Neck Surgery Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur from January 2012 till December 2012. Patients who presented to the outpatient clinic or were admitted in the indoor ward with adenoid facies were included in the study. After detailed history taking and clinical examination, data was analysed with appropriate statistical methods. Results: 30 patients with adenoid facies of varying degrees were included in the study. Nasal block was the most commonly presenting symptom. Pain in throat was complained of by 66.66% of cases. In 50% of cases the parents complained of irregular dentition. Decreased airflow upon functional examination of the nose was seen to be bilateral in majority of cases. A hitched upper lip was found in 100% of cases. High arched palate was seen in all cases, grade III tonsil enlargement was seen in 63.33% cases while grade II tonsil enlargement was seen in 30%. It was seen that mastoid pneumatization was affected by adenoids, being partial cellular in 48.33% of the cases and sclerosed in 18.33% ears. Conclusions: This study concluded that adenoids affect each part of ear nose and throat system, thus its effect can actually be quite devastating in growing children
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Introduction: Epistaxis is one of the most common encountered otolaryngologic emergency and affects up to 60% of the population in their lifetime, of which 6% require medical attention. This study was done to find out the relationship between general diseases and the occurrence of epistaxis and to evaluate the methods required to manage bleeding from the nose. Materials and methods: Cases were taken for this study from various indoor and outpatient departments of N.S.C.B Medical College and Hospital Jabalpur from October 2013 till September 2014. Detailed history, clinical information was noted for all patients. All included patients underwent investigations as ordered by their doctor, and relevant clinical examinations were performed. Data was analyzed using appropriate statistical methods. Results: In this study, maximum number of subjects had bleeding from both nares followed by left and right nares respectively. Deviation to left was more common in this study with not much significant difference between the two sides. Tumors of nose (17.78%) were the most common associated disease in this study followed by hypertension (13.3%), diabetes mellitus was associated with 6.67% of subjects. 11.11% patients had nasal bone fracture and 11.11% of patients had enlarged external framework of nose mainly due to nasal masses. Most commonly used modality was anterior nasal packing in 40% cases, followed by surgery in 35.56% cases. Conclusions: These results illustrate the relation of epistaxis with past medical history, duration of bleeding. More research is required to understand the management patterns in different geographical locations.
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We compared three angiotensin-converting enzyme (ACE) inhibitors, captopril, perindopril, and ramipril, in the presented prospective study for their effectiveness in patients having left ventricular (LV) systolic dysfunction and undergoing coronaryartery bypass grafting (CABG). We enrolled 27 patients in captopril, 43 patients in perindopril, and 70 patients in ramipril group. There was about 25%–36% rise in LVEF after 3 and 6 months of ACE inhibitor administration in all three groups. The reduction in LV diameters did not differ significantly amongst the three groups. There was a significant decrease (p < 0.05) in LV end-diastolic diameter from baseline levels in captopril and perindopril groups after 3 months that got increased after 6 months but remained below pretreatment levels in both the groups. In ramipril group, there was no much change in this parameter from baseline levels at 3 and 6 months of treatment. After 6 months of treatment, the percent reduction in LV end-systolic diameter was also sustained in perindopril-treated patients. The percent reduction was greater in the perindopril group (3 and 6 months: 7.39 ± 5.94 and 7.73 ± 3.43, respectively) as compared to that observed in captopril group (3 and 6 months: 5.67 ± 1.05 and 2.52 ± 3.11, respectively) and ramipril group (3 and 6 months: 7.30 ± 2.75 and 4.93 ± 3.22, respectively). Mitral-valve regurgitation was greatly reduced in the captopril group at 3 as well 6 months of ACE inhibitor administration. However, the percent reduction from baseline levels was not statistically significant amongst the three groups. The percent improvement in functional status was significantly greater in the ramipril treatment group (36.46 ± 3.14) after 6 months of treatment as compared to that of captopril (6.67 ± 10.64) and perindopril (4.17 ± 2.73) group. In conclusion, our data show equal beneficial effects with all three ACE inhibitors under investigation in CABG patients with LV systolic dysfunction, with marginal superiority for perindopril.
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Chemical preservatives have been used in the food industry for many years. However, with increased health concerns, consumers prefer additive-free products or food preservatives based on natural products. This study evaluated antimicrobial activities of extracts from Emilia sonchifolia L. (Common name: lilac tassel flower), Tridax procumbens L. (Common name: tridax daisy) and Vernonia cinerea L. (Common name: Sahadevi), belonging to the Asteracea family, to explore their potential for use against general food spoilage and human pathogens so that new food preservatives may be developed. Three methanol extracts of these plants were tested in vitro against 20 bacterial species, 3 yeast species, and 12 filamentous fungi by the agar diffusion and broth dilution methods. The V. cinerea extract was found to be most effective against all of the tested organisms and the methanol fraction showed the most significant (p < 0.05) antimicrobial activity among all the soluble fractions tested. The minimum inhibitory concentrations (MICs) of extracts determined by the broth dilution method ranged from 1.56 to 100.00mg/mL. The MIC of methanol fraction was the lowest in comparison to the other four extracts. The study findings indicate that bioactive natural products from these plants may be isolated for further testing as leads in the development of new pharmaceuticals in food preservation as well as natural plant-based medicine.
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Pleural effusions in multiple myeloma are relatively infrequent and more so myelomatous ones. We report a 66-year-old man who presented with multiple myeloma and a myelomatous right-sided pleural effusion. The diagnosis was made by repeated cytopathological pleural fluid examinations. The patient received one cycle of cyclophosphamide and methylprednisolone but despite therapy patient showed a downhill course. We reviewed the clinical features of this case and literature concerning multiple myeloma presenting as pleural effusion.
Subject(s)
Aged , Cyclophosphamide/therapeutic use , Humans , Male , Methylprednisolone/therapeutic use , Multiple Myeloma/complications , Pleural Effusion/diagnosisABSTRACT
The incidence of primary central nervous system lymphoma (PCNSL), previously a rare tumor, has increased significantly over the past few decades, partly due to the AIDS epidemic but also in immunocompetent individuals. Studies from Western countries have shown a consistent association of tumors occurring in immunocompromised individuals with the Epstein-Barr virus (EBV) suggesting an important role for the virus in the pathogenesis of these tumors, but an infrequent association of the virus with PCNSL in the immunocompetent host has also been noted. We studied 11 patients with PCNSL who had no evidence of an immunocompromised state. All the tumors were aggressive B cell lymphomas. EBV association was studied using EBER in-situ hybridization. 10 out of the 11 tumors were negative for EBV, indicating that tumors in immunocompetent individuals in developing countries are also infrequently EBV associated and that a different pathogenetic mechanism is operative in the evolution of these tumors.