Study of medical methods of abortion and self-attempted abortion

Background: Medical abortion in the early stages of pregnancy is considered safe, but it relies on having accurate information and support from a qualified healthcare professional. Despite this, many women opt to use medical abortion pills independently or with the assistance of unqualified practitioners, or pharmacists, as these drugs are readily available over-the-counter without requiring a medical prescription.Methods: This retrospective analytical study was undertaken at the department of obstetrics and gynaecology, at Smt. SCL municipal general hospital, Ahmedabad between December, 2022 to December, 2023.Results: The present study clearly suggests 50% cases of self-attempted medical abortion with drug purchased ‘over the counter’ needs surgical evacuation, 30% managed with further medical intervention and blood transfusion, while comparing with cases which were prescribed MTP Pills in tertiary health care centre need surgical intervention in only 10% cases and the complete abortion rate was 90%.Conclusions: In India the drugs for medical abortion are easily available and accessible without prescription, so most women feel it can be carried out in privacy and they only come to hospital when they develop complications. When MTP pills are prescribed under care of properly trained healthcare personnel with proper guidelines, they have a high success rate and fewer complications.

Study of consumption of blood and blood components in emergency obstetrics patients

Background: Most of the emergencies in the labour room, which require blood and blood product transfusion includes, complications of abortion, placenta previa, ruptured ectopic pregnancy and haemorrhage in labouring patients. Patients may come with severe anaemia and may develop post-partum haemorrhage or any other complications resulting in massive blood loss and rapid deterioration in well-being of the mother. Blood transfusion has become life-saving in management of haemorrhage in obstetric patients. However, like all treatments, it may result in acute or delayed complications.Methods: This retrospective study has included the patients who came with obstetric emergencies requiring blood and blood products during antepartum, intrapartum and postpartum period at the obstetrics and gynaecology department, at tertiary care hospital between December 2022 to December 2023.Results: Multigravida patients required more blood transfusion (69.23%) compared to primigravida (30.76%). Anaemia (38.46%) was the commonest indication for blood transfusion followed by post-partum haemorrhage (21.53%). Fever and shivering (3.07%) were seen to be the commonest adverse reactions. This study observed 92.3% live birth and 7.7% intrauterine foetal demise. Wound gap developed in 3(4.61%) patients following blood and blood products transfusion.Conclusions: Transfusing blood or its components holds utmost importance in comprehensive obstetric care, as emphasised by the current study. Haemorrhage in labouring patients and anaemia are leading causes of maternal morbidities and mortalities. The most effective outcomes in management are achieved through a carefully planned multidisciplinary protocol. Prompt availability of blood and blood components helps to avert mortality in a considerable number of cases.

A COST VARIATION COMPARISON AMONG ORAL ANTI-MIGRAINE DRUGS AVAILABLE IN THE INDIAN MARKET

Objective: Our study aimed to evaluate the cost percent variation and cost ratio of different brands of oral anti-migraine drugs available in Indian market.Methods: The cost of various commonly used oral anti-migraine drugs were taken from the latest issue of Current Index of Medical Specialities January 2022, Drug Today January-April 2022 and 1 mg online site. Cost percent variation and Cost ratio were calculated.Results: A total of 7 single anti-migraine drugs and 9 Fixed-Dose Combinations (FDCs) showed a wide range of cost variation. The highest cost percent variation of 433% was seen in Sumatriptan 50 mg with a cost ratio of 5.33, whereas Amitriptyline 10 mg showed the lowest cost percent variation of 47.9% with a cost ratio of 1.47. Among FDCs Naproxen 500 mg+Sumatriptan 85 mg showed the highest cost per cent variation of 400% with a cost ratio of 5.25 and Propranolol 40 mg+Flunarizine 10 mg showed the lowest cost per cent variation of 46.56% with a cost ratio of 1.46.Conclusion: Our study showed a wide variation in the cost of oral anti-migraine drugs available in the Indian market, which provides insight to the healthcare professional and gives Drug Price Control Order (DPCO) authorities to minimize the financial burden and improve patient compliance.

DESIGN AND DEVELOPMENT OF NANOEMULSION OF SMILAX CHINA FOR ANTI-PSORIASIS ACTIVITY

Objective: The present investigation aimed to prepare a smilax china loaded nanoemulsion using tween 80 as a surfactant and propylene glycol as a co-surfactant. Formulation of such drugs in nanoparticulate drug delivery will be advantageous for reducing dosing frequency, longer residence time, improved permeation, and patient compliance.Methods: High-speed homogenization method. The smilax china oil was prepared by collecting the extract of smilax china leaves into the coconut oil and then used as a solvent. The authentication studies of smilax china and coconut oil were evaluated for their organoleptic and physicochemical characteristics. The quantitative estimation and pre-formulation study of quercetin was carried out which has major anti-psoriatic properties. Surfactant and co-surfactant were selected and the solubility studies of oil and Surfactants were done. The nanoemulsion was characterized by particle size, polydispersity index, zeta potential, and entrapment efficiency (%).Results: This nanoemulsion provides the particle size and entrapment efficiency range between 80.52 to 89.78 nm and 68.66 to 70.16 % respectively. Batch SC1 showed the lowest particle size, PDI, and optimized drug entrapment effectiveness (%), indicating good particle size consistency within the remaining formulation batches. The optimized formulation SC 1 was found to be stable for 90 d.Conclusion: The formulated nanoemulsion showed significant antipsoriasis activity due to the presence of quercetin which has a rhetorical yield of 1.066 mg per 5 gm powder of smilax china leaves. Formulated smilax china-loaded nanoemulsion, has the potential as an effective antipsoriasis agent with a good spreading property with faster absorption which is beneficial for reducing drug concentration with maximum therapeutic effect.

SICKLE CELL DISEASE IN JHABUA AND KHARGONE DISTRICT: UNVEILING PREVALENCE AND SEVERITY

Objective: To assess the prevalence among Sickle cell disease (SCD) affected individuals emphasizing the neglected health challenges in various tribes.Methods: Cross-sectional, observational study was conducted during the district residency program for 9 mo. The data has been collected from the record room of patients diagnosed with Sickle cell Anemia. Statistical analysis was done using Microsoft Excel.Results: A total of 295 patients’ data revealed demographic skew toward Jhabua (50%), with Sickle cell anemia diagnosed at the mean age of 23±3.9. Most patients (72.3%) were Hindu, with Bhil and Bhilaya tribes having higher frequencies. Symptoms varied; 94% had Sickle cell trait, 16.3% had sickle cell disease, and 60% experienced painful crises. Treatment included prophylactic care for all, 37.57% required blood transfusions and 29.7% were on hydroxyurea.Conclusion: The study underscores the significant SCD burden and the need for heightened awareness and targeted interventions in socio-economically disadvantaged tribal regions to mitigate the impact of SCD.

IMMUNE THROMBOCYTOPENIC PURPURA: A HAEMATOLOGICAL DISORDER

Immune (idiopathic) thrombocytopenic purpura (ITP) is an autoantibody-mediated condition characterised by an unusually low level of platelets in the bloodstream. When thrombopoiesis was not occurring quickly enough to counteract the increased rate of platelet destruction, rapid antibody-mediated platelet destruction was initially thought to be the cause of ITP. However, recent research has concentrated on the creation of therapies that boost platelet production as it has emerged that insufficient or inadequate platelet production is also a factor in low platelet counts. ITP can be acute or chronic and affects both children and adults. Because the clinical manifestation of ITP can differ greatly from patient to patient, a thorough assessment of the signs and symptoms must be done in order to manage and treat ITP effectively. Due to the lack of data on clinical and laboratory characteristics, the diagnostic method for ITP now relies heavily on a process of exclusion. Obtaining the patient's medical history and conducting a physical examination are common diagnostic techniques used on both children and adults. Patients with suspected ITP have standard laboratory tests, such as a complete blood count and a peripheral blood smear. With various levels of success, a number of specialised laboratory assays have been created. There is still room to streamline and enhance the diagnostic procedure for detecting ITP.

Effect of Spacing and Biofertilizers on Growth and Yield of Chickpea

The field experiment was conducted during rabi 2022-23, at Crop Research Farm, Department of Agronomy, SHUATS, Prayagraj (U.P). The soil of the experimental plot was sandy loam in texture, nearly neutral in soil reaction (pH 6.9), low in organic carbon (0.32%), available N (283.93 kg/ha), available P (18.3 kg/ha) and available K (223.5 kg/ha). The experiment was laid out in Randomized Block Design with ten treatments viz. T1: Spacing 20 cm x 15 cm + Uninoculated, T2: Spacing 20 cm x 15 cm + Rhizobium, T3: Spacing 20 cm x 15 cm + PSB, T4: Spacing 30 cm x 10 cm + Uninoculated, T5: Spacing 30 cm x 10 cm + Rhizobium, T6: Spacing 30 cmx 10 cm + PSB, T7: Spacing 40 cm x 10 cm + Uninoculated, T8: Spacing 40 cm x 10 cm + Rhizobium, T9: Spacing 40 cm x 10 cm + PSB and T10: Control: 100% RDF each replicated thrice. The results of the experiment obtained that application of Rhizobium (20 g/kg seeds) along with the Spacing 30cmx10cm significantly increased the growth parameters viz. plant height (46.79 cm), number of nodules (31.93/plant), plant dry weight (22.11 g/plant) and yield parameters viz. number of pods per plant (36.80), seed index (22.15 g), seed yield (3.44 t/ha) and stover yield (4.28 t/ha). This treatment also showed its positive effect on economics viz. gross returns (1,71,834 INR/ha), net returns (1,24,486 INR/ha), B:C (2.63). As the majority of Indian farmers are marginal and poor who cannot afford the use of high cost fertilizers with the result that crops are exposed to nutritional constraints. In such conditions biofertilizers can play an important role in contributing towards soil health and crop productivity. Biofertilizers are a cost effective renewable energy source that plays a crucial role in reducing inorganic fertilizer application and at the same increasing crop yield besides maintaining soil fertility. The optimum spacing for any crop means maintaining uniform and healthy crop stand so as to get optimum yield of crop. The growth and yield of crop is closely related to number of plants per unit area.

Constraints Perceived by the Farmers Regarding Opportunity and Challenges of Climate Smart Agriculture in Central Plain Zone of Uttar Pradesh, India

This research article discussed about the constraints faced by farmers in the adoption of climate smart agriculture in the Central Plain Zone of Uttar Pradesh. Climate Smart Agriculture (CSA) is basically a management strategy for agriculture in the face of climate change. Farmers face obstacles to adopting diverse Climate Smart Agriculture practices. Farmers face many barriers when it comes to adopting new or unfamiliar practices, such as Climate Smart Agriculture. These include lack of awareness, high cost of machines and input, and insufficient knowledge and guidance. Garrett's ranking technique is used to determine the most important factor influencing the response. The major constraints faced by the farmers in their knowledge and adoption of Climate Smart Agriculture were ‘lack of awareness', 'uncertain returns', 'limited extension activities’ common problems in the study area having the Garrett rank of first (Average Value 114.95), second (Average Value 113.26) and third (Average Value 101.22) respectively, and so forth the other constraints too. The study sought to identify the barriers to Climate Smart Agriculture adoption as well as potential solutions.

In-vitro Screening of EMS and Sodium Azide Induced Mutant Population at Seedling Stage for Drought Tolerance in Wheat (Triticum aestivum L.)

Drought caused by climate change result in water shortages, decreased global wheat production and unevenly distributed heavy rains. About 50% of the global wheat production is affected by water deficit conditions. The effects of different concentrations of EMS and SA on HD-3226 and HI-1620 wheat genotype for drought tolerance capability were investigated at seedling stage under water and osmotic stress conditions. In the present study, 15% concentration of polyethylene glycol (PEG-6000, to mimic drought stress) was used for in-vitro screening of EMS and SA induced mutant lines of both wheat genotypes. Current study revealed that SA decreased germination of seeds, seedling length, seed vigour index and survival rate percentage while it increased morphological mutation frequency percentage as comparison to EMS treatment in both wheat genotypes under water and PEG stress. Moreover, osmotic stress significantly reduced seed germination, shoot length, root length, seed vigour index, survival rate percentage compared to control-wild type.

Effect of Integrated Nutrient Management on Growth, Yield, Nutrient Uptake and Economics of Rabi Sorghum (Sorghum bicolor (L.) Moench)

Long term study on different crops indicated that application of balanced NPK fertilizer couldn’t meet higher yield due to poor physical properties and micronutrient deficiencies. Keeping in view to the above concept a experiment entitled “Effect of Integrated Nutrient Management on Growth and Yield of Rabi Sorghum (Sorghum bicolor (L.) Moench)” was conducted at post graduate experimental farm of M.S. Swaminathan School of Agriculture, Centurion University of Technology and Management, Paralakhemundi during the rabi season, 2022. The experimental soil was sandy loam with low in available nitrogen and medium in phosphorus and potassium. The experimental design was randomized block design, which consists of 10 numbers of treatments as different combinations of recommended dose of fertilizer (RDF) and farmyard manure (FYM), each treatment replicated thrice. The treatments are T­1: Control, T2: 50% RDF, T3: 75%RDF, T4: 100%RDF, T5: 50%RDF+5t FYM ha-1, T6: 50% RDF + 10t FYM ha-1, T7: 75% RDF + 5t FYM ha-1, T8: 75%RDF+10t FYM ha-1, T9: 100%RDF + 5t FYM ha-1, T10: 100%RDF + 10t FYM ha-1. Among all the treatments significantly highest growth, yield attributes and nutrient uptake were recorded from the treatment 100% RDF + 10t FYM ha-1(T10). Application of 100% RDF + 10t FYM ha-1 recorded highest sorghum grain yield (2416 kg ha-1) and gross return (?85108/- ha-1). However, maximum net return (?48010/- ha-1) was recorded from 100%RDF + 5t FYM ha-1 but B:C ratio (1.49) from 75%RDF.

Identification of Contrasting Parents and Development of Mapping Population for Sucking Pest Resistance in Cotton

The current study was conducted to identify the best parents with good agronomical features and contrasting characteristics for sucking pest resistance to develop a population that can be used for Quantitative Trait Loci mapping of resistance component traits. Initial attempts at this university have enabled to identify of five potential parents (viz., KC3, NDLH 1938, CO18, K12, and RG8) with improved sucking pest resistance and yield characters and they were crossed with the recently released high-yielding variety CO-17, which is also suitable for high-density planting. All these six parents were evaluated for fiber yield and quality traits besides anatomical characters such as trichomes density, length, width, and sharpness that confers sucking pest resistance and genotyped with 200 Simple Sequence Repeats markers that span the entire genome. Efforts have been dedicated to the careful selection of optimal parents, namely CO17 and KC3, each possessing distinct traits related to resistance against sucking pests and also fiber quality characters in addition. This strategic approach aims to combine their contrasting genetic components for sucking pest resistance, to develop a new generation of plants that exhibit heightened resilience to these types of pests. CIR139, a polymorphic SSR marker of these two parents was used to fix the true hybrids which were advanced to generate an F2 mapping population. This population is believed to be useful for QTL mapping of anatomical features that confer sucking pest resistance such as trichome length, density, breadth, and sharpness besides fiber yield and quality traits.

Prevalence of foot posture deformities using foot posture index in various intensive care unit nurses

Background: This study aims to determine the prevalence of foot posture deformities among various intensive care unit nurses using the Foot Posture Index. Nurses working in ICUs often face long hours of standing and walking, which can contribute to the development of foot-related problems. Understanding the extent of these deformities can contribute to the development of preventive measures, such as ergonomic interventions and targeted exercises, to mitigate the risk of foot-related issues. Methods: A study was conducted among 159 nurses from various Intensive Care Units. The Foot Posture Index, a validated tool for assessing foot posture was used to assess foot deviations in nurses. Results: In total159 participants were evaluated, with 6 (4%) being males and 153 (96%) being females. The mean age of the participants was (Mean=40.67) and standard deviation (SD=9.6). Prevalence percentage of foot posture deviations were found to be bilateral as demonstrated by Foot Posture Index. Out of 159 participants 43% participants had pronated foot, 14% participants had highly pronated foot, 16% participants had supinated foot, 7% had normal highly supinated foot posture and 20% participants had normal foot. Conclusions: To conclude the present study, pronated foot posture was the most common foot deviation. Moreover, when BMI was compared with the pronated foot deviation, there was a positive association between pronated foot and the nurses who were overweight.

A Review on Mitigation of Greenhouse Gases by Agronomic Practices towards Sustainable Agriculture

Agriculture is one among the sources of greenhouse gas emission in the World. Agriculture, being a prominent source of economic sectors in developing countries its impact on environmental climate changes both directly and indirectly through emission of greenhouse gases. To achieve reduced GHGs emissions in agriculture sector, there is a need to adopt climate smart activities and improved food and nutritional security to ensure a climate-smart sustainable agriculture. This short article explores the key ways to mitigate green house gases emissions in agriculture and critically highlights the potential for bacterial nitrogen fixation in soybean which is a recent approach. Symbiotic nitrogen fixation shows a great potential for GHGs mitigation while supporting the agriculture simultaneously. Other agronomic practices include tillage, residue management, rice field management, climate smart agriculture, organic farming and bio energy etc. This will help the farmers and other stakeholders to bring an environmentally friendly agriculture towards more ecological farming approach for future sustainability.

The Terminal Heat Stress and its Effect on Yield and Yield Contributing Traits of Wheat (Triticum aestivum L.) Genotypes

An experiment was conducted with wheat genotypes NWL-14, K-9162, NWL-1014, NWL-12-2, NWL-12-4, NWL-10-4, K-910-30, NWL-4035, DBW-16, DBW-187, NWL-12 (3) T, Halna, HD-2967 to evaluate heat tolerant in wheat at instructional farm and in the laboratory of Crop Physiology & Plant Molecular Biology and Genetic Engineering, Acharya Narendra Deva University of Agriculture and Technology, Kumarganj, Ayodhya, India, during rabi season of 2021-2022. Heat stress was induced by delayed sowing 45 days from normal date of sowing (02 December 2022)-(17 January 2023) so that delay sown wheat genotypes could experience heat stress at reproductive stage. Heat tolerant wheat genotypes screened on the basis of Relative Water Content, Catalase activity, plant height, tiller number, number of grains per spike, test weight and grain yield per plant over control under heat stress condition. Heat stress reduces the the growth and yield irrespective of wheat genotypes but heat tolerant genotypes Halna, NWL-1293)T, NWL 10-2 and NWL-12-4 showed less reduction over susceptible ones. Relative water content, proline and catalase activity can be used as a physiological screening indices for heat tolerant genotypes.

Renal involvement and early prognosis in patients with Covid-19 pneumonia in tertiary health care centre

Background: The corona virus disease (Covid-19) is a pandemic which is rapidly evolving and expanding, has infected a population of more than 77 million across the globe and around 10 million in India as of 25th December 2020. This virus was first recognized in December 2019 in Wuhan of China when pneumonia of unknown origin came into limelight. It was identified as Covid -19, a neo virus causing severe pneumonia that rapidly led to a major health crisis with devastating consequences not only in India but also in major developed countries of the world. Initially data from China and Italy, which was identified as caused by Covid-19, shows that death rate worsens in persons with increasing age more than 50 years and also leads to higher risk due to co-morbidities like hypertension (HTN), cardiac disease, diabetes mellitus, chronic renal disease, cancer, etc. Severe acute respiratory viral infections are frequently accompanied by multiple organ dysfunction, including acute kidney injury (AKI). While diffuse alveolar damage and acute respiratory failure are the main features of Covid-19, and the incidence of AKI is not well described. The present study was conducted to assess the Renal Involvement and its association with Prognosis among Patients admitted with Covid- 19 Pneumonia. Aim: To assess the renal involvement and its association with prognosis among patients admitted withCovid-19pneumonia. Materials and methods: A single centered cross-sectional study was conducted at Malla Reddy Institute of Medical Sciences during 15th March to 1stMay 2021 where 151 Patients admitted with Covid-19 Positive on RT-PCR were included. Renal function tests include Creatinine and Urea. The most commonly used endogenous marker for the assessment of glomerular function is creatinine. The calculated clearance of creatinine is used to provide an indicator of GFR. Urea is a nitrogen- containing compound formed in the liver as the end product of protein metabolism and the urea cycle. Serum urea levels increase in conditions where renal clearance decreases (in acute and chronic renal failure/ impairment). Urea may also increase in other conditions not related to renal diseases such as upper GI bleeding, dehydration, catabolic states, and high protein diets. Data entry was done using Excel 2013 and analysis using SPSS v16. Student t test and chi-square test were used to find the significant association without come. Results: A total of 151 patients who had tested positive for COVID-19 were included in the study. The mean age in years of the study participants was 47.76�.85. 72.8% were male and 27.2% were female. The mean serum creatinine was 1.44�94 and mean Blood urea was 41.35�.06. Mortality observed in the study was 44.4%. Significantly high levels of serum creatinine (2.06�10) were reported among those who died due to COVID-19 compared to those who recovered (0.93�28) (p<0.0001) in the study. Our study poses a conclusion of increase in serum creatinine in COVID 19 affected patients that shows a temporal association of SARsCOV�with AKI. Conclusion: The Covid pandemic has posed major challenge around the globe. Renal clinical presentation ranging from mild proteinuria, hematuria to progressive AKI necessitating renal replacement therapy (RRT), thrombotic microangiopathy and rhabdomyolysis. More research is needed to obtain adequate evidence to support current clinical approaches and to develop new approaches to management. Kidney failure occurs in most patients with COVID-19 pneumonia. Although proteinuria, hematuria and AKI are usually resolved in such patients within 3 weeks after the onset of symptoms, kidney problems in COVID-19 have been associated with higher mortality. AKI is independent predictor of mortality in Covid-19

FIELD TRIAL OF CYANOBACTERIA BASED BIOFERTILIZER FOR CULTIVATION OF TRITICUM AESTIVUM PLANT

The continuous growth of the global human population and the depletion of natural energy resources are posing a threat to the environment and the sustainable supply of food and energy. To address this issue, a solution known as "green technology" has been developed, focusing on the use of eco-friendly approaches. One of these approaches involves harnessing the power of cyanobacteria, which are ancient microorganisms that have existed on Earth for a long time. This approach was used to probe the diversity of phototrophic microorganisms in Wheat samples. The presence of nif genes allows cyanobacteria to x nitrogen which plays a vital role in nitrogen cycle and biological processes such as plant growth and soil fertility. Wheat production test in current study evaluates the yield and quality of wheat crops. It shows factors such as improvement in growth, heat resistance and environmental adaptability, improvement in production; provide insights for optimizing cultivation practices and ensuring successful high yield. Identication of Cyanobacteria for their combination of nif and molecular identity is prior for production of bio fertilizers. Cyanobacteria can be cultivated on a large scale to produce biomass that has multiple uses, including biofertilizer, secondary metabolites, cosmetics, and medicines. In the eld of agriculture, production of healthy crop cyanobacterial biofertilizer are being increasingly used in eco-friendly and sustainable practices. These biofertilizer are produced through mass cultivation of cyanobacteria and offer several benets.

Outcomes of children with idiopathic steroid resistant nephrotic syndrome: a single centre observational study / Desfechos de crianças com síndrome nefrótica idiopática córtico-resistente: um estudo observacional de centro único

ABSTRACT Introduction: Idiopathic steroid resistant nephrotic syndrome (SRNS) has variable outcomes in children. The primary objective of the present study was to assess the cumulative remission rate and the secondary objectives were to assess factors affecting the remission status, kidney function survival, and adverse effects of medications. Methods: One hundred fourteen patients with SRNS were included. Calcineurin inhibitor-based treatment protocol along with prednisolone and angiotensin-converting enzyme inhibitor were used, and patients were followed over 5 years. Results: Median age was 4.5 years; 53.5% of cases were between 1 to 5 years of age. Sixty-two patients (54.4%) were at initial stage and 52 (45.6%) were at a late SRNS stage. Median eGFRcr was 83.5 mL/min/1.73m2 at presentation. Of the 110 patients, 63 (57.3%) achieved remission [complete remission 30 (27.3%), partial remission 33 (30%)], and 47 (42.7%) had no remission. Kidney function survival was 87.3% and 14 cases (12.7%) had progression to CKD (G3-8, G4-3, G5-1, and G5D-2). Median duration of follow up was 36 months (IQR 24, 60). Age of onset, cyclosporine/tacrolimus, eGFRcr, and histopathology (MCD/FSGS) did not affect remission. Similarly, remission status in addition to age of onset, drug protocol, and histopathology did not significantly affect kidney function during a period of 5 years. Hypertension, cushingoid facies, short stature, cataract, and obesity were observed in 37.7, 29.8, 25.5, 17.5, and 0.7% of cases, respectively. Conclusion: About half of the cases achieved remission. Age of onset of disease, cyclosporine/tacrolimus use, and histopathological lesion neither affected remission status nor short-term kidney function survival in SRNS.

RESUMO Introdução: A síndrome nefrótica idiopática córtico-resistente (SNICR) apresenta desfechos variáveis em crianças. O objetivo principal deste estudo foi avaliar a taxa de remissão cumulativa. Os objetivos secundários foram avaliar fatores que afetam status de remissão, sobrevida da função renal e efeitos adversos de medicamentos. Métodos: Foram incluídos 114 pacientes com SNCR. Utilizou-se protocolo de tratamento baseado em inibidores de calcineurina juntamente com prednisolona e inibidor da enzima conversora de angiotensina. Os pacientes foram acompanhados durante 5 anos. Resultados: A idade mediana foi 4,5 anos; 53,5% dos casos tinham entre 1 e 5 anos. 62 pacientes (54,4%) estavam em estágio inicial; 52 (45,6%) em estágio tardio da SNCR. A TFGecr mediana foi 83,5 mL/min/1,73 m2 na apresentação. Dos 110 pacientes, 63 (57,3%) alcançaram remissão [remissão completa 30 (27,3%), remissão parcial 33 (30%)], e 47 (42,7%) não apresentaram remissão. A sobrevida da função renal foi 87,3%; 14 casos (12,7%) progrediram para DRC (G3-8, G4-3, G5-1, G5D-2). A duração mediana do acompanhamento foi 36 meses (IIQ 24, 60). Idade no início, ciclosporina/tacrolimus, TFGecr e histopatologia (DLM/GESF) não afetaram a remissão. Igualmente, status de remissão, além da idade no início, protocolo de medicamentos e histopatologia não afetaram significativamente a função renal por 5 anos. Observou-se hipertensão, fácies cushingoide, baixa estatura, catarata e obesidade em 37,7; 29,8; 25,5; 17,5; e 0,7% dos casos, respectivamente. Conclusão: Aproximadamente metade dos casos alcançou remissão. Idade no início, uso de ciclosporina/tacrolimus e lesão histopatológica não afetaram o status de remissão nem a sobrevida da função renal a curto prazo na SNICR.

Effect of phototherapy on platelet count in neonates with unconjugated hyperbilirubinemia

Background: Hyperbilirubinemia in newborn is quite common. Phototherapy (PT) is one of the most common noninvasive methods for the treatment of this hyperbilirubinemia. There are limited studies available on effect of PT on platelet count with contrasting results. So, this study was conducted to determine the effect of phototherapy on platelet counts of hyperbilirubinemic neonates in tertiary care hospital.Methods: This was a hospital based prospective study on 60 eligible neonates admitted in neonatal intensive care unit (NICU) for neonatal hyperbilirubinemia and phototherapy during January 2021 to June 2022. Platelet count was done before starting phototherapy, 24 hours after phototherapy and before discontinuing phototherapy. The results were analyzed statistically using Chi square test and t-test. P value <0.05 was considered as statistically significant.Results: In this study, total of 60 neonates were included of which 33 were males and 27 were females. The mean (±SD) platelet counts were 201764.92±18 before phototherapy and 156578.33±38 after phototherapy. There was a significant decline in the mean platelet count 24 hours after phototherapy and before stopping phototherapy. (p<0.05).Conclusions: In our study, the mean platelet count was decreased significantly after phototherapy. Hence, unnecessary use and prolongation of phototherapy should be avoided.

Solar retinopathy in India: Clinical presentation and demographic distribution in 253 patients (349 eyes)

Purpose: To describe the demographics, clinical characteristics, and presentation of solar retinopathy in patients who presented to a multi?tier ophthalmology hospital network in India. Methods: This cross?sectional, hospital?based study included 3,082,727 new patients presenting to the hospital between August 2010 and December 2021. Patients with a clinical diagnosis of solar retinopathy in at least one eye were included in the study. All the data was collected using an electronic medical record system. Results: Three hundred and forty?nine eyes of 253 (0.01%) patients were diagnosed with solar retinopathy and included in the study, and 157 patients (62.06%) had a unilateral affliction. Solar retinopathy was noted to be significantly more common in males (73.12%) and adults (98.81%). The most common age group at presentation was during the sixth decade of life with 56 (22.13%) patients. They were more commonly from the rural geography (41.9%). Among the 349 eyes, 275 (78.8%) eyes had mild or no visual impairment (<20/70), which was followed by moderate visual impairment (>20/70–20/200) found in 45 (12.89%) eyes. The most commonly associated ocular comorbidity was cataract in 48 (13.75%) eyes, followed by epiretinal membrane in 38 (10.89%) eyes. The most common retinal damage seen was interdigitation zone (IZ) disruption (38.68%), followed by inner segment–outer segment (IS–OS) disruption (33.52%). Foveal atrophy was seen in 105 (30.09%) eyes. Conclusion: Solar retinopathy is predominantly unilateral and is more common in males. It usually presents during the sixth decade of life and rarely causes significant visual impairment. The most common retinal damage seen was disruption of the outer retinal layers