Search

One of the tribes of Arunachal Pradesh, the Adis, lacked the skill to produce finished goods they used, yet they obtained them from Tibet by means of long-distance trade. Tibetan material culture adopted by the Adis was borrowed directly through cross-border trade and indirectly from the neighbouring tribes. The exotic goods had multitude of functions in the Adi society. The use of such goods in the Adi society had no relation with the purpose they were actually produced for. Some had different values in terms of utility. The cultural value of such goods got inculcated in Adi society due to their meaning-based application. In due course of time, some got indigenised and carried face value as wealth of the Adis. This paper aims at understanding the hegemony of the Tibetan material culture in Adi society. Focus shall be shed on the overview of the dynamism of material culture with an illustration which is prevalent at present too. It brought changes in the belief and socio-economic life of the Adis. It is significant to bring it to light because the appropriation of exotic materials played a vital role in the historical trajectory of the Adis. The study here is empirical as well as historical. Primarily, oral narratives of the persons who have witnessed this process during the second half of the twentieth century are considered in data collection. In addition, available written accounts are taken into account to theme out this paper. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to evaluate the role of ultrasound elastography in differentiation of solid breast masses, to calculate the elasticity score and strain ratio of all solid breast masses, and to determine the sensitivity and specificity of ultrasound elastography in differentiating between benign and malignant breast masses. Methods: This was a hospital based prospective diagnostic analytical study, conducted among 50 female patients who presented with solid breast masses to the Department of Radiodiagnosis, VIREC, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, over a period of 2 years, from November 2019 to October 2021 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: There was strong evidence of relationship, found between BI-RADS interpretation and histopathology interpretation (p<0.0001), radiological interpretation and histopathology interpretation (p<0.001), and interpretation of Tsukuba score and histopathology interpretation (p<0.0001). Diagnostic significance of ES in class 2 lesions was shown to have a significant association between histopathological interpretation and ES. (P<0.001). Diagnostic significance of Tsukuba score in lesion with largest diameter (mm) >20 mm was assessed. A significant association was noted between histopathological interpretation and Tsukuba score (p<0.0001). In association of Tsukuba score with histopathological diagnosis, significant difference in frequency distribution was observed (p<0.0001) indicating a higher frequency of malignant lesion in subjects with a higher Tsukuba score. Conclusion: B-mode sonography which is well known for its high sensitivity but poor specificity, in combination with qualitative sonoelastography with high specificity, may increase diagnostic performance when differentiating between benign and malignant breast masses. Sonoelastography works best in combination with B-mode sonography and thus represents a technologically advanced extension of the same. [ABSTRACT FROM AUTHOR]

Introduction: Liver abscess are more prevalent due to pyogenic, amoebic or mixed infection. Sometimes these may be fungal in origin. The primary mode of treatment is medical, but 15% of these may be refractory to medical treatment. Percutaneous drainage continues to be the basis of care in these situations. For the purpose of curing sepsis, liver abscesses greater than 5 cm in size must be promptly drained. In contrast, surgical drainage enables the rupture of multiloculi and the draining of viscid pus from large abscesses that are multiloculated or contain thick viscid pus. Our aim is to assess the effectiveness, success rate, clinical improvement, time required for complete abscess resolution, and length of hospital stay for patients undergoing USG guided pigtail catheterization vs. open drainage in the management of liver abscess. Materials And Method: After obtaining approval from institutional ethical committee this prospective study was conducted in 32 patients with liver abscess who admitted in surgery department of M.K.CG. MCH, Berhampur. On the basis of the clinical history, serologic testing (IgM Elisa), and inspection, followed by USG, a liver abscess was diagnosed. Standard investigations were conducted. The patients included in the study were having non complicated abscesses with no features of rupture, no feature of impending rupture (liver tissue rim >1cm), no compression effect and abscess size >5 cm diameter. Patients who had multiple abscess cavities, ruptured or threatened abscesses, peritonitis symptoms and signs, and abscesses larger than 5 cm in diameter were excluded from the study. Results: Mean age in group PD was 36yr while in group SD it was 35.9yr. There is male predominance in both the groups. A commonest symptom in both the groups was abdominal pain. Next common symptom was fever which was present in all patients of group PD and 13 patients in group SD. In both the groups (table 1) Haemoglobin and Liver function test was in normal range. Leucocytosis was present in 85% of cases and raised ESR in 90% of cases in both the groups. Volume of abscess ranged from 114 to 1200 ml 9. In group PD, success rate was 94.4 % while in group SD success rate was 100%. Total clinical improvement was seen in 4-8 days and 4-7days in Group PD and Group SD respectively. Time needed for total reduction was 5-17 weeks in Group PD and 7-24 weeks in group SD. Hospital stay was 5-18 days and 6-21 days in group PD and SD respectively. Morbidity is 27% in group PD and 50% in group SD. Conclusion The conventional treatment for liver abscess is percutaneous catheter drainage (PCD), which is both safe and efficient. It leads to early symptom alleviation and quicker abscess cavity clearance. Surgery is an option for liver abscess drainage with concurrent intraabdominal pathology, multiloculated abscess with biliary communication, and failure of percutaneous drainage. PCD also has low morbidity and a good success rate, allowing it to be used as first line management in liquefied moderate sized abscesses. [ABSTRACT FROM AUTHOR]

Background: No single modality of treatment for breast cancer can be the mainstay of therapy. One of them is breast conservation treatment (BCT) comprises BCS and whole breast radiotherapy. BCT is not popular among the surgeons in India (11-23% vs. > 60-70% in west). The advantages of BCS over MRM include, better body image, sexual functioning and better psychological adjustment. In view of this, the present study was undertaken to highlight the importance of BCT and comparison of post-operative events with MRM. Aim And Objective: To evaluate the possibility of BCT in cases of LABC after neo-adjuvant chemotherapy. To compare BCT with MRM in terms of quality of life and postoperative complications. Patients And Methods: The study was carried out in the PG department of General Surgery and Oncosurgery Wing of M.K.C.G. Medical College & Hospital from August 2018 to June 2021 (including 12 months of follow up period). Total no of cases included in this study are 20. We have selected stage I & II and few cases of stage III A for our study. Results: In our study, as the study period is only 2 years and follow-up period was only 12 month, so overall survival is 100% for both BCT & MRM. Recurrence rate for BCT is 15% and for MRM is 5%. Out of Several studies maximum show that overall survival rate for both BCT and MRM group are almost same and comparable. Recurrence rate in case of BCT is high as compared to MRM except in study of Fisher et al and Blichert-Toft et al where recurrence rate in MRM is high. Conclusion: It is a challenge for a surgeon to do BCS in early breast cancer case, as till now both the patients and the surgeons are in favour of MRM for reasons of safety and due to fear of recurrences. We felt that both the surgeons in the periphery and the women folks need to be made aware about the huge benefits of BCT in comparison to MRM. While selecting the patients, proper criteria must be adhered to. Radiation is a must after BCT but failing, for which the incidence of local recurrences goes up. [ABSTRACT FROM AUTHOR]

Introduction: Ischaemic Heart Disease(IHD) causes more death and disability and incurs greater economic costs than any other illness in the developed as well as developing countries. Patients with IHD fall into two groups: patients with Coronary Artery Disease (CAD) who most commonly present with Stable Angina and patients with Acute Coronary Syndrome (ACS). Uric acid is the final oxidation product of purine metabolism, and its elevated levels reflect increased xanthine oxidase activity. For decades, it has been hypothesised that the oxidant properties of uric acid might be protective against ageing, oxidative stress and oxidative cell injury. MATERIAL AND METHODS: This is a Cross-sectional Study conducted in the General Medicine ward, Cardiology ward, Medical ICU, CCU of MKCGMCH, Berhampur. The study was conducted in 100 cases of ST elevated myocardial infarction patients admitted to our hospital. Patients are selected according to inclusion and exclusion criteria from internal medicine and cardiology departments of MKCG Medical College & Hospital. Diagnosis of ST elevated myocardial infarction is based on chest pain>20 minutes, ECG changes and elevation of cardiac biomarkers (two out of three). Detailed history and physical examination were carried out. Results: In our study, 9 deaths occurred in the study group of 100 patients. 8 patients had died of ST elevation MI and 1 patient died of Non ST elevation MI. Out of the 9 deaths that occurred, 6 were males and 3 were females. X2 value was 0.965 and this was not found to be statistically significant. Most of deaths occurred in the age group 50 to 70 years (77.78%). 54 % of the study group had high levels of troponin and this high values were seen in all 9 cases of myocardial infarction that died. The p value as per fisher's exact test was 0.003 indicating that the result is statistically highly significant. The proportion of hyperuricemics in the study population was 59%. The presence of hyperuricemia in the patients those died was 100%. 41% had normal serum uric acid levels and there were no death noted in these subgroup. Conclusion: Serum uric acid levels are elevated in patients with ST Elevated myocardial infarction. There is a strong correlation between serum uric acid levels at the time of admission and in-hospital and short-term mortality in patients with ST elevated myocardial infarction. Patients with elevated SUA levels had higher mortality rates and Major adverse cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is one of the leading causes of cancer deaths among women. It results due to human papillomavirus (HPV) infection. Cervical intraepithelial neoplasia (CIN) is the preinvasive condition of cervical cancer. Various objective immunohistochemical (IHC) markers have been studied for cervical cancer. This study is aimed at studying the expression of B-cell lymphoma-2 (Bcl-2) IHC marker among preinvasive and invasive lesions of cervical cancer and its association with HPV infection.Methodology: This prospective study was conducted over a period of 1 year in a tertiary care hospital in central India, included 73 women suffering from CIN and cancer cervix. The expression of Bcl-2 and the presence of HPV genotypes were studied.Results: Out of 73 patients, 34 had cancer cervix, out of which 15 (44%) had Bcl-2 positivity, 24 had CIN 1, out of which 13 (54%) had Bcl-2 positivity, 10 had CIN 2, out of which 4 (40%) had Bcl-2 positivity and 5 had CIN 3, out of which 3 (60%) had Bcl-2 positivity. No significant difference was found in Bcl-2 positivity among CIN-1, CIN-2, CIN-3, and cancer cervix cases with a Chi-square value of 1.116 and P = 0.77. HPV positivity was found in 41 (56%) out of 73 patients where HPV 16 subtype was the most common (31.5%), followed by HPV 18 (13.7%). No significant association between HPV positivity and Bcl-2 positivity was found with P = 0.34.Conclusion: Bcl-2 IHC seems to have variable expression among CIN cases. Although its expression is low among invasive cancer cases when compared with preinvasive lesions, the difference is not significant. Similarly, no significant association was found between Bcl-2 expression and HPV infections. [ABSTRACT FROM AUTHOR]

Objectives Due to differences in the method of assay and population-specific factors, each laboratory needs to establish its own gestation-specific reference intervals (GRIs) for thyroid hormones. Materials and Methods Three-hundred forty-one women with less than 14 weeks gestation were screened at a tertiary care hospital in Chhattisgarh, India. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and thyroid peroxidase antibody (anti-TPO) were measured using an ADVIA Centaur XP immunoassay. GRIs (2.5th and 97.5th percentiles) were determined for TSH and fT4. TSH and fT4 concentrations were converted to multiples of the median (MoM) values. Effect of maternal age, gestational age, and maternal weight was analyzed. Statistical Analysis Quantitative variables were expressed as means and standard deviations (SD), and qualitative variables were expressed as frequencies and percentages. Normality of the data was checked using the Kolmogorov–Smirnov test. Values that were normally distributed were expressed only as means and SD. Those that were not normally distributed were expressed as medians and interquartile range. For all statistical analysis, p < 0.05 was considered as statistically significant. Results First-trimester GRI was 0.245 to 4.971 mIU/L for TSH, 10.2 to 18.9 pmol/L for fT4, and 27.0 to 56.89 kIU/L for anti-TPO. There was no significant difference in the mean serum TSH (p = 0.920), fT4 (p = 0.714), or anti-TPO (p = 0.754) values among women in 4 to 7th week and 7 to 14th week of gestation. The 1st and 99th centile MoMs were 0.03 and 4.09 for TSH and 0.66 and 1.39 for fT4. There was a significant positive correlation between the maternal weight and TSH MoM values (p = 0.027, r = 0.120). Conclusion These laboratory- and first-trimester-specific GRI for TSH and fT4 shall help in proper diagnosis and treatment of subclinical thyroid dysfunctions. TSH and fT4 MoM values can be used to indicate high or low values in a quantitative manner independent of the reference ranges and may be used by other laboratories. [ABSTRACT FROM AUTHOR]

Background: Dysregulation in Wnt/β-catenin signaling has been associated with the initiation and metastasis of cancer cells. Transcription factor 4 (TCF4) (also named as transcription factor 7-like 2) is a key transcriptional factor of the Wnt signaling pathway, which, when interact with β-catenin activates Wnt genes which plays an essential role in tumor development. The expression pattern and clinical significance of TCF4 in gallbladder cancer (GBC) are not yet established.Aims: This study was performed to assess the expression pattern of TCF4 in GBC tissue and attempted to correlate its expression with different clinicopathological parameters.Materials and Methods: The study was conducted on 33 surgically resected specimens of gallbladder carcinoma (GBC) and 12 cases of chronic cholecystitis (CC) as control, which had been confirmed from histology. The expression of TCF4 was performed by the reverse transcription polymerase chain reaction and immunohistochemistry.Results: Relative mRNA expression levels of β-catenin and TCF4 in GBC tissues were significantly (P < 0.05) higher than in CC samples. TCF4 protein expression was observed in 81.82% (27/33) GBC cases. Specifically, among GBC samples, 21.21% (7/33) was graded as strongly positive, 60.61% (20/33) graded as moderately positive, whereas 18.18% (6/33) graded as negative. All 12 CC samples graded as negative. Overall, TCF4 expression in GBC tissues was statistically significant over CC samples (P < 0.05). Moreover, we observed that TCF4 expression was significantly higher (P < 0.05) in high tumor grades than low grade, higher (P < 0.05) in Stage 2 and Stage 3 than Stage 1.Conclusion: The present study suggests that TCF4 may exert an oncogenic role in the progression of GBC and may serve as a new potential candidate biomarker for tumor progression, and it might be a potential therapeutic target against GBC. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer which is preventable, occurs due to humanpapiloma virus infection and results in a preinvasive condition called cervical intraepithelial neoplasm (CIN) before the development of cancer. Majority of the patients with CIN or early stage of cervical cancer present with symptoms such as abnormal vaginal discharge or bleeding, and unhealthy looking cervix. Selectively screening these symptomatic patients, can detect more number of positive cases and also most effective screening technique for these selective patients can be advocated.Materials and Methods: All married women between 21 and 65 years attending gynecology outpatient department of a tertiary care health center in Central India and having unhealthy cervix or abnormal vaginal discharge were included. All women were subjected to Pap smear, visual inspection under acetic acid (VIA), visual inspection under Lugol's iodine (VILI) and colposcopy. Biopsy was taken in all cases. Diagnostic value of each screening method was determined in terms of sensitivity, specificity, positive predictive value and negative predictive value.Results: Out of 352 patients, around 20% of them were found to have abnormal cytology. The sensitivity and specificity of Pap smear was found to be 34% and 94%. But colposcopy has high sensitivity and low specificity, i.e., 99% and 31%, respectively. On the other hand the sensitivity and specificity of VIA and VILI are comparable i.e., 65% and 45% and 64% and 48% respectively. Pap smear shows high positive predictive value among all, i.e., 85% and colposcopy shows 58% for the same.Conclusion: Pap smear carries low sensitivity but high positive predictive value. As compared to Pap smear, VIA and VILI are more sensitive and are of low cost. Colposcopy can be considered as a preferred method of screening due to its extremely high sensitivity. [ABSTRACT FROM AUTHOR]

The sudden outbreak SARS-CoV-2 in Wuhan, China, which rapidly grew into a global pandemic, marked the third introduction of a virulent coronavirus into the human society, affecting not only the healthcare system, but also the global economy. In this article, we present a succinct overview of the epidemiology, pathophysiology, and targets of SARS-CoV-2. In the past 14 years, the onset of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have thrust HCoVs into spotlight of the research community due to their high pathogenicity in humans. The study of Human coronavirus (HCoV) host interactions has contributed extensively to our understanding of HCoV pathogenesis. We systematize the current clinical trials that have been rapidly initiated after the outbreak of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of chronic and non-communicable health disorders like cardiovascular diseases and metabolic syndrome is increasing worldwide including in India. The various risk factors for these health issues need to be addressed. The role of vitamin D deficiency in the causation of all these abnormal health conditions among postmenopausal women is a matter of debate now-a-days. Aim: To determine the correlation of serum vitamin D levels with various cardio-metabolic risk factors and metabolic syndrome (MetS) in postmenopausal women (PMW). Materials and Methods: Total of 64 PMW were included in this cross-sectional study. Clinical (waist circumference, body mass index, blood pressure) and biochemical (fasting plasma glucose, lipid profile and serum 25-hydroxyl vitamin D levels) parameters were measured. MetS was defined using modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) guidelines. Serum 25-hydroxyl vitamin D levels <50 nmol/l, between 52.5-72.5 nmol/l and >75 nmol/l were classified as deficient, insufficient and sufficient, respectively. Results: MetS was prevalent in 33 (52%) subjects. There were no differences in serum vitamin D levels or proportion of vitamin D deficient individuals in those with and without MetS. 33 women (52%) had vitamin D deficiency. Cardio-metabolic risk profile was similar in both vitamin D deficient and replete women. Conclusion: Despite a high prevalence of vitamin D deficiency and MetS in Indian PMW, serum vitamin D concentrations do not correlate with the cardio-metabolic risk factors or MetS. [ABSTRACT FROM AUTHOR]

Since its introduction in 1984, laparoscopic ovarian drilling has evolved into a safe and effective surgical treatment for anovulatory, infertile women with polycystic ovary syndrome (PCOS), unresponsive to clomiphene citrate. It is as effective as gonadotropins interms of pregnancy and live birth rates, but without the risks of ovarian hyperstimulation syndrome and multiple pregnancies. It improves ovarian responsiveness to successive ovulation induction agents. Its favorable reproductive and endocrinal effects are sustained long. Despite its advantages, its use in unselected cases of PCOS or for non-fertility indications is not prudent owing to the potential risks of iatrogenic adhesions and ovarian insufficiency. [ABSTRACT FROM AUTHOR]

Pelvic floor dysfunction (PFD) is commonly associated with the weakness of pelvic floor muscles and the supporting connective tissue structures, which may lead to prolapse of the pelvic organs. There are various researches which have shown the significance of pelvic floor exercise (PFE) on the PFD. The last few years have seen a growing interest in the field of yoga. "Mudra" and "Bandha" are reported as pelvic floor yogic exercises (PFYEs) in the ancient Indian texts. These yogic exercises involve the coordination of breath, maintain the structural integrity of the pelvic floor, and thereby prevent PFD. It is recognized that all the female patients of PFD can be benefited from education on PFYE. So, in this article, we have tried to highlight the significance of PFYE in the preventive and therapeutic aspects of PFD. [ABSTRACT FROM AUTHOR]

This article reports on a study which compared two criteria for diagnosing gestational diabetes mellitus (GDM) in South Indians. Topics discussed include the World Heath Organization criteria, the International Association of Diabetes and Pregnancy Study Groups criteria, and the prevalence of GDM. The role of glucose oral tolerance test in the diagnosis of GDM is cited.

Background: Evidence regarding impact of pre-ovulatory hormone levels on assisted reproductive technique (ART) outcomes in different ovarian response groups is sparse., Aims: The objective of this study was to evaluate and compare the association between pre-ovulatory hormonal profile and ART outcomes in different ovarian responses., Setting and Design: This is a single-centre retrospective cohort study of 273 non-donor fresh ART cycles between January 2013 and June 2016., Materials and Methods: Data on clinical profile, basal and peak hormonal levels, characteristics of controlled ovarian stimulation and ART outcomes were collected. Progesterone elevation (PE) was defined as pre-ovulatory serum progesterone >1.5 ng/mL or progesterone to oestradiol ratio >1. The association between peak hormonal levels and ART outcomes in poor (≤4 oocytes retrieved), intermediate (5-13 oocytes retrieved) and high (≥14 oocytes retrieved) ovarian responders was analysed and compared., Statistical Analysis: Continuous and categorical variables were summarised as median (interquartile range) and percentages, respectively, and compared using Kruskal-Wallis H-test or Mann-Whitney U-test and Chi-square test or Fisher's exact test, respectively., Results: The incidence of PE, by both criteria and clinical pregnancy rates (35.7%, 36.8% and 18.6% in high, normal and poor responders, respectively; P = 0.073), was similar among the three response groups. Except fertilisation rates in normo-responders, PE did not influence ART outcomes in any response group. Furthermore, there were no differences between peak hormone concentrations or incidence of PE between those who conceived and those who did not., Conclusion: Pre-ovulatory sex steroid levels do not seem to be the primary determinant of ART outcomes in any ovarian response category; hence, decision to freeze all embryos in the event of PE should be tailored., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Human Reproductive Sciences.)