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Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi commonly affecting nasal mucosa, conjunctiva, and urethra. Subcutaneous tumor nodule presentation is rare and often mimics as sarcoma. Such tumoral rhinosporidiosis has been reported rarely. This report describes a 60-year male who presented with a solitary, firm, nontender swelling in posterior aspect of right leg with an ulcer and mimicking clinically as soft tissue sarcoma. Histopathology was diagnostic. Surgical excision was found to be useful.
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Background: Lack of knowledge of pharmacovigilance and underreporting of adverse drug reaction (ADR) are worldwide problems of big concern. Gross underreporting of ADR in India led to increased hospital admissions, increase in length of hospital stay, and increase in healthcare cost burden. Aims and Objectives: This study was planned to assess knowledge, attitude, and practice on ADR and pharmacovigilance among nursing staff in Gandhi Medical College and Associated Hospitals, Bhopal Madhya Pradesh. Materials and Methods: A questionnaire-based, cross-sectional, and observational study was conducted among nursing staff in a tertiary care Centre. Data were collected in the form of a validated questionnaire comprised of 17 questions regarding knowledge, attitude, and practice of nursing staff toward ADR and Pharmacovigilance. Data were analysis by descriptive statistics and result was computed. Results: Around 33% of respondents were aware of Pharmacovigilance program of India and 99% of them had knowledge about main objective of pharmacovigilance. Out of total filled questionnaire received, only 12% nurses practiced reporting ADR. The major factor discouraging participants from reporting ADR was lack of time to report. The majority of nursing staff had a positive attitude toward awareness of pharmacovigilance and ADR reporting. Conclusion: Our study has shown that there is lack of correct knowledge regarding ADR reporting and pharmacovigilance among staff nurses. Although, the attitude toward ADR reporting was adequate, the actual practice of ADR reporting is unsatisfactory. Hence, it is essential to train staff nurses regarding pharmacovigilance and ADR reporting
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Background: Vitamin D deficiency and associated complications are widely prevalent in the Indian subcontinent. Hypovitaminosis D is known to play deleterious effects on cardiovascular and skeletal functions in human beings. Yet, its effect on carbohydrate metabolism and diabetes mellitus (DM) is less known. Aim and Objectives: In the current case– control study, our primary aim is to find out the potential effect of hypovitaminosis D on glycemic control in type 2 DM (T2DM) patients. Materials and Methods: The study population comprised 250 T2DM patients recruited primarily from Madhya Pradesh, India. The case group of 125 T2DM patients with hypovitaminosis D was compared with a control group of 125 T2DM patients with sufficient vitamin D. We mainly investigated the effect of hypovitaminosis D (both deficiency and insufficiency) on glycemic control in T2DM patients. Results: We observed that both fasting and 2-h postprandial blood glucose were found to be elevated significantly in T2DM patients with hypovitaminosis D (P < 0.01). The glycated hemoglobin level was also elevated (P < 0.01) in the case group suggesting impaired glycemic control for a chronic period. An inverse association is found between glycemic status and serum vitamin D (OH)D3 levels. Conclusions: Our results show the significance of maintaining sufficient plasma vitamin D levels, along with hypoglycemic medication in T2DM patients to improve their glycemic control and avoid diabetic comorbidities.
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Introduction: Protocol for immunocytochemical (ICC) staining in May-Grünwald Giemsa (MGG)–stained smears has been difficult to establish. It is the need of the hour to be able to use prestained slides for ICC in specific cases to deliver timely diagnoses and reduce inconvenience to patients. Aims and Objectives: To evaluate and compare the use of MGG-stained smears for the purpose of ICC, after de-staining and saline rehydration to that of routine standard ICC. Materials and Methods: A prospective study was conducted on 40 FNAC samples: 25 cases of breast disease and 15 cases of reactive lymphoid hyperplasia known to express pancytokeratin and leukocyte common antigen (LCA)/CD45, respectively. Air-dried smears of each case were stained by standard MGG stain and after the report was dispatched, one smear was selected and sent for ICC. The smears were analyzed to determine the overall result and grade each smear semi-quantitatively with respect to staining-intensity, stain-localization, staining-uniformity, counter-staining, and background-staining. Observations and Results: The proposed protocol was inferior to conventional ICC in all the parameters, more pronounced in pancytokeratin than LCA/CD45. Only 8% of air-dried smears stained for pancytokeratin showed optimal stain intensity (as opposed to 44% of wet-fixed smears), whereas only 14.3% of air-dried smears were optimally stained for LCA (as opposed to 85.7% of wet-fixed smears). Conclusion: The proposed protocol of de-stained Giemsa smears as an alternative to conventional technique for ICC was unsuccessful in giving satisfactory results.
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In recent years, there has been a surge in the awareness regarding the phyto cannabinoid; cannabidiol. Between the time period from 1963 to 2000, only 460 publications can be found in a PubMed search while using cannabidiol as the keyword. The former pales in comparison to the record of 2769 publications found from 2008 to the present time. However, a limited amount of literature is available that discusses the therapeutic potential of cannabidiol, pertaining to the field of dentistry. In 1940, cannabidiol was isolated from cannabis for the first time, its structure being reported much later in 1963. Further research on Cannabis resulted in the declaration that “THC” is the active compound. Subsequent studies were then directed essentially based on the virtual exclusion of cannabidiol and other cannabinoids from cannabis. This was primarily due to the belief that the activity of cannabis was merely psychological activity. In retrospect, this seems unfortunate as many of the beneficial properties of cannabidiol which might have had a therapeutic benefit were overlooked. In the present review, attention will be focused on the therapeutic potential of Cannabidiol and the impact this may have on dentistry with the supplemental vision of encouraging further studies to reveal any other beneficial properties that may be present.
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Despite the relative decline in communicable diseases, India witnesses hundreds of outbreaks every year. Including the current Covid-19 pandemic, India has suffered through several major pandemics and large-scale epidemics since 1900s. However, the response to most of the epidemics has been inadequate. The Epidemic Diseases Act, enacted in 1897 (EDA 1897), has been in action since and is based on the science and the socio-political environment of the country in the nineteenth century. India has several legal mechanisms to help contain and control the spread of epidemics, but on different platforms. There has been a paradigm shift in the socio-political milieu as well as scientific advancements in the prevention and control of epidemics. The century-old EDA 1897 has not been effective in containing and controlling such epidemics/pandemics, as has been witnessed during the ongoing Covid-19 pandemic. Hence, it needs to be revised to define an appropriate structural scalar chain, provide clear-cut and unambiguous terms/definitions and guidelines, delineate ethics and human rights, determine the duties and responsibilities of the affected population/community, determine the role of the private health sector, and provide for appropriate punitive measures to deter repeated violations.
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Background: Human in close inhabitation with the cattle due to unventilated or inadequately ventilated establishments or inadequate living space, is always at a risk of sustaining infection from the cattle through different modes of disease transmission. This study hints at the increased incidences in respiratory infections among dairy workers in unorganized and small scale dairy farms due to amendable unhygienic practices. Methods: This survey was part of a larger study, conducted after ethics approval. Number of households involved in dairy work surveyed were 60. From every house, two members actively involved in dairy work were chosen and total respondents were 120. The study tool was a semi structured, mixed questionnaire. Results: 67.5% dairy workers self-reported occurrence of respiratory symptoms which included the complaints like cough,breathing difficulty on exertion. None of the dairy workers were vaccinated against any milk borne disease.Conclusion: The housing, civic amenities accessed by them and their awareness are probably the main reasons for wide variety of self perpetuated practices and deviations of standard requirement.Use of protective gear (gloves,caps,masks) should be strictly emphasized and popularized.
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Background: Deranged thyroid function may be caused by autoimmune disorders like auto-immune thyroiditis. The medical staging of the disease shows an extensive display of symptoms like overt hypothyroidism. Various scientific studies had shown that auto-immune thyroiditis may be due to the interaction of cytokines (tumor necrosis factor-alpha � TNF-?). Current studies had shown that TNF-? plays a crucial role in the regulation of thyroid transcription factors. Aims and Objectives: The study aimed to assess the comparative changes of inflammatory markers in diagnosed thyroid patients and control subjects. Materials and Methods: The present study comprises 200 subjects of both sexes whom 00 are healthy controls and 100 are clinically confirmed cases of hypothyroidism, with an age group ranging from 25 to 70 years. Serum TNF-? and serum thyroid stimulating hormone were estimated by ELISA Method. Results: The inflammatory marker (Serum TNF-?) was significantly (P > 0.05) raised in clinically diagnosed hypothyroid patients (4.09 � 0.94) as compared to age and gender match healthy control subjects (3.06 � 0.55). Conclusion: Many studies have shown that inflammatory markers are the primary cause of thyroid function problems. The current cogitation proved that raised serum TNF-? is concerned with the pathogenesis of autoimmune thyroid destruction. It seems that TNF-? is highly significant in the case of Hypothyroidism.
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Background: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%). None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines.
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Bio therapeutic product tends to similar properties like- efficacy, Safety and qualityto a licensed bio- originator. USFDA guideline clearly said that Bio-Similar drugs are not genericmedications nor identical to the innovator medicine and also it’s not ensuring therapeuticequivalence with innovator drug. Getting Bio-Similar product marketing approval is achallenging task. To improve access of Bio-Similar drugs within the US market, US-FDA allowsabbreviated pathway for their approval. Recently India is becoming a most preferabledestination for Bio-Similar manufacturers, because of Make in India program. Introduction ofrecombinant technique to prepare Monoclonal antibody based Bio-Similar drug becomingpopular within pharmaceutical manufactures because of many recent patent expiries ofBiologics. The biologies are produced by cell culture method; hence, chances of variability’s aremore as comparable with the chemically synthesized conventional medicine and variousbiological medicines has led to developed Bio-Similar drugs across the globe. The biologies areproduced by cell culture method; hence, chances of variability’s are more as comparable withthe chemically synthesized conventional medicine. Therefor it is impossible to produce anidentical copy of an innovator product; hence, Bio-Similar is not considered as generic drugs.These drugs are Twin but not a clone of the innovator drug. The Bio-Similar drugs always facechallenges regarding verification of the similarity, the interchange ability, unique naming todifferentiate the various Bio-Pharmaceutical products, commercial opportunities, IPR andpublic safety.
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Background: Alloxan-induced diabetes model is used as a “study tool” to elucidate the pathophysiology of the disease and much more as a “search engine” for antidiabetic compounds with better therapeutic characteristics. It was the first agent used in the category of chemically induced diabetes to create a model of insulin dependent diabetes mellitus. Other chemicals being streptozocin, dexamethasone, insulin antibodies-induced diabetes.Methods: Albino rats were divided into four groups with ten rats in each group. Alloxan monohydrate 2%, solution which was dissolved in 0.9% of sodium chloride (normal saline) as a diluent and given intraperitoneally to rats and blood glucose estimation made by using glucometer. Total 40 albino rats were taken and divided into 4 groups. 10 rats receiving normal saline were grouped as Group A, 10 rats received alloxan at a dose of 150 mg/kg as Group B, 10 rats received alloxan at a dose of 160 mg/kg as Group C and 10 rats received alloxan at a dose of 170 mg/kg as Group D.Results: Highest rate of mortality and alopecia were noted in group D receiving alloxan at a dose of 170 mg/kg whereas highest percentage of fluctuation in fasting blood glucose range was seen in group C receiving alloxan at a dose of 160 mg/kg.Conclusions: Such unpredictable response shows that alloxan is not ideal drug for induction of diabetes in experimental animal. Mortality, fasting blood glucose returning to non-diabetic range and alopecia are the chief drawbacks.
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Background: India recently launched Ayushman Bharat – National Health Protection Mission – an upgraded version of Rashtriya Swasthya Bima Yojna (RSBY), which is projected as world's largest public insurance scheme by numbers. The new scheme can certainly draw learning from the former (RSBY) to ensure better reach and success. RSBY has been extensively analyzed for supply-side barriers but sparsely for demand and supply-side barriers simultaneously. Objectives: Through this study, authors intend to determine causality as well as configurations (pathways) of demand and supply barriers that make beneficiary vulnerable even under the scheme. The study explores the interaction of barriers that lead to patient dis/satisfaction, overcharging for a medical procedure and high disease severity among beneficiaries. Methods: The study uses RSBY insurance claim records from 2013 to 2015 backed up by posthospitalization survey of the state of Chhattisgarh, India. It employs a fuzzy set qualitative comparative analysis to determine causality and configuration (path-way) of parameters leading to the outcome. Results: Provision of medicine emerges as a necessary condition for patient satisfaction. Waiting time did not appear as a necessary parameter of satisfaction. Overcharging the cashless card in case of minor surgical procedures is observed irrespective of beneficiaries' education and occupation status. Urban male and rural female appear to bear high disease severity. Conclusions: Results have implication for policymakers and implementors to recognize the segment that remains vulnerable under the scheme and gain insights on the parameters of patient satisfaction.
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Malignant peritoneal mesothelioma is a rare lethal malignancy of the serosal membranes of the peritoneum. The pathogenesis and association is strongly related with industrial pollutants asbestos, but less than pleural mesothelioma. Symptoms are nonspecific and related to the tumor spread within the abdominal cavity. CT scan is the investigation of choice and mostly disease is discovered incidentally on routine imaging. Diagnosis is confirmed on histopathology as well as immunohistochemical analysis of markers. The mainstay of treatment is cytoreductive surgery with Hyperthermic intraperitoneal chemotherapy. Here we present a very unusual case of malignant peritoneal mesothelioma diagnosed on routine evaluation of a 62 year old male admitted in emergency for obstructed inguinal hernia. Introduction: Malignant peritoneal Mesothelioma MPM is a very rare malignancy of the abdominal cavity. Mesotheliomas usually originate from the serosal membrane of different body cavities. Pleura is most commonly affected by mesothelioma followed by peritoneum and also other cavities pericardium and tunica vaginalis testis.10 to 30% of all mesothelioma affects peritoneum. Malignant peritoneal mesothelioma is a highly lethal malignant tumor of peritoneum and its pathogenesis is strongly related with industrial pollutant asbestos exposure. Diagnosis is difficult in most of the cases because of its nonspecific presentation and detected on routine abdominal imaging or Surgery.
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Background: Blood is precious as well as scarce lifesaving medication. Proper screening of transfusion-transmitted infections (TTIs) such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and malarial parasite (MP) with appropriate methods is needed to ensure that the donated blood is made innocuous for transfusion. Objective: The aim of the study was to estimate the prevalence of TTI and their epidemiological aspects in blood donors in a hospital-based blood bank in Nerul, Navi Mumbai. Materials and Methods: A retrospective study of the total of 4708 donors was carried out from January 2015 to December 2018 year. Screening of HIV was done using the fourth-generation enzyme-linked immunosorbent assay (ELISA) and for hepatitis B surface antigen (HbsAg) and HCV by the third-generation ELISA kit. Testing for syphilis was done with rapid plasma reagin and MP was tested with rapid card test. Results: Voluntary donors were 4702 (99.9%) while replacement constituted for 6 (0.12%) number of cases. Among 4708 donors, 4079 (96%) were male and 629 (4%) were female. Among 66 (1.4%) transfusion transmitted diseases (TTD)-positive donors, the highest number of donors 28 (42%) belongs to 18–27 years of age group while the lowest 5 (2%) belonged to 48–57 years. Overall prevalence of HIV, HbsAg, HCV, syphilis, and MP was 0.08%, 1.1%, 0.2%, 0.04%, and 0.02%, respectively. Conclusion: The prevalence of TTD was more in males, in 18–27 age groups, and in voluntary donors. The most common TTI was HBV, followed by HCV, HIV, syphilis, and MP, respectively.
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Background: Still many Indian states observe low spaced births and high fertility above replacement level; mostly contributed by disadvantaged society. Factors influencing are entrenched in ignorance, male child desire and traditional culture to some extent.
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Introduction: Acute kidney injury (AKI) is a heterogeneous syndrome of different aetiologies, and often multifactorial. Occurrence of Acute kidney injury in patients with chronic liver disease is frequent finding which makes prognosis of CLD even poorer. Material and methods: A prospective cohort observational study on 100 adult patients of chronic liver disease with AKI conducted over a period of 24 months from August 2016 to August 2018 at Sri Aurobindo medical college and postgraduate institute. Detailed clinical examination and biochemical tests were done. Univariate and multivariate logistic regression (odds ratio) analyses were used. Result: 87% are males and 13 % are females. The most common cause of cirrhosis is alcoholic 77% followed by hepatitis Bvirus related 10%, unknown etiology 7%, hepatitis C 3%, NASH 2%, Wilson 1. The most common sign of decompensation of liver is jaundice 78% followedby ascites 70%, hepatic encephalopathy 37% and upper GI bleed 30%. Distribution of child class as a prognostic indicator showed the maximum no. ofpatients found in class C 56% followed by class B 34% and class A 10%. Conclusion: Acute kidney injury is very common in chronic liver disease patient in our hospital and majority of them have intrinsic cause of AKI
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Two staged bilateral total hip replacement (THR) is commonly performed for bilateral hip end stage arthritis and is preferred as THR is a complex planned surgery and performing both sides simultaneously may be fraught with risks and complications. However, many studies now indicate that in carefully selected patients , single stage or simultaneous bilateral THR can be performed with successful and cost effective results. We report a case of one-stage bilateral THR performed in a 22 year old with bilateral severe arthritis due to ankylosing spondylitis. Patient was severely disabled due to pain and was only ambulating on wheelchair. After a successful single stage bilateral THR, patient recovered fully and after 6 weeks was walking independently without any pain, with full function of both hips and performing his occupation normally. The surgical costs to the patient and hospital were both economical. We conclude that single stage bilateral THR is a better surgical option for young and fit patients with bilateral hip arthritis.
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Context: C-cell hyperplasia (CCH) is characterized by increased mass of C-cells and has been identified as a precursor condition for medullary thyroid carcinoma (MTC). Varying proportion of MTCs is associated with CCH in different studies. This could be due to the lack of uniformity of the definitions and techniques used to identify CCH in these studies. Aims: This study aims to study the occurrence, clinicopathological, and immunohistochemical features of CCH in MTC diagnosed during a 22-year period at a tertiary care center in North India and to review the available literature on CCH. Materials and Methods: Eighty-seven consecutive cases of MTC were included in the study. Histological evaluation for the presence of CCH and neoplastic CCH was performed. Confirmation of CCH was done by immunohistochemistry for calcitonin and chromogranin. The presence of neoplastic CCH was correlated with clinical factors and prognostic factors. Results: Of 87 cases of MTC included in the study, 71 (82%) patients were sporadic and 16 (18%) had familial MTC. Neoplastic CCH was seen in 12 (75%) familial and in 9 (13%) sporadic MTC. Patients with familial MTC were more frequently associated with neoplastic CCH than sporadic MTC (P < 0.001), were younger (P < 0.001), and had more often bilateral and multifocal tumors (P < 0.001). However, there was no significant difference in mean survival time and progression-free survival in patients with and without CCH. Conclusion: CCH, though more common in familial MTC, can also be seen in sporadic tumors. CCH is not associated with patient survival and disease progression.
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Introduction: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital. Diabetic dyslipidemia in India is one of the main causes for Coronary Artery Disease (CAD) mortality of the world. Dyslipidemia are disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. It is a preventable risk factor which is mostly observed in diabetes patients and that may precipitate the cardiovascular disorders. Our aim of the study is to determine the impact of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic patients reporting at tertiary care hospital. Materials and methods: It was a cross sectional study conducted at Civil Hospital and Gujarat Medical Education Research Society, Medical College, Valsad, Gujarat, India. Total 140 diabetic patients were randomly selected form OPD and IPD of our hospital and they were examined for dyslipidemia. Fasting blood glucose concentration and Lipid Profile [Total Cholesterol (TC), High Density Lipoprotein (HDL), Very Low Density Lipoprotein (VLDL) and Triglycerides (TG)] were investigated by using commercially available reagent kits in Biochemistry analyzer. Collected data was analyzed by using appropriate software. Results: Out of total 140 diabetic patients examined, the mean age of patients was 48.93 ± 12.1 years. In present study we found the mean Fasting Blood Sugar (FBS) was 188.76 ± 54.63 mg/dl. The prevalence rates in our study for high Total Cholesterol (TC) and Triglycerides (TG) were 13.6% and 41.4% respectively. The prevalence rates for high LDL-C, very high LDL-C and low HDL-C in the diabetic subjects were 8.6%, 5.0% and 72.9% respectively. Conclusion: The diabetic patients had elevated serum total cholesterol, elevated triglyceride (triacylglycerol) and slightly elevated low density lipoprotein (LDL-C) and reduced levels of high Gamit DN, Mishra A. A lipid profile study amongst the patients of type 2 diabetes mellitus - A cross sectional study. IAIM, 2018; 5(2): 1-5. Page 2 density lipoprotein (HDL-C) indicating that diabetic patients were more prone to cardiovascular diseases.
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Background: Acute disseminated encephalomyelitis is an acute demyelinating disorder of the central nervous system and is characterised by multifocal white matter involvement. Diffuse neurological signs with multifocal lesions in brain and spinal cord characterise the disease. It do not invade central nervous system. Aim: To evaluate role of MRI in acute disseminated encephalomyelitis. Materials and methods: A prospective study of 10 cases which was conducted in the pediatric department in Dhiraj hospital. MRI brain was done on 1.5 Tesla MRI machine. Results: ADEM can be distinguished from acute viral encephalitis because the disease is not the result of primary tissue invasion by an infectious organism. It was thought to be immune-mediated and is characterized neuropathologically by perivenular inflammation and demyelination. Conclusion: ADEM is more common in female and more associated with previous infection as compared to previous vaccination. Neurological deficit is mostly associated with it. CSF showed raised protein in almost cases. It showed hyperintense lesion on T2W and FLAIR sequences. Periventricular area of brain is commonly associated.