Clinical characteristics and colposcopy appearance of cervical intraepithelial neoplasia

Background: Cervical cancer ranks as the second most prevalent cancer among women globally, particularly affecting those in economically disadvantaged regions. This study aimed to explore the epidemiology and clinical characteristics of cervical intraepithelial neoplasia (CIN).Methods: The cross-sectional study was conducted at the Colposcopy Center, Comilla Medical College Hospital, spanning from July 2015 to December 2015. Face-to-face interviews using a preformed questionnaire were employed for data collection. Inclusive criteria were followed for the enrolment of 200 participants, and a simple random sampling technique was utilized. Statistical analysis was planned in the SPSS program. Ethical clearance was obtained from the Comilla Medical College Hospital Ethical Review Committee to ensure confidentiality.Results: Among the 200 women studied, 15% were aged 20-29, 42% were 30-39, 38% were 40-49, and 5% were >50 years old. Illiteracy was prevalent in 30%, with 50% having primary education. CIN incidence was higher among illiterates and those in poor socioeconomic status (55.56%). Early sexual exposure, longer duration of exposure, and higher parity correlated with increased CIN risk. Non-use of contraception was observed in 30% of women, with 44.44% exhibiting CIN. Clinical features included predominant complaints of P/V discharge and various bleeding patterns.Conclusions: CIN prevalence was higher among 30-39-year-olds, emphasizing the impact of illiteracy, low socioeconomic status, early marriage, prolonged marital duration, high parity, and limited contraception use. Clinical manifestations primarily comprised P/V discharge and diverse bleeding patterns. This study underscores the need for targeted interventions addressing socio-demographic risk factors for effective cervical cancer prevention.

COVID-19 and Personal Protective Equipment-Related Challenges Faced by Pediatric Dentists during patient care: A Qualitative Study

Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients' COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.

Harnessing the Potentialities of Arsenic Resistant Fungal Endophytes for Improved Growth Promoting Traits under in vitro Condition

Endophytic fungi enhance the plant’s ability to tolerate stressful conditions including heavy metal stress via secretion of numerous secondary metabolites. However, the role of heavy metal resistant fungal endophytes in growth promotion of plants in extreme environments is need to be understood. Therefore, eight endophytic fungal isolates having arsenic tolerance potential up to 2000 ppm explored from the arsenic stressed plants were subjected to various in vitro growth promoting traits viz., phytohormones production, phosphate solubilization, siderophore production, ammonia production, HCN production and ACC deaminase activity under normal and arsenic stress (100 ppm) condition. Indole acetic acid produced by fungal endophytes ranged between 120-610 ?g/ mL, which was reduced to 50-340 ?g/ mL when they were grown on arsenic induced medium. In the siderophore production test, fungal isolate S3P1S1 produced significantly higher siderophore (96 ±?0.002 ?mol) compared to other isolates and reference culture. In addition, HCN production was observed in only one isolate. Therefore, present study clearly identified specific traits in the fungal endophytes, which make them good candidates as PGPR and might contribute to plant adaption to arsenic contaminated soils. These fungal endophytes, possessing metal tolerance as well growth promoting properties under in vitro conditions could have vital implications for the agricultural sector if used as biofertilizer.

A study of clinical profile and outcome in children with dilated cardiomyopathy

Background: Objective was to analyse the clinical profile of children diagnosed with Dilated cardiomyopathy and to correlate the same with the severity and functional status on 2-D echocardiography.Methods: It was a prospective, retrospective and observational study. A total of 150 subjects were selected from patients visiting the cardiology OPD, admitted in medical wards, paediatric Intensive Care Unit of a tertiary care referral centre. The demographic profile, symptomatology, heart functions and compliance were recorded. The cases were evaluated by detailed history, general and cardiovascular examination and laboratory investigations along with 2D echocardiography.Results: The demographic profile is significant as the age at diagnosis predicts the risk of mortality with older children having the worst outcome. A significant association observed between decreasing ejection fraction and increasing mortality with a p value (p=0.02). Signs of pedal edema and hepatomegaly are associated with unfavourable outcome with a significant p value of (p=0.03). The overall prognosis of children with Dilated cardiomyopathy steadily improved with timely use of appropriate medications. Only 1 patient in this study had undergone orthotopic heart transplant at the age of 15 years (case of chemotherapy induced Dilated cardiomyopathy).Conclusions: Dilated cardiomyopathy is a difficult entity to treat in children as most cases are idiopathic and the therapy remains mostly supportive. Hypovitaminosis-D and hypocalcemia are common treatable causes of dilated cardiomyopathy in children and must be ruled out in all cases of dilated cardiomyopathy. Patients refractory to medical therapy should be considered for ventricular assist devices and orthotopic heart transplantation.

Farmers’ Perception towards Climate Change and its Effect on Agriculture in Kolar District of Karnataka, India

This study aimed to assess farmers' perception of climate change and its implications for agriculture in Kolar district, Karnataka, during the year 2021-22. Data from 80 respondents were collected using a multi-stage random sampling technique, employing a well-structured, pre-tested questionnaire administered through personal interviews. Descriptive statistics, regression analysis, and Garret's ranking technique were employed for data analysis. The results revealed that 40% of the respondents had been aware of climate change for the past five years, with farmers' personal observations being a primary source of information. Most farmers identified climate change through rising temperatures, irregular rainfall patterns, and increased overall rainfall. Respondents also noted climate change effects on agriculture, such as increased pest and disease occurrences, altered sowing periods, and heightened competition from weeds. Regression analysis indicated that factors such as education, the use of social media, sources of weather information, and farming experience had a positive and significant influence on farmers' perception levels. As a result, this study suggests the development of climate-based advisory services, including weather alerts, climate-resilient crop varieties, adaptation strategies, and enhanced weather forecasting systems by relevant government departments to mitigate the impacts of climate change on agriculture in the region.

A COMPARATIVE STUDY OF OLOPATADINE 0.01% COMBINED FLUOROMETHOLONE 0.1% TREATMENT VERSUS OLOPATADINE 0.01% COMBINED KETOROLAC 0.4% TREATMENT IN ALLERGIC CONJUNCTIVITIS IN SAROJINI DEVI EYE HOSPITAL

Objective: Comparative study of the efficacy of olopatadine 0.01% combined fluorometholone 0.1% treatment versus olopatadine 0.01% combined ketorolac 0.4% in the treatment of Allergic Conjuctivitis.Methods: This was a randomized control trial done on 80 subjects with 40 subjects in each group. The clinical signs (chemosis, mucus secretion, eyelid edema) and symptoms (itching, redness, watery eyes, burning) of the patients were evaluated by summing up the scores using a 3-point scale at baseline,1st and 7th day of initiation of treatment. Results were analyzed by Student’s Independent t-test to assess the significant difference of means between the groups. p-value less than 0.05 was considered significant.Results: The mean age of the study subjects was 29.8±13.5 in Group A and 32.6±8.8 in Group B. Majority were females in both group A and group B with 52.5% and 62.5% respectively. The reduction was high for chemosis (87.7%) followed by mucous secretion (87.5%) in group A. Highest reduction was seen with itching (59.9%) followed by burning (52.5%) in group B. Significant difference between the groups was noticed with itching (p=0.04), mucous secretion(p=<0.001), chemosis (p=0.01) and eyelid oedema (p=0.009). No significant difference was observed between the two groups (p=0.15) regarding adverse events.Conclusion: Olopatadine 0.01% combined fluorometholone 0.1% had better efficacy than olopatadine 0.01% combined ketorolac 0.4%.

Schimke immunoosseous dysplasia: a multisystem disorder

Schimke immunoosseous dysplasia is an autosomal recessive disorder characterized by spondyloepiphyseal dysplasia, lymphopenia with defective cellular immunity, and renal insufficiency. It is caused by a biallelic mutation in SMARCAL 1 gene. In this study, we described clinical and genetic diagnosis of a 5 years old girl who presented to our centre with short stature and repeated infections in the past. She had one episode of stroke in the past due to infarction and she was diagnosed with hypertension 1 year back. Last admission in the hospital, she had new stroke episode and found to have steroid resistant nephrotic syndrome.

Synoptic and Dynamical Characteristics of Severe Cyclonic Storm ASANI May 2022

The synoptic and dynamical conditions for the genesis and intensification of tropical cyclone Asani are clearly highlighted in the present paper. The observationally favourable conditions for the genesis of Asani are high SST, 200 hpa STWJ, and weak vertical shear of horizontal wind, which enhanced the convection and intensified the system. The SCS Asani entered a region with lower SST and lower ocean heat content, causing it to weaken into a deep depression in the Bay of Bengal before making landfall. Because of the anticyclone over Indian landmass, Asani remained within 50 km of the coastline for the entire day; as a result, the system moved slowly and remained nearly stationary. The slow movement led to upwelling of sea water and rainfall over the sea, leading to further cooling of the sea surface. There was also land interaction, thereby increasing friction for a longer period. There was a cold and dry air incursion from the Indian Land region in the middle and upper troposphere, leading to weakening.

Computed tomography brain scan findings in eclampsia

Background: Eclampsia is characterized by sudden onset of generalized tonic-clonic convulsion or coma in pregnancy or postpartum unrelated to other cerebral conditions. It is a life-threatening complication of pregnancy; the exact cause is still not conclusively elucidated. Recent studies using computed tomography and magnetic resonance imaging (MRI) gives valuable neuroimaging findings to determine the prognosis and early management of neurovascular complications that will reduce maternal mortality and morbidity.Methods: This is a prospective study done over 6 months to study population was chosen by eclampsia patients who were admitted through the emergency ward and also indoor patients who developed eclampsia after admission. A total of 50 patients were analyzed. Computed tomography (CT) scan of brain performed after a confinement of fetus and after stabilizing the mother. Maternal and fetal outcomes were observed in these cases.Results: A total of 50 eclampsia patients and their CT scan findings were studied. In these positive CT scan findings were noticed in 23 patients. 1 patient expired with massive cerebral hemorrhage and cerebral oedema (40%) was the most common CT scan finding and the most common area is the parietal lobe (32%) followed by the occipital (8%) and frontal 4% and all lobes (1%).Conclusions: CT scan findings provide valuable information about the neurovascular complication in eclampsia patients, early diagnosis and prompt management of these complications will reduce maternal and perinatal mortality to some extent.

ANCHORAGE PREPARATION FOR VARIOUS ORTHODONTIC TREATMENT

There are many kinds of orthodontic movements that make the clinical schedule a genuine test. With the appearance of the skeletal anchorage, it became more straightforward to take care of numerous issues, like anchorage, tipping, interruption among others. The reason for this article was to survey outright anchorage, including signs, implantation site, and any kind of orthodontic element

MSRSGC: A prospective study of heterogenous group atypia of undetermined significance

Context: Many standard books, literatures, and internet described the characteristic lineament of each salivary gland lesion. Nevertheless, there are dozens of disarray, confusion, and unmanageable morphological features regarding proper reporting. To fight with these issues, Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018, but still the third category, Atypia of undetermined significance (AUS), poses difficulties for the pathologists and clinicians for a definite interpretation. Aim: The aim is to analyze the risk of neoplasia (RON) and risk of malignancy (ROM) of Milan's category III (AUS) by subdividing into six groups based on cytolomorphology. Settings and Design: The duration of study was from March 2018 to may 2021 with the focus on ROM and RON of all Milan's categories with especial attention on AUS. Methods and Material: Result of total 329 Fine Needle Aspiration Cytology of salivary glands was categorized according to MSRSGC. On the basis of cytomorphology, further subtyping of AUS and its cytohistopathology correlation was done. The ROM and RON of each subtype was analyzed. Statistical Analysis: All data were calculated by existing formulas. Results: Out of 329 aspirates, 24 (07.29%) cases belong to AUS with availability of histology in 13 (54.17%) cases. RON and ROM was 84.62% and 53.85%, respectively. Cases of lymphocytes with nuclear atypia (L-NA) was the most prevalent (29.17%). The RON were 60.00%, 68.57,% 84.62%, 94.87%, 87.50%, 100%, 100% and the ROM were 20.00%, 11.42%, 53.85%, 05.13%, 43.75%, 83.33% and 100% in each Milan's categories I, II, III, IVa, IVb, V, and VI, respectively. ROM was the highest in cystic fluid with nuclear atypia (C-NA) (100.0%), followed by basaloid cells (75%), L-NA (66.675), and SC (50%), but ROM was zero in NA and oncocytic cells. Conclusions: Subgrouping of AUS helps to dissipate the muddiness and provide more exact and reproducible diagnostic and prognostic tool.

Clinico - pathological profile of Adenoid Cystic Carcinoma of the Lacrimal gland - A Retrospective Study at Tertiary Cancer Care Hospital, Punjab

Background: A retrospective study conducted in the department of radiation oncology to review the management aspects of the adenoid cystic carcinoma of the lacrimal gland and identify the outcome and corelation of the recurrence pattern with pathological and clinical findings. Methods: Data of 10 patients of adenoid cystic carcinoma of the lacrimal gland treated over a period of six years were reviewed with respect to presentation, treatment received , end points and outcome. Results: All of the 10 patients underwent surgery followed by adjuvant radiation therapy. Five patients received adjuvant chemotherapy . Eight (80%) patients were alive at a median follow up of 2 years. Five ( 50%) patients withou t evidence of disease and 3 patients with the disease. One patient developed scalp metastasis during the course of radiation therapy and another one developed lung metastasis. Conclusion: Ad enoid cystic carcinoma of the lacrimal gland is a rare neoplasm wi th aggressive outcome. It is often treated with surgery and adjuvant radiotherapy and needs long follow up.

Clinical Usefulness of Cancer Markers in Cancer

Background: Objectives: Cancer is the uncontrolled growth of abnormal cells anywhere in a body these cells can infiltrate normal body tissues of body. The definitive diagnosis of cancer being histo - pathological examination of tissue. The measurement of tumor markers is currently one of the most rapidly growing areas in laboratory medicine and is helpful in differential diagnosis of tumor type in metastatic deposits and also during follow - up evaluations. Methods: Advanced Cancer Institute is a tertiary care cancer institute in Mal wa region of Punjab, old cases with proven history and in the advanced stage of disease, measurement of tumor markers in them is a very important tool for their evaluation of treatment outcome and in staging, emphasis of our study is to highlight and to encourage tumor marker assays for early diagnosis of cancer by checking baseline levels in healthy and in high risk population for screening for the presence of cancer. Results: The Study was carried out Department of Microbiology, Total of 300 Blood Samples were checked in Automated Immune Analyzer (Biomeriux) with different panels of Tumor markers (PSA,AFP,CEA19.9,CA - 125,CA15.3)Kits available in our Lab. of commonly diagnosed cancer. Conclusion: Focus has to be directed towards identification a nd proper use of suitable tumor markers which may prove to be an invaluable tool to early detect the deadly disease in mankind and not to use markers only as a prognostic indicator in proven cases.

Goal-Directed Fluid Therapy Based on Pulse-Pressure Variation Compared with Standard Fluid Therapy in Patients Undergoing Complex Spine Surgery: A Randomized Controlled Trial

Methods@#Sixty adults (18–70 years) patients undergoing complex spine surgeries at Siriraj Hospital, Mahidol University, Thailand were enrolled. Patients were allocated to two groups (30 patients in each) using computer-generated randomization. Intraoperative fluid and vasopressor were administrated via either GDT or standard care. The GDT algorithm used PPV and fluid protocol as the primary tool to guide hemodynamic management. The incidences and episodes of perioperative hypotension were measured as the outcomes. @*Results@#Fifty-seven patients were analyzed (three patients in the GDT group were excluded). The baseline characteristics and surgical procedures of the two groups did not differ significantly. The prevalence of intraoperative hypotension was 80.0% for the control group and 66.7% for the GDT group (p=0.25). Two episodes (1–3) of intraoperative hypotension occurred in the control group, and one episode (0–3) occurred in the GDT group; the difference was not significantly different (p=0.57). The intraoperative blood transfusion requirements and postoperative complications were similar in both the groups. In the subgroup analysis, patients with intraoperative hypotension exhibited a higher incidence of postoperative bowel dysfunction. @*Conclusions@#PPV-guided GDT and fluid protocol, as compared with standard practice, did not show significant advantages with respect to intraoperative hypotension, blood transfusion, or postoperative complications in patients undergoing complex spine surgery in the prone position.

Yoga nidra practice shows improvement in sleep in patients with chronic insomnia: A randomized controlled trial

BACKGROUND Yoga nidra is practised by sages for sleep. The practice is simple to use and has been clearly laid out, but its role in the treatment of chronic insomnia has not been well studied. METHODS In this randomized parallel-design study conducted during 2012–16, we enrolled 41 patients with chronic insomnia to receive conventional intervention of cognitive behavioural therapy for insomnia (n=20) or yoga nidra (n=21). Outcome measures were both subjective using a sleep diary and objective using polysomnography (PSG). Salivary cortisol levels were also measured. PSG was done before the intervention in all patients and repeated only in those who volunteered for the same. RESULTS Both interventions showed an improvement in subjective total sleep time (TST), sleep efficiency, wake after sleep onset, reduction in total wake duration and enhancement in subjective sleep quality. Objectively, both the interventions improved TST and total wake duration and increased N1% of TST. Yoga nidra showed marked improvement in N2% and N3% in TST. Salivary cortisol reduced statistically significantly after yoga nidra (p=0.041). CONCLUSION Improvement of N3 sleep, total wake duration and subjective sleep quality occurred following yoga nidra practice. Yoga nidra practice can be used for treatment of chronic insomnia after supervised practice sessions.

A comparative evaluation of bone marrow biopsy and bone marrow aspiration in different haematological condition with special reference to leukaemia and lymphoma

Background: For diagnosis of haematological disorders there are three modalities to examine bone marrow, bone marrow aspiration cytology (BMA), bone marrow imprint (BMI) and bone marrow biopsy (BMB). BMA gives cytological picture; BMI also gives cytological picture but cells are less in number and BMB gives cytological as well as architectural picture. BMA alone may not be sufficient to reach diagnosis therefore the present study was undertaken to compare the above modalities. The study was conducted with the aim to perform cytomorphological evaluation of bone marrow in various haematological disorders with special reference to leukaemia and lymphoma and to compare bone marrow aspiration smears with bone marrow trephine biopsy.Methods: The present study was conducted in department of pathology, LLRM Medical College, Meerut inpatients attending the outpatient department and in-patient department of pediatrics and medicine of SVBP Hospital attached to LLRM Medical College, Meerut, over a period of one year i.e. from March 2018 to May 2019. A detailed clinical history, physical examination and laboratory examination of all the cases was done.Results: Out of 50 cases, maximum number of cases were of anemia 26/50 (52%) followed by leukemia 17/50 (34%), lymphoma 5/50 (10%), multiple myeloma 1/50 (2%), myelofibrosis 1/50 (2%), leishmaniasis 1/50 (2%) and idiopathic thrombocytopenic purpura 1/50(2%). BMA smears were compared with biopsy and concordance and discordance was established. The overall diagnostic accuracy of aspiration was 94%.Conclusions: Bone marrow examination is a safe, quick easy and cost-effective procedure with very less patient discomfort. BMA shows better cellular details when compared to BMI and BMB. BMB is diagnostic investigation in dry tap cases like aplastic anemia, myelofibrosis, myelodysplastic syndrome and metastatic tumors. In present study, concordance between BMA and BMB was seen in majority of the cases and diagnostic accuracy was 94% study concludes that bone marrow aspiration cytology and trephine biopsy complement each other and should be performed simultaneously for complete bone marrow work up and evaluation.

Quality of life, perceived stress and caregiver burden in mothers of children with childhood psychiatric disorders in Kerala, India

Background: Common childhood psychiatric problems like attention deficit hyperkinetic disorder (ADHD), Pervasive developmental disorder (PDD) and learning disability (LD) often co-exists with each other and form a constellation of behavioural manifestations that require extra attention from the caregivers. Having a differentially-abled child is challenging and most parents have to learn to restructure their lives around that of the child. There is a difference in the attitudes of both the parents as far as parenting a disabled child is concerned. Mothers often shoulder the primary caregiving role however the psychological costs borne by women go unrecognized. The study aims to assess the care giver burden (BOC) and perceived stress (PS) and quality of life (QOL) in mothers of children with ADHD, PDD and LD.Methods: It was a cross-sectional study with 336 child mother pairs. The mothers were asked to rate their burden and stress symptoms on the perceived stress scale and Burden of care scale. The mothers were also asked to rate their quality of life on the quality of life scale.Results: The mean PS score was highest in the PDD group. The mean BOC was lowest in the LD group. The QOL score was highest in the LD group.  There is statistically significant difference in the PS, BOC and QOL scores among the three groups.Conclusions: There is a hidden lacuna of psychological stress in mothers of children with common psychiatric problems. The study also establishes that these mothers have poorer quality of life. It is necessary to address these psychological issues of the mother at every visit and equip them with coping strategies so that they can look after both themselves and their special needs child.

Denture Adhesives - Knowledge and Tradition among Denture Wearers in Western Maharashtrian Population - A Survey.

Denture adhesives play a vital role in retention of complete dentures, wherever indicated. Dentists need to know about denture adhesives to be able to identify those patients who actually need them and to be able to educate them about the advantages, disadvantages and correct use of these products. The aim of the study was to evaluate the knowledge about denture adhesives among complete denture wearers indicated for use of denture adhesives visiting Dental Colleges in Western Maharashtra. METHODSThe study was conducted on 300 completely edentulous patients with conventional complete dentures indicated for use of denture adhesives. RESULTSPatients (n= 300) who were wearing ill - fitting complete dentures and required use of denture adhesives were selected, their response about knowledge was assessed by questionnaire survey and those who knew about it were instructed to demonstrate the application of denture adhesive to the intaglio surface of complete denture. 34.7% (n1= 104) of the total subjects (n= 300) had heard about denture adhesives. Out of these 104 subjects, 69.2% (n1= 72; CP= 24%) had used and 77.8% (n1= 81; CP= 27%) knew when to use denture adhesives. Out of 72 subjects who had used denture adhesive, only 30.5% (CP= 7.3%) could demonstrate the adequate technique to use denture adhesive. CONCLUSIONSKnowledge about use of denture adhesives for those who are in need per se has to be spread along with right technique of its use. The indication of its use, and correct technique/techniques of application, should be taught to the patients who demand the use of denture adhesives.

Evaluation of Selection of Various Treatment Modalities Chosen by Subjects for Replacing Single Missing Tooth - A Questionnaire Survey in Western Maharashtra Population.

This survey was done to evaluate awareness of various treatment modalities forreplacing single missing tooth among the people of western Maharashtra. Wewanted to assess gender wise awareness of patients regarding fixed dentalprosthesis as a treatment modality for replacement of missing tooth.METHODSThis cross-sectional study was done on 150 subjects visiting the dental college usinga self-administered structured questionnaire. The questionnaire was pre-testedthrough a pilot survey. Data was evaluated using version 16.0 of the SPSS. ChiSquare test and ANOVA were used as test of significance at p < 0.05.RESULTSOut of 150 subjects, 87 were males and 63 females. Around 64% of the subjectswanted to replace missing tooth due to difficulty in masticatory function; yet 14%knew the importance of aesthetic and speech as well. All subjects preferred fixedprosthesis for replacement of missing tooth, but higher cost of the procedure andfear of surgical trauma were the main factors for not undergoing implant treatment.Dental professionals were the main source of information about different treatmentprocedures followed by media.CONCLUSIONSThere is a strong level of awareness among the subjects about the fixed treatmentprocedure, but more than half of the subjects did not have knowledge about theimplants. It also revealed the need to provide the subjects with more knowledgeabout this treatment modality. Dental awareness is therefore necessary in order tocultivate a positive attitude towards dental implants amongst the community