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Background: Oral health is a key indicator for general health, overall well-being and quality of life. This study evaluated the oral hygiene knowledge, practice and its association with oral problems and create awareness about oral health, oral diseases and its treatment to the people in Ahmedabad. Methods: Sample size was estimated to be approximately 260 based on pilot study and by convenience sampling method. Chi-square test using SPSS statistical software. Results: It was observed that around 74.22% of participants felt tooth pain, of which female were more expressive of their pain as compared to their male counterpart. Of which a staggering 73.07% participants brushed their teeth only once in a day. It was observed that there was a failure among population to use interdental aids for cleaning and maintaining oral hygiene. Approximately 70% of population visited their dentist not even once in the year. Conclusions: It was observed and hence concluded on the basis of the derived results that there was a lack of appropriate oral health awareness among the local people in Ahmedabad even among the literate.
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The utilization of cannabis in oncology presents a multifaceted approach to addressing the complex challenges associated with cancer treatment. With roots tracing back to ancient medicinal practices, cannabis contains numerous compounds, including cannabinoids like tetrahydrocannabinol (THC) and cannabidiol (CBD), that interact with the body's endocannabinoid system. These interactions offer potential therapeutic benefits, ranging from antiemetic and analgesic effects to the inhibition of cancer growth processes. While clinical evidence supports the efficacy of cannabinoids in managing symptoms and enhancing the quality of life for cancer patients, caution is warranted due to potential interactions with conventional medications. Understanding the mechanisms of action, optimal administration routes, and potential side effects is crucial for integrating cannabis into personalized cancer care plans. By navigating these considerations thoughtfully, medical practitioners can harness the therapeutic potential of cannabis to complement traditional cancer treatments and improve patient outcomes in the field of oncology.
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The role of myelin-oligodendrocyte glycoprotein (MOG) in central nervous system (CNS) myelin and its association with optic neuritis. It emphasizes the importance of early detection and suitable diagnostic investigations for optic neuritis, a condition often linked to multiple sclerosis. A 65-year-old female with MOG-positive CNS demyelination, optic neuritis, and underlying conditions such as hypertension and type 2 diabetes mellitus. The patient's clinical examination, diagnostic test results, and imaging findings are presented, including fundoscopy, 2D Echo, and magnetic resonance imaging (MRI) of the spine. The treatment chart outlines medications administered to the patient. It delves into challenges in identifying optic neuritis, emphasizing the significance of clinical-MRI phenotypes associated with MOG-associated disorders (MOGAD) and reliable laboratory assays for detecting MOG-IgG. It highlights the need for caution in interpreting positive MOG-IgG results and underscores the importance of follow-up for individuals with MOG-IgG seropositivity. The article also discusses various aspects of optic neuritis, including visual field impairments and retinal changes associated with anti-MOG antibodies. It emphasizes the importance of timely and accurate identification of MOGAD through anti-MOG antibody detection. It calls for standardized diagnostic criteria and the refinement of models to enhance understanding and therapeutic approaches for MOGAD. Overall, the article provides insights into the diagnosis, management, and challenges associated with MOG-related disorders.
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Background: In the study, we have tried to assess some preoperative factors (history, clinical and ultrasonographic factors) that might make the laparoscopic cholecystectomy difficult. Objective was to study the predictive scoring pattern in difficult laparoscopic cholecystectomy cases. Methods: It was a prospective observational study. Ninety cases of suspected cholecystitis were identified for study presented to Jehangir hospital, Pune with upper abdominal pain or vomiting or dyspepsia or jaundice. Such patients were studied in detail clinically, admitted and investigated. Ultrasound abdomen was done in all patients. Results: Out of 90 cases studied, 64 patients (71.1%) had pre op score between 0-5 i.e. easy level, 21 patients (23.3%) had pre-op score between 6-10 i.e. difficult level and 5 patients (5.6%) had pre-op score between 11-15 i.e. very difficult level against intra-op scoring of 57 patients (63.33%) being easy, 28 patients (31.1) difficult and 05 patient (5.6%) had very difficult surgery. Conversion rate in present study to open surgery was 5.6%. For predicting easy laparoscopic cholecystectomy, accuracy of preop score was 85.6% and for predicting very difficult lap cholecystectomy, accuracy of preoperative score was 95.6%. Conclusions: Strongly significant factors predicting difficult laparoscopic cholecystectomy were number of hospitalisations, impacted stone and obesity. This study demonstrated that a scoring system predicting the difficulty in laparoscopic cholecystectomy is feasible and easy way. Identification of these factors preoperatively might help to psychologically prepare the patients for open surgery and for prolonged convalescence.
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From plot to national scales, sampling, analysis, and visual inspection of soil are common methods used to evaluate its condition and potential for use. However, due to the complexity and site-specificity of soils, the legacy impacts of past land use, and trade-offs across ecosystem services, selecting relevant soil parameters and interpreting measurements are not simple tasks. Here, we go over the definition, methods of assessment, and choices and interpretations of indicators for soil quality and related concepts. Assessing soil condition and potential usage involves a range of methods, from small-scale sampling to nationwide analyses. Despite their prevalence, these approaches face challenges due to the intricate nature of soils, their site-specific characteristics, historical land use impacts, and the need to balance various ecosystem services. Selecting pertinent soil parameters and interpreting measurements becomes a complex task. In this context, we delve into the definition, assessment methods, and the choices and interpretations of indicators related to soil quality. Our focus is on widely used indicators within agricultural land use. Notably, explicit evaluations of soil quality for specific risks, functions, and ecosystem services remain limited. Furthermore, there is a scarcity of systems providing clear frameworks for interpreting measured indicator values, hampering their acceptance by both policymakers and land managers. We explore innovative indicators that shed light on often overlooked soil properties and processes. Biological/biochemical indicators are under-represented but show great potential. Soil quality assessment should specify targeted soil threats, functions and ecosystem services. Increasingly interactive assessment tools must be developed with target users.
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Carrying out fieldwork in private infertility clinics poses its own specific set of challenges. Gaining access to these field sites not only obliges researchers to negotiate with gatekeepers but also to deal with structures of hierarchy and power. Based on my preliminary fieldwork in Lucknow city of Uttar Pradesh, I discuss the challenges of conducting fieldwork in infertility clinics and how methodological challenges push the researcher to question the academically established notions of the “field”, “fieldwork” and “research ethics”. The paper stresses the importance of discussing the challenges of doing fieldwork in private health setups and is an attempt to answer vital questions about the nature of fieldwork, how the fieldwork was conducted, and the need to include questions and dilemmas that anthropologists might face in the process of making decisions in the field.
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Background: The majority of adult tribal subjects in the western part of India, show microcytic hypochromic red cells, and borderline anemia with a normal iron profile, suggesting a high prevalence of thalassemia in this population. Methods: The current study was designed to perform qualitative (to screen for Hb Bart’s) and quantitative (to estimate percentage of Hb Bart’s) hemoglobin electrophoresis with modification of the method, to evaluate the prevalence of ? thalassemia and to determine gene frequency of ?+ thal gene. Furthermore, the present study also aimed to evaluate common hematology parameters like MCV and MCH as screening tools to suspect ? thalassemia at birth. Results: Based on hemoglobin electrophoresis, the prevalence of ? thalassemia in all its forms was found to be 66.66%. The estimated gene frequency for ?+ thal was found to be 0.7453 and based on that, the extrapolated prevalence of ? thalassemia was 93.52% (55.55% homozygous and 37.97% heterozygous). MCV<100 fl and MCH<31 pg were found to be reliable screening tools to predict ? thalassemia at birth in full-term uncomplicated pregnancy. Conclusions: Tribal community in the western part of India bears a very high prevalence of ? thalassemia, it’s a reality and not a myth. Simple hematological parameters like MCV (<100 fl) and MCH (<31 pg) measured at birth can prove to be cost-effective surrogate markers for ? thalassemia. Large scale study using confirmatory genetic analysis is required to validate the findings.
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A field experiment was conducted at Potato Research Station, S. D. Agricultural University, Deesa during 2018-19 and 2019-20 for evaluation of efficacy of insecticides against whitefly in potato. The seven different treatments viz. T1: Control, T2: Seed treatment with imidacloprid (200 SL) @ 0.04% followed by foliar sprays of imidacloprid @60 gm a.i./ha at 85% emergence + second spray with thiamethoxam 25WG @100g a.i./ha, T3: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence, T4: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence followed by second spray of diafenthiuron after 10 days, T5: Foliar spray of castor oil @0.05% at 85% emergence, T6: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05%, T7: Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05% by second spray with diafenthiuron after 10 days. Based on pooled data of two years, the significantly highest per cent reduction (i.e. 68.57 %) after 2nd spray was recorded in T7 i.e. foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence mixed with castor oil @0.05% by second spray with diafenthiuron after 10 days which was at par with T4 (Foliar spray of diafenthiuron 50WP 350 g a.i. at 85% emergence followed by second spray of diafenthiuron after 10 days). The tuber highest yield and benefit cost ratio were also recorded with T7.
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Breast cancer is the most common malignancy among women worldwide. In addition to being the most prevalent, breast cancer also kills more women from cancer than any other type. It has now overtaken lung cancer as the leading cause of cancer incidence globally in 2020, with approximately 2.3 million new cases, accounting for 11.7% of total cancer cases. As per the cancer registry report by NCDIR, In India, the majority of breast cancer cases are identified at an advanced stage. Here, we'd like to talk about a breast cancer case that was diagnosed early in our hospital through the cancer screening out-patient department (OPD) running within the institute.
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Background: Medical as well as surgical methods for abortion is performed worldwide since many years. Medical methods are safe till first trimester of pregnancy. The present study is intended to compare success rate and side effects of both method of abortion during first trimester. Aims and Objectives: The aim of the study was to study and compare the success rate in both the methods of termination of pregnancy in first trimester and to study side effects and complications as well as satisfaction among study participants undergoing termination of pregnancy during first trimester in both methods. Materials and Methods: A prospective comparative study was conducted at the Department of Obstetrics and Gynecology of one of the teaching medical institute of Ahmedabad among women seeking Medical termination of pregnancy with less than or equal to 9 weeks of gestation. Total 150 participants were selected using purposive sampling (75 in each group). Group A consist of patients having medical termination of pregnancy by medical method and Group B consist of cases that required termination of pregnancy by surgical method. Results: Mean age of the patients in Group A was 27.98 � 4.57 years and Group B was 27.58 � 4.22 years. Proportion of complete abortion in medical and surgical method was 88% and 96%, respectively. Surgical method had more effectiveness and success rate for complete abortion as compare to medical method. The mean duration of bleeding per vagina in both groups were more among Group A. Abdominal pain and gastrointestinal symptoms such as nausea, vomiting, diarrhea, and fever were also found to be more in Group A as compared to Group B. Those who had medical method were more satisfied than surgical method. Conclusion: Both methods are safe and effective as far as termination of first trimester pregnancy is concerned. Proper counseling with appropriate selection can bring safe and effective outcome in first trimester of termination of pregnancy
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Background: During pregnancy, hemodilution of plasma volume leads to reduction in platelets count by approximately 6–7% during 3rd trimester. Pregnant women with thrombocytopenia have higher risk of bleeding excessively during pregnancy, labor, and puerperium. The present study focuses on fetomaternal outcome among pregnant women having thrombocytopenia. Aims and Objectives: This study aims to study the incidence of thrombocytopenia in pregnancy, to identify various factors responsible for thrombocytopenia in pregnancy, and to evaluate fetomaternal outcome in patients with thrombocytopenia in pregnancy. Materials and Methods: A prospective study was conducted in the department of obstetrics and gynecology at tertiary care center of Ahmedabad. A total of 96 cases of thrombocytopenia in pregnancy were included in the study. Fetomaternal outcome was assessed among the study participants. Results: The incidence of thrombocytopenia in the present study was 0.77%. Obstetric causes (53.12%) accounted for most common cause of thrombocytopenia, followed by gestational thrombocytopenia (27.08%), dengue (10.41%), malaria (4.16%), and immune thrombocytopenia (4.16%). Postpartum hemorrhage (15.62%), eclampsia (14.58%), disseminated intravascular coagulation (11.45%), and abruption (8.33%) were the most common maternal complications. The most common neonatal complication was prematurity (67.7%) followed by intrauterine growth retardation (23.95%) and birth asphyxia (9.3%). Conclusion: Hypertensive disorders of pregnancy including severe preeclampsia, eclampsia, and HELLP syndrome are found to be the most common cause of thrombocytopenia followed by gestational thrombocytopenia and infectious causes. The present study widened the spectrum of the causes for thrombocytopenia in pregnant women. Gestational thrombocytopenia is associated with mild-to-moderate thrombocytopenia and hardly having any complications.
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Background: Head and Neck cancer (HNC) is a recognized major public health concern all over the world Objectives: To study age and gender predilection and clinical profile of Head & Neck Cancers Materials and Methods: This was a retrospective study including 21121 patients with Head & Neck Cancer presented to tertiary care centre, Ahmadabad. Patients' details of age, sex, site of carcinoma, stage at presentation and Outcome were recorded. The data was analyzed using MS office excel 2010 and Epi info software version 7.0. Result: Male to female ratio was 4.8:1. The most common site of presentation of tumour was in cheek mucosa (29.01 %). On comparison of different anatomical sites, majority of patients were presented in locally advanced stage. Significant association (p<0.05) was found between presentation of disease and literacy status. Overall 5 - year survival rate was 60.5% � 1.6% when disease was localized. Conclusion: Majority of patients diagnosed in locally advanced stage. Strategies for the early diagnosis and prevention of Head & Neck cancer must be undertaken by government to overcome this situation.
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A 65?year?old male post?CABG surgery presented with history of ventricular storm refractory to antiarrhythmics and requiring multiple DC shocks. He got posted for VATs bilateral cardiac denervation for sympathetic remodulation. Patient was induced with high dose opioids and Etomidate and intubated with 37Fr left double lumen tube. A multidisciplinary approach was planned to tackle peri?operative cardiac event along with the placement of invasive monitors. Events that might lead to sympathetic overactivation because of laryngoscopy, pain, capnothorax, and surgical handling were kept in mind and avoided with optimum depth of anesthesia, analgesia, and pharmacological sympatholysis. There was no major cardiac event intraoperatively as well as in postoperative period.
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Background:Labour progress in partograph plotting helps to early recognition and prevention of the complication of labour. This helpful in better maternal and perinatal outcome. Aim of the study is to evaluate the maternal and perinatal outcome in primigravida and multigravida by comparing their partograph in labour.Material And Methods:This prospective observational study was carried out in Smt. SCL General Hospital a teaching tertiary care hospital from May-2018 to November-2019. Total 250 cases out of which 125 cases of primigravida and 125 cases of multigravida admitted in labour room were randomly selected and monitored by using modified WHO partograph. All the cases reporting to labour room and fulfilled the inclusion criteria were included in thisstudy. Individual partograph was studied to know the various aspect of course of labour.Result:208 out of 250 cases were before alert line, 34 cases were between alert and action line and 8 cases were beyond action line. Rate of cervical dilatation in most primigravida was between 1.1-2cm/hour and in multigravida was >2.1cm/hour. In Zone A, in primigravida 90.7% had VD and 9.3% had LSCS whereas in multigravida 96.4% had VD and 3.6% had LSCS. In Zone B, in primigravida 47.8% had vaginal delivery and 52.2% had LSCS whereas in multigravida 54.4% had VD and 45.5% LSCS. In Zone C, in primigravida and multigravida there were no VD and 100% had LSCS. Protracted active phase (50%) was presents the most common abnormality of first stage of labour in both group inpresent study and in second stage, arrest of decent (82%) was more common. In both groups, NICU admission were more in Zone C (3.2%) as c ompared to Zone A (2%) and Zone B (1.6%).Conclusion:This study has shown that using the partograph can be highly effective in reducing complications from both mother and neonate. It is also helpful in monitoring of labour and early diagnosis of abnormal labour. It prevents maternal mortality and morbidity.
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Erythema ab igne is a characteristic reticular telangiectatic and pigmented dermatosis, resulting from repeated or prolonged exposure to heat or infrared radiation insufficient to cause burns. Occupational history has played a pivotal role in dermatological diagnosis, and its importance cannot be overstated. It could lead to the provisional or final diagnosis in many instances.Over the course of time, the site and cause of erythema ab igne has evolved. From commonly being found on knees shins and palms due to tapnas (a practice in Indian villages to sit in front of fire); the disease is now observed on other sites such as on thighs and trunk after the discovery of heating pads and laptops.In thisparticular case, a 26-year-old male presented with erythematous to light brown patches on his right arm. The site of presentation was quite unusual, thus making occupational history the key to diagnosis.
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Background:In current maternal mortality situation in India, it is pertinent to determine the relationship between booking status of mother and maternal and fetal outcomes. Material And Methods:In present study 1500 patients were studiedfrom July 2019 to June 2021 in department of Obstetrics and Gynaecology Smt. S.C.L general hospital, Ahmedabad. Amongst these 1000 were booked (>= 3 antenatal visits) and 500 were emergency (unbooke d) cases (<3 antenatal visits). Result:Majority of patients was between 21 to 30 year age group, lower socioeconomic class and from urban area. In booked patients incidence of Antepartum, Intrapartum, Postpartum complications, medical complications, blood transfusion requirement, rate of caesarean section, incidence of Preterm babies, low birth weight babies, NICU admission, perinatal mortality and maternal mortality was less. Conclusion:In booked cases fetomaternal outcome was good. Hence targeted, integrated, patient friendly, affordable, accessible health services need to be delivered in an equitable manner and through routine screening, monitoring and follow up complications, mortality and morbidity can be reduced.
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Background:Bleeding per vaginum in the first trimester is a common obstetric situation ranging from an insignificant episode to life threatening emergency. The major causes are abortion, ectopic, and molar pregnancy. Ultrasonography is playing an increasing role in the management of such patients. The aim of this study was to determine the role of first trimester bleeding on obstetrical ultrasound.Material And Methods:This was a retrospective observational study done at urban health care Hospital Ahemdabad, a tertiary care teaching hospital. All obstetric cases with a history of bleeding per vaginum in the first trimester of pregnancy between July2019 and December2019 were included. A complete general physical and pelvic examination was done to arrive at a clinical diagnosis. Patients were then subjected to ultrasound examination. Clinical diagnosis and ultrasound diagnosis were correlated.Result:150 of all 2000 obstetric cases had the first trimester bleeding (incidence of 7.5%). Commonest causes were abortion (78.66%), ectopic (6%), and molar pregnancy (2%). Of 150 cases, 106 cases were correctly identified by ultrasonography. 44 cases proved by sonography were misdiagnosed by clinical examination with a disparity of 52.38%. In this study, 56% pregnancies were clinically diagnosed as viable, but only 34% pregnancies were viable.Conclusion:When the first trimester of pregnancy is complicated by vaginalbleeding, the history and clinical findings are often misleading and if relied upon can only lead to a delay in diagnosis and management.This study reinforces that USG is important to establish a definitive diagnosis, differential diagnosis and subsequent management.
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Background:The aim of our study was to explore the demographics, surgical outcomes and performance of diagnostic imaging modalities namely Ultrasound and Magnetic Resonance Imaging for predicting abnormal placental invasion spectrum in females with history of past caesarian sections.Materials & Methods:We conducted a prospective study from February 2017 till December 2019 at a tertiary referral public hospital in western India. During this time-period we had 26 females satisfying our study criteria. They were subjected to imaging diagnostics to confirm abnormal placental invasiondisorder in their present pregnancy. The imaging findings were compared with the final findings at the time of delivery and pathological examinations of placental specimens.Results:More than two thirds of our study patients were young and belonged to the age group of twenties (mean age 29.5 +/-4.64). Half of them were 3rdgravidas and 77 % (> 3/4 th) of them were diagnosed in their second trimester of pregnancy. Majority of them had history of single past caesarian delivery and the commonest indication for performing it was placenta praevia. Both Ultrasound and MRI were found to be fairly accurate in diagnosing abnormal placental invasion with good sensitivities. Overall, in our series MRI scored an upperhand as a diagnostic imaging modality in posteriorly implanted placentas and cases with ambiguous USG findings.Conclusion:Both diagnostic imaging modalities USG and MRI can predict abnormal placental invasion spectrum with high sensitivity in the antenatal period. These imaging modalities can have a complimentary role, although MRI was found to be superior over USG in our case series with inconclusive findings.
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Cisplatin is a major antineoplastic drug for the treatment of solid tumors. Nephrotoxicity is dose- limiting side effect associated with clinical use of cisplatin. The present study was executed to determine whether bartogenic acid containing fraction of Barringtonia racemosa fruits (BREAF) possesses a nephroprotective effect against cisplatin-induced nephrotoxicity in rats. Furthermore, the study was also aimed to explore the mechanisms underlying this effect of BREAF. The BREAF was orally administered at the doses of (2, 5 and 10 mg/kg) for five consecutive days following single dose administration of cisplatin (5 mg/kg, i.p.). Treatment of animals with cisplatin resulted into the significant body weight changes, oxidative stress, elevated levels of serum biomarkers and histological alterations in the kidney architecture. The BREAF administration reduced relative body weight and organ weight changes in cisplatin-treated rats. The BREAF exhibited nephroprotective effect through the significant reduction of cisplatin-induced rise in the serum creatinine, and blood urea nitrogen levels as well as renal levels of malondialdehyde (MDA) the makers of lipid peroxidation. Additionally, the treatment with BREAF resulted into the increased renal levels of reduced glutathione (GSH), superoxide dismutase (SOD) and catalase activity. Histopathological examination established the nephroprotective effect of BREAF. In conclusion, the anti-oxidant, and anti-inflammatory effects of BREAF has important role underlying its nephroprotective effect.
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Nitrofurantoin is effective against many urinary tract pathogens. It acts as bacteriostatic and/or bactericidal by inhibiting DNA-RNA protein& cell wall synthesis. Nanostructured Lipid Carriers (NLCs) of NFT was prepared by Hot Homogenization Process. Glyceryl Monostearate and Miglyol 812 were heated at 80ºC temperature on hot plate. In the melted lipid, drug was added with continuous stirring at high speed homogenization. Formulation NLC12B has % Entrapment efficiency 89.1 ± 0.5, PDI 0.11 ± 0.01 and mean particle size 237 ± 7nm represents narrow particle size distribution. Spherical feature of NLCs with better uniformity without aggregation of Nitrofurantoin loaded NLC was confirmed by TEM. Moreover, efficient miscibility of drug in lipids was confirmed by the absence of intense and characteristic peak of NFT in XRPD. After 6 month storage at 2-8°C there was no significant changes in the PDI as well as mean particle size.