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Transgender care needs a multidisciplinary team approach. The awareness about transgender health has increased over the past few years in India. The pyramid of transgender health helps to demystify the care of transgender individuals. The 7 S's of lifestyle modification need to be followed in the routine clinical care of transgender individuals. The individuals also need psychological care and support, metabolic and medical care, endocrine management, and later surgery in some cases. The policy makers can use the pyramid to decide about financial help to the community for their holistic care. The physicians involved in the care of transgender individuals can also take guidance about comprehensive care and management of transgender and gender diverse individuals.
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Benzene is a notorious toxicant that is responsible for a host of diseases including leukemia. Its concentration in the environment is increasing day-by-day due to excessive automobile use, accelerated industrial activities and cigarette smoke. The awareness on the harmful effects of benzene on health is limited and no antidote has been reported yet. In this study, an attempt has been made to find out a suitable remedy to overcome benzene toxicity in a living organism from a natural source with the seeds of the plant Moringa oleifera (MO). Thirty six Wistar rats were considered for the study and divided into six groups (n=6). While group I remained as control with normal animals, those in groups II – VI received benzene by oral route (800 mg/kg body weight) for 28 consecutive days. On day 29, the benzene-treated animals in groups III – VI received respectively the standard drug ascorbic acid (AA, 25 mg/kg body weight) and MO (50, 100 and 200 mg/kg body weight) for the following 7 days. Group II rats that received only benzene served as negative control without any treatment. On day 36, all the animals were sacrificed and vital organs liver and kidney were removed for studying lipid peroxidation (LPO) and antioxidant markers [Superoxide dismutase (SOD), Total reduced glutathione (TRG), Glutathione peroxidase (GPx) and Catalase (CAT)] in addition to histopathological changes in the tissues. The results of the study revealed that significant changes occurred in the above parameters due to benzene dosing to animals were reverted to near normal values on MO administration in the liver and kidney tissues as compared to untreated animals, suggesting MO’s pro-active role in attenuating benzene toxicity.
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Objectives@#Work stress is associated with non-communicable diseases, increased healthcare costs, and decreased work productivity among employees in the information technology sector. There is a need for regular work-stress screening among employees using valid and reliable tools. The Tool to Assess and Classify Work Stress (TAWS-16) was developed to overcome limitations in existing stress assessment tools in India. This study aimed to test the reliability of TAWS-16 in a sample of managerial-supervisory employees. @*Methods@#This observational reliability study included data from 62 employees. Test-retest and inter-method reliability were investigated using a TAWS-16 web application and interview by telephone, respectively. Kappa values and intra-class correlation coefficients were calculated. Internal consistency was assessed through Cronbach’s alpha. @*Results@#For both test-retest and inter-method reliability, the agreement for both work-related factors and symptoms suggestive of work stress exceeded 80%, and all kappa values were 0.40 or higher. Cronbach’s alpha for test-retest and inter-method reliability was 0.983 and 0.941, respectively. @*Conclusions@#TAWS-16 demonstrated acceptable reliability. It measured stressors, coping abilities, and psychosomatic symptoms associated with work stress. We recommend using TAWS-16 to holistically identify work stress among employees during periodical health check-ups in India.
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Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.
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The advent of civilization and overuse of life modifying gadgets like cell phones, computers, etc. leads to greater incidence of neck pain worldwide, of which Cervical spondylosis is the prime cause, which is a natural ageing process characterized by sequence of degenerative changes in the spinal structure. In Ayurveda, it can be closely correlated with Vishvachi, which is a Nanatmaja vatavyadhi, in which there is restriction of movement in arms associated with Ruk, Stambha, etc. features. Aims and Objectives: 1. To study etiopathogenesis, symptomatology, and progress of Vishvachi w.s.r. to cervical spondylosis. 2. To assess the efficacy of Dashamooladi taila nasya and Dashamooladi ghana vati individually and compare the effect of both schedules clinically. Materials and Methods: After proper identification, the selected raw herbs are used for Taila (oil) preparation according to Taila paka vidhi for Nasya and Kwatha was made for oral medication. The study was carried out in two parts- a). Literary- Textual references from various books, journal and papers on Internet were studied. b). Clinical- After considering the selection criteria, a total of 60 patients were treated in two groups- i) Group A: 30 patients were treated with Dashamooladi taila nasya for consecutive 21 days preceded by Abhyanga (oleation) & Svedana (fomentation). ii) Group B: 30 patients were treated with Dashamooladi Ghana vati consecutively for 21 days. Scoring was done on the basis of 09 parameters and statistical analysis was done. Result: Group A patients showed marked effect on Avamotana, Sanchari, Spandana, Aruchi & moderate effect on Ruk, Toda, Stambha & Tandra. Group B showed marked effect on Toda, Stambha, Spandana; and moderate effect on Ruk, Avamotana, Sanchar. Conclusion: Dashamooladi yoga (Dashamoola, Bala, Masha) is used both for shamana and Nasya medicine. These are effective in Vata-kaphaja ailments, Sotha, Shula, etc., and possess Balya, Brimhana, Rasayana, Vrishya etc., qualities.
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Abstract Nanotechnology has been used in the field of medicine and pharmacology for its greater efficacy of drug delivery than crude molecules of drugs. In the present study medicinal mushroom Ganoderma applanatum extract mediated silver nanoparticles (AgNPs) were synthesized, characterized by Ultraviolet-visible (UV-Vis.) spectroscopy, scanning electron microscopy (SEM), X-ray diffraction, Dynamic light scattering (DLS) and Furior transform-infrared (FTIR) spectroscopy. Maximum absorbance was recorded at 435nm by UV-Vis. The synthesized nanoparticles of 13.54nm-255nm in size with an average particle size of 58.77nm were analyzed by DLS. FTIR-Spectroscopy provided high transmission at 3606cm-1 corresponds for phenolic capping biochemical. Thus G. applanatum extract can be used for synthesis of silver nanoparticles and the synthesized nanoparticles may be used for development of future therapeutic agent for treatment of diseases.
Subject(s)
Silver , Nanoparticles , X-Ray Diffraction/methods , Microscopy, Electron, Scanning/methods , GanodermaABSTRACT
@#Introduction: Reducing radiation dose for CT examinations has been accompanied by an increase in image noise. Studies have highlighted the application of a higher matrix size for improving image quality when assessing the lungs. This study aims to evaluate the influence of a low kVp and higher matrix size on radiation dose and image quality for abdominopelvic CT. Methods: This experiment was done on a 32 cm body phantom and scanned using a 128 slice CT scanner. The study utilised various combinations of kVp settings (140, 120, 100, 80 & 70) and matrix sizes (1024, 768 & 512). The image obtained was analysed objectively and subjectively. For objective analysis, we calculated SNR, and CNR. For subjective analysis, two radiologists evaluated the image in a 3-point scoring scale. Results: The study reported an increase in SNR (0.8%) and CNR (46%) at 120 kVp when increasing the matrix size from 512 x 512 to 768 x 768. Similarly, there was an increase of 14.5 % and 56.4 % in CNR and SNR using 1024 matrix size. The DLP was reduced by 4.5%, 50% and 70.6 % using 100, 80 and 70 kVp respectively. However, there was no change in DLP with higher matrix sizes. Conclusion: The study reported a combination of 100 kVp and 768 matrix size resulted in an almost similar (↓0.9 %) SNR and improved CNR (↑46.4 %) compared to 120 kVp and 512 matrix size. Qualitative analysis also showed a similar image quality with decreased radiation dose for abdominopelvic CT.
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@#Introduction: Radiation exposure during the CT examination has always been a concern due to its associated cancer risk. The guidelines suggest the optimization of radiation dose reduction. Therefore, this study aims to determine the feasibility of dose reduction strategies on radiation dose reduction using a phantom. Methods: Head and body phantoms of 16 cm and 32 cm, respectively, were used to calculate the radiation dose and measure the quantitative image quality. The phantoms were positioned and scanned with the standard protocol and low dose protocol. For dose reduction strategies, scan length was reduced in head phantom, and tube voltage and tube current were manipulated individually and by combining both and tested in both head and body phantoms. Also, the influence of rotation time was investigated in body phantom. Quantitative image quality was determined by drawing a region of interest on the obtained image. Results: Reducing scan length showed 41% reduction of radiation dose and reducing tube current, and tube voltage showed up to 75% reduction of radiation dose in head phantom and 70% reduction of radiation dose in body phantom compared to the standard protocol. The reduction of the rotation time, however, reduced the scan time and the radiation dose but the maximum mAs or tube current allowed was limited. Quantitative image quality was reduced when using a lower dose protocol. Conclusion: The dose reduction strategies showed a reduced dose, but the quantitative image quality score was reduced when scanned with low dose protocol. Further manipulation can be performed to maintain image quality.
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Introduction: Primary maternal rubella virus infectionduring the first trimester of pregnancy carries a high risk fordevelopment of congenital rubella syndrome. According tothe estimate of World Health Organization, worldwide morethan 100,000 children are born with CRS each year. Mostof these children are born in developing countries. Severalguidelines suggest routine rubella serology testing in womentrying for pregnancy. Objectives: This study was conductedto assess immunity (seroprevalence) to rubella among Indianwomen of childbearing age attending subfertility clinic and toobserve the trend over the years.Material and methods: Women attending subfertility clinichad serum sample tested to determine the seropositivityas part of subfertility work up. Rubella seropositivity wasdetermined by estimating IgG antibodies to rubella virus usingCLIA method.Results: The study period was from January 2011 to December2018. Three hundred and seventy seven women were testedfor estimation of Rubella IgG. Overall seronegativity was29.4%. Interestingly this seronegativity rate was very similarover the study period, demonstrating overall nearly one-thirdof the subfertile women were susceptible to rubella.Conclusion: These observations indicate high rubellasusceptibility among women in the childbearing age grouptrying for pregnancy. There is a need for detection ofseroprevalence in subfertile population in Eastern India; sothat appropriate vaccination can prevent this preventabletragedy of perinatal / neonatal morbidity. Further study isneeded to determine the magnitude of problem in other settings(Government hospital, rural population, low socioeconomicstatus).
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Humans , Male , Penile Induration , Microbial Collagenase , Penis , Injections, IntralesionalABSTRACT
BACKGROUND@#Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India.@*METHODS@#Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use.@*RESULTS@#Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use.@*CONCLUSION@#Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Cities , Craniocerebral Trauma , Cross-Sectional Studies , Head Protective Devices , India , Motorcycles , TransportationABSTRACT
Introduction: Hearing is an important factor in the processof learning to talk. Speech and hearing is important fordevelopment of interpersonal relationships. Index study aimsto screen high risk newborn for hearing loss by Transientevoked oto-acoustic emission (TEOAE) and Auditory brainstem evoked Response (ABER) technique and to identify therisk factor associated with hearing loss in neonates.Material and Methods: A total of 105 high risk neonates wererandomly selected from NICU of this hospital after stabilizingtheir clinical condition. All the neonates have undergoneTransiently evoked otoacoustic emissions. Neonates whopassed transiently evoked otoacoustic emissions test weresubjected to Auditory Brainstem Evoked Response (ABER)test for confirming the diagnosis of hearing loss.Results: Hearing assessment done in all 105 neonates anda total of 9 neonates were reported to be having hearingabnormalities, out of these 5 newborns had conductive hearingloss and 4 had sensorineural hearing loss. Low Birth weightand mechanical ventilation were observed significantlyassociated with diagnosis of hearing loss. No significantassociation of hearing loss was reported with gestational age,sex, infection, and associated diseases.Conclusion: Low Birth weight and mechanical ventilatorsupport were significantly associated with hearing loss.
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PURPOSE: The purpose of this study was to evaluate the relative utility and benefits of free-hand 2-dimensional intraoperative ultrasound (FUS) and navigated 3-dimensional intraoperative ultrasound (NUS) as ultrasound-guided biopsy (USGB) techniques for supratentorial lesions. METHODS: All patients who underwent USGB for suspected supratentorial tumours from January 2008 to December 2017 were retrospectively analyzed. The charts and electronic medical records of these patients were studied. Demographic, surgical, and pathological variables were collected and analyzed. The study group consisted of patients who underwent either FUS or NUS for biopsy. RESULTS: A total of 125 patients (112 adults and 13 children) underwent USGB during the study period (89 FUS and 36 NUS). NUS was used more often for deep-seated lesions (58% vs. 18% for FUS, P<0.001). The mean operating time for NUS was longer than for FUS (156 minutes vs. 124 minutes, P=0.001). Representative yield was found in 97.7% of biopsies using FUS and in 100% of biopsies using NUS (diagnostic yield, 93.6% and 91.3%, respectively). The majority of lesions (89%) were high-grade gliomas or lymphomas. Postoperative complications were more common in the NUS group (8.3% vs. 1.2%), but were related to the tumour location (deep). CONCLUSION: Despite the longer operating time and higher rate of postoperative complications, NUS has the benefit of being suitable for biopsies of deep-seated supratentorial lesions, while FUS remains valuable for superficial lesions.
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Adult , Humans , Biopsy , Electronic Health Records , Glioma , Lymphoma , Neuronavigation , Postoperative Complications , Retrospective Studies , UltrasonographyABSTRACT
Damage to the inferior alveolar nerve (IAN) while extracting lower third molars is often caused by the intimate relationship between the nerve and the roots of the teeth. The aim of this study was to compare the sequelae of coronectomy with odontectomy in impacted mandibular third molars. Patients and Methods: This study included thirty patients which were divided into two groups, Group-I (test group) including 15 patients undergoing coronectomy and Group-2 (control group) of 15 patients undergoing odontectomy. Investigations included digital orthopantomogram. The parameters for this study included pain, swelling, nerve paresthesia, trismus, postoperative infection, postoperative wound dehiscence, postoperative pocket depth, and migration. Results: In Group-1 (coronectomy group), the patients underwent follow-up for 6 months to evaluate migration of the retained mandibular third molar root which was in proximity with the IAN. There was a mean increase in migration when the distance from the inferior border of IAN until the apex of the retained mandibular third molar root was measured which was by 3.43 mm after 6 months of follow up. Conclusion: On statistical analysis, the result in this study showed no statistical difference in both the groups in all the parameters that were taken.
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Background: Many diseases and conditions weaken the strength of tooth making it to fracture. Many cavity designsand materials are used to restore the tooth to bring about the normal function. The present study was done to determine which one of the three class II cavity design offer the best fracture resistance to the teeth when used with different restorative materials. Methods: 165 molars (150 intact and 15 carious) were collected and preserved in hydrogen peroxide. These teeth were divided into five groups and restored with silver amalgam, compomer (Dyract AP) and metal modified ionomer cement (Miracle mix). The restored teeth were subjected to a compressive load using Universal Testing Machine by flat and metallic die. Results: Conventional designs with amalgam restoration seemed to withstand more load when it was imparted through a flat surface (741 kg ±158 SD) compared to the box or slot designs. However, when the load was imparted through a metallic die, the slot design with compomer restoration gave the maximum value (SD) of 472 (±88) kg. When analyzed statistically on the difference in the fracture resistance among the different restoration materials and the different cavity designs, statistically significant values were found between certain combinations. Conclusion: The study concluded that in the case of silver amalgam material, the test conducted by flat surface gives the best strength for the conventional design which is 3% and 23% better than that of box type and slot type respectively. However, when tested with a metallic die, slot type takes 8.3% more load than the conventional type. Among the various restoration materials tested for, amalgam provides more strength followed by compomer and miracle mix.
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Background: Gypsum products are being used for construction of dental prosthesis. Most of the researches done sofar on gypsum materials are on its use as fixed and removable prosthodontics. And although many studies have looked at a multitude of means for altering its properties, relatively less has been explored on examining the abrasion resistance of the gypsum product itself. Objectives: The current study was done to determine the abrasion resistance of three commercially available type IV gypsum products on application of three die-hardeners when abraded with 20gm and 50gm load stylus. Methods:An experimental in vitro study was done in the Dept. of Prosthodontics, UP Dental College & Research Center and the Dept. of Pharmacy, BBD National Institute of Technology & Management, Lucknow. A standardized machined die was fabricated so that the die consisted of 27 vertical ridges of 1mm depth. Three type IV gypsum products viz., Kalrock, Elite Rock and Denstone Plus and three die-hardeners viz., Hartebad die-hardener, Handae die-hardener and Maarc die-hardener were included in the study. 40 samples were prepared from each of the die-stones by pouring into impressions made by using the putty-wash technique. Resultantly, 120 samples were prepared which were let to mature. These 120 samples were divided into 24 groups, each group consisting of 5 samples. They were grouped as uncoated, coated with Hartebad die-hardener, coated with Handae die-hardener and coated with Maarc die-hardener. They were sub-grouped further for abrading under 20gm and 50gm loads by using an abrasion-testing machine. After 10 oscillations, the loss of mass was measured using analytical electronic machine. The different findings were compared by using appropriate statistical analytic tests. Results: The abrasion resistance of type IV gypsum products increased with the application of surface-hardeners irrespective of the load and Elite Rock showed better abrasive resistance while Denstone Plus showed lesser abrasion resistance among all the type IV gypsum products tested. Conclusion: Elite Rock when coated with Hartebad die-hardener showed maximum abrasion resistance irrespective of the load applied.
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The understanding of the biological behavior of breast cancer has deepened, hence, local treatments for breast cancer have changed from resection to minimally invasive surgery. For patients with early breast cancer, constructing a minimally invasive interven-tion with low systemic toxicity is a problem, especially for cases involving precancerous lesions. Intraductal therapy for breast cancer, which is performed by inserting reagents through breastfeeding openings using suitable carriers, is a promising, accurate, and minimal-ly invasive method for breast cancer prevention and treatment. The combination of intraductal therapy with new therapeutic strate-gies, such as targeted therapy, endocrine therapy, and immunotherapy, might improve the therapeutic effect. Moreover, the mecha-nisms of intraductal therapy for breast cancer incorporate nanotechnology, molecular imaging, and gene sequencing. Intraductal thera-py is based on clinical and pathologic characteristics of Chinese breast cancer patients, and such characteristics must be determined prior to clinical application. This article mainly discusses the research progress of breast intraductal intervention.
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Introduction: Acts of self-injury and self-poisoning that have not resulted in death are described by various terms such as attempted suicide, parasuicide, and deliberate self-harm. Due to the wider utility in various studies, the term attempted suicide is used in this study also. While suicide attempt is defined as intentional self-inflicted poisoning, injury or self-harm which may or may not have a fatal intent or outcome the term attempted suicide is used here for patients who have completely recovered from their attempt and referred for psychiatry opinion. Aim: Aim of the study was to evaluate the socio-demographic factors, methods of the attempt, psychiatric morbidity, and other causes of attempted suicide. Materials and methods: Victims of attempted suicide who were treated and referred from general medicine inpatient care for a regular psychiatric opinion were selected for this study. In the planned period of 3 months span 102 consecutively referred individuals were assessed. Through unstructured, comprehensive clinical interview individuals were evaluated and psychiatric diagnoses were made by using ICD-10-criteria. Datas were entered in a self-structured proforma, results were analyzed. Results: Women (63%), less than 30 years of age (74%), married persons (66%), studied up to secondary and higher secondary education (62%), rural population (80%), semi-skilled workers including housewives (60%), outnumbered others. 21% had a family history of suicide. 13% have attempted in the past. 56% have attempted through organophosphorus and natural plant poisoning. 39% had psychiatric morbidity. Depressive, alcohol, personality disorders were common. 57% of suicidal attempts have resulted from Dysfunctional family living in the form of Interpersonal conflicts and quarrels. Conclusion: Although identifying and treating the psychiatric condition is an immediate need, addressing the Healthy family functioning through school level educational and community level programmes would have long term impact on preventing suicidal attempts.
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Introduction: Neurological signs, are traditionally classified into “Hard” and “Soft” signs. Soft signs are defined as minor, nonlocalizable, objective abnormalities that are thought to reflect damage in connections between subcortical and cortical areas or between cortical areas. In contrast, hard neurological signs can be linked to specific areas of neuroanatomical damage. Aim: Aim of the study was to assess the prevalence of Neurological soft signs in patients with the first-episode psychotic disorder in comparison with control group. Materials and methods: 30 patients with a diagnosis of first episode psychotic disorder and same age and sex matched 30 healthy individuals as the control group was selected for the study based on inclusion and exclusion criteria. Neurological soft signs (NSS) were assessed by the original version of Neurological evaluation scale (NES). Results were entered in a self-structured proforma. Psychiatric diagnoses were made by using ICD-10 criteria. Results were statistically analyzed. Results: There was no significant difference in age, sex and years of education between two groups. On the presence of 2 signs, patient group had 96.7% of prevalence but control group had 56.7% of prevalence which was statistically significant. Conclusion: This study is in conformation with other studies in reporting significantly higher NSS in first-episode psychotic patients than in controls, and adds substance to the claim that NSS could be a biological marker for schizophrenia and other psychotic disorders.
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BACKGROUND: N-acetyl transferase (NAT) inactivates the pro-drug isoniazid (INH) to N-acetyl INH through a process of acetylation, and confers low-level resistance to INH in Mycobacterium tuberculosis (MTB). Similar to NAT of MTB, NAT2 in humans performs the same function of acetylation. Rapid acetylators, may not respond to INH treatment efficiently, and could be a potential risk factor, for the development of INH resistance in humans. METHODS: To understand the contribution of NAT of MTB and NAT2 of humans in developing INH resistance using in silico approaches, in this study, the wild type (WT) and mutant (MT)-NATs of MTB, and humans, were modeled and docked, with substrates and product (acetyl CoA, INH, and acetyl INH). The MT models were built, using templates 4BGF of MTB, and 2PFR of humans. RESULTS: On the basis of docking results of MTB-NAT, it can be suggested that in comparison to the WT, binding affinity of MT-G207R, was found to be lower with acetyl CoA, and higher with acetyl-INH and INH. In case of MT-NAT2 from humans, the pattern of score with respect to acetyl CoA and acetyl-INH, was similar to MT-NAT of MTB, but revealed a decrease in INH score. CONCLUSION: In MTB, MT-NAT revealed high affinity towards acetyl-INH, which can be interpreted as increased formation of acetyl-INH, and therefore, may lead to INH resistance through inactivation of INH. Similarly, in MT-NAT2 (rapid acetylators), acetylation occurs rapidly, serving as a possible risk factor for developing INH resistance in humans.