Age Related Neurodegenerative Disorders w.s.r to Dementia

Aging can be defined as the gradual anatomical and physiological decline which begins to after the achievement of sexual maturity. Vriddhavastha (senility) is Vata dosha prominent phase of life. Gunas (qualities) of Vata dosha are degenerative by the nature which is increased; they result in degenerative changes in the body in terms of Dhatukshaya, Ojakshaya and Balakshaya which result in Neuro degeneration. Dementia is the progressive deterioration of intellect, emotional control, behavior and motivation along with loss of memory. Vriddhavastha (aging) is Vata dosha prominent Avastha. Vata has some Guna (qualities) that get involved in the degenerative process in the body like Laghu guna and Khara guna which is act as Lekhaniya (scraping), Vishada guna has Kshalanashakti (elution power) and, Ruksha guna has Shoshanashakti (absorbability), etc. With increasing Vata dosha, these above Gunas are also be increased, might be together or separately and will initiate the process of degeneration in the body in the terms of Dhatukshaya, Ojakshaya and Balakshaya causing various degenerative diseases. Dementia is one among them. Symptomatology of dementia are similar to Vata vriddhi lakshana, Vata nanatmajavyadhi and Ojakshaya lakshana. Manifestation of the disease condition is purely due to degenerative changes in senile periods. The disease condition is not a reversible but with the healthy changes in dietary habits and lifestyle, the disease condition might be preventable and delayed.

Implementation of case-based learning method for teaching biochemistry for undergraduate medical students

Background: First year MBBS curriculum in Biochemistry is taught by the conventional methods of teaching in which didactic lectures share almost 70% of the total content load, in which students fail to grasp the importance of biochemistry and its significant contribution in medical laboratory science. Hence, case-based learning (CBL) is being used in the medical curriculum, so that students are exposed to the real-life medical problems. Aim and Objectives: The study aimed implementation of CBL sessions in 1st year MBBS students and to analyze perception of students and faculty about the effectiveness of CBL method. Materials and Methods: A group of 150 students of Phase 1 MBBS course was selected for interventional study comprising two teaching-learning sessions on two core topics in biochemistry. Pre-test and post-test were conducted before and after the CBL session. A third test was conducted 1 month after the post-test to assess retention of knowledge gained by the students. The performance of the students was analyzed. Results: Pre-test and post-test analysis showed a very significant improvement in performance of the students after the CBL sessions. About 95% of the students and 90% of faculty reported that CBL sessions were useful to facilitate critical thinking through active learning. About 85% of students and 80% of faculty expressed that CBL helped in bridging the gap between theory and practice. Conclusion: It is evident from the present study that CBL in biochemistry can be implemented as innovative and effective teaching module to achieve the learning objectives. Case studies encourage active learning, promote critical thinking, and instill motivation in the subject.

A Comparative Study Of Endoscopic And Microscopic Type-1 Tympanoplasty

Background:Chronicsuppurative otitis media tubotympanic type is a common pathology for which tympanoplasty is done. The decision to decide the approach for tympanoplasty de pends upon multiple factors like extent of disease, site and size of perforation, size of external auditory canal and surgeon’s own expertise and preference. This study was undertaken to compare endoscopic and microscopic approach for type-1 tympanoplasty.Material And Methods:This study data was collected from 50 patients who underwent tympanoplasty in our department in our hospital from July –2017 to November 2019.Patients above 15 years of age with inactive chronic otitis media tubotympanic type operated for type-1 tympanoplasty. Pre-operative, intra-operative and post-operative data collected as per performa and evaluated.Result:Equal (25) number of cases underwent microscopic and endoscopic type-1 tympanolasty. As far as graft taken up is concern both approaches have good and comparable result. Hearing gain is almost similar in both approaches -Endoscopic approach-10.80 dB; microscopic approach-11.23 dB.Both methods do not have any major complications. Endoscopic approach has advantage of depth and angled vision. Endoscopic approach (57.2 min.) also saves surgical time than microscopic approach (89.4 min.) and comparatively good cosmetic result. Microscopic approach has upper hand over endoscopic appr oach in having two hande d surgery with magnified surgical view. Patient compliance and satisfaction is more with endoscopic approach.Conclusion:Both microscopic and endoscopic methods are excellent for type-1 tympanoplasty with advantage and limitation of each method. A careful selection of patient is necessary for endoscopic approach.

Scorpion Bite Atypically Presenting As Acute Transverse Myelitis And Sub Arachnoid Hemorrhage: A Case Report And Review

Scorpion bite is an important health issue as it has been reportedthatabout tenpersons are killed by a venomous scorpion for each killed by a venomous snake.Scorpion venom may be cardiotoxic, hemotoxic, nephrotoxic or even neurotoxic. It acts on the autonomic nervous system producing parasympathetic and sympathetic manifestations.However, few have reported sub arachnoid haemorrhage and transverse myelitis occurring due to scorpion venom.Case Report:We are reporting a case of 50year old male who prese nted three days after an episode of scorpion bitewith paraplegia and inability to pass urine and stool due to transverse myelitis and subarachnoid hemorrhage. He was investigatedand treated accordingly. Clinical improvement was seen within tendays after the initiation of therapy. Conclusion:Scorpion sting,though rarely may present as SAH and transverse myelitis which are reversible and easily treatable.Clinical Significance:As scorpion bite is treatable,having high index of suspicion for scorpion sting inpatients of SAH and acute transverse myelitis in whom the cause of their clinical features could not be recognised may help in improving the outcome considerably in these cases.

Gastro-Protective Drug Utilization Study In Various Departments Of Tertiary Care Teaching Hospital

Introduction:Four out of ten prescriptions in indoor-patient departments contains gastro-protective drugs. Study aimed to detect classes of gastro protective drugs prescribed with other therapies, to assess trend of co-prescription of gastro-protective with NSAIDs, Anticipated drug interactions with the prescribed gastro-protective and most commonly prescribed gastro-protective group of drug.Materials and Methods: It is Prospective, Observational study, approximately 133 prescription analyzed. Written informed consent was taken from the eligible patients included in the study. Drugs data collected by reviewing the prescriptions prescribed. Gastro-protective duringstudy period. Rationality of drug use was assessed by referring to standard textbooks and guidelines.RESULTSOut of 200 prescriptions, 133 (66.5%) were found prescribing the gastro-protective drugs and more prescribed in the age group of 31-40 (39.84%). Gastro-protective drugs were co-prescribed with different classes of drugs of which NSAIDs (34.83%) were the most common. The Paracetamol (48.10%) were found to be the most commonly prescribedNSAIDs with gastro-protective drugs. The PPIs (66.66%) were found to be the most commonly prescribedgastro-protective. Drug interactions with co-prescribed drugs could be anticipated in 45 cases.Conclusion:The usage of gastro-protective is essential in drug therapy; however,over-use can increase adverse effects, drug interactions, and even wrong therapy.

Adverse Drug Reactions Monitoring In Pentavalent Vaccination Program At A Tertiary Care Teaching Hospital

ABSTRACT Introduction:Four out of ten prescriptions in indoor-patient departments contains gastro-protective drugs. Study aimed to detect classes of gastro protective drugs prescribed with other therapies, to assess trend of co-prescription of gastro-protective with NSAIDs, Anticipated drug interactions with the prescribed gastro-protective and most commonly prescribed gastro-protective group of drug.Materials and Methods: It is Prospective, Observational study, approximately 133 prescription analyzed. Written informed consent was taken from the eligible patients included in the study. Drugs data collected by reviewing the prescriptions prescribed. Gastro-protective during study period. Rationality of drug use was assessed by referring to standard textbooks and guidelines.RESULTSOut of 200 prescriptions, 133 (66.5%) were found prescribing the gastro-protective drugs and more prescribed in the age group of 31-40 (39.84%). Gastro-protective drugs were co-prescribed with different classes of drugs of which NSAIDs (34.83%) were the most common. The Paracetamol (48.10%) were found to be the most commonly prescribedNSAIDs with gastro-protective drugs. The PPIs (66.66%) were found to be the most commonly prescribedgastro-protective. Drug interactions with co-prescribed drugs could be anticipated in 45 cases. Conclusion:The usage of gastro-protective is essential in drug therapy; however,over-use can increase adverse effects, drug interactions, and even wrong therapy.

Imaging in neurofibromatosis type 1: An original research article with focus on spinal lesions

Background: Neurocutaneous syndromes encompass a group of disorders that affect the embryonic ectodermal plate, which includes the central and peripheral nervous systems, as well as the overlying skin. Materials and methods: All patients were known case of neurofibromatosis type 1. All patients for this study had undergone MRI whole spine with brain screening. Conventional radiographs were also taken when and where needed after taking informed consent. Results: In our study we found that 15 (60%) patients having lumbar neurofibromas, 7 (28%) patients having cervical neurofibromas, 2 (8%) patients having thoracic neurofibromas and 1 (4%) patients having sacral neurofibromas. Conclusion: MRI allows non-invasive detection of spinal neurofibromas and helps determine intrdural or extradural origin and their relationship to the neural foramina, spinal canal, and thecal sac and spinal cord. The target sign (bright on T2, with dark collagen centrally) is highly suggestive of a peripheral neurofibroma on MRI.

Sunitinib in metastatic renal cell carcinoma: Experience from single center study, efficacy and safety.

BACKGROUND: The 5‑year survival rate for metastatic renal cell carcinoma (RCC) is estimated to be <10%. RCC is highly resistant to chemotherapy. Targeted agents are now first choice of therapy for metastatic RCC such as sunitinib and sorafenib. METHODS: This study is a retrospective analysis of 15 patients having metastatic RCC treated with sunitinib. Apart from three patients, all had clear cell histology. Thirteen patients received dosage of 50 mg/d (4 weeks on/2 weeks off cycles). In 14 patients sunitinib was used as 1st line. The primary end point was objective response rate. Secondary end points were progression free survival (PFS) and safety. RESULTS: Until date of reporting, 3 out of 15 patients are currently on sunitinib. The most common Memorial Sloan = Kettering Cancer Centre poor prognostic factor was an interval of <1 year between diagnosis and starting of treatment (80%). The objective response rate was 13.66% (complete response [CR] + partial response [PR] = 0 + 2). Clinical benefit rate (CR + PR + stable disease) was 60% (n = 9). Median PFS in this study was 7.5 months, with a range of 2‑22 month. Median overall survival (OS) of patients in this study was 12 months with a range of 3‑24 month. An impact of the dose or/and number of cycles on response was seen in this study, with patients having average cycles >3 showing better response rates, PFS and OS. Major toxicities seen were fatigue ( n = 7), diarrhea (n = 3) and skin rash (n = 4) with majority patients experienced Grade 1‑2 toxicities. While Grade 3‑4 toxicities include fatigue (n = 1), mucositis (n = 1) and nausea (n = 1). CONCLUSIONS: These results confirm efficacy and safety profile of sunitinib in metastatic RCC, particularly as a first line. Sunitinib produced a 60% disease control rate for metastatic RCC in Indian patients, with acceptable rates of toxicity at a dose of 50 mg daily. Response rates were well matched to other studies confirming the efficacy of sunitinib.

Comparison of USG guided modified rectus sheath block with intraperitoneal instillation with Inj Bupivacaine for postoperative pain relief in diagnostic laparoscopy

Background: Laparoscopic surgery is associated with considerable postoperative pain, though it is less compared to open surgery. Post laparoscopic pain results from phrenic nerve irritation caused by residual gas, stretching of the intraabdominal cavity and peritoneal inflammation. The Modified Rectus Sheath Block (MRSB) is fairly easy and reliable procedure when performed using ultrasound guidance so it is compared with the intraperitoneal instillation method by using Inj. Bupivacaine for postoperative analgesia in diagnostic laparoscopy. Aim of the study was to assess and compare the effect of the USG guided modified rectus sheath block (MRSB) with the intraperitoneal instillation using Inj. Bupivacaine in diagnostic laparoscopy. Material and methods: It was prospective randomized study. The Patients were randomly allocated in two groups. Group A were given USG guided rectus sheath block and Group B was given Patel V, Mehta K, Patel K, Parmar H. Comparison of USG guided modified rectus sheath block with intraperitoneal instillation with Inj. Bupivacaine for postoperative pain relief in diagnostic laparoscopy. IAIM, 2016; 3(1): 85-89. Page 86 intraperitoneal 25 mg Bupivacaine. Patients with obesity, local anesthetic agent allergy and emergency surgeries were excluded. Pain was assessed 1, 6, 10 and 24 hours postoperatively by visual analogue pain score. Results: Postoperative pain was assessed by visual analogue pain score (VAS) at every hour for 24 hours postoperatively. The VAS was significantly lower in Group A at 6 and 10 hours postoperatively. After 6 hours the median pain score was 3 in group A while it was 7 in group B. After 8 hourrs the median pain score was 2 in group A compared with 5 in group B and after 10 hours the median score were 2 and 5 in group A, group B respectively (p<.001 and <0.004 respectively). No significant difference noted in pain score at 1 hour and 24 hour post laparoscopy among the two groups. Conclusion: USG guided modified rectus sheath block (MRSB) provides prolonged post operative analgesia than intraperitoneal instillation in diagnostic laparoscopy.

Single dose amoxicillin induced toxic epidermal necrolysis A rare life threatening dermatological condition.

Toxic epidermal necrolysis is a severe cutaneous drug reaction, mainly involving skin and mucous membranes. We have presented here a case report of 16 year old female patient who was diagnosed with toxic epidermal necrolysis clinically as well as histopathologically. The patient presented with history of fever, oral cavity ulcer, skin lesions which were ill defined, erythematous macular with darker hemorrhagic centre. Skin biopsy showed full thickness necrosis of dermis, dermal-epidermal separation and paucity of upper dermal cellular infiltration. The patient was treated with intravenous immunoglobulins, low dose steroids and systemic antibiotics and the patient improved significantly. The main purpose of the case report was to emphasize that even one single dose of amoxycillin can induce a toxic epidermal necrolysis.

Effect of breath holding during abdominal exercise on blood pressure and heart rate in hypertensive individuals.

Background: Abdominal exercises have become an important part of fitness and rehabilitation. Sit ups are most common abdominal exercise performed by people without proper training. Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiology in which the blood pressure in the arteries is elevated. Material and methods: An experimental study including 30 hypertensive males and females aged 30-60 years was done. Exclusion criteria were back pain, spinal disorders, diabetes, renal disease, cardiovascular disease. They were divided into two groups: Group 1 performed straight and oblique sit ups with breath holding. Group 2 performed straight and oblique sit ups without breath holding. Instructions were given to perform 10 repetitions of straight and oblique sit ups with 10 min rest period between. Heart rate and blood pressure were measured before and after each set of repetition. Wilcoxon Signed Rank Test was used for within group analysis and Mann-Whitney ‘U’ Test was used for inter group analysis. Results: For group A, W= -3.426, -3.458, -3.458 respectively for heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (BDP) and p=0.001 and for group B, W= -3.426, -3.475, - 3.464 and p=0.001. The U value for inter group analysis is U=103.00, 73.00, 81.00 respectively for HR, SBP and DBP and p= 0.68, 0.099, 0.183 respectively for HR, SBP and DBP. Conclusion: When performing the OPSU and SPSU exercises as used in this investigation hypertensive individuals may experience peak heart rate and blood pressure increases. Voluntary breath holding significantly increased the blood pressure elevations for both the exercises, but particularly for the OPSU.

Comparison of bone marrow aspiration cytology, touch imprint cytology and bone marrow biopsy for bone marrow evaluation.

Introduction: For diagnosis of hematological disorders there are three modalities to examine bone marrow, bone marrow aspiration cytology (BMA), bone marrow biopsy (BMB) and touch imprint cytology (BMI). BMA gives cytological picture, BMI also gives cytological picture but cells are less in number and BMB gives cytological as well as bone marrow architectural picture. BMA alone may not be sufficient to reach diagnosis therefore the present study was undertaken to compare the above three modalities. Material and methods: The present study was a prospective study done from January 2013 to December 2013. Total 51 cases, where BMA, BMI and BMB were performed on OPD and IPD patients at Dhiraj General Hospital, Vadodara were included. Complete clinical data were recorded including physical examination, complete hematological study along with other relevant investigations and proforma filled. Results: The various diseases diagnosed by BMA, BMI and BMB were megaloblastic anemia (19.6%), aplastic/ hypoplastic anemia (13.7%), iron deficiency anemia/ micronormoblastic erythroid hyperplasia (2.0%), dimorphic anemia (5.9%), idiopathic thrombocytopenic purpura (2.0%), plasma cell dyscrasias (3.9%), Myeloproliferative disorders (3.9%), leukemia (15.7%), normocellular marrow (13.7%), metastasis (15.7%) and miscellaneous (3.9%). Conclusion: BMA is found to be the superior procedure for evaluation of hematological disorders compared to BMI and BMB.

An unusual presentation of lupus vulgaris in pediatric patient: A clinico-histopathological diagnosis.

Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis which usually occurs in patients previously sensitized to Mycobacterium tuberculosis. We present a case of a 12 years old boy who was diagnosed as lupus vulgaris clinically as well as histopathologically simultaneously. He had well demarcated, irregularly bordered, pink, infiltrated plaques on the nose showing apple-jelly appearance on diascopy with multiple lymphadenopathy on bilateral submandibular and cervical group of lymph nodes. The histopathological examination showed tuberculoid granulomas with Langhans type giant cells. The Mantoux test showed positive reaction (20 mm) and no acid-fast bacilli was found in the lesion, either by direct stained smears or by culture. The lesions showed significant improvement on anti-tuberculosis treatment. The main purpose of this case report was to emphasize that histopathological examination has diagnostic value in clinical suspicion of LV on face, when direct analysis or culture is negative.

Solid pseudopapillary tumor of the pancreas: A retrospective analysis of 36 cases from a single institution in India.

BACKGROUND: Solid pseudopapillary tumor (SPT) of the pancreas is uncommon, occurring predominantly in young women. We analyzed the clinicopathological features of SPT diagnosed in our institution. MATERIALS AND METHODS: A retrospective analysis of all cases of SPT diagnosed in the Department of Pathology from January 2001 to September 2012, utilizing an electronic database search, was carried out. In all, 36 cases (35 resections and 1 fine needle aspiration cytology with cell block material) were found. All these cases were then analyzed for clinical presentation, duration and histopathological features, including immunohistochemistry and correlated with the clinical outcome. RESULTS: The mean age of patients (31 females) was 24.1 years. The SPT was suspected preoperatively in 25% of cases. Tumor location was equally common in head (15), body (9), tail (8), distal body and tail (3), and neck (1). Thirty five patients underwent resection. The mean tumor size was 7.16 cm. Grossly, the tumors were solid and cystic (22), predominantly solid (11) or entirely cystic (2). Histologically, pseudopapillary structures, cholesterol clefts, hemorrhage, necrosis, and foam cells were commonly seen. Infiltration into the adjacent pancreas or capsule and perineural invasion were seen in some cases. Immunostaining for CD 10, CD56, and vimentin were positive. Chromogranin and cytokeratin were negative. Follow up in 20 patients from 2-82 months did not show evidence of recurrence or metastasis, even in those with limited surgery or minimal parenchymal or focal perineural infiltration. CONCLUSION: This study suggests that a management approach with only limited complete tumor resection would be adequate in these tumors.

Demographics of animal bite victims & management practices in a tertiary care institute in Mumbai, Maharashtra, India.

Background & objectives: Rabies is an important public health problem worldwide and more than 55,000 people die annually of the disease. The King Edward Memorial Hospital, Mumbai, is a tertiary referral centre where a rabies clinic runs 24 hours. In view of lack of information about the demographics of the disease in an urban environment the present study was carried out. Methods: Data on 1000 consecutive animal bite victims presenting to the institute in 2010 were collected over a 15 wk period. An electronic database was specially created for capturing information and was modelled on the information available from the WHO expert consultation on rabies, 2005. Economic burden from the patients’ perspective was calculated using both direct and indirect costs. Results: The victims were largely males (771 subjects). The dog was the major biting animal (891, 89.1%).Bites were mainly of Category III (783, 78.3%). One twenty three subjects used indigenous treatments only for local wound care. Of the Category III bites, only 21 of 783 (2.7%) patients were prescribed human rabies immunoglobulin (HRIG) which was primarily for severe bites or bites close to or on the face. A total of 318 patients did not complete the full Essen regime of the vaccine. The median cost to the patient per bite was ` 220 (3.5 USD). Interpretation & conclusions: Our findings showed that the use of HRIG was low with less than 2 per cent of the Category III patients being prescribed it. As vaccine and HRIG continue to remain expensive, the intradermal vaccine, shorter regimes like the Zagreb regime and monoclonal antibodies may offer safer and cost-effective options in the future. Further studies need to be done in different parts of the country.

A cross sectional study on the prevalence of reproductive tract infections amongst married women in the rural area of Surendranagar district.

Background: In the recent years, the issue of gynaecological problems of poor women in the developing countries has been receiving increasing attention. High levels of gynaecological morbidity, especially reproductive tract infections and sexually transmitted infections may turn out to be fatal if not treated properly. Objectives of current study were to find out the prevalence of reproductive tract infections amongst married women, to co-relate the disease with certain socio demographic variables and to assess the awareness about reproductive tract infections in the study population. Methods: Sample size - Various community based studies carried out in the different regions world showed the prevalence of reproductive tract infections 36-84%. The sample size of study as per statistical calculation (4pq/l2, where p =50, q=100-p and l= 10% of p) came out to be 400. Method of Sampling - Prior enlisting all villages of Surendranagar district, one village was selected randomly. After random selection the village found was Khodu. Results: 56.5% of women reported either one or more symptoms of reproductive tract infections; vaginal discharge (29.7%) was the commonest symptom. Basic awareness about disease was 64.0%; Maximum prevalence of reproductive tract infections (62.90%) was found in the age group of 25-34 years. Conclusions: There is a significant association between socio-economic class, educational status and women having symptoms of reproductive tract infections.

Diabetic foot resulting in amputation: our experience.

Background: The aim of our study was to early diagnosis of diabetic foot so that the complications can be prevented, to control the systemic infection and prevent the complications, to study the effectiveness of regular dressing in diabetic foot so as to prevent the local spread of infection and the ulcer and to conclude that early diagnosis, care and proper meticulous treatment of diabetic foot can prevent amputation. Methods: The present study was prospective, observational and longitudinal. Protocol of the procedure was formed along with Performa, Patient Information Sheet, Informed Consent Form and approval from Ethical Committee. The present study was carried out in surgery department of C.U Shah medical college, Surendranagar; Gujarat state. The study was carried out from 1st August 2011 to 30th September 2013. A total of one hundred patients admitted in surgery ward with diabetes type 1 or 2 with ulcer on foot having grade 1 or 2 of Wagner’s classification without any other co morbid condition. These patients undergo daily dressing with various dressing solutions according to their ulcer characteristics. All the patients given diet/oral hypoglycaemic drug/insulin for control of diabetes. Antibiotics given according to the infective status of the patients. Patients were either completely treated, went under skin grafting or ended up with amputation were recorded. Results: Of 100 cases studied, youngest patient was 32 years and oldest was 80 years of age. Highest number of cases was found in the age group 61-70 years (30%). Of the 100 cases studied in this series 36 (36%) patient were having Wagner’s class 1 ulcer and 64 (64%) patient having class 2 ulcers. Of 100 cases, various surgical treatment given to the patients according to the ulcer. In that 65(65%) debridement, 20 (20%) Incision & drainage, 10 (10%) STG, 5 (5%) fasciotomy. Most of the patients were undergone basic surgical procedure which is debridement on the 7th day follow up, out of 100 cases 70 patients came for follow up. Out of 70, all patients having healing ulcer. Out of 70 patients, 15(21.43%) patients were underwent STG on 15th day and other 55 (71.57%) patients having healing ulcer advised daily dressing with follow up after 1 week. Out of 30 patients, 3 (10%) patients underwent amputation on 7th day of follow up. On the 15th day new 5 (16.67%) patients underwent amputations, so total number of amputation done till date was 8 (26.67%). On 21st day, new 7 (23.34%) patients were underwent amputations and total number of amputations till date were 15 (50%). On 30th day, new 15 (50%) patients underwent amputations. Conclusions: Foot ulceration in diabetic patients is a resource consuming, disabling morbidity that often is the first step towards lower extremity amputation. Prevention is the best treatment.

Polymeric nanoparticle formulation of Octapeptide (NP-OP): In vitro release and in vivo effect in common marmosets, Callithrix jacchus Linn.

yielded an average particle size of 120 nm with 70% encapsulation-efficiency. In vitro release profile of NP-OP showed sustained release of OP for 21 days. In vivo anti-fertility studies were conducted in marmosets. Results indicated that control animals conceived in the same cycle while two of three treated animals failed to conceive in treatment cycle. The in vivo studies thus corroborate with in vitro release of OP, demonstrating its anti-fertility activity in 66% of animals.

Health seeking attitude of women regarding reproductive tract infections in a rural area of Surendranagar district.

Background: In the recent years, the issue of gynaecological problems of poor women in the developing countries has been receiving increasing attention. High levels of gynaecological morbidity, especially reproductive tract infections and sexually transmitted infections may turn out to be fatal if not treated properly. The objective of this study was to assess the health seeking attitude of women regarding reproductive tract infections, to elicit the past history pertaining to it, to assess the personal hygiene measures relevant to it. Methods: Various community based studies carried out in the different regions world showed the prevalence of reproductive tract infections 36-84%. The sample size of study as per statistical calculation (4pq/l2, where p =50, q=100-p and l= 10% of p) came out to be 400. Prior enlisting all villages of Surendranagar district, one village was selected randomly. After random selection the village found was Khodu. Results: 75.3% of women narrated treatment was necessary; 44% told that preferably to be taken from doctor and 24.7% told treatment should not be taken because of social and personal reason. 56.5% of women having one or the other kind of symptom of reproductive tract infections. Women with poor menstrual and personal hygiene has got 2.5 times chances of reproductive tract infections (OR= 2.35, CI= 1.374-4.01, P value: 0.001). Thus the overall prevalence in our study is 56.5%. On statistical analysis it was found that women who used clothes were two times more symptomatic as compared to women who used sanitary pads, a significant association between women having symptoms of reproductive tract infections and their sexual history. The present study showed 61.94% of women had taken treatment which shows that the health seeking behavior had improved. Conclusions: Women who used sanitary pads during menstrual periods had lower prevalence. Women with complaints of dyspareunia, bleeding during and or after intercourse and history of forceful intercourse had maximum prevalence of reproductive tract infections. 19.8% of women gave past history of reproductive tract infections and out of that 15.16% of women had taken treatment for it. Regarding health seeking attitude of symptomatic women, 61.94% of women had taken treatment and majority of them had taken treatment from doctors. This implies that health intervention measures directed towards reducing morbidity from reproductive tract infections need not focus mainly on treatment of reproductive tract infections but rather on disease preventing strategies.