Knowledge regarding breast self-examination among middle aged women of Uttarakhand

Background: Breast self-examination involves the women herself looking at the mirror and feeling each breast for possible lumps and distortion or swelling. It is seen that more than 10% to 20% breast cancer is detected by breast self-examination. Methods: A descriptive cross-sectional study was conducted to assess knowledge regarding breast self-examination among middle aged women in a selected community setting of Uttarakhand. A total of 62 samples were selected through systematic randomized sampling technique. A structured knowledge questionnaire was administered through interview technique to assess the knowledge. Results: Most of the (49%) women had poor knowledge regarding breast self-examination. There was significant association between age of the samples, education status, family income and previous information regarding breast self-examination with knowledge score. Conclusions: The study concluded that there was inadequate knowledge regarding breast self-examination among middle aged women in Uttarakhand. There is a need for educational programs to create awareness and improve knowledge regarding routine breast self-examination.

Shatavari Ghrita Aschyotana In Computer Vision Syndrome A Pilot Study

Computer Vision Syndrome (CVS) is one among major lifestyle hazard of superfast and advanced 21st century. According to contemporary science, only palliative measures in the form of Tear supplements are available which has to be used lifelong by the patients. So considering the grave nature of the disease, higher incidence and lack of effective measure it has been selected for the present study. As CVS is a technological occupational hazard there are no direct references available in our classics. Though few features mentioned in Netra rogas provide indirect references through which one can understand doctrines behind its treatment. Symptoms of CVS mainly indicate vitiation of Vata and Pitta dosha. So there is a need of finding effective measures which can fulfil the criteria such as Vatapittahara, Snehana, Chakshusya and Rasayana.Considering above facts Aschyotana with Shatavari ghrita is expected to yield better results. In the present study, 10 patients were randomly selected and treated with Shatavari Ghrita Aschyotana, 10 drops i.e., Snehana type, twice daily for a period of 30 days. Follow up study was undertaken for every 15 days upto 3 months. There is significant improvement in condition especially related to subjective symptoms like eye strain, dryness, diplopia and redness. The collected data was statistically analysed and at the end of present study overall response was moderate i.e., 65.96%. Hence we can infer that Ayurvedic siddhantas are eternal and can be applied in understanding any disease. Shatavari Ghrita Aschyotana proved effective in management of Computer Vision Syndrome. So this simple, cost effective formulation can be used in treating CVS.

Cerebrotendinous xanthomatosis: a treatable cause of metabolic ataxia.

Cerebrotendinous xanthomatosis is an exceptionally rare condition in Indian subcontinent, however, it is potentially treatable if diagnosed. We present and discuss the clinical presentation and investigations in a case of cerebrotendinous xanthomatosis (CTX).

Caspofungin: a major breakthrough in treatment of systemic fungal infections.

Invasive fungal infections are difficult to eradicate especially in immuno-compromised host. Amphotericin B and voriconazole have been the mainstay of treatment but both have significant toxicity. Caspofungin belongs to a new class of antifungal agents, the echinocandins. It acts on the fungal cell wall by selective inhibition of beta-(1,3)-D-glucan syntheses, which is not present in mammalian cells. In vitro data and experimental studies have demonstrated that it has antifungal activity against yeasts of the genus Candida (including those resistant to amphotericin B and azoles), severe species of filamentous fungi, including aspergillosis and certain dimorphic fungi. As an empirical antifungal therapy in neutropenic patients, it has comparable clinical efficacy but superior tolerability compared with liposomal amphotericin B. In patients with invasive candidiasis, it is as effective as amphotericin B deoxycholate. In addition, it showed a significantly superior safety profile. Same has been shown in patients with oropharyngeal/oesophageal candidiasis. In patients with invasive aspergillosis refractory to or intolerant to other antifungal agents, 45% showed a partial or complete response to Caspofungin given as a salvage treatment. Caspofungin is cidal for all Candida species and is static against Aspergillus species. It also possesses activity against Pneumocystis jiroveci. In vitro and in animals, Caspofungin shows additive or synergic antifungal activity with amphotericin B and triazoles. Recently, it's use in paediatric patients, including after bone marrow transplantation, has also been shown to be safe. With compare to other antifungal agents known to be effective in systemic fungal infections, Caspofungin has the best safety profile, tolerability with very low potential for drug interactions. This makes Caspofungin an interesting and extremely valuable new antifungal agent that broadens the available therapeutic armamentarium for the treatment of systemic fungal infections.

Therapeutic trial of sodium antimony gluconate alone and in combination with ketoconazole in post-kala-azar dermal leishmaniasis.

BACKGROUND: Drugs used in PKDL include parenteral sodium antimony gluconate (SAG), amphotericin-B, pentamidine, and ketoconazole (KTZ). SAG is the most effective one. Given alone, SAG has to be given for a long duration, leading to poor patient compliance and treatment failure. This study was carried out to compare the effectiveness of SAG alone and a combination of SAG and KTZ for sixty days. METHODS: Ten patients of PKDL were included in the study. Five patients (Group A) were given SAG intravenously, in the dose of 20 mg/kg per day and five (Group B) were given SAG (intravenously 20 mg/kg per day) and KTZ (200 mg twice daily orally). Both treatment regimens were given for sixty days. RESULTS: In Group A, the nodules and/or plaques showed approximate 80-85% clinical improvement, and macules showed 25-30% improvement. In group B (SAG + KTZ), there was 90-95% clinical improvement in the nodules and/or plaques and 25-30% in macules. CONCLUSION: This study suggests the therapeutic superiority of the combination treatment regimen in a shorter duration but is not conclusive as the number of patients was low. Further trials are recommended.

Localized cutaneous sporotrichosis lasting for 10 years.

A case of localized cutaneous sporotrichosis lasting for 10 years is being reported. The fixed cutaneous variety creates diagnostic difficulty by mimicking other conditions, chiefly lupus vulgaris.

Ketoconazole 2% shampoo in pityriasis versicolor: an open trial.

Pityriasis versicolor is a common superficial fungal infection caused by a lipophilic yeast. The aim of the study was to evaluate the efficacy of ketoconazole 2% shampoo in the treatment of pityriasis versicolor, for which thirty patients were included. The shampoo was applied daily for 3 days and found to be very effective in clearing the signs and symptoms of the disease. There was no serious adverse effects.

Amelioration of experimental diabetic neuropathy and gastropathy in rats following oral administration of plant (Eugenia jambolana, Mucuna pruriens and Tinospora cordifolia) extracts.

Extract of M. charantia (200 mg/kg), E. jambolana (200 mg/kg), M. pruriens (200 mg/kg) and T. cordifolia (400 mg/kg) was administered for 50 days in STZ induced diabetic mice, the plasma glucose concentration was reduced by 24.4, 20.84, 7.45 and 9.07% respectively. Tail flick latency (TFL) and gastric transit percentage were significantly higher in diabetic controls versus normal controls. M. charantia and E. jambolana modified it favorably while M. pruriens and T. cordifolia did not exert any favorable change.

Association between lower hair zinc levels and neural tube defects.

Though folic acid supplementation has reduced the incidence of Neural Tube Defects (NTD), NTD still constitutes one of the important congenital malformations having wide medical, social and ethical implications. Zinc deficiency has been reported to produce NTD in animals. This study was designed to evaluate zinc status of the newborn babies with NTD and their mothers. Eighty newborn babies with NTD and their mothers served as cases. Eighty apparently normal newborn babies and their mothers served as controls. Serum and scalp hair zinc levels were analyzed by atomic absorption spectrophotometry. The mean (+/- SD) serum and hair levels in normal mothers were 74.1 +/- 4.1 micrograms/dl and 142.3 +/- 8.0 micrograms/g respectively. The mean (+/- SD) serum and hair levels of the mothers who delivered NTD babies were 75.7 +/- 5.6 micrograms/dl and 129.9 +/- 5.3 micrograms/g respectively. The mean (+/- SD) serum and hair levels in normal newborn babies were 77.8 +/- 5.3 micrograms/dl and 188.8 +/- 6.2 micrograms/g respectively. The mean (+/- SD) serum and hair levels in NTD babies were 80.1 +/- 12.9 micrograms/dl and 174.2 +/- 10.7 micrograms/g respectively. The hair zinc levels of the affected babies and their mothers were significantly lower (P < 0.001) than the controls. This study has found association between NTD and decreased hair zinc levels and large population based studies are recommended to confirm the association between zinc and NTD and to investigate whether zinc supplementation would reduce the overall incidence of NTD.

Zinc levels in women and newborns.

Zinc is an important trace element having a definitive role in the metabolism, growth and development and reproduction. During pregnancy the requirements for zinc increase. This study was designed to evaluate the zinc status of normal women, normal pregnant women and their newborn babies. Forty normal adult females, 40 normal pregnant women and their newborn babies were randomly selected and their serum and hair zinc levels were analysed using atomic absorption spectrophotometer. The mean serum and hair zinc levels in normal women were 69.47 +/- 1.4 micrograms/dl and 147.45 +/- 6.12 micrograms/g respectively. The mean serum and hair zinc levels in normal pregnant women were 69.0 +/- 3.22 micrograms/dl and 142.83 +/- 4.39 micrograms/g respectively while the mean serum (cord blood) and hair levels in normal new born babies were 72.77 +/- 5.14 micrograms/dl and 188.36 +/- 4.12 micrograms/g respectively. There was a significant (p < 0.001) decrease in hair zinc levels during pregnancy. There was a significant (p < 0.05) decrease in zinc levels in new born babies when the time interval between the previous delivery and the present delivery was less than 3.4 years. The results of the present study reinforce the need for zinc supplementation during pregnancy especially if the interval between pregnancies is short.

Diagnostic and prognostic role of CRP and m-ESR in neonatal septicemia.

Serial estimation of CRP and m-ESR was done in 65 clinically suspected cases of septicemia and 25 healthy controls. Of these 65, 12 (18%) had a negative CRP test at the time of diagnosis and rest all had significantly elevated CRP and m-ESR compared to matched controls at the time of diagnosis. A persistently negative CRP test indicated bad prognosis. With treatment a declining trend of CRP was seen in survivors, but in deteriorating/expired babies the levels kept on increasing. However, m-ESR had no prognostic significance.