Mid upper arm circumference cutoffs for identifying underweight and severe underweight among infants less than six months: A Hospital Based Cross-Sectional study

Background: Prevalence of undernutrition among infants <6 months are very high in India. WAZ is the most sensitive predictor of mortality among infants <6 months as compared to other anthropometric parameters. However, taking weight and calculating z-score in the community setting have many challenges. Taking mid upper arm circumference (MUAC) is more feasible in a field setting. Methodology: A cross-sectional study was conducted with 419 infants <6 months in a tertiary care hospital in India to identify appropriate MUAC cutoffs for identifying underweight (WAZ<-2) and severe underweight (WAZ<-3) among infants <6 months by calculating sensitivities, specificities and Youden indices. Cohen kappa coefficients were calculated to assess agreements between MUAC and WAZ cutoffs. Results: The MUAC cut-offs for underweight and severe underweight were calculated as 11cm (Youden Index: 0.503; sensitivity: 83.4%; specificity: 66.9%) and 10.9cm (Youden Index: 0.504; sensitivity: 76.3%; specificity: 74.1%), respectively. Kappa coefficients to diagnose underweight with MUAC<=11cm was highest at 0.48. Conclusions: The MUAC cut-off of 11cm could reliably be used to screen infants <6 months with underweight and severe underweight for providing appropriate care in the Indian settings.

Evaluation of Recurrence and Hearing Outcome for Inactive Squamosal Disease after Cartilage Strengthening Tympanoplasty

Abstract Introduction Inactive squamosal disease is unique for having a conflicting treatment protocol, with an age-old debate between early surgical intervention or keeping patients in a long-term follow-up. The shifting paradigm is early intervention to prevent further progress into active disease and improve hearing outcome in its nascent stage. Objective To evaluate recurrence and hearing outcome in cases of inactive squamosal disease after cartilage strengthening tympanoplasty. Methods The study was conducted on 50 patients with inactive squamosal disease. Detailed examination was done to grade the retraction. All patients underwent autologous conchal cartilage tympanomastoidectomy with temporalis fascia grafting. Recurrence and hearing evaluations were done by pure tone audiogram at regular intervals for one year. Results Hearing loss was the most common presenting symptom. Isolated pars tensa retractions were more common (54%) than pars flaccida (12%), or those involving both (34%). Ossicular status was normal in only 14% of the cases, and the most common ossicular damage was to the lenticular process of the incus (52%). Three of the patients (6%) had residual perforation at the 3rd month of follow-up. Subjective improvement in hearing was reported by 42% patients. Hearing improvement greater than 10 dB was found in 24 patients (48%). Air-bone gap reduced from 25.16 ± 8.15 dB preoperatively to 12.90 ± 6.20 at 1 year of follow-up. Recurrence was seen in three patients (6%). Conclusion Early intervention by cartilage strengthening of weakened tympanic membrane and ossicular reconstruction not only offers better hearing results, but also prevents progress to active disease.

Household symptomatic contact screening of sputum smear positive tuberculosis patients at the DOTS clinic of SGT hospital, Gurugram

Background: Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram. Objective: To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India.

Comparative study of effect of stress on peak expiratory flow rate and body mass index in medical and non-medical students

Background: This study was done to compare the effect of stress on peak expiratory flow rate (PEFR) and body mass index (BMI) in medical and non-medical students. Aim and Objective: The aim of the study was to compare the effects of stress on PEFR and BMI in medical and non-medical students. Materials and Methods: In this study, stress, PEFR, and BMI comparison were made between 200 medical and non-medical students of S.N.M.C, Agra and Agra College, respectively, aged between 17 and 21 years. To estimate the prevalence of stress, we used perceived stress scale, PEFR was measured using Rossmax Portable Peak Flow Meter, which having a range of 60–800 l/min. BMI was calculated using formula, Quetelet Index. Cutoff for the subjects was taken as 25 as per the revised WHO standards. Results: In this study, moderate and high perceived level of stress was more common in medical students as compared to non-medical students and the result was found to be statistically significant (P < 0.0001). PEFR was 400 ± 102 in medical students and 420 ± 86.77 was in non-medical students. By applying unpaired t-test, significant changes were observed in PEFR among both groups (P < 0.05). BMI was 22.5 ± 3.12 in medical students and 22.6 ± 1.98 in non-medical students. By applying unpaired t-test, insignificant changes were observed in BMI among both groups (P ? 0.05). Conclusion: From the results obtained from our study, incidence of stress was greater in medical students and that of highly perceived grades. Significant changes were observed for PEFR and insignificant change was observed for BMI among both groups.

CARCINOMA COLON SIGNET-RING CELL TYPE: A RARE CASE REPORT

Carcinoma colon ranks third among the commonest cancer in the world, while seen less common in the Asian countries however lately an increasing trend has been observed. Majorly the elderly population is at an increased risk of colon cancer however early onset of the disease has also been observed in past few years. Various histologic subtypes with different prognoses are present, but the most common histological type is Adenocarcinoma (1). Signet-ring cell carcinoma (SRCC) is a known rare subtype of colorectal carcinoma (< 1%) officially recognized by the WHO, mucinous types are aggressive with poor outcomes and are most commonly diagnosed around the fourth to fifth decade of life comprising only 1% of colorectal cancers. So we report a case of a 40-year-old male with adenocarcinoma colon of signet ring cell type. The patient presented with localized abdominal discomfort with only generalized weakness and fatigue which was later evaluated to be a near-obstructing right-sided colonic mass. Patient was taken up for surgery and was found to have diffuse carcinomatosis

PARATHYROID ADENOMA: A RARE TUMOUR CASE REPORT

Parathyroid adenoma is a rare tumour and are generally small size (< 2 cm) and <1gm weight. Giant adenomas are infrequent, are mostly elucidated as > 3.5 gm weight, along with few reports weights up to 110 gm. Parathyroid adenoma are usually found with primary hyperparathyroidism syndrome which is common, seen as third most common endocrine disorder. In this study a case of 52-year-old lady was refereed with complain of neck swelling, lethargy and generalized drowsiness. The results obtained from laboratory revealed increased serum calcium and increased parathyroid hormone. There is no significant history of renal stone, renal dysfunction or any family history of endocrinal tumours. Ultrasonography revealed a composite nodule with cystic and solid elements. Focused surgical neck exploration was performed with removal of 4 gm adenoma . Microscopic examination showed, encapsulated lesion formed of chief cells of parathyroid organized within network of capillaries. The most exact mechanism for localizing a Parathyroid Adenoma is altogether MIBI scan along with neck ultrasonography. Surgical excision with monitoring of parathyroid hormone screening during operation is the recommended conductance. Need for the intraoperative Parathyroid hormone monitoring is debatable in Parathyroid adenoma due to accuracy of preoperative imaging.

AMELANOTIC MELANOMA- RARE CASE REPORT

Amelanotic melanoma is an uncommon type of of melanoma which lacks melanin pigment (1). Of all the melanoma cases, approximately 2- 8% cases represents amelanotic melanoma. The exact prevalence of this malignancy is more due to misdiagnosis. Due to lack of clinical criteria and pigmentation, the condition often detected late (2). Amelanotic melanomas are commonly found on the face, which shows microscopically the characteristics of desmoplasia (desmoplastic melanoma), but other body parts can also be involved (4)

Role of Prescription Practice in Ensuring Patient Safety in the Primary Health-Care Settings in India

“Completeness (a measure of adequacy)” and the “appropriateness (a measure of the quality of care)” are two dimensions of good prescription practice. The study assessed the prescription practices at the primary health centers (PHCs); to demonstrate the effect of individual and system‑level factors, on adequacy and appropriateness of prescription practices, with special reference to e‑prescription over manual prescription given the rising acceptance of teleconsultation in health care. A total of 600 manual and 1000 e‑prescriptions were randomized using a probability‑proportional‑to‑size sampling method to distribute/allocate samples across manual and e‑prescriptions. Findings revealed that while adequacy and appropriateness of prescriptions depend on individual training and clinical practice; adequacy of prescription, especially the manual was compromised by systemic factors, such as nonavailability of space in a prescription, forcing doctors to prioritize documentation of diagnosis, advising tests, and prescribing medicines, over other details (chief complaints and examination findings).

Impact of co-morbidities in COVID -19 infected patients

Background- During the COVID- 19 pandemic in the first wave, infected patients age was range from 4 weeks to 90 years and those who have more age and with comorbidities are more susceptible to develop serious illness and have high mortality rates. Objective-To study the association between survivor vs non survivor on the basis of demographic profile and high risk factors. Material & methods: This study was done in the Government Medical College, Kannauj on the COVID-19 patients who were admitted in the isolation wards, from 1st September 2020 to December 31st 2020. Statistical Analysis- Analysis was done using SPSS- 23 trial version software. Results: case fatality rate was 2.7% in this study. Most common symptoms was cough (61.0%) and among these admitted patients the most common comorbidities was hypertension (26.7%), followed by diabetes (20.7%), and COPD (14.0%) respectively. Platelets (< 0.02), post prandial blood sugar (PPBS) (< 0.01) have significant role in survivability of COVID- 19 patients. Conclusion: This study concludes that those patients who were older in age and with comorbidity especially (hypertension, COPD, high PPBS, High platelets) have poorer prognosis as compare to those without.

Identification of oviposition deterrents from pink bollworm, Pectinophora gossypiella(Saunders)

Aim: The present study was carried out to identify and explore novel areas of semiochemical based pest management like oviposition deterrents.Methodology: The oviposition deterrents were identified from larval faecal pellets of pink bollworm using methanol as solvent and analysed in GC-MS. Three fatty acids were identified and evaluated for oviposition deterrent effect. Results: In the present study, three major compounds namely; oleic, linoleic and palmitic acids were identified for the first time from larval faecal pellets of pink bollworm. Their oviposition deterrent effect was confirmed in bioassays carried out with different concentrations of identified compounds. The avoidance index (Ai) 0.78 ± 0.05 and per cent effective deterrency (PED) 87.42% was recorded in oleic acid at highest concentration followed by linoleic acid (Ai: 0.77 ± 0.03; PED: 86.61%) in reducing the egg laying by conspecific female. This clearly showed the role of these compounds as oviposition deterrent. Interpretation: The compounds, oleic and linoleic acids evaluated in laboratory showed oviposition deterrent effect on female pink bollworm reducing egg laying considerably. However, further field studies need to be conducted to validate these observations.

S100 proteins: An emerging cynosure in pregnancy & adverse reproductive outcome

S100 proteins are calcium (Ca2+)-binding proteins and these have an important function in progression, manifestation and therapeutic aspects of various inflammatory, metabolic and neurodegenerative disorders. Based on their involvement in intracellular or extracellular regulatory effects, S100 proteins are classified into three subgroups: one subgroup is specialized in exerting only intracellular effects, other performs both intracellular and extracellular functions and the third subgroup members only display extracellular regulatory effects. S100 proteins are expressed particularly in vertebrates and have cell-specific expression. Functionally, S100 proteins act through their surface receptors and regulate cell functions in autocrine or paracrine mode. Receptor for advanced glycation end products (RAGEs) and toll-like receptor 4 are the main surface receptors. S100 proteins participate in the regulation of cellular differentiation, proliferation, apoptosis and inflammation along with Ca2+ homeostasis, energy metabolism and cellular migration, and perform the respective functions through their interaction with transcription factors, nucleic acids, enzymes, receptors, cytoskeleton system, etc. Currently, their role in adverse pregnancy outcomes and compromised reproductive health is being explored. These proteins are present in amniotic fluid, endometrium tissue and foetal brain; therefore, it is quite likely that alterations in the expression levels of S100 family members will be affecting the particular function they are involved in and ultimately affecting the pregnancy in adverse manner. The current review discusses about an association of S100 proteins in pregnancy disorders such as endometriosis, intrauterine growth retardation and miscarriage.

Rare yeasts causing fungemia in immunocompromised and haematology patients: Case series from Delhi.

Systemic fungal infection related to fluconazole‑resistant yeasts are emerging in immunocompromised patients. In this case‑series, we report eight cases of fungemia caused by Trichosporon spp. (2), Stephanoascus ceferrii (1), Kodamaea ohmeri (1), Pichia kutrawersi (2), Candida rugosa (1) and Candida lusitianae (1) in immunocompromised patients. All the yeasts except (Trichosporon asahii) were sequenced. As these rare species are inherently resistant to antifungal agents and they may lead to the development of nosocomial outbreaks, therefore, accurate identification followed by antifungal susceptibility testing is crucial for proper treatment and management.

Studies on Electrode Kinetics of Mixed Legand Complexes of Mn (11) In Dioxan At DME.

Mixed ligand complexes of Mn (11) with pyridines and halides and pseudohalides have been synthesised. The reduction of synthesised complexes at dropping mercury electrode in various percentage of dioxan have been studied. The reductions are diffusion controlled. Slope values indicate reduction to be irrversible. Kinetic parameters [K0 fh,αn &ε] have been calculated by Meites Isreal and Gaur Bhargava Methods. The effects of various compositions of dioxan have been investigated.

Novel Eco-Friendly Approaches for the Reduction of Selected Carbonyl Compounds.

This paper reports reduction of (-)-verbenone, 1,3-indanedione, 3-indolyl methyl ketone and 2- furyl methyl ketoneinvolving two green and environment friendly methods viz. biotransformation using Baker’s yeast as microbial catalyst in free as well as immobilized form and electrochemical method. Microbial transformation was carried out in water – isopropanol mixture (4:1) for selected substrates. The electrochemical reduction of these substrates was also carried out at constant current by using Stainless Steel Electrode (SS- 316). The reduction products were isolated and purified by chromatographic techniques and characterized on the basisof spectral analysis.

Analysis of methyl parathion in biological samples using thin layer chromatography.

Pesticides are major contaminating chemicals in agriculture environment and a hazard to exposed population. The pesticides form a strong class of environment pollutants, as they are sometimes nonbiodegradable, damaged not only the environment and agriculture but also have entered into the food chain thereby affecting health and development. Methyl parathion is a broad-spectrum organophosphorus insecticide generally used to control a variety of insects. The present study was planned to develop a new method for analysis of Methyl parathion in human blood samples using thin layer chromatography technique, which is simple and quick. Methyl Parathion was extracted from blood using solvent extraction methods and then identified on the TLC plates. For chromatographic separation, various binary and tertiary solvent systems were used and for detection on developed plates, palladium chloride reagent was used which successfully increased the sensitivity without dispensing with the simplicity of the method. Statistical analysis was performed on four solvent systems namely benzene: chloroform (80:20), hexane: carbontetrachloride (50:50), hexane: carbontetrachloride (20:80), hexane: propanol (20:80) which included the calculation of mean Rf value, value of standard deviation and coefficient of variance. It is evident from the statistical data that hexane: carbontetrachloride (50:50), hexane: carbon tetrachloride (20:80) is preferably good solvent systems for parathion identification by thin layer chromatography.

Pharmacognostical Potential of Capparis deciduas Edgew.

Capparis decidua (Family, Capparidaceae) is commonly known as ‘Kair’. It is distributed throughout the arid regions of India and other countries. Kair is a caducous plant, so in the foliage condition mainly stem and fruits are common. It is also known as Capparis aphylla. Since the plant is xerophytic, it is generally found in dessert area and is highly draught resistant plant which can survive for long. Tribal people prepare pickle from the fruits of Kair. Some of the communities use Kair fruits as vegetables and food additives. The plant is used traditionally as anti-inflammatory, laxative, anti-diabetic, anthelmintic, antibacterial, astringent, digestive, diaphoretic and anodyne. It is reported to possess beneficial effects in various ailments, like rheumatism, asthma, diabetes, liver disorders, hypercholesterolemia, hypertension and microbial infections. Studies have revealed the presence of various phytoconstituents especially spermidine alkaloids, glucosinolates and other glycosides, β-sitosterol, rutin, l-stachydrine, hydrocarbons and terpenolides. The present review is an attempt to highlight the traditional uses, pharmacognostical, phytochemical and pharmacological reports on Capparis decidua.

Biocatalytic and electrochemical reduction of selected phenyl alkanones with antibacterial activity of the corresponding phenyl alkanols.

This paper reports the production of some phenyl alkanols by the biocatalytic and electrochemical reduction of selected Phenyl alkanones viz. Propiophenone, Butyrophenone, and Valerophenone. Baker‘s yeast was used in its free as well as immobilized form for biocatalytic reduction. Substrates showed the higher conversion rate when the cells were used in immobilized form. The electrochemical behavior of substrates was investigated cyclic voltammetrically to explore electrochemical reduction as alternative synthetic route for the preparation of alcohols. Results obtained from cyclic voltammetric studies were used for establishing optimum conditions for electrochemical reduction which was then carried out galvanostatically using economically viable stainless steel (SS-316) electrodes. The reduction products were isolated and purified by chromatographic techniques and characterized on the basis of spectral analysis. The products thus obtained also exhibited significant antibacterial activity against four strains of bacteria viz. Staphylococcus aureus, Enterococcus faecaulis, Escherichia coli, Pseudomonas aeruginosa.

Major Depression: A Short Term Naturalistic Study in Outpatients.

Background: Surprisingly data regarding naturalistic or observational studies carried out in India to study Major Depressive Disorder in patients seeking outpatient treatment is almost non-existing. So this study was conducted to study the presentation and baseline characteristics of Major Depressive Disorder in Indian outpatients and the subsequent treatment and outcome after a three month follow up. Methodology: Patients seeking outpatient treatment were recruited after diagnosing an episode of Major Depressive Disorder through a clinical interview for DSM IV TR. Sociodemographic and clinical characteristics were recorded at the time of recruitment and follow up evaluations done for 3 months. All the patients were given outpatient treatment best suited to the patient profile. Results :.More than 90% patients reported one or more somatic symptoms spontaneously on presentation . Barely half of the patients out of 119 recruited completed three month follow up. 50 (81%) patients out of 62 who received adequate treatment met recovery criteria at the end of three months. Initial depression severity and receiving regular adequate antidepressant therapy was found to be associated with recovery. While sociodemographic variables were not found to significantly affect treatment outcome or compliance. Conclusion : Somatic presentation of depression is quite common in Indian patients .The high noncompliance indicate the need for strategies to be made to improve compliance and the good response to treatment found in naturalistic conditions in this study calls for more such studies to be done for better understanding of predictors of outcome in naturalistic conditions in India.

Synthesis, characterization and biocidal studies of some aromatic alcohols.

The synthesis and characterization of aromatic alcohols such as 1-(4-bromo phenyl) ethanol, 1-(4-Hydroxy-3-methoxyphenyl) ethanol, (4-Hydroxy-3-methoxy-benzyl alcohol) employing biotransformation (using whole cells of Baker’s Yeast in their free as well as immobilized form in mixtures of glycerol and water) and Electrochemical technique are reported. The electrochemical behavior of 4-bromoacetophenone, 4-Hydroxy-3-methoxyacetophenone, and 4-Hydroxy-3- methoxybenzaldehyde was analyzed using cyclic voltammetry at glassy carbon electrode (GCE) and constant current electrolysis. Effect of scan rate and pH on the reduction peaks has been calculated. The kinetic parameters were also calculated and the process was found to be diffusion controlled. The products obtained were purified & then characterized by spectroscopic techniques. All the compounds have been tested in vitro against a number of microorganisms in order to assess their antimicrobial properties. Biocatalytic and Electrochemical procedures were found to be more effective, safe, economical, environmental friendly, easy to handle. These green methodologies over conventional chemical methods provide new and improved synthetic routes to many valuable compounds.