Significance of immune-inflammatory markers in predicting clinical outcome of COVID-19 patients

Background: The epidemic of coronavirus disease 2019 (COVID-19) has been rapidly spreading on a global scale affecting many countries and territories. There is rapid onset of generalized inflammation resulting in acute respiratory distress syndrome. We, thus, aimed to explore the potential of immune-inflammatory parameters in predicting the severity of COVID-19. Materials and Methods: Age, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), Lactate Dehydrogenase (LDH), C-reaction protein (CRP), and procalcitonin (PCT) of 611 patients with laboratory-confirmed COVID-19 were investigated and compared. Patients were divided on the basis of severity and survival into two groups. Data were expressed as mean or median values and percentages. The receiver operating characteristic curve was applied to determine the optimal cut-off values of these biomarkers. Results: The median age was 50 years and the male to female ratio was 3.7:1. The mean NLR, LMR, PLR, LDH, CRP, and Procalcitonin for the non-severe group were 4.16, 10.8, 133.7, 666.1, 49.9, and 0.15, respectively. In the severe group mean values of the above-mentioned immune-inflammatory markers were 17.8, 4.69, 268.2, 1277, 158.6, and 3.05, respectively. Elevated levels were significantly associated with disease severity. In ROC curve analysis, NLR had the largest area under the curve at 0.923 with the highest specificity (0.83) and sensitivity (0.88). Conclusion: This study shows that NLR, PLR, LDH, CRP, and Procalcitonin may be a rapid, widely available, useful predictive factor for determining the severity of COVID-19 patients.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Prevalence of active HCV infection and genotypic distribution among the general population of district Mardan, Pakistan / Prevalência de infecção HCV ativa a distribuição genotípica entre a população geral do distrito de Mardan, Paquistão

Abstract Hepatitis C virus (HCV) is the serious global public health burden of liver disease. Approximately 170 million people in the world are infected with (HCV). In Pakistan, where the disease has high occurrence rate. The present study envisages an up-to-date prevalence of HCV and genotypic distribution in the general population of Mardan District, Khyber Pakhtunkhwa (KP), Pakistan. The blood samples from 6,538 individuals including 3,263 males and 3,275 females were analyzed for hepatitis C surface antigen by Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and reverse transcription-polymerase chain reaction (PCR). It was found that 396 (12.13%) out of 3263 individuals contained antibodies in their blood against HCV, while among the different age groups, the highest incidences of HCV antibodies were found in the 31-40 age group (11.01%). The ICT positive samples were further screened by nested PCR to determine the existence of active HCV-RNA. It was identified that 7.11% (3263) of the total population (6538) tested was positive, among which the 461 (14.07%) females possessed antibodies in their blood against HCV. Our data showed total HCV infection in the investigated population was 5.78%. Higher percentage of HCV prevalence was detected in males than females in the age group 31-40 and 41-50. To compare the prevalence of HCV genotypes age-wise in male and female genotype 3a was found most prevalent genotype followed by 1a, 2a and 3b, respectively.

Resumo O vírus da hepatite C (HCV) é o grave problema de saúde pública das doenças hepáticas. Aproximadamente 170 milhões de pessoas no mundo estão infectadas com HCV; no Paquistão, a doença tem alto índice de ocorrência. O presente estudo prevê uma prevalência atualizada do HCV e distribuição genotípica na população geral do distrito de Mardan, Khyber Pakhtunkhwa (KP), Paquistão. As amostras de sangue de 6.538 indivíduos, incluindo 3.263 homens e 3.275 mulheres, foram analisadas para o antígeno de superfície da hepatite C por teste imunocromatográfico (ICT), ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase de transcrição reversa (PCR). Verificou-se que 396 (12,13%) de 3.263 indivíduos continham anticorpos no sangue contra o HCV, enquanto entre as diferentes faixas etárias as maiores incidências de anticorpos anti-HCV foram encontradas na faixa etária de 31 a 40 anos (11,01%). As amostras positivas para ICT foram posteriormente rastreadas por nested PCR para determinar a existência de HCV-RNA ativo. Identificou-se que 7,11% (3.263) do total da população (6.538) testada foram positivos, dentre os quais 461 (14,07%) mulheres possuíam anticorpos no sangue contra o HCV. Nossos dados mostraram que a infecção total pelo HCV na população investigada foi de 5,78%. Maior porcentagem de prevalência de HCV foi detectada em homens do que em mulheres nas faixas etárias de 31-40 e 41-50. Para comparar a prevalência de genótipos de HCV com relação à idade no genótipo masculino e feminino 3a foi encontrado o genótipo mais prevalente seguido por 1a, 2a e 3b, respectivamente.

Morphometric and biomechanical analysis of gracilis and semitendinosus tendons: A cadaveric study in the South Indian setting

Background: Semitendinosus and gracilis muscle tendons are among the most frequently used grafts in anterior cruciate ligament reconstructive surgery. Gracilis is also frequently used in breast reconstruction as well as in upper and lower limb reconstruction as a free graft. Materials and Methods: A total of 60 human cadaver lower limbs were studied of 30 adults (12 men and 18 women) who have been embalmed at a tertiary care institution. Those cadavers whose lower limb had undergone surgery in the past and those with concomitant pathology that would have affected the local anatomy were excluded. Gracilis and semitendinosus tendons were taken out of embalmed remains after the cutaneous and subcutaneous tissues had been carefully dissected. Results: It was observed that the maximum load of all the semitendinosus tendons studied had a mean value of 768.2 ± 130.4 N. The semitendinosus tendon’s maximal load in males ranged from 698.4 to 1133.9 N. However in females, the semitendinosus tendon’s maximal load ranged from 589.5 to 780.0 N. Conclusion: The topographical and morphometric data from this study can be utilized as a database of anthropological parameters for the Semitendinosus and Gracilis muscle tendons of a population in a south Indian setting,

Serological prevalence of hepatitis B virus (HBV) in Mardan district, Khyber Pakhtunkhwa, Pakistan / Prevalência sorológica do vírus da hepatite B (HBV) no distrito de Mardan, Khyber Pakhtunkhwa, Paquistão

Hepatitis B virus infection is perilous among the five types of Hepatitis, as it remains clinically asymptomatic. The present study draws up-to-date prevalence of Hepatitis B virus (HBV) in the general population of Mardan, Khyber Pakhtunkhwa Pakistan. The blood samples from 4803 individuals including 2399 male and 2404 females were investigated. All the suspected samples were analyzed for hepatitis B surface antigen using Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and followed by Reverse transcription-polymerase chain reaction (RT-PCR). Results showed that 312 (13.00%) out of 2399 individuals contained antibodies in their blood against HBV, while among the different age groups, the highest incidences of HBV antibodies were found in the age of 21-30 groups (10.73%). Furthermore, the ICT positive samples were screened by nested polymerase chain reaction to detect the existence of active HBV-DNA. It was observed that 169 (7.04%) out of (2399) male of the total population (4803) tested was positive. On the other hand, the female 463 (19.25%) possessed antibodies in their blood against HBV. Accumulatively, our results showed a higher percentage of HBV prevalence in males than females in the age group 21-30 years. The total HCV infected in Mardan general population was recorded at 5.7% comprising both male and female.

A infecção pelo vírus da hepatite B é perigosa entre os cinco tipos de hepatite, pois permanece clinicamente assintomática. O presente estudo traça a prevalência atualizada do vírus da hepatite B (HBV) na população geral de Mardan, Khyber Pakhtunkhwa, no Paquistão. Amostras de sangue de 4.803 indivíduos, incluindo 2.399 homens e 2.404 mulheres, foram investigadas. Todas as amostras suspeitas foram analisadas para o antígeno de superfície da hepatite B usando teste imunocromatográfico (ICT), enzyme-linked immunosorbent assay (ELISA), seguido por transcrição reversa-reação em cadeia da polimerase (RT-PCR). Os resultados mostraram que 312 (13,00%) de 2.399 indivíduos continham anticorpos no sangue contra o VHB, enquanto, entre as diferentes faixas etárias, as maiores incidências de anticorpos VHB foram encontradas nos grupos de 21 a 30 anos (10,73%). Além disso, amostras positivas para ICT foram rastreadas por reação em cadeia da polimerase aninhada para detectar a existência de HBV-DNA ativo. Observou-se que 169 (7,04%) de 2.399 homens do total da população (4803) testados foram positivos. Por outro lado, 463 mulheres (19,25%) possuíam anticorpos no sangue contra VHB. Acumulativamente, nossos resultados mostraram uma porcentagem maior de prevalência de HBV em homens do que em mulheres na faixa etária de 21 a 30 anos. O total de HCV infectados na população geral de Mardan foi registrado em 5,7%, incluindo homens e mulheres.

Serological prevalence of hepatitis B virus (HBV) in Mardan district, Khyber Pakhtunkhwa, Pakistan

Abstract Hepatitis B virus infection is perilous among the five types of Hepatitis, as it remains clinically asymptomatic. The present study draws up-to-date prevalence of Hepatitis B virus (HBV) in the general population of Mardan, Khyber Pakhtunkhwa Pakistan. The blood samples from 4803 individuals including 2399 male and 2404 females were investigated. All the suspected samples were analyzed for hepatitis B surface antigen using Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and followed by Reverse transcription-polymerase chain reaction (RT-PCR). Results showed that 312 (13.00%) out of 2399 individuals contained antibodies in their blood against HBV, while among the different age groups, the highest incidences of HBV antibodies were found in the age of 21-30 groups (10.73%). Furthermore, the ICT positive samples were screened by nested polymerase chain reaction to detect the existence of active HBV-DNA. It was observed that 169 (7.04%) out of (2399) male of the total population (4803) tested was positive. On the other hand, the female 463 (19.25%) possessed antibodies in their blood against HBV. Accumulatively, our results showed a higher percentage of HBV prevalence in males than females in the age group 21-30 years. The total HCV infected in Mardan general population was recorded at 5.7% comprising both male and female.

Resumo A infecção pelo vírus da hepatite B é perigosa entre os cinco tipos de hepatite, pois permanece clinicamente assintomática. O presente estudo traça a prevalência atualizada do vírus da hepatite B (HBV) na população geral de Mardan, Khyber Pakhtunkhwa, no Paquistão. Amostras de sangue de 4.803 indivíduos, incluindo 2.399 homens e 2.404 mulheres, foram investigadas. Todas as amostras suspeitas foram analisadas para o antígeno de superfície da hepatite B usando teste imunocromatográfico (ICT), enzyme-linked immunosorbent assay (ELISA), seguido por transcrição reversa-reação em cadeia da polimerase (RT-PCR). Os resultados mostraram que 312 (13,00%) de 2.399 indivíduos continham anticorpos no sangue contra o VHB, enquanto, entre as diferentes faixas etárias, as maiores incidências de anticorpos VHB foram encontradas nos grupos de 21 a 30 anos (10,73%). Além disso, amostras positivas para ICT foram rastreadas por reação em cadeia da polimerase aninhada para detectar a existência de HBV-DNA ativo. Observou-se que 169 (7,04%) de 2.399 homens do total da população (4803) testados foram positivos. Por outro lado, 463 mulheres (19,25%) possuíam anticorpos no sangue contra VHB. Acumulativamente, nossos resultados mostraram uma porcentagem maior de prevalência de HBV em homens do que em mulheres na faixa etária de 21 a 30 anos. O total de HCV infectados na população geral de Mardan foi registrado em 5,7%, incluindo homens e mulheres.

Serological prevalence of hepatitis B virus (HBV) in Mardan district, Khyber Pakhtunkhwa, Pakistan / Prevalência sorológica do vírus da hepatite B (HBV) no distrito de Mardan, Khyber Pakhtunkhwa, Paquistão

Hepatitis B virus infection is perilous among the five types of Hepatitis, as it remains clinically asymptomatic. The present study draws up-to-date prevalence of Hepatitis B virus (HBV) in the general population of Mardan, Khyber Pakhtunkhwa Pakistan. The blood samples from 4803 individuals including 2399 male and 2404 females were investigated. All the suspected samples were analyzed for hepatitis B surface antigen using Immuno-chromatographic test (ICT), Enzyme-linked immunosorbent assay (ELISA), and followed by Reverse transcription-polymerase chain reaction (RT-PCR). Results showed that 312 (13.00%) out of 2399 individuals contained antibodies in their blood against HBV, while among the different age groups, the highest incidences of HBV antibodies were found in the age of 21-30 groups (10.73%). Furthermore, the ICT positive samples were screened by nested polymerase chain reaction to detect the existence of active HBV-DNA. It was observed that 169 (7.04%) out of (2399) male of the total population (4803) tested was positive. On the other hand, the female 463 (19.25%) possessed antibodies in their blood against HBV. Accumulatively, our results showed a higher percentage of HBV prevalence in males than females in the age group 21-30 years. The total HCV infected in Mardan general population was recorded at 5.7% comprising both male and female.

A infecção pelo vírus da hepatite B é perigosa entre os cinco tipos de hepatite, pois permanece clinicamente assintomática. O presente estudo traça a prevalência atualizada do vírus da hepatite B (HBV) na população geral de Mardan, Khyber Pakhtunkhwa, no Paquistão. Amostras de sangue de 4.803 indivíduos, incluindo 2.399 homens e 2.404 mulheres, foram investigadas. Todas as amostras suspeitas foram analisadas para o antígeno de superfície da hepatite B usando teste imunocromatográfico (ICT), enzyme-linked immunosorbent assay (ELISA), seguido por transcrição reversa-reação em cadeia da polimerase (RT-PCR). Os resultados mostraram que 312 (13,00%) de 2.399 indivíduos continham anticorpos no sangue contra o VHB, enquanto, entre as diferentes faixas etárias, as maiores incidências de anticorpos VHB foram encontradas nos grupos de 21 a 30 anos (10,73%). Além disso, amostras positivas para ICT foram rastreadas por reação em cadeia da polimerase aninhada para detectar a existência de HBV-DNA ativo. Observou-se que 169 (7,04%) de 2.399 homens do total da população (4803) testados foram positivos. Por outro lado, 463 mulheres (19,25%) possuíam anticorpos no sangue contra VHB. Acumulativamente, nossos resultados mostraram uma porcentagem maior de prevalência de HBV em homens do que em mulheres na faixa etária de 21 a 30 anos. O total de HCV infectados na população geral de Mardan foi registrado em 5,7%, incluindo homens e mulheres.

Type B congenital pyloric atresia: a case report

This is a case of congenital pyloric atresia type B not associated with any other anomaly rare condition, seen as an isolated anomaly with excellent prognosis) of  two days female child presenting with vomiting since birth. X-ray abdomen showed only stomach air bubble, sonography showed distended stomach with echoes and on barium meal no passage of contrast was seen beyond pyloric antrum even after 24 hours. Patient underwent Heineke-Mikulicz pyloroplasty and postoperative recovery was uneventful.

Treatment of Idiopathic Immune Mediated Hemolytic Anaemia in Dogs

Immune-mediated hemolytic anemia (IMHA) is the most common autoimmune disease in dogs. This study was conducted to evaluate prednisolone and azathioprine therapeutic protocols for the management of idiopathic IMHA in dogs. The anaemic dogs brought with clinical signs such as pale or icteric mucous membranes were screened for IMHA by saline agglutination and spherocyte count and confirmed by flow cytometry. The positive cases were further subjected to haematology, biochemistry, coagulation profile, MAT and polymerase chain reaction (PCR) for the diagnosis of underlying secondary causes like Babesia spp, Ehrlichia canis and Leptospira spp (secondary IMHA). Thirty two cases were positive for IMHA, out of which thirteen cases were primary (Idiopathic) IMHA (17.3 %) and remaining nineteen cases were secondary IMHA (82.7 %) due to underlying causes such as Babesia gibsoni (13), Ehrlichia canis (3) and Leptospira spp. (3) respectively. Immunosuppressive therapy with prednisolone and prednisolone in combination with azathioprine and specific therapy of etiological agent with supportive therapy was used. Significant increase in Hb, PCV, RBC and thrombocyte count, significant decrease in leucocyte, neutrophil, monocyte and total protein and significant increase in ALT activity was recorded after therapy. Prednisolone was found to be effective in the management of canine IMHA than prednisolone combined with azathioprine

Antibiotic susceptibility profiling in diabetic foot ulcer patients and evaluating treatment outcomes at a tertiary care hospital

Background: Diabetic foot infections are the predominant complications of diabetes mellitus with uncontrolled hyperglycemia levels. Multiple microbial invasion is the primary cause and the causative organism are aerobic gram positive cocci, gram negative bacilli such as Pseudomonas species, Escherichia coli, Klebsiella species, Proteus species and anaerobes.Methods: This is a prospective, observational study conducted in the Department of General Surgery. 50 patients constituted the sample in our study. Patients pus and wound swab samples were collected using sterile and moist swab sticks under aseptic conditions and processed.Results: More gram negative bacteria (66%) were isolated than gram positive bacteria (34%). E. coli (38%) is the major isolated microorganism. Among the isolated organisms many of them are susceptible to amikacin (60%), imipenem (52%) and ciprofloxacin (46%) respectively.Conclusions: E. coli is the most common cause of infection. The antibiogram study showed an incidence of multiple resistant microorganisms to commonly used antibiotics.

A Study of Clinical Profile and Management of Nodular Goiter

Introduction: Nodular goiters are enlargements of the thyroid gland. In the absence of thyroid dysfunction, autoimmune thyroid disease, thyroiditis, and thyroid malignancy, they constitute an entity described as non-toxic nodular goiter, which occur both endemically and sporadically. Aim: The aim of the study was to study the clinical presentation and management of patients with nodular goiter. Materials and Methods: In this prospective observational study, patients admitted with nodular goiter – solitary or multinodular were included in the study. The patients diagnosed as a case of solitary or multinodular will undergo detailed history taking, clinical examination, and investigations such as complete blood count, thyroid profile, fine-needle aspiration cytology, X-ray chest and neck, and ultrasonography of the neck. Histopathology of the excised specimens was studied to evaluate the incidence of malignancy. Results: A total of 18 patients were included, 68% of cases were in 21–40 years age group, all patients had swelling, 33% had pain, 22% had difficulty in swallowing, 16 patients were euthyroid, and 2 patients had hypothyroidism. The incidence of malignancy was found to be 8%, 42% of the patients had benign follicular adenomas. The incidence of inflammatory goiter was 11% and 3% of patients showed evidence of toxicity. Preoperatively, regional lymph node metastasis evaluated and hemithyroidectomy in adenoma thyroid and colloid nodules, subtotal and total thyroidectomy in multinodular goiters and total thyroidectomy in carcinoma thyroid were done. About 89% had an uneventful post-operative period. Conclusion: Nodular goiter of the thyroid was found to be more common in young and middle-aged patients. The majority of nodular goiter was found to be a benign lesion. The incidence of malignancy was found to be 8% overall, 12.5% nodules in female were malignant.

Comparative, Prospective Study Regarding Efficacy, Safety & Adverse Effects of Anti-Asthmatic Drugs in Case of Mild to Moderate Chronic Stable Persistent Bronchial Asthma in Adults.

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation, bronchoconstriction and airway hyper responsiveness. The addition of an inhaled corticosteroid (ICS) to an inhaled long-acting β2-agonist (LABA) gives optimal control of asthma in most patients. There are few international studies regarding efficacy and safety of LABA/ICS. But in India there is paucity of such studies. Hence the present study was undertaken.METHODSA comparative, prospective, observational study was conducted among 120 patients attending the Out Patient Department of Chest Medicine and Pharmacology of Burdwan Medical College and Hospital, diagnosed as having mild to moderate chronic stable persistent bronchial asthma, receiving combination of LABA and ICS therapy, out of which 16 patients were lost due to follow up, and 104 patients were studied. Patients were divided into 2 groups. Group A received respicaps of combined formoterol 6 μg and budesonide 400 μg DPI, Group B received combined formoterol 6 μg and mometasone 400 μg DPI, twice daily. During exacerbations inhaled salbutamol was utilized as rescue medication. Spirometric parameters, clinical parameters, and adverse effects were recorded on three visits (at 4th, 8th and 12th weeks) and analysed by using different statistical tests.RESULTSComparable clinical improvement of spirometric parameters, Asthma Control Test score of both groups were observed (p-value>0.05). Adverse effects like tremor, pharyngitis, headache, oral candidiasis and dysphonia were recorded among both the groups which was statistically insignificant.CONCLUSIONPatients who received ICS with LABA in both groups experienced a statistically significant improvement in symptoms. Improvement was seen in spirometric parameters as well with a comparable degree of safety

Seroprevalence of transfusion transmitted infections in voluntary and replacement blood donors in a tertiary care hospital blood bank of Anantapur, Andhra Pradesh, India: 5 years retrospective study

Background: Critical part of transfusion is effective screening of TTI, to reduce the risk of transmission is as safe as possible. The present study has undertaken to focus on seroprevalence of TTIs among both voluntary and replacement donors and also to project epidemiological data of TTIs in this community.Methods: This is a retrospective study conducted from January 2014 to December 2018. All blood samples collected from donors were screened for HIV, HBV, HCV, Syphilis and malaria according to blood bank policy. Before drawing blood, donors were asked to fill pre structured Blood bank questionnaire and consent form.Results: In this present 5-year study, total number of blood donor population was 54937, among them voluntary donors were 33891 and replacement donors were 21046. Out of 33891 voluntary donors, 33486(98.8%) were males and remaining 405(1.19%) were females. All replacement donors (21046) were males. The seroprevalence of HBV was highest, 1.82% (1003/54937) followed by HCV 0.31% (175/54937) in all the donors. The seropositivity for HIV is 0.23% (129/54937), for syphilis 0.04% (24/54937) and for malaria 0.01% (6/54937).Conclusions: National blood transfusion policy should be strengthening the standards and quality of screening across the country. For blood screening, resources and appropriate screening assays must be available at all health centres.

Evaluation of efficacy and safety profile of tamsulosin in benign prostatic hyperplasia

Background: To evaluate the efficacy and safety profile of alpha-1A receptor subtype specific antagonist-tamsulosin in benign prostatic hyperplasia.Methods: An open label, non-randomised, prospective, single centred study who were visiting urology department with confirmed diagnosis of benign prostatic hyperplasia (BPH) were included in the study. Thirty patients with BPH were prescribed tamsulosin and were followed up to three months. The initial or baseline data collected were identification of the patients such as international prostate symptom score (IPSS), prostate specific antigen, urine analysis, and ultrasonography of prostate including post void residual urine. The patients were followed up to 3 months to measure clinical and laboratory outcomes (IPSS score, post void residual urine, uroflow rates etc.).Results: In our study, patients receiving tamsulosin 0.4 mg once daily showed a significant improvement in post-void residual urine (PVRU), uroflow rates and IPSS score. The improvements in the above parameters were found to be statistically insignificant at first and third month of follow-up.Conclusions: In our study, tamsulosin an alpha-1A receptor subtype specific antagonist showed significant improvement in BPH symptoms and the drug was well tolerated.

Clinical Study and Management of the Incisional Hernia: A Retrospective Study

Introduction: Incisional hernia is the most frequent post-operative complication following abdominal surgery. Several studies have shown that incisional hernias have different etiologies that are related to the patient, the surgical technique, the suture material, and the experience of the surgeon. Aim: This study aims to study various factors leading to the development of this condition and surgical techniques practiced to repair the incisional hernia. Materials and Methods: This retrospective study was conducted in the Department of General Surgery at Government Headquarters Hospital, Ramanathapuram, inpatient underwent surgery for incisional hernia. Data on clinical examination, type of operative procedure, and post-operative complications were collected. Results: Eighteen cases underwent surgery for an incisional hernia, female predominance, and age group of 31-40 years were common, the common previous surgery was laparotomy (56%), the common surgical incision is median vertical (50%). About 28% of patients had post-operative pain, 22% of patients had seroma, and 17% of patients had wound infection, no mesh-related infection noted in our study. Conclusion: In incisional hernias, the choice of operative technique is crucial. Incisional hernias occur more often in females as they are more likely to undergo lower abdominal surgeries. Mesh repair is considered superior to anatomical repair alone and we recommend laparoscopic hernioplasty as the first line of treatment.

Evaluation of hyperglycaemic risk of atorvastatin: a dose dependent study on hyperlipidaemic rats

Background: Statins (?-hydroxy ?-methylglutaryl-CoA (HMG-CoA) reductase inhibitors) are the most prescribed medications worldwide to treat hyperlipidaemia with a proven ability to reduce major cardiovascular events. Recent data have revealed that statin therapy is associated with an increased risk for developing diabetes. The risk was most significant in patients taking atorvastatin, rosuvastatin and simvastatin.Methods: Rats were divided into 3 groups, each comprising of 6 rats. Hyperlipidaemia was induced in all the animals after feeding with high fat diet for 15 days. Rats of groups 1, 2 and 3 were given atorvastatin 1.8 mg/kg (low-dose), 3.6 mg/kg (moderate-dose) and 7.2 mg/kg (intensive-dose) respectively orally for 60 days. 12 hours fasted blood samples were collected and analyzed for serum lipid profile, fasting blood glucose and HbA1c levels.Results: The percentage increase in plasma blood glucose after 60 days of treatment in groups 1, 2, and 3 is 29.93%, 60.03% and 72.42% respectively and the variation in all the groups is statistically significant, p<0.0001. Regarding HbA1c values, the variation in low-dose group is statistically insignificant whereas the percentage increase in moderate-dose and intensive-dose groups is 19.45% (p<0.001) and 43.37% (p<0.0001) respectively.Conclusions: In conclusion, there is significant increase in blood glucose and HbA1c levels leading to new-onset diabetes in both moderate-dose and intensive-dose groups. The risk is more in intensive-dose group when compared to moderate-dose group.

Serum Iron Parameters, Adenosine Deaminase and Zinc – As Diagnostic Significant Markers of Preeclampsia

Introduction: Preeclampsia is characterized by persistently elevated blood pressure of >140/90 mmHg, proteinuria, and edemaafter 20 weeks of gestation (ACOG, 2002). It is described as a transient but potentially dangerous complication of pregnancy.Those affected need rest and close monitoring or, in severe cases, admission in the hospital.Materials and Methods: In the present study, 90 pregnant women were studied. 30 women who had normal uncomplicatedpregnancies were matched for maternal age and gestational age with patients and were selected as a control group. Another60 women presented with clinical features of preeclampsia were selected as cases.Results: A total of 90 women in third trimester from Government Maternity Hospital participated in the present study, of which30 pregnant women with uncomplicated pregnancies included 60 pregnant women with preeclampsia.Conclusion: Preeclampsia a multisystemic syndrome characterized by hypertension, proteinuria, and edema that occurs after20 weeks of gestation and usually resolves soon after delivery. It is one of the most important complications of pregnancy thatis associated with increased maternal and fetal mortality

Clinical Study of Acute Kidney Injury in Tropics with Special Reference to Malaria

Introduction: Acute kidney injury (AKI) is characterized by a reversible decline in the glomerular filtration rate, leading toretention of nitrogenous waste products and an inability to maintain fluid and electrolyte homeostasis.Aim: This study aims to know the etiology, clinical features, and outcomes of AKI in tropics, AKI in special reference to malaria,and the factors influencing the outcome of the AKI.Materials and Methods: This is a retrospective clinical descriptive case study done between October 2009 and April 2012.150 patients of acute renal failure admitted to Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar, were includedin the study.Results: A total number of 150 cases of ARF patients admitted to Mahatma Gandhi Memorial Hospital, Warangal, who met theinclusion criteria were studied.Of 150 patients, 102 were male and 48 were female, constituting 68% and 32%, respectively.Male-to-female ratio in this study is 2.125:1.Conclusion: ARF is potentially a reversible condition. Mean age of presentation 50.54 years.Fever present in 70% and oliguriain 64.7% of cases. 76% of ARF cases recovered completely, 8% of cases partially recovered, and 16% of cases were notimproved and dead.60.7% of cases were treated conservatively and 39.3%of cases required hemodialysis.