New cost-effective human leukocyte antigen testing algorithm for screening of human leukocyte antigen-matched related donor in thalassemia major patient pretransplant workup: A single-center study from resource-constrained settings

Introduction: India has a huge disease burden of thalassemia major with an estimated 40 million carriers and over a million thalassemia major patients. Very few patients are optimally treated, and the standard of care “hematopoietic stem cell transplant” (HSCT) is out of reach for most patients and their families. The cost of HSCT is significant, and a substantial proportion of it goes to human leukocyte antigen (HLA) testing of family members (HLA screening) in hope of getting a matched related donor (MRD) for HSCT. The aim of this study was to establish that a new proposed testing algorithm of HLA typing would be more cost-effective as compared to the conventional HLA screening within MRD families for possible HSCT. Material and Methods: Buccal swab samples of 177 thalassemia patients and their prospective family donors (232) were collected. Using a new HLA testing algorithm, samples were tested for HLA typing in a sequential manner (first HLA-B, then HLA-A, and finally HLA-DR) using the sequence-specific oligonucleotide probe method on the Luminex platform. Results: The new sequential HLA-A, HLA-B, and HLA-DRB1 testing algorithm showed a 49.1% reduction in cost compared to the conventional HLA testing algorithm. Furthermore, 40 patients (22.59%) were found to have HLA-MRD within the family among other samples that were tested. Conclusion: The new HLA testing algorithm proposed in the present study for identifying MRD for HSCT resulted in a substantial reduction in the cost of HSCT workup.

Expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2/neu in gallbladder carcinoma in North Indian population

Background: Gallbladder carcinoma (GBC) although rare is most frequent malignant neoplasm of biliary tract system and sixth most common malignancy of digestive tract. GBC is more common in females and there are studies which show expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 neu (HER2/neu) in GBC suggesting possible molecules for targeted therapy, but results are inconsistent. Aims and Objectives: The aim of this study was to find out expression of ER, PR, and HER2/neu in GBC in North Indian population and their possible association with clinicopathological features. Materials and Methods: A total 59 resected cases of GBC diagnosed by histopathological examination were included in the study. Expression of ER, PR, and HER2/neu was accessed by immunohistochemistry method and correlated with various clinicopathological features. Results: ER expression was absent in all GBC cases. PR expression was present in only one case. Positive expression of HER2/neu was present in 13 (22%) cases, in which 12 cases were of conventional adenocarcinoma and one case was of papillary adenocarcinoma. Well and moderately differentiated tumor had significantly higher HER2/neu expression as compared to poorly differentiated tumors (P = 0.001). Pre-obese patients had significantly higher HER2/neu expression as compared to non-obese patients (P = 0.008). Conclusion: In our study, there was no expression of estrogen and PR in GBC in North Indian population. Although small in number, there is a subset of patients who overexpress HER2/neu receptor that may benefit from targeted therapy.

Comparison of above elbow and below elbow immobilisation for conservative treatment of distal end radius fracture in adults: A systematic review and meta-analysis of randomized clinical trials / 中华创伤杂志(英文版)

PURPOSE@#The aim of this study was to analyze if any difference exists on the type of immobilisation (above elbow vs. below elbow) in the conservative treatment of distal end radius fractures in adults.@*METHODS@#The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic literature search was performed up to 1st October 2021 in Medline, Embase, Ovid and Cochrane database using the search terms, "distal end radius fractures OR fracture of distal radius", "conservative treatment OR non-surgical treatment", "above elbow immobilisation" and "below elbow immobilisation". Randomized clinical trials written in English, describing outcome of distal end radius fractures in adults by conservative or non-surgical means using above elbow immobilisation or below elbow immobilisation were included and assessed according to the risk of bias assessment (RoB2) tool by Cochrane collaboration. Non-randomized clinical trials, observational studies, retrospective studies, review articles, commentaries, editorials, conference presentations, operative techniques and articles without availability of full text were excluded from this review. The meta-analysis was performed using Review Manager version 5.4.1 (The Cochrane Collaboration, Copenhagen, Denmark).@*RESULTS@#Six randomized clinical trials were included for quantitative review. High heterogeneity (I2 > 75%) was noted among all the studies. The standard mean difference (MD) between the disability of the arm, shoulder and hand scores in both the groups was 0.52 (95% CI: -0.28 to 1.32) which was statistically non-significant. There was no statistical difference in the radial height (MD = 0.10, 95% CI: -0.91 to 1.12), radial inclination (MD = 0.5, 95% CI: -1.88 to 2.87, palmar tilt (MD =1.06, 95% CI: -0.31 to 2.43) and ulnar variance (MD = 0.05, 95% CI: -0.74 to 0.64). It was observed that shoulder pain occurred more commonly as a complication in above elbow immobilisation and the values were statistically significant (above elbow: 38/92, 41.3%; below elbow: 19/94, 20.2%).@*CONCLUSION@#This two-armed systematic review on the above elbow or below elbow immobilisation to be used for conservative treatment of the distal end radius fracture in adults resulted in non-significant differences in terms of functional and radiological scores among the 2 groups but significant increase in the complication rates in the above elbow group.

Recent Cyclones Causing an Increased Incidence of Intracranial Haemorrhage in India — A Cross-sectional Study

Background : Seasonal variations in the incidence of Intracerebral Haemorrhage (ICH) have been extensively evaluated in the studies conducted in various parts of the world. The prevalence per 100,000 person-years of spontaneous cerebral haemorrhage is regularly highest in the winter and lowest in the summer. However, these seasonal variations of ICH in India have not been comprehensively described in any published literature. Methodology : In this retrospective cross-sectional study, data of 15000 patients were collected from various State Government-owned Hospitals of India of the months April, May and June. The present study examined the association between temperature variations and spontaneous ICH incidence during recent severe Cyclonic Storms ‘Yaas’, and ‘Tauktae’ in India with the brain’s Computed Tomography (CT) scans. A CT brain persists in being the investigation of choice in the initial diagnosis of ICH, as it is readily available, accessible and fast. Results : During these Cyclones, there was a significant temperature drop associated with an increased incidence of ICH in the specified time. Conclusion : Sudden temperature drop during a Cyclone can cause spontaneous Hypertension, which causes rupture of arteries in the brain and results in Stroke. The Government, Physicians and the general public need to be made aware of such associations

A STUDY OF SOCIODEMOGRAPHIC CHARACTERSTICS, ANXIETY & DEPRESSION IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Background: Polycystic ovarian syndrome (PCOS) is the most common and distressing disorder of reproductive age group female which include symptoms like amenorrhea, hirsutism, obesity, acne, infertility etc. Because of these distressing symptoms PCOS has been associated with significant psychiatric morbidity. Aims & objectives: 1.To study the sociodemographic characterstics of females with PCOS. 2.To find out the frequency of different symptoms in females suffering from PCOS. 3.To study the prevalence of anxiety and depression among females suffering from PCOS. Materials & methods: 30 consecutive female patients attending gynae OPD from 1/3/2022 to 1/4/2022 suffering from PCOS as per Rotterdam criteria diagnosed by a consulatant gynaecologist were taken for the study. They were thoroughly evaluated on a specially designed semistructred proforma,GHQ-12,Hamilton anxiety rating scale, Beck's depression inventory and PCOS questionnaire. Results were analysed using suitable statistics. Result and conclusion: Majority (60%) of the patients were from the age group 25-30 years. Most common symptom of PCOS in the patient was menstrual irregularity(90%) followed by obesity(80%), hirsutism(50%), acne(40%), alopecia(20%) and acanthosis nigricans(10%), 33%of the patients showed clinically significant anxiety symptoms, 10% shown clinically significant depression and 10% showed mixed anxiety depression disorders.

AN OBSERVATIONAL ANALYSIS OF CLINICAL PROFILE ASSOCIATED WITH OVULATION INDUCTION USING LETROZOLE AMONG INFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Background- Polycystic ovary syndrome (PCOS) is major endocrine and metabolic disease in reproductive women. As per latest procedures, letrozole should be taken as the first-line pharmacological treatment for infertile women with PCOS. This study was planned to study the role of clinical profile in ovulation induction after letrozole therapy among infertile women with polycystic ovarian syndrome. This was a prospective analytical observational st Methods- udy carried out at the IVF centre, SMS Medical College, Jaipur. The present study enrolled 100 patients attending the IVF centre for fertility treatment who were diagnosed with PCOS as per Rotterdam criteria. Anthropometric measurements like Body mass index (BMI calculated as weight in kilograms divided by square of height in meters) and waist circumference (the smallest circumference at the level of umbilicus) was taken. A comprehensive physical examination of all patients was done to note signs of clinical hyperandrogenism like acne, alopecia, and hirsutism. Treatment response was defined as ovulation in response to letrozole in doses from 2.5 mg to 7.5 mg. In this study, women from 20 to 25 years of age w Results- ith shorter duration of infertility, lower BMI, lower waist circumference, absence of hirsutism, or mild hirsutism on clinical examination showed better response to Letrozole. ConclusionLetrozole can be considered a suitable ovulation induction agent in infertile PCOS patients with lower BMI, lower waist circumference, and absence of hirsutism. A predictive ovulation score can be developed from basic clinical parameters. Identification of various factors affecting response to letrozole may help the clinician to individualize ovulation induction protocols in PCOS women.

Clinical profile of patients with inter vertebral disc disorders / clínica de pacientes con trastornos de los discos intervertebrales

Introduction: Intervertebral disc disorders (IDDs) are being commonly observed nowadays among the young and middle aged population. Objectives: This hospital record based study was done to study the risk factors, clinical presentation, imaging findings and management practices among patients with all types of IDDs. Methods: A validated proforma was used to obtain information of patients confirmed with IDDs over the past three years. Results: Mean age at onset of disc disorders among the 219 patients was 44.7±14.2 years. History of poor exercising habits were present among 72(32.9 percent) patients. The most common site of disc involvement was L4-L5 [151(68.9 percent)]. 143(65.3 percent) patients had single site disc involvement. The most common clinical symptom was lower back pain [180(82.2 percent)]. Nerve root compression was present among 154(70.3 percent) patients. Disc bulge, protrusion, extrusion and sequestration were present among 116(53 percent), 90(41.1 percent), 52(23.7 percent) and 4(1.8 percent) patients respectively. Age at onset >65 years (p=0.035), age at onset ≤55 years (p=0.004) and history of direct impact to the neck region (p=0.017) were associated with disc prolapse at L2-L3 level, L4-L5 level and C5-C6 level respectively, among patients with single site disc involvement. Risk of multiple level disc involvement was found to increase after 35 years (p<0.001). It was seen more involving cervical vertebrae (p=0.0068). Lumbar (p<0.0001) and lumbosacral vertebrae (p<0.0001) involvement were seenmore among patients with single site disc involvement. NSAIDs [155(70.8 percent)] were the most the commonly used medication. Microdiscectomy was done among 35(76.1 percent) out of the 46 patients who underwent surgical management. Conclusions: Exercising habits need to be encouraged among people for the prevention of IDDs. The various high risk groups identified in this study need to be periodically screened for IDDs(AU)

Introducción: Actualmente, los trastornos de los discos intervertebrales (TDI) son frecuentes en la población joven y de mediana edad. Objetivos: Este estudio hospitalario de las historias clínicas se realizó para examinar los factores de riesgo, la presentación clínica, los hallazgos imagenológicos y las prácticas de tratamiento entre los pacientes con todos los tipos de trastornos de los discos intervertebrales. Métodos: Se utilizó una proforma validada para obtener información de los pacientes confirmados con trastornos de los discos intervertebrales en los últimos tres años. Resultados: La edad media de aparición de los trastornos discales entre los 219 pacientes fue de 44,7 ± 14,2 años. El historial de malos hábitos de ejercicio estuvo presente en 72 (32,9 por ciento) pacientes. El sitio más común de afectación del disco fue L4-L5 [151 (68,9 por ciento)]. 143 (65,3 por ciento) pacientes tenían compromiso de disco en un solo sitio. El síntoma clínico más frecuente fue el dolor lumbar [180(82,2 por ciento)]. La compresión de la raíz nerviosa estuvo presente en 154 (70,3 por ciento) pacientes. Se mostró presencia de protuberancia, protrusión, extrusión y secuestro discal en 116 (53 por ciento), 90 (41,1 por ciento), 52 (23,7 por ciento) y 4 (1,8 por ciento) pacientes, respectivamente. La edad de inicio >65 años (p=0,035), la edad de inicio ≤55 años (p=0,004) y el antecedente de impacto directo en la región del cuello (p=0,017) se asociaron con prolapso discal a nivel L2-L3, L4- Nivel L5 y nivel C5-C6 respectivamente, entre pacientes con compromiso discal en un solo sitio. Se encontró que el riesgo de afectación del disco en múltiples niveles aumenta después de 35 años (p<0,001). Se vio más involucradas las vértebras cervicales (p=0,0068). La afectación de las vértebras lumbares (p<0,0001) y lumbosacras (p<0,0001) se observó más entre los pacientes con afectación del disco en un solo sitio. Los fármacos anti-inflamatorios no esteroideos (AINE) [155 (70,8 por ciento)] fueron los medicamentos más utilizados. La microdiscectomía se realizó en 35 (76,1 por ciento) de los 46 pacientes que se sometieron a manejo quirúrgico. Conclusiones: Es necesario fomentar hábitos de ejercicio entre las personas para la prevención de los TDI. Los diversos grupos de alto riesgo identificados en este estudio deben someterse a pruebas periódicas de IDD(AU)

Clinical evaluation of cases of lower genitourinary tract trauma with special reference to primary realignment in cases of posterior urethral distraction defect

Background: The exact management strategy for lower genitourinary tract trauma remains controversial. Primary realignment with/without suprapubic catheterization provides definitive procedure with low complications and avoids the need for further open surgeries.Methods: This was a prospective longitudinal study done on 31 cases with different complaints related to lower tract genitourinary trauma. All patients underwent suprapubic catheterization and/or primary realignment. The outcome was measured in the terms of time for discharge, urinary incontinence, stricture formation, erectile dysfunction and impotence.Results: Maximum proportion of patients with lower genitourinary injuries in the study was in 10-20 years age group (48.4%). Blunt trauma was accounted for 93.6% of lower genitourinary injuries. Road traffic accidents were the most common cause (90.32%) of lower genitourinary injuries. Urinary bladder injuries accounted for 41.9% of all lower genitourinary injuries. Blood at meatus is present in only about half of the significant urethral injuries. Primary realignment of urethral injury results in lesser duration of hospital stay (9.24±2.44 days), shorter length of suprapubic catheterization (11.67±4.78 days) and early spontaneous voiding (40.93±15.79 days). The stricture rate following primary realignment is low (31.25%). Erectile dysfunction was noted only in two patients (16.6%).Conclusions: Management of traumatic urethral disruption by primary realignment serves as ultimate therapy in majority of patients.

Yoga is an effective technique of stress reduction within the medical population: a biochemical study in MBBS students of BRD Medical College, Gorakhpur, Uttar Pradesh, India

Background: Medicine is a profession with high-stress prevalence. There are many stress markers but cortisol is one of the commonly used stress marker. Stress begins in the first year of medical carrier and increases with subsequent years of medical education. There is a decrease in overall academic performance and many health-related adverse effects due to stress. In this study, yoga was performed in the first year MBBS students of BRD Medical College, Gorakhpur and the impact of yoga in stress reduction was studied using serum cortisol as stress a marker.Methods: Study groups, yoga and control contained 26 and 27 subjects including male and female MBBS students. Yoga group practiced selected yogic asana, pranayama, and yoga nidra for 3 months. The control group as a stress marker had been kept in touch and allowed to go on their usual activity as before. Morning (8.00 AM to 9.00 AM) serum cortisol level was used as a stress marker in both group, pre and post-study.Results: There was a significant reduction in morning serum cortisol level (stress level) in yoga group (p-value = 0.0271) but there was no significant change in morning serum cortisol level of the control group (p-value = 0.8573).Conclusions: Yoga is an effective stress reduction technique for medical students. Yoga classes should be introduced in the first year of the medical carrier under the supervision of expert physiologists. This may lead to the implantation of a healthy lifestyle in our future healthcare providers. Yogic practice by health care providers may have long term positive impacts on our healthcare system.

First Report of Agrobacterium rhizogenes-induced Hairy Root Formation in Selaginella bryopteris: a Pteridophyte Recalcitrant to Genetic Transformation

Abstract we report A. rhizogenes-induced hairy root formation in S. bryopteris, a medicinally and commercially important plant. A. rhizogenes strain LBA1334 co-cultivated with explants (root, rhizophore, stem portion near the root, and stem with intact fronds) for 24 and 48 h after transformation for induction of hairy roots. The induction of hairy root was observed after 6 days of infection in case of 48 h co-cultivation only. PCR with rolA and virC gene specific primers confirmed the induced hairy roots were due to Ri T-DNA integration and not due to contaminating A. rhizogenes. The root network as explants showed the maximum transformation efficiency. We tested different media like MS, SHFR (Stage Hog Fern Root) and KNOP's during transformation for hairy root induction. The SHFR based media showed good response in transformation as well as propagation. Further, transformation efficiency was enhanced by addition of TDZ (2 mg/L) and Bevistin (0.1%) in SHFR media. The present work would be helpful in hairy roots-based in vitro production of secondary metabolites and on aspect of functional genomics of S. bryopteris.

A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients

Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most common group prescribed was angiotensin receptor blocker (ARB) (29.45%) and ARB+CCB (calcium channel blockers) (34.92%) were the commonest fixed drug combination. Overall, it was amlodipine (21.47%) that was most frequently prescribed among all antihypertensive drugs.Conclusions: ARB was the most commonest class, ARB+CCB was the most frequent fixed drug combination prescribed to the study patient while amlodipine was the highly utilized individual antihypertensive drug in the study. Prescriptions evaluation revealed that 94.88% prescription were rational and were in accordance with the JNC-8 hypertension treatment guidelines except the use of beta blockers (5.12%).

Sonographic and Doppler Evaluation of Carotid Artery in Hypertension - A Correlative Study with Biochemical Parameters.

Introduction: Hypertension is an important cause of seriouscardiovascular diseases and premature mortality from suchdiseases. 80–95% of hypertensive patients are diagnosedas having “essential” hypertension. Hypertension plays animportant and critical role in atherosclerotic cardiovasculardisease. Increase in Intima-media thickness (IMT) of anartery has been used as a surrogate marker of the earlyatherosclerotic process. Duplex Sonography combining highresolution Imaging and Doppler spectrum analysis has provedto be a popular, noninvasive, accurate, cost effective meansof detecting and assessing carotid disease. The present crosssectional study was undertaken to assess the Carotid IMTchanges and associated changes in hypertensive patients usinghigh frequency ultrasound and color Doppler.Material and methods: This case control study was carried outat Aarupadai Veedu Medical College & Hospital, Pondicherryfrom September 1st 2016 to August 31st 2018(2years) withtotal of 100 cases (50 patients and 50 controls).Results: Out of 100 cases, we selected 50 hypertensivepatients aged above 50 years and 50 normotensive subjectsof same age group. In normotensives, 25 (50%) of patientswere between 55-60 years, and in hypertensives, 26 (52%) ofpatients were between 55-60 years. Mean of both right and leftCCA Intima Media Thickness (IMT) was significantly higherin hypertensive patients when comparing to normotensivepatients. The mean CCA Resistive Index (RI) wassignificantly higher in hypertensive patients when comparingto normotensive patients.Conclusion: High frequency ultrasound and Color Dopplercan be effectively used to study both IMT and RI of CCAtogether which are significantly increased in hypertensivepatients.

Green synthesis of acetohydroxamic acid by thermophilic amidase of Bacillus smithii IIIMB2907

Acetohydroxamic acid is a pharmaceutically active metal chelating agent which has various applications in the field of medicine. Current study focuses on the enzymatic synthesis of acetohydroxamic acid catalysed by thermophilic amidase from Bacillus smithii IIIMB2907. Bacterial cells were grown in 7 L fermenter for amidase production and effect of pH, temperature and substrate concentration for the biotransformation of acetamide to acetohydroxamic acid was studied. Batch reaction was also successfully optimized at bench scale with the recovery of ≈ 81% acetohydroxamic acid (purified).

Effect of ethanolic extract of Vitex negundo leaves on experimentally induced inflammatory bowel disease in albino rats

Background: Ulcerative colitis (UC) and Crohn’s disease (CD) are collectively known as inflammatory bowel disease (IBD). Pathophysiology of IBD is not known with certainty. Immunological processes and reactive oxygen species (ROS) have been proposed to contribute considerably to development of tissue injury. Some of the intestinal and/or colonic injury and dysfunction observed in IBD is due to elaboration of these reactive species. Commonly used drugs, in particular sulfasalazine and its active moiety 5-aminosalicylic acid, are potent ROS scavengers. The present study was carried out to evaluate the effect of ethanolic extract of Vitex negundo (EEVN) leaves on experimentally induced inflammatory bowel disease in albino rats.Methods: The rats were divided into four groups of six animals each. Group A and group B received gum acacia per orally, group C received EEVN in dose of 500 mg/kg/day per orally, and group D received 5-amino salicylic acid (5-ASA) in the dose of 100 mg/kg/day per orally. All the animals were pre-treated with respective drugs (volume of drugs was kept constant at 10 ml/kg) for five days, along with the normal diet. On fifth day animals were kept fasting for 12 hours (overnight) and IBD was induced next morning in Groups B, C and D by administration of one ml of 4% acetic acid solution transrectally (TR). Group A (normal control) received 0.9% normal saline transrectally (TR) instead.Results: The results have been shown that EEVN has significant activity against experimentally induced IBD when compared to the experimental control, with near normalization of colon architecture both macroscopically as well as microscopically. Tissue oxidative stress was reduced with significant improvement in tissue levels of superoxide dismutase (SOD) and catalase (CAT). Also, significant improvement in levels of myeloperoxidase (MPO) was observed.Conclusions: It is concluded that ethanolic extract of leaves of Vitex negundo has got potent activity against experimentally induced IBD due to its anti-inflammatory and anti-oxidant properties.

Comparison of Epidural and Spinal Anesthesia in Patients Undergoing C-Section

Caesarean section is the most common surgical procedure performed in India. Although it has been generally agreed that spinal anesthesia (SA) is the preferred anesthetic technique for Cesarean delivery (CD), epidural anesthesia is advised when an epidural catheter is already in place. However, the efficacy of epidural anesthesia has been reported as inferior to that of SA in both elective and emergency situations. Aim of the study: To compare epidural and spinal anesthesia in patients undergoing C-section. Methods: The study was conducted in the Department of Gynecology and Obstetrics and Department of Anaesthesia, Narayan Medical College and Hospital, Jamuhar, Sasaram, Bihar, India. For the study, patients scheduled for caesarian section were included. Patients who had malfunctioning epidural catheter or improper epidural placement or complicated pregnancy were excluded from the study. A total of 30 patients were included. A written informed consent was obtained from all the participants in the study. To include the patients in the study, it was made sure that they had physical status of I-II; full-term, singleton pregnancy. On the day of surgery, patients were advised to fast for at least 8 hours before the surgery. For the anesthesia, patients were randomly grouped into two groups, Group I and Group II. Patients in Group I was anesthetized with epidural anesthesia and patients in Group II were anesthetized with spinal anesthesia. Results: In the present study, a total of 30 patients were selected. Patients were randomly grouped into Group I and Group 2. The mean age in group 1 was 36.32 years and in group 2 was 35.11 years. The mean height in group 1 was 160.21 cm and in group 2 was 159.21 cm. The mean body weight was 71.11 kg in group 1 and was 70.26 kg in group 2. The Apgar scores at 1 min in Group I was 9.22 and in group II was 8.89. The Apgar scores at 5 min in Group I was 9.56 and in group II was 9.32. VAS pain scores on postoperative day 1 in Group 1 was 2.89 and in Group 2 was 3.16. Conclusion: From the present study, this can be concluded that the effect of anesthesia on the newborn in both the groups was similar and had no different effects.

A Study Of Obese Patients Admitted At A Tertiary Care Hospital

Introduction: Obesity is a chronic non-communicable disease, characterized by deposition of fat and adipose tissue resulting from the discrepancy between energy consumption and expenditure. Obesity is largely a lifestyle disease and its two largest causes are poor eating habits and inactivity.Aims: To study the demographic data, causes & associations of obesity with other disease processes and how emergency physicians should approach obese patients in the emergency department.Material & Method: This was a hospital-based, cross sectional observational study carried out over a period of one year from NOVEMBER 2017 to OCTOBER 2018.Result: Details about demographic data, risk factors, clinical presentation, co-morbid conditions and lipid profile & TSH level were collected & analyzed. In our study maximum no of obesity was seen in 41-60 yrs of age group & more common in females with dietary habits as the most common risk factor & HTN is the most common co-morbidities. Conclusion: The result in our study shows dietary habits and life style has a major role in obesity. Emergency physicians with good knowledge and specially equipped departments are helpful to decrease the morbidity and mortality.

Visual evoked potentials’ responses in hypothyroidism and hyperthyroidism

Background: Visual Evoked Potentials (VEP) provides important diagnostic and prognostic information regarding the functional integrity of the visual system. This study, describes the effects of less or excess thyroid hormones of adults in visual conduction that helps to know the progression to neurological functional defects.Methods: The study was done in 75 consenting subjects (hypothyroid = 24, hyperthyroid = 25, euthyroid = 26). The VEP parameters N75, P100, N145 latencies and its amplitudes within different thyroid status (hypothyroidism, hyperthyroidism and euthyroidism) were compared. One way ANOVA was used to compare VEP parameters among three groups and Pearson’s correlation to find relation between thyroid hormones and VEP parameters.Results: There was positive correlation of 0.335, 0.338 and 0.301 between amplitudes of N75, P100 and N145 waves and fT3 hormone respectively. Furthermore, fT4 showed a positive correlation of 0.186 and 0.185 with the wave amplitudes of N75 and N145 waves respectively and negative correlation of TSH levels of -0.492, -0.280, -0.397 with amplitudes of N75, P100, N145 waves respectively. Hyperthyroid group had higher in VEP latency than euthyroid group in N75 (73±5.77 vs. 68.54±4.32), P100 (106.42±9.74 vs. 100.94±8.17) and N145 (153.03±16.39 vs. 144.37±7.02) waves. Similarly, hypothyroid group had higher in VEP latency than euthyroid group in N75 (72.12±6.34 vs. 68.54±4.32) wave.Conclusions: Both hypothyroidism and hyperthyroidism led to conduction delay in adults, possibly adversely affecting function of myelin. The prominent visual evoked potential abnormalities in hyperthyroidism and less change in hypothyroidism show that the visual neuropathy is more common in hyperthyroidism.

Prevalence of Exercise-Induced Broncho- Constriction in Medical Students

Exercise-Induced Bronchoconstriction (EIB) is a transient acute narrowing of the airway which occurs as a result of exercise. EIB is common in children. The prevalence of EIB has been estimated to be 20% in general individuals without a known diagnosis of asthma. Eighty percent of all asthma individuals experience exercise-related symptoms (ERS). The purpose of this study was to investigate the prevalence of EIB in medical students using an exercise challenge test. Aims And Objectives – To study the prevalence of prevalence of EIB in medical student and to investigate the relationship between EIB and the history of asthma, history of ERS, allergy including rhinitis, atopic dermatitis, hay fever, allergies to food and animals. Methods: This study was done on medical student of NMCH, Jamuhar between January 2019 and March 2019. Medical students underwent exercise challenge test on bicycle -ergometry. Spirometry was performed a few minutes before and immediately after performance of the exercise. The criterion for a positive test was a greater than 10% decrease in FEV1 from the baseline measurement. Results: Total 188 students completed the study, out of which 24 came to be EIB positive. 17 had history of asthma of which 15 came to be EIB positive. 13 had history of ERS of which 11 came to be EIB positive. Conclusion: In our study prevalence of EIB came to be 12.7%. EIB in student having history of asthma came to be 88.2%. EIB in student having history of ERS came to be 84.6%.

MR imaging of primary malignant bone tumors with surgical and histopathological correlation

Background: A bone tumor is a neoplastic growth of tissue in bone. Abnormal growths found in the bone can be either benign (noncancerous) or malignant (cancerous). Aims and objectives: The purpose of this study was to evaluate the role of MRI in cases of primary malignant bone tumors and MRI characteristics of different primary malignant bone tumors, to compare the imaging findings with surgical and gross pathological findings, Staging of tumor on MRI, correlating them with operative and histopathological findings. Materials and methods: This was a prospective study done in Department of Radiodiagnosis of NRIGH comprising of 40 patients 21 male and 19 female who were suspected or proven cases of the malignant bone tumor. Plain radiographs in AP and Lateral views (including the adjacent joint) were taken in all cases. The primary pulse sequences included T1 and T2 WI using spine echo and gradient echo techniques with TR of 600 msec. and TE 30msec. for T1WI and TR of 2740 msec. and TE of 85 msec. for T2 WI . The MR morphology was correlated with surgical and histopathological features. Results: The study “Multiplanar MR Imaging of primary malignant bone tumors with surgical and histopathological correlation” comprised of 40 patients in a two year period starting from august 2010 to September 2012 the age ranged from 8 years to 71 years (mean 40 years). There were 21 males and 19 females. Conclusion: MRI in combination with plain radiography is an excellent modality for evaluation of the musculoskeletal pathologies especially differentiating a malignant from a benign lesion. The multiplanar imaging capabilities place a major role in delineation of tumour extent in to the bone and Karuna V, R Vikash Babu. MR imaging of primary malignant bone tumors with surgical and histopathological correlation. IAIM, 2019; 6(10): 8-21. Page 9 soft tissues with high contrast and resolution with additional information of neurovascular bundle involvement, joint involvement and staging.