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Background and Objective: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality worldwide, with high-risk patients requiring effective management to reduce their risk of cardiovascular events. Bempedoic acid is a novel therapeutic agent recently approved as an add-on therapy to statins in patients with uncontrolled LDL-c. Bempedoic acid inhibits cholesterol synthesis in the liver, which ultimately reduces the risk of cardiovascular events. Therefore, the present study aims to assess the efficacy and safety of bempedoic acid in patients with uncontrolled LDL-c (Previously on moderate or high-intensity statins) with a high risk of CVD in real-world settings. Methods: This is a multicenter, retrospective, observational study on the data of high-risk-CVD patients collected from Bempedoic Acid on Efficacy and Safety in patients (BEST) Registry. The clinical data of 140 patients who were already on statin therapy and were receiving Bempedoic acid at a dose of 180 mg, along with measurements of the level of LDL-c, HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, serum creatinine was taken into consideration. The primary outcome includes a change in LDL-c level, and secondary outcomes involve a change in the level of HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, and serum creatinine at week 12 and 24. Adverse events were reported at both time points. Results: A total of 140 patients were included in the present study with a mean age of 51.8 ± 9.2 years and had primary confirmed diagnosis of dyslipidemia with uncontrolled LDL-c. The mean levels of LDL-c decreased from the mean baseline value of 142.67 ± 46.49 mg/dL, to 106.78 ±33.92 mg/d; a statistically significant reduction by 23.23% (p < 0.01) at week 12. Similarly, at week 24, the mean LDL-c value reduced to 90.39 ± 38.89 mg/dL. A 33.38 % decrease was observed (p < 0.01). Other parameters such as non-HDL, FPG, PPPG, AST and serum creatinine also showed statistically significant reduction at week 12 and week 24. Conclusion: The present study demonstrates that bempedoic acid is an effective add-on medication in lowering LDL-c levels in high-risk CVD patients with uncontrolled LDL-c.
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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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Background:There is a sudden rise of fungal infection with coronavirus disease. This is attributed to the immunomodulation by the disease and the drugs used, diabetes mellitus, steroid use, oxygen inhalation using dirty water, use of zinc and iron supplements, etc. Early diagnosis and prompt medical and surgical intervention is the mainstay of treatment. This can greatly reduce the high morbidity and mortality associated with this disease. The objective of the retrospective study is to describe the imaging findings of acute invasive rhino-orbito-cerebral mucormycosis (ROCM) in 58 patients with severe acute respiratory syndrome coronavirus 2, from SVP hospital with proven mucormycosis. Special emphasis is placed on the signal patterns of sinonasal mucosa, the earliest and most common findings.Material And Methods:We report the sinonasal, orbital and neuroimaging findings in patients of suspected acute invasive ROCM. A total of 58 patient’s scans were analyzed. The study comprises cases performed at two different imaging modalities and a tertiary care hospital from March 23,2021 to September 1, 2021. All the patients had positive reverse transcriptase polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 and were hospitalized with clinically severe disease as per the guideline s laid down during the second wave in India. They were on intravenous steroids and oxygen. Thirty patients (52%) had diabetes mellitus. All of them presented with headache, facialand/or orbital pain,periorbital puffiness with decreased vision, during the course of treatment. CT or MRI examination of the paranasal sinuses, orbits and brain was done, with intravenous contrast wherever possible. The presence of mucormycosis was confirmed by histological diagnosis in all of them following clinico-radiological diagnosis of acute invasive ROCM. Result:Computed tomography (CT) and magnetic resonance imaging (MRI) of 58 patients showed most commonly involved sinuse s as maxillary and ethmoid sinuses together. Sino-nasal mucosal thickening was the most common finding. Periantral infiltration preceded orbital, cerebral complications, with grossly intact bones. Sinus wall erosions were seen in only patients and maxillary alveolar arch erosionwere frequent findings. CT showed hypodense soft tissue thickening or fat stranding as the predominant finding in involved areas, while MRI showed T2 iso-to hyperintense mucosal thickening with T2 hypointense component as the main finding. Conclusion:MRI is better at demonstrating early mucosal abnormalities, turbinate necrosis, devitalized tissues, orbital apex involvement and intra-cerebral extension. Imaging findings of inflammatory tissue infiltration adjacent to the paranasal sinuses in premaxillary, retroantral fat, facial muscles, pterygopalatine fossa, temporal, infratemporal fossa and extraconal orbital-fat along with typical patterns of sinonasal mucosal thickening should raise the suspicion of acute invasive fungal etiology given the short duration of history and immunocompromised status. High incidence of periantral and orbital extension of the disease is suggestive of acute invasive form of fungal infection. Also the rapidly progressive inflammatory changes without much bone involvement should suggest the suspicion of ROCM. Bony, cerebral and vascular involvements are relatively late complications.
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Background:Anaemia is prevalent in society as leading disorder is for dissertationwhich starts usually since birth and it is seen at any age during life time irrespective of sex, area, community or life style. It seems to be difficult to treat or prevent the occurrences by the government because it is multi facet illness, in the sense that there are several types of anaemia and with different causative factors, the line of treatment varies with each and every group of patient with same causative factor or similar symptoms totality. Aim:To evaluate the efficacy of Homoeopathic medicines and Homoeopathic Approach in Increasing Haemoglobin Level in Pregnant Anaemic Women. Material And Methods:Number of cases:60, Duration of study: 24 months. Result:Laboratory Findings: Haemoglobin levels before and after the treatment, Case record form is especially modified to take the historyof Anaemia, Inclusion criteria: Only pregnant anaemic women of child bearing age are included in the study.Conclusion:As per the totality of case the most similar remedy were chosen to satisfy Susceptibility. And the Indicated Constitutional Dynamic Medicine was administered to establish a state of Health and in few cases, Biochemic Medicines were also been prescribed, depending on the deficiency of concerned salts.
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Background:Preterm birth is the most common of neonatal morbidity and mortality. 85% of neonatal morbidity and mortality is due to premature birth. A large number of studies demonstrate an association between specific organisms and preterm delivery. Material And Methods:A retrospective cohort study of pregnant women who received antenatal care between august 2017 and November 2018 at our tertiary care hospital. 70 Cases with high risk for preterm labor were included in the study and 70 cases with term labor in the control group. High vaginal swabs were collected from the posterior fornix of the vagina. Result:This study shows that there is no association of preterm labor with age, parity and numbers of previous abortions. There are high chances of preterm birth in patients with history of previous preterm birth. 48(68%) patients with preterm labor had vaginal infection in which bacterial vaginosis is more common. Other contributing factors for preterm delivery: Anaemia and lower socio-economic status. Conclusion:In this study, a significant difference in the presence of vaginal infection in patients of preterm labor and term labor was found (P<0.05).Women at risk for preterm birth or preterm premature rupture of membranes because of vaginal infections should be screened, diagnosed, treated , reevaluated, and re-treated if necessary.
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Background:A maternal near miss case is defined as a “a woman who nearly died but survived a complication that occurred during pregnancy,child birth or within 42 days of termination of pregnancy”1.MMR is defined as ratio of number of maternal deaths per 1000 live births. All pregnant women deserve a good quality of care especially Emergency Obstetric Care including proper infrastructure, human resources that can detect and manage such complications earliest. The objective of this study was to evaluate the causes of maternal near miss cases, various management modalities performed and maternal and fetal outcome in near miss cases. Material And Methods:A retrospective study was carried out in obstetrics and gynaecology department of SCL municipal general hospital, Ahmedabad for identification of MNM as per MNM-R operational guidelines (2014) in a tertiary care hospital from August 2020 to March 2022. Result:Total deliveries during our study period were 9266 out of which 535 number of patients developed complications, 75 patients ended up becoming near miss cases and 30 maternal mortalities were observed.Hypertensive disorders (38.6%) followed by severe anemia (18.6%) and haemorrhage (13.3%) were the commonest underlying causes leading to MNM. More than one management modality was followed in one case. 25% of patients required blood transfusion. Out of which 11 patients required massive blood transfusion (>5 units of blood) and 16% of patients required blood products along with blood resulting from either severe anemia or altered coagulopathy (DIC). 69.3% of patients required ICU stay of <5 days and majority of patients required hospital stay of 9-14 days.63.6% of patients required ICU stay of 1-4 days.Live birth rate was 82.6%.Conclusion:Maternal health is the direct indicator of prevailing health status in a country. Reduction in maternal mortality is one of the targets of MILLENIUM DEVELOPMENT GOALS13for 2015 but in spite of full efforts by all the health care professionals, it still remains a challenge in developing countries.There should be prompt and proper management of high-risk groups by frequent antenatal visits. Aggressive management of each complication and close monitoring of women in labour, decision making in mode and time of termination of pregnancy are important to prevent further complications.
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Background:Pregnancy-related morbidity and mortality continue to have a huge impact on the lives of Indian women and their newborns. Any pregnant woman can develop life-threatening complications with little or no advance warning. All women need access to quality maternal health services that can detect and manage such complications1. Complications during pregnancy and childbirth remain a leading cause of death among women of reproductive age in India2. Each year in India, roughly 28 million women experience pregnancy and 26 million have a live birth. Of these estimated 67000 maternal and 10,00000 newborn deaths occur every year3. The maternal near-miss event was defined as “any acute obstetric complication that immediately threatens a woman’s survival but does not result in her death either by chance or because of hospital care she receives during pregnancy, labor or within 6 weeks of termination of pregnancy4.Maternal mortality data in practical terms is the tip of an iceberg while the maternal near-miss data is invisible and whic h is a very important tool to reduce maternal mortality.Material And Methods:This is a retrospective observational study carried out among 80 maternal near-miss cases who were admitted in obstetric ICU fulfilling criteria for identification for maternal near-miss cases as per Maternal Near Miss Review Operational Guideline (December 2014)in the Department of Obstetrics and Gynecology, in our tertiary care teaching hospital, between October 1, 2018, to October 31,2020.Patient fulfilling criteria for identification of near-miss cases as per Maternal Near miss Review Operational Guideline (December, 2014)Minimum 3 criteria were included in the study.Result:During the study period total of 18360 obstetric patients were admitted, out of which 80 patients ended up becoming maternal near-miss cases. Among them majority of patients were in age group of 18-25 years and occurrence was high in multipara women. In many patients more than one underlying disorder was present. Hemorrhage (67.5%) followed by a hypertensive disorder of pregnancy (30.0%) was the commonest presenting disorder in near-miss cases. In spite of being highly preventable, maternal sepsis (6.2%) also contributes to being a major cause of morbidity.In our study, 15% of near-miss cases had associated medical conditions. 5 % of cases (n=4) in the present study faced acute severe respiratory depression (ARDS) after getting infected with covid-19 infection. There was need for massive blood transfusions in 63.75 %, magnesium sulfate therapy in 17.25%, use of cardiotonic /vasopressor drugs in 10.0%, obstetric hysterectomy in 23.75 % of cases. More than one management modality was followed in many patients. All the near-miss cases were covered with broad spectrum antibiotic therapy. Total 21 near-miss cases (26.25%) were identified to have delays. Delay in the decision to seek care (Delay 1) occurred in 2.5% of women. Educational backwardness, ignorance of pregnancy itself, lack of regular antenatal care, and failure to give importance to warning signals may be the contributing factors. Delay in accessing adequate care (Delay 2) was identified in 7.5% of women. Conclusion: Hemorrhage, hypertensive disorders of pregnancy, abnormalities of labor, anemia, and sepsis are still major contributing factors for maternal near-miss cases. Anticipation, early diagnosis, and prompt treatment of maternal complications can reduce maternal morbidity and mortality. Sensitization of the population for proper utilization of available maternal health care facilities is very vital for reducing maternal near-miss cases.All the maternal near-miss cases are living le ssons, who de spite their misery show us our deficiencies.
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Background:Tonsillectomy is one of most commonly performed surgical procedure in otorhinolaryngology. In past, various surgical techniques for tonsillectomy have been de veloped. And coblation tonsillectomy is one of the latest techniques developed. We carried this study to check feasibility of powered instrument (coblator) in view of patient and surgeons benefit with advantages and disadvantages for tonsillectomy. Material And Methods:We carried out this study in randomly selected total 125 patients who presented to our ENT department with chief complain of recurrent tonsillitis. All patients underwent coblation techniques and were analysed for total time consumption during operation, amount of bloodloss during operation, immediate postoperative pain, postoperative haemorrhage whether primary or secondary, time needed to return back to the normal activity and diet ,total percentage of healing post operatively. Each patient had preoperative blood investigation to exclude any coagulation disorder and anemia. Postoperative analgesics and broad spectrum antibiotics were administered. Result:Mean operation time was 12±2.45 minutes in coblation group. Intraoperative blood loss turned out to be 20.00±5.0 ml for the coblation. Mean return to normal diet period was significantly shorter (5.00±1.50). Otherwise, return to normal behaviour was significantly earlier with coblation(10.50±2.00 ). Postoperative we have not seen any case of primary hemorrhage or secondary hemorrhage in our study.Conclusion:We found that coblation technique for tonsillectomy offers considerable advantages in the operation time and intra operative blood loss. Coblation is related with timely return to routine activities and normal adequate diet. To endorse its significance over conventional tonsillectomy warrants further study.
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Background:Perioperative evaluation is an important step before considering a patient for surgery to deal with cardiovascular risk factors.The aim of the study is to e valuate the risk of cardiovascular events during perioperative period in non-cardiac & non-vascular surgery, even in patients with no previous evidence of cardiac disease.Material And Methods:All patients admitted in Orthopaedic, Surgery, Gynaecology department were evaluated clinically as well as with laboratory and radiological investigation. All patients with age > 40 years were subjected to electrocardiography. All the data was collected & recorded in standard Proforma. Clinical evaluation was done preoperatively & 24 hour post operatively. In patients developing cardiovascular complications, additional evaluation was done on the basis of need. Result:Highest number of patients undergoing elective non-cardiac surgery belonged to the younger age group. General surgery had the highest number of patients 45.3%, followed by Orthopaedics (36%), Gynaecology (18.7%). In view of surgery done by 3 above-mentioned surgical branches, there was not much difference in the rate of risk ofcardiovascular events. Diabetes mellitus, hypertension, and cardiac diseases were found as frequent risk factors (44 (29.3%), 52 (34.6%), 26 (17.3%) respectively.) Postoperative cardiovascular complication rate was most commonly seen in cardiac diseases, which were 8 (30.7%) patients. The incidence of perioperative cardiac complication in our study was 8.7% with 4% mortality. Conclusion:The incidence of complication was highest in patients undergoing high risk surgeries like intraperitoneal surgery. The RCRI classification was a good preoperative tool for risk stratification of patients undergoing non-cardiac surgery.
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Background:Tuberculosis (TB) is a worldwide leading public health problem even today. It affects all tissues of the body, but pulmonary tuberculosis is the most common type of tuberculosis (80% total tuberculosis cases). Extrapulmonary TB (EPTB) has major challenge for its clinical detection, definitive diagnosis and treatment. Out of all extrapulmonary cases, TB occurring in head and neck region is uncommon.Material And Methods:A prospective analytical studyof 50 patients who presented toENT OPD setupof ourtertiary carehospital with extra pulmonary TB. We look at the various clinical and laboratory aspects of tuberculosis of theotorhinolaryngeal region that would help to diagnose this uncommon but important form of extra pulmonary tuberculosis.Result:Male: Female ratio was 1.8:1 exhibiting male preponderance. Majority of the patients belonged to the age group of 20-40 years. Our study included patients with tuberculous cervical lymphadenopathy (84%), laryngeal TB (2%), tuberculous otitis media (12%), and retropharyngeal abscess (2%). FNAC seems to be de finitive and easier mode to diagnose TB of cervical nodes and Excision Biopsy can be done when FNAC is inconclusive.Conclusion:Extra pulmonary TB is significant health problem worldwide. It presents as a challenging task for diagnosis and overall surveillance of the treatment. The ear, nose, PNS, pharynx, larynx and cervical nodes are very important anatomical sites of extra pulmonary affliction. Its early diagnosis and definitive management will seize its sequence and further complications. The practical implications of an awareness of ENT tuberculosis are a benefit of anti-tubercular therapy and hence conservative management usually suffices.
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Background and aims: Smartphones have become an indelible part of a student’s life; but, their effect on academic performance of medical students is unclear with sparse data. The objective of the study was to estimate the prevalence of smartphone addiction among undergraduate medical students, pattern of its use, and the association of smartphone addiction with academic performance. Method: We conducted a cross-sectional study on all the undergraduate medical students in the Medical College Baroda, Anandpura, Vadodara, Gujarat, India, from second year to internship after getting written informed consent. Sociodemographic details, patterns of smartphone use, and scores of the final examination appeared for, were obtained to assess academic performance using a self-report semi-structured questionnaire. Smartphone addiction was diagnosed using the Smartphone Addiction Inventory (SPAI). Result: Out of the 523 students approached, 427 returned completed questionnaires. Ninety five students (22.2%) had smartphone addiction, with the addicted students being more likely to change their phone often, use it for longer periods and in restricted places. No association was found with gender, age, years of use, and academic performance. Conclusion: Nearly one-fifth of the medical undergraduate students were suffering from smartphone addiction. However, it does not seem to have an association with academic performance among undergraduate medical students.
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Aim: The objective of the study was to assess the effect of dietary incorporation of different feed attractants viz. tubifex, earthworm and fish meal on growth and survival of O. bimaculatus (pabda fish) fry. Methodology: Fifty numbers of fifteen days weaned fry (0.105±0.008g; 2.14±0.14cm) were stocked into each aerated aquariums (30.0 x 15.0 x 15.0 cm) following a completely randomized design (CRD) consisting of four treatments including the control with three replicates each. Four iso-nitrogenous purified diets were prepared including three treatment diets with attractants (5%) by replacing an appropriate amount of casein and cellulose and fed to the fishes twice daily. Results: Results from the study showed that growth of fry as measured by final weight, weight gain, mean daily weight gain and specific growth rate of fries were significantly (p<0.05) higher in tubifex supplemented group and lower in control group. Survival was significantly higher in tubifex supplemented group (42.66±1.3%) and lower in control group. Moreover, other yield parameters such as total biomass, condition factor and performance index also followed the same trend as survival. Further, higher protease activity was found in control group (2.233±0.038 units mg protein-1 min-1) followed by earthworm (0.354±0.031 mg protein-1 min-1) supplemented group (p<0.05). The lipase and amylase activity were higher (p<0.05) in tubifex and control groups, respectively. Interpretation: It could be concluded that the dietary supplementation of tubifex at 5% inclusion level could be a promising aquaculture feeding strategy for pabda fish due to its rich nutrient content, increased feeding stimulation and more palatability.
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Objective: The objective of this study was to evaluate the cytotoxic potential of A3AR agonist (ABMECA) against human lung cancer cell line A549 by using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. Methods: Adenocarcinoma cell line A549 was used to assess MTT based cells viability. In vitro cytotoxic activity was evaluated for 3 different concentration of doxorubicin and A3AR by MTT cytotoxicity assay. Cytotoxicity assay carried out for 3 consecutive days that involves culturing cells into Dulbecco’s MEM medium modified with 10% FBS for 24 h then treatment with different dose of standard and test drug with incubation period of 24 h followed by treatment with MTT for estimation of cytotoxicity and finally, optical density (OD) was measured at 570-630 nm. Results: Different concentration of doxorubicin (1, 5, 10 µM) and ABMECA (10-6M, 10-5M and 10-4M) shown dose-dependent cytotoxicity. There was a significant decrease (p<0.05) in cell viability in both doxorubicin and ABMECA concentration in a dose-dependent manner. This study may guide further for in vivo evaluation of test drug in the lung cancer model. Conclusion: A3 Adenosine Receptor agonist could be potential moiety for the treatment of lung cancer and it would require in vivo study for further research.
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INTRODUCTION:Because patients covered by medical insurance are being denied legitimate claims, doctors are working shoulder to shoulder with them and have garnered significant experience in this matter. We, therefore, decided to a systematic survey under the Medic LAWgic banner and presented the data.METHODS:A short, 8-question multiple-choice survey was conducted online among doctor clinicians. Duplicate replies were removed. The remaining replies were evaluated, interpreted, and the data are being presented here.RESULTS:A total of 377 doctors responded. The majority (208, 55%) had faced problems with medical insurance claims in more than 10% of their patients. Almost half of them (48%) had outright rejection of the claims in more than 10% of their patients. Reduction in claim amounts was faced in more than 10% instances by 262 (70%). The five most common causes for refusal or rejection of claims included failure of patient to disclose pre-existing illness (234, 62%), other insurance policy terms related issues (157, 42%), oral medication (199, 53%), treatment without admission (155, 41%), and treatment with new modes of therapy (152, 40%). As many as 301/377 (80%) doctors had written letters to the insurance companies for supporting their patients’ claim. Such supporting letters from the treating doctors resulted in the claim being accepted or approved in 216 instances (57%).DISCUSSION:Mediclaim denial is a major and growing problem. People who need financial assistance the most are also the most vulnerable to denial. In the USA, such denial rates ranged from 1% to 45% of in-network claims in the year 2017. Unfortunately, <0.5% of patients appealed such claim denial. The insurance regulatory and development authority of India (IRDA) have issued guidelines that all claims need to be settled within 30 days and that insurance companies must fulfill their contractual commitment for genuine claims, even if timely intimation was not possible. Insurance companies are running a business for profit. Hence, even the most expensive plans will have a list of exclusions, in the fine print. Indian patients need to be proactive in following up when claims are rejected or reduced. Doctors are their pillar of support, whose advantage needs to be taken by them. IRDA and consumer courts are also looking after patients’ rights in this matter.CONCLUSION:Patients are increasingly facing challenge of medical insurance companies denying legitimate claims. Doctors help by writing to the insurance companies supporting their patients claim and such letters help in the majority of instances. Patients and their families need to follow up aggressively when their claims are not approved, rejected or reduced. They should also request the help of their doctors when facing such challenges.
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Purpose: To report endoscope-assisted fascia lata harvest (EAFH) as a minimally-invasive technique for correction of severe blepharoptosis. Methods: This was a retrospective case series between January 2013 and April 2017. Medical records of all consecutive patients who underwent frontalis suspension by EAFH in the study period were reviewed and outcome was analyzed. Results: Fourteen patients (10 males) were included in the study. Mean age of the group was 18.14 + 17.03 years (range 4-65 years) and 11 patients had simple congenital blepharoptosis. Blepharophimosis syndrome was seen in 3 patients. Eleven patients had bilateral blepharoptosis. The mean preoperative and postoperative MRD1 was –1.60 ± 0.87 mm and +2.12 ± 1.37 mm respectively. Mean lengths of the incision and fascial harvest were 2.25 ± 0.43 cm and 13.0 ± 2.35 cm (range 10-17 cm) respectively. The median follow-up of patients was 4.57 + 4.03 months (range 1-15 months). Complications included a wound dehiscence in two patients and these were resutured. The donor sites healed well in all patients leaving a small thigh scar and none needed scar revision. Conclusion: EAFH is a promising minimally-invasive technique performed with a small incision and achieved adequate length of fascial harvest.
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BACKGROUND:Diagnostic imaging is an integral aspect of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries (LMICs) such as Tanzania. The introduction of ultrasound can significantly impact treatment in these countries due to its portability, low cost, safety, and usefulness in various medical assessments. This study reviews the implementation of a four-week ultrasound course administered annually from 2013–2016 in a healthcare professional school in Mwanza, Tanzania by first-year allopathic US medical students. METHODS:Participants (n=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were predominantly clinical officer students, but other participants included other healthcare professional students, practicing healthcare professionals, and school employees. Data collected includes pre-course examination scores, post-course examination scores, course quiz scores, demographic surveys, and post-course feedback surveys. Data was analyzed using two-tailed t-tests and the single factor analysis of variance (ANOVA). RESULTS:For all participants who completed both the pre- and post-course examinations (n=229, 39.1％ of the total recruited), there was a significant mean improvement in their ultrasound knowledge of 42.5％, P<0.01. CONCLUSION:Our data suggests that trained first-year medical students can effectively teach a point of care ultrasound course to healthcare professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impact of ultrasound training on knowledge of human anatomy and diagnostic capabilities, and how expansion of an ultrasound curriculum has impacted access to care in rural Tanzania is warranted.
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Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.
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Background: Amniotic fluid is vital to the well-being of the fetus. Disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome. Aim and objectives: To find out incidence of polyhydramnios and oligohydramnios in our setup and to study possible etiological factors for abnormal AFI. Material and methods: We performed a study on 200 patients over a period of one year. Detailed history, general examination and local examination were done. All the cases were subjected to ultrasonography to see for maturity, AFI, congenital anomalies. Analysis were made regarding mode of delivery and perinatal outcome which includes maturity, birth weight, incidence of SGA or macrosomia, NICU admission, maconium stained amniotic fluid, low apgar score, incidence of birthasphyxia and congenital anomalies. Results: There were total 82 cases of oligohydramnios and 18 cases of polyhydramnios. And 100 cases with normal AFI. In ultrasonography 154 cases had full term maturity and 46 cases were preterm 82 cases had AFI ≤5 cm, 18 cases had AFI > 24, and 100 cases had AFI between 6-23. Conclusion: Amniotic fluid index assessment has become an important part of ante-partum fetal surveillance and also it has a prognostic value for fetal and newborn outcome.
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Bovine tropical theileriosis caused by Theileria annulata is a tick-borne disease associated with high morbidity and mortality in the livestock. The conventional method of diagnosis is by the demonstration of the parasite stages by microscopic examination. This method suffers from low sensitivity, making it even more difficult to detect piroplasms in the carriers. PCR based assays are known to be more sensitive. The present study was undertaken to detect and quantify T. annulata in the blood of clinically infected and carrier animals using a quantitative PCR protocol targeting the gene encoding the major merozoite piroplasm surface antigen Tams 1. A total of 116 samples were collected from infected as well as apparently healthy cattle and buffaloes. Of these, 74 samples (63.79%) were positive for T. annulata by real-time PCR, including the 15 samples that were positive by Giemsa staining. The parasite load ranged from 1.39 x 106 to 3.35 x 109 and 0.35 x 106 to 2.83 x 107 ml-1 of blood in cattle and buffalo samples, respectively by qPCR. Our study suggests that real-time PCR assay can be used to detect and quantify the load of T. annulata in the blood of cattle and buffaloes. It also serves as a support to clinical diagnosis and assessment of carrier status in apparently healthy animals.
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Thrombotic thrombocytopenia purpura (TTP) is a rare hematological disease and only 20%–30% of patients present with classic pentad. About 20% of patients with TTP are resistant to plasma exchange. We have described a 28-year-old female patient with TTP who did not have classic pentad of TTP. We ruled out all other differential diagnosis. She was refractory to plasmapheresis and was treated successfully with rituximab. It was thus concluded that on the basis of the literature review, rituximab should be considered in TTP patients who fail to respond after 7–14 days of standard treatment with daily plasmapheresis and glucocorticoids.