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Objectives: Using data from a hospital-based cancer registry (HBCR) in the private sector in Northern India, we provide overall survival (OS) and event-free survival (EFS) for childhood cancer patients. Methods: All newly diagnosed childhood (age <18 years) cancer patients in our HBCR registered between March 1, 2013 till July 31, 2021 were eligible. 3-year and 5-year OS (death was an event), EFSc (death, progression/relapse was an event), and EFSa (death, progression/relapse, abandonment of treatment was an event) were calculated using the Kaplan-Meier method. Regression analysis was done to see their association with demographic, diagnostic and treatment variables. Results: 705 newly diagnosed children (36.2% female) with cancer were registered. Common cancers were leukemias (26%), CNS tumors (20%) and bone tumors (16%). 202 (28.6%) had experienced an event at median follow up of 1.95 years (range 0-8.14 years), which included 23 (3.3%) who abandoned treatment. The 3- year OS, EFSc, EFSa were 70.8%, 64.4% and 63.6%, respectively. Correspondingly, 5-year OS, EFSc, EFSa were 66%, 58.6% and 57.5%, respectively. There was no significant difference by age group, gender, nationality, and if cancer directed treatment initiated elsewhere. The OS, EFSa and EFSc by the main and the extended International Childhood Cancer Classification categories varied significantly (P<0.001). Conclusion: We add more recent registry-based OS data on childhood cancer in India and present the first estimates on EFS.
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Background: Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients. Aims: The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes. Methods: A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy. Results: Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs. Limitations: The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group. Conclusion: We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.
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Manual small-incision cataract surgery (MSICS) preserves its utility as a cost-effective and efficient strategy for mitigating cataract-associated blindness. Numerous techniques of nucleus delivery in MSICS have been described in the literature. The fish hook technique of nucleus extraction was advocated in 1997 and has been popular for high-volume surgery in limited pockets of the world. This article describes in detail the steps involved in the construction of a fish hook, tips of nucleus extraction with the help of a fish hook, and the pros and cons of fish hook-based MSICS through text, diagram, and video supplement.
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Background & objectives: Serology testing is essential for immunological surveillance in the population. This serosurvey was conducted to ascertain the cumulative population immunity against SARS-CoV-2 among adults in Jammu district and to understand the association of seropositivity with sociodemographic and clinical correlates. Methods: On September 30 and October 1, 2020, a household survey was done in 20 villages/wards chosen from 10 health blocks in district Jammu, India. Demographic, clinical and exposure information was collected from 2000 adults. Serum samples were screened for IgG antibodies using COVID Kavach MERILISA kit. Tests of association were used to identify risk factors associated with IgG positivity. Crude odds ratio with 95 per cent confidence intervals (CIs) was calculated during univariate analysis followed by logistic regression. Results: Overall adjusted seroprevalence for SARS-CoV-2 was 8.8 per cent (95% CI: 8.78-8.82); it varied from 4.1 per cent in Chauki choura to 16.7 per cent Pallanwalla across 10 blocks in the district. Seropositivity was observed to be comparatively higher in 41-50 and 61-70 yr age groups, among males and in rural areas. Fever, sore throat, cough, dyspnoea, myalgias, anosmia, ageusia, fatigue, seizures, history of exposure, medical consultation, hospitalization and missing work showed significant association with seropositivity on univariate analysis. On logistic regression, only sore throat, myalgia and missing work showed significant adjusted odds of IgG positivity. Extrapolation to adult population suggested that exposure to SARS-CoV-2 was 14.4 times higher than reported cases, translating into Infection fatality rate of 0.08 per cent. Interpretation & conclusions: Since a major part of population was immunologically naive, all efforts to contain COVID-19 need to be vigorously followed while these baseline results provide an important yardstick to monitor the trends of COVID-19 and guide locally appropriate control strategies in the region
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Background: Tobacco use is a major preventable cause of morbidity as well as mortality worldwide. To combat the increasing trend of this problem, Government of India formulated the COTPA (Cigarettes and Other Tobacco Products Act) in 2003. The study aimed to assess the awareness about COTPA and impact of pictorial warnings among smokers attending outpatient services in a tertiary care hospital in Jammu.Method: The present study was conducted among 320 patients attending the outpatient department of Internal Medicine, Government Medical College, Jammu who happened to be cigarette smokers. The questionnaire was developed by authors with the help of literature review and pilot tested before its final use. Information was elicited about demographic details, awareness about COTPA and impact of pictorial warnings on quitting of smoking.Results: More than half of the respondents were in 30-50-year age group and were urban residents. Awareness about COTPA was good on some parameters but was relatively low on other parameters. Despite all, the respondents noticing pictorial warnings on tobacco packages, only 69.37% of them were contemplating to quit. About half of them were of the view that warning statements preferably be written in local languages.Conclusion: Health and pictorial warnings on tobacco packages remain an important pillar in filling the gap of knowledge and communicating the health risks of tobacco use to the consumers. Only 69.3% of the respondents were planning to quit and awareness levels about COTPA were mixed.
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Background: Climate change has emerged as one of the greatest challenges of the present century. The current study explores the knowledge, attitudes and practices about climate change of the adults aged 18 years and above in Jammu city of North India.Methods: A cross-sectional study was conducted among attendants of the patients visiting medical OPD of a tertiary care teaching hospital. A pilot tested questionnaire eliciting information on knowledge, attitudes and practices about climate change was administered to those who were willing to participate. The data collected was presented in proportions.Results: Majority (95%) of the respondents had heard of the term climate change, and 43.9% of them related it to changes in the weather pattern. Plastic use as a major cause of climate change was agreed upon by 95% of the respondents. About half of the respondents were very much concerned about climate change and 80% of them were very much interested in knowing more about climate change and its impact. Only 24.8% of the respondents read/watch stories on climate change.Conclusions: Knowledge levels of the respondents were found to be reasonably good but the same cannot be said about their attitude and practices. Role of NGOs, social communities and media is of utmost importance to make people aware of the harmful effects of climate change on both the environment as well as the health of the people.
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Background: Cervical cancer is known for its late detection due to a variety of reasons chiefly lack of knowledge, undesirable attitudes and poor practices. Early screening and adequate knowledge about the disease remains the important safe guards against this disease. The study aimed to assess the knowledge, attitudes and practices of the women aged 18 years and above regarding cervical cancer visiting a tertiary care teaching hospital.Methods: The present cross sectional hospital based study was conducted in Jammu city, Jammu and Kashmir, India. All the women aged 18 years and above visiting OPD of gynaecology-obstetrics department of Government Medical College Jammu and willing to participate were administered a pretested questionnaire to collect the relevant data.Results: It was found that 91.56% of the respondents had heard of cervical cancer with 83% reporting that it was both preventable as well as curable. Multiple sex partners were the most important risk factor identified. Among the attitudes, 62% agreed that screening was harmless to the client. Only one third knew about the availability of preventive vaccine. About 83.6% of them had never been screened by Pap smear. However willingness to get HPV vaccination was found to be high.Conclusions: Though knowledge among the respondents was found to be adequate but it lacked transformation into attitudes and practices. In this connection, authors recommend health promotion campaigns to educate women and the community about cervical cancer and its preventability through screening.
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Violence against women a social evil in the society despite a lot of talk of women empowerment. Assessmentof burden in terms of prevalence will go a long way in planning the services for those affected bydomestic violence. To find the prevalence of domestic violence and associated risk factors among marriedfemales in a rural area of Jammu. This community based cross-sectional study was conducted amongrural married females using a structured and pretested questionnaire. Data was analysed using simpleproportions, chi-square test and logistic regression. 171/301(56.6%) of the respondents reported someform of the domestic violence. Psychological, physical and sexual violence rates were found to be32.16%, 9.9% and 2.33% respectively. A statistically significant association was found with variables likeliteracy, type of family, family income, sex of children etc. Relatively high levels of domestic violence inthis rural setting calls for a multidisciplinary approach involving improvement of literacy levels amongfemales, creating awareness about legal aid and screening the victims at primary health centres to mitigatethis problem.
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Background: Chronic paronychia, earlier considered to be an infection due to Candida, is currently being considered as a dermatitis of the nail fold. Irritant, allergic and protein contact dermatitis are the suggested major pathogenic mechanisms. Hypersensitivity to Candida is more likely to be the etiology, rather than the infection itself. Aims: To assess the clinico‑etiological profiles of patients with chronic paronychia and to determine the role of contact sensitization and hypersensitivity to Candida. Methods: All consecutive patients of chronic paronychia attending the dermatology outpatient department (OPD) were assessed for risk factors, number of nails affected, clinical presentation and presence of fungus, patch tested for contact allergy and prick tested for hypersensitivity to Candida allergen. Results: A total of 80 patients of chronic paronychia were recruited into our study. There was female preponderance (66 patients, 82.5%), with the most common group affected being housewives (47 patients, 58.8%). Frequent washing of hands (64 patients, 80%) was the most common risk factor. Fungal culture was positive in 56.1% (41 patients), the predominant species cultured was Candida albicans (15 patients, 36.5%). Patch testing with Indian standard series was positive in 27.1% patients (19 out of 70 patients tested), with nickel being the most common allergen. Prick test with Candida allergen was positive in 47.6% patients (31 out of 65 patients tested). Limitations: Prick test and patch test provide indirect evidence of hypersensitivity, with inherent limitations. Conclusion: Our study shows that chronic paronychia is probably a form of hand dermatitis associated with prolonged wet work, and that there is a higher incidence of contact sensitization and Candida hypersensitivity in these patients.
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Oxidative stress has been shown to play a critical role in the pathogenesis of ulcerative colitis (UC). Entada pursaetha has been demonstrated to have antioxidant and anti-inflammatory effects. In this study, we investigated the effects of stem of alcoholic extract of E. pursaetha (PSE) in dextran sodium sulfate (DSS)-induced colitis in mice. The protective effect of PSE was determined at three different doses of 30, 100 and 300 mg/kg body weight by oral gavage for 7 days. Morphological (colon length and colon weight/length ratio), clinical (disease activity index) and macroscopic (damage score) features were determined using standard criteria. Lipid peroxides (determined as malonaldehyde; MDA), enzymatic (superoxide dismutase; SOD and catalase; CAT) and non- enzymatic antioxidants (reduced glutathione; GSH), nitrate and nitrite (NOx) levels and myeloperoxidase (MPO) activity in colon tissues were determined. The DSS damaged the colonic tissue, increased MPO activity, lipid peroxidation and NOx levels, reduced the antioxidant enzymes and glutathione and lowered the body weight. PSE significantly reduced the inflammation of colon and reversed the increase in MPO activity induced by DSS. It also significantly increased the SOD and catalase activities and did not elicit any effect on depleted levels of GSH in the colonic tissue. In addition, PSE also significantly decreased colonic NOx and MDA levels compared to DSS-treated mice; reduced both infiltration of inflammatory cells and the mucosal damage in colon on histopathological examination. The results suggested the protective potential of PSE in DSS-induced colitis and this might be attributed to its anti-inflammatory and antioxidant activities.
Subject(s)
Animals , Antioxidants , Colitis, Ulcerative/chemically induced , Dextran Sulfate/toxicity , Fabaceae/chemistry , Fabaceae/therapeutic use , Mice , Oxidative Stress , Plant Extracts/chemistry , Plant Extracts/therapeutic useABSTRACT
Background & objectives: Osteoarthritis (OA) is a degenerative disease characterized by joint pain and progressive loss of articular cartilage. Entada pursaetha has been traditionally used in the treatment of inflammatory disease, liver ailment, etc. In this study we investigated suppressive effect of ethanolic extract of E. pursaetha (EPE) on monosodium iodoacetate (MIA)-induced osteoarthritis pain and disease progression by histopathological changes in joints in a rat model. Methods: OA was induced in right knee of rat by intra-articular injection of 3 mg of MIA and characterized by pathological progression of disease and pain of affected joint. Spontaneous movements, mechanical, thermal and cold sensitivity were monitored at days 0 (before drug and MIA injection), 7, 14 and 21 of MIA administration. EPE (30, 100 and 300 mg/kg), vehicle or etoricoxib (10 mg/ kg; reference drug) were administered daily for 21 days by oral route. Results: EPE at various doses significantly reduced mechanical, heat, cold hyperalgesia and increased the horizontal and vertical movements in intra-articular MIA injected rats. EPE prevented the damage to cartilage structure and reduced the cellular abnormalities. Articular cartilage of rats treated with EPE at 300 mg/kg group was almost normal with well-developed smooth surface and chondrocytes were distributed individually or arranged in column. Interpretation & conclusions: the present findings showed that the EPE was not only able to mitigate pain and hyperalgesia but also inhibited MIA-induced cartilage degeneration in vivo. EPE may have the potential to become therapeutic modality in the treatment of osteoarthritis. However, further studies need to be done to confirm these findings in other models and clinical trials.
Subject(s)
Child , Female , Humans , Lipomatosis/pathology , Nevus/pathology , Skin Neoplasms/pathology , Vulvar Neoplasms/pathologyABSTRACT
The alcoholic extract of stem of E. pursaetha (PSE, 30, 100, 300 mg/kg body weight, po for 7 days) showed hepatoprotective activity against CCl4 (2 mL/kg body weight, ip)-induced hepatotoxicity. The extract exhibited a significant dose-dependent hepatoprotective effect comparable to standard drug silymarin, by preventing increase in serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total protein, and total bilirubin, lactate dehydrogenase; by lowering hepatic levels of malonaldehyde, nitrate-nitrite, myeloperoxidase activity; enhancing activities of antioxidant enzymes, superoxide dismutase, catalase and increasing reduced glutathione levels in liver, which suggests the antioxidant property of PSE. Histopathological studies also supported the above biochemical parameters. The results suggested that alcoholic extract of E. pursaetha possesses significant hepatoprotective activity in CCl4-induced acute hepatotoxicity in rats and this is likely to be mediated through its antioxidant activities.