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Background: Scrub typhus is a zoonotic infectious disease presenting commonly with acute febrile illness of variable severity and symptoms. It mimics other more prevalent tropical febrile illnesses such as dengue, malaria, and leptospirosis. Prevalence is high in and around Udaipur due to hilly terrains and agricultural farmlands. Multisystem involvement is common but liver dysfunction is a fatal comorbidity. Methods: In a retrospective observational study, we analyzed the clinical, biochemical, and demographic parameters of 85 patients of scrub typhus. The study population was distributed into four groups for abnormal liver chemistries based on American College of Gastroenterology (ACG) clinical guidelines: normal, borderline high, mild elevation, and moderate elevation. Results: Almost 80% of patients had abnormal liver chemistries including either serum bilirubin or transaminases. More than 30% of patients were categorized in group 2 and group 3 of the abnormal liver chemistries. Group 4 with moderate to severe liver dysfunction had 15.3% (n=13) patients. Thrombocytopenia and elevated blood urea and Creatinine were significantly seen in patients with both scrub typhus and liver dysfunction. Conclusions: Thus, in our study prevalence of hepatitis and jaundice with multiorgan failure in scrub typhus patients was significantly high. Timely identification of systemic complications and screening of liver chemistries on presentation is of utmost importance for better outcomes, among seriously ill patients.
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Background: Mobile phone because of the ever availability and its mobility application has created a dramatic interest for youth in comparison with other communication technologies. Unfortunately, communication technology has some negative effects also. Constant usage and addiction to cell phones has affected the people physically, psychologically, and socially. Aims and objective were to assess the pattern and impact on health of mobile phone use among students of Government Medical College, Jalaun. Methods: A descriptive cross-sectional study was conducted on GMC Jalaun from October to December (3 months). All students of MBBS final year part 1 were selected as sample, so total 98 students were selected in the study. Students were requested to complete a pre-tested self-administered questionnaire. The data were analyzed by using appropriate statistical test. Results: Our study shows that mobile phone use was very high among the medical students and 54.1% of them spending 4-6 hours per day. Most of the students were frequently using mobile phone for taking pictures, videos, playing games, listening to music and internet surfing other than for calling and messaging purpose. Majority of the students used mobile phones at night (62.2%). Majority were suffered from sleep disturbance (52.1%) followed by lack of concentration (47.9%) and behavioural disorder (36.8). Out of total students, 31.6% were having refracting error. Conclusions: Our study showed pattern of mobile phone use among the medical students and it was found that mobile phone use was very high among the medical students.
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Chronic kidney disease is often accompanied with a syndrome known as protein-energy wasting, which is defined by decreased protein consumption, protein loss due to metabolic disturbances, and physical consequences include sarcopenia and frailty. Due to population aging and advancements in the treatment of other chronic illnesses, this problem has drastically increased in recent years. The frequency of morbidity and death in chronic kidney disease patients may be greatly decreased with proper therapy of as protein-energy wasting. Therefore, it's crucial to prevent and manage as protein-energy wasting in chronic kidney disease patients by doing a thorough evaluation and offering each patient a customized, evidence-based treatment plan. Once protein-energy wasting is recognized, a nutritionist should be contacted to create a management strategy. A thorough diet specifically designed to fit the patient's requirements, any required nutritional supplements, and counselling about dietary changes, symptom management, and psychological support should all be part of this strategy. The risk of protein-energy wasting may be decreased with proper assessment and care. This includes changes to one's diet, resistance training or other forms of exercise, dialysis or organ transplantation when necessary, and drugs to treat any underlying disorders.
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This comprehensive review explores the critical role of soil management practices in enhancing carbon sequestration, thereby contributing to climate change mitigation. Recognizing soil as a significant carbon sink capable of holding substantial carbon amounts, the review delves into the dynamics of soil organic carbon (SOC) and the impact of various agricultural practices on carbon flux. Key topics include the fundamental processes of carbon sequestration in soil, the dynamics of soil organic matter (SOM), and the factors influencing carbon sequestration such as climate, soil texture, land use, and management practices. It provides an in-depth analysis of soil management strategies like no-till farming, crop rotation, and the use of organic amendments (compost, biochar, and manure), highlighting their benefits in enhancing soil structure, fertility, and carbon storage capabilities. It also examines the role of cover cropping and agroforestry in promoting soil health and carbon sequestration. The review discusses the technical, socioeconomic, and environmental challenges in implementing these practices and emphasizes the importance of technological advancements in monitoring and validating soil carbon sequestration. Case studies from different geographic and climatic contexts illustrate the practical applications and outcomes of these soil management practices.
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The field experiment was carried out at Horticulture Research Farm No.1, Babasaheb Bhimrao Ambedkar University, Lucknow during Rabi season 2021-22. In this, twenty genotypes including check cultivars were evaluated to estimate the genetic variability, heritability and genetic advance for different characters. The experiment was laid out in Randomized Block Design (RBD) with three replications. Characters viz., days to 50% flowering, plant height, number of primary branches per plant, polar diameter of fruit, equatorial diameter of fruit, total soluble solids, number of fruits per cluster, average fruit weight, number of fruits per plant, marketable fruit yield per plant, unmarketable fruit yield per plant and total fruit yield per plant were studied during the experiment. Analysis of variance showed significant differences among genotypes for all the characters under study during the investigation. The Phenotypic coefficient of variance (PCV) was higher than the genotypic coefficient of the variation (GCV) for the characters studied. The highest genotypic coefficient of variation (GCV) was observed for unmarketable fruit yield per plant. The moderate GCV was reported for total fruit yield per plant followed by plant height and average fruit weight, polar diameter of fruit, no. of primary branches per plant, marketable fruit yield per plant and equatorial diameter of fruit whereas it was least for TSS followed by days to 50% flowering and number of fruits per cluster. Therefore these characters exhibited high heritability coupled with genetic advance thus show some scope for improvement through selection.
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Background: This was a prospective study to analyses the maternal and fetal outcome among pregnant women with jaundice and deranged LFTs in a tertiary care hospital. Methods: This was a prospective observational study conducted in the department of Obstetrics and Gynaecology at SLBSGMC Nerchowk for a period of 6 months. The pregnant women with jaundice and deranged LFTs were included in the study after fulfilling inclusion and exclusion criteria. History, clinical examination and relevant investigations done. All patients followed till seven days in post-partum period. The maternal and fetal outcomes were noted. Results: During study period we encountered 59 pregnant women with deranged LFTs. Majority of women were in primigravida (74.6%) in 20-30 years (55.9%) of age group. Most common symptom was pruritus in 59.3% of women. ICP was the most common cause amongst 64.4% of women. 40.7% 0f women had FTVD and 40.6% had cesarean delivery. AFD with MSL (87.5%) being the most common indication for cesarean delivery amongst these women. A total of 49 (83.1%) of newborn were delivered alive with good Apgar score, 1 (1.7%) was premature, 1 (1.7%) had respiratory distress syndrome (RDS). Conclusions: In contrary to older Indian studies our study concluded that though liver disease is less common, but on evaluation we found that intra-hepatic cholestasis being the number one cause of deranged LFTs in pregnancy in our hospital. Amongst these patients with high index of suspicion, prompt investigations, early diagnosis and timely management can improve the maternal and perinatal outcome.
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COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) first reported in December 2019 in Hubei province of Wuhan, China. Most people infected with COVID-19 disease experienced mild to moderate symptoms or even no symptoms at all, but growing body of evidence has shown that large number of COVID-19 survivors are experiencing multitude of long-lasting symptoms persisting for varied number of periods after the acute phase of infection. This condition is known as long COVID and since July 2021 has been added as a recognized condition that could result in a disability under the American with disability act (ADA). We will undertake a systematic search in PubMed, PubMed Central and Google scholar from December 2019 till June 2022. The study designs to be included will be cross-sectional, case-control, cohort, follow-up, observational studies. No ethical issues are anticipated. Dissemination will be done by submitting article to academic peer review journals. To add into the pool of knowledge of long COVID and provide evidence-based insight, this systematic review was planned to know about the prevalence of long COVID sequalae, commonly reported symptoms by COVID-19 survivors at an interval of 3, 6 and 12 months and possible risk factors attributable to the emergence of these symptoms. PROSPERO registration (CRD 42022340175).
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Excessive application of pesticides on crops has been noticed to gain maximum yield. It results in heavy damage to human health as well as environment. Pesticides application beyond permissible limit has detrimental effects on ecosystem. Organochlorine compounds are widely used as pest controller. These are considered as substantial environmental pollutant and carcinogens due to their extensive environmental release. There are sufficient numbers of studies that supports positive co-relation of organochlorine pesticides with cancer. To evaluate these detrimental effects on human health we have reviewed various studies and concluded the positive co-relation of organochloro compounds with cancers. In this study, the altered metabolism effects of organochlorine pesticides on cytochrome P450 enzyme have been observed.
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Background: Morbidity and mortality from chronic lung diseases are increasing worldwide. A combination of various cytological and histopathological techniques are required for the high diagnostic accuracy. This study aims to evaluate and compare diagnostic accuracy of fiberoptic bronchoscope aided cytohistological techniques such as BAL (bronchoalveolar lavage), TBNA (Transbronchoscopic needle aspiration) and FB (forceps biopsy) in diseases of lung. Method: A prospective study conducted on 100 patients with symptoms and signs of various respiratory diseases who underwent fibreoptic bronchoscopy. Diagnostic accuracy of various samples alone and in combination were analysed. Results: Sensitivity of BAL-24%, TBNA 64% and FB 66%. Addition of BAL to FB increased the sensitivity to 69%. Addition of BAL to TBNA increased the sensitivity to 70%. Sensitivity of cytological methods (FB and TBNA) 90%. Addition of both BAL and TBNA to FB increased overall senstivity to 93%. FB the most specific amongst the three techniques with specificity of 94% followed by TBNA (59.4%) and BAL (50%). Conclusions: There are variable results regarding diagnostic yields and utilities of various fibre-optic bronchoscope aided cytohistological techniques but there combination adds the yields. Thus a combination of various cytohistological samples should be taken in a patient undergoing fiberoptic bronchoscopic examination to increase the diagnostic yield, to cut short the diagnostic time and early start of treatment.
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Background: With improvement in living conditions in the population and the availability of treatments for various communicable and non-communicable diseases, the life expectancy and consequently the elderly population have increased. Stress leads to mental and physical problems. Aim and Objective: The aim of this study was to assess the effect of stress on muscle functions in the elderly. Materials and Methods: One hundred apparently healthy persons (50 males and 50 females) took part in the study. Perceived stress scale was used to measure their level of stress. Maximum voluntary contraction (MVC) and endurance time were measured with the help of a handgrip dynamometer. Results: The elderly population sample in our study showed a moderate level of stress, but there was no significant difference between the three age groups under study. Conclusion: A significant positive correlation between MVC and stress level was observed in our study subjects.
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Background: With over 560 million internet users, India is the second largest online market ranked only behind China as of January, 2019. Rapid expansion and proliferation of the internet has provided better opportunities for communication, information, and social interaction. In addition, when this use becomes obsessive and at the expense of other aspects of a person’s life, the internet could be problematic which has led to the emergence of the concept of internet addiction. The present study was conducted with the objective to find out the status of internet addiction in school going adolescent students and its determinants. Methods: A multicentre cross-sectional study was carried out in 160 school going adolescent students of Raipur city. Young’s Internet Addiction Scale consisting of 20-item was used in the study. Results: Out of 160 students, 94 (58.8%) were in the score range of 20-49 i.e., mild addiction and 33.8% (54) were in score range of 50-79 i.e., moderate addiction. Internet addiction was more common in boys as compared to girls and was statistically significant (p<0.05). Type of school was also significantly associated with internet addiction. Conclusions: As addiction of internet is seen in majority of students, there is an urgent need to use a comprehensive approach including periodical awareness of the students as well as parents regarding balancing the time between internets surfing, studies and outdoor physical activities.
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Abstract: The most important aspect of Public Health Emergency Preparedness (PHEP) involves the circulation of trustworthy and accurate information in the public health interest domain. Strict stringency measures such as nationwide lockdown impacted people's mental health. Hence, this study was planned to assess the knowledge, practice, and anxiety among the Indian population about the ongoing pandemic in the initial phase. Methods: A web-based cross-sectional study was conducted between August 1, 2020, to October 5, 2020. Coronavirus Anxiety Scale was used to determine dysfunctional anxiety. Results: Among 553 participants, 73.6% had overall good knowledge of COVID-19 with mean correct score of 6.9±1.1. Majority of participants (97%) wore mask regularly, and 93% of respondents regularly washed their hands with soap and water. Only 14 participants scored ?9 on CAS, suggesting probable cases of dysfunctional anxiety associated with the COVID19 crisis. Conclusion: The knowledge and practices of citizens in a nation reflect their preparedness and ability to deal with a pandemic of such proportion. Good knowledge translates to good practices and therefore reduces anxiety among the population. It is deemed necessary that people's knowledge and habits, including the mental impact, be accessed at periodic intervals to track their adaptation to pandemics over time
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Guillain Barre syndrome (GBS)is a collection of clinical syndromes that manifest as an acute inflammatory poly radiculopathy. It usually presents as an acute, non-febrile, monophonic, post infectious illness manifesting as ascending weakness and areflexia. It is an autoimmune disorder characterized by production of antibodies against the myelin and is often triggered by bacterial and viral infections, vaccines against rabies, flu and COVID-19. Here we present a case of 31 years old male with characteristic signs and symptoms of GBSpossibly triggered by Covishield vaccine.
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India is trying to maintain stability in the current circumstances; another immediate threat has developed in the shape of coronavirus disease- associated mucormycosis. Mucormycosis is uncommon but lethal disease, caused by a group of molds known as mucormycetes. If not treated properly, an infection might be fatal. The most ordinary risk factor is diabetes mellitus, followed by hematological malignancies. Patients with postpulmonary tuberculosis and persistent renal diseases are further probable to extend mucormycosis in India. Trauma increases the risk of cutaneous mucormycosis. Despite a rise in illness awareness among treating physicians, disease-related morbidity and mortality remain high, as patients seek medical attention late in the disease process and medication is expensive. Despite the fact that it has been present since the beginning of the pandemic, the cause of this fungal infection remains unknown. In this review we aimed to summarize about mucormycosis and its epidemiology, pathogen, and treatment options in context to COVID-19.
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Thyroid cancer is the prevalent endocrine cancers, and its incidence is growing all over the world, according to the World Health Organization. About 5–10 per cent of individuals with differentiated thyroid carcinoma may experience destructive behavior and metastasis, and their disease will be refractory to therapeutic techniques such as radiation therapy for an unknown cause, despite the favorable prognosis. Most aggressive, deadly, and unresponsive type of the cancer is thyroid carcinoma. Regrettably, existing treatments are not specific and are thus considered poor in treating thyroid malignancies. Consequently, mortality in this malignancy despite progress in diagnosis and treatment is a prominent issue in medicine. evidence linking cellular, molecular, and genetic to a diagnostic and therapeutic simplification. With the new idea of personalized therapy for thyroid cancer diagnosis, arranging the treatment, discovering the success of the treatment and assessing the visualization has improved in the last ten years. Personalized medicine treatment for thyroid cancer is supported by these studies. According to the findings of this review, cellular and molecular processes of cancer will lay concrete on the way for the development of narrative biomarkers for personalized medicine that take individual variations into account
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Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide which unfortunately has no known effective cure to date. Despite many clinical trials indicating the effectiveness of preclinical treatment, a sensitive tool for screening of AD is yet to be developed. Due to multiple similarities between ocular and the brain tissue, the eye is being explored by researchers for this purpose, with utmost attention focused on the retinal tissue. Besides visual functional impairment, neuronal degeneration and apoptosis, retinal nerve fiber degeneration, increase in the cup-to-disc ratio, and retinal vascular thinning and tortuosity are the changes observed in the retinal tissue which are related to AD. Studies have shown that targeting these changes in the retina is an effective way of reducing the degeneration of retinal neuronal tissue. Similar mechanisms of neurodegeneration have been demonstrated in the brain and the eyes of AD patients. Multiple studies are underway to investigate the potential of diagnosing AD and detection of amyloid-? (A?) levels in the retinal tissue. Since the tissues in the anterior segment of the eye are more accessible for in vivo imaging and examination, they have more potential as screening biomarkers. This article provides a concise review of available literature on the ocular biomarkers in anterior and posterior segments of the eye including the cornea, aqueous humour (AH), crystalline lens, and retina in AD. This review will also highlight the newer technological tools available for the detection of potential biomarkers in the eye for early diagnosis of AD.
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Background: Hypertensive disorders of pregnancy are a major cause of adverse pregnancy outcomes. Though the etiology of spectrum of vascular disorders of pregnancy is still not understood completely, yet abnormally elevated homocysteine level has been implicated in the causal pathway and pathogenesis. Hyperhomocysteinemia has been significantly associated with increased risk of poor maternal and foetal outcomes in terms of PIH, abruption, IUGR, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present prospective study was conducted among 180 pregnant women (57 exposed and 123 non exposed) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of determining association of abnormally elevated homocysteine level in pregnancy and adverse pregnancy outcomes. Socio-demographic, clinical, biochemical including homocysteine level, laboratory, ultrasonographic parameters and foeto-maternal outcomes of pregnancy of all the participants were documented.Results: The mean homocysteine level of exposed group (23.26±10.77 µmol/L) was significantly higher than the unexposed group (8.99±2.47 µmol/L). Among hyperhomocysteinemic subjects, 10.5% had abruption, 15.8% had PRES and 8.7% PPH which was significantly higher than normal subjects. Similarly, patients with homocysteinemia had significantly higher proportion (21.3%) of poor Apgar score, more (41.9%) NICU admissions and higher frequency (4.7%) of meconium aspiration syndrome.Conclusions: The present study generates necessary evidence for associating abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and adverse pregnancy outcomes. It further demands the need of robustly designed studies and trials to further explore the phenomenon. Moreover, it emphasizes on a simple and timely intervention like estimating the much-neglected homocysteine levels during pregnancy which can definitely contribute in predicting and preventing adverse perinatal outcomes.
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Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.