A comparative study of sagittal abdominal diameter and other anthropometric indices of obesity in adults with family history of cardiovascular risk factors

Background:Obesity is evolving into a modern day epidemic in India. Visceral Adipose Tissue is the main culprit, being the metabolically active component that is responsible for the cardiovascular risk factors. The day-to-day anthropometric indices fail to take bodycomposition and distribution into account and hence miss a chance at early detection. Family history plays an important role by serving as a genetic link in the transmission of risk factors. There is a need for vigorous screening techniques which are clinically plausible for an early diagnosis of visceral adiposity in individuals predisposed to the numerous risks caused by its accumulation. Sagittal abdominal diameter is a useful tool in measuring the visceral adipose tissue clinically and in the current study; a comparison was done between SAD and already existing anthropometric indices.Methods:The study was done on 223 subjects in Bangalore during the period of November 2015 to May 2017.Among the subjects studied, 54.7% were Male and 45.3% were female. When compared to BMI, WC andWHR, SAD correlated better with total cholesterol, fasting blood sugar, post prandial blood sugar and HbA1c.Results:The mean SAD was more in people with a combined history of DM and HTN than in individuals with history of either DM or HTN alone. Conclusions:We could conclude that Sagittal Abdominal Diameter is comparable to Body Mass Index, but it correlates better with metabolic risk profile of an individual than BMI, WC andWHR.

Study of effect of glycemic control on haemoglobin levels in patients with type 2 diabetes mellitus

Background: Anemia is more frequent and severe in diabetics compared to non-diabetic patients. Chronic anemia results in tissue hypoxia, which is known to play a key role in diabetes-associated organ damage. Hence it is important to diagnose and correct anemia in diabetic patients. This study was done to elucidate the effect of glycemic control on haemoglobin levels in patients with type 2 Diabetes mellitus.Methods: The present study is an observational, cross sectional study conducted between November 2017 to May 2019 carried out in hospitals attached to Bangalore Medical college and Research Institute. A sample of 60 patients with Diabetes mellitus were included, out of which 28 were female and 32 were male patients.Results: Study was conducted on 60 patients, the age distribution was between 29yrs to 88yrs with mean age was 56±11yrs. Out of 60 patients 23 patients had anemia. There was slight positive correlation between haemoglobin percentage and HbA1c. But this was not statistically significant.Conclusions: The study concludes that Glycemic control was not found to influence the Haemoglobin levels in patients with Type 2 diabetes mellitus in a significant manner. In subjects with anemia, multiple other issues need to be addressed for improvement in haematocrit value and prevention of complications of diabetes apart from glycemic control.

Drug utilization pattern of antimicrobials in OPD of ENT in teaching hospital

Background: A drug utilization study may be helpful to identify the problems, suggest the remedial measures and promote rational use. Antimicrobials are commonly used to treat infections caused by bacteria, viruses, protozoa and fungi, evidently require huge prescriptions in India.Methods: A prospective, observational study was carried out for a period of four months from February to May 2019 in the Department of ENT (OPD) at NRI Medical College and General Hospital. Prescriptions were collected randomly from around 300 patients attending the ENT outpatient department after obtaining informed consent. The data were collected in the predesigned proforma for analysis.Results: 300 ENT patients were selected for the study, 62% were male and 38% were female. Out of 300 patients 190 ear disorders, 50 nasal, and 60 throat infections. Antimicrobial therapy were most commonly instituted in ear diseases (67.66%), nose (16.95%) and throat (15.37%) respectively. The most commonly used agents were amoxicillin with clavulanic acid- n=295, cefixime- n=1260, gentamicin- n=200, ciprofloxacin- n=157, azithromycin- n=199, nitroimidazoles (metronidazole- n=111).Conclusions: Cefixime and amoxicillin+clavulanic acid combination was the most commonly prescribed antibiotic in our study. Interventions to rectify the use of brand names are necessary to promote rational drug use. An antibiotic policy has to be developed for the doctors in treating infections so that rationality in using the antibiotics will be developed and the occurrence of antibiotic resistance can be reduced.

Cholesterol Loaded Cyclodextrin Increases cryopreservability of Marwari Stallion (Equus ferus caballus) Spermatozoa by Increasing Cholesterol to Phospholipid Ratio

The study was conducted to investigate the effects of different levels of cholesterol loaded cyclodextrin (CLC) addition on cooled and frozen-thawed spermatozoa of Marwari stallion. A total of 48 ejaculates were collected from six adult Marwari stallions (8 ejaculates from each stallion) aged between 4 to 7 years. Immediately after collection semen sample was macroscopically evaluated and filtered into a warm, graduated measuring bottle to get gel free semen. The level of cholesterol (C) and phospholipid (P) in fresh spermatozoa were measured using ELISA. The semen sample was divided in to five equal aliquots (T0, T1, T2, T3 and T4). Primary extender containing different concentrations of CLC was added to each aliquot (0, 1, 1.5, 2 and 3 mg/ml CLC in T0, T1, T2, T3 and T4, respectively). All the aliquots were incubated for 15 minutes at 37°C for incorporation of CLC in sperm plasma membrane and then cryopreserved. Level of C and P in spermatozoa was also evaluated at pre-freeze and post-thaw stages. The mean C, P and C: P ratio in fresh sperm was 15.36±0.47 μg/100 × 106 sperm cells, 46.21±1.27 μg/100 × 106 sperm cells and 0.33±0.071, respectively. The mean C content and C: P ratio were significantly higher (P<0.05) in group T3 as compared to other groups at both pre-freeze and post-thaw stages. It was concluded that addition of CLC may be helpful in increasing cryopservability of stallion spermatozoa

Study of spectrum of sepsis and prediction of its outcome in patients admitted to ICU using different scoring systems

Background: Although sepsis is one of the leading causes of mortality in hospitalized patients, information regarding early predictive factors for mortality and morbidity is limited. The aim was to identify reliable and early prognostic variables predicting mortality in patients admitted to ICU with sepsis.Methods: Patients fulfilling the Surviving Sepsis Campaign 2012 guidelines criteria for sepsis within the ICU were included over two years. Apart from baseline haematological, biochemical and metabolic parameters, APACHE II, SAPS II and SOFA scores were calculated on day 1 of admission. Patients were followed till death or discharge from the ICU. Chi-square test, student t-test, receiver operating curve analyses were done.Results: 100 patients were enrolled during the study period. The overall mortality was 35% (68.6% in males and 31.4% in females). Mortality was 88.6% and 11.4% in patients with septic shock and severe sepsis and none in the sepsis group, respectively. On multivariate analysis, significant predictors of mortality were APACHE II score greater than 27, SAPS II score greater than 43 and SOFA score greater than 11 on day the of admission. On ROC analysis APACHE II had the highest sensitivity (92.3%) and SAPS II had the highest specificity (82.9%).Conclusions: All three scores performed well in predicting the mortality. Overall, APACHE II had highest sensitivity, hence was the best predictor of mortality in critically ill patients. SAPS II had the highest specificity, hence it predicted improvement better than death. SOFA had intermediate sensitivity and specificity.

A Case Series Of Sarcomatoid Transitional Cell Carcinoma Of Renal Pelvis And Collecting Duct Carcinoma Of Kidney

Sarcomatoid transitional cell carcinoma (TCC) of the renal pelvis and collecting duct carcinoma (CDC) of the kidney are rare types of malignant renal tumors with aggressive behavior. Here, we report a case series of these tumors, in males of age 65 years and 72 years, respectively. In both the cases, the left kidney was affected and they underwent the left-sided radical nephroureterectomy. Histologically, sarcomatoid TCC showed two components with invasive TCC and areas with spindle cells and osteoclastic type of giant cells. The immunohistochemistry showed diffuse positivity for CK7 and negativity for CK20 and p63 in both the components. CDC showed tubule-papillary patterns with marked desmoplasia. The patients were disease free after a follow-up of 12 months and 2½ years, respectively, without any adjuvant therapy

Study of awareness of diabetes mellitus among diabetics and non-diabetics and drug utilisation pattern in diabetics attending tertiary care general hospital in India

Background: Diabetes Mellitus (DM) is one of the most challenging public health problems. It is important to know about the awareness level of a disease condition in a population, which plays a vital role in future development, early detection and prevention of disease.Methods: A total of 200 subjects were interviewed and their details were noted in a specially designed data collection form. The questionnaire contained a series of questions related to demographic characteristics and awareness of DM including general knowledge, risk factors and complications of diabetic and non-diabetic patients.Results: Among 150 subjects were diabetic and 50 were non-diabetic. 60 (40%), 14(28%) of diabetics and non- diabetics were between the age of 41-50. 101 (67.3%) were male, 49 (32.6%) were female. 101 (67.3%) of the study participant had family history of diabetes in diabetic. 45 (44.5%) diabetic, 20 (40.81%) non-diabetic male knows the risk factor for diabetes mellitus and 35 (34.6%), 21 (42.8%) were aware of symptoms, 09(8.9%), 03(6.1%) awareness on complication of diabetes. 21 (20.7%), 06 (12.2%) doesn’t know about Risk factors.Conclusions: The present study conclude a current situation of knowledge and awareness of diabetes mellitus and also emphasizes the need for improvement in knowledge and awareness on diabetes mellitus among the diabetic as well as non-diabetic subjects in order to achieve prevention and better control of diabetes risk factors, complications and its management.

Study of awareness of insulin usage in diabetics attending NRI Medical College and General Hospital

Background: India had 69.2 million diabetic patients. Insulin is an important part of diabetes treatment, but one-third of patients fail to take their insulin as prescribed, and many adults intentionally skip their doses. Since, diabetes treatment continues for lifetime, there is a need to assess the knowledge and understanding of patients in relation to their disease process and its management.Methods: A cross sectional, observational, knowledge and attitude survey were carried on patients with type II diabetes mellitus who are taking insulin therapy and attended medicine diabetes OPD in tertiary care Hospital during the period of April 2017 to Dec 2017. 200 diabetic patients’ ?18 years of age who were willing to respond to the study questionnaire were interviewed.Results: Total of 200 study participants were interviewed using structured questionnaires, almost 75 (37.5%) of the respondents were age group of 41 - 50 years. 109 (54.5 %) male, 67 (33.5%)Hindus, 121 (60.5 %) married,79 (39.5%) were primary school, 120 (73.8%) were family history of diabetes, duration of treatment1-3 years 72 (31.5 %), 160 (63%) of the study subjects know about diabetes is high blood glucose, 119(59.5%)of subjects know complications of diabetes, 165(82.5%) were know about insulin used for diabetes, 115 (57.5%) of patients know other substitute for insulin, 94 (47%) of the study subjects have knowledge of complications of insulin therapy, 85 (42.5) were know different types of insulin preparations, 141 (70.5%) were know insulin is mandatory in some patients,159 (79.5%) were understood the route of administration of insulin.Conclusions: The finding of present study showed that, diabetes patients had average knowledge and less favourable attitude among diabetic patients toward insulin therapy.

A study of phacoemulsification cataract surgery preference over Small Incision Cataract Surgery in rural eye center of Bodhan, Nizamabad District

Cataract is a major cause of decreased vision in elderly aged population. In rural areas till last decade small incision cataract surgery with IOL implantation is the only surgical option for treating cataracts. In recent past after introduction of the phacoemulsification with foldable IOL implantation is becoming popular surgical technique in urban areas. In our study conducted at rural eye center, phacoemulsification with IOL is gaining popularity over SICS with IOL. This shows increased awareness among the rural population towards minimal invasive surgery and latest surgical techniques regarding better recovery procedures.

Evaluation of efficacy of photodynamic therapy as an adjunct to nonsurgical periodontal therapy in treatment of chronic periodontitis patients: A clinico-microbiological study.

Background and Objectives: Photodynamic therapy (PDT) is a local noninvasive treatment modality without side effects caused by antibiotics. The aim of this study was to evaluate the efficacy of adjunctive use of PDT with scaling and root planing as compared with SRP alone in the treatment of chronic periodontitis. Subjects and Methods: Twenty participants with chronic periodontitis having probing pocket depths (PDs) of ≥5 mm were selected for the study. Patients were randomly divided into control group and test group with ten patients in each group. Full-mouth SRP was performed in both the groups, followed by PDT in test group. Assessment of plaque index (PI), gingival index (GI), PD, and clinical attachment level (CAL) was done at baseline and after 3 months. Microbiological assessment of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola was done by polymerase chain reaction (PCR) at baseline and 3 months after the therapy. Results: There was a significant reduction in PI, GI, PD, CAL, and microbiologic parameters in test group, following SRP and PDT, when compared with SRP alone in control group. Conclusion: PDT in conjunction with SRP has shown additional improvement in periodontal parameters when compared to SRP alone and has a beneficial effect in chronic periodontitis patients.

Comparative evaluation of soft tissue changes in Class I borderline patients treated with extraction and nonextraction modalities

Abstract Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap.

RESUMO Objetivo: comparar as alterações sofridas nos tecidos moles em casos limítrofes de Classe I tratados com extrações e sem extrações. Métodos: uma amostra inicial de 150 pacientes com má oclusão esquelética e dentária de Classe I (89 pacientes tratados com extrações de pré-molares e 61 pacientes tratados sem extrações) foi aleatoriamente selecionada e submetida a uma análise discriminante, a qual permitiu selecionar uma amostra de 44 pacientes limítrofes (22 tratados com extrações e 22 tratados sem extrações). Telerradiografias obtidas antes e depois do tratamento dessa subamostra de pacientes limítrofes foram analisadas, utilizando-se 22 grandezas em tecidos moles. Resultados: nos casos limítrofes tratados com extrações, houve maior retração dos lábios superior e inferior e um maior aumento na espessura do lábio superior (p < 0,01); bem como o ângulo nasolabial tornou-se mais obtuso e o espaço interlabial sofreu redução (p < 0,01). Já nos casos limítrofes tratados sem extrações, o lábio inferior, o espaço interlabial e o ângulo nasolabial não apresentaram alterações significativas. Conclusão: as grandezas em tecidos moles que podem ajudar na tomada de decisão entre o tratamento com e sem extrações nos casos limítrofes de Classe I são: protrusão dos lábios superior e inferior em relação ao plano E e em relação à linha Sn-Pg', protrusão do lábio inferior em relação à linha vertical verdadeira (LVV), a espessura do lábio superior, o ângulo nasolabial e o espaço interlabial.

Acquired Toxoplasmosis Presenting with a Brainstem Granuloma in an Immunocompetent Adolescent.

Background: Toxoplasmosis is an uncommon disease in immunocompetent people. Case characteristics: We report an adolescent boy with central nervous system toxoplasmosis who presented with progressive lower cranial nerve palsies and a ring-enhancing lesion on neuroimaging. Intervention: Diagnosis of toxoplasmosis was confirmed on histopathology of the excised lesion. Message: Toxoplasmosis should be considered in the differential diagnosis of focal brain lesions irrespective of immune status.

BI-Layer technology- an emerging trend: A review.

Combination therapy has various advantages over monotherapy. In the last decade, interest in developing a combination of two or more Active Pharmaceutical Ingredients (API) in a single dosage form (monolithic or bilayer tablet) has increased in the pharmaceutical industry, promoting patient convenience and compliance. Bilayer tablets can be a primary option to avoid chemical incompatibilities between API by physical separation, and to enable the development of different drug release profiles (immediate release with extended release). Several pharmaceutical companies are currently developing bi-layer tablets, for a variety of reasons: patent extension, therapeutic, marketing to name a few. To reduce capital investment, quite often existing but modified tablet presses are used to develop and produce such tablets. This article explains why the development and production of quality bi-layer tablets needs to be carried out on purpose-built tablet presses to overcome common bi-layer problems, such as layer-separation, insufficient hardness, inaccurate individual layer weight control, cross-contamination between the layers, reduced yield etc. Using a modified tablet press may therefore not be best approach in producing a quality bi-layer tablet under GMP conditions, especially when high production output is required. There are various applications of the bi-layer tablet consists of monolithic partially coated or multilayered matrices.

Influence of mating histories and age on female remating behaviour in a few closely related species of Drosophila nasuta subgroup.

Female remating with more than one male leads to coexistence of sperm from different males in the same female, thus creating a selection pressure on sperm. To understand the extent of divergence in the reproductive behaviour among closely related species, in the present study, the influence of first mating histories like mating latency, duration of copulation and age of flies have been analysed on female remating behaviour in closely related Drosophila nasuta subgroup species with varying levels of reproductive isolation. The time taken for the once mated females to remate varied from 7 days in D. s. sulfurigaster to 19 days in D. s. neonasuta after first mating. The female remating frequency varied from a minimum of 29% in D. s. neonasuta to a maximum of 95% in D. s. sulfurigaster. The younger flies, which had remating latency of three times less than aged flies, show 100% remating frequency. In addition, it was observed that the duration of copulation in the first mating influences the remating behaviour among the nasuta subgroup members. The results revealed that D. nasuta subgroup members despite being closely related differ in their reproductive behaviour.

Gene therapy, promises, problems and current status

Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient. One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells. Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to wide variety of diseases. Based on the nature of the viral genome, these gene therapy vectors can be divided into RNA and DNA viral vectors. The majority of RNA virus-based vectors have been derived from simple retroviruses. A major shortcoming of these vectors is that they are not able to transducer nondividing cells. This problem may be overcome by the use of novel retroviral vectors, such as human immunodeficiency virus [HIV]. The most commonly used DNA virus vectors are based on adenoviruses and adeno-associated viruses. Although the available vector systems are able to deliver genes in vivo into cells, the ideal delivery vehicle has not been found. Thus, the present viral vectors should be used only with great caution in human beings and further progress in vector development is necessary. The Food and Drug Administration [FDA] has not yet approved any human gene therapy product for sale. Current gene therapy is still in experimental stage and has not proven very successful in clinical trials

A Coverage Evaluation Survey of JE Vaccination in Two Districts of Karnataka.

A coverage evaluation survey was conducted in Mandya and Koppal districts of Karnataka state following the Japanese Encephalitis (JE) vaccination campaign. The purposes of the survey were to assess coverage of children in target age group by JE vaccination and to assess adverse events following immunisation against JE, the knowledge of health care providers and community about JE & mass vaccination for JE. The study design consisted of both quantitative and qualitative methods. The quantitative data was used to know the coverage levels for children. The qualitative data collected through interviews of head of the family in the sample households, selected health care workers using a structured pretested questionnaire. The standard cluster sampling method was used for selecting the sample of children to be evaluated. In Mandya district the evaluation showed 92 % coverage in the selected sample of 313 children against the reported 83.85 %. In Koppal district the evaluation showed 70 % coverage, among the selected sample of 251 children, against the reported coverage of 69.8 %. The incidence of adverse events was 4% in Mandya sample and 6.37 % in Koppal sample. In Mandya district, about 42 % of households had knowledge of JE. About 68 % of households had prior knowledge of the immunization day. In Koppal district, the survey has revealed that only 19.85 % of the heads of household had the knowledge of JE and 48.53% had the knowledge of JE vaccination before the day of vaccination campaign.

Male accessory gland secretions in hybrids of Drosophila nasuta nasuta and D. n. albomicans neither show luxuriance nor breakdown.

Male accessory gland secretions, which have a role to play in reproduction have been investigated. The number of cells that make up the gland, the quantity of secretions synthesized and the influence of these secretions on fecundity of the female have been studied in D. n. nasuta, D. n. albomicans and their F1 progeny. The results revealed that the hybrid males show a trend towards D. n. nasuta in the synthesis of male accessory gland proteins and the fecundity of the female is influenced more by its genetic constitution rather than the quantity of accessory gland secretions.

Audit of laparoscopic cholecystectomies in a district general hospital

Laparoscopic cholecystectomy was first performed in Buraydah Central Hospital, Al Qassim in September 1993. Since more than 125 open cholecystectomies were performed annually, there was a need to be able to deliver this type of service to the patients in our hospital. Continued audit is needed to ensure that the results with low complication rates achieved in tertiary centers are reproduced by the surgeons at district level. Our study of 340 laparoscopic cholecystectomies performed between September 21,1993 and September 2O, 1995 describes the results with incidence of complications, conversion to open procedure, mean operation time and the extend of postoperative stay in a district hospital. Our complication rates compare favorably with the results achieved in laparoscopic cholecystectomy in many centers. Data obtained by us suggests that laparoscopic cholecystectomy is safe and effective for the treatment of cholecystitis, and this technique can be introduced safely in a district general hospital in Saudi Arabia