FACTORS RESPONSIBLE FOR DELAYS IN SEEKING DIAGNOSIS AND TREATMENT OF PULMONARY TUBERCULOSIS IN A TERTIARY CARE HOSPITAL OF DEHRADUN– A CROSS SECTIONAL STUDY

Tuberculosis (TB) is an infectious disease, in which Mycobacterium tuberculosis is the causative agent. When a person progresses from infection to disease, they may not experience obvious symptoms for a long time, (e.g cough, fever, hemoptysis, weight loss etc). This might lead to delay in diagnosis and treatment seeking. One of the components of timely diagnosis and treatment of tuberculosis is estimating the delay in diagnosis of TB and assessing the factors contributing to the delay. To Aim and Objectives: describe the delays in the diagnosis and treatment of pulmonary Tuberculosis and to study the socio demographic determinants responsible for the same. A time bound institution based study was conducted in a tertiary care Methodology: hospital in department of pulmonary medicine. A total of 50 patients were included in the study by means of total enumeration. diagnosti Result: c and consultation delays were the most common cause of delays in seeking diagnosis and treatment of Pulmonary Tuberculosis.

Study of Incidence of Depression, Anxiety and Stress Among the First Year Medical Students in Government Medical College

To study the incidence of depression, anxiety and stress in first year MBBS students of governmentmedical college Jammu. Materials and Methods: the study was conducted on 120 first year MBBS studentsof Govt. Medical College Jammu after informed consent and ethical clearance. All of them were asked tofill DASS - 21 questionnaire without disclosing their identity. Only 118 students responded by filling up theform. The DASS - 21 questionnaire forms so obtained were analyzed, statistically and tabulated. Themean scores for depression was 6.66+5.82, (range-0.00-21), Anxiety was 5.16 ± 3.79 (range-0.00-19.00)and stress was 7.88±5.03 (range-0.00-21). The scores are more in male hostler and student less than 19years of age. Medical studies are highly demanding and cause stress, depression and anxiety to medicalstudents and so should be rescheduled and made student friendly

To Determine the Incidence of Accessory Foramen Transversarium

To find the incidence of accessory foramen transversarium in dried cervical vertebrae. 150 dried cervicalvertebrae were collected from Postgraduate department of Anatomy Government Medical College Jammuand examined for the accessory foramen transversarium.Out of 150 cervical vertebrae, only 24 hadaccessory foramen transversarium with preponderance in sixth cervical vertebrae. Amongst the vertebraewith accessory foramen transversarium, 14 were bilateral and 10 were unilateral. In the present study theincidence of accessory foramen transversarium was 16%. This is important for Radiologists to interpretComputed Tomography Images and Magnetic Resonance Imaging of cervical spine.

A Study of Carrying Angle of Elbow Among Young Adults of Jammu & Kashmir

Introduction - carrying angle is the angle between the median axis of arm with the median axis of fullyextended & supinated forearm. This angle is important for swinging of arm during walking & carryingobjects. There is variability in the carrying angle among different age groups, gender and races. Currentstudy was done to evaluate carrying angle in young adults of J&K. The study was conducted in 150 (75male and 75 female) healthy MBBS students of Government medical college Jammu after obtaininginformed consent. Measurements for carrying angle were taken in both the arms of volunteers. Goniometerwas used to measure the carrying angle. Carrying angle was more in females than males (15.2 in femalesand 12.9 in males) however it was not statistically significant. The carrying angle was more on thedominant side in both the gender i.e. in males right side 13.09, left side 11.2 and females right side 16.54,left side 14.9. All subjects were right handed. No significant sexual dimorphism found though carryingangle was more in females and also on dominant side in both the sexes.

Oncological outcome following TORS in HPV negative supraglottic carcinoma

Objective: The aim of this study was to determine the oncological and functional outcomes following transoral robotic surgery (TORS) in human papilloma virus negative supraglottic cancers. Study Design: A prospective observational study at a tertiary cancer care center, New Delhi, India. Materials and Methods: From February, 2013 to December, 2015, 45 patients with supraglottic lesions underwent TORS using the da Vinci® surgical system. Results: Forty-five patients underwent TORS for supraglottic laryngectomy (SGL), with all patients undergoing bilateral neck dissection. The most common site was Ary-epiglottic fold. 47.9% were cT1 and 52.1% were cT2. Average robotic set-up time was 8.8 min and average robotic operative time was 42.9 min. A positive or close margin was seen in 12 patients (26.7%) on frozen, which were revised intraoperatively. On final histology, 3 (6.7%) patients had a margin of <5 mm. The average closest margin was 5.7 mm. Patients tolerated oral feeds within 2 weeks of procedure. All patients were HPV negative. Postoperatively, all patients had adequate swallowing and speech. Follow-up ranged from 24 to 58 months. Thirty-eight (84.4%) patients were alive and disease free. Conclusion: TORS is a safe, feasible, minimally invasive, and oncologically safe procedure in patients with early HPV supraglottic cancers. It has less morbidity and offers benefits in terms of early airway and feeding rehabilitation and avoids complications resulting from radiation therapy for these patients.

Effect of Malnutrition on the Sequence and Time of Appearance of the Ossification Centres of the Wrist and Hand in Malnourished Children.

Appearance of ossification centres of 500 malnourished children (250 boys and 250 girls) from birth to eight years was observed in the radiographs of the wrist i.e. lower end of radius and ulna and the hand i.e. carpals, metacarpals and phalanges. There was no marked difference in the sequence of appearance of ossification centres, capitate and hamate were first to appear followed by other bones as occurs in healthy children. The centres most commonly retarded in the hand and wrist in the children with malnutrition comprising the current series were the middle and distal phalanges and those least retarded were the capitate and hamate.

Light Microscopic Study of The Lumbar Intervertebral Disc Showing Inherent Difference Between Anterior & Posterior Annulus Fibrosus - A Risk Factor For Posterior Disc Herniation.

The present study is based upon the light microscopic observations made on the foetuses to determine the structural discrepancy in anterior and posterior annulus fibrosus in the development of human foetal lumbar intervertebral disc. A morphological comparison of the structure of anterior and posterior annulus fibrosus was made to consider the arrangement of lamellar bundles. As the foetus advances in age, the anterior annulus fibrosus becomes thicker than the posterior annulus. A very intricate structure was observed in posterior annulus with large number of loose and discontinuous lamellar bundles and more fibre-interlacing angles. Loose connection of the lamellar bundles in posterior annulus of almost all the foetuses indicates an inherent weakness which may lead to posterior rupture of the disc in later life.

Undivided Retromandibular Vein Continuing As External Jugular Vein With Facial Vein Draining Into It : An Anatomical Variation.

Despite the fact that the blueprint of the whole body is unravelled, faultlessly during the growth and development of an animal; but amazingly variations do occur. During routine dissection of head and neck in a middle aged cadaver in the Post Graduate Department of Anatomy of this medical college, we found variation in the formation of external jugular vein on both sides, which was formed by the continuation of undivided trunk of retromandibular vein. The facial vein and posterior auricular vein were the tributaries of external jugular vein. The sound anatomical knowledge of variations of the veins of head and neck is essential to the success of surgical procedures. The embryological evaluation of the above anomaly was done and compared with the available literature which showed that the observed variation was rare.

Induction of in vitro flowering in Capsicum frutescens under the influence of silver nitrate and cobalt chloride and pollen transformation

The influence of silver nitrate (AgNO3) and cobalt chloride (CoCl2) on shoot multiplication and in vitro flowering in Capsicum frutescens Mill. was investigated. Exogenous administration of AgNO3 and CoCl2 at a concentration of 30 micronM resulted in the maximum tissue response in terms of shoot length and number of shoots after 45 days culturing on MS medium. Both silver nitrate (40 micronM) and cobalt chloride (30 micronM) influenced in vitro flowering after 25 and 45 days respectively. This is the first report on in vitro flowering in C. frutescens. The study also demonstrated successful transformation of pollen obtained from the in vitro flowers. Since capsicum is highly recalcitrant to in vitro plant regeneration, the results of the study may be highly useful in transformation of capsicum using germ free in vitro flowers.

A Giant Inguinoscrotal Hernia.

We report a case of giant inguinoscrotal hernia. Such hernial formations are rare (5% cases) and largely a problem of developing countries. Problems arise in the management for both the patient and the surgeon because of the rarity of the reported cases as there is no standard surgical procedure in place for their treatment. Surgical management of such giant hernias has to be individualised.

Agrobacterium rhizogenes mediated genetic transformation resulting in hairy root formation is enhanced by ultrasonication and acetosyringone treatment

The phytopathogenic bacteria Agrobacterium rhizogenes genetically transforms plants by transferring a portion of the resident Ri plasmid, the T-DNA to the plant. Plant species differ in their temporal competence for transformation. But various physical and chemical methods are found to enhance transformation frequency. Agrobacterium rhizogenes mediated transformation efficiency was assessed under the influence of sonication, calcium treatment, acetosyringone and macerating enzymes in suitable combinations in Nicotiana tabacum as a model system. Manual wounding resulted in 21 percent transformation frequency. Where as sonication resulted in 2.2 fold increase, followed by sonication with CaCl2 treatment resulted in 2.5 fold increase and sonication with acetosyringone treatment resulted in 4.1 fold increase in transformation frequency. However, sonication with macerating enzyme treatment resulted in 1.5 to 5.25-fold decrease in transformation frequency. Micro wounding through sonication followed by acetosyringone treatment enhanced transformation frequency substantially. The results of this study may be very useful in genetic manipulation of plants by Agrobacterium rhizogenes mediated gene delivery to higher plants, which are recalcitrant to A. tumefaciens mediated genetic manipulation.

In vitro clonal propagation of bird eye chilli (Capsicum frutescens Mill.).

An efficient and highly reproducible protocol for micropropagation of bird eye chilli Capsicum frutescens was attempted. Murashige and Skoog (MS) medium containing 0.5-3.0 mgl(-1) of 6-benzyladenine (BA), 2-isopentenyl adenine (2iP), kinetin and 0.5-2.0 mg l(-1) of indole-3-acetic acid (IAA), indole-3-butyric acid (IBA) along with 1 gl(-1) activated charcoal (AC) were used for shoot regeneration from both shoot tip and nodal explants. Shoot tip explants (100%) grew well on medium containing 1 mgl(-1) of kinetin and 1 mgl(-1) of IBA. Shoot proliferation (1-3) from nodal explants was effective on this medium. The regenerated shoots with 4-7 nodes had further growth upon sub-culturing onto kinetin (1 mgl(-1)) and IBA (1 mgl(-1)) and rooted simultaneously. The rooted plants were transferred to pots after hardening under controlled conditions. The survival percentage in pots was 80-90%.