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Background: Urinary tract infection is a very common clinical entity and are the leading causes of nosocomial infections. The options for antibiotics especially for nosocomial infections are very limited. Fosfomycin a good drug to be used in UTI and is recommend as first line agents for acute uncomplicated UTIs. The emergence of resistance to fosfomycin is a concern. Limited resistance data for fosfomycin is available from India. This study was conducted in order to monitor the trends of resistance to fosfomycin in E coli and Enterococcus faecalis causing UTI. Methods: Urine samples received in the laboratory from all patients were included in the study. Microscopy of uncentrifuged urine sample was done. Culture and sensitivity was done as per the CLSI guidelines. Susceptibility testing of the isolates to fosfomycin was performed interpretation done as per CLSI. Results: Total 150 isolates were taken for the study which included 100 isolates of E. coli and 50 isolates of Enterococcus faecalis. None of the E. coli isolates were resistant to fosfomycin and 82.0% of the isolates were found to be sensitive to nitrofurantoin. None of the Enterococcus faecalis isolates were resistant to linezolid. The percentage susceptibility was 52 % and 70 % for nitrofurantoin and fosfomycin respectively. Conclusions: The increasing resistance to fosfomycin is a matter of concern. An increased fosfomycin resistance rate in E. faecalis was observed. Performing antimicrobial susceptibility testing should be the most important criteria before starting the antibiotic to avoid undue usage and more such studies need to be conducted.
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The experiment was conducted to study the effect of auxin and cytokinin on grafting and growth of sapling of guava (Psidium guajava L.) at department of Horticulture, College of Agriculture, ummedganj, KOTA, KVK Modal nursery Agriculture university Kota during the year of 2020-21.In the investigation, L-49 cultivar of guava (Psidium guajava L.) was selected as mother plant for obtaining scion bud. The foliar spray of NAA and BA (50 and 25 ppm each) either on rootstock or/and scion branch was applied 10 days prior to grafting. The most responsive treatments was foliar spray on rootstocks with BA at 25 ppm concentration. Rootstocks treated with BA (25 ppm) resulted in length of scion shoot after grafting (16.63 cm), diameter of sprouted scion (2.80 cm), diameter of rootstocks (3.41 cm), number of leaves (20.83), leaf area (24.76 cm2), number of lateral shoot (7.89) as compared to others treatments.
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Background: Low birth weight is a major public health problem in India. Amongst several many factors affecting birth weight, the two factors are demographic characteristics of mothers and utilization of antenatal care services after timely registration of pregnancy. Aims were to access ANC and its association with pregnancy outcomes at Jhalawar medical college, Jhalawar Rajasthan. Methods: All the pregnant women were admitted to the maternity ward for delivery in November 2022. The interview consisted of a demographic characteristic of mothers, utilization of ANC services, live birth weight of the baby, and records of the mother from the hospital. Data collection was done from the maternity ward and vaccination site. It was a hospital-based cross-sectional study. Results: Among mothers who registered in 1st trimester, 81.6% delivered at full term, 77% of new-born were normal birth weight and only 8.5% of new-born needed NICU admission; compared to those who registered in 2nd and 3rd trimesters delivered at full term 67.1% and 55% respectively, 63.3% and 50% new-born had normal birth weight and NICU admission needed by 17.7% and 55% new-born needed NICU admission respectively. Those mothers who received ?4 ANC visits had delivered 186 (78.8%) new-born with normal birth weight and required NICU admission for 24 (10.2%) new-born as compared to those who had <4 ANC visits delivered 109 (64.9.8%) new-born with normal birth weight. Conclusions: Early registration of pregnancy prevents chances of LBW baby, long stay in NICU also leads to a reduction in preterm delivery.
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Background: Rapid detection and early re-exploration is the key to salvage congested flap. Various methods have been described in literature to monitor flaps in post operative period. We evaluate the efficacy of measurement of flap and fingertip blood glucose level and its role in predicting the flap congestion and salvage. Methods: prospective observational study conducted in a tertiary care centre in North India between December 2020 to December 2022. A total of patients 500 underwent 507 free tissue transfer were included in this study. Flap congestion was noted clinically in 41 flaps. In these 41 flaps, flap and fingertip blood glucose level were measured. Results: Congested appearing flaps divided into 2 groups. Group A consist of 8 flaps out of 41. The difference in flap and fingertip blood glucose level is less than 10%. Out of 8, 5 does not required re-exploration and were successfully salvaged. In 3 flaps, difference in flap and fingertip glucose level rises with time and were taken for re-exploration. Out of these 3, 2 were successful salvaged. Group B consist of 31 flaps. In these 31 flaps, 41. the difference in flap and fingertip blood glucose level is more than 10%. All these flaps were re-explored and 21 were salvaged. Conclusions: Flap and body glucose level monitoring is a simple and reliable method for flap monitoring and it can be performed by residents as well as nursing staff.
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Background: Rapid detection and early re-exploration is the key to salvage congested flap. Various methods have been described in literature to monitor flaps in post operative period. We evaluate the efficacy of measurement of flap and fingertip blood glucose level and its role in predicting the flap congestion and salvage. Methods: prospective observational study conducted in a tertiary care centre in North India between December 2020 to December 2022. A total of patients 500 underwent 507 free tissue transfer were included in this study. Flap congestion was noted clinically in 41 flaps. In these 41 flaps, flap and fingertip blood glucose level were measured. Results: Congested appearing flaps divided into 2 groups. Group A consist of 8 flaps out of 41. The difference in flap and fingertip blood glucose level is less than 10%. Out of 8, 5 does not required re-exploration and were successfully salvaged. In 3 flaps, difference in flap and fingertip glucose level rises with time and were taken for re-exploration. Out of these 3, 2 were successful salvaged. Group B consist of 31 flaps. In these 31 flaps, 41. the difference in flap and fingertip blood glucose level is more than 10%. All these flaps were re-explored and 21 were salvaged. Conclusions: Flap and body glucose level monitoring is a simple and reliable method for flap monitoring and it can be performed by residents as well as nursing staff.
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Primary leiomyosarcoma (PLMS) of the ovary is extremely rare tumors comprising 1% of ovarian tumors. About 3% of all ovarian malignancies are primary ovarian sarcomas. Only 72 cases have been reported till date. A 57-year-old postmenopausal female presented with abdominal pain for the last 6 months. Ultrasonography and MRI revealed a heterogeneously enhancing solid lobulated mass in the left adnexa abutting the fundus of the uterus and bowel loops. The endometrial cavity was normal. Ovarian markers CA 125, CEA, CA 19.9, and all hematological parameters were within normal limits. LDH was near normal (284 IU/ml). The specimen was sent for frozen section and a diagnosis of malignant spindle cell lesion of ovary was rendered. Histopathology of the ovarian mass revealed intersecting fascicles of tumor cells consisting of ovoid to spindle-shaped cells having a moderate amount of cytoplasm. Bizarre and atypical cells were seen singly dispersed and in small aggregates along with the brisk mitotic activity. Focal areas of necrosis and hemorrhage were also noted. Immunohistochemistry showed strong positivity for smooth muscle actin and Caldesmon while focal positivity for Desmin and Epithelial Membrane Antigen (EMA) was noted. The lesion was negative for Inhibin, Calretinin, and CD 117 and S100. The final diagnosis of primary ovarian Leiomyosarcoma was given based on histopathology and Immunohistochemistry. PLMS of the ovary are rare incidental findings in postmenopausal women. These are highly malignant tumors and carry a poor prognosis. Hence, early diagnosis and surgical treatment with cytoreduction improve patient survival.
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Background: At present, there is an escalating concern regarding possible role of 5-HT3 receptor in psychopharmacology and the therapeutic potential of their antagonists. Moreover, inclusion of 5-HT3 receptor antagonist may curtail the antidepressant-induced LTP decrease causing memory deficits, thereby improving efficacy of current antidepressants. Aim and Objective: This study aims to evaluate the antidepressant activity of 5-HT3 antagonist, that is, ondansetron (OND) in rodent models of depression. Materials and Methods: Male Swiss albino mice (20–30 g bw) and Wistar rats (100–200 g bw) were divided into five groups. Animals received either OND p.o. (0.1, 0.5 and 1 mg/kg), venlafaxine (10 mg/kg), or vehicle (1 ml distilled water p.o.) in control. Tail suspension and forced swim test were used to evaluate the effects of drugs and control after 60 min of their administration. Furthermore, assessment of locomotor activity (LA) was done by photoactometer after 24 h of drug administration. Results: Ondansetron exhibited significant antidepressants activity (P < 0.05) in rodent models. However, LA was not significantly altered by OND. Conclusion: Ondansetron exhibited significant antidepressant activity in rodent models hence paving the way for exploration of 5-HT3 receptor antagonist in future researches and its therapeutic application in depression.
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Background: Calcium supplementation during pregnancy has a proven potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during gestation. Objective: to evaluate various factors influencing the consumption of iron folic acid and calcium tablets supplementation during pregnancy. Methodology: A community based analytical cross-sectional study was conducted among 200 women in the rural field practice area of Jhalawar. Data were collected by house to house visit and analysed using chi-square test. Results: Only 55.5% pregnant women have taken IFA tablets while 23.5% women have taken tablets of calcium during their pregnancy. IFA consumption were significantly associated with level of education of women and their husband, socio-economic class, type of family, number of ANC visits and presence of husband during those visits and mass media exposure Calcium consumption were also associated with level of education of women, socio-economic class, number of ANC visits and presence of husband during those visits. Conclusions: Consumption of IFA tablets was higher than the national level however calcium consumption was low. Emphasis should be given on early registration, multiple ANC visits, role of family and husband in caring of mother during pregnancy to improve consumptions of IFA and Calcium supplements.
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Introduction: The patients with Type 2 diabetes Mellitus may often remain asymptomatic for a longer period of time. The Indian Diabetes Risk Score (IDRS), a simple screening tool for prediction of undiagnosed diabetes. Objective: Validation of IDRS with standard test for type 2 diabetes among urban population of Jhalawar, Rajasthan. Material and Methods: A Community based Cross-sectional study was carried out in urban field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. The study was conducted using a two-stage sampling design. A predesigned, pretested proforma and Indian Diabetes Risk Score (IDRS) sheet was used to collect data from the study participants. The IDRS is based on four parameters: age, family history of diabetes, waist circumference and physical inactivity. Data was collected using the World Health Organization stepwise approach to surveillance (STEPS). Results: Among 450 participants, 12.7% participants were in low risk, 59.1% were in moderate risk and 28.2% were in high risk of developing diabetes according to IDRS score. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes with sensitivity 92.3% and specificity 82.6%. Positive Predictive value and Negative Predictive value were 47.3% and 98.5% respectively. Conclusion: Association of IDRS was found significant with diabetes. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes. IDRS is found valid screening tool for early detection of Diabetes.
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Increasing HER-2/neu resistance in gastric carcinoma has encouraged search for new biomarkers for targeted therapy. Cellular mesenchymal epithelial transition (C-MET) is one such tyrosine kinase inhibitor proposed for personalized salvage treatment. We determined frequency of C-MET gene copy number variation (CNV) by Fluorescent in-situ hybridization (FISH) in gastric adenocarcinoma (GAC) and sought its correlation with conventional clinicopathologic parameters. Dual-coloured FISH was done on 32 GAC cases. C-MET gene and centromere 7 signals were counted under fluorescent microscope and ratio was calculated for each case. Correlation between C-MET CNV and conventional clinic-pathologic parameters was done by Fischer exact test. CNV was identified in the form of amplification and polysomy (3.1% each) and associated with poorer prognostic parameters. Our pilot study highlights limited subset of patients that may benefit from anti-C-MET-targeted therapy and thus could be a novel biomarker for targeted intervention in GAC.
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Curcumin being component of Curcuma longa is a natural polyphenol. Observing on a chemical level, curcumin is a natural polyphenol which is denominated (1E,6E)-1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene3,5-dione) which is usually extracted through the rhizomes of Curcuma longa. Structurally, it is composed of a trio of chemical identities on a molecular level: dual aromatic ring system. The objective of the research was to design, development and characterization of herbal drug loaded albumin nanoparticles to cure parkinson’s disease for improving and increasing the therapeutic efficacy and also reducing the frequency of dose. The optimized formulations were obtained after applying the design of experiment which was Box Behnken method where three independent variables; polymer concentration, stirring time, crosslinker concentration were selected. Curcumin nanoparticles loaded with albumin were formulated by ph coacervation method in which ethanol was used as desolvating agent along with a cross linking agent (Glutaraldehyde) and albumin as the polymer. The particle size and polydispersity index of curcumin loaded albumin nanoparticles was measured via dynamic light scattering technique. Drug release research conducted using in vitro method over the duration of 24 hours. Ex vivo drug release study of the albumin nanoparticles was performed using nasal membrane of goat. It has been shown that in case of hydrophilic matrices, swelling of polymer occurs followed by release of drug by diffusion which was best explained by Korsmeyer- peppas equation, which indicates drug release through diffusion which occurs by swelling of polymer matrix and remained constant throughout the release of drug in body. By virtue of particle size, the designed nanoparticles effortlessly goes into the nasal mucosa.
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Ceftriaxone, a third generation cephalosporin antibiotic is an important antibiotic used in the treatment of invasive infections caused by the certain bacteria such as the penicillin-resistant microorganisms like Staphyloccocus aureus, strains of S. pneumonia, S. aureus and Enterobacteriaceae , particularly among E. coli. There is increasing antimicrobial resistance of Ceftriaxone in particular against these strains of bacteria. This study has been conducted to formulate, evaluate and optimize chitosan coated ceftriaxone loaded microparticles with better efficacy and also observes the MIC against strains of bacteria. Emulsion crosslinking method was used for the formulation of microparticles of ceftriaxone by using chitosan as a polymer and glutraldehyde as a cross linking agent which is optimized by using Box-Behnken Design. Three independent variables were taken; effect of drug and the polymer ratio, effect of the stirring speed and effect of crosslinking agent and dependent variables were microparticles entrapment efficiency and the In vitro drug release. Following optimization of the formulations, physical characterization as well as entrapment efficiency and ultimately in-vitro evaluation was performed. Physical characterization include optical microscopy, SEM and DLS to check there physical properties. The method used for the formulation of microparticle had the optimum entrapment efficiency of 61.7% which was increase with the increase in the addition of the more amount of chitosan and glutraldehyde and method also achieved the good in vitro release. MIC studies of microparticles were done against Klebsiella pneumonia, Staphylococcus aureus, Streptococcus mutans, Escherichia coli and it was found that the formulations showed decrease in MIC.
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A 30-year-old insomniac, an off-label user of quetiapine, presented with blurring of central vision, eventually diagnosed as central serous chorioretinopathy. A potential association was suspected based on the drug's actions on the autonomic nervous system. He showed improvement on drug withdrawal; then he unwittingly resumed quetiapine and had a recurrence. Possible underlying mechanisms that include alteration in choroidal perfusion through serotonin and dopamine receptors are discussed. Although retinal vein occlusions and pigment epithelial detachment have been described with quetiapine, to the author's knowledge, this is the first case report of quetiapine-associated central serous chorioretinopathy.
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Purpose: Rhegmatogenous retinal detachment (RRD) is a vision-threatening complication of X-linked juvenile retinoschisis (XLRS). The aim of this study is to report the anatomical and functional outcomes of vitreoretinal surgery for the treatment of RRD in X-linked juvenile retinoschisis (XLRS). Methods: This is a retrospective, interventional, consecutive case series in which case records of 34 eyes of 28 XLRS patients, who underwent surgery for RRD, were reviewed. Statistical analysis used is as follows: visual outcomes were categorized into three groups: improved, remained stable or deteriorated. Wilcoxon signed-rank test was used to determine the difference in visual acuity at baseline and at final visit. Univariate binary logistic regression analysis was used to determine the risk factors for retinal detachment. Any P value < 0.05 was considered as statistical significant. Results: Mean age of the boys at presentation was 9.2 ± 3.5 years. Indication for surgery was RRD in all eyes. Concurrent vitreous haemorrhage was present in four eyes (11.8%). The primary surgical intervention was scleral buckle in 12 eyes and pars plana vitrectomy in 22 eyes. Persistence of subretinal fluid/redetachment was seen in 15 eyes of which 11 eyes underwent additional surgeries. At final follow up, 27 eyes (79.4%) were noted to have an attached retina. Of the total eyes, in 20, 6 and 8 eyes the visual acuity improved, stabilized and deteriorated, respectively. Conclusion: Favourable outcomes are seen in a majority of eyes after vitreoretinal surgery for RRD in XLRS; however, multiple surgical interventions may be necessary.
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Context: In India, lung carcinoma is the fifth-most common tumor and second-most common tumor in the males as per the Indian Council of Medical Research registry of 2002. It has been seen that ALDH1 expression in non-small cell lung cancer (NSCLC) and the presence of marker was linked to a more tumorigenic potential in the in vivo assessment and shorter disease-free survival in NSCLC patients with platinum treatment. Aims: Hence, our objective was to detect association of cancer stem cell (CSC) marker aldehyde dehydrogenase 1 (ALDH1) with clinicopathological profile in lung carcinoma patients. Settings and Design: This is a Pilot study. Subjects and Methods: It was a Pilot study where biopsies from 55 fresh previously untreated lung cancer patients visiting the Pulmonary Medicine Department of Era's Lucknow Medical College and Hospital Lucknow and King George's Medical University were taken for 18 months November 2014–April 2016, after taking proper informed consent from them. Paraffin blocks were taken and stained by hematoxylin and eosin (Sigma) to make the histopathological diagnosis and immunohistochemistry was done for detection of CSC marker ALDH1 (Daco). Statistical Analysis Used: The statistical analysis was done using Statistical Package for Social Sciences Version 15.0 Statistical Analysis Software. The values were represented in number (%) and mean ± standard deviation. Results: Expression of stem cell marker ALDH1 with the staging of the tumor was observed in 62.5% of Stage I, 80% of Stage II, 94.1% of Stage III, and 100% of Stage IV cases. Statistically, there was a significant association between ALDH1expression and stage of disease (P < 0.001). Diagnostic efficacy of ALDH1 expression in the detection of any positive clinical stage, it was found to be 88.6% sensitive and 90.9% specific. Conclusions: Strong ALDH1 expression correlates with higher stage of lung carcinoma making it a prognostic marker needing in-depth study.
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Introduction: Human immunodeficiency virus (HIV) may result in variable haematological manifestations. Thrombotic events are more common among HIV-infected persons than the general population, possibly due to the increased inflammatory/hypercoagulable state and presence of concurrent comorbidities. Aims and Objectives: (1) Screen for coagulation abnormalities in HIV-infected patients. (2) Detect certain prothrombotic factors such as deficiency of protein C and protein S and elevation of homocysteine as possible precursors of coagulation defects in HIV patients. (3) Correlation of coagulation abnormalities with CD4 counts. Methods: A pilot study of 1-year duration conducted in the Department of Pathology in collaboration with ART centre, KGMU Lucknow. All diagnosed HIV-seropositive patients (n = 30) who were not taking Vitamin K, antithrombotic and antiplatelet drugs including aspirin, oral contraceptives and not having known protein C/S deficiency were included in the present study as cases. Apart from this, 30 age- and sex-matched healthy individuals were also included in the present study. Assessment of the bleeding time, prothrombin time and activated partial thromboplastin time, complete blood count was done. Protein C and S were measured by calorimetric assay. Serum homocysteine was measured by the semi-automated method. CD4 count was done by flow cytometry. Results: The findings of the present study suggest a relationship between HIV, its complications and thrombosis. The HIV-seropositive patients have reduced levels of haemoglobin, CD4 counts, platelet counts, mean platelet volume, protein C and S activity as compared to the healthy individuals. Thrombophilic abnormality in the form of hyperhomocysteinaemia is more frequent in HIV-infected patients. All these parameters have a definite correlation with CD4 count.
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Lentil, as an economical source of protein, minerals and vitamins, plays important role in nutritional security of the common man. Grown mainly in West Asia, North Africa (WANA) region and South Asia, it suffers from several biotic stresses such as wilt, rust, blight and broomrape. Lentil rust caused by autoecious fungus Uromyces viciae fabae (Pers.) Schroet is a serious lentil disease in Algeria, Bangladesh, Ethiopia, India, Italy, Morocco, Pakistan and Nepal. The disease symptoms are observed during flowering and early podding stages. Rust causes severe yield losses in lentil. It can only be effectively controlled by identifying the resistant source, understanding its inheritance and breeding for host resistance. The obligate parasitic nature of pathogen makes it difficult to maintain the pathogen in culture and to apply it to screen segregating progenies under controlled growth conditions. Hence, the use of molecular markers will compliment in identification of resistant types in different breeding programs. Here, we studied the inheritance of resistance to rust in lentil using F1, F2 and F2:3 from cross PL 8 (susceptible) x L 4149 (resistant) varieties. The phenotyping of lentil population was carried out at Sirmour, India. The result of genetic analysis revealed that a single dominant gene controls rust resistance in lentil genotype L 4149. The F2 population from this cross was used to tag and map the rust resistance gene using SSR and SRAP markers. Markers such as 270 SRAP and 162 SSR were studied for polymorphism and 101 SRAP and 33 SSRs were found to be polymorphic between the parents. Two SRAP and two SSR markers differentiated the resistant and susceptible bulks. SSR marker Gllc 527 was estimated to be linked to rust resistant locus at a distance of 5.9 cM. The Gllc 527 marker can be used for marker assisted selection for rust resistance; however, additional markers closer to rust resistant locus are required. The markers linked to the rust resistance gene can serve as starting points for map-based cloning of the rust resistance gene.
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Introduction: Cervical cancer is the third most common type of cancer among women worldwide, following breast cancer and colon cancer. The micronucleus test is a simple and widely used technique to evaluate genetic damage due to exposure to carcinogenic or mutagenic agents. We undertook this study to compare the MN (micronucleus)score in the whole spectrum of cervical lesions Materials and methods:In this retrospective study, we had compared the MN score in the whole spectrum of cervical lesions which comprised of seven different groups like normal (20), inflammatory (30), ASC-US (20), ASC-H (13), LSIL (20), HSIL (10) and IC (19) over aperiod of 1year (January 2014 to December 2014)which includeda total of 132 cases.Results:In the present study,there was a stepwise gradual increase in MN count from inflammatory to ASC-US to LSIL to HSIL group, followed by a slight increase in IC. The mean MN count was most significant in the LSIL and HSIL group. Thus micronucleated cells as well as the total number of micronuclei show increasing trend towards malignization.Conclusion:Our study showed that MN counting can be a helpful screening tool in conjunction with conventional Pap test for screening of cervical cancer.