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Tuberculosis is known as one of the long-standing and dominating health problems affecting people and the extent further escalates in a developing country like India. A pre-evaluated feedback structured questionnaire was validated and adopted to get their quantitative data from 424 respondents. In the present study urban respondents (60.8%) gave affirmative responses regarding awareness of TB, especially with mobile media as their major source of information, followed by information from healthcare workers. Rural respondents were less expressed and deficient on knowledge of TB transmission and preventive methods. Prevention practices toward TB are claimed to be high in urban population because 79.48% believed that early diagnosis, prompt treatment and avoiding poor hygiene and crowded environment are effective strategies to cease the transmission of TB. Effective preventive and informative strategies should be employed in rural border areas to make up for the knowledge gap found among rural and urban populations in this study.
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Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India.
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Background: Disaster and mental health preparedness are inseparable domains highlighted during all the major disasters in India. To build Disaster-Mental health Preparedness (Disaster MHP), one has to understand the existing strategies, systemic efforts, and ground-level implementation. In this scoping review, we have analyzed the mental health preparedness efforts during major disasters in India. Methodology: We followed the Peters MDJ et al framework for scoping review named ‘Guidance for conducting systematic scoping reviews. This included the searching relevant articles on PubMed and google Scholar, and concept-context of the review. Results: The review identified major efforts taken during ten disasters in past 40 years and mapping of the potential areas for development of sustainable efforts towards Disaster MHP. Conclusion: This is the first systematic scoping review from India that provides insight into strength and sustainability of disaster mental health preparedness in India. The mapping of the review focuses on the models emerged from Bhopal, Odisha, Tamilnadu and NIMHANS for the future infrastructure, capacity building, and environment required for Disaster-MHP in India.
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Background: Ocular surface squamous neoplasia (OSSN) comprises neoplasm arising from the ocular surface, which includes conjunctiva, cornea, and limbus and ranges from mild dysplasia to invasive squamous cell carcinoma. Purpose: The aim of this work was to study the spectrum of OSSN based on histopathological analysis. Materials and Methods: This was a retrospective cross-sectional study comprising 776 histopathologically diagnosed cases of OSSN from January 2004 to December 2014. Results: The mean age of presentation of OSSN was 45 years (median, 45 years; 2 to 87 years) with male preponderance (74%). The most common age group of presentation was 41–60 years (n = 299; 39%). The most common type of OSSN was invasive squamous cell carcinoma seen in 50% (n = 383) eyes followed by severe dysplasia/carcinoma in situ in 31% (n = 250) eyes. Tumor infiltration at base was seen in 16% (n = 124), positive margins in 32% (n = 248), scleral infiltration in 14% (n = 109), intraocular extension in 3% (n = 23), and orbital extension in 4% (n = 26) eyes. OSSN was associated with actinic keratosis in 21% (n = 165) cases. Conclusion: Based on histopathology, invasive squamous cell carcinoma is the most common form of OSSN in the Asian Indian population.
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To define the pain and functional improvement of the patient with chronic Achilles tendinitis treated with a single PRP (platelet-rich plasma) injection. Chronic Tendoachilles tendinitis is a severe cause for a decrease in physical activity and persistent pain. It arises secondary to an account of repetitive use or exaggerated overload. Platelet-rich plasma therapy is used to provide local regenerative healing of the tendon. This report describes a 50-year-old Active female who presented with continuous pain in bilateral Tendoachilles for Approximately 6 years duration. A single Platelet-rich plasma injection is given to the patient with chronic tendoachilles tendinitis to reduce pain and improve function and improved VAS (visual analogue score) score from 9 to 0 seen at 1-year follow-up. The patient has been pain-free for the past 2 years and is back to daily functional physical activity. A single injection of PRP in each tendoachilles distally has shown significant relief in pain and improvement in day-to-day physical activity and a rapid recovery from chronic TA tendinitis.
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@#Introduction: The aim of this study is to assess the outcomes of ala carte posteromedial release in children over two years of age who were not responding to the Ponseti method of treatment of idiopathic clubfoot. Materials and Methods: A retrospective observational study from September 2013 to August 2015 was conducted at a tertiary level medical teaching institution. The clubfeet were classified according to the Harold and Walker classification. Radiographic parameters assessed were the talocalcaneal angle (AP, lateral), talus-first metatarsal angle (AP, lateral) and calcaneal-fifth metatarsal angle. The scar and the functional score, according to Laaveg and Ponseti, were evaluated as outcome measures at the final follow-up. Results: Twenty-four children with a mean age of 43.7 ± 24.7 months were enrolled in the study. There was a total of 36 clubfeet: 21 (65.6%) with a poor functional outcome; 12 (37.4%) with excellent to good scar in both horizontal and vertical components. There was a statistical significance between the pre-operative and post-operative radiological parameters (p<0.05). None of the patients presented with any limitation of activities of daily living despite the poor functional outcome in many of the children. There was no significant association between the qualities of scar (horizontal, vertical) and the functional outcome with age at presentation, pre-operative Harold and Walker classification and pre-operative radiographic angles. Conclusion: Surgical intervention in terms of ala carte posteromedial soft tissue release could not produce a good outcome over four years in CTEV. The threshold for surgery in CTEV should be high, given the poor results.
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Aim: To screen wheat generations derived from cross HD2967 × Kharchia65 for two Nax loci imparting salt tolerance and background selection of the plants using polymorphic SSRs.Methodology: The study for salt tolerance was carried out on three generations, i.e., BC1F3, BC2F2 and F4, derived from the cross HD2967 × Kharchia65 in net house. Salt stress was provided at germination stage and the plants were grown to maturity. Data was recorded for various agro-morphological traits which contributed to yield. DNA isolated from young leaves of morphologically superior plants were checked for the presence of Nax1 and Nax2 genes using gene specific primers. Plants having either or both Nax loci were then subjected to polymorphic SSR markers screening for background selection of foreground selected plants. Results: On the basis of agro-morphological performance and presence of either or both Nax genes, 68 high yielding plants were selected. Out of total 178 SSR markers screened covering the whole genome uniformly (A, B and D), 31 markers were polymorphic for the parents HD2967 and Kharchia65. These polymorphic SSR markers were used to produce molecular diversity among the selected progeny plants. Cluster analysis of parents and all the three generations, showed that all the selected plants were inclined towards recurrent parent. Interpretation: This study showed that a linked marker like Nax1 and Nax2 could be a promising tool for breeding wheat with enhanced tolerance to salinity conditions. However, growth rates and biomass production provide reliable criteria for assessing the degree of salt stress and the ability of a plant to withstand it. Therefore, initial screening of seeds in the presence of salt stress provides additional advantage in directional selection. Plants selected with Nax loci, better mean performances, high heritability, and high genetic advance as 5% of mean for the studied traits could be further backcrossed with the recurrent parent to develop salt tolerant wheat lines.
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Introduction: Dengue is most important arthropod-borneviral disease worldwide, with approximately 390 millioninfection occurung per year, of which approximately 96 milliocause sign of disease. Dengue virus is single stranded RNAvirus belonging to flaviviridae family having four serotypes.Case report: We are thus reporting a case of Dengue feverwhich presented as encephalitis. Very few cases of dengueencephalitis has been reported worldwide and the literatureavailable on the illness is limited.Conclusion: Dengue is classically thought to be a nonneurotropic virus. Most common dengue serotype causingneurological complication are DEN 2 and DEN 3. Neurologicalcomplication are rare in dengue.
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Present study was undertaken to study the neurotoxicity of oral acrylamide (ACR) and its amelioration using α-tocopherol, reduced glutathione (GSH) and hot aqueous extract (HAE) of Ocimum sanctum. Forty five male Wistar rats were divided into 12 groups. The study showed a significant reduction in the body weight of the rats fed with ACR in comparison to the other groups while body weight was restored in the rats fed with α-tocopherol and HAE. Neurotoxicity in rats fed with ACR was evident with the results of histopathology and oxidative stress (high MDA and decreased activities of GSH, SOD, GST and CAT in brain). Co-administration of α-tocopherol and HAE lowered these changes however, there was no marked improvement seen in neural damage but improvement was evident in behavioral as well as physiological changes at a marked point. Histopathology of brain in ACR alone fed group showed extensive neural degeneration and massive deposition of fibrin which was substantially decreased and ameliorated with the co-administration of α-tocopherol and HAE. These results support the oxidative stress results as well. Our results suggests that α-tocopherol and HAE can be useful for protecting brain tissue against ACR induced neurotoxicity through minimizing the free radical mediated oxidative stress
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Background: Thyroid cancer is the most common endocrine malignancy accounting for >90% of malignancies of endocrine glands. The inter and intraobserver variation in the histomorphological diagnosis of Papillary Thyroid Carcinomas may sometimes pose a diagnostic difficulty. Application of IHC biomarkers may play an active or complementary role in their accurate classification. Aim: The present study was conducted to evaluate if HBME-1 and TPO immunohistochemical analysis can reliably differentiate papillary carcinomas from other thyroid lesions. Material and Methods: 50 cases of benign and malignant thyroid lesions were taken. Immunohistochemical staining for HBME-1 and TPO was performed. HBME-1 and TPO score was interpreted as absent and positive. Medical records were retrieved and their clinical data, surgical treatment, and pathological findings were noted. Results: Out of 50 cases, 19 (73.1%) cases were diagnosed PTC, 4 (15.4%) cases were FTC, 3(11.5%) cases were of MTC and 24 cases of benign thyroid lesions. TPO expression was found positive in 91.7% of cases of Benign thyroid lesions. In malignant thyroid lesions, negative expression of TPO was seen in 63.16%, 0% and 33.33% of PTC, FCT, and MCT respectively. HBME-1 showed negative expression in 83.3% of cases of benign thyroid lesions. Whereas, in malignant thyroid lesion HBME-1 expression was positive in 78.95%, 50% and 0% cases of PTC, FCT, and MCT respectively. Conclusion: Testing for expression of HBME-1 has been shown to improve the diagnostic accuracy for thyroid malignant nodules. The combination of HBME-1, and TPO may contribute to an accurate diagnosis of papillary thyroid carcinoma.
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Aims and Objectives: We examined the prognostic value of Tumor stroma ratio (TSR) in breast tumor core biopsy (TCB) specimen to determine response to neoadjuvant therapy (NAT) prior to modified radical mastectomy (MRM). Methods: This was a retrospective analysis of patients with breast cancer who underwent TCB before NAT between August 2016 and July 2018. TSR in TCB was studied independently by 2 pathologists ( VM, VS) defined as stroma rich (TSR?50%) or stroma poor (TSR>50%). MRM specimen of these patients were subsequently studied .Residual cancer burden (RCB) was calculated using the MD Anderson RCB calculator, categorized as complete (0), good (1) Partial (2) and no response (3). Statistical analysis was done to assess correlation of TSR to RCB. Results: A total of 62 patients were analyzed. Mean(SD) age was 48(11) years.Twenty eight (45%) and 34 (55%) patients were stroma rich and stroma poor respectively. Twenty six (42%) patients were responders and 36 (58%) non-responders to NAT. Among stroma rich patients, only 3 (10%) were responders (Class 0 &1)and 25 (90%) non-responders(Class2&3)to NAT, among stroma poor patients 23 (68%) responded well and 11 (32%) did not.TSR had a moderate negative correlation with RCB (-0.6). On univariate analysis, only TSR had a significant effect on RCB class (<0.001). Conclusions: TSR on TCB is a useful prognostic factor to determine response of breast carcinoma patients to neoadjuvant therapy.It is cost effective, simple and quick. Larger multi-centric studies would be useful to study its clinical implications.
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Purpose: To validate the smartphone photography as a screening tool for amblyogenic conditions in children. Methods: Children between 5 to 8 years attending eye out patient department (OPD) were photographed (by an optometrist) with a smartphone to capture their pupillary red reflexes followed by clinical examination by the principal investigator (PI). The PI on the basis of clinical examination identified children with significant amblyogenic conditions and, subsequently, two ophthalmologists independently categorized the photographs on the basis of color, symmetry, and shape of the pupillary reflex into normal or abnormal. The identification of amblyogenic conditions on clinical examination was compared to that on photography. Refractive errors <3D and anisometropia <2D were excluded. Sensitivity, specificity, positive predictive value, and negative predictive value of smartphone photography screening were determined. Results: In all, 250 children were screened. Clinically 23.6% were harboring amblyogenic conditions. The mean sensitivity and specificity of screening by smartphone were 94% and 91%, respectively. Conclusion: Smartphone photography is a reliable tool for detection of amblyogenic conditions in children.
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Simple limbal epithelial transplantation (SLET) is an innovative limbal stem cell transplantation technique that has gained increasing popularity over the last few years. Different groups from across the world have published the clinical results of SLET in large case series with varying types and severities of limbal stem cell deficiency (LSCD). This review attempts to place all the available knowledge on SLET together in one place for the benefit of not only cornea specialists and trainees but also for residents and general ophthalmologists. It follows a balanced approach of blending evidence with experience by providing an objective analysis of published results along with helpful insights from subject experts, starting from preoperative considerations including the role of newer imaging modalities to the technical aspects of the surgery itself and the management of possible complications. Original data and novel insights on allogeneic SLET for bilateral LSCD are included in the review to address the few remaining lacunae in the existing literature on this topic. This review intends to inform, educate, and empower all aspiring and practicing SLET surgeons to optimize their clinical outcomes and to have maximal positive impact on the lives of the individuals affected by unilateral or bilateral chronic LSCD.
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Background: Diabetes mellitus (DM) is one of the major causes of mortality & morbidity, and patient’s with better control of glycaemic parameters have lesser chronic complications associated with it. Though monotherapy with metformin is first choice for T2DM but is effective in less than 50% of patient and they should be managed with two drug therapy. Both Glimepiride and Sitagliptin are effective with metformin but there has been no study done in this region hence, we planned to study comparison of effects of glimepiride and sitagliptin with metformin in patient of T2DM.Methods: This prospective, open-label, randomized study was done in all patient diagnosed with T2DM, not adequately managed by metformin alone. The patient was divided into two group G (Glimepiride with Metformin) and Group S (Sitagliptin with Metformin) and had a follow up at 3 and 6 months. The biochemical parameters were assessed at 12 weeks and 24 weeks.Results: The result of this study show that both glimepiride and sitagliptin with metformin significantly (p<0.05) lowered both the fasting blood sugar as well as postprandial blood glucose at 3 and 6 months. Glimepiride was more effective in lowering (p<0.05) the plasma glucose at 3 months but both the drugs had comparable result at 6 months. This study also showed that glycosylated haemoglobin was lowered in both groups at three and six months as compared to Day 0 (p<0.05), with glimepiride having better control of glycosylated haemoglobin at 3 months with both groups having comparable result at 6 months.Conclusions: To conclude, this study compared effects of sitagliptin and glimepiride on glycaemic parameters in patients of T2DM and found that both drugs had comparable results.
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Background & objectives: Salmonellosis due to the consumption of contaminated poultry products is a well-known public health concern, and assessing the distribution of Salmonella serovars among poultry becomes important for better prevention and control. The objective of the present study was to assess the distribution of Salmonella serovars among poultry. Methods: The isolates received at National Salmonella and Escherichia Centre during 2011-2016 were subjected to biochemical identification, followed by serological characterization to identify the Salmonella serovars, and the data were presented to exhibit the distribution of Salmonella serovars among poultry. Results: Salmonella was found to be present in poultry in all the regions included in the study. Salmonella Typhimurium, S. Gallinarum and S. Enteritidis were the most prevalent serovars accounting for 96.2 per cent of isolates. Salmonella was identified in poultry from all major egg-producing and egg-consuming States. Other serovars which were scantly identified included S. Infantis (2.7%), S. Montevideo (0.64%), S. Newport (0.26%) and S. Pullorum (0.13%). Interpretation & conclusions: Diverse distribution of Salmonella serovars in poultry in India, with known potential to infect human population and/or other poultry flocks, requires urgent nationwide stringent control measures.
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Aims: This study aims to explore the utility of GATA binding protein 3, a zinc finger transcription factor, expression in genitourinary carcinoma, especially urothelial carcinoma. Settings and Design: It is a prospective study where 74 consecutive cases of urothelial carcinoma along with 10 cases each of prostatic adenocarcinoma (PC) and conventional clear cell renal cell carcinoma were included between August 2016 and January 2017. Methods and Materials: All the cases were histopathologically evaluated and immunohistochemically stained for GATA binding protein 3. Only nuclear positivity was considered as positive. Immunoreactivity score for GATA expression was calculated based on the staining intensity as well as percentage. Statistical Analysis Used: The statistical analysis was done using Statistical Package for Social Sciences Version 15.0 statistical analysis software. P value of <0.05 was considered statistically significance. Results: GATA3 expressions were seen in 77% of the cases of urothelial carcinoma, whereas none of the clear cell renal cell carcinoma and prostatic adenocarcinoma cases was GATA3 positive. GATA3 expression significantly correlated with histological grade and muscle invasion with a weaker or negative expression in high-grade muscle invasive tumor as compared to low-grade and noninvasive neoplasm. Significantly weaker expression of GATA3 was found in cases with severe nuclear pleomorphism, mitosis >10/10 hpf, presence of necrosis, and tumor-infiltrating lymphocytes. No significant change in the status of GATA3 expression was seen in follow-up cases between initial Transurethral resection of bladder tumor (TURBT) and post-recurrence TURBT or radical cystectomy specimens. Conclusions: GATA3 as a sensitive and specific marker for urothelial carcinoma can be effectively used to exclude other genitourinary malignancies, PC, and renal cell carcinoma, at metastatic site. This marker can also be effectively used in predicting the probable grade and invasion in biopsy material with poor morphological characteristics, thereby helping in appropriate management in such cases.
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Background: Cervical cancer is one of the most prevalent cancers among Indian women. Cervical cancer incidence reduces dramatically when effective screening programs linked with access to treatment are in place and are readily accessible. Peripheral health workers (PHWs) being frontline workers have a major influence on raising awareness among community about acceptability of available screening programmes. This study was thus conducted to assess the awareness of PHWs regarding risk factors, signs and symptoms, early detection and prevention for cervical cancer.Methods: A questionnaire-based study was conducted among 450 PHWs (ASHAs and BHWs). Information was collected regarding their bio-social characteristics, awareness about female cancers, risk factors, signs/symptoms, early detection methods and services available for screening and prevention of cervical cancer.Results: Awareness of different aspects of cervical cancer was found to be very low. Only eight per cent of the PHWs had good awareness score. BHWs obtained statistically significant better mean scores as compared to ASHAs. Few (7.6%) PHWs had received training for any type of female cancers. Only 17 per cent of the PHWs were aware of HPV vaccine availability and only 29 per cent from them could name the vaccine.Conclusions: Majority of the PHWs had poor awareness about cervical cancer and available screening facility in our health system. They had almost no idea of availability of free HPV vaccination at the Sampoorna clinics. This low level of awareness calls for regular training of PHWs on cervical cancer which would ultimately trickle down to the community.