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Research on money management practices followed by selected homemakers was conducted among purposively selected 150 homemakers 50 each from beginning, expanding and contracting stage of family life cycle. Personal interview method with prescheduled questionnaire was conducted to collect information on financial practices followed in family living. The data were analysed statistically by applying Z test and correlation co-efficient test. It was observed from the study that purchasing lists were prepared by more number of homemakers from beginning and expanding stage of family life cycle. More than eighty per cent of the homemakers from beginning (86%), expanding (98%) and contracting (90%) stages of family life cycle felt necessity of maintaining the account of expenses. It was observed that in beginning and expanding stages of family life cycle the homemakers involved in majority of purchases and payments were more as compared to the homemakers from contracting stage of family life cycle.

Introduction: Aerosols and droplets contaminated with bacteria and blood are produced during ultrasonic scaling. Measures to control aerosol contamination in dental clinics are recommended by the Centers for Disease Control and Prevention. This study aimed to evaluate the efficacy of preprocedural boric acid (BA) mouthrinse in reducing bacterial contamination in dental aerosols generated during ultrasonic scaling. Materials and Methods: This was a randomised clinical trial in 90 systemically healthy subjects (25-55 yrs) diagnosed with chronic periodontitis who were allocated into three groups of 30 subjects each to receive, Group A - 0.12% chlorhexidine (CHX), Group B - 0.75% BA and Group C-water, as a preprocedural rinse for 1 min. The aerosol generated while performing ultrasonic scaling for 30 min was collected at three locations on blood agar plates. Incubation of the blood agar plates at 37°C for next 48 h for aerobic culture was performed and subsequently colony-forming units (CFUs) were counted. Results: CFUs in Group A were significantly reduced compared with Group B (P < 0.001). When we compare CFUs in all the three groups, CFUs in Groups A and B were statistically significantly reduced compared with Group C (P < 0.001). Furthermore, it was also observed that the assistant's chest area had lowest CFUs whereas patient's chest area had highest. Conclusion: This study recommends routine use of preprocedural mouthrinse as a measure to reduce bacterial aerosols generated during ultrasonic scaling and that 0.12% CHX gluconate is more effective than 0.75% BA mouthwash in reducing CFUs count.

The present study was carried among 30 pesticide applicators from Marathwada region. Incidence of musculoskeletal problems of the pesticide applicators was identified by using Psychophysical techniques developed by Corlett and Bishop (1976). It is concluded that the majority of the pesticide applicants had light pain in neck (46.66), severe pain in shoulder (83.33%)and upper back (70%) while performing the task of pesticide application. Itching (70%), skin rash (86.66%) omitting and headache (53.33%) were the other health issues reported by pesticide applicators.

Blended oils have many uses when compared with single oils, due to presence of high Omega9 levels. They help in brain development and reduce the risk of heart diseases. This investigation of blended oils was chosen taking into consideration the regular use of coconut oil (CO), palm oil (PAO), peanut oil (PO), and groundnut oil (GO), and using these blends three popular South Indian snacks were prepared. The oil blending was in the proportion of 50:50 using four different oils. This study includes the physicochemical properties of blended oils such as their pH, colour, nutritional assessment, and changes in the parameters of mixed oils. Additionally, these oil mixes were utilized for preparing different types of gram flour snacks including potato fries, pakoda, and karasev. The shelf life of the snacks was studied, considering the changes in their synthetic and tangible attributes. The changes seen in the oil separated from the fried items were very close to that of the control. Tangible assessment of the prepared fritters showed that they were synthetically safe to eat for up to two weeks. Six oil blends (CO:PO, CO:PAO, CO:GO, PO:GO, PO:PAO, and GO:PAO) were prepared successfully. Among the blended oils, coconut oil with peanut oil showed the highest spread ability, while groundnut oil with palm oil showed the lowest spread ability. The coconut and groundnut oil blend showed the highest ratio (58.8%) of unsaturated to saturated fatty acids. Polyunsaturated linoleic acid (18:2; 24.3%), α-linoleic acid (18:2; 5%), oleic acid (18:1; 25%), capric acid (2.8%), lauric acid (1.8%), myristic acid (1.6%), palmitic acid (16:0; 14.5%), and steric acid (18:0; 9.2%) were seen in the coconut and groundnut oil blend. The palm and peanut oil blend showed the least ratio (51.4%) for unsaturated and saturated oils, with oleic acid (21%), lauric acid (1.9%), and α-linoleic acid (2%). Among all the blended oils, coconut oil mixed with groundnut oil showed the highest level of acceptability for gram flour products. The content of free fatty acids was very high in the combination of palm and peanut oil. The three gram flour products prepared using blends of coconut oil and groundnut oil showed good appearance (8%), flavour of the product prepared with combinations of groundnut (refined) oil has high acceptability, good texture (8%), high acceptability (8%) in taste and overall acceptability of sensory evaluation. These blends in the future may develop good quality oils giving a high shelf life to food products.

Introduction: Patients admitted in Intensive Cardiac Care unit (ICCU) are critically ill cardiac patients. Cardiovascular diseases (CVDs) are the main cause of mortality globally and are the leading cause of death in India also. The Intensive Cardiac Care unit is routinely equipped with a system that permits continuous monitoring of the cardiac rhythm of each patient and hemodynamic monitoring in selected patients. The various drugs used in ICCU and there clinical outcome was investigated in this study. Materials and Methods: Patients admitted between January 2017 – June 2018 in Medicine Intensive cardiac care unit were included in this study. Results: Total of 359 prescriptions was analyzed from the Intensive cardiac care unit. Out of 359 patients, 228 (63.51%) were male, while 131 (36.49%) were female. The mean age of the patients admitted in ICCU was 55.68 +13.54 years. The most common type of patients admitted in ICCU have the diagnosis of Acute myocardial infarction (77.16%), followed by Ischemic heart disease (8.36%), Cardiogenic shock (4.18%), Left Bundle Branch Block (3.62%), Rheumatic heart disease (2.79%) and Supraventricular tachycardia (2.23%). The most common drugs prescribed in ICCU were Aspirin, Clopidegrol and Atorvastatin. Other drugs most commonly used are Metoprolol (95.82%), Ramipril (92.48%), Isosorbitedinitrate (86.07%), Ranitidine (83.29%). Conclusion: In conclusion, after analyzing the prescriptions we found that the drugs used in ICCU like anti-platelets (clopidogrel and aspirin), anti-coagulants (LMWH), statins (atorvastatin) and nitrates (Isosorbidedinitrate) were in large quantities. This finding correlates with the standard recommended guidelines for cardiovascular emergencies. The present study provides valuable insight about the overall pattern of drugs used in intensive cardiac care unit. Keywords: Drug utilization study, Intensive cardiac care unit, Anti-platelets.

Phishing is the despicable utilization of electronic interchanges to trick clients. Phishing assaults resolve to increase delicate data like usernames, passwords, MasterCard information, network qualifications, and the sky is the limit from there. Phishing assaults endeavor to increase touchy, secret data, for example, usernames, passwords, charge card data, network qualifications, and then some. Phishing Websites copy the first sites so clients believe that they are utilizing the first sites. On account of phishing assaults, each individuals and associations are at threat. Phishing assaults might be forestalled by identifying the sites and serving to clients to detect the phishing sites. To distinguish the phishing sites, there have been various strategies applied. Diverse machine learning methods, information mining procedures, neural organization and different calculations have been utilized for anticipating or ordering or distinguishing the phishing sites. This paper aims at surveying on recently proposed phishing detection techniques.

Initially Internet is used for data communication but now a day with the help of VoIP technology we are able to transmit voice and video streams over the internet. This paper describes IP-PBX server based on Asterisk. Asterisk is one of the first open source PBX software. Traditional EPABX system have many disadvantages over Internet Protocol Private Branch Exchange (IP-PBX). This paper contains brief introduction about SIP and IAX protocol along with its channel configuration in Asterisk. Bandwidth comparisons of SIP and IAX calls with two different codecs G.711 and GSM is done by online erlag’s B software.

The amount of textual data that we are exposed to is growing each day. It is very difficult to browse through all the available textual matter to find relevant material or to read through all the information in order to stay updated. To keep up with the pace, the need for a tool that can automatically reduce the amount of content while also retaining the key points and essence of long pieces of text arises. Automatic text summarization mechanisms form a solution well suited to this problem which is what our proposed model aims to implement. In this paper, a Natural Language Processing based extractive approach is used for summarization of a single document. An extractive summary is assembled by selection of a subset of information rich sentences from the source document. A supervised approach is used here in which Support Vector Machine, K-Nearest Neighbour and Decision Tree algorithms are used to generate models whose performances are compared using ROUGE metric. The highest scoring model is used to summarize an unseen document. The summary is displayed as text and converted to audio form. The results obtained using the proposed approach are sufficiently good as average F1 scores secured for ROUGE-1, ROUGE-2 and ROUGE-L are 0.706, 0.630 and 0.434 respectively.

In Chaps. 2, 3, and 4, we discussed point estimation of a parameter and studied the large sample optimality properties of the estimators. We also discussed interval estimation for large n. The present and the next chapters are devoted to the large sample test procedures. All the results about the estimators established in Chaps. 2, 3, and 4 are heavily used in both the chapters. Most of the theory of testing of hypotheses has revolved around the Neyman-Pearson lemma, which leads to the most powerful test for simple null against simple alternative hypothesis. It also leads to the uniformly most powerful tests in certain models, in particular for exponential families. A likelihood ratio test procedure, which we discuss in the second section, is also an extension of Neyman-Pearson lemma in some sense. Likelihood ratio test procedure is the most general test procedure when the parameter space is either a subset of \(\mathbb {R}\) or \(\mathbb {R}^k\). Whenever an optimal test exists, such as the most powerful test, uniformly most powerful test, uniformly most powerful unbiased test, the likelihood ratio test procedure leads to the optimal test procedure. In Chap. 5, we discuss likelihood ratio test procedure when the null hypothesis is simple or composite. We derive the asymptotic null distribution of the test statistic in all such cases under the assumption that the probability law \(f(x, \theta )\) belongs to Cramer family. In the last section we illustrate use of R software in large sample test procedures and in likelihood ratio test procedures.

Chapter 6 presents the theory related to the asymptotic null distribution in goodness of fit test procedures and in tests for contingency tables. All tests related to contingency table and all goodness of fit tests are the likelihood ratio tests when the underlying probability model is a multinomial distribution. Section 6.2 is devoted to a study of multinomial distribution, where we discuss the maximum likelihood estimation of cell probabilities and study the asymptotic properties of these estimators. Some tests associated with multinomial distribution are also developed. Section 6.3 presents the role of multinomial distribution in goodness of fit tests, which are essentially the tests for validity of the model. In goodness of test procedures the most frequently used test statistics is Karl Pearson’s test statistic. We prove that the likelihood ratio test statistic and Pearson’s test statistic for testing some hypotheses in a multinomial distribution are equivalent, in the sense that their asymptotic null distributions are the same. In Sect. 6.4, we study Wald’s test procedure and score test procedure. It is proved that asymptotic null distribution of likelihood ratio test statistic, test statistics in Wald’s test procedure and score test procedure is the same. An important finding of this section is the link between a score test statistic and Karl Pearson’s chi-square test statistic. It is proved that while testing any hypothesis about the parameters of a multinomial distribution, these two statistics are identical. A contingency table provides a technique for investigating the suspected relationships. Section 6.5 is devoted to various test procedures for two way and three way contingency tables, which are again likelihood ratio test procedures when underlying probability model is a multinomial distribution. Consistency of a test procedure is an optimality criterion for a test procedure. It is briefly discussed in Sect. 6.6. Section 6.7 elaborates on the application of \(\texttt {R}\) software to validate various results proved in earlier sections, to perform the goodness of test procedures and tests for contingency tables.

As discussed in Chap. 1, in asymptotic inference theory, we study the limiting behavior of a sequence \(\{T_n, n \ge 1\}\) of estimators of \(\theta \) and examine how close it is to \(\theta \) using various modes of convergence. The most frequently investigated large sample property of an estimator is weak consistency. Weak consistency of an estimator is defined in terms of convergence in probability. We examine how close the estimator is to the true parameter value in terms of probability of proximity. Weak consistency is always referred to as consistency in literature. In Sect. 2.1, we define it for a real parameter and illustrate by a variety of examples. We study some properties of consistent estimators, the most important being the invariance of consistency under continuous transformation. Strong consistency and uniform consistency of an estimator are discussed briefly in Sects. 2.3 and 2.4. In Sect. 2.5, we define consistency when the distribution of a random variable or a random vector is indexed by a vector parameter. It is defined in two ways as marginal consistency and joint consistency, the two approaches are shown to be equivalent. This result is heavily used in applications. Thus, to obtain a consistent estimator for a vector parameter, one can proceed marginally and use all the tools discussed in Sect. 2.2. From examples in Sects. 2.2 and 2.5, we note that, for a given parameter, one can have an uncountable family of consistent estimators and hence one has to deal with the problem of selecting the best from the family. It is discussed in Sect. 2.6. Within a family of consistent estimators of \(\theta \), the performance of a consistent estimator is judged by the rate of convergence of a true coverage probability to 1 and of MSE to 0 for a consistent estimator whose MSE exists, faster the rate better is the estimator. Section 2.7 is devoted to the verification of the consistency of an estimator by simulation. It is illustrated through some examples and \(\texttt {R}\) software.

In Chapter 7, the solutions to almost all the conceptual exercises from Chaps. 2 to 6 are presented. Chapter 2 has 36 exercises while Chap. 3 contains 37 exercises. Chapters 4, 5 and 6 contains 11, 11 and 6 exercises respectively. There are 85 multiple choice questions with the answer key.

Chapter 3 addresses the concept of consistent and asymptotically normal (CAN) estimators. Suppose \(T_n\) is a consistent estimator of \(\theta \). In view of the fact that convergence in probability implies convergence in law, \(T_n {\mathop {\rightarrow }\limits ^{L}} \theta , ~~\forall ~~~ \theta \). Thus, the asymptotic distribution of \(T_n\) is degenerate at \(\theta \). Such a degenerate distribution is not helpful to find the rate of convergence or to find an interval estimator of \(\theta \). Hence, we try to find a blowing factor \(a_n\) such that the asymptotic distribution of \(a_n ( T_n - \theta )\) is non-degenerate. In particular, we find a sequence \(\{a_n, n \ge 1\}\) of positive real numbers tending to \(\infty \) as \(n \rightarrow \infty \), such that the asymptotic distribution of \(a_n ( T_n - \theta )\) is non-degenerate. It is particularly of interest to find a sequence \(\{a_n, n \ge 1\}\) of real numbers tending to \(\infty \) as \(n \rightarrow \infty \), so that the asymptotic distribution of \(a_n ( T_n - \theta )\) is normal. Estimators for which large sample distribution of \(a_n ( T_n - \theta )\) is normal, are known as CAN estimators. These play a key role in large sample inference theory, in particular, to construct large sample confidence intervals and approximating the distribution of test statistic in large sample test procedures. We discuss variance stabilization technique and studentization technique to construct large sample confidence intervals. In Sects. 3.2 and 3.3 , we investigate various properties of CAN estimators based on sample moments and sample quantiles, for a real as well as a vector parameter respectively and illustrate with several examples. Section 3.4 is concerned with verification of CAN property by simulation using R software.

Objective: The objective of this study was to analyze demographics, management pattern, and clinical outcomes in patients with organophosphorus poisoning. Methods: In this subgroup analysis of retrospective data of patients admitted in intensive care unit (ICU) with a diagnosis of acute organophosphorus poisoning, demographic details, pattern of use of medicines, dose of atropine and pralidoxime (PRAM), duration of ICU stay, and clinical outcomes were analyzed. Results: A total of 92 patients with organophosphorus poisoning (mean age 34.7 years; male 69 [75%]) were included. The age of male patients was more than female patients (36.2 vs. 30.0 years; p=0.047). Atropine and PRAM were given to all patients. Ondansetron was used in all patients, whereas ranitidine was used in 91 (98.9%) patients. The mean total dose of atropine in male and female population was 99.5 mg and 89.0 mg, respectively (p=0.298). The mean total dose of PRAM in male and female population was 12.2 mg and 12.0 mg, respectively (p=0.772). There was no difference in the mean (standard deviation) duration of stay in ICU between male patients and female patients (7.6 [4.5] vs. 6.4 [3.9] days; p=0.249). A total of 61 (66.3%) patients were transferred to the ward, whereas 30 (32.6%) died. Conclusion: Atropine and PRAM are the primary drugs for the treatment of organophosphorus poisoning. Ondansetron and ranitidine are useful drugs for the treatment of vomiting and gastric irritation, respectively, in these patients.

We deal with estimation of parameters of lifetime distribution of components which form a coherent system. It is assumed that the system lifetime and the number of failed components up to the moment of the system failure, including the component which fails at the system failure epoch, are observed for each system.We apply the theory of optimal estimating functions and obtain optimal estimators of the parameters assuming that component lifetime has exponential and Weibull distribution. We apply Fisher’s conditionality principle and obtain properties of estimators of the system based on the conditional distribution of the system life-time, given the number of failed components in the system. Exact conditional distributions of the estimators as well as conditional consistency and asymptotic normality have been discussed for both the models. We also compare the proposed estimators with some of the existing estimators.

Background: Nutraceuticals use is increasing in a health-conscious society. Because of varying lifestyle diseases, people have changed their outlook towards nutraceuticals. The objective of the study was to study the prescription pattern of nutraceuticals by doctors in paediatric outpatient department of government medical college and hospital, Aurangabad, Maharashtra, India.Methods: This study was done between November 2018 to March 2019. Total of 156 patients were included in the study after obtaining written informed consent from parents of patients. The data was gathered, analysed and results were concluded.Results: Total 156 patients were prescribed nutraceuticals in paediatric outpatient department of which 51.92% female patients and 48.78% male patients received nutraceuticals. In this study, 62% patients received vitamins and 38% patients received vitamins and minerals. 67.31% patient receiving nutraceuticals were above the age of 6 years and 32.69% patients were under the age of 6 years. Among patients receiving nutraceuticals, B complex was received 55.77%. After that calcium lactate + vitamin D tablet were prescribed 21.80%. Ferrous sulfate + folic acid was received by 8.33% patients. Calcium carbonate + vitamin D3 were received by 7.69% patients. Folic acid tablet was received by 5.13% patients and poly-vitamin tablet by 1.28% patients. 100% prescriptions were prescribed in generic names.Conclusions: Nutraceuticals are being increasingly perceived as beneficial to health and are being continuously used in the treatment. The future of nutraceuticals is bright and can transform healthcare in a developing country like India.

Background: A mental disorder or psychiatry disorder is a behavioural or mental pattern that causes significant distress or impairment of personal functioning. Schizophrenia is one of the most common psychiatric disorders. Aim of the study is to study drug utilization pattern in schizophrenia patients in outpatient department of psychiatry.Methods: A prospective and observational study was conducted in psychiatry outpatient department between May 2018 to October 2018 at Government Medical College and Hospital Aurangabad. Approval from ethics committee was taken. Data collected was of age, sex, final diagnosis, drugs prescribed to patients from case report form. The data obtained was then analyzed in Microsoft excel.Results: Total prescriptions of 129 patients were analyzed. Out of 129 patients 99 (76.74%) were male, while 30 (23.26%) were female. The mean age of the patients admitted in Psychiatry OPD was 36.71±11.76 years. Number of drugs prescribed per patient being 3.40±1.12 (mean±SD). The most common drugs used were olanzapine (66.6%), trihexyphenidyl (51.9%), lorazepam (44.9%), risperidone (39.5%), trifluoperazine (27.9%).Conclusions: Our study shows that atypical antipsychotics were the most common drugs prescribed in patients. Olanzapine was the most common medication used followed by risperidone. Our prospective study is carried out to get a more comprehensive data so that we can improve the drug utilization in our hospital.

Background: The medical intensive care unit (MICU) is a setting were patients who are critically ill are admitted and thus usually receive a large number of drugs of different pharmacological classes due to life threatening illnesses which may be fatal. The various drugs used in MICU and there clinical outcome was investigated in this study.Methods: Patients admitted between January 2017 to June 2018 in Medicine ICU of GMC Aurangabad were included in this study.Results: Total of 351 prescriptions was analyzed from the medicine intensive care unit. Out of 351 patients 243 (69.23%) were male, while 108 (30.77%) were female. The mean age of the patients admitted in MICU was 42.78±18.14 years. The most common type of patients admitted in MICU have the diagnosis of organophosphorous poisoning (25.36%), followed by cerebrovascular accident (15.95%), pneumonitis (10.26%), snake bite (7.12%), chronic kidney disease (5.98%), diabetic ketoacidosis (5.70%) and seizure disorder (3.42%). The most common drugs used were ranitidine (99.71%) and ondansetron (99.43%). Among antibiotics cephalosporins were most commonly used, ceftriaxone (39.03%), cefotaxim (40.46%), cefoperazone and sulbactum (24.22%). Other antibiotics most commonly used were metronidazole (61.25%), amoxicillin and potassium clavulanate (26.78%), piperacillin and tazobactum (11.68%), meropenem (11.40%).Conclusions: In conclusion, we found that in MICU utilization rate of gastroprotective (ranitidine), antiemetic (ondansetron) and antibiotics (cephalosporins) was high. The present study provides valuable insight about the overall pattern of drugs used in medicine intensive care unit.

Background: Hepatitis B is the most important infectious occupational disease for the dental health care workers (DHCWs). DHCWs frequently come in contact with blood and saliva and hence are at risk for Hepatitis B virus (HBV) exposure. Studies indicate that DHCWs, through occupational exposure, may have a 10 times greater risk of becoming a chronic hepatitis B carrier than the average citizen. The study was conducted to estimate the seroprevalence of HBV infection among dental students enrolled at a private dental institution in Mysuru, Karnataka, India. Methods: A cross sectional seroprevalencestudy was conducted which included dental students who were enrolled in the dental institution. Data were collected by administering a standard questionnaire to every student regarding their personal health information. Their blood samples were collected and tested by Enzyme Linked Immunosorbent assay (ELISA) for Hepatitis B surface antigen. Results: 352 dental students who gave consent were screened out of a total of 453 dental students. Out of 352 students, 163 (46%) were vaccinated and 189 (54%) were non-vaccinated. All the dental students were found to be seronegative for HBV infection. Conclusions: Though a low rate of HBV infection was observed among dental students, a significant number of dental students were non-vaccinated which suggests a need for proactive implementation of HBV vaccination programme.

OBJECTIVE A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled. The major (>10%) indications for surgery were carcinoma/tumor - 25 (22.73%), perforation peritonitis - 20 (18.18%), and intestinal obstruction - 11 (10%). All patients received ranitidine plus metoclopramide. Injections of ondansetron, midazolam, pentazocin, anticholinergic agents, and fentanyl were used in 103 (93.64%), 103 (93.64%), 92 (83.64%), 84 (76.36%), and 23 (20.91%) patients, respectively. The dosage of ondansetron was 4 mg in 95 patients (86.36%), while 89.09% patients received 1 mg of midazolam. In 86 patients (78.18%), pentazocine was used in a 15 mg dose. Among the anticholinergic agents, glycopyrrolate was used in 76 patients (69.09%). Glycopyrrolate was used in a 0.2 mg dose in 74 patients (97.37%). The major indications for the use of fentanyl were carcinoma - 8 (34.8%), perforation peritonitis - 4 (17.4%), and surgery for intestinal obstruction - 3 (13%). CONCLUSION The administration of ondansetron, midazolam, and pentazocin is very common (>80% patients) as pre-anesthetic medication. Glycopyrrolate was the preferred anticholinergic agent. In cancer patients, the use of fentanyl is common.

Mucocutaneous and cutaneous candidiasis, though common in children, is often under-reported. The prevalence ofCandida dubliniensisin causing these infections in this age group is also largely unknown. A prospective epidemiological cross-sectional study for candidiasis was performed in paediatric patients clinically suspected of candidiasis with oropharyngeal lesions (75 patients), cutaneous lesions (18 patients) and lesions at both sites (2 patients).Candidaspecies were identified by conventional tests. ForC. dubliniensis, chlamydospore production, growth on tobacco agar and growth at 45 °C were performed. Nine isolates were confirmed at a reference centre. The rates of candidiasis were 77.3 % (58 out of 75 patients clinically suspected of candidiasis) and 83.3 % (15/18) in oropharyngeal and cutaneous lesions respectively, and 1 of the 2 children with lesions at both sites was diagnosed as having chronic mucocutaneous candidiasis due toC. dubliniensis. The commonest species isolated wasCandida albicans, in 41 (70.7 %) patients with oropharyngeal candidiasis and 11 (73.3 %) with cutaneous lesions;C. dubliniensiswas isolated from 11 and 3 children respectively. In the paediatric population,C. albicanspredominates in mucocutaneous and cutaneous candidiasis, withC. dubliniensisalso contributing substantially.

Granulicatella elegans is a nutritionally variant streptococci generally associated with infective endocarditis. Meningitis due to G.elegans is very rare and it has always occurred in cases following neurosurgical procedures. We report the case of acute pyogenic meningitis with bacteremia with parenteral diarrhea in a ten month old immunocompetent child without any preceding neurosurgical intervention or dental manipulations. This case emphasizes the need of high degree clinical suspicion, use of appropriate culture media for isolation and identification of G.elegans and rapid initiation of adequate antibiotic therapy. Keywords: Bacteremia, Granulicatella elegans, Meningitis, Nutritionally variant Streptococci I. Introduction Nutritionally Variant Streptococci (NVS) are Gram Positive Cocci first identified in 1961 from a patient with Infective endocarditis by Frenkel and Hirsch (1). NVS are normal flora of the upper respiratory, urogenital and gastrointestinal tracts of humans (2). They cause sepsis and bacteremia and are isolated as causes of various infections like infective endocarditis, otitis media, keratoconjunctivitis, pancreatic abscess, total knee arthroplasty infection, osteomyelitis, intramammary foreign body infection, postpartum sepsis and central nervous system infections. The two important genera of NVS are Abiotrophia (A. defectiva) and Granulicatella (G. adiacens, G. balenopterae and G. elegans) (3). Infections by Granulicatella most commonly occur in patients with underlying cardiac disease, febrile neutropenia or chemotherapy associated mucositis and neutropenia. Higher rates of orointestinal colonization by Granulicatella and subsequent mucositis may predispose for bacteremia in such patients (4). The isolation of NVS is difficult, since they do not grow on ordinary culture media and requires the use of media supplemented with pyridoxal and L-cysteine or grow faintly on chocolate agar (2). Fastidious nature of the growth and high prevalence of beta lactum, and macrolide resistance pose challenge to treat invasive infections caused by these NVS (5). In this paper, we describe the case of a ten months old child with acute pyogenic meningitis with septicemia with parenteral diarrhea caused by Granulicatella elegans. II. Case report A ten months old male child was brought to Paediatric OPD with complaints of fever, vomiting and loose stools of 3 days duration. Fever was high degree (104oc) intermittent type associated with chills. The child passed 25-30 loose stools/day, watery, foul smelling and non blood tinged, associated with nausea and vomiting. The child was born to a non consanguinous couple by caesarean section at 40 weeks because of the presence of cord around the neck with a birth weight of 3.9 kgs. There was no abnormality in the prenatal, natal or postnatal period. On examination, the child was conscious and irritable. Liver was palpable 3 cm below the right costal margin. Slight bulge of the anterior fontanelle was observed and fundoscopy revealed signs of early papilloedema. Other signs of meningeal irritation were not seen and cardiovascular and respiratory system was normal.

like UP, that is showing signs of emerging epidemic. These emerging districts and sub-epidemics are related to population migration, and lack of focus on preventive measures. Kanpur is one of the industrial centers of UPwith considerable migrant population. The low awareness regarding HIV transmission noted in the study (0e5.6%) among road-side barbers is of special concern andmay point to lack of focus on IEC and other preventive strategies in this geographical area. It is important to bring this to the notice of the state AIDS Control Organization and NACO. Though the results of the study may not be of major concern with regard to HIV epidemic in India, it has implications on other blood borne infections. There is greater need for effective strategies to control transmission of HBV and HCV in the community. Vaccination and ensuring improved hygienic practices are the best answers to this problem. I am sure that the information generated in the article will help us to refocus our efforts in strengthening the strategies to control blood borne infections in the country.

Context- Pelvic masses are common in women of all age groups and their accurate diagnosis poses a clinical challenge because of atypical and non specific presentation. The combination approach of exploratory laparotomy and histopathological examination remains the corner stone for management. CA 125, a biomarker has been evaluated in several studies as a surrogate tool in these cases. OBJECTIVES: To determine the diagnostic value of CA 125 in pelvic mass and to know its sensitivity and specificity in ovarian cancers. MATERIAL AND METHODS - 80 patients suspected of pelvic mass at JSS Hospital, Mysore subjected to clinical examination, CA 125 detection and laparotomy followed by histopathological correlation. RESULTS: CA 125 levels were seen to be more in large fibroids. High levels were recorded in extensive adenomyosis and endometrial carcinoma stage1A onwards. Sensitivity and specificity in post-menopausal women was 100% for malignant ovarian tumors. CONCLUSION -CA 125 estimation can be used as an adjunct tool in the evaluation of pelvic mass and is a highly useful assay in the diagnosis of ovarian cancers in the post-menopausal women.

Specific learning disability (dyslexia, dysgraphia, and dyscalculia) afflicts 5–15% of school-going children. Over the last decade; awareness about this invisible handicap has grown in India. However, much needs to be done to ensure that each afflicted child gets an opportunity to achieve his or her full academic potential in regular mainstream schools. In order to achieve this ideal scenario, all ‘regular’ classroom teachers should be sensitized to suspect, and trained to screen for this disability when the child is in primary school. School managements should become proactive to set up resource rooms and employ special educators to ensure that these children receive regular and affordable remedial education; and be diligent in ensuring that these children get the mandatory provisions both during school and board examinations. Once specific learning disability is recognized as a disability by the Government of India, these children with the backing of the Right to Education Act, would be able to benefit significantly.

Background- Systemic Lupus Erythematosus (SLE) is an inflammatory and multisystem autoimmune disorder. Patients of SLE are at increased risk of infections owing to underlying immunological derangements and to the use of therapeutic regimens like immunosuppressive agents. Among the bacterial infections presenting as bacteremia in these patients, non typhoidal and typhoidal salmonellosis are commonly encountered. We report a rare case of Salmonella Paratyphi B bacteremia in a patient with juvenile onset SLE on treatment with corticosteroids.