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Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder and has complex etiopathogenesis. The most appropriate hypothesis states that genetic susceptibility in the presence of environmental risk factors predisposes to SLE. HLA class II alleles are critical to immune response and are highly polymorphic. Various alleles in HLA-DR and -DQ regions were analyzed in SLE patients and healthy controls to see their role in susceptibility or protection to SLE. Materials and Methods: This was a prospective observational study, in which a total of 100 SLE patients and 100 controls were analyzed. HLA typing was done by polymerase chain reaction (PCR)-sequence-specific oligonucleotide (SSO) method (SSO probe). Results: DR?1*0301 was significantly increased in SLE patients when compared to controls and had the highest odds ratio. Other risk factor alleles found to be increased were DR?1*0701, DQ?1*0202, and DQ?1*0301, which had a significant positive association with SLE, suggesting their role in susceptibility to SLE. In contrast, DR?1*0401, DR?1*1401, DR?1*1404, DR?1*1501, DQ?1*0501, and DQ?1*0201 showed statistically significant reduction in SLE patients, while these were much more common in controls, suggesting their protective role. Conclusion: This study is only the second study in patients from North India and it determines the role of DR?1*0301, DR?1*0701, DQ?1*0202, and DQ?1*0301 alleles as risk factors in SLE patients.
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Background: Medical ethics teaching has received little attention in India's undergraduate medical curriculum, so the National Medical Commission’s formal inclusion of medical ethics in the new competency-based curriculum (CBME) is creditable. However, the policymakers have left out the most crucial stakeholders — the teachers. This study was conducted to find out how physiology educators in Delhi felt about the implementation of ethics teaching in physiology in the CBME. Methods: This was a pilot, cross-sectional, observational, feasibility study conducted using a questionnaire, involving faculty and senior residents (post-MD) in the departments of Physiology at nine medical colleges in Delhi, conducted over the period from February to October 2020. Results: The response rate was 76% (60/79), of which 40% (24/60) were senior residents and 60 (36/60) were faculty. Around 55% (n=33) felt bioethics and clinical ethics are not synonymous; 53% (n=32) believed ethics education can be accomplished in a large group setting; 75% (n=45) believed it should be the responsibility of the physiology faculty, rather than the clinical faculty, and 61.7% (n=37) wanted it to be included in the formative assessment. The respondents shared ethical concerns that should be included in the physiology curriculum and the best candidates to teach them to achieve integration. Despite the challenges, the majority 65% (n=39) felt ethics in the physiology CBME should be an inseparable part of teaching in all instructional modalities. Conclusion: Early clinical exposure was considered preferable to the Attitude, Ethics, and Communication (AETCOM) programme. Using the five W’s and one H method, we talk about how our findings can be used as a road map to help physiologists teach ethics to medical students in the new CBME.
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Intersex people are viewed from the medicalised lens of having a “disorder” of sex development rather than a difference in sex development. This inherent indifference to diversity is also visible in LGBTQIA+ advocacy, as they were initially excluded from the Yogyakarta Principles promoting the human rights of sexual and gender minorities. This paper attempts to explore the issues of discrimination, social exclusion, and unnecessary medical treatments through the lens of the Human Rights in Patient Care framework to advance the human rights of the intersex community and highlight the need for the state to take responsibility. The discussion touches upon intersex people’s right to bodily integrity; the right to freedom from torture and cruel, inhuman, and degrading treatment; the right to the highest attainable standard of health; and the right to legal and social recognition. The concept of human rights in patient care moves beyond the traditional philosophical principles of bioethics as it applies legal norms in a patient care context derived from judicial interpretations and international conventions upholding human rights at the intersection of cure and care. As socially accountable health professionals, it is our duty to defend the human rights of intersex people who are marginalised within the marginalised community.
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This study investigated the relationship between dental hygiene and child maltreatment, malnutrition, and overall development. The researchers examined 900 students aged 5-15 years from government schools in Lucknow district, Uttar Pradesh. The study observed nutritional status by assessment of the physiological status of the body based on its height and weight and signs of abuse/neglect. The results showed that 260 abused students had poor dental hygiene, and 236 of them were mild to moderately malnourished. In comparison, 362 non-abused students had dental neglect, and 232 were moderately malnourished. These findings highlight a significant association between dental care neglect, child maltreatment, and malnutrition. It is crucial to address the social stigma surrounding this issue, normalize discussions, and encourage dentists to identify signs of abuse and inform relevant authorities about potential discrepancies.
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Background: Skin diseases occur in all age groups in developed and developing countries. Various types of skin diseases are found worldwide and depend on factors like environment, surrounding ecology, dietary habits, socioeconomic status, mental health, and literacy. Health-related quality of life (HRQOL) improves after treatment or cure of the diseases. Objectives: To estimate the pattern of skin disease. To find out the quality of life and association of skin disease with sociodemographic factors among patients. Methods: This observational cross-sectional study was done in skin OPD at the tertiary care center, Banda district of Uttar Pradesh, India from May 2022 to July 2022. All patients who attended to skin OPD during study period were included in the study after taking informed verbal consent. Results: Skin diseases had further divided in subcategories which were infectious conditions, pigmentary disorders, inflammatory dermatoses, miscellaneous skin conditions, benign tumor and other lesions with their percentage 44.8, 10.5, 28.6, 7.1, 2.9 and 6.2%, respectively in this study Classes of DQLI where major portion of patients (49.52%) were in ‘Small effect on patient’s life’ category. The relation of age, religion, education and member of household with history of skin disease were found to be highly statistically significant. Conclusion: Infectious skin diseases were found more common in study area. Male populations were more commonly affected. Skin diseases were more common in age group of 18–60 years. Study participants showed no predominant effect on quality of life. But small effect class had major effect on participant’s quality of life.
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Introduction: Melkersson-Rosenthal Syndrome (MRS) is a rare neuro-mucocutaneous condition. It mainly includes three triads as orofacial swelling, facial palsy and fissured tongue. All of the classical triad may not be seen at the same time, as symptoms may appear in different interval of time and has a recurrence. MRS is diagnosed based on oligosymptomatic when two or more clinical features are present or monosymptomatic cases when there evidence of a non-necrotising, granulomatous cheilitis in patients with isolated facial or lip edema can be noted in biopsy. Case Presentation: In this case report a 18 year old male patient all the three classic clinical characteristic features as granulomatous cheilitis, unilateral facial muscle palsy and a fissured tongue are seen. The clinical features of this rare condition along with treatment procedure are presented. Conclusion: Oral corticosteroids are the mainstay in the treatment of MRS. Intralesional triamcinolone acetonide used in oro-facial edema. In recurrent cases of MRS need second-line immunosuppressants like methotrexate and thalidomide. In refractory recurrent facial nerve palsies Surgical decompression of the facial nerve may be considered.
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Background- Rag picking is one of the inferior economic activities in the urban informal sector, largely undertaken by children belonging to weaker sections of society for their survival and for supplementing their family income. Rag picking is one of the most dangerous activities in India. Rag pickers are working in a filthy environment surrounded by dust, dogs, and pigs. They suffer from many diseases, such as respiratory problems, anemia, fever, and other problems which include cuts, rashes, and injuries. Waste pickers are the general term adopted by the 1 st World Conference of Waste Pickers in 2008. Objective- [a] To assess the socio-economic condition of ragpickers in Varanasi, [b] To know the health condition and treatment behavior of ragpickers in Varanasi. Materials and Methods- A community-based descriptive cross-sectional study in which ragpickers reside in the slum area of Varanasi. All men and women present at the time of the interview who were involved in rag picking from the last 6 months were included. Seriously ill men and women were excluded. Since we had no prior knowledge about the proportion of cases (P) so a pilot study was conducted in which prevalence of health problem found in rag pickers in the last 6 months (P) = 0.90. Total estimated sample size is 100. In this study, Simple Random sampling was used. By using this sampling 100 individuals were selected randomly, fulfilling the inclusion criteria. Results-82 (82.0%) rag pickers were not educated in which 75 (91.5%) rag pickers suffered from health problems. Maximum 74 (74.0 %) rag pickers were migrants. Maximum 74 (74.0%) rag pickers were married in which 36 (48.0 %) rag pickers were married between 14- 18 ages. 80 (80.0%) rag pickers had not used any precautionary measure during rag picking in which 73 (91.2%) rag pickers faced health problems. Maximum 39(39.0%) were affected by dust during rag picking. Only 17(17%) ragpickers preferred government hospitals for treatment. 75 (75.0 %) rag pickers were addicted to intoxication in which 66 (88.0%) rag pickers faced health problems. 91 (91%) ragpickers affected by any health problems in the last 6 months in which a maximum of 63.7% of rag pickers suffered from fever, 60.4% of rag pickers complained about injuries, 56.2 % of rag pickers suffered from weakness problems, 52.7% of rag pickers affected by cough problems. There is a highly significance between educational status and any kind of intoxication. Discussion- The literacy level among the rag pickers was 18% which is much lower than the average literacy rate of Varanasi 75.60% (2011census). A study on slum dwellers in Dhaka showed the literacy rate higher than the finding of this study (18 vs 25 %). 28.0% of rag pickers adopted this work because they had no education. There is a high significance between educational status and any kind of intoxication. Chances of intoxication are high when no education among rag pickers. It is highly significant between educational status and health problems of rag pickers in the last 6 months. Uneducated rag pickers were not aware of the health effects.
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Objectives: Capsaicin, the most pungent constituent of chilli pepper (Capsicum annuum L.), is known to alter the physiological activity of the gut. Capsaicin mediates its action through a transient receptor potential vanilloid type 1 (TRPV1) channel. The action of capsaicin on gut smooth muscle varies from segment to segment in different species. The earlier studies were carried out in adult animals only, and its status in the neonate gut, which is in a development stage, is not known. Objective: Therefore, the present study was done to assess the effect of capsaicin on the large gut of neonates. Materials and Methods: In an organ bath preparation, isometric contractions were recorded from segments of dissected rat colon and rectum. The gut segments were exposed to cumulative concentrations of capsaicin (0.01 nM–3 µM) and a capsaicin-induced contractile response was observed. TRPV1 receptor antagonist capsazepine (1 µM) and a nitric oxide synthase inhibitor, L-NAME (100 µM), were used to assess their blocking effect on capsaicin-induced contractile response. Results: Capsaicin raised contractile tension in the colon and rectum of adult rats but not in neonate rats. In adult rats, capsazepine pre-treatment (1 µM) failed to block the capsaicin-induced response in the colon, but in the lower concentrations, it increased contractile tension in the rectum. Pre-application of L-NAME (100 µM) potentiated capsaicin-induced response in the adult rectum and neonate’s colon but had no effect in the neonate rectum and adult colon. Capsaicin with a low concentration (0.01 nM–0.01 µM) increased contractile frequency in both the colon and rectum of adult rats. However, the effect of capsaicin on frequency was abolished at higher concentrations (0.01 µM–3 µM). A capsaicin-evoked change in contractile frequency in adult rats was blocked by capsazepine and L-NAME. At lower concentrations (0.01 nM–0.01 µM), capsaicin did not show any change in frequency in the neonatal colon, while a decrease in contractile frequency was observed with the higher concentrations (0.1 µM–3 µM) of capsaicin. In neonates, capsazepine pre-treatment produced changes in frequency for both the colon and rectum. However, pre-application of L-NAME decreased frequency in the neonate rectum but not in the colon. Conclusion: Capsaicin-induced changes in contractile activity may or may not involve TRPV1 or the Nitric Oxide (NO) pathway, depending on the part of the large gut and developmental maturity.
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Background: Contemporary society has led to the increasing use of electronic equipment that is very much responsible for the burden of electronic waste (e-waste). E-waste contains very hazardous substance that harms health and environmental conditions. There is no delicate mechanism for the management of e-waste in Lucknow city, Uttar Pradesh. This study assessed knowledge, practice, and awareness of e-waste management among residents of this city. Material and methods: The study was conducted amongst users of electronic equipment living in the Lucknow City of Uttar Pradesh. The study was a cross-sectional descriptive study. Multi-stage random sampling was done for the selection of participants for the study. A predesigned and pretested questionnaire was administered in a single setting for all phases. The total optimum sample size is 700 individuals who participated in the study. Data were entered in MS Excel 2016 and descriptive statistics such as frequencies and percentages were calculated, applying the chi-square test for association using R-4.2.1 Statistical software. Aim and objectives: To assess the knowledge, attitude and practices regarding the management of electronic waste among users of electronic equipment residing in Lucknow city. Results: Only 37% of users are aware that e-waste adversely affects health. Only 34.3% of users knew that e-waste should be given to the seller or manufacturer for recycling while rest told that it should be stored at home, sold to a scrap dealer, or disposed with normal waste. 87.3% users are not aware about e-waste govt guidelines. In the current study electronic and print media like television, radio and news paper were not found to be source of information for e-waste disposal. Conclusion: Education regarding the ill effects of e-waste is essential for people and awareness of proper disposal of e-waste is the need of the hour. Electronic and print media as well as companies producing electronic equipment should play a significant role to awaken the respondent about the disposal of e-waste
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Background: Pediatric diarrhea is the 3rd foremost cause of childhood mortality all over the world. Although these are self-limiting, irrational antibiotic use and polypharmacy are prevalent in their treatment. Antimicrobial therapy is recommended in bacterial diarrhea and severely malnourished children only. Inappropriate use of drugs for the treatment of acute diarrhea can be minimized by adhering to standard guidelines. Aims and Objectives: The objectives of this study were as follows: (1) To evaluate the appropriateness of drug treatment in Acute Pediatric Diarrhea and (2) to assess the appropriateness of antibiotic treatment in diarrhea based on modified Kunin’s criteria. Materials and Methods: A prospective observational study was conducted for 12 months at the pediatric inpatient unit of Bidar Institute of Medical Sciences, Bidar. Prescriptions of 400 cases of acute diarrhea were evaluated for the appropriateness of drug usage using Indian Academy of Pediatrics (IAP) guidelines and modified Kunin’s criteria. Results: Among the 400 acute diarrhea cases, majority were male (54.75%) and below 5 years (58.25%). Oral rehydration solution (ORS) was given to 337 patients and IV fluids to 324 cases. About 55.5% patients were prescribed antibiotics. In 75.67% prescriptions, the antibiotic use was not necessary (modified Kunin’s criteria category V). Only 12.5% prescriptions adhered to IAP guidelines (2006), which included ORS and Zinc. About 54.5% patients were prescribed probiotics and 80% were prescribed antiemetics (ondansetron), which is not appropriate as per guidelines. Conclusion: Majority of patients were prescribed ORS, but only few were given zinc as an adjunctive therapy. Thus, we found that adherence to IAP 2006 guidelines was very low in our setup. Based on our observations, we suggest that prescribers should make use of standard treatment guidelines and choose appropriate drugs and their formulations so that irrational use of drugs can be minimized.
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@#【Objective】 To investigate the therapeutic effect of Hibiscus cannabinus Linn. (H. cannabinus) leaves on cholelithiasis and urolithiasis. 【Methods】 The study evaluated the effect of aqueous leaf extract of H. cannabinus on thiouracil and cholesterol cholic acid diet induced cholelithiasis in BALB/c mice and ethylene glycol induced urolithiasis in Wistar rats. Three doses of aqueous extract (40, 80, and 160 mg/kg) were selected to evaluate the effectiveness in cholelithiasis in mice; another three doses of aqueous extract (400, 800, and 1 600 mg/kg) were administered for evaluating the effect on urolithiasis in rats. Biochemical parameters such as biliary cholesterol, biliary phospholipid, and bile acid were determined in cholelithiasis model. Similarly, 24-hour urine output, urinary parameters such as creatinine, uric acid, protein, urea, presence of calcium oxalate crystals, red blood cells (RBCs), and pyuria were determined in urolithiasis model. 【Results】 Statistically significant differences were noted in the biliary and urinary parameters after administrating three test doses of H. cannabinus aqueous extract (P < 0.05). 【Conclusion】 H. cannabinus was found to be effective against high fat lithogenic diet urolithiasis and cholelithiasis.
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Objectives: To study the histological variants and mimickers of basal cell carcinoma (BCC) alongwith different risk factors among a group of patients from eastern India. Methods: The specimen for the study was sent by the dermatology department for histopathology after skin biopsy. Results: Out of 42 patients, 15 patients studied were males and the rest of the cases were females. The male to female ratio was 0.55:1. Maximum (15 cases) cases were in the age group of 50–59 years. Apart from sunlight, chronic arsenic exposure is an important risk factor of BCC. Basal cell hyperplasia and squamous cell carcinoma are the histological differential diagnosis of nodular BCC and basosquamous BCC. Conclusion: BCC is a disease of the older age group and with female preponderance in our study. Nodular basal cell carcinoma was the most common histologic type of basal cell carcinoma. The face was the most common site for BCC followed by the scalp. UV radiations and Arsenic do play role in the pathogenesis of BCC. CD10 helps differentiate superficial BCC from basal cell hyperplasia.
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Background: Vaccines are considered as the one of the main pillars in halting and ending the presently on-going coronavirus disease (COVID-19 disease) pandemic which has spread globally since it was first detected in Wuhan, China in December 2019. In the absence of specific therapy, infection prevention practices and mass vaccination remains the mainstay in controlling the disease. Objectives: Objective of the study was to assess COVID-19 vaccination status, socio-demographic and clinical profile among healthcare workers diagnosed with COVID-19. Methodology: A cross-sectional survey from 1st March 2021 to 30th June 2021 among healthcare workers who were diagnosed with COVID-19 in a tertiary care institute of Uttarakhand, India was conducted, and universal sampling was used. Institutional Ethics Committee approved this study. Results: Total 662 healthcare workers were diagnosed with COVID-19. 429 (64.8%) of these COVID-19 diagnosed healthcare workers had received either single (129,30%) or both dose (300,70%) of COVID-19 vaccine while remaining 233 (35.2%) belonged to non-vaccinated group. History of exposure to COVID-19 positive patients was higher in vaccinated (66.4%) than in non-vaccinated group (55%) (p = 0.004). Hospitalisation was found to be higher among non-vaccinated (5.6%) than vaccinated group (2.3%) (p = 0.029). Conclusions: This study concludes that being vaccinated against COVID-19 disease provides protection against severe infection and reduces the need for hospitalization.
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Background: Little is known about iron deficiency (ID) and anemia in chronic obstructive pulmonary disease (COPD). To study the prevalence and treatment of anemia in patients of COPD and to check the hemoglobin level in all patients with COPD and to assess the quality of life (QOL) by administering the questionnaire in anemic COPD patients and comparing it with nonanemic COPD patients. Methods: We examined the subjects and administered a questionnaire based on dyspnea score to assess the impact of anemia on quality of life in patients of COPD. A total of 250 COPD patients were enrolled in the study, in that 62 patients were anemic and 188 patients were nonanemic in COPD patients. Results: The proportion of patients of nonanemic was found to be higher as compared with anemia having modified medical research council (mMRC) grade I (35.71% vs 20.00%), grade II (40.48% vs 26.67%), and grade IV (11.90% vs 6.67%), while the proportion of patients of anemia was found to be higher than that of nonanemic having mMRC grade III (46.67% vs 11.90%). Difference in mMRC grade of patients of anemia and nonanemic was found to be statistically highly significant. Out of 250 patients of COPD, hemoglobin levels of 62 (26.32%) were found to be below normal levels and were diagnosed as anemic and classified as anemia in the present study, while hemoglobin levels of the rest 188 (73.68%) patients were found to be normal and were classified as nonanemic. Prevalence of anemia in COPD = 24.87%. Conclusion: Anemia occurs frequently in patients of COPD and is associated with poor quality of life and increased morbidity in the form of number of exacerbations and hospital admissions. Correcting anemia in these patients may improve their clinical outcomes
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We report a case of a 24 years old lady at 32 weeks 5 days of gestation, who was referred to our hospital with severe pain the upper abdomen and radiating to the back , associated with vomiting with history of raised blood pressure. After investigations she was diagnosed with acute pancreatitis with non severe pre eclampsia. She was managed by multidisciplinary team approach and improved.
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Background: The study is designed to evaluate the different learning styles of the present first professional MBBS students. Students were requested to complete the visual-aural-read/write-kinesthetic (VARK) questionnaire at VARK-LEARN.COM. Results of the questionnaire were collected by email and analyzed using Microsoft Excel. We found that 68.2% had multimodal learning preferences and 31.7% had single learning preference. Aims and Objectives: The objective of this study is to analyze the different learning styles of MBBS 1st year students of United Institute of Medical Sciences, Prayagraj, using the VARK questionnaire. Materials and Methods: This study includes the informed consent taken from each student before participating. The Institutional Ethics Committee approved the study. Copyright permission was taken from the website vark-learn.com, from VARK Learn Limited, New Zealand. One hundred and two students had consented, and out of them, 85 students participated in the study. The students were asked to complete the questionnaire on the website. The data on their learning styles were collected and analyzed using Microsoft Excel. Results: Out of 85 Students, 58 (68.2%) had multimodal learning preferences. Of these, 28.2% of students had four-part VARK or quadrimodal preferences, 28.2% of students had bimodal, and 11.7% had trimodal learning preferences. Twenty-seven (31.7%) had single learning preferences, and, out of these 27 students, 17 (20%) had kinesthetic, 6 (7.05%) had visual learning preferences, and 4 (4.7%) students had aural learning preferences. Conclusion: With the help of this study, we concluded that most of the students who participated in our study are multimodal learners, and out of the students who had a single learning preference, most had kinesthetic learning preferences.
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Background: Recently there is an explosive growth of internet usage among youth worldwide. Internet addiction is defined as psychological dependence on the Internet leading to inability to control one’s use of the Internet. Objective: To study the prevalence of internet addiction and quality of sleep among medical students of Delhi and to find out the factors associated with internet addiction. Methods: A cross-sectional study, using stratified random sampling method was conducted among un-dergraduate students of VMMC & Safdarjung hospital Delhi. Young’s internet addiction test and Pitts-burgh sleep quality index was administered. Results: Mean age of study participant was 20.3 ± 2.3 SD years. Internet addiction was found in more than half of the study participant. Poor sleep quality was also found in more than half (57.2%) of them. On analysing internet addiction with associated factors, it was observed that gender, monthly data usage, source of internet use, phone use while eating, ever notice by teacher in class while using phone, month-ly expenditure and quality of sleep were statistically significantly (p < .001) associated. Conclusion: This study implies that internet addiction was high among medical student. More than half of the study participants was suffering from poor sleep quality.
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A geomagnetic storms is a global disturbance in Earth's magnetic field usually occurred due to abnormal conditions in the interplanetary magnetic field (IMF) & solar wind plasma emissions caused by various solar phenomenon. 138 solar wind streams in solar cycle 22 & 173 solar wind streams in solar cycle 23, have been found, which are associated with proton density, observed during 1986 to 2010. We have analyzed & studied them statistically. We have found that yearly occurrences of geomagnetic streams are strongly correlated with proton density in 11-years sunspot cycle, but no significant correlation between the maximum & minimum phase of solar cycle 22 & 23 have observed
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Background: There are multiple protocols currently being followed worldwide for effective management of COVID-19 depending on the disease severity as a consequence, of which the prescribing patterns and therapeutic choices still remain unclear. Drug utilization studies provide insight into the current prescribing practices and help us in facilitating the rational use of drugs. Aim and Objectives: The aims of this study were to evaluate utilization pattern of medications used to treat COVID-19 in hospitalized patients with moderate disease as defined by Indian Council of Medical Research (ICMR) guidelines. Materials and Methods: Hospital-based prospective, observational, and cross-sectional study was conducted in Designated COVID Hospital, Bidar Institute of Medical Sciences, Bidar for 4 months from March 1, 2021, to June 31, 2021. Data were collected from patients, every 10th inpatient was randomly selected. Rationality of prescriptions was evaluated using the WHO core drug prescribing indicators. A total of 234 hospitalized patients aged more than 18 years with laboratory confirmed COVID-19 of moderate severity according to ICMR guidelines were included in the study. Results: In our study, we found average number of drugs per encounter as 7.29. Percentage of drugs prescribed by generic name as 89.05%. Percentage of encounters with antibiotic as 96.58%. Percentage of encounters with an injection prescribed as 100%. Percentage of drugs prescribed from essential drug list as 83.25%. Conclusion: Drug utilization in COVID-19 is diverse and is in accordance with the existing guidelines. Medications used are highly corresponding to the disease severity. Polypharmacy detected, here, is not irrational as it suppressed the COVID-related mortality. Steroids, anticoagulants and oxygen being the key determinants.