A prospective evaluation of microvascular complications in diabetes mellitus patients at time of diagnosis

Background: The microvascular complication is also showing increasing trend. This is because of lack of awareness and lack of regular screening programme. Early diagnosis and Intensive glycemic control has been the most effective approach to prevent the progress of microvascular complication.Methods: Based on exclusion and inclusion criteria 100 patients were enrolled for this study. For diagnosis of diabetes mellitus, we used American Diabetes Association (ADA) guidelines was followed. Detail history of patient was taken related to microvascular complication and they underwent extensive medical examination for the assessment of microvascular complications.Results: Mean age of patient with microangiopathy was 59.942±7.18 years and without microangiopathy was 54.31±13.15years. Microangiopathy was common in patient whose HbA1c was more than 10.7. Out of 26 patient 20 patient having microangiopathy. Neuropathy was present in 31 patients and absent in 69 patients.Conclusions: It was observed that a continuous linear association between HbA1c and microvascular complications. This is more common in patient in patient with higher HbA1c. Neuropathy is most common which is followed by nephropathy and retinopathy least among all.

Study on knowledge, attitude and practice of ante-natal care among pregnant women attending antenatal tertiary care institution

Background: The primary aim of antenatal care is to achieve a healthy mother and baby. Antenatal care helps to identify the complications and to remove anxiety and dread associated with delivery. Current study designed to assess knowledge, attitude and ante natal care practice among pregnant women attending to antenatal tertiary care hospital.Methods: A cross-sectional study was conducted on 500 pregnant women attending antenatal care centre at department of obstetrics and genecology, Narayana Medical College and Hospital, Nellore during June 2017 to June 2019 under Narayana Mathru Seva Pathakam. Face to face interview was conducted to assess their knowledge, attitude and practice using a structured questionnaire.Results: A total 86% belongs to 20-29 years age group and 71.4% belongs to multiverdia. 20.6% women responded that they had completed 3 antenatal visits, 26.6% are those who thought that at least more than 5 ANC checkup should be done during pregnancy. 96.1% pregnant responded that registration for antennal care and visits is essential. 87.2% responds to take iron and folate during pregnancy and 11% responds does not taken the same. 92% pregnant responded that tetanus toxoid (TT) should be given during pregnancy but 3.2% told don’t know. When they asked about resting period, 24.2% responded 5-6 hours, 35.4% responded 7-8 hours, 35.6% responded > 8 hours per day to rest they are taking. 55.8% pregnant responded that they had taken decision to give birth the baby in the hospital. 71.2% pregnant females reported that they knew about the danger signs during pregnancy. The reasons for not attending antenatal check-up were financial reasons, illiterate (15.4%), transport and unaware about ANC.Conclusions: Information, education and communication activities should be increased on ANC through community campaign and mass media to motivate women to utilize maternal care services.

A Study of Lipid Profile Abnormalities among Patients with Essential Hypertension Attending Tertiary Care Centre

Introduction: Hypertension is an important public healthproblem both in developed and developing countries.Hypertension is known to be associated with alterations inlipid metabolism which gives rise to abnormalities in serumlipid and lipoprotein levels but the cause and effect relationshipis not known. The study was initiated with objective to assessthe lipid profile abnormalities among primary hypertensivepatients attending tertiary care center.Material and Methods: A case control study was done inoutpatient department (OPD) of General medicine, GITAMInstitute of Medical Sciences & Research, Visakhapatnamduring May to October 2019. A total of 200 study participantswere included based on inclusion & exclusion criteria, 100were primary hypertensive cases and 100 were age and gendermatched controls. After obtaining approval from InstitutionalEthics Committee and informed consent taken from all studyparticipants data was collected. Data entered in MS excelsheet and analyzed by using SPSS software.Results: Out of 200 study participants 88(44%) were femaleand 112(56%) were male. Majority of the study participantswere in the age group 50 to 70 years. The mean values of thetotal cholesterol, low density lipoprotein (LDL) cholesterol,and triglycerides were significantly higher in hypertensivepatients compared to control group. The mean high densitylipoprotein (HDL) cholesterol was lower among cases thancontrols. These differences were found to be statisticallysignificant.Conclusion: Dyslipidemia and hypertension in combinationincreases the risk of cardiovascular diseases, stroke etc. Henceearly detection of dyslipidemia in hypertensive patients andaggressive treatment of both the conditions should be carriedout to prevent complications.

A Study of the Profile of Heart Failure Patients with Reduced Left Ventricular Ejection Fraction at a Tertiary Care Hospital.

Introduction: Despite the advancement in medicine,management of heart failure (HF), which usually presentsas a disease syndrome, has been a challenge to healthcareproviders. The study was commenced with objective tostudy the profile of patients presented with heart failure withreduced left ventricular ejection fraction (LVEF) in a tertiarycare hospital.Material and Methods: It was a cross sectional hospitalbased study. Both male and female patients presented withheart failure with reduced ejection fraction (HFrEF) treated indepartment of General Medicine, GITAM Institute of MedicalSciences & Research were included based on inclusion andexclusion criteria. A total of 100 consecutive patients werestudied during February to October 2019. After obtainingapproval from Institutional Ethics Committee and informedconsent taken from all study participants data was collected.Data entered in MS excel sheet and analyzed by using SPSSsoftware.Results: Among total 100 heart failure patients males were69, females were 31. The mean age of study population was56.61±13.01 years. All patients presented with shortness ofbreath of varying degree of New York Heart Association(NYHA) class. The common risk factors observed werehypertension (53%), diabetes (36%), alcohol (14%), smoking(40%). The common causes for heart failure found wereIschemic heart disease (64%), followed by non-ischemicdilated cardiomyopathy (21%) and rheumatic heart disease(15%). Majority of the study participants were receivingtreatment with diuretics (66%), statins (65%), followed bybeta blockers (25%), aldosterone antagonist (25%), ACEinhibitors (30%).Conclusions: Early detection and optimal treatment ofcommon risk factors might play role in preventing Heartfailure and thereby reducing disease burden in the country

A 3 years study of vaginal hormonal cytology at tertiary hospital

Background: Vaginal cytology is an efficient inexpensive and a rapid method for identifying diseases including establishing the hormonal condition of the patient. The Evaluation of the endocrinologic status of the female patient by means of the study of vaginal cells is actually one of the earliest diagnostic applications of clinical cytology. Though the vaginal cytologic characteristics of gynecologic patients have been studied throughout the world this subjected has received little attention. Vaginal cytology is useful for assessing ovarian function from puberty throughout the reproductive years, menopause and senium. Also it is used to estimate time of ovulation, to determine ovarian dysfunction, to assess placental function or dysfunction in obstetrics, to assist in selecting hormonal therapy and to follow hormonal treatment results. Aim and objectives: To ascertain the effective utilization of cost effective test of vaginal hormonal cytology as a supplement for costly biochemical hormonal estimation. A prospective study was undertaken with the following objectives: To study the normal hormonal patterns in females of different age groups and to study abnormal hormonal patterns in high risk pregnancies and in different clinical situations. Materials and methods: A prospective, hospital based study was done on vaginal smears obtained from One hundred and Sixty (160) patients, attending Gynecology and Obstetrics Out-patient department and few In-patients at Gandhi hospital, Secunderabad during the period of August 2004 to October 2006. The study group included randomly selected female patients of reproductive age groups (18 years to 35 years.);.with normal menstrual cycles; normal perimenopausal (36 years to 45 years.) and postmenopausal (above 45 years.) women, pregnant patients in the 1st, 2nd, 3rd trimesters T. Sundari Devi, Rajyalakshmi, S. Srujana, K.R.K. Prasad, O. Shravan Kumar. A 3 years study of vaginal hormonal cytology at tertiary hospital. IAIM, 2017; 4(8): 20-32. Page 21 and 1st stage of labour as well as post partum patients. The study group also included patients with primary infertility, menorrhagia, secondary oligomenorrhoea (scanty menstruation), threatened abortions, inevitable abortions, pre mature rupture of membranes, post maturity and patients with neoplastic lesion i.e. ovarian tumor. The material collected for the vaginal smear dried very rapidly during collection. Hence fixation was done within 30 sec. of spreading. The fixatives used were – 95% Ethanol or 80% Isopropyl Alcohol. Other fixatives used were ether / 95% alcohols; 100% methanol; Rapid fixative as cytospray; 2 to 10% carbowax in 95% ethanol (for mailing unstained smears). The stains used were Papanicolaou’s stain and Giemsa stain. Results: Vaginal hormonal cytology is a useful diagnostic aid in the female reproductive process. It may also provide a key to more effective conception control, as well as improvement in the treatment of menstrual disorders, anovulation, and other underlying disorders. In the present Indian scenario with lack of adequate clinical history available to the pathologist, in a rural setup as well the urban conditions; vaginal hormonal study is still a low cost diagnostic and prognostic test procedure. Hence the present study emphasizes the utility of vaginal smear study even today compared to the costly biochemical parameters available in the market which is a financial burden to poor patients. Conclusion: Vaginal smear collected between 4-11 days and 12-16 days of the normal menstrual cycle showed scattered intermediate and superficial cells. Vaginal smears collected between 17-28 days of normal menstrual cycle showed, predominately intermediate cells with folding and crowding. The KPI peak is between 12-16 days. This is extreme midzone shift, with clusters of navicular cells in all the three trimesters, of pregnancy. First stage of labour could be suspected with identification of increase in the number of superficial cells, with marked decrease in the intermediate cell values.

Griscelli syndrome type 2: A rare and fatal syndrome in a South Indian boy.

Griscelli syndrome (GS) is a rare autosomal recessive disorder caused by mutation in the MYO5A (GS1), RAB27A (GS2), and MLPH (GS3) genes, characterized by a common feature, partial albinism. The common variant of three, GS type 2, in addition, shows primary immunodeficiency which leads to recurrent infections and hemophagocytic lymphohistiocytosis. We, herewith, describe a case of GS type 2, in a 4‑year‑old male child who presented with chronic and recurrent fever, lymphadenopathy, hepatosplenomegaly, and secondary neurological deterioration; highlighting the cytological and histopathological features of lymph nodes. Hair shaft examination of the child confirmed the diagnosis.

A comparative study of safety and efficacy of tiotropium bromide with salbutamol in moderate persistent bronchial asthma in a tertiary care hospital.

Background: The objective of this study was to compare the safety and efficacy of tiotropium bromide with salbutamol in moderate persistent cases of bronchial asthma at tertiary care hospital. Methods: This was an open label, randomized parallel group study done in Government General Hospital, Srikakulam for a period of 12 weeks. Group-1 was given tiotropium bromide metered dose inhalational therapy 18mcg once daily in 50 patients. Group-2 was given salbutamol metered dose inhalational therapy 100mcg thrice daily in 30 patients. Results: Symptomatic improvement was observed in l two groups. At end point, mean FEV1 in tiotropium bromide treatment group improved by 149.96% compared with 135.16% salbutamol treatment group. At end point, mean FVC value in tiotropium bromide treatment group improved by 145.71% compared with 122.34% in salbutamol group. Mean FEV1 / FVC also improved by 155.41% in tiotropium bromide group compared with 105.41 % in salbutamol group. Conclusion: The present study proved tiotropium provide superior safety and efficacy relative to control drug in bronchial asthma patients in both clinical assessment score and spirometrically.

Chylomicronemia Syndrome–A Rare Metabolic Disorder of Infancy

Chylomicronemia syndrome is a disorder passed down through families in which the body does not metabolize lipids. This causes fat particles called chylomicrons to build up in the blood. It is also known as Familial lipoprotein lipase (LpL) deficiency. Chylomicronemia syndrome occurs due to a rare genetic disorder in which the enzyme LpL is broken or missing and it causes accumulation of chylomicrons. This is known as Chylomicronemia. LpL is normally found in adipose tissue and muscle. It helps in the breakdown of lipids. Symptoms may start in infancy and include: Abdominal pain due to pancreatitis, neurological symptoms, xanthomas and failure to thrive. Peripheral smear showed blasts with normocytic hypochromic anemia and thrombocytopenia and the Refrigeration test was positive. We report 3 cases of Chylomicronemia syndrome in the last 2 years.

Human malaria in C57BL/6J mice: An in vivo model for chemotherapy studies.

The present work deals with the development of Plasmodium falciparum stages in mouse model and its potential for the study of efficacy of antimalarial drugs. C57BL/6J mice were infected with multidrug resistant P. falciparum strain then treated with arteether and artesunate. A response was observed to antimalarial drugs in terms of decrease in parasitemia. Mice infected with P. falciparum strain were successfully cured after treatment with either arteether or artesunate. The speed of parasite clearance time and burden of parasitemia differed for each drug and matched the previously reported observations, hence stressing the relevance of the model. These findings thus suggest that P. falciparum. infected human RBC (iRBC) – C57BL/6J mice can provide a valuable in vivo system and should be included in the short list of animals that can be used for the evaluation of P. falciparum responses to drugs.

Immune reconstitution syndrome following initiation of antiretroviral therapy in a patient with HIV infection and multidrug-resistant tuberculosis.

Paradoxical exacerbation of the signs and symptoms of tuberculosis may occur not only after antituberculosis therapy, but also soon after the initiation of a potent combination of antiretroviral drugs in human immunodeficiency virus (HIV) serpositive patients with tuberculosis. We report a case of immune reconstitution syndrome in response to antiretroviral therapy in a HIV-positive patient on antituberculosis therapy for multidrug-resistant tuberculosis.

Lipid peroxidation in different tissues: effect of high cholesterol and fish oil in the diet.

Malonyldialdehyde was measured in erythrocytes, aorta and spleen on feeding mice with high cholesterol diet in presence and absence of fish oil. Mice were grouped as: Group I: Control laboratory diet Group II: 0.16% cholesterol (sunflower oil) Group III: 1.16% cholesterol (sunflower oil) Group IV: 1.16% cholesterol (fish oil) After 7 weeks on their respective diets, erythrocytic, and splenic MDA levels were significantly higher in group III compared to controls. Also, MDA levels in aorta and spleen showed a significant increase in group IV males compared to group III males. However in group IV the erythrocyte MDA levels were almost equal to that in controls. This suggests that high cholesterol diet increases lipid peroxidation in erythrocytes, spleen and aorta. Addition of fish oil in the diet further increases lipid peroxidation in aorta and spleen, but not in the erythrocytes.

Description of a new species of the genus raphidascaroides Yamaguti 1941 from the sphyrna zigaena shark at Visakhapatnam India

Se describe una nueva especie del género raphidascaroides Yamaguti, 1941 obtenida del intestino del tiburón cabeza de martillo sphyrna zigaena. Los especímenes no concuerdan con la descripción de especies conocidas de dicho género. Raphidascaroides zigaenai queda establecida como nueva especie por el tamaño de su cuerpo, longitud de su esófago y apéndice esofágico, tamaño de las espículas, número y distribución de las papilas caudales, posición de la vulva y estructura de la extremidad caudal

Procamallanus diacanthum n. sp from the intestine of marine fish johnius diacanthus, India

Se describe una nueva especie de nematode de la familia camallanidae railliet et Henry, 1915 del intestino del pez de mar johnius diacanthus (lacépede) de la costa de kalingapatnam. Estos ejemplares no concuerdan con la descripción de las especies del género descritas hasta ahora. Por lo tanto, una descripción detallada y posición taxonómica se dan en este artículo. La nueva especie se caracteriza por sus medidas corporales, estructura de los engrosamientos espirales, posición del anillo nervioso y poro excretorio, ausencia de gubernaculum, número y disposición de las papilas caudales, largo de las espículas y del extremo terminal de la cola. Así, puede ser considerado una nueva especie, procamallanus diacanthum

Description of a new species of the genus camallanus Railliet et Henry 1915 from freshwater fish barbus ticto from Krishna River, Andhra Pradesh India

Se describe una nueva especie de un nematode de la familia camallanidae railliet et Henry, 1915 del ovario del pez de agua dulce barbus (Puntius) ticto (Günther). La descripción se basa en dos ejemplares machos y dos ejemplares hembras, de un gran número de huéspedes examinados. Los ejemplares no concuerdan con descripciones de especies conocidas del género camallanus, en consecuencia, una nueva especie camallanus praveeni ha sido nominada para ubicar los presentes ejemplares. La nueva especie podría ser distinguida por las medidas del cuerpo, la naturaleza de los tridentes, posición del anillo nervioso y del poro excretorio, posición y largo de las espículas, número y posición de las papilas caudales posición de la vulva y forma de extremo de la cola

Porrocaecum muraenesoxi n. sp. (Nematoda: Heterocheilidae) from the intestine of marine Eel fish muraenesox talabonoides (Bleeker)

Se describe una nueva especie de nematode del género Porrocaecum Raillet et Henry, 1912 obtenida de la anguila marina Muraenesox talabonoides (Bleecker) de Kakinada (Andhra Pradesh). Las características de los especímenes examinados no concuerdan con la descripción de especies conocidas del género Porrocaecum, por lo que una nueva especie Porrocaecum muraenesoxi se ha establecido para describir a estos nematodes. La nueva especie se caracteriza por el tamaño del cuerpo, ubicación del anillo nervioso, largo del ciego intestinal, número y disposición de las papilas caudales, largo de las espículas, cola cónica en ambos sexos y presencia de glándulas rectales