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Purpose: To evaluate peripapillary?RNFL thickness in myopia by Cirrus OCT among north Indian population by spherical equivalent (SE), age, gender, and axial length (AL). Methods: This was a cross? sectional study held during 2019–2020. Patients aged 18–60 years underwent ophthalmic examination including retinoscopy, AL, and OCT RNFL thickness. Persons with previous ocular surgery or ocular ailment other than refractive error were excluded. The peripapillary?RNFL thickness was noted and compared by demographic determinants. Results: We examined 300 eyes of 300 persons (mean age: 30.75 ± 8.57 years; 144 males/156 females). Among them, 224 were myopes and 76 were emmetropes (EM). The mean SE was ? 3.3 ± 0.4D (range: ?11.0D to + 0.37D). The mean AL was 24.61 ± 1.92 mm (22.1–29.5). Overall temporal, nasal, superior, inferior, and mean peripapillary?RNFL thickness was 66.31 ± 7.58, 78.57 ± 16.00, 120.63 ± 11.69, 116.60 ± 15.80, and 95.50 ± 10.84 ?m, respectively. Temporal, nasal, superior, inferior, and mean peripapillary?RNFL thickness was 73.97 ± 8.36, 94.84 ± 7.63, 127.96 ± 8.96, 136.89 ± 6.53, and 108.34 ± 6.28 ?m, respectively, in EM eyes as compared to 63.71 ± 6.18, 73.05 ± 14.24, 118.21 ± 11.53, 109.71 ± 11.50, and 91.14 ± 8.31 ?m, respectively, in myopic eyes (P < 0.001). Association of peripapillary?RNFL thickness with myopia and its different grades was P < 0.001. Association of mean peripapillary?RNFL thickness with age was P > 0.005 and gender was P = 0.168. Correlation between SE and RNFL thickness was positive and significant. Correlation between AL and RNFL thickness was negative but statistically significant. Association of AL with SE was P < 0.001. Conclusion: We provide normative peripapillary?RNFL thickness in the north Indian population in order to help in screening for myopia with comorbidity such as glaucoma based on RNFL thickness.
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Abstract This study was aimed to develop the haloperidol (HPL) loaded solid lipid nanoparticles (SLNs) for brain targeting through the intranasal route. SLNs were fabricated by the emulsification diffusion technique using glyceryl behenate as lipid and tween 80 as a surfactant. SLNs were evaluated for particle size, zeta potential, structure, entrapment efficiency, solid state characterization by differential scanning calorimetry (DSC), and in-vitro release. In-vivo biological evaluation was performed on albino Wistar rats for the determination of pharmacokinetic as well as brain targeting parameters. Particle size, PDI, zeta potential, and entrapment efficiency of optimized formulation (HPL-SLNs 6) were found to be 103±09 nm, 0.190±0.029, -23.5±1.07 mV, and 79.46±1.97% respectively. In-vitro drug release studies exhibited that 87.21± 3.63% of the entrapped drug was released from the SLNs within 24 h. DSC curves confirmed that during entrapment in SLNs, the drug was solubilized in the lipid matrix and converted into the amorphous form. Enhanced HPL targeting to the brain was observed from HPL-SLNs as compared to HPL-Sol when administered intranasally. The value of AUC 0-∞ in the brain for HPL-SLNs i.n. was found to be nearly 2.7 times higher than that of HPL-Sol i.v., whereas 3.66 times superior to HPL-Sol administered i.n. Stability studies revealed that the formulation remains unchanged when stored at 4±2 °C (refrigerator) and 25±2 °C /60 ±5% RH up to six months. Finally, it could be concluded that SLN is a suitable carrier for HPL with enhanced brain targeting through i.n administration, as compared to the HPL-Sol, administered i.n. and i.v.
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Goats are considered as an important animal not in present scenario but also from ancient time. Due to increasing frugal interest of goat farming globally, profound animal husbandry practices are attaining importance under the target of obtaining quality products along with good animal health and welfare. During the transition phase of life, noticeable alterations in the endocrine and metabolic status of the dairy ruminants were registered. Among small ruminants i.e. goat’s hypocalcaemia, hypoglycemia/Pregnancy toxemia and hypomagnesaemia are the common metabolic disorders which normally precipitated during metabolic anxiety phase. The present study was conducted during the period of 1st January 2019 to 31st December 2019. During this period we had registered total 957 goats at Kalsi, Chakrata areas of district Dehradun, Chorgalia, Kotabagh, Kaladhungi areas of district Nainital and Shetlai, Pantnagar, Bazpur areas of district Uddham Singh Nagar beside this we had also included the concerned cases from Government Veterinary Hospital Outpatient departments (OPDs) of the above said areas in Uttarakhand. In the present study, we had performed a prevalence study over common occurring metabolic diseases of goats like hypocalcaemia, hypoglycemia/pregnancy toxemia and hypomagnesaemia. Besides this, we had also studied the dissemination pattern of common occurring metabolic diseases on the basis of their age groups and parity
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The present study was aimed to evaluate the ameliorative potential of melatonin against L-arginine induced acute pancreatitis in rats. Male Sprague Dawley rats (150–240 g) were divided into 3 groups, viz. group I (control group), group II (acute pancreatitis control group) and group III (treatment control) which were further subdivided into 3 subgroups according to time points of 24 hours, 3 days and 7 days. Rats from groups II and III received two injections of L-arginine (2 g/kg i.p.) at 1 h intervals for induction of acute pancreatitis. Melatonin was administered to group III daily at a single dose of 10 mg/kg i.p. On 6 hours, 24 hours, 3 days and 7 days, blood samples were obtained from each group and subjected for the assays of oxidative stress and serum biochemical parameters. Erythrocytic lipid peroxides contents in acute pancreatitis group were significantly higher, while reduced glutathione contents were significantly lower in comparison with the normal controls. The activities of other antioxidant enzymes were also significantly low in these rats. Moreover, significantly increased activities of serum amylase and serum lipase were found in these rats. Administration of melatonin significantly reduced the over production of malonaldialdehyde levels. Other antioxidant enzymes viz. reduced glutathione, superoxide dismutase and catalase activities were improved significantly in melatonin treated rats. Melatonin had also considerably ameliorated the altered serum amylase and serum lipase levels towards normalcy. Thus, it can be concluded that melatonin may possess therapeutic efficacy against L-arginine induced acute pancreatitis in rats
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Background: Chronic kidney disease (CKD) is a major health deteriorating factor worldwide as well as in India. It encompasses various pathophysiological processes involving abnormal kidney function and thereby declination in glomerular filtration rate (GFR). CKD is known risk factor for dyslipidemia. Due to lack of studies of association between different lipid parameters and its association with severity of CKD in non-diabetic patients in Indian population, we designed a study aimed to describe the serum lipid profile in non-diabetic CKD patients.Methods: This hospital based observational analytical was carried out in 60 subjects with CKD and non-diabetic. They were investigated for blood sugar parameters, lipid profile and renal function tests. Lipid profile was associated with different stages of CKD. Data was expressed as percentage and mean±SD.Results: Mean BMI was found to be 21.6±2.7kg/m2. Most common symptom encountered was H/o edema in 98% subjects. Out of total sixty subjects’ maximum subjects were found to be in stage 4 (22 subjects, 36.7%). Significantly higher levels of serum creatinine (p <0.0001), and serum urea (p <0.0001) was observed in higher grade CKD stages in study subjects.Conclusions: Total cholesterol (TC) and LDL were found to be significantly different amongst CKD stages having higher mean values in non-diabetic subjects. Serum TC, TG, LDL and VLDL were found to be significantly higher in subjects with advanced CKD (stage 3, stage 4). TC/HDL and LDL/HDL ratio were significantly higher in subjects with advanced CKD compared to initial stages of CKD in non-diabetic subjects.
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Background: Mandibular foramen (MF), present on the medial surface of ramus of the mandible, leads to themandibular canal through which inferior alveolar nerve (IAN) and vessels transmit. IAN block is a commonanaesthetic procedure before dental and reconstructive surgeries. Surgeons usually do IAN block in their clinicsand encounter failure of block because of variable position of MF.Objective: The present study was carried out to find the most common position of MF in north Indian population.Materials and Methods: Study was done on 50 dry adult human mandibles of unknown sex and age of northIndian origin. Height was measured from the angle of the mandible to the highest point on condyloid process.Mid point of the line joining these points was noted. The position of MF was observed in relation to pre noted midpoint.Results: MF was placed below the level of mid point in 40 mandibles (80%).Conclusion: The knowledge of most common position of MF will help the surgeons to reduce the chance ofunsuccessful IAN block.
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Background: Inguinal hernia is a common condition dealt by surgeons in our country. It is said to be asoociated with increasing age, male gender, smoking, connective tissue disorder and factors responsible for increased intraabdominal pressure. Development of inguinal hernia and its relation with body weight is controversial. So present study has been carried to find out relation of body mass index with development of inguinal hernia in both gender, various age groups and its association with type of inguinal hernia. Methods: This was a prospective study carried out on patients of primary inguinal hernia belonging to Bundelkhand region of India. Patients were categorized according to Body Mass Index (BMI) as normal weight (BMI=18.5-24.9), overweight (BMI=25–29.9), class 1 obese (BMI=30–34.9), and morbid obese i.e. class 2 & 3 obese (BMI≥35). Data were further classified in groups formed on the basis of BMI of patient versus age, gender of patients and type of inguinal hernia viz. direct/ indirect hernia. All the findings were tabulated and inferences were drawn followed by statistical comparison with the help of “Statistical Calculator v 4.0” using suitable test viz. chi-square test with p value <0.05 considered as significant. Results: Age groups ranging from 21 years up to 70 years had highest number of patients who were having normal weight (BMI =18.5-24.9). Among the male gender, highest number of patients belonged to BMI group of 18.5-24.9 (i.e. normal weight). Patient group with BMI of ≥ 35 (i.e. class 2 & 3 obese) had the least frequency distribution in males as well as in females. Among the patients of primary direct inguinal hernia and primary indirect inguinal hernia, patient group with BMI of 18.5-24.9 (normal weight) showed highest frequency and patient group with BMI ≥ 35 (class 2 & 3 obese) showed least frequency. Conclusion: Present study shows that in our study population, high Body mass index is not associated with high occurrence of inguinal hernia among the genders and different age groups, rather it seems to be protective for inguinal hernia
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Background: Anatomical variations of the skeleton provide information on daily activities, living conditions, cultural behaviour and health problems of any society. Squatting is a good example of such behaviour/function producing skeletal markers due to remodelling, on the bones of lower limb by putting strong pressure and traction forces on the knee and ankle joints. It is associated with modifications of the neck of the talus (squatting facets) and its trochlear- malleolar surfaces (trochlear extensions). Methods: An observational analytical study was designed to observe anatomical variations in 616 dry, macerated human tali of both sides in north Indian population where squatting is a part of regular behaviour. Differences in the form and extent of this facet, trochlear extensions or articular (malleolar) extensions may be noted. Results: The frequency of occurrence of these facets and extensions has been found to vary considerably in different races. A much more pronounced forward prolongation has been found to be present in the north Indian talus in this series. A high frequency of forward prolongation of medial articular surface in Indian population suggests that, not only the squatting posture and habitual sartorial posture (palthi position/ tailor position) but the prevalence of walking for long distances may be responsible for this. Conclusion: The results provide an opportunity to study the relationship between past and modern population, and also describe the daily activity of life and cultural structure. Anatomical variations of the neck of the talus (squatting facets) and its trochlear- malleolar surfaces (trochlear extensions) can be of help in pathologies of foot for reconstruction and rehabilitation procedures. It will also provide ethnic data for anthropologists and forensic experts about talar variations and would be of direct relevance in anatomy teaching
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Lung cancer is a leading cause of cancer related death worldwide. It is increasing at a very fast rate in both men and women. Some significant mutations occurring at molecular level in lung adenocarcinoma, like ALK, EGFR, KRAS, MET, and, ALK (anaplastic lymphoma kinase) gene mutations for an ALK encoded transmembrane receptor tyrosine kinase domain and subsequently participating in the progression of Non-Small Cell Lung Adenocarcinoma (NSCLC). Some fusion partner genes involved in this process are EML-4, KLC1, KIF5B and TFG. The ALK-EML-4 rearrangement is the second most common oncogenic mutation in the nonsmall cell lung adenocarcinoma. There is 3-7% ALK mutation occurring in early or never-smokers in accompanying NSCLC. The NSCLC with ALK gene mutation generally do not have EGFR or KRAS gene mutation which are also molecular markers, which get mutated in cancer. For the detection of ALK mutation in NSCLC, different types of techniques like Fluorescence in situ Hybridization (FISH), Immunohistochemistry (IHC) and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) are being used. On the basis of sensitivity and specificity, FISH is gold standard in detecting the mutation when compared with other methodologies like IHC and RT- PCR. However in the Indian setting, FISH is more expensive and hence not available everywhere. In this review the efficacy of these different techniques in detecting ALK mutation and the detailed interpretation of results obtained with FISH has been discussed. For the treatment of ALK/MET mutated NSCLC patients an orally administered drug, crizotinib drug (tyrosine kinase inhibitor) has been approved by Food and Drug Administration (FDA) of United States. Highly sensitive and specific techniques are used for the detection of ALK gene mutation in NSCLC patients which have to be given for crizotinib treatment.
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Abstract: Background: Aim of present study was to note the frequency of accessory infraorbital foramen in north Indian population and to determine the distance of infraorbital foramen from various anatomical landmarks in adult dry human crania. Methodology: 64 adult north Indian dry human crania of unknown age and gender were analysedfor the presence ofaccessoryinfraorbital foramen and their unilateral or bilateral prevalence was calculated.Shortest distance between the infraorbital foramen from midline, pyriform margin, nasion, infraorbital margin, anterior nasal spine and frontozygomatic suture was measuredon both sides in each craniawith Vernier caliper accurate to 0.1 mm for linear measurement.Observations thus made were compiled and tabulated followed by comparison using appropriate statistical tests. Results: Prevalence of accessory infraorbital foramen is 7.81%, while bilateral prevalence of accessory infraorbital foramen is only 1.56 %, however unilaterally accessory infraorbital foramen is present in 6.25% (2.34 % on right side and 3.9 % on left side). Mean shortest distance of infraorbital foramen from midline was 34.78 ± 3.19mm, while mean shortest distance between the infraorbital foramen to the pyriform margin was 21.26 ± 2.78 mm.Mean shortest distance of infraorbital foramen to the nasion andinfraorbital marginwas 44.95 ± 4.62mm. and 6.58 ± 1.59 mm respectively.Mean shortest distance of infraorbital foramen to the anterior nasal spine and frontozygomatic suture was 36.63 ± 3.16mm.and 35.62 ± 1.98 mm respectively. Conclusion: The knowledge of the distances from surgically encountered anatomic landmarks may be of assistance in locating these important maxillofacial neurologic structures during many procedures. Understanding the location of these foramina will also assist the clinician in performing local anesthetic blocks.
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Abstracts: Background & Objective: Aim of present study was morphological and morphometric observation of papillary muscles of tricuspid valve of human heart. Methodology: This study was carried out in 36 human (24 males and 12 females) heart from adult cadavers, which were dissected according to standard technique. All papillary muscles were observed for their shapes, numbers and dimensions in centimeters. Data were tabulated and statistical comparison were done using “chi square” and “z” test. Results: The average length of anterior, posterior and septal papillary muscle was 1.42 ± 0.29 cm, 0.94 ± 0.23 cm and 0.18 ± 0.08 cm while average breadth of anterior, posterior and septal papillary muscle was 0.41± 0.12 cm, 0.29± 0.09 cm and 0.11± 0.01 cm respectively. The anterior papillary muscles presented 1 head in 27.78% and 2 heads in 25%, while posterior papillary muscles presented 1 head in 27.78% and 2 heads in 25%. All the septal papillary muscles presented with 1 head. Single anterior papillary muscle was found to be 97.22% while posterior papillary muscle was found to be single in 72.28% and double in 27.78. Septal papillary muscle was found to be single in 25% cases and absent in 38.89% cases. Conclusion: Data obtained from this study might be helpful for reparative surgical procedures of tricuspid valve.
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Background: Non metric cranial variants have always been a topic of considerable interest for research workers, as they possess racial, regional and sex dimorphic differences. These variants are also of anthropometric, genetic, morphological and forensic importance. Material and Methods: 71 skulls from north indian region were studied to analyse the prevalence of variations in number and location of mastoid foramen and to draw significant inferences. Results: Prevalence of absent mastoid foramen is 5.19%, while bilateral prevalence of absent mastoid foramen is only 1.29%, however unilaterally mastoid foramen is absent in 3.9%. Prevalence of single, double, triple and quadruple mastoid foramina was 75.97%, 19.48%, 1.95% and 2.6% respectively. Amongst all mastoid foramina in 71 skulls, 23.38% foramina were exsutural, out of which 20.13% were present on temporal bone and 3.25% were present on occipital bone. Conclusions: Findings are discussed and compared with other global studies and are found to be of considerable racial and regional significance. Knowledge of this variant can be valuable in some neurosurgical procedures.
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Background: Maternal mortality has been the indicator of measurement of maternal health. Over the last decade, identification of severe acute maternal morbidity (SAMM) has emerged as a compliment or alternative to investigation of maternal deaths. A review of causes of SAMM will help to find out the potential problems which in turn will enable women to get the treatment on time. Recent researches have suggested that proper identification of SAMM cases can prove to be a better method to monitor the quality and effectiveness of obstetric care than mortality alone. Although there have been many criteria which have been introduced from time to time to identify these cases, because of vast variation of different level of facilities, these criteria cannot be applied across the regions. WHO has recently come up with certain set of criteria which could be more applicable to low resource settings. Aims & Objective: Present study tried to identify SAMM cases through various criteria and compared the applicability of them in our setup which is resource poor setting catering mainly to a huge rural population. Materials and Methods: It is a prospective study done over a period of one year, from September 2012 to August 2013. All severely morbid pregnant women or who had delivered or aborted within 42days were included. Initial identification of these cases was done on the basis of general criteria and later on other criteria were applied according to the primary obstetric event, clinical features, Lab findings or management provided. A comparison was done amongst all criteria and their individual applicability was checked as per the facility available in our set up. Results: During the study period total 7819 women delivered in the hospital out of which 6498 delivered vaginally and 1321 delivered through caesarian section. Total live births during this period were 5219. The present study found an incidence of severe maternal morbidity/near miss ranging from 5.56 to 40 per 1000 live births. Among 244 women suspected to be SAMM/MNM, 179(73%) met Waterstone’s criteria, 48(20%) met Mantel’s Criteria and 63(26%) met WHO criteria, 20% women met Mantel and Waterstone’s criteria both while 17% met all three criteria. Conclusion: The study of SAMM cases and their identification through suitable criteria can contribute to know its magnitude, as well as to identify most frequent characteristics and clinical conditions which will help to recognize the problems in antenatal services, peripheral health care facilities and referral system. The criteria which are available now cannot be applied uniformly, and need to be tailored to identify more specific criteria according to infrastructure of a particular setting in order to utilize resources effectively.
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Cyclosporin A (CsA) an immunophilin, discovered in 1969 and approved in 1983 to be used as immunosuppressant agent and is widely used in organ transplantation and auto-immune disorders. Its ability to alter mitochondria and apoptotic pathways makes it attractive agent to be employed in variety of diseases including age related neurodegenerative diseases. Mitochondria play pivotal role in cell energetics and reactive oxygen species production and are known to be key regulator of apoptosis hence it is important in a wide range of diseases. The structural and functional properties of mitochondria enable the targeting of drugs supposed to modulate the function of organelle for therapeutic advantage. By targeting mitochondria we can prevent oxidative damage associated with neurodegenerative diseases and ischemia and reperfusion tissue injury. Similarly targeting Bcl-2 can be helpful in cancer by triggering apoptosis.
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Irritable bowel syndrome (IBS), principal morbidity being visceral hypersensitivity, consumes significant speciality gastroenterologic and general practitioner’s care. The complex etiology perhaps varying among the patients makes therapeutic address very challenging. Continuous researches on neurophysiological aberrations in IBS have continued. The drugs and the neurophysiological understanding with regard to addressing visceral hypersensitivity are relevant to be appraised. The translation of research wisdom into clinical practice may be facilitated by gastroenterology experts. The issues of effectiveness of the options in general and in particular patients may thus be addressed.
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Background: Newer generation cephalosporin-resistance among Klebsiella pneumoniae organisms has increased recently. Present study is undertaken to find incidence, antimicrobial susceptibility and prevalence of extended spectrum beta-lactamase (ESBL) in K. pneumoniae isolates in a tertiary care hospital. Methods: Prospective study was carried out between June to December 2011. Samples of pus, blood, urine, cerebro-spinal fluid, stool, peritoneal, pleural and synovial fluid were collected from indoor and outdoor patients for isolation and antimicrobial susceptibility pattern of K. pneumoniae in the department of microbiology, G.R. Medical College Gwalior, M.P. Ceftazidime resistant K. pneumoniae were subjected to Phenotypic Confirmatory Disc Diffusion Test (PCDDT) and Double Disc Synergy Test (DDST) for detection of ESBL. Results: Out of 2480 samples collected a total of 530 K. pneumoniae were isolated and subjected to antimicrobial susceptibility. Antibiotic sensitivity to imipenem, cefoperazone, amikacin and ofloxacin were 82, 74, 73 and 72% respectively whereas sensitivity to ceftizoxime, ceftriaxone cefotaxime, ceftazidime ranged between 47-50%. K. pneumoniae were found to be resistant to ampicillin, co-trimoxazole, doxycycline and gentamicin, by 91, 82, 54 and 50% respectively. Among third generation cephalosporins K. pneumoniae were least sensitive (47%) to ceftazidime. About 33 and 32% of the ceftazidime resistant strains were found to be ESBL positive by PCDDT and DDST respectively. Conclusions: This study has shown that prevalence of ESBL producing K. pneumoniae is the most important reason for increased resistance to third generation cephalosporins. There is need to carry out tests for detection of ESBL producing bacteria routinely.
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Background: Head injuries are increasing cause of overall disability which needs aggressive researches on neuroprotective agents to prevent or rectify the sequelae of brain damage. The outcomes on functional recovery following add on therapies either nimodipine or vinpocetine was done to compare merits of either therapies. Methods: 90 head injury cases admitted to S.S. hospital were divided into standard treatment group given neither vinpocetine nor nimodipine & other two groups given either nimodipine or vinpocetine dependent entirely on clinician’s discretion. The patients data on initial severity on GCS scale and functional recovery on Barthel Index, head injury watch scale, Disability rating score were collected at discharge & at one month follow up thereafter to compare the recovery profiles. Results: Vinpocetine treatment proved superior to nimodipine or standard treatment on examining the outcomes. Significance of time since injury was emphasized for improved outcome to nimodipine but not so necessary for vinpocetine. Conclusions: Nimodipine delayed administration had no consequence while vinpocetine is useful treatment at any stage to enhance functional recovery in cases of head injury.
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The goal of delivery system is to get optimal therapeutic management. But, it still remains a challenge in the field of pharmaceuticals for delivery of ionic species and some non ionic. Several transdermal approaches have been used and recently there has been a great attention in using iontophoretic technique for the transdermal drug delivery of medications, both ionic and non ionic. This technique of facilitated movement of ions across a membrane under the influence of an externally applied electric potential difference is one of the most promising physical skin penetrations enhancing method. The payback of using iontophoretic technique includes improved systemic bioavailability ensuing from bypassing the first metabolism. Variables due to oral administration, such as pH, the presence of food or enzymes and transit times can all be eliminated. This article is an overview of the history of iontophoresis, mechanism, principles and factors influencing iontophoresis and its application for various dermatological conditions.
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Tubercular spinal epidural abscess (SEA) is an uncommon infectious occurrence. SEA was first described in 1761. Clinical prospects of tubercular SEA are graver, if not promptly diagnosed and treated appropriately. We present two cases of spinal epidural abscess of tubercular etiology who progressed to paraplegia over the course of disease. MRI pointed towards an epidural abscess in the dorsal spine. Histopathological analysis revealed SEA, tubercular in nature in both cases. Patients responded to surgical decompression and anti-tubercular therapy (ATT). Such type of clinical entities has least been documented.