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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.

Breakage of the needle and missing while repairing the uterine wound during cesarean section is an uncommon event. Subsequently it was removed under fluoroscopic guidance on the 7th postoperative day

A rare case of Placental Site Trophoblastic Tumor with multiple metastases was managed with initial chemotherapy (EMA-CO) and radiotherapy followed by surgery with good prognosis

Food poisoning is known to occur sporadically from time to time due to poor hygienic preparations. Its occurrence rarely assumes epidemic proportion. The objective was to report the occurrence of food poisoning due to yam flour among three families which occurred almost in quick succession between March and July 2007 among three families in Kano. They presented with diarrhea, vomiting, abdominal pain, convulsion and loss of consciousness. They all recovered within 48hours of admission. Investigations indicated that the use of certain lethal preservatives for the processing of the yam flour might be responsible. Poisoning from consumption of yam flour should be a differential diagnosis of acute seizure disorders or occurrence of vomiting, diarrhea and abdominal pain in the tropics. It is recommended that education on proper processing of all food products in view of the public health implication

Primary non-Hodgkin’s lymphomas (NHL) of the sinonasal tract are rather uncommon entities. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non- neoplastic processes. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and invasive fungal infection respectively. We report a case of primary NHL involving sinonasal tract in elderly female, which was clinically and radiologically mimicking as sinonasal malignany and was proven as NHL on histological examination and confirmed by immunohistochemistry. A high index of suspicion, appropriate histopathological examination and immunohistochemistry is necessary to differentiate sinonasal lymphomas from other possibilities. Failure to do so may miss the diagnosis and delay appropriate treatment

Pregnancy is a state, which is more prone for oxidative stress. Various studies report development of a strong defence mechanisms against free radical damage, as the pregnancy progresses. Aim of our study is to assess the antioxidant status by measuring the total antioxidant activity. Methods: Total antioxidant activity was assayed by Koracevic’ et al’s method, with the plasma of twenty five pregnant women (with normal blood pressure) as test group and twenty five age matched non-pregnant women as control group. All complicated pregnancies are excluded from the study. Results: Highly significant decline (P< 0.001) in antioxidant activity was observed in pregnant women with a value of 1.40 ± 0.25mmol/l, as compared to controls, 1.63 ± 0.21 mmol/l. Conclusion: Reduction in total antioxidant activity could be due to the fall in individual antioxidant levels. But several studies report an elevated enzymatic and non-enzymatic antioxidants during pregnancy. Any way total antioxidant activity is not a simple sum of individual antioxidants, but the dynamic equilibrium & cooperation between them. So inspite the rise in individual antioxidants , total antioxidant activity may be low. Further studies need to be done with antioxidant activity as a marker of complicated pregnancies like pregnancy induced hypertension.

Background & objective: Early detection and prompt treatment is the basis of tuberculosis control through reducing the reservoir of infection. The objective of the present study was to study the effect of reducing the screening criteria of chest symptomatics from existing ≥ 3 weeks to ≥ 2 weeks on case detection of smear positive tuberculosis and laboratory load. Methods: The present cross-sectional study was carried out at General Out-Patient Department (GOPD) of Kasturba Hospital, Sewagram. All the chest symptomatics with cough of two weeks or more than two weeks duration attending in GOPD were screened for pulmonary tuberculosis by examining the three sputum smears in designated microscopy center as per RNTCP guidelines. The data was entered and analyzed using epi_info 6.04d. Results: Number of sputum positive cases detected using RNTCP guideline (cough ≥ 3 weeks) for screening the chest symptomatic for AFB was 104. When, the screening guideline was modified from cough ≥ 3 weeks duration to cough ≥ 2 weeks duration, it yielded 138 cases. The yield of sputum positive cases of tuberculosis was increased by 32.7%. This also increased the laboratory load by 54.8%. Conclusion: The modifications of existing screening criteria from cough ≥ 3 weeks to cough ≥ 2 weeks increased the yield of sputum positive cases by 1.3 times and the laboratory (microscopy center) load by 1.5 times

Medical tourism aims at providing cost-effective customized health care in collaboration with the tourism industry in distant locations wherein the hospitality component is handled efficiently so that fixing appointments, making arrangements for accommodation and other logistics become hassle-free for the patient. This allows more concentration on the procedure at hand and the interaction between the medical fraternity and the patient becomes smoother. More and more hospitals in India are gearing up to provide such services to neighbouring countries and even to the developed nations across the world. The purpose of this study was to study the knowledge, attitude and experiences of the population of a suitable cross-section regarding the emerging scenario of medical tourism with special interest vis-à-vis Non Resident Indians (NRIs) specifically to the state of Karnataka and Mangalore in particular. It was found that compared to the locals (kannadigas or non-kannadigas), the Non-resident Indians were more dissatisfied with the health care facilities available in their proximity. Though a majority of them do have medical insurance, it still looks as if the care is more cost-effective when sourced to India. NRIs are more aware of the potential of medical tourism through their communication with the medical fraternity as well as the general public and 11.1% of NRIs have really utilized the services of medical tourism. An e-mail survey which was also conducted among a number of foreigners yielded the interesting fact that they indeed had a greater awareness regarding medical tourism with an emphasis on health tourism. The reason why these foreigners opted for medical tourism was due to the substandard medical care available in their locality, rather than due to the cost of medical care as such.

Background and Objective: Utilization of antenatal care in rural India is far from universal. It requires monitoring and identification of specific needs at field level for timely corrective actions. To pilot test the triangulation of rapid quantitative (Lot Quality Assurance Sampling) and qualitative (Focus Group Discussion) monitoring tools for ensuring antenatal care in a community based program. Methods: The present study was undertaken in surrounding 23 villages of Kasturba Rural Health Training Centre (KRHTC), Anji, which is also a field practice area of Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The monthly monitoring and action system of the study was based on the rapid quantitative monitoring tool (Lot Quality Assurance Sampling, LQAS)to find out poor performing supervision areas and overall antenatal service coverage and the qualitative methods (Focus group discussions (FGDs), and free listing) for exploring ongoing operational constraints in the processes for timely decision making at program and community level. A trained program supervisor paid house visit to 95 randomly selected pregnant women from 5 supervision areas by using pre-designed and pre-tested questionnaire. For poor performing indicators, semi structured FGDs and free listing exercise were undertaken to identify unmet service needs and reasons for its poor performance. Results: Registration of pregnancy within 12 weeks improved from 22.8% to 29.6%. The consumption of 100 or more IFA tablets during pregnancy significantly improved from 6.3% to 17.3%. There was significant improvement in awareness among pregnant women regarding danger signs and symptoms during pregnancy. Over three months period, the overall antenatal registration improved from 253 (67%) to 327 (86.7%). Conclusion: The present field based monitoring and action approach constructively identified the reasons for failures and directed specific collective actions to achieve the targets.

to create awareness, to screen samples of school adolescents and then to reach their community through them by doing surveillance for sickle cell disease. Design: Field based cross-sectional study. Settings: St Xavier`s high school and Vanraj high school of Umarpada taluka of Surat district. Subjects: School adolescents, their parents and friends. Method: After taking permission from school authority, blood samples of 948 school adolescents were taken for DTT test and then for electrophoresis. Blood samples of motivated parents and friends of those adolescents found positive for DTT was taken in subsequent visit and results were communicated to them. Results: Blood samples of 948 school adolescents, out of 1081 were tested for DTT test. It was positive in 242 samples, giving a prevalence of 25.5% for sickle cell disease. On subjecting the positive blood samples to electrophoresis, the proportion of sickle cell trait and sickle cell disease was found to be 92% and 8% respectively. Then electrophoresis was done in 64 parents and friends, 24 (37.5%) of them were found positive of which, 14 (58%) were having sickle cell trait and 10 (42%) having sickle cell disease. Conclusion: approaching community can be possible through school adolescents for conduction of surveillance of sickle cell anemia

Evaluating the needs of People Living with HIV / AIDS (PLHA) and providing them with adequate care and support is important in combating the Acquired Immunodeficiency Syndrome (AIDS) epidemic. Objectives: The study was conducted to ascertain the needs of PLHA, the support obtained and required, extent of involvement in programs related to HIV and evaluate the impact of Government programs as perceived by PLHA. Methods: A cross sectional study was conducted on 150 PLHA in the districts of Indore, Neemuch and Ujjain in the state of Madhya Pradesh (India) using semi-structured interview schedules. The data was analyzed using SPSS version 12.0. Results: The major support available to the patients is the free Anti-Retroviral Therapy (ART) available at Government health care centers. The other supports obtained from self help groups and NGOs were medicines for opportunistic infections, nutritional supplements, traveling allowance to ART center for monthly doses, free monthly ration and school fees for one child in the family. The major support required were an educational plan for children, free investigations at hospitals, decentralization of ART centers and adequate employment opportunities. Involvement of PLHA in health programs was minimal: the reasons for non-involvement being unwillingness, fear of disclosure and lack of opportunity. The respondents stated that Government policies have had a positive impact and changed the perception of the society towards HIV patients. Conclusion: PLHA have a number of unmet needs and a collaborative attempt from the government and support groups is needed to meet the needs of PLHA.

Thiols are the organic compounds that contain a sulphydryl group. Among all the antioxidants that are available in the body, thiols constitute the major portion of the total body antioxidants and they play a significant role in defense against reactive oxygen species. Total thiols composed of both intracellular and extracellular thiols either in the free form as oxidized or reduced glutathione, or thiols bound to proteins. Among the thiols that are bound to proteins, albumin makes the major portion of the protein bound thiols, which binds to sufhydryl group at its cysteine-34 portion. Apart from their role in defense against free radicals, thiols share significant role in detoxification, signal transduction, apoptosis and various other functions at molecular level. The thiol status in the body can be assessed easily by determining the serum levels of thiols. Decreased levels of thiols has been noted in various medical disorders including chronic renal failure and other disorders related to kidney, cardiovascular disorders, stroke and other neurological disorders, diabetes mellitus, alcoholic cirrhosis and various other disorders. Therapy using thiols has been under investigation for certain disorders

Sexual dysfunction is the impairment or disruption of any of the three phases of normal sexual functioning, including loss of libido, impairment of physiological arousal and loss, delay or alteration of orgasm. Each one of these can be affected by an orchestra of factors like senility, medical and surgical illnesses, medications and drugs of abuse. Non-pharmacological therapy is the main stay in the treatment of sexual dysfunction and drugs are used as adjuncts for a quicker and better result. Management in many of the cases depends on the primary cause. Here is a review of the major etiological factors of sexual dysfunction and its management

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’