ABSTRACT
Introduction: Pain is a complex subjective sensation that is difficult to quantify in a repeatable manner. Surgical pain is observed to be more intense post-surgery and then fades in the next 24 h. Epidural anesthesia/analgesia is the most widely used technique for lower limb surgeries because of its good sensory and motor block property, reduces stress response, and maintains sufficient spontaneous respiration and hemodynamic stability. Materials and Methods: The study looked at 100 individuals between the ages of 20 and 60 who underwent elective lower limb surgery and were classified as ASA I and II. The patients were split into two 50-person groups. The adverse effects of nausea, vomiting, respiratory depression, urine retention, and pruritus, as well as the quality and duration of postoperative analgesia, were investigated. The patient was monitored for 48 h after surgery. Results: A total of 100 patients were included in the study, where the least age of the patient was 19 years and the greatest age was 75 years. In group T, maximum patients belong to the age group of 26–35 years, whereas in group F maximum patients belong to the age group of 36–45years. In group T, 41 (82%) were males and 9 (18%) were females. In group F, 37 (74%) were males and 13 (26%) were females. Conclusion: Our findings show that epidural tramadol and epidural fentanyl are equally effective, except for fentanyl’s shorter duration of action. Fentanyl also has a moderate sedative effect, which is beneficial in the postoperative period.
ABSTRACT
Paradoxical reactions (PRs) can be viewed as an abnormal immune response toward the anti-tubercular treatment (ATT). It is characterized by clinical worsening of the patient’s symptoms and signs following an initial improvement despite definitive treatment with ATT. Tubercular lymphadenitis is the most common extrapulmonary manifestation seen under PR. Other sites of involvement include the pleura, central nervous system, bones, and muscle. Although some paradoxical events may not require any intervention, studies have shown to have good outcomes using glucocorticoid therapy. This case reports a PR that involves tubercular lymphadenitis and osteomyelitis, which showed marked improvement of patient ailment following a 1-month course of oral steroid
ABSTRACT
The brown planthopper (BPH) Nilaparvata lugens (Stål) (Homoptera: Delphacidae) is considered a threat to rice (Oryza sativa ssp.) crop in many parts of the world including India. Among the BPH-resistance (R) genes so far reported in rice, most of them are ineffective against BPH biotype 4 predominant in the Indian sub-continent. In this study, we show the introgression line RPBio4918-230S was identified as BPH resistant after five years of rigorous screening at seedling stage and two years at tillering and reproductive stages. The inheritance of resistance indicated that two recessive genes are involved at seedling and reproductive stages. The allelic relation with known genes using linked reported markers suggested that the genes present in RPBio4918-230S are different. We report here the genetics of the two newly introgressed BPH resistance genes from O. nivara in the background of Swarna which are effective at all the important growth stages. The genes have been tentatively named as bph39(t) and bph40(t). The honeydew area (feeding rate) and days to wilt parameters observed at 30 days after sowing in BC1F3 indicated that newly introgressed genes have both antibiosis and tolerance mechanisms for resistance. The BPH resistance genes identified in this study would facilitate the breeding of broad spectrum and durable resistance in rice against BPH biotype 4.
ABSTRACT
Introduction: At present, 2.3 billion people are consuming alcohol worldwide. It is one of the most widely used substances, second only to tobacco. About 20–30% of all hospital admissions in India are due to alcohol-related problems. One gram of alcohol gives 7 kcal of energy. Energy consumed by alcohol comprises as much as 10% of average daily dietary intake. Most of the recent studies show that heavy drinking is associated with decreased body mass index (BMI). This study was planned as Indian literature in this area is sparse.Aim: The aim of this study was to determine the association of alcohol dependence with dietary intake and BMI.Materials and Methods: Sixty male patients admitted in the Department of Psychiatry, Kempegowda Institute of Medical Sciences, Bangalore, with a diagnosis of alcohol dependence syndrome (ICD-10) were included in the study. Twenty-four-hour diet chart was collected and BMI calculated. Statistical analysis was done using non-parametric tests.Results: The mean age of the patient population was 41.53 years. Majority of them had completed primary education (47%), mostly engaged in skilled work (48%), and were self-employed (48%). Dietary proteins, fats, and total energy were deficient in 50, 42, and 57 patients, respectively. The majority of patients had normal BMI (42%), while some were underweight (28%), overweight (18%), pre-obese (7%), and obese (5%). Results show that despite the majority of patients having a deficient macronutrient intake, BMI was normal.Conclusions: It is possible that a normal BMI was maintained in the study population despite being malnourished due to calorific contribution by alcohol.
ABSTRACT
Introduction: Cardiovascular disease (CVD) is the leading cause of mortality for women in India and globally. Coronary arterydisease (CAD) has traditionally been considered a disease of men.Aims and Objectives: The aim of the study was to study the clinical profile, risk factors, and extent of CAD in women with anacute coronary syndrome.Materials and Methods: A total of 50 patients fulfilling the inclusion criteria will be a part of this study. Patients admitted in theCardiology Department of Nizam’s Institute Of Medical Sciences, Telangana.Observations and Results: Atotal of 50 subjects were enrolled in the study after meeting the inclusion criteria. The enrollmentperiod was from November 2018 to December 2018. Out of these 36 (72%) had ST segment elevation myocardial infarction(STEMI), 9 (18%) were non-STEMI, and 5 (10%) were diagnosed as unstable angina.Conclusions: The incidence of CAD increases with age in females with more adverse outcomes in elderly females. Riskscoring systems such as Killip’s Class and TIMI score were fairly accurate in female patients in predicting adverse outcomesand complications.
ABSTRACT
Thyroglossal duct cyst is a congenital malformation occurring due to incomplete closure of the thyroglossal duct. The infrequency with which it is encountered in thyroid makes it a formidable diagnostic challenge. Authors report this case because of the rarity of intrathyroid location of thyroglossal cyst.
ABSTRACT
Background: An important factor to effectiveness of ART is good adherence to treatment. This study aims to investigate the adherence levels to ART among people living with HIV (PLHIV) attending a Government ART centre in Anakapalli, Andhra Pradesh, India.Methods: A cross sectional study was done among 1000 adult PLHIV receiving ART. Out of nearly 4500 patients on ART we selected 1000 patients by simple random sampling technique. The average of adherence for a period of 2 years and socio demographic details were taken from the patients treatment card. Chi square test was performed to find out significant difference between the socio-demographic variables and adherence level < 95%.Results: Out of 1000 patients, 53.9% were male. 42.2% were in age group 31 to 40 years. 50.1 % had adherence >95%. Major factors influencing poor adherence were: decrease in weight (OR=18.65, p=0.000); decrease in CD4 counts (OR=20.12, p=0.000), presence of opportunistic infections (OR=12.67, p=0.000), WHO stage 3 and 4 illness (OR=6.50, p=0.000), travel distance to ART >50 kilometres (OR=1.94, p=0.000), smoker (OR=1.82, p=0.000),being illiterate (OR=1.72, p=0.000), and alcohol consumption (OR=1.58, p=0.001).Conclusions: Careful monitoring of weight, CD4 counts and opportunistic infections can help to identify poor adherence early.
ABSTRACT
Background: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and post-operativeanalgesia. Among them, clonidine and dexmedetomidine are two α2-agonists which can be used as neuraxial adjuvants.Dexmedetomidine, a highly selective α2- adrenergic agonist, is a newer neuraxial adjuvant gaining popularity.Objectives: The objective of the study was to compare sensory and motor block characteristics, hemodynamic effects and sideeffects of low doses of clonidine or dexmedetomidine as an adjuvant to 12.5 mg hyperbaric bupivacaine in spinal anesthesiain lower-limb surgeries.Materials and Methods: A total of 90 patients of American Society of Anesthesiology I and II posted for lower-limbsurgeries were randomly allocated into three groups of 30 each. Group B received plain 12.5 mg of hyperbaric bupivacainediluted to 3 ml with normal saline. Group C received 30 mcg clonidine added to 12.5 mg hyperbaric bupivacaine anddiluted to 3 ml. Group D received 3 mcg dexmedetomidine added to 12.5 mg hyperbaric bupivacaine and diluted to 3 mlwith normal saline.Results: Patients in Group D and Group C had a significantly shorter onset time of sensory and motor block and significantlylonger duration of sensory and motor block compared to bupivacaine group. The mean time for sensory regression to S1 segmentwas 301.90 ± 31.96 min in Group D, 283.23 ± 13.59 min in Group C, and 181.70 ± 18.55 min in Group B (B vs. D and B vs. C,P < 0.001). There was a statistically significant difference in the two segment regression of sensory block in Group D (140.32± 17.6 min) when compared to Group C (124.5 ± 16.10 min) and Group B (92.13 ± 11.45 min). The regression of motor blockto Bromage 0 was 262 ± 24.40 min in Group D, 261 ± 24.19 min in Group C, and 164.40 ± 15.26 min in Group B (B vs. D andB vs. C, P < 0.0001). The onset and regression times were comparable between Groups D and C. Time for the first request ofrescue analgesia was nearly equal in Groups D and C and prolonged compared to Group B. Patients were hemodynamicallystable in all the groups.Conclusion: Dexmedetomidine and clonidine have a similar onset of sensory and motor block, prolonged duration of analgesia.Dexmedetomidine provides better analgesia than clonidine
ABSTRACT
Background: Smoking harms nearly every organ of the body and diminishes a person’s overall health. Millions and millions of peoples have health problems due to the habit of smoking. It is now a burden worldwide because smoking addiction of teenagers increasing immensely. Globally, smoking is not only a leading cause of cancer as well as various heart diseases. Smoke contains several carcinogenic pyrolytic products like Polycyclic Aroma0tic Hydrocarbons (PCAH), acrolein etc. are irreversible binds to DNA, causes genetic mutation and cancer. Aim: To evaluate the effect of smoking on Blood biochemistry parameters. Materials and methods: Totally 68 subjects were included in the study. 34 current smokers who came from in and around Chidambaram to the RMMC and Hospital who fulfilled the inclusion criteria were selected as an experimental group. Another 34 non-smokers of the same age group were included separately in this study as a control group. So a total of 68 respondents were contacted for the study. The primary data were collected during the 2016-2017 period of around one year. biochemical parameters such as blood glucose, blood urea, and lipid profile were analyzed using standard methods. Results: While comparing the mean Blood sugar, Serum Cholesterol, Triglycerides, HDL, and LDL values, it was found to be more in smokers compared to that of non-smokers and this was significant at 5% level for Blood sugar and at 1% level for other values like cholesterol, TGL, HDL, and LDL. The mean Blood urea value had no significant association with smoking. Conclusion: Subchronic and acute exposure to tobacco smoke and various tobacco smoke constituents have been shown to elicit a wide variety of cardiovascular effects in animal models. These effects include decreased oxygen-carrying capacity, resulting in ischemia, platelet activation, endothelial damage, altered lipoprotein levels and increased arterial wall thickness which can promote atherosclerosis, and thrombosis. Ischaemia, atherosclerosis, and thrombosis increase the risk of myocardial infarction and other serious cardiovascular effects.
ABSTRACT
Background: Tobacco cigarette smoking is one of the major leading causes of death throughout the world. Smoking has both acute and chronic effect on hematological parameters. The aim of the present study was to assess the extent of adverse effects of cigarette smoking on biochemical characteristics in healthy smokers. Materials and methods: Totally 68 subjects were included in the study. 34 current smokers who came from in and around Chidambaram to the RMMC and Hospital who fulfilled the inclusion criteria were selected as an experimental group. Another 34 non-smokers of the same age group were included separately in this study as a control group. So a total of 68 respondents were contacted for the study. The primary data were collected for 6 months in the year 2017. Hematological parameters were analyzed using standard methods. Results: The mean Hb level in smokers was less than that of the nonsmokers and it was significant at 5% level (p<0.05). Regarding the differential, count means eosinophil and polymorph values were high in the smokers but the lymphocyte value was less in smokers and these changes were significant at 1% level (p<0.01). The WBC-Total count and the ESR value changes were nonsignificant. Conclusion: Effects of smoking on alterations of the hemostatic and fibrinolytic system, antioxidant status and hematology parameters were extensively studied, but the studies presented inconsistent results. The present study was conducted to compare the effect of cigarette smoking on some hematological parameters between smokers and age-matched non-smoker controls.
ABSTRACT
A bacteriologically proven case of brain abscess, due to Streptococcus oralis is being reported in a 12‑year‑old girl who is a known case of congenital heart disease. The patient presented with fever, headache and vomiting. Pus cultures yielded S. oralis.
ABSTRACT
Dermatoglyphics is the study of dermal ridge configurations of fingers . The oral structures and the dermal structures embryonically develop at the same time. Both are influenced by environment and are not exclusively governed by the genetic factors. This is a review of how dematoglyphics can be related to the malocclusion and other developmental disturbances of the oro facial structures.
ABSTRACT
Caffeine (1, 3, 7-trimethylxanthine), a natural alkaloid present mainly in tea and coffee products has been suggested as an environmental pollutant. Decaffeination is an important process for the removal of caffeine from coffee industrial wastes. In the present study, caffeine removal (through degradation) by yeast isolate, Trichosporon asahii immobilized on various conventional matrices (sodium alginate, carboxymethyl cellulose, chitosan, agar and agarose) was investigated using the method of entrapment. The biofilm forming ability of T. asahii was monitored by atomic force microscopy and scanning electron microscopy. Exopolysaccharide produced by T. asahii biofilm was characterized by FT-IR spectroscopy and HPLC analysis. Caffeine removal from coffee processing industrial effluent was found to be 75 and 80 % by alginate immobilized yeast and yeast biofilm formed on gravels over a period of 48 hr in batch mode. Effectiveness of the process was also tested involving the continuous - flow column studies.
ABSTRACT
Mealey bug (Maconellicoccus hirsutus) causes dreadful infection in Hibiscus rosa sinensis.Infections are highly virulent and alters biochemical components of the species. Therefore an attempt has been made to evaluate the alteration of biochemical components in Hibiscus stem at various stages of infection. The results reveal that partial infected stem had shown 78% decrease in its aminoacids whereas highly infected had shown 64% decrease. The results also show that proteins had increased significantly(72%) in highly infected stem and noticeable increase (63%) in partial infected.
ABSTRACT
Mealey bug (Maconellicoccus hirsutus) causes dreadful infection in Hibiscus rosa sinensis.Infections are highly virulent and alters biochemical componenets of the species. Therefore an attempt has been made to evaluate the alteration of biochemical components in Hibiscus stem at various stages of infection. The results reveal that partial infected stem had shown 14.2% increase in its total soluble sugars whereas highly infected had shown 40% decrease.The results also show that total soluble sugars had increased significantly(14%) in highly infected stem and noticeable increase (3%) in partial infected.
ABSTRACT
Cherubism is a rare non-neoplastic disease of the bone characterized by bilateral painless enlargement of the jaws giving a cherubic appearance to the patient. It is an autosomal dominant disorder but may occur sporadically. In this paper, we have tried to explain about the clinical, radiological and histopathologic features of cherubism by presenting a case study. A case study of a 7 year old male patient, who first presented with mandibular bilateral swellings to our department in 1998, has been presented. In-depth clinical, radiological and histopathologic examination was done. An extensive long-term follow-up till 11 years was maintained. When presented for the first time, radiological investigation showed characteristic multilocular lytic lesions of the mandible bilaterally. Histopathological examination of the biopsy specimen showed proliferating fibrous connective tissue interspersed by multinucleated giant cells. It was diagnosed as a case nonfamilial cherubism. Follow-up after 5 years showed involvement of the maxilla as well, which was then corrected by surgical methods. Upon follow up 11 years after the first presentation, it was seen that the lesion was regressing by itself and there was improvement in facial contour. The natural course of Cherubism through its progression, stabilization and involution of the disease after puberty, has been highlighted in this case. More, in-depth studies to understand the nature and the pathogenesis of this condition better are required.
Subject(s)
Biopsy , Cherubism/diagnosis , Cherubism/pathology , Child , Follow-Up Studies , Histocytochemistry , Humans , Jaw/pathology , Jaw/diagnostic imaging , Male , Maxilla/pathology , Maxilla/diagnostic imaging , Microscopy , Tomography, X-Ray ComputedABSTRACT
India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form.
Subject(s)
Budgets , Decision Support Systems, Clinical , Evidence-Based Medicine , Humans , Immunization Programs , India , /economicsABSTRACT
Cladophialophora bantiana, a dematiaceous fungus and a member of the family Phaeohyphomycetes, is primarily a neurotropic fungus causing central nervous system (CNS) infection. We report a case of a well preserved, young adult male presenting with a capsuloganglionic abscess caused by C. bantiana, a rare entity. Diagnosis was made based on the mycology and histopathology findings of the aspirate from the abscess through a burr hole. The patient responded clinically to amphotericin B.