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POEMS syndrome is a rare paraneoplastic syndrome due to an underlying plasma cell disorder. The diagnosis of POEMS syndrome can be a challenge. A good history, physical examination, and appropriate testing can aid in establishing its diagnosis. We are presenting the case of a 75-year-old man who was diagnosed with POEMS syndrome.
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Objective: To study the risk factors of first episode simple febrile seizures in children. Methods: This case control study was conducted at the pediatric department of our tertiary care hospital. Cases were children of age group 6 months to 5 years presenting with first simple febrile seizures (n=214), and Controls were children of same age group presenting with short febrile illness but without any seizures (n=214). Blood investigations were done to diagnose iron deficiency, which was diagnosed by adopting cut off of hemoglobin value <11 g/dL, serum ferritin < 12 ng/mL and red cell distribution width >15%. Other risk factors studied included age, gender, socioeconomic status, prematurity, family history of febrile seizure and epilepsy in first degree relatives, consanguinity, neonatal hospital admissions, day care attendance (for >1 mo), under nutrition, and immunization status of the child. Univariate analysis for crude odds ratio and multivariate analysis (logistic regression) was performed to study the adjusted odds ratio and independent risk factors. Results: The significant risk factors for first episode simple febrile seizure were iron deficiency [OR (95% CI) 5.78 (3.56-9.38); P=0.001], family history of febrile seizure [OR 4.31 (2.37- 7.83), P<0.001] or epilepsy [OR 4.25(2.21-8.19), P<0.001] in first degree relatives, day care attendance for >1 month [OR 4.81 (2.41-9.59), P<0.001], and prematurity at birth [OR 5.18 (2.48-10.84), P<0.001]. Conclusion: Iron deficiency, family history of febrile seizure and epilepsy in first degree relatives, day care attendance and premature birth are the risk factors for first episode simple febrile seizures in children.
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Pharmacoscintigraphy is a non-invasive technique for determining the fate of drugs after administration into humans. Collecting valuable information through the pharmacoscintigraphyabout absorption and release mechanisms of drugs from formulations, and thus proving to be an invaluable tool in developing newer and more effective formulations. Such studies can be used to determine the behavior of drugs, formulation as well as diagnostic agents that are administered. In this technique, radiolabelled formulations are administered to patients by their intended route of administration. Their transit through the body is monitored using sophisticated imaging cameras. Since the amount of radiotracer that is used is very low, this is a safe, efficient, and accurate method for studying the behavior of drugs in the human body. Preclinical studies of newer drugs have successfully been carried out using the pharmacoscintigraphic technique
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Super porous hydrogels (SPHs) basically developed initially create as a novel drug delivery system to absorb and continue to hold the drugs in the gastric medium which allows absorption in stomach and upper part of the gastrointestinal tract. These systems get swollen in the stomach instantly and in the harsh stomach environment they maintain their integrity, while the pharmaceutical active ingredient is being released. Instant and fast swelling property of hydrogel is based on water absorption through open porous structure by capillary force. SPHs have the poor mechanical strength which has got over by developing the second-generation SPH composites (SPHCs) and the third-generation SPH hybrids (SPHHs). The present review has been focused on the preparation, characterization and application of SPHs
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Aminoglycosides antibiotics are considered to be the antimicrobial agents used frequently in the treatment of human diseases caused by a bacterial infection. Most of the aminoglycosides antibiotics are highly polar in nature and they are lacking the UV absorbing chromophore in the molecules. The present articles accentuate the analytical method associated with the analysis of aminoglycosides molecules. Various chromatographic techniques like liquid chromatography, gas chromatography; mass spectrometry were used for the detection of aminoglycosides antibiotics. However, due to its limitation in the ultraviolet-visible spectrophotometry (UV/Vis) technique, different types of detection techniques like corona-charged aerosol detector (CAD), electrochemical detector (ECD) were used as a most powerful and versatile technique for the demonstration of these molecules in the analytical field. Analytical methods help to ensure the quality of the drug products. This review paper is devoted to providing an overview of the key performance technique used for the application and detection of these aminoglycosides molecules.
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Background: The serum lipid profile in premenopausal and perimenopausal/postmenopausal women gets deranged not only due to hormonal changes in different patterns of menstrual cycle but also due to body mass index (BMI) and dietary influence. Objective: The objective of this study was to determine the effect of BMI and dietary influence in serum lipid profile in among groups of premenopausal and perimenopausal/postmenopausal women. Materials and Methods: A hospital-based study was carried out on total (n = 161) healthy women in different phases of menstrual cycle. Results: Dietary factor has not any influence on the lipid profile in these women and BMI has got an effect to a lesser extent on lipid profile in postmenopausal group. Conclusions: Dietary habits and BMI status do not influence the serum lipid levels as most of the women belonged to low socioeconomic status, subsiding on fiber-rich diet and being more physically active.
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Background: Multiple births have been a subject of great interest to various Scientists such as endocrinologists and geneticists, a source of fascination to some people and a causes concern to obstetrician and pediatricians. Multiple pregnancies are associated with many problems for the obstetrician during ante-natal, intranatal and postnatal periods. For the mother the prognosis is worse than a singleton pregnancy and for the fetus the prognosis is very depressing and it is associated with very high fetal mortality. Aim: To study various factors leading to maternal and fetal morbidity and mortality in multiple fetal gestations. Material and methods: Prospective observational study was carried out on 100 antenatal women with twin gestations who attended Victoria Government Hospital, a referral hospital for women and child at Visakhapatnam from October 2015 to September 2017. Maternal and perinatal morbidity and mortality and their causes were analyzed. Results: In this study, 73 women (73%) were booked and 27 women (27%) were unbooked. Maternal and perinatal complications were more in unbooked cases. Incidence of preeclampsia was 22%, gestational hypertension cases 10% and eclampsia cases twice more than the singleton pregnancy. Incidence of poly-hydromnios 5%, Anemia was 40%, APH was 1%, pre-term labour – 30%. Gundu Vanaja, Polumuru Usha Devi, D Hemalatha Devi, Usha Prasad, P Durga Kumari, Y Madhuri. Maternal and Perinatal Outcome in Twin Gestation in a Referral Hospital at Visakhapatnam. IAIM, 2017; 4(12): 153-157. Page 154 Intrapatrum and postpartum complications like PROM – 20%, uterine inertia – 6%, cord prolapse – 2%, PPS – 13%, LSCS rate – 40%. Conclusion: Twin gestation is a high risk pregnancy associated with antenatal, intranatal and postnatal complications which cases increased morbidity and mortality of both mother and fetus. Early diagnosis, good antenatal care and treatment of antenatal complications, labor management in the tertiary center, liberal use of C-section also NICU will improve perinatal, maternal outcome.
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Background: Preterm labor has increasing evidence of infectious cause especially ascending infections from lower genital tract of late attention is being given to bacterial vaginosis. in many of the case control and prospective studies bacterial vaginosis has been associated with lat miscarriage, preterm labor, premature rupture of membranes, chorioamnionitis. Treating bacterial vaginosis can reduce the preventable cause of preterm birth. Aim: The association of bacterial vaginosis in preterm and its fetal outcome. Material and methods: A case control study of 120 pregnant women (study group-60 and controls 60 cases). Pregnant women with preterm labor, 28 weeks to 37 weeks were selected. vaginal discharge pH was measured. Sterile cotton swabs were used for vaginal smear preparation for gram staining and the organisms were scored based on Nugents scoring system. Clue cells were also noted on the smear. Diagnosis of bacterial vaginosis is done in women with pH above 4.5 and a score of 7 or more on gram staining of vaginal smear based on Nugents criteria. Outcome of delivery was observed. Results: 61.6% were < 34 weeks of gestation. High vaginal pH >4.5 is seen in 55%. Chi Square test and the P value 0.001 (99.9%) showed significance of the test. Gram staining revealed bacterial vaginosis infection 41.6% in study group and 16.6% in control group. This study was in aconcurrance with the study made by saifon Chawanpaiboon which showed an association between high vaginal pH, Amsels criteria and various stages of preterm labor. Neonatal complications were seen in women with preterm <34 weeks and positive for bacterial vaginosis. Conclusion: Association between bacterial vaginosis and preterm labor was established. Screening and treatment will reduce the incidence of preterm delivery.
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Background: The description of the human body has been a major concern since ancient times. The use of medical terminology enhances reliability of comparison made between studies from different areas thereby contributing higher level of scientific evidence. Cephalic index is an important parameter in forensic medicine, anthropology and genetics to know the sex and racial differences between individuals. Facial index is useful index for forensic scientists, plastic surgeons and anatomist. The parameters are useful for plastic surgeons during treatment of congenital and traumatic deformities, identification of individuals in medicolegal cases by forensic scientists and identifying craniofacial deformities of genetic syndromes by geneticist. Methods: 170 males and 110 female adults from Visakhapatnam, Andhra Pradesh, India region are included in this study. Anthropometric points for cephalic index were measured by using spreading calipers. Facial index measurements were taken by measuring tape. All measurements were taken in subjects sitting in relaxed condition and subjects head is in anatomical position. Cranial index and facial index were calculated as per the formula. Results: Maximum number of males with mean cephalic index values of 80.21 were observed as mesocephalic and female with mean value of 79.25 observed as brachycephalic. Regarding facial index males were leptoprosopic and females were mesoprosopic. Conclusion: Cephalic index and facial index were terms used by anthropologists, anatomists, plastic surgeons and forensic scientists to identify individual’s race and sex for treatment of craniofacial deformities.
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Gynaecomastia is a common pathological condition of breast seen in men. This is defined as benign enlargement of breast tissue in males. It was first described by Palus Aegineta (AD 635-690). Herewith we are presenting cases of 14 year old twins attending the surgical O.P.D with bilateral enlarged breasts and pain. A diagnosis of pubertal gynaecomastia was made with no evidence of malignancy by histopathological examinations and mammography. One boy with 5 x 6 cm of right breast and 2 x3 cm of left breast was treated by subcutaneous mastectomy. Other boy had only enlargement of nipple and areola. He was reassured and sent home without surgical intervention. A rare case of idiopathic gynaecomastia in pubertal twins is described here.
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Purpose: We sought to determine the characteristics and relative frequency of transmission of MDR‑TB in North India and their association with the clinical and epidemiological characteristics of TB‑patients. Materials and Methods: To achieve the objectives PCR‑SSCP, MAS‑PCR and direct DNA sequencing were used against 101 Mycobacterium tuberculosis isolates. Results: Multidrug‑resistant‑TB isolates were found to be significantly higher (P = 0.000) in previously treated patients in comparison to newly diagnosed patients. Further, significant differences (P = 0.003) were observed between different age groups (Mean ± SD, 28.6 ± 11.77) of the TB patients and multidrug resistance. Most frequent mutations were observed at codons 531 and 315 of rpoB and katG genes, respectively, in MDR‑TB isolates. Conclusion: Routine surveillance of resistance to anti‑TB drugs will improve timely recognition of MDR‑TB cases and help prevent further transmission in Northern India.
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Objective: To study the role of iron deficiency as a risk factor for simple febrile seizures. Design: Case control study. Setting: Pediatric department of a tertiary care teaching hospital. Participants: 154 cases and 154 controls were included in the study. Consecutive cases and concurrent controls were selected. Cases were children of age group 6 months to 3 years presenting with simple febrile seizures. Controls were children of same age group presenting with short febrile illness but without any seizures. Methods: After informed consent, detailed history was taken and clinical examination done in both cases and controls and blood investigations were done to diagnose iron-deficiency in both cases and controls. Iron deficiency was diagnosed as per WHO criteria (hemoglobin value <11g%, red cell distribution width of >15% and serum ferritin value < 12ng/mL). Other explanatory variables, which can be the potential confounders were also included in the study and considered for analysis. Results: Highly significant association was found between iron deficiency and simple febrile seizures in both univariate and multivariate analysis. Crude odds ratio was 5.34 (CI 3.27- 8.73, P<0.001) and adjusted odds ratio in the logistic regression analysis was 4.5 (CI 2.69- 7.53, P <0.001). Conclusions: Iron deficiency is a significant risk factor for simple febrile seizures in children of age group 6 months to 3 years.
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Broiler birds (Vencob chicken of 3 days old) when given feed mixed with powdered rhizome of Curcuma longa (CL; @ 1 g/kg) for 42 days of age, showed significant decrease in serum uric acid and albumin as compared to control, whereas significant increase was recorded in the level of serum total protein and globulin. Level of serum glucose, alkaline phosphatase, aspartate amino transferase and calcium showed no significant variation between the two groups. Micronutrient assay revealed significantly higher level of manganese, zinc, iron and copper in treated group as compared to control group. HA/HI test revealed better humoral response against RD vaccine in CL administered birds. Haematological study showed significantly higher haemoglobin and absolute neutrophil count in treated group. Addition of CL as feed additive also resulted in better growth rate, feed consumption and F:C efficiency in the treated birds. Thus, it could be concluded that powdered CL might be a useful feed additive, since it enhanced the F:C efficiency and had nephroprotective properties.
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Animal Feed , Animals , Chickens , CurcumaABSTRACT
BACKGROUND & OBJECTIVES: The prevalence of anaemia during pregnancy and lactation was significantly lower in the National Family Health Survey 1998-1999 (NFHS-2), using the hemocue method for haemoglobin estimation compared to earlier surveys. The present study selected seven States and used the same districts and villages studied in the NFHS-2, to see if the reported reduction in prevalence of anaemia was due to health and nutrition inputs and/or due to a different method for haemoglobin estimation. METHODS: A total of 1,751 women (1,148 pregnant and 603 lactating- exclusively breastfeeding up to 3 months of age), from seven States- Himachal Pradesh and Haryana in north; Assam and Orissa in east; Kerala and Tamil Nadu in south and Madhya Pradesh in central India, were selected. Haemoglobin was estimated by the cyanmethaemoglobin method, so that comparison was possible with earlier studies. Data on socio-demographic characteristics, pregnancy, nutritional status and dietary intakes were collected. RESULTS: Prevalence as well as severity of anaemia was significantly higher in the present study as compared to the NFHS-2 study data. The difference could be due to haemocue method, which gives higher haemoglobin values. The contributing factors found on multiple regression analysis for anaemia in pregnancy and lactation were: literacy, occupation and standard living index of the study women; their awareness about anaemia, its prevention by regular consumption of ironfolate tablets and increase in food intake. Maternal height, age of marriage, parity and foetal loss also contributed to haemoglobin level. There were interstate differences; lower fertility, higher literacy and better diet was observed in Himachal Pradesh as compared to Haryana. The literacy and nutritional status of women in Tamil Nadu was lower than Kerala. The remaining 3 states had poor fertility, lower social living index and nutritional status with >90 per cent women being anaemic in pregnancy and lactation. Low prevalence of severe anaemia in Orissa as compared to Assam was due to availability and consumption of iron folate tablets. The antenatal services in the first trimester and checkup by a doctor, along with availability and consumption of iron folate tablets over 3 months in all the States influenced haemoglobin levels. INTERPRETATION & CONCLUSION: Despite the measures taken to control anaemia in pregnancy and lactation in the last two decades, the severity of nutritional anaemia continues to remain a public health issue of great magnitude, suggesting that these measures have been largely ineffective. The present findings also showed interstate differences particularly in fertility, women education, nutrition status and occupation; availability of antenatal services and iron folate tablets as possible factors responsible for differences in prevalence of anaemia.
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Adolescent , Adult , Anemia/epidemiology , Female , Hemoglobins/analysis , Humans , India/epidemiology , Lactation/blood , Pregnancy , Pregnancy Complications, Hematologic/epidemiology , Prevalence , Regression AnalysisABSTRACT
Spontaneous mutants resistant to methionine sulfoximine (Msx), methyl alanine (Mal) and methyl ammonium chloride (Mac) were derived from A. chroococcum strain A103. Msx and Mal-resistant mutants expressed 1.73 to 10.98% of the fully derepressed nitrogenase activity when grown in Burk's medium containing ammonium acetate. Mac-resistant mutants did not express nitrogenase activity in ammonium acetate supplemented medium. The mutants excreted ammonia even after 2 days of growth and some mutants excreted more ammonia as compared to the parent. Selected mutants were inoculated on wheat (Triticum aestivum) and barley (Hordeum vulgare) under field conditions. Majority of the derepressed mutants increased grain yield of wheat and barley varying from 1.2 to 33.3%. However, host-dependent effects on grain yield were observed with different mutants. Two mutants, Mal 27 and Mac 19 showed significant increase in grain yields of both the crops. The results suggest that metabolic analogue-resistant mutants of Azotobacter have potential for use as a biofertilizer for cereal crops.