Study the role of hepcidin in diagnosis of iron deficiency anemia in young females of northern India

Background: Iron deficiency is one of the most common nutritional disorder. Maintenance of body iron status is an integral part of healthcare in young female of reproductive age group. Thereby early detection could lead to early intervention and reduce its comorbidity.  Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of serum hepcidin in iron deficiency and to access the baseline value of hepcidin in young female.Methods: This sectional study was conducted in the Department of biochemistry SGT Medical College Hospital and Research Institute, Budhera, Gurugram. It included non-pregnant female students of age 18-25 years with normal RBC indices and hemoglobin >12 gm%. Estimation of serum hepcidin-25 was by ELISA.Results: The reference range of hepcidin established in this study was 12.14-139.89 ng/ml for females with the mean being 42.4±29.13 ng/ml. It showed higher discriminating power in evaluating iron status in young healthy women (AUC 0.984) with best combination of diagnostic sensitivity (95.7%) and specificity (93.2%) at a cut off of >15.7 ng/ml. Serum hepcidin identified 17% of young healthy females with normal hemoglobin to have functional or storage iron deficiency.Conclusions: The prevention of iron deficiency anemia remains insufficient worldwide especially among underprivileged women and children Therefore, estimation of serum hepcidin may be considered as a valuable tool in assessing iron status in young healthy female population who are the prime target group for iron supplements to reduce comorbidity associated with iron deficiency and anemia.

Three delay model: to find out the reason for maternal deaths

Background: Each year in India, roughly 28 million women experience pregnancy and 26 million have a live birth. Of these, an estimated 67,000 maternal deaths and one million new-born deaths occur each year. A woman dies as a result of complication arising during pregnancy and childbirth every 90 seconds in the world, and every 7 minutes in India. The three delay model can be used to find the causes of delays in relation to maternal deaths.Methods: A retrospective study was carried out in a tertiary care centre. All cases of maternal mortality between July 2010 to June 2016 were included in the study. Then data analysis was done.Results: Out of the total 382 maternal deaths, Majority of maternal deaths 43% were due to type 1 delay. 150 patients had delay in seeking help, 9 patients refused treatment and 5 patients refused admission to health care centre. 13% maternal deaths were due to type 3 delay which include delay in receiving adequate treatment, Delay in diagnosis and intervention, Lack of facilities etc.Conclusions: Type-1 delay was major contributors of maternal deaths in the study region. Therefore, to prevent the preventable maternal deaths effective action should be taken.

Studying prevention of parent to child transmission services, interventions, coverage and utilization

Background: Human immunodeficiency virus (HIV) infection is increasing at an alarming rate globally. Apart from heterosexual route, mother to-child transmission is the next most important route of HIV transmission accounting for over 90% of infections in children. The present retrospective study is undertaken to evaluate the effectiveness of implementation of PPTCT programmed in GMERS Medical College, Sola, Ahmedabad, Gujarat, India.Methods: At ICTCs, registered ANCs are counseled and tested for HIV. HIV+ve ANCs are linked to services and followed-up for institutional delivery. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery and children testing. HIV+ve ANCs since 2014 to 2016 subsequently delivered till December 2018 and their exposed children followed up till 18 months for confirmation of their seropositivity status in PPTCT were study at GMERS medical college, sola, Ahmedabad, Gujarat, India.Results: 13595 ANCs registered, 100% were counseled pre-test, and 99.5% of them tested, 79.5% were counseled post-test.  CD4 testing was carried out in all HIV+ve ANCs. 55 ANCs were detected HIV+ve inclusive of 37 new registered, 16 re-pregnancy and 2 unregistered cases. 55 pregnancy outcomes reported institutionally total 85.9% delivered at institute out of them 26.5% were caesarian sections and 62.4% delivered vaginally. Out of 48 live births, 47 sdNVP-MB-Pair were given. 48 children were traced till 18 months, 82.5% of live births were alive, and 68.75% of live births were tested. 1 was found HIV+ve with history of adherence to all prescribed PPTCT guidelines.Conclusions: PMTCT services - counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.

Study of antenatal prevalence of HIV and its trend in a tertiary care hospital

Background: HIV/AIDS has become a global problem since first detection in 1981.Women of childbearing age constitute nearly half of the 30 million adults currently living with HIV/AIDs worldwide. Pregnant women are considered as low risk for HIV so estimating prevalence in such low risk people provides us a good basis for long term strategy for implementation of HIV/AIDS control programme. The objective of this study was to study acceptance of antenatal HIV testing during routine ANC checkups using opt in strategy. To study prevalence of antenatal HIV and its trend.Methods: Observational and analytic study. Antenatal women coming for routine antenatal care in obstetric OPD were counseled and blood sample were taken according to guidelines for HIV testing from period 1/1/2014 to 31/12/2018.Results: Out of total 23907 women attending antenatal clinic 23841 accepted HIV testing, Out of these 72 were found positive, making HIV seroprevalence rate of 0.30. 42 spouses were also found positive.Conclusions: Though seroprevalence of HIV in antenatal women is low, slowly rising trend worths a caution for us.

A Study of Musculo Skeletal Disorders among Bank Workers Employed in and Around Arera Hills Bhopal

Introduction: Work related musculoskeletal disorders areone of the most common occupational diseases which mainlyaffect lower back, neck and upper and lower extremities. Workrelated MSDs can affect shoulders, arms, elbows, wrists,hands, back, legs and feet. Symptoms include tenderness,pain, tingling, stiffness and swelling. The study aimed to findout the prevalence and pattern of musculoskeletal disordersamong the bank employees.Material and Methods: A cross sectional study was carriedout among the bank employees (272) employed at AreraHills Bhopal and evaluation of MSD’s with NORDICmusculoskeletal questionnaire.Results: The mean age of study paricipants was 34.8±10.6years,and the number of male staffs (67.95%) outnumberthat of females (32.05%). The mean hours spent per week onwork is around 50.3±9.8 hours. Lower back associated MSDwere more common (65.25%) among the staffs, while ankleswere the least effected (6.5%). Most disabling MSD wasseen to be that of wrist/hand (34.3%) followed by lower back(27.8%).Conclusion: Moderate prevalence of musculoskeletaldisorders and associated disability was reported by bankworkers in Arera Hills. Lower back associated morbiditieswas more prevalent among the bank workers

Study of diagnosis and management of ectopic pregnancy

Background: Diagnosis of ectopic pregnancy was frequently missed. Aim of the study was to determine the clinical presentation, and treatment associated with ectopic pregnancy.Methods: This is a prospective study which was carried out at Obstetrics and Gynaecology department, GMERS SOLA civil hospital from August 2017 to October 2018. Total 416 patients were admitted during study period out of them 50 patients diagnosed with ectopic pregnancy were enrolled in the study and information was collected and analysed.Results: 80% patients were between the age group of 21-30 years. 56% patients were nulliparous. Amenorrhea (92%) with lower abdominal pain (94%) is the most common presenting symptom. 26% of patients show typical triad of amenorrhea, abdominal pain and bleeding per vagina. UPT and USG were most commonly performed investigations. 96% cases showed UPT positive. 100% USG showed adnexal pathology. Serum beta-hCG was done in 37 patients as an aid for diagnosis and to decide the line of management. Conservative medical management with Injection MTX was done in 4 patients of which 1 patients required laparotomy later on. Surgical management was done in 90% of patients. Laparoscopic management was done in 54% of cases.Conclusions: Early diagnosis and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.

Syndromic approach to identify cases of vaginal discharge: a cross-sectional study among females of Shaheed Nagar, Bhopal, Madhya Pradesh

Background: Management of Sexually Transmitted Infections (STIs) is important in controlling STIs and to break the chain of infection and transmission.Syndromic case management is a standardized evidence-based approach which utilizes clinical management algorithms and flowcharts that are handy and can be consistently used across health care providers. The objectives of the study were to identify cases of vaginal discharge in Shaheed Nagar, Bhopal and to provide them treatment following syndromic approach.Methods: Prospective cross-sectional study carried out over a period of three months among reproductive age group females (15-45 years) in Shaheed Nagar, Bhopal. Purposive sampling by conducting door- to- door survey until 150 women fulfilling study criteria was interviewed. A pre-designed questionnaire used for data collection. Educational intervention given to all participants. 37 participants identified with vaginal discharge syndrome and were assisted by study team to gynecological OPD for obtaining treatment based on syndromic approach. Data entered in MS Excel 2007 and statistical analysis carried out using epi-info 7.2. Proportions and percentages were calculated. Chi-square was used to find out association between prevalence of vaginal discharge and qualitative variables. P value <0.05 considered statistically significant.Results: Prevalence of vaginal discharge was 24.67%. The most common presenting complaint was general weakness (52%). The most common diagnosis was cervicitis (8.67%) followed by vaginitis (4.67%). Statistically significant correlation was found between presence of disease (STI) and use of intra- uterine device (IUD), non-use of sanitary pads, marital status, occupation and socio- economic class.Conclusions: Abnormal vaginal discharge can both be the cause as well as the effect of pelvic inflammatory disease.

Abdominal Tuberculosis: Clinical-pathological Profile and Role of Surgery in its Management

Background: Abdominal tuberculosis (TB) is an essential clinical element having a varied mode of clinical presentation. Diagnosis of abdominal TB is a troublesome and cautious way to deal with the patients, and strong examination and supportive investigations are important to make the last finding. Objectives of the study were to evaluate the clinic-pathological profile of patients with abdominal TB and the role of surgery in its management in a tertiary care center in northern India. Methods: This is a retrospective study conducted in the department of general surgery and medical college DOTS center of northern India. A total of 97 patients with abdominal TB diagnosed on the basis of clinical profile and supported investigation data were selected for this study. Radiological findings, diagnostic laparoscopy, laparotomy, and histological findings are taken into account. Results: Of the 97 patients, 56 were males and 41 females with age ranging 16–82 (mean 32.3) years. Abdominal pain was the most common presenting symptom in 84 (86.59%). The diagnosis of abdominal TB was confirmed by histopathology in 78 (80.41%). Remaining 19 (19.5%) cases were diagnosed microscopically and with supportive clinical and imaging background. All the patients were treated under DOTS. Conclusions: Early diagnosis is the key factor in avoiding systemic and local complications of intestinal TB. No clinical features, laboratory, radiological or bacteriological, and histopathological findings are gold standard in the diagnosis of abdominal TB. In emergency cases, prompt surgical exploration, anti-TB drugs, and vigilant care are met with good recovery

Scale up of dextran production from a mutant of Pediococcus pentosaceus (SPAm) using optimized medium in a bioreactor

The mutant of Pediococcus pentosaceus (SPAm) produced earlier by UV-mutagenesis exhibiting higher dextransucrase activity as compared to wild-type was used. The generated mutant SPAm gave 12.2 mg/ml, a 20 percent higher dextran than wild-type. Response surface methodology was carried out for further enhancement of dextran production. To enhance dextran production by the mutant SPAm, Plackett-Burman Design and a 2² full factorial Central Composite Design was employed. After response optimization, the optimum concentration of sucrose and yeast extract was 5.115 percent (w/v) and 0.635 percent (w/v), respectively. The experimental values of dextran 36.0 mg/ml at flask level and 35.0 mg/ml at bioreactor level were in good agreement with the predicted value of 40.8 mg/ml. The increase in dextran production by the mutant SPAm using the optimized medium was 3 fold higher as compared to unoptimized medium.

Esthetic correction in open bite.

Deleterious oral habits, which are persistent, can lead to poor esthetics of a beautiful face. Conventional treatment modalities for an open bite usually include orthodontic treatment and/or skeletal surgery. This article focuses on a different treatment modality for an anterior open bite.

Evaluation of efficacy of nizer versus nimesulide tablets in otitis media.

An evaluation of clinical efficacy of nizer versus nimesulide tablets was undertaken in 118 patients suffering from otitis media. Nizer demonstrated rapid and powerful analgesic and antipyretic effects compared to plain nimesulide, without additional side effects.