Immunogenicity of measles-rubella vaccine administered under India’s Universal Immunization Programme in the context of measles rubella elimination goal: A longitudinal study

Background & objectives: There is a paucity of data regarding immunogenicity of recently introduced measles–rubella (MR) vaccine in Indian children, in which the first dose is administered below one year of age. This study was undertaken to assess the immunogenicity against rubella and measles 4-6 wk after one and two doses of MR vaccine administered under India’s Universal Immunization Programme (UIP). Methods: In this longitudinal study, 100 consecutive healthy infants (9-12 months) of either gender attending the immunization clinic of a tertiary care government hospital affiliated to a medical college of Delhi for the first dose of routine MR vaccination were enrolled. MR vaccine (0.5 ml, subcutaneous) was administered to the enrolled participants (1st dose at 9-12 months and 2nd dose at 15-24 months). On each follow up (4-6 wk post-vaccination), 2 ml of venous blood sample was collected to estimate the antibody titres against measles and rubella using quantitative ELISA kits. Seroprotection (>10 IU/ml for measles and >10 WHO U/ml for rubella) and antibody titres were evaluated after each dose. Results: The seroprotection rate against rubella was 97.5 and 100 per cent and against measles was 88.7 per cent and 100 per cent 4-6 wk after the first and second doses, respectively. The mean (standard deviation) titres against rubella and measles increased significantly (P<0.001) after the second dose in comparison to the levels after the first dose by about 100 per cent and 20 per cent, respectively. Interpretation & conclusions: MR vaccine administered below one year of age under the UIP resulted in seroprotection against rubella and measles in a large majority of children. Furthermore, its second dose resulted in seroprotection of all children. The current MR vaccination strategy of two doses, out of which the first is to be given to infants below one year of age, appears robust and justifiable among Indian children.

Electroconvulsive Therapy in a Patient with Left Main and Triple Vessel Coronary Artery Disease (CAD): Anaesthetic Management

Electroconvulsive therapy (ECT) is a safe and effective treatment for many psychiatric disorders. The passage of electrical current lead to hemodynamic alterations which may be detrimental to patients suffering from severe coronary artery disease. We describe perioperative anesthetic management of a patient having severe left main coronary artery stenosis (LMCAS) with severe triple vessel coronary artery disease (TVD).

HISTOMORPHOLOGICAL STUDY OF CHOLECYSTECTOMIES IN A TERITIARY CARE CENTER

Introduction: Cholecystectomy is the most common surgical procedure performed for cholelithiasis (gall stones). Cholelithiasis is one of the most common gastro intestinal disorder worldwide. Usually asymptomatic, but commonly encountered symptoms may be right upper quadrant pain, dyspepsia and belching. The incidence of cholelithiasis is 2-4 times more in women than in men. The aim of the present study is to identify various morphological patterns and frequency of gall bladder lesions in cholecystectomy specimens. The Materials And Methods: present study was a cross sectional descriptive study of all cholecystectomy specimens received in the department of pathology, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam, Andhra Pradesh; conducted over a period of 12 months from September 2021 to August 2022. The relevant and detailed clinical history were taken and processing was done in these specimens for histopathological examination. A total of 80 cholecystectomy specimens were received in the Results: department. Out of which, 79 were in?ammatory gall bladder lesions and only one case was reported as malignancy. The most common age group affected were in 4th to 5th decade with female preponderance comprising of 47cases (58.75%) while the gall bladder carcinoma was reported in 72 years of age. Among the in?ammatory lesions, most common one was chronic cholecystitis comprising of 64 cases, 80.5% (63.6% associated with gall stones) were chronic cholecystitis, followed by 10 cases (12.5%) of acute cholecystitis (100% associated with gall stones), 2cases (2.5%) of polyps & Adenomyomatosis each. Only one case (1.25%) of each Cholesterolosis & gall bladder adenocarcinoma was reported. Chronic cholecystitis is the Conclusion: most common gall bladder disease for which cholecystectomies are being done. The present had reported various morphological patterns encountered in the cholecystectomy specimens received in the department

Utility of Subjective Global Nutritional Assessment Tool for the Assessment of Malnutrition in Pediatric Patients with Chronic Liver Disease / 대한소아소화기영양학회지

Purpose@#Approximately 30% of children with chronic liver disease (CLD) are malnourished.However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. @*Methods@#This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. @*Results@#A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), midupper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). @*Conclusion@#In our study, more than one-third of children with CLD were malnourished.Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.

Cyto-histological study of Thyroid Lesions in an institute in a rural area.

Introduction: Thyroid swellings are a common clinical problem. The Bethesda system of FNAC has been used for the past 5-6 decades for the investigation of thyroid lesions. This system helps in categorising thyroid lesions and also suggests possible management. Histopathology is the gold standard for confirming diagnosis. Aims and Objectives: To determine the incidence of thyroid lesions according to age and sex. To compare cytological diagnosis according to the Bethesda system of reporting with histological diagnosis and determine accuracy. Materials and methods: This is a study done over a period of 5 years from January 2016 to December 2020 in the department of pathology in a medical college in a rural area. The number of thyroid aspirations done were 232. Smears were classified as per The Bethesda system. Cytological and histopathological findings were correlated in 50 cases that underwent surgery. Cases with diagnostic discrepancy were reviewed. The sensitivity and specificity, negative predictive value, positive predictive value and diagnostic accuracy values were calculated using standard statistical formulae. Results: The thyroid lesions on cytology in the nondiagnostic, Benign, Atypia of unknown significance, Follicular neoplasia, Suspicious for malignancy and malignant category were 3.4%, 81.89%, 1.72%, 7.7%, 0.8% and 4.3% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy in our study was 78%, 84%, 78%, 87% and 84% respectively Conclusion: The Bethesda system of classification of thyroid lesions on cytology helps in the diagnosis of thyroid lesions and their further management. Histopathological correlation helps in evaluating diagnostic accuracy and helps in quality assurance.

Hypokalemic Rhabdomyolysis — A Rare Presentation

Hypokalemia leading to Rhabdomyolysis is a potentially fatal disorder if not identified and treated early. In this case report we present a patient who had one week history of asymmetric painful Quadriparesis with neck drop and preserved reflexes. Evaluation revealed Hypokalemia with raised creatine.

Post-transplant Diabetes Mellitus: What Physicians Need to Know

Monkeypox was a zoonotic infection, first detected in parts of northern Africa in the 1970s. Monkeypoxvirus, the causative agent of monkeypox, is a species of genus Orthopoxvirus and is closely related to long-eradicated smallpox caused by variola virus. Outbreaks in the West (in USA, UK, and Ireland) along with periodic re-emergence of the disease in parts of Africa have generated concern among global health bodies due to the existent deficiency of guidelines for management of the disease. Genetic variations and altered mechanisms favoring better survival of the virus have made early identification of the disease during screening difficult, particularly in resource-limited settings like rural areas of Africa. Through evidences gathered from experimental studies conducted after these outbreaks, the virus is known to be transmitted from several animal reservoirs along with human-to-human contact of blood, body fluids, or aerosol. Early diagnosis through immunoassays and polymerase chain reaction (PCR) tests, although not very specific, allows early treatment and subsequently better patient survival and recovery. Presence of lymphadenopathy along with fever, sore throat, and a vesiculopustular rash is diagnostic. The virus affects the gastrointestinal, hematological, ocular, and respiratory systems, in like manner producing afflictions of the specific system. Treatment, through experimental data, has been preferred to be symptomatic, with the aim to prevent superinfections. Antivirals like cidofovir and tecovirimat have been studied upon and used in clinical trials with favorable outcomes. Antiviral immunoglobulins have also been used with success in certain patients for postexposure prophylaxis.

Study of erectile dysfunction in patients of type 2 diabetes mellitus and its association with cardiovascular risk

Background: Diabetes is a chronic metabolic disorder that is characterized by high level of blood glucose levels, which over a period of time can lead to micro-vascular or macro-vascular complications. Erectile dysfunction (ED) is common not much discussed and distressing complication of diabetes. ED in type 2 may be independent marker of coronary artery disease (CAD).Aim and objectives were to assess the ED in subject of type 2 diabetes mellitus (DM). Assessment of correlation of ED with CAD. Methods: The present cross-sectional study consisted total 180 diabetic patients. On basis of international index of erectile function (IIEF) questionnaire EDpatients were assessed.Result: Out of180 diabetic patients 36.11% had varying degree of ED. Out of 65 EDpatients, maximum frequency of moderate ED (47.69%) was found then severe ED (32.30%), mild to moderate ED (12.30%) and mild ED (7.69%). Most of the patients were in the age group of 40-50 years35 (53.84%), 50-60 years22(33.4%), <40 years(9.23%) and 60-70 years 2 (3.07%) showed ED. Fasting blood sugar and postprandial blood sugar showed significant (p<0.05) relation with ED. HbA1c show an insignificant correlation (p>0.05) with ED. In patient with ED was having more value of atherosclerotic cardiovascular disease (ASCVD) (9.11±4.84) than patient without ED (8.82±5.72). There was no significant (p>0.05) difference in term of ASCVD risk score in ED patient’s ED and without ED patients.Conclusions: Poor glycemiccontrol was a strongest risk factor for ED.

A single-centre, observational, retrospective study to evaluate coexistence of cardiovascular comorbidities and obstructive sleep apnoea in South Indians using apnea link air home sleep testing device

Background:The aim of thestudy was to explore whether there is a relationship between Cardiovascular (CV) comorbidities and the prevalence and severity of Obstructive sleep apnea (OSA).Methods:Secondary data analysis of 146 patients with suspected sleep-disordered breathing was conducted who were presented to the department of medicine, KIMS Hospital, Hyderabad, from June 2021 to November 2021. Participants aged ?18 years were included in the analysis. Demographic details, clinical history, comorbidities, medication history, were analyzed. AHI score, ODI (Oxygen desaturation index) score and average O2saturation were recorded with the help of a home sleep testing device. Data were entered and analyzed with Epi info 7.Results:The overall prevalence of OSA was 78.8% in patients with suspected sleep-disordered breathing. Prevalence of mild, moderate, and severe OSA was 28.8%, 15.1%, and 34.9%, respectively. Proportions of diabetes and hypertensionwere significantly high among patients with obstructive sleep apnea. Correlation analysis revealed a weak positive linear relationship (r=0.14) between the number of risk factors and the AHI score.Conclusions:Thisstudy showed high prevalence of OSA among out patients presented with suspected sleep disordered breathing. Hypertension, diabetes and obesity were highly prevalent CV comorbidities among South Indian patients diagnosed with OSA.

Critical Review of Ayurvedic and Contemporary Concept of Dushi Visha and its Treatment

Poisoning is a major public health concern that is becoming more common by the day. Poison can be consumed directly or indirectly from a variety of sources. Poisoning can now be found in a variety of areas, including junk food with chemical preservatives, various sorts of growing products like rice and wheat, and pesticide-laced veggies. As a result of diverse human behaviours, water, air, and soil have become contaminated, posing a hazard to human health. According to Ayurvedic doctrine, there are several sources of obtaining of toxins i.e., either through animate, inanimate or Kritim(artificial). Such toxins are accumulated without eliminating through the body or remains with being the less potent inside the body for several years generally called Dushi Visha. All the sign and symptoms of Dushi Visha looks like that of chronic poisoning and varies from organs to organs, where it becomes deposited. Such accumulated Visha then vitiates Dosha and that leads to vitiation of different kinds of Dhatus respectively. like, Rakta Dusti, Kitiva, Vrana, Kotha are the major manifestations that will see after prolong exposure to Dushi Visha. The main line of treatment of Dushi Visha is through Detoxification (i.e., Vamana, Virechana, Raktamokshana karma) followed by Dushivisari Agad Paana, that has mentioned by Charak. Classical text book has mentioned different level of clinical manifestations including sign and Symptoms and its complication along and its management with specific Justification.

A Case Study on the Management of Psoriasis (Kitibha) by Ayurvedic Intervention

Psoriasis (Kitibha) is one of the most common chronic skin disorders, which has psychological and social impact on patient’s life. This disease is not contagious and may affect people of any age, but it commonly begins around 15 to 40 years. Psoriasis is commonly red and white hues of scaly patches appearing on the top of skin. This disease is equated to Kitibha in Ayurveda due to its invariable similarities in signs and symptoms. This case study aims to investigate whether Ayurvedic intervention can manage moderate to severe Psoriasis (Kitibha). A 41‑year old male came to the Outpatient Department (OPD) of Central Ayurveda Research Institute, Guwahati with clinical features indicative of Psoriasis. This case was diagnosed as Kitibha and was managed by Ayurvedic interventions of Kaishore Guggulu 1gm twice a day, Arogyavardhini vati 500mg twice a day, Panchtiktaguggulu Ghrit 3 gm twice a day and Brihat Marichyadi tail local application twice a day for 3 months at OPD level. The response to the treatment was found to be highly effective. At the end of the treatment period and follow up of 1 month as compared with baseline, highly significant changes were observed. Kaishore Guggulu, Arogyavardhini vati, Panchtiktaguggulu Ghrit and Brihat marichyadi tail in the above‑mentioned doses were found to be very effective and safe in moderate to severe case of Psoriasis (Kitibha).

Morphometry and Sexual Dimorphism of the Human Clavicle in South Indian Population

Background: In forensic anthropology, determining an individual’s sex is the fundamental criteria of identification, but this is a tough task that gets considerably more difficult when only a single bone, such as the clavicle, is available. In physical anthropology, determining the sex of a deceased individual is a fundamental prerequisite. Physical anthropologists have gotten more concerned about the difficulties of human identity in recent years. Traditional techniques of sexing bone are subjective and ineffective when absolute sexing precision is desired, hence this study. Methods: Measurement of clavicular length and circumference using an Osteometric board or sliding and Vernier Callipers product from 1128 dry clavicles of unknown sex and age procured from various medical institutions and departments of anthropology in south India. Length, inner angle, outer angle, the sum of angles, inner segment, middle segment, outside segment, width at the inner end at an inner angle, least width at conoid tubercle, at the outer end, and mid circumference have all been measured. Results and Discussion: The male mid-shaft circumference is 38.0±0.5mm on the right side and 36.5±0.5mm on the left side, whereas the female mid-shaft circumference is 31.4±0.3mm on the right side and 31.4±0.6mm on the left side. The length of the left clavicle is greater than the length of the right collarbone. The curvature of the right collarbone is higher than that of the left, resulting in a shorter right bone than the left. The clavicle of males has a higher mean across all parameters than females. Male clavicle length is more than female clavicle length, midshaft circumference is less in females than males, and breadth at an inner angle is shorter in females than men, all of which are statistically significant. The Mid-shaft Circumference as a sex-determination metric is statistically significant in differentiating the clavicle’s sex. This delivers a better result than clavicle weight since clavicle weight fluctuates with age and the health state of the individual. Male clavicles have a larger Midshaft Circumference than female clavicles.

Role of Peroral Endoscopic Myotomy in Advanced Achalasia Cardia With Sigmoid and/or Megaesophagus: A Systematic Review and Metanalysis

Background/Aims@#Sigmoid esophagus and/or megaesophagus are considered as an advanced stage in the natural history of achalasia cardia. The role of peroral endoscopic myotomy (POEM) in these subset of patients is emerging. We performed a systematic review and metanalysis to study the efficacy of POEM in advanced achalasia cardia with sigmoid and megaesophagus. @*Methods@#A literature search in PubMed and Embase was done from inception till August 3, 2021 to look for studies reporting exclusively on the role of POEM in advanced achalasia cardia with sigmoid and/or megaesophagus. The random effect method with inverse variance approach was used for the computation of pooled prevalence. For 2 groups’ analysis of continuous outcome standardized mean difference was used as the summary measure. @*Results@#Eleven studies with 428 patients were included for analysis. The pooled technical and clinical success was 98.27% (95% CI, 96.19-99.22; I 2 = 0%) and 89.38% (95% CI, 84.49-92.86; I 2 = 26%) and on subgroup analysis into sigmoid and megaesophagus it was (98.06% [95% CI, 95.41-99.19; I 2 = 0%], 98.47% [95% CI, 92.72-99.69; I 2 = 0%] and 87.92% [95% CI, 80.68-92.70; I 2 = 37%], 88.36% [95% CI, 62.62-97.17; I 2 = 77%]) respectively. The clinical success at < 1 year and 1-3 year follow-up was 89.37% (95% CI, 82.82-93.61; I 2 = 0%) and 88.66% (95% CI, 81.65-91.22; I 2 = 46%) respectively. There was a significant reduction in the post-POEM scores with standardized mean difference for Eckardt score (4.81), for integrated relaxation pressure at 4 seconds (1.93), and for lower esophageal sphincter pressure (2.06). @*Conclusions@#POEM is an effective modality of treatment even in the subset of patients of advanced achalasia cardia with sigmoid and megae sophagus.

Clinical presentation of COVID-19 in patients with inflammatory bowel disease: a systematic review and meta-analysis

Background/Aims@#Coronavirus disease 2019 (COVID-19) is recognized to have variable clinical manifestations. The clinical presentation of patients with inflammatory bowel disease (IBD) having COVID-19 is unclear. @*Methods@#We identified articles reporting about the clinical presentation of COVID-19 in those with underlying IBD from PubMed and Embase. The studies, irrespective of design or language, were included. The overall pooled frequency of various symptoms was estimated. Joanna Briggs Institute Critical appraisal checklist was used to assess the quality of studies. @*Results@#Eleven studies, including 1,325 patients, were included in the pooled analysis. The pooled estimates for clinical presentation were; fever: 67.53% (95% confidence interval [CI], 45.38–83.88), cough: 59.58% (95% CI, 45.01–72.63), diarrhea: 27.26% (95% CI, 19.51–36.69), running nose: 27% (95% CI, 15.26–43.19) and dyspnea: 25.29% (95% CI, 18.52–33.52). The pooled prevalence rates for abdominal pain, nausea and vomiting were 13.08% (95% CI, 9.24–18.19), 10.08% (95% CI, 5.84–16.85) and 8.80% (95% CI, 4.43–16.70) per 100 population, respectively. @*Conclusions@#The clinical presentation of COVID-19 in IBD patients is similar to the general population.

Anti urolithiatic activity of Cyperus rotundus tubers: In silico, In vitro and In vivo approaches

Abstract The present research evaluated the anti urolithic potential of Cyperus rotundus tubers extract using in silico, in vitro and in vivo techniques. In silicostudy was performed of Cyperus rotundus constituents and pathological protein oxalate oxidase (PDB Id: 2ETE). In vitrostudy, nucleation and aggregation assay involved for assessment of ethanol extract of Cyperus rotundus tuber (50-3000 µg/ml).In vivo studies involved that the Cyperus rotundusethanolic extract (100, 200 and 400 mg/kg B.wt.) wastreatedonsodium oxalate induced urolithiatic rats for seven days,evaluated kidney function by urine and serum biochemical analysis and statistical analysis performed usingGraphPad prism5 software.In silico results showedthat Cyperus rotundus constituents,Humulene epoxide, 4-Oxo-alpha-ylangene, Cubebol were exhibited better binding energyonoxalate oxidase.Ethanolic extract of Cyperus rotundustuber was exhibited nucleation, aggregation of calcium oxalate monohydrate crystals inhibition in dosedependent manner. Sodium oxalate treatment was triggered biochemical changesin the urine that have been substantially prevented by the ethanolic extract of Cyperus rotundus tuber. The current findings Cyperus rotundus anti urolithic activity due to antioxidant essential oils. The molecular docking results could be used to optimize lead and develop the appropriate urolithiasis treatment.

Fenugreek seed extract alleviates hippocampal dendritic atrophy in streptozotocin induced diabetic rats / El extracto de semillas fenugreek alivia la atrofía dendrítica del hipocampo en ratas diabéticas inducidas por estreptozotocina

SUMMARY: Herbal extracts used for treatment of diabetes has focused mostly on the hypoglycaemic and anti-oxidant property.There are no studies which focused on its effect on dendritic architecture of pyramidal neurons of hippocampus caused by diabetes. This study was taken up to explore the effect of administration of Trigonella foenum-graecum (fenugreek) seed extract on diabetes induced dendritic atrophy in hippocampus. Experimental diabetes was induced in rats by administering single dose of Streptozotocin (60 mg/kg)intraperitoneally.Treatment groups of rats were orally administeredfenugreek seed extract of 1 g/kg body weight for 6 weeks. Followingly they were sacrificed and the brains were removed, processed for the Golgi-Cox stain method.The number of dendritic branching points and intersections were counted in successive radial segments of 20 µm up to a radial distance of 100 micron from soma and analysed by the Sholl's method. The rats with diabetes showed a significant decrease in the dendritic length and branching points in most of the apical and basal dendrites of CA1 and CA3 pyramidal neurons.Treatment with fenugreek seed extract were able to significantly alleviate the dendritic atrophy in most of the segments except in the apical branching points of the CA1 neuron. The present study demonstrates that fenugreek seed extract having a proven hypoglycaemic and anti-diabetic property also possess protection to the hippocampal pyramidal neurons form diabetes associated neuronal atrophy.

RESUMEN: Los extractos de hierbas para el tratamiento de la diabetes se han basado principalmente en las propiedades hipoglucémicas y antioxidantes. En la literatura no hay estudios basados en su efecto sobre la arquitectura dendrítica de las neuronas piramidales del hipocampo, causadas por la diabetes. El objetivo de este estudio fue investigar el efecto de la administración de extracto de semilla de Trigonella foenum graecum (fenogreco) sobre la atrofia dendrítica inducida por la diabetes en el hipocampo. Se indujo diabetes experimental en ratas mediante la administración de una dosis única de estreptozotocina (60 mg / kg) por vía intraperitoneal. Se administró a grupos de ratas extracto de semilla de fenogreco a razón de 1 g / kg de peso corporal durante 6 semanas. Las ratas fueron sacrificadas posteriormente y se procesaron los cerebros mediante método de tinción de Golgi-Cox. El número de puntos de ramificación dendrítica e intersecciones se contaron en segmentos radiales sucesivos de 20 µm hasta una distancia radial de 100 micras del soma y se analizaron mediante el método de Sholl. Las ratas con diabetes mostraron una disminución significativa en la longitud dendrítica y los puntos de ramificación en la mayoría de las dendritas apicales y basales de las neuronas piramidales CA1 y CA3. El tratamiento con extracto de semilla de fenogreco alivió significativamente la atrofia dendrítica en la mayoría de los casos, excepto en los puntos de ramificación apical de la neurona CA1. El estudio demuestra que el extracto de semilla de fenogreco además de tener propiedades hipoglucémicas y antidiabéticas, también protege las neuronas piramidales del hipocampo contra la atrofia neuronal asociada a la diabetes.

Inheritance pattern of okra enation leaf curl disease among cultivated species and its relationship with biochemical parameters

Okra production in eastern India at present is severely threatened by whitefly-mediated okra enation leaf curl disease(OELCuD). Identification of resistant genotype and understanding the genetic control and biochemical relationship of OELCuD resistanceare prerequisite for developing an effective breeding strategy. This study was conducted employing six populations (P1, P2, F1, F2, BC1 andBC2) of two selected (resistant 9 susceptible (R9S)) crosses. Associationship between severity of OELCuD and biochemical parametersof parents and hybrids at preflowering and flowering stages was studied. Segregation pattern of the genotypes in F2 generation showingOELCuD reaction of two crosses suggested that two duplicate recessive genes was operative for resistance to OELCuD. Generation meananalysis revealed involvement of both additive and nonadditive effects in the inheritance of disease resistance. Hence, postponement ofselection in later generations or intermating among the selected segregates followed by one or two generations of selfing to break theundesirable linkage and allow the accumulation of favourable alleles could be suggested for the development of stable resistant genotypeagainst this disease. Higher peroxidase activity and total phenol content in leaf emerged as reliable biochemical markers for early selectionof genotype resistant to OELCuD.

Is it safe to combine ventral hernia repair with bariatric surgery?

Obesity is one of the important precipitating factors for primary and incisional ventral hernias. There is controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing bariatric surgery. We reviewed our series of 250 patients who underwent bariatric surgery over 6 years period. 7 morbidly obese patients undergoing bariatric surgery had simultaneous ventral hernia repair. Roux-en-Y gastric bypass (RYGB) in 2 patients and laparoscopic sleeve gastrectomy (LSG) were done in 5 patients. 6 patients had primary midline paraumbilical hernia and 1 patient had large recurrent incisional hernia. Open intraperitoneal onlay mesh (IPOM) repair was done in 5 cases with hernia defect <5 cm. Sutured repair was done in 1 patient, recurrence occurred after 3 months. IPOM repair was done 6 months later after significant weight loss. 1 patient of large incisional hernia (10 cm defect) with cholelithiasis underwent open mesh hernioplasty and panniculectomy. Postoperative seroma occurred in one patient, it subsided after repeated aspirations. After average follow up of over 2 years there has been no recurrence.

Level of Awareness and Attitude towards Topical Steroids among Medical Interns.

Topical steroids are the most commonly prescribed drugs in dermatological setting, and they are also one of the most abused ones, as these drugs are very cheap, easily available over the counter, and provide quick relief in symptoms. This study aims to find the level of awareness and attitude regarding topical steroids among medical interns. MethodsThis was a cross sectional questionnaire-based study conducted among medical interns of 2014 batch of Rohilkhand Medical College in the Department of Dermatology, Venereology and Leprosy. The study was conducted with the help of a questionnaire that was modified from the study, Verma P, et al. This was followed by a presentation on topical steroids use, misuse and what steps can be taken to prevent their rampant misuse. Finally, a feedback was taken on importance of the study. ResultsTotal 69 medical interns were included in the study. Fifty-two interns had previously prescribed or used topical corticosteroids. Steroids (clobetasol, betamethasone, mometasone) in combination with either tretinoin & hydroquinone or antimicrobials were commonly abused. The commonest indication for which they were used were infections of which tinea was the most common followed by dark spots or as a fairness cream, acne, eczema, and other conditions such as pruritus, insect bite, burn, etc. ConclusionsThis study shows significant knowledge gap among medical interns regarding topical steroids. Thus, knowledge regarding topical corticosteroids is very essential and should be emphasized more during the MBBS period. More studies are required to study regarding their awareness and misuse.

Value Addition on Trend of Tuberculosis Disease in India- The Current Update

Tuberculosis (TB) is infectious diseases were the lungs are mostly affected. It is caused by the Mycobacterium tuberculosisbacteria and is spread when a person already affected with TB coughs, sneezes, spits,laughs, or talk. Even though it’s is contagious does not easily catch i.e. chances of catching TB are much higher with someone you live with or work than from a stranger. Multidrug-Resistant TB (MDR-TB) arises when the antibiotic fails to kill bacteria. MDR-TB can be treatable and curable with specific anti-TB drugs but unfortunately, these are limited in quantities or not readily available. As per WHO around 4,50,000 people developed MDR-TB in the year 2012. People with a weak immune system are at maximumrisk of active TB development. For instance, HIV conquers the immune system, making it harder for the body to control TB bacteria. People infected with both HIV and TB are 20-30% more probable to develop active TB than those who do not have HIV. Besides, WHO estimates, every year 9 million people get sick with TB and 3 million with these are “missed” by health systems. Among the top 3 causes of death in women between 15-44 TB is one the major cause. The symptoms of TB may be mild for many months and can infect 10-15 other people through close contact. This study involves a comparative evaluation of the presence of Tuberculosis concerning factors such as socioeconomic status, sex ratio, age, addiction of nicotine or alcohol, etc. All the screenings were based upon various methods of diagnosis used in pulmonary tuberculosis such as Ziehl Neelsen staining, culture on L.J media, Petroff’s concentration method, and DNA PCR method