Nutritional Status of Pre-School Children Attending Anganwadi Centres in Chittoor, Andhra Pradesh, India

Context/Background: Malnutrition among children is a major public health problem in India. The objective of the study is to assess the nutritional status of pre-school children and to identify the so-cio-demographic determinants of malnutrition. Methodology: In this community-based cross-sectional study, 194 under-five children were recruited from rural and urban areas of Chittoor district, Andhra Pradesh. Anthropometric measurements were measured and age standardized weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) were calculated. The proportion of under nutrition (WAZ <-2 standard deviation (SD)), stunt-ing (HAZ <-2SD), and wasting (WHZ <-2SD) were calculated along with the determinants. Results: The mean age of the participants was 40.5 months (SD- 9.1 months), 101 (52.1%) were from rural areas, and 96 (495%) females. The HAZ values were significantly low in- urban children (-0.81; 95%CI: -0.4, -1.21), among the non-Hindu children (-0.92; 95%CI: -0.35, -1.5). The overall prevalence of underweight, stunting, and wasting were- 13.4% (95%CI: 8.5%, 18.3%), 23.7% (95%CI: 17.6%, 29.8%), and 19.6% (95%CI: 11.9%, 25.3%) respectively. Urban residence (OR 6.75; 95% CI: 3.03 – 15.04) was a strong predictor of stunting. Conclusion: Malnutrition remains to be a public health problem in this area. Strengthening of existing programs should be the key strategy in combating malnutrition.

Rhinosporidioma: Primary Cutaneous Rhinosporidiosis - A Rare Case Report.

Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. Rhinosporidium seeberi causes granulomatous inflammation of mucocutaneous sites, presenting most frequently as polypoidal lesions in the nose. Sites like the conjunctiva, trachea, nasopharnyx, skin, and genitourinary tract are less frequently involved. Primary cutaneous lesion is extremely rare and it is often mistaken for soft-tissue tumour. We present a case of 55 years male patient from Thanjavur, Tamilnadu, with primary cutaneous rhinosporidiosis without mucosal involvement.

Al-Amal Al-Ehteqan [the enemata] an ancient way of complementary treatment

Enemata are the liquid preparations that are injected into the rectum and colon through anus. They are either intended to be returned or to be retained into the colon. Enema is an excellent treatment for removing superfluous matter from the bowels. It is the treatment of choice for intestinal colic. That's why it is called as Moalijah Al Fazilah [the Superfluous Therapy]. It allays pain and inflammation of the bowels, kidney, bladder and other pelvic organs. Enemas have been in practice from ancient time and helped to cure a lot of disorders like constipation, poisoning, acute headache, flu, common cold, meningitis, measles and many more. On the other hand enemas were largely practiced for many other therapeutic and diagnostic purposes also. Classical literature of Unani medicine describes enema in a scientific manner. Our ancestors had an ensuring experience in treating various kinds of disorders by this simple way. Unani scholars have mentioned even adiposgenous [Fattening] and aphrodisiac enemata. As per the necessities in the medical field enema has many types according to their mode of actions

Disease patterns and outcomes of neonatal admissions at a secondary care hospital in Pakistan

This study aimed to determine the disease patterns and outcome of patients admitted to the neonatal unit of a secondary care hospital in Pakistan from January to December 2009. Retrospective data from the medical records of all neonates admitted during the study period were reviewed and analysed for age, weight, sex, reason for admission, duration of hospital stay, diagnosis and final outcome. Trends were examined to identify the indicators of inpatient neonatal deaths. The total number of neonates admitted during the study period was 1,554; 979 were male [63%], and 575 were female [37%]. A total of 891 patients [57.3%] were born in the hospital while 663 [42.7%] were born elsewhere. The majority were admitted during the first 24 hours of life [51.3%]. A total of 13 patients [0.8%] weighed <1 Kg; 85 [5.4%] weighed 1-1.49 Kg, and 587 [37.7%] between 1.5-2.5 Kg. Prematurity and infection were the main reasons for admission [27.9% and 20.33%, respectively], followed by birth asphyxia [13%] and neonatal jaundice [11.3%]. A total of 1,287 patients [82.8%] were discharged, 41 left against medical advice [2.6%], 59 were referred to tertiary care hospitals [3.79%] and 106 [6.8%] died. Prematurity, low birth weight, birth asphyxia and neonatal jaundice were the major causes of neonatal admissions. This could be reduced by appropriate antenatal care, timely intervention, and in-time referral to tertiary care centres for the deliveries of all high-risk pregnancies. The major cause of neonatal mortality was prematurity

Lymphoepithelioma-like carcinoma of the urinary bladder: report of a rare case

Lymphoepithelioma-like carcinoma [LELC] is a rare malignant neoplasm in the urinary bladder, which can histologically mimic lymphoma, poorly differentiated invasive transitional cell carcinoma or poorly differentiated squamous cell carcinoma with a lymphoplasmacytic background. A urinary bladder tumor was identified in a 65-year-old man suffering from hematuria for several weeks. Transurethral biopsy revealed an undifferentiated tumor with prominent lymphocytes and plasma cell infiltration. Immunohistochemical evaluation showed positive staining for cytokeratin and epithelial membrane antigen. Subsequent radical cystectomy showed pure LELC. We present the case to highlight the significance of recognizing this unusual bladder tumor and discuss the important differential diagnosis, treatment options and prognosis

How to decrease the emotional impact of cadaver dissection in medical students

Teaching of anatomy is based on cadaver dissection. Working with cadavers whether through active dissection or by examination of prosected specimens, constitutes a potential stressor in medical education. To reduce the anxiety level by mentally preparing the student before going to the dissection hall. Two questionnaires were distributed among 68 medical students. The pre-dissection questionnaire No.1 comprised questions relating to demographics and first encounter with a cadaver.Then all the students were randomly divided into experimental and control groups.The experimental group was prepared psychologically prior to dissection but the control group had no such preparation. After the first dissection class all the students were surveyed by questionnaire No.2 which included physical and cognitive symptoms of anxiety, resulting from exposure to the dissection room at the first visit and six weeks later. There was a significant difference p<0.05 in the rate of anxiety between experimental and control group in the initial visit. The difference in the rate of anxiety between the first exposure and six weeks later was significant in control group [p<0.008], while it was not significant in experimental group. The initial preparation could relatively reduce the rate of stress, so that the experimental group experience less emotional effects during dissection compared to control group

Effects and a dose response relationship of physical activity to high density lipoprotein cholesterol and body mass index among Saudis

The objective of our study was to examine the effects and a dose response relationship of physical activity on plasma high density lipoprotein cholesterol [HDL-C] levels and body mass index [BMI] among Saudi men and women living in the metropolis of Riyadh, Kingdom of Saudi Arabia [KSA]. The sample population of 474 Saudi men and women visiting the health centers in and around Riyadh was studied from September 2003 to February 2004. The population was classified in 4 physical activity groups on the basis of frequency [F], intensity [I] and time [T] of exercise. The F, I and T value was calculated by multiplying the scores of 3 parameters. Plasma HDL-C and BMI were measured and the association of HDL-C and BMI with all 4 levels of physical activity, sedentary, light, moderate and heavy were calculated applying Pearsons correlation coefficient. We found that the sedentary Saudi men had mean HDL-C levels of 0.65 +/- 0.25 and BMI of 28.7 while women had 0.70 +/- 0.22 HDL-C levels and 31.06 BMI. The moderate and heavy physical activity showed an increase of 53-92% and 44.2-95% in the HDL-C levels in both men and women. The physical activity had a strong association to HDL-C and an inverse association to BMI. The substantial increase in the levels of plasma HDL-C and a moderate reduction in BMI is seen in men and women who are at moderate and heavy physical activity status, however the HDL-C level does not reach to the coronary heart disease protective level, if not combined with proper dieting. A health awareness program is urgently needed at the primary care level in KSA to educate people regarding the significance of physical activity and proper diet

Bone and renal stone disease in patients operated for primary hyperparathyroidism in Pakistan: is the pattern of disease different from the west?

OBJECTIVE: To document the clinical presentation of primary hyperparathyroidism [PHPT] in a developing country and note differences from the West. SETTING: A tertiary care teaching hospital. METHOD: The records of 37 patients operated for PHPT between January 1986 and December 1997 were reviewed. Symptoms, laboratory parameters and histopathology results were analyzed. Surgery for PHPT accounted for 0.055% of 67,566 operative procedures performed in the Department of Surgery during the 12 year period. The mean age of our patients was 38.4 +/- 13.2 years [range 17 to 73 years]. Ninety% of patients were less than 60 years old and 51% less than 40 years. At presentation, the mean serum parathyroid hormone [sPTH] level was 618 +/- 741% above the upper limit of normal [range 0-2900% using a variety of assays]. A solitary adenoma was present in 86.5%, hyperplasia in 5.4% and carcinoma in 5.4% of patients. There was one [2.7%] negative exploration. Thirty-five% of patients had renal stone disease [StD], 32.4% had bone disease alone [BD] and 27% had both bone abnormality and stones [BStD]. There were neither bone disease nor stones in 5.4% of patients. BD was associated with a statistically non-significantly [p = 0.08] higher alkaline phosphatase level [sALP] as compared to the StD and BStD groups. The mean urinary calcium [Ca] was higher in the BD group [482 +/- 340 mg/24 hours] as compared to StD group [265 +/- 89 mg/24 hours] [p = 0.013]. The post-operative hospital stay was longer in the BD group [14.4 +/- 16 days] as compared to the StD group [6.7 +/- 3.7 days] [p = 0.001]. As compared to reports from the Western world, PHPT is less commonly diagnosed in our country and occurs at a younger age. In the absence of a screening programme, symptomatic disease and bone involvement occur more frequently. The high levels of PTH may indicate long-standing disease in our population, which may account for higher proportion of patients with symptoms. Unexpectedly, patients with bone disease had higher levels of urinary calcium than patients with stone disease