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Background and objectives: Non-communicable diseases (NCDs) are highly prevalent in the tribal populations; however, there are limited data regarding health system preparedness to tackle NCDs among these populations. We estimated the availability of human resources, equipment, drugs, services and knowledge of doctors for NCD management in the selected tribal districts in India. Methods: A cross-sectional survey was conducted in 12 districts (one from each State) with at least 50 per cent tribal population in Andaman and Nicobar Islands, Himachal Pradesh, Madhya Pradesh, Odisha and eight northeastern States. Primary health centres (PHCs), community health centres (CHCs) and district/sub-district hospitals (DHs) were surveyed and data on screening and treatment services, human resources, equipment, drugs and information systems indicators were collected and analysed. The data were presented as proportions.Results: In the present study 177 facilities were surveyed, including 156 PHCs/CHCs and 21 DHs. DHs and the majority (82-96%) of the PHCs/CHCs provided outpatient treatment for diabetes and hypertension. Overall, 97 per cent of PHCs/CHCs had doctors, and 78 per cent had staff nurses. The availability of digital blood pressure monitors ranged from 35 to 43 per cent, and drugs were either not available or inadequate. Among 213 doctors, three-fourths knew the correct criteria for hypertension diagnosis, and a few correctly reported diabetes diagnosis criteria. Interpretation & conclusions: The results of this study suggest that the health system of the studied tribal districts was not adequately prepared to manage NCDs. The key challenges included inadequately trained workforce and a lack of equipment and drugs. It is suggested that capacity building and, procurement and distribution of equipment, drugs and information systems to track NCD patients should be the key focus areas of national programmes
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Background: Ovarian torsion is one of the most common causes of emergency surgery in gynecology. Though it is more common in reproductive age group, it can occur in extremes of age group. So, we had analysed the clinical presentation, surgical characteristics, and causes of adnexal torsion among adolescent population, reproductive-age women, and postmenopausal women.Methods: Patients with adnexal torsion who were treated in department of obstetrics and gynecology, SRM Medical College Hospital and Research Centre from October 2016 to March 2019 were retrospectively analyzed.Results: Among the 53 cases of adnexal torsion during the study period, maximum (38, 71.6%) were in the reproductive age group. There were three patients with ovarian torsion during pregnancy. Acute pain abdomen was the significant presenting symptom in adolescent group compared to other two group (100% versus 80.6% versus 40%, p = 0.03). Adnexal pathology was in the ovary in 76% and isolated tubal pathology in 5%. Bilateral salpingo-oophorectomy with or without total abdominal hysterectomy was more commonly performed in postmenopausal patients (100%), as opposed to conservative surgery- detorsion and cystectomy in premenopausal women (56%). In Adolescent patients 62% had polycystic ovaries as intraoperative finding. Histopathology were benign except for a patient in postmenopausal age group who had granulosa cell tumour.Conclusions: An early identification of adnexal torsion is necessary in order to achieve conservative treatment in order to maximize the future reproductive potential in younger patients.
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MircroRNAs (miRNAs) are short non-coding RNAs with a length of approximately 20-22 nucleotides, which interact with their target mRNAs at 3'-untranslated region by partial pairing. The miRNA-mRNA interaction leads to induction of mRNA degradation and eventually translational inhibition. Thus, miRNAs play an important role in virtually all cellular processes, especially differentiation, proliferation, migration, and apoptosis. The deregulation of miRNAs may lead to serious diseases including cancer. There is mounting evidence demonstrating the participation of miRNA regulation during carcinogenesis. In this review, we discuss an updated miRNA biogenesis, mechanisms involved in their deregulation, and their role in cancer development. This review also summarizes updated information on potential medicinal plants which regulate miRNA expression as a promising molecular miRNA therapeutic approach for cancers.
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MircroRNAs (miRNAs) are short non-coding RNAs with a length of approximately 20-22 nucleotides, which interact with their target mRNAs at 3'-untranslated region by partial pairing. The miRNA- mRNA interaction leads to induction of mRNA degradation and eventually translational inhibition. Thus, miRNAs play an important role in virtually all cellular processes, especially differentiation, proliferation, migration, and apoptosis. The deregulation of miRNAs may lead to serious diseases including cancer. There is mounting evidence demonstrating the participation of miRNA regulation during carcinogenesis. In this review, we discuss an updated miRNA biogenesis, mechanisms involved in their deregulation, and their role in cancer development. This review also summarizes updated information on potential medicinal plants which regulate miRNA expression as a promising molecular miRNA therapeutic approach for cancers.
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Background: Effective communication plays a crucial role in establishing strong Doctor patient relationship which plays a dominant role in the treatment. Since Attitude forms the basis for the behaviour, the attitude of the students towards learning communication skills have major impact on developing effective communication skills. The objective of this study is to assess the level of attitude of medical students towards learning communication skills.Methods: A cross sectional study was conducted over 2 months among first to 4th year medical students in Karpaga Vinayaga Institute of Medical College and Research Centre, Kancheepuram using communication skills attitude scale. Data regarding the attitude and various socio demographic profile were collected through self-administered questionnaire. Hierarchical cluster analysis and K mean cluster analysis was done and Chi square test applied to find out association between the attitude and demographic variables.Results: With K mean cluster analysis, 183 students (47.9%) had high and 52.1% had moderate attitude towards learning communication skills. There is no significant association between socio demographic profiles and attitude towards learning communication skills except for the year of study and the gender.Conclusions: Overall all the students showed positive attitude towards learning communication skills, however there was decrease in level of attitude with higher the year of study.
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Background: Momordica charantia (M. charantia), bitter melon is commonly used in traditional medicine forits wide variety of medicinal properties.Aim and objectives: To study the effect of successive extract of M. charantia on smooth muscle contractilityof the isolated guinea pig ileum compared to that of standard drugs and to evaluate the receptors mediatingthe effects of M. charantia on intestinal smooth muscle using appropriate antagonists.Materials and methods: An adult albino male guinea pig of weight 700 g was euthanased and the ileumwas dissected out for isolated tissue experiment in organ bath using tyrode as physiological salt solution,aerated with air, maintained at pH of 7.4 and temperature 37°C. Successive extract of M. charantia wasprepared in soxhlet apparatus using petroleum ether, methanol, ethanol and water. 100 mg of this extractwas diluted in 10 ml of water to get a stock solution of 10 mg/ml w/v which was used after appropriatedilutions to obtain the working standard solutions. Experimental procedures were done in accordance to thestandard principles of isolated tissue experiments.Results: Contractile response was noted for M. charantia and its dose response curve was obtained followingthose of standard drugs, acetylcholine and histamine. The receptor actions were studied using atropine(muscarinic antagonist) and pheneramine maleate (histamine antagonist) and adrenaline (adrenergic agonist)which are gut smooth muscle relaxants and we found that all the three drugs did not alter the response ofM. charantia proving that none of these three receptors systems, muscarinic, histaminic or adrenergic wereinvolved in mediating the contractile actions of M. charantia.Conclusion: This study has evaluated the contractile effect and the underlying receptor mechanismscontributing to this effect of M. charantia on the intestinal smooth muscle of guinea pig using isolated tissueexperiment
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Background: The measurement of bicarbonate level in blood is extremely common and often provides vitally important data used in the care of critically ill patients. The bicarbonate level in blood can be directly measured or derived from calculations using the Henderson-Hasselbalch equation; mostly adopted by the blood gas analyzers. Arterial blood gas (ABG) analysis is commonly performed for clinical evaluation, but the procedure has certain limitations in the form of reduced patient acceptability (because the procedure can be painful) and the potential to cause complications such as arterial injury, thrombosis with distal ischemia, hemorrhage, aneurysm formation, median nerve damage and, rarely, reflex sympathetic dystrophy. The aim of the study: If there is discordance between arterial and venous blood gas parameters including pH, pCO2, bicarbonate, Sodium, Potassium, chloride and discordance between measured and calculated bicarbonate in both arterial and venous blood samples. Materials and methods: Comparison study involving 250 patients for whom clinical Judgment was made that arterial blood sample is needed for assessment of acid-base status. Both arterial and venous blood samples were collected using heparinized autosampler syringes PICO 50 as close in time as possible and were analyzed in Arterial Blood Gas analyzer ABL 80 flex. Results: There was a statistically significant difference between arterial and venous pO2 (126+48.5 vs 62+30.5, p= 0.001) and SO2 (95% vs 68%, p=0.03). Conclusion: According to the study results traditionally measured venous bicarbonate can be a Shanmugapriya Chandrasekaran, Poonguzhali Gopinath. Evaluation of pKa as a cause of discordance between calculated and measured bicarbonate in arterial and venous blood. IAIM, 2019; 6(3): 127-131. Page 128 convenient substitute for calculated arterial bicarbonate in critically ill ICU patients. However, more accurate assessments will require ABG for additional parameters. Besides, the present study design did not involve the collection of data on patient demographics, the severity of illness, and a requirement for inotropic support or prognosis.
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Background: Type2 diabetes mellitus (T2DM) is a highly inheritable disease. Transcription factor 7- like 2 (TCF7L2) gene regulates the expression of glucagon-like peptide 1 (GLP-1) in L cells of small intestine. GLP1 plays a critical role in blood glucose homeostasis by stimulating postprandial insulin secretion and increasing insulin sensitivity. Aim of the study: TCF7L2 gene variants may affect the susceptibility to Type 2 diabetes by altering GLP-1 levels. Materials and methods: This case-control study was conducted with 90 newly diagnosed patients with Type2 diabetes mellitus as cases and 90 age and sex-matched healthy volunteers as controls. TCF7L2 rs7903146 genotyping was done and we also estimated Fasting and postprandial GLP -1 level, Fasting and Postprandial insulin level and calculated HOMA-IR in both cases and controls. Results: Out study showed that T+ genotype, lower fasting GLP-1 level and lower postprandial GLP1 levels were more observed among cases as compared to controls. Low mean GLP 1 activity, high Mean HOMA-IR, low postprandial insulin, low percentage rise in insulin were observed among T+ genotype than among T- genotypic individuals. Conclusion: Hence, the study concludes that T+ genotype causes a decrease in GLP-1 levels, which in turn by decreasing postprandial insulin levels and by increasing insulin resistance increases the risk of Type2 diabetes.
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Migration of labor is a universal phenomenon. The most common reason for migration are the economic stability for better livelihood. However, the various demographic and social patterns along with the lack of awareness about the health-care facilities in the migrated place and poor economic security make them highly vulnerable to various diseases. Health and economic security of the migrants play crucial role not only in safeguarding the health of migrants but also in overall development of the country by increasing the productivity. With this, the study was conducted to assess the economic and health security of the migrants. Materials and Methods: A descriptive cross-sectional study was conducted over a period of 2 months from November to December 2018 in urban and rural field practice area of a tertiary care hospital in Trichy among 51 migrant population using semi-structured questionnaire. Results: The median monthly wages were found to be Rs. 10,000/month. With respect to the health and economic security, only about 13.7% of the study participants received medical allowances from their employers. 5.9% had job security and 27.5% excise travel allowances for their travel to native place. Conclusion: Although the average monthly income is good, the number of dependents is more and job security is poor. Since majority are not registered with L27district authorities and working in unorganized sector, the social and economic security is very uncertain increasing their risk for poor utilization of services.
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Objective: To elucidate the in vivo hypoglycemic capability, antihyperglycemic and antihyperlipidemic activities of Pereskia bleo (Kunth) leaves extracts and bioactive fraction. Methods: The various solvent extracts of Pereskia bleo were investigated for the hypoglycemic and antihyperglycemic activities using a relevant in vivo normal rat model and streptozotocin-induced diabetic rat model with glibenclamide and metformin utilized as positive controls. The effects of the most potent extract and its bioactive fraction on the insulin level, lipid profile and body weight of the diabetic rats were also analyzed. Results: All the extracts showed no hypoglycemic effect while petroleum ether, chloroform and aqueous extracts demonstrated significant (P<0.05) reduction in blood sugar level in the intraperitoneal glucose tolerance test. Aqueous extract and aqueous fraction significantly (P<0.05) reduced the blood glucose level in streptozotocin-induced diabetic rats as early as day 6 compared to the diabetic control as well as significantly restored the serum insulin of diabetic rats. Moreover, the aqueous extract and aqueous fraction disclosed a significant (P<0.05) reduction in total cholesterol, triglycerides, and low-density lipoprotein levels. An elevation in high-density lipoprotein as well as improved body weight loss of the diabetic rats were also observed. Conclusions: In summary, Pereskia bleo appears effective in the management of diabetes and correlated impairments arising from high blood sugar level. Further studies will possibly bring about the discovery of effective and secure plant derived antidiabetic drugs.
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Objective: To elucidate the in vivo hypoglycemic capability, antihyperglycemic and antihyperlipidemic activities of Pereskia bleo (Kunth) leaves extracts and bioactive fraction. Methods: The various solvent extracts of Pereskia bleo were investigated for the hypoglycemic and antihyperglycemic activities using a relevant in vivo normal rat model and streptozotocin-induced diabetic rat model with glibenclamide and metformin utilized as positive controls. The effects of the most potent extract and its bioactive fraction on the insulin level, lipid profile and body weight of the diabetic rats were also analyzed. Results: All the extracts showed no hypoglycemic effect while petroleum ether, chloroform and aqueous extracts demonstrated significant (P<0.05) reduction in blood sugar level in the intraperitoneal glucose tolerance test. Aqueous extract and aqueous fraction significantly (P<0.05) reduced the blood glucose level in streptozotocin-induced diabetic rats as early as day 6 compared to the diabetic control as well as significantly restored the serum insulin of diabetic rats. Moreover, the aqueous extract and aqueous fraction disclosed a significant (P<0.05) reduction in total cholesterol, triglycerides, and low-density lipoprotein levels. An elevation in high-density lipoprotein as well as improved body weight loss of the diabetic rats were also observed. Conclusions: In summary, Pereskia bleo appears effective in the management of diabetes and correlated impairments arising from high blood sugar level. Further studies will possibly bring about the discovery of effective and secure plant derived antidiabetic drugs.
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Ayapodi Elagam (A.E) was used in Siddha system of medicine for many years to treat Pandu (Anemia). This medicine contains Nellikai, Keezhanelli, Karisalai and Ayam. These herbs are helps to improve the blood to correct the anemia. This study was carried out to evaluate the acute and chronic toxic effect on Ayapodi Elagam and to determine the LD50. The toxicity study was done as per the guidelines of world health organization (WHO) guideline. As the herbs and Ayam were used for treating anemia by traditional practitioners for years together, the toxicity study was also proposed to study in both sexes. In acute study the animals were divided into two groups A.E was administered at 5000mg/kg orally and animals were observed for toxic sign at 0,5,1,4,24 hour and for 14 days. In chronic toxicity study A.E was administered at 450,900 and 1800 mg/kg body weight/day to 3 groups of animal, respectively. The distilled water was administered to control animals. The result showed that the acute toxicity study of A.E. at the dose level of 5000mg/kg does not produce any toxic sign and mortality among the experimental groups and the LD50 value of the drug was found to be more than 5000mg/kg bodyweight. The weight of rats, wellness parameters, mortality, hematological parameters, biochemical parameters and histological analysis of all vital organs were observed to know the chronic toxic effect of the drug. All the parameters of the study do not show the any significant chances between the control and experimental groups.
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Back ground: Sexually transmitted infections are a significant public health problem worldwide as they cause widespread morbidity and mortality in both male & female. In developing countries, STI are the third most common public health problem in young people of reproductive age group. Aim of the Study: This study was conducted to determine the prevalence of Candida species causing genital candidiasis in patients attending STD clinic in tertiary care hospital & to know the fluconazole resistance pattern of the isolated Candida species. Materials and methods: KOH mount is done by adding 10% KOH to the smear made with the vaginal discharge to look for the presence of yeast cells/ hyphal elements. Gram stain is done to look for the presence of gram positive budding yeast cells. Results: In this present study, Candida glabrata was the most common species causing vaginal candidiasis (47%) and fluconazole resistance is more among the Candida non-albicans isolates (62%). Candida albicans is the most common species isolated from male samples. Fluconazole resistance is also increasing among the Candida albicans isolates (32% in females and 30% in males). Conclusion: Prevalence of fluconazole resistance among Candida isolates is also increasing. This is due to the inappropriate and over the counter usage of antifungal agents. The emergence of Kavitha M, Hemalatha S, Shanmugapriya V. A study on fluconazole resistance among candida species isolated from patients attending STD OPD in a tertiary care hospital. IAIM, 2017; 4(4): 35-40. Page 36 fluconazole resistant C. albicans and non albicans species emphasises the need of species identification and antifungal susceptibility in the diagnosis and management of vaginal candidiasis.
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Stress is the reaction of the body to a change that requires physical, mental or emotional adjustments. Individual differences in stress reactivity are a potentially important risk factor for gender-specific health problems in men and women. The Autonomic regulation of the cardiovascular system is most commonly affected by stress and is assessed by means of short term heart rate variability (HRV).The present study was undertaken to investigate the difference in the cardiovascular Autonomic Nervous System response to mental stress between the genders using HRV as tool. We compared the mean RR interval, Blood pressure and indices of HRV during the StroopColor Word Test (SCWT).Twenty five male (Age19.52±0.714, BMI 22.73±2 kg/m2) and twenty five female subjects (Age 19.80±0.65, BMI 22.39±1.9) performed SCWT for five minutes. Blood Pressure (SBP p<0.01, DBP p<0.042) & Mean HR (p<0.010) values showed statistically significant difference among the genders. HRV indices like LFms2 (p<0.051), HF nu (p<0.029) and LF/HF ratio (p<0.025, p<0.052) show statistically significant difference among the genders. The response by the cardiovascular system to a simple mental stressor exhibits difference among the genders.
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Yersinia enterocolitica is rapidly emerging worldwide as an enteric pathogen and has become a major cause of diarrhea even in developed countries. The aim of this study was to characterize and genetic diversity analysis among Y. enterocolitica strains isolated from fish and chicken sources. From 44 strains, 55% [24 strains] found to be positive for Y. enterocolitica by colony morphology, biochemical tests and 16S rRNA. We investigate the diversity of Y. enterocolitica by hemolytic activity, antimicrobial resistance, RAPD, ERIC and REP-PCRs PCR, profiling of outermembrane proteins and lipopolysaccarides. Forty one percent of the strains were found to be the producers of haemolysin at 37 [degree sign] C but not at 28 [degree sign] C. All the isolates were exhibiting multi-drug resistance and found sensitive to chloramphenicol, and resistant to ciprofloxacin and amoxicillin. Eight, eleven and twelve different genotypic patterns were observed in RAPD, ERIC and REP-PCRs respectively. Five isolates have produced high molecular weight protein [HMWP] with a molecular weight of 150 - 220 kDa. Mostly LPS produce identical profiles, 22 strains have produced smooth LPS, while 2 strains have produced the rough LPS pattern. Genotyping tools strongly confirm the co-existence wide genetic diversity among the strains tested. By using any or the combination of these molecular tools, epidemiological investigation on Y. enterocolitica could be elucidated effectively. These results showed that the REP-PCR is more informative and discriminative than other for analysis of Y. enterocolitica diversity
Subject(s)
Animals , Genetic Variation , Chickens , Fishes , Drug Resistance, Multiple , Lipopolysaccharides , GenotypeABSTRACT
Background: Thyroid hormones plays an important role in control of metabolism in human. Hyperlipidaemia particularly hypercholesterolemia, is a well-documented significant health consequence associated with hypo-thyroidism. Oxidative stress is a common factor associated with several clinical conditions including hypothyroidism. Aims & Objective: To evaluate the association between BMI, Hyperlipidaemia, Lipid Peroxidation and Atherogenic risk in newly diagnosed hypothyroid patients. Material and Methods: 85 newly diagnosed hypothyroid cases and 41 euthyroid controls were studied for their Thyroid profile [TSH, T4 andT3], Lipid profile , Oxidative stress marker, Malondialdehyde {MDA} Lipid risk ratios, [TC/HDL-C and LDL-C / HDL-C ratio] , Atherogenic index [AIP] - log TG/HDL-C and Body Mass Index [BMI]. Results: Hypothyroid patients had hyperlipidaemia, especially hypercholesterolemia [224 ± 43.8 mg/dl], increased LDL-C level [150.4 ± 42.3 mg/dl] when compared to controls [169.5 ± 25.1 and 97 ± 25.5 respectively]. MDA was significantly increased [p< 0.0001] in hypothyroid subjects [6.14± 1.83μ mol/L] versus the controls [2.9 ± 0.86 μmol/L] .BMI had positive correlation with TSH [r =4.421; p<0.0001]. Conclusion: Hypothyroidism leads to hyperlipidaemia enhancing risk for cardiovascular diseases, the connecting link being oxidative stress. It was found that TSH had positive significant correlation with BMI, Lipid profile and oxidative stress in hypothyroid patients when compared to the controls making them more prone for coronary artery diseases.
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Various organic and aqueous extracts of Skeletonema costatum were screened for their antibacterial activities. The extracts were tested against different species of human pathogenic bacteria by the agar-solid diffusion method. Water extract of Skeletonema costatum showed maximum antimicrobial activity of 19.0 mm against Klebsiella pneumoniae and a minimum activity of 9 mm against Proteus vulgaris. All the tested microorganisms were resistant to methanol, ethanol and propanol extracts except Escherichia coli and Staphylococcus aureus which exhibited a least inhibition zone of 6.0 and 7.0 mm respectively in propanol. Acetone extract of Skeletonema costatum also showed the highest biological activity of 19.0 mm against Klebsiella pneumoniae, moderate activity of 12.0 mm against Salmonella typhi, and 11.0 mm against Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus. Sequential extract of Spirulina exhibited maximum antimicrobial activity. Inhibition zone of 23.2 mm was observed for Klebsiella pneumoniae and 14.0 mm for Proteus vulgaris.
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Myiasis maggots were isolated from the cancerous wounds, when the patients reported to the Department of ENT-OPD, JIPMER, Pondicherry. Maggots were identified to Chrysomyia bezziana based on characteristic patterns of posterior and anterior spiracles. Although the categories of cancer wounds were different, invasions were due to C. bezziana, which is very common in suburban areas of Tamil Nadu and Pondicherry in southern parts of India. This observation showed the importance of hygiene and sanitation in tropical countries with high fly population and emphasised the need for correct diagnosis of this obligatory myiasis, which was destructive. Through proper health care, further destabilization due to myiasis was avoided.
Subject(s)
Aged , Animals , Carcinoma/complications , Diptera/classification , Female , Humans , India , Larva/classification , Male , Middle Aged , MyiasisABSTRACT
Circadian variations in the incidence of hypertension and coronary events are well known with early morning surges. Effect of lunar cycles on various medical illnesses like seizures and psychiatric disturbances are documented. However, the effect of lunar cycles on coronary events has been sparsely documented. The authors studied the incidence of acute coronary events and admission patterns in the departments of emergency medicine and cardiology. Inclusion criteria included unstable angina, non-ST elevation myocardial infarction (MI) and ST elevation MI. Exclusion criteria included chest pain syndromes which were subsequently deemed non-cardiac by invasive or non-invasive investigations. Data from 1999 to 2001 were analysed. Admissions on full moon days were compared with those on new moon days. There were 30 full moon days and 30 new moon days and 223 admissions on full moon days and 266 on new moon days. This difference was statistically significant [p = .005]. Sixty-seven per cent were males and the rest were females. Subgroup analysis of mortality, postinfarction angina, effect on diabetics and hypertensives were done which showed an increased trend in new moon days. It is concluded that there is increased incidence of acute coronary events associated with new moon days.