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Byline: Reena. Sharma, Sunil. Sharma, Shramika. Pawar, Ajay. Chaubey, S. Kantharia, D A R. Babu The screen-film system is replaced by computed radiography system for recording the images of the [...]

Introduction: Leptospirosis is a zoonotic disease with worldwide distribution caused by pathogenic leptospira. Leptospirosis is more prevalent in South Gujarat due to heavy rain, salinity of soil and water logging. Aims & objectives: The current study was conducted to know the profile of patients who were admitted as suspected Leptospirosis cases in New Civil Hospital, Surat (NCHS). Material and Methods: A prospective study, carried out between July to October 2013. The profile of patients who were suspected for Leptospirosis and admitted in NCHS was obtained using standard pre designed structured questionnaire. Statistical Analysis: Data entry and analysis was done in excel and SPSS v 16. Results: Among the 159 suspected cases of Leptospirosis, 111 (69.8%) were males and age of patients ranged from 15 to 80 years with mean age of 37.45 years. Fever, myalgia, and headache were predominant complaints and all had history of contact with animals or contaminated environment. Liver functions and renal functions were deranged in 52.2% and 45.3% cases respectively. Calftenderness having higher negative predictive value of 84% and fever having the higher positive predictive value of 92.9% so we can say suspected cases having both symptoms together has higher chance of Leptospirosis. Conclusions: Majority of the patients belong to the rural area and almost all had history of contact with animals. Fever, myalgia (calf tenderness), jaundice and conjunctival suff usion were characteristic findings. Jaundice and renal failure are associated with severity of the disease and are considered bad prognostic signs with high mortality rate (54%). More than 50% of patients, who died due to Leptospirosis, were alcoholic. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the cognitive impairment and depression among elderly patients in India. The subjects were patients from the Curative and Preventive General Practice with 82 male and 71 female. The screening test Mini-Mental Status Examination was used to screen for cognitive impairment while Geriatric Depression Scale-15 was used to evaluate for depression. The results of the study were explored.

Introduction: New digital media have dramatically altered the communication landscape, especially for youth. “Indian web users spend 26 minutes online each day”. This study is concerned with effect of social networking on youth regarding potential risk, safety, wellbeing & skill development because they are still maturing & forming the ability to attain & implement communication & conflict resolution skill on interpersonal level. Aim & objective: To explore the impact of social networking on communication & conflict resolution skills among first MBBS students. Material & Methods: A cross-sectional study was carried out on 122 first year MBBS students using semi structured questionnaire after taking their consent. Data collection was based on purposive sampling. Data entry and analysis was done using excel and SPSS v16. Result: Mean age of participants was 17.7 + 0.62 years, All the participants 122 (100%) have their own cell phone & 112 (91.8%) were using internet. Majority of participants have their profile on Facebook 100 (81.9%) and What’s app 105 (86.1%). Twenty seven percent (33) participants strongly agreed that “people who rely on social networking are losing the ability to talk with others”, while 50 (41%) strongly disagreed to it. More than forty seven percent (58) of participants were of strong belief that “people cannot effectively solve problem using social networking”. More than half (52.4%) of participants said that “it’s easy to take things the wrong way during social networking”. Conclusion: The study shows that participants have replaced traditional methods of communication with social networking on which they spend a fair amount of time. Use of social networking sites helped half of the adolescents to open up to the world but these sites did not help much in conflict resolution as responded by nearly half of participants.

Introduction: Gujarat State AIDS Control Society with support from UNICEF Gujarat has initiated as unique project for prevention of HIV /AIDS at rural set up since 2008, which is known as Link Workers’ scheme. Link Workers (LWs) are working in each cluster of villages around a 5,000+ population village which will serve as the node for intervention. They are supported in their work by village level volunteers selected from the available groups in the community. Methodology: 140 Link workers and 70 volunteers from 70 villages of 14 blocks of district Surat were invited for the study. Due to few vacant posts, total 183 participants took part in the study; out of these 117 were link workers (LWs) while 66 were volunteers. Their Knowledge regarding HIV/AIDS and STI were assessed on a predesigned pretested semi structured study tool. Result: 96.59% link workers and 93.44% volunteers had knowledge about condom use as a method of preventing HIV infection. The concern issue is that only 11.11% LWs and 13.64% volunteers revealed that HIV testing during ANC check up can also prevent HIV transmission from mother to child, inspite of receiving induction training. Only 74.36% LWs and 68.31% volunteers were able to tell about three or more HIV preventive methods. Recommendations: Refresher training and exposure visit to HIV care centres are needed for these workers to strengthen their knowledge.

174 children of 9 to 23 months age from different localities of Surat city (Gujrat) were studied for sero-conversion by estimation of pre and post measles immunization H.I. antibody titres. 71 children and detectable H.I. antibody titres (16). Sero â€" conversion rate was 74.7 % in children having detectable H.I. antibodies. Increasing age, higher levels of H.I. antibody titres and prolonged interval between immunization and collection of post immunization blood sample had negative effects on sero â€" conversion. There was no effect of malnutrition and Socio- economic status on sero- conversion is discussed. The filter paper technique though simple and very suitable for field conditions, has a tendency to under report the sero â€" conversion after measles immunization.

Cancer is a multifactorial, multi-step process of pathogenesis; however, in the case of familial cancers, genetic aetiology can play a significant role. Identifying genetic variants in cancer patients having a strong family history of cancer as well as their unaffected blood relatives can unravel their role in predisposition to cancer. Here, we report the findings of whole-exome sequencing in a patient (77/F) diagnosed with ovarian cancer and her daughters (61/F) and (59/F) who were diagnosed with breast and ovarian cancers along with her asymptomatic son (53/M). All the four family members show segregation of RAD51D (rs200564819). Other incidental findings ADAMTS13 (rs142572218) and SYCE1 (rs201873178) genetic variants in proband and son, and LIAS (rs546751789) and PDHA1 (rs747051654) genetic variants in son have also been reported.

Introduction: Certain elbow pathologies can give rise to considerable loss of joint function, which would severely affect the daily living activities of the patients. Total elbow arthroplasty (TEA) can be a safe and reasonable motion-preserving and pain-relieving option in such debilitating elbow conditions. The aim of this case series is to evaluate the functional outcome of TEA in young patients with four different indications after an 8-year follow-up., Case Report: We report a case series of four TEA cases done for different indications, namely rheumatoid arthritis, chronic elbow dislocation, post-traumatic elbow ankylosis, and failed primary total elbow replacement, all in relatively young patients. All patients were given a semi-constrained Coonrad-Morrey prosthesis using a posterior Bryan-Morrey approach. The cases were done during the years 2013-2014. Eight-year follow-up of each case showed excellent functional outcome and persistent pain relief with a high Mayo Elbow Performance Score. All the patients have given written consent for publishing this article., Conclusion: Despite being uncommon, total elbow replacement can be the choice of surgery for certain elbow affections, giving satisfactory functional recovery and good pain relief, even in a younger population., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Background: Using prior mammograms from patients with delays in their breast cancer diagnoses, we sought to describe in-vivo growth kinetics of untreated breast cancer to determine if the time they became clinically apparent can be predicted., Methods: Patient and tumor characteristics were collected from those who presented with "missed," untreated breast cancer to a breast center in a single institution. Only patients whose biopsied masses revealed estrogen receptor-positive, Her2-negative (ER+/Her2-) invasive cancers were included. Two attending radiologists reviewed images from prior mammograms. Rates of change in volume were calculated in mm 3 /day, and a logarithmic equation was used to calculate tumor volume doubling time (TVDT). A Spearman's Rho correlation was performed for the continuous variables, and the Mann-Whitney U and Kruskal-Wallis tests were used to compare categorical data. A p value < 0.05 was considered statistically significant. Logistic regression was performed to determine if patient or tumor characteristics were correlated to tumor growth velocity., Results: Of the 36 ER+/Her2- invasive breast cancers included in the analysis, 13 (36%) were at least cT2 (of TNM), 7 (19%) were grade 3, and 7 (19%) were node positive at diagnosis. Grade (p = 0.043) and pathologic invasive tumor size (p = 0.001) were positively correlated to tumor growth velocity. Median TVDT was 385 days (23-1897). Age, nodal positivity, Oncotype Dx® Recurrence Score, time of diagnostic delay, and spheroid-ellipsoid discrepancy (SED) were not related to tumor growth velocity in this sample., Conclusion: In this cohort of patients with untreated ER+/Her2- invasive breast cancers, grade and pathologic tumor size were found to be positively correlated to growth velocity. The growth rates in a homogeneous group of tumors varied widely and could not be predicted. One possible explanation for this finding is that other difficult-to-measure biologic factors such as tumor microenvironment may play a greater role in tumor progression than traditional clinicopathologic characteristics.

This study evaluates a family with two siblings having severe growth retardation and facial dysmorphism, born to consanguineous normal healthy parents. Affymetrix CytoScan 750K microarray showed a 34-Mb pericentric homozygous region on chromosome 6 for both siblings. CUL7 was one of the 141 genes present in this region. Sanger sequencing of CUL7 gene detected a 2-bp novel deletion in the 15th exon (c.2943&#95;2944delCT of the cDNA). This deletion leads to a frameshift and a premature termination signal much upstream of the wild-type termination signal, leading to a nonsense mediated decay of the mRNA. CUL7 protein plays an important role in formation of 3M complex, ubiquitination, microtubule dynamics and cell cycle regulation. Mutations in CUL7 gene is known to cause a rare 3M syndrome. Information about the novel mutation has been accepted in the ClinVar database with rs1064792895.

Indian women with breast cancer are usually diagnosed in advanced stages leading to poor survival. Improving breast awareness and increasing access to early diagnosis and adequate treatment has been advocated for breast cancer control. We implemented a program to increase awareness on breast cancer and access to its early detection in an occupational health care scheme in Mumbai, India. Breast awareness brochures were mailed annually between June 2013 and June 2016 to a cohort of 22,500 eligible women aged 30-69 years old receiving universal health care from an occupational health care scheme comprising of primary health centres and a referral secondary care hospital in Mumbai. Women with suspected breast cancers were provided with diagnostic investigations and treatment. Socio-demographic information and tumour characteristics were compared between the breast awareness pre-intervention period (Jan 2005-May 2013) and the breast awareness intervention period after four rounds of mailers (June 2013-June 2016). The proportion of women with early tumours and axillary lymph node negative cancers increased from 74% to 81% and 46% to 53% respectively, between the two periods. While the proportion of patients receiving breast conserving surgery increased from 39% to 51%, the proportion receiving chemotherapy decreased from 84% to 56%. Interim results following efforts to improve breast awareness and access to care in a cohort of women in an occupational health care scheme indicate early detection and more conservative treatment of breast cancers. Creating awareness and improving access to care may result in cancer down-staging., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Fibroblasts and macrophages are the two major types of cells responding to implanted biomaterials. They play crucial roles in inflammatory responses, host-material interactions and tissue remodeling. However, the synergistic interactions of these two cell types with biomaterials are not fully understood. In this investigation, an in vitro fibroblast/macrophage co-culture system was utilized to examine the biocompatibility and the potential to induce inflammatory responses of an electrospun Dextran/PLGA scaffold. The scaffold did not affect the morphologies, attachments, proliferations and viabilities of both the fibroblasts and macrophages, cultured separately or together. Moreover, it only activated a small subset of the macrophages implicating a low potential to induce either severe acute or chronic inflammatory response. Additionally, fibroblasts played a role in prolonging macrophage activation in the presence of the scaffolds. Using antibody arrays, IL-10, SDF-1, MIP-1 gamma and RANTES were found to be up-regulated when the cells were incubated with the scaffolds. The results of subdermal implantation of the Dextran/PLGA scaffolds confirmed its biocompatibility and low inflammatory potential.

Background & Objective: Iodine deficiency disorders (IDDs) are one of the worldwide public health problems of today. IDDs are endemic in various districts of Gujarat. We undertook this survey in Panchmahal district of Gujarat to study the prevalence of goiter in a sample of school children, to asses the level of iodine in salt samples, and to determine median urinary iodine concentration in a sample of children., Methods: In a cross-sectional study, 15,900 school-going children in the age group of 6-12 yr were studied from 10 talukas. A total of 15 clusters were selected by cluster sampling method. Goitre was assessed in the children and urine and salt samples were studied for iodine concentration., Results: The overall prevalence of goitre was 20.5 per cent among the children examined. The median iodine concentration was 70 mg/l indicating mild iodine deficiency; also 61 per cent of the urine samples examined showed iodine insufficiency. Iodine content was found to be adequate in 54.3 per cent of salt samples., Interpretation & Conclusion: Our study showed that goitre is still an important public health problem in the district. This calls for identification of factors to strengthen NIDDCP and the need to reimpose ban on sale of non-iodized salt in Gujarat.

An industrial area with poor sanitation and inhabited by migrant, male predominant population, situated South to Surat City, experienced an outbreak of pyogenic meningitis during 1985-87. A total of 197 cases of meningitis with 34 deaths were reported during a period of 1 1/2 years. Neisseria meningitidis was the predominant pathogen isolated from 66 out of 138 CSF samples. Recently migrated males of productive age groups drawn from the States of Uttar Pradesh and Orissa were predominantly affected. Male to female ratio was found to be 7.2:1. Nearly 2/3rd of the cases were reported during the dry colder months of winter and spring. Pregnancy and childbirth appeared to be important predisposing factors in females. Nine cases were reported from the family contacts of cases. Majority of the cases were labourers doing manual work.