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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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Introduction: The commonest day to day ailment of humanbeings is the gastrointestinal diseases. Apart from traditionaluses, there are several reports on important pharmacologicalactions of musa sapientum. Study aimed to compare acidsecretion and ulcer healing effect of methanolic extract ofbanana, ranitidine, and omeprazole.Material and methods: The present study was carried out on30 albino rats for a period of 7 days. The animals were dividedrandomly into 5 groups of 6 animals each. Group I or controlgroup received 3% gum acacia suspension orally for 7 days.Group II, III, IV and V received 100mg/kg of aspirin orally asa single dose the 7th day. Group III was pretreated with 100mg/kg of MSE orally for 7 days. Group IV was pretreated with 20mg/kg omeprazole and Group V was pretreated with 150mg/kg of ranitidine orally for 7 days. After the administration ofthe drugs on the 7th Day, the albino rats were fasted for 24 hrsand then sacrificed after 4 hrs of pyloric ligation.Results: In the control group (n=6) the values of ulcer index(µmol tyrosin/ml), free acidity (mEq/l), total acidity (mEq/l),and volume of gastric juice (ml/4 hrs) were 0.22±0.01,53.25±2.59, 72.24±4.19 and 5.1±0.32 respectively. Whencompared to aspirin treated group, the MSE pretreated group(100 mg/kg) single dose orally on 7th day showed significantreduction (p<0.01, n=6) of ulcer index, free and total acidity(mEq/l), and volume of gastric juice (ml/4 hrs), whosevalues were 5.3±0.46, 71.31±4.15, 72.24±4.19 and 65.4±2.9respectively.Conclusion: The present study suggests that themethanolic extract of musa sapientum possesses significantulceroprotective effect, which is comparable to omeprazoleand ranitidine, except for gastric juice, where the effect ofomeprazole was more. The observations of the present studyputs forward omeprazole as a promising ulceroprotectiveagent, but further studies with more refined extracts andtechniques on animal and human subjects are requiredto establish the true potential in terms of therapeutic andeconomic viability of this herbal plant.
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Introduction: The increasing prevalence of hypertension isattributed to population growth, ageing and behavioural riskfactors, such as unhealthy diet, harmful use of alcohol, lackof physical activity, excess weight and exposure to persistentstress. The present study was conducted to study on variousfacets of antihypertensive drugs prescribing at present scenarioat Dr B.C. Roy Hospital, Haldia, and with objectives of studyingprescribing patterns and rationality of antihypertensive drugsin essential hypertension with or without specific co-morbidconditions and to check compliance of treatment as per JNC-8hypertension treatment guidelines in the outpatients attendingthe Department of Medicine.Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation forrational drug therapy by evaluating average number of drugsper prescription, fixed dose combination (FDC) prescriptionrate, prescription laying down importance of lifestylemanagement, prescription with defined anti-HTN goals,prescriptions with correct dose strength and dosage schedulewas evaluated.Results: Out of 100 hypertensive patients under evaluation 67was males (67%) with a M:F ratio of 2.03:1. Mean SBP wasslightly higher in male patients. Hypertension was classifiedaccording to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension),and 13% (stage 2 hypertension) cases. Dyslipidemia wasnoted much more common associated disorders among newlydiagnosed hypertensive of either sex.Conclusion: Diuretics (8%) were most widely prescribeddrugs followed by ARBs (6%), ACE Inhibitors (5%) andcalcium channel blockers (4%) as monotherapy. Adherence ofJNC 8 guidelines among all study hypertensive participantswhile prescribing medications varied between 62% to 92%,with an average of 75%. None of the prescriptions mentionedban drug formulation(s). Still 15% of the prescriptionshad suggested combined drugs with debated rationalityformulations.
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Introduction: The diabetes mellitus is described as metabolicdisorder of multiple etiology characterized by chronichyperglycemia with disturbance of carbohydrate, protein andfat metabolism resulting in insulin secretion, insulin action orboth. This study was done to check the prevalence of coronaryartery disease (CAD) risk factors in diabetic patients andcompare with normal subjects.Material and methods: Sixty diagnosed cases of diabetes and60 normal subjects from patients attending Diabetic Clinic,Tribhuvan University Teaching Hospital, Kathmandu, Nepal.This was hospital based cross sectional observational study.Diagnosed case of diabetes was taken and non-modifiable andmodifiable risk factors of CAD were compared with normalsubjects with available data of risk factors CAD.Results: Mean age of the case group was 48.51 yrs, 46.6% ofcase group had hypertension, in comparison of control grouphad only 15%. Study showed overweight (BMI>25 Kg/m2)was observed in 25 (41.6%) diabetic patients in comparisonto control which had only 2 (3%) subjects being overweight.About 5% of diabetic cases had family history of CAD. Familyhistory of diabetes was present in 32% of diabetic patients andfamily history of hypertension was present in 18% of diabeticpopulation.Conclusion: This study showed the prevalence of risk factorof CAD in diabetic patients was significantly higher comparedwith normal subjects
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Background: Megaloblastic anaemia is the hematologic manifestation of faulty proliferation of blood cell precursors. The present study was done to facilitate the diagnosis prior to performing any bone marrow aspirate by estimation of the value of serum LDH in the diagnosis of megaloblastic anaemia.Methods: The cases were selected from patients attended the OPD and admitted in Sanjay Gandhi Memorial Hospital & Gandhi Memorial Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh. Following investigations were then done to classify anaemia and to establish the diagnosis of megaloblastic anaemia like Haemoglobin estimation by cyanmethaemoglobin method, PCV, RBC count and absolute values, general blood picture, reticulocyte count, bone marrow examination and serum LDH estimation before and after treatment.Results: Of the 100 cases, 50 cases (50%) of the cases were microcytic hypochromic anaemia. 15 cases (15%) were normocytic normochromic anaemia; 35 cases (35%) were macrocytic anaemia on the basis of general blood picture and absolute values. The incidence of megaloblastic anaemia in Indian adults was 20%. Maximum number of cases (90%) of the cases had serum LDH level of more than 1000 U/L. Range of serum LDH level was 520 U/L to 4520 U/L. Thus, there was 2 to 20-fold of highest reference value (240 U/L at37 C) rise in serum LDH level in megaloblastic anaemia.Conclusions: Megaloblasatic anaemia is not uncommon in Indian adults and serum LDH levels provide an important means of diagnosis. It is a non-invasive procedure, safe, and does not require any expertise.
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The knee joint is one of the most vulnerable and frequently injured joints of the body. X-ray, arthrographic, scintigraphic, ultrasound examinations hold their place in diagnosing knee injuries, but they are loosing precedence to computerised tomography (CT), magnetic resonance imaging (MRI) and arthroscopy. Role of magnetic resonance imaging (MRI) in the diagnosis of knee lesions has now become more evident. To find out the efficacy of MRI in diagnosing various ligamentous and meniscal injuries in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Methods: In this prospective interventional comparative study patients of all age group of either sex attending the orthopaedic OPD of IPGMER & SSKM Hospital with clinical features suggestive of soft tissue around knee were included in the study during the period of Feb 2008 to Aug 2009. MR imaging with GE make of 1.5 tesla (super conductive in nature) was used. The patients was evaluated in sagital, coronal and axial imaging planes. Results: In the present study 100 cases of knee evaluated based on the clinical history and examination a provisional diagnosis was made. About 44% of the patients were subjected to MRI within 10 weeks after the onset of their sufferings. Most common structure being injured was medial meniscus in about 64% cases. In our study, arthroscopy had been taken as gold standard but arthroscopy is useful for intraarticular structures and its injuries only. So the correlation of intraarticular structures i.e. meniscus & cruciates can be done only. Out of 100 patients, 48 cases showed ACL tears, 22 patients showed PCL tear arthroscopically. Out of 48 ACL tears confirmed by arthroscopy the diagnosis 5543by MRI was 48. Conclusions: MR is highly specific and highly sensitive in detection of cruciate ligament injuries in patients with acute as well as chronic injury. MR is more sensitive in detection of multiple meniscal tear that may be overlooked on sonography or arthroscopy.
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In the absence of effective vector control measures and vaccines against leishmaniasis, effective chemotherapy remains the mainstay of treatment. Identification of post-kala-azar dermal leishmaniasis (PKDL) is important due to the long and toxic treatment and the fact that PKDL patients may serve as a reservoir for visceral leishmaniasis (VL). This retrospective study was done to assess the outcome of pharmacotherapy in post-kala-azar dermal leishmaniasis (PKDL) patients in a specialty public hospital in Kolkata. Methods: The hospital records of all consecutive PKDL patients admitted at Calcutta School of Tropical Medicine (CSTM), Kolkata during the last five years - 2010-2014, were reviewed and the relevant information inputs as documented studied to realize the noted objectives. Clinical presentation on admission including presence of co-infections (particularly HIV), trends and patterns of treatment regimens and rationale thereof, if available; treatment (anti-leishmaniasis) outcomes in reference to efficacy, safety and tolerability, fatality like serious complications and mortality and adverse drug reactions (for anti-leishmaninal drugs primarily), if any was noted. Results: PKDL cases presented with insidious onset skin lesions of different types without much systemic illness. 2 out of 19 cases presented with fever and 2 other cases had mild anemia. PKDL cases presented with 4 types of skin lesions. Multiple macular or hyppigmented macular lesions were commonest, 8 out of 19 cases (42.10%). In PKDL cases treatment outcome was difficult to say unless parasitologically declared negative, though clinically regression of the lesions were visible in all cases. Tolerability was least with AmB followed by SSG and best with miltefosine. Conclusion: So, it can be concluded from this study that in this institute PKDL were treated with conventional and liposomal AmB as well as with SSG, miltefosine and combination therapy. Among the regimens short course L-AmB was found to be the most efficacious and tolerable in respect to ADRs and hospital stay.
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Background: This comparative study was done to evaluate the change from baseline in HbA1c levels with teneligliptin vs. metformin treatments at week 12 among recently diagnosed type 2 DM patients attending Medicine OPD of Dr. B. C. Roy Hospital, Haldia, West Bengal (a tertiary care teaching hospital).Methods: In this prospective parallel group clinical study patients were divided into two groups. Group A patients were on metformin monotherapy therapy and Group B patients were on teneligliptin monotherapy. Data of 40 patients (20 patients in each group) were available for analysis in the present study. Secondary endpoints included changes from baseline FPG and 2h-PPG values at 12 weeks were evaluated. Safety and tolerability were assessed by the incidence of adverse events (AEs) throughout the study period.Results: The mean age of patients was 50.05±12.35 years and out of the entire patient population 70% were males and 30% were females. At the end of 12 weeks or 3 months of metformin therapy, mean HbA1c, FBG, and PPG were significantly reduced by 0.52%, 16.2mg/dL, and 36.8mg/dL, respectively, and 37.75% of patients achieved the HbA1c target of <7%. At the end of 12 weeks or 3 months of teneligliptin therapy, mean HbA1c, FBG, and PPG were significantly reduced by 0.60%, 19.4mg/dL, and 49.8mg/dL, respectively (Table 2), and 40% of patients achieved the HbA1c target of <7%.Conclusions: Teneligliptin, a DPP4 inhibitor reduced HbA1C significantly compared with monotherapy of metformin in treatment naive patients at week 12. It also reduced FBG and 2-h PPBG as compared with metformin at week 12.
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report describes a patient suffering from somatoform disorder that developed suicidal ideation specifically due to the treatment with sertraline. After 6-7 months on the regimen, she presented slight suicidal ideations. However, with gradual progress of time and continuation of the therapy, the ideation became intense. She complained of intense restlessness and anxiety. She presented with fresh cuts and bruises on her left arm and neck. On reporting the problem, the drug was withdrawn. Patient experienced gradual improvement in her state. The case report underlines the importance of onset of suicide risk in panic disorders due to specific antidepressants, selective serotonin reuptake inhibitors (SSRIs). The exact neurobiological basis of depression though being uncertain, the role of serotonin has been mostly implicated. Hypothetically, biological alterations in the serotonergic system might have contributed to the suicidal ideation/attempt in the presence of an SSRI. The present case attempts to highlight an incidence of development of suicidal ideation in a patient who is on chronic SSRI therapy.
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Background: Aim of current study was to determine the clinical characteristics, radiological, laboratory features and anti-tubercular drug sensitivity in new smear positive (category I) pulmonary tuberculosis cases in a tertiary care dedicated TB OPD, Delhi. Methods: The study was a cross-sectional observational study and consists of 100 cases of new smear positive pulmonary tuberculosis cases (category I) irrespective of age and sex. The sputum were collected, stained with Ziehl-Nielsen (Z-N) staining and ultimately inoculated on Lowenstein-Jensen (L-J) media for six weeks. All sputum smear positive cases were subjected to culture and drug-susceptibility testing by 1% proportion method on Lowenstein-Jensen (LJ) medium. The Drug-Susceptibility Testing (DST) for isoniazid (INH), rifampicin (R-cin), ethambutol (EMB) and streptomycin (SM) were performed. Results: The age & sex distribution of 100 patients showed that majority of the patients (79%) belonged to 2nd, 3rd and 4th decades & 60 % were males and 40% were female with male to female ratio 3:2 respectively. Cough (83%), fever (77%) and weight loss (76%) were the most common presenting clinical features. The chest X-ray of 100 smear positive patients showed that 53% of patients had evidence of 35% unilateral and 18% bilateral consolidation and 46% had cavitary lesions on chest X-ray (PA view) with 37% and 9% of patients having unilateral and bilateral cavities respectively. Of these 82 culture positives, 56.1% (n=46) were susceptible to all first-line anti-tubercular drugs, while 43.9% (n=36) were resistant to mostly one or other anti-tubercular drugs (INH, R-cin, SM or EMB). Conclusion: We stressed the importance of early diagnosis of new cases by clinico-pathological features, identifying of drug resistance trends in anti-tubercular treatment naïve patients, in order to assess the efficacy of current interventions. Overall, these findings emphasize the importance of early diagnosis of drug resistance pattern of M. tuberculosis isolates to anti-tubercular in category I patients as well as its association with HIV across the country to timely modify and strengthen the national programs in order to prevent the emergence of MDR-TB strains and avert the threat of XDR-TB.
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Background: Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein (HDL) cholesterol levels, and a preponderance of small, dense, low-density lipoprotein (LDL) particles. In addition to their glucose-lowering properties, oral anti-diabetic agents may have effects on lipid levels, especially triglycerides (TGs), HDL-C, LDL-C and total cholesterol levels. Methods: A prospective, open-labeled, randomized, parallel-group study was carried out in sizable number of patients (n=40) of established type 2 diabetes on combined oral anti-diabetic drugs, to investigate the effects of combined oral anti-diabetic on lipid parameters who was not receiving any hypolipidemic agent in addition. Results: Statistically significant mean reduction of triglycerides (TGs) of 25.1mg/dl (a 15.30% reduction from baseline value) and by 13.5 mg/dl (a 8.94% reduction from baseline value) in the SU (sulfonylurea) plus PIO (pioglitazone) and SU plus MET (metformin) group respectively. Present study also shows improvement in HDL cholesterol with SU plus PIO group by 13.18% which is almost twice that observed in SU plus MET group (8.06%). Present study also shows increase in LDL cholesterol with SU plus PIO group by 2.10%, is just opposite to SU plus MET group (4.92 % decrease). With SU plus PIO group, a statistically significant mean reduction of total cholesterol (TC) of 8.33mg/dl (5.14 % decrease) and by 7.62 mg/dl (4.28% decrease) in the SU plus MET group. Conclusions: Pioglitazone, a thiazolidinedione, has been shown to improve the lipid profile in patients with type 2 diabetes by increasing HDL-C levels and by decreasing triglyceride and total cholesterol levels in monotherapy or combination regimens with sulfonylurea. Metformin also has been shown to reduce LDL-C, TC, and TG levels and increase HDL-C levels in monotherapy and in combination regimens with sulfonylurea. In contrast, LDL cholesterol levels mild increase with pioglitazone monotherapy or with SU combination therapy. Thus the results of this study have demonstrated that SU plus pioglitazone is an effective combination regimen for patients insufficiently treated with SU monotherapy and may provide possible positive effects on other coronary risk factors/ dyslipidemias associated with the type 2 diabetes.
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Aims: In an attempt to explore novel agents for application in agriculture, the strain Serratia entomophila AB2 was investigated. Study design: Pesticidal, Fertilizing and Toxicological effects. Place and Duration of Study: Department of Botany (Microbiology Unit), Visva-Bharati, Santiniketan, West Bengal, India and M/S Ajay Biotech (India) Ltd., Pune, India, between December 2006 to August 2007. Methodology: Pesticidal activity of the isolate Serratia entomophila strain AB2 was tested against 5 day old larvae of Heliothis armigera, Spodoptera litura, and Plutella xylostella through feeding assay. Fertilizing capacity of the strain was determined by inorganic phosphate and zinc solubilizing experiments. Conventional T-tests were performed to check effect against certainr rhizospheric organisms (Azotobactor chroococcum NCIM 2452, Rhizobium japonicum NCIM 2746, Azospirillum brasiliensis NCIM 5135, Erwinia amylovora MDVB). In animal toxicity experiments, adult male Swiss albino mice (body wt ≈ 25 g) were used to find LD50 within the experimental doses and male Sprague Dawley strain of Swiss albino rat (body wt ≈ 110 g) were used to find out the effect of feed inoculation treatment in liver and blood as general target of intoxication through standard thiobarbituric acid reactive substance (TBARS) and serum glutamic pyruvic transaminase (SGPT) assay. Results: The mortality rate of, lepidopteron larvae tested was determined between 89.5 to 94.3% while LC50 value estimated between 0.44x105 to 1.44x105 CFU (colony forming unit) mL-1 through probit analysis. As a part of fertilizing activity, S. entomophila AB2 was found to solubilize phosphorus and zinc in in-vitro condition. In cross reactivity study with other rhizospheric bacteria, the isolate proved as non reactive. No mortality was recorded with Swiss albino mice and other toxicological data resulted from the experiment with Sprague Dawley strain of Swiss albino rat were found insignificant. Conclusion: The isolate S. entomophila AB2 showed its potential in in vitro conditions for both pesticidal and fertilizing activity. The data generated in this study show much promise of S. entomophila AB2 for its field application in integrated crop management (ICM). These predictors, however, need further work for field validation.
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Emerging datas have shown a high failure rate of longterm monotherapy in preventing the vascular complications of DM II. It establishes the significance of meal time hyperglycemia and the role of post-prandial glucose excursions in the development and progression of vascular complications. This prospective, randomized, open parallel group study was conducted on patients selected from those who were attending O.P.D. of Department of Endocrinology and Human Metabolism of SVBP Hospital, L.L.R.M. Medical College, Meerut. The study have demonstrated that the combination therapy with Sulfonylurea plus Pioglitazone (SUP) is an effective regimen for patients who are insufficiently treated with Sulfonylurea mono-therapy. This regimen may provide a possible positive effect on other coronary risk factors/ dyslipidemias associated with the type 2 Diabetes.