A STUDY OF HEMATOLOGICAL AND BIOCHEMICAL PARAMETERS IN ASSESSING SEVERITY IN COVID-19 PATIENTS

Background: The severity of COVID-19 could be evaluated by examining several blood parameters mainly white blood cell (WBC) count, granulocytes, platelet, and novel hemocytometric markers neutrophils to lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR),lymphocyte to monocyte ratio (LMR) and biochemical parameters such as CRP,D-dimer,Serum ferritin, LFT, KFT etc. The present study has been carried out Methods and Material: on 100 RTPCR conrmed covid-19 patients over a period of one year from July 2021 to June 2022. Clinical features, investigations, and history of associated risk factors were extracted from case records.Samples were processed in Medonic M series ve part haematology analyzer.SELECTRA PRO M and ARCHITECT plus machine was used for LDH, AST, ALT,C- reactive protein (CRP),Serum creatinine and serum urea.Samples for electrolytes were processed in INNOLYTE MACHINE. The sample for D-dimer and PT INR were processed in STA SETELLITE Max haemostasis analyser. Samples for procalcitonin were processed in CARDIAMARKER HIA-1200 machine.Chi squre test was used for analyzing signicant correlation among different parameters and covid-19 severity.P value<0.05 was dened as statistically signicant for all statistical test. Statistical analysis used: Results:Retrospective observational study Among 100 RTPCR conrmed cases,40,36,20 and 4 were mild, moderate, severe and critical respectively.Total total neutrophils count signicantly raised in critical patients(p value<0.05) while absolute lymphocyte count was signicantly decreased in critical patients(p value<0.05).NLR was signicantly raised in critical patients and LMR,PLR were also signicantly related to disease severity.CRP,S.ferritin and D- dimer were signicantly raised in critical patients(p value<0.05).Besides above parameters, Serum LDH,Serum electrolytes,AST,AL,.PT-INR were also raised in critically ill patients(p value<0.05). The severity of COVID-19 can Conclusions: be identied at an early stage by following the different routine biochemical marker levels and subsequently improve prognosis.parameters

An interpretive phenomenological analysis of hope in cancer patients: A qualitative study

Background: In positive psychology, increased recognition of the phenomenon of hope among people suffering from cancer, along with alleviating their negative mental states like anxiety, depression, and fear of death is evident and promising. The aim of the study was to explore the lived experience of hope in cancer patients. Materials: Qualitative phenomenological research approach was used. A semi-structured in-depth interview with open-ended questions was administered to explore the patient抯 hope related experiences during the journey of cancer. A purposive sampling technique was used to select a total of 10 participants for the study. The size of the sample was decided on the basis of literature for the interpretive phenomenological study. Results: Results revealed five major common themes related to hope during illness: (1) survival expectation; (2) will to live; (3) prognostic clarification; (4) positivity of health providers; and (5) recovery of other patients: A source of hopefulness. Conclusion: The lived experiences of cancer patients shows that hope is the positive expectation of survival, which is a source of motivation during their journey of illness. It also denotes goal setting behaviour. Thus, hope is the 搘ill to live� which is related to social support, positive communication with healthcare providers, and recovery of fellow patients.

Comparative evaluation of displacement and stress distribution pattern during mandibular arch distalization with extra and inter-radicular mini-implants: a three-dimensional finite element study

ABSTRACT Objective: To compare the initial stress distribution and displacement on mandibular dentition using extra and inter-radicular mini-implants for arch distalization, by means of finite element analysis. Methods: For this study, two finite element models of the mandible were designed. The models consisted of periodontal ligament (PDL) and alveolar bone of all teeth until second molars. In the Case 1, bilateral extra-radicular buccal-shelf stainless steel mini-implants (10.0-mm length; 2.0-mm diameter) were placed between first and second permanent molars. In the Case 2, bilateral inter-radicular stainless steel mini-implants (10.0-mm length; 1.5-mm diameter) were placed between second premolar and first permanent molar. Power hook was attached between canine and first premolar at a fixed height of 8mm. In the two cases, 200g of distalization force was applied. ANSYS v. 12.1 software was used to analyze and compare von Mises stress and displacement in the mandibular dentition, PDL and bone. Results: Higher stresses were observed in mandibular dentition with the inter-radicular implant system. The amount of von Mises stress was higher for cortical bone (85.66MPa) and cancellous bone (3.64MPa) in Case 2, in comparison to cortical bone (41.93MPa) and cancellous bone (3.43MPa) in Case 1. The amount of arch distalization was higher for mandible in Case 1 (0.028mm), in comparison to Case 2 (0.026mm). Conclusion: Both systems were clinically safe, but extra-radicular implants showed more effective and controlled distalization pattern, in comparison to inter-radicular implants, in Class III malocclusion treatment.

RESUMO Objetivo: Comparar a distribuição da tensão inicial e o deslocamento na dentição inferior usando mini-implantes extra e inter-radiculares para distalização da arcada, por meio da análise de elementos finitos. Métodos: Dois modelos de elementos finitos da mandíbula foram criados, os quais consistiram de ligamento periodontal (PDL) e osso alveolar de todos os dentes até os segundos molares. No Caso 1, mini-implantes extra-radiculares de aço inoxidável (10,0 mm de comprimento; 2,0 mm de diâmetro) foram colocados bilateralmente na buccal-shelf entre o primeiro e o segundo molares permanentes. No Caso 2, mini-implantes de aço inoxidável inter-radiculares (comprimento de 10,0 mm; diâmetro de 1,5 mm) foram colocados bilateralmente entre o segundo pré-molar e o primeiro molar permanentes. Um Power hook foi preso entre o canino e o primeiro pré-molar a uma altura fixa de 8mm. Nos dois casos, foi aplicada força de distalização de 200g. O software ANSYS v. 12.1 foi usado para analisar e comparar a tensão de von Mises e o deslocamento na dentição inferior, ligamento periodontal e osso. Resultados: Maiores tensões foram observadas na dentição inferior com o sistema de implantes inter-radiculares. A quantidade de tensões de von Mises foi maior para osso cortical (85,66MPa) e osso esponjoso (3,64MPa) no Caso 2, em comparação com osso cortical (41,93MPa) e osso esponjoso (3,43MPa) no Caso 1. A quantidade de distalização da arcada inferior foi maior no Caso 1 (0,028 mm), em comparação com o Caso 2 (0,026 mm). Conclusão: Ambos os sistemas foram clinicamente seguros, mas os implantes extra-radiculares mostraram um padrão de distalização mais eficaz e controlado, em comparação com os implantes inter-radiculares, para tratamento da má oclusão de Classe III.

In vitro and in vivo anticancer potential and molecular targets of the new colchicine analog IIIM-067 / 中西医结合学报

OBJECTIVE@#The current study evaluated various new colchicine analogs for their anticancer activity and to study the primary mechanism of apoptosis and in vivo antitumor activity of the analogs with selective anticancer properties and minimal toxicity to normal cells.@*METHODS@#Sulforhodamine B (SRB) assay was used to screen various colchicine analogs for their in vitro cytotoxicity. The effect of N-[(7S)-1,2,3-trimethoxy-9-oxo-10-(pyrrolidine-1-yl)5,6,7,9-tetrahydrobenzo[a] heptalene-7-yl] acetamide (IIIM-067) on clonogenicity, apoptotic induction, and invasiveness of A549 cells was determined using a clonogenic assay, scratch assay, and staining with 4',6-diamidino-2-phenylindole (DAPI) and annexin V/propidium iodide. Mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) levels were observed using fluorescence microscopy. Western blot analysis was used to quantify expression of proteins involved in apoptosis, cell cycle, and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling. Pharmacokinetic and in vivo efficacy studies against Ehrlich ascites carcinoma (EAC) and Ehrlich solid tumor models were conducted using Swiss albino mice.@*RESULTS@#IIIM-067 showed potent cytotoxicity and better selectivity than all other colchicine analogs screened in this study. The selective activity of IIIM-067 toward A549 cells was higher among other cancer cell lines, with a selectivity index (SI) value of 2.28. IIIM-067 demonstrated concentration- and time-dependent cytotoxicity against A549 cells with half-maximal inhibitory concentration values of 0.207, 0.150 and 0.106 μmol/L at 24, 48 and 72 h, respectively. It also had reduced toxicity to normal cells (SI > 1) than the parent compound colchicine (SI = 1). IIIM-067 reduced the clonogenic ability of A549 cells in a dose-dependent manner. IIIM-067 enhanced ROS production from 24.6% at 0.05 μmol/L to 82.1% at 0.4 μmol/L and substantially decreased the MMP (100% in control to 5.6% at 0.4 μmol/L). The annexin V-FITC assay demonstrated 78% apoptosis at 0.4 μmol/L. IIIM-067 significantly (P < 0.5) induced the expression of various intrinsic apoptotic pathway proteins, and it differentially regulated the PI3K/AKT/mTOR signaling pathway. Furthermore, IIIM-067 exhibited remarkable in vivo anticancer activity against the murine EAC model, with tumor growth inhibition (TGI) of 67.0% at a dose of 6 mg/kg (i.p.) and a reduced mortality compared to colchicine. IIIM-067 also effectively inhibited the tumor growth in the murine solid tumor model with TGI rates of 48.10%, 55.68% and 44.00% at doses of 5 mg/kg (i.p.), 6 mg/kg (i.p.) and 7 mg/kg (p.o.), respectively.@*CONCLUSION@#IIIM-067 exhibited significant anticancer activity with reduced toxicity both in vitro and in vivo and is a promising anticancer candidate. However, further studies are required in clinical settings to fully understand its potential.

Assessment of anti-inflammatory activity of Tridax procumbens in wistar rats

Background: Tridax procumbens Linn. is a spreading herb found throughout India. Tridax procumbens is known for several potential therapeutic effects like antiviral, antioxidant, anti-infective, wound healing, insecticidal and anti- inflammatory, hepatoprotective, and antidiabetic. Novel therapies for inflammation are essential to overcome the adverse effects of existing anti-inflammatory drugs. Thus, this study was designed to evaluate anti-inflammatory activity in the experimental animal. Objective: To evaluate anti-inflammatory efficacy in experimental animal Materials and Methods: Tridax procumbens plant leaves were taken for the study. The Plant extraction was prepared by using the Soxhlet apparatus. The ethanolic extract was used as a test drug. Indomethacin and Dexamethasone were used as control drugs. Wistar rats weighing 150g to -200g were used in the study. Results: At dosages of 200 and 400 mg kg-1 , the ethanolic leaf extracts of Tridax Procumbens demonstrated substantial anti-inflammatory activity against Irish Moss-triggered inflammation. After 3 hours, 400 mgkg-1 showed a significant reduction in inflammation (48 percent), with the impact increasing after 3 hours (52 percent). The anti-inflammatory efficacy of Tridax Procumbens ethanol (EtOH) extracts was substantial and comparable to that of indomethacin (10 mg/kg). Tridax procumbens ‘s Ethanol (EtOH) leaf extract at a dose of 200 and 400 mgkg-1 , demonstrated considerable anti-inflammatory action. The average weight of granulomatous surrounding tissue in the threading was considerably smaller in the Tridax procumbens extraction group after 7 days than in the comparison group. The 400 mg kg-1 dose was shown to be the most effective of the two. the greatest reduction in the production of granuloma tissue. Tridax procumbens at doses of 200 mg/kg and 400 mg/kg resulted in substantial reductions in granuloma weights of 38.16 ± 0.04 (7.4 percent inhibition) and 34.58 ± 0.04 (16.1 percent inhibition), respectively. The lower dose of 400 mg/kg resulted in a little lesser reduction in granumola weight than the conventional medication dexamethasone (28.92 ± 0.04). (29.8 percent inhibition). Conclusion: The present study concludes that Tridax Procumbens possess anti-inflammatory effects in animal models.

Microbial Profile of Neonatal Septicemia and its Antibiogram Prevalent in a Tertiary Care Hospital of Western Odisha

Introduction : A disseminated disease with positive Blood Culture during the first month of life and encompasses various systemic infections of the newborn such as septicemia, meningitis, pneumonia, arthritis, osteomyelitis and Urinary Tract Infection is defined as Neonatal Sepsis. It is one of the leading causes of morbidity and mortality amongst neonates of developing countries. Aim : To determine the microbial profile of Blood Culture-positive Septicemia cases and study their antimicrobial susceptibility pattern. Materials and Methods : Blood Culture and C-reactive Protein (CRP) estimation were done for all 220 clinically suspected neonates. All the pure Bacterial and Candida isolates were identified using standard biochemical tests. Antimicrobial susceptibility testing was done for all bacterial isolates using the Kirby-Bauer disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results : Out of 220 cases, 68.2% were culture positive. Early-onset Neonatal Septicemia (EONS) cases were 74% and Late-onset Neonatal Septicemia (LONS) 26%. The male to female ratio was 1.9:1. Bacterial cases were 66% and 34% were due to Candida. Gram-negative isolates predominated, with Klebsiella pneumonia being the most common one. In the case of Gram-positive isolates, Staphylococcus aureus was most common. The best overall sensitivity of Gram-negative isolates was to Amikacin (100%), Colistin (100%), and Imipenem (96%). Grampositive isolates reported 100% sensitivity to Vancomycin, Teicoplanin and 97.4% to Linezolid. Conclusion : Gram-negative isolates were the leading cause of Sepsis in our study. Strict antimicrobial stewardship should be implemented to prevent the emergence of multi-drug resistant strains.

FEELINGS OF ABUSE AND ITS ROLE IN THE ACCEPTANCE OF SELF AMONG FEMALE SEX WORKERS IN INDIA

Approximately three billion female sex workers are working willingly and unwillingly in India. Research has shown that female sex workers have to face stereotypes and violence from society. Due to this, they feel more depressed, yet they are not able to report everything to police personnel because of the unequal treatment because society considers them taboo. Keeping in mind, the present research aims to investigate the role of feelings of abuse and acceptance of self among female sex workers in India. A sample of 300 women (100- female sex workers, 100-working women, and 100- homemaker women) belonging to the age group of 25-40 was randomly selected from the women living in the Delhi NCR region on an availability basis. Composite Abuse Scale (Revised) Short Form and Unconditional Self-Acceptance Questionnaire were used to collect the data. After applying the Composite Abuse Scale (revised) and Unconditional Self-Acceptance Questionnaire, unconditional self-acceptance found a significant association with all dimensions of CAS among female sex workers. In this sense, working women are found higher on self-acceptance than the other two groups. Also, obtained results showed a significant difference in abuse among female sex workers, working women, and homemaker females, and all variables, female sex workers have found a significantly higher mean than homemakers and working women which stated that female sex workers are mentally, physically and sexually harassed daily which led to bad health consequences.

Solubility enhancementofcefixime trihydrate by solid dispersions using hydrotropic solubilization technique and their characterization

Abstract The aqueous solubility of cefixime trihydrate (a water insoluble drug) using different hydrotropic agents was determined and solid dispersions of cefixime trihydrate were prepared by hydrotropic solubilization technique. The drugs content were determined. The aqueous solubility of v was increased many fold in presence of sodium acetate trihydrate as hydrotropic agent. This hydrotropic agent was used to prepare solid dispersion of cefixime trihydrate. Cefixime trihydrate and sodium acetate trihydrate were accurately weighed and taken in a 200 mL beaker. Distilled water 10-15 mL was taken to dissolve hydrotropic agent using heat (48-50 °C). The drug was then added to it and magnetically stirred till whole mass get viscous. The solid dispersions of cefixime trihydrate were characterized by XRD, DSC and IR studies. DSC thermogram, XRD and Infra-Red spectra were studied. Solid dispersions, thus prepared, showed faster release of the drug as compared to pure drug and physical mixture.

Family Members’ Satisfaction Levels : Impact Of An Intensive Care Unit Information Leaflet With Verbal Information Compared To Conventional Verbal Information

@#Introduction: Patients admitted to the Intensive Care Unit (ICU) experience intense physical stress. Family members of these patients also experience stress during the admission. Therefore, it is an important task of the ICU staff to provide the family members with appropriate and clear information. There are many methods to do this. This study aimed to compare the impact of two methods of information sharing on the satisfaction levels among families of ICU patients. The novel method being introduced and investigated was a locally designed information leaflet in combination with verbal explanation. This new method was compared with the traditional method of verbal explanation only. Methods: This was a randomized controlled study, conducted at the ICU of Teluk Intan Hospital. A total of 60 participants were enrolled, with 30 participants each in the intervention and control group. The Malay version of the Validated Critical Care Family Satisfaction Survey (CCFSS) was used to measure family satisfaction with the care received during their ICU admission. Results: The intervention group reported significantly higher level of satisfaction in all of the components (Assurance, Proximity, Information, Support and Comfort). Upon further examination of the results of the intervention group, the scores in the Assurance, Proximity and Comfort component were significantly higher compared to the scores in the Information and Support component. Conclusion: Integrating an information leaflet with the traditional verbal method of delivering information has proven to provide a significant difference in satisfaction levels to the family members of patients who were admitted to the ICU.

Determinants of COVID-19 Vaccination Willingness among Health Care Workers: A Quick Online Survey in India / 가정의학회지

Background@#The coronavirus disease 2019 (COVID-19) pandemic has caused a large number of deaths along with severe socio-economic effects. The vaccine is considered to be the last hope to control viral transmission. This study aimed to explore the determinants of health care workers’ (HCWs) willingness to take the COVID-19 vaccination. @*Methods@#A structured, pre-validated, and pre-tested questionnaire was administered online to 599 HCWs including physicians, residents, and nurses from different types of healthcare set-ups across India. Information was collected regarding vaccine acceptability, attitude toward vaccination, and reasons for hesitancy. The chi-square test, followed by multinomial regression analysis, was applied to determine the factors associated with HCWs’ vaccination willingness. @*Results@#It was found that 73 % (n=437) of HCWs were willing to accept the vaccines, while 10.85% (n=65) refused and 16.2% (n=96) needed more time to decide. Gender (P<0.001), occupation (P=0.040), working as front-line workers (P=0.008), vaccine manufacturing country preferences (P<0.001), and perceived risk of catching COVID-19 in the next 6 months (P=0.005) had a significant association with intent to receive vaccination (the response were “yes” vs. “no” and “not sure”). The reasons for vaccine hesitancy were vaccine safety and efficacy concerns, antivaccine attitude and beliefs, personal choice, and not wanting to take a vaccine before others. @*Conclusion@#The majority of HCWs agreed to take COVID-19 vaccines once available. Nevertheless, providing support to manage evolving vaccine environments will help change the perception of HCWs who refuse or are reluctant to take the vaccines.

Stakeholders’ Perceptions of the Implementation of a Patient-Centric Digital Health Application for Primary Healthcare in India / 대한의료정보학회지

Objectives@#Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation. @*Methods@#Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding. @*Results@#Healthcare workers highlighted that working with the digital health system was initially arduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports, rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computers saved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensive about the use of computer-based data for monitoring their work performance. Patients appreciated that their previous records were now available on the computer for easy retrieval. @*Conclusions@#The usefulness of the digital health application was appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibility in delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependence on computers and digital technicians.

A Novel Natural Product for Bone Regeneration in Dentistry - A Review

Herbal medicine has been regarded as a safer and more natural method to promote health and alleviate illness and has gained notable popularity. Plants continue to be the primary source of new chemicals and drugs and hence play a pivotal role in the continual improvement in therapeutic medicine. India has a huge asset of indigenous plants and minerals which have been broadly used for therapeutic claim. One such plant which has immense benefits derived from it is Cissus quadrangularis [CQ] colloquially known as hadjod or pirandai. CQ is one of the most significant plants. However, practically the entirety of its parts are utilized in medicine among which seeds, stems, roots, and shoots are the most significant parts. Concentrates and powders of Cissus quadrangularis have been utilized for a long time to aid bone and tissues healing, as an antioxidant, for relieving pain & swelling, to fight against infection, as an anabolic, and also to help in weight reduction. The most important usage has been for bone regeneration and fracture healing. Numerous studies have been done to prove its pharmacological effects and to substantiate its use clinically. The aim of this review is to elaborate on CQ, its ethnopharmacology, phytochemistry and principle constituents, pharmacological actions, formulations and to review previous literature such as animal studies, in vitro studies and clinical trials to understand in detail about the applications of this plant in medicine and dentistry

Pregnancy outcome of external cephalic version in singleton pregnancy with breech presentation at term

Background: Breech delivery is associated with poor perinatal outcomes irrespective of the route of delivery. External cephalic version can be a useful tool in management of breech presentation at term by converting it to a cephalic presentation. A study was conducted to evaluate maternal and neonatal outcome of external cephalic version in singleton pregnancies with breech presentation in third trimester.Methods: A prospective observational study was carried out at a tertiary care hospital over a period of 2 years. This study included a total of 65 uncomplicated cases of breech presentation who fulfilled the inclusion criteria. External cephalic version was carried out after 36 weeks of period of gestation in primigravida and after 37 weeks in multigravida women. These patients were followed up till delivery and data was collected and analysed regarding the mode of delivery, maternal and fetal outcome.Results: External cephalic version was successful in 41 patients with a success rate of 63%. Out of them, vaginal delivery could be achieved in 31 cases (75.6%) and LSCS was done for rest of the 10 cases. The success rate was higher in multigravida ladies compared to primigravida ladies. No major procedure related adverse event was noticed in our study.Conclusions: External cephalic version is a very safe and easy procedure which can reduce the rate of cesarean delivery in singleton pregnancies with breech presentation. The results of this study are in favor of wider practice of this procedure in selected cases.

Clinical profile of hypochromic microcytic anemia in Chittoor district, India

Background: Anemia is not a diagnosis by itself like fever but merely is an objective sign of the presence of disease. The correct diagnostic terminology for a child with anemia requires the detection of etiology, pathology, and pathogenesis of the anemia. To evaluate the role of therapeutic oral iron therapy as a diagnostic approach to hypochromic microcytic anemia.Methods: The present study is a retrospective study conducted at the teaching hospital, Chittoor district from September 2019 to December 2019. A total number of 350 cases of anemia were studied from both inpatient and outpatient services in the age group 2 months to 12 years. Hemogram, Hb Electrophoresis, and bone marrow study as necessary based on individual cases.Results: From the above analysis, the mean Hb% at the time of entry to study was 7.36gms%. The mean Hb% after the iron therapy was 11.8gms%. The mean increase in Hb was 4.4gms%. In this study, the average RBC count was 2.9 million cells/cumm.Conclusions: A therapeutic trial of oral iron is an appropriate initial step in the diagnostic approach of hypochromic microcytic anemia. Costly investigations like Hb electrophoresis and bone marrow study are required only in selected cases.

Correlation of serum level and selective blood indices in children with feberile seizures in Chittoor district, India

Background: A seizure or convulsion is a paroxysmal, time-limited change in motor activity and/or behavior that result from abnormal electrical activity in the brain. Seizures are common in the pediatric age group and occur in approximately 10% of children. Most seizures in children are provoked by somatic disorders originating outside the brain, such as high fever, infection, syncope, head-trauma, hypoxia, toxins, or cardiac arrhythmias. To study the association between iron deficiency and the first febrile seizure.Methods: The present study is a retrospective study conducted at the teaching hospital, Chittoor district from August 2019 to December 2019. In this study to detect low iron status as a possible risk factor for first febrile seizures, 63 cases, and 63 age and sex-matched controls are studied and analyzed.Results: In this study family history of febrile seizures is seen only in 28.5% of cases. The mean serum ferritin level in this study is 14.5ng/ml. Thus the mean serum ferritin, HB, and MCV are found to be signed on the lower side among children with febrile seizures.Conclusions: Plasma ferritin level and blood indices are significantly lower in children with febrile seizures as compared to children without febrile seizures suggesting that iron-deficient children are more prone to febrile seizures.

Muscular Dystrophy- Facioscapulohumeral Dystrophy - A Rare Autosomal Dominant Disorder

A 24-year-old man presented to the Medicine OPD of Sanjay Gandhi Memorial Hospital, Rewa (M.P.), with complaints of weakness of limbs and decrease in muscle mass from past 12 years. He was apparently normal till the age of 8 years, after which, he started developing weakness in the limbs.Weakness of limbs was insidious in onset and gradually progressive in nature, due to which he had to leave schooling. He noticed that he could not get up from sitting position without support, and was unable to climb stairs. The weakness gradually progressed and currently patient is finding it difficult to even walk. It is associated with difficulty in lifting arms above shoulder, combing hair as well as holding heavy objects. He also has complaints of inability to smile, whistle, hold air in mouth, incomplete closure of eyes as well as difficulty in chewing. There was no history of any distal muscle weakness, numbness, abnormal body movement, dysphagia, dysarthria, nasal regurgitation, chest pain, palpitation, breathlessness, bladder and bowel involvement. He is also having no history of any recurrent hospital admission.

Role of urinary nitrites in predicting steroid responsiveness of nephrotic syndrome: a study conducted in tertiary care center

Background: Nephrotic Syndrome (NS) is a common chronic disorder, characterized by alterations of selective permeability at the glomerular capillary wall, resulting in its inability to restrict the urinary loss of protein. Urinary nitrite excretion serves as a useful investigation in differentiating between steroid responsive and steroid resistant nephrotic syndrome. The aim of the study was to assess the relation between urinary nitrite levels and steroid responsiveness in nephrotic syndrome in children.Methods: 76 children were enrolled in the study suffering with nephrotic syndrome of which 58 children were Steroid Sensitive (SSNS) and 18 were Steroid Resistant (SRNS). 25 children were enrolled as controls. The urinary nitrites were estimated in these subjects and the results were analyzed.Results: All the control subjects were tested negative for urinary nitrites. After achieving remission with steroids, out of 58 SSNS subjects' 27 subjects tested positive for urinary nitrites, remaining 31 tested negatives for the same. Of the 18 SRNS subjects 1 subject tested positive for urinary nitrites remaining 17 subjects were tested negative for the same.Conclusions: The findings of present study suggest that urinary nitrite excretion is increased in patients with steroid responsive nephrotic syndrome. The urinary nitrite estimation has low NPV and high PPV in predicting steroid responsiveness.

Applicability of respiratory severity score and modified TAL criteria in pediatric age group for grading and management of acute respiratory illness

Background: Acute respiratory tract infections (ARI) are the leading cause of death in children in the world (11.9 million per year) with the greatest number of deaths occurring in developing countries like India. We compared respiratory severity scoring system RSS (Respiratory Severity Score) with Modified TAL, so that we can find out which of the above scores are better and whether they can be implemented to assess pediatric ARI patients.Methods: This prospective observational study was conducted in Pediatrics wards, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra and data were collected from 290 children below 12 years of age by purposive sampling. All the children presenting with respiratory symptoms were subjected to these scoring system (RSS AND MODIFIED TAL) at the time of admission and were classified based on the scores obtained in respective scoring system. Data was analysed using frequencies, percentages and contingency tables and comparison was made between the above scoring systems to find which one is better applicable in pediatric ARI patient.Results: Incidence of pediatric patients presenting with only respiratory tract infections who are admitted in ward was 25.15 %, with more incidence being reported in children below 12 months (49.31%), males more affected. For both the ARI scoring systems (RSS and MOD TAL) as the severity increased so is the number of patients requiring oxygen and duration of hospitalization increased significantly (p<0.05), with RSS having stronger association.Conclusions: Both the scoring systems predicted that on admission if the score is more than chances of requirement of oxygen is more and also duration of hospitalization is more, with RSS being better predictor.

Technology- Can it Emancipate the Void in India s Mental Healthcare Delivery?

Mobile application-based delivery of mental health awareness programs may help in reducing the knowledge gap in mental healthcare in India. Apps can be used to educate our community about mental health first aid protocols. Apps have shown effectiveness in high-income settings, but they suffer from lack of applicability in low resource scenarios due to challenges of availability of apps in local vernaculars and digital illiteracy. We wanted to determine the potential of technology usage in mental healthcare awareness. We also wanted to explore the acceptability and willingness of caregivers in using mobile based mental health apps.METHODSA cross-sectional quantitative survey was conducted in outpatient setting of Dr. Bhimrao Ambedkar Memorial Hospital, Raipur, in which a semi structured questionnaire was provided electronically to collect data. A total of 120 participants, including 60 caregivers of mentally ill patients and rest 60 caregivers of patients suffering from diseases other than mental illness were included in the study. All 120 participants were included for data calculation. Data obtained was analysed statistically, using Cross Tab Analysis which includes chi-square and Cramer’s V with the help of SPSS (16th) version.RESULTSOut of 120 participants, 85 (70.83%) use smart phone with internet facility. 34 (28.33%) participants already use internet as their primary source of health-related information. 42 (35%) cases and 30 (25%) controls were keen to learn about Mental Health First Aid (MHFA) protocols. Those who had a mentally ill patient in their family were more likely to use a MHFA learning App (Pearson chi square = 11.528; df = 4; p = 0.02 < 0.05; Cramer’s V = 0.031; p= >0.021). There was no significant difference in both the groups’ eagerness to help their loved ones after learning MHFA protocols. Lack of knowledge and awareness and unavailability of an appropriate app were significant barriers.CONCLUSIONSThe study looks into the scope and limitations of implementing a mobile technology-based intervention for low resource setting. Handholding of caregivers and frequent encouragement from treating doctors might significantly help in technology adoption and in surmounting the apprehension related to using technology. The scope of delivering mental health services through technology is immense.

Knowledge and Awareness towards Periodontal Diseases among Medical Students

Introduction: Oral health is an important factor in maintainingsound psychological and physical health. Periodontaldiseases, including gingivitis and periodontitis, are infectionsthat if left untreated, can lead to tooth loss. The main causeof periodontal disease is bacterial plaque, the initiation andprogression of gingivitis and periodontitis. The aim of thisstudy was to evaluate the knowledge and awareness regardingperiodontal disease among medical students.Material and methods: The present cross-sectional studywas carried out among the MBBS students to evaluatethe knowledge regarding periodontal disease. All theundergraduate students studying in the college were eligibleto participate in the study. 300 students of first, second andthird professional enrolled in MBBS program were selectedfor the study. The students who had attended lectures ofDentistry or exposed to clinical practice were excluded thestudy and questionnaires were distributed the students. Theself-administered questionnaire was used to assess the studyparticipant's personal data and level of knowledge on issuesrelating to periodontal diseases. The data were collected andanalyzed using the Statistical Package for the Social Sciencesversion 21.0 for Windows (SPSS Inc., Chicago, IL, USA).Statistical significance was based on P < 0.05.Results: In the present study total students were 270. 37.66%students think vertical brushing technique is better for goodoral health. 31.66% students think vitamin C deficiency is themost common cause for bleeding gums. 72.66% students thinkpoor oral hygiene is the most common cause for bad breath.68.33% students think coffee or tea causes staining of teeth.61.66% students think bad oral hygiene affects your generalhealth. 65.66% students think improper tooth brushing is themost common cause for receding gums. In 86.66% studentsno family member lost more than 6 teeth at young age of <35years.Conclusion: The students showed reasonable knowledgeregarding periodontal health. But, also there is need tostrengthen the diagnostics for early detection of periodontaldisease in young adults.