Prevalence of nocturnal enuresis among children aged 05 to 10 years

Background: Enuresis is common and considered to be normal among children younger than 3 years of age. Nocturnal enuresis is involuntary passage of urine during sleep among children five years of age or older. It is not a serious health problem, and children usually develop control over the bladder as they grow older but it can be upsetting for children as well as parents. India estimates 7 to 15 % prevalence rate among children and the numbers drop to 3 to 5% by the age of ten years. Objectives were to identify the children with Nocturnal Enuresis and assess their clinical profile.Methods: A descriptive survey was conducted among the children age 05 to 10 years. Data were collected from two villages of Aurangabad district and the information was gathered from parents of 413 with the use of structured questionnaire. The first section included the socio- demographic characteristics of the children and their parents. The second section included variables related to the clinical profile and history of nocturnal enuresis in the family.Results: The prevalence of nocturnal enuresis was 10.91% in which 06.94% were males and 03.97% females. With regard to severity 55% children were found to be in moderate category while 09% belonged to severe category of nocturnal enuresis. Conclusions: The prevalence rate was higher in selected villages. Most of the parents consider nocturnal enuresis as social stigma. Counseling and education of parents would help in improving general health of children in rural area.

Psychological health problems and associated factors among perimenopausal women in rural Prayagraj

Background: The perimenopause is an ill-defined time period that surrounds the final years of a woman’s reproductive life. It begins with the first onset of menstrual irregularity and ends after one year of amenorrhea has occurred. Various psychological illnesses also mark this period. Methods: A cross-sectional study was conducted among 320 perimenopausal women aged between 40 to 55 years in rural Prayagraj. The study participants were interviewed and examined for psychological illnesses. A structured and predesigned questionnaire was used for the same. In this study, the scales used were PHQ-9, ISI, and GAD-7 for assessing depression, insomnia and anxiety respectively. Results: Study found average age of perimenopausal women to be 46.55±2.64 years. Among the psychological problems depression, insomnia and anxiety was analysed using scales- PHQ-9, ISI and GAD-7 respectively. It was found that 84.69% perimenopausal women had depression, 82.50% women had anxiety and only 35.31% women had insomnia. Of all women with depression majority had mild depression (70.94%). Regarding anxiety status majority had mild anxiety (68.13%). whereas 30.94% of women were found to have sub threshold insomnia. Conclusions: Present study shows association between psychological symptoms and employment status. Depression was found to be associated with type of family and age of woman. Insomnia was found to be associated with marital status and age of woman. Anxiety was found to be associated with type of family. Most common psychological morbidity among perimenopausal women was found to be depression.

An overview of inflammatory breast cancer

Inflammatory breast cancer is an uncommon and severe malignancy that frequently goes undiagnosed at first because it presents similarly to more benign breast diseases like mastitis, resulting in delayed treatment. Inflammatory breast cancer affects 1% to 5% of all occurrences of breast cancer and accounts for 8% to 10% of all breast cancer-related deaths. Erythema, skin abnormalities, nipple inversion, edema, and warmth of the affected breast are all signs of inflammatory breast cancer. Recognized risk factors for inflammatory breast cancer include young age at the time of diagnosis, obesity and African American ethnicity. Rapid onset within 3 months and pathologic evidence of invasive carcinoma leads to diagnosis of disease further including erythema occupying at least one-third of the breast, tumour may or may not be present in this case. Chemotherapy, surgery, and radiation make up the trimodal therapy used to treat inflammatory breast cancer. A modified radical mastectomy performed as part of an aggressive surgical strategy improves survival rates. Although patients with inflammatory breast cancer have worse outcomes than those with noninflammatory breast cancer, those who complete trimodal therapy have a positive locoregional control rate, highlighting the significance of an early diagnosis. Physicians must be aware and examine any clinical manifestation of inflammatory breast cancer if present to make a prompt diagnosis and refer patient for expert care timely also awareness and cancer screening can help in prevention of disease. The purpose of this research is to review the available information about an overview of inflammatory breast cancer.

Advantages and disadvantages of endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy

Obesity and its associated comorbidities, such as diabetes mellitus, hypertension, and cardiovascular disease, are one of today's most pressing health issues and increasing incidence of obesity has marked it a global health challenge. For obese individuals with a high risk of morbidity and mortality who have not lost enough weight with lifestyle and medicinal care and who are experiencing the repercussions of obesity, bariatric surgery should be taken into consideration. Significant weight loss, the remission of coexisting diseases, and an improvement in quality of life are all possible outcomes of bariatric surgery. Laparoscopic procedures account for 96% of all bariatric procedures performed globally, with laparoscopic sleeve gastrectomy (LSG) being the most popular and prevalent. The current gold standard for bariatric surgery is LSG, since it is associated with significant complications such as gastroesophageal reflux disease hence a less invasive replacement for LSG was developed, which is endoscopic sleeve gastroplasty (ESG). In the past few years, ESG, a relatively new technique of endoscopic bariatric therapy, has become more well-known. Several multi-center studies have established the safety, viability, repeatability, and potential for reversibility of ESG. Although it is inferior to LSG in terms of percentage of total body weight loss (TBWL), but within a year of follow-up, it carries a reduced risk of unfavourable outcomes than other surgical procedures. The purpose of this research is to review the available information about advantages and disadvantages of ESG versus LSG.

Wound-healing and cytokine-modulating potential of medicinal oil formulation comprising leaf extract of Murraya koenigii and olive oil / Potencial de cicatrização de feridas e modulação de citocinas de formulação de óleo medicinal compreendendo extrato de folhas de Murraya koenigii e azeite de oliva

The study investigated the wound healing effect of medicinal oil (MO) formulation prepared from Murraya koenigii leaves extract (methanolic) incorporated in olive oil. The MO was visually transparent, homogenous, smooth in texture, the viscosity grade was observed as 140 cP and easily spreadable. Pro-inflammatory cytokines IL-1ß, IL-6, and TNF-α were significantly reduced to 82.3 ± 3.5, 156 ± 6.2, 137.3. ± 5.5 pg/ml, respectively after treatment with MO when compared to disease control animals that showed IL-1ß, IL-6, and TNF-α levels of 170 ± 6, 265 ± 7, and 288.6 ± 11, pg/ml respectively. The level of pro-inflammatory cytokine in povidone iodine solution (PIS) group was 95.3 ± 3, 162 ± 6, 177.6 ± 8.9 pg/ml of IL-1ß, IL-6, and TNF-α respectively. Interestingly, the wound-healing efficacy of MO was found better as compared to povidone iodine treated standard group and concluded that MO has excellent wound healing effect.

O estudo investigou o efeito cicatrizante da formulação de óleo medicinal (MO) preparado a partir do extrato de folhas de Murraya koenigii (metanol) incorporado ao azeite de oliva. O MO era visualmente transparente, homogêneo, de textura lisa, o grau de viscosidade observado foi de 140 cP e facilmente espalhável. As citocinas pró-inflamatórias IL-1ß, IL-6 e TNF-α foram significativamente reduzidas para 82,3 ± 3,5, 156 ± 6,2, 137,3. ± 5,5 pg/ml, respectivamente, após o tratamento com MO quando comparados aos animais controle da doença que apresentaram níveis de IL-1ß, IL-6 e TNF-α de 170 ± 6, 265 ± 7 e 288,6 ± 11, pg/ml, respectivamente . O nível de citocina pró-inflamatória no grupo solução de iodopovidona (PIS) foi de 95,3 ± 3, 162 ± 6, 177,6 ± 8,9 pg/ml de IL-1ß, IL-6 e TNF-α, respectivamente. Curiosamente, a eficácia de cicatrização de feridas de MO foi encontrada melhor em comparação com o grupo padrão tratado com iodopovidona e concluiu que a preparação de MO tem efeito de cicatrização de feridas.

Efficacy of Arteether Against Theileriosis in Cattle

The present study was done with the objective of comparative efficacy of arteether and buparvaquone against theileriosis in cattle. Total 67 cattle suspected for theileriosis were screened on the basis of clinical and blood smear examination. Group I (n=6) was treated with Inj. buparvaquone @ 2.5 mg/kg body weight once and Group II (n=6) was treated with Inj. arteether @5 mg/kg body weight intramuscularly for three consecutive days. Rectal temperature, heart rate and respiration rate were significantly increased before treatment and in both the groups after treatment showed significant improvement. Haematological parameters showed significant decreased in Hb, PCV, TEC, TLC and neutrophil and significant increase in lymphocytes, monocytes and eosinophil. Non significant difference in basophil count was observed. After treatment, significant improvement was observed in mean hemoglobin, PCV, TEC, TLC, neutrophil, lymphocyte and eosinophil. Non significant improvement was observed in monocyte and basophil count. Present study revealed percent efficacy of arteether was 66.66% and buparvaquone 100%

Obsessive Compulsive Symptoms In Patients With Epilepsy

Obsessive Compulsive Symptoms in Patients with Epilepsy. To find out the prevalence of obsessive compulsive symptoms / disorder among patients of epilepsy. Patients with epilepsy diagnosed clinically at psychiatric out patients department were selected for the study. Yale-Brown Obsessive Compulsive Scale was applied to find out the prevalence and nature of obsessive compulsive symptoms. A total of 93 patients were participated and it was found that 20.4 % of epilepsy patients had obsessive compulsive symptoms. The prevalence of obsessive compulsive symptoms among the patients of epilepsy was found to be 20.4%.

The Second Brain

The ability of the microbiota of the gut to communicate with the brain and influence behaviour is an emerging topic of research.The enteric microbiota interacts with the host to form a relationship that governs homeostasis. Despite the unique enteric bacterial fingerprintof each individual there appears to be a certain balance that confers health benefits. A decrease in desirable bacteria therefore leads to a disturbed gastrointestinal, neuroendocrinal and immune relationship leading to a diseased condition. Studies are focussing on the impact of the microbiota on the host specially its effect on the brain.There are many studies which have demonstrated germ free mice displaying altered stress response, neurochemistry and anxiety in comparison to normal mice. Data obtained from such experiments show that modulation of enteric microbiota may be a useful strategy in stress related disorders, gastrointestinal disorders such as Irritable Bowel Syndrome (IBS) and Inflammatory bowel disease

A Massive Left Ovarian Mucinous Cystadenoma: A Case Report.

We report the occurrence of a rare case of a huge ovarian tumor in Saint George’s Hospital in Mumbai, India. Our patient was a middle-aged woman presented with marked abdominal distension and discomfort at the emergency surgical department. The data were documented through history, clinical examination, laboratory investigations, ultrasound examination, and by computed tomography scan abdomen and pelvis. The case was found to be as a rare massive ovarian mucinous cystadenoma. This case report emphasizes the significance of thorough evaluation of all women presented with vague abdominal pain. Although the condition that is extremely rare, it is a potential danger in its massive form, if timely diagnosis and management are not done. With the increasing awareness about such conditions, more cases are detected and reported.

Isolated Retrobulbar Orbital Hydatid Cyst: A Rare Case Report.

Isolated orbital hydatid cyst is a rare manifestation most commonly situated in superomedial and superolateral angles of orbit. We report a case of a 24 years old female with a large retrobulbar orbital hydatid cyst causing proptosis which was not associated with any cyst in other organs. USG and CT scan aids to diagnosis while surgical excision and histopathology confirms the diagnosis.

Smoking habits of medical students in a private medical college of Bangladesh.

Objective: To assess trends of smoking and the relation between smoking behavior of undergraduate medical students and their attitudes towards smoking and treatment of tobacco dependence. Methodology: Data was collected from the medical students of Rajshahi Islami Bank Medical College, Bangladesh. A total of 200 male students completed the anonymous questionnaire. Response rate was 80.0%. Results: Of the respondents 20% and 80% were regular smokers and non-smokers respectively. Only 32.50 % of the regular smokers smoke less than ten cigarettes, 30.0 % smoke ten to twenty cigarettes whereas, 37.50% smoke more than 20 cigarettes per day. 25% started smoking at nineteen years of age, 22.5% started before this age and 27.5% and 25.0 % started at twenty and twenty one years of ages respectively. 70% started smoking just for pleasure. Only 29.72% smoke light cigarettes whereas 33.78% and 36.48% smoke medium and heavy cigarettes respectively. Almost 75% smokers agreed with the fact that smoking is harmful to health and 45% realized that their cigarette smoke bother others and again 70% of smokers have attempted to quit smoking but failed and 42.5% still wanted to quit smoking. About 55% of smokers complained that they suffer from chronic cough, 60% were lacking concentration in their studies and 45% felt that they were short of memory. Conclusions: Attitudes of smokers were significantly different on most items of tobacco, but knowledge of tobacco problem in the undergraduate medical students was not sufficient. Teaching about tobacco and related issues remains essential in the undergraduate medical course.

Homology modeling and active site analysis of leptin receptor of homo sapiens involved in obesity.

The discovery of leptin has initiated a flurry of research into the molecular basis of weight control. In obese people levels of leptin found in the blood are normally very high and more than sufficient to suppress the appetite and increase the metabolism. This however does not happen and it is believed that obesity may be the result of a resistance to leptin. This suggests that the problem in these individuals may be related to a lack of binding of the leptin protein to its receptor. No known structure of leptin receptor is known. Therefore in present the present study we model the 3D structure of leptin receptor using MODELLER. This was done using the template GP130 of H. sapiens (PDB code: 1BQU). On the basic of results MODEL 6 was selected as the best model. The observed G-factors for the present model were -0.22 for dihedrals, -0.32 for covalent and overall -0.25. The MODEL 6 contains 88.7% of the residues in the most favored region, 11.3 % in the additional allowed and no single residue in generously allowed regions and disallowed region. The predicted model was further analyzed to locate the residues in the active sites those provide interactions with the ligand.

Homology modelling and docking studies of FGFR3 protein to search most effective drug against achondroplasia.

The present investigation was carried out with the aim of modeling the 3D structure of FGFR3 protein and predicting the most effective drug using SU5402 and its analogues. FGFR3 protein, responsible for long bone growth, causes Achondroplasia in H. sapiens when it becomes mutated. When mutated, the dimmer of FGFR3 stabilizes without interacting with its ligand results in constitutive activation of downstream pathway and inhibits the bone growth. No known structure of FGFR3 was available. The 3D modeling of FGFR3 was done using Robetta server and from the various model predicted, model 5 was selected as the best model after evaluating the models using PROCHECK. . The total number of residues in selected model was found as: 589 (86.5%) residues in most favored region, 84 (12.3%) in additional allowed region, 8 (1.2%) in generously allowed region and 0 (0.0%) in disallowed region of the Ramachandran plot. Three analogues were constructed by using the existing FGFR3 specific inhibitor SU5402. Receptor-analogue interaction study was performed in FlexX3 docking software. Ligand 3 (IUPAC Name: 3-{2-[Z)-(4-hydroxy-2-oxo-1,2-dihydro-3Hindol- 3-ylidene) methyl]-4-oxo-4,5-dihydro-1H-pyrrol-3-yl} propanoic acid) was showing the best binding energy (-10.458 KJ/Mol) that can be predicted the most effective inhibitor for FGFR3. It should be noted that these predicted data should be validated using suitable assays for further consideration.

Cardiovascular activity of the n-butanol fraction of the methanol extract of Loranthus ferrugineus Roxb

We investigated the vascular responses and the blood pressure reducing effects of different fractions obtained from the methanol extract of Loranthus ferrugineus Roxb. (F. Loranthaceae). By means of solvent-solvent extraction, L. ferrugineus methanol extract (LFME) was successively fractionated with chloroform, ethyl acetate and n-butanol. The ability of these LFME fractions to relax vascular smooth muscle against phenylephrine (PE)- and KCl-induced contractions in isolated rat aortic rings was determined. In another set of experiments, LFME fractions were tested for blood pressure lowering activity in anesthetized adult male Sprague-Dawley rats (250-300 g, 14-18 weeks). The n-butanol fraction of LFME (NBF-LFME) produced a significant concentration-dependent inhibition of PE- and KCl-induced aortic ring contractions compared to other fractions. Moreover, NBF-LFME had a significantly higher relaxant effect against PE- than against high K+-induced contractions. In anesthetized Sprague-Dawley rats, NBF-LFME significantly lowered blood pressure in a dose-dependent manner and with a relatively longer duration of action compared to the other fractions. HPLC, UV and IR spectra suggested the presence of terpenoid constituents in both LFME and NBF-LFME. Accordingly, we conclude that NBF-LFME is the most potent fraction producing a concentration-dependent relaxation in vascular smooth muscle in vitro and a dose-dependent blood pressure lowering activity in vivo. The cardiovascular effects of NBF-LFME are most likely attributable to its terpenoid content.

Inflammatory markers, insulin resistance and carotid intima-media thickness in North-Indian type 2 diabetic subjects.

OBJECTIVE: To study the interrelationship of the inflammation, insulin resistance and atherosclerosis in recently diagnosed type 2 diabetes. METHODOLOGY: Eighty-one newly diagnosed type 2 diabetic patients were compared with 81 healthy age, sex and BMI matched controls. Plasma glucose and insulin (fasting and after 2 hours of 75 gm of oral glucose), lipids and serum levels of C-reactive protein (CRP), fibrinogen and Tumour Necrosis Factor (TNF)-alpha were measured. Carotid (Intima-Medial Thickness) IMT was measured using high "resolution B-Mode ultrasonography. Insulin resistance was calculated using HOMA-IR model. Electrocardiogram (ECG) and exercise ECG were recorded for the evidence of coronary heart disease (CHD). RESULTS: Carotid IMT was significantly thicker in diabetic patients than in control group across the whole age range (p < 0.01). In merged group of diabetes, composite IMT was significantly correlated with LDL-cholesterol, fasting insulin, serum cholesterol, BMI and HOMA-IR (p < 0.01). After controlling for age and sex, all glycaemic parameters were correlated with IMT in both diabetic and control group. HOMA-IR, waist hip ratio, serum triglycerides, serum cholesterol, fasting serum insulin and CRP were significant predictor of IMT. Concentrations of inflammatory markers were significantly higher in diabetic patients than in control group. Serum levels of CRP (p < 0.05) were found to be higher in diabetic patients with CHD than without CHD. CRP was significantly correlated with IMT (r = 0.603, p < 0.01) in diabetic subjects with and without CHD after controlling for age and sex. CONCLUSION: Inflammatory markers are associated with type 2 diabetes but only CRP is associated with development of accelerated atherosclerosis and subsequent CHD.

Caudal anesthesia in pediatric surgical practice.

Prospective study was carried out on 100 patients since May 2005 in my private practice and in the department of pediatric surgery of MMCH. Under caudal anesthesia along with or without ketaminie induction and gas inhalation all the patients underwent different surgical procedure namely anorectal surgery (eg. anoplasty, rectal polyp), urogenital surgery (Circumcision, hypospadias, meatotomy), groin surgery (hernia, hydrocele) and foot & leg surgery. Calculated dose schedule of drugs used in anesthesia and volume were maintained. Time of giving anesthesia and time of starting analgesia were recorded. Per-operative and postoperative analgesia were evaluated. Every parent was explained regarding the merit of caudal anesthesia calculated and compared with that of general anesthesia. Application of caudal anesthesia with or without ketamine & diazepam induction can be used safely and cost effectively and may be put into protocol in many of the pediatric surgical practice both in institute and also in private practice.

Treatment of non union of humerus using G. A. Ilizarov technique.

The management of the non union of humerus is one of the most challenging problems that the surgeon confronts in his practice. The procedures traditionally used are: I.M. Nailing, interlocking, plating, transplantation of allograft. In our series, 36 cases with non union has been treated by G.A. Ilizarov technique. The age range were: 21-62 years with an average of 32 years. The initial treatment were done by DCP, rush nails & plates with screw fixation. The duration of treatment ranged from 5-11 months (average 8 months). With the application of Ilizarov fixator a good range of elbow & shoulder motion were achieved. The average follow up period was 5 years with a range of 1-8 years. Union was achieved in all the 36 cases.