Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.

Fractional CO2 laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial

Background: Onychomycosis accounts for 20–40% of all nail disorders. It is difficult to cure with resistance to anti-fungal drugs, their side effects and drug interactions limiting treatment options. Itraconazole is a widely accepted oral medication used for onychomycosis while fractional CO2 laser along with a topical anti-fungal has shown promising results for nail plate clearance in onychomycosis. Aim: To compare the efficacy of fractional CO2 laser with 1% terbinafine cream versus itraconazole in the management of onychomycosis. Methods: A prospective, randomised, single-centre, two-arm, parallel-group interventional study was conducted at Command Hospital Air Force, Bangalore. Onychomycosis cases confirmed by KOH mount/culture-positive were included. Patients were randomly divided into two groups. Group A received 4 sessions of fractional CO2 laser every fourth week with twice-daily application of 1% terbinafine cream; Group B received one-week pulse therapy with capsule itraconazole once every four-week for three pulses. The response was assessed by Onychomycosis Severity Index, a validated onychomycosis assessment scale, at baseline and at six months. Results: Group A had 50 patients with a total of 98 nails. Clinical improvement was seen in 83/98 (84.7%) nails. The average reduction in Onychomycosis Severity Index was 8.65 (P < 0.05). Group B had 50 patients with a total of 136 nails. Clinical improvement was seen in 104/136 (76.5%) nails. The average reduction in Onychomycosis Severity Index was 7.37 (P < 0.05). Both groups showed statistically significant improvement measured by ‘Reduction in Onychomycosis Severity Index’ at six months; however, there was no significant difference between the two arms. Limitations: The main limitations of the study are the small sample size and lack of long-term follow-up to assess recurrence of infection. Conclusion: Fractional CO2 laser with 1% terbinafine cream is an effective and safe method for inducing nail clearance in onychomycosis and has efficacy similar to itraconazole pulse therapy.

Níveis de conscientização da comunidade rural, desafios e estratégias adotadas para combater o COVID-19: uma e-survey transversal / Rural community awareness levels, challenges and strategies adopted to combat COVID-19: A cross-sectional E-survey

COVID-19 tem um efeito generalizado nas economias rurais em todo o mundo. Tem afetado a renda familiar e os negócios em todos os setores das economias rurais. O lockdown devido ao surto de COVID-19 limita a atividade física regular e ao ar livre, e ainda pode levar a um risco aumentado de condições crônicas de saúde. A atividade física e a ioga desempenham papel vital para quebrar o tédio causado pelo lockdown e, assim, podem melhorar a qualidade de vida. OBJETIVO: Identificar o nível de consciência e desafios enfrentados pelas pessoas de comunidades rurais devido ao surto COVID-19. MATERIAIS E MÉTODOS: Um total de 36 participantes foram recrutados pelo método de amostragem de conveniencia de cinco aldeias diferentes no Distrito, Ambala, Haryana, Índia. Os questionários da pesquisa eletrônica foram distribuídos por meio do aplicativo móvel de mensagens WhatsApp. O questionário foi elaborado incorporando a escala Likert de três pontos com três domínios, 1) Conscientização, 2) Desafios e, 3) Estratégias e 12 itens. A validação do questionário foi realizada pelos juízes por meio do método Delphi survey até S-CVI / Ave > 0,8. A tendência central e a dispersão da variável contínua idade foram expressas em média com intervalo de confiança (IC) de 95%. Os dados categóricos foram relatados em frequências, porcentagem (%) e tamanho da amostra (n). Os níveis de significância foram estabelecidos em 0,05 para minimizar o erro Tipo 1. RESULTADOS: Índice de validade de conteúdo do questionário, S-CVI / Ave = 0,90. Ao entrar em contato com 36 participantes em potencial, um total de 27 respostas da pesquisa foram registradas. Consequentemente, a taxa de resposta (RR) foi encontrada em 75%. A média com IC de 95% de idade foi de 30,8 (27,3; 34,3) anos. Um total de 94% (n = 25) dos moradores estavam cientes do COVID-19, 88% (n = 24) estavam enfrentando desafios e 86% (n = 23) dos participantes estavam adotando as melhores estratégias que incluem, de zona de contenção, uso de máscara artesanal composta de roupas, consumo de fitoterápicos tradicionais como potenciadores de imunidade para profilaxia e envolvimento em atividade física regular e ioga . CONCLUSÃO: As populações rurais que está ciente de COVID-19 e ter conhecimento adequado sobre COVID-19. Eles estavam enfrentando desafios devido ao COVID-19 e preparados com as melhores estratégias / métodos de combate ao COVID-19.

COVID-19 has a widespread effect on rural economies all over the world. It has affecting household incomes, and businesses in every sector of rural economies. Lockdown due to COVID-19 outbreak limiting the outdoor and regular physical activity, and further can leads to increased risk of chronic health conditions. Physical activity and yoga play a vital role in breaking the boredom due to COVID-19 lockdown and thereby, improves the quality of life. OBJECTIVE: To identifying the level of awareness and challenges faced by the people of rural communities due to the COVID-19 outbreak. MATERIALS AND METHODS: A total of 36 participants were recruited by convenient sampling method from five different villages in District, Ambala, Haryana, India. E-survey questionnaires were circulated through WhatsApp messaging mobile-based application. The questionnaire was formed incorporating the three-point Likert scale with three domains, 1) Awareness, 2) Challenges and, 3) Strategies and 12 items. The questionnaire validation was carried out by the experts through Delphi survey method until S-CVI/Ave > 0.8. The central tendency and dispersion of continuous variable age were expressed in mean with a 95% confidence interval (CI). Categorical data were reported in frequencies as a percentage (%) and sample size (n). The levels of significance were set at 0.05 to minimize Type 1 error. RESULTS: The content validity index of the questionnaire, S-CVI/Ave = 0.90. By contacting 36 potential participants, a total of 27 survey responses were recorded. Hence, the response rate (RR) was found to be 75%. The mean with 95% CI of age was 30.8 (27.3 to 34.3) years. A total of 94% (n=25) of villagers were aware of COVID-19, 88% (n=24) were facing challenges, and 86% (n=23) of participants are adopting the best strategies which includes, sealing of containment zone, usage of homemade mask made up of clothes, consuming traditional herbal medicine as immunity boosters for prophylaxis and involving in regular physical activity and yoga. CONCLUSION: The rural populations were aware of COVID-19 and having adequate knowledge about COVID-19. They were facing challenges due to COVID-19 and prepared with the best strategies/methods to combat COVID-19.

Ensaio clínico randomizado: padrão ouro de desenhos experimentais - importância, vantagens, desvantagens e preconceitos / Randomized clinical trial: gold standard of experimental designs - importance, advantages, disadvantages and prejudice

Ensaios clínicos randomizados (ECR) são o padrão ouro para desenho experimental de estudo ou ensaio clínico. Apenas por meio de uma investigação do tipo ECR é possível avaliar e demonstrar a relação de causa-e-efeito entre um conjunto de variáveis independentes e dependentes. O ECR adicionou vantagens em relação aos outros modelos experimentais, principalmente devido à presença de um grupo controle. Existem várias críticas à validade interna das pesquisas em saúde, incluindo preconceitos e desvantagens que são apontadas para seu descrédito. OBJETIVO: O objetivo do presente estudo é informar características, vantagens, desvantagens e desvios deste método científico. MATERIAL E MÉTODOS: Análise crítica de método científico com base em revisão narrativa da literatura. Foi consultada a base de dados Medline por meio dos portais PubMed e Scopus, sem data de início e até julho de 2020, para extração das informações relativas aos ECR. Apenas artigos de língua inglesa foram incluídos, usando as palavras-chave "estudo randomizado controlado", "ensaio clínico randomizado", "projeto experimental" e "estudo experimental", intercaladas pelos operadores booleanos "AND ," "OR" e "NOT". Anais de conferências e resumos não foram considerados para a análise dos dados. RESULTADOS: Dos ECR selecionados, foram extraídas características, vantagens, desvantagens, importância e vantagens dos controles em pesquisa, o princípio de equilíbrio, ensaios clínicos randomizados na população pediátrica, ECR na população geriátrica, ameaças à validade interna e medidas para minimização de viéses e preconceitos em ECR. CONCLUSÃO: Tópicos relevantes dos ECR foram explicados nesta revisão que devem guiar pesquisadores clínicos.

Randomized controlled trial (RCT) is the gold standard of experimental design or clinical trial design. Only by RCT in research, the cause-and-effect relationship between a set of independent and dependent variables could be demonstrated. RCT has added advantages over other experimental designs due to the presence of the control group. The importance of control in health research trials and its advantages to be elaborated. Though various threats to internal validity in health research trials could be minimized by RCT, various biases in RCT and disadvantages add to its discredit. OBJECTIVE: The aim of the present narrative review is to brief the characteristics, advantages, disadvantages, and various biases in RCT. METHODS: This review does not follow the PRISMA statement, as it was a narrative review. Two databases, namely, Medline through PubMed and Scopus, were searched from inception to July 2020 for the information pertaining to RCTs and included in this narrative review. Only English language articles were searched with the keywords, "Randomized controlled trial," "Randomized clinical trial," "experimental design," and "experimental study." These keywords are linked together by the Boolean words, "AND," "OR" and "NOT." Conference proceedings and only abstracts were not considered for the review. RESULTS: RCTs were explained under characteristics, advantages, disadvantages, importance, and advantages of controls in research, the principle of equipoise, RCTs in the pediatric population, RCTs in the geriatric population, threats to internal validity and steps to minimize them and various biases in RCTs. CONCLUSION: The narrative presentation of RCTs under various important topics have been explained in this review.

Vitamin D level as a predictor of pneumonia and asthma in children less than 5 years of age

Background: Childhood pneumonia is a global health problem .It the leading cause of death for children under the age of five years. 95% of all pneumonia cases under the age of five occurs in developing countries. Asthma remains the most common chronic disease of childhood in the world. The observation that vitamin D deficiency and asthma share risk factors such as urban residence, obesity and African American ethnicity has generated interest in exploring a link between these two conditions. This study was taken up to assess the role of vitamin D as a predictor of pneumonia and asthma in children less than 5 years of age.Methods: A prospective observational case control study was conducted in MLB Medical college, Jhansi from January 2015 to December 2016 (1 year 11 months). A total of 60 children including 30 asthma cases, 20 pneumonia cases and 10 controls, aged, 6-60 months were enrolled. Controls were healthy children attending outpatient services for immunization.Results: The mean age of the pneumonia patient was 1.5 years, while mean age in asthma patients was 3.1yrs. Ratio of male and female in pneumonia cases was1.5:1, while is asthma ratio was 2:1. In our study 45% pneumonia cases had deficient level of vitamin D (<20ng/ml) and mean level was 11.08±4.68 while 40% of control had deficient level of vitamin D and mean level was 16.04±1.61, p value was 0.0166 and there was significant difference in both the groups. In Asthma cases 53.33% patient had deficient level of vitamin-D and mean level was 10.62±2.908 as compared to 40% control (mean : 16.04±1.62) ‘p’ value was <0.0001 and was highly significant.Conclusions: Our study has illustrated that vitamin-D levels were significantly low in pneumonia and asthma patients as compared to control.

Magnitude, risk factors and outcome of low birth weight babies admitted to neonatal intensive care unit of a tertiary care centre in Puducherry, India

Background: This study was undertaken to know the magnitude, risk factors and outcome of LBW babies admitted in NICU in a tertiary centre.Methods: This is a hospital based, retrospective study, of LBW babies admitted to NICU of Sri Venkateshwara Medical College hospital and research centre, Puducherry, from Jan 2019 - Dec 2019.Results: About 340 babies were admitted to NICU and 56 were LBW babies, 5 were excluded and 51 LBW babies analysed. Magnitude of LBW babies, 51 (15%). Socio demographic pattern showed, IUGR (62.7%). Term IUGR (52%) and preterm IUGR (9.8%). Preterm babies (37.2%). Preterms <28 weeks of gestation (7.8%), 28-34 weeks (9.8%) and 34 to < 37 weeks (19.6%). LBW babies <1kg (7.8%), 1-1.5kg (1.9%) and 1.5 to 2.49 kg (90.1%). Male (52.9%), female babies (47%). LBW babies from rural area (62.7%), urban area (37.2%). Among the maternal risk factors, maternal anemia was common (31.3%). Elderly primi (13.7%), PROM and twin pregnancy in (9.8%) each, bad obstetric history (7.8%). PIH, APH, GDM and oligohydramnios in (3.9%) each. Rh negative pregnancy, grand multipara, teenage pregnancy, ART with hypothyroidism and unbooked pregnancy seen in (1.9%) each. Fetal distress (19.6%). Morbidity was (92.1%). Most common was jaundice (31.9%), sepsis (21.2%). Feeding difficulties (19.1%), TTNB (17%), apnea of prematurity (14.8%). Hypoglycemia and HIE in (12.7%) each. Hypothermia and HMD in (10.6%) each. Seizures in (8.5%) MAS and NEC (4.2%) each, congenital anomalies and hypocalcemia in (2.1%) and mortality in (7.8%). Extreme prematurity, ELBW with sepsis and RDS being common cause of mortality.Conclusions: Iron tablets intake, nutritional care, regular antenatal checkup, spacing pregnancy, avoidance of teenage and elderly pregnancy is important. Improving the infrastructure, manpower in NICU to manage preterm babies, when surfactant and ventilation is given.

Clinical profile and outcome of patients admitted to pediatric intensive care unit in a tertiary care teaching hospital of Puducherry, India

Background: This study was undertaken to know about the clinical profile and outcome of patients admitted in paediatric ICU in a tertiary care teaching hospital.Methods: This is a hospital based, retrospective, descriptive study, done on patients admitted to paediatric ICU of Sri Venkateshwara Medical College Hospital and Research Centre Puducherry from Jan 2019 - Dec 2019 (12 months).Results: As about 424 patients were admitted paediatric ICU. 79 patients were excluded from the study. Remaining 345 PICU patients were analysed. According to the age distribution of patients, it showed that < 1year were (25.2%), 1-5 years were (44.3%), > 5years of age were (30.4%). There was a female preponderance (58.8%), males were (41.1%). Patients from rural area were 243 (70.4%) and 102 (29.5%) from urban area. Clinical profile showed that pneumonia was the most common diagnosis (8.4%) for admission in PICU. This was followed by bronchiolitis (6.9%), enteric fever in (6.6%), febrile seizures (6.3%), poisoning (6.0%), renal problems (5.7%), occult bacteremia (5.5%), unknown bite (5.2%), acute severe asthma (4.9%), sepsis (4.6%), severe gastritis (4.3%), clinical dengue (3.7%), seizure disorder (3.4%), croup (3.1%), traumatic head injury (2.8%), wheeze associated LRI (2.6%), acute otitis media (2.3%), migraine (2.0%), meningitis (1.7%), CHD with complications (1.7%), severe anaemia with CCF (1.4%), acute urticarial (1.4%), foreign body (1.1%), electric shock (1.1%), scorpion sting (0.8%), viral hepatitis (0.8%), clinical malaria (0.8%), nephrotic syndrome with complications (0.5%), scrub typhus (0.2%) and (0.2%) was angioedema. The outcome noted was, (87.8%) were discharged, (10.7%) patients went against medical advice, (1.4%) patients were referred at parent's request.Conclusions: Respiratory illness, infectious diseases, neurological problems and poisoning are the most common cause for PICU admissions. But seronegative dengue cases, electric shock, reemergence of scrub typhus, are being increasingly diagnosed. So, emphasis is therefore placed on high index of suspicion for this type of conditions. We also recommend better manpower and infrastructure to improve the outcome of patients admitted to PICU.

Mending aesthetics in anterior region - A case report

Lately esthetic rehabilitation has come to be a demanding treatment as a way to correct malposed as well as missing anterior dentition, the advent of creating an esthetic smile has become a part of routine dental practice. An attractive or appealing smile sincerely enhances the recognition of an individual in our society with the aid of enhancing the initial impact in interpersonal relationships. Any esthetic correction calls for right expertise and knowledge. Such rehabilitation can be achieved successfully with the aid of numerous treatment approaches. Orthodontic treatment is one of the most conservative approach for such cases but it is not an acceptable treatment option for most of the patients due to various reasons like long treatment time, financial constraints, appearance during the therapy, and relapse after the treatment. Alternatively, endodontic approach combined with prosthodontics offers a brief, reliable and economic treatment modality for such cases. Placement of implants has also become a treatment of choice for replacement of teeth in esthetic zone with advantages like preservation of unrestored adjacent teeth and halting the resorption of edentulous spaces to provide support for the prosthesis. This case report illustrates the multidisciplinary approach for rehabilitating aesthetics in anterior region.

Evaluation of Wound Healing Properties of Herbal Medicaments on the Basis of Clinical and Haemato-biochemical Changes

The present study was conducted on 24 dogs irrespective of sex, breed and aged between 1year to 8 years with different types of wounds. The animals were randomly divided into four groups. Each group consisted of 6 dogs. The animals of group I were treated with povidone iodine (5.0%) and in group II, III, IV animals were treated with the herbal ointment which were prepared from hydroalcoholic extract of Marigold leaves, Guava leaves and 1:1 mixture of both extract for 7 consecutive days. Clinical and haematological parameters were recorded at different time intervals in all four groups. The study revealed better wound healing properties of the Ointment of 1:1 mixture of Marigold and Guava (10% w/w) leaves extract without any side effect as compared to povidone iodine 5%, ointment of Marigold leaves extract (10% w/w) and ointment of Guava leaves extract (10% w/w) on the basis of clinical and haematological parameters

Efectos del tratamiento homeopático individualizado en la hipertensión esencial de estadio I: ensayo aleatorizado, simple ciego, controlado con placebo / Effects of Homeopathic Treatment Individualized in Hypertension Stage I Essential: Randomized Trial, Single Blind, Placebo controlled

Fundamentos: la hipertensión arterial es el cuarto principal factor de riesgo de muerte e incapacidad, así como el responsable de más de 1.6 millones de fallecimientos en la India. Los informes de casos clínicos, los estudios observacionales y los ECA evidencian los efectos de los medicamentos homeopáticos en la hipertensión. Objetivos: los resultados de este estudio se añaden a la evidencia de la eficacia del uso de los medicamentos homeopáticos individualizados en la hipertensión de estadio I. Materiales y métodos: Se ha realizado un ensayo aleatorizado, simple ciego y controlado por placebo entre octubre de 2013 y marzo de 2018. El parámetro primario fue evaluar los cambios en la presión sistólica (PS) y la presión diastólica (PD) mensualmente durante tres meses. 217 pacientes de los 2,127 pacientes examinados cumplieron los criterios de selección y fueron aleatorizados para recibir un medicamento en potencias Q (o potencias LM) más indicaciones para la modificación del estilo de vida (MEV) (116 pacientes) o bien placebo + MEV (101 pacientes). La modificación del estilo de vida incluyó actividad física y dieta como parte de la pauta terapéutica. El análisis fue de intención de tratamiento. Resultados: Las mediciones ANOVA repetidas entre los grupos mostraron una diferencia estadística significativa (Lambda de Wilks 0.85, F=12.12, dF=213, P=0.0001) tanto en la PS como en la PD a favor de la Homeopatía individualizada. La prueba t independiente post hoc mostró una reducción media significativa de la PS [diferencia media 7.12 mmHg, IC del 95%; CI 4.72 a 9.53, P=0.0001] y un descenso medio de la PD [diferencia media 5.76 mmHg, IC del 95%: 4.18 a 7.23, P=0.0001] a favor del grupo con Homeopatía más MEV. Los medicamentos más utilizados fueron: Sulphur (n=24), Natrium muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) y Phosphorus (n=10). Conclusiones: Se ha constatado que la Homeopatía individualizada junto con la MEV fue más eficaz que el placebo junto con la MEV en los pacientes que sufren hipertensión en estadio I. Se precisan más ensayos en un marco estricto. (AU)

Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebocontrolled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2,127 patients screened, 217 patients who fitted the inclusion criteria were randomised to receive either homoeopathic Q potencies (or LM potencies) plus lifestyle modification (LSM)=116 or placebo + LSM=101. LSM included physical activity and diet as part of the treatment regimen. Analysis was by intention to treat. Results: Repeated-measure ANOVA between the groups showed statistically significant difference (Wilk lambda 0.85, F=12.12, df=213, P=0.0001), in both SBP and DBP favouring Individualised Homoeopathy (IH) along with LSM. Post hoc independent t-test showed a significant mean reduction in SBP (mean difference 7.12 mmHg, 95% confidence interval [CI] 4.72-9.53, P=0.0001) and DBP (mean difference 5.76 mmHg, 95% CI: 4.18-7.23, P=0.0001) favouring Homoeopathy plus LSM group. Sulphur (n=24), Natrum muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) and Phosphorus (n=10) were the most useful medicines. Conclusion: IH in LM potency along with LSM was found effective over placebo along with LSM in the patients suffering from Stage I HTN. Further trials in rigorous setting are warranted. (AU)

Role of serum Vitamin-C and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Background: Vitamin C's functions as an antioxidant and as an enzyme cofactor are well established, but the ways in which these functions may modify chronic disease risk are less well established. The belief that vitamin C may benefit heart health has stemmed from multiple pieces of evidence and lines of reasoning. Thus, we took the objective of this study to evaluate the correlations of serum concentrations of trace elements including vitamin-C with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis. Vitamin C by NATELSON method on colorimeter.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the vitamin-C levels were significantly low than the controls. There was significant difference in lipid levels among smokers and nonsmokers. When vitamin C levels were compared there was no statistically significant difference in their levels. There was no significant correlation between serum vitamin C levels and Lipids.Conclusions: The physical characteristics such as diet, residence, smokers, non-smokers, showed significant difference in the controls and cases. Women seemed to have higher proportion of lipid abnormality than men. It is concluded from this study that lower levels of ascorbic acid definitely increase the risk of cardiovascular disease and inclusion of ascorbic acid in the normal diet will control the level of lipids.

Role of serum copper and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Background: It is clear that deficiencies of some trace elements cause marked alterations in lipid and lipoprotein metabolism. The mechanisms of their effects are not completely obvious and inspite of intense research, the role of these microelements need further elucidation. Thus, the objective of this study is to evaluate the correlations of serum concentrations of trace elements including copper with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the copper levels are higher than the controls. Copper levels were more in males 95.40±18.93 than in females 86.93±14.54 (p<0.05). Lipid levels were higher in urban population related to rural, TC (238.47 V/s 266.59), TG (219.83 V/s 202.40), HDL (64.39 V/s 54.19) and LDL (131.28 V/s 139.48) (p<0.05). Significant negative correlation was seen in study group between serum copper levels and TC (r=-0.288, p<0.05), TG (r =-0.236, p<0.05), HDL (r=-0.946, p<0.05) and VLDL levels (r=0.102, p<0.05). This indicates that as copper level reduces lipids increases.Conclusions:Our findings indicate the possible effect of Cu level in serum lipid profile and this effect may be due to the role of Cu as an antioxidant. The correlations between the serum concentrations of trace elements with lipid profile in physiological concentrations may not be the same as the changes observed during deficiencies of the trace elements as in hyperlipidemic patients

Peritoneal Fluid Analysis Clinicocytological Study

Introduction: Appropriate peritoneal fluid analysis is themost efficient and effective method of diagnosing the causeof peritoneal effusion. Both nonmalignant and malignantcauses of effusion can be identified by cytology in severalcases in correlation with clinical history and examination.With this basis, the present study on cytology of peritonealeffusion was taken up. Current research aimed to study thecytology of the peritoneal fluid in various diseases to establishclinicocytological correlation, for proper management ofpatient.Material and Methods: 115 samples of peritoneal fluidwere subjected to physical, biochemical and cytologicalexamination.Results: Peritoneal effusion was seen in 62.61% of femalesand 37.39% of males. 66.96% samples were transudative and33.04% were exudative. TLC was less than 500 cells/cu.mm inmost (74.02%) of transudative effusions. 47.36% of exudativeeffusion had TLC greater than 1000 cells/cu.mm and 39.47%of exudative effusion had TLC between 500-1000 cells/cumm. 95 (82.60%) samples had predominantly lymphocytes.18.26% of peritoneal effusions were positive for malignantcells. Most (85.71%) of malignant effusions were exudative.Primary site could be assessed by cytological examination in(57.14%) of malignant effusions.Conclusion: Cytological study of body effusions is neither ascreening test nor a method of early diagnosis of cancer. It isin fact a complete diagnostic modality which aims at pointingout the etiology of effusion as well as in certain cases a meansof prognostication of the disease process. Non malignantcauses are the more common causes of peritoneal effusion.Metastatic carcinomas are the most common tumors found ineffusions.

Can personal hygiene act as a proxy indicator of morbidity profile? A study on orphans of Uttarakhand region

Background: A healthy childhood is essential for future growth and development. It is greatly influenced by parent, family, society and environment which formulate attitude, behavior, manner and emotions. Millions of children across the world are deprived of this crucial phase of life; those are the orphans and abandoned children.Methods: This institution-based cross sectional study was carried out with the help of pre-designed semi-structured questionnaire amongst 193 orphans aged 5-14 years to assess the personal hygienic practices and morbidities among orphans and to find out the association between the morbidity with personal hygiene and other risk factors.Results: The leading morbidities observed were poor oral hygiene (57.51%) as a morbidity followed by dental caries (50.58%) and pallor (30.57%). The average morbidity per child was found to be 2. There was significant association between ages, education, personal hygienic practices with the presence of morbidity in the orphans.Conclusions: Practices related to personal hygiene was not satisfactory. There was a significant association between morbidity and personal hygiene. Despite of the fact that these children are highly vulnerable; their health needs are poorly understood and ill served.

Comparison of Wound Healing Properties of Herbal Ointments with Povidone iodine on Basis of Histological Changes

Present study was conducted on 24 dogs, aged between 1 to 8 years, irrespective of sex, breed. The animals were randomly divided in to four groups. In group I, animals were treated with standard dressing material Povidone iodine (5.0%). In animals of group II, III, IV herbal ointments (10% w/w) of hydroalcoholic extract of Marigold leaves, Guava leaves and mixture of both Marigold and Guava leaves extracts respectively were used for dressings of wounds for 7 consecutive days. In animals of group IV, marked re-epithelialization and moderate inflammatory cells, neovascularization and thicker but scattered collagen fibrils were seen on day 7 and mature collagen fibres were observed with least number of inflammatory cells on day 14 as compared to other three groups. Therefore, it can be concluded that group IV (mixture of Marigold and Guava leaves hydroalcoholic extract) revealed better wound healing properties as compared to group I (Povidone iodine 5.0%), group II (Marigold leaves hydroalcoholic extract) and group III (Guava leaves hydroalcoholic extract).

An insight into risk factors profile of oral cavity and oropharyngeal cancer patients attending two tertiary care hospitals in Jaipur, India

Background: Oral cancer is the second most prevalent cancers among males in Jaipur city. Assessment of risk factors profile of patients will help the policy makers in initiating new ways to curb the usage of tobacco among masses. The present study aims to find out the risk factors profile of oral and oropharyngeal cancer patients at two hospitals of Jaipur city.Methods: It was a prospective and observational study. The patients with histologically confirmed diagnosis of oral cavity and oropharyngeal cancers and fulfilling the inclusion criteria were recruited. Data on the demographic profile and clinical information were obtained from hospital and clinical records. The data were analyzed using SPSS version 14 (SPSS Inc., Chicago, IL, USA). Chi-square test was performed to analyse the data.Results: Out of 400 oral cancer patients included in this study majority of the patients were in the age range of 40-60years and with a significant male preponderance in all the age groups (P <0.05). The most common habit among males and females was chewing. Buccal mucosa was the most commonly affected site followed by tongue. Both males and females were more likely to be diagnosed in stage 3 (p <0.05).Conclusions: There is a need to reduce the burden of this disease by educating the people about various risk factors which play role in oral cancer development.

Administration of Fenugreek Seed Extract Produces Better Effects in Glibenclamide-Induced Inhibition in Hepatic Lipid Peroxidation: An in vitro Study / 中国结合医学杂志

OBJECTIVE@#To evaluate the comparative effects of fenugreek (Trigonella foenum graecum) seed extract (FSE) alone and in combination with an antidiabetic conventional medicine, glibenclamide (GLB), on the inhibition of in vitro lipid peroxidation (LPO) in liver, the major target organ of a drug.@*METHODS@#LPO was induced by ferrous sulphate (FeSo), hydrogen peroxide (HO) and carbon tetrachloride (CCl) and the effects of test seed extract and/or GLB were evaluated.@*RESULTS@#While FeSo, HO and CCl markedly enhanced the hepatic LPO, simultaneous administration of FSE reduced it in a concentration dependent manner. However, when both FSE and GLB were added to the incubation mixture, chemically induced hepatic LPO was further inhibited. The test extract also exhibited high antioxidative activity in 1,1-diphenyl-2-picrylhydrazyl radical and in 2,2'-azinobis, 3-ethylbenzothiazoline-6-sulphonic acid radical scavenging assays.@*CONCLUSION@#FSE therapy in moderate concentration along with a hypoglycemic drug may prove to be advantageous in ameliorating diabetes mellitus and other diseases that are LPO mediated.

Impact of coronary artery disease on augmentation index as measured by estimated central blood pressure: A case control study in Asian Indians

Aims We compared various components of blood pressure and arterial stiffness of healthy control with those of coronary artery disease (CAD) patients using BP+ machine™. Methods In this prospective, case-control study, total 585 individuals of both the genders were enrolled. The study population consisted of 277 controls (healthy siblings of diseased subjects not having CAD – group A) and 308 CAD patients (group B). Age and sex adjusted regression and receiver operative curve (ROC) analysis was performed to assess the strength of association of these parameters. Results We found that mean systolic blood pressure (SBP) (137.14 ± 22.49 vs. 129.26 ± 19.86), central systolic blood pressure (CSBP) (130.78 ± 21.89 vs. 117.53 ± 17.98), augmentation index (AI) (108.55 ± 44.98 vs. 49.38 ± 21.03) and pulse rate variability (98.82 ± 231.09 vs. 82.86 ± 208.77) were significantly (p < 0.05) higher in CAD population as compared to healthy counterparts. Left ventricular contractibility as measured by dP/dt was significantly lower in CAD patients. All these parameters were significantly abnormal in CAD as compared to healthy control population irrespective of the gender of the patient except for SBP in females. Both – odds ratio (1.108; 95% CI: 1.081–1.135; p < 0.0001) and ROC analysis (AUC: 0.937; 95% CI: 0.919–0.956; p < 0.0001) showed AI as the strongest predictor of CAD, closely followed by CSBP. Conclusion Central aortic blood pressure parameters such as AI and CSBP measured noninvasively with BP+ machine could be the effective predictors of CAD in Asian Indians.

Low-grade Squamous Intraepithelial Lesion with Chlamydia Trachomatis Infection in Pap Smear: A Rare Association.

The role of Pap smear in detecting cervical carcinoma has been extensively acknowledged. However, it can also be very well utilized for detecting cervicovaginal infections such as fungi, bacteria, and parasites. Identifying these infections can help in providing immediate and correct treatment to the patient along with detection of any squamous intraepithelial abnormality, if present. Chlamydia trachomatis causes sexually transmitted disease along with cervical squamous dysplasia. However, as mentioned in literature, an association of chlamydial infection with squamous intraepithelial lesion is still not clear. Herein, we report a rare case of the low-grade squamous intraepithelial lesion along with chlamydial infection in the same patient.