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Introduction/Purpose: The outbreak of methanol poisoning described in this paper occurred in Ahmedabad, Gujarat, India in July 2009. Our intention is to share the experience of clinical features, laboratory investigations and their relation during this tragedy. Materials and Methods: Single center, retrospective study of clinical features and laboratory parameters of 178 cases of methanol toxicity treated at tertiary care hospital in Ahmedabad, Gujarat. Results: Maximum patients (39.8%, n = 45) were received in 48 h; Mean age of presentation was 41.9 ± 10.2 years. Most of them were men (175 out of 178). On presentation, 83% patients had gastro-intestinal symptoms, 46% had neurological symptoms, 73% had visual symptoms and 32% had dyspnoea. 62% had blurred vision, 10.5% had blindness. Patients with visual symptoms had high mean level of methanol (120.12 ± 23.12 vs. 55.43 ± 29.24, P = 0.014). On fundus examination 52.8% (n = 62) had bilateral hyperaemia of discs, 8.4% (n = 12) had bilateral disc pallor and 4.5% had papilledema (n = 5). Patients with hyperaemia of discs, discs pallor or papilledema, had higher mean methanol level (121.1 ± 32.2 mg% v/s 70.1 ± 23.2 mg%, P = 0.032). Mean of pH values was 7.17 ± 0.22 and bicarbonate was 12.3 ± 7.3 mmol/L. Both pH and bicarbonate levels correlated well with mortality and serum methanol level. Mean serum methanol level was 87.1 mg/dL, and correlated significantly with the mortality (53.1 ± 41 mg/dL v/s 121 ± 92 mg/dL, P value < 0.05). Conclusion: GI symptoms, neurological symptoms and breathlessness are important clue to ED physician for diagnose methanol poisoning. Visual symptoms and fundus findings correlate well with the methanol level. Arterial Blood Gas derived pH and bicarbonate levels correlate significantly with the methanol level and mortality. [ABSTRACT FROM AUTHOR]

Information about the 22nd National Conference of Indian Society for Dental Research (ISDR) which was held on December 5-6, 2009 at the Government Dental College and Hospital in Ahmedabad, India. It notes that the event was themed "Oral Cancer and Precancer and Recent Advances in Dental Research." It was attended by 415 delegates from all over the country.

Introduction: Medical education in India is evolving/changing in view of implementation of new curriculum in undergraduate schools. Dundee Ready Educational Environment Measure (DREEM) is one of the tools developed specifically to assess the educational environment of medical institutions as perceived by the students. DREEM-12, an abridged version of DREEM-50 had been developed which retains its factors structure, validity, reliability and at the same time avoids respondent fatigue. We used the DREEM-12 questionnaire to assess final M.B.B.S students' perception about their learning environment at our institute. Materials and Methods: A cross-sectional study was done including 215 undergraduate students from the final MBBS. The DREEM-12 questionnaire was shared with all the participants as Google form. The mean score for each variable was calculated. Variable scores were summed up to get each domain score and interpreted. Results: We received responses from 60% of students. The highest score was given to faculty's encouragement towards learning with a mean score of 3.1. Least score - 2.1 was given to the stress support system for students. In the cumulative score, students' perception of teacher (SPOT) was 8.8 which is interpreted as "model course organizers," while student's social self-perceptions was 4.7 which infers "not too bad." The overall DREEM-12 score of our study is 33.1, which is indicative of a "More Positive than Negative" educational environment. Conclusion: The stress support system has the lowest score which suggests that efforts should be made to provide continuous psychological support to students may be in the form of periodical assessment by psychologists to find vulnerable ones early and provide them timely help. Items in SPOT are scored highest, pertaining to faculty's knowledge about the subject and their encouragement to students about their learning. As this was the first-ever study done at this institute using DREEM-12 it can serve as a baseline to monitor the effects of changes made over a period of time. [ABSTRACT FROM AUTHOR]

Background: Acute viral hepatitis (AVH) is a major health concern in developing nations like India in regard to morbidity and mortality. Objective: To identify incidence, clinical presentation, laboratory abnormalities, severity, and complication of AVH in young adults. Materials and Methods: A prospective study was conducted from August 2016 to August 2018 among 70 young adult patients of AVH at Civil Hospital, Ahmedabad. Data on clinical presentation, laboratory values, complication, and severity were obtained, and analysis was performed. Results: Hepatitis E viral (HEV) infection was seen in 70% case and was more common in age group of 21–30 years followed by Hepatitis B and Hepatitis A, 15.8% and 12.8% case respectively. Most common presenting symptom was jaundice in 80–85% of patients followed by anorexia 65.7% and nausea and vomiting 57.1% of patients. Most common clinical sign was icterus followed by hepatomegaly. Total serum bilirubin and serum SGOT elevated in all cases. Acute liver failure was seen in seven cases. Six cases were due to hepatitis E and one case was due to hepatitis A. Acute kidney injury was present in seven cases. Coagulopathy was found to be major complication in 25.7% cases. Conclusion: HEV is the major etiological agent of AVH in young adults. It is not possible to differentiate viral hepatitis based on clinical features and biochemical parameters. However, cholestasis is found to be significantly associated with hepatitis‑E infection. [ABSTRACT FROM AUTHOR]

Aim: The study was designed to establish relationship between the plasma concentration and QTc interval prolonging effect of fexofenadine and demonstrate the phenomenon of anticlockwise hysteresis. Materials and Methods: Six subjects were given fexofenadine 60 mg tablet orally under stable conditions, and their drug concentrations were measured at regular intervals. At predetermined time, their ECGs were recorded. Data were analyzed and plotted graphically. Design and Setting: Randomized parallel design, single group study conducted at clinical research organization of Ahmadabad. Results: In all subjects time taken for maximum plasma concentration of fexofenadine (Tmax) was around 3 h and the value of average maximum plasma concentration was 460.63 ng/mL, the effect of fexofenadine on the heart (measured as QTc interval prolongation) was maximum (Emax) after 6 h and average QTc interval was 469.75 ms. Thus, the time to maximum concentration of fexofenadine did not match with the maximum effect on the heart as measured by QTc interval. Conclusion: The relationship between the drug concentration and drug effect on the heart are at two different time scales. It can be understood by two-compartment model of pharmacokinetics, and this retardation or lagging of an effect behind the concentration is known as hysteresis. The increase of QTc was not beyond 500 ms and not sustained, demonstrating overall cardiac safety of fexofenadine. [ABSTRACT FROM AUTHOR]

Objectives: To determine the unit cost of curative care provided at Primary Health Centers (PHCs) and to examine the variation in unit cost in different PHCs. Materials and Methods: The present study was carried out in three PHCs of Ahmedabad district namely Sanathal, Nandej, and Uperdal, between 1 April, 2006 and 31 March, 2007. For estimating the cost of a health program, information on all the physical and human resources that were basic inputs to the PHC services were collected and grouped into two categories, non-recurrent (capital resources vehicles, buildings, etc.) and recurrent resources (salaries, drugs, vaccines, contraceptives, maintenance, etc.). To generate the required data, two types of schedules were developed, daily time schedule and PHC/SC (Subcenter) information schedule. Results: The unit cost of curative care was lowest (Rs. 29.43) for the Sanathal PHC and highest (Rs. 88.26) for the Uperdal PHC, followed by the Nandej PHC with Rs. 40.88, implying severe underutilization of curative care at the Uperdal PHC. Conclusions: Location of health facilities is a problem at many places. As relocation is not possible or even feasible, strengthening of infrastructure and facilities at these centers can be taken up immediately. [ABSTRACT FROM AUTHOR]