Sociodemographic determinants of high tobacco use in Gond tribe of central India

BACKGROUND The prevalence of tobacco use is high in rural India, but limited information on tobacco use among the tribal population is available. We assessed the prevalence of tobacco use and type of tobacco use in the Gond tribal population. METHODS We did a cross-sectional survey among the Gond tribal population residing in the Kundam block of Jabalpur district in Madhya Pradesh state in India. The study was carried out among persons aged 6 years and above during February–May 2017. Pre-tested interview schedules were used by trained field investigators to collect information on tobacco use. RESULTS A total of 3351 individuals were included in this study, of which 58% were using some form of tobacco. The prevalence of tobacco use was higher among men compared to women, and it increased significantly from age 6 to 25 in both men and women. Tobacco use was significantly associated with age, gender and educational status of the respondents. CONCLUSION The study highlights a high tobacco use in the Gond tribe population. The high prevalence of tobacco use in younger ages is a matter of serious concern. The study establishes a need for information, education and communication and behavioural change communication activities; health camps focusing on the harmful effects of tobacco use and tobacco control campaign among tribal communities, tribal schools and ashrams.

A Conceptual Study on the Role of Vasa Bhavit Haridra Churnam in Vataja Kasa (Dry Cough) w.s.r. to Allergic Bronchitis: A Review

In the present era of COVID -19, management of respiratory disorders is becoming a challenge to the world. Ayurveda, the science of life, provides a lot of hope in the present condition by assuring better results in the field of prevention and management of respiratory diseases. Cough carries out an essential protective function for the respiratory tract and lungs. Kasa (cough) is one of the commonest complaints in day-to-day life and it is also a symptom of various diseases of the respiratory system. In Ayurveda, Acharyas have explained Kasa in detail. They have described five types of Kasa. Among the various respiratory diseases, Vataja Kasa (dry cough) has been selected here. In the contemporary science, it can be correlated to Allergic Bronchitis, which is one of the common problems throughout the world. In the present study Vasa Bhavit Haridra Churnam (VBHC) has been selected from Siddh Bhaisajya Manimala and further details regarding the ingredients were collected from various text books, PubMed, research articles, previous works done etc. As per the data collected, Allergic Bronchitis when treated with Vasa Bhavit Haridra Churnam will be effective in relieving the symptoms. Ayurveda has a vital role to play in the field of respiratory ailments.

Study of Correlation of CD4, CD8 Count with Tuberculous Pneumonia and Non Tuberculous Bacterial Pneumonia in Type_x0002_2 Diabetes Mellitu

Aim: Type-2 DM patients are susceptible for various types of infections. Long standing Type2 DM patients have strong predilection for tuberculosis as seen in various studies. Here, we aimed to study susceptibility of tuberculosis as compared to other non tuberculous pneumonia in type-2 DM on the basis of CD markers. Material and Methods: A case control study on 150 subjects was conducted in S.P. Medical College and Associated Group of P.B.M. Hospitals, Bikaner. Subjects were divided into 3 groups each of 50 type-2 diabetic patients having tuberculous pneumonia, of 50 type-2 diabetic patients having non tuberculous pneumonia and 50 patients of type 2 diabetes as a control group attending Medical Outdoor and those Admitted in Hospital IPD Wards. All participants were subjected to detailed clinical examination and relevant investigations. Flow cytometry was used for CD4 and CD8 count. Results: Diabetic patients with tuberculous pneumonia have significantly (p-value <0.05) elevated numbers of CD4 and CD8 cell count in comparison of both controls and nontuberculous pneumonia. Diabetic patients with non tuberculous pneumonia have significantly (p-value <0.05) lower CD4 and CD8 cell count in comparison of diabetic controls and diabetic patients with tuberculous pneumonia. Conclusion: DM is associated with an alteration in the immune response to tuberculosis, leading to a induction of CD4 and CD8 mediated cellular responses and likely contributing to increased immune pathology in M. tuberculosis infection.Our study also provides an impetus to perform longitudinal studies examining the role of immunological biomarkers in the development of tuberculosis in diabetic patients.

A comparative study of various types of intravenous fluids on the changes during induction of general anaesthesia

Background: The induction and endotracheal intubation is the most risky and initial process of general anaesthesia. Without induction and endotracheal tube placement one cannot imagine the general anaesthesia. Propofol and fentanyl are the commonly used drugs for induction of general anaesthesia. These drugs produce hypotension and other cardiorespiratory disturbances. These hazardous and sometimes fatal effects can be reduced and eliminated by preloading the patients with colloid or crystalloid solutions.Methods: We selected 90 patients who visited our hospital in the last 2 years from June 2017 to May 2019. All the investigations and pre-anaesthetic check-up was done routinely. These patients had to undergo different surgical procedures under general anaesthesia. The induction of anaesthesia was done with propofol and fentanyl. These patients were divided in three groups A, B and C. Group A patients did not receive any preloading. Group B was given colloids (3.5% gelatins) and group C received crystalloids (Ringer’s lactate solution). The haemodynamic changes were noted and analysed statistically.Results: The study showed that IV fluids given before induction of general anaesthesia blunts the adverse cardiovascular response.Conclusions: We concluded that preload with fluids whether colloids or crystalloids are beneficial to counter the detrimental effects of propofol and fentanyl for induction of general anaesthesia. The preload fluids stabilise the patient haemodynamically. When compared the two, colloids were better to blunt the cardiovascular changes.

Dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries: a comparative evaluation

Background: Epidural anesthesia is the most frequently used technique for providing operative analgesia in lower abdominal and limb surgeries. This study aimed at comparative evaluation of dexmedetomidine and fentanyl for epidural anaesthesia in lower limb orthopedic surgeries.Methods: This study was conducted in the department of Anesthesiology and critical care Medicine, MLB Medical College Jhansi. Patients undergoing lower limb orthopaedic surgery aged between 21 to 50 years and belonging to American Society of Anaesthesiologist (ASA) grade 1or 2 were included. Informed and written consent was obtained. Subjects were divided into two groups. Statistical analysis was done using SPSS version 16.0 software. t-test, Chi-square test, and Mann-Whitney tests were applied.Results: Age wise distribution, body weight and mean duration of surgical time was comparable in both groups and found statistically insignificant. Time to achieve sensory level at T10 was found to be significantly less in Group RD as compared to Group RF. Early onset of motor block in Group RD was seen (10.12min) as compared to fentanyl (13.36min). Complete motor block was achieved in significantly lower time by Group RD as compared to Group RF. Duration of motor block was significantly higher in Group RD as compared to Group RF subjects. Better sedation score was found in Group RD.Conclusions: Dexmedetomidine is better as an adjuvant to ropivacaine than fentanyl for epidural anaesthesia because of intense analgesia, better quality of motor block and prolong post-operative analgesia, along with higher sedation scores.

Comparative evaluation of lithium disilicate ceramic surface and bond strength to dentin surface after treatment with hydrofluoric acid and acidulated phosphate fluoride gel: An In Vitro study

Long-term retention of the restoration depends on strength and durability of the bond of the luting composite resin to the tooth and the porcelain substrates. Aims: This in vitro study was conducted to compare and evaluate the influence of hydrofluoric acid (HF) and acidulate phosphate fluoride (APF) gel-etched treatments on surface roughness and bond strength to dentin of a commercially available lithium disilicate ceramic (E-Max). Subjects and Methods: Sixty lithium disilicate ceramic disks measuring 5 mm in diameter and 2 mm thick were fabricated and divided into three groups: Group A (n = 24), Group B (n = 24), and Group C (n = 12) and were subdivided to Group A1, A2, and A3which were surface treated with 1.23% APF gel (pH = 3–4) at different time intervals 4, 7, and 10 min, respectively. Group B1, B2, and B3 were surface treated with 1% APF gel (pH = 1–2) at different time intervals 4, 7, and 10 min, respectively. Group C were surface treated with 9.6% HF (pH = 1–2) for 1 min. Morphological changes obtained with the surface treatments were analyzed using a surface profilometer. Statistical Analysis: All specimens were subjected to a tensile bond strength test using a tensometer, and the obtained data were statistically analyzed using Kruskal–Wallis test. Results: The surface roughness (μm) and bond strength (MPa) of lithium disilicate discs (samples) etched with 1.23% APF gel and 1% APF gel for 10 min and etched with 9.6% HF for 1 min showed no statistical significant difference among them. Conclusions: In this study, the lithium disilicate discs etched with 1.23% APF gel and 1% APF gel for 10 min showed similar surface roughness and bond strength to those etched with 9.6% HF for a minute.

The Cost Of Dialysis In Malaysia: Haemodialysis And Continuous Ambulatory Peritoneal Dialysis

@#In Malaysia, dialysis-treated end stage renal disease (ESRD) patients have been increasing rapidly. Haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) use a disproportionately large amount of limited healthcare resources. This study aims to estimate the costs of HD and CAPD from the Ministry of Health (MOH) perspective. One year prospective multicentre study was conducted from October 2016 to September 2017 to assess direct medical costs of 90 HD patients and 73 CAPD patients from five large MOH dialysis centres. A mixed method of activity-based costing and step-down was used. The capital costs included land, building, medical equipment and furnishing. The recurrent costs included staff emoluments, facility utilities, patients’ medical costs and dialysis consumables. One-way sensitivity analysis was performed to investigate variability in the data. One hundred and forty-one patients (82%) completed the study comprising of 77 patients on HD and 64 patients on CAPD. Majority of the patients were between 46-65 years old (n=75, 53.2%). The most common aetiology of ESRD was diabetes mellitus (44.2% in HD and 48.4% in CAPD). Cost per patient per year was RM39,790 for HD and RM37,576 for CAPD. The main cost drivers were staff emoluments (37.6%) and dialysis consumables (70.5%) for HD and CAPD respectively. HD is highly sensitive towards all the variables analysed except for dialysis consumables. In CAPD, there are minimal sensitivities except for the 5% discount rate. Knowledge of the costs of modalities are useful in the context of planning for dialysis services and to optimise the number of kidney failure patients treated by dialysis within the MOH.

A Study of Frequency of Glomerular Diseases (Biopsy Proven) from a Tertiary Care Center of North West Rajasthan.

Aims and Objective: Glomerular disease (GD) is one of the most common forms of renal diseases and can have many different clinical presentations and there is a variation in the prevalence of the type of GD according to geographical location and race of the study population, so our aim is to report the frequency of biopsy-proven glomerular disease (GD) in a single center in North-west Rajasthan. Materials and Methods: Medical records of 48 patients with biopsy-proven GD over a period of 1 year from October 2013 to October 2014 were prospectively analyzed. The clinical, laboratory, and histological data were recorded. All biopsy specimens were examined by the same pathologist with light and immunofluorescence microscopy. Electron microscopic analysis was performed only in selected cases. Results: According to renal biopsies, chronic thrombotic microangiopathy was present in 1 patient and it belonged to secondary glomerular disease, 2 patients had diffuse lupus nephritis class IV and they also had secondary glomerular disease, 17 patients had FSGS and out of them 16 belonged to primary glomerular disease, 9 patients had IgA Nephropathy. We identified 5 patients each had MPGN and MGN and they all belonged to primary glomerular disease. Three patients had mesangioproliferative glomerulonephritis. Minimal change disease was present in 3 patients while 1 patient had renal amyloidosis. Out of total 48 patients, 31 had nephrotic syndrome while 17 patients had nephritic syndrome out of them 28 and 15 patients had primary glomerular disease respectively. Conclusion: Our study showed that FSGS as most common cause of primary glomerular disease {the most common variant is not otherwise specified (NOS)}, followed by IgA nephropathy in North West Rajasthan. Lupus nephritis was more common in patients who had secondary glomerular disease in our study. The spectrum of GD varies according to the area of study and changes over time.

Effect of Herbal Medicine "Jod Aram" in Rheumatoid Arthritis Patients - Randomized Placebo Controlled Study.

This study is conducted to evaluate the efficacy and safety of the poly herbal drug preparation “Jod Aram” in Rheumatoid arthritis patients. The ingredients are hydro alcoholic extraction of different parts of plants. Material and method: A double blind, randomized, fixed dose, placebo controlled clinical trial using “Jod Aram” was carried out on 24 (14 Patients of “Jod Aram” and 10 patients on placebo) patients of rheumatoid arthritis, who were followed up for a period of 6 months. Result: There is significant improvement in clinical variables of rheumatoid arthritis in “Jod Aram” group compared to placebo at the end of 24 weeks of randomization trial. The drug is most effective in reducing pain and tenderness in the joint as the observed p value < 0.001. It is also effective in reducing signs of inflammation and improving disability associated with arthritis. Conclusion: This randomized drug trial demonstrated potential efficacy, safety in symptomatic treatment of rheumatoid arthritis over 24 weeks.

A Rare Presentation of Osler-Weber-Rendu Disease as Severe Anemia.

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is a rare fibrovascular dysplasia that makes vascular walls vulnerable to trauma and rupture causing skin and mucosal bleeding. It is of autosomal dominant inheritance characterized by recurrent epistaxis and telangiectasia on the face, hands and oral cavity; visceral arteriovenous malformations (AVMs) and positive family history. Epistaxis is often the foremost manifestation. It is associated with AVMs in several organs. There are possible hematologic, neurologic, pulmonary, dermatologic and gastrointestinal complications. Treatment is supportive and helps prevent complications. We report herein a patient with this syndrome who came to Medicine Unit first at our hospital.

The expression of immunohistochemical markers estrogen receptor, progesterone receptor, Her-2-neu, p53 and Ki-67 in epithelial ovarian tumors and its correlation with clinicopathologic variables.

Background: This study aims to evaluate the expression of estrogen receptor alpha (ER α), progesterone receptor A (PRA), Her-2-neu, p53, and Ki-67 in epithelial ovarian tumors and their correlation with various clinicopathologic variables. Materials and Methods: This study included 60 consecutive cases of epithelial ovarian tumors. Sections of 4 μm were taken from paraffin embedded tissue blocks for immunohistochemistry (IHC). Statistical analysis was done using Chi square test, ANOVA. Results: ER α had lower expression in benign (29%) and PRA higher expression in malignant (63.6%) tumors. ERα, PRA had higher expression in serous (72.72%, 57.14%), postmenopausal (81.8%, 71.42%), advanced stage (63.63%, 52.38%), grade 3 (45.45%, 38.09%), and tumors with ascites (90.90%, 85.7%). Her-2-neu, p53 were negative in benign and higher in malignant (21%, 57.6%), serous (71.42%, 57.89%), grade 3 (57.14%, 31.57%), and tumors with ascites (85.7%, 84.21%). Ki-67 had a significant higher expression in malignant (48.6± 26.76), serous (55.43± 27.85), and grade 3 tumors (68 ± 22). CA-125 levels were significantly higher in malignant, serous, advanced stage, grade 3 and ER α, Her-2-neu and p53 positive tumors. Conclusion: ERα, PRA expression in tumors with adverse prognostic factors support the mitogenic role of estrogen and estrogenic regulation of PR. Her-2-neu and p53 expression only in malignant tumors suggest their carcinogenic role and aid in the differentiation of borderline and malignant tumors. Higher Ki-67 in tumors with adverse prognostic factors would help in prognostication and differentiation. Lack of co-expression of markers proves the extreme heterogeneity of ovarian tumors. These markers may aid in differentiation and prognostication of ovarian tumors.

Homology modeling and QSAR analysis of 1,3,4-thiadiazole and 1,3,4-triazole derivatives as carbonic anhydrase inhibitors.

Carbonic anhydrase (CA) inhibitors are very interesting target for designing anticancer (hypoxic) and antiglaucoma drugs. In the present study, a 3D homology modeling of human carbonic anhydrase-IX (hCA-IX) isozyme, based upon the crystal structure of murine CA-XIVA (PDB CODE 1RJ5) was performed, as no experimental 3D structures are available. A homology model of hCA-IX was developed and validated. To explore the responsible physicochemical properties of 1,3,4-thiadiazole and 1,3,4-triazole derivatives for carbonic anhydrase inhibition, a quantitative structure activity relationship (QSAR) study was performed having hCA-II and hCA-IX inhibitory activity respectively. In hCA-II and hCA-IX inhibitory activities, four significant models with good correlations ( 0.945 & 0.926) were obtained; two models (models 1 and 3) were selected based on statistical criterion. The QSAR study revealed that in case of hCA-II, overall increase in size and volume of molecule, introduction of electropositive surfaces might increase the inhibitory activity, whereas in case of hCA-IX, decreasing the hydrophobicity and introduction of electron releasing substituents might increase the hCA-IX inhibitory activity.

Significance of eosinophils in diagnosing Hashimoto's thyroiditis on fine-needle aspiration cytology.

Background: Hashimoto's thyroiditis (HT) is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Fine-needle aspiration cytology (FNAC) can accurately diagnose this lesion in most of the patients. However, a small percentage of cases may be missed due to inherent limitations of this procedure. Therefore, cytologic clues to increase sensitivity of diagnosis need to be searched for. Aims: To assess whether an eosinophilic infiltration of the thyroid gland has a higher association with HT than colloid goiter. Materials and Methods: The study was a case-control study. Smears obtained by FNAC of 50 case, each of HT (which served as cases) and colloid goiter (which served as controls) were observed. The number of eosinophils and neutrophils per high-power field (HPF) was counted in all the smears. The eosinophil-neutrophil ratio in the smears, diagnosed as HT, was then compared with that of colloid goiter using unpaired t-test. Results: Smears diagnosed as HT was found to have a significantly higher eosinophil-neutrophil ratio than smears diagnosed as colloid goiter (P value 0.0001). Conclusion: Eosinophilic infiltration of the thyroid gland has higher association with Hashimoto thyroiditis.

Accuracy, limitations and pitfalls in the diagnosis of soft tissue tumors by fine needle aspiration cytology.

The diagnosis of soft tissue tumors is one of the biggest diagnostic challenges in pathology. In this study, we attempted to measure the accuracy of FNAC in diagnosing soft tissue tumors. All the cases of FNAC with cyto-histological correlation between January 2003 and August 2005 (a total of 72 cases) were collected and sensitivity, specificity, positive and negative predictive values measured. The sensitivity and positive predictive value for differentiating between benign and malignant lesions was 0.8421, while the specificity and negative predictive value was 0.9412 for the same. The main problem was false negatives due to a borderline or low grade spindle cell sarcoma being classified as benign. However, only 18 cases could be typed precisely. Therefore, FNAC has a role in the initial diagnosis of soft tissue sarcomas, but it should be used as a complement rather than a competitor to histopathology.

Undernutrition & childhood morbidities among tribal preschool children.

BACKGROUND & OBJECTIVE: Undernutrition and various morbidities go hand in hand, particularly in children. Nutritional status is a sensitive indicator of community health and nutrition. The present study is an attempt to assess the nutritional status of pre-school children of Gond tribal community in Madhya Pradesh. METHODS: The study was a community-based, cross- sectional survey carried out in tribal preschool children. Anthropometric measurements were taken. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. The children were examined for nutritional deficiencies and other morbidities. The haemoglobin concentration was measured and the children were classified into various grades of nutritional anaemias. Data on socio-cultural and hygienic practices were also collected. RESULTS: More than 60 per cent children were underweight. Micronutrient deficiency disorders such as anaemia and vitamin A deficiency were common among them. Unhygienic personal habits and adverse cultural practices relating to child rearing, breast-feeding and weaning were also prevalent among them. INTERPRETATION & CONCLUSION: The findings of the present study revealed the widespread prevalence of undernutrition among pre-school tribal children and highlight a need for an integrated approach towards improving the child health as well as nutritional status in this area.

Interference of three weed extracts on uptake of nutrient in three different varieties of paddy through radio tracer techniques.

Interference of three dominant weed extracts viz., Ageratum conyzoides L., Melilotus indica All. and Parthenium hysterophorus L. were examined on seed germination, seedling growth, and nutrient uptake (32P and 65Zn) in three different varieties (PD-10, PD-12 and PB) of paddy (Oryza sativa L.). Among the three different varieties irrespective of weed extracts, PD-10 and PD-12 were resistant and PB was susceptible in terms of seed germination, radicle length and plumule dry weight; and PD-12 and PB were resistant and susceptible, respectively, in terms of plumule length and total seedling dry weight. A. conyzoides caused maximum reduction in seed germination and M. indica in seedling growth in different varieties of paddy. The weed extracts interfered in uptake of both 32P and 65Zn and there was a gradual decrease in uptake of both nutrients with increasing concentration of extracts in both root and shoot. The uptake of 32P and 65Zn was more inhibitory with the extracts of A. conyzoides and M. indica, respectively in different varieties. The inhibition in seed germination, seedling growth and nutrient uptake may be due to the presence of phenolics and other secondary metabolities. The phenolics such as gallic, vanillic, protocatechuic and p-hydroxybenzoic acids were identified from these weed extracts.