Background: Severe Acute Respiratory Syndrome- Corona Virus-2 (SARS-CoV-2) infection becomes the pandemic of coronavirus disease 2019 (COVID-19) shows drastic changes in health care system. Aims and objectives: (1) To assess different biomarkers in COVID-19 cases, (2) To correlate biomarkers with cycle threshold (CT) value of Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and it's role for prognosis of severe cases. Material and Methods: Consecutive patients with positive for SARS-CoV-2 by RT-PCR with CT value less than 36 were included. A CT values were found for envelope (E-gene) as a screening gene and RNA dependent RNA polymerase (RdRp) as a confirmatory gene were amplified during RT-PCR. The severity of illness was assessed using different biochemical parameters for C-reactive protein (CRP), serum ferritin, D-dimer, lactate dehydrogenase (LDH), serum urea, and creatinine.
The outbreak of Novel corona virus is a global health emergency which has pushed mankind in the silhouette of darkness Humanity has accustomed to several pandemics since evolution and mankind has propensity in genes to endure and proved himself to survival of fittest Despite global efforts to hold the disease stretch, the outbreak is still climbing the graph as the community spreads pattern of this infection has started In response to the emerging circumstances, this article endeavors to provide a timely and comprehensive analysis of the history of pandemics, its consequences, co-morbidities, factors involved, and potential uncertainty of the future While, several questions emerge to be addressed in confronting advanced COVID-19 in more waves that could be more devastating for humanity History is riddled with references to pandemics or extreme epidemics of respiratory viruses However, we only used those episodes for which there are reasonable contemporary accounts We are confident that this overview will support in recognizing and interpreting the vista of the threatening disease with historical reference
Six groups of five albino rats per group were fed ad libitum with rat diet contaminated with petroleum at concentrations of 3.88, 7.75, 15.51, 31.01, 62.02 g/kg and the last group fed only rat diet as control. Another six groups of five albino rats were fed ad libitum with rat diet contaminated with petroleum at the same concentrations mixed with 20% sugar (Granulated) with the last group fed only rat diet as control to determine glucose effect of sugar on petroleum induced toxicity. The hepatic enzymes aspartate amino transferase (AST), alanine amino transferase (ALT), gamma glutamyl transpeptidase (GGT) and alkaline phosphatase (ALK PHOS) activities with albumin, Total protein and liver /body weight were monitored in the animals. There was dose dependent decrease in enzymes activities (ALT, AST, GGT and ALKPHOS) with dose dependent increase in albumin and Protein in Sugar fed albino rats compared with Petroleum fed albino rats (P<0.05). There was dose dependent increase in enzymes activities and dose dependent decrease in proteins in petroleum fed rats compared with their controls (P<0.05). The study showed that 20%sugar reduced enzyme induction caused by petroleum contaminated diet through reducing cAMP concentrations. Therefore sugar cane represses enzymes induction through the process of glucose effect.
Background: Excessive consumption of citrus fruits apparently results in destructive effects on the teeth which cause perplexing problems. Patients with loss of tooth surface due to attrition, abrasion and erosion have been increasingly seeking for help. Attention has been drawn to the effect of erosion on dental enamel due to excessive intake of fruit juices. Materials & Methods: Sample of one hundred extracted adult human central incisors was used to estimate the demineralizing effect of lemon and orange fruit juices on human enamel. Levels of calcium and phosphorus were evaluated. The pH of fruit juice, weight of the tooth before and after the observation period, quantitative estimation of calcium and phosphorus in the fruit juices were estimate. Gross changes on the enamel were studied and the results tabulated. Results: There is a gradual and significant loss of weight of the tooth due to demineralization as the period observation increases. The rate of demineralization is rapid in the first 30 minutes in both orange and lemon juices. Statistical analysis suggested that lemon and orange juice have definite demineralizing effect on human enamel at various intervals Conclusion: Human enamel has the tendency to demineralize in the presence of lemon as well as orange juice. Overall the lemon juice has marked demineralizing effect on human enamel as compared to orange juice.
Background: Oral health is an important health status indicator of an individual. In India poor economic group mostly accommodate in rural areas, where there is lack of facility. The present study was carried out to determine the oral health status of the school going children in rural area. We tried to assess the oral health habits know more about the type of treatment they may need to increase awareness and attention towards oral health. Materials & Methods: The observational study was carried out in a school where a team of dentists examined the children and recorded their findings. Various study parameters like demographic profile, oral hygiene status, oral habits, dental caries, gingivitis, malocclusion etc. were assessed. Results: In total 133 children were studied, majority of them were girls. Dental caries was seen in 33.1%, gingivitis in 12%, Malocclusion in 21% & Hypocalcificaion in 12.7%. Overall health hygiene was poor 64.66%. There was a definite correlation of poor oral hygiene & use of toothbrush with dental caries. Conclusion: Poor oral hygiene is hazardous to oral health. Discoloration & poor oral hygiene warrants a complete dental examination. This can be achieved by educating the children as well as parents through school dental health program.
Background: To evaluate the effect of transversus abdominis block for intra and post-operative analgesia in patients undergoing abdominal hysterectomy under general anaesthesia.Methods: Prospective, double-blind, randomized, clinical study on 80 patients of age 40-60 years undergoing total abdominal hysterectomy under general anaesthesia. Patients were randomly divided into 2 equal groups; Group N (n=40): TAP block with 30 ml of normal saline; Group B (n= 40): TAP block with 30 ml of 0.25% bupivacaine. All patients were given general anaesthesia followed by transversus abdominis plane block (TAP). All parameters like postoperative VAS Score, intraoperative haemodynamic changes (HR, SBP, DBP, MAP) were recorded. In the postoperative period diclofenac 1.5 mg/kg was given. If VAS ≥ 4 inj tramadol 2mg/kg i.v. was given as rescue analgesia. Total dose of diclofenac and tramadol in 24 hr post operative period was recorded.Result: The time for first analgesic request was increased in Group B 134.67±16.23 min as compared to Group N 42.85±18.13 min (P value <0.05). Maximum VAS score up to 24 hrs postoperative was lower in the Group B (2.77 ± 9.73) as compared to group N (5.6±1.42) (P value <0.05). The rescue analgesic consumption within 24 hours post operatively was lower in Group B (105.75±71.24 mg) compared to Group N (218±40.01 mg) (P value <0.05).Conclusion: TAP block provide significant postoperative analgesia in first 24 hour and excellent hemodynamic stability being a safe modality for intra and post operative analgesia for total abdominal hysterectomy.
We studied 51 children with clinical setting of portal hypertension over a period of one and half years. Out of these, 27 (52.94%) were males and 24 (47.05%) were females. All the cases were subjected to biochemical, diagnostic, radiological investigations and liver biopsy. Portal hypertension was diagnosed by demonstrating on USG abdomen/ Doppler, the presence of collaterals of portal vein and esophageal varices on endoscopy. Treatment was initiated depending upon clinical presentation. The most common presenting complaints were hematemesis and malena (35.3%) followed by their combination with abdominal distension (19.6%). 86.3% patients had anemia mostly due to upper GI bleed. 35.3% patients had leucopenia while 47.1% had thrombocytopenia. Only 18 (i.e. 35.3%) had Hypersplenism. Maximum patients who bled more than twice had a mild (41.2%) or severe (29.4%) derangement of prothrombin time. The etiology of portal hypertension turned out to be extra- hepatic portal vein obstruction in 86.3% cases. There were 2 cases each (3.9% each) of Wilson’s disease and Budd-Chiari syndrome. One (2%) was secondary to chronic liver disease due to hepatitis C infection, one was extra- hepatic biliary atresia and one was autoimmune hepatitis. 9.8% cases required drugs in the form of somatostatin drip and all these required a packed cell transfusion as well. 23 patients (45.1%) required only blood transfusion without a somatostatin infusion. Those with severe acute bleeding usually were given somatostatin infusion. The variceal size at presentation was a very important predictor of the morbidity and outcome.
Aim and Objectives: The present study was carried out with an objective to evaluate ease of insertion of catheter and suctioning through Flexo-metallic tube versus Ring Adair Elwin (RAE) tube, to know the incidence of kinking of RAE tube and to note down the endo-bronchial placement of Flexo-metallic versus RAE tube and surgeon’s comfort zone. Methods: A prospective observational randomized study was conducted on 60 ASA grade I and II pediatric patients of age group 4 month to 16 years undergoing cleft lip and palate surgeries. Patients were randomly allocated in two groups of 30 each. Group R: intubated with RAE South pole tube and group F: intubated with flexo-metallic tube. The ease of insertion of suction catheter, ease of suctioning of secretions, refixation required, kinking of tracheal tube, incidence of displacement, airway complications and surgeons’ feedback- Comfort zone were noted. Results: The ease of suctioning through lumen of Tracheal tube was easier in group ‘F’ as compared to RAE tube. No kinking of tracheal tube was found in any group. The displacement of tracheal tube was observed in 2 patients in group ‘R’. Refixation of tracheal tube was required in 2 patients in group ‘R’. Bronchospasm and cough was noted in 1 patient in group ‘R’. No variations in vitals (e.g. blood pressure and heart rate) were observed in any group. Surgical team was comfortable in both groups but more so with Flexo-metallic tracheal tube group. On extubation we found retained secretions at distal portion of RAE tube in 2 patients. Conclusion : Flexometallic tracheal tube provides advantage of easy suctioning of tracheal secretions. Do not kink in mouth gag of surgical field, provides better airway security and stability, less intra-operative manipulation by anaesthetist, less airway complications, provides better surgical field.
Objective: This study was conducted to determine the values of the blood count of blood donors in Antananarivo.Methodology: This is a descriptive and cross-sectional study from September 20th to November 09th, 2017 at the National Center for Blood Transfusion and the laboratory of Befelatanana University Hospital Antananarivo. The blood counts of all blood donors who met the inclusion and exclusion criteria were measured. Normal values were defined by values between 2.5 and 97.5 percentiles.Results: Among the 249 blood donors selected, 126 were men and 123 were women. For erythrocyte parameters, the values of hemoglobin are between 129 g/l -181g/l in men and 116 g/l -161g/l in women. Regarding leukocyte parameters, the values of leukocytes are between 3.8G/l-10.2G/l in men and 4.0G/l - 9.9G/l in women. The numbers of platelets are between 148G/l- 425G/l in men and between 155G/ l-482G/l in women.Conclusion: Blood count values of blood donors in Antananarivo showed variations by age and sex and showed differences from those of the Caucasian population. Thus, Madagascar should establish its own reference values to ensure proper management of the health of the Malagasy population.
Objective: The aim of this study is the comparison ultrasonography used as diagnostic tool preoperatively comparing it. Clinical assessment was used as diagnostic protocols. Study design: This is a prospective observational study comparing the adverse outcome in two different groups of patients admitted with suspected acute appendicitis. The first group l00 patients were managed without ultrasonography. In the second group we use routinely graded compression abdominal ultrasonography preoperatively. Diagnostic accuracy of the protocol in each group was measured statistically and rates of negative appendectomy and perforation were determined. Result: Addition of routine ultrasonography in clinical assessment for acute appendicitis decrease the sensitivity but significantly increases the specificity of the protocol there by reducing the false positive rate translating into decrease negative appendicectomy rate. Rate of negative appendectomy was 22.5% in group one and 4.7% in group two. Perforation rate was 15.61 in group 1 and 15% in group 2. Conclusion: Proper clinical assessment is the mainstay of diagnosis in acute appendicitis and by adding graded compression ultrasonography technique can improve the diagnostic accuracy and adverse outcome.
Surface epithelial tumours are the most commonly encountered neoplasms of the ovary. Among these, Mucinous tumours accounts for 14% of ovarian tumours. Coexistence of mucinous tumour with another surface epithelial tumour is rare. We report here a rare case of mucinous cystadenocarcinoma with Brenner’s component in a 70-year-old post-menopausal female. She presented with chief complaints of Constipation and abdominal distention since 4 months. The symptoms were gradually progressive in nature. Co-occurrence of these two tumours favours the theory of common origin of surface epithelial tumours from coelomic or germinal epithelium, and hence, it undergoes metaplastic changes to transitional or urothelial- likes morphology.
Aims and Objectives: The present research was undertaken to study the diagnostic utility of TBSRTC at our institution and correlate the cytological diagnosis with the histological diagnosis wherever available. Methods: A total of 108 patients with thyroid swellings were subjected to fine needle aspiration cytology (FNAC) during a period of 10 months i.e. from January 2016 to October 2016 were included in the study. Out of these 31 patients (28.70%) underwent surgery subsequently and histopathological examination was done. Cytological diagnosis was compared with histopathology diagnosis wherever it was available. Results: Out of 108 patients, majority were females (87.03%) and in younger age group (n = 66 [61.11%], 21–40 years). The FNAC diagnosis was categorized as unsatisfactory (2.77%), benign (87.03%), Atypia of Undetermined Significance (0.92%), Follicular/ Hurthle cell neoplasm (4.62%), suspicious for malignancy (0.92%) and malignant (3.70%). The malignancy rate for benign category was 4.5%, 20% for follicular neoplasm, 100% for each suspicious for malignancy and malignant category. 29 cases (93.54%) out of 31 had a consistent cytological diagnosis with histological diagnosis while 2 cases (6.45%) showed discordance. There was a good correlation between cytological and histopathological diagnosis. Conclusion: The Bethesda system is very useful standardized system of reporting thyroid cytopathology. It improves communication between cytopathologist's and clinicians, leading to more consistent management approaches.
Background: Low levels of serum magnesium have been associated in development of post operative atrial fibrillation (AF) in patients undergoing coronary artery bypass grafting. However, the role of magnesium in the development of AF in ambulatory patients is limited. Aim: To evaluate the relation between serum magnesium levels and presence of atrial fibrillation either paroxysmal or permanent. Material and Methods: Hospital-based prospective observational study, between May 2015 and November 2016 in 100 patients (50 cases and controls each) aged ≥ 18years . Admitted patients who had detectable AF on electrocardiography constituted the cases. Patients with any other irregular rhythm , valvular heart disease , history of electrolyte disorder, alcoholism and potassium sparing diuretic use were excluded. Chi-square test, Fisher’s exact test and Pearson’s correlation analysis was used to examine the possible relations between serum magnesium level and other parameters . A p value of <0.05 was considered for statistical significance. Results: The mean age 65.39 ± 11.4 years and 67.18 ±10.6 in the AF and control group respectively. In the AF group 36% had paroxysmal AF and 64% had permanent AF. The serum magnesium levels were significantly lower in the patients with atrial fibrillation (p <0.01) than in controls. The mean serum magnesium levels in paroxysmal AF were 1.49 ± 0.29 while the mean magnesium levels in permanent AF: 1.66 ± 0.36. (p=0.07). Conclusion: Serum magnesium levels were significantly lower in the patients with atrial fibrillation. Correction of magnesium deficiency may be a potential target for the prevention of development of atrial fibrillation.
Introduction: The annual number of AIDS-related deaths globally has been decreasing due to the significant scaling up of ART over the past few years. The estimated number of people who died from HIV- related illness in 2009 was 1.8 million. To tackle AIDS, prevention is the most effective and cheapest way and possible through behavioural changes. The college going students of Delhi-NCR are thought to be more enlightened towards HIV infection and don’t shy away from indulging or experimenting in risky sexual behaviour. So, the present study was undertaken to assess the high risk behaviour among students of selected professional institutes.Material and Methods: The study was conducted among Students of selected medical, para-medical & other technical institutes in Ghaziabad (U.P.) during February 2011 to August 2011. Data were collected through self administered, well designed pre-tested and close ended study proforma. The information regarding socio-demographic variables and behavioral pattern was collected and analyzed using Epi-info statistical software.Results: All students from professional colleges maximum no. of the students were between less than 20 years age (59.16%). Among 1200 students male students were 868 (72.33%) and female students were 332(27.66%). 188(17%) students responded about presence of sexual activity which they have acquired by virtue of marriage and otherwise respectively 40.42% & 59.58% and that too with a single regular partner 41.48%.Conclusion: Among all respondents predominance of age group of 15-20 years. The most common high-risk group was having sex with multiple partners.
Background: Thoracic vertebral synostosis is of interest not only to the anatomist but also to surgeons, neurologist, orthopedician, radiologist, anaesthetics and for forensic medicine also. Various vertebral anomalies have been reported by different authors such as Sacralisation, Lumbarisation, Occipitalisation, absence of posterior elements of vertebral arch and vertebral synostosis. Methods: The present study was conducted on 408 dry adult human vertebrae of unknown age & sex obtained from the Department of Anatomy, All India Institute of Medical Sciences, Phulwari-Sharif, Patna. Result: According to our study, we found presence of one set of fused 4th and 5 th thoracic vertebrae (2.94%), one set of 5 th to 8 th thoracic vertebrae (2.94%). Out of 34 sets of vertebral columns we got 2 sets of fused thoracic vertebrae 5.88%. 2 sets of fused thoracic vertebrae presents ossification of the anterior longitudinal ligament. Conclusions: Knowledge about any deviation from the normal anatomy of vertebral column can lead to major or minor complications affecting the different system of the body. This study is also clinically important as they might be associated with genitourinary, neurological and musculoskeletal abnormalities.
Background: Oligohydramnios is defined as when the maximum vertical pockets of liquor is less than 2 cm or when amniotic fluid index (AFI) is less than 5 cm or less than 10 th centile. It is one of the major causes of maternal and perinatal morbidity and mortality. Aim: The present study was undertaken to assess the maternal and fetal outcome in AFI of 5 cm or less (oligohydramnios) in term pregnancies. Method: In this prospective study total 100 cases with oligohydramnios (< or = 5cm) diagnosed by ultrasound after 37 weeks of gestation were enrolled and studied for maternal and fetal outcome after meeting inclusion and exclusion criteria. Results: Mean maternal age was 25.48 years. Incidence of oligohydramnios was more (53%) in primigravida. Non stress test (NST) was reactive in 59% and nonreactive in 41% cases. 43% patients delivered vaginally, 4% delivered instrumentally and 53% by caesarean section with most common indication being fetal distress (52.83%). The occurrence of meconium stained amniotic fluid was 30%. Incidence of Low birth weight was 68% and incidence of abnormal doppler changes was found in 25% of cases. 41% of newborns were admitted in neonatal ward (NICU) with tachypnoea was commonest indication followed by baby not cried immediately after birth and meconium aspiration. There were no neonatal or maternal deaths observed in the study. Conclusion: Oligohydramnios is associated with adverse perinatal outcome and increased maternal morbidity in terms of operative interference. Thus, proper antepartum surveillance and timely intervention is needed for better results.
This article highlights some classic formulations used by the traditional practitioners of Bangalee community in Belonia bio – region of South Tripura district for the treatment of various ailments. A field survey revealed nine classic formulations those are important folklore medicines for various ailments, where 23 different plants species and five organic and inorganic entities have identified those used as components for nine formulations and two species of plants Citrus limon Linn, Azadirachta indica (A). Juss recorded in more than one formulation. The name and address of traditional practitioners, the composition of formulations, disease, sign and syndrome have detailed in this article. Apart from traditional knowledge few traditional mindset on ghost action, restriction for pregnant women has also documented. With the advent of the modern exotic culture and the parallel development of modern or allopathic medicines, the rich Indian traditional system of health care practices have sidelined and neglected. Resultantly, the village-based wisdom of the traditional system of health care practices has not seriously referred, not well documented and conveyed properly over generations. With this background, our survey on Tripura traditional medicine (TTM) may help in the discovery of safe, natural remedy for some dreaded ailments and sustainable development of ethno-medicinal bioresources.
Objective : The objective of this study was to evaluate the diagnostic accuracy of various ultrasound parameters in the diagnosis of malignant thyroid nodules and to correlate ultrasonographic findings with cytological diagnosis as reference.Material & Methods: In this prospective study a total of 165 patients attending the surgery/ENT OPD with complaints of thyroid swelling were included. On Ultrasonography the nodules were assessed on the basis of composition , echogenecity, margins , calcification , internal vascularity and presence of any associated lymphadenopathy. Sensitivity, Specificity and diagnostic accuracy of each individual US parameter was calculated . The results were then compared with cytological diagnosis.Results: The incidence of malignancy in our study was 6.66% (11/165). Of all the ultrasound characteristics, a predominantly solid composition, presence of fine calcifications and irregular borders had high sensitivity but low specificity for the diagnosis of malignancy.On the other hand, presence of internal vascularity within the nodule had the highest specificity and overall diagnostic accuracy. The sensitivity ,specificity and overall diagnostic accuracy of Ultrasound for characterising a malignant nodule was found to be 78.5% , 99.3% and 97.57% respectively.Conclusion : Ultrasonography along with FNAC is useful in the initial evaluation of thyroid nodules .While histopathology remains the gold standard for establishing the final diagnosis, attention to specific ultrasound patterns appear to be useful indicators in suspicious nodules which in turn may avoid unnecessary surgical intervention in benign nodules.
Objectives: The aim of this work was to assess the kidney function tests in Diabetes Mellitus patients under insulin doses in Arar regionIntroduction: Diabetes Mellitus (D.M) is a prevalent endocrinal disorder in Kingdom of Saudi Arabia. Present study is to highlight the effect of long lasting cases of controlled D.M on Kidney Functions in a local region. Diabetic renal disease in human often requires the better part of two decades to develop the signs and symptoms of advanced/clinical diabetic nephropathy with underlying extensive damage to the various segments of the nephron, thereby causing albuminuria, rising blood pressure, and a progressive decline of glomerular filtration.Materials and Methods: The serum biochemistry investigation for Glucose, Urea and Creatinine.1-Glucose: The fasting serum glucose level was obtained from the laboratory of Clinical Biochemistry using department Autoanalyser (Dimension model RXL MAX) of the Arar Central Hospital, Arar.2-Urea: Urea Kit (Randox) and a spectrophotometer were used to determine the serum urea concentration in the samples.3-Creatinine: Serum creatinine was measured by a Kit (Randox), using the compensated kinetic Jaffe assay.Results & Discussions: It is clear from the result that in almost all patients blood glucose is within normal range but their kidney function test i.e. urea and creatinine lies in high range. Measurements of Blood pressure (SBP &DBP) also found to be in normal range for all patients. So obtained results could be interpreted as: The patients are controlled diabetics under insulin therapy but with very high serum creatinine level indicating severely affected glomerular filtration rate.Conclusion: Based on this study it could be concluded that long duration of diabetes mellitus can affect renal function through destructive effects on vascular bed of renal tissues as a part of general vascular and nervous pathological effects of diabetes mellitus. These patients are advised to go for dialysis regularly and should be under observation of well qualified Nephrologists.
