Knowledge, Attitude & Practices related to Epilepsy among Parents of Epileptic Childrenattending Tertiary Care Hospitals in Ahmedabad city, Gujarat

Introduction: Epilepsy is one of the most common pediatric neurological disorders and is a brain condition that causes a child to have seizure. Misconceptions and poor understanding about the nature of epilepsy contribute to the burden of disease and lead to stigma. Misconceptions and negative attitudes cause people with epilepsy to feel shame, embarrassment, and disgrace. The purpose of this study wasObjective: to assess the knowledge, attitude, and practices (KAP) related to Epilepsy amongst the parents of epileptic children. A cross-sectional study was conducted 187 parents of epileptic child who attendedMethod: outpatient department of selected hospitals of Ahmedabad. A structured interview of the parents of epileptic children was conducted using modified international questionnaires. Modified Bloom’s cut-off points were used to determine KAP levels. Kruskal–Wallis test was applied on knowledge, attitude and practice levels. Chi square test was used to find out association. The study showed that out of 187 respondents, aroundResults: 61% were from age group 31 to 40 years and 54.5% were females. Among all participants, 53.5% had Good knowledge, 84.5% of parents had good attitude. Around 18.2% parents had good practices and about 9.1% had poor practices related to epilepsy. There were statistically significant associations between knowledge, attitude, and practice score with respect to gender, age, and occupation. Parents knowledgeConclusion: regarding epilepsy was good as more than half of parents were having good knowledge. Majority of the parents had good attitude towards epilepsy. There was significant positive correlation between knowledge and practices about epilepsy. Attitudes and practices related to epilepsy also showed positive correlation.

Metronomic palliative chemotherapy in locally advanced, recurrent and metastatic head-and-neck cancer: A single-arm, retrospective study of a regional cancer center of North India (Asia)

Background: Head-and-neck cancer is the most common cancer in developing countries of Southeast Asia. Most of the patients present to the hospital in advanced stage and have a poor prognosis. This study aims to evaluate the efficacy and toxicity profile of oral metronomic chemotherapy (MCT) in the form of methotrexate and celecoxib in locally advanced, recurrent and metastatic head-and-neck cancers. Materials and Methods: This was a single-arm retrospective observational study that included posttreatment patients with locally advanced, recurrent and metastatic disease in the year 2016 (January 1, to December 31, 2016). A total of 84 patients warranting palliative chemotherapy but not willing to take intravenous chemotherapy were included in the study. The oral MCT schedule consisted of oral celecoxib (200 mg twice daily) and oral methotrexate (15 mg/m2/week). Response evaluation was done using the Response Evaluation Criteria in Solid Tumors criteria version 1.1, and toxicity profile was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03. Descriptive statistics and Kaplan–Meier analysis were performed. Results: Eighty-four patients, 68 males and 16 females, with a median age of 62 years (range: 35–80 years), were enrolled in the study to receive oral MCT. The Eastern Cooperative Oncology Group performance status was 0–1 in 62 patients and 2–3 in 22 patients. The primary sites of disease were buccal mucosa (18), tongue (22), tonsil (24), lower alveolus (7), hypopharynx (10), and soft palate (3). The best clinical response rate in post oral MCT was seen in the first 4 months (120 days). Objective response was observed in 67% of patients in the form of stable disease (56%) and partial response (11%). Disease progression was observed in 27% of patients. The median follow-up was 192 (6.4 months) days. The median estimated overall survival was 195 (6.5 months) days. The median estimated progression-free survival was 110 (3.6 months) days. Symptomatic relief with respect to pain was reported in about 75% of patients. Eighteen (21%) patients had Grade I–II mucosal reactions. Grade III–IV mucosal reactions were observed in five (6%) patients. Seventy-eight (93%) patients died at the end of the study at 1 year. Dose reduction was required in 15 (18%) patients. Conclusion: Oral MCT using celecoxib and methotrexate is an effective, economical, and well-tolerated regimen with good pain control and low toxicity profile in patients with locally advanced, recurrent and metastatic head-and-neck cancer.

Acute treatment-related toxicity in elderly patients with good performance status compared to young patients in locally advanced esophageal carcinoma treated by definitive chemoradiation: A retrospective comparative study

Introduction: The benefit of definitive chemoradiotherapy (CRT) in elderly patients with locally advanced esophageal cancer is not well established. We perform a single institutional retrospective study of CRT in terms of toxicity in elderly patients (age more than 60 years) as compared with young cohort (age <60 years) in locally advanced nonmetastatic esophageal cancer. Patients and Methods: A total 145 of patients, 79 in young age (Group A) and 66 patients of elder age (Group B) with Stage II and III squamous cell carcinoma of the esophagus with ECOG PS of 0–1, who had undergone definitive CRT at our institute from January 2015 to November 2018 were selected for this analysis. Chemotherapy was cisplatin (40 mg/m2) given concurrently on weekly basis with radiotherapy (RT). Total prescribed dose of RT was 50.4 Gy at the rate of 1.8 Gy per fraction. Median age was 40 years (25–60 years) and 65 years (60–75 years) in young and elderly group, respectively. Follow-up is done at median of 28 months (1–48 months) after treatment. Results: Acute Grade 2–3 esophagitis was seen in 48.10% in young cohort, while it was 60.6% in older group. Grade 2–3 nausea and vomiting was seen in 32.91% in young age patients, while it was 45.5% in elder patients. No statistically significant difference is seen in acute treatment-related toxicity in young and elderly group. Conclusion: Our conclusion is that patients with adequate functional status should not be excluded from curative CRT based on age alone

Curcumin supplementation shows modulatory influence on functional and morphological features of hippocampus in mice subjected to arsenic trioxide exposure / 대한해부학회지

Since, oxidative stress has been suggested as one of the mechanisms underlying arsenic-induced toxicity, the present study focused on the role of antioxidant (curcumin) supplementation on behavioral, biochemical, and morphological alterations with context to mice hippocampus (CA1) following arsenic trioxide (As2O3) administration. Healthy male Swiss albino mice were divided into control and experimental groups. As2O3 (2 mg/kg bw) alone or along with curcumin (100 mg/kg bw) was administered to experimental groups by oral route for 45 days whereas the control groups received either no treatment or vehicle for curcumin. Animals were subjected to behavioral study towards the end of the experimental period (day 33–45). On day 46, the brain samples were obtained and subjected either to immersion fixation (for morphometric observations) or used afresh for biochemical test. Behavioral tests (open field, elevated plus maze, and Morris water maze) revealed enhanced anxiety levels and impairment of cognitive functions in As2O3 alone treated groups whereas a trend of recovery was evident in mice simultaneously treated with As2O3 and curcumin. Morphological observations showed noticeable reduction in stratum pyramidale thickness (CA1), along with decrease in density and size of pyramidal neurons in As2O3 alone exposed group as compared to As2O3 +Cu co-treated group. Hippocampal glutathione levels were found to be downregulated in animals receiving As2O3 as against the levels of controls and curcumin supplemented animals, thereby, suggestive of beneficial role of curcumin on As2O3 induced adverse effects.

Curcumin supplementation shows modulatory influence on functional and morphological features of hippocampus in mice subjected to arsenic trioxide exposure / 대한해부학회지

Since, oxidative stress has been suggested as one of the mechanisms underlying arsenic-induced toxicity, the present study focused on the role of antioxidant (curcumin) supplementation on behavioral, biochemical, and morphological alterations with context to mice hippocampus (CA1) following arsenic trioxide (As2O3) administration. Healthy male Swiss albino mice were divided into control and experimental groups. As2O3 (2 mg/kg bw) alone or along with curcumin (100 mg/kg bw) was administered to experimental groups by oral route for 45 days whereas the control groups received either no treatment or vehicle for curcumin. Animals were subjected to behavioral study towards the end of the experimental period (day 33–45). On day 46, the brain samples were obtained and subjected either to immersion fixation (for morphometric observations) or used afresh for biochemical test. Behavioral tests (open field, elevated plus maze, and Morris water maze) revealed enhanced anxiety levels and impairment of cognitive functions in As2O3 alone treated groups whereas a trend of recovery was evident in mice simultaneously treated with As2O3 and curcumin. Morphological observations showed noticeable reduction in stratum pyramidale thickness (CA1), along with decrease in density and size of pyramidal neurons in As2O3 alone exposed group as compared to As2O3 +Cu co-treated group. Hippocampal glutathione levels were found to be downregulated in animals receiving As2O3 as against the levels of controls and curcumin supplemented animals, thereby, suggestive of beneficial role of curcumin on As2O3 induced adverse effects.

Quality of Life after Chronic Post Stroke Patients

Background/objectives: To assess the quality of life among patients presented with chronic post-stroke patients in our population. Materials and methods: This was a survey type study conducted at physiotherapy department of Liaquat University of Medical and Health Science. Study duration was six months from June 2014 to November 2015. All the patients with the chronic stage of stroke, age 20 to 60 years and patient should not have any disability other than stroke were included study. Patient’s demographic data and information regarding quality of life was assessed by self-maid questioner. Data were analyzed by SPSS version 16.0. Results: Total 100 cases were selected in the study, their mean age was 45.35+3.4 years, most of the cases 73 (73.0%) were with right side affected by stroke. Majority of the cases 47 (47.0%) had acceptable health and 18 (18.0%) patient’s health was poor. 66 (66.0%) patients presented with a history of previous stroke. Most of the patients were moved by help of someone, almost half of patients can move by himself, few patients can’t move and they were completely dependent on others. When patients were interviewed psychologically 41 (41.0%) patients feeling lonely and 31 (31.0%) were depressed and unhappy, 19 (19.0%) had suicidal thought. When patients were interviewed regarding behavior with your family 36 (36.0%) answered as not good behavior of family members, these cases justified that they belong to the poor families and they are as a burden. Conclusion: It was concluded that there was poor quality of life among chronic post-stroke patients especially patients belongs to poor families

Anemia In Pregnancy: Risk Factors And Adverse Maternal And Perinatal Outcomes In Tertiary Care Hospital

BACKGROUND: Menstruation is an important milestone event in a girl's life with the beginning of reproductive life. Still, menstruation and menstrual practices are clouded by taboos and socio-cultural restrictions, particularly in rural areas leading to ignorance of adolescent girls regarding menstrual hygiene practices and its scientific facts. AIMS AND OBJECTIVES:1. To find out status of menstrual hygiene practices among adolescent girls. 2.To find out association between different socio-demographic factors and menstrual hygiene. MATERIALANDMETHOD:Across sectional study was conducted between March 2017 to September 2017 among 400 adolescent girls (10-19 years) of rural area of Katihar. Data were collected from 273 girls, who have achieved menarche, on a pre tested and pre designed questionnaire after taking parental consent and was analysed using MS Excel and Epi info 7. RESULT:Menarche was found to be achieved by the girls in age group 10-16 years, mostly in the age group 12-13 years (69.59%). Among 273 respondents, 82(30.04%) girls were aware about menstruation prior to menarche and the source of information was mostly sister (54.95%) followed by friends (19.05%) and mothers (15.75%). In my study, only 31 (11.36%) girls used sanitary pads during menstruation. Majority of them (95.24%) were using soap and water to clean external genitalia while more than half of girls (69.60%) did not possess a covered toilet. Menstrual hygiene was taken care mostly by those girls, whose mothers were literate (77.42%). Around 260 (95.23%) of the participants followed one or the other cultural restrictions and majority (76.15%) were avoiding religious functions. CONCLUSION:In our study, hygiene during menstruation is not satisfactory hence there is a need to educate the adolescent girls about healthy and hygienic practices during menstruation to prevent the reproductive tract infections.

Assessment of Anemia status among school going adolescent of Raipur and Jashpur district of Chhattisgarh

Background: According to WHO, adolescence is the population of 10-19 years of age. According to NFHS III, in Chhattisgarh, 58.7% adolescent girls and 34.6% adolescent boys aged between 15-19 years were anemic. So, to combat anemia MoHFW launched weekly iron and folic acid supplementation (WIFS) programme with the objectives to reduce the prevalence. Thus the present study was in attempts with the objective to assess anemia status among school going adolescent of Raipur and Jashpur districts of Chhattisgarh.Methods: It was a school based cross-sectional study conducted in the two districts of Chhattisgarh during 2017-18 among the students aged between 12-19 years and the sample size was 480. By using simple random sampling method, four schools from each district and from each school total 60 students i.e. 10 students from each class 7th -12th were selected by using systematic random sampling method. Permission from DEO of the respective district followed by permission from the principal of each schools and consent from parents of the student was taken and then study was proceeded.Results: In the present study, the mean age of the students in Raipur and Jashpur district was 15.1±1.8 years and 15.2±1.8 years respectively. Out of all the students, in Raipur district, 101 (42.1%) students were found to be anemic and mean Hemoglobin level was 12.5±1.9 gm/dl. In Jashpur district about two third 147 (61.2%) of the students were anemic and mean Hemoglobin level was 11.9±1.9 gm/dl.Conclusions: This study concluded that anemia is still high among adolescent boys and girls

Comparison of the inferior vena cava index and inferior vena cava collapsibility index obtained by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome

Background: There is triad of hypoalbuminemia, edema, and hyperlipidemia in nephrotic syndrome patients. Management of nephrotic syndrome includes general measures like fluid restriction, emergency albumin transfusions and diuretics that provide symptomatic relief till steroids act. These measures require an assessment of body fluid volume to avoid circulatory failure which is very difficult in these patients because of edema. The objective of the study was to measure and compare the Inferior Vena Cava (IVC) Index and Inferior Vena Cava Collapsibility (IVCC) Index by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome.Methods: The present observational study was conducted in all children of age more than 1 year up to 18 year. There were two groups; group 1 was nephrotic syndrome patients-Initial episode or in relapse and group 2 (Control) was age and sex-matched non-nephrotic children. IVC index and IVCC index were measured and compared in both the groups.Results: Mean value of minimum diameter of IVC during inspiration in cases was 5.91'1.60 mm as compared to 4.53'0.94 mm in controls which was significantly higher in case group {P ?0.0001}. Mean value of IVC index in cases was 0.88'0.20 cm/m2 as compared to 0.93'0.19 cm/m2 in controls which was non-significant. Mean value of IVCC index in cases (35.61'13.68) was significantly less as compared to controls (52.23'2.01) {P ?0.0001}.Conclusions: The present study concluded that IVCC index is better indicator of body fluid volume status in nephrotic patients as compare to IVC index.

Deep vein thrombosis in patient with pulmonary tuberculosis: a rare and interesting causative link?

Pulmonary tuberculosis is a devastating disease affecting millions of people in developing countries such as India. Many complications of this disease are known, however only few of its hematological complications have been reported. Discovery of its unknown thrombogenic potential is one such disturbing new entity. Tuberculosis can induce a hypercoagulable state and can lead to thromboembolic complications and deep vein thrombosis. Here we report an interesting and rare case of 20-year-old male, newly diagnosed case of Pulmonary Tuberculosis presenting with complaints of acute onset right lower limb swelling and pain. He was diagnosed with thrombosis of external iliac vein. All possible causes for a provoked deep vein thrombosis were evaluated for and ruled out. The patient was started with first line anti tubercular treatment-rifampicin, isoniazid, pyrizinamide, ethambutol along with anti-thrombotics injection enoxaparin and warfarin and followed up for 6 months. He made complete recovery of both his pulmonary and limb disease.

Assessment of stability of orthodontic mini‑implants under orthodontic loading: A computed tomography study.

Objectives: Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. This prospective clinical study was undertaken to evaluate the mobility of orthodontic miniscrews under orthodontic loading using computed tomography. Materials and Methods: Ten adult patients (7 females and 3 males with mean age of 19 years, 7 mm overjet) who required en masse retraction of upper and lower anterior teeth in first premolar extraction spaces were included in this study. After initial alignment of anterior teeth, the 0.019” ×0.025” stainless steel archwire were placed in preadjusted edgewise appliance. The miniscrews (diameter - 1.3 mm, length - 7 mm) were inserted in between second premolar and the first molar in the maxilla (zygomatic buttress) and in mandible on the buccal side as direct anchorage. Immediately after placement of miniscrews without waiting period, NiTi coil springs (force of 150 g in the maxilla and 100 g in the mandible) were placed for the retraction. Denta Scans were taken immediately before force application (T1) and 6 months later (T2). The mean changes obtained at T1 and T2 in Denta Scans (axial plane, coronal plane, paraxial plane) were evaluated to determine any movement of different parts of miniscrews using one-way ANOVA test and Student’s unpaired t-test. Results: On average, miniscrews were extruded and tipped forward significantly, by 1 mm at the screw head in the axial plane (Group III) and 0.728 mm in the coronal plane (Group IV). Tail of miniscrews showed average tipping of 0.567 mm in the axial plane (Group I) and 0.486 mm in the paraxial plane (Group V). Least average mobility was shown by screw body of 0.349 mm in the axial plane (Group II). Clinically, no significant mobility was observed. Conclusion: Miniscrews are a stable anchorage for orthodontic tooth movement but do not remain absolutely stationary like an endosseous implant throughout orthodontic loading although miniscrews might move according to placement site, orthodontic loading, and inflammation of peri-implant tissue. Waiting period between miniscrews placement and orthodontic loading does not significantly affect the miniscrew mobility so immediate loading can be recommended. To prevent hitting any vital organs because of miniscrew mobility, it is recommended that they can be placed in a nontooth-bearing area that has no foramen, major nerves, or blood vessel pathway, or in a tooth-bearing area allowing a 1.5 mm safety clearance between the miniscrew and dental root.

Prevalence and determinants of hypertension in elderly population of Raipur city, Chhattisgarh.

Background: Demographic transition across globe leading towards greying of population. Worldwide, raised blood pressure is estimated to cause 12.8% of the total annual deaths. This account for 3.7% of total DALYs. Several community-based studies have served to emphasize that hypertension is rapidly emerging as a major public health problem. However, only a few of these studies included elderly people. The objectives of the present study were to evaluate the prevalence and factors influencing hypertension among elderly population of Raipur city. Methods: This community based cross-sectional study was carried out in capital of Chhattisgarh, including urban and slum area from July 2013 to June 2014. Multistage simple random sampling methods were used. Study population comprises of all elderly 60 years and above residing in the study area for at least one year. A total of 640 subjects were included in study. Results: The overall prevalence of hypertension in present study was 50%, prevalent among females (55.49%), shows a significant positive association with body mass index, physical activity and age up to old age group (75-84) yrs. Surprisingly inverse association was observed with alcohol (P <0.001) and smoking (P <0.05) status. Conclusion: Our findings emphasize the public health importance of hypertension in the elderly in Raipur city, and need to strengthen the national programme for hypertension. From a public health perspective, there is definite need for screening of elderly.

Conceptual framework on - establishing healthy life style centre in Chhattisgarh state, India.

Lifestyle diseases characterized by those diseases whose occurrence is primarily based on the daily habits of people and are a result of an inappropriate relationship of people with their environment. The main factors contributing to lifestyle diseases include bad food habits, physical inactivity, wrong body posture, and disturbed biological clock. Lifestyle diseases are the most common causes of disability, morbidity and premature mortality. They account for 52% of deaths, 43% Disability Adjusted Life Years (DALYs) and 62% of total disease burden in India. Life style disease can be prevented through focused and comprehensive public health intervention by establishment of Healthy Life Style Centre (HLSC). HLSC will be a comprehensive approach which will provide health services for Non-Communicable diseases under the one roof. The HLSC will offer consultation, learning, counselling and testing facilities regarding Diabetes and other Non-Communicable diseases (NCD). Life style diseases can be prevented through public health intervention by special task force and policy document related to life style disorders.

Study Of Road Traffic Accidental Deaths (RTA) In and Around Valsad (Gujarat).

Accidents are now one of the major causes of death. Present study consists of 439 medico legal post mortems performed in Forensic Medicine Department, GMERS Medical College and Hospital, Valsad, Gujarat during the period of last 2 calendar years (1st January. 2012 to 31st December. 2013). Out of them, 90.66% cases were of unnatural deaths. Out of unnatural death we found 146 cases (36.68%) died in road traffic accidents. In 36.98% cases were age group of 21- 30 years. 44.83% accidents occur in time period of 12- 18 hours. Thus all data including type of vehicle involved, head injuries, regional injuries,type of skull fracture in head injury, type of haemorrhage and how long victim survived.

Natural Treatment Alternative for Psoriasis: A Review on Herbal Resources.

Psoriasis is an immune mediated inflammatory disease, which is having no permanent cure. Though, there are several treatment methods to treat psoriasis, no particular medication claims a satisfactory and complete remedy. A wide range of synthetic therapeutic agents have also been reported to cause psoriasis as their adverse effect. Herbal drugs by virtue of their safe nature and easy availability may lend themselves as potential anti-psoriatic moieties. Before developing a herbal drug candidate the key players of psoriasis to develop should be thoroughly understood, which includes T-cell activation, T-cell trafficking, Cytokinase inhibition. The paper aims to explore the proliferation and activation mechanism of psoriasis, psoriasis caused by certain drugs and different plant resources known to have anti-psoriatic potential. A more scientific investigation on these herbal resources must be performed to develop a potent, safe and reliable therapy.

A bony foreign body found in a patient with no bony injury: a case report / 中华创伤杂志(英文版)

Open fractures with bone loss are a common occurrence following high energy trauma. But usually the bone fragments are lost on the roadside and are not usable. We report a patient who was involved in a head-on collision between two wheelers and presented with a bone fragment embedded in his thigh. Radiological survey revealed no bony injury in that patient. Another patient, who presented at the same time, sustained a segmental fracture of shaft femur and was found to have lost a bone fragment that was similar to the one found in previous patient. CT scan with 3D reconstruction revealed this missing fragment to be the same as that found in previous patient. Both patients had a history of head-on collision while travelling on a two-wheeler. Present case report throws some highlights on the probable mechanism of injury.

Effect of growth hormone in the management of short bowel syndrome in neonates

Management of short bowel syndrome is a challenge in the postoperative period due to defect in the absorptive surface area which leads to diarrhea with loss of a large amount of fluids and nutrients that necessitates specific enteral and parenteral nutrition. These manifestations improve when the process of intestinal adaptation starts. There is a controversy about the role of growth hormone in accelerating the process of intestinal adaptation. In this study, 24 patients with short bowel syndrome were divided into two groups. The first group consists of 14 patients received growth hormone and a second group consists of 10 patients that didn't receive growth hormone. In both groups, enteral and parenteral nutrition, loperamide to delay intestinal motility and ranitidine in the first week to decrease gastric hypersecretion were given. The beginning of intestinal adaptation beside histological examination of the intestine was compared in both groups. Growth hormone appeared to have a positive effect on accelerating the intestinal adaptation in short bowel syndrome clinically. The histological examination which was done 3-6 months postoperatively revealed increase of the length of the villi with thickened mucosa in both groups without significant difference because, most probably, the histological study was done after the intestinal adaptation has started in both groups