THE PREVALENCE OF THYROID HORMONES DISORDER IN TERTIARY CARE CENTRE, GWALIOR WITH SPECIAL REFERENCE TO ANTENATAL CASES

Multiple studies had been conducted world wide on the prevalence of thyroid hormone disorder in past and recent years. Hypothyroidism during pregnancy is also very common affecting both mother and foetus. A prospective study is conducted in department of pathology, GRMC Gwalior including 1554 patient with symptoms and previous history and analysed by SNIBE MAGLUMI series fully automated ChemiluminescenceImmunoassay analyzer (Clia) for the quantitative determination of thyroid hormone profile. Out of 1554 patients, prevalence of thyroid hormone disorders discussed separately in 1271 cases and 283 antenatal cases. Among 1271 patients, prevalence of thyroid hormone disorder is 32.9% where as 67.1% were euthyroid with higher prevalence of hypothyroidism (26.3%) than hyperthyroidism (6.6%). Females are affected more than male (7:1) and most commonly affected age group is 20 to 39 years. Prevalence of primary, secondary and subclinical hypothyroidism were 4.16%, 2.04% and 20.06% respectively where as in case of hyperthyroidism were 0.94%. 5.43% and 0.23% respectively. Antenatal cases shows 33.6% prevalence of hypothyroidism and 0.4% prevalence of hyperthyroidism. Women in first trimester shows maximum prevalence of 15.9% including 15.55% hypothyroidism and 0.35% hyperthyroidism followed by 9.9% and 8.13% prevalence of hypothyroidism in second and third trimester respectively. Our study conclude that prevalence of thyroid hormone disorders are increasing with recent advances and time and further evaluation is needed to rule out the cause behind increasing trends

To Study the Effect of Antiepileptic Drugs on Serum Alkaline Phosphatase Levels in the Epileptic Patients

Epilepsy is treated with anti-epileptic drugs (AEDs) mainly in most of the patients. AEDs are to be initiated after having 2 seizures within a 6-month period. These have been observed to be associated with an increased frequency of hypocalcemia, hypophosphataemia, elevated serum alkaline phosphatase activity, reduced 25-hydroxy Vitamin-D concentrations, and decreased bone mass in patients receiving long term therapy. It is also observed that duration of AED therapy was the most important contributing factor for the alterations of these biochemical parameters. Objective: To study the effect of antiepileptic drugs on serum alkaline phosphatase levels in epileptic patients and to compare the relationship of change with duration of drug intake. Study Design: A Case Control Prospective Study. Methods: A total number of 100 subjects presenting with epilepsy in the OPD of Neurology department of Guru Nanak Dev Hospital, attached to Government Medical College Amritsar, were selected. Results: 50 epileptic patients taking Antiepileptic Drugs for more than 6 months constituted case group and 50 epileptic patients not taking Antiepileptic Drugs constituted control group. The study group patients were further divided according to duration of drug intake. Conclusion: AEDs causes significant increase in Alkaline phosphatase levels and this increase is further related to duration of drug intake.

Effect of Antiepileptic Drugs on Thyroid Profile in Patients of Epilepsy

Antiepilectic drug is the main stay of treatment for most patients with epilepsy. These may cause Patients with epilepsy are often required to take antiepileptic drugs (AEDs) for a long period of time. However, prolonged use of AEDs is known to be associated with adverse effects such as metabolic and organ toxicity, endocrine disturbance, negative cognitive effects, and psychiatric problems; particularly with alterations in thyroid function in patients with epilepsy and is thought to correlate with type of AED taken. Objective: To study the effect of antiepileptic drugs on serum thyroid profile in epileptic patients and to compare the relationship of change with type of drug intake. Study Design: A Case Control Prospective Study. Methods: A total number of 80 subjects presenting with epilepsy in the OPD of Medicine of Guru Nanak Dev Hospital, attached to Government Medical College Amritsar, were selected. 40 epileptic patients taking Antiepileptic Drugs for a minimum period of 1 year constituted case group and 40 normal healthy individuals constituted control group. They were again divided according to type of drug intake. Results: AEDs causes significant increase in TSH levels and this increase is further related to type of drug intake. Conclusion: ?

Screening of flavonoids rich fractions of three Indian medicinal plants used for the management of liver diseases

ABSTRACTThe decoctions of the Butea monosperma (Lam.) Taub., Fabaceae, Bauhinia variegata L., Fabaceae, and Ocimum gratissimum L., Lamiaceae, are traditionally used for the treatment of various types of hepatic disorder. Phytochemical studies have shown that total flavonoids from these plants were the major constituents of the picked out part of each plant. The present study was planned to investigate the hepatoprotective effect of flavonoid rich fractions of the B. monosperma, B. variegata and O. gratissimum against paracetamol induced liver damage. Flavonoid rich fractions were isolated by solvent fractionation from each plant. Each fraction was subjected to various qualitative chemical tests to findout the metabolites. Flavonoid fractions of each plant were subjected for pharmacological screening. The rats were monitored for change in liver morphology, biochemical parameters like serum glutamate pyruvate transaminase, serum glutamate oxaloacetate transaminase, alkaline phosphatase and total bilirubin for the groups receiving the flavonoid-rich fractions. All flavonoid rich fractions showed significant hepatoprotective activity. The histological studies supported the biochemical parameters. From the results of biochemical analysis and histopathological studies, it can be accomplished that in the ethyl acetate fraction of O. gratissimum showed highest hepatoprotective activity as compared to other fractions. The present study was the first evidence of flavonoid-rich fractions of each plant have a remarkable hepatoprotective effect. All fractions contain a potent hepatoprotective agent suggested to be a flavone, which may find clinical application in amelioration of paracetamol-induced liver damage.

Visceral Leishmaniasis (Kala Azar) Elimination from Indian Sub-continent by 2015.

Objective: To review the progress towards the goal of elimination of visceral leishmaniasis (Kala azar) from the Indian sub-continent by 2015. Method: Both electronic and print databases were searched for studies related to Kala azar. Finding: The burden of Kala azar is grossly underestimated by the health systems in the Indian sub-continent due to over-reliance on passive surveillance. Poly-parasitism and co-infections are the major emerging problems in the world of Kala azar. Resistance has been reported for DDT indoor residual spraying. Treatment drugs are not ideal, and supplies of these drugs are irregular as well. Conclusion: Achievement of elimination of Kala azar from Indian sub-continent is still unpredictable. To improve the elimination of Kala azar it should be classified as a notifiable disease. There is a need to refocus current strategies and monitor the program more closely. Furthermore, there is a need to assess alternative vector control methods. Policies to control Kala azar will have to include health education and behaviour change. Kala azar may not affect the national economy or the national GDP, but it devastates the families affected.

PCNL - a comparative study in nonoperated and in previously operated (open nephrolithotomy/pyelolithotomy) patients - a single-surgeon experience

PURPOSE: Re-procedure in patients with history of open stone surgery is usually challenging due to the alteration in the retroperitoneal anatomy. The aim of this study was to determine the possible impact of open renal surgery on the efficacy and morbidity of subsequent percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: From March 2009 until September 2010, 120 patients underwent PCNL. Of these, 20 patients were excluded (tubeless or bilateral simultaneous PCNL). Of the remaining 100, 55 primary patients were categorized as Group 1 and the remaining (previous open nephrolithotomy) as Group 2. Standard preoperative evaluation was carried out prior to intervention, Statistical analysis was performed using SPSS v. 11 with the chi-square test, independent samples t-test, and Mann-Whitney U test. A p-value < 0.05 was taken as statistically significant. RESULTS: Both groups were similar in demographic profile and stone burden. Attempts to access the PCS was less in Group 1 compared to Group 2 (1.2 + 1 2 vs 3 + 1.3 respectively) and this was statistically significant (p < 0.04). However, the mean operative time between the two groups was not statistically significant (p = 0.44). Blood transfusion rate was comparable in the two groups (p = 0.24). One patient in Group 2 developed hemothorax following a supra-11th puncture. Remaining complications were comparable in both groups. CONCLUSION: Patients with past history of renal stone surgery may need more attempts to access the pelvicaliceal system and have difficulty in tract dilation secondary to retroperitoneal scarring. But overall morbidity and efficacy is same in both groups.

Epidural Analgesia in High Risk Patients During Labour.

In this prospective observational study, 28 high risk patients were analyzed after giving epidural analgesia (EA) for labor pain relief over a period of 3 years. 5 cc Bupivacaine (0.125%) + 1 cc Fentanyl (10 mcg) were given and the maternal pain relief and fetal outcome were analyzed. Onset time of analgesia and level of analgesia was assessed by pin prick method.21 patients were primigravidae. 15 patients had a single risk factor while 13 patients had 2 risk factors affecting simultaneously. Pregnancy Induced Hypertension (PIH) was the commonest high risk condition occurring in 20 patients. Average analgesia onset time was 7.8 minutes. Analgesia lasted for > 2 hrs after administration of first dose in 23 patients. Rate of LSCS was 7.1% (2 patients) and instrumental delivery was 14.2 % (4 patients). 24 babies had an Apgar score of >/= 7. Complete pain relief was observed in 10 patients while 16 had moderate, 1 had slight and 1 had no pain relief. No major maternal or fetal complications were reported. EA is a very safe and effective form of analgesia in the interest of maternal and fetal welfare not only in normal pregnant gravidas, but also in high risk patients.

Amplification of rat microsatellite loci in Mastomys coucha Smith, 1836.

The multimammate rat M. coucha is the most widespread strain to be introduced in biomedical research and various stocks of this strain are maintained in laboratories across the globe. It is an ideal carrier of normally non-human disease to the domestic environment. In order to analyze genetic purity, strains of M. coucha were subjected to PCR-based DNA fingerprinting using sequence tagged microsatellite markers to evolve molecular signature to them. For this, 10 rats sequenced tagged microsatellite markers were used to investigate for their applicability of cross-species amplification in the genome of M. coucha. Out of 10 microsatellite primers tested, four (40%) microsatellite primer pairs [Carboxypeptidase B (CBP), Calmodulin (CALM3), Cell surface protein (CSPMO2) and Insulin like growth factor-I (IGF-1)] could be amplified successfully with exact with product size of 159, 145, 186 and 203 bps respectively in rat. The results suggest that since the above mentioned microsatellite primers get amplified successfully in M. coucha, they may be useful for genetic characterization, evaluation, strain improvement and biomedical research.

Serum surfactant protein-A levels in chronic bronchitis and its relation to smoking.

BACKGROUND: Surfactant protein-A (SP-A), which is an important constituent of natural surfactant, occurs physiologically in small amounts in blood. Tobacco smoke induces increased alveolo-capillary leakage of surfactant proteins into blood and its level in blood may help in the assessment of lung injury caused by smoke. Little is known on the SP-A levels in patients with chronic obstructive pulmonary disease (COPD). METHODS: Prospective analytical study of 30 patients with clinical diagnosis of chronic bronchitis, which was made on the basis of symptoms, signs and chest radiographic findings. Serum SP-A and serum cotinine levels were measured. RESULTS: Out of 30 patients, 21 were smokers and nine were non-smokers. The serum SP-A level in smokers with chronic bronchitis is significantly higher than the non-smokers. The plasma cotinine levels are also high in smokers. However, there was no correlation between the serum SP-A level and plasma cotinine level (r=0.044). Serum SP-A levels were related to age in smokers (r=0.566, p<0.01) but not in non-smokers with chronic bronchitis (r=0.017, p>0.05). CONCLUSION: The increase in SP-A level in smokers with chronic bronchitis suggests that tobacco smoking causes a chronic increase in permeability of the lung parenchyma. The SP-A, a lung-specific secretory protein, is a potential marker for non-invasive assessment of the integrity of the lung epithelium. Further studies are required to find out whether SP-A can be used as a marker for early identification of smokers who are at risk of COPD.