A study of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsiaMethods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.

Health seeking behaviour of women with unwanted pregnancies: a tertiary care centre based study of eastern Uttar Pradesh, India

Background: Termination of an unwanted pregnancy is legal in India. Many women in this region are still not aware about safe abortion services and its consequences. Especially young, economically deprived and those without a supportive male partner are at higher risk of unsafe abortion. There is no clear and established evidence on this issue in our region. In the study, the aim was to explore the health seeking behaviour of women with unwanted pregnancies.Methods: Present cross-sectional study was conducted among 303 patients visiting to obstetrics and gynecology ward of BRD Medical College, Gorakhpur from April 2018 to September 2018. Their socio demographic profile, reasons for current termination of pregnancy and health seeking behaviour was explored.Results: Most common reason given for terminating the current pregnancy was completed family size 65.3%. Unmarried girls with pregnancy were 5.6 % who wanted termination of pregnancy. Majority (67.0%) took medication for termination of pregnancy from nearby medical store without an expert consultation 15.8% of women consulted to a local quack or local dai for termination of pregnancy. 12.9% of women tried a method as advised by family/friends for termination of pregnancy. About 4% of women 1st tried traditional and herbal medicines, drinking tea or juice for termination of pregnancy. Majority of women (84.5%) visited to medical college for management of complications of earlier tried method of termination of pregnancy.Conclusions: Completed family size was found most common reason for termination of pregnancy. Self medication without consultation of authorised doctor was found most common practice of abortion leading to complications.

An in vitro evaluation of Tribulus terrestris L. fruit extract for exploring therapeutic potential against certain gut ailments

The enteric pathogens and oxidative stress are known to generate intestinal inflammation, chronic gut ailments and oncogenesis. Modulation of the gut microbial peak populations through herbal agents, offers a promising therapeutic modality. Tribulus terrestris Linn. (Tt), a widely documented medicinal herb in Ayurveda, was investigated for antioxidant, anti-inflammatory and antimicrobial activities in vitro. Fruit extract of Tt and quercetin, evaluated for free radical scavenging by DPPH method, revealed IC50 values as 98.83 and 24.77 µg/mL, respectively. Anti-inflammatory attributes of Tt fruit extract and indomethacin, a known anti-inflammatory drug, rendered IC50 values as 10.8 and 12.9 µg/mL against protein denaturation. MTT assay on HCT-15 cells revealed a decrease in viability from 78 to 22% against 30 and 70 µg/mL of Tt fruit extract, respectively. Zone of inhibition against E. coli increased from 0.19 to 9.82 cm2 at 200 and 1000 µg/mL of Tt, respectively. The fruit extract of Tt enhanced the growth of probiotic Lactobacillus rhamnosus (L.rh) by 19, 44 and 50 % over the control at 100, 150 and 200 µg/mL, respectively. This study indicated the potential of Tribulus terrestris fruit extract against inflammatory, oxidative and microbe generated pathogenic ailments in the digestive system.

Comparative Evaluation of Efficacy of Various Antibiotics in Treating Patients with Diarrhea: A Hospital Based Study

Background: Diarrhea is a condition of altered intestinal water and electrolyte transport. The pathophysiologic mechanisms of diarrhea include osmotic, secretory, inflammatory, and altered motility. Hence; we planned the present study to assess and compare the efficacy of ofloxacin and combination of Norfloxacin and metronidazole (Nor Metrogyl) in treating patients with acute watery diarrhoea. Materials & Methods: The present study was conducted in the department of general medicine of RBM Hospital, Bharatpur, Rajasthan and included comparative evaluation of efficacy of ofloxacin and combination of Norfloxacin and metronidazole (Nor Metrogyl) in treating patients with acute watery diarrhoea.  A total of 24 patients with chief complaint of acute watery diarrhea were included in the present study and were randomly divided into two study groups; group A and group B. group A included subjects who were treated with ofloxacin therapy while group B included subjects who were treated with Nor Metrogyl. All the results were analyzed by SPSS software. Results: A total of 24 patients were included in the present study and were randomly divided into two study groups with 12 patients in each group. We observed non-significant results while comparing the clinical success and biological success among patients of both the study groups. Conclusion: Both the treatment regimens are equally effective in treating diarrhea patients.

Evaluation of RECIST, PERCIST, EORTC, and MDA Criteria for Assessing Treatment Response with Ga68-PSMA PET-CT in Metastatic Prostate Cancer Patient with Biochemical Progression: a Comparative Study / 대한핵의학회잡지

PURPOSE@#The aim of the study was to compare response evaluation criteria in solid tumours 1.1 (RECIST 1.1), positron emission tomography response criteria in solid tumours (PERCIST), European organisation for research and treatment of cancer (EORTC), andMDAnderson (MDA) criteria for response assessment by Gallium 68-prostate-specific membrane antigen positron emission tomography-computed tomography (Ga68-PSMA PET-CT) in metastatic adenocarcinoma prostate cancer (mPCa) patients with biochemical progression.@*METHODS@#Eighty-eight mPCa patients with pre and post treatment Ga68-PSMA PET-CTwere included. A ≥ 25% increase and ≥ 2 ng/ml above the nadir if prostate specific antigen (PSA) drop or ≥ 2 ng/ml above the baseline if PSA does not drop was considered as biochemical progression. RECIST 1.1 and MDA criteria for morphology and PERCIST and EORTC criteria for molecular response were investigated. Percentages of progressive disease (PD), partial response (PR), and stable disease (SD) were calculated. Chi-square test was used for statistical significance.@*RESULTS@#Proportion of PD, SD, and PR by RECIST 1.1 and MDA criteria were 44 (50.57%), 39 (44.83%), 4 (4.6%), and 33 (39.76%), 48 (57.83%), 2 (2.41%) respectively. Proportion of PD, SD, and PR by PERCIST and EORTC criteria were 71 (80.68%), 11 (12.50%), 6 (6.82%), and 74 (84.09%), 8 (9.09%), 6 (6.82%) respectively. Chi-square test showed statistically significant (P < 0.05) higher proportion of progression detected by both molecular criteria as compare to both morphological criteria.@*CONCLUSION@#We concluded that for Ga68-PSMA PET-CT response evaluation, molecular criteria performed better than morphological criteria in mPCa patient with PSA progression.

Evaluation of RECIST, PERCIST, EORTC, and MDA Criteria for Assessing Treatment Response with Ga68-PSMA PET-CT in Metastatic Prostate Cancer Patient with Biochemical Progression: a Comparative Study / 대한핵의학회잡지

PURPOSE: The aim of the study was to compare response evaluation criteria in solid tumours 1.1 (RECIST 1.1), positron emission tomography response criteria in solid tumours (PERCIST), European organisation for research and treatment of cancer (EORTC), andMDAnderson (MDA) criteria for response assessment by Gallium 68-prostate-specific membrane antigen positron emission tomography-computed tomography (Ga68-PSMA PET-CT) in metastatic adenocarcinoma prostate cancer (mPCa) patients with biochemical progression.METHODS: Eighty-eight mPCa patients with pre and post treatment Ga68-PSMA PET-CTwere included. A ≥ 25% increase and ≥ 2 ng/ml above the nadir if prostate specific antigen (PSA) drop or ≥ 2 ng/ml above the baseline if PSA does not drop was considered as biochemical progression. RECIST 1.1 and MDA criteria for morphology and PERCIST and EORTC criteria for molecular response were investigated. Percentages of progressive disease (PD), partial response (PR), and stable disease (SD) were calculated. Chi-square test was used for statistical significance.RESULTS: Proportion of PD, SD, and PR by RECIST 1.1 and MDA criteria were 44 (50.57%), 39 (44.83%), 4 (4.6%), and 33 (39.76%), 48 (57.83%), 2 (2.41%) respectively. Proportion of PD, SD, and PR by PERCIST and EORTC criteria were 71 (80.68%), 11 (12.50%), 6 (6.82%), and 74 (84.09%), 8 (9.09%), 6 (6.82%) respectively. Chi-square test showed statistically significant (P < 0.05) higher proportion of progression detected by both molecular criteria as compare to both morphological criteria.CONCLUSION: We concluded that for Ga68-PSMA PET-CT response evaluation, molecular criteria performed better than morphological criteria in mPCa patient with PSA progression.

Stress and mental health problems in 1st year medical students: a survey of two medical colleges in Kanpur, India.

Background: Incidence of stress among medical students has been reported to be between high and very high. Medical students in pre-clinical phase are more likely to develop psychological distress than medical students in clinical phase. It may affect academic performance and lead to anxiety, depression and substance abuse. Methods: First year students of one government medical college and one private medical college of Kanpur, Uttar Pradesh, India, were surveyed to find out stress and mental health problems shortly after their admission. Results: The two colleges showed difference in the frequencies of a number of factors- current stress, sleep problem, sad mood, both parents working, parents giving sufficient time, non-participation in extra-curricular activities, sharing problem with their families, having break-up in a romantic relationship and poor relationships with classmates and roommate. More students of the government medical college reported to have current stress compared to the students of the private medical college. While all students of the government medical who had stress since admission did not recover from it, 55.56% of students of the private medical college recovered from it at the time of our survey. Conclusion: a) Psychiatry Department of every medical college should be involved in screening 1st year students having stress and mental health problems and managing them. b) Medical education should be imparted in more relaxed and fun filled manner to help students cope with the long and difficult course.

The quality of antenatal care services in Shivrajpur block of district Kanpur: a community based survey.

Background: India is amongst the top five countries in terms of absolute numbers of maternal deaths. In Uttar Pradesh MMR is even higher than national average. In spite of better utilisation of ante-natal services, pregnancy outcome is not significantly improving. Reason behind it is that worrying gaps in quality of antenatal care exist which lead to poor effectiveness of ANC in practice. Methods: In the present study quality of antenatal care services utilised by 286 recently delivered women (RDWs) in last one year in Shivrajpur block of district Kanpur was conducted from August 2012 to July 2013. A predesigned questionnaire was used for data collection. Information regarding age, parity, and detailed history of antenatal care & place of antenatal care were collected after taking verbal consent. Results: Majority (76.1%) of women were within 20 to 30 year of age who had delivered in last one year while 13.6% of women were within 20 year of age. In present study we find 91.9% coverage of antenatal care which was based on receiving at least one antenatal check-up. Majority (73.1%) of women received antenatal care from public facility (SC/PHC/CHC/Govt. Hospital). Out of 263 RDWs who received ANC, three-fourths had weight measurement (74.9%), their abdomen examined (76.4%) and hemoglobin estimation (69.6%) done. Less than two-thirds had height (60.8%) and blood pressure measured (66.2%). Nearly one of the two RDWs had urine examination (50.2%) and told about pregnancy complications & danger signs. Only 14.8% RDWs consumed 100 IFA tablet. TT injection was received by 79.5% of RDWs. Full ANC was taken by only 16.3% RDWs. Conclusion: Poor qualities of antenatal have a limited potential to affect maternal mortality. High-risk screening during antenatal care, as a means of identifying women for facility-based intra-partum care, is not effective for women who subsequently failed to obtain complete package of antenatal care.

Ocular involvement in diabetic patients attending tertiary care centres of eastern U.P., India: a prospective study.

Background: Diabetes mellitus is increasing day by day in developing countries especially in India. It is a main treatable cause of morbidity in eye. Diabetic cataract, neovascular glaucoma and retinopathy are important ocular complications due to diabetes mellitus. The objective was to study the variations in ocular complications in patients of diabetes mellitus. Methods: A prospective study from July 2012 to June 2013 was conducted in RMCH and RC, Kanpur & GSVM Medical College, Kanpur. One hundred one selected diabetic patients who are having abnormal slit lamp and fundus examination were included in this study. Results: In our study it was found that more the duration of diabetes, greater the severity of diabetes. Well controlled diabetics have lesser complications in eyes due to diabetes. Conclusion: Patient’s age, sex, duration and control of diabetes play important role in development and severity of complications in eye due to diabetes mellitus.

Bone marrow aspirate showing Leishmania donovani in polymorphs

No abstract available.

Bone marrow aspirate showing Leishmania donovani in polymorphs

No abstract available.

Histoplasmosis on bone marrow aspirate cytological examination associated with hemophagocytosis and pancytopenia in an AIDS patient

A 38-year-old woman who presented with unexplained fever and pancytopenia was subjected to a bone marrow examination. Her bone marrow aspirate smear showed no obvious pathological finding except for the presence of hemophagocytosis and mild plasmacytosis. In view of hemophagocytosis, a thorough examination of the smear was conducted and revealed the presence of histoplasmosis. She was advised to undergo evaluation of her immunological status, and she tested positive for human immunodeficiency virus (HIV) infection. This case highlights that hemophagocytosis in the marrow may be an early sign of underlying disease, and that careful examination of bone marrow smears may reveal subtle infections. In addition, histoplasmosis with hemophagocytosis may be associated with pancytopenia, and hence, the HIV status of the patient should always be investigated.

Gametocytes of Plasmodium falciparum in the megakaryocytes

No abstract available.

Profiling of antioxidant superoxide dismutase in saliva of oral submucous fibrosis patients to categorize its diagnosis in varying stages

Oral submucous fibrosis is a premalignant condition in Indian and South-East Asia. Role of oxidant-antioxidant in causation and progression of cancer and pre cancers is known. Reactive oxygen species are generated in the oral cavity during chewing areca nut, the major etiological agent in oral submucous fibrosis. To see the alterations in the salivary superoxide dismutase levels in various clinical and histopathological grades of oral submucous fibrosis. Unstimulated saliva was collected from 25 oral submucous fibrosis patients and age and gender matched controls. The saliva was assessed for superoxide dismutase value by spectrophotometric method using assay kit [Bio Vision Catalog # K335-100]. The oral submucous fibrosis cases were grouped into clinical stages and histopathological grades and superoxide dismutase values were compared in different clinical stages and histopathological grades. The superoxide dismutase levels were reduced in oral submucous fibrosis as compared to controls. A steady decline in the levels was seen as the clinical stage and histopathological grade of oral submucous fibrosis advanced. Salivary superoxide dismutase levels can be alternatively used as a surrogate marker for the diagnosis of oral submucous fibrosis. Oral physicians should advise the pan chewers to regularly check their salivary superoxide dismutase levels so as to ease the early diagnosis of oral submucous fibrosis

An outbreak of hepatitis E tracked to a spring in the foothills of the Himalayas, India, 2005.

In July 2005, cases of hepatitis were reported from three villages in Nainital district, Uttarakhand, India. We investigated this cluster to identify the source and propose recommendations. A door-to-door search for cases of acute hepatitis was carried out in the three villages. We described the outbreak by time, place and person and conducted a cohort study to identify the source of infection. In addition, sera from cases were tested. We identified 205 cases among 1238 persons (attack rate: 16%, no deaths) between May and September 2005. Of the 23 sera tested, 21 were positive for IgM antibodies against hepatitis E virus. The attack rate was highest among 15–44 years old (19%). Cases began on May 3, 2005, peaked in July and decreased rapidly. The incidence was highest (23%) in one of the villages predominantly using water from an unprotected spring, which was distributed after stone bed filtration alone. In this village, the attack rate increased from 9% among those not using the spring, to 13.8% among those partly using it (RR [95% CI] 1.6 [0.8-3.4]), and to 29% among those exclusively using it (RR [95% CI] 3.4 [2.0-6.0]). Untreated drinking water from an unprotected spring may have been the source of this outbreak in a rural area. Sources of water supply must be protected and treated, including with chlorination. Reporting and investigation of smaller outbreaks in rural areas should be improved.

Role of Ca++ gradient in functional dilatation in the microvessels of rat skeletal muscle.

During skeletal muscle contraction functional dilatation (FD) is a well established phenomenon, which is usually linked to the accumulation of various vasodilator metabolites. The present study aimed to establish the role of calcium ions (Ca++) in the functional dilatation of skeletal muscle microvessels especially during single & few twitches. The FD was studied in urethane anaesthetized rats whose spinotrapezius muscle was prepared for intravital microscopy. After stimulating the muscle with few twitch (1 & 3 Hz) and tetanic frequency (40 Hz), muscle contracted and showed dilatation. However the dilator response was quickest (1 Hz : 10 +/- 0.40, 3 Hz : 02 +/- 0.47 sec and 40 Hz : 02 +/- 0.10 sec) and maximum in magnitude (1 Hz : 25 +/- 0.30%, 3 Hz : 35 +/- 0.49% and 40 Hz : 55 +/- 0.39%) in terminal arteriole and with tetanic frequency. Calcium channel blockade by Diltiazem abolished the FD response except for tetanic stimulation contraction. Findings suggested possible involvement of Ca++ movement in functional dilatation which was initiated by passive efflux of Ca++ from smooth muscle of vessel and then maintained during higher frequency stimulation by release of local metabolities.