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Background: Vitamin D along with calcium plays an important role for the maintenance of musculoskeletal health during whole life, and it is essential to address their deficiency pediatric and adolescent population is vital. Ideally, all the children should be screened for Vitamin D deficiency because a large number of Vitamin D deficient are asymptomatic, but it is practically difficult to do Vitamin D levels in all the healthy children. Aims and Objectives: The aim of the study is screening children presenting with signs and symptoms suggestive of Vitamin D deficiency and tried to correlate the presenting clinical feature with the level of Vitamin D with the following objectives: (i) to study the level of Vitamin D (25 hydroxy Vitamin D) in apparently healthy children with clinical features indicating of Vitamin D deficiency and (ii) to correlate the specific clinical features with Vitamin D level. Materials and Methods: This study was approved by the institutional ethics committee, and informed consent was obtained by writing from the parents before starting of the study. Cross-sectional observation study conducted between November 2021 and November 2022 by convenient sampling method. Young children and adolescents of age group of 2–14 years attending OPD at SRVS Medical College Shivpuri was the study population. Results: The present study done in Shivpuri belt the prevalence deficiency of Vitamin D was found to be 52% in children. Prevalence of Vitamin D deficiency in Madhya Pradesh is high, pointing as the severe and critical public health issue. Conclusion: Vitamin D deficiency done by serum concentrations of 25 (OH) D if less values proper suggestive treatment is recommended.
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Background: Ineffective erythropoiesis is a predominant feature in ?-thalassemia major (?-TM), causing marked erythroid expansion leading to highly raised levels of growth differentiation factor-15 (GDF-15), which, in turn, suppresses hepcidin production in liver resulting in increased iron absorption from gut. We aim to study the serum GDF-15 in polytransfused ?-TM patients and its correlation with serum ferritin and serum hepcidin. Method: Thirty-nine polytransfused ?-TM children aged between 5 and 17 years and 33 age- and gender-matched healthy controls were enrolled in the study. Complete blood count, serum GDF-15, serum ferritin, and serum hepcidin were performed. Results: The mean serum GDF-15, serum hepcidin, and serum ferritin levels were 638.65 ± 306.96 pg/ml, 108.21 ± 191.30 ng/ml, and 2274.60 ± 1216.08 ng/ml, respectively, which were significantly higher than control group (P < 0.001, P = 0.003, P < 0.001, respectively). There was significant positive correlation of GDF-15 with blood transfusions (r = 0.415, P = 0.009), positive correlation with serum ferritin (r = 0.653, P = 0), and significant negative correlation with serum hepcidin (r = ?0.508, P = 0.001). Conclusion: The findings of the present study suggest that GDF-15 is an important regulator of hepcidin in ?-TM patients. GDF-15 and serum hepcidin together can be used to monitor iron overload and its related complications in such patients.
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Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder associated with habit of chewing betel quid containing arecanut. Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1? (HIF-1?) which is also said to be associated with malignant transformation of epithelial cells in various other carcinomas like prostate and cervical carcinoma. Therefore, the main objective of this study was to investigate the role of HIF-1? in progression and malignant transformation of OSMF. Materials and Methods: The study group consisted of histo-pathologically diagnosed 30 cases of oral submucous fibrosis and 10 cases of OSCC were taken as control. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1?. Statistical analysis was done using SPSS software version 2.0. Results: A gradual and significant rise in the expression of HIF-1? was observed in various grades of OSMF and OSCC cases. HIF 1? expression was increased in cases showing hylanization and constricted blood vessels. A cut off value of 39.6% of HIF-1? positive cells was determined statistically to categorize the cases into high risk and low risk group for malignant transformation. Conclusion: Overexpression of HIF-1? may contribute to the progression and malignant transformation of OSMF. Cases expressing more than 40% of HIF-1? positive cells are at a greater risk for malignant transformation.
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?-Glutamyltransferase (GGT) has been extensively studied because it mediates the intracellular uptake of extracellular glutathione, a key component of the antioxidant mechanism. The most common modifiable risk factor for cardiovascular disease is hypertension, and has been found to be associated with serum GGT levels, especially in middle-aged and older adults. Serum GGT is involved in the pathogenesis of hypertension. A case-control study was conducted for 24 months with patients with pre-diagnosed hypertension in the ophthalmology department. Patients were classified into two groups, group 1 with 50 patients previously diagnosed hypertensive patients aged 40 years without hypertensive retinopathy and group 2 (100 patients) with had hypertensive retinopathy. Serum gamma-glutamyl- transferase was measured using the CORAL Colorimetric Assay Kit. Majority of patients were aged between 40 to 59 years and were females. SBP, DBP and MAP significantly increased in group 2 when compared with group 1. Majority of group 2 patients had GGT levels >40 U/l (89.0%), while the majority of group 1 had her GGT levels less than <40 U/L (62.0%). According to our study, GGT was significantly increased in patients with high blood pressure (SBP and DBP) and a family history of hypertension.
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Jealousy and Envy are essential part of human emotions and behavior. In today’s fast-moving world where everyone is in rush to cut-throat competition, it is more important to discuss these emotions than ever before. Jealousy and envy somewhere connected. Jealousy is a practice to defend something that is owned and threatened whereas envy is a tendency to obtain something that does not own by one. Jeal-ousy and envy develop naturally and also test their character by the response they give due to emotional burnout. Sometimes these situations broke and turn healthy competition into a rivalry at cost of long-standing personal relationships. Jealousy and envy include compound emotional experiences during the exercises to acquire or not lose something desirable. The impact of envy and jealousy is not assessed in academia and research area moreover it is important to understand that envy is often hidden in the classroom context, but it must still be discussed.
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There is no doubt that consequences of health workforce migration are serious for any developing coun-try. The world's largest health care migrating population is from India. India has a population of 1.38 bil-lion, about 17.7% of the world’s population and we, as a nation, are struggling to prepare future-ready health care professionals and our own health professionals’ needs are not met. However, large numbers of Indian nurses migrate to developed countries due to numerous factors. Economic factors are consid-ered main force for migration, but not always purely responsible, as nurses look for safety, security, re-spect, and dignity of their profession. This scoping review is employed to find causes, consequences, and strategies related to international migration of Indian Nurses.
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Aim: The study was undertaken to isolate, characterize and molecularly identify plant growth promoting rhizobacteria (PGPR) associated with rice rhizosphere occurring in Gangetic plains of the country. Methodology: One hundred forty three plant growth promoting rhizobacteria were isolated on various culture media and characterized culturally and morphologically through Scanning Electron Microscope. These rhizobacterial isolates were further screened for plant growth promoting activities like HCN production, siderophore production and phosphate solubilisation. The 16S rDNA sequencing was done to decipher phylogenetic relationship among 19 selected PGPRs. Besides, these were also tested for anti-oxidative enzyme production to mitigate deleterious effects of various stresses on plant growth and metabolism. Results: Nineteen potential plant growth promoting rhizobacteria were characterized for plant growth promoting attributes and were indentified at molecular level. Rice is well colonized by bacteria mainly Bacillus spp., Pseudomonas spp., Burkholderia sp., and Acinetobactor spp., Rice seeds treated with microbial consortium of MAU 143 + MRT 84 recorded in increased antioxidant production–SOD activity (0.02 U mg−1 f.w.t.), POX activity (0.16 U mg−1 f.w.t.), POP activity (0.06 U mg−1 f.w.t.) and TPC assay (1.17 µg gallic acid mg-1 extract) which might have stimulated the growth of radical (2.2 cm) and plumule (1.6 cm) over control. These three PGPRs viz., MAU 143, MRT 84 and MRT 92 strain showed great potential to improve antioxidant and total polyphenol production and seed vigour of rice seedlings. The identified rhizobacterial strains may be used for plant growth promotion and improvement in nutrients mobilization and oxidative stresses in rice production. Interpretation: The study suggested that plant growth promoting rhizobacteria isolated from rice rhizosphere have greater potential to improve soil nutrients status while provide resistance against infection of pathogenic microbes due to production of anti-oxidative enzymes and phenolic compounds in rice seedlings.
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Background: Infection from scrub typhus has been documented in different areas of Nepal and Chitwan is one of the risk-prone areas. Objective: This study aimed to find out the prevalence of scrub typhus in patients suffering from an acute febrile illness (AFI) as well as their knowledge about it. Materials and Methods: Descriptive study was conducted in Chitwan Medical College (CMC), a tertiary care teaching hospital in Chitwan. A total of 301 patients with AFI admitted in different medical units and screened for scrub typhus by immunoglobulin M enzyme-linked immunosorbent assay method were selected purposively as a study sample. Face to face interview, record review, and blood reports were used to collect the required information. Data were collected from May 1, 2018, to December 2018. Before data collection, ethical approval was obtained from CMC Institutional Review Committee. Obtained data were entered into IBM-SPSS version 20 for window and analyzed using descriptive and inferential statistics. Results: The findings of the study revealed that 13.3% of patients with AFI were positive for scrub typhus. The most common symptoms among patients were fever (100%), headache (59.1%), vomiting (27.0%), and cough (26.7%). Out of 301 patients, only 70 (23.3%) had heard about scrub typhus. Among 70 patients, more than half 41 (58.6%) had a high level of knowledge on scrub typhus. On item wise knowledge, more than half of the patients knew that scrub typhus as infectious disease (52.9%), transmitted through the bite of mites (61.4%) but not transmitted through person to person (65.7%). However, only 38.6% knew that scrub typhus rapidly spread in the rainy season. Moreover, less than half of the patients knew that wearing closed footwear (41.4%), using insect repellents (48.6%), and avoiding traveling to mite infected areas (45.7%) are the preventive measures of scrub typhus. Conclusion: Our results highlight that scrub typhus infection is an important cause of AFI, and patients must be routinely screened for the proper diagnosis and timely treatment. Moreover, very few had heard about scrub typhus and its preventive measures, so awareness program on scrub typhus is needed for the risk groups to enhance their knowledge.
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Background: Birth weight is probably the single most important factor that affects neonatal mortality, infant and childhood morbidity in both developed and developing countries. Objective of the study was to formulate a model for prediction of fetal weight at term based on individualized fetal growth parameters.Methods: 131 participant low risk gravidas were enrolled into the study. The participants underwent an ultrasound 7 days prior to delivery. All fetal variables of growth of a random 100 participants were incorporated in an equation derived using multiple regressions to predict birth weight at term. The new equation was then prospectively applied to another 31 pregnant women for validation. The diagnostic performance of the new regression formula was then compared to the Hadlock formula.Results: The customised birth weight formula predicted a higher accuracy with MPE±SD of 0.790±9. compared to the Hadlock formula with MPE±SD - 4.42±8.73. The new formula also explained a greater variance in birth weight of 56% compared to the Hadlock formula of 49%.Conclusions: The new model based on individualized fetal growth parameters recognizes the capacity to modulate an accurate final birth weight, thus emphasizing the need for customized population specific birth weight formulas.
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Aim: The study was conducted to determine the impact of landuse on soil physical properties and erodibility. Methodology: Representative soil samples were collected from surface and sub-surface soil depths. Soil physical properties and erodibility indices viz suspension percentage, dispersion ratio, clay/moisture equivalent ratio, erosion ratio, percolation ratio, clay ratio, erosion index and modified clay ratio were determined using standard procedures. Interrelationship among soil properties and erodibility indices were evaluated using Pearson correlation analysis (at 95% and 99% significance level). Results: Among landuse systems, the clay was highest in forest while least in soils under barren landuse. Lowest bulk density and highest value of maximum water holding capacity was found in forest soils. According to susceptibility to erosion, the landuse systems were found in the following order barren lands > cultivated systems (agriculture and horticulture) > forest lands. The ‘r’ values showed positive and highly significant correlations between sand content and bulk density with suspension percentage (SP), clay ratio (CR), modified clay ratio (MCR), dispersion ratio (DR), percolation ratio (PR), erosion ratio (ER), erosion index (EI) while negative and significant correlations of these erodibility indices were found with clay and porosity. Among the erodibility indices SP, DR, PR, ER and EI were positively and significantly correlated with each other. Interpretation: Physical quality of soil was higher in forest compared to other landuse systems. Erodibility of different landuse systems could be arranged in order barren lands > cultivated systems (agriculture and horticulture) > forests. The study was useful for suggesting remedial measures and landuse planning for future
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Background: Medication adherence is crucial for optimizing clinical outcomes in chronic obstructive pulmonary disease (COPD) patients because non-adherence possess significant burden in health and economy. Patients’ medication adherence is influenced by numerous factors. Objective: The objective of this study was to identify the factors affecting medication adherence among COPD patients attending at teaching hospital, Chitwan. Materials and Methods: A descriptive cross-sectional study was carried out among 121 clinically diagnosed COPD patients attending at a teaching hospital, Chitwan. Non-probability purposive sampling technique was used to select patients for the study. Ethical approval was taken from Chitwan Medical College – Institutional Review Committee and informed consent was obtained from patients. Pre-tested semi-structured interview schedule and a standardized tool “Morisky Medication Adherence Scale, 2008" were used to gather the data by the researcher from November 16, 2016, to December 15, 2016. Bivariate and multinomial logistic regression analyses were performed to analyze the data. Results: Findings of the study revealed that out of 121 patients, 55.4% had medium level, 28.9% had a high level, and 15.7% had a low level of medication adherence. Bivariate analysis showed that patients’ level of medication adherence was significantly associated with an understanding of disease condition from family members (P = 0.03), support from neighbors as needed (P = 0.02), having own monthly income (P = 0.04), and affordability of medication cost (P = 0.02). Multinomial logistic regression analysis identified that patients who can afford the cost of medication (odds ratio [OR]: 6.39, 95% confidence interval [CI]: 1.27–32.11), had family understanding about disease condition (OR: 11.18; 95% CI: 1.76–70.66), get support from neighbor as needed (OR: 11.92; 95% CI: 2.39–59.34), and had accessible to health facilities at <30 min distance (OR: 0.10; 95% CI: 0.02–0.55) were more likely to have high level of medication adherence. Conclusion: Only one-third of the COPD patients have a high level of medication adherence. Hence, local health-care planners need to organize the educational program on medication adherence for COPD patients by considering the notable factors to enhance their quality of life.
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A healthy and clear facial impression plays the important part for the development of the personality. Since ages, Acne vulgaris has always been one of the most burning problem of the adolescents. It affects the most prominent part of our body, the face. Among the multifactorial etiology of acne hormonal imbalance and infections are most important. Acne is a cutaneous pleomorphic disorder of the pilosebaceous unit involving abnormalities in sebum production and is characterized by both inflammatory (papules, pustules and nodules) and non-inflammatory (comedones, open and closed) lesions. Propionibacterium acnes is responsible for the development of acne vulgaris. Acne Vulgaris can be correlated with Mukhadushika or Yuvanpidika on the basis of similarity in the etiopathogenesis, symptoms, treatment and complication. In Ayurveda it is the Shalmali thorn like eruptions on the face of adolescent due to vitiation of Kapha, Vata and Shonita. Allopathic treatment includes treatment for all forms of acne as topical retinoids and benzoyl peroxide, oral antibiotics, steroids etc. But these causes serious adverse effects. So it is necessary to find out effective and safe treatment for Acne Vulgaris. Ayurveda is for it which plays important role through its principles i.e. Shodhana, Shamana and Nidanparivarjana. As described by various Acharya the Shodhanachikitsa includes Vamana, Virechana and Shiravedha. Among Shodhana, Virechana process is the safe and effective treatment, providing long lasting result for better life of patient.
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Background: Visceral fat or intra-abdominal fat is the adipose tissue surrounding mesenteries and omentum. This has been linked to lifestyle diseases like heart diseases, arthritis, stroke and even cancer. At present we have three tools to measure visceral fat area (VFA) – Bio impedance analysis, Magnetic resonance analyser and DEXA scan. Neck circumference measurement is a simple, easy to do and a quantifiable method of measuring visceral fat. Aim & Objective: This study aims to find correlation of visceral body fat with Neck Circumference (NC) and Body Mass Index. Methodology: A cross sectional study was carried out in a medical college of western Maharashtra, wherein 290 healthy males (>18 years) were selected by simple random sampling over a period of 7 months from (February 2018 – August 2018). Data was analyzed using SPSS version 20.0. Visceral body fat was measured using Body Space 720 and neck circumference using measuring tape. Results: We found a significant association between neck circumference and VFA. There is a strong association between NC of >35cm and VFA >100cm2. NC can be useful in field settings as it can be used easily by health care workers in predicting risk of lifestyle diseases.
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Aim: Root architecture of 220 diverse barley germplasm of Indian (134) and exotic (86) origin was evaluated for polyethylene-glycol simulated drought stress to identify drought tolerant genotypes. Methodology: The evaluation of root images was done using root scanner (WinRHIZO Pro software v2009). Variance, Principal Component Analysis (PCA) and Ward’s agglomerative hierarchical clustering were carried out using SAS software. Correlation matrices were generated using R. Results: Analysis of variance indicated that under stress treatment, differences among the tested germplasm accessions were highly significant (P0.01) with respect to total root length (RL), seminal root number (SRN), root surface area (RSA), root volume (RV), root diameter (RD), lateral root number (LRN) and root dry weight (RDW) per seedling. LRN was stimulated while other root traits such as RL, RSA, RV and RDW were significantly inhibited under stress. PCA indicated that first three components accounted for 80.50% of the total multivariate variation with PC1 accounting for 44.83%, PC2 for 19.84% and PC3 for 15.87% and it was mainly explained by RL, RSA, RV and RDW. Cluster analysis grouped 220 barley accessions into five major clusters, with cluster I being drought susceptible, cluster II being drought tolerant, cluster III being moderately drought tolerant, Cluster IV being highly drought tolerant and Cluster V being highly drought sensitive, respectively. Interpretation: Accessions IC393980, IC082719, IC329556, EC492318, EC578789, EC578790, IC335811 and wild barley H. marinum ssp. gussoneanum proved to be potential genetic resources for drought tolerance, which can be used in cereal breeding program for rain-fed agriculture.
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Background & objectives: The risk estimation for foetal aneuploidies in the first trimester of pregnancy uses reference curves based on western data. The objective of this study was to construct the reference curves of first-trimester foetal aneuploidy screening parameters for the Indian women. Methods: Cross-sectional data were obtained from 1204 singleton pregnancies between the crown-rump length (CRL) of 40-84 mm. Linear regression models were constructed; the mean, median and standard deviation were derived as a function of CRL. Results: The mean value of CRL was 61.3 mm. The regression analysis showed a significant correlation between all variables and CRL (P< 0.001). There was a positive correlation of CRL with nuchal translucency (NT) (y=0.010x+0.629, R2=0.116) and pregnancy-associated plasma protein-A (PAPP-A) (y=0.107x?1.079, R2=0.173), whereas inverse correlation was seen with free ?-human chorionic gonadotropin (?-hCG) (y=?0.409x+75.025, R2=0.018) and Doppler parameters pulsatility index (PI) (y=?0.008x+1.924 R2=0.053). The centile charts of NT, PAPP-A, free ?-hCG and uterine artery (Ut A) Doppler PI were constructed. Interpretation & conclusions: The reference centile charts of first trimester aneuploidy screening along with Doppler parameters were derived in Indian pregnant women. These centile charts may be used as a reference for clinical use in Indian population.
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Ensuring quality in healthcare today has become extremely essential to ensure adequate utilization of healthcare services andimproved outcomes. In addition to essential infrastructure in terms of safe and adequate space, knowledgeable and skilled healthworkers, and essential equipment and supply, the healthcare teams and administrators must also acquire knowledge and skills relatedto quality improvement (QI) methodologies. This review describes the role of learning platforms in teaching QI skills to the busyhealthcare teams. Through Review of the published literature, we discuss challenges of learning and applying new skills of QI in day-to-day work by healthcare teams, and how learning platforms can assist in capacity building. There is a significant body of literature onthe role of web-based teaching technology and learning platforms in medical education. Using modern communication technology,learning platforms can be established to bring together the healthcare teams, with QI experts to collaboratively learn, execute andshare their experiences in improving quality of care in their own healthcare settings.
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Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that is often preventable and treatable. In Ayurvedic texts Shwasa Roga has been described having symptomatology close to COPD. COPD damages the airways in lungs and leads to shortness of breath, impacting patient`s work, exercise, sleep and other everyday activities. More than 11 million people in the U. S. suffer from COPD and its prevalence has been increasing steadily over the past 20 years. It causes serious long-term disability and early death. COPD includes both chronic bronchitis and emphysema. Risk factor includes exposure to air pollution, second-hand smoke and occupational dusts and chemicals, smoking, cold weather etc. which are also mentioned in Ayurvedic classics. Identification, reduction and control of risk factors to prevent the onset of COPD are important steps towards developing strategies for prevention of COPD. The aims and objectives of Ayurveda are to maintain the health of a healthy person and to cure the diseases of the patients. It is signifies that “prevention is better than cure.” To maintain the health, Ayurveda laid many basic principles like Ritucharya (seasonal regime), Dincharya (diumal regime) etc. The Yogic procedures and the concept of Pathya (wholesome) and Apathya (unwholesome) is the peculiarity of Ayurveda for the management of COPD and the treatment module includes- Panchakarma (Vamana, Virechana, Dhumapana and Nasya), external therapies (Lepas, Dhara, Sthanika Abhayanga and Swedana) and internal medications are very effective in COPD.
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Background: Vitiligo is an acquired, hypomelanotic disorder characterized by circumscribed depigmented macules in the skin resulting from the loss of functional melanocytes from the cutaneous epidermis. It also causes significant psychological and social distress. Aims and Objectives: To compare the efficacy of follicular unit extraction and non cultured melanocyte transfer in patients of stable vitiligo with respect to repigmentation, vitiligo noticeability and global treatment success. Material and Methods: A total of 15 patients with stable vitiligo (as per IADVL guidelines) were enrolled in the study. In the same patient follicular unit extraction (FUE) was done in the vitiliginous lesions and the hair was transplanted approximately 3-5 mm apart on the left side of the body, while another vitiliginous lesion in the same patient was selected for non cultured melanocyte transfer (NCMT) which was done on the dermabraded area on the right side of the body. These patients were followed-up for a period of 6 months, initially at every 2 weeks or till first signs of repigmentation, then monthly follow-ups for two times and then followed-up in every 2 months. Visual analogue scale was used for assessment of repigmentation, VNS scale was used to evaluate vitiligo noticeability and global treatment success was calculated. Results: There were 2 (13.3%) females and 13 (86.7%) males in our study, showing a male preponderance. Majority of the patients were in the age group 21-40 years (66.7%). There was statistically significant increase in the mean pigmentation at each follow-up in comparison to the earlier follow-up in both the groups (p<0.05). The mean pigmentation and mean pigmentation difference, between the two groups was also comparable (p>0.05). Excellent pigmentation was seen in 60% patients of FUE and 73.3% patients of the NCMT group. Vitiligo was ‘not noticeable’in 33.3% patients of FUE and 40.0% patients of NCMT group. Global treatment success was 80% in both the groups. Bony prominence, greying and loss of follicles in FUE group; and graft displacement and herpes zoster in NCMTgroup were the factors responsible for low pigmentation. Conclusion: From the above study, we conclude that repigmentation was seen in both the groups, with equal efficacy seen between the two methodologies. Thus, any method can be applied for repigmentation with due considerations to complications of each method used.