PURPOSE:The aim of this study is to determine the effect of rafting and paragliding exercises by sedentary males on serum lipids.MATERIAL AND METHODS:17 male rafters and 10 male paragliders volunteers (non-smoker, no known history of cardiovascular disease, body mass index <25 kg/m2, and no intake of prescription medications) participated in the study. Participants had blood samples taken a day before and after rafting and paragliding practices. Data were analyzed by Wilcoxon and Mann-Whitney U tests.RESULTS:Significant decreases occurred for the low-density lipoprotein (LDL)/very low-density lipoprotein (VLDL) ratio in the rafting group after the exercise; though, there was no significant difference in serum lipids parameters of the paraglide group after the exercise.CONCLUSION:While acute rafting and paragliding exercises have similar effects on TG and HDL, effect on LDL/VLDL ratio is different.
Introduction: Intestinal obstruction accounts for 20% of surgical admissions of patients with acute abdomen. The early diagnosis of bowel obstruction is critical in preventing complications, particularly perforation and ischemia. Mechanical large bowel obstruction is 4-5 times less common than small bowel obstruction, most common cause being neoplasm. Materials and Methods: This is a hospital-based cross-sectional study (observational study) done on 53 patients, suspected to have intestinal obstruction referred for computed tomography (CT) scan of the abdomen to the Department of Radio Diagnosis at Saifee Hospital, Mumbai. The study period was 2 years (July 2013-June 2015). Results: This study comprised of 53 cases with suspicion of intestinal obstruction. The age group of patients ranged from 1 to 83 years with a mean of 49.2 years. Out of 53 cases, 26 cases were males (49.06%) and 27 were females (50.94%). Abdominal distention and inability to pass stools were most common symptoms in the study. Overall performance of CT in diagnosis of intestinal obstruction consisted of 75% true positive cases, 14.58% true negative cases, 8.33% false positive cases, and 2.08% cases of false negative. Thus, on statistical analysis (McNemar's Chi-square test) CT was found to be 97.29% sensitive and 63.63% specific in diagnosis of intestinal obstruction. Conclusion: CT has become the most important non-invasive imaging tool to diagnose small and large bowel diseases as it has the potential to provide significant information which leads to timely appropriate treatment and thus positively affect the outcome, morbidity, and mortality of patients.
Introduction: Maternal body mass index (BMI) is one of the most important predictor of nutritional status of pregnant lady. Both nutritional intake and maternal weight are modifiable factors which can influence pregnancy outcome. Either underweight or overweight, both can have significant impact on outcome of pregnancy. Most of the developing countries including India are now facing double burden because of extreme socioeconomic distribution. Obese women are more prone for developing gestational hypertension, preeclampsia, gestational diabetes mellitus, macrosomia, postpartum hemorrhage, and increased incidence of operative deliveries.Aims and Objectives: To determine the maternal risk in terms of antepartum, intrapartum, postpartum complications and perinatal outcome in relation to extremes of maternal BMI.Materials and Methods: This was a prospective study conducted for a period of 1 year. Total 150 patients were taken for study after satisfying all inclusion and exclusion criteria. However, 40 patients were excluded from study due to loss of follow-up. All patients were followed up till delivery and various outcomes were studied and analyzed.Results: A total of 72 (65.45%) patients were in the age group of 21-30 years. Our study has shown that both underweight and overweight women had adverse maternal and perinatal outcome. In underweight group, there was high incidence of anemia which has affected 35% of patients. Low APGAR score and neonatal intensive care unit admissions were more frequent in BMI Group 3, 4, and 5 patients.Conclusion: It can be concluded from our study that extremes of maternal BMI is associated with adverse maternal and perinatal outcome. Adequate preconceptional counseling should be given to all women in reproductive age group so that they can attain normal BMI before conception.
In a prospective study of 69 children with febrile convulsions, serum sodium levels were often lower than normal (52% had levels <135 mmol/l). The mean level (134.4±0.4 mmol/l) was significantly lower as compared to a group of children without fever (140.6±0.4 mmol/l,n=23) and as compared to a group with fever but without convulsions (137.6±0.6 mmol/l,n=31). The probability of a repeat convulsion within the same febrile period appeared to be significantly related to the serum sodium level.
Background: Anemia is the most common illness, the human being is suffering even on today. About 50% of Indian population suffer from this disease. Evaluation of anemia is the most important step in the management. Blood loss from gastrointestinal (GI) tract is one of the common causes of anemia in adults, but its evaluation is expensive and multistep procedures. On the contrary, if there is delay in evaluation, it may be too late to offer the optimal therapy.Aims and Objective: The aim of this study is to evaluate the profile of GI disorders in unexplained anemia in adult patients and need of its evaluation.Materials and Methods: A total of 146 patients with the unexplained anemia attaining Clinical Haematology Department of SCB Medical College, Cuttack, from January 2014 to January 2017 were taken in the study. A detailed GI evaluation was done in all cases. All the analyses were done in SPSS 17 software.Results: A total of 46 cases responded to treatment after addressing to known primary etiology. A total of 100 cases did not respond to treatment and underwent further evaluation in the present study. The mean age was 50 years (range 15-72 years). Male-to-female ratio was 1.086. The mean duration of the illness was 8 months, and the mean hemoglobin was 7.2 g/dl (range 4.5-9 g/dl). Among 100 patients not responding to treatment, GI causes for anemia found in 50 (50%) patients, 10 (10%) patients had a disease outside GI tract, and in 40 (40%) patients no cause for anemia established. GI malignancy was the most common finding (26%) followed by chronic duodenal ulcer and ileocecal tuberculosis.Conclusions: GI disorders are the leading cause of unexplained anemia in adults (50%). Malignancy was identifying as the most common cause with colon and stomach being the frequent sites of involvement, followed by benign etiology with chronic duodenal ulcer and ileocecal tuberculosis. We strongly recommend a thorough GI evaluation in this subset of unexplained anemia of adult patients.
Background: The purpose of this study was to assess the photocatalytic titanium oxide surface modified stainless steel and nickel-titanium (NiTi) wires for its antiadherent and antibacterial properties against Streptococcus mutans.Materials and Methods: The study was preceded on 80 specimens of stainless steel and NiTi wires which were divided into four groups each having two subgroups. Groups containing uncoated wires acted as control groups for their respective experimental groups containing coated wires. Surface modification of wires was performed with TiO2 sol which was further heated at 400 degrees C. For assessment of antiadherent and antibacterial properties of wires, microbiological test against S. mutans was performed.Result: Orthodontic wires coated with TiO2 showed antiadherent effect against S. mutans as compared to uncoated wires. The groups containing surface modified wires showed a statistically significant decrease in the survival rate of S. mutans expressed in the colony-forming unit when compared to the groups containing uncoated wires.Conclusion: Surface modification of the orthodontic wires can be used to prevent accumulation of dental plaque, hence, the development of periodontal problems as well as dental caries during fixed orthodontic treatment.
Introduction: Congenital glaucoma (CG) is more common, aggressive, and difficult to control. It results in raised intraocular pressure and diminished visual acuity in children. Many surgical procedures are described in the literature in its surgical management. Trabeculectomy in chronic simple, narrow-angle, aphakic, and secondary glaucoma is good. Its response in CG is scanty ion literature. The present study evaluates results of different procedures adopted in surgical treatment of CG.Aim: The aim of this study is to evaluate the long-term results of surgery for CG.Study Design: This is a retrospective comparative study.Materials and Methods: Children aged below 14 years with CG surgically treated by methods such as goniotomy, trabeculotomy, trabeculectomy, combined trabeculotomy - trabeculectomy, cyclocryotherapy and Nd-Yag cyclophotocoagulation from January 2010 to December 2016.Observations and Results: A total of 36.42 (85.71%) of the children were diagnosed as CG at birth. A total of 66 eyes (89.18%) were diagnosed as primary infantile glaucoma, 6 eyes (8.10%) had developmental glaucoma, and 2 eyes (2.70%) had secondary glaucoma. The mean corneal diameter 11.8 +/- 0.35 (range 9-18) mm and mean cupping 0.8 (range 0.3-1.1). The mean intraocular pressure was reduced from 27.8 +/- 3.45 to 15.66 +/- 1.50 mmHg. Trabeculectomy proved to be the most useful in achieving reduction in the mean intraocular pressure to 14 +/- 1.0 mmHg.Conclusions: The safe surgical procedure in treating CG was primary trabeculectomy. The success rate of all surgical procedures decreased on long-term follow-up. The visual outcome was satisfactory in 78.37% of the total eyes operated with a follow-up of 5 years.
Background: That intestinal parasitosis is a major health problem in developing countries including India is well known. Many a studies have been done in our country on this issue, but most of them are from South India and a few from North and Central India. However, very few studies in recent years have been done from Bihar. Ours being a rural medical college in Bihar, we have ventured to study the epidemiology of intestinal parasites to find the recent changes in trend and differences from other parts of India and from other developing countries.Materials and Methods: An institution-based retrospective study was done on the stool examination reports of the past 2 years. All symptomatic patients clinically suggesting intestinal parasitosis in the Medicine Outpatient Department were referred to the Microbiology Department for routine stool examination to detect the intestinal parasites in that population. Only adults above 18 years were included in the study irrespective of sex. Apart from naked eye observation, each sample was examined microscopically for ova, parasites, and cysts, after preparing the sample with saline wet mount and Lugol's iodine wet mount.Results: Out of 3343 samples examined, 1346 (40.26%) were positive for parasites. The rest 1997 were parasite negative. Out of those positive, 1113 had only one parasite in their stool specimen, 221 had two parasites, and only 12 had three parasites. The prevalence of Entamoeba histolytica, Giardia lamblia, and Ascaris lumbricoides was the highest in that order.Discussion: The prevalence of E. histolytica (similar to 40%) was almost common throughout India. G. lamblia was the next common in Bihar, but Blastocystis was the second most common in South Indian studies and those in all coastal regions of the country. Incidences of hookworm have reduced throughout India compared to that in 1980s studies.Conclusion: Our studies reveal that the situation of intestinal parasitosis is a matter of concern and drastic steps should be taken to minimize the gravity of this malady.
Background: Knowledge of the variations in the arterial supply of hand has reached a point of practical importance with the advent of microvascular surgery for revascularization, replantation, and composite tissue transfers. Superficial palmar arch (SPA) has many interesting variations, of them, the median artery (MA) contribution is been evaluated in this study.Materials and Methods: Present study was conducted on 40 adults upper limbs of unknown sex. All the specimens were obtained from the Anatomy Departments of Government Medical College and Hospital, Chandigarh, India.Results: In this study, 7.5% of specimens showed median-ulnar type of incomplete SPA.Conclusion: The clinical importance of the persistence of this artery at wrist level is well documented as a cause of the carpal tunnel syndrome but it has also been associated with the "pronator teressyndrome" in cases where the persistent MA pierces the median nerve in the proximal third of the forearm.
Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder causing deficiency of enzymes involved in adrenal steroidogenesis. Steroid replacement therapy plays a vital role in the treatment. Hyperandrogenism due to the accumulation of intermediate metabolites is the important cause of symptoms. These hormonal imbalances would result in growth abnormalities and hence should be monitored stringently.Aims and Objectives: The aim of this study is to study the physical functioning in children with CAH on treatment and to compare simple virilizers and salt wasters.Materials and Methods: A total of 55 children between 2 and 12 years of age who met the inclusion and exclusion criteria were enrolled in the study. Detailed history, anthropometry, body mass index (BMI), blood pressure, X-ray for bone age, and 17-hydroxy progesterone levels were obtained.Observation and Results: In our study, 82% (n = 45) were females and only 18% (n = 10) were males. CAH in males has been under diagnosed in our population. As expected salt-wasting type constituted the majority about 62% (n = 34). Simple virilizing type was only 38% (n = 21). Mean dose of steroid administered to our patients in this study is 16.3 +/-4.4 mg/m(2) body surface area. Mean height z-score in our study was -0.2+/-2.1. About 67% (n = 37) of the total population had their height z-scores between -2 and + 2. About 11% (n = 6) of them were >+ 3 z-score and 9% (n = 5) of them were <-3 z-score. Among the patients with height z-scores >+ 3 z-score, 5 patients were on recommended dose. 47% (n = 26) of our patients had normal BMI. 20% (n = 11) of them were obese while 18% (n = 10) of them were overweight.Conclusion: 20% of the total study population had abnormal growth profile, and 53% of the kids had abnormal BMI due to infrequent monitoring. Hence, frequent monitoring of height, weight, and BMI is essential for all patients with CAH irrespective of the type of disease. Based on the clinical findings and hormonal assays, individualized dosage modification should be done regularly.
Introduction: The treatment option for benign enlargement of prostate gland (benign prostatic hyperplasia) ranges from watchful waiting, medical therapies to various surgical interventions. While various in vitro studies have indicated that silodosin has the greatest selectivity for a1 receptors, there are other studies that mention that silodosin is just non inferior to tamsulosin and is an alternative a1-AR blocker.Materials and Methods: This is a prospective, randomized double-blinded crossover drug trial over a period of 21/2 years. 60 patients were enrolled in our study. 30 patients were assigned silodosin preceding group (SPG) and 30 others were assigned to tamsulosin preceding group (TPG). The total duration of the study was 2 months and 1 week (4 weeks initial treatment with 1 week of washout period and 4 weeks of crossover drug for each patient).Results: International Prostate Symptom Score (IPSS) was the more objective assessment taken into consideration to assess the magnitude of symptomatology and the responses to treatment. Maximal urinary flow rate significantly improved from baseline with both groups in the first treatment period with SPG producing more significant change 9.1-11.3 (P = 0.0005). With silodosin, the quality of life (QOL) is significantly improved (mean of 3.1-2.4 with P = 0.0005) compared to tamsulosin. No patients had a bothersome adverse drug reaction which persuaded for withdrawal of the drug.Conclusions: Silodosin has significantly improved both storage and voiding symptoms in both the initial period and in the crossover group. Silodosin has scored over tamsulosin in the subgroup analysis of IPSS in nocturia, urgency, max flow rate, and residual urine volume showing an objective improvement. In addition, it has significantly improved the QOL index suggesting that the drug is both objectively and subjectively effective.
William syndrome is a chromosomal anomaly characterized by developmental abnormalities, cardiac involvement, and craniofacial dysmorphic features. These set of pediatric patients present for various non-operating room anesthesia requiring imaging or procedure. This poses a unique challenge to anesthesiologists. Here, we report a case of anesthetic management of a 4-year-old child with William syndrome requiring cardiac magnetic resonance imaging. A thorough systemic review and anticipation of difficult airway ensured an uneventful anesthesia course for the child.
Periodontal diseases leading to deterioration of tooth supporting structures are a serious concern for clinicians. The clinical application of amniotic membrane for guided tissue regeneration (GTR) while fulfilling the current mechanical concept of GTR, amends it with the modern concept of biological GTR. Amniotic membrane not only maintains the structural and anatomical configuration of regenerated tissues but also contribute to enhancement of healing.
Introduction:The ratio between the length of the 2nd and 4th digit (2D:4D) is sexually dimorphic, with mean male 2D:4D lower than mean female 2D:4D, which will prove useful to determine sex when more reliable means of sex estimation are not available during medicolegal examination.Aims:To find out whether 2D:4D ratio of Madhya Pradesh region shows sexual dimorphism in both right and left digit ratio measuring dermatoglyphics lengths.Materials and Methods:A total of 620 adults (310 males and 310 females) of the age group 18-25 were studied. The length of the index and ring finger were measured and 2D:4D ratios were calculated and statistically analyzed.Results:There was a significant difference (P < 0.0001) in 2D:4D ratio with an overall accuracy of 83.55%. The final result of the analysis shows that 85.8% of males and 81.3% of females were sexed correctly.Conclusion:We conclude that 2D:4D ratio is sexually dimorphic and suggests that the 2D:4D ratio is a constant feature among different age groups in different population.
Introduction: Outcome of schizophrenia has been repeatedly demonstrated to be "good" and "favorable," which generally implies that most of the patients treated adequately are able to maintain a reasonable quality of life, remain free from distressing symptoms, can function at a moderate level and live a life outside psychiatric institutions in the community.Aim: To study clinical and social determinants of duration of untreated psychoses in drug naive schizophrenic patients.Methods: 100 consecutive patients diagnosed and admitted as inpatient schizophrenia in institute of mental health, Madras Medical College Hospital. Study variables include scales scale for assessment of positive symptoms (SAPS), scale for assessment of negative symptoms (SANS), CGI-SCH, and global assessment of functioning were given and age criteria 18-45 years, drug naive patients and patients with a diagnosis of schizophrenia.Results: A total of 100 patients were selected for the study of which 97 was obtained assessed at baseline with SAPS and SANS for psychopathology, PSA scale to assess premorbid functioning, duration of untreated psychosis and a sociodemographic profile were obtained, 63 patients were assessed at 8 weeks of follow-up for psychopathology.Conclusion: Longer duration of untreated psychoses is associated with higher age at presentation, higher negative symptoms, and poor premorbid functioning. Improved patients have a shorter duration of untreated psychoses and better premorbid functioning than unimproved patients.
Objectives: The aim of this study is to assess the post-menopausal symptoms and to correlate it with parity and various sociodemographic data.Materials and Methods: It was a cross-sectional study hospital-based assessment conducted at the Department of Obstetrics and Gynecology at IRT Perundurai Medical College. A total of 43 healthy participants who presented in the outpatient department were included in the study. All the 43 study participants filled out the menopausal rating scale (MRS) providing data for statistical analysis. The age of participants ranged from 40 to 60 years. Women with surgical menopause, receiving hormonal treatment, having serious medical comorbidities such as thyroid disorders, cardiovascular disorders, diabetes mellitus, and hypertension and those who refused to participate were not included. MRS was used to assess the post-menopausal symptoms assessing the urogenital, psychological, and physical domains.Results: A total of 60 participants were identified, 17 were excluded and 43 participated. The menopausal age was lower and the total mean MRS score was higher among the study population. The parity and age of the participants were inversely correlated, and also parity and age at menopause were also inversely correlated. Musculoskeletal pain and depression were the most severe symptom cluster.Conclusions: Menopausal symptoms were highly prevalent, often underdiagnosed with pain symptoms and psychological cluster predominating.
Introduction: The biggest challenge that orthodontist face in the clinical practice is debonding of the brackets. The best way to avoid bond failure is to adhere strictly to the rules of good bonding.Aims and Objectives: Aims and objectives of the study were to measure shear bond strength of orthodontic brackets which were rebonded using different tooth surface reconditioning methods that are diamond bur and air abrasion with aluminum oxide particles on debonded tooth surfaces and to evaluate the enamel surface topography of reconditioned enamel surface after debonding using scanning electron microscope study.Materials and Methods: This in vitro study consisted of three groups with 25 samples in each group. Metal brackets were pressed with 2 ounce of horizontal pressure. After debonding, reconditioning of the tooth surface was performed by the finishing diamond bur and air abrasion. Rebonding of the reconditioned teeth was again performed. Universal testing machine was used to evaluate the shear bond strength of the orthodontic brackets. Enamel surface topography was evaluated using scanning electron microscope.Results: Shear bond strength was highest in the air abrasion group (7.68 +/- 0.99 megapascal [MPa]) diamond bur group (6.7 +/- 1.3 MPa). There was a relationship between surface roughness and the bond strength achieved. The method which created rougher surface achieved the higher shear bond strength.Conclusions: Air abrasion can be used as preferred method of reconditioning the tooth surface after bond failure to achieve optimal bond strength of rebonded brackets.
Introduction: High risk group (HRG) for sexually transmitted infections (STI) includes female sex workers (FSW), transgender (TG) with high risk behavior, and homosexual's men having sex with men (MSM). They have high risk of being infected with STI and HIV.Aims: To estimate the prevalence of high risk individuals in Tirunelveli, to compare the number of high risk individuals turning up to STD OPD during master health check-up period and previous years, to assess the type of STI in each HRG, and to estimate venereal disease research laboratory (VDRL), HIV and VIA-VILI positivity among master health check-up attendees.Methods: Master health check-up was conducted at STD OPD, Tirunelveli Medical College Hospital, Tirunelveli. With the help of non-governmental agencies, all the people with high risk behavior were recruited for master health check-up during the stipulated time of 15 months and detailed history was taken, physical and genital examination was done. Investigation for HIV, syphilis, and other sexually transmitted diseases were also done.Results: A total of 474 HRG turned up, among them, 384 were male, 86 were FSW, and 4 were TG. About 14 cases among HRG were VDRL positive and 9 were positive for HIV (all of them were MSM) and 1 case (of FSW) was positive for VIA-VILI. The most common STI symptom found in these MSM was burning micturition followed by itching over the genitals. Trichomoniasis is the common sexually transmitted disease affecting the FSW and it is present in about 5 cases. The next common infection present in them was bacterial vaginosis, which was found in 3 cases. All the 4 TG were asymptomatic and non-reactive for ICTC and VDRL.Conclusion: Among all the HRGs, the STI burden was high in the male having sex with males. Syphilis is the most common infection affecting male homosexuals. Trichomoniasis is the common cervico-vaginal discharge syndrome affecting the FSW. TG, in this study, was asymptomatic and seronegative.
Background: The availability of adequate, accessible health-care delivery systems, modern diagnostic, and therapeutic modalities has paved the way for prompt diagnosis of congenital heart defects and the institution of appropriate intervention before complications set in, thus reducing the high levels of morbidity and mortality due to these defects in developed countries. In developing countries where there is a scarcity of similarly advanced health-care delivery set up, that goal has not been attained as in case of developed countries. Hence, a regular update in the knowledge of the prevalence and causes of heart failure in children will remain a necessity for their appropriate treatment.Objectives: The objectives of the study are to analyze the incidence of cardiac failure among children and its etiological profile in a tertiary care center in Tamil Nadu, India.Materials and Methods: Children between 1 month and 12 years of age admitted with a clinical diagnosis of cardiac failure over a period of 1 year.Results: Among 7095 cases admitted during the study period, 2.09% (n = 148) of children had cardiac failure. The majority of the cases were males constituting 57.4% (n = 85) of cardiac failure cases. Among the cardiac etiologies for heart failure, congenital heart diseases (CHDs) tops the list (59.85%). The most common CHD causing heart failure is ventricular septal defect (n = 29). Anemia is the most common noncardiac cause of heart failure (n = 8).
Background: The literature pertaining to third molar extractions is widespread and considered to be the most frequent procedure in oral and maxillofacial surgery. The prophylactic removal of asymptomatic impacted third molars is defined as the surgical removal in the absence of local pathology. Consensus states that extraction of symptomatic and/or diseased third molars is an appropriate treatment, however, prophylactic removal of asymptomatic molars is controversial among dental practitioners. Systematic reviews suggest no evidence either in support or against the prophylactic removal of asymptomatic impacted third molars, particularly from India thereby giving rise to the need of this study.Materials and Methods: A cross-sectional analytical study carried out among 407 general dental practitioners and specialists from Mumbai and Navi Mumbai city in the span of 2 months. Variables such as age, gender, and qualification of the respondents were compared with the answering pattern thereby reflecting the knowledge attitude and practice.Results: The present study evaluates the contemporary views and practices regarding prophylactic third molar extractions and shows a significant disparity among younger, middle-aged, and older dentists regarding the age group, investigations, techniques, and etiology pertaining to prophylactic third molar extractions. Majority of the dentists justify prophylactic third molar extractions, among which the number is significantly higher of younger dentists suggestive of the attitudes of the upcoming dental practitioners. Similar differences are noted among the male and female dentists and also among general and specialty dental practitioners.Conclusion: The dentists should have a greater scientific foundation from a clinical standpoint in the decision-making process regarding prophylactic third molar extraction before concluding the treatment protocol.
