Jigsaw Method of Interactive Teaching to Unpuzzle Neuroanatomy

Introduction: Student driven interactive methods of teaching are a major part of andragogy, which drives them to professional competency. Jigsaw method is one such interactive teaching modality which fosters self-directed learning and peer interaction. The aim of this study is to access the effectiveness of Jigsaw method of interactive teaching qualitatively and quantitatively among 1st year MBBS students. Materials and methods: this study was done in 1st year medical students. The students were exposed to jigsaw method of interactive teaching in small groups and the program was evaluated by assessing the short and long term memory of the students. Feedback also was obtained from the students. Results: There was a statistically significant difference in the mean scores as compared to traditional teaching methods. The perception of students also showed promising results. Discussion: there have been many studies on student perception on such interactive teaching methods which revealed that the students were showing better academic performances. A few studies like the present one, on quantitative assessment of students score after Jigsaw method of interactive teaching has also shown good results. Conclusion: the jigsaw method of interactive teaching encourages student participation and enhances self directed learning and peer assisted learning.

Enhanced antitumor effect of curcumin loaded solid lipid nanoparticles in Dalton’s ascites lymphoma mice

Curcumin is widely known for its antibacterial, antioxidant and anti inflammatory effects and has been reported to possess anticancerous activity as well. However, its medical application is limited because of poor bioavailability and rapid metabolism. In this study, we encapsulated curcumin in solid lipid nanoparticles and studied its anticancerous effect in Dalton’s Ascites Lymphoma (DAL) mice model. The physicochemical characteristics of curcumin solid lipid nanoparticles (CUR-SLN) were assessed and the anticancer efficacy was determined by in vivo studies. The curcumin solid lipid nanoparticles were synthesized by solvent emulsification evaporation method with particle size less than 100 nm. Antitumor effect of nanocurcumin (50 mg/kg) and curcumin (100 mg/kg) was evaluated in Dalton’s Ascites Lymphoma bearing mice. Pathological and immunohistochemical parameters were studied. Mean survival time and percentage increase in lifespan were assessed. Nanocurcumin group showed more significant influence in reducing tumor volume and weight, inducing apoptosis, reducing angiogenesis and invasion restoring antioxidant parameters and increased mean survival time. Curcumin and nanocurcumin inhibited the activation of nuclear factor-kappa B (Nf-kB), and thereby proved the pathway by which it induced anti-angiogenic and anti-invasive property.

Uptake pattern of training programs over two decades at an International Ophthalmic Training Institute in India

Purpose: Inadequacy of trained human resources is a critical challenge for eye?care delivery worldwide. Recognizing this, the World Health Organization (WHO) and the International Agency for Prevention of Blindness had identified the development of human resources as one of the focal areas in the global initiative “Vision 2020: The Right to Sight.” The global action plan of the WHO also emphasized the need for trained workforce for ensuring comprehensive eye?care services. We aimed to present the uptake pattern of training programs offered at a high?volume training institute in India. Methods: We did a retrospective analysis of data related to training programs conducted between 2000 and 2019. Trainees included ophthalmologists, allied ophthalmic personnel, and eye?care management professionals from all over the world. We analyzed the overall growth over the 20 years in the WHO regions. The uptake patterns were also analyzed across four segments of 5?year?periods by the type of training. Results: Overall, 9091 trainees from 118 countries attended training in over 40 courses that included long? and short?term clinical training for ophthalmologists (54.2%) and short?term training for eye?care managers (29.5%), allied ophthalmic personnel (6.2%), and eye?care technicians (10.2%). The majority of the trainees (81.3%) came from the Southeast Asian region, of which 87.4% were from India. Most (98.3%) of the trainees belonged to developing countries. We found an overall average growth of 4.8% in the training uptake across the four 5?year segments over the 20 years. Conclusion: Comparatively better representation of trainees from the developing countries is encouraging as the prevalence of blindness and visual impairment is higher in those countries, warranting improved eye?care delivery. Given the strong influence of distance and associated costs of accessing training, the development of similar institutes in other regions might help enhance the global efforts to eliminate needless blindness.

An Open-Label Non-Randomized Clinical Trial on Siddha Purgation Therapy (Bhedhi) for Pacifying Vatha disease using diagnostic tool Neikuri

Siddha system granting preventive, curative and rejuvenating healthcare. According to Siddha system three humours- Vatham, Pitham and Kapham- mediate the body’s physiological function. Derangements of trihumour lead to diseases. Vatha diseases are the most common diseases presenting in Siddha hospitals nowadays. In Siddha system the primary goal of the treatment is to restore the balance of trihumours. The first and foremost treatment for Vatha disease is Bhedhi (purgation). The quote ‘BhedhiyaalVathamthaalum’ indicates purgation therapy will reduce Vatham. For this study the purgative drug Agasthiyarkuzhambu is used. Aim and Objective: To make a validation of purgation therapy to alleviate Vathaim balance. To describe purgation therapy in alleviate Vathaim balance by giving Agasthiyarkuzhambu to outpatient and inpatient Department, Govt. Siddha Medical College, Palayamkottai. To observe the increased Vatha symptoms and Neikuri changes before and after treatment. Materials and methods: ANon randomized clinical trial was done with 40 patients, data were collected by interviewing with structured questionnaire about increased Vatha symptoms and samples of urine were collected to the analysis. The data will be analysed using SPSS. Results: Out of 40 patients, based on relief of Vatha symptoms 45% of cases reported good relief and 13% of cases reported better relief from their symptoms. In Neikuri before treatment 40% of cases had typical Vathaneikuri (fast, irregular, Aravu pol) and after treatment the Neikuri pattern changed to Pithavatham, Pitham and Kapham and only 10% of cases had Vathaneikuri. Neikuri and Vatha symptoms are better parameter for assessing alleviated Vatha imbalance in this study.

Craniocerebral and Spinal Dysraphism with Omphalocele – A Case Report of Primary Neurulation Defect

Background: Anencephaly and Spina bifida are the two most common types of neural tube defects (NTDs). Disrupted formation and closure of neural folds leads to Craniocerebral and spinal dysraphisms. Materials and methods: An 18 week old foetus was received in the department of Anatomy after elective medical termination of pregnancy due to the diagnosis of neural tube defect and associated congenital anomalies. Case Report: The foetus had anencephaly, thoracic-lumbar spina bifida, omphlocele and clubbed foot and hands. The foetus was dissected and studied, to look for abnormal internal structures. On meticulous dissection it was found that there were abnormalities in spine, gastrointestinal system and cranium. Conclusion: Anencephaly is a neural tube defect which has multiple neural and non-neural associated anomalies. A detailed description of the combination of associated anomalies goes a long way in updating knowledge on the same.

Exploring the Learner’s Perception about Embryology – Before and After Introduction of Competency Based Medical Curriculum (CBME)

Background: The perceived relevance of a subject/area will decide how much the student will study that. Competency based Medical Curriculum helps students to understand the subject relevance due to its structured format. The feedback from students about subject relevance is needed as they are the primary stakeholders for learning. In this era of involving molecular biology and genetics in medical field, it is very difficult to determine how much to teach a basic subject like embryology. This questionnaire study was done to know the viewpoints of 3rd semester & 5th semester medical students about the relevance and necessity of embryology in medical education. Method: An anonymous questionnaire was sent to 3rd semester, CBME batch & 5th semester students, traditional or regular batch of Sree Balaji Medical College, Chrompet. The pre validated questionnaire contained questions regarding the perceived relevance & importance of embryology. Results: Students reported the relevance of embryology knowledge for learning other medical subjects & they more often acknowledged embryology as being of great importance for their professional careers. This perception has increased especially after introduction of Competency based Medical Curriculum. Overall, study results suggest that medical students have a positive attitude toward embryology undergraduate course. Conclusion: This evidence could be used as an additional motive for the development embryology courses, with special emphasis on practical application of knowledge in clinically-oriented setting.

Effectiveness of Flipped Class Room Approach as a Teaching Methodology in Anatomy for Early Clinical Exposure Modules for First-Year Medical Students – An Interventional Study

Background: The National Medical Commission (NMC) of India has rolled out the competency based undergraduate medical curriculum in the year 2019 where there is more emphasis on integration of basic and clinical sciences, early clinical exposure (ECE) and clinical competence and skills. To achieve this it is essential to work on higher forms of cognitive work. Hence it reckons for the change in the teaching–learning methodology currently in practice. Thus we introduced a innovative teaching methodology such as flipped class room (FCR) methodology among first year medical graduates for early clinical exposure modules in anatomy. Materials and methods: This interventional study was conducted among the 1st year MBBS students of Sree Balaji Medical College & Hospital (2019–2020 academic year). The ECE modules were taught using both traditional lectures and FCR methodology. Pre and post tests were conducted for both the methodology. A comparative analysis of FCR teaching method with lecture based session was done by obtaining the scores of the students. A Structured questionnaire to assess the learner’s perception about FCR teaching methodology was obtained from the participants. The Results were analyzed using microsoft excel and SPSS software version 23. Evaluation of teaching tool was done by using Kirkpatrick model Results: Repeated measures Anova was applied and there was a significant difference within the two methodology and the interaction effect was also significant with P value 0.001. Although both methods show increase in mean from pre to post test the mean increase in flipped class method is more than the lecture. Spearman’s correlation was done which showed there is a significant relationship between both the methods with p value 0.001 correlation co-efficient r was 0.377. Overall Response to FCR method received higher rating. Conclusion: FCR methodology creates the opportunity to meet the needs of students through various instructional activities. There is a positive reinforcement and improvement in the student’s performance.

Corrigendum to “Antiobesity and antihyperlipodemic effect of Ixora coccinea on Triton X-100 induced hyperlipidemia in rats: An approach to evaluate asymmetrical temperature distribution analysis using thermography” Chinese Herbal Medicines 11 (2019) 326–331 (Chinese Herbal Medicines (2019) 11(3) (326–331), (S1674638419300498), (10.1016/j.chmed.2019.05.006)) / 中草药·英文版

When this paper was first published the following ethical statement was omitted in error: The experiment was approved by Institutional Animal Ethical committee (IAEC) with an approval number (KSRCT/BT/IAEC/2017/20) and the experiment was conducted at Animal House facility, KS Rangasamy College of Technology, Tiruchengode, Namakkal District, Tamil Nadu, India. The authors would like to apologise for any inconvenience caused.

A Study on Association between Androgenetic Alopecia and Cardiovascular Risk Factors in Males with History of Hair Fall.

Review of literature revealed that Androgenetic Alopecia (AGA) or Male Pattern Baldness (MPB) and Coronary Artery Disease (CAD) are closely associated. Few studies showed an increased incidence of certain factors such as family history of CAD, family history of baldness, hypertension, increased Body Mass Index (BMI), central obesity, hyperglycaemia, and dyslipidaemia in all men with MPB, which were considered as cardiovascular risk factors. Recently newer risk factors such as Serum Lipoprotein a (SL-a), serum homocysteine (SH), and serum adiponectin are reported. A meta-analysis study showed that vertex type of baldness is more commonly associated with CAD. We wanted to study the association between androgenetic alopecia and cardiovascular risk factors in male patients with history of hair fall and family history of coronary artery disease.METHODSThis study was done among 136 men aged between 20 and 65 years with the history of hair fall and a family history of coronary artery disease. In all the subjects, blood pressure and pulse rate were recorded. Lipid profile and fasting blood sugar were done. Other parameters such as weight, height, BMI, waist circumference, and the pattern of baldness were documented.RESULTSIn majority of the subjects, 42.6 % belonged to the age group of 45-65 years with mean age of 48.63 years. Vertex type of baldness was observed in 78 persons constituting 57.3%. Among the grades of baldness, Grade - IV, V, and VI baldness were observed in majority of the subjects in the age group of 31-40 years. 73.0 % of persons with vertex type had positive family history of baldness and family history suggestive of ischemic heart disease. All subjects with vertex type had more cardiovascular risk factors in comparison to none type such as total Cholesterol, low LDL, high VLDL, and TC/HDL more than 5 and diabetes. Hence vertex type may be considered as a marker for the evaluation of well-known cardiovascular risk factors.CONCLUSIONSAll persons having history of hair fall and MPB especially vertex type should be evaluated for the well-known cardiovascular risk factors and should be advised to have periodical tests to be done to reduce the co-morbidity associated with increased cardiovascular risk factors.

Evaluation of Thyroid Dysfunction in Abnormal Uterine Bleeding with Ovarian Dysfunction (AUB - O)

Introduction: Abnormal uterine bleeding with ovarian dysfunction (AUB-O) is one of the most frequently encountered conditionsin gynecology and defined as an abnormal bleeding from the uterus in the absence of organic disease of genital tract anddemonstrable extragenital cause.Aims and Objectives: The objectives of the study were to study the menstrual pattern in patients with thyroid dysfunction andto study the thyroid dysfunction from puberty to premenopausal age group in AUB-O.Results: AUB-O is one of the most frequently encountered conditions in gynecological practice which will give a descriptiveanalysis of the age distribution, the parity distribution, symptomatic distribution of AUB-O, and its association with thyroiddysfunction.Conclusion: Our study concludes that thyroid dysfunction should be considered as an important etiological factor for menstrualabnormality. Thus, biochemical evaluation of T3, T4, and thyroid-stimulating hormone estimations should be made mandatoryin AUB-O cases to detect apparent and occult thyroid dysfunction

A comparative study on analysis of various teaching learning methodologies in anatomy

Background: Teaching medical students the subject of Anatomy has always been a challenging task. This studywas conducted to understand the student’s perspective of the various methodologies of teaching and learning inAnatomy.Materials and methods: This study was done in Sree Balaji Medical College and Hospital, Chennai. In this studya questionnaire was prepared, where in there were 12 questions, which was circulated to the MBBS students of1st year and second year. The questionnaire had questions as to which modality of teaching gives betterunderstanding of Anatomy. The results obtained were tabulated.Results: The results showed that cadaveric dissection gave better understanding. A power point presentation ona topic followed by dissection of same topic was well appreciated. Students preferred small group teaching withwet and dry specimens to didactic lectures using power point. A good feedback was obtained for problem basedlearning also.Conclusion/ Implication: After analyzing the observations it can be concluded that small group teaching in theform of cadaveric dissection or demonstration is the method which the students feel is best to understandAnatomy. Problem based learning also has conferred a lot of advantages in making the students analyze andcorrelate Anatomy with its clinical implications. The modern methods of teaching anatomy in lecture hall withpower point presentation or virtual anatomy is only a supportive method to understand anatomy.

Assessment and evaluation of drug information services provided by drug information centre at a multispecialty hospital in Erode, Tamil Nadu, India

Background: To evaluate the performance of Drug Information Centre (DIC) in providing quality drug information services to the health care professionals.Methods: It was a prospective study carried out for a period of six months (June-November 2017). The drug information services provided by the pharmacist at the DIC during ward rounds, direct access, telephone and mail were documented in the drug information request and documentation forms. The quality of drug information provided was assessed with the help of feedback questionnaire which was filled by receivers.Results: A total of 283 queries were received, with a maximum from ward rounds 140(49.47%). On evaluation, it was found that most of the queries were from physicians 207 (73.14%) followed by nurses 33(11.66%), pharmacists 26 (9.18%), patients 17 (6.07%). Among that 178 (62.89%) queries were received from department of general medicine. Most of the queries were intended to update knowledge 110 (38.86%) and for the purpose of better patient care 90 (31.81%). The time frame for an authentic reply ranged from minutes to 24 hours, where a maximum of 110 (38.86%) queries had sent a 24 hours deadline. The majority of the queries were for adverse drug reactions [ADR-60 (21.20%)] and most preferred resources were primary 188 (66.43%).Conclusions: The DIC has always presented and offered itself to be an impressive resource, which is used routinely as an information source by all levels of professionals involved in the health system, in addition to the patients themselves.

Risk Of Down Syndrome In Elderly Mothers: A Retrospective Study In Tumkur

Background: Down syndrome being the most common chromosomal disorder is researched extensively. The onlyetiology that is well established is increased maternal age. In the developing countries, the incidence of Downsyndrome is increasing in younger mother.Method: 75 cases of Down syndrome children and age matched 75 children without known congenitalabnormalities were taken for this study. The parental age was noted and statistical analysis was done tocorrelate the maternal age withy DS.Result: Only 26.4% of DS children were born in mothers aged above 35. There was a decrease in number ofchildren born in aged mothers of both group, but there was no much difference in the groups.Conclusion: Maternal age is not only the risk factor for occurrence of DS. There is generally a tendency of earlypregnancy in India, which leads to increase in number of DS children being born to mothers below 35

Comparative evaluation of addition of either fentanyl or clonidine to bupivacaine in spinal anesthesia - a randomized controlled trial

Background: Single dose subarachnoid anesthesia is a commonly used anesthetic technique for pelvic and lower limb surgeries. Various adjuvants, e.g. opioids, alpha 2 agonists, neostigmine, midazolam etc. have been used to counter some of the shortcomings of the technique. Synthetic lipid soluble opioids like fentanyl for hemodynamic stability or clonidine for prolongation of duration have been used. We wanted to compare both the drugs with a control when used in conjunction with local anesthetics in lower abdominal and pelvic surgeries with regard to sensory and motor block with early postoperative analgesia along with their side effect profile

Methodology: One hundred and fifty adult patients of ASA status I and II, posted for lower abdominal and pelvic surgeries, were randomly divided into three groups. Group BC [bupivacaine + clonidine] received 50 micro g clonidine while BF [bupivacaine + fentanyl] received 50 micro g of fentanyl, the third group received equal volumes of normal saline [Group NS, bupivacaine + normal saline] for subarachnoid block. The duration of anesthesia, analgesia, motor blockade and side effects like sedation, bradycardia and hypotension were noted and subjected to statistical analyses with ANOVA [analysis of variance] and Kruskal-Wallis test as and when appropriate

Results: All of the 150 patients completed the study. The duration of surgical anesthesia was not significantly higher in the experimental groups. But the duration of analgesia was higher in BC than BF which in turn was higher than the Group NS [281.26 +/- 97.57, 237.80 +/- 58.49 min and 190.48 +/- 61.94 min respectively]. The sedation and the intraoperative motor blockade were similar, in Group BC, L1 regression time was 232.76 +/- 94 min which was higher compared to Group BF [202.34 +/- 60 min] and Group BN [172.28 +/- 56 min] but statistically insignificant. The hemodynamic instability with regard to hypotension was more in Group BC than BF

Conclusion: Addition of 50 micro g of clonidine to intrathecal bupivacaine produces prolonged duration of analgesia in surgical anesthesia. The onset of hemodynamic imbalance was from forty minutes in Group BC which prompts for an additional monitoring in those cases. There is no excess sedation with the above said dose of clonidine

Evaluation of Peak Expiratory Flow Rate in Pregnancy in a South Indian Tertiary Care Centre

Background: Pregnancy is a physiological state causing significant physical and functional changes in Cardiovascular and Respiratory system. It is important to recognize the adaptive changes during pregnancy in order to identify and manage Respiratory impairment. The Respiratory system undergoes structural and functional alterations affecting the thoracic cage, abdominal cavity and diaphragm. There is a decrease in Functional Residual Capacity (FRC), Expiratory Reserve Volume (ERV), Chest wall Compliance & increases in Tidal Volume (TV), Minute Ventilation (MV) during pregnancy. However, Airway function is postulated to largely remain unchanged during pregnancy with Peak Expiratory Flow Rate (PEFR), FVC and Forced Expiratory Rates like FEV1 showing little change. Hence, PEFR which is a simple, portable, cheap and reproducible parameter can be utilized to assess airway function during pregnancy. Due to conflicting reports of PEFR with advancing gestation in different ethnic groups and limited studies in the South Indian population, the present study was undertaken to evaluate the PEFR variation in different trimesters of normal pregnancy. Aim: To Evaluate the Peak Expiratory Flow Rate in Pregnancy in different trimesters. Aruna Shanmuganathan, Krishnaveni R, Meenakshi Narasimhan, Viswambhar V, Ragulan R, Nisha Ganga, Gangaiamaran M, SSJ Shiek Fareeth Ahmed. Evaluation of Peak Expiratory Flow Rate in Pregnancy in a South Indian Tertiary Care Centre. IAIM, 2017; 4(7): 61-66. Page 62 Materials and methods: Total of 165 pregnant women in the age group of 20-35 year with no respiratory illness or co morbidities (55 in each trimester) were included in our study. Control group consisted of 55 age and height matched non pregnant women. Informed consent was obtained and PEFR was performed using Mini Wright s Peak Flow Meter and best of three recordings noted. Data analyzed using SPSS package version 21.0. Association between PEFR with Age and BMI performed using Pearson correlation. The Bonferroni’s Multiple Comparison Test executed to determine the significant variance of PEFR between control and study groups. Results: PEFR was significantly lower in all trimesters of pregnancy compared to controls. However, there was no significant difference in PEFR across trimesters. Age and BMI did not correlate with PEFR. Conclusions: PEFR was significantly lower in all trimesters compared to controls. Hence, prospective Indian studies with larger samples are needed to arrive at Normograms for PEFR in each trimester of normal pregnancy which would enable us to use PEFR as a simple tool to assess airway obstruction in pregnancy.

Evaluation of platelet indices among patients with exacerbation of COPD in a tertiary care center in South India

Introduction: Mean platelet volume (MPV) and Platelet Distribution Width (PDW) is a relatively simple, inexpensive tool that indicates the platelets size, the rate of platelet production, platelet activation and the severity of inflammation since inflammation plays an important role in COPD, any alteration in platelet activity can cause alteration in MPV. Red blood cell distribution width (RDW) reflects morphology of erythrocytes whereas RDW can also vary due to systemic inflammation and ineffective erythropoiesis. Hence we aimed to study Platelet indices in patients with exacerbation of COPD. Aim and objectives: Our aim is to evaluate the role of platelet Indices in COPD patients. Since only limited data were available on the relationship between COPD and platelet indices, we aimed to evaluate and find out the correlation between Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW), Platelet Distribution Width (PDW) and Plateletcrit (PCT) in exacerbation of COPD patients at a tertiary care hospital in south India. Materials and methods: A total of 135 subjects, 79 men and 56 women, who were admitted in our hospital with exacerbation of COPD during a period of one year were enrolled in this prospective Ragulan R, Viswambhar V, Krishnaveni R, Meenakshi Narasimhan, Aruna Shanmuganathan, Nisha Ganga, Gangaiamaran M. Evaluation of platelet indices among patients with exacerbation of COPD in a tertiary care center in South India. IAIM, 2017; 4(7): 161-166. Page 162 observational study. The levels of MPW, RDW, PDW and PCT were assessed during the course of hospital stay in patients with COPD exacerbation Results: In our study we found out that there exists a statistical significance among male and female COPD exacerbation patients with respect to Mean Platelet Volume (P=<0.0001) and Red Cell Distribution Width (P=<0.0001). There also exists statistical significance between our COPD patients with other study stable controls (p=<0.005). Using ROC curve, considering optimal level of MPV <8.8Fl, male population showed sensitivity of 95% and specificity of 85% with Average age in men with diagnosed COPD is 49 and average age of female COPD patient is 55. Conclusion: Our study suggests that Mean Platelet Volume and Red Cell Distribution Width values may be useful for identifying patients who are at high risk for exacerbation of COPD. RDW per se is an important risk factor for Ischemic heart disease (IHD) and elevated RDW may suggest increase in risk of IHD in patients with COPD

Surgical management of extensive oral tumors by bilateral rostral mandibulectomy in two dogs

Two dogs of different age groups were presented with the history of oral growth, bleeding, excessive salivation, bad breath, inappetance and dysphagia. Physical examination revealed cauliflower like reddish growth in the gingiva enclosing the mandibular incisiors and canine tooth. Haematology and serum biochemical profiles were within the normal range. Plain radiography revealed extensive growth involving the lower mandible and gingiva. Hence rostral mandibulectomy was performed to excise the tumor mass. The dogs recovered uneventfully after surgery with no difficulty in feeding liquid and semisolid diet. The post operative prognosis for dogs with oral neoplasia depends on type of tumor and extent of disease at the time of surgery. In the above two cases the tumors were benign and rostral mandibulectomy provided excellent prognosis and recovery with no recurrence of tumor

A cross sectional study on combined prevalence of allergic rhinitis (AR) and bronchial asthma (BA) among construction workers

Background: Asthma is a heterogeneous syndrome with multiple phenotypes, the most prevalent of which is allergic asthma in association with allergic rhinitis. Construction is one of the important industries, which employs a large number of people on its workforce. In India about 340 million (92%) workers are in unorganized sector and about half of them are in construction industry. The construction workers are one of the most vulnerable occupational groups, prone to wide range of illnesses especially to respiratory morbidities like Asthma and allergic rhinitis. Despite this high risk very few studies are available on extent of asthma and AR in construction workers. Viswambhar V, Reddy GMM, Ragulan R, N. Meenakshi, Aruna Shanmuganathan, Krishnaveni R. A cross sectional study on combined prevalence of allergic rhinitis (AR) and bronchial asthma (BA) among construction workers. IAIM, 2016; 3(5): 174-183. Page 175 Objectives: To assess the prevalence and factors influencing allergic rhinitis and bronchial asthma among construction workers and to assess the degree of disease control using CARAT questionnaire Materials and methods: The study was a cross sectional study conducted in sub urban areas of metropolitan city of Chennai. The participants were selected by multistage Cluster random sampling. World Health Organization (WHO)-sponsored Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, Spirometry and CARAT scoring were used in the study. Results: A total of 231 participants were included in the final analysis. The prevalence of any respiratory morbidity was 39% among study population. Out of the diseased 11 (4.8%) had AR alone, 12 (5.2%) subjects had BA alone and remaining 67 (29%) had both AR and BA. The prevalence of respiratory morbidity gradually increased with increasing age and was more in males. Upper airway symptoms were poorly controlled in 100% of the affected patients, this proportion was 66.7% for lower airway symptoms and 83.58% for combined airway score Conclusion: Co-existence of Bronchial asthma and Allergic rhinitis is more common among construction workers compared to general population. Male workers in middle age group are more prone to airway allergy. Bronchial asthma is poorly controlled in workers with coexisting allergic rhinitis

Clinical presentations of small bowel tumor

Introduction: Small bowel tumors are amongst the uncommon in the gastrointestinal tract. The accumulation of data regarding their clinical presentation, etc. has been difficult. Most of the symptomatic lesions and tumors detected during surgery are malignant. Aim: To observe the clinical presentations of the small bowel tumors. Materials and methods: This was a prospective study of 17 cases of small bowel tumors done in Osmania General Hospital between 1994 and 1997, included both benign and malignant tumors and both primary and secondary tumors as well. Results: These tumors were seen between 30-80 years of age. Male to female ratio of the benign and malignant small bowel tumors was1.8: 1 and 1.75:1 respectively. 65% were Incidental findings. Anemia was seen in 58.8%. 83% of benign and 90% of malignant tumors presented with pain. 47.1% of the cases were diagnosed pre-operatively and 41.2% of the cases during emergency surgery. Benign tumors constituted 35.3% and the rest were malignant. 83.3% of the benign lesions were in the jejunum and 16.6% in the duodenum. Amongst, the malignant lesions, 54.60% of them were in the duodenum, 36.3% were in the jejunum and 9% were in the lleum. Conclusion: 65% of the small bowel tumors were found incidentally. Pain, obstruction, bleeding, palpable mass were the other modes of presentation, while anorexia and weight loss were noted in only the malignant ones. High index of suspicion is required to prevent delays.

Chitosan Extraction from F.solani sps, Study of its Antibacterial and Dye Degradation Ability.

Recent advances in fermentation technology have led to new innovative techniques to obtain useful by-products from various soil microbes. F.solani CBNR KRRR, isolated from the marine soils of Pichavaram, Tamil Nadu was used for the economic production of Chitosan using Hesseltine and Anderson medium. The polysaccharides were extracted by alkali-acid treatment, and characterized by infrared spectroscopy. The highest growth rate was with Henderson and Anderson medium with a mycelial dry weight of 14 g/L. The best yield of the chitosan so obtained is (33.57 mg/g or 3.3%). The antimicrobial activity of Chitosan was tested against E.coli and S.aureus using Growth kinetics. It was found that the Extracted Chitosan have antimicrobial activity comparable to the Commercial Chitosan as well as the standard antibiotic used. Subsequently the extracted Chitosan was also tested for its photocatalytic ability to degrade dye-methylene blue and was found to exhibit 94.5% inhibition in 72 hours.