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Background- Antenatal depression is affecting 10% pregnant women worldwide with higher prevalence in developing countries. This causes poor maternal and foetal outcome and also affects cognitive development of the child. Aim and objective: To estimate magnitude of antenatal depression and its risk factors. Methodology- A cross-sectional survey was done at the antenatal clinic of community health department catering to an urban resettlement colony, East Delhi. Estimated sample size was 216 (including 10% non-response rate). Pregnant women attending the ANC clinic from October 2019 to February 2020 were enrolled. EPDS questionnaire was used to assess depression during pregnancy. Results-The antenatal depression was found in 11.8% subjects as per EPDS score. Working female and belonging to Muslim religion, past history of abortion, complications in previous pregnancy, financial debt, physical violence and substance use in family showed significant association with antenatal depression. Conclusion –Depression was prevalent among antenatal women and was found to be associated with various risk factors.
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The Nagi Dam Bird Sanctuary situated in the Jamui district of Bihar lies between latitude N 24.49' and longitude E86.23' & E86. 24' is spread over an area of 2.0957 square kilometres constructed by Bihar government. The Nagi Dam and Nakti Dam both are sanctuaries so close to each other. Nagi Bird sanctuary is approximately 19 km from Sono and 10 km from Jhajha within the district of Jamui, Bihar. Nakti bird sanctuary is approx 3 Km from Nagi, occupying similar habitat of flora and fauna. Both Nagi and Nakti bird sanctuaries are belted by rocky hillocks. In Nagi Dam there are total 14 waterfowl avifauna were recorded - Lesser Whistling-Duck, Bar-headed Goose, Ruddy Shelduck, Cotton pygmy Goose, Tufted Duck, Common Pochard, Ferruginous Duck, Eurasian Wigeon, Gadwall, Mallard, Northern Pintail, Red-crested Pochard, Ruddy Shelduck and Greylag Goose, Great crested Grebe.
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Context: Atypia of undetermined significance/Follicular lesion of undetermined significance [AUS/FLUS] is a heterogeneous category with a wide range of risk of malignancy [ROM] reported in the literature. The Bethesda system for reporting thyroid cytopathology [TBSRTC], 2017 has recommended subcategorization of AUS/FLUS. Aims: To evaluate the ROM in thyroid nodules categorized as AUS/FLUS, as well as separate ROM for each of the five subcategories. Settings and Design: Retrospective analytic study. Methods and Materials: A retrospective audit was conducted for all thyroid fine-needle aspiration cytology (FNAC) from January 2013 to December 2017. Slides for cases with follow-up histopathology were reviewed, classified into the five recommended subcategories, and differential ROM was calculated. Statistical Analysis Used: z test for comparison of proportions was done to evaluate the difference in ROM among different subcategories of AUS/FLUS. The P value of less than 0.05 was taken as statistically significant. Results: Total number of thyroid FNACs reported was 1,630, of which 122 were AUS/FLUS (7.5%). Histopathology was available in 49 cases, out of which 18 were malignant (ROM = 36.7%). The risk of malignancy (ROM) for nodules with architectural and cytologic atypia was higher (43.8%) than ROM for nodules with only architectural atypia (16.7%). Conclusions: The sub-classification of AUS/FLUS into subcategories as recommended by TBSRTC, 2017 may better stratify the malignancy risk and guide future management guidelines.
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Two cases of immunoglobulin (IgG4)-related biliary and pancreaticobiliary disease are reported to define its diagnostic features. Case 1 presented with obstructive jaundice and showed IgG4-related disease (RD) involving right and left hepatic duct, common bile duct and gallbladder. Case 2 presented as periampullary mass. Both patients underwent surgical intervention. However, certain clinical and radiological features were present in these cases indicative of the possibility of IgG4-RD.
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Background & objectives: The increasing prevalence of extended-spectrum ?-lactamases (ESBLs) has abated therapeutic options worldwide. This study was undertaken to investigate the molecular profile and resistance patterns of ESBLs among clinical isolates of Escherichia coli and Klebsiella pneumoniae at four tertiary care centres in India. Methods: Clinical isolates of E. coli and K. pneumoniae were collected from the All India Institute of Medical Sciences (AIIMS), New Delhi; the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry; Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh and Christian Medical College (CMC), Vellore, over one and a half year period. Antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion method. ESBLs were confirmed phenotypically, and multiplex PCR was performed to identify genes for ?-lactamases (blaTEM, blaSHV, blaOXA-1, blaCTXM-1, blaCTXM-2, blaCTXM-9 and blaCTXM-15). Results: Among 341 E. coli isolates collected during the study period, 171 (50%) harboured blaTEM, 145 (43%) blaOXA-1,70 (21%) blaCTXM-1, 19 (6%) blaSHV and four (1%) harboured blaCTXM-2. Phenotypically, combined disc test detected ESBL production in 98/298 (33%) E. coli. Among 304 K. pneumoniae isolates, 115 (38%), 89 (29%), 83 (27%), 64 (21%) and two (0.6%) harboured blaTEM, blaOXA-1, blaCTXM-1, blaSHV and blaCTXM-2, respectively. Combined disc test (CDT) detected ESBL production in 42 per cent K. pneumoniae. Most of the blaCTXM-1positive isolates were also blaCTXM-15 positive. The carbapenem susceptibility ranged from 56 to 88 per cent for E. coli and from 20 to 61 per cent for K. pneumoniae. Antibiotic sensitivity patterns showed that colistin (CST) was the most sensitive drug for both E. coli (271/274, 99%) and K. pneumoniae (229/234, 98%). Interpretation & conclusions: The prevalence of ESBL among four study centres varied, and blaTEM, blaOXA-1 and blaCTXM-15 were the most common genotypes in E. coli and K. pneumoniae isolates in India. The growing carbapenem resistance and emerging colistin resistance warrant the judicious use of these antimicrobials.
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Background: Facial defects can be acquired or congenital, but irrespective of etiology, any maxillofacial structure if damaged or missing will result in an unaesthetic and unappealing personality of individual. Orbital defects are very evident and effect the appearance and social front of the individual. Many modalities are available to rehabilitate the defect of an orbit but prosthetic rehabilitation with silicone prosthesis is a simple and effective approach. Retention is generally achieved by engaging available undercuts or using mechanical accessories or skin adhesives etc. This case report describes successful rehabilitation of right orbital defect using a non-surgical approach with room temperature vulcanized silicone and skin adhesives. Case Report: A 45 yr old male reported with, chief complaint of missing right orbit and unaesthetic appearance secondary to gunshot wound. Patient was not ready for any more surgical procedures or additional accessories and available retentive undercuts were minimal. Hence, conventional silicone prosthesis was made using stock eye shell and room temperature vulcanized silicone retained with skin adhesives. The approach was simple to a complex problem and gave reliable result in very limited time. Conclusion: With extensive orbital defect, rehabilitation is difficult and complex as retention is compromised and it is difficult to match the shade of the prosthesis.This case represents a simple and predictable approach to a case of exenterated right orbit with conventional roomtemperature vulcanized silicone and silicone skin adhesives.
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Background: To evaluate the various factors associated with recurrence of Amblyopia. Methods:In this prospective observational study, 100 patient’s diagonised anisometropic and strabismic amblyopia. All patients were undergone squint workup and were treated with optical correction, occulusion therapy or penalization. Patients were divided three groups - group 1 age (4-7 year) , group 2 age(8-12 year), group 3 age(13-17 year) . Patients were followed upto 12 month and various factors assessed which could be responsible for amblyopia and compared between three group. Results:Recurrence of amblyopia was seen in 24% of patients which was more in group 1 & mixed amblyopia type (statically significant p < 0.05). Recurrence of amblyopia was found to be patients independent of binocular vision and mode of treatment. Recurrence and its relation with length and dose of occlusion therapy were significant those who were weaned off 6 hrs patching as compared 2 hrs patching. Recurrence of amblyopia was found to be more in those who improved five lines as compared to two lines with statistically significant p < 0.05. Recurrence was more in first 6 month as compared to last six month during follow up. Conclusion: Recurrence is more commonly seen between the ages of 4-7 yrs and those who with mixed amblyopia should be closely monitored during follow up. Occlusion therapy should be prescribed weaning off, it should not be abruptly stop. Since recurrence may occur even beyond 1 year hence, a longer follow up period would be advisable.
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Background: To review the clinical manifestations and neuroimaging features of patients with Sturge-Weber syndrome(SWS) treated at a tertiary care centre over a 3 year period. Methods:A retrospective study of six patients with SWS (4 males and 2 females) was conducted. Data was collected by reviewing the clinical histories of patients diagnosed with SWS over the last 3 years. Results: All patients had port-wine stain (PWS) involving the eyelid. Glaucoma was the main ocular disease being diagnosed in 2 eyes of three patients (66.66%). Five patients (83.33%) had neurological impairment including seizure, hemiparesis, headache, and delayed development. However, the most common neurological manifestation was epilepsy (83.33%), which could be controlled with antiepileptic drugs. In neurological imaging intracranial abnormalities were demonstrated which included cerebral atrophy (75.0%), cerebral calcification (50.0%), leptomeningeal angioma (25.0%), and enlarged choroidal plexus (25.0%). The ocular complications and intracranial abnormalities were usually ipsilateral to the PWS.. Conclusion: Port-wine stains, glaucoma, and seizure were the most common clinical presentations of Sturge-Weber syndrome detected in this study. Complete ophthalmic and neurological evaluation should be performed at the time of diagnosis
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Background: HIV destroys the CD4+T cells progressively thus making the HIV infected persons susceptible to a number of opportunistic infections (OIs).Methods: The study was conducted in the Medicine Department and ART Centre, VIMSAR. It is a prospective study from July 2016 to September 2017.Results: 86 patients register, detail history, clinical examination and investigation were done and then the data is complying in detail. Most of the patients were male (72%) male female ratio is 2.6:1. The majority of patients presented with fever, weight loss and anorexia seen in more than 73% of the study population.Conclusions: (42%) cases belonged to the CD4+T cell count range of 101-200/µl with aCD4+T cell count of 183/µl, so there is increased chance of hospitalization in patients having CD4+T cell count below 200/µl. The most common OI was tuberculosis (51%) with pleural effusion as its commonest manifestation. The second most common OI was candidiasis (43%) with most cases suffering from oral candidiasis was seen to occur at higher CD4+T cell counts than tuberculosis.
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Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies.Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks.Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%.Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications.
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Uterine tumors resembling ovarian sex cord tumors are rare neoplasms with varied histological and immunophenotypic profile, uncertain histiogenesis and biological behavior. A critical evaluation of histological features is essential for diagnosis and management of these cases.
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Background: “Malnutrition is a silent emergency”. Malnutrition is not only an important cause of childhood mortality and morbidity, but also leads to permanent impairment of both physical and mental growth of those who survive. Aims & Objectives: To determine the prevalence of malnutrition and association with various risk factors among children of age 06-59 months in rural area of Jabalpur district Madhya Pradesh. Material and Methods: Study was conducted among 517 children of age group 06-59 months in two randomly selected blocks of Jabalpur District. Multistage random sampling technique was used. Predesigned questionnaire was used to collect data and anthropometric measurements were done. Data analysis was done using Epi Info™ 7.1.5 and SPSS 20.0 (free trial version). Result: The prevalence of underweight, stunting and wasting were found to be 35.8%, 41.4% and 19.7% respectively while the prevalence of obese and overweight was 2.7% & 5.6% respectively. Children born with low birth weight, having higher birth order, more number of siblings, those with incomplete immunization status and inappropriate feeding practices were associated with malnutrition. Conclusion: The present study demonstrates the multiple risk factors for childhood malnutrition requiring multisectoral approach to fight against this silent killer.
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A 12‑year‑old boy presented with trauma to left eye with a wooden stick. On examination, there was full thickness corneal laceration with cataractous lens behind the laceration. The laceration was sutured, and intravitreal injections of vancomycin, ceftazidime and clindamycin were administered. Vitreous tap grew Streptococcus parauberis. The isolate was sensitive to amoxicillin, erythromycin and vancomycin, and topical vancomycin was used to treat the infection. We present the first case of human post‑traumatic infective endophthalmitis caused by the rare agent S. parauberis.
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Dealing with carbapenem‑resistant Klebsiella pneumoniae (CR‑Kp) strains, which are generally pan‑drug resistant, is an uphill task for health care professionals. Owing to limited therapeutic options and the possibility of development of resistance to commonly used biocides in hospital settings, CR‑Kp infections pose a serious threat of emergence of a dreaded pandemic. The aim of the study was to highlight the possibility of emergence of biocide resistance among CR‑Kp strains. A case study was conducted in a Super‑specialty Hospital in September 2015. A 65‑year‑old female patient post‑laparotomy was admitted to the General Intensive Care Unit of a Super‑specialty Hospital. CR‑Kp was isolated from the blood and mucus trap samples of this patient. Susceptibility testing of three commonly used biocides in our hospital, namely sodium hypochlorite (4% available chlorine), 5% w/v povidone iodine (0.5% w/v of available iodine) and absolute ethanol (99.9%), respectively, was carried out using K. pneumoniae ATCC 700603 as control. The test isolate showed reduced susceptibility to sodium hypochlorite in comparison to K. pneumoniae ATCC 700603. The possibility of emergence of biocide resistance among CR‑Kp strains poses a threat of disrupting our ongoing efforts for implementation of effective infection control measures.
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Aims: The study was conducted to compare the efficacy of natural growth promoter AV/AGP/10 with antibiotic supplements on overall growth performance and intestinal micrometry of broiler birds. Study Design: Total of 150 healthy day old Vencob broiler chicks of nearly similar live body weight were equally divided into 5 groups of 30 birds each with three replicates in each group. All the groups were fed with basal diet. Group-I was positive control without any supplement, Group- II was supplemented with AV/AGP/10 @ 250g/ton of feed, Group- III supplemented with AV/AGP/10@500g/ton of feed, Group-IV supplemented with Bacitracin Methylene Dicyticylate @100g/ton of feed and Group-V supplemented with Oregostim @ 250g/ton of feed. Place and Duration of Study: the study was conducted in the department of Animal Nutrition, College of Veterinary and Animal sciences, Udgir, Dist. Latur, Maharashtra, India during the month of April- June 2012 for 42 days. The mean maximum daily temperature recorded at the time of trial was 41±2ºC and relative humidity (RH) 80.57 ± 1.50 %. Methodology: the efficacy of the products was assessed on the basis of feed consumption, body weight gain, feed conversion ratio (FCR), metabolic trial / nutrient retention trial, intestinal micrometry and carcass yield / dressing percentage. Results: at the end of sixth week, significantly higher live body weight (1874.19, 1921.51, 1720.39 and 1673.58) with more economical FCR (1.74, 1.71, 1.78 and 1.78) along with marked improvement in digestibility of nutrients from supplementation of herbal growth promoter with equal competence as that of synthetic antibiotic was observed. The intestinal micrometry at day 21 and 42 also revealed better results with natural growth promoter as compared to synthetic growth promoter and control group in terms of villous height, width and crypts depth. Conclusion: Considering the overall trial results and harmful effects of antibiotic growth promoter such as bacterial resistance or undesired residues in animal products, the natural product AV/AGP/10 is better option as growth promoter and performance enhancers in broiler birds.
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In the last few years there has been an increasing incidence of infection due to non-neoformans Cryptococcus spp. especially in immunocompromised host. Cryptococcus laurentii is a non-neoformans Cryptococcus which has rarely been known to cause bacteremia and pulmonary infection in humans. Here we report a case of fungemia due to Cryptococcus laurentii.
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Sickle cell disease (SCD) is an inherited disorder of hemoglobin synthesis and the oxidative stress has major role in the pathogenesis of SCD. Thiobarbituric acid reactive substances formation by lipid peroxidation is a marker of oxidative damage in membrane.The study was under taken to measure the oxidative stress in sickle cell patients of Chhattisgarh rural population because of low natural antioxidants in their diet. The patients of sickle cell anemia group (homozygous, n=9) and sickle cell trait (heterozygous, n=21) shows TBARS level 2.28±0.66μM/l and 2.23±0.7μM/l respectively as compared to control (without S.C.D) 1.25±0.41μM/l. the study shows TBARS concentration is approximately double in sickle cell disease than control.