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Coronavirus disease 2019 (COVID-19) is a systemic disease, impacting multiple organs in the human body. But COVID-19 also impacts other diseases of relevance to public and planetary health. To understand and respond to the COVID-19 pandemic, we need an intersectional conceptual lens and systems thinking. For example, the strain on health care systems due to COVID-19 has adversely impacted global malaria elimination programs. With many epidemiological, clinical, and biological parallels documented, we examined in this study the scenario of malaria and COVID-19 syndemic in India. The disruptive influence of COVID-19 on the National Framework for Malaria Elimination (NFME), impact of unintended chemoprophylaxis, population genetic influences, and the shifting patterns of epidemiology are compared. Importantly, a time series analysis forecasted the burden of malaria increasing in the upcoming years. Although reported malaria cases showed a decline in 2020 compared to the previous years, an increase in cases was documented in 2021, with nine states reporting an increase up to July 2021. Pandemics often cause crosscutting disruptions in health care. Reshaping the priorities of the malaria elimination program and a diligent implementation of the priorities in the NFME would, therefore, be well-advised: (1) vector control, (2) antimalarial therapy recommendations, (3) monitoring drug resistance, (4) prevention of the spread of asymptomatic disease-causing low-density transmission, and (5) large-scale testing measures. In conclusion, the findings from the present study inform future comparative studies in other world regions to better understand the broader, systemic, temporal, and spatial impacts of the COVID-19 pandemic on existing and future diseases across public health systems and services.

Introduction: Uterine leiomyoma is the commonest tumour of female genital tract. Earlier myomectomy at caesarean sections was generally avoided due to fear of intractable haemorrhage and atonicity leading to subsequent hysterectomy and future fertility issues. The aim of this study is to compare the intraoperative and post-operative complications following caesarean myomectomy and caesarean section alone in antenatal patients with myomas. Materials and Methods: A hospital based observational comparative study was peformed on 38 antenatal woman with myomas, include 19 antenatal patients with myomas who were posted for caesarean myomectomy compared with age matched 19 antenatal women who were posted for caesarean alone , were selected for the study in the department of obstetrics and gynecology. Results: In the present study patients mean age was of 30.8+5 yearsand 30.8+5 years respectively for caesarean myomectomy and caesarean group. Out of the 38 patients 15 patients were primipara and 13 patients were multipara. The duration of surgery for caesarean myomectomy was 65 12.9minutes compared to 47.4 +4.2 minutes in caesarean only group. Out of the 38 patients mean and standard deviation of hemoglobin fall during surgery in caesarean myomectomy was 1.1+0.7gm/dl when compared to 0.7+0.2gm/dl in caesarean group. And 2 patients needed blood transfusions post-operatively in caesarean myomectomy compared one patient in caesarean group. The hospital stay in hours in caesarean myomectomy was 126.310.9 hours and 121.35.5 hours in caesarean group. None of them ended on obstetric hysterectomy. Conclusion: In this study, No significant difference was observed in haemoglobin change, incidence of intra-operative complications and length of hospital stay, in the caesarean myomectomy group as compared to other post caesarean group. The possibility of performing myomectomy during caesarean section has become a safe procedure with experienced surgeons and anaesthetic facilities Keywor

Software testing is a very important and effort-consuming activity. If the observed behaviour of the software is different from the expected behaviour, we treat this as a failure condition. Failure of a software adversely affects the reputation as well as the monetary status of the development organization. Thus locating faults and fixing it is very important in the development process. Test cases are the input values given to a program in order to find out faults in a program. Testing may be done by static or dynamic method. In static testing, the target code is not executed, whereas in dynamic method, the target code is executed. A major static testing method is the code review, in which the syntax and usage of various elements of the code are reviewed. The goal of this work is to generate test cases to statically validate the array index so that the unexpected array index boundary violations can be tested. For this the Java source code is analysed using SDG and the proposed tool is implemented using Antlr with Java grammar by embedding action codes in the grammar.

Presenting a case of endometrioid adenocarcinoma of the endometrium, benign cystic teratoma of one ovary, fibrothecoma in the other ovary and adenomyosis in the uterus. Such a combination of synchronous lesion is very rare and is not reported in the English medical literature. (J Menopausal Med 2018;24:133-137)

Objective: Cancers of the adnexae, including ovarian and fallopian tube, constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of ovarian cancer. Intraoperative frozen section diagnosis of ovarian tumors is widely used in making this distinction and to decide the course of surgery. Therefore, the accuracy of this technique is very important. The aim was to determine the overall accuracy, sensitivity, specificity, and predictive values of frozen section for ovarian tumors and to evaluate the role of frozen section in the surgical management of ovarian tumors. Materials and Methods: This was a descriptive longitudinal study conducted in the gynecology department of a tertiary care hospital. During the 1 ½ year period of data collection, frozen section was performed among 60 cases of ovarian neoplasms. The overall accuracy, sensitivity, specificity and predictive values of frozen section for benign, borderline and malignant categories of ovarian tumors were studied. Results: Out of the 60 patients of ovarian tumors, frozen section diagnosis showed that 43 (71.7%) tumors were benign, 11 (18.3%) were malignant and 6 (10%) were of borderline nature. Final histopathological diagnosis showed that 45 (75%) tumors were benign, 11 (18.3%) were malignant and 4 (6.7%) were borderline. Frozen section for benign tumors had 95% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 88% negative predictive value (NPV). Malignant tumors had 90% sensitivity, 97% specificity, 90% PPV and 97% NPV with frozen section. However, frozen section had low sensitivity (75%) and PPV (50%) for borderline tumors. Specificity was 94% and NPV 98% in this group of tumors. Conclusion: Frozen section was found to be an accurate and useful modality in the intraoperative evaluation of patients with ovarian neoplasm. The results can help to decide the type and extent of surgery.

Background: Expectant management as first line management of early pregnancy miscarriages is less accepted due to failure and increased complications reported in few studies. Proper selection of cases improves outcome of expectant management. Aim of this study was to compare success rate and complications in expectant management in three groups of early pregnancy miscarriages- Incomplete miscarriage, anembryonic pregnancy and early fetal demise.Methods: Prospective observational study conducted in tertiary care centre for 3 years, including 107 patients with USG confirmed pregnancy miscarriage

A study on standard water quality parameter requirements and management strategies suitable for fish farming is presented. The water quality criteria studied based on physical, chemical and biological properties of water include temperature, turbidity, total suspended solids TSS , total dissolved solid TDS , nitrate nitrogen, pH, Dissolved oxygen DO biochemical oxygen demand BOD and total hardness. Water samples from around Gurgaon Canal in NCR union territerian New Delhi capital of India, were analyzed based on the afore mentioned criteria to assess its suitability as a source of water for fish farming. The results of the analysis compared with international standards and also Indian standards revealed that the river temperature of 30.7 0C fall within the acceptable range for fish farming. However, the pH of 7.1, total hardness of 470 mg l, total dissolved solids of 13.60 mg l and biochemical oxygen demand of 36 mg l all differed slightly from the standard recommended values. This study will aid fish farmers on the necessary treatment needed to effectively use water from this source for fish farming. Warish Khan | Abdul Vahab | Adil Masood | Najib Hasan "Water Quality Requirements and Management Strategies for Fish Farming (A Case Study of Ponds Around Gurgaon Canal NUH Palwal)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-2 | Issue-1 , December 2017, URL: https://www.ijtsrd.com/papers/ijtsrd5914.pdf

An experiment was carried out to study the correlation between yield components and their direct and indirect effects on the vegetable pod yield in cluster bean using 100 accessions. The correlation study revealed significant positive association of vegetable pod yield and characters viz., pod weight, pod length, pod girth, pods per plant, pod clusters per plant, plant height, shelf life and 100 seed weight. Pod length, pods per plant, plant height and pod clusters per plant were the characters responsible for maximum vegetable pod yield by imparting highest direct effect in path coefficient analysis. The correlation was also positive for these characters. The direct effect of the traits indicated its true relationship with pod yield. Hence, emphasis should be given for these characters, while making selection for high yielding genotypes in cluster bean.

Background: Pelvic organ prolapse is a common condition and a major cause of gynecological surgery. The lifetime risk of having an operation for prolapse may be 11%. Uterine conserving surgeries using synthetic mesh, especially in younger age group can restore normal anatomy relieving their pelvic symptoms. To evaluate the safety, intra operative and postoperative complications and efficacy of the laparoscopic cervicopexy.Methods: This Prospective observational study was carried out on women aged below 45 years attending gynaecology outpatient department with uterine prolapse at MES Medical College, Perinthalmanna between January 1st and December 31st, 2015. 39 women underwent laparoscopic cervicopexy and follow up assessments was done among them at 2 weeks, 3 months and 6 months. Results: The mean operative time was 27.6 minutes and blood loss was 0.4 gm/dl. No intraoperative and postoperative complications occurred. Short duration of hospital stay with mean of 1.4 days. 7.7% patients and 5.5% had mersilene tape reaction at 3 months and 6 months. The POP Q score C was significantly away from hymen at 2 weeks,3 months and 6 months (+4.4 - -4.3). 7.7% and 2.6% had recurrence at 3 month and 6 months. 5.1% underwent vaginal hysterectomy to get relieved from symptom.Conclusion: Laparoscopic cervicopexy is an effective option for women with pelvic organ prolapse who desire uterine preservation.

The essential route to blood parasitaemia in malaria, erythrocyte invasion is facilitated by activation of the G-protein coupled receptor signaling pathway mediated by the β2-adrenoreceptor as one of the proteins on the surface of red blood cells. The effectiveness of bronchodilators and inhaled corticosteroids in the clinical treatment for asthma patients also depend on polymorphisms in the β2-adrenoreceptor gene (ADRB2). In a case control study, individuals affected by Plasmodium falciparum malaria, asthma and controls were tested for association of six ADRB2 single nucleotide polymorphisms (SNPs) viz. rs1042711, rs1801704, rs1042713, rs1042714, rs1042717 and rs1042718, by direct DNA sequencing. The rs1801704 locus was significantly associated with malaria when compared against controls. The rs1042713 polymorphism was associated with forced expiratory flow between 25% and 75% of the FVC in asthma patients, pre (p = 0.048) and post (p = 0.038) treatment measurements. Predicted haplotype of the six SNPs computed from genotype data showed T-T-A-C-G-C conferred significant risk of malaria (p = 0.02) whereas T-T-A-C-G-A was associated with risk of asthma (p = 0.02). The haplotype T-T-G-C-G-C was protective against both malaria (p = 0.02) as well as asthma (p = 0.026) and C-C-G-G-G-C was protective uniquely for asthma (p = 0.04). A significant outcome was that all variant alleles at the SNP loci were part of the haplotype conferring resistance to malaria disease and asthma, except rs1042713 and rs1042718 which showed very high frequency in asthma. The pairwise linkage disequilibrium (LD) estimates showed a distinct LD block of all SNP loci (D′ = 1 or >0.8) in malaria patients. This characteristic haplotype block was disrupted in the controls due to non-significant pairwise LD of the SNP loci; and a more extensive disruption of the block was noted in asthma patients. The study provides evidence for the proposed role of β2-adrenoreceptor mediated molecular mechanisms in etiology of malaria, as well as asthma disease and drug response, for further clinical and therapeutic application studies.

The more than 1.5 billion people who live in South Asia are correctly viewed not as a single large population, but as many small endogamous groups. We assembled genome-wide data from over 2,800 individuals from over 260 distinct South Asian groups. We identify 81 unique groups, of which 14 have estimated census sizes of more than a million, that descend from founder events more extreme than those in Ashkenazi Jews and Finns, both of which have high rates of recessive disease due to founder events. We identify multiple examples of recessive diseases in South Asia that are the result of such founder events. This study highlights an under-appreciated opportunity for reducing disease burden among South Asians through the discovery of and testing for recessive disease genes.

Objective: In the present study, we have chosen a fish Stolephorus commersonnii which is abundant in whitebait catches along Kerala coast. This fish is reported to contain higher content of essential amino acids, monounsaturated fatty acids, polyunsaturated fatty acids and minerals. The medicinal values of this species have not been reported and remain unexplored. Hence, there is a necessity to explore their uses and to conduct the pharmacological studies to ascertain their therapeutic properties. Based on literature search, no study has been carried out to scientifically validate the fish S. commersonnii possesses hepatoprotective property. Hence, this study was carried out to investigate the hepatoprotective effect of the S. commersonnii. Materials and Methods: The fish was purchased from the fish market, Ernakulam, Kerala, India. The fish were kept on ice until processed in the lab. Fish is washed and cleaned properly. The tissue is homogenized and extracted with chloroform: methanol solvent system. The extract is transferred to a dark glass container and stored in a freezer. The preliminary analysis of fish extract was carried out by simple qualitative methods. The hepatoprotective activity of Stolephorus commersonnii (SC) extract at 300 mg/kg is carried out in isoniazid induced hepatotoxic model. The albino rats of either sex were used for these studies. Results: The results of hepatoprotective study revealed that the SC extract showed a liver protective action against isoniazid induced toxicity. Conclusion: The present study suggests that the extract of S. commersonnii fish has therapeutic potential in the management of drug induced liver toxicity.

Bacterial artificial chromosomes (BACs) are used in genomic variation studies due to their capacity to carry a large insert, their high clonal stability, low rate of chimerism and ease of manipulation. In the present study, an attempt was made to create the first genomic BAC library of an anonymous Indian male (IMBL4) consisting of 100,224 clones covering the human genome more than three times. Restriction mapping of 255 BAC clones by pulse field gel electrophoresis confirmed an average insert size of 120 kb. The library was screened by PCR using SHANK3 (SH3 and multiple ankyrin repeat domains 3) and OLFM3 (olfactomedin 3) specific primers. A selection of clones was analyzed by fluorescent in situ hybridization (FISH) and sequencing. Fine mapping of copy number variable regions by array based comparative genomic hybridization identified 467 CNVRs in the IMBL4 genome. The IMBL4 BAC library represents the first cataloged Indian genome resource for applications in basic and clinical research.

There are many studies documenting increased prevalence of periodontal infection in women with preeclampsia. But, very few studies have attempted to establish causal relationship between the two.To find out causal circumstantial evidence by isolating specific periodontal pathogens in oral and placental samples.Antenatal periodontal screening and subgingival plaque collection was carried out in ten women with hypertension in pregnancy and ten normotensive controls on their hospital admission at term for cesarean delivery. Placental biopsy was obtained after aseptic placental collection at the time of elective cesarean delivery. Subgingival plaque and placental biopsy were studied for Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia and Aggregatibacter actinomycetemcomitans using quantitative polymerase chain reaction technique. Periodontist and laboratory personnel were unaware of case or control status. Periodontal status was not informed to the obstetrician recruiting the cases and laboratory. Microbiology report was not revealed till end of the study.Periodontal pathogens were found to be high in the group with hypertension than the controls. P gingivalis was found in all the samples from subgingival plaque and placenta, irrespective of the periodontal disease status.In cases with hypertension, periodontal pathogens are present in higher proportion in subgingival plaque and placenta.

Prenatal diagnosis of 3 HBB gene mutations causing β-thalassemia and hemoglobin D Punjab segregated in a South Indian nuclear family is reported along with a method identified as control for maternal cell contamination (MCC). Amplicons of the HBB gene from genomic DNA obtained from the blood of a thalassemic first child (proband), both parents, and a chorionic villus sample of their second pregnancy were directly sequenced. A test for MCC was performed by genotyping polymorphic microsatellite markers (D21S11 and D21S1270) by quantitative fluorescence polymerase chain reaction (QF-PCR) and capillary gel electrophoresis. The pedigree analysis showed proband as a compound heterozygote of NG_000007.3:g.70691G>C and NG_000007.3:g.72128T>C mutations; showed the father as a compound heterozygote of NG_000007.3:g.72128T>C and NG_000007.3:g.71938G>C mutations; and showed the mother as a heterozygous carrier of the NG_000007.3:g.70691G>C mutation. The fetus inherited a normal maternal allele and a mutant paternal allele NG_000007.3:g.72128T>C and was ascertained a carrier of β-thalassemia. Analysis of cosegregation of 5 other single nucleotide polymorphisms (SNPs) in the family, including NG_000007.3:g.70603T>C , NG_000007.3:g.71055G>C , NG_000007.3:g.71113T>G , NG_000007.3:g.72332G>A , and NG_000007.3:g.72334A>C , defined the disease allele haplotypes. QF-PCR showed no extra maternal alleles in the fetal sample. Prenatal diagnosis of mutations and an absence of MCC was confirmed by cosegregation of the SNPs, suggesting the utility of a panel of such polymorphisms that can serve to identify MCC quickly and reliably.

The more than 1.5 billion people who live in South Asia are correctly viewed not as a single large population but as many small endogamous groups. We assembled genome-wide data from over 2,800 individuals from over 260 distinct South Asian groups. We identified 81 unique groups, 14 of which had estimated census sizes of more than 1 million, that descend from founder events more extreme than those in Ashkenazi Jews and Finns, both of which have high rates of recessive disease due to founder events. We identified multiple examples of recessive diseases in South Asia that are the result of such founder events. This study highlights an underappreciated opportunity for decreasing disease burden among South Asians through discovery of and testing for recessive disease-associated genes.

Introduction: Patient satisfaction is an important issue for the health care sector. Hospitals routinely collect patient satisfaction data so that they can improve the quality of their services. There is a dearth of research in the field of satisfaction among people living with HIV (PLHIV) in India. Aim: The aim of our study was to determine the level of satisfaction among PLHIV attending the HIV clinic of tertiary health centre in Southern India. M aterials and Methods: This descriptive cross-sectional study was done in the HIV clinic attached to Kasturba Medical College (KMC) Hospital, Mangalore, India from August 2012 - August 2013. PLHIV of age more than 18 years were included. During the study period 422 consecutive patients who consented for the study were enrolled. To determine patient satisfaction towards healthcare service, we used the Short Form Patient Satisfaction Questionnaire (PSQ-18). Data was analysed using SPSS Version 11.5 statistical software. R esults: A total of 422 patients were included in the study out of whom 253(60%) were males and 169(40%) were females. Mean age of the patients was 37.08±7.2 years. The median CD4 count was 345 cells/mm3 (IQR 245-451.2). The mean score for general satisfaction was 4.43±0.48, for technical quality 4.77±0.26, for interpersonal manner 4.59±0.4, for communication 4.64±0.42, for financial aspects 3.20±0.78), for accessibility and convenience 4.50±0.72 and for time spent with the doctor was 4.59±0.45. Subscale scores for general satisfaction, technical quality, accessibility, interpersonal manner, finance and communication were higher in females when compared to males which were found to be statistically significant. Younger PLHIV (≤ 35 years) had significantly higher scores in technical quality, interpersonal manner and time spent with the doctor when compared to older PLHIV. C onclusion: Patient satisfaction was highest for technical quality and it was lowest for financial aspects. If hospitals wish to improve the quality of health services they should give priority to decreasing costs and improving accessibility.

There is a sixfold increase in the incidence of ectopic pregnancy over the last decade due to increasing popularity of ART procedures and tubal recanalization surgeries and increasing incidence of pelvic inflammatory diseases [1]. The most common clinical presentation of ectopic pregnancy is first-trimester vaginal bleeding and/or abdominal pain [2].

Background Surgical, medical and expectant management are the various options available to manage early pregnancy miscarriages; each with its own merits and demerits. In the last two decades, the efficacy and safety of expectant management which allows for the spontaneous passage of retained products of conception has been studied and confirmed. Aim To compare the safety and efficacy of expectant management of early pregnancy miscarriages with surgical uterine evacuation. Materials and methods The prospective study conducted in tertiary care centre for 5 years, included 212 patients with USG confirmed pregnancy miscarriages of less than 13 weeks, who were allocated to expectant management (Cases, n=112) and surgical evacuation (Control, n=100). Patients were allocated for expectant management as outpatients for 2 weeks, without any intervention till they had spontaneous complete miscarriage which was confirmed by sonography. Those who failed to do so, underwent a planned surgical uterine evacuation. Emergency admission and evacuation was done, if the patients became symptomatic in the waiting period. Patients allocated to surgical group underwent planned surgical evacuation once diagnosed. Success rate and complications like emergency evacuation, vaginal bleeding, abdominal pain, limitation of physical activity and patient satisfaction were assessed. Both groups were followed up for 6 more weeks. Statistical analysis was done with Z-test. Results Success rate of the expectant management was 71% as against 97% in surgical group. Severe vaginal bleeding was comparable (5% in both groups), 8% of expectant had severe abdominal pain versus 4% in surgical group. Unplanned admissions and emergency evacuation rate was high in expectant 9% against 1% in surgical group. Twenty one percent patients in expectant and 17% patients in surgical group experienced limitation of physical activity. Overall patient satisfaction rate was comparable (74% in expectant 80% in surgical group). Conclusion Expectant management of miscarriages has a success rate of 71%. Compared to surgical management, abdominal pain, unplanned admissions, emergency evacuation and limitation of physical activity were more in expectant group. Success rate can be improved and complications can be minimised with proper patient selection and counseling.