Prediction of pre-eclampsia in diabetic pregnant women

Background & objectives: Gestational or preexisting diabetes is one of the risk factors of pre-eclampsia. Both are responsible for higher maternal and fetal complications. The objective was to study clinical risk factors of pre-eclampsia and biochemical markers in early pregnancy of women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) for the development of pre-eclampsia. Methods: The study group comprised pregnant women diagnosed with GDM before the 20 wk of gestation and DM before pregnancy and the control group had age-, parity- and period of gestation-matched healthy women. Sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and 25-hydroxy vitamin D [25(OH)D] levels and the polymorphism of these genes was evaluated at recruitment. Results: Out of 2050 pregnant women, 316 (15.41%) women (296 had GDM and 20 DM before pregnancy) were included in the study group. Of these, 96 women (30.38%) in the study group and 44 (13.92%) controls developed pre-eclampsia. Multivariate logistic regression analysis indicated those who belonged to the upper middle and upper class of socio-economic status (SES) were likely to be at 4.50 and 6.10 times higher risk of developing pre-eclampsia. The risk of getting pre-eclampsia among those who had DM before pregnancy and pre-eclampsia in their previous pregnancy was about 2.34 and 4.56 times higher compared to those who had no such events, respectively. The serum biomarkers [SHBG, IGF-I and 25(OH)D] were not found to be useful in predicting pre-eclampsia in women with GDM. To predict risk of development of pre-eclampsia, the fitted risk model by backward elimination procedure was used to calculate a risk score for each patient. Receiver operating characteristic (ROC) curve for pre-eclampsia showed that area under the curve was 0.68 (95% confidence interval: 0.63-0.73); P<0.001. Interpretation & conclusions: The findings of this study suggested that pregnant women with diabetes were at a higher risk for pre-eclampsia. SES, history of pre-eclampsia in previous pregnancy and pre-GDM were found to be the risk factors.

Hirayama Disease: A Rare Case Report and Review

Hirayama disease, or brachial monomelic amyotrophy, is not a common neurological disease characterized by unilateral or asymmetric bilateral lower motor weakness of distal upper limbs. The basic pathophysiology is compression of the dural sac and spinal cord during flexion of the neck. A case of a 21-year-old male presented with chief complaints of tremors in both hands (right more than left) with gradually progressive weakness of the right hand and forearm. Electromyography (EMG), nerve conduction velocity (NCV), and magnetic resonance imaging (MRI) neck in flexion showed focal atrophy of lower cervical myotomes and confirmed the diagnosis of monomelic amyotrophy.

Impact of COVID-19 on lifestyles related etiquette among nursing staff in India: a cross sectional descriptive e-survey / Impacto de COVID-19 en las etiquetas relacionadas con el estilo de vida entre el personal de enfermería en la India: una encuesta electrónica transversal / Impacto do COVID-19 nos rótulos relacionados ao estilo de vida entre a equipe de enfermagem na Índia: uma pesquisa eletrônica transversal

Objective. To analyze the impact of COVID-19 pandemics on lifestyle-related etiquettes like eating, physical activity, and sleep behavior among nursing staff in India. Methods.A crosssectional descriptive E-survey was conducted among 942 nursing staff. The validated electronic survey questionnaire was used to assess the changes in lifestyle-related etiquette before and during COVID-19 Pandemic. Results. A total of 942 responses (mean age 29.01±5.7years) were collected, 53% of the respondents were men. A slight decline in healthy meal consumption pattern (p<0.0001) and a restriction of unhealthy food items were observed (p<0.0001), and also reduction in physical activity coupled with decreased participation in leisure-related activities was seen (p<0.0001). The stress and anxiety slightly increase during COVID­19 pandemics (p<0.0001). Additionally, social support extended by family and friends to maintain healthy lifestyle-related behaviors also significantly decreased during COVID-19 PANDEMIC pandemics compared to before (p<0.0001). Although the COVID-19 Pandemic slightly reduced the intake of healthy meals and deterred participants from consuming unhealthy food, this this may have led to individual weight loss. Conclusion. In general, there was a negative impact on, lifestyle like diet, sleep and mental health was observed. A detailed understanding of these factors can help to develop interventions to mitigate the harmful lifestyle-related etiquette that has manifested during COVID-19 Pandemic.

Objetivo. Analizar el impacto de la pandemia por COVID-19 en las etiquetas relacionadas con el estilo de vida (alimentación, actividad física y comportamiento del sueño) entre enfermeras de la India. Método. Se realizó un estudio de corte transversal en el que participaron 942 enfermeros de todo el país. Se utilizó un cuestionario electrónico validado para evaluar los cambios en los estilos de vida antes y durante la pandemia por COVID-19. Resultados. La edad media fue de 29.01±5.7años, 53% fueron hombres. En comparación con antes de la pandemia por COVID-19, durante la misma se observó un ligero descenso en el patrón de consumo de comidas saludables (p<0.0001) y se observó una restricción de alimentos poco saludables (p<0.0001, además de una reducción de la actividad física junto con una menor participación en actividades relacionadas con el ocio (p<0.0001). El estrés y la ansiedad aumentaron ligeramente (p<0.0001). Además, el apoyo social prestado por la familia y los amigos para mantener comportamientos saludables relacionados con el estilo de vida también disminuyó significativamente durante la pandemia en comparación a antes (p<0.0001). Aunque la pandemia por COVID-19 redujo ligeramente la ingesta de comidas saludables y disuadió a los participantes de consumir alimentos poco saludables, esto puede haber conducido a una pérdida de peso individual. Conclusión. En general, se observó un impacto negativo en el estilo de vida, como la dieta, el sueño y la salud mental. Una comprensión detallada de estos factores puede ayudar a desarrollar intervenciones para mitigar la etiqueta nociva relacionada con el estilo de vida que se ha manifestado durante la pandemia COVID-19 en los enfermeros en India.

Objetivo. Analisar o impacto da pandemia de COVID-19 nos rótulos do estilo de vida (dieta, atividade física e comportamento do sono) entre enfermeiras na Índia. Método. Foi realizado um estudo transversal do qual participaram 942 enfermeiros de todo o país. Um questionário eletrônico validado foi usado para avaliar as mudanças no estilo de vida antes e durante a pandemia de COVID-19. Resultados.A média de idade foi de 29.01±5.7 anos, 53% eram homens. Comparado com antes da pandemia de COVID-19, observou-se uma leve diminuição no padrão de consumo de refeições saudáveis durante a pandemia (p<0.0001), além de redução da atividade física e menor participação em atividades relacionadas ao lazer (p<0.0001). O estresse e a ansiedade aumentaram ligeiramente (p<0.0001). Além disso, o apoio social fornecido pela família e amigos para manter comportamentos de estilo de vida saudável também diminuiu significativamente durante a pandemia em comparação com antes dela (p<0.0001). Conclusão. Em geral, foi observado um impacto negativo no estilo de vida, como dieta, sono e saúde mental. Uma compreensão detalhada desses fatores pode ajudar a desenvolver intervenções para mitigar a etiqueta prejudicial relacionada ao estilo de vida que se manifestou durante a pandemia de COVID-19 entre enfermeiras na Índia.

Therapeutic Patient Education in Transgender Care

This communication visits the concept of therapeutic patient education (TPE), and explores its relevance to transgender health care. It suggests a novel term, therapeutic education (TE), and defines it as “educational activities essential to the optimization of health, offered by health care providers duly trained in the field of education, designed to help a transgender individual (or a group of individuals and their families) to manage their treatment and prevent avoidable complications, while maintaining or improving their quality of life. It describes the soft and hard skills required for TE, and suggests a classification that can help in structuring TE programs.

Isolation and therapeutic efficacy of enteropathogenic E. coli phage cocktail against colibacillosis in neonatal goats

Phage based therapeutics have shown promising results against the infections caused by the drug resistant bacteria. To combat the problem of antibiotic resistance posed by diarrhoeagenic E. coli, here, we identified and characterized 38 E. coli phages which were isolated from 70 solid sources (goat-faeces and soil). The in vitro lytic range of phage isolates (n=38) against 439 isolates of E. coli was found between 16 and 53%. Three phage isolates with highest host range showed lytic efficacy against 53, 48 and 46% of E. coli isolates, respectively. A preparation with above three phages was developed, and the phages of the preparation were found stable at wide range of temperature, pH and chloroform treatment. Endotoxin content of the preparation was found below the threshold level and it also passed safety and sterility tests. a total of 40 diarrheic goat kids were administered orally with the therapeutic phage preparation for two days twice daily. Total 21 diarrheic goat-kids were successfully treated using the therapeutic phage preparation, whereas 19 kids could not be treated (success rate: 52.5%; 21/40). The results of the current study provide insight for using lytic bacteriophages for therapeutic interventions against drug resistant E. coli responsible for colibacillosis in neonatal goat kids

An insight into the altered ophthalmic dynamics during the COVID-19 pandemic

Purpose: The objective of this survey?based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods: The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results: A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic?appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion: The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department?based and surgical procedures in ophthalmology

Evaluation of visual field changes with retinal nerve fiber layer thickness in primary congenital glaucoma

Purpose: To evaluate visual field changes in primary congenital glaucoma (PCG) with retinal nerve fiber layer thickness on optical coherence tomography. Methods: In this cross?sectional, observational study, consecutive PCG children who underwent combined trabeculotomy with trabeculectomy and on regular follow?up were enrolled. All patients were aged over four years and co?operative for RNFL OCT and visual field examination. Perimetry was done on Humphrey visual field (HVF) analyzer using 30?2 and 10?2 SITA standard algorithms as appropriate. If a reliable automated perimetry was not feasible, kinetic perimetry was done. The following were noted at baseline and every follow?up: age, sex, visual acuity, intraocular pressure (IOP), cup–disc ratio (CDR), corneal diameters, refraction, any topical antiglaucoma medications, surgeries underwent, age at surgery and duration between surgery and final examination. Results: Forty?eight eyes of 34 children operated for PCG and 19 eyes of 17 controls were analyzed. A statistically significant thinner average RNFL thickness of 87.2 ± 28 ?m was noted in PCG eyes as compared to controls with 100.6 ± 7.2 ?m (P = 0.04). The mean cup–disc area ratio on OCT in PCG eyes was 0.43 ± 0.2 (0.02–0.93) and in control eyes was 0.23 ± 0.07 (0.1–0.4) (P < 0.001). On RNFL OCT, there was significant focal RNFL loss in temporal superior (P = 0.003), nasal inferior (P = 0.037) and temporal inferior (P < 0.001) quadrants compared to controls. Among PCG eyes, 20/48 eyes (41.7%), had definitive, reproducible glaucomatous VF defects. Mean baseline IOP in PCG eyes with VF defect was 28.7 ± 5.7 mmHg and in eyes with normal VF was 24.6 ± 5.9 mmHg (P = 0.03). On univariate regression analysis, higher baseline IOP was significantly associated with both RNFL loss (odds ratio (OR): ?2.17) and VF defects (OR: 3.35). Fluctuation in follow?up IOP (OR: 3.33) was also significantly associated with the presence of VF defects. On multivariable regression analysis maximum, IOP was significantly associated with RNFL loss and VF defects. Conclusion: Peripapillary RNFL thickness could be used to identify PCG eyes having visual field loss and possibly poor visual function from PCG eyes without visual field defects. Baseline and follow?up IOP, significantly correlated with RNFL thickness in PCG eyes

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches-Supplementary data

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches-Supplementary data

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

Identification of potential AChE inhibitors through combined machine-learning and structure-based design approaches

Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative disease characterised by dementia.The depletion of acetylcholine (ACh) is involved the synaptic cleft is responsible for dementia due to neuronal loss. The acetylcholinesterase (AChE) enzyme isinvolved in the hydrolytic degradation of ACh and its inhibition is therapeutically beneficial for the treatment in memory loss.The use of machine learning (ML) for the identification of enzyme inhibitors has recently become popular. It identifies important patterns in the reported inhibitors to predict the new molecules. Hence, in this study, a set of support vector classifier-based ML models were developed,validated and employed to predict AChE inhibitors. Further, 247 predicted compounds obtained through PAINS and molecular property filters were docked on the AChE enzyme. The docking study identified compounds AAM132011183, ART21232619 and LMG16204648 as AChE inhibitors with suitable ADME properties. The selected compounds produced stable interactions with enzymes in molecular dynamics studies. The novel inhibitors obtained from the study may be proposed as active leads for AChE inhibition.

Effect of waterlogging on physiological traits and yield in black gram (Vigna mungo L.) in field condition

Waterlogging is an important abiotic factor affecting crop productivity worldwide. Black gram (Vigna mungo L.) is very sensitive to waterlogged conditions. A field experiment was conducted in randomized complete block design to evaluate three black gram genotypes for waterlogging tolerance. Stress was imposed by maintaining the water level above the soil surface for 10 days after 30 days of sowing. Different physiological parameters including chlorophyll (Chl), chlorophyll fluorescence, normalized difference vegetation index (NDVI), sugars, along with the yield per plant and thousand grain weight (TW) were recorded in control and stressed plants. Results showed that NDVI, Chl, chlorophyll fluorescence, sugars, seed yield and TW reduced significantly during stress. Stress susceptibility index (SSI) for grain yield varied from 0.32 to 2.38. Linear correlation study showed that SSI was negatively correlated with NDVI (0.43),Chl (0.68) and TW (0.42) and grain yield (0.96). NDVI and sugars were correlated to TW under stress. IC530491 and IC559933 (SSI < 0.5) were waterlogging tolerant under field conditions. The study concluded that identified black gram lines may be utilized as trait donors in breeding program.

An unusual nasopharyngeal foreign body with unusual presentation

Upper aerodigestive tract may harbour foreign bodies such as sponges, grains, toy parts, stones, paper, insects, cotton, glass ball, etc. These objects may go undetected for days or even weeks. A metallic foreign body after being inhaled and ultimately being lodged in the nasopharynx is a rare entity. We report a case of an unusual nasopharyngeal foreign body (glass ball) presenting with symptoms of nasal regurgitation and change in voice in a 2-year boy. The foreign body was diagnosed by X-ray skull lateral view including nasopharynx and was removed under general anesthesia.

Rare Form of Crusted Scabies in Diabetes: A Case Report

Crusted scabies is an uncommon manifestation of parasitic infection caused by Sarcoptes scabiei var. hominis. This variant of scabies is seen in various immunocompromised states. Uncontrolled diabetes is an immunocompromised state which is characterized by increased incidence of various infections, and rarely, may be associated with this rare crusted scabies, which may pose a real diagnostic challenge. A high index of suspicion is required for timely and correct diagnosis in the best interest of the patient and the public health point of view to prevent the spread of this highly contagious infestation.

Comparison of Serum 25-Hydroxyvitamin D Levels After A Single Oral Dose of Vitamin D3 Formulations in Mild Vitamin D3 Deficiency

Objective:To compare the levels of serum 25 Hydroxyvitamin D levels after a single large oral dose (60,000 IU) of different vitamin D3 formulations. Materials and Methods: Ninety?one volunteers with mild vitamin D deficiency (18–29 ng/ml) were selected and randomly assigned to three parallel groups. Groups-I received liquid, Group-II received sachet, and Group-III received tablet formulation of cholecalciferol as a single dose of 60,000 IU orally after 8–10 h of overnight fasting. Serum 25(OH) D concentrations were measured at baseline, 24 h, 7 days, and 14 days after drug administration. Various hematology and biochemical parameters were also assessed for baseline safety evaluation. Results: Baseline serum 25(OH) D concentrations in Groups I (liquid), II (sachet), and III (tablet) was 24.75 ± 4.77 ng/mL, 23.25 ± 4.15 ng/mL, and 23.18 ± 5.52 ng/mL, respectively. After supplemented with three formulations, only tablet group after 24 h showed increase in serum 25-OH-D concentration of 8.07 units from its baseline. Whereas after 7th day, no significant difference in absorption was observed but after 14 th day, all three groups showed increase in serum 25-OH-D concentration, in which tablet group (50.10 ± 94.99 ng/ml) showed highest increase in absorption (26.92 units) from their baseline values. During intergroup comparison between three formulations at the time of investigation, only liquid group after 24 h showed increased serum concentration by P values (0.03, 0.02) as compared to sachet and tablet group. However, After 7th and 14th day, there was no statistically difference was observed between three groups. Conclusion: Single oral dose of 60,000 IU dose of vitamin D liquid formulation has higher absorption value as after 24 h and tablet formulation showed higher absorption after 7th days. In emergency paucity of vitamin D, these observations findings can have critical conclusions to state the suitable dietary formulation of vitamin D.

Prevalence and correlates of microvascular complications among patients with diabetes mellitus: a cross sectional study

Background: Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia and associated with various microvascular, macrovascular and nonvascular complications leading to increasing morbidity and mortality. Microvascular complications are daibetes specific and their relation with associated comorbidities studied worldwide. To estimate the prevalence of microvascular complications in diabetic patients and to find their relation with various comorbid conditions.Methods: A total of hundred diagnosed patients of diabetes mellitus with age ranging from 18 to 75 years were enrolled in the study. Patients were assessed for the presence of microvascular complications and associated comorbidities. The effect of various comorbidities on frequency of microvascular complications was also determined. Data collected was statistically analyzed.Results: In this study, the mean age of the study group was 55.77±11.75 years. Mean age of onset of the disease was 48.89±11.50 years. Mean duration of the disease in the study group was 6.86±5.02 years. Diabetic retinopathy, neuropathy and nephropathy was found in 76%, 63% and 69% patients, respectively. Among patients with hypertension, 91.7%, 83.3%, and 81.7% cases were found to have retinopathy, neuropathy and nephropathy, respectively. The corresponding figures for those with comorbid IHD were 91.1%, 83.9% and 76.8% respectively whereas among patients with coexisting metabolic syndrome, 92.5%, 80.6%, and 79.1% were found to have retinopathy, neuropathy, and nephropathy, respectively.Conclusions: The most frequent microvascular complication reported by this study was diabetic retinopathy. comorbid conditions like hypertension, ischemic heart disease, and metabolic syndrome were associated with higher prevalence of microvascular complications in diabetic patients.

Study of Determinants of Various Anthropometric Measurements of Neonates at Birth.

Birth weight is considered as one of the most important factors that affect the neonatal mortality in both developing and developed countries. In addition, it is a significant determinant of post neonatal mortality, infant and childhood mortality and morbidity. This study was conducted to evaluate the various factors influencing anthropometric measurements of neonates at birth.METHODSThis is a hospital based cross sectional study consisting of neonates and their respective mothers delivered at Darbhanga Medical College, Laheriasarai, Bihar, during the period April 2018 to September 2019. Neonates were divided into three groups < 2500 gms, 2500-3500 gms, >3500 gms and these groups were studied in relation to the determining factors of mothers.RESULTSAmong 1000 babies, 56.3% were male and 43.7% were female. Mean birth weight was 2596.90 ± 542.79 gms ( ± SD). Mean birth weight was higher in males and LBW rate was higher in males. 37.3% of babies were LBW babies. Duration of gestation determines birth weight and other anthropometric parameters proportionately increase with birth weight. In the present study, 15.7% were preterm babies, and 1.8% of babies were post term babies. Factors like maternal age, weight, pregnancy weight gain, socio economic status, Muslim religion, maternal literacy, birth order (2nd onwards), male sex, singleton pregnancy, non-anaemic status, higher period of gestation and spacing had positive correlation with birth weight and negative correlation with LBW incidence. 1/3rd of LBW babies were preterm and 2/3rd were IUGR babies. In this study, anaemia and diabetes was 79.9% and 3% respectively. Maternal diabetes mellitus is an important risk factor for macrosomia.CONCLUSIONSBy avoiding teenage pregnancies, adapting family planning methods, providing good quality antenatal care, improving maternal nutrition, spacing of more than three years, correcting anaemia, early recognition of obstetric complications and timely intervention will reduce percentage of LBW babies, increase the mean birth weight and increase the other newborn anthropometric parameters at birth, which will lower the infant mortality and improve the survival.

Single centre randomized comparative trial of lateral internal sphincterotomy versus 2% diltiazem in chronic anal fissure

Background: Anal fissures are often encountered in surgical practice with surgery the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. In our study we compare topical 2% diltiazem with lateral sphincterotomy with respect to symptoms such as relief of pain, ulcer healing, and side effects of treatments.Methods: A prospective comparative study, a total of 80 patients were randomized into 2 groups 40 each. Group A patients were subjected to open internal lateral sphincterotomy and group B to 2% topical diltiazem. The patients in both groups were followed up at 1st, 4th, 14th weeks and 6 months in OPD and were assessed for pain, sphincter tone and complications.Results: In group A (lateral anal sphincterotomy), patients achieved a good pain relief with a mean pain score of 1.98 by one week post procedure whereas group B (2% diltiazem) had taken 14 weeks to achieve similar pain relief (pain score of 1.5). At the end of 6 months, healing of fissure was noted in 100% of group A and in 90% of group B. 4 patients (10%) had recurrences in group B. Flatus incontinence was reported in 2 patients (5%) in group A although transient.Conclusions: Lateral anal sphincterotomy is superior to 2% diltiazem especially in healing of fissure, pain relief, quality of life and recurrence. Pharmacologic agents should be reserved for patients who are unfit or unwilling for surgery or can be used as a bridge therapy till sphincterotomy can be planned.

Role of Bacterial and Parasitic Pathogens in Occurrence of Neonatal Diarrhoea in Goat-Kids

Infectious diarrhoea in neonates of animals is one of the most common and economically important conditions encountered in the livestock industry. Faecal samples (n=210) from diarrhoeic neonatal goat-kids of different livestock sheds of ICAR-CIRG, Makhdoom, Mathura (U.P.), were aseptically collected, and immediately processed for isolation of bacterial pathogens and parasitic evaluation. A total of 178 isolates of E. coli from 210 samples were identified on the basis of cultural, morphological, biochemical and molecular characteristics. Out of 178 E. coli isolates, 3.93 % (7/178) isolates were identified as STEC by PCR amplification of stx-1 and stx-2 gene. A total of 64 isolates of E. coli were sent to National Salmonella and Escherichia Centre, Central Research Institute, Kasauli for the serotyping. The common serogroups of E. coli responsible for neonatal diarrhoea in goat-kids were identified as O36, O26, O59, O29, O43, O91, O82, O9 and O171, out of which, 46.15% were O36, O26 and O59. Cryptosporidium spp. infection was detected in 46 samples out of 148 faecal samples by ZN staining and nested PCR.Based on cultural, morphological, biochemical and molecular characteristics,16 isolates of Salmonella spp. and 5 of Klebsiella spp. were identified from 210 fecal samples. The present study concluded that E. coli followed by Cryptosporidium spp. and Salmonella spp. were the prevalent infectious agents associated with neonatal diarrhoea in goat-kids

Management of chronic anal fissures: a narrative review

Anal fissures are often encountered in surgical practice in both sexes. It is a distressing disease impacting quality of life and causes profound morbidity among those affected. If left untreated, it may lead onto perianal abscess or even malignancy in long standing cases. Surgery is the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. The management of chronic anal fissures has migrated to an era of multifaceted approach. This narrative review looks into various studies spanning over a period of 16 years. Various articles were shortlisted and analyzed for efficacy of various treatment methods, their impact in hospital stay, quality of life improvement, recurrence rate and complications among various treatment methods. We concluded from this review, that open lateral internal sphincterotomy is still the gold standard method of treatment for chronic anal fissure. Among pharmacological agents, 2% diltiazem has the best effectiveness with good compliance rate. Modern surgical techniques like VY plasty can be reserved for special situations. We do not recommend the practice of manual anal dilatation.

Role of low-lying pubic tubercle in the development of inguinal hernia

Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.