Prevalence and pattern of substance abuse among male adolescents in urban and rural areas of Dehradun

Background: Substance abuse is a serious problem because it is engulfing the younger generation with serious health, social and economic concern. This study was conducted to determine the prevalence of substance abuse among male adolescents and study the habit pattern of substance abusers.Methods: A cross sectional study was conducted among 776 male adolescents residing in urban and rural field practice areas under the department of Community Medicine, through randomly selected house to house visit. Data regarding the current use of alcohol and tobacco was collected in a predesigned and pretested proforma by oral questionnaire method.Results: The prevalence of substance abuse among male adolescents was found to be 22.8% and majority of them used some form of smokeless tobacco, followed by smoking tobacco. Consumption of alcohol or tobacco by adolescents is significantly associated with alcohol or tobacco consumption by their family members.Conclusions: Prevalence of substance abuse was high among the male adolescents and they should be motivated through IEC to give up the habit.

Primary Non-Hodgkin’s Lymphoma Of Epidural Space- A Case Report Of Great Mimicker And Review Of Literature

Primary Non-Hodgkin’s lymphoma of epidural space is a rare entity. Clinical presentation and imaging studies were bizarre and posed the difficulty in diagnosis. Since the management protocol of spinal lymphoma is yet to be standardized, so the prognosis is still looming. Here we are reporting a case of epidural primary Non-Hodgkin’s lymphoma in young adult female, who presented with backache and weaknes

Association of TP53 gene codon 72 polymorphism with incidence of cervical cancer in Chhattisgarh

TP53 gene encoding polymorphisms is a risk allele in terms of carcinogenesis. Here, we studied the risk assessment and association of TP53 to understand the cancer biology and behaviour in cervical cancer patients and possible anticancer drug development interfering with p53 protein production. TP53 gene encodes a central protein of apoptosis pathway p53 and its allelic variant has been postulated to play a vital role in carcinogenesis in addition to a variety of neurodegenerative disorders. We undertook a case control study, to examine the possible association of TP53 gene codon 72 polymorphism in leukocyte DNA from a total of 200 subjects (100 controls and 100 cases). TP53 codon Arg72Pro (rs1042522) genotype was identified using allele specific PCR and RFLP with statistical analysis using Vassar Stats (online). In Chhattisgarh population, individuals with GC and GG genotypes of TP53 gene codon 72 polymorphism has a significantly higher risk of cervical cancer (OR=6.36, 95%CI=2.8-14.03 and OR=7.42, 95%CI=3.5-15.9) as compared to CC genotype (OR=1) which was taken as reference. The 'G' allele was found to confer a significant risk of cervical cancer (OR= 3.69, 95%CI= 2.40-5.5) compared to 'C' allele. The present case control study demonstrated the prevalence of the Arg/Arg (GG) genotype in women with cervical cancer among Chhattisgarh population.

Unchecked Hyperparathyroidismand Von Recklinghausen’s Disease Of Bone: Great Mimicker In Diagnosis

Incidence of new cases of a severe form of unchecked primary hyperparathyroidism is decreasing day by day. Here, we report the case of a 40-year-old female patient of primary hyperparathyroidism with a maiden visit to the hospital with multiple osteolytic lesions and multiple pathological fractures. The diagnosis was installed and managed accordingly

Prevalence of depression among geriatric persons in a rural community from Uttar Pradesh, India

Background: Senior Citizen Elderly or old age consists of ages close to or exceeding the average life span of human beings. The limit of old age cannot be defined precisely because it does not have the same meaning in all societies by the middle of this century, there could be 100 million elderly people living in the India according to United Nations World population prospects report. Depression is the common psychiatric disorder among elderly. The aim of the study was to estimate the prevalence of Depression among elderly in a rural population. Design of the study was a cross sectional study conducted among 450 elderly populations in rural community of Lucknow, Uttar Pradesh. Methods: A validated geriatric depression scale (GDS 30) was used to assess their depression status and the various demographic details, socio economic status and living arrangements were analyzed to see for any association with depression. Statistical analysis was chi square test and odds ratio. Results: Among the 450 elderly subjects studied The prevalence of depression among elderly males was found to be 56.8% and among females 79.2% and the difference in the prevalence of depression among males and females was found to be statistically significance (p<0.001). Conclusions: The results confirmed that there is a high prevalence of depression among the elderly population. There is a need to improve geriatrics health care services combined with proper monitoring and evaluation.

Study of breast feeding practices, problems and factors affecting exclusive breastfeeding in Barabanki District of Uttar Pradesh - A Hospital Based Study

Background: Breast feeding and colostrum is the first birthright of every newborn. It is the least expensive, safe, healthiest, natural feed that can be given very easily to any newborn baby for proper physiological growth and psychological development. Exclusive Breast feeding is a term used to define the process by which only breast milk is given to the new born till the first six months of life. Early initiation of breast feeding is very important in reducing infant morbidity and mortality. Rate of exclusive breast feeding is only 35% world-wide and complementary feeding is not started timely. Objective: To know the current situation of exclusive breast feeding, problems encountered by lactating mothers, factors affecting exclusive breast feeding and complementary feeding. Material and Method: This descriptive cross-sectional study was carried out on 200 mothers having children less than 2 years of age attending pediatrics OPD, Gynecology & obstetrics OPD and postpartum ward of Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh. The information about subjects’ demography and practices towards breast feeding were collected from the mother on structured proforma. Result: 200 lactating mothers were included in the study. Majority of mothers are from age group 24-29 years ie 105 (52.5%).out of 200 babies 110 are female and 90 are male and 20 (10%) lactating mothers initiated breastfeeding within 1 hours of delivery. Majority of mothers 102 (51%) initiated breastfeeding within 1-6 hours and only 46.5% babies were exclusive breastfed upto 6 months. 89% of mothers given colostrum to their babies. 47% of mothers given pre-lacteals to babies and formula milk (23%) was the common pre-lacteals followed by cow’s milk (11%). Only 49.3% children were started complementary feeding between 6-9 months. 45% do not encountered any problem during breastfeeding. 55% were having some problem during feeding. 20% mothers were having feeling of insufficient milk secretion followed by 12.5% not knowing about time and frequency of feeding. Conclusion: There were many demographic, social-economic factors and literacy of mother affecting exclusive breastfeeding. Breast feeding is almost universal in India but the rate of early initiation of breast feeding and exclusive breastfeeding are very low. Several factors can be attributed on the breast feeding practices. Social awareness programs, benefits of breast feeding and mass education of family regarding feeding practices should be started to promote exclusive breast feeding and complementary feeding.

Association of Socioeconomic Status on STI/STD Awareness Among OPD patients attending a Tertiary Care Hospital

Background: Sexually transmitted infections (STI) are a major public health, social, and economic problem leading to morbidity, mortality and stigma. This study was conducted to determine the relationship between the STIs and demographic factors. In Indian society, discussing STDs is considered taboo; where ethics and social factors give rise to many obstacles. This study is designed to explore the conception and knowledge about protection against STDs within the patient community. In the present study we aim to study the association of various socioeconomic variables; and the knowledge and awareness level of STI/STDs. Methods: The convenience sample was taken from the adult patients attending and consenting to participate in the study during April- June 2018, using a semi-structured Performa. Collected data was analysed using SPSS soft ware. Results: Age, Education, and income were associated with the awareness about the STI/STD awareness. Conclusions: Socio-economic factors have an association with STI/STD awareness, and hence carry public health importance.

Mobile phone addiction among MBBS students of a Medical College leading to Sleep Cycle Disturbances

Introduction: Mobile phone has become such a daily routine essential part of our life causing good and adverse effects both in our performance. The aim of the present study is to see the effects of mobile addiction and sleep cycle disturbances in today’s life among medical students. Methods: The study was carried out among 218 MBBS students age group of 18 to 25 years, out of which 108 (49.5%) were females &110 (50.5%) were male. Internet addiction Test and PSQI Scale was used to assess the subjects and Chi square test was done for statistical analysis and p value (<0.05) is taken as significant. Result: The results are as follows: 218 undergraduate medical students participated in the study out of which 108 (49.5%) were females and 110 (50.5%) were male's age group between 18 to 25 years. Majority of them 204 (93.6%) were smart mobile phone users and 75 (34.4%) uses phone for near 2 hours per day, (34.4%) slept for less than 5 hours at night, 61(28%) reported ringxiety, ie, false perception of ring. Conclusion: We conclude that mobile use in present scenario affects sleep disturbances of the students. Identifying it early in life and motivating the students to indulge more in out-door sports and activities to refresh them.

Long-term quality of life postacute kidney injury in cardiac surgery patients

Background: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed. Materials and Methods: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included. They were propensity-matched 1:1 to patients without renal impairment (control). Data were prospectively collected, and health-related QOL questionnaire was sent to patients who were alive at least 1-year postoperatively at the time of the study. Results: There was no significant difference in the preoperative characteristics between the two groups (age, gender, left ventricular ejection fraction, procedure, urgency, logistic Euroscore), respectively. Median follow-up was 52 months. Survival data were available in all patients. Questionnaires were returned in 64% of eligible patients. Long-term survival was significantly lower, and QOL, in particular the physical aspect, was significantly worse for the AKI group as compared to non-AKI group (38.8 vs. 44.2, P = 0.002), especially so in patients who required RRT. In alive respondents, despite an 18% (66/359) incidence of ongoing renal follow-up, the need for late RRT was only in 1.1% (4/359). Conclusion: AKI and especially the need for RRT following cardiac surgery are associated with increased long-term mortality as well as worse quality of life in a propensity-matched control group.

Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series.

Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real‑time monitoring of cerebral oxygenation with near‑infrared spectroscopy (NIRS). The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery) in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8). In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends) was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO2, etc.,) were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our “work in progress,” and we aim to conduct a larger study.

The role of point-of-care assessment of platelet function in predicting postoperative bleeding and transfusion requirements after coronary artery bypass grafting.

Objective: Objective platelet function assessment after cardiac surgery can predict postoperative blood loss, guide transfusion requirements and discriminate the need for surgical re‑exploration. We conducted this study to assess the predictive value of point‑of‑care testing platelet function using the Multiplate® device. Methods: Patients undergoing isolated coronary artery bypass grafting were prospectively recruited (n = 84). Group A (n = 42) patients were on anti‑platelet therapy until surgery; patients in Group B (n = 42) stopped anti‑platelet treatment at least 5 days preoperatively. Multiplate® and thromboelastography (TEG) tests were performed in the perioperative period. Primary end‑point was excessive bleeding (>2.5 ml/kg/h) within first 3 h postoperative. Secondary end‑points included transfusion requirements, re‑exploration rates, intensive care unit and in‑hospital stays. Results: Patients in Group A had excessive bleeding (59% vs. 33%, P = 0.02), higher re‑exploration rates (14% vs. 0%, P < 0.01) and higher rate of blood (41% vs. 14%, P < 0.01) and platelet (14% vs. 2%, P = 0.05) transfusions. On multivariate analysis, preoperative platelet function testing was the most significant predictor of excessive bleeding (odds ratio [OR]: 2.3, P = 0.08), need for blood (OR: 5.5, P < 0.01) and platelet transfusion (OR: 15.1, P < 0.01). Postoperative “ASPI test” best predicted the need for transfusion (sensitivity ‑ 0.86) and excessive blood loss (sensitivity ‑ 0.81). TEG results did not correlate well with any of these outcome measures. Conclusions: Peri‑operative platelet functional assessment with Multiplate® was the strongest predictor for bleeding and transfusion requirements in patients on anti‑platelet therapy until the time of surgery. Study registration: ISRCTN43298975 (http:// www.controlled‑trials.com/ISRCTN43298975/).

Anterior urethral valves and diverticulum.

Anterior urethral valves with associated urethral diverticulum is a rare but important cause of infravesical obstructive uropathy in children. This condition can be a cause of significant morbidity and can even lead to end-stage renal disease. This rare condition should be included in the differential diagnosis while evaluating male infants with infravesical obstructive uropathy.

Isolation, molecular characterization and growth-promotion activities of a cold tolerant bacterium Pseudomonas sp. NARs9 (MTCC9002) from the Indian Himalayas

A bacterium that grows and expresses plant growth promotion traits at 4°C was isolated from the rhizospheric soil of Amaranth, cultivated at a high altitude location in the North Western Indian Himalayas. The isolate was Gram negative and the cells appeared as rods (2.91 x 0.71 μm in size). It grew at temperatures ranging from 4 to 30°C, with a growth optimum at 28°C. It exhibited tolerance to a wide pH range (5-10; optimum 8.0) and salt concentrations up to 6 percent (wt/vol). Although it was sensitive to Rifampicin (R 20 μg mi-1), Gentamicin (G 3 μg mi-1), and Streptomycin (S 5 μg mi-1), it showed resistance to higher concentrations of Ampicillin (A 500 μg mi-1), Penicillin (P 300 μg mi-1), Polymixin B sulphate (Pb 100 μg mi-1) and Chloramphenicol (C 200 μg mi-1). The 16S rRNA sequence analysis revealed maximum identity with Pseudomonas lurida. The bacterium produced indole Acetic Acid (IAA) and solubilizes phosphate at 4, 15 and 28°C. It also retained its ability to produce rhamnolipids and siderophores at 15°C. Seed bacterization with the isolate enhanced the germination, shoot and root lengths of thirty-day-old wheat seedlings by 19.2, 30.0 & 22.9 percent respectively, as compared to the un-inoculated controls.