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Amebiasis is an infectious disease caused by Entamoeba Histolytica is more common in devolping countries, with various clinical manifestations and sequalae. Amoeboma , is an unusual sequelae which manifests as a tumor like mass within the colon. We present an unusual case of 5 year old child with signs of acute abdomen. A mass was found on expoloratory laparotomy attached to the small intestine. Histopathological examination of the mass revealed numerous amoebic trophozoites and the diagnosis of amoeboma was made. Our case is unusual because amoebomas presenting as an extraluminal mass attached to small intestine is extremely uncommon.

Uterine papillary serous carcinoma (UPSC) is an uncommon histologic variant of endometrial carcinoma that typically arises in post menopausal women, that may present with extrauterine spread, resulting in high relapse rate and poor prognosis. Mature cystic teratomas (MCT) are common tumors that occur during the reproductive years. We report a case of a 60 years old female with UPSC with MCT of left ovary. To our knowledge, this is the second report of UPSC combined with ovarian MCT.

Sporadic medullary microcarcinoma of thyroid is a rare disease detected usually in 0.15% of all thyroid malignancy. We report a case of sporadic medullary microcarcinoma (MMC) of thyroid in a 24 year old male presenting as solitary thyroid nodule. There was no family history of medullary carcinoma of thyroid. Although medullary carcinoma in a familial setting have been reported, sporadic MMC is rare especially in a young patient.

Gastrointestinal stromal tumors (GIST) are relatively rare tumors of gastrointestinal (GI) tract, most commonly arise from the stomach followed by small intestine and colon, clinically GIST present with occult GI bleeding, abdominal pain and intestinal obstruction. We present a case of a jejunal GIST, which presented as an obscure GI haemorrhage. This case highlights how oesophagogastrodudenectomy and colonoscopy proved inconclusive in determining source of bleeding and the importance of RBC labeled 99m-Tc scan in detecting the source of GI bleeding and also emphasizes on histopathology and immunohistochemistry in diagnosis of GIST

Primary cutaneous mucinous adenocarcinoma is a rare adnexal neoplasm, eyelid being the most common site of presentation. Clinically it is mistaken for a benign / cystic lesion. Its morphologic similarity to metastatic deposits from breast, gastrointestinal tract (GIT) or any visceral sites adds to the diagnostic difficulty mandating the role of ancillary techniques in precise diagnosis and hence planning the management. We report a case of primary cutaneous mucinous adenocarcinoma of eyelid with emphasis on pathology along with a brief review of literature.

Pleomorphic adenoma is the most common benign mixed tumor of major salivary gland. Ectopic occurrence of pleomorphic adenoma are seen in minor salivary glands of pharynx, trachea, larynx and very rarely in nasal septum. We report a case of 40 year old female who presented with right sided nasal mass and mild nasal obstruction since six months. Cytologically a possibility of pleomorphic adenoma was made which was confirmed by histopathological study. We present this case due to 1) rarity in the nasal septum 2) pitfalls at cytology due to abundance (predominance) of myoepithelial cells and scanty or even absent mesenchymal component and 3) under reporting in English literature to the best of our knowledge.

We report a case of a 37 year-old man who developed persistent hiccups after elective stapedectomy. Method and Results: The diagnostic approach is discussed as well as the non-pharmacologic and pharmacologic treatments and overall management. The aim is to stress that there is a variety of potential factors that can induce hiccups perioperatively and in cases like this a step by step approach must be taken. Conclusion: Persistent hiccups are very rare following stapedectomy, control of them is crucial for the successful outcome. The trigger may be more than one factors and the good response to treatment may be due to dealing successfully with more than one thing.

Nosocomial infections are the major concern in tertiary hospitals. Health care workers and their belonging are known to act as vector in transmission of infections. In present study, the writing pen of health care workers was worked out for carrying infection. The swab from writing pen of health care workers were cultured for any growth of microorganism and compared with swab from pen of the non health care workers. It was found that the rate of growth of microorganism were more in pen of health care workers. Similarly the organism attributed to the nosocomial infection was grown from the pens of health care workers. These organisms might be transmitted from the hands of health care workers. The writing pen which health care worker are using became the vectors of transmission of infection. So to prevent it, the most important way is to wash the hands and pen properly after examining the patients.

The study focused on the comparative analysis of energy cost and gait efficiency between a below knee (BK) amputee and a reference subject (without amputation). It also attempted to indicate the specific feature responsible for a controlled gait with optimum energy cost for BK amputees. Selection criteria of the subjects were similar physical parameters and quality of life studied with WHOQOL-100 quality of life assessment. A Cosmed® k4 b2 Respiratory Analyzer system was used for the measurement of Oxygen Uptake (VO2), Energy Expenditure per minute (EE) and Heart Rate (HR). Gait efficiency (p < 0.0002) was found higher for BK amputee than normal subject. The therapeutic activities and mainly walking rhythm contributed to improve the mobility & balance. This ensures the optimum time & co-ordination of movements and hence improves the gait efficiency for the BK amputee. Comparison with control group was performed to validate the data.

It is estimated that between 10% and 30% of the general practice population are mentally or emotionally disturbed. Physical complaints, multiple aches and pains are construed as signs and symptoms of stress. Although yoga is considered as beneficial, any hidden psychiatric morbidity may go undetected and thus untreated. Thus the aim of this study was to obtain an estimate of hidden psychiatric morbidity in clients seeking consultation at the Department of Yoga. Fifty respondents were administered Life Satisfaction Scale and General Health Questionnaire-12. Majority were females, younger, graduates, married and also scored above the cut off on GHQ, suggesting minor psychiatric disorder/distress; reasons for consultation were related to being over weight, stress, aches and pains, poor concentration. A significant number of persons reported of some dissatisfaction in life. The perceived benefits were related to reducing symptoms, stress, weight, relaxation and improvement in concentration and memory.

Background: Compliance to therapy is one of the important factors that affect the outcome. Non-compliance to self administered multi drug tuberculosis treatment regimens is an important cause of failure of initial therapy and relapse as well as acquired drug resistance, requiring more prolonged and expensive therapy. Objective: To know the compliance of DOTS therapy in TB patients in District Raipur and to find out the reasons of non-compliance of DOTS therapy among the patients. Study Design: Cross sectional observational community based study. Study Setting: Microscopic Centers in District Raipur. Participants: 695 patients of Tuberculosis. Result: Study revealed that 65.93% patients had complied with the DOTS therapy and 33.38% were non compliant. Conclusion: Most of the reasons of non-Compliance can be averted by proper counseling of target group. Hence to achieve the goal of RNTCP, proper counseling of target group must be given top priority.

Background and objectives: A survey based study on rural areas of Aligarh District was conducted to assess the prenatal checkups pregnant women and its effects on health status of children between the age of (0-3 years), and immunization received by children and its effects on their health status. Methods: Five hundred children from five villages of rural areas of Aligarh District were randomly selected. For the purpose of the study, a self prepared structured interview schedule was used. To get the qualitative information of the study anthropometric measures include height weight were used for assessing growth pattern of the child. The stepwise analysis of two variables height for age and weight for age was done on the basis of Water low’s and Gomez’ classification. To examine the relationship between Health Status of the child and selected variable that affects Health Status of children, Chi-square test was employed. Results: Based on Gomez’ classification out of 88% mothers who did not go for prenatal ups majority 80% of children were underweight, and 80% of children who did not receive immunization majority 60% were underweight. Based on Waterlow’s classification majority 68% of children were stunted whose mother did not go for prenatal checkups and 50% of their children were stunted who did not receive immunization. Conclusion: Majority of children were stunted whose mother did not go for prenatal checkup and the children who did not receive immunization.

Butorphanol, an opioid derivative has been shown to have, in addition to its analgesic properties, several other advantageous effects like antistressor, sedative and anti-shivering action. The efficacy and safety profile of ketorolac, yet another widely used post-operative analgesic is well documented. This study aims to compare the two analgesics. Aims and objectives: This study was conducted to compare the analgesic efficacy and other effects of butorphanol and ketorolac, administered intramuscularly, in post-operative patients who have undergone lower abdominal and pelvic surgeries. Materials and methods: 50 patients undergoing lower abdominal and pelvic surgeries under general or spinal anaesthesia were randomly divided into two Groups (25 each). At a particular level of post-operative pain, the patients Groups I and II were administered intramuscular ketorolac 30mg and butorphanol 2mg respectively. The analgesic effect was studied using Visual Analogue Scale (VAS) and the verbal category scale. Patients were monitored for the sedative action, respiratory status and other vital parameters for 300 minutes and for other adverse reactions over the next twelve hours. Observations: Butorphanol provided better analgesia within the first two hours of administration, while ketorolac was more effective at 4-5 hours. Better sedative action without any significant respiratory depressant effect was demonstrated with butorphanol. There were no clinically significant hemodynamic fluctuations or adverse reactions with butorphanol or ketorolac. Conclusions: Butorphanol provides better early analgesia as compared to ketorolac with a desirable and safe sedative effect in post-operative patients who have undergone lower abdominal and pelvic surgeries.

Background: Technological progression made drastic changes in health care. Still there is a growing concern about proper utilization of health information within hospitals for various research activities. Huge volumes of such health information in majority of hospitals are redundant due to lack of appropriate and cost-effective technological tools for retrieving relevant health information for research purpose. Objective: To develop a cost-effective and user-friendly computerized medical record database for psychiatry using available technology with the department. Methodology: Study performed at a tertiary care teaching hospital in Udupi district of South India. Various datasets from psychiatry medical records were utilized for the design and creation of database. A computerized database called PsyCase was developed with the help of technology available within the department. A 4612 patient’s data were entered into the PsyCase and subjected to various analyses. Results: Applications of PsyCase in various epidemiological studies were explored through performing numerous analyses with actual data. PsyCase was found effective in supporting psychiatric research as well as routine clinical and administrative activities. Conclusion: This study emphasizes need of appropriate use of technology available within a healthcare system to facilitate medical research in psychiatry and role of health information professional in such initiatives. Healthcare organization must focus on collective utilization of resources within the system to improve the utilization of health information for medical research.

Selection of the best and safest medicine should be one of the national economic policies in a country for good health care services. Introduction of detailed module in rational use of medicine (RUM) to pharmacology syllabus needed prior analysis of the existing knowledge among health care workers. Therefore we assessed the knowledge and attitudes of essential drug list (EDL) on medical practitioners (MPs) and medical students (MSs). Forty two MPs and 120 MSs from hospital and Faculty of Medicine were given a pretested structured questionnaire related to core policies of EDL, contents, criteria for selection and time frame for revision in RUM. Our study showed that only 29% of MPs were confident about their knowledge in EDL and 17% of them had marked it as don’t know. Study was expanded for quantitative analysis of the knowledge on the core policies of EDL on them. Knowledge on contents, criteria for selection and the time frame for revision of EDL were 63%, 83% and 17% in MPs. Of MSs, 87% had sound knowledge in core contents, 32% in criteria for selection and only 50% of MSs were aware about the correct time frame of revision of EDL. Knowledge in contents of EDL was higher in MSs (87%) than MPs(63&). MPs were not aware about EDL preparing criteria such as inclusion of generic names, common ailment, majority ailments of the people (59%, 56% and 56% respectively). In contrast, MSs had > 93% of the knowledge in all three areas. However MSs had poorer knowledge (32%) in criteria for selection of EDL than MPs (83%). Knowledge in time frame for revision of EDL was 17% in MPs and 50% in MSs. We found that MPs in the service were not convinced about their knowledge in EDL. Deficiency was significant in the core contents of the EDL preparation. Therefore we suggest that MPs need repetitive in-service training programme for practicing of RUM in the national health facilities. We need to reiterative programme in the core curriculum regarding the criteria for EDL selection. Though MSs had good knowledge in content of EDL, they are poor in criteria for selection and time frame for revision.

Case of a 22 year old male with past medical history of attention deficit disorder, found to have callosities and skin abrasions on knuckels and dorsum of his interphalangeal joints in both hands

Background: With the advent of real time ultrasonography of the abdomen, the spleen is no longer an inaccessible organ. Wandering spleen is a rare entity with only less than 500 cases reported so far. Method: This case report presents a 16-year- old Nigerian girl admitted in a medical centre but referred for ultrasonography on account of a clinical history of lower abdominal tenderness. Result: Ultrasonography examination revealed that the spleen was not found in its normal anatomical position. However, a well defined acoustic signature of the spleen was seen in the pelvis. Conclusion: Ultrasonography which is far cheaper than magnetic resonance imaging (MRI) and computed tomography (CT) is a valuable diagnostic aid in this condition

We present an extensive capillary hemangioma of right ear in an 11-year-old child involving external auditory canal, middle ear and mastoid. Patient was presented with chronic purulent discharge and aural mass in right ear. The Computarize tomography (CT) scan revealed enhancing soft tissue filled density in external ear, middle ear and mastoid for that modified radical mastoidectomy (MRM) was done. The histopathological report of surgical specimen confirmed the diagnosis of capillary hemangioma

Dietary fish oil has been shown to inhibit bone resorption and, therefore, the aim of the present study was to test the hypothesis that fish oil alters lipopolysaccharide (LPS)-induced hydroxyapatite loss in rat alveolar bone. Rats were divided into four groups. The animals injected with saline or Escherichia coli-derived LPS into the maxillary alveolar mucosa on the buccoapical site of the molar region daily for 8 days were served as a negative or positive control, respectively. Other groups of animals were injected with LPS and orally treated with fish oil at the same day with or after LPS injection. The results of the present study showed that the hydroxyapatite contents of alveolar bone in rats treated with fish oil at the same day with or before LPS injection were significantly higher than those in rats injected with LPS alone, but still lower than those in untreated animals. Therefore, the present study suggests that oral treatment with fish oil may reduce LPS-induced hydroxyapatite loss in rat alveolar bone

To identify the medications that medical students, interns and casualty medical officers are likely to prescribe when treating an adult patient with anaphylaxis, and to ascertain the dose and route of administration of adrenaline they would use. Design: A questionnaire study survey. Setting: Kasturba medical college hospital, Manipal (Udupi District) and public health centers of Udupi district, Karnataka. Subjects: Data collected from 39 second year medical students, 35 interns and 35 casualty medical officers. Main outcome measure: To determine the percentage of use of adrenaline for the treatment of anaphylaxis in the correct dose, strength and route. Results: Majority (73 .3%) of participants correctly opted to use adrenaline. Only 9 participants have written the correct dose, route and concentration of adrenaline. 41.28% and 66.05% participants preferred to use antihistamines and corticosteroids respectively. Conclusion: This study has shown that confusion exists regarding the correct route of administration and dose of adrenaline to be used when treating anaphylaxis. This confusion applied to medical students, interns and medical officers. Therefore doctors must be made aware of the guidelines to treat anaphylaxis effectively.

Objectives of the study: The individuals with laryngopharyngeal reflux are prone for aspiration of refluxed contents and so there is a need for aerodynamic evaluation in these individuals. Hence, the present study investigated the aerodynamic characteristics in individuals with Laryngopharyngeal reflux. Study design: Prospective control group design. Method: Thirty laryngopharyngeal reflux subjects and 30 normal subjects participated in the study. Aerodynamic parameters such as vital capacity, mean air flow rate, maximum phonation duration and phonation quotient were measured using Aero Phone Instrument ((Model 6800). Independent t test was employed for statistical inference. Results: The results revealed that the vital capacity and maximum phonation duration values were lower for laryngopharyngeal reflux subjects when compared to normal controls. No significant differences were observed for mean air flow rate and phonation quotient. Conclusions: The results revealed that the laryngopharyngeal reflux individuals showed significant deviations in aerodynamic parameters when compared to normal individuals. Thus study confirms aerodynamic abnormalities in laryngopharyngeal reflux subjects

Background: Oral fluids and food are traditionally introduced slowly after total abdominal hysterectomy (TAH). This descriptive study examined the effect and tolerance of early oral intake following this surgery. Methods: A retrospective chart review was conducted on 164 patients who had been on a clinical pathway following TAH. Comparisons in initiation of fluids and foods, and gastrointestinal effects were made between the early fed group (n=82) and the traditionally fed group (n=82). Results: Both groups had the similar gastrointestinal symptoms postoperatively, but the early fed group had an earlier bowel movement. The early fed group had a statistically significant shorter length of stay. Similar usage of anti-nausea medication and pain medication usage was noted between the two groups, except for a lower usage of Tylenol #3 (acetaminophen with codeine) in the early fed group. Conclusions: This study found that early feeding could be tolerated well in TAH patients, with statistically significant improvements in usage of some pain medication and length of stay were noted in the early fed group.

Forty eight E-Beta thalassaemia patients were studied in NRS Medical College, Kolkata, West Bengal during the period from 2000-2006. In all patients Hb% ranged from 5.2g% - 9.6g%. It was more than 8g% in 17 (35.4%), 6-8g% in 22 (45.8%) and less than 6g% in 9(18.7% ) patients. 72.9% patients required regular blood transfusion while the rest (27.1%) received blood transfusion occasionally.81.25% pregnancy were carried up to term whereas 18.75% pregnancy ended in preterm delivery. Vaginal delivery was possible in 85.5% patients.14.5% patients had caesarean delivery due to underlying obstetric problem. Amongst the babies born, 22 (45.8%) were intrauterine growth retarded (IUGR) babies,8.3% pregnancies ended in stillbirth. There were 4 (8.3%) maternal deaths in this study.

Uterine arterio venous malformation is uncommon cause of menorrhagia. We report a rare case of arteriovenous malformation diagnosed after 18 years of suffering from menorrhagia

Aims: To describe the number, types and reasons of consultations amongst patients of pulmonary tuberculosis from an urban area. Settings and Design Cross sectional study was conducted amongst new patients of pulmonary tuberculosis initiated on DOTS at District Tuberculosis Centre (DTC), Yavatmal from January to June 2006. Material and Methods: The data regarding consultations were collected along a time line. The reasons for consultations were studied by in-depth interviews. Statistical analysis: Logistic regression analysis and transcripts of interviews. Results and Conclusions A total of 55 patients were studied in whom median duration between first consultation to treatment initiation was 15 days. A majority of cases (87.27%) had first consulted a private practitioner. A total of 32 patients reported more than two consultations and 19 had consulted more than two private health service providers. Amongst the movements between consultations, a majority were from private to government. Only four patients had come to DTC without any prior consultation. Many patients came to government health service provider on their own when the symptomatic treatment prescribed by the private practitioners did not relieve their symptoms

The objectives of the present formative research were to explore the medical undergraduates’ study problems and their perceptions about various teaching approaches in currently practiced teaching curriculum of Community Medicine. Material and Methods: The present formative research was undertaken at Dr. Sushila Nayar School of Public Health incorporating Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram. The respondents were 17 (26.5%) conveniently selected final year exam appearing medical undergraduates from 2004 regular batch of 64 students. A triangulation of qualitative research methods like free listing, pile sort exercise and a Focus Group Discussion (FGD) were used. A two dimensional scaling and hierarchical cluster analysis was completed with the pile sort data. The data was analyzed by using software Anthropac 4.98.1/X software. Results: The medical undergraduates could understand the topics like Integrated Management of Neonatal and Childhood (IMNCI), Primary Health Care (PHC), cold chain system for vaccines, immunization and health education, dietary survey and cluster survey method taught in the community based camp approaches. Students found it difficult to comprehend the core of subject from the scattered lecture series over a long teaching period, especially using lengthy over head projector/liquid crystal display presentations. The major problems encountered in studying the subject of Community Medicine were difficulty in understanding the concepts of biostatistics, confusions due to apparently similar text in National Health Programs and difficulty to recall disease statistics due to vast syllabus. Conclusions: Students perceived the community based camp approach of teaching as a best method to understand the subject, which is an integration of task oriented assignments, integration of social sciences within medical domain and active community involvement. Hence, the community based camp approach can be scaled up as a best Community Medicine teaching approach. The active learning methods could be used to improve the lectures and the clinics which should be more concentrated in final year of teaching

For the first time in Africa, an entomological study went beyond the conventional practice of determining parity and survival rates of field-collected adult anopheline mosquitoes but also related these variables to duration of Plasmodium sporogony and estimated the expectation of infective life. Blood-seeking female mosquitoes were collected in Ilorin, Nigeria, from January 2005 to December 2006, and dissected for ovarian tracheations following WHO recommended techniques. The results indicated an annual mean parous rate of 70.92%, and significantly higher parous rates in the rainy than dry season, which also had very low densities. Mean probability of daily survival of the mosquitoes was 0.80, with annual mean life expectancy of 12.24 days. The probability of surviving the sporogonic cycle was low (< 0.4) but the expectation of infective life was long, especially in the rainy season (mean = 8.31 days). The epidemiological implications of these results were discussed. The An. gambiae population in Ilorin is dominated by older mosquitoes with high survival rates thus, suggesting a high vector potential for the species in the area. These information on the survival rates of An. gambiae in relation to malaria transmission would enhance the development of a more focused and informed vector control interventions.

The disseminated intra-peritoneal hydatid disease is a very rare finding. A case of disseminated intra abdominal hydatid disease is presented along with a review of literature and various therapeutic modalities

We report two patients who injected themselves a strong organophosphate compound, dichlorvas, and showed the typical clinical picture of organophosphate intoxication. There are very few case reports of parenteral organophosphorous poisoning. With the appropriate therapy, their symptoms disappeared in a few days. The cases are reported because of unusual and interesting way of intoxication.

Orbital lymphoma is a rare presentation of extranodal non-Hodgkin's lymphoma, accounting for less than 1% of the total. The role of radiotherapy in its management is well-established. This is a report of a case of orbital lymphoma Materials and Methods: Clinical records and pathologic material of a patient woman of 62 age treated with local radiotherapy for localized orbital lymphoma. Treatment consisted of 36 Gy in 1.8-Gy fractions of irradiation using 6-MV photons with complex treatment planning for retrobulbar lesions. Median follow-up was 18 months Results: Local control was 100%. Cataracts was not observed in 8 of the treated eyes. Conclusion: In this case, localized orbital MALT lymphoma was well controlled with radiotherapy.

Rhinolith is an uncommon nasal mass in children and adolescents. We report a 8 years old boy with a history of long standing foul smelling right sided nasal discharge, progressive nasal obstruction and recurrent epistaxis, which was clinically suspected as being due to the presence of a long standing foreign body. Rhinolith in the right nasal cavity was diagnosed on rigid endoscopic examination. Rhinolith was removed by using a 00 rigid nasal endoscope.

Hypoxia is a condition in which an area of the body or a tissue is deprived of sufficient supply of oxygen. The lack of nutrients in a hypoxic tissue generally causes apoptosis but some cells are able to adapt to this hypoxic environment and resist apoptosis. This adaptation occurs as a result of gene activation. Hypoxia is a characteristic feature of many cancers and is the stimulus for overexpression of HIF-1α - a basic loop-helix PAS protein family subunit of HIF, which allows the cell to adapt and survive in hostile environment. The presence of hypoxia and HIF-1α is correlated with an increased risk of metastasis and techniques that can inhibit hypoxia inducible factor may be instrumental in finding a cure for cancer

The study was conducted to determine the desirability or otherwise of mathematically correcting every normal foetal head shape to an ideal shape prior to dating using the biparietal diameter (BPD). Transabdominal Sonography was performed in 118 pregnant women in their second- and third- trimesters. The BPDs and fronto-occipital diameters (FODs) were measured. A study of 100 foetuses with normal head shapes was used to derive in this environment, a regression equation for an area corrected BPD (BPDa): BPDa = - 2. 853 + 0.483 (BPD + FOD). The BPDa of 18 foetuses with normal head shapes, were computed with this equation. Z test was performed to compare the mean BPD and Mean BPDa. Z statistic showed no significant difference (p>0.5) between BPDa and BPD in this group of foetuses with normal head shapes. There is no need to mathematically correct normocephalic foetal head shapes to ideal shapes before dating using the BPDs

Background: Recently the worldwide usage of earphones has increased especially among the school and college students who have a high rate of sharing among them. Alike airline headsets, headphones and stethoscope ear-pieces, ear phones can easily be a vector of potential pathogens, which can give rise to otitis externa. Purpose: To compare the bacterial growth of the external ear in association with earphone and assess the role of earphones as vector or microorganisms. Material and Methods: 50 voluntary male subjects (age 18-25 years) were chosen and divided into two groups, A and B, according to the use of earphones. Swabs were taken from their left ear and the left earpiece of the earphone. Samples were processed as recommended. Results: In group A, bacteria were found in 20 (80%) ear and 14 (56%) earphone swabs. In group B, bacteria were found in 23 (92%) ear and 17 (68%) earphone swabs. Group B showed heavy growth and a significant increase in the number of bacterial growths after frequent and constant use. Conclusion: Frequent and constant use of earphones increases the bacterial growth in the ear and sharing of earphones might be a potential vector of commensals. It is therefore, always better not to share or else to clean the earphones before sharing

Background: Human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) co-infection is reported to be common among HIV infected subjects due to share routes of transmission. The fact that HCV infection may act as cofactor for HIV disease progression has been suggested. Objective: To determine if HCV and HIV co-infection affect the immunocompetence (CD4) of the infected subjects and response to Highly Active Anti Retroviral therapy. Subjects and methods: Fifty HIV/HCV co-infected and fifty HIV monoinfected adults were retrospectively studied. Their baseline CD4 cell counts were done using Dynal beads technique before commencement of HAART and repeated after six months. Results: The CD4 cell counts of co-infected subjects were lower than the mono-infected subjects. Sixty eight percent of the co-infected subjects had CD4 cell count less than 200cells/uL, and they responded poorly to HAART therapy than the mono-infected subjects (P<0.05). Those with CD4 cell count greater than 200cells/uL responded better to treatment than those with CD4 cell count less than 200cells/uL (P<0.001) Conclusion: HCV/HIV co-infection affects the immunocompetence of the patients and HCV may acts as cofactor for HIV disease progression. It is needful to screen all HIV positive subjects for HCV antibody as this will improve their clinical management and outcome.

The purpose of this paper is evaluating the impact of stump length of unilateral below knee amputees (BKA) on different gait parameters. Nine unilateral BKA were chosen and divided into three groups comprising patients with short, medium, and long stump length. Each of them underwent gait analysis test by Computer Dynography (CDG) system to measure the gait parameters. It was found that the ground reaction force is higher in the patients with medium stump length whereas the velocity, step length both for the prosthetic and sound limb and cadence were high in longer stump length. Statistical analysis shows a significant difference (p<0.05) between the gait parameters of BKA with medium and longer stump length. The patients with longer stump length were more efficient than medium and short stump patients as they consumed comparatively lesser energy while walking with self-selected velocity and conventional (Solid ankle cushioned heel) SACH foot.

To evaluate the effect of socially marketed faucet fitted to earthen vessel / sodium hypochlorite solution on diarrhea prevention at rural household level as a social intervention for diarrhea prevention under ‘Community Led Initiatives for Child Survival (CLICS) program. Methods: Unmatched case-control study was carried out in 10 villages of Primary Health Centre, Anji, located in rural central India. During the study period, 144 households used either faucet fitted earthen vessel to store drinking water or used sodium hypochlorite solution (SH) for keeping drinking water safe. These served as case households for the present study. 213 neighborhood control households from same locality who used neither of the methods were also selected. Results: Odds ratio for households who used faucets fitted to earthen vessel was 0.49 (95% CI= 0.25 – 0.95). Odds ratio for households who used sodium hypochlorite solution was 0.55 (95% CI= 0.31 – 0.98). Use of these methods by the community, would prevent about 27 percent and 22 percent cases of the diarrhea (Population attributable risk proportion = 0.25 by faucets fitted to earthen vessels and 0.22 by use of sodium hypochlorite solution) respectively. Conclusion: To ensure safe drinking water at household level, the effective and cheap methods like fitting faucet to traditionally used earthen vessel and/or use of sodium hypochlorite solution must be promoted through community participation at household level for cost and culture sensitive rural people in India

Vaccines are a cost effective, time tested means of reducing morbidity and mortality. As more and more new vaccines are introduced and more diseases come under the purview of ‘vaccination net’, the routine immunization program is sidelined. This is compounded by vaccination practices in private health care system and anti vaccine propaganda and confusing pro vaccine propaganda. The primary purpose of the vaccine is shifting from prevention of diseases to monetary gains for the health care providers and manufacturers. There is a need to regulate the vaccination practices in the private health care system especially in the developing countries. The regulatory process should educate not only the community but also the health care providers and take adequate measures to control the ‘vaccine market forces’

Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory demyelinating disease of the central nervous system. The disease typically occurs after infections or vaccinations. However, in many patients with ADEM, no evidence of prior infection or vaccination can be found. We are reporting a patient who developed clinical and radiological features of acute disseminated encephalomyelitis after trauma of repeated attempts at lumber puncture for spinal anesthesia

Nasopharynx is an exceptionally rare anatomical location for foreign body impaction. We present a rare case of nasopharyngeal foreign body (NFB) in a 7 years old child. The diagnosis was confirmed by nasal endoscopy. Immediate removal of foreign body (FB) in the nasopharynx was performed under general anesthesia. This rare situation is potentially dangerous, since its dislodgment may cause fatal airway obstruction. Therefore, in all cases with missing foreign bodies in the aerodigestive system, nasopharyngeal impaction should be kept in mind and endoscopic examination of the region should be considered

HIV infection is associated with impairment of hearing function, at any stage of disease causing complication to the external, middle, inner ear and CNS. Audiological manifestation of HIV is a direct consequence of virus or secondary to the pharmacological treatment or viral complication. Objectives: There is paucity of information pertaining to hearing status in HIV. As the deafness can occur at any stage of HIV with varying degree and people with HIV live longer, there is need to address the hearing problems in these individuals. So this study aimed detecting the outer hair cell functioning by doing DPOAE in normal hearing HIV infected adults. Method: The experimental group comprised of 12 HIV infected (24 ears) within 20 to 40 years. The age matched control group comprised of 15 subjects (30 ears). All the subjects had normal hearing sensitivity. Initially puretone audiometry and immittance was performed for the subject selection. Subsequently DPOAE procedure was done. Results: The DPOAE was abnormal in 50% of the subjects. Conclusion: It can be concluded that the cochlear involvement is a common observation in HIV infected individuals. DPOAE test can be used as a tool for early identification of cochlear pathology in HIV infected.

Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation, the fluorescent treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests. The four alternative modes for diagnosis of syphilis can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the author reports an evaluation of cost utility of these tests in medical practice. It is shown that the cost per accurate diagnosis with VDRL + TPH is the least expensive choice. Therefore, this alternative is the best method for serological diagnosis for syphilis, based on medical laboratory economics principles.

Renal cell carcinoma is a rare but serious malignancy. Since a reduction in the level of retinoic acid receptor beta 2 (RARbeta2) expression in cancer cells due in part to histone hypoacetylation which is controlled by histone deacetylase (HD), the study on the interaction between cellular retinoic acid-binding proteins II (CRABP II), which is proposed to have its potential influence on retinoic acid (RA) response, and HD can be useful. Comparing to CARBP II and HD, the CARBP II-HD poses the same function and biological process as HD. This can confirm that HD has a significant suppressive effect on the expression of CARBP II. Therefore, reduction in the level of RARbeta2 expression in cancer cells can be expected and this can lead to failure in treatment of renal cell carcinoma with RA. The author hereby purpose that additional HD inhibitor should be added into the regiment of RA to increase the effectiveness of treatment.

Antenatal care is concerned mainly with prevention, early diagnosis and treatment of general medical and pregnancy associated disorders. For it to be meaningful, early booking is recommended, however, late booking is still a major problem. Objective: To determine the prevalence of late booking in our environment and factors related to it. Methodology: A descriptive cross-sectional study using structured interviewer assisted questionnaires. Results: Mean gestational age at booking was 20.3±6.2 weeks. Prevalence of late entry to antenatal care was 82.6%. Maternal education and age remained significant factors influencing late booking. Conclusion: Late booking is still a major problem in this part of the world. Public enlightenment, health education coupled with women empowerment would be helpful in reducing the problem

To find out the nutritional status of under-six children attending ICDS scheme and to study Anganwadi workers’ (AWW) perceived work load and operational problems. Material and Methods: A triangulated research design of quantitative (survey) and qualitative (Venn diagram, seasonal calendar) methods was used. Nutritional status of children was assessed by a survey. Participatory methods like Venn diagram and Seasonal calendars were used to collect qualitative data regarding AWWs perceived work load and food security with malnourished children. Results: Overall, prevalence of underweight and severe underweight among children under-six was found to be 53% and 15% respectively and among children below three years it was 47% and 15% respectively. Venn diagram showed AWWs’ multiple responsibilities. In seasonal diagram exercise, the mothers of severely malnourished children showed enough food availability in their house across all months of a year. Conclusion: To efficiently tap the potential of AWWs for reducing multidimensional problem of malnutrition, ICDS needs to design and implement flexible, area-specific and focused activities for AWW

Background: To determine the knowledge, attitude and practices about immunization among respondents of children aged 12-23 months. Methods: A total of 510 respondents were interviewed in the urban slums of Lucknow district of India, using 30 cluster sampling technique from January 2005 to April 2005. A pre-tested structured questionnaire was used to elicit the information about the knowledge, attitude and practices of the respondents regarding immunization. Results: Knowledge regarding the disease prevented, number of doses and correct age of administration of BCG was highest among all the categories of respondents. The paramedical worker was the main source of information to the respondents of completely (52.0%) and partially immunized (48.5%) children while community leaders for unimmunized children. Those availing private facilities were more completely immunized, as compared to the government facilities. 55.8% of those who took 20 minutes to reach the immunization site were completely immunized as compared to 64.1% of those who took more than 20 minutes. Conclusion: Considering the incomplete knowledge, and inappropriate practices of the people, the policy makers and medical professionals require Herculean efforts to raise the knowledge and to break the old beliefs of the people

Free peritoneal perforation is a rare complication of Crohn's disease with a report of only 100 cases in the literature. It needs an emergency exploration and an unaware general surgeon is confounded in intraoperative decision-making. We present our experience when this rarity struck us in a district hospital and briefly review the guidelines of optimal management of this complication of Crohn's disease.

Free peritoneal perforation is a rare complication of Crohn's disease with a report of only 100 cases in the literature. It needs an emergency exploration and an unaware general surgeon is confounded in intraoperative decision-making. We present our experience when this rarity struck us in a district hospital and briefly review the guidelines of optimal management of this complication of Crohn's disease.

Fallopian tube carcinoma is a very rare malignancy and we report a case of stage IIC primary fallopian tube cancer.

We report a case of tracheal stenosis that required the creation of a uniquely adapted permanent tracheostomy. The patient’s case was especially challenging because she had multiple disabilities causing limited movement in her upper extremities that prevented her from active involvement in self-care activities. Co-ordinated efforts by an interdisciplinary team in a Czech health care environment helped the patient to gain as much independence as possible despite her multiple disabilities.