Morphological and Morphometrical Analysis of The Vermian Fossa In Dry Adult Skulls of Western Uttar Pradesh Population: An Osteological Study.

Aim: The internal occipital crest (IOC) occasionally diverges at the lower end around the foramen magnum, giving rise to roughly triangular shaped vermian fossa. Variations occur in the vermian fossa in the form of shape and size. There is paucity of such study in the available literature, hence the present study was undertaken to evaluate the incidence, morphology and morphometry of the VF in the adult population of Western Uttar Pradesh. Material and method: Adult human 30 cranial bases (vault removed) and 25 occipital bones of both the sexes, which were obtained from the osteology section of department of anatomy in LLRM Medical College, Meerut (UP), formed the basis for this study. The fossa were macroscopically examined and classified into Type1 (triangular shape), Type 2 (quadrangular shape), and Type 3or atypical type (fossa shape was other than the above said). Result: Out of the 55 specimens the VF was observed in 40(72.7%) specimens, and was found absent in the remaining 15(27.2%) specimens. The VF was triangular shaped in 29(72.5%) specimens and quadrangular in 4(10.0%) specimens. In 7(17.5%) specimens it was having unusual morphology and considered as atypical. Among the atypical types, two specimens were having deep fossa, one was having partitioned VF, and four of them had widened VF. The average length and width of the fossa were 14.2 mm and 12.1 mm respectively. Conclusion: The incidence is higher in our study as compared to the previous studies and it might be because of racial variations. Accurate knowledge of the variability of the human morphology and morphometry improves the diagnosis and therapeutic performance and also helpful in the study of the diseases that cause alterations of size and morphology of inferior vermis of cerebellum and clinician who operates intracranially or interprets radiological imaging. Hence this study is enlightening for the neuroanatomists and morphologists.

Comparative study of prostaglandin E2 gel with oxytocin infusion for induction of labor.

Objectives - To compare the safety and efficacy of prostaglandin E2 gel with I.V. oxytocin for induction of labour. Methods - Over 200 pregnant women admitted for induction of labour were randomly allocated into two groups; Group A (100 women) who had pre induction cervical ripening with prostaglandin E2 gel; Group B(100 women) who received IV oxytocin without cervical ripening. Statistical analysis used: Student t test, Z test, correlation of coefficient. Results: The demographic characteristics of the women and indications of labor in both groups were comparable. The mean Bishop score at 12 hours in group A and group B were 9.33 ±1.63 and 5.76 ±3.07 respectively and were statistically significant (p<0.05). The mean duration of labor in group A was 8.99±4.7 hours and in group B was 16.22±5.11 hours. The difference was highly significant (p< 0.0005). The complications and side effects were minimal with good neonatal outcome in group A compared to group B. Conclusion: Prostaglandin E2 gel when used intracervically is a safe and effective method for induction of labour.

Osteotic Variations in Paracondylar Region of Adult Human Skulls – Incidence and Clinical Significance.

Aim: In the paracondylar region(lateral to the occipital condyles)there might be morphological variation in the form of an anomalous foramina. This anomalous foramina may represent the course of an emissary vein in absence of posterior condylar canal or an aberrant course. Material & Method: 82 dry adult skulls (164 sides), of Indian origin and of both the sexes formed the basis for this study. The region anterior, posterior and lateral to the occipital condyles was carefully examined for the presence of foramina. Complete foramina were only considered for this study. The patency was ascertained by passage of a probe through it. Results: paracondylar foramina was observed in 12.1% specimens ,in 10.9% it was predominantly located on the left side and in 1.2% it was bilateral. No right sided paracondylar foramina was observed. Unilateral left sided Double hypoglossal canal was seen in 4.8% specimens . Posterior condylar canal was present in 9.7% out of which 6.0% were on the left side exclusively and 3.6% bilateral in position. Conclusion: Misinterpretation may occur as neoplasm or an abnormal lymph node during radiodiagnosis Surgical procedures in this area such as paracondylar approach and far lateral supracondylar approach could be impacted upon by this.

ESBL- A continuous diagnostic challenge to clinical microbiology laboratories.

Objectives: Extended spectrum beta lactamase (ESBL) producers have posed a great threat to the use of many classes of antibiotics, particularly cephalosporins. Their detection has proved to be difficult for many laboratories because the resistant ESBL producing organisms appear to be susceptible by in vitro routine testing but result in treatment failure.The present study aims to detect the prevalence of ESBLs in organisms like E.coli and Klebsiella spp. which are responsible for many serious infections. Method: Isolates were screened for ESBL production using cefotaxime, ceftazidime and ceftriaxone by disk diffusion method. Isolates showing resistance to one or more than one of these drugs were futher subjected to Phenotypic Confirmatory Test (PCT) using CAZ/CAZ-CAC as per CLSI guidelines. Results: Of the 230 isolates, 116 (50.43%) tested positive by initial screening method. But on PCT only 94 tested positive. Out of 94 ESBL producers, 59 (62.76%) were E.coli and 35(37.23%) were Klebsiella spp. Of the various clinical samples urine 90(39%) showed maximum number of ESBL producers (32, 34%), followed by pus (27, 29%). Out of 230, 126 (54.7%) were females and 104 (45.2%) were males with a male to female ratio of 0.82:1 showing female preponderance. This study also showed increasing resistance to fluoroquinolones among ESBL producers. Conclusion: The results of our study show that there is an increased prevalence of ESBL producers in our tertiary care centre and also an increased resistance to fluoroquinolones among ESBL producers. Hence infections caused by E.coli and Klebsiella spp. which are prime producers of ESBL have to be considered seriously and proper screening methods and antibiotic policies have to be drawn to confine their spread.

A Review on biological and phytochemical investigation of plant genus Callistimon

Objective: The large flowering plant genus Callistemon is belongs to family Myrtaceae and reported for its medical importance. Various parts of different species exhibit different medicinal importance and yet to be phytochemically investigated. In the different time various scientist have investigated the genus and reported the chemical constituents. A survey of literature on genus Callistemon reported the isolation of triterpenoids and steroids from leaves, seeds and stem bark of different species.

Biocatalytic and electrochemical reduction of selected phenyl alkanones with antibacterial activity of the corresponding phenyl alkanols.

This paper reports the production of some phenyl alkanols by the biocatalytic and electrochemical reduction of selected Phenyl alkanones viz. Propiophenone, Butyrophenone, and Valerophenone. Baker‘s yeast was used in its free as well as immobilized form for biocatalytic reduction. Substrates showed the higher conversion rate when the cells were used in immobilized form. The electrochemical behavior of substrates was investigated cyclic voltammetrically to explore electrochemical reduction as alternative synthetic route for the preparation of alcohols. Results obtained from cyclic voltammetric studies were used for establishing optimum conditions for electrochemical reduction which was then carried out galvanostatically using economically viable stainless steel (SS-316) electrodes. The reduction products were isolated and purified by chromatographic techniques and characterized on the basis of spectral analysis. The products thus obtained also exhibited significant antibacterial activity against four strains of bacteria viz. Staphylococcus aureus, Enterococcus faecaulis, Escherichia coli, Pseudomonas aeruginosa.

Presence of two intussusceptions with meckel’s diverticulum : a case report.

During the routine cadaveric dissection a Meckel’s diverticulum was observed which was about 50 cms, proximal to the ileocaecal junction. The length of the diverticulum was about 7 cm. After exploring the abdomen we observed intussusceptions at two places; first intussusception was seen at about 30 cms from duodeno-jejunal junction & other one was 21 cm distal to the first one. Since presence of two intussusceptions along with Meckel’s diverticulum is a rare and interesting finding, hence this case was considered suitable for discussion.

Aluminium induced microscopic changes in the kidney.

Reports of aluminium toxicity on kidneys through dietary source is less reported even though it’s adverse effects such as encephalopathy, dementia, osteomalacia and fractures have been reported in renal failure cases after ingestion of aluminium gel. As Majority of Indian population is exposed to aluminium through dietary source, therefore, the effects of alumuinium toxiciy was studied in albino rats after oral administration of Aluminium salts. The present study was carried out on 40 albino rats divided into two equal group: control and experimental. Each of twenty animals of experimental group were given 37.5 mg of aluminium chloride per day orally for 3 weeks. All the animals were sacrificed on 22nd day. Small pieces of kidney were procured, fixed in 10% neutral buffered formaline and embedded in paraffin. Sections of 7µ thickness were cut and stained with Haematoxylin and Eosin for general morphology and PAS for basement membrane. Significant histopathological changes were observed. Breakdown of general architectural pattern with degenerative changes were seen more in cortex as compared to medulla. Haemorrhage and inflammatory cell reaction was also observed in cortex.

Immune reconstitution inflammatory syndrome.

BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a paradoxical deterioration in clinical status in a patient on antiretroviral treatment (ART) despite satisfactory control of viral replication and improvement of CD4 count. AIM: To study development of IRIS as a part of ART. METHODS: Hundred patients on antiretroviral treatment were studied prospectively in the Department of Skin and VD over a period of 2 years. Patients were asked to come if they developed any symptoms or on a monthly basis. They were screened clinically and investigated suitably for evidence of opportunistic infections. RESULTS: Out of 100 patients, 10 patients did not come for follow-up. Twenty (22.2%) out of the 90 patients developed IRIS. Herpes zoster (HZ), herpes simplex virus (HSV), and tuberculosis (TB) were the cases of IRIS seen in the present study. CONCLUSIONS: IRIS in terms of HSV/TB is known to accelerate HIV disease progression. Hence early detection and prompt treatment, along with continuation of highly active ART, are of utmost importance.

Adverse effects of antiretroviral treatment.

BACKGROUND: The introduction of highly active antiretroviral therapy (HAART) has led to significant reduction in acquired immune deficiency syndrome (AIDS)-related morbidity and mortality. Adverse drug reactions (ADRs) to antiretroviral treatment (ART) are however, major obstacles in its success. AIMS: We sought to study the adverse effects of ART in a resource-restricted setting in India. METHODS: Hundred patients on ART were studied prospectively over a period of two years. All patients were asked to visit the clinic if they developed any symptoms or on a monthly basis. They were screened clinically and investigated suitably for any ADRs. RESULT: Out of the 100 patients, ten patients did not come for follow-up; only 90 cases were available for evaluation. ADRs were observed in 64 cases (71.1%) - the maximal frequency of ADRs was seen with zidovudine (AZT) (50%) followed by stavudine (d4T) (47.9%), efavirenz (EFV) (45.4%) and finally, Nevirapine (NVP) (18.4%). Most common ADRs were cutaneous (44.4%) followed by hematological (32.2%), neurological (31.1%), metabolic (22.2%) and gastrointestinal (20%). Most common cutaneous ADRs observed were nail hyperpigmentation (14.4%) and rash (13.3%). Immune reconstitution inflammatory syndrome (IRIS) was observed as a paradoxical reaction to ART in 20 (22.2%) cases. CONCLUSION: To optimize adherence and thus, efficacy of ART, clinicians must focus on preventing adverse effects whenever possible, and distinguish those that are self-limited from those that are potentially serious.

Expression of Hb b-T and Hb b-E genes in Eastern India—Family studies.

The distribution patterns of different haemoglobins were observed amongst the family members of β-thalassaemia homozygous and HbE-β-thalassaemia patients with the aid of gel electrophoretic and alkali denaturation techniques. Of the 18 families studied, four belonged to β-thalassaemia homozygous and 14 to HbE-β-thalassaemia patients. Interaction of HbE and β-thalassaemia genes resulted in major clinical abnormalities with increase in the percentages of haemoglobins F and E. The percentages of HbA2 in homozygous β- thalassaemia were within the normal range. Although in Southeast Asia the β° type of HbEthalassaemia is more prevalent, only one individual with this type of thalassaemia was observed during this survey. In the rest of the patients examined the percentages of adult haemoglobin ranged from 5.2 to 42.5 indicating the presence of a b+ type gene.