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Background: Long-term exposure to silica dust makes people prone for silicosis which raises the risk of the individual in developing pulmonary tuberculosis (PTB). Silicosis is a progressive lung disease characterize with shortness of breath, cough, fever, and bluish skin, caused due to inhalation of crystalline silica dust found in abundance in sand, rock, and quartz. Aims and Objectives: The disease is known to effect the functioning of macrophages making it unable to defend mycobacterium species, thus allowing the bacterium to invade and develop tuberculosis. Materials and Methods: A retrospective cross-sectional study is carried out to estimate the prevalence of PTB in newly diagnosed silicosis patients at Madurai Medical College, Madurai, Tamil Nadu. All the patients who got registered in Occupational Lung Diseases Registry from January 2016 to December 2021 are included in the study. Silicosis patients tested positive on sputum CBNAAT are considered as silicotubercular patients, whose prevalence is calculated. Results: Our study included a total of 54 subjects (90.8% males and 8.2% female) with mean SD age of 38±6.7 years ranging from 26 to 53 years. Of which 22 patients, 40.7% tested positive for Mycobacterium tuberculosis (MTB) on sputum CBNAAT. The prevalence of MTB in among silicosis patients was found to be 40.7%. Conclusions: Association of TB and silicosis is very strong with the prevalence of TB among silicosis patients as 40.7%. Our study also observed the male sex and elder age as elevated risk of developing silicotuberculosis. All the people getting exposed to silica dust need to be educated in the usage and usefulness of protective equipment.

Introduction: Dengue fever is a common mosquito-borne viral disease which has reached alarming size in the past few years. It is endemic in more than 100 countries and significant differences were found in clinical profile and atypical manifestation. Aim of the Study: A retrospective observational study of clinical profile and atypical manifestations in patients with dengue fever. Materials and Methods: Serum samples were collected from clinically suspected cases of dengue fever and it was confirmed by NS1 antigen, IgM, and IgG antibody by ELISA. Clinical details and atypical manifestations were recorded. Observation: During the study period, a total of 2502 patients were suspected to have dengue infection, of which 464 (18.5%) samples were found to be positive for dengue viral infection. A majority of the cases were males [268 (57%)] when compared with females [196 (42%)]. Fever was the most common clinical presentation seen in all the patients, followed by headache (78.4%), myalgia (61%), body pain (49.3%), vomiting (40%), joint pain (31.5%), dry cough (19%), nausea (14%), abdominal pain (8%), diarrhea (5.6%), retro-orbital pain (04%), burning micturition (2.4%), and rashes (0.6%). Among atypical manifestations, hepatomegaly [32 (7%)] was the most common, followed by splenomegaly [23 (5%)], bradycardia [18 (4%)], meningitis [6 (1.2%)], hemoptysis [5 (1%)], acalculous cholecystitis [4 (0.8%)], and acute pancreatitis [2 (0.4%)]. The study of hematological parameters showed thrombocytopenia was present in 179 (38.5%) patients, followed by leukopenia [77 (17%)] and raised hematocrit [29 (6.2%)]. Conclusion: During ongoing epidemics, the clinical profile and atypical manifestations in clinically suspected dengue patients should be investigated early so that severe forms can be treated promptly.

Guillian-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of covid 19 infection. Here we present a case of 64 years old female who presented to us with worsening respiratory failure and progressive flaccid symmetrical sensorimotor neuropathy following covid infection. She was diagnosed to have GBS as post covid complication . Hence started on Intravenous Immunoglobulin infusion following which she had improvement in respiratory failure and prevented from intubation and mechanical ventilation.

Guillain–Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy that is often related to a previous infectious exposure. GBS emerged as a potentially serious complication of COVID-19 infection. Here, we present the case of a 64-year-old female who presented to us with worsening respiratory failure and progressive flaccid symmetrical sensorimotor neuropathy following COVID infection. She was diagnosed to have GBS as post-COVID complication. Hence, started on intravenous immunoglobulin infusion following which she had improvement in respiratory failure and prevented from intubation and mechanical ventilation.

Introduction: Maternal morbidity and mortality is still a major public health challenge. Lack of proper birth plan and delay in identification of pregnancy complications is one of the major causes of maternal morbidities and deaths, especially in the rural areas. Aim: The study was conducted with the aim to evaluate the health-seeking behaviour for obstetric care services among the antenatal and postnatal mothers in a rural area of Tamil Nadu. Materials and Methods: This descriptive cross-sectional study was done among antenatal and postnatal mothers registered in the Rural Health Training Centre, in Sripuram area of Kancheepuram district, Tamil Nadu during 2017. About 150 antenatal and 150 postnatal mothers were selected by simple random sampling method. A pre-tested structured questionnaire was used to collect relevant data which was analysed using the SPSS version 22. Results: Only 21% of the study participants had adequate knowledge regarding the danger signs of pregnancy and the major determinants were maternal literacy and adequate prenatal care. Regarding the health-seeking behaviour, 62.3% of them preferred primary health centres as preferred place of delivery, 87.3% of them had received adequate prenatal care and it was found to have statistically significant association with adequate gestational weight gain, exclusive breastfeeding, proper weaning practices and consumption of iron and folic acid supplements. Conclusion: The study shows the need to provide health education regarding the danger signs of pregnancy and importance of adequate prenatal care to all pregnant women and expectant mothers, to make them aware of when and how to seek medical care, which in turn could reduce the overall maternal morbidity and mortality.

IntroductionPatient decision-aids (PDAs) support patients in selecting evidence-based treatment options. PDA is useful only if the user understands the content to make personalised decisions. Cultural adaptation is a process of adjusting health messages so that the information is accurate, relevant and understandable to users from a different population. A PDA has been developed to assist Malaysian patients with secondary drug failure to initiate insulin therapy to control their type 2 diabetes mellitus (T2DM). Likewise, patients with T2DM in neighbouring Singapore face similar barriers in commencing insulin treatment, which a PDA may facilitate decision-making in selecting personalised therapy.ObjectiveThe study aimed to explore the views and perceptions of Singaporean primary care providers on the Malaysia PDA to initiate insulin therapy and described the cultural adaptation process used in the design and development of a new PDA, which would be trialled in a Singapore primary healthcare institution.MethodQualitative research method was deployed to conduct one-to-one in-depth interviews of the healthcare providers at the trial site (SingHealth Polyclinics—SHP), including six primary care physicians and four nurses to gather their views and feedbacks on the Malaysian PDA. The interviews were transcribed, audited and analysed (standard content analysis) to identify themes relating to the content, layout, concerns of the original PDA and suggestions to the design of the new SHP PDA.ResultsCultural adaptation of the new PDA includes change to the overall design, graphics (including pictograms), presentation styles, additional contextualised content (personalisation, subheadings, cost and treatment option), modified phrasing of the subtitles and concerns (choice of words) relevant to the new users.ConclusionA PDA on insulin therapy underwent cultural adaptation before its implementation in another population in a neighbouring country. Its relevance and effectiveness will be evaluated in future research.

Introduction: The construction industry is one of the world’s major industries. Construction industries are an unorganised sector involving huge number of skilled and semi-skilled work force. Construction workers are at a greater risk of developing certain health disorders and sickness due to their poor working conditions and living environment. Aim: To determine the morbidity profile and to identify the association between risk factors and morbidities among the construction workers in an urban area of Kancheepuram District, Tamil Nadu, India. Materials and Methods: This was a cross-sectional descriptive study carried out in the urban area in Kancheepuram district. Using probability proportional to size and simple random sampling method, 312 construction workers were identified. The data were collected using a pretested structured questionnaire followed by clinical examination. Data was analysed using SPSS version 21 software and presented as descriptive and analytical statistics. Results: It was observed that, 80.1% of the workers had at least one health related morbidity problem at the time of the study. It was identified that musculoskeletal problem (71.5%) was the major cause of morbidities. This was followed by skin problems (59.3%), eye problems (53.3%), abdominal problems (52%), respiratory problems (51.7%) and external injuries (44.3%). There was a strong statistical association between the presence of morbidity and the presence of smoking, alcohol consumption, and use of other forms of tobacco, type/nature of work, marital status and type of diet they consumed. Conclusion: There is a need to create awareness among the workers about their health and environmental safety issues at work place. Provision of health insurance coverage and health screening services should also be made available to help them lead a socially and economically productive life.

Introduction: India is the second most populous country in the world having a rapidly growing population. To strike a balance between population growth and resource usage, strategies like family planning came into force. People may have different levels of awareness and acceptance of methods of family planning. Research must identify best practices in the program implementation and the awareness levels among the population to propagate it further. Aim: To study the knowledge and practice of adopting small family norms among married women in the urban field practice area of a Medical College (Sree Balaji Medical College and Hospital, Bharath University, Chennai, Tamil Nadu, India). Materials and Methods: This cross-sectional descriptive study was carried out in the urban field practice area attached to a medical college in Kancheepuram district. Using simple random sampling method, 300 married women of reproductive age was identified. The data were collected using a pretested structured questionnaire containing five questions for assessing the knowledge and nine on practice. Data were analysed using SPSS software version 17.0. Results: It was observed that, of 300 married women, almost 78% of the women uses contraceptive. Nearly 72% of the mothers said they were aware about the idea of small family norm and about 70% of them informed that they know how small family norm is practiced. Nearly 68% of the mothers said small family norm means a family with 2 or less children. Conclusion: Awareness about small family norm should be enhanced through various strategies under the family welfare programs. More people should be encouraged to embrace family welfare measures in order to control the population.

Oral Tongue Squamous cell carcinoma (OTSCC), the most frequently affected oral cancer sub-site, is associated with a poor therapeutic outcome and survival despite aggressive multi- modality management. Till date, there are no established biomarkers to indicate prognosis and outcome in patients presenting with tongue cancer. There is an urgent need for reliable molecular prognostic factors to enable identification of patients with high risk of recurrence and treatment failure in OTSCC management. In the current study, we present the meta-analysis of OTSCC microarray based gene expression profiles, deriving a comprehensive molecular portrait of tongue cancer biology, showing the relevant genes and pathways which can be pursued further to derive novel, tailored therapeutics as well as for prognostication. We have studied 5 gene expression profiling data sets available on exclusively oral tongue subsite comprising of sample size; n = 190, consisting of 111 tumors and 79 normals. The meta- analysis results showed 2405 genes differentially regulated comparing OTSCC tumor and normal. The top up regulated genes were found to be involved in Extracellular matrix degradation (ECM) and Epithelial to mesenchymal transition (EMT) pathways. The top down regulated genes were found to be involved in detoxication pathways. We validated the results in clinical samples (n = 206), comprising of histologically normals (n = 10), prospective (n = 29) and retrospective (n = 167) OTSCC by evaluating MMP9 and E-cadherin gene expression by qPCR and immunohistochemistry. Consistent with meta-analysis results, MMP9 mRNA expression was significantly up regulated in OTSCC primary tumors compared to normals. MMP9 protein over expression was found to be a significant predictor of poor prognosis, disease recurrence and poor Disease Free Survival (DFS) in OTSCC patients. Analysis by univariate and multivariate Cox proportional hazard model showed patients with loss of E-cadherin expression in OTSCC tumors having a poorer DFS (HR = 1.566; P value = 0.045) and poorer Overall Survival (OS) (HR = 1.224; P value = 0.003) respectively. Combined over-expression of MMP9 and loss of E-cadherin membrane positivity in the invasive tumor front (ITF) of OTSCC had a significant association with poorer DFS (Log Rank = 16.040; P value = 0.001). These results suggest that along with known clinical indicators of prognosis like occult node positivity, assessment of MMP9 and E-cadherin expression at ITF can be useful to identify patients at high risk and requiring a more intensive treatment strategy for OTSCC. Meta-analysis study of gene expression profiles indicates that OTSCC is a disease of ECM degradation leading to activated EMT processes implying the aggressive nature of the disease. The triggers for these processes should be studied further. Newer clinical application with agents that can inhibit the mediators of ECM degradation may be a key to achieving clinical control of invasion and metastasis of OTSCC.

Introduction: Polycystic ovarian syndrome (PCOS) is the main cause of anovulatory infertility. Various combination of drugs have been tried to induce ovulation in PCOS patients with varied result. So, this study was planned to compare the effect of bromocriptine combined with Clomiphene Citrate and Clomiphene Citrate alone, in patients of polycystic ovarian syndrome with normal prolactin level. Materials & Methods: On the basis of inclusion and exclusion criteria, seventy four PCOS patients with normal prolactin level (< 20 ng/ml) and BMI between 20-30 were randomly assigned into two groups. One group (n=38) received 50 mg clomiphene citrate (CC) from day3 to day7. The other group (CC+Bcrt) was given 50 mg of clomiphene citrate from day3 to day7 along with 0.8mg of bromocriptine daily for full cycle (n=36). Both the groups were treated for 3 cycles. The outcomes were measured by the hormonal status, follicular size, ovulation rate and pregnancy outcomes. Results: The serum prolactin level was normal in both the groups before treatment. After 3 cycles the prolactin level decreased in (CC+Bcrt) group (p< 0.01). Follicular development (size >15mm) was observed in 30 patients (78.9%) in CC group and 28 patients (82.3%) in CC+Bcrt group. There was no significant change in hormonal status (LH, FSH and Estradiol) of both the groups. The rate of ovulation was 69.4% in CC group and 75.8% in CC+Bcrt group. During the treatment period, nine patients in CC group and seven patients in CC+Bcrt group became pregnant. Conclusion: There is no added benefit of bromocriptine with clomiphene citrate as compared to clomiphene alone in ovulation induction as well as pregnancy outcomes in PCOS patients with normal prolactin.

Genomic aberrations are common in cancers and the long arm of chromosome 1 is known for its frequent amplifications in breast cancer. However, the key candidate genes of 1q, and their contribution in breast cancer pathogenesis remain unexplored. We have analyzed the gene expression profiles of 1635 breast tumor samples using meta-analysis based approach and identified clinically significant candidates from chromosome 1q. Seven candidate genes including exonuclease 1 (EXO1) are consistently over expressed in breast tumors, specifically in high grade and aggressive breast tumors with poor clinical outcome. We derived a EXO1 co-expression module from the mRNA profiles of breast tumors which comprises 1q candidate genes and their co-expressed genes. By integrative functional genomics investigation, we identified the involvement of EGFR, RAS, PI3K / AKT, MYC, E2F signaling in the regulation of these selected 1q genes in breast tumors and breast cancer cell lines. Expression of EXO1 module was found as indicative of elevated cell proliferation, genomic instability, activated RAS/AKT/MYC/E2F1 signaling pathways and loss of p53 activity in breast tumors. mRNA-drug connectivity analysis indicates inhibition of RAS/PI3K as a possible targeted therapeutic approach for the patients with activated EXO1 module in breast tumors. Thus, we identified seven 1q candidate genes strongly associated with the poor survival of breast cancer patients and identified the possibility of targeting them with EGFR/RAS/PI3K inhibitors.