ELEMENTAL CONCENTRATION OF PACKAGED MEALS (BAKED ANDEXTRUDED GOODS MADE USING COMPOSITE CEREAL-PULSE FLOUR) PROCURED AT DEBRE TABOR MARKETPLACES IN ETHIOPIA

The elemental analysis of packed food items which is collected in Debre Tabor markets, Ethiopia namely Pasta, Macaroni, cookies, biscuit, wheat bread, white teff injera, Red teff injera, barley so, barleycorn and maiz bread samples were carried out using EDX spectrometer. An X-ray beam was used to excite each sample and spectra were recorded with a high-resolution Si(Li) detector. The data analysis was carried out by software. Trace elements P, K, Na, Cl, Mg, Ca, Fe, Al and Zn were estimated, and elemental concentrations were determined. To get the exact results of the present study the analysis repeats three times.

Tillage and nutrient management influence net global warming potential and greenhouse gas intensity in soybean-wheat cropping system

Conservation tillage has proven advantageous in improving soil health and productivity. However, the greenhouse gases (GHGs) emission and intensity from different conservation tillage and nutrient management systems under Indian conditions are less understood. Therefore, here, we compared the effect of tillage and nutrient management on GHGs emissions, net global warming potential (NGWP), and greenhouse gas intensity (GHGI) from a field experiment under five years in a soybean-wheat cropping system in the Vertisols. The tillage treatments comprised of reduced tillage (RT) and no tillage (NT). The three nutrient management treatments included application of 100% NPK (T1), 100% NPK + 1.0 Mg FYM-C ha-1 (T2), 100% NPK +2.0 Mg FYM-C ha-1 (T3). The results showed significantly higher SOC sequestration under NT (1388 kg ha-1 yr-1) followed byRT (1134 kg ha-1 yr-1) with application of FYM (2.0 Mg C ha-1) (T3) every year. Across tillage, integrated nutrient management(T2 and T3) lowered NGWP and GHGI compared to NPK (T1). The GHGI of NT system was less by 33% compared to RT. The results suggest that GHGs mitigation and sustained food production in the soybean-wheat system can be achieved in NT and RT with integrated use of organic and inorganic fertilizer as the major component of nutrient management.

Epidermolysis bullosa dystrophica with renal failure

Inherited epidermolysis bullosa (EB) is a family of diseases with blistering of skin and mucous membrane even with mild trauma. It has different subtypes based on the affected protein. Epidermolysis bullosa dystrophica (EBD) is associated with mutations in the COL7A1 gene encoding type VII collagen leading to the fragility of skin and mucosal membranes. EBD may be dominant or recessive. They should be distinguished because increased prevalence of SCC is associated with the recessive form. Here we are reporting a case at our hospital presented with various clinical features, history, clinical spectrum, renal biopsy and gene analysis giving appropriate diagnosis for the disorder. Treatment remains challenge. A multidisciplinary approach is needed for the effective management of EBD.

Study Of Potential Drug Interactions Among Eight Major Departments-General Medicine, Orthopedics, Gynecology, Pulmonology, General Surgery, Psychiatry, Otolaryngology And Dermatology Of A Tertiary Care Teaching Hospital In Southern India

Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population. Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used. Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared. Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.

Awareness about adverse drug reaction monitoring and pharmacovigilance among final year medical students in tertiary care teaching hospital in Andhra Pradesh: a cross sectional study

Background: Adverse drug reaction (ADR) is an unwanted, undesirable effect of a drug that occurs during clinical use. ADRs will occur daily in health care institutions and can unfavourably affect a patient's quality of life, frequently causing considerable morbidity and mortality. Pharmacovigilance is defined as the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem.Methods: It was a non-interventional study was done among hundred final year medical students at Kurnool Medical College, Kurnool, Andhra Pradesh. The study instrument was a predesigned questionnaire was structured by following the precedence, which was set by parallel studies. The participants were given forty-five minutes to answer the questionnaire; the questionnaires were then analyzed by grading the respondents into three categories: poor, unsatisfactory and satisfactory.Results: This study showed satisfactory results about awareness, knowledge and methods of application of pharmacovigilance among final year medical students 55%, 47%, 54% respectively and positive correlation between awareness, knowledge and methods of application of pharmacovigilance among final year medical students significantly (<0.0001) correlated.Conclusions: The present study revealed that the final year medical students were satisfactory in awareness and knowledge and methods of application of pharmacovigilance. The correlations told that the higher the awareness, the more was the knowledge and better were the methods of application. Likewise, the knowledge and practices were significantly and positively related to a correlation.

Genetics of fruit yield and its component traits under different fruiting habit backgrounds in chilli (Capsicum annuum L.)

The six basic generations (two parents, F1, F2 and backcrosses) of 14 crosses developed from nine parents differing in fruits node−1 and fruit orientation were evaluated to decipher the genetics of three quantitative traits (average fruit weight, fruits plant−1 and green fruit yield plant−1) during the rainly season of 2016 and 2017. The magnitude and direction of the additive genetic effects [a], dominance genetic effects [d], magnitudes of additive genetic variance (σ2 A) and dominance genetic variance (σ2 D) varied with the genetic background of the crosses and traits. In the genetic background of crosses involving parents differing in fruit node−1, the inheritance of average fruit weight, fruits plant−1 and fruit yield plant−1 were controlled by the genes with both additive and ambidirectional dominant effects. On the contrary, genes with only additive effects controlled the inheritance of average fruit weight, fruits plant−1 and fruit yield plant−1 in most genetic backgrounds of crosses involving parents differing in fruit orientation and those differing in both fruits node−1 and fruit orientation. Further, the genes controlling the inheritance of all the traits are dispersed among the parents used in the investigation. These results are discussed in relation to strategies to be used in breeding chilli.

Ameloblastic fibro-odontoma in a 14 year old girl: A case report

Ameloblastic fibro-odontoma (AFO) is a benign, epithelial odontogenic tumor with odontogenic mesenchyme having the histologic characteristics of both ameloblastic fibroma and complex odontoma. This report describes the case of a 14-year-old girl with AFO on the right posterior mandibular region that mimics complex odontoma on incisional biopsy due to the presence of atypical dentin- and cementum-like areas. On histological examination, sections of excisional biopsy showed odontogenic epithelial islands with embryonic connective tissue and decalcified sections showed atypical dentin with dentinal tubules and islands of cementum. These features led to the diagnosis of AFO.

A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the   age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs)  in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

A clinical study of ulcers of the leg

Background: Chronic ulceration of the lower leg is a frequent condition; incidence of ulceration is rising as a result of the ageing population and increased risk factors for atherosclerotic occlusion such as smoking, obesity and diabetes. Aim: To compare and analyze the distribution of age, sex, systemic disease and location of the ulcer among the study group. Materials and methods: Prospective study of 200 cases of chronic leg ulcers admitted with regular dressing, debridement, treating the underlying systemic disease, skin grafting and amputation were done. Results: The highest age incidence of leg and foot ulcers in this study was in the age group of 51 years and above (45.5%). There was a marked male predominance of 86%. Foot was the most commonly affected region 88%. 87.5% of venous ulcers were situated in the gaiter zone. 88% of diabetic ulcers were situated in the foot. 100% of the arterial ulcers were situated in the foot. Of malignant and other ulcers 60% were situated in the foot and 40% in the leg. Staphylococcus was found to be the most common pathogen to be isolated from the ulcers i.e., 28.9%. Conclusion: Underlying vascular disorders are the main etiological factors for leg and foot ulcers with diabetes forming a major risk factor. Diabetes was the commonest disease associated with chronic leg ulceration

Markers of alcohol use disorder-its impact on the comorbid diseases and outcomes in patients admitted into tertiary care hospital

Background: The treatment for medical complications of alcohol misuse has been restricted by primary care providers recently by referring patients to specialized alcohol treatment. Aim: The proposed study aimed to identify the patients with alcohol use disorder and estimation of selected biomarkers like Gamma-glutamyl transferase (GGT) and Carbohydrate-deficient transferrin (CDT) in selected patients with objective of comparing its impact on co-morbid condition, assessment of its outcomes in selected patients. Materials and Methods: This was a multi-arm observational, interventional study, in which patients of alcohol use disorder were selected as the study population. This study was conducted in Department of General Medicine, Mahatma Gandhi Memorial Hospital, Warangal, Telangana. Results: In alcoholic patients, age in years was 55.1±8.5 and in non-alcoholic patients’ age in years was 58.4±11.6, in alcoholic patients males were 50% and females were 5% and in non-alcoholic patients, males were 40% and females were 4%. In hepatic encephalopathetic alcoholic patients 40% was seen and in hepatic encephalopathetic non-alcoholic patients, 36% was seen. In the alcoholic patients, Ascitis was observed in 49% and 48% of the non-alcoholic patients. 48% of the alcoholic patients had upper gastro-intestinal bleeding and it was 3% in non-alcoholic patients. Conclusion: The heavy use of alcohol prevalence was very high and was associated with poor prognosis in hospitalised patients which further increased the risk of infection and death.

Yield of AFB by direct sputum smear examination with bronchial washings and post bronchoscopy sputum smear examination

Background and objectives: The objective of the present study is to evaluate the yield of AFB by direct sputum smear examination with Bronchial Washings and Post Bronchoscopy sputum smear examination. Materials and methods: This prospective study was conducted on 100 patients with suspected pulmonary TB October 2015 – September 2017 at S.V.S Medical College, Mahabubnagar. Results: Out of 100 clinically suspected, sputum smear negative cases, 38 cases were diagnosed as active pulmonary tuberculosis. Bronchial washings for AFB smear was positive in 32/100 (32%) of cases and post bronchoscopic sputum smear was positive in 16/100 (16%) of cases. Both bronchial washings and post bronchoscopic sputum smear for AFB was positive in 10 (10%) of cases. 4/16 additional cases are diagnosed by post bronchoscopic sputum smear over the bronchial washings. Total yield of bronchoscopy in the diagnosis of sputum negative Pulmonary Tuberculosis was A.N.V. Koteshwar Rao, L. Bhaskar, K. Vamshi, Pradyut Waghray. Yield of AFB by direct sputum smear examination with bronchial washings and post bronchoscopy sputum smear examination. IAIM, 2017; 4(11): 113-116. Page 114 38.00% of which bronchial washing smear samples are superior in the diagnosis and is contributed to 32% . Conclusion: It has shown that additional yield of 38% more than direct sputum smear examination, which helps to initiate early treatment of tuberculosis.

Bladder Metastasis: An Unusual Presentation of Stomach Cancer.

Linitus plastica of the stomach is a type of gastric carcinoma usually diagnosed at a late stage due to a lack of early pathognomonic symptoms. A diagnosis is usually by endoscopy and biopsy, however, lack of mucosal involvement leads to false negative reports. Over 50% of patients present with distant metastasis. Metastasis to bladder is rare and synchronous detection of bladder metastasis along with the primary tumor has only been reported in 5 cases in English literature. We present a case where clinical suspicion of a gastric malignancy was made in retrospect after biopsy of bladder tumor confirmed metastasis from a gastrointestinal primary.

Clinico-pathological study of intradural extramedullary spinal tumors.

Background: The intradural extramedullary tumours of the spine are one of the commonest tumours of the spine. Early diagnosis and surgical removal helps in best outcome. The objective of the study was to analyze the clinical presentation, imageology, resectability, to know the incidence of different types of tumours in intradural extramedullary compartment and to study the surgical outcome. Methods: This was a prospective study of 32 cases of intradural extramedullary tumours. The clinical presentation, imageology, resectability, histopathology, surgical outcome were studied. The patients were investigated with plain spinal radiography and MRI. All cases were treated surgically by posterior or posterolateral approaches. Outcome and complications were evaluated. They were followed up regularly and the results were analyzed. Ambulatory status was classified on admission by using Nurick-grading scheme. Results: The incidence of intradural extramedullary spinal tumours was 57.14%. Most of the tumours presented in the third decade (37.5%). Mean age of Presentation for meningioma was 36 years and for nerve sheath tumours was 39.5 years. The nerve sheath tumours contributed 35% followed by meningioma 28%. Nerve sheath tumours were found to be most commonly located in thoracic region (56%). Total excision of tumour was achieved in 87.7% cases. Conclusions: Nerve Sheath tumours and Meningiomas were the most common in intradural extramedullary spinal lesions and complete excision was possible in almost all cases. Prognosis was usually good, in spite of poor neurological status at the time of presentation.

Computational prediction of MHC class I epitopes for most common viral diseases in cattle (Bos taurus).

Viral diseases like foot-and-mouth disease (FMD), calf scour (CS), bovine viral diarrhea (BVD), infectious bovine rhinotracheitis (IBR) etc. affect the growth and milk production of cattle (Bos taurus) causing severe economic loss. Epitope-based vaccine designing have been evolved to provide a new strategy for therapeutic application of pathogen-specific immunity in animals. Therefore, identification of major histocompatibility complex (MHC) binding peptides as potential T-cell epitopes is widely applied in peptide vaccine designing and immunotherapy. In this study, MetaMHCI tool was used with seven different algorithms to predict the potential T-cell epitopes for FMD, BVD, IBR and CS in cattle. A total of 54 protein sequences were filtered out from a total set of 6351 sequences of the pathogens causing the said diseases using bioinformatics approaches. These selected protein sequences were used as the key inputs for MetaMHCI tool to predict the epitopes for the BoLA-A11 MHC class I allele of B. taurus. Further, the epitopes were ranked based on a proposed principal component analysis based epitope score (PbES). The best epitope for each disease based on its predictability through maximum number of predictors and low PbES was modeled in PEP-FOLD server and docked with the BoLA-A11 protein for understanding the MHC-epitope interaction. Finally, a total of 78 epitopes were predicted, out of which 27 were for FMD, 25 for BVD, 12 for CS and 14 for IBR. These epitopes could be artificially synthesized and recommended to vaccinate the cattle for the considered diseases. Besides, the methodology adapted here could also be used to predict and analyze the epitopes for other microbial diseases of important animal species.

Anesthetic Management in an Established Case of Anterior Spinal Artery Syndrome Posted for Inguinal Hernioplsty.

Anterior spinal artery syndrome (ASAS) is a rare and permanent damage, caused as a neurological complication of spinal anesthesia. In this case study, we have given account of our experience of anesthetic management of a documented case of ASAS, posted for inguinal hernioplasty. We did a thorough pre-anesthetic evaluation and found that patient had paraplegia and confi ned to bed with aspiration pneumonitis. He is a known hypertensive and on control with tablet amlodipine 5 mg/day. He was subjected to antibiotic therapy, mucolytics with respiratory physiotherapy and incentive spirometry. After preparing the patient thoroughly, patient was subjected to general anesthesia. Post-operative analgesia was provided with injection fentanyl, given with a syringe pump. Post-operative period was uneventful.

Regulation of Growth and Function of Lifeline Placenta.

Placenta is an association of fetal and maternal tissues which develops during pregnancy. Placenta is often called lifeline, because it is the link between mother and growing fetus. It serves variety of functions, which include transport of nutrients to growing fetus, waste products from fetus, exchange of gases and also immunological protection to the fetus. It has a unique ability to function as a hypothalamo-pituitary-gonadal-axis as it can produce a variety of peptide, protein and steroid hormones. Thus, it is an autonomous unit capable of regulating its own growth and function.

Assessment Effects Of Maintenance Therapy On Quality Of Life Of Opiate Abusers

Objective: This study was conducted to assess the effects of Methadone Maintenance Therapy (MMT) and buprenorphine-naloxone Maintenance Therapy (BNX) on the Quality of life (QoL) of opiate abusers. Methods: The QoL status of opioid-dependent patients was assessed using the WHOQOL-BREF questionnaire. It is a cross-sectional study involving a total of 108 patients who received MMT or BNX therapy in Malaysia from May 2011 to September 2011. Results: A statistically significant difference in the overall QoL and psychological aspect among patients on MMT was observed. On the contrary, the scores of overall QoL and quality of social relationship for BNX group were higher in patients with lower dosage. Conclusion: The comparison between patients on high dose MMT and high dose BNX exhibited significant difference in the overall QoL especially in psychological, social relationship and environment domains, with the high dose MMT group having better mean score.

Atherogenic dyslipidemia in diabetic nephropathy: lipoprotein (a), lipid ratios and atherogenic index.

Background: Atherogenic lipid profile is reported to become pronounced with onset of nephropathy. Lipid ratios also indicate atherogenic dyslipidemia. Lipoprotein (a) [(Lp(a)] considered as an independent risk factor for cardiovascular diseases (CVD), may play an important role in development and progression of nephropathy in type 2 diabetes mellitus (T2DM). The present study aimed to assess atherogenic dyslipidemia in T2DM and diabetic nephropathy patients. Methods: Total cholesterol (TC), triglycerides(Tgl), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), Lp(a), lipid ratios: TC/HDL, Tgl/HDL, LDL/HDL, non-HDL cholesterol and atherogenic index (AI) was assessed in T2DM (n=35), diabetic nephropathy (n=30) and healthy individuals (n=30). Means of biochemical parameters were compared by ANOVA (analysis of variance). Pearson correlation was performed to study the association between parameters. Receiver operating characteristics (ROC) curve analysis was done to assess the predictive ability of the variables. Results: Atherogenic dyslipidemia with elevated Lp(a), TC, Tgl, VLDL, LDL, non-HDL cholesterol, lipid ratios, AI and low HDL levels were observed in both T2DM patients with and without nephropathy when compared to controls. Significantly high Tgl/HDL, TC/HDL and AI were observed in diabetic nephropathy when compared to T2DM. Conclusion: T2DM and diabetic nephropathy are associated with dyslipidemia which was more pronounced in diabetic nephropathy. Elevated Lp(a) levels may be considered as an independent CVD risk marker in T2DM and diabetic nephropathy patients along with atherogenic lipid ratio indicators.