Pereira Carlsen Bernard, Sheldon G Mathias
Introduction: Breast cancer is the 2nd most common cause of cancer among women worldwide. Women in India it presents at a younger age who present themselves at an advanced stage with poorer prognosis compared to western counterparts. Estrogen and Progesterone play a key role in the growth kinetics of the breast. Tumors that are positive for both estrogen and progesterone receptors have a better possibility of remission following Hormonal therapy (70%). Objectives: Hence this study was done to correlate the histological grading, tumor size and Nodal status with ER/PR and HER2neu status in women undergoing Modified Radical Mastectomy for breast cancer. Results and Discussion: 50 female patients who underwent Modified Radical Mastectomy for breast cancer proved by FNAC from Jan 2013 till September 2014 evaluated for correlation. Among 50 patients 25 had ER (+) receptor status, with tumor size of 2-5cm was seen in 19 patients. 9 patients with ER (+) status had zero lymph node status. 20 patients were SBR grade 2.16 patients had PR (+) status, among these patients 12 had a tomor size of 2-5 cm, 6 patients had 0 lymph nodes and 14 patients were SBR grade 2. 26 patients had HER2neu (+), 8 patients with HER2neu + status had a tumour size of more than 5 cm. 6 patients with HER2neu +receptor status had more than 10 lymph nodes, 21 patients were SBR grade 2. Conclusion: Study concludes presence or absence of estrogen, progesterone and HER2 neu receptor status can help to decide on further plan of treatment and prognosis in breast cancer patients.
1. Barrel SN, Hall RE, Tilley WD. Role of the androgen receptor in human breast cancer.1998; 3:95-103. 2. Payne SJ, Bowen RL, Jones JL, Wells CA. Predictive markers in breast cancer the present. Histopathology.2008; 52:82-90. 3. Ferlay J, Bray F, Pisani P, Parkin DM.GLOBOCAN 2002.Cancer Incidence, Mortality and Prevelance Worldwide. IARC Cancer Base No5.Version2.0 IARC Press, Lyon 2004. 4. Dent R, Wedad M, Trudeau M. Pattern of metastatic spread in triple-negative breast cancer. Breast Cancer Research and Treatment. 2009; 115:423-28. 5. Onitilo A, Engel J, Greenlee R, Mukesh B. Breast Cancer Subtypes Based on ER/PR and Her2 Expression: Comparison of Clinicopathologic Features and Survival. Clinical Medicine & Research; 7: 4-13. 6. Tiwari M, Krishnamurthy A, Shukla HS. Predictive markers of response to neoadjuvant chemotherapy in breast cancer. Surg Oncol.2008; 7:301-11. 7. Mohla S, Sampson CC, Enterline JP, Estrogen and Progesterone Receptors in Breast Cancer in Black Americans, Correlation of Receptor Data with tumour differentiation, Cancer Journal 1982;50:552-59. 8. Eisenberg ALA, Koifman S. Hormone receptor association with prognostic factors for breast cancer. Revista Brasileria de Cancerologia 2001; 47:49-58. 9. Almasri MN, Hamad M. Immunohistochemical evaluation of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma in Jordan Breast Cancer Research 2005;7:598-604.
Mukund Joshi, Kuldip Singh Sodhi, Rajesh Pandey, Jasbir Singh, Subhash Goyal
Within a very short time period, the use of genetically modified plants for the production of therapeutic compounds has moved from being an experimental system with significant potential to a commercially viable process poised to deliver products useful in animal and human therapies. In roads have been made not only in more traditional areas of therapeutic development (e.g., the identification and isolation of bioactive secondary metabolites), but also in relatively uncharted areas such as the production of novel bioactive peptides and proteins, antibody production for passive immunization therapy, and edible oral vaccines. The rapid pace of development witnessed thus far is likely to accelerate in the very near future as additional, novel uses of transgenic plants as production systems for human therapeutics are explored. The limitations for the use of genetically modified plants will likely arise from our still somewhat unsophisticated knowledge of how plant gene expression is controlled and how various metabolic pathways within a plant interact and regulate themselves. The use of plants as production factories is already seen as an economically attractive alternative for the production of clinically important compound.
1. Winslow LC, Kroll DJ: Herbs as medicines: Arch Intern Med, 1998; 158 (20):2192-9.
2. Fischer R, Emans N: Molecular farming of pharmaceutical proteins: Transgen Res, 2000; 9(4-5):279-99.
3. Daniell H, Streatfield SJ, Wycoff K: Medical molecular farming: production of antibodies, biopharmaceuticals and edible vaccines in plants: Trends Plant Sci, 2001; 6(5):219-26.
4. Goldstein D.A. Thomas J.A: Biopharmaceuticals derived from genetically modified: Q J Med, 2004; 97:705-16.
5. Moraga CA: High Tech Business Decisions Report. Biopharmaceutical Contract Manufacturing: Meeting Demand for Increased Capacity: High Tech Business Decisions, 2001; 1(3):3-20.
6. Ma JKC, Vine ND: Plant expression systems for the production of vaccines: Curr Topics Microbiol Immunol, 1999; 236:275-92.
7. Ganz P.R: Expression of human blood proteins in transgenic plants: the cytokine GM-CSF as a model protein. In: Owen MRL, Pen J, editors. Transgenic plants: a production system for industrial and pharmaceutical proteins. John Wiley and Sons, (London), 1996; 281-97.
8. Pen J: Comparison of host systems for the production of recombinant proteins: In Owen, MRL, Pen J. eds. Transgenic plants: a production system for industrial and pharmaceutical proteins: John Wiley and Sons (London), 1996; 149-167.
9. Whitelam GC: The production of recombinant proteins in plants: J Sci Food Agric.1995; 68: 1-9.
10. Moloney MM: “Molecular farming” in plants: achievements and prospects: Biotechnol. Eng, 1995; 9:3-9.
11. Parmenter DL: Production of biologically active hirudin in plant seeds using oleosin partitioning: Plant Mol. Biol, 1995; 29:1167-80.
12. Kusnadi A, Nikolov ZL, Howard JA: Production of recombinant proteins in transgenic plants: practical considerations: Biotechnol Bioeng, 1997;56:473-84.
13. Ma, J.K.C. and Hein, M.B. Antibody production and engineering in plants, In: Collins GB , Sheperd RJ. Eds. Engineering plants for commercial products and applications: Academy of Sciences, New York, 1996:72-81.
14. Smith MD, Glick BR: The production of antibodies in plants: Biotechnol Adv, 2000;18:85-89.
15. Cabanes-Macheteau M, Fitchette-Lainé AC, Loutelier-Bourhis C, Lange C, Vine ND, Ma JK. et al: Glycosylation of a mouse IgG expressed in transgenic tobacco plants. Glycobiology, 1999; 9(4):365-72.
16. Conrad U, Fiedler U, Artsaenko O, Phillips J: High-level and stable accumulation of single-chain Fv antibodies in plant storage organs: J. Plant Physiol, 1998;152:708-11 .
17. Sijmons PC, Dekker BM, Schrammeijer B, Verwoerd TC, van den Elzen PJ, Hoekema A: Production of correctly processed human serum albumin in transgenic plants, 1990; 8(3):217-21.
18. Glynis Giddings, Gordon Allison, Douglas Brooks, Adrian Carter Transgenic plants as factories for biopharmaceuticals: Nat Biotechnol, 2000;18:1151 -55.
19. Bauer A: Pharma crops, state of field trials worldwide.
Trupti D Ramteke, Sucheta Ghule, Rajesh Jambhulkar, Avinash Jadhao
In patients of cervical cancer, a simple and easy blood based tumor marker system might be an additional tool to derive tumor status and to correlate with the response to anticancer treatment and disease recurrence. Being simple, rapid, inexpensive, easily assayable, serum levels of LDH and GGT were measured in 50 histopathologically diagnosed cases of cervical cancer and compared with age matched healthy controls in the age group of 35-75 years and analysed by unpaired Student’s ‘t’ test (2- tailed) for parametric analysis. The cases of cervical cancer were further divided into study subgroups i.e. stage I, II, III. The comparison was also done among study subgroups. The biochemical parameters were compared among three study subgroups using one way analysis of variance (ANOVA). Results of the study showed significant higher levels of serum Lactate dehydrogenase, Gamma-glutamyltransferase in cases of cervical cancer as compared to their age matched controls. Interstage comparison between study subgroups was also significant.Thus it is concluded that Serum LDH and GGT may be better indicators of cervical cancer and may help in early detection of the disease and assist in assessing the extent and therefore prognosis of this malignancy along with clinical findings.
1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int. J. Cancer 2010 Dec 15;127(12): 2893–917. 2. Park K. Park’s Textbook of Preventive and Social Medicine. 22nd ed. Jabalpur, M.P.(India): M/S Banarsidas Bhanot; 2013. p. 358-9. 3. Kaarthigeyan K. Cervical cancer in India and HPV vaccination. Indian J Med Paediatr Oncol 2012 Jan-Mar;33(1):7–12. 4. Farhath S, Vijaya PP, Mumtaj P. Cervical Cancer. Is Vaccination Necessary in India? Asian Pacific J Cancer Prev 2013;14(4):2681-84. 5. Thulaseedharan JV, Malila N, Hakama M, Esmy PO, Cheriyan M, Swaminathan R et al. Socio Demographic and Reproductive Risk Factors for Cervical Cancer – a Large Prospective Cohort Study from Rural India. Asian Pacific Journal of Cancer Prevention 2012;13:2991- 95. 6. Basu P, Biswas J, Mandal R, Choudhury P. Is Interferon –α and retinoic acid combination along with radiation superior to chemoradiation in the treatment of advanced carcinoma of cervix. Indian Journal of Cancer 2006;43(2):54-9. 7. Singh S, Badaya S. Factors Influencing uptake of Cervical Cancer Screening among Women in India: A Hospital based Pilot Study. J Community Med Health Educ 2012;2(6):2-6. 8. Patel PS, Rawal GN, Balar DB. Importance of Serum Sialic Acid and Lactate Dehydrogenase in Diagnosis and Treatment Monitoring of Cervical Cancer Patients. Gynecologic Oncology 1993;50:294-9. 9. Burk RE, Harris SC, Mc Gurie WL. Lactate dehydrogenase in estrogen responsive human breast cancer cells. Cancer Research 1978;38:2773-76. 10. Whitfield JB. у-glutamyltransferase. Crit Rev Clin Lab Sci 2001;38(4):263-355. 11. Rollason JG, Pincherle G, Robinson D. Serum у-gammaglutamyl transferase in relation to alcohol consumption. Clin Chim Acta 1972;39:75-80. 12. Strasak A, Pfeiffer R, Klenk J, Hilbe W. Oberaigner W, Gregory M et al. Prospective study of the association of gamma-glutamyltransferase with cancer incidence in women. Int J Cancer 2008 Oct 15;123(8):1902-6. 13. Ruhl CE, Evehart JE. Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology 2009 Feb;136(2):477-85. 14. Strasak AM, Goebel G, Concin H, Pfeiffer RM, Brant LJ, Nagel G et al. VHM&PP Study group. Prospective study of the association of serum gamma-glutamyltransferase with cervical intraepithelial neoplasia III and invasive cervical cancer. Cancer Research 2010 May 1;70(9):3586-93. 15. Polterauer S, Hofstetter G, Grimm C, Rahhal J, Kohl M, Concin N et al. Releavance of gamma –glutamyltransferase - a marker for apoptotic balance –in predicting tumour stage and prognosis in cervical cancer. Gynecologic Oncology 2011;122:590-94. 16. у –Glutamyl transferse kit [kit insert]. Goa (India): Coral Clinical Systems; 2013. 17. LDH (P-L) kit [kit insert]. Goa (India): Coral Clinical Systems; 2013 18. Graph pad prism version 6.0.[Online]; Available from: URL:http//www.graphpad.com 19. Shrinivasan A, Poongothai AR, Chandrashekhar Rao S.Shrinivasulu M, Vishnupriya S. Serum lactate dehydrogenase (LDH) levels in breast cancer. Ind J Hum Genet 1999;5(2):21-27. 20. Marshall MJ, Nealt FE, Goldberg DM. Effect of radiotherapy upon enzymes of the glycolytic and related pathways in human uterine cancer. Br. J. Cancer 1979 Jan;39(1):90-95. 21. Nugmanov EU, Uteshev AB, Dzhilikbaeva RN. Changes in lactate dehydrogenase activity in cervical precancer and cancer. Voprosy Onkologii 1981;27(9):27-30. 22. Das HK, Chakravorty M, Sanyal B. Serum Enzymes as Bio-chemical Markers in the Diagnosis and Prognosis of Carcinoma of the Cervix Uteri. Indian journal of cancer 1985;22:121-31. 23. Iglesias J, Borras G, Lailla JM, Fortuny A, Molina R, Ballesta A, Sentís J. Total LDH and its isoenzymes in gynecological malignancies and other gynecological conditions. Eur J Gynaecol Oncol 1988;9(1):32-5. 24. Chougule A, Hussain S, Singh DP. Management of Malignancies by Radiotherapy and Role of Biochemical Parameters. Asian J. Exp. Sci 1999;13(1-2):37-46. 25. Lee DH, Blomhoff R, Jacobs Jr.DR. Is Serum Gamma-Glutamyl transferase a Marker of Oxidative Stress? Free Radical Research 2004 June;38(6):535-9. 26. Lee DH, Gross MD, Steffes MW, Jacobs Jr.DR. Is Serum Gamma-Glutamyltransferase a Biomarker of Xenobiotics, Which Are Conjugated by Glutathione? Arterioscler Thromb Vasc Biol 2008;28:26-28. 27. Srivastava S, Natu SM, Gupta A, Pal KA, Singh U, Agarwal GG et al. Lipid peroxidation and antioxidants in different stages of cervical cancer: Prognostic significance. Indian J Cancer 2009;46:297-302. 28. Nirmala JG, Narendhirakannan RT. Detection and Genotyping of High-Risk HPV and Evaluation of Anti-Oxidant Status in Cervical Carcinoma Patients in Tamil Nadu State, India - a Case Control Study. Asian Pacific J Cancer Prev 2011;(12);2689-95. 29. Kim JW, Choi EK, Lim JH, Kim YT, Kim DK, Lee YC et al. Antioxidant System and Oxidative Stress in Uterine Cervical Neoplasia of Korean women. Korean J Obstet Gynecol 2002Jan;45(1):145-152. 30. Subramanyam D, Subbaiah KCV, Rajendra W, Lokanatha V. Serum selenium concentration and antioxidant activityin cervical cancer patients before and after treatment. Experimental Oncology June 2013;35:97–100. 31. Malkin A, Kellen J, Lickrish G, Bush R. Carcinoembryogenic Antigen (CEA) and other Tumor markers in Ovarian and Cervical cancer. Cancer 1978;42:1452-6. 32. Desai P, Chetana K. Evaluation of Enzyme Markers in Carcinoma Cervix Indian Journal of Clinical Biochemistry 2009; 24 (Supplement).
Dash Satyanarayan, Ukey Ujwala U
Introduction: Introduction: Health care providers (HCPs) are considered to play a pivotal role in reducing the burden of STI/RTI and stemming the spread of STI through effective preventive and curative services to individuals suffering from HIV/AIDS and STIs. Aims and Objectives: To assess awareness of the medical officers about the STI/ RTI and to judge the impact of the training in capacity building towards improvement of their awareness. Materials and Methods: Observational cross sectional study was conducted in 30 medical officers attending the training. A structured questionnaire containing 30 close ended questions on the various aspects of awareness about STI /RTI was administered to them for pre and post tests. Chi square test and Z test were applied as the tests of significance. Results: During pre-test, 13 (43.33%) of the participants were aware that STI/RTI can exist without any symptoms or signs. The correct response to the same question rose to28 (93.33%) in the post-test. During the pre-test it was observed that 15 (50%) of the study participants had the correct awareness that asymptomatic carriers can pass infections to their partners during sexual contact. The correct response was given by 24 (80%) study participants during post-test. Mean score for all the questions considered together increased from 17.5 during pre test to 26.2 during post test with a Z of 15.67 and p value of < 0.0001. Conclusion: Medical officers were found to have sufficient awareness about STI/RTI. The significant increase in the post test scores showed that the training was also proved to be effective in improving the awareness on STI/RTI.
1. Trends in Reportable Sexually Transmitted Diseases in the United States, 2007 National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis.From centre for disease control and prevention. (Online) (Cited 2009 April 1). Available from URL: http://www.cdc.gov/std/stats07/trends.htm. 2. Prevention and control of sexually transmitted infections: draft global strategy, Report by the Secretariat. From WHO. (Online) (Cited 2008 Oct 13). Available from URL: http://www.who.int/gb/ebwha/pdf_files/WHA59/A59_11-en.pdf. 3. Somnath Roy, Deoki Nandan. Development towards achieving Health/ reproductive Health for All and Millennium Development Goals: A Critical Appraisal for strengthening action programmes (Part-II). Health and Population-Perspectives and Issues [online] 2007 [cited on 2011 Sep 30]; 30(3):150-176. Available from: URL: htp://medind.nic.in/htab/t07/i3/habt07i3p150. 4. World Health Organisation (WHO) Global prevalence and incidence of selected curable sexually transmitted infections: Overview and estimates, Geneva: WHO, 2001. 5. National Guidelines on Prevention, Management and Control of Reproductive Tract Infections including Sexually Transmitted Infections Ministry of Health and Family Welfare Government of India [online] 2007 Aug [cited on 2011 Sep 30] Available from: URL: http://www.nacoonline.org/upload /Policies%20and%20 Guidelines /14,%20 National_ Guidelines_ on_PMC_ of_RTI_ Including_STI.pdf 6. Westrom L. Incidence, prevalence and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. Am J Obst and Gynaec, 1980; 138:880-892. 7. Wasserheit J, Epidemiological synergy: interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases, Sexually Transmitted Diseases, 1992;19(2):61–77. 8. Cohen M. Sexually transmitted diseases enhance HIV transmission: no longer a hypothesis, Lancet 1998; 351(3):5–7. 9. Khan MS, Unemo M, Zaman S, Lundborg CS. Knowledge, attitudes and practices regarding human immunodeficiency virus/acquired immune deficiency syndrome and sexually transmitted infections among health care providers in Lahore, Pakistan.J Ayub Med Coll Abbottabad.Oct-Dec 2009; M21 (4):1-6. 10. World Health Organization. Global Strategy for the Prevention and Control of Sexually Transmitted Infections: 2006-2015. Key Messages. Geneva, Switzerland: World Health Organization; 2006. http:// whqlibdoc.who.int/hq/2006/WHO_RHR_06.10_eng.pdf. 11. Hussain MFA, Khanani MR, Siddiqui SE, Manzar N, Raza S, Qamar S. Knowledge, Attitudes and Practices (KAP) of General Practitioners (GPs) regarding Sexually Transmitted Diseases (STDs) and HIV/ AIDS in Karachi, Pakistan. J Pak Med Assoc. February 2011; 61(2):262-265. 12. Lan TP, Mogren I, Phuc HD, Lundborg CS. Knowledge and practice among healthcare providers in rural vietnam regarding sexually transmitted infections. Sexually transmitted diseases. December 2009; 36 (12): 1-7. 13. Phrasisombath K, Thomsen S, Hagberg J, Sychareun V, Faxelid E. Knowledge about sexually transmitted infections (STIs) and attitudes towards female sex workers with STI symptoms among health care providers in Laos. Asia-Pacific Journal of Public Health. 20(10):1-13. 14. Kermode M, Holmes W, Langkham B, Thomas MS, Gifford S. HIV-related knowledge, attitudes and risk perception amongst nurses, doctors and other healthcare workers in rural India. Indian J Med Res. September 2005; 122: 258-264. 15. Islam MT, Mostafa G, Bhuiya AU, Hawkes S, Francisco A. Knowledge on, and attitude toward HIV/AIDS among staff of an international organization in Bangladesh. J Health Popul Nutr. Sep 2002; 20(3): 271-278. 16. Mayaud P, Mabey D. Approaches to the control of sexually transmitted infections in developing countries: old problems and modern challenges. Sex Transm Infect. 2004; 80:174 –182.
Sanjiv Zangde, Anjali Deshmukh
Introduction: India has nearly 30% of global tuberculosis burden. With an estimated burden of new smear positive tuberculosis of 85 per 1 lakh population, nearly one million new smear positive case and about 2 million total new cases are added every year. More adults die from tuberculosis than from any other infectious disease in India, one every minute more than 1,000 every day. Aims and objective: To study of various characteristics of Pulmonary and extra pulmonary tuberculosis patients enrolled for DOTS under RNTCP. Material and method: All the newly diagnosed cases of pulmonary and extra pulmonary tuberculosis attending OPD/IPD of Govt. Medical College Nanded and residing in area under coverage of RNTCP centre of GMC Nanded were included in this study. Name, age, sex, address, occupation, income, number of family members, presenting complaints in chronological order, past history, personal history, through general and systemic examinations, investigations were carried out and the findings were recorded. All the standard definitions defined by Central TB division of Directorate General of Health Services were used. Results: 57.01% patients were having pulmonary Tuberculosis and 42.99% patients were having extra pulmonary tuberculosis. Among the cases of extra pulmonary tuberculosis TB Lymph Nodes contributes 23.08%, followed by pleural effusion 13.57%. It was seen that 84.13% parinets were subjected to category I (sputum positive and seriously ill sputum negative) and only 15.87%patients i.e. sputum negative and not seriously ill were subjected to category III. Maximum number of patients enrolled in present study were between15- 44 i.e. economically productive age group of life. Cough was the most common symptom observed and next was fever Conclusion: Sputum positive pulmonary tuberculosis was the most common type of tuberculosis as compared to extra pulmonary and sputum negative pulmonary tuberculosis. Young male belonging to lower socioeconomic class was most common group suffering from tuberculosis.
1. Prabha Jagota: RNTCP - A success story. Indian Journal of Tuberculosis: 2002, 49, 69. 2. Christopher Dye: India’s leading role in Tuberculosis epidemiology and control. Indian Journal of Medicine Res.123, April 2006, 481 – 484. 3. Treatment of tuberculosis: guidelines – 4th ed. WHO Library Cataloguing-in-Publication Data. World Health Organization 2010. 4. Khatri GR, Frieden TR: The status and prospects of Tuberculosis control in India International Journal of Tuberculosis and lung disease, 4(3):193.200. 5. Tahir M, Sharma, S.K, Rohberg D. Gupta D, Singh VB, Sinha DK: DOTS at tertiary care centre in northen India : Success, challenges and next steps in tuberculosis control Indian journal of Medicine Res 123, May 2006. 702-706. 6. Md. Shamim Akhtar, Rakesh Bhargava Zuber Ahamad, DK Pandey, Naveed Nazir Shah, Khurshid Anwar: To study effectiveness of DOTS at JN Medical College Aligarh. Lung India 207;24;128-131. 7. Managing RNTCP in your area atraining course module 5-10: central TB Division Directorate General of health Services Ministry of Health and family Welfare, Nirman Bhavan, New Delhi 1100-11. 8. Kolappan C. R Subramani, Karunakaran and PR Narayan: Mortelity of Tuberculosis patients in Chennai, India. Bullerin of WHO; 2006: 84: 555 – 560. 9. Central TB division directorate general of health services, Ministry of Health and family welfare TB India 2006 RNTCP performance report First – fourth quarter 2006. 10. Chadha S.L. and R.P. Bhagi: Treatment outcome in TB patients placed on Directly Observed Treatment Short course Chemotherapy : A Cohart study, Indian Journal of Tuberculosis 2000 ; 47, 155. 11. Balsubramanian VN, Oomen K, Saumel R: DOT OR NOT? Direct observation antituberculosis treatment and patient outcome, Kerla state, India. International Journal of Tuberculosis and Lung disease 2000, 4 (5). 409 – 413. 12. Hill PC, Stevens W, Hills. Bah J. Donkar S.A. Jallow A, Lienhardt C: Risk factors for defaulting from Tuberculosis treatment ; A prospective study of 301 cases in Gambia. International Journal of Tuberculosis and Lung disease 9 (12) ; 2005, 1349 – 1354. 13. Managing RNTCP in your area atraining course module 5-10: central TB Division Directorate General of health Services Ministry of Health and family Welfare, Nirman Bhavan, New Delhi 1100-11. 14. Jagota P, Sreenivas TR, Parimala N, Bhat et al: Improving Treatment compliance by observing difference in treatment irregularities. International journal of tuberculosis and lung disease, 1996; 43, 75.
Jayaram Swati, Krishnamurthy U
Undiagnosed thyroid diseases in pregnant women can result in miscarriage, preterm birth and gestational hypertension. Autoimmunity has been implicated as one among the causes for thyroid illness in pregnancy. This study intended to define the prevalence of autoimmune thyroid disease by measuring thyroid peroxidase autoantibodies (ATPO) in pregnant women which can aid in predicting the hypothyroidism and early intervention. Pregnant women (n=107) were screened for Thyroid Stimulating Hormone (TSH) and ATPO. This study revealed that the prevalence of thyroid illness in pregnant women by TSH as 14.1% and the prevalence increased to 29.9% on combining TSH with ATPO. The sensitivity and specificity of positive ATPO for the thyroid illness was 26.6% and 81.5% respectively. Hypothyroid subjects had high levels of ATPO which was statistically significant by one-way analysis of variance. Therefore, detection of raised ATPO in pregnant women may be of use in early diagnosis of thyroid illness and help in preventing adverse out comes.
1. Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. N Engl J Med 1994; 331:1072–1078 2. Becks GP, Burrow GN. Thyroid disease and pregnancy. Med Clin North Am 1991; 75:121-50. 3. Ruf J, Czarnocka B, Ferrand M, et al. Thyroid peroxidase is the organ-specific 'microsomal' antigen involved in thyroid autoimmunity. Acta Endocrinol (Copenh) 1987; Suppl 281: 49 - 55. 4. Stagnaro-Green A, Roman SH, Cobin RH, el-Harazy E, Alvarez-Marfany M, Davies TF. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA. 1990; 264(11):1422-5. 5. Negro R, Stagnaro-Green A. Clinical aspects of hyperthyroidism, hypothyroidism, and thyroid screening in pregnancy. Endocr Pract. 2014; 20(6):597-607. 6. Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society. The Journal of Clinical Endocrinology and Metabolism 2005, 90(1), 581-585. 7. Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, Menon PS, Shah NS. Prevalence and impact of thyroid disorders on maternal outcome in asian-Indian pregnant women. J Thyroid Res. 2011(2011). 8. Galofre JC, Davies TF. Autoimmune thyroid disease in pregnancy: a review. J Womens Health (Larchmt). 2009; 18(11):1847-56.
Sufia M Siddiqui, Arvind B Deshmukh, Prasad L Bhanap
Aims and Objectives: A total 206 women attending the antenatal clinic at our rural hospital were evaluated for asymptomatic bacteriuria over a period of 3 months. Direct smear examination with wet mount examination, gram staining of uncentrifuged urine, and then culture and sensitivity testing to detect significant bacteriuria was carried out. Results: Of these 8.7% (18 women) showed significant bacteriuria. and the maximum incidence was found to be in the <25 age group(83.3%).Prevalence was found to be higher in second gravid (38.9%) and in second trimester of pregnancy(44.4%).Gram stain was found to be more sensitive and specific than wet mount examination. Eschrechia coli was found to be the predominant isolate (38.88%) followed by coagulase negative staphylococcus (33.33%) Conclusions: It is advised to screen all ANC women for asymptomatic bacteriuria repeatedly in all the three trimesters of pregnancy and to advocate treatment only if repeated samples show significant bacteriuria.
1. Betty. A. Forbes, Daniel F Sahm, Alice S Weissfeid, Bailey and Scotts Diagnostic Microbiology; Twelfth Edition, Mosby Publications. Chapter 57 :Pages 842-856 2. Emilie Katherine Johnson, J Stuart Wolf Jr, Edward David Kim, Urinary tract infections in pregnancy, Medscape, medpulse Assessed on 14-8-2014 3. Nicole LE, Badley S, Colgan R et al. I nfectious disease society of American guidelines for diagnosis and treatment of Aymptomatic Bacteriuria in adults. Clin Infect Dis 2005; 40: 643-54. 4. Hamdan, Z., H.A. Haliem, M. Ziad, S.K. Ali, and Adam, I. 2011. Epidemiology of urinary tract infections and antibiotics sensitivity among pregnant women at Khartoum North Hospital. Ann. Clin, Microbiol. Antimicrob. 10: 2. 5. Gomez, R., R. Romero, S.S. Edwin, and David, C. 1997. Pathogenesis of pretermlabor and preterm premature rupture ofmembrances associated with intraamniotic infections. Infect. Dis. Clin. North America, 11: 135-76. 6. Goldenberg, R.L., J.C. Hauth, and Andrews, W.W. 2000. Intrauterine infection and preterm delivery. New Eng. J. Med.342:1500-1507. 7. Bhabani Pegu1, Bhanu Pratap Singh Gaur1, Ishani Bora1, Nalini Sharma2, Ahanthem Santa Singh3. Detection of Urinary Tract Infection among Pregnant Women in a Tertiary Care Hospital. International Journal of Health Sciences and Research (www.ijhsr.org) Vol.4; Issue: 7; July 2014:84-88 8. Pezzlo MT: Laboratory diagnoses of urinary tract infections: Current concepts and controversies, Infect Dis Clin Pract 2; 469, 1993. 9. Collee JG, Duguid JP, Fraser AG, Marmion BP, Simmons A. Laboratory strategy in the diagnosis of infective syndromes. In: Collee JG, Fraser AG, Marmion BP, Simmons A, editors. Mackie and McCartney, practical medical microbiology. 14th ed. Edinburgh: Churchill Livingstone; 1996. p. 84-90. 10. JOHN E. DELZEL and MICHAEL L. LEFEVRE, Urinary Tract Infections During Pregnancy Am Fam Physician. 2000 Feb 1; 61(3):713-720. 11. Lavanya, S.V., and Jogalakshmi, D. 2008.Asymptomatic bacteriuria in antenatal women. Indian J. Med. Microbiol. 2002 (2):105-106. 12. Gayathree L, Shetty S, Deshpande S R, Venkatesha D T Screening For Asymptomatic Bacteriuria In Pregnancy: An Evaluation Of Various Screening Tests In Hassan District Hospital, India. Journal of Clinical and Diagnostic Research 2010;Vol 4(4):2702-2706 13. Jayalaxmi J, Jayaram. VS; Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women: IJPM: 51(3), 2008; 379-81. 14. T. Jeyaseelan Senthinath, P. Chitra Rajalaksmi, R. Keerthana, R.S. Vigneshwari, P. Revathi, N. Prabhu, A.R. Susethira. Prevalence of asymptomatic bacteriuria among antenatal women in rural tertiary care hospital, Tamilnadu, India Int. J. Curr. Microbiol. App. Sci (2013) 2(1): 80-85 15. Girishbabu, R. J., R. Srikrishna, and Ramesh, S.T. 2011. Asymptomatic bacteriuria in pregnancy. Int. J. Biol. Med. Res.2 (3):740 - 742. 16. A. Masinde, B. Gumodoka, A. Kilonzo and S.E. Mshana Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania; Tanzania Journal of Health Research, Vol. 11, No. 3, July, 2009, pp. 154-161 17. Kalantar EnayatI; Farhadifar FaribaII; Nikkho BahramIII Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran Int. braz j urol. vol.34 no.6 Rio de Janeiro Nov./Dec. 2008 18. Sandberg, T., Kaijser, B., Lidin-Janson, G., Lincoln, K., Orskov, F., Orskov, I., Stokland, E. and Svanborg-Eden, C. (1988) Virulence of Escherichia coli in relation to host factors in women with symptomatic urinary tract infection. J Clin Microbiol, 26, 1471-1476.
Sarika Munghate, Vinita Belsare, Bhushan Mahajan, Sandip Lambe
Infertility is defined as inability of a couple to achieve conception after 1 year of unprotected coitus. 10 to 15% of marriages contracted by men and women prove to be childless. Hormonal conditions like hypothyroidism are one of the etiological factors responsible for female infertility. The aim of the present study was to determine the incidence and prevalence of thyroid dysfunction in patients seeking treatment of infertility. 50 women subjects and 50 controls were selected for the study in the age group 19 years to 35 years. Serum T3, T4 and TSH levels were estimated in both population. It was found that the levels of serum TSH were increased significantly and serum T4 levels were decreased significantly in the study group compared to the controls.
1. Viniker DA et al. Investigations for infertility management. In Rainsbury PA, Viniker DA (eds), Practical Guide to Reproductive medicine, P. No. 93-110, New York Parthenon Publishing Group, 1997. 2. Yao Mylene and S. Daniel. Infertility. Novak’s gynecology. Berek J. 13th edition 2002. Lippincott Williams and William, P.No.973 to 1002 3. Liel Y. Harman-Boehm I et al. Medical conditions leading to infertility. Infertility male and female; Vaclav I, Lunenfeld B, 2nd edition, 1993, Churchill Livingstone P. No. 715. 4. Howkins and Bourne. Shaw’s textbook of gynaecology 11th edition, V. Padeibidri and Daftary N. Shirish (as editors) P. No. 203 to 223. BI Churchill Livingstone. 5. Akande EO, 1975. Plasma concentration of gonadotropins, estrogen and progesterone in hypothyroid women. Br. J of obstet gynecol 82:552. 6. Goldsmith RE, Sturgis SH, Lerman J 1952. The menstrual pattern in thyroid disease. J Clin endocrinol metab. p 12: 846. 7. Nath JD, Barooah B et al. Serum T3, T4 level in infertile women. J of obstet and gynaec of India. June 1990; 40(3): 407-409. 8. Lakshmi Singh, C.G. Agrawal. Thyroid profile in infertile women. J of obstet and gynaecology of India. 40(2), April 1990, 248-253. 9. Thomas R, Reid RL et al. Thyroid disease and reproductive dysfunction a review obstet gynecol. 1987; 70:789-798. 10. Lerman: Quoted from Buxton CL, Walter LH et al. Effect of thyroid therapy on menstrual disorders and sterility J.A.M.A. july 17, 1954, Vol (155) No.12; 1035.
Tanmoy Banerjee, Nataraj S M, Suhas Y Shirur
Introduction: Chronic kidney disease(CKD) is a multisystem disorder, the major pulmonary alterations seen in CKD patients are obstructive disorders such as air flow limitation in distal airways and reduced pulmonary diffusion capacity. Hemodialysis can reduce the incidence and severity of many of these disturbances so much so that the overt and florid manifestations of uremia have largely disappeared in modern health setting. Aims and objective: The present study was undertaken to assess the changes in pulmonary function in CKD patients following dialysis. Material and Methods: The study was conducted on 30 patients within age group of 20-50 years suffering from ESRD undergoing regular hemodialysis for more than 3 months. Spirometry was performed on subjects before dialysis and was repeated after dialysis. Results: There was a significant improvement of pulmonary function, Forced Vital Capacity(FVC), Forced Expiratory Volume in first second (FEV1) and Maximum Expiratory Pressure(MEP) from pre to post dialysis. Conclusion: Uremia in ESRD patients causes obstructive pulmonary dysfunctions such as pulmonary edema, small air way obstruction and decreased diffusion capacity of the alveoli. Hemodialysis by removing and reducing uremic products improves the obstructive changes in the lungs. It reduces pulmonary edema (residual edema), improves pulmonary capillary permeability and elevates respiratory muscle functions.
1. Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo. Harrison’s Principles of Internal medicine.18th ed. Mc Graw Hill. 2011. 2. Agarwal SK, Srivastava RK. Chronic kidney disease in India: challenges and solutions. Nephron Clin Pract.2009;111:c197-203. 3. Douglas C, Murtagh FE, Chambers EJ, Howse M, Ellershaw J. Symptom management for the adult patient dying with advanced chronic kidney disease: a review of the literature and development of evidence-based guidelines by a United Kingdom Expert Consensus Group. Palliat Med. 2009;23:103-10. 4. Rolla G, Bruno M, Bommarito L, et al. Breath analysis in patients with end-stage renal disease: effect of haemodialysis. Eur J Clin Invest. 2008;38:728-33. 5. Ricci Z, Ronco C. Pulmonary/renal interaction. Curr Opin Crit Care. 2010;16:13-8. 6. Peneva S. Types of ventilatory insufficiency in chronic kidney insufficiency. Vutr Boles. 1980;19:75-82. 7. Fawcett S, Hoenich NA, Laker MF, Schorr W Jr, Ward MK, Kerr DN. Haemodialysis-induced respiratory changes. Nephrol Dial Transplant. 1987;2:161-8. 8. Igarashi H, Kioi S, Gejyo F, Arakawa M. Physiologic approach to dialysis-induced hypoxemia. Effects of dialyzer material and dialysate composition. Nephron. 1985;41:62-9. 9. Senatore M, Buemi M, Di Somma A, Sapio C, Gallo GC. Respiratory function abnormalities in uremic patients. G Ital Nefrol. 2004;21:29-33. 10. Hamer RA, El Nahas AM: The burden of chronic kidney disease. BMJ 2006; 332: 563– 564. 11. Gibson, D. G. (1966). Haemodynamic factors in the development of acute pulmonary oedema in renal failure. Lancet, 2, 1217. 12. Pastan S, Bailey J. Dialysis therapy. N Engl J Med 1998;338(20): 1428- 37. 13. Hill, R. B. Jr., Dahrling, B. E. II., Starzl, T. E., and Rifkind, D. (1967). Death after transplantation; an analysis of 60 cases. American Journal of Medicine, 42, 327. 14. Rahgoshai R, Raham R, Khosraviani A, Nasiri AA, Solouki M. Acute Effects of Hemodialysis on Pulmonary Function in Patients With End-stage Renal Disease. IJKD 2010;4:214-7. 15. Kovacevic P, Matavulj A, Veljkovic S, Rajkovaca Z, Ponorac N, Huskic J. Ventilator function improvement in patients undergoing regular hemodialysis: relation to sex differences. Bosn J Basic Med Sci. 2006;6:29-32. 16. Wanic-Kossowska M. Immediate effect of hemodialysis with cuprophane membrane and acetate containing dialysis fluid on respiratory function in patients with chronic renal failure. Pol Tyg Lek. 1993;48:175-7.
Salve P L
Detailed hydrogeochemical analysis of twentytwo samples of groundwater collected from parts of Phulambri block of Aurangabad district, has been carried out in an effort to assess the quality of groundwater in the area. These samples were analysed for pH, EC, TDS, TH, Ca, Mg, Na, K, Total Alkalinity, Cl NO3 and SO4. The suitability of the water from the groundwater sources for drinking purposes was evaluated by comparing the values of different water quality parameters with Bureau of Indian Standards and World Health Organization guideline values. The result of the analysis shows that the Water chemistry of Phulambri block is deteriorated at some places. The Suitability of groundwater for irrigation was determined by analyzing sodium adsorption ratio (SAR), Kelly’s ratio (KR), Sodium percentage (Na%), Magnesium Ratio (MR) and study reveals that most of the samples of the study area falls below the permissible limit indicating groundwater is suitable for irrigation purpose. The geochemical characteristics of the groundwater’s are impeded by natural geology and anthropogenic activities, and a proper groundwater management strategy is necessary to protect sustainably this valuable resource.
1. Aher K.R. and Deshpande S.M., Groundwater Hydrogeochemistry of Mula river Basin, Maharashtra, India, Gondwana Geological Magazine, 2014;Spl Vol. 14: 167-716. 2. APHA.,Standard Methods for the Examination of Water and Waste Waters, American Public Health Association, 18th Edition, Washington, DC.1992. 3. BIS. Specifications for Drinking Water, IS: 10500: 1991, Bureau of Indian Standards, New Delhi, India.1991. 4. Bouwer, H.,Groundwater hydrology. New York: McGraw-Hill. 1978;480 p. 5. CGWB (2010) Ground water information Aurangabad district Maharashtra, CGWB. 2010; 1646/DBR/2010. 6. Datta, P. S., and Tyagi, S. K.,Major ion chemistry of groundwater in Delhi area: Chemical weathering processes and groundwater flow regime. Journal of Geological Society of India, 1996;47:179–188. 7. Deshpande, S.M. and Aher K.R.,Quality of groundwater from Tribakeswar-Peth area of Nasik District and its Suitability for Domestic and Irrigation Purpose, Gondwana Geological Magzine, 2011;V.26 (2),pp 157-162. 8. Eaton, F. M. Significance of carbonate in irrigation waters. Soil Sci. 1950, 95: 123-133. 9. EEC (European Economic Communities),Richtlinic des Rates Vem., 15.7 1980 liber die qualitat Von Wasser fur den menschlichen Gebrauch. Amtslelatt der Europaischen gemeinschaft vom. 1980;30-8 No. L 229, pp. 11-29. 10. Haritash, A. K., C. P. Kaushik, A. Kaushik, Ankur Kansal, and Asheesh Kumar Yadav. "Suitability assessment of groundwater for drinking, irrigation and industrial use in some North Indian villages., Environmental monitoring and assessment, 145, no. 1-3 (2008): 397-406. 11. Karnath, K. R.,Groundwater assessment, development and management, New Delhi: Tata McGraw Hill,1987,p 720. 12. Kelepertsis, Α.,Applied geochemistry (in Greek). Athens, Greece: Machedonian press,2000; 37 pp. 13. Kelley, W.P., Brown, S.M. and Liebig, G.F. Jr, Chemical effects of saline irrigation waters on soils. Soil Sci., 1940,vol. 49, pp. 95-107. 14. Konstantinos Skordas; Georgios Papastergios; Lamprini Tziantziou ; Nikolaos Neofitou and Christos Neofitou .,Groundwater hydrogeochemistry of Trikala municipality, central Greece, Environ Monit Assess, 2012;DOI 10.1007/s10661-012-2535-y. 15. Langenegger O.,Groundwater quality in rural areas of Western Africa. UNDP Project.1990, 81-026:10p 16. Paliwal, K.V., Irrigation with saline water, I.A.R.I., Monograph no.2, (New Series), New Delhi, 1972,p. 198. 17. Pawar, N.J., Pondhe, G.M. and Patil, S.F., Groundwater pollution due to sugar-mill effluent at Sonai, Maharashtra, India. Environmental Geology, 1998; 34 (2/3), pp. 151-158. 18. Purushotham, D., A. Narsing Rao, M. Ravi Prakash, Shakeel Ahmed, and G. Ashok Babu.,Environmental Impact on Groundwater of Maheshwaram Watershed, Ranga Reddy District, Andhra Pradesh." Journal of the Geological Society of India 77, no. 6 (2011): 539-548. 19. Ravikumar, P., K. Venkatesharaju, K. L. Prakash, and R. K. Somashekar. Geochemistry of groundwater and groundwater prospects evaluation, Anekal Taluk, Bangalore urban district, Karnataka, India. Environmental monitoring and assessment 179, no. 1-4 (2011): 93-112. 20. Richards, L.A., Diagnosis on improvement of saline and alkali soils, U.S.D.A., Handbook no.60. Agri. Handb. U.S. Dep. Agric.1954; p. 160. 21. Siegel, R. F., Environmental geochemistry of potentially toxic metals (p. 218). New York: Springer-Verlag Berlin Heidelberg.2002. 22. Stamatis, G., Voudouris, K. and Karefilakis, F., Groundwater pollution by heavy metals in historical mining area of Lavrio, Attica, Greece. Water, Air, and Soil Pollution, 2001;128, 61–83. 23. Subba Rao and Krishna Rao G.,Groundwater quality in Visakhapatnam Urban area, Andhra Pradesh. Indian J. Env. Health, 1991;Vol. 33, no. 1, pp. 25-30. 24. Subba Rao N., P. Surya Rao .,G. Venktram Reddy., M. Nagamani ., G. Vidyasagar and N. L. V. V.Satyanarayana., Chemical characteristics of groundwater and assessment of groundwater quality in Varaha River Basin, Visakhapatnam District, Andhra Pradesh, India, Environ Monit Assess.2011; DOI 10.1007/s10661-011-2333-y. 25. Sullivan, J.P., Agardy, J.F. and Clark, J.J.J.,The Environmental Science of Drinking Water. Elsevier Butterworth-Heinemann, 2005,384 pp. 26. Tatawat, R. K., and Chandel, C. P. S.,A hydrochemical profile for assessing the groundwater quality of Jaipur City. Environmental Monitoring and Assessment, 2008; 143, 337–343. 27. Trivedi, R.K. and Goel,P.K.,Chemical and biological methods for water pollution studies. Environmental Publications Karad, India,1984; 215. 28. U.S.Salinity Lab. Staff Diagnosis and improvement of saline and alkali soils. U.S. Dept. Agri. Hand book-60, 1954., p. 160. 29. Vijay, Ritesh, Puja Khobragade, and P. K. Mohapatra.,Assessment of groundwater quality in Puri City, India: an impact of anthropogenic activities. Environmental monitoring and assessment 177, no. 1-4 (2011): 409-418. 30. WHO.,Guidelines for drinking water, Vol. 2, Recommendations. Geneva: World Health Organization.1996. 31. Wilcox, L. V., Classification and use of irrigation waters, US Department of Agriculture (p. 19). Washington DC.1995. 32. Wilcox, L. V.,The quality water for irrigation use, US Dept. Agricultural Bulletin, 1948, 40.
Suhas Y Shirur, Rajeshwari L, Swathi H N
Introduction: The prevalence of hypertension amongst children and young adults in India is increasing nowadays, increased adiposity is considered to be one of the major factors implicated in the pathogenesis of hypertension and is associated with low cardiorespiratory fitness levels. Aims and Objective: To study the relationship between cardiorespiratory fitness and blood pressure among young obese individuals. Material and Methods: Sixty young obese individuals in the age group of 20 to 25 years were included in this study group. Body mass index was measured as weight in kilograms divided by height in meters square. Resting blood pressure was recorded. Cardio respiratory fitness in terms of VO2max was predicted by standard Bruce Treadmill protocol. Pearson’s correlation test was used to find out correlation between VO2max and blood pressure. Results: VO2max showed significant negative correlationship with the blood pressure in both male and female subjects. An important finding was that there was a gender difference in the association of VO2max with blood pressure profile. While in females, VO2max showed a significant negative correlationship with DBP, in males, it showed a significant negative correlationship with PP. Regarding the correlationship with SBP and MAP, VO2max showed significant correlationship in both gender, but again a stronger correlationship was found amongst females as compared to male subjects. Conclusion: It may be concluded that a correlation exists between cardio respiratory fitness and blood pressure. In order to have higher fitness profile and to avoid cardiovascular complications, young adults should take care of their food habits and physical activity to maintain optimal body weight.
1. Kaur S, Kapil U, Singh P. Pattern of chronic diseases amongst adolescent obese children in developing countries. Current Science 2005; 88: 1052–1056. 2. Selvan MS, Kurpad AV. Primary prevention: Why focus on children and young adolescents ? Indian J Med Res 2004; 120: 511–518. 3. Thakor HG, Kumar P, Desai VK. An epidemiological study of hypertension amongst children from various primary schools of Surat city. Indian J Community Medicine 1998; 25: 110–115. 4. Mohan B, Kumar N, Aslam N, Rangbulla A, Kumbkarni S, Sood NK, Wander GS. Prevalence of Sustained Hypertension and obesity in urban and rural school going children in Ludhiana. Indian Heart J 2004; 56: 310–314. 5. Nageshwari K, Rajeev S, Divyanshoo RK. Assessment of respiratory and sympathetic cardiovascular parameters in obese school children. Ind J Physiol Pharmacol 2007; 51(3):235-243. 6. Prabhu S, Padmanabha BV, Doddamani BR. Correlation between obesity and cardiorespiratory fitness. International journal of medical science and public health. 2013;2 (2): 300-304 7. Duck-chul Lee, Enrique GA, Xuemei S and Steven NB. Mortality trends in the general population: the importance of cardiorespiratory fitness, J Psychopharmacol. 2010 November; 24(4_supplement): 27–35. 8. Umesh KP, Joshi AS. Comparison of VO2max in obese and non-obese young Indian population. Indian J Physiol Pharmacol 2011; 55 (2) : 188–192 9. Anderson KM, Shephard RJ, Denolin H, Varnauskas E, Masironi R. Fundamentals of exercise testing, WHO, Geneva 1971. 10. Dagan SS, Segev S, Novikov et al. Waist circumference vs body mass index in association with cardiorespiratory fitness in healthy men and women: a cross sectional analysis of 403 subjects. Nutrition Journal 2013, 12:12. 11. Shephard RJ. World standards of cardiorespiratory performance. Archieves of Environmental Health 1966; 13:664-672 12. Banerjee PK, Chatterjee S, Chatterjee P, Maitra SR. Maximal oxygen uptake in boys. Indian Journal of Medical Research 1982;75:380-386 13. Chatterjee S, Chatterjee P and Bandyopadhyay A. Cardiorespiratory fitness of obese boys. Indian J Physiol Pharmacol 2005; 49 (3) : 353–357. 14. Berry S, Shyamal K and Sandhu JS. Relationship between cardiorespiratory fitness, body composition and blood Pressure in Punjabi Collegiate population J. Hum. Ecol 2007; 22(3): 215-219. 15. Rheaume C, Arsenault BJ, Belanger S, Perusse L, Tremblay A. Low Cardiorespiratory Fitness Levels and Elevated Blood Pressure: What Is the contribution of visceral obesity? Hypertension. 2009;54:91-97. 16. Wasim AS, Minal CP, Singh SK. Association of physical activity and physical fitness with blood pressure in Gujarati Indian Adolescents. Indian J Physiol Pharmacol 2011; 55 (4):322-28. 17. Ahimastos AA, Formosa M, Dart AM, Kingwell BA. Gender differences in large artery stiffness pre- and post puberty. J Clin Endocrinol Metab 2003; 88: 5375–5380. 18. Herman SM, Robinson JT, McCredie RJ, Adams MR, Boyer MJ, Celermajer DS. Androgen deprivation is associated with enhanced endothelium-dependent dilatation in adult men. Arterioscler Thromb Vase Biol 1997; 17: 2004–2009.
Suhas Y Shirur, Rajeshwari L, Swathi H N
Introduction: Obesity and cardiorespiratory fitness are considered as modifiable and independent risk factors for cardiovascular mortality. Aims and Objective: The current study was designated to evaluate cardio respiratory fitness in terms of VO2max in young healthy males and to correlate between obesity and cardio respiratory fitness. Material and Methods: Sixty young healthy male subjects in the age group of 20 to 25 years were included in this study group. Body mass index was measured as weight in kilograms divided by height in meters square. Cardio respiratory fitness in terms of VO2max was predicted by standard Bruce Treadmill protocol. Results: There was a highly significant negative correlation between obesity and VO2max, r= -0.84 p<0.05. In contrast, obesity shows a highly significant direct correlation with maximal heart rate, r=0.82 p<0.05. Conclusion: The result proved that cardiorespiratory fitness was significantly affected by obesity. In view of current obesity trend and increasing cardiovascular diseases, it’s advisable to decrease the daily calorie intake and also to improve cardiorespiratory fitness in young individuals by methodical and scientifically validated exercise regimen.
1. Duck-chul Lee, Enrique GA, Xuemei S and Steven NB. Mortality trends in the general population: the importance of cardiorespiratory fitness, J Psychopharmacol. 2010 November; 24(4_supplement): 27–35. 2. Anderson KM, Shephard RJ, Denolin H, Varnauskas E, Masironi R. Fundamentals of exercise testing, WHO, Geneva 1971. 3. Dagan SS, Segev S, Novikov et al. Waist circumference vs body mass index in association with cardiorespiratory fitness in healthy men and women: a cross sectional analysis of 403 subjects. Nutrition Journal 2013, 12:12. 4. Shephard RJ. World standards of cardiorespiratory performance. Archieves of Environmental Health 1966; 13:664-672 5. Banerjee PK, Chatterjee S, Chatterjee P, Maitra SR. Maximal oxygen uptake in boys. Indian Journal of Medical Research 1982;75:380-386 6. Chatterjee S, Chatterjee P and Bandyopadhyay A. Cardiorespiratory fitness of obese boys. Indian J Physiol Pharmacol 2005; 49 (3) : 353–357 7. Umesh KP, Joshi AS. Comparison of VO2max in obese and non-obese young Indian population. Indian J Physiol Pharmacol 2011; 55 (2) : 188–192 8. WHO: Obesity. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva. World Health Organisation; 1998. 9. Pontiroli AE, Pizzocri P, Saibene A, Girola A, Koprivec D and Fragasso G. Left ventricular hypertrophy and QT interval in obesity and hypertension: Effects of weight loss and of normalisation of blood pressure. Int J of Obesity 2004; 28:118-1123. 10. Nageshwari K, Rajeev S, Divyanshoo RK. Assessment of respiratory and sympathetic cardiovascular parameters in obese school children. Ind J Physiol Pharmacol 2007; 51(3):235-243. 11. Prabhu S, Padmanabha BV, Doddamani BR. Correlation between obesity and cardiorespiratory fitness. International journal of medical science and public health. 2013;2 (2): 300-304 12. Ozcelik O, Aslan M, Ayar A, Kelestimur H. Effects of body mass index on maximal work production capacity and aerobic fitness during incremental exercise. Physiol Res 2004; 53:165-170. 13. Wei M, Gibbons LW, Mitchell TL, Kampert JB, Lee CD, Blair SN. The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Med 1999;130:89-96. 14. Perseghin G, Price TB, Petersen KF. Increased glucose transport, phosphorylation and glycogen synthesis after exercise training in insulin resistant subjects. N Engl J Med 1996;335:1362. 15. Melanson EL, Freedson PS. The effect of endurance training on resting heart rate variability in sedentary adult males. Eur J Appl Physiol 2001;85:442-449. 16. Hager RL, Tucker LA, Seljaas GT. Aerobic fitness, blood lipids and body fat in children. Am J Public Health 1995;85(12):1702-1706. 17. Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiol Rev 1994; 74:761-811. 18. Watanabe K, Nakadomo F, Maeda K. Relationship between body composition and cardiorespiratory fitness in Japanese junior high school boys and girls. Ann Physiol Anthropol 1994;13(4);167-174. 19. Welsh BE, Rieneau RP, Crisp CE, Isenstein RS. Relationship of maximal oxygen consumption to various components of body composition. J Appl Physiol 1958; 12:395-398. 20. Rowland TW. Effects of obesity on aerobic fitness in adolescent females. Archives of Pediatrics and Adolescent Medicine 1991; 145(7).
Shrinivas S Chitta, Prerna D Nandedkar, Prashant T Tayade, Piyush M Kherde
Background: In postmenopausal women Coronary heart disease is one of the most important causes of death. Obesity, hypertension and dyslipidemia are modifiable risk factor of this disease. The yogic practices are important for prevention and treatment of dyelipidemia. Therefore, the present investigation is focused at efficacy of SKY practices on cardiovascular risk factors like obesity, hypertension and lipid profile in postmenopausal woman within 6months. Aim: To estimate lipid profile and to measure BMI, WHR and BP in postmenopausal women who are at risk of CAD on 0 day and 6 months after regular SKY yogic practices. Settings and designs: This cross sectional study was undertaken in the Department of physiology and Department of Biochemistry of Government Medical College and hospital Akola, Maharashtra. Material and method Statistical Analysis: BMI, WHR and BP measured and lipid profile were analyzed and compared between 30 age matched postmenopausal women who are on risk of CAD study group and normal healthy control group of age group 40‐55 years using unpaired two‐tailed Student‘t’ test. Results: Values of BMI (p<0.05), WHR (p<0.05), Systolic BP (p<0.05) and diastolic BP (p<0.05) were significantly lower in both study and control group. Values of TG (p<0.05), TC (p<0.05), LDL-C(p<0.05), VLDL-C(p<0.05) were significantly lower in control group expect HDL-C which is not significantly increased while all parameters of lipid profile are improved in study group. Conclusion: Regular Yogic practices are more effective in postmenopausal women who are at risk of CAD.
1. Schenck GK. Risk factors for cardiovascular disease in women: assessment and management. Eur Heart J 1996; 17 Suppl. D: 2–8. 2. Das S, Yadav D, Narang R, Das N. Interrelationship between lipid peroxidation, ascorbic acid and superoxide dismutase in coronary artery disease. Current Science 2002; 83 No. 4: 488–491. 3. Mahajan AS, Reddy KS, Sachedva U. Lipid profile of coronary risk subjects following yogic lifestyle intervention. Indian Heart J 1999; 51: 37–40. 4. IBM SPSS Statistics [computer program].Version 19.0.0. Somers (NY): IBM coporation;2010 5. Manchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmananda S, Rajani M, Bijalani RL(2000). Coronary Atherosclerotic reversal potential of yoga life style intervention JAPI 48(7) 687-689. 6. Schmidt T, Wijga A, Von ZurMuhlen A, Brabant G, Wagner TO Changes in cardiovascular risk factor and hormones during acomprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl 1997; 640: 158-162. 7. Bera TK, Rajapurkar MV. Body composition, cardiovascular endurance and anaerobic power of yogic practitioner, Indian Journal of Physiology and Pharmacology 1993; 37(3):225-228. 8. Murugesan R., Govindarajulu, N., andBera, T.K. Effect of selected yogic practices on the management of hypertension. Indian Journal of Physiology and Pharmacology 2000; 44: 207-10. 9. Anand BK. Yoga and medical sciences. Indian J Physiol Pharmacol 1991; 35(2): 84–87. 10. Young JD, Taylor E. Meditation as a voluntary hypometabolic state of biological estivation. News Physiol Sci 1998; 13: 149–153.
S M Deshpande, R A Suryawanshi, K R Aher, G D Gaikawad, R K Aher
The present paper deals with the assessment of variation in the groundwater samples and its suitability for drinking purposes. Spatial distribution of pH, electrical conductivity (EC), total dissolved solids (TDS), Calcium, Magnesium, Total hardness, chloride, and total alkalinity content of 30 ground water samples collected from the kamlapur village, near industrial area of Aurangabad has been studied. In the study area majority of samples shows high content in parameters such as electrical conductivity (EC), total dissolved solids (TDS), Calcium, Total hardness and Chloride. The degradation of water quality can be attributed to the use of agricultural fertilizer, urbanization and industrial discharges in the study area.
1. Aher K.R. and Deshpande S.M., Groundwater Hydrogeochemistry of Mula river Basin, Maharashtra, India, Gondwana Geological Magazine, 2014;Spl Vol. 14: 167-716. 2. APHA,Standard methods for examination of water and waste water 15th Ed. American pub. Health Asso., Washington D.C. 1980. 3. Ballukraya, P.N. and Ravi, R.Characterization of groundwater in the unconfined aquifer of the Chennai city, India. Jour. Geol. Soc.1999,V.54, pp1-11 4. BIS., Bureau of Indian Standards IS: 10500, Manak Bhavan, New Delhi, India. 5. Deshpande, S.M. and Aher K.R.,Quality of groundwater from Tribakeswar-Peth area of Nasik District and its Suitability for Domestic and Irrigation Purpose, Gondwana Geological Magzine, 2011;V.26 (2),pp 157-162. 6. Deshpande, S.M. and Aher K.R.,Evaluation of Groundwater Quality and its Suitability for Drinking and Agriculture use in Parts of Vaijapur, District Aurangabad, MS, India, Research Journal of Chemical Sciences,2012, Vol. 2(1), 25-31. 7. Kaplay R. D.,Groundwater quality in an industrial area of Tupa, Nanded Pol. Res., 1998, V.17, pp 251-254 8. Pawar N.J., Pondhe G.M. and Patil S.F.,Groundwater pollution of sugar mill effluents at Sonai Maharashtra, India. Env. Geology, 1998,V.34, pp 151-158 9. Pondhe G.M., Hase P. C., Thitame S.E. and Patil S.S.,Characteristic and quality of groundwater in Ghulewadiand Malad villages near sugar factory, Sangamner, District Ahemadnagar, Maharashtra J. Aqua, Biol.,2008, V.2 3, pp 51-54 10. Trivedy, R.K.and Goel, P.K.,Chemical and biological methods for water pollution studies. Environmental Publ. Karad, India,1984. 11. WHO., International standards for drinking water, WHO, Geneva,1993.
Fating Prasanna M, Tadas Arun K, Katore Sarika D, Tadas Swati A
Background: Cardiovascular disease (CVD) is major cause of mortality and morbidity among patients with Chronic kidney disease (CKD). More than 50% of patients with CKD die due to cardiovascular complication and dyslipidemia is an independent risk factor for CKD. The incidence of coronary artery disease is seen in 28 percent of dialysis patients. So we considered to study this relation of chronic renal failure (CRF) and lipid profile in dialysed patients. Aim: To estimate lipid profile in hemodialysed patients of chronic renal failure. Settings and Designs: This cross sectional study was undertaken in the Department of Biochemistry and kidney Unit, Department of Medicine and Department of Nephrology of Government Medical College and superspeciality hospital Nagpur, Maharashtra (India). Material and Methods: Total cholesterol (TC), Triglycerides (TG), High density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), atherogenic ratio i.e. TC/HDL, LDL/HDL, was assessed in hemodialysed CRF patients (n=50) and healthy individuals (n=50). Mean of biochemical parameter were compared by performing student’s t-test. Results: Values of triglyceride, LDL-C and TC/HDL, LDL/HDL were significantly higher in hemodialysed patients of CRF but values of HDL-C (p<0.001) were significantly lower in hemodialysed patients of CRF as compared to controls. Conclusion: Atherogenic dyslipidemia was more pronounced in hemodialysed patients as compared to normal patients.
1. Angelantonio ED, Danesh J, Eiriksdottir G, Gudnason V. Renal Function and Risk of Coronary Heart Disease in General Populations: New Prospective Study and Systematic Review PLoS Medicine September 2007; 4(9):1497-1507 www.plosmedicine.org 2. Sanjay Kumar Agarwal, Suresh Chand Dash, Mohammad Irshad, Sreebhuasn Raju, Ravinder Singh and Ravinder Mohan Pandey Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant (2005) 20: 1638–1642 3. Kaya Y, Ari E, Demir H, Soylemez N, Cebi A, Alp H et al. Accelerated atherosclerosis in haemodialysis patients; correlation of endothelial function with oxidative DNA damage, Nephrol Dial Transplant (2012) 27: 1164–1169. 4. Cholesterol reagent set [Kit insert]. Thane (India): Accurex Biomedical Pvt. Ltd; 2009 5. Triglyceride reagent set [Kit insert]. Thane (India): Accurex Biomedical Pvt. Ltd; 2009. 6. HDL-cholesterol reagent set [Kit insert]. Thane (India): Accurex Biomedical Pvt. Ltd; 2009. 7. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18:499-502. 8. Lacquaniti A, Bolignano D, Donato V, Bono C, Fazio MR, Buemi M. Alterations of Lipid Metabolism in Chronic Nephropathies: Mechanisms, Diagnosis and Treatment. Kidney Blood Press Res 2010; 33:100–10. 9. Tsimihodimos V, Dounousi E, Siamopoulos KC. Dyslipidemia in Chronic Kidney Disease: An approach to pathogenesis and treatment. Am J Nephrol 2008; 28:958-73. 10. Wanner C. Importance of hyperlipidaemia and therapy in renal patients. Nephrol Dial Transplant 2000; 15(5):92–6. 11. Blaton V. Dyslipidemia at chronic renal failure. eJIFCC 2009; 20(1):58-68. 12. Chan DT, Dogra GK, Irish AB. Chronic kidney disease delays VLDL apoB-100 particle catabolism: potential role of apoC-III. J Lipid Res 2009; 50:2524-31. 13. Galli F, Benedetti S, Floridi A et al. Glycoxidation and inflammatory markers in patients on treatment with PMMA-based protein-leaking dialyzers.Kidney Int2005; 67:750–759 14. Himmelfarb J, McMonagle E. Albumin is the major plasma protein target of oxidant stress in uremia.Kidney Int2001;60:358–363 15. Guarnieri GF, Moracchiello M, Campanacci L,Ursini F, Ferri L, Valente M et al. Lecithin cholesterol acyltransferase (LCAT) activity in chronic uremia. Kidney Int Suppl 1978; 8:S26–S30. 16. McLeod R, Reeve CE, Frohlich J. Plasma lipoproteins and lecithin:cholesterol acyltransferase distribution in patients on dialysis. Kidney Int 1984;25: 683– 688 17. Shoji T, Nishizawa Y, Nishitani H, Billheimer JT, Sturley SL. Impaired metabolism of high density lipoprotein in uremic patients. Kidney Int 1992; 41:1653–1661. 18. Kimura H, Miyazaki R, Imura T, Masunaga S, Suzuki S, Gejyo F et al. Hepatic lipase mutation may reduce vascular disease prevalence in hemodialysis patients with high CETP levels. Kidney Int 2003; 64:1829–1837. 19. Vaziri ND, Liang K, Parks JS. Downregulation of lecithin: cholesterol acyltransferase (LCAT) in chronic renal failure.Kidney Int 2001; 59:2192– 2196. 20. Vaziri ND, Sato T, Liang K. Molecular mechanism of altered cholesterol metabolism in focal glomerulosclerosis. Kidney Int 2003;63:1756 –1763 21. Chan CM. Hyperlipidaemia in Chronic Kidney Disease. Ann Acad Med Singapore 2005; 35:31-5. 22. Nasstrom B, Stegmayr B, Olivecrona G, Olivecrona T. Lipoprotein lipase in hemodialysis patients: indications that low molecular weight heparin depletesfunctional stores, despite low plasma levels of the enzyme. BMC Nephrology, 2004;5:17 23. Solski J, Kimak E, Janicka L, Ksaziek A, Janicki K.. Concentration Of Lp(A) And Other Apolipoproteins In Predialysis, Hemodialysis, Chronic Ambulatory Peritoneal Dialysis And Post-Transplant Patients, Clin Chem Lab Med 2000 May;38(5):421-50 24. Jeong TK, Kim HS, Nah MY, Jeong GH, Jung K, Lee SC. Korean J Nephrol 1998 25. Siamopoulos KC, Elisaf MS, Bairaktari HT, Pappas MB, Sferopoulos GD, Nikolakakis NG, et al. Lipid Parameters Including Lipoprotein (A) In Patients Undergoing Capd And Hemodialysis. Perit Dial Int 1995 Oct-Dec; 5(8):342-7. 26. Steele J, Billington T, Janus E, Moran J. Dept of Chemical Pathology, St Vincent’s Hospital, Fitzroy, Victoria, Australia. Atherosclerosis 1989 Sep; 79(1):47-50.
Hilda Fernandes, Lovely George, Jacintha Martis, Nagaratna
Background: Vulval lesions may present in a variety of ways ranging from asymptomatic to chronic disabling conditions. The differential diagnosis may include a wide range of diseases. This study was undertaken to find out the distribution and type of diseases affecting the vulva. Materials and Methods: All the vulval lesions encountered in the histopathology section for a duration of 3 years were included in this retrospective study. Results: A total number of 35 cases of vulval lesions were encountered in the study .The age group of patients ranged from 21 to 86 years .Majority of the women had ithching or mass as a presenting complaint. Out of the 35 cases ,28 cases ( 80% ) were found to be benign and 7 cases ( 20 % ) were found to be malignant . Bartholin’s cyst was the commonest benign lesion which was found in the reproductive age group. Squamous cell carcinoma was the next common lesion in our study which was seen in older age groups. Conclusion: The vulval lesions are one of the most neglected especially by the Indian women. Since the vulva can harbour lesions starting from a benign bartholin’s cyst to aggressive malignancies, more importance should be given to the timely detection , diagnosis and appropriate treatment of these lesions .
1. Sosnik H, Sosnik K, Halon A: The Pathomorphology of Bartholin’s Gland. Analysis of Surgical Data. Pol J Pathol 2007; 58: 99–103. 2. Amankwah Y, Haefner H. Vulvar edema. Dermatol Clin 2010 :765-77. 3. Murphy R. Lichen sclerosus. Dermatol Clin 2010 :707-15. 4. Hewitt J. Histologic criteria for lichen sclerosus of the vulva. J Reprod Med. 1986;31:781-7. 5. Leighton PC, Langley FA: A clinico-pathological study of vulval dermatoses. J. clin. Path 1975; 28: 394-402 6. Chiasson MA , Ellerbrock TV , Bush TJ ,Sun XW, Wright TC :Increased prevalence of vulvovaginal condyloma and vulvar intraepithelial neoplasia in women infected with human immunodeficiency virus : Obstet Gynecol 1997; 85: 108-11 7. Curry JL ,Jeffrey L. Olejnik,Wojcik EM : Cellular Angiofibroma of the Vulva with DNA Ploidy Analysis . Int J Gynecol Pathol 2001;20:200-3 8. Vlastos AT, Malpica A,Follen M : Lymphangioma Circumscriptum of the Vulva : A Review of the Literature. Obstet Gynaecol 2003;101:946-54 9. Roy KK, Agarwal R, Agarwal S, et al. Recurrent vulval congenital lymphangioma circumscriptum – a case report and literature review. Int J Gynecol Cancer. 2004;14:564-6. 10. Echeverri C, Stoler MH, Valente PT: Vulvar Keratinizing Squamous Cell Carcinoma in a 26-Year-Old Woman. Arch Pathol Lab Med, 2001;125:267-270. 11. Hacker NF. Vulvar cancer. In: Berek S, Hacker NF, editors. Practical gynaecologic oncology. 5th edition. Philadelphia: Lippincott Williams and Wilkins 2000. P. 553-96. 12. van derAvoort I, Shirango H, Hoevenaars BM, et al.Vulvar squamous cell carcinoma is a multifactorial disease following two separate and independent pathways. Int J Gynecol Pathol 2006;25(1):22–9. 13. Nieuwenhof HP, Avoort IAM, Hullu JA. Review of squamous premalignant vulvar lesions. Critical Reviews in Oncology/Hematology 68 (2008) 131–156. 14. Lam C, Funaro D. Extramammary Paget’s disease : Summary of current knowledge. Dermatol Clin 28 (2010) 807-826. 15. Shepherd V, Davidson EJ, Davies HJ. Extramammary Paget’s disease. BJOG 2005;112:273-9. 16. Kanitakis J. Mammary and extramammary Paget’s disease. J Eur Acad Dermatol Venereol. 2007;21(5):581-90. 17. Chanda JJ. Extramammary paget’s disease progression and relationship to internal malignancy. J Am Acad Dermatol. 1985;13(6):1009-14.
Balaji V Ukarande, A S Nagaonkar
Introduction: Death in children constitutes more than 34% of total death in India. Seven out of ten of these deaths are due to respiratory infection, diarrhea and malnutrition. There is high under five morbidity and mortality in India. Methodology: Present study is cross-sectional, observational study infield practice area snd sample size was selected by simple random sampling method. Result: Proportion of undernutrition was more i.e. 92.86% in un- immunized children followed by 91.92% in partially immunized and 22.03% in completely immunized children. The problem Undernutrition was more i.e. 65.13% among children who had history of persistent diarrhea in past 12 months compared to 55.56% of undernutrition among whom there was no history of persistent diarrhea in past 12 months. Undernutrition was more i.e. 77.87% among children who had history of persistent febrile illness in past 12 months compared to i.e. 51.98% of undernutrition among children who did not have history of persistent febrile illness in past 12 months. Conclusion: All children should be fully immunized and early treatment of the children suffered from diarrheal and respiratory infections should done.
1. Harishankar, Dwivedi S, Darbal SB et al. Nutritional status of children Under 6 years of age. Ind J Prev Soc Med, 2004 July –Dec; 35(3&4):156-62. 2. K.Park, Park’sTextbook of Preventive and Social Medicine, Jabalpur; 21sted.; M/sBanarsidas Bhanot Publishers; 2011: 590,491,113. 3. Umesh k, Sachdev HPS. Management of Children with Severe Acute Malnutrition: A National Priority. Indian pediatric, August 2010; 651-653. 4. Lawanga SK, Lemeshow S, A practice manual of sample size determination in health studies. Geneva: World Health Organization 1991; 25-26. 5. International institute for population sciences (IIPS) & ORC MACRO: National Family Health Survey (NFHS-3)2005-2006: India 2007 Mumbai: IIPS. 6. UNICEF Annual Report 2005. 7. WHO Child Growth Standards weight-for-age [cited Nov 2012] available from http:// www.who.int/childgrowth/publications 8. Padmadas S,Inge H, Frans W, Weaning initiation patterns and Subsequent linear growth progression among children aged 2–4 years in India. International Journal of Epidemiology 2002;31: 855–863. 9. Ayaya SO, Esmai FO, Rotich J,Socio-economic factors predisposing under five-year-old children to severe protein energy maknutrtion at Moi Teaching and Referral Hospital,Eldoret,Kenya.East Afr Med J2004 Aug;81(8): 415- 421. 10. Luthara M, Kishore S, Jain K, Epidemiology of Under-Nutrition In Children between 0-5years from Rural Areas of Deharadun. Indian Journal of Community Health 2009 July; 21(2): 18-21. 11. Farzana A, Farhat J, Impact of Prenatal Checkups of Mothers and Immunization of Children on the Health Status of Children (0-3 years) – A Study in Rural areas of Aligarh District, Uttar Pradesh. Online J Health Allied Scs. 2010; 9(3):1-3. 12. Jhani V, Naithani P, Lamourex E et al. Impact of Prenatal Checkups of Mothers and Immunization of Children on the Health Status of Children (0-3 years) - A Study in Rural areas of Aligarh District, Uttar Pradesh. Am J Ophthalmol. 2011 Jun; 151 (6):1035-1040 13. Basit A, Nair S, Chakraborty KB et al. Risk factors for under-nutrition among children aged one to five years in udupi taluk of Karnataka,India:a case conrol study.AMJ 2012 ;5(3):163-167. 14. Bhutta ZA, Nizami SQ, Thobani S, et al. Risk factors for mortality among hospitalized children with persistent diarrhoea in Pakistan. J Trop Pediatr. 1997 Dec; 43(6):330-336. 15. Nikhil Chandra Roy. Use of Mid-upper Arm Circumference for Evaluation of Nutritional Status of Children and for Identification of High-risk Groups for Malnutrition in Rural Bangladesh. Health Popul Nutr Dec 2000; 18(3):171- 180. 16. Ray SK, Haldar A, Biswas B, et al, Epidemiology of undernutrition. Indian J Pediatr 2001; 68(11):1025-1030. 17. Bhatia V, Puri S, Swami HM et al , Malnutrition among Under-Six Children in Chandigarh: Scarcity in Plenty. Journal of Clinical and Diagnostic Research.2007 Dec; 1(6):483-487. 18. Pore PD, Ghattargi CH, Rayate MV. Study Of Risk Factors Of Acute Respiratory Infection (ARI) In Underfives In Solapur. NJCM 2010; 1(2):64-67. 19. Aklima J, Shelby S, Yamamoto, Malik AA. Prevalence and Determinants of Chronic Malnutrition among Preschool Children: A Cross-sectional Study inDhaka City, Bangladesh. J Health Popul Nutr. 2011 October; 29(5): 494-499.
Shastrakar Rupali Sureshrao, Kasote Arunkumar P
The present study was carried out on 200 subjects with 100 asymptomatic control and 100 symptomatic cases of low backache, sciatica and neurogenic claudication of more than 6 months duration of age group 30 -80 years. The aim of the study was to find out the dimensions of the lumbar spinal canal on plain radiographs of the lumbar spine in normal and symptomatic subjects and to compare them. It was found that the lower normal limit of the transverse diameter of the lumbar spinal canal was 20 mm and antero-posterior diameter was 15.2 mm on plain radiographs of asymptomatic healthy subjects. Anteroposterior diameter was found to be more adversely affected in narrow spinal canal.
1. Amonoo – Kuofi H. S., Patel P. J., Fatani J. A; Transverse diameter of the lumbar spinal canal in normal adult Saudis. Acta Anat. Vol 137.1990,pp 124-128. 2. Amonoo- Kuofi H. S; Maximum and minimum interpedicular distances in normal adult Nigerians. J. Anat. Vol. 135(2). 1982, pp 225-233. 3. Baddeley H; The lumbar spine and back pain. 1st Edn.1976, pp151. 4. Eisenstein S;The morphometry and pathological anatomy of the lumbar spine in South African Negroes and Caucasoids with specific reference to spinal stenosis. J Bone Joint Surg. Vol 59 B.2. May 1977, pp 173-180. 5. Epstein J., Epstein B., Lavine L; Nerve root compression associated with narrowing of the lumbar spinal canal. J. Neurology, Neurosurgery, Psychiatry. Vol 25. 1962, pp 165. 6. Garfin S. R., Rydevik B., Lipson S., Herkowitz H; Spinal Stenosis. The spine. 4th Edn. Vol 1. 1999, pp 779-806. 7. Gelderen V; Ein Orthotisches (Lordotisches) Kauda –syndrome.Acta Psychiatr. Neurol.Vol 23. 1948, pp 57-68 (Quoted by reference no.19). 8. Getty C. J. M; Lumbar spinal stenosis. J Bone Joint Surg .Vol 62 B, 4. Nov 1980, pp 481-85. 9. Hink V. C., Clark W. M., Hopkins C. E; Normal interpediculate distances (minimum and maximum) in children and adults. American Journal of Roentgenology. Vol 97, no 1. May 1966, pp 141-153. 10. Ivanov I., Melenkovic Z., Stefanovic I;Lumbar spinal stenosis. Symptomatology and methods of treatment. - Srp Arh Celok Lek. Vol 126(11- 12). Nov – Dec 1998, pp 450-6. 11. Janjua M. Z., Muhammad F; Measurement of the normal adult lumbar spinal canal. J Pak Med Assoc. Vol 39 (10). Oct1989, pp 264-8. 12. Jones R. A. C., Salford, Thomson J. L. G; The narrow lumbar canal. J Bone Joint Surg. Vol, 50B 3. 1968, pp 595-605. 13. Naylor A;J Bone Joint Surg. Vol 61B. 1979, pp306-309. 14. Nirvan A. B., Pensi C. A., Patel J. P., Shah G. V; A study of inter-pedicular distances of the lumbar vertebrae measured in plain antero-posterior radiograph in Gujratis. J. Anat Soc. India. Vol 54 (2) .2005,pp 58-61. 15. Roberson G. H., Llewellyn H. J., Taveras J. M; The narrow lumbar spinal canal syndrome. Radiology, Vol 107,April 1973, pp 89-97. 16. Tacar O., Demirant A., Nas K., Altindag O; Morphology of the lumbar spinal canal in normal adult Turks. Yonsei Med J. Vol 30 44 (4). Aug 2003, pp 679-85.
Wagh Kailash B, Ghule Shubhangi B, Mohite S T
Objective: Acute otitis media (AOM) has been associated with much morbidity including economic burden. Many bacterial organisms were identified to be the causative agents and several risk factors have been identified to increase the incidence of AOM. Considering the differences in the etiological agents and their susceptibility pattern, it becomes necessary to have up-to-date information on microbial resistance to guide the rational use of the existing antimicrobials. Hence, the present study has been envisaged to evaluate the spectrum of micro-organisms causing AOM and their antimicrobial susceptibility pattern in a tertiary care hospital. Methods: The present study was a cross-sectional study and was initiated following approval from the institutional ethics committee and written informed consent was obtained from all the study participants. Patients who have been diagnosed to have AOM by clinical symptoms and signs were enrolled in the study. Demographic details (age, sex), history associated with risk factors (unhygienic mopping, past history of antibiotic use/ear infection/surgery in the ear or head) were collected from each study participant. Three cotton swabs were used to collect the discharge and were subjected to Gram stain; aerobic culture and direct examination (KOH Preparation) for fungal elements and fungal culture were done. Results: A total of 106 consecutive AOM patients were identified of which, 76 (71.7%) were males and 30 (28.3%) were females. Majority [94/106 (88.7%)] had unilateral and one-third of the individuals (32%) were less than 10 years old. Majority of the study participants [79/106 (77.5%)] had purulent discharge and a total of 84/106 (82.4%) had history of unhygienic mopping of the ear discharge with sticks and 51/106 (50%) reported of having applied oil or hot water in the ears. Culture was positive in 102/106 (96.2%) patients. A total of 118 organisms have been grown in the culture, of which 117 were bacterial isolates and the remaining one was Candida albicans. Of the 117 bacterial isolates, 51 (43.6%) was Staphylococcus aureus and 42 (35.9%) was Klebsiella pneumoniae. Many of the isolated organisms [80/117(68.4%)] were sensitive to ciprofloxacin, 69/117 (59%) were sensitive to Amikacin, 63/117 (53.9%) to Piperacillin and 60/117 (51.3%) to Gentamicin. Conclusion: We found that majority of the patients of AOM had clinical presentation similar to other parts of the world. Even the growth and sensitivity of the isolated micro-organisms were similar to previous studies.
1. Froom J, Culpepper L, Jacobs M, DeMelker RA, Green LA, van Buchem L, et al. Antimicrobials for acute otitis media? A review from the International Primary Care Network. Br. Med. J. 1997; 315:98-102. 2. Deshmukh CT. Acute otitis media in children – treatment options. Journal of Postgraduate Medicine 1998; 44:81-4. 3. Niemelä M, Uhari M, Möttönen M, Pokka T. Costs arising from otitis media. Acta Paediatr. 1999; 88:553-6. 4. Coyte PC, Asche CV, Elden LM. The economic cost of otitis media in Canada. Int. J. Pediatr. Otorhinolaryngol. 1999; 49:27-36. 5. Kilpi T, Herva E, Kaijalainen T, Syrjanen R, Takala AK. Bacteriology of acute otitis media in a cohort of Finnish children followed for the first two years of life. Pediatr Infect Dis J 2001; 20:654-62. 6. Pichichero ME. Acute otitis media: Part II. Treatment in an era of increasing antibiotic resistance. Am Fam Physician 2000; 61:2410-6. 7. Appelbaum PC. 2012 and beyond: Potential for the start of a second pre-antibiotic era? J Antimicrob Chemother 2012; 67:2062-8. 8. Ghafur A, Mathai D, Murugananthan A, Jayalal JA, Kant R, Chaudhary D, et al. “The Chennai Declaration” recommendations of “A roadmap – to tackle the challenge of antimicrobial resistance” – A joint meeting of medical societies of India. Indian Journal of Cancer 2012; 49:71-81. 9. Alho OP, Koivu M, Sorri M, Rantakallio P. The occurrence of acute otitis media in infants. A life-table analysis. Int J Pediatr Otorhinolaryngol. 1991; 21:7-14. 10. Wang P-C, Chang Y-H, Chuang L-J, Su H-F, Li C-Y. Incidence and recurrence of acute otitis media in Taiwan’s pediatric population. Clinics 2011; 66:395-99. 11. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989; 160:83-94. 12. Daly KA, Brown JE, Lindgren BR, Meland MH, Le CT, Giebink GS. Epidemiology of otitis media onset by six months of age. Pediatrics 1999; 103:1158-66. 13. Ilechukwu GC, Ilechukwu CGA, Ubesie AC, Ojinnaka CN, Emechebe GO, Iloh KK. Otitis media in children: review article. Open Journal of Pediatrics 2014; 4:47-53. 14. Taneja MK. Contributing factors in otitis media. Indian Journal of Otology 1999; 5:111-14. 15. Neto JFL, Hemb L, e Silva DB. Systematic literature review of modifiable risk factors for recurrent acute otitis media in childhood. Jornal de Pediatria 2006; 82:87-96. 16. Klein JO, Bluestone CD. Otitis media. In: Feigin RD, Cherry JD, Demmler GJ, Kaplan SL, editors. Textbook of pediatric infectious diseases. 5th ed. Philadelphia:Saunders; 2004. p. 215-35. 17. Iseh KR, Adegbite T. Pattern and bacteriology of acute suppurative otitis media in Sokoto, Nigeria. Annals of African Medicine 2004; 3:164-66. 18. D. Vijaya, Geeta SH. Microbiological study of discharging otitis media. Indian Journal of Otology 2009; 9:17-19. 19. Chonmaitree T. Acute otitis media is not a pure bacterial disease. Clin Infect Dis. 2006; 43:1423-5.
N Ramulu, V Thirumurugan, R Rajajeyaganthan
Adsorptive removal of Methylene blue from aqueous solution was studied by adsorption on Wood apple rind (WAR- Limonia acidissima rind) Wastes. Kinetics study was carried out to observe the effects of various process parameters. The results follow kinetics of pseudo second order rate equation for the removal of Methylene blue by WAR. The suitability of the WAR adsorbent for removal of Methylene blue from aqueous solution was tested by fitting the adsorption data with two isotherms, namely Freundlich and Langmuir isotherms. The characteristic parameters for each isotherm have been determined. The Langmuir equation represented the best fit for the experimental data of WAR in removal of Methylene blue than the Freundlich isotherm equation. It was observed that WAR adsorbent is suitable for removal of Methylene blue from aqueous solution.
1. B.H. Hameed, M.I. El-Khaiaryb, Journal of Hazardous Materials, (2008), 159, 574–579. 2. Kannan N. and Sundaram M, Kinetics and mechanism of removal of Methylene Blue by adsorption on carbons : a comparative study. Dyes and Pigments (2001)1(1), 25-40. 3. K.G. Bhattacharyya, A. Sharma, Azadirach indica,-Leaf powder as an effective biosorbent for dyes. Journal of Environmental Management. (2004), 71, 217-229. 4. Jayaraj R. Chandramohan M. Martin Deva Prasath and Khan T. H . Malachite Green dye removal using seaweed Enteromorpha. J. Chem . (2011)8 (2): 649-656. 5. Tehrani-Bagha, A.R., Nikkar, H., Mahmoodi, N.M., Markazi, M., Menger, F.M., The sorption of cationic dyes onto kaolin:kinetic, isotherm and thermodynamic studies. Desalination (2011),266, 274–280, 6. Han, R., Zhang, J., Han, P., Wang, Y., Zhao, Z., Tang, M., Study of equilibrium, kinetic and thermodynamic parameters about methylene blue adsorption onto natural zeolite, Journal of Chemical Enginnering.(2008), 145, 496–504. 7. Rastogi, K., Sahu, J.N., Meikap, B.C., Biswas, M.N., Removal of methylene blue from wastewater using fly ash as an adsorbent by hydrocyclone. Journal of Hazardous Material,(2008), 158, 531- 540. 8. Kushwaha, A.K., Gupta, N., Chattopadhyaya, M.C., Enhanced adsorption of malachite green dye on chemically modified silica gel. Journal of Chemical and Pharmachutical Research.,(2010), 2 (6), 34–45. 9. Mahmoodi, N.M., Salehi, R., Arami, M., Bahrami, H., Dye removal from colored textile wastewater using chitosan in binary systems. Desalination,(2011), 267, 64–72. 10. Ncibi, M.C., Ben Hamissa, A.M., Fathallah, A., Kortas, M.H.,Baklouti, T., Mahjoub, B., Seffen, M., Biosorptive uptake of methylene blue using Mediterranean green alga Enteromorpha spp. J. Hazardous Material. (2009), 170, 1050–1055. 11. Zhang J. L. Y. and Zhang C. Adsorption of Malachite Green from aqueous solution onto carbon prepared from Arundodonax root. Journal Hazardous Material, (2008) 150(3): 774-782.
Sandip Pattanshetti, Nishith Shetty
Primary peritoneal hydatidosis is rare and accounts for 2% of all abdominal hydatidosis. Very few cases are reported in literature so far. We report a case of a 46 year old woman presented with complaints of pain abdomen and recurrent fever of one month duration. On physical examination abdomen was distended and a mass was palpated in the lower abdomen and left lumbar region. Contrast-enhanced CT scan of the abdomen showed multiple intra peritoneal cystic lesions with minimally enhancing walls and similar lesions in liver and spleen. Cysts were excised and pathological analysis was consistent with hydatid cysts.
1. Kushwaha JK et al. Primary disseminated extra hepatic abdominal hydatid cyst: a rare disease. BMJ Case Reports 2012;10.1136/bcr.02.2012.5808. 2. Karakaya K. Spontaneous rupture of hepatic hydatid cyst into the peritoneum causing only mild abdominal pain. World J Gastroenterology 2007; 13: 806-808. 3. Khuroo MS. Hydatid disease: Current status and recent advances. Ann Saudi Med 2002; 22:56-64. 4. Pedrosa I, Saiz A, Arrazola J, et al. Hydatid disease: radiologic and pathologic features and complication. Radiographics 2000; 20:795–817. 5. Singh RK. A case of disseminated abdominal hydatidosis. J Assoc Physicians India 2008; 56:55. 6. Iuliano L, Gurgo A, Polettini E, Gualdi G, De Marzio P: Musculoskeletal and adipose tissue hydatidosis based on the iatrogenic spreading of cystic fluid during surgery: Report of a case. Surg Today 2000; 30:947-9. 7. Astarcioglu H, Kocdor MA, Topalak O et al. Isolated mesosigmoidalhydatid cyst as an unusual cause of colonic obstruction: report of a case. Surg Today. 2001; (31):920-2. 8. Shailaja Shukla et al. Multiple disseminated abdominal hydatidosis presenting with gross hydatiduria: A rare case report. Indian J Pathol Microbiol. 2009; (52):213-4. 9. Necdet Ozalp et al. Peritoneal hydatidosis with ileus. Bratisl LekListy. 2009; 110(3):197-199.
R Sujitha, Sowmya S
Spermatocytic seminoma is an uncommon germ cell neoplasm found in elderly male patients, which carries excellent prognosis. It usually presents as a slow growing painless testicular swelling. Clinical history, physical examination, and ultrasound provide important clues as to the nature of testicular swellings in general. Rarely the diagnosis of testicular tumours in patients may be missed because testicular swelling is attributed to orchitis, as indeed happened in our case. Histopathological examination is confirmatory in such cases.
1. Bosl GJ, Motzer RJ. Testicular germ-cell cancer. N Engl J Med. 1997; 337:242-253. 2. Steele GS, Richie JP, Oh WK, et al. Clinical manifestations, diagnosis, and staging of testicular germ cell tumors. In: Kant off PW, ed. Up To Date. Waltham, MA: Up to Date; 2010. 3. Wein AJ, Kavoussi LR, Novick AC. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: Saunders/Elsevier; 2007. 4. Vaidyanathan et al.: Seminoma masquerading as orchitis. The Scientific World journal (2008) 8, 149–156.
Gaurav Salunke, Maria Jose Wiseman Pinto, Savio Rodrigues
Introduction: Surgical Site Infections are one of the most important causes of healthcare associated infections and are associated with considerable morbidity and mortality. This study was conducted to analyze postoperative wound infection in clean and clean contaminated surgeries, to determine spectrum of bacteria responsible, study their antimicrobial sensitivity pattern and to identify various factors responsible for them. Materials and Methods: Patients suffering from post operative wound infection during the period from January 2013 to December 2013 were included in the study. Patients were randomly selected. Pus samples were collected and processed in Microbiology department for aerobic and anaerobic organisms, according to standard procedures. Results: Cases were well spread in all age groups above 31 years. The male: female ratio was 1.4: 1. Clean contaminated cases accounted for more than half the number of cases. Staphylococcus aureus was the single most commonly isolated pathogen, followed by Acinetobacter baumanii and Pseudomonas aeruginosa. Most gram positive organisms were sensitive to Vancomycin, Amikacin and Linezolid, while gram negative organisms showed maximum sensitivity to Imipenem and Cefoperazone - sulbactum. An increase in the isolation of most bacterial species was observed when the duration of surgery and duration of pre operative stay increased. Conclusion: Despite intensive attempts at eradication during last 20 years, MRSA continues to be the major nosocomial pathogen worldwide. Antimicrobial prophylaxis is a critically timed adjuvant used to reduce microbial burden of post operative contamination. There is pressing need to reduce indiscriminate use of antibiotics and develop alternatives to reduce SSI.
1. Leaper DJ. Surgical Infection. In: Williams NS, Bulstrode CJK, O’Connell PR, editors. Short practice of surgery. 25th ed. London. Hodder Arnold; 2008 2. Fitzyerald R. Deep wound sepsis following total hip arthroplasty. J. Bone. Jt. Surg 1977:59 (A):847–55 3. Society for Healthcare Epidemiology of America, Association for Professionals in Infection Control and Epidemiology, Centre for Disease Control and Prevention, Surgical Infection Society. Consensus paper on the surveillance of surgical wound infections. Infect Control Hosp Epidemiol 1992; 13(10):599-605 4. Emori TG, Gaynes RP. An overview of healthcare-associated infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993; 6(4):428-42 5. Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VP. The efficacy of infection surveillance and control programs in preventing healthcare-associated infections in US hospitals. Am J Epidemiol 1985; 121:182-205 6. Centers for Disease Control and Prevention. Guideline for prevention of surgical site infection. Infect Control Hosp Epidemiol 1999; 20(4):247-78 7. Klevens RM, Edwards JR, et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007; 122:160-6 8. Facilities Guidelines Institute. Guidelines for design and construction of health care facilities. American Society for Healthcare Engineering; Chicago IL; 2010 9. Yi M, Edwards JR, et al. Improving risk-adjusted measures of surgical site information for the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2011; 32(10):970-86 10. Condon RE, Schulte WJ, Malangoni MA, Anderson-Teschendorf MJ. Effectiveness of a surgical wound surveillance program. Arch Surg 1983; 118:303-7 11. Sisirak M, Zvizdic A, Hukic M. MRSA as a cause of nosocomial wound infections. Bosn J Basic Med Sci 2010;10(1):32-7 12. Agarwal SL: Study of postoperative wound infections. Ind J Surg 1972:314-20. 13. Rao AS, Harsha M. Postoperative wound infections. J Indian Med. Assoc 1975; 64:90-3. 14. Anvikar AR, Deshmukh AB, Karyakarte RP, Damle AS, Patwardhan NS, Malik AK et al. 'A one year prospective study of 3280 surgical wounds. Indian J Med Microbiol 1999; 17 (3) 129-32. 15. Naik G, Deshpande S. Surgical site infections caused by Staphylococcus aureus. J Clin Diagn Res 2011 June;5(3):502-08 16. Bhatia JY, Pandey K, Rodrigues C, Mehta A, Joshi VR. Postoperative wound infection in patients undergoing coronary artery bypass graft surgery. Indian J Med Microbiol 2003;21(4):246-51 17. Cruickshank R, Duguid JP, Marmion BP, Swain RHA. Medical microbiology. 12th ed. Edinburg: Churchill Livingstone;1975 18. Wayne. Clinical and Laboratory Standards Institute / NCCLS Performance standards for Antimicrobial disc diffusion tests; Approved standards. 9th ed. CLSI Document M2-M9. Clinical and Laboratory Standards Institute; 2006; 4456. 19. Lizan-Garcia M, Garcia-Caballero J, Asensio-Vegas A. Risk factors for Surgical Wound Infection in general surgery: A prospective study. Infect Control Hosp Epidemiol 1997 May; 18(5): 310-5. 20. Davidson. AIG, Smith G and Smylie HG.’A Bacteriological study of the immediate environment of a Surgical wound’, Brit.J.surg 1971; 58(5):326-33. 21. Altemeier WA. Surgical infections: Incisional Wounds. In: Bennett JV, Brachman PS, eds. Hospital infections. Boston. Little, Brown and Co. 1979; 287-306. 22. Lee JT. Operative complications and quality improvement. Am J Surg 1996; 171:545-7. 23. Nooyen SM, Overbeek BP, Brutel de la Riviere A, Storm AJ, Langemeyer JM. Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypasses grafting. Eur J Clin Microbiol Infect Dis 1994; 13:1033-7. 24. Mehta PA, Cunningham CK, Colella CB, Alferis G, Weiner LB. Risk factors for sternal wound and other infections in pediatric cardiac surgery patients. Pediatr Infect Dis J 2000; 19:1000-4 25. Eltahawy AT, Mokhtar AA, Khalaf RM, Bahnassy AA. Postoperative Wound Infection at a university hospital in Jeddah, Saudi Arabia. J Hosp Infect 1992 May; 21 79-83. 26. Haley RW, Schaberg DR, Crossley KB, Von Allen SD, McGowan JE Jr. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med 1981; 70:51-8. 27. Tripathi BS, Roy N. Post operative wound sepsis. Indian J Surg 1984 June – July:283 -88 28. Lee NR. Surgical wound infection. Am J Med 1991;91(3b):55–63
Alveera, Prema D’ Cunha
Objectives: to determine the utility of serum lactate as an effective and independent indicator of severe sepsis in patients with obstetric related sepsis. Methods: the study was conducted on 40 patients admitted to our hospital on in patient basis with 2 or more signs and symptoms of infection, along with a suspected source of infection. Once sepsis was diagnosed, a baseline serum lactate was done in these patients and further evaluated over a period of time. Results: out of the 40 patients studied, it was found that not all patients with sepsis had an elevated serum lactate levels. During the study, it was found that patients with an initial raised lactate level (>2.2mmol), needed more aggressive treatment and a closer follow up during their period of stay in the hospital. Although all patients with elevated serum lactate had severe sepsis, lactate was not the only determining factor, patients in whom other laboratory parameters were altered, and where lactate was normal were also found to be in severe sepsis. Conclusion: Serum lactate is an independent and effective predictor of obstetric related sepsis.
1. Centre for Maternal and Child Enquiries (CMACE). Saving Mother’s Lives: reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG 2011; 118(suppl. 1):1-203. 2. Dellinger RP, Levy MM, Rhodes A, Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock. Intensive Care Med 2013; 39(2): 165-228 and Crit Care Med 2013; 41(2): 580-637. 3. Green JP, Berger T, Garg N, Shapiro NI. Serum lactate is a better predictor of short-term mortality when stratified by C-reactive protein in adult emergency department patient’s hospitals for a suspected infection. Ann Emerg Med. 2011 mar; 57(3):291-5. 4. Krishna U, Joshi SP, Modh M .An evaluation of serial blood lactate measurement as an early predictor of shock and its outcome in patients of trauma or sepsis. Indian J Crit Care Med. 2009 Apr-Jun; 13 (2); 66-73. 5. Stephen T, Dellinger RP, Michael EC, Ryan CA, Christa S, BM. Serum lactate as a predictor of mortality in patients with infection. Intensive care med 2007; 33:970-977 6. Bardale RV, Dixit PG, Pregnancy-related deaths: A three year retrospective study, J Indian Aca Forensic Medicine, 32(1) 7. Puri Alka , Yadav Indra, Jain Nisha, Maternal Mortality in an urban tertiary care hospital of north India. The Journal of Obsteterics and Gynaecology of India. May – June 2011 pg 280-285 8. Prabha S, Saswati N, Indranil S, Dilip KD, Deaths amongst women of reproductive age group in the gynaecology and obstetrics department of a tertiary care hospital of eastern India. Safety science monitor Vol 15, Issue 3. 9. Meharun NK, Shahla B, Aneela S, Risk factors and complications of puerperal sepsis at a tertiary healthcare centre. Pak J Med Sci. 2013 July – Aug; 29(4): 972-976 10. Shivakumar HC, Umashankar KM, Ramaraju HE, Shankar J, Analysis of maternal mortality in tertiary care hospital, International journal of basic and applied medical sciences 2013 Vol 3, May – Aug, pg; 237- 242 11. Prabha C, Jyoti L, Chauhan VK, Maternal mortality among tribal women as per gravidity at a tertiary level of care in Bastar Chhattisgarh,India. Int J Biol Med Res, 2012; 3(1): 1377-1384. 12. Jaspinder K, Kawaljit K, Obsteteric complications: Primiparity Vs Multiparity. European Journal of Experimental Biology, 2012, 2(5):1462 – 1468 13. Mikkelsen, Mark E, Miltiades, Andrea N, Gaieski, DF. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. 2009; 37(5):1670-1677 14. Shapiro NI, Christopher F, Michael D, Lauren C, Aimee T, Stephen T. The feasibility and accuracy of point of care lactate measurement in emergency department patients with suspected. Infection J Emerg Med. 2010 July; 39(1);89-94 15. Londono J, Leon AL, Rodriguez F, Barrera L, Rosa G, Dennis R. Serum lactate in the emergency department as a prognostic factor in patients with sepsis without hypotension. Med Clin (Barc). 2012 Jul; 30 16. Borthwick HA, Brunt LK, Mitchem KL, Chaloner C. Does lactate measurement performed on admission predict clinical outcome on the intensive care unit? A concise systematic review. Ann Clin Biochem. 2012 jul;49(4):391-4 17. Revelly, Jean P, Tappy, Luc, Martinez, Alexandro, Bollmann, Marc, Cayeux, Marie RN, Berger MM, Chiolero, Rene L. Lactate and glucose metabolism in severe sepsis and cardiogenic shock. Critical care medicine, 2005 oct;33(10):2235-2240.
Saroj A Bolde, Smita S Pudale, Smita S Shette, Ashwini Raut, Nitin Kole
Introduction: Intra-abdominal masses always remain an enigma in surgical practice. Fine needle aspiration cytology (FNAC) preferably ultrasonographically guided (USG) of 50 cases of intraabdominal lump was performed and co-rrelated with histopathology. Aims: To co-rrelate the study of cytology with histopathology in cases of intraabdominal lumps. Material and Methods: This study included 50 intraabdominal lesions which were detected clinically.USG guided FNAC was done in 40 cases. Under light microscopy the lesions were reported, cytohistopathological correlation was done in 36 cases. Hematoxylin, eosin and papanicolau’s stains were used. Results: Cases from all age group were included. Maximum number of cases14 (28%) were in age group of 51-60 yrs, with Male: Female ratio of 1.63:1.The diagnostic yield was higher in USG guided FNAC. There were 24(48%) malignant, 09 (18%) inflammatory, 09 (18%) suggestive of malignancy,02(4%) nonneoplastic and06(12%) unsatisfactory smear. Hepatic lesions were most common. Hepatocellular carcinoma and Adenocarcinoma were the most common malignant lesions. Accuracy rate for cytohistopathological correlation was90% as out of 40 cases 36 cases were showing same diagnosis histologically. We found various lesions of liver, gastrointestinal tract, kidney and few cases of pancreas, gall bladder, spleen , mesenteric lymph nodes. We have came across a rare lesion of Gaucher disease (2 cases) diagnosed successfully both by cytology and histopathology. Conclusion: Intra abdominal FNAC is a simple, economical and safe procedure with high sensitivity, specificity and diagnostic accuracy. It can be utilized as pre- operative procedure for the management of intra- abdominal lump.
1. Aftab Khan A,JanGM,Wani NA.Fine needle aspiration of Intraabdominal masses for cytodiagnosis. J. Indian Med Assoc 1996;94(5):167-69. 2. Nautiyal S. Mishra RK,Sharma SP.Routine and ultrasound guided FNAC of Intraabdominal lumps-A comparative study. J.of cytology 2004;21(3):129-132. 3. S. Shamshad Ahmed, Kafil Akhtar, S. Shakeel Akhtar et al .Ultrasound Guided Fine Needle Aspiration Biopsy of Abdominal masses.JK Science2006;8(4):200-204. 4. Sobha Rani G,Md K Faheem N,Sai Prasad B.V,Sudhakar Reddy E. Efficincy of ultrasound guided aspiration cytology in deep seated lesions-a diagnostic evaluaton. Int J Med Health Sci2012;1(1):1-12. 5. R.C Adhikari,A Tuladhar,S Shrestha,SK Sharma:Deep seated Thrasic and Abdominal lesions:Usefullnes of ultrasound Guided FNAC a 3 year experience.Nepal Med coll. J2010;12(1):20-25. 6. Sanjay Kumar Nigam,Umesh Paliwal,Nitu Nigam.Role of Fine Needle Aspiration Cytology in the Diagnosis o Intra abdominal lumps.J of evalution of Med and Dent Sci 2014;vol-3(09):2095-2402. 7. Shrinivasan Radhika et al. Abdominal Tuberculosis Diagnosis by Fine Needle Aspiration cytology.Acta cytologica1993;37(5),673-677. 8. Henry k Domaski, Annika Dejmek et al. Gauchers Disease In An Infant Diagnosed by Fine Needle Aspiration of the and spleen.Acta cytogica,1992;36(3),40-412. 9. Nadir Paksoy, Rune Willeng et al.Dianostic Accuracy of Fine Needle Aspiration cytology in pancreatic lesions.Acta cytologica,1993;37(6),889-893. 10. Ibrahim M Zardawi.Renal Fine Needle Aspiration cytology.Acta cytological,1999;43(2),184-190. 11. Sidhaling Reddy,Sainath K Andold:Fine Needle Aspiration Cytology of Intraabdominal lesions.Journal clinical and Diagnostic Research 2011