Ruptured Splenic Abscess with Pneumoperitoneum: A Rare Presentation

Splenic abscess is a rare entity encountered during clinical practice, with a high mortality rate. Formation of gas in splenic abscess is usually localized to the left upper quadrant of the abdomen. Here we report a case where the splenic abscess ruptured and presented with generalized peritonitis. The erect chest radiograph showed free air under the right dome of the diaphragm, thus masquerading a hollow viscera perforation (most common cause of pneumoperitoneum).

Narcissism Of School Students In Relation To Their Self-Compassion And Social Loafing

The study was conducted to explore the relationship of narcissism with social loafing and self-compassion. The study was conducted on 200 government school students.The Narcissism scale was developed by the researchers, Social Loafing Scale (SLS) by Q.G. Alam and Ramji Srivastava (2008) and Self-compassion Scale (SCS) by Kristin Neff (2003) were used to collect the data. The results revealed a no significant gender differences in narcissism of school students. But there were significant locale wise differences in narcissism among school students. It was also found that there is a significant positive relationship of narcissism with both self-compassion and social loafing.

Narcissism Of School Students In Relation To Their Meta-Cognition And Demographic Variables

The study was conducted to explore the relationship of narcissism with meta-cognition and demographic variable. The study was conducted on 200 government school students. The Narcissism scale was developed by the researchers and Meta-Cognition scale by Mubarak Singh and Ana Bali (2017) were used to collect the data. A separate sheet was given to the students to fill their demographic information. The results revealed a significant locale and category wise difference in narcissism of school students. But there was no significant difference in narcissism scores among school students in relation to their parental education and parental income. It was also found that there is a significant positive relationship between narcissism and meta-cognition.

Management Of Comminuted Tibial Diaphyseal Fractures By Means Of Interlocking Nails

Introduction:This study assesses the outcome of interlocking tibia nail in comminuted fractures of tibial diaphysis. Objectives: To study the functional outcomes of interlocking tibia nail in comminuted tibial diaphyseal fractures, with respect to time to bony union, mobility achieved, complications of the procedure and secondary procedures. Material and Methods: The present prospective study included 25 patients of comminuted fracture shaft of tibia admitted to the Department of Orthopaedics at MMIMSR, Mullana and at Civil Hospital, Rajpura who were managed with interlocking tibia nail. Results:All 25 cases united with interlocking nailing. 1 case needed additional exchange nailing and bone grafting. 3 cases had a malunion but had an acceptable functional outcome. Conclusions: Due to the simple surgical technique, good healing rate and minimum complications, it is recommended that interlocking tibia nail should be used in comminuted fractures of tibial diaphysis

Development and Introduction of Module on Medical Ethics in Patient Care To 2nd Professional MBBS Students

Background: There is complete absence of teaching of ethicsas a part of medical curriculum. There is now an urgent need toteach ethics to medical graduates in India because ofincreasing incidence of disconnect between doctors andpatients leading to allegations like unethical treatment practicesby doctors and use of force by patients and relatives againstdoctors. Medical Council of India (MCI) has also realized theurgency to impart the training of ethics to medical graduates inIndia as described in its Vision-2015 document.Aim and Objectives: To develop a module on “Medical Ethicsin patient care” and to assess its feasibility.Methodology: The study was conducted in the Department ofPharmacology, Gian Sagar Medical College and Hospital,Punjab from the period of March 2017 to December, 2017 afterIEC approval. The topics to be covered in the module forteaching “Medical ethics in patient care” were finalized throughFocus Group Discussions (FGDs) with the core faculty and themembers of Medical Education Unit (MEU). A module forteaching Medical ethics in patient care was developed. Modulewas of 10 hours’ duration and involved interactive lectures,PowerPoint presentations, case-based learning as the mostcommon teaching-learning methods. Along with the module,pre-post-test questionnaire to assess the improvement in theknowledge of students was developed and validated.Feedback questionnaires, based on 5-point-Likert scale, weredeveloped and validated to know the students’ perceptionregarding the teaching of medical ethics and faculty’sperception on the effectiveness of the module. A pilot run of themodule was conducted on 15 students of 2nd Prof MBBS todetermine the feasibility of the module. Pre-post-testquestionnaires were administered to the students and thefeedback taken from the students and the participating faculty.Findings: A module on medical ethics on patient care wasdeveloped and validated. There was significant improvement inknowledge of the students as evident from their pre and posttest scores (10.47 to 25.47). The improvement in knowledge ofvarious aspects of medical ethics was also calculated. Therewas a statistically significant improvement in knowledge in allsessions. The observations of the qualitative data analyzedfrom the feedback given by the students revealed that theyfound it useful and relevant and would implement theknowledge gained.Conclusions: The feedback of the students and the facultywas very positive and encouraging. The development of thismodule would help in teaching the 2nd Prof students in medicalethics, which would be helpful to them in clinics and life-long.The seed of medical ethics would help grow a tree of gooddoctor-patient relationship which would ultimately help to growhealth of the society.

To Study Clinico-Radiological Profile of Multi-Drug Resistant Tuberculosis Patients

Drug resistance is a threat to TB control program worldwide. Patient infected with multiple drug resistant strains are less likely to become cured. Management of resistant cases is complex and presents therapeutic limitations. Patients with multidrug resistant strains are more prone to treatment failure, progresses to more chronic forms of the disease and death. In most areas of the world, the routine use of drug susceptibility tests, let alone cultures to diagnose tuberculosis or multidrug resistant tuberculosis is beyond the scope of health care resources. According to Global Tuberculosis Report 2015, about 3.3% of newly diagnosed patients had multidrug resistant tuberculosis and 20% of previously treated Tuberculosis cases were estimated to have Multidrug resistant Tuberculosis (MDR-TB). This present study was conducted in the department of chest and TB, Government medical college, Amritsar, with an aim to study the clinico-radiological profile of patients with multidrug resistant tuberculosis. Methods: A prospective study was conducted at the Chest and TB hospital, Amritsar which included 100 diagnosed patients of Multidrug Resistant Tuberculosis. Clinicoradiological profile of these patients was determined. Results: Out of 100 study population, maximum number of patients belonged to the age group of 21-30 years i.e. 26% followed by 22% in the age group of <20 years. Most common symptom was cough with expectoration which was present in 94 (94%) patients. 97 (97%) patients were having previous history of ATT, 3 (3%) patients were not having any previous history of ATT. On radiology unilateral disease was present in 48 (48%) patients, bilateral disease present in 52 (52%) patients. Parenchymal infiltration was present in 79 (79%) patients. Cavitation was present in 23 (23%), Fibrocavitary disease was present in 37 (37%) study subjects. Previous history of ATT had significant association with extent of lesion on chest x- ray (p < 0.05). Conclusion: clinico-radiological characteristics should always be determined where appropriately administered drugs have not achieved necessary drug levels to deal with all the population of mycobacteria, to timely modify and strengthen the national programs, and evaluation of trends in drug resistance pattern.

To Study the Prevalence of HIV Seropositivity in Drug Resistant- Tuberculosis Patients

Drug resistance is a threat to TB control program worldwide. Patient infected with multiple drug resistant strains are less likely to become cured. Multidrug – resistant and extensively drug -resistant tuberculosis continues to emerge in high HIV prevalence settings, and their mortality in HIV co-infected patients remain high. Methods: This retrospective study was carried out at DR-TB centre, Amritsar. This study included drug resistant TB cases registered over the period of 2012 to 2018 at DR-TB centre, Amritsar. Results: A total of 1163 patients of Drug resistant tuberculosis were registered during the period of 7 years , among these 1027, 39 and 97 patients were of MDR, XDR and isoniazid monoresistance respectively. The prevalence of HIV seropositivity was 2.7%, 2.9% and 2.6% in total drug resistant cases, MDR and XDR cases respectively. No case of isoniazid mono-resistance was found positive for HIV. And only one case with primary MDR tuberculosis was HIV positive. Conclusion: In this high drug-resistant TB settings, previous TB treatment failure was strong risk factor for both MDR and XDR-TB in HIV seropositive patients. And HIV seropositivity was more prevalent in MDR-TB cases.

To Study The Percentage of HIV Seropositivity in Smear Positive Tuberculosis Cases

Tuberculosis is the commonest opportunistic infection and the leading cause of death in HIV patients in developing countries and accounts for about 40% of all manifestations seen in HIV patients. Correct diagnosis and treatment of tuberculosis helps to reduce burden of TB. However there are difficulties in achieving this goal such as difficulties in diagnosing tuberculosis in HIV infected patients due to unusual clinical picture with increase in smear negative AFB pulmonary tuberculosis and atypical findings on chest radiography. There is a paucity of literature regarding determination of percentage of HIV seropositivity in smear positive tuberculosis cases in Northern India. Hence, this study was planned to study the correlation and burden of HIV seropositivity in smear positive tuberculosis cases. Methods: A prospective study was conducted at the Chest and TB hospital, Amritsar which included 150 smear positive tuberculosis cases. HIV seropositivity was determined in all the patients. Results: In our study, the HIV seropositivity detected in 150 smear positive tubercular cases was 3.33% which is more than the prevalence seen in most of the northern states and lower than the southern and north eastern states of India. Conclusion: The HIV seropositivity detected in 150 smear positive tubercular cases was 3.33% which is more than the prevalence seen in most of the northern states and lower than the southern and north eastern states of India.

To Determine the Percentage of Isoniazid Monoresistant Tubercular Mutations Via Kat G V/S INH A Genes

Some important challenges for TB control strategies include the increasing prevalence and rapid distribution of drug-resistant TB. Recently, this concern has been further intensified by reports of multi drug resistant (MDR) and extensively drug resistant-TB (XDR-TB). Although resistance to first and second line drugs poses the important risk to patients, resistance to isoniazid (INH) alone is also important. INH is the most potent anti-TB drug and is the main part of any first-line treatment regimen for TB. Our objective is to determine the percentage of isoniazid monoresistance mutations via Kat G v/s Inh A gene. Methods: We conducted a retrospective record review of 100 INH monoresistant TB patients without rifampicin resistance registered during Feb 2017 - March 2018. Results: Of the 100 INH monoresistant patients taken in a year, 82% were found to be resistant via Kat G gene and only 18% were found to be resistant for Inh A gene. Conclusion: In conclusion, our study showed increased prevalence of isoniazid resistance via Kat G gene mutation than with Inh A gene.

Buspirone along with melatonin attenuates oxidative damage and anxiety-like behavior in a mouse model of immobilization stress / 中国天然药物

AIM@#Stress is recognized to precipitate anxiety and related psychological problems characterized by a wide range of biochemical and behavioral changes. The present study was carried out to investigate the protective effects of melatonin and buspirone, and their combination, against six hours immobilization stress-induced, anxiety-like behavioral and oxidative damage in mice.@*METHOD@#Male Laca mice were pre-treated with melatonin (2.5, 5 mg·kg(-1)), buspirone (5, 10 mg·kg(-1)), and their combination for consecutive five days. On the 6(th) day, animals were immobilized for six hours, and thereafter various behavioral tests were performed followed by biochemical tests.@*RESULTS@#Immobilization stress significantly impaired body weight, locomotor activity, and caused anxiety-like behavior, along with increased oxidative damage. Pretreatment with melatonin and buspirone significantly improved the loss in body weight and locomotor activity, attenuated anxiety-like behavior (in both the mirror chamber and plus maze performance tasks), further restored the levels of brain total proteins, and caused antioxidant-like effects, as evidenced by reduced lipid peroxidation, nitrite concentration, and restoration of reduced glutathione and catalase activity, as compared to control animals. In addition, combination of melatonin (2.5, 5 mg·kg(-1)) with buspirone (5 mg·kg(-1)) significantly potentiated their protective effects, as compared to their effects individually.@*CONCLUSION@#The present study suggests that melatonin potentiates the beneficial effect of buspirone against immobilization stress-induced, anxiety-like behavioral and oxidative damage in mice possibly by involving a serotonergic mechanism.

Screening of Eclipta Alba Extracts for Anticancer activity.

Sleep deprivation can lead to various alterations at physiological and psychological levels such as EEG changes, metabolic changes, irritation, blurred vision, memory lapses, hallucinations, psychosis and can even lead to death. Treatment still remains a challenge as hypnotics are associated with side effects. The objective of the present study was to investigate the protective effects of melatonin and buspirone and their combinations against the biochemical and behavioral alterations induced by 48 hrs sleep deprivation in mice. Pretreatment with melatonin (2.5 mg/kg and 5 mg/kg), buspirone (5 mg/kg and 10 mg/kg), and melatonin (2.5, 5 mg/kg) in combination with buspirone (5 mg/kg) showed significant improvement in behavioral parameters such as increase in body weight, increase in locomotor activity, and reduction in anxiety like behavior. Biochemical parameters estimation also revealed similar results such as significant attenuation of lipid peroxidation and nitrite concentration and significant elevation of glutathione and catalase levels following treatment with melatonin (2.5, 5 mg/kg) and buspirone (5,10 mg/kg) and melatonin (2.5, 5 mg/kg) in combination with buspirone (5 mg/kg) as compared to their effect per se. Thus, preliminary findings suggest the protective effect of melatonin and buspirone and their combinations against sleep deprivation and associated alterations.