URBANIZATION AND THE ROLE OF SC, ST URBAN SLUM DWELLERS IN INDIA

Strati?cation on the basis of caste is found all over India. Caste system as a form of strati?cation has a stronghold in urban slum areas also. City-ward migration for Scheduled Caste and Scheduled Tribe populations is synonymous with social development, as the city life offers socio-economic opportunities, better standards of living, educational and health facilities as compared to rural areas. The proportion of Scheduled Castes was higher in the slum areas (28.10%) compared to the population of Scheduled tribe in the country (21.19%). The state of Maharashtra has the largest number of Scheduled Castes and Scheduled Tribes living in urban slums. Andhra Pradesh had highest share of Scheduled Caste and Scheduled Tribe slum population in urban SC/ST population compared with other states

A Rare Case of Wilkie’s Syndrome or Superior Mesenteric Artery Syndrome

Superior Mesenteric Artery (SMA) syndrome (known as Wilkie’s syndrome) is a rare cause of upper gastrointestinal obstruction. It is an acquired disorder, causes compression of the third part of the duodenum between the SMA and the aorta, due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a case of 18 year old female presented with history of intermittent abdominal pain, vomiting of 6 months duration followed by significant weight loss for which she is hospitalized. Patient underwent extensive invasive and non-invasive tests, thereafter revealed her diagnosis. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity.

Utility of Echocardiography in Cardiac Evaluation of COPD Patients and Its Relationship with Severity of Disease

COPD is a leading cause of death and disability worldwide as well as in India. It is a multisystem disorder among which cardiac manifestations are common. Echocardiography provides a rapid, non-invasive, portable, and accurate method to evaluate such changes. We wanted to assess the cardiac changes due to COPD by echocardiography, evaluate the correlation between echocardiographic findings and severity of COPD using GOLD guidelines (2011 updates).METHODSThis study was a hospital based cross sectional study conducted in M.L.B. Medical College, Jhansi (U.P.). The study included admitted COPD patients in Internal Medicine Department and T.B. Chest Department. The study was conducted after obtaining permission from the Institutional Ethics Committee and identity of the patients has not been revealed.RESULTSOut of 200 admitted patients, 98 patients had cor pulmonale and were further classified by using GOLD guidelines 2017. Upon comparing FEV1 with mPAP in each group we observed p value of 0.001 which is statistically significant. A positive correlation was also found between duration from onset of the disease and mPAP.CONCLUSIONSBy estimating PAP early in the disease process, even in those patients who are not able to perform lung function test correctly due to other co-morbidities, we can determine the progression of the disease and can achieve a better outcome by planning a more appropriate and intense line of management.

Pattern of clinical manifestation and antibiotics sensitivity of Burkholderia Cepacia sepsis in Neonatal Intensive Care Unit of tertiary care centre of North India

Background: Neonatal sepsis is a major cause of morbidity and mortality worldwide. Now a days, neonatal sepsis due to Burkholderia cepacia is on rise. This study was conducted to delineate clinical presentation and antibiotic sensitivity pattern from blood culture proven Burkholderia sepsis. Methods: In this retrospective analytical study, thirty-six neonates admitted to Neonatal Intensive Care Unit of a tertiary care hospital with blood culture proven Burkholderia sepsis were included. Clinical manifestation, laboratory findings and antibiotic sensitivity patterns of blood culture proven Burkholderia sepsis were analyzed.Results: : All neonates were inborn and were admitted within 24 hours of birth. Difficulty in breathing was most common presenting symptom and seizure was second in number. There was no association with mode of delivery. Male to female ratio is 1.4:1. Progressive thrombocytopenia was the most consistent feature and in 6 patients also associated with anaemia. Average hospital stay was increased and more in preterm neonates. In this setup piperacillin + tazobactem was found to be most sensitive against Burkholderia cepacia and cotrimoxazole was 2nd in sensitivity.Conclusions: Proper and timely identification of Non Fermentative Gram Negative Bacilli (NFGNB) other than Pseudomonas can help confine morbidity due to such infections. High degree of suspicion helps in early recognition. Efficient housekeeping is necessary to prevent nosocomial infections due to these pathogens.

A rare case of Vitamin D dependent rickets type II: a case report

Vitamin D-dependent type II rickets (VDDRII) is a rare autosomal recessive disorder caused by mutation in the vitamin D receptor gene, leading to end-organ resistance to 1,25(OH)2 vitamin D3. It presents with refractory rickets and growth retardation presenting in the first year of life. It is frequently associated with alopecia totalis. Due to target organresistance, its response to vitamin D is poor. The recommended treatment is giving supra physiological dose of 1,25(OH)2 vitamin D3 and a high dose of oral or intravenous calcium. The response of alopecia to treatment is generally poor. We present a 3 ' year-old male child with VDDR II whose alopecia and rickets partially responded to 1,25(OH)2 vitamin D3.

Gynecological problems and reproductive health awareness amongst late adolescent girls pursuing professional courses: a questionnaire based survey

Background: Dysmenorrhoeais a debilitating menstrual problem and may be related to body mass index (BMI). This study was done to explore the various gynecological problems in girls in their late adolescence that is pursuing professional courses in medicine, dental and nursing.Methods: This was a prospective, questionnaire based study conducted between January and February 2019 in a medical college in Visakhapatnam, India. The survey included female undergraduate students of the Medical, Dental and Nursing colleges to find out their menstrual history and reproductive awareness with the help of a self-structured questionnaire. Participants were categorized based on BMI. Data was reported as number and percentage.Results: Of the 190 participants, 154 participants (age range; 16-19 years) were included in the study. Fifty percent of the total participants reported to have dysmenorrhoea, of which 21% reported severe dysmenorrhoea. A very high % of participants in the obese category (77.8%) reported severe dysmenorrhoea, followed by 27.3% in the underweight category. A U-shaped relationship between percentage of participants with severe dysmenorrhoea and increasing BMI was observed. A fair percentage of obese participants reported for infrequent periods beyond 35-45 days and androgenic features like excess hair, acne and dark pigmentation around neck, suggestive of polycystic ovarian syndrome (PCOS). The participants possessed a high level of awareness and reported in the range of 87.1 to 96.8% related to reproductive health.Conclusions: Despite high level of awareness among the participants we observed a considerably high prevalence of dysmenorrhoea which was even more prevalent, in the obese category.

Abnormal uterine bleeding in women of peri-menopausal age: a retrospective study

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of abnormal uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders.Methods: A retrospective study of randomly selected 200 cases of abnormal uterine bleeding between 40–55 years of age during January 2018 to January 2019, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months.Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 60% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (21%) uterus was most common. Maximum number of patients (75%) was treated surgically and 20% got medical treatment.Conclusions: Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.

Congenital B-cell Acute Lymphoblastic Leukemia with Congenital Rubella Infection

Background: Congenital B-cell Acute lymphoblastic leukemia (ALL) is a rare malignancy.Case Characteristics: A newborn infant presented with purpuric spots and ecchymoticpatches, blueberry muffin rash, depressed neonatal reflexes, respiratory distress andhepatosplenomegaly. Peripheral smear revealed atypical blast cells. Serum ELISA waspositive for Rubella IgM and IgG antibodies. Flow cytometry suggested congenital B-cellALL. Outcome: The baby died after 3 days due to suspected intracranial hemorrhage.Message: Congenital leukemia may be rarely associated with congenital rubella infection.

Study of ECG changes in patients with acute stroke: a hospital based cross sectional study

Background: Physicians are confronted on having ECG in patients with acute stroke as it can mimic that of myocardial infarction/ischemia. They should be aware of these changes taking place in patients with acute stroke and not due to myocardial infarction/ischemia. The objective of the present study was to study ECG changes in patients with acute stroke.Methods: A hospital based cross sectional study was carried out for a period of six months at Malla Reddy Hospital. A total of 100 patients were included who were eligible for the presents study as per the inclusion and exclusion criteria. Detailed clinical examination, history, lipid profile, blood pressure, BMI, addictions, RBS and ECG were done for all selected patients. Data was analysed using means, proportions. Statistical tests like chi square test and t test were used.Results: Majority of patients with acute stroke were above 60 years of age, males, urban residents, professional and skilled persons, and alcoholics. Based on the study of ECG among patients with acute stroke it was found that T wave inversion was the most common ECG change found in 33% and this was more in females (36.1%) compared to 31.3% in males. LVH was next common condition found on ECG of acute stroke patients but this time its incidence was more in males (25%) compared to females with only 13.9%. Factors like age, BMI, SBP, DBP, TC, TG, LDL, VLDL, HDL, addictions, residence, sex, family history were not found to be associated with ECG changes.Conclusions: T wave inversion and left axis deviation along with left ventricular hypertrophy were common ECG changes in patients with acute stroke. No studied factor was found to be associated with ECG changes in patients with acute stroke.

Profile, types, duration and severity of muscular dystrophy: a clinical study at a tertiary care hospital

Background: The cause of muscular dystrophies is genetic. It is a disorder of muscular system. The classification of the muscular dystrophies is based on the signs and symptoms. Present study was done to evaluate the profile, types, duration and severity of muscular dystrophy at a tertiary care hospital.Methods: A hospital based cross sectional study was carried out at department of General Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad from October 2015 to December 2017. During the study period, it was possible to study the 20 cases of muscular dystrophy.Results: Muscular dystrophy was more common in males. Maximum cases were of Duchenne type of muscular dystrophy. Majority of the patients presented at 5-10 years of age. Muscular dystrophy was seen in early childhood. Out of 10 patients of Duchenne muscular dystrophy five patients were of grade I. There was no correlation between the duration of the disease and the severity of the disability. All patients had lower limb proximal weakness. Pathological Q wave (width > 30 ms) and Pathological Q wave (depth >more than 25% of the QRS amplitude) were present in 35% of the cases. All patients had rhythm NSR and QRS +60 to +75. Conduction abnormality was present in 5% of the cases. In half of the patients, serum creatinine kinase levels are moderately elevated.Conclusions: Muscular dystrophies are a common disorder of the childhood. Detailed studies will help to focus more light on this condition to improve outcome in future patients.

A Biological Approach in Repair of Damaged Dental Pulp and Periapical Tissues using Platelet Rich Fibrin, Mineral Trioxide Aggregate and Laser Biostimulation.

This article describes about a biological approach in the repair of dental pulp and periapical tissues using biomaterials (platelet rich fibrin [PRF] and mineral trioxide aggregate [MTA]) and laser biostimulation. Case 1: Pulpotomy with PRF, MTA, and laser biostimulation. Patient follow-up was done at 1, 3, and 6 months. On 6 months follow-up, the patient was asymptomatic and tooth responded positively to pulp tests. Radiograph revealed normal periodontal ligament space and trabecular bone pattern. Case 2: Apexification procedure using PRF, MTA, and laser biostimulation in 31 and 41. Patient follow-up was done at 1, 3, and 6 months. On 6 months follow-up, radiograph revealed relative root lengthening, thickening of the canal walls in the apical one-third of root, and a healing lesion. Repair and regenerative potential of PRF, an enhanced cellular metabolism with laser biostimulation in combination with the sealing ability of MTA enhances the clinical success outcomes in pulpotomy and apexification procedures.

Apoptosis: role in myeloid cell development

Hematopoiesis is the process that generates blood cells in an organism from the pluripotent stem cells. Hematopoietic stem cells are characterized by their ability to undergo self-renewal and differentiation. The self-renewing ability ensures that these pluripotent cells are not depleted from the bone marrow niche. A proper balance between cell death and cell survival is necessary to maintain a homeostatic condition, hence, apoptosis, or programmed cell death, is an essential step in hematopoiesis. Recent studies, however, have introduced a new aspect to this process, citing the significance of the apoptosis mediator, caspase, in cell development and differentiation. Extensive research has been carried out to study the possible role of caspases and other apoptosis related factors in the developmental processes. This review focuses on the various apoptotic factors involved in the development and differentiation of myeloid lineage cells: erythrocytes, megakaryocytes, and macrophages.

Antimicrobial and antiproliferative prospective of kosinostatin-a secondary metabolite isolated from Streptomyces sp / 药物分析学报

Cancer is a communal health hazard worldwide. The present investigation attempts to evaluate anti-microbial and anticancer potential of kosinostatin on mammary carcinoma cell line (MCF-7). The an-ticancer and antiproliferative activities of kosinostatin were analyzed on MCF cell line by MTT assay and cytotoxicity assays like lactate dehydrogenase (LDH) and glutathione (GSH). The secondary metabolite kosinostatin exhibited its apoptotic nature by expressing p53 protein. Collectively, the results acquired from this study promise that kosinostatin shows the potent anticancer activity.

α-Glucosidase Inhibitory Activity of 4-Aryl-N-(2,4-Thiazolidinedione-5-Acetyl)-1,3-Thiazol-2-Amines.

A series of N-(4-aryl-1,3-thiazol-2-yl)-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamides 3a-k and N- (1,3-benzothiazol-2-yl)-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamides 3l-n are synthesized and evaluated for their α-glucosidase inhibitory activity. N-[4-(m-Chlorophenyl)-1,3-thiazol-2yl]-2-(2,4-dioxo-1,3-thiazolidin-5- yl)acetamide (3g) and N-[4-(o-fluorophenyl)-1,3-thiazol-2-yl]-2-(2,4-dioxo-1,3-thiazolidin-5-yl)acetamide (3j) have shown very good inhibition. The remaining compounds have exhibited moderate to good activity ranging from 37- 63 % of α-glucosidase enzyme inhibition.

FEV1, FVC, FEV1/FVC ratio in children of 7-14 years of age from Western Rajasthan.

Background: The knowledge of pulmonary function tests (PFTs) is a basic requirement to understand the respiratory physiology for all medical physiologists and clinicians Pulmonary Function Tests provide objective evidence of nature and severity of lung disease. Objective: To observe FEV1, FVC, FEV1/FVC ratio in healthy male and female school children from 7-14 years of age in Western Rajasthan and to find out the relationship of FEV1, FVC, FEV1/FVC ratio with their height, weight, BSA and sex Methods: The present study was carried out on 112 male and 76 female children of 7-14 years. For Pulmonary Function Tests, FEV1, FVC and FEV1/FVC along with anthropometric data of each subject was recorded.. Data were analyzed by unpaired t test, Pearson correlation coefficient test, simple and multiple regression analysis. Results: FVC and FEV1 values were found significantly (p<0.001) higher in male than those of female. Significant positive correlation of FVC and FEV1 whereas non significant negative correlation of FEV1/FVC were observed with age, height, weight, body surface area in all children. Conclusion: As the weight, age, height and BSA of subjects increases, FEV1 and FVC increases while FEV1/FVC ratio decreases in both the sexes.

study of guar gum and starch on disintegration time and drug release of fast dissolving tablet in rabbit using single dose randomized parallel design method

The aim of this study is to find the effect of starch and guar gum 4000 on disintegrating time and dissolution behavior of drug Zolmitriptan from fast dissolving tablet [FDT]. The FDT was prepared by direct compression method. The precompression parameters were evaluated with subjected to angle of repose, bulk and tapped density, hausnefs ratio and Carr's index and all were within limit. The prepared tablets were evaluated for thickness, uniformity of content, hardness, friability, wetting time and in vitro disintegration time and in vivo release of drug. The in vitro release and assay of drug was performance by UV spectrophotometer. The in vivo study reveals that when guar gum [5%] and starch [10%] were used in formulation, the plasma concentration of drug was increased because, it disintegrate tablet rapidly and drug was released rapidly from dosage form and reach quickly in to systemic circulation resultant bioavailability is increased

Endodontic Management Of Radix Entomolaris - Two Case Reports.

A mandibular first molar with two distal roots is an interesting example of anatomic variation. This paper describes 2 case reports of mandibular first molar with three roots (one mesial and two distal) and four canals (two in mesial and one in each distobuccal and distolingual root). The canals were shaped with protaper rotary files and irrigated with 2.5% sodium hyochlorite and 0.2 %w/v of chlorhexidine gluconate and normal saline as the final irrigant. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described.

In vitro cytogenetic studies of cypermethrin on human lymphocytes.

Assessment of cytotoxicity and response to external factors like pesticides were evaluated by 3-(4,5-dimethylthiazol-2-yl)-2.5-diphenyltetrazolium bromide (MTT) or MTT assay, which measures mitochondrial metabolism in the entire cell culture and provides information about the percentage of cell survival. Utilizing the MTT assay, the cytotoxicity of cypermethrin was determined on lymphocyte cultures from human peripheral blood samples, the short-term lymphocyte cultures were incubated with various aliquots of the cypermethrin and the LC50 was found to be 33.6 microM. Lymphocytes treated with low-doses (1/10 of LC50) of cypermethrin showed an increase in the frequency of chromosomal aberrations and found to be significant. Karyotype analysis revealed more satellite associations and chromosomal breaks in cypermethrin treated samples. Low-doses of the pesticide also induced single-strand breaks in the DNA as assessed by comet assay. The pesticide caused increase in the comet tail length with increase in pesticide concentration, implicating genotoxicity in somatic cells. It is concluded that In vitro assays could give important information of the mechanism of toxicity at low dosages and impact on genetic material of human origin.