Abstract Objective: to evaluate the incidence of cardiac arrhythmia in chronic cor pulmonale and to focus on the contributing etiological factors. Material & Methods: 35 cases of chronic cor pulmonale were thoroughly examined for the presence of arrhythmia. After recording history & physical examination blood was collected for various investigations like serum potassium, blood urea, blood volume and ABG study before and after the development of arrhythmia. Along with this X-ray & ECG were done in every case. Results: incidence of cardiac arrhythmia among all cor pulmonale patients was found to be 20% of which supraventricular ectopic beats was the most common. Respiratory infection may be thought to be the major factor in the development of congestive heart failure & different cardiac dysarrhythmia. Besides this, not a single possible factor has been found to be associated with cardiac arrhythmia. Conclusion: cor pulmonale has a low incidence in this part of country. Not a single factor associated with cardiac arrhythmia could be found out except pulmonary infection. Further studies are required in this field on a larger number of patients.

Abstract Background: During the last decade efforts has been made globally by academic experts in changing curriculum with essential requirements and core competences, so that medical graduates must become a good physician. This study aims to evaluate medical students’ level learning and satisfaction towards Obstetrics and Gynaecology course. Methods: A Cross sectional survey was carried out during November2009 and June 2010 at College of Medicine, King Saud University, Riyadh. The fourth year medical students (n=128) who were undertaking the Obstetrics and Gynaecology course constitute the study subjects. A structured questionnaire was used to quantify the outcome variables knowledge, skills and satisfaction from various components of the curriculum in obstetrics and gynaecology course. Results: The overall internal consistency (alpha) of various components scales in the curriculum was 0.94 with a range of alpha 0.82-0.91 in various domains. The study showed an increase in the proportion of knowledge and clinical skills of excellence (72.3%) among medical students than they were at the beginning of the course (20.7%, p<0.001). Faculty support, study materials, theoretical lectures, and clinical training have greatly influenced students’ satisfaction. Conclusions: Although various components of the curriculum appear to give greater level of knowledge, skill and satisfaction, their potential influence on graduate outcomes, in terms of delivering health care providers who are patient-centred, creative thinkers and compassionate leaders should not be discounted.

Abstract Background: Dyslipidemia, one of the classical Framingham risk factors of cardiovascular diseases, accounts significantly to the rise of non communicable diseases in India. Urbanization, along with greater consumption of dietary fats and decreased physical activity, has led to an increase in this problem manifold. Objectives: To determine the prevalence of dyslipidemia among urban adults of Siliguri city, West Bengal and to identify the cardio-vascular risk factors associated with it. Methods: This descriptive, cross-sectional study was carried out among the 226 adults aged ≥20yrs in an urban area of Siliguri city, West Bengal, India. Data was collected by detailed history and physical examination; biochemical measurements were done using standards procedures. Dyslipidemia was defined by the presence of one or more than one abnormal serum lipid concentration. Statistical analysis was done using chi-square test, t test and logistic regression analysis using SPSS 20 software (Chicago, IL, USA). Results: Dyslipidemia was prevalent among 78.4 % of the total study subjects. Dyslipidemia was more in males than in females & in both males and females it was more prevalent in the age group 40 -59 years than in any other age group. It was associated with higher odds of major cardiovascular risk factors like hypertension, hyperglycemias, and tobacco use. Conclusion: Dyslipidemia remains a significant and growing problem in this part of the country. The reduction in the disease burden will require changes in life style as well as in national policies.

Abstract Background & objectives: It is a prospective, randomized, controlled study involving adults admitted to medical Intensive care unit (ICU) who were receiving mechanical ventilation. Methods: On admission, patients were randomly assigned to receive intensive insulin therapy (maintenance of blood sugar at a level between 80 and 110 mg/dl) and were found to have hyperglycemic. We study the clinical profile of critically ill hyperglycemic patients and associated metabolic profiles of all such patients were analyzed in relation to final outcome. Results: The benefit of intensive insulin care was from 8.0 percent with conventional treatment to 4.6 percent (P<0.04, with adjustment for sequential analyses). Intensive insulin therapy to maintain blood glucose at or below 110mg per deciliter reduced the morbidity and motility among critically ill patients in the surgical intensive care unit. Hyperglycemia was present in 38% of patient admitted to the hospital, of whom 26% had a known history of diabetes, and 12% had no history of diabetes before admission. Interpretation & conclusions: New hyperglycemic patients had a longer length of hospital stay, a higher admission rate to an intensive care unit, and were less likely to be discharged to home, frequently requiring transfer to an intermediate care unit.

Abstract Background Gestational diabetes is emerging as a serious public health problem in Nigeria where the largest number of people with diabetes in Africa occurs. Current studies in Nigeria give an overall prevalence of gestational diabetes as 13.4% among pregnant women with unidentified risk factors. Aims and Objectives This study aimed at investigating the risk factors associated with gestational diabetes. Materials and Methods A cross-section analytical study design was adopted for this research and comprising a total of 100 pregnant women receiving ante-natal health care service at the Federal Medical Center, Owerri. A structured questionnaire including a set of detailed pre-determined questions was administered on the subjects. Data collected were analyzed statistically, using chi-square and T test. Results The results obtained suggest that there is a significant relationship (p<0.05) between previous macrosomic baby, parity, previous history of caesarean section, family history of diabetes and occurrence of gestational diabetes, respectively. However, there is no significant relationship (p>0.05) between history of miscarriages and stillbirth, socioeconomic status and occurrence of gestational diabetes. A family history of diabetes is independently and significantly associated with the development of gestational diabetes itself even after adjusting for other risk factors. Conclusion This study will be a working tool to guide obstetricians and midwives in counseling and advising women of their risk of developing GDM.

Abstract Spread of squamous cell carcinoma (SCC) commonly occurs vialocal lymphatic channels. Owing to scanty lymphatic drainage and vascular supply, SCC arising from the glottis rarely metastasizes. A 39-year-old male, operated for SCC of the glottis, presented 13 months later with complaints of headache. Computed tomography revealed a single ring-enhancing lesion in the right temporo-parietal region of the brain, suggestive of brain abscess. However, histopathological examination of the excised brain lesion showed metastasis of moderately differentiated SCC. Here, we report a rarecase of distant hematogenous brain metastasis of SCC of the glottis.

Abstract Background: Vibrio parahaemolyticus (V. parahaemolyticus) is the commonest source of seafood poisoning and has a very high incidence in the countries of Asian. Aims and Objectives: This study aims to investigate the presence of V. parahaemolyticus in seafood from Brunei seafood market using the Most Probable Number- Polymerase Chain Reaction (MPN-PCR). Results: None of the twnety-three seafood samples that were purchased at random from unselectively chosen wet markets and hypermarkets in Brunei Darussalam yielded V. parahaemolyticus. Conclusion: This could be due to any or a combination of: the absence or low level of V. parahaemolytius from where the samples were harvested, inactivation of V. parahaemolyticus during the processing and preservation of the samples, possible sampling factors as well as good hygienic practices in Brunei’s seafood market

Abstract Objective: With technological evolution, use of power point presentation has been increased tremendously for classroom teachings in medical education. There is dearth of information that whether this technology is really liked by the students in anatomy or not. Therefore present study was conducted to assess which methodology of teaching anatomy was preferred by students: traditional (chalk & black-board), computer assisted or both when combined. Methods: A questionnaire based study was conducted that involved 250 1st year MBBS students. Students were asked to fill semi structured questionnaire that contained closed and open ended questions regarding teaching methodology. Results & Conclusion: 70.37% students favored combination of power point presentations along with traditional method, 25.93% preferred chalk and blackboard method and only 3.7% students opined that power point presentations should be the sole method of teaching. Therefore the study concludes that traditional method of lecture delivery in anatomy should be carefully amalgamated with power point presentations to meet the aspirations of students and to combat the limitations of chalk and board method.

Abstract During routine undergraduate dissection in the upper extremities of a 65 years old male cadaver in the department of Anatomy at Dr. PSIMS & RF, coexistence of muscular and neurovascular variants were identified .Muscular variations included presence of additional head(third) of biceps brachii in the left arm, accompanied with medially positioned median nerve in relation to brachial artery bilaterally . Teres minor muscle was not identified and the origin of long head of triceps brachii extended upto the lateral border of scapula on the left side. Both the medial cutaneous nerves of arm and forearm arouse from a single trunk bilaterally. In the right limb the axillary artery showed only four branches instead of six branches, with common trunk for thoraco-acromial and lateral thoracic artery and common trunk for subscapular and posterior circumflex humeral artery. Knowledge of coexistence of these variations would of profound importance surgically and clinically, especially in limb injuries and surgical repairs.

Abstract Background: Reactive oxygen species have been identified as mediators of cell injury in a variety of cardiovascular complications including Myocardial Infarction (MI). It is conceivable that vitamin E supplementation can be used therapeutically due to its role in ameliorating antioxidant status and free radicals scavenging activity. Aim: Therefore, the present study was undertaken to assess the markers of oxidative stress i.e. erythrocyte glutathione peroxidase (GSHPx) & malondialdehyde (MDA); plasma vitamin C, E, A and uric acid level in the blood samples of MI patients and to investigate the effect of in-vitro vitamin E supplementation in ameliorating the levels of these antioxidants in the blood sample of MI patients. Material & Method: 60 MI subjects (age group 30-60 years) were taken for the study and 60 healthy individuals served as controls. In-vitro vitamin E supplementation in the blood samples of MI subjects were performed and above mentioned parameters were estimated by using standard methods. Data was compared statistically by using student t-test. Result: Vitamin E supplementation brought about an improved antioxidants status with significantly raised vitamin C, E, A and GSHPx levels (p<0.05, p<0.001), and simultaneously depleted level of erythrocyte MDA (p<0.001) in blood samples of MI subjects. However, plasma uric acid levels remain unaltered (p<0.1). Conclusion: These findings further support the preventive and cardio protective role of vitamin E supplementation in reducing oxidative stress levels in the blood samples of MI patients.

Abstract Background: Diabetes Mellitus (DM) is frequently associated with the development of premature atherosclerotic vascular disease and is the major cause of morbidity and mortality. Approximately 80% of all deaths and more than 75% of all hospitalizations are due to CAD. Individuals with DM are usually associated with accelerated atherosclerosis. Common Carotid artery intima-media thickness (CCAIMT) is now also considered as a surrogate marker of atherosclerosis. Materials and Methods: This case-control study was conducted from Jan, 2011 to June, 2012 among Type-II diabetes, aged between 30-80yrs. Patients with Type-I diabetes, aged <30yrs or >80yrs and other secondary causes of diabetes, hypertensive, smokers and patients under therapy with lipid lowering drugs were excluded from this study. The biochemical tests were done in the department of Biochemistry, Nilratan Sarkar Medical College and Hospital, using standardized reagent kits. CCAIMT was measured by high resolution imaging using 10MHz transducer in the department of Radiodiagnosis, Nilratan Sarkar Medical College and Hospital. Results: The results of our study indicate that dyslipidemic diabetic patients had significantly higher blood glucose at any phase along with glycated haemoglobin compared to controls. The lipid variables were also significantly higher in the diabetes patients with dyslipidemia compared to controls except HDL levels were significantly higher in control. CCAIMT was higher in the dyslipidemic group (1.71 ± 0.57mm) compared to the non-dyslipidemic group (0.77 ± 0.10) which was statistically significant (p value <0.001). Conclusion: CCAIMT reflects the cumulative burden of atherosclerosis and is highly correlated and predicted well by Total-C/HDL-C ratio in Type-II diabetic patients. So it is advised that a direct examination of the vessel wall is extremely essential for early detection of the affected individuals so that the cost burden in Intensive coronary care unit can be minimized and also the individual can be advised to control the extensive dyslipidemia through dietary restrictions and exercise.

Abstract Background: Uterine atony accounts for 80 % of causes of PPH and is one of the important cause of maternal death. Objective: To analyze the efficacy of Dutta’s score for early detection and management of uterine atony during emergency LSCS to prevent PPH. Study methods: This study was undertaken at JNM, NSGN, CN at Kalyani, Nadia, West Bengal India from 1st January 2007 to 31st December 2011. Three hundred cases undergoing emergency LSCS were selected for randomized trial. Clinical observations were made after placental expulsion for scoring which includes shape and size of uterus, rugosity, tone, placental localization and time of placental expulsion. Score of 0, 1, 2 were given on each observation. Three groups are created depending on scoring-Group A (130) -8 to 10, Group B (N-100) -5 to 7 and Group C (N-70) - <5 for better management. Management protocols were formulated in the three groups for prevention of PPH Group A:- Oxytocin 10U (5U IM + 5U IV 40drops/min in Ringer Lactate 500ml) Group B:- Oxytocin 15U (5U IM + 10U IV 40drops/min in Ringer lactate 500 ml) + methyl ergometrine (0.25mg IM) + anterior posterior uterine wall compression Group C:- Oxytocin 20 U- (5U IM plus 15 U IV 40 drops in Ringer Lactate 500 ml) + methyl ergometrine (0.5mg IM) + carboprost (250 mcg IM) + lateral followed by anterior posterior uterine wall compression + compression of isthmic region of uterus + misoprostol 800mg per rectal during post operative period. Results: After adopting Dutta’s score and management protocols it was interesting to observe that intra and post operative blood loss within 2hr were found to be significantly reduced in group A-69.3% (<300CC), 84.6%(<200CC) and group B-70%(<300cc), 72%(<200CC). Intra operative blood loss >500cc were also found to be reduce in group A- 7.6%, group B-14%. In group C intra operative blood loss >500cc were seen in 47.1 % and post operative -32.9% cases. Hemoglobin level <11gms after 24 hrs of LSCS was found to be minimally reduced (in comparison to preoperative hemoglobin level) in group A (1.5%), group-B (2%) and group C (11.4%). Conclusion: Early diagnosis and management of uterine atony during emergency LSCS after adopting Dutta’s score were found to be not only reduce intra and post operative blood loss but also was found to maintain a satisfactory hemoglobin level and hemodynamic status. Maternal mortality was found to be nil. This randomized trial highlighted the importance of prompt treatment in group C to reduce intra and post operative blood loss and maternal morbidity and mortality.

From the Desk of Editor: It gives us immense pleasure to release the current issue of AJMS Volume 5 Number 2, 2014. We apologize for the dormancy of the journal for quite some time. The delay in publication was very unfortunate and currently we are publishing issues ahead of time schedule. We thank all resource personals involved directly or indirectly with AJMS and with a team work we would take this journal to high standards. We thank all the potential reviewers who reviewed the manuscripts and without their timely review and constructive criticisms, the release of this issue would not have been possible. The board of reviewers for the current issue of AJMS are as follows- We also thank to all authors who entrusted on us and published their original research works, case reports with AJMS and in future we wish to publish more good quality papers. Thank you all for publishing with us. Dr. Arun Kumar Editor-in-Chief, Asian Journal of Medical Science

Abstract Introduction-External beam radiotherapy is one of the principle treatment options for locally advanced prostate cancer. Over the past several decades, RT techniques have evolved to allow higher doses of radiation to be administered safely. We report our experience of Image guided intensity modulated radiotherapy (IGRT) and CBCT based position verification. Material and methods- In this study we are presenting data of 17 consecutive patients that were treated from august 2009 to october 2010. All patients received 76 -78 Gy Gy to clinical target volume for primary disease. Daily online matching was performed by using KV CBCT scan before treatment. In each patient, soft tissue (prostate) matching was done by the radiation oncologist. Results – Median Follow up of our patients is 16 months with minimum follow up of 13 months. 3(17.6%) patients developed grade 2 acute rectal toxicity and 4 (23.5%) bladder toxicity. Till date none of our patients had late bladder or rectal toxicity. None of our patient developed local recurrence. Conclusion-Our study concludes that we can follow the dose escalation with CBCT based position verification .With CBCT we can consider entire prostate and normal structures volume for localization.

Abstract Background: Most workers of carpet factory and sawmills suffer from non-specific lung diseases and ventilatory disorders. There is so many such industries operative in Lalitpur district and so far not many studies have been reported on pulmonary function in these workers. Method: A brief clinical sheet regarding age, occupational particulars, smoking habits and presence or absence of major complaints was recorded for each worker. Spirometric parameters were recorded using an electronic (MEDSPIROR) spirometer. The groups consisted of control subjects not exposed to industrial dusts (n=50) for each group of workers (carpet factory, n=50 and saw mill, n=50). Result: This study indicated an overall reduction in pulmonary function parameters; in particular FVC, FEV1 and FEV1/FVC % in carpet factory workers and FEV1 and FEV1/FVC % in saw mill workers. Comparison of pulmonary function parameters between carpet factories workers and sawmill workers revealed a significant reduction in FEV1 and MVV in carpet workers. Conclusion: Exposure to cotton dust and wood dust leads to combined type of spirometric deficit revealing obstructive or restrictive lung diseases. Workers exposed to industrial dusts also suffer from various upper or lower respiratory symptoms.

Abstract Post-traumatic stress disorder (PTSD) is a serious debilitating syndrome with significant personal, social, and economic consequences. People with PTSD experience one or more major symptoms that include flashbacks and paranoia, difficulty in interpersonal relationships, and problems engaging in work and activities of daily living. In severe cases they can harm themselves or the others; but these events are preventable by appropriate therapies. PTSD is a well-characterized serious psychological and behavioural abnormality that occurs after exposure to one or more acute severe stressful events. It often occurs among soldiers returning from battlefields and the civilian victims of war. However, it also occurs in non-war situations, such as terrorist attacks or serious accidents; sexual abuse, rape, or other violent acts; and school or workplace bullying, harassment, or retaliation. Nevertheless, the diagnosis of PTSD is made too infrequently, particularly in the post-conflict periods in developing countries. This is in part because of inadequate awareness but also due to limited resources and expertise. Consequently, the resources for clinical care and research are diverted to other forms of behavioral issues, such as adjustment disorders. The treatment of PTSD needs to be well coordinated so that all stakeholders work synergistically using the resources necessary for the prolonged treatment and follow-ups. PTSD is underdiagnosed, and even misdiagnosed or mislabeled as depression or adjustment disorders. The failure to make a timely diagnosis or mislabeling of PTSD likely will harm victims and their families and may lead to negative outcomes, including suicide. The provision of appropriate, well organized, individualized, cost-effective treatment plans should alleviate PTSD symptoms and enable those with the disorder to return to their normal productive lives.

Abstract Background and Objectives: Parents of children with chronic illness like global developmental delay exhibit varied psychopathology in response to their child’s illness. Mothers of these children are more susceptible when compared to fathers, and hence show various psychopathological changes. Analysis of their psychological status is important to identify those families which need psychological help and counseling. The main aim of our study was to evaluate psychopathology in mothers of children with global developmental delay due to spastic diplegia. We also assessed the impact of intervention of the child on the psychological state of the mother over a 12 month follow up. Materials and methods: 60 mothers of children with global developmental delay due to spastic diplegia were selected from Neurodevelopmental Clinic of a tertiary care institution. Symptom Checklist 90 Revised (SCL90R) was used to assess psychopathology. A repeat evaluation of mothers was done after 12 months of conventional intervention (Bobath technique) for their child. Data was analyzed using appropriate statistical measures. Results: On assessing the psychiatric morbidity by SCL 90R, significant psychopathology was found in 54(90%) out of 60 mothers. Depression was the predominant psychopathology in the study population. Anxiety was also significantly elevated. The GSI (General Symptomatic Index), a measure of general distress was extremely high in 90% of the mothers. On follow up analysis of mothers using SCL 90R, 33% of the mothers showed no improvement in their psychological status following conventional intervention for their child. Conclusions: Chronic illness like global developmental delay affects the psychological health of mothers. In addition to purely focusing on the medical management of the child it is essential to focus attention on the distress experienced by their parents. Psychological therapy is hence required to improve the quality of life of mothers.

Abstract Objective: The objective of this study was to define the injury types found intracranially when head trauma occurs and possibly predict the type of injury seen with the different mechanisms of injury. Methods: We prospectively studied ninety-one patients presenting at the University of Calabar Teaching Hospital (UCTH) over twenty-four months (February 2011 to February 2013) with head injury. Their socio-demographics and clinical data as well as the CT findings were collected. Statistical analysis was done using stata 10, stat corp, Texas USA, 2007. Frequency tables, bar chats, histograms and chi-square were used to analyse the data. Results: Ninety-one patients with head injury were seen. The age group of 20-29 and 40-49years were the commonest, median being twenty-nine years, interquartile range, 22-42years. Sixty four (70.3%) males, twenty seven (29.7%) females. The commonest mechanism of injury was RTA. Diffuse cerebral oedema, cerebral haemorrhage were the commonest brain events. No normal scan was seen. Skull fractures, especially comminuted ones were the commonest. CT findings in each case could not be predicted from the mechanism of injury. Conclusion: This study reveals that a typical head injured patient in our locality is a male aged 20 – 29 years, involved in an RTA. Since it is impossible to predict the CT scan findings using the mechanism of injury, CT scans should be made available in all hospitals so as to appropriately manage these types of patients.

Objectives: Reproductive Tract Infections (RTIs) are common morbidities among women during reproductive age. These may lead to adverse health consequences including life threatening conditions. This study aims to identify prevalence and factors associated with RTIs among married women of reproductive age. Methods: Cross sectional study was conducted in 7 randomly selected Primary Health Care Centres and Health Posts of Kaski district, Nepal. 282 participants attending in aforementioned health facilities were probed for RTI symptoms according to WHO syndromic case management guideline. Data were collected by using pretested semi-structured schedule and analyzed by SPSS (16.0 Version). Chi square, Fisher’s Exact Test, Odds ratio were calculated and P 0.05 was considered significant. Results: Prevalence of RTI symptoms was estimated to be 78.9 percent. Common reported symptoms were backache (71%), low abdominal pain (67%), watery vaginal discharge (56%), genital itching (51%), burning urination (44%) and curdy discharge per vagina (26%). Most women with RTI were ?30 year’s age, ?19 year’s age at first pregnancy, had monthly income (NRs) 10000 and parity ?2, had sex during menstruation and did not clean genitalia after sex. Consistently, more than nine out of every ten illiterates, high parity (?4), having irregular menstrual cycle and abnormal bleeding had more RTIs as compared to their counterparts respectively. Illiterates, those who had sexual contacts during menstrual periods and those who do not clean genitalia after sexual act were significantly more at risk (OR=5.35,8.33 and 3.11) of having RTIs than those who do not had these attributes correspondingly. Illiterates, those who had sexual contacts during menstrual periods and those who do not clean genitalia after sexual act were significantly more at risk (OR=5.35,8.33 and 3.11) of having RTIs than those who do not had these attributes correspondingly. Conclusions: Burden of the RTIs among women is unexpectedly high; indicating the women’s vulnerability to reproductive morbidities, limited service accessibility and their reproductive fates. Further, majority were modifiable factors; reflecting the needs of information and empowerment and behavior changes for the effective prevention and management of RTIs.

Abstract Background: The field of mechanical engineering in association with electronics and computer science concerned with developing robotic devices that can move and react to sensory input. However the implementations and application of robotics in clinical practice was really a question? We planned to study the assessment of awareness, will and work level of medical robotics from medical professionals in clinical practice in India. Study Design: We used self prepared model questioner containing information related to applications, awareness, will etc. of medical professionals for application of medical robotics in clinical practice. The questioner was approved by IJBAMR Forum, Pune, India. The data was collected during June 2012 to January 2013. Such 220 questionnaires were filled and analyzed. Observations and Results: Only 1.36 % professionals observed with professional training. It was also observed that, only 54.54% professionals were known about current aspects about robotics application & knowledge regarding training centers. Conclusion: It is promising fact found in study that 88.63% professionals were very excited and willful for the application of robotics in their practice in future. From our study, it is concluded that there is noted a huge lake of awareness regarding application of medical robotics technology in Indian medical professionals.

Abstract Pandrug resistant Pseudomonas keratitis is an emerging cause of bacterial keratitis challenging clinicians for prompt and prudent treatment to avoid disaster of loss of eye. We report two cases of pandrug resistant keratitis following penetrating keratitis caused by Pseudomonas spp. It was only after a detailed laboratory characterization of the isolates that revealed their pandrug resistant character and helped in successful management of the condition.

Objective: The major pathophysiological features of ?-thalassemia are anemia and ineffective erythropoiesis. Ineffective erythropoiesis has been shown by an intense marrow erythroid hyperplasia and increased apoptosis during basophilic to orthochromatic normoblast stages. Some cytokines like interferon-? (IFN-?), tumor necrosis factor ? (TNF-?) and interleukin-1 (IL-1) have been found to involved in apoptosis. Although the pro-apoptotic activity of IFN-? and TNF-? is well documented, there are only few studies on IL-1, especially on erythroid lineage. In this in vitro study, the role of cytokine IL-1? and IL-1? in apoptosis of erythroid progenitor cells from ?- thalassemia/HbE patients was assessed. Methods: Erythroid progenitor cells were isolated from peripheral blood of healthy subjects and ?-thalassemia/HbE patients. Cells were then cultured, with and without 20 ng/ml IL-1? and IL-1?. Total cells and percent cell viability were performed by using trypan blue staining. Percent cell apoptosis was analyzed by using flow cytometer. Results: Both IL-1? and IL-1? were significantly decreased erythroid progenitor cells. IL-1 at 20 ng/ml reduced the glycophorin A positive cells and percent cell viability of erythroid progenitor cells from ?-thalassemia/HbE patients, while there was increased apoptosis in this group. The highest percent apoptosis was observed in 20 ng/ml IL-1? treated ?-thalassemia/HbE erythroid progenitor cells. Conclusion: IL-1? could be involved in apoptosis of erythroid and progenitor cells from ?-thalassemia/HbE patients which might be related with ineffective erythropoiesis of the disease.

Abstract Background: Gonococcal infection remains an important public health problem worldwide. The incidence of reported gonorrhoea cases in Sweden raised by 32%, from 5.9 to 7.8 cases per 100,000 in 2001 to 2008.The aim of this study is to estimate the lag time or time elapsed between onset of symptoms and diagnosis of gonorrhoea, and to identify the factors associated with diagnostic delay in a sample of reported gonorrhoea cases in Sweden. Methods: A retrospective cohort study was conducted using all reported gonorrhoea cases at the Swedish Institute for Communicable Disease Control (SMI) from the time period 1999-2009. Total number of cases included in final analysis was 2161. Descriptive statistics, ANOVA, independent t-test and multiple linear regression analysis were applied for data analysis. Results: The mean lag time between onset of symptoms and diagnosis of gonorrhoea was 12.3 ± 18.8 days. There was a significant association of lag time with sex, region, type of clinics and type of specimen and year of diagnosis. In multivariate analysis with adjusted model, type of specimen was found to have independent effect on lag time and there was a significant interaction observed between region and sex indicating difference between sexes was due to difference in regions. Conclusion: The result of our study revealed a significant delay in establishing a diagnosis in Gonorrhoea patient sample in Sweden. The variables influencing this delay in diagnosis should be addressed to shorten the lag time leading to an early diagnosis and a proper treatment in our patients. However, more research needs to be carried out in this area to better understand the factors at work.

Background: Thyroid disorders constitute the most prevalent endocrine disorder in our country. Thyroid disorders are classified broadly as hyperthyroidism and hypothyroidism depending on the functional capacity of the thyroid gland. These two entities are further segregated as sub clinical and overt dysfunction. The present study attempts to evaluate the prevalence of thyroid disorders in north Indian population which is more prone to hypothyroidism due to iodine deficiency observed in the Himalayan belt. Materials and Methods: A total of 7474 patients presenting to the department of Biochemistry, G B Pant hospital, Delhi, were enrolled in the study. The patients were examined and asked to report after overnight fast for sample collection on a prescribed date. Thyroid hormone estimation was done with commercially available ELISA kits supplied by Cal biotech, USA. Statistical Analysis was done using Microsoft Office “Excel” with Windows 2007 Operating System and multiple comparisons were made using SPSS 12.0 statistical software package. Rsults: The majority of the patients (approximately 85%) were Euthyroid. Only 1.22% of the total number of referred patients turned out to be hyperthyroid. Hypothyroidism was more prevalent with the number of patients diagnosed with both sub clinical and overt hypothyroidism being 987 (13.2%). Conclusions: We have strived to provide a baseline orientation regarding the prevalence of thyroid disorders in the representative north Indian population in the post iodine fortification era.

Abstract Objectives: The present study addresses this important issue of NSI and aims at determining their occurrence among the nursing staff in Dr Rajendra Prasad Government Medical College (RPGMC) and hospital, Kangra at Tanda (H.P). Methods: A cross sectional study undertaken amongst the nursing staff of Dr RPGMC and hospital, Kangra at Tanda. Results: Out of the 164 respondents, 35(21.3%) reported to having one or more NSIs in their career and the maximum of these were amongst the nurses whose work experience was less than five years (13.4%). Conclusions: The results of this study confirm the importance of the need for an increased awareness of the risk of needlestick injury, the need to provide for the training and education of health-care workers

Background In Nepal, 1 - 2 % of the population suffers from severe mental illness, 5 % from moderate mental problems, while 20 - 30 % of all the patients coming to health institutions have some problems related to mental illness. Aims The aim of the study was to describe the socio-demographic profile and problems of the female patients with depression attending psychiatry OPD of Western Regional Hospital aND Manipal Teaching Hospital, Pokhara Settings and Design The study was carried out in the Out Patient Department of Psychiatry at Manipal Teaching Hospital and Western Regional Hospital, Pokhara, from May 2005 to April 2006. Material and Method Cohort data of 50 patients from MTH and 50 patients from WRH were collected. The screening criteria for cases for inclusion in the study were as follows: Female patients with headache, mental tension, feeling of hopelessness and persisted sadness in women with abnormal behavior. The diagnosis and management of all the cases were done by the Psychiatrists and doctors of MTH and WRH. The primary source of data was interview of the patients, their relatives and doctors and observation by the study group Statistical Analysis Data were analyzed using descriptive statistics with SPSS, version 16, statistical analysis program (SPSS, Inc., Chicago, IL). Results 71.51% female patients and 48.29% male patients visited psychiatry OPD at MTH during the study period. Likewise, compare to male patients (47.5%), female patients (52.5%) were higher in WRH during the study period. Most of the women in depression were in productive age group in both the hospitals ; 42% between 21-30 yrs followed by 33% in 31- 40yrs, 16% in 41-50yrs and 4% in 51-60 yrs . 17% women were service holder in different fields, 39% were housewives, 7% in Business, 33% were working in Agriculture / laborer and 4% were in miscellaneous fields. Conclusion Higher caste women suffered more from depression and incidence is more in rural than in urban areas. Due to lack of awareness, most of the mental disorders go unreported. Sociological intervention in needed for the treatment of mental health problems.

Abstract Objective: To identify practice and pattern of self-medication use among new patients in ophthalmology clinic in a suburban community. Background: Self medication is a common practice all over the world. When consumers self-medicate without first consulting the eye care giver, issues of safety and inappropriateness of use arise. Methods: A cross sectional, analytic and questionnaire based study of 470 consecutive patients seen between April and June 2011 in a tertiary eye care centre in Nigeria was conducted. Data were analyzed using SPSS and p value <0.05 was considered significant. Results: The mean age was 43 ±24 years with a M: F ratio of 1:1.3. There was utilization of an initial medication in 73.6% (346) of the respondents before presentation. Of the group that utilized medication, 108(31.3%) could neither mention name nor show sample of medication used. Only 14.9% of patients consuming nonprescription drugs sought assistance from any health professional regarding proper selection or use. Majority (73.6%) of the patients got their medication following assistance sought from retail outlets of non-prescription medicine, friends, relations or self prescription. The utilized medications were inappropriate in 90% of the respondents who utilized them. The most common symptoms necessitating the utilization of initial medication were blurring of vision and itching. Conclusion: There was a high rate of self medication with blurring of vision and itching as the commonest complaints among the patients. There is still a very low incidence of preventive eye care in terms of ophthalmic check-up among our people.

Abstract Background: Adipocytokines, secreted from the adipose tissues have profound effect on complex metabolic and endocrine functions. Among them, leptin and adiponectin are the most recognized molecules which influence body homeostasis and metabolism. Moreover, patients with thyroid disease usually exhibit disturbances of these metabolic activities. Thus adipocytokines and thyroid hormones may influence similar aspects of metabolic functions. Objective: The main objective of current study was to evaluate the association and impact of leptin and adiponectin on thyroid stimulating hormone (TSH) among hypothyroid patients. Materials and Methods: For the present study a total 350 individuals were enlisted, out of which 200 were hypothyroid patients and 150 age and sex matched healthy controls aged ≥ 12 years. The serum TSH, leptin and adiponectin concentration were measured by CLIA method and results were computed by statistical methods such as mean, standard deviation, standard error and correlation using MS-Excel 2007. Result: Our data showed that hypothyroidism was more prevalent in the age group 30-50(62%) and an elevated TSH level was observed with advancing age among the patients as compared to controls. The inverse relation of leptin and adiponectin has been seen among the patients. When patients were compared with controls, they were with normal values which were in the range of standardized lab values leptin (3.7-13ng/dl) and adiponectin (5-10μg/ml). Conclusion: In conclusion, our data interpreted variations in the level of leptin and adiponectin among the hypothyroid individuals with high TSH level. As abnormal levels of these adipocytokines indicates the risk for other metabolic diseases like cardiovascular disease, obesity etc.

Abstract Objective: Obesity down regulated the adiponectin gene expression, but differences in adiponectin gene expression in gluteal adipose tissue (GAT) and in abdominal adipose tissue (AAT) are not well known. Therefore, the purpose of this study was to examine the differences in adiponectin gene expression in GAT and in AAT. Material & Methods: Nineteen healthy obese middle aged men (aged 41.4±6.1 years; mean ± SD) Adipose tissue (AT) biopsies from the subcutaneous abdominal and subcutaneous gluteal depots were obtained. Results: Adiponectin gene expression was 22.7% higher in subcutaneous GAT than in subcutaneous AAT. Conclusion: Adiponectin gene expression is higher in GAT than in AAT, suggesting GAT to be more important for circulating adiponectin levels.

Giant vesical calculus is a rare clinical entity in the recent urological practice. Males are affected more than the females. We report a case of 55years old male patient non diabetic or hypertensive who presented with urinary symptoms. His biochemical parameters were within normal limits. Urine analysis and culture sensitivity showed infection. His ultrasonography revealed a giant vesical calculus with intra prostatic extension and bilateral hydroureteronephrosis and small prostate. After controlling the urinary infection with course of antibiotics, he underwent an open cystolithotomy and post-operative recovery was uneventful.

Abstract Cavum vergae is a triangular fluid filled cavity posterior to foramen of Monro. They are seen in premature and term infants up to 2 months of age. It is of little clinical significance. Our patient is a 14year old girl with cavum vergae diagnosed with brain computed tomography and magnetic resonance imaging. These investigations were sequel to episodes of headache and one hour loss of consciousness with no antecedent complaints. Since no complicating evidence of hydrocephalus was seen, she was managed symptomatically.

Introduction: The average age of menarche has declined over the last century but the magnitude of the decline and the factors responsible remain subjects of contention. Aims and Objectives: To study a group with delayed menarche in a cohort of Bengali Indian females with low to normal body weight. To investigate anthropometric characteristics (height, mid-parental height, weight, BMI), Socio-economic Status, Sexual Maturity Rating (SMR) stages and 2D: 4D ratio ( ratio of lengths of second and fourth digits of both hands) in those with delayed menarche. To analyse the correlation of these factors with delayed age of menarche. Materials and Methods: A total of 614 children , aged 11- 16 completed years, of low to middle income family groups and attending suburban schools, were evaluated on the basis of predetermined questionnaire and anthropometric measurements. Correlation of factors with delayed age of menarche was done by appropriate statistical methods Results and Analysis: Out of 190 children having delayed menarche (cases) and 424 children with normal age of menarche (controls) , the height percentile (p value: 0.642), BMI ( p value: 0.091), weight (p value: 0.12)and Mid-Parental Height (p value: 0.26) had no significant correlation , while SMR ( p value:0.00), 2D:4D ratio (p value:0.002) and low Socio-economic Status (p value: 0.00) had a significant correlation with delayed menarche. Conclusion: This study is the first to examine such a wide variety of anthropometric and socio-economic factors at a time in a single cohort of females with delayed menarche.

Abstract Objective: Multiplex PCR assay was used for diagnosis of diarrheagenic Escherichia coli (DEC) in stool samples of children (under 5 years) with acute diarrhea. Methods: Samples were collected from January 2011 to December 2011, from Dhaka Medical College Hospital and Dhaka Shishu Hospital. Multiplex PCR with five specific primer pairs to detect enteropathogenic E. coli (eae, bfp), enterotoxigenic E. coli (lt, st) and enteroaggregative E. coli (aat) were used. However, enteroinvasive E. coli, enterohemorrhagicE. coli and diffusely adhererentE. coli were not sought. Result: In total, 135 (67.5%) E. coli were isolated from 200 stool samples. The prevalence of DEC was 68 (34%). Among DEC, most frequently isolated pathotype was EPEC 40 (58.82%), followed by ETEC 24 (35.29%) and EAggEC 18 (26.47%). Among the EPEC, 5 (12.5%) were typical EPEC. Among the 68 DEC positive cases, 22 samples contained more than one pathogenic gene in various combinations. Among the combination of DEC, EPEC+ETEC combination was 6 (27.27%) followed by ETEC+EAggEC 4 (18.18%), EPEC+EAggEC and ETEC+EPEC+EAggEC were both in 3 (13.6%). Conclusion:This study shows that DEC is a common cause of childhood diarrhea in Dhaka city of Bangladesh. By using multiplex PCR assay, DEC can be diagnosed in one PCR reaction that makes a conclusive diagnosis of diarrhea.

Abstract Background: The major nutritional problem among young children in India is anaemia that affects the ability to study and work and is significantly associated with increased morbidity and mortality. Objectives: To analyze the prevalence of anaemia among Indian children of underfive years and to identify the significant risk factors associated with it. Methods: Data of 35851 children from NFHS-III, India were analyzed and binary logistic regression model was fitted by using SPSS 15.0 software. Anaemia was defined as haemoglobin concentration level below 11 g/dl. HemoCue Hb 201+ analyzer was used to measure haemoglobin concentration. Results: Overall, 69.5 percent were anaemic with the highest proportion in Bihar and the least in Goa. The age and birth order of child; religion, caste and wealth index of household; anaemia level, education, age at first birth, intake of iron supplements during pregnancy and vegetarian habit of mother showed significant influence on child anaemia. Conclusion: Child anaemia prevails significantly in India and the findings suggest for urgent prevention and treatment measures giving importance to the different socioeconomic characteristics.

Abstract Objective: Anemia is the most frequently observed nutritional diseases in the world. It is a major health problem that affects 25-50% population of world and nearly 50% of pregnant women. In India, anemia is the second most common cause of maternal deaths, accounting for 20% of maternal deaths. The main objective of the present study is to determine the prevalence of anemia among rural pregnant women of Vizianagram and to explore associated factors with anemia. Materials and Methods: The study was conducted in the Mother and child hospital, Vizianagram, Vizianagram district, Andhra Pradesh, India. Pregnant women with any age of gestation period, parity and age were recruited for study. Estimation of hemoglobin was carried by standard sahli’s pipette method. Anemia was classified according to WHO grading criteria. Results: Nine hundred eighty-six subjects were enrolled for the study of whom all the study subjects did not meet the criteria of WHO standards of normal grade i.e >11gm/dl. 100% anemic condition was seen. 52.73% has a mild degree of anemia, 40.97% have moderate degree of anemia and 6.28% of population has severe degree of anemia. Pregnant women in 1st trimester of their gestation period has higher prevalence rate than in 2nd and 3rd trimesters. Parity has not showed any significant relation with anemia. Conclusion: The study confirms that preventing anemia is a challenge. Efforts should be geared towards the early detection and treatment of anemia before delivery to avoid various maternal and fetal complications.