Comparison of Decellularized Bubaline Diaphragmatic Scaffold with Synthetic Polygalactin and Polypropylene Composite Mesh for Perineal Hernioplasty in Dogs

Present study was planned to compare xenogenic decellularized bubaline diaphragmatic scaffold with synthetic polygalactin and polypropylene composite mesh for repair of perineal hernia in dogs. Twelve dogs suffering with perineal hernia were randomly divided in to two equal groups. In group I perineal hernioplasty was done with Synthetic polygalactin and polypropylene composite mesh while in group II, with decellularized bubaline diaphragmatic scaffold (dBDS). Mean surgical time was 59.17 ± 14.04 and 57.50 ± 6.15 minute in group I and II respectively. Swelling, redness and warmth increased significantly (p<0.05) on day 3 in both the groups. In group II initially significantly (p<0.05) increased exudation was observed on day 3 which reduced gradually. Degree of pain after surgery was significantly (P<0.05) decrease on day 3 in both the groups. Neutrophil count was significantly (p<0.05) increased and correspondingly lymphocyte count significantly (p<0.05) decreased on day 7 in group I while in group II no significant difference within the group was observed. Colour Doppler ultrasonographic examination revealed no vascularization on 0 day in both the groups. Neovascularization was observed on day 30 in group I and day 14 in group II on Colour Doppler ultrasonographic examination. It was increased on day 90 in both the groups. The complication encountered in the present study includes local seroma, suture dehiscence due to self mutilation, constipation and fistula formation. Decellularized bubaline diaphragmatic scaffold was well accepted by all the animals and showed less complication than synthetic mesh

Laboratory and clinical profile of dengue: a study from coaching city, Kota, India

Background: Dengue, an endemic disease in most subtropical and tropical regions of the world and it causes severe epidemics in India. Dengue is one of the most common acute viral illness associated with considerable morbidity and mortality. The objective of this study was to study laboratory findings and clinical profile of patients with dengue fever at a tertiary care hospital of coaching city Kota.Methods: This study was cross sectional study. The patients were examined at one point of time and later they were never followed which is similar to the cross-sectional study design. A total of 100 patients of dengue fever who were NS1 Antigen or IgM dengue positive, admitted to department of medicine of government medical college, Kota included in the study. Through clinical examination and relevant laboratory investigations performed in all patients.Results: In the present study, there were 74 males and 26 females. The sex ratio was 2.8:1. Maximum number of males (50%) was in the age group of 15-25 Years. Among females the maximum (42.3%) were in the age group of 15-25 years. The most common presenting symptom was fever in all cases followed by headache in 96%. Among bleeding manifestation, Epistaxis, gum bleeding and melena (24%) were the common symptom. 47% patients showed hepatomegaly and 38% showed splenomegaly. 12% patients were anemic and 51% showed leucopenia while 93% showed thrombocytopenia.Conclusions: Males were commonly affected. Young age group of 15-25 was more commonly affected. Fever and headache were the most common presenting symptom. As dengue causes increased morbidity and mortality and requires prompt diagnosis and treatment for the proper management of these cases, this study helps physicians in early diagnosis of dengue by suspecting the features as of dengue and can prevent morbidity and mortality associated with dengue.

A cross sectional study to determine the reasons for non-utilization of reproductive and child health services in district Etawah

Background: The utilization of social services, including health services, has never been equitably distributed in the society. Cost, distance, attitude of health providers, and other factors put the secondary care and private sector facilities out of reach of most of the poor residents. The socioeconomic factors also have a complex relationship with some of the supply factors, and often in the scarcity of good data, it is very difficult to explain the poor utilization of reproductive and child health (RCH) services.Methods: A cross sectional study conducted on 80 recently delivered women at home in the villages covered under the selected subcentre to interview all recently delivered women to find out the reasons for non-utilization of RCH services. The data was collected by using pre designed semi-structured questionnaire.Results: Most of the participants belong to age group of 20 to 24 (55%) and joint family (51.3%). Main reason for not having institutional delivery was found to be long waiting time in hospital/lack of proper facilities (50%) followed by non-cooperative hospital staff (36.2%). The study showed that most common reason for not getting money under JSY was found to be non-issuance of JSY card (33.3%) and non-cooperative hospital staff (33.3%). It was found that non utilisation of contraceptive services was mainly due to objection by husband (45.5%).Conclusions: This study revealed lack of knowledge, no felt need and financial constraints as the most common reason for not utilizing the different RCH services.

Awareness and behavior patterns regarding road safety measures among undergraduate medical students of western Uttar Pradesh: a cross-sectional study

Background: More than 1.2 million deaths occur each year on the world's roads. In India, the number of motor vehicles on the road is increasing with the population and economic growth. It has been estimated that if effective and immediate action is not taken, deaths due to road traffic accidents will become the fifth leading cause of deaths by 2020. Objectives was to assess the level of awareness and behavior regarding road safety rules among undergraduate medical students.Methods: The present cross-sectional study was conducted in a Medical College of western Uttar Pradesh. In the present study 200 final and pre-final year, undergraduate medical students were selected with the help of simple random selection, who drive/use vehicles either of their own or others. The study period was from June 2019 to August 2019.Results: About 29 percent of participants responded that they do not follow lane rules while driving. Study showed that 72.1% and 42.0% were aware that what documents to be carried with them while driving among those who attend and did not attend any program on road safety measures respectively. About 58.1 % and 38.2% were aware that penalty for driving without a helmet can be imposed among those who attend and did not attend any program on road safety measures.Conclusions: Awareness of road safety measures among participants was satisfactory, but the gap was also seen between awareness and behavior patterns regarding road safety measures.

Awareness of vaccine cold chain handlers about vaccine cold chain in district Etawah

Background: Vaccine potency can be lost when exposed to non-recommended temperatures. Hence for the proper running of the universal immunization programme (UIP) factors like vaccine cold chain and vaccine management wants great focus and attention skills and knowledge of the vaccine cold chain handlers so for good implementation of UIP vaccine cold chain handlers are important.Methods: This was an observational cross-sectional study. Study duration was carried out from October 2017 to March 2018. All the 16 cold chain handlers of district Etawah were interviewed.Results: All 16 (100.0%) were male and 1 (6.3%), 2 (12.5%), 8 (50.0%) and 5 (31.3%) of the respondents were high schools, intermediate, graduate, and post-graduate respectively. It had been observed that the hundred percent of the cold chain handlers with the knowledge of vaccine cold chain. It has been observed from the study that 15 (93.7%) cold chain handlers had knowledge of temperature range for vaccine storage.Conclusions: Quality of immunization program depends upon cold chain management at peripheral health institutions. In our study, we have found that most of the vaccine handlers were reported to have appropriate knowledge regarding the cold chain.

A cross sectional study to ascertain various causes of neonatal mortality using verbal autopsy in Etawah district

Background: Neonatal death is defined as no. of deaths during the first 28 completed days of life per 1000 live births in a given year or period. Around 2.6 million deaths or roughly 46% of all under five deaths had occurred during this period in 2016 which means that 7000 newborn deaths occur each day. Most of the neonatal deaths occur on the first day and week accounting to about 1 million dying on the 1st day. Objective of this study was to ascertain various causes of neonatal mortality using verbal autopsy in Etawah district.Methods: The present study was a retrospective cross-sectional study carried out for a period of 1 year (July 17 to June 2018) using WHO verbal autopsy questionnaire by finding out the study subjects from medical information system of UPUMS, Saifai and district hospital, Etawah. A total of 89 neonatal deaths were found out of which 87 were interviewed by going to their residences to get the relevant information regarding the causes of deaths.Results: Most common cause of neonatal mortality came out to be low birth weight with prematurity 44 of 87 (50.6%), followed by birth asphyxia 23 of 87 (26.4%) and sepsis 8 of 87 (9.2%).Conclusions: Effective interventions should be incorporated into policy decisions to reduce neonatal mortality due to these causes.

Comparative study to determine self-medication practice and pattern in urban and rural areas of Etawah district

Background: According to William Osler, a great feature which distinguishes man from animals is the desire to take medicine. Self-medication is an age old practice. According to World Health Organization guidelines “self-medication is defined as use of medicinal products by the individuals to treat self-recognized disorders or symptoms, or the intermittent or continuous use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.Methods: It was a cross sectional study, which was conducted among residents of urban and rural areas of Etawah district, Uttar Pradesh by using 40×5 cluster sampling. The data was collected by using pre designed, semi-structured questionnaire. Proforma included socio- demographic profile, practice of self- medication and pattern of self-medication.Results: Most of the participants who indulged in self-medication in urban areas 69.5% and rural areas 65% belong to the age group 20-39 years. Majority of the participants (51.0%) in urban areas belonged to the nuclear family while most of the participants (50%) belonged to joint family followed by nuclear family (40%) in rural areas. most common reason for self-medication in urban area was the availability of old prescription which is present in 30.0% (60) of subjects but in rural area most common reason for self-medication was high fee of doctor which was 29.0% (58).Conclusions: Most common age group indulged in self-medication was 20-39 years. Most common reason for self-medication was availability of old prescription at home while in rural area, high fees of doctor was the common reason for self-medicatio

A study on clinical profile and etiological agents of empyema in hospitalised children in Jaipur, India

Background: Objective is to study the clinical profile and etiological agents of empyema in hospitalised children in Jaipur.Methods: This hospital based prospective study was carried out in the Department of Pediatrics, SMS Medical College, Jaipur between April 2016 to March 2017. Children between 1 month to 18 year of age having empyema thoracis (pleural tap showing pus cells under microscopy or on gross examination purulent exudates) were included in the study. Children with Empyema secondary to post-surgical or post-traumatic cause and with tubercular effusion were excluded from the study. Relevant history, clinical examination and investigation were done. Pleural fluid studies were done for cytology, biochemical analysis , culture and antibiotic sensitivity pattern.Results: Total 100 patients were included in study. Out of total 100 patients 62 (62%) were between 1 month to 5 years. Most common symptoms were fever (94%), breathlessness (87%) and cough (85%). 27% patients were severely malnourished as per IAP classification of PEM. Pleural fluid culture was positive in 29 (29%) patients. Most common organism isolated was Staphylococcus aureus (27%), 87.5% isolates of Staphylococcus aureus had sensitivity to vancomycin and linezolid.Conclusions: Empyema thoracis is frequently encountered complication of bacterial pneumonia. Fever, cough, and respiratory distress were the most common presenting complaints and severe acute malnutrition was an important risk factor. Staphylococcus aureus was found to be the most common organism for childhood empyema.

Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region

Background: Secondary hyperparathyroidism is known and early complication of chronic renal failure patients. Aim of this study was to assess the prevalence of secondary hyperparathyroidism and correlation between serum parathyroid hormone level with biochemical parameters in renal failure patients in tertiary care hospital in Kota, Rajasthan.Methods: A cross sectional observational study was carried out in 50 patients who had creatinine clearance of 30ml/min/1.73m2 or less for greater than 6 weeks attended the OPD of department of General Medicine, New Medical College hospital, Kota, Rajasthan from May 2018 to November 2018. Investigations like complete blood count, renal function test, urine routine microscopy and USG abdomen with serum parathyroid hormone, serum phosphorus, serum calcium levels were done. Serum parathyroid hormone level was done by calorimetric method.Results: The prevalence of secondary hyperparathyroidism in our study was 72%.In hyperparathyroidism patient’s serum calcium level was low and the difference was highly significant (p<0.001). There is negative correlation between S.PTH and S. calcium level (r=-0.536). Mean serum calcium level in our study is 1.6mmol/l. In hyperparathyroidism patient’s serum phosphate level was high and the difference was highly significant (p<0.001). There was positive correlation between S.PTH and S.PO4 level (r=0.402). Mean serum phosphorus level in our study is 5.7 mg/dl. Prevalence of hyperparathyroidism was high among CRF patients with normal BP than hypertensive patients and with normal sugar than diabetics but the difference in proportion was not significant (p=0.87, p=0.98 respectively). 90% patients were on haemodialysis while 10% patients were on conservative management.Conclusions: Early detection of secondary hyperparathyroidism in chronic renal failure patients can reduce its complications like bone fracture and cardiovascular complications.

Assessment of quality of life among elderly population of rural areas of Etawah district: a cross sectional study

Background: All the aspects of health status, lifestyle, life satisfaction, mental health and well-being together reflects the multidimensional nature of quality of life (QOL) in an individual. The objective of the study was to assess the quality of life among rural elderly population of Etawah district and their association with various socio demographic factors.Methods: A community based cross-sectional study was conducted among 316 elderly subjects in rural areas of Etawah district. QOL was assessed by using WHOQOL-OLD tool. Socio-demographic factors were assessed by using a self-structured questionnaire. Data was analysed by using Microsoft Excel 2010 and statistical software SPSS-22. Transformed facet sore were calculated using WHOQOL- OLD manual and Independent sample t- test were applied.Results: Majority (86%) were in the (?75) years of age. Among the study participants, 52.8% were females, 67.5% were illiterate, 72.5% belong to nuclear family. The mean scores of QOL domains was maximum in death and dying (83.20), followed by sensory ability (62.99).The lowest mean score was seen Intimacy domain (22.80). Gender, type of family, financial status and staying with partner were found to be the determinants of better QOL (p>0.05).Conclusions: The mean quality of life score was below average in intimacy domain. It was maximum in death and dying domain

Radiological Evaluation Of Carpal Instability Associated With Conservatively Managed Fracture Of Distal Radius.

.Distal radius fracture is one of the most common fractures of the forearm and accounts for approximately 16% of all skeletal fractures. Distal radial fractures are associated with injuries to the TFCC and carpal ligaments that may lead to carpal malalignment later. The purpose of this study was to assess the frequency of carpal instability on radiological basis following conservative management of distal radius fractures. Other objective was to identify other factors including carpal malalignment in an attempt to predict the final functional outcome. In a prospective study, 100 distal radial fractures treated with conservative method were followed-up with serial radiographs for assessment of various radiological parameters. The alignment of each wrist was checked radiographically in pre reduction, immediate post-reduction and subsequently at 6-week follow-up radiographs. Serial measurements of radial length, dorsal tilt, radial inclination, scapho-lunate, radio-lunate, radioscaphoid, scapho-capitate angles and effective radiolunate flexion (ERLF) angle were made. Regression analysis showed high correlation among the severity of axial shortening, prereduction dorsal angulation and radio-carpal malalignment pattern with loss of reduction at 6 week. Two patterns of carpal malalignment were identified depending upon the effective radiolunate flexion (ERLF) measured on pre-reduction radiographs. The midcarpal malalignment was seen in 82% radial fractures with the lunate following the dorsiflexed fracture fragment and a measured ERLF of less than 250. The second pattern of radio-carpal malalignment showed the fracture fragment to dorsiflex without taking the lunate with a measured ERLF of more than 250. The scaphoid did not follow the fracture fragment in both the patterns of malalignment. Our study highlights the importance of various radiological parameters on post-reduction radiographs as a predictor of carpal instability.

Hypolipidemic activity of Moringa oleifera Lam., Moringaceae, on high fat diet induced hyperlipidemia in albino rats / Atividade hipolipidemica de Moringa oleifera Lam., Moringaceae, na hiperlipidemia induzida por dieta rica em gordura em ratos albinos

The leaves of Moringa oleifera Lam., Moringaceae, are used by the Indians in their herbal medicine as a hypolipidemic agent in obese patients. Albino Wistar rats were fed with methanolic extract of M. oleifera (150, 300 and 600 mg/kg, p.o.) and simvastatin (4 mg/kg, p.o.) along with hyperlipidemic diet for 30 days. Moringa oleifera and simvastatin were found to lower the serum cholesterol, triacylglyceride, VLDL, LDL, and atherogenic index, but were found to increase the HDL as compared to the corresponding high fed cholesterol diet group (control). The Moringa oleifera methanolic extract was also investigated for its mechanism of action by estimating HMG CO-A reductase activity. Moringa oleifera was found to increase the excretion of fecal cholesterol. Thus, the study demonstrates that M. oleifera possesses a hypolipidemic effect.

As folhas de Moringa oleifera Lam., Moringaceae, são usados na medicina natural da Índia como um agente hipolipemiante em pacientes obesos. Ratos albinos Wistar foram alimentados com extrato metanólico de M. oleifera (150, 300 e 600 mg/kg, p.o.) e sinvastatina (4 mg/kg, p.o.), juntamente com dieta hiperlipídica por 30 dias. Moringa oleifera e sinvastatina reduziram o colesterol, triacilglicerídeoss, VLDL, LDL e índice aterogênico, mas não aumentaram o HDL em comparação com o grupo controle, com dieta rica em colesterol. O mecanismo de ação do extrato metanólico de Moringa oleifera foi também investigado estimando atividade de HMG CO-A redutase. Moringa oleifera aumentou a excreção fecal de colesterol. Assim, o estudo demonstra que a M. oleifera parece ter efeito hipolipemiante.

Unusual presentations of malaria in children: an experience from a tertiary care centre in north east India.

Objective. To identify cases of malaria with unusual presentations. Methods. The medical record of all the cases of malaria admitted to PICU and pediatric general ward from Oct 2006 to Sep 2009, were reviewed and cases with unusual presentations were identified. The study design was retrospective descriptive study. Results. Sixteen (10%) out of 162 malaria cases had unusual presentations - three had hemiplegia, two each with viral hepatitis-like presentation, acute abdomen, gastrointestinal bleed, generalized edema and hyperglycemia and one each with ptosis, severe headache and subacute intestinal obstruction-like presentation. Eleven cases had mixed parasitemia and two each with P. vivax and P. falciparum. One case was diagnosed on clinical grounds. Conclusions. Malaria is a common disease, but both typical and atypical presentations deserve attention for early diagnosis and management.

Measles related complications and the role of vitamin A supplementation.

OBJECTIVE: Measles is associated with high rate of complications and contributes to a major proportion of childhood morbidity and mortality. The role of vit A supplementation (VAS) in the case management of measles and prevention of complications is partially understood and not sufficiently supported by epidemiological data. This paper analyses the possible role of vit A supplementation in prevention of measles related complications and associated fatality. METHODS: A cross sectional study was carried out during an outbreak of measles in Shivpuri, India. A total population of 193,000 was covered by house to house visit and, the caregivers of total 1204 measles cases, including 214 cases with complications, were interviewed using a semi structured interview schedule. The analysis of data was done using Epi Info. RESULTS: The attack rate of 6.7% and rate of complications at 17.8% were found in this investigation. The coverage with routine measles vaccine and the vit A supplementation was 18.3% and 28.9% respectively. The management of measles cases was poor with only 15.8% cases receiving therapeutic doses of vit A. Both complications and case fatality rate was higher amongst children who had not received vit A supplementation in previous 6 months (p<0.05). Measles vaccine also found to have preventive effect on development of complications (p<0.05). CONCLUSION: Routine vit A supplementation and measles vaccination reduce the chances of complications amongst cases of measles. The role of VAS becomes more important when the case management is poor. While, measles is frequently associated with complications in the Indian setting, there is a need of enhancing the efforts to improve the delivery of vit A supplementation and measles vaccine to the children in rural areas.