The study of computed tomography angiography in the evaluation of acute stroke

Background: When it comes to residual lumen diameters and areas, calcifications, and stenose length, computed tomography angiography (CTA) offers genuinely anatomic, non-flow dependent information. Compared to traditional catheter arteriography, CTA is less costly, causes less discomfort to patients, and has a significantly lower risk of stroke and other vascular complications. Additionally, it is helpful when performing magnetic resonance (MR) is not recommended or is not possible. Generally speaking, CTA is more accessible than MR, particularly in emergency situations. As there are no limitations on the kind and quantity of related support equipment, such as intravenous pumps, ventilators, or monitoring hardware, CTA, in contrast to MR angiography (MRA), is well suited for the imaging of critically ill patients. Our goal was to assess how useful CT angiography is for determining the etiology of vessel occlusion and stroke. Methods: Non enhancing CT scan of all patients was evaluated first for significant findings, after that contrast enhanced scan was evaluated and compared with non-enhancing CT scan. Direct volume rendering (dVR) is the most sophisticated method for 3D visualization. When dVR is used to create CT angiograms, the voxels of high attenuation containing information about bony structures are selected separately from those voxels with an attenuation between 100 and 300 HU containing information about contrast- enhanced vascular structures. Results: We observed sensitivity of CTA in evaluation of acute stroke as 93.33%, specificity 80%, positive predictive value (PPV) 87.5% and negative predictive value (NPV) 88.88%. Conclusions: CT angiography, when closely correlated with patients’ clinical conditions, has the potential to become the screening method of choice for evaluating patients with significant vascular lesions amenable to acute intracranial transcatheter thrombolytic therapy.

Breast self-examination: knowledge, awareness, and practices among females of reproductive age group

Background: Breast cancer occurs in an observable organ, thus awareness regarding its symptoms can help in its early detection and treatment. Although breast self-examination (BSE) is an old technique, evidence reveals many of females are not aware regarding this, and those with knowledge about breast cancer examination either fail to practice it or do so incorrectly. Methods: It was a cross-sectional exploratory survey. 505 females attending outpatient department (OPD) at selected tertiary care hospital were recruited in the study using simple random sampling. Each participant was given a set of validated questionnaires to answer. The questionnaire was designed to obtain information regarding socio demographic data, knowledge, awareness, and practice regarding BSE. All data were coded, validated, and analyzed utilizing both descriptive and inferential statistics techniques. Results: The study revealed that the largest proportion (42.06%) of subjects fell within the age range of 20-30 years. Total mean score of knowledge and awareness regarding breast self-examination was 9.68±3.5. Maximum 58.42% of the subjects had average knowledge and awareness followed by 23.96% having good knowledge and awareness and least (17.62%) had poor knowledge and awareness regarding BSE. Almost half i.e., 50.49% (255) of participants reported to perform BSE and 49.51% of participants had never practiced BSE. Conclusions: The study revealed that while participants had average knowledge levels, they showed low involvement in routine BSE. This underscores the need for educational interventions to promote BSE practices, identify risk factors and warning signs, and encourage early-stage management of breast cancer, ultimately contributing to primary prevention in healthcare.

Rapunzel syndrome and gastric Peutz Jeghers (hamartomatous) polyps: case report

Rapunzel syndrome is an extremely rare complication of a trichobezoar. These females have a history of trichophagia and trichotillomania. Peutz Jeghers syndrome (PJS) is an uncommon autosomal dominant syndrome with a variable to high penetrance that leads to the development of the polyps within the gastrointestinal mucosa. This case report of a 25-year-old deaf and dumb female presented with pain and lump in upper abdomen, vomiting, nausea, loss of appetite, loss of weight. An exploratory laparotomy with anterior gastrotomy was performed and a giant trichobezoar with tail extending into the duodenum was removed. There were multiple polyps in the lower stomach excised. Histopathology reports showed Peutz Jeghers (hamartomatous polyps). She recovered well and was discharged on the 10th day. Patient was advised regular follow up.

Influence of Different Plant Growth Regulators and Boron on Growth, Yield and Sex Expression of Bottle Gourd (Lagenaria siceraria Mol.) under Garhwal Valley

The present investigation was carried out at Horticultural Research Centre, Department of Horticulture, H. N. B. Garhwal University, Uttarakhand, India during summer season, 2018-19. The existing experiment was laid out in randomized block design following 13 treatments replicated thrice. The various growth parameters as well as yield attributes and yield were recorded during the experimentation. The result of the present investigation showed that GA3 @ 50 mg/kg was registered as the best treatment in terms of vine length (376.13 cm), fruits per vine (6.60), sex ratio (F:M) 1:11.07 and yield per vine (1357.33 g) and NAA @ 200 mg/kg+ Boron @ 0.1% with relation to the number of main branches per vine (10.87), length of fruit (24.57 cm), diameter of fruit (90.10 mm), yield per plot (10.29 kg/plot) and yield per hectare (457.33 q) in bottle gourd. However, GA3 @ 50 mg/kg+ Boron @ 0.1% number of node per vine (24.27), number of node bearing first flower GA3 50 @ mg/kg(4.20) and NAA @ 150 mg/kg(4.20), weight of fruit NAA @ 100 mg/kg+ Boron @ 0.1% (838.0 g) , total soluble solid GA3 @ 30 mg/kg(5.04 ºBrix) and NAA @ 200 mg/kg ascorbic acid (12.90 mg/100g). The cultivar (Pusa Naveen) gives better response with the application of GA3 @ 50 mg/kg for sex expression and NAA @ 200 mg/kg+ Boron @ 0.1% for various growth and yield parameters. It can be recommended to enhance the production of bottle gourd under Garhwal valley of Uttarakhand.

Effect of Fertility Levels and Boron on the Development and Production of Cauliflower

A field experiment consisting five levels of fertility and four levels of boron in RBD with three replications was conducted at Horticulture Farm, SKNAU, (Jaipur) during Rabi season. The findings showed that different levels of fertility used to have a significant impact on the growth, yield of cauliflower. Plant height at 30 and 60 DAT, the number of leaves per plant at 30 and 60 DAT and leaf area were all highest when 75% RDF through inorganic fertilizers and 25% RDF through vermicompost were applied. Also, it was found that the application of 50% RDF using inorganic fertilizers and 50% RDF through vermicompost treatment resulted in the highest curd yield per plot and curd yield per ha (190.89 q/ha).

Informed consent in psychiatry outpatients

Background & objectives: Comprehension and process of consent are important for persons with mental illness as they may not be impaired in considering research participation. The American Psychiatric Association developed a detailed Cultural Formulation Interview (CFI). The present study was a part of field testing of CFI, aimed to standardize cultural information affecting the patients' management in India. This paper describes the process and conclusions from the consent-seeking process of this study. Methods: The purpose and procedures about field trial of the CFI were introduced and the patient and caregiver were requested for participation. Consent process was carried out step by step, by reading out the consent form to the first new patient of the day in the psychiatry outpatients department of a tertiary care hospital in north India, inviting questions followed by the 'comprehension' questions. The entire process was audiotaped without any personal identifiers. The process was repeated if not comprehended. Results: A total of 67 patients consented, 11 refused and majority were educated more than secondary school. Some concerns shown by the patients and caregivers included risk of participation, loss or benefits of participation, privacy, etc. All types of mentally ill patients participated in the study. Interpretation & conclusions: Translations of consent forms used simple words, consonant with understanding of the potential participants. Patients' belief that participating in this long process would improve their care, and serve humanity, influenced their decision to participate. Except for intoxication and severe psychosis, patients could understand and comprehend issues around consent. Main issues were confidentiality and culture. Our experience in the psychiatry OPD refutes the commonly held belief that mentally ill persons lack comprehension and ability to consent.

Status of Female Adolescents Living at Rajshahi Slum in Bangladesh.

Objective: To avoid the social consequences of unplanned pregnancy, transmission of STIs and HIV/AIDS, adolescents need to be awaked of their reproductive health. That is why; the study is aimed to know the present status of adolescents in terms of socio-demographic and menstrual management status living in slum areas of Rajshahi City Corporation (RCC), Bangladesh. Materials and methods: The data for this study were collected purposively in 2012 from 200 girls aged 10-19 who were slum living at RCC using a pre-designed questionnaire. The purpose and importance of this study were explained to the respondents before participating in this study. Results and discussion: The result showed that 64% of the respondents were in the group of 18-19 years. Around 9.5% of the adolescents had never gone to school. The maintenance of hygiene during menstruation is a vital aspect of adolescent reproductive health. But the result showed that about 94% of the respondents answered that they do not know the underlying reasons for what menstruation occurred. Only 5% of the respondents maintained some form of hygiene measurements (pad or clean cloth) during the onset of their menstruation. The result also indicated that 24.5% of the respondents felt physical illnesses during their menstruation. Conclusion: The authority should commit to ensuring that the needs, challenges, aspirations, vulnerabilities and rights of adolescents, especially for girls, are fully considered in this new development agenda. Keeping this in mind, adolescent friendly health services should be ensured by arranging special hours or special days for them, orienting and providing training to healthcare providers on how to counsel adolescents.

Study On Harmful Effects Of Opium On Liver And Lungs In Chronic Opium Addicts Of Western Rajasthan.

Background: Today opium dependence is widely prevalent in certain states of India, especially Rajasthan, Punjab, Haryana, Madhya Pradesh (MP) etc. In rural areas of western Rajasthan crude opium is consumed with a social acceptance by a notable proportion (8.0%) of adult male population. Later on they become addicted to it. Objective: to observe the changes in some liver and lung function parameters in opium addicted subjects of Barmer city of Western Rajasthan. Methods:The present study was conducted in district hospital of Barmer, Rajasthan. Total fifty (50) adult male subjects with age ranged from 30 to 50 years were participated in this study. Among them 25 were opium addicted and were considered as study group (Group B) and another 25 apparently healthy adult male of same age group were designated as control group (Group A). Opium addicts were consuming about 5–11 gm/day opium for >2 years. Then liver function tests were evaluated by estimating serum aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase and lung function tests by measuring FVC, FEV1 , FEV1/FVC% , PEF, FEF 25-75% of both the groups. Results: In this study AST, ALT and alkaline phosphatase levels were found significantly (p<.05) higher in group B as compared to those of group A. Again, FVC, FEV1, FEV1/ FVC were significantly (p<.05) lower in group B as compared to those of group A. PEF (L/sec) and FEF25-75% were also significantly (p<0.001) lower in group B as compared to those of group A. Conclusion: it is concluded that chronic long term use of opium, increases the risk of hepatic and pulmonary damage.

Vernal keratoconjunctivitis: modes of presentation in Nepalese population.

OBJECTIVE: To determine pattern of clinical presentation in Vernal Keratoconjunctivitis (VKC) in our context. METHODS: Thirty-four VKC patients were included in this study. RESULTS: The study revealed prepubertal onset with male preponderance and most frequently encountered symptom in the study among VKC cases was itching (100%) followed by redness of eyes and discharge (76.5% each) and the commonest sign was tarsal papillae (100%) followed by conjunctival hyperemia (91%) in 68 eyes of 34 cases of VKC. CONCLUSION: The clinical presentation of VKC cases in our country is very much similar to the findings of other parts of the world.

Gastric teratoma in infants--a report of two cases.

Gastric teratoma is an exceeding rare lesion seen most often in male infants. Two cases of gastric teratoma, the first in a three and half month male, and the second in a one year old male child are reported. In the first case, the tumour was more solid, while in the second case it was a solid-cystic mass. These two cases represent the additions to the few, limited, known gastric teratomas reported in the world literature.

Patterns of immunoglobulins in the serum of leprosy patients.

There have been considerable variations in the levels of immunoglobulins in the serum of leprosy patients which needed elucidation. An attempt has been made in this direction to find out the levels of IgG, IgM and IgA in the serum samples of 145 cases of various grades of leprosy. The patients were selected in the age group of 11 to 60 years and have received treatment with DDS from a period ranging from 6 months to 5 years. A constant increase in the levels of immunoglobulins has been noted and the effect of treatment over variation in the levels has been discussed.