A cohort study on risk factors for preterm births in rural Gujarat

Background: Prematurity is one of the leading causes of neonatal and under-five mortalities globally and also in India. It is an important determinant of short- and long-term morbidities in infants and children. Unfortunately, risk factors of majority of preterm births (PTBs) remain unexplained which calls for appropriate action. There is a dearth of community-based research on PTB and its risk factors, especially in high burden countries like India. Objectives: The objective of the study was to explore different risk factors for PTB. Methods: A cohort of 1977 antenatal mothers was enrolled at household level by trained field investigators and was followed up in four districts of Gujarat, India, to document the outcome of pregnancy. Pretested and structured questionnaires were used to collect information. A hierarchical regression model was used to analyze the risk factors for PTB. Results: Proportion of PTB was 9% among the enrolled cohort. Risk factors which were found to be significant on applying the hierarchical model were periodontal disease, long sleep duration, and sex during any trimester. Conclusions: The study suggests an urgent need for strengthening of existing guidelines for effective, evidence-based, and culturally appropriate interventions for prevention of PTB. Maintenance of good oral hygiene should find a place in routine recommendations for pregnant women, and antenatal examinations should include screening for oral hygiene also.

A Case of Bilateral Retinal Hemorrhage with Cotton Wool Spot Following Viper Bite.

A 38 years male, admitted in the department of Internal Medicine with a history of snake bite in his left lower leg during agriculture work. He was treated with anti snake venom after admission. He had history of dimness of vision in both eyes. On examination, swelling and subcutaneous hemorrhage was noted in his left leg. His best corrected visual acuity (BCVA) was 6/60 in the both eyes. Fundus examination with 90 D lens and Indirect Ophthalmoscopy of both eyes showed retinal hemorrhage with cotton wool spots. Blood tests revealed increased titers of D-dimer and fibrin degradation products. The patient was followed up regularly at 2 weeks interval and BCVA and Fundus examination was carried out. At the end of 10 weeks, retinal hemorrhages had significantly cleared in both eyes with improvement of vision in both eyes (BCVA of right eye at last follow-up 6/6 and left eye 6/9).

KAP study on early diagnostic signs of risk factors for cancer.

Background: - Risk factors for cancer are also risk factors for other non-communicable diseases. The studies were done for knowledge, attitude & practice on risk factors of oral cancer, breast cancer and risk factors of cervical cancer and early diagnostic techniques for oral cancer, breast cancer and cervical cancer. Objectives:(1) To assess the knowledge of administrative staffs of New Sachivalaya, Gandhinagar regarding the risk factors for cancer and the awareness level among them on cancer prevention and treatment. (2)To assess their attitude towards cancer risk factors identification and early self diagnostic techniques. (3)To assess their behaviour towards practicing regarding self examination technique of oral cavity, self breast examination and cervical screening. Methods:- Detail list of all administrative staffs were obtained from General Administrative Department after the permission letter from Commissioner of Health & Secretariat of General Administrative Department of Sachivalaya. All 3429 staffs of New Sachivalaya were included in Simple random technique. Out of them 350 (10%) participants were taken for this study by their consent. Results: Study result showed knowledge were mix type of because 79.7% (n=279) had answer lump in breast or bleeding from nipple of breast were early signs for breast cancer, but 48.9% had answer on painful lump in breast is an early signs for diagnosis. 64.4% were had belief on cancer that cancer is a deadly diseases and cancer means cancel. Only 34.6% had belief as cancer can be prevented if early diagnosed. Knowledge level was different as they were on different position but the attitude and the practice to cancer risk factors identification and early diagnostic signs were almost same. They had more attitude and practice towards hospital visit rather than doing Self-Examination technique 93.7% (n=328) were willing to create awareness on cancer risk factors and its screening tests and early diagnostic signs for early identification of cancer.

Clinical profile of myasthenia gravis.

Seventy three patients with myasthenia gravis were studied over 9 years period (1987-1995) in departments of neuromedicine, respiratory care unit, cardiothoracic unit of Institute of Postgraduate Medical Education and Research and Bangur Institute of Neurology, Calcutta, with reference to their clinical presentations, laboratory findings and various modes of treatment. Commonest age of presentation was 5th decade in men and 3rd decade in women. Fifty five percent of patients belong to type 2A myasthenia gravis (Osserman classification). Presentation was insidious (67.2%) and course was slowly progressive (65.7%) in majority of cases. Fatigability and ptosis were commonest clinical presentation and diurnal variation was noticed in 60% of cases. Edrophonium test was positive in 90.4% of cases and repetitive nerve stimulation showed 93.5% positivity in 30 cases. 27 patients (36.9%) underwent thymectomy and out of these, 89% of patients showed hyperplastic change and thymoma in 11% of cases. Mortality rate including both operated and nonoperated patients was recorded to be 9.6%. We observed earlier onset of myasthenia in male, higher incidence of oculo-bulbar involvement and lower incidence of respiratory problem and thymoma.

Prognostic factors in intracerebral haemorrhage.

In a prospective study, the prognostic value of clinical characteristics and CT scan findings in 50 patients of intracerebral haemorrhage (ICH) has been examined. Follow up has been done over 6 months period. Each patient has been individually followed up for 8 weeks. At the end of the follow up period 34% of the patients died, 36% were dependent on outside help for daily living while 30% were capable of independent existence. Age of more than 60 yrs, Glasgow Coma Scale (GCS) Score of 6 or less (in a modified Scale of 10) at the time of admission, ICH volume greater than 30 ml., midline shift in CT scan of more than 3 mm and presence of intraventricular haemorrhage (IVH) and hydrocephalus had an adverse impact on outcome. Young age, GCS score of more than 8, ICH volume of less than 20 ml, presence of lobar haemorrhage and absence of IVH/hydrocephalus were associated with relatively favourable outcome.

Colonization ability & intestinal pathology of rabbits orally fed with Vibrio cholerae O139 Bengal.

The colonization ability of a representative epidemic strain of V. cholerae O139 Bengal was studied in the oral rabbit colonization model and the nature of colonization in the ileal and jejunal tissues was examined ultrastructurally. Results of the colonization study and ileal loop assay indicated that the strain proliferates and colonizes the small intestine of the rabbit mucosal surface. Further, the electronmicroscopic study revealed the disruptive effect of the strain on the apical membrane of the epithelial cells. The results of this study suggested that apart from colonization, invasion of the bacteria was important in the pathogenesis of V. cholerae O139 mediated infections.

Atrial natriuretic peptide: pathophysiological considerations.

Atrial natriuretic peptide (ANP) is a cardiac hormone with potent diuretic and natriuretic properties. This hormone mediates a finely tuned control mechanism for the maintenance of blood pressure and volume. The altered pressure and volume in many important cardiovascular diseases suggest that understanding the functional role of ANP is integral to these conditions. ANP levels are increased in a wide variety of cardiac disorders such as hypertension, diabetes, congestive heart failure, myocardial infarction and valvular heart diseases. Several studies have indicated a positive correlation between the severity of cardiac disorders and plasma ANP levels highlighting its importance as a prognostic factor in cardiovascular diseases. Furthermore, its compensatory role in these situations has prompted a world-wide investigation on the use of ANP as a drug in cardiac diseases and it is not surprising that there has been a wealth of scientific papers on this subject. This review attempts to summarize the present knowledge concerning the physiology of ANP and evaluates some of the latest experimental findings and opinions on the involvement of ANP in cardiovascular diseases.