Background: Suicidal ideation is common in major depressive disorder, and it is thought to be a strong contributing factor for completed or attempted suicide. Hyperglycemia and hyperinsulinemia may increase the risk of depression and also suicide risk. Therefore this study was conceived to explore the possible relationship between suicidal behaviour and impaired glucose metabolism in major depressive disorders. Materials and Method: This study was undertaken in Department of Biochemistry and Psychiatry, Government Medical College, Nagpur. 60 diagnosed cases of major depressive disorder in the age range of 21-60 years of either sex were enrolled. The diagnosis was determined by DSM IV criteria. HAMD scale was used to assess the severity of depression. Fasting and postprandial blood glucose along with HbA1c was determined in the study participants. Results: Out of 60 patients, nearly more than half of (53.33%, n=32) patients were having suicidal ideation and attempt. The male depressive cases (73.33%, n=22) outnumbered the female depressive cases (33.33%, n= 10) in having suicidal ideation and attempt. Statistically significant differences were found in fasting, postprandial blood glucose and HbAa1c of the major depressive cases with no suicidal ideation and behaviour, and with suicidal ideation and attempt. Conclusion: The observed association between blood glucose levels, HbA1c and suicidal behaviour suggests that disturbances in glucose metabolism are associated with suicidal ideation and attempts
1. Chadda RK. Social support and psychosocial dysfunction in depression. Indian J Psychiatry.1995; 37:119-23.
2. Chaudhary PK, Deka K, Chetia D. Disability associated with mental disorders. Indian J Psychiatry. 2006; 48:95-101.
3. Tharoor H, Chauhan A, Sharma PS. Across sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness. Indian J Psychiatry. 2008;50:24-9.s
4. Chakrabarti S, Kulhara P, Verma SK. Extent and determinants of burden among families of patients with affective disorders. ActaPsychiatr Scand. 1992; 86:247-52.
5. Gabrielle A, Carlson MD, Dennis P, Cantwell MD. Suicidal behaviour and depression in children and adolescents. Journal of American Academy of Child Psychiatry. 1982; 21:4:361-368.
6. CerettaLB,ReusGZ,Albelaira HM, Jordana LK, Schwalm MT, Hoepers NJ, et al. Increased prevalence of mood disordesr and suicidal ideation in type 2 diabetes patients. ActaDiabetol. 2012;49 suppl 1:S227-34
7. Bot M, Pouwer F, de jonge P, Tack JC, Geelhoed-Duijvestin PHLM, Snoek FJ. Differential associations between depressive symptoms and glycemic control in outpatients with diabetes. Diabet Med. 2013;30:e115-22
8. Kan C, Silv N, Golden SH, Rajala U, Timonen M, Stahl D, et al. A systemic review and meta-analysis of the association between depression and insulin resistance. Diabetes Care. 2013; 36:480-9.
9. American Psychiatric Association. Diagnostic and Statistical manual of mental disorders, fourth edition. 4thedn. American Psychiatric Association: Washington,DC (2001)
10. Hamilton, M. A rating scale for depression. J. Neurol Neurosurg.23,56-62 (1980)
11. Zimmerman M, Martinez J, H Young, D Chelminski I andDalrymple K. Severity classification on the Hamilton Depression Rating Scale. J Affect Disord. 150,384e8 (2013).
12. Sokero PT, Melartin TK, Rytsala HJ, Leskelä US, Lestela-Mielonen PS, IsometsaET. Suicidal ideation and attempts among psychiatric patients with majordepressive disorder. J Clin Psychiatry. 2003; 64:1094–100.
13. Nandi D N, Banarjee G, Boral GC. Suicide in west Bengal- A Century apart. Indian J Psychiatry.1978; 20:155-60.
14. Hedge RS. Suicide in rural community. Indian J Psychiatry. 1980;22:368-70.
15. Han SJ, Kim HJ, Choi YJ, Lee KW, Kim DJ. Increased risk of suicidal ideation In Korean adults with both diabetes and depression. Diabetes Res ClinPract. 2013; 101:14–7.
16. Dunn AJ, Swiergiel AH, de Beaurepaire R. Cytokines as mediators of Depression: What can we learn from animal studies? NeurosciBiobehav Rev. 2005; 29:891–909.
17. Banerjee M, Saxena M. Interleukin-1 (IL-1) family of cytokines: Role in Type 2 Diabetes. ClinicaChimicaActa. 2012; 413:1163–70.
18. Kressel G, Trunz B, Bub A, Hülsman O, Wolters M, Lichtinghagen R, et al. Systemic and vascular markers of inflammation in relation to metabolic Syndrome and insulin resistance in adults with elevated atherosclerosis risk. Athetosclerosis. 2009; 202:263–71.
19. Sublette ME, Galfalvy HC, Fuchs D, Lapidus M, Grunebaum MF, Oquendo MA, et al. Plasma kynurine levels are elevated in suicide attempters with Major disorder. Brain Behav Immun. 2011; 25:1272–8.
20. Brent DA, Perper JA, Goldstein JE, KolkoDJ,Allan MJ. Risk factors in adolescent suicide: A comparison of adolescent suicide victims with suicidal inpatients. Archives of General Psychiatry, 45, 581-588.
21. Stetler C, Miller GE. Depression and hypothalamic-pituitary-adrenalactivation: A Quantitative summary of four decades of research. Psychosomatic Med. 2011; 73:114–26.
22. Belvedere Murri R, Pariante C, Mondelli V, Masotti M, Atti AR, Mellacqua Z ,et al. HPA axis and aging in depression: Systematic review andmeta-analysis. Psychoneuroendocrinology. 2014; 41:46–62.
A study of the cutaneous manifestations in patients of diabetes mellitus
A study of the cutaneous manifestations in patients of diabetes mellitus
1. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20(7):1183-97.
2. Park K. Epidemiology of chronic non communicable diseases and conditions. In: Parks Textbook of Preventive and Social Medicine. 21th ed. Jabalpur: Banarsi Das Bhanot publishers; 2011. p. 341-2.
3. Munichoodappa C. Epidemiology and burden of type 2 diabetes mellitus. In: Type 2 diabetes- The Indian Scenario, Jayaram BM (ed). Banglore: Microlabs Ltd. 2002; 13.
4. Davidson MB, Peters AL, Schriger DL. An alternative approach to the diagnosis of diabetes with a review of the literature. Diabetes Care. 1995; 8:1065-71.
5. Kalus AA, Chien AJ, Olerud JE. Diabetes Mellitus and Other Endocrine Diseases. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's Dermatology in General Medicine. 7th ed. USA (NY): McGraw-Hill; 2008. p. 1461-70.
6. Paron NG, Lambert PW. Cutaneous manifestations of diabetes mellitus. Prim Care. 2000; 27:371-83.
7. Dwivedi G, Dwivedi S. Sushruta-the Clinician-Teacher par Excellence. Indian I Chest Dis Al tied Sci 2007; 4V. 243-244
8. Bilous R, Donnelly R. History of Diabetes. In: Handbook of Diabetes. 4thed. Oxford : \Viley- Blackncll;20 I 0;5-8
9. Tattersall RB. The Histop’ of Diabetes Mellitus. In:Holt RIG, Corkrain CS, F-lyvbjerg A, Goldtsein JB, editors. Textbook of Diabetes. 4thed. Oxford:\Viley- BlackwclI;2010; 3-23
10. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012; 16(1):27 -36.
11. Graham PL, Lin SX, Larson EL. A U.S. population based survey of Staphylococcus aureus colonization. Ann Intern Med. 2006; 144:318-25.
12. Montes LF, Dobson H, Dodge BC, et al. Erythasma and diabetes mellitus. Arch Dermatol. 1969; 99:674-80.
13. Lai CF. Cutaneous manifestations in Diabetes Mellitus. Update article, social hygiene service, department of health, London, 2005.
14. Jelinek JE. Cutaneous manifestations of diabetes mellitus. Int J Dermatol. 1994; 33:605-17.
15. Lugo- Somolonos A, Sanchez JL. Prevalence of dermatophytosis in patients with diabetes. J Am Acad Dermatol. 1992; 26:408-10.
16. Sueki H, Fugisawa R. Pigmented pretibial patches with special references to the clinical classifications and the correlation to HbAlc which serves as an index of diabetic control. Nihon Hifuka Oakkai Zasshi. 1986 Mar; 96(3): 157-63.
17. Bhat R, Khaitan BK. Skin Manifestations in Internal Diseases. In: Valia RG, editor. IADVL Textbook and Atlas of Dermatology.3rd ed. Mumbai: Bhalani Publishing House; 2008.p.1369- 72.
18. Morgan AJ, Schwartz RA. Diabetic Dermopathy: A subtle sign with grave implications. J Am Acad Dermatol. 2008; 58:447-51.
19. Shemer A, Bergman R, Linn S, Kantor Y, Friedman Birnbaum R. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998; 37: 113-5.
20. Sibbald RG, Landolt SG, Toth D. Skin and diabetes. Endocrinol Metab Clin North Am. 1996; 25:463-72.
21. Muller SA. Dermatologic disorders associated with diabetes mellitus. Mayo Clin Proc. 1966; 41:689-703.
22. Jelinek J E. Cutaneous Manifestations of Diabetes Mellitus. Int J Dermatol. 1994; 33(9):605- 17.
23. Levy L, Zeichner JA. Dermatologic manifestation of diabetes. J Diabetes. 2012; 4(1):68-76.
24. Mutairi N. Skin diseases seen in diabetes mellitus. Bulletin of the Kuwait Institute for Medical Specialization. 2006; 5:30-9.
25. Libecco JF, Brodell RT, Finger Pebbles and Diabetes: A Case with Broad Involvement of the Dorsal Fingers and Hands. Arch Dermatol. 2001; 137(4):510-1.
26. Huntley AC. Finger pebbles: A common finding in diabetes. J Am Acad Dermatol. 1986; 14:612-7.
27. Cabo H, Woscoff A. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol.1995; 32(4):685.
28. Sreedevi C, Car N, Renar IP. Dermatologic lesions in diabetes mellitus. Diabetologia Croatica. 2002; 31 (3): 147-59.
29. Van Hattem S, Bootsma AH, Thio HB. Skin manifestations of diabetes. Cleve Clin J Med. 2008 Nov; 75(11):772-7.
30. Grandhe NP, Bhansali A, Dogra S, Kumar B. Acanthosis nigricans: Relation with type 2 diabetes mellitus, anthropometric variables, and body mass in Indians. Postgrad Med J. 2005; 81 :541-4.
31. Crook MA. Skin tags and the artherogenic lipid profile. J Clin Pathol. 2000; 53:873-4.
32. Kahn CR, Flier JS, Bar RS, Archer JA, Gorden P, Martin MM, et al. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med. 1976 Apr 1; 294(14):739-45.
33. Kahana M, Grossman E, Feinstein A, Ronnen M, Cohen M, Millet MS. Skin tags: A cutaneous marker for diabetes mellitus. Acta Derm Venereol. 1987; 67: 175-7.
34. Thappa DM. Skin tags as markers of diabetes mellitus: An epidemiological study in India. J Dermatol I 995; 22( 10):729-31.
35. Jowkar F, Fallahi A, Namazi MR. Is there any relation between serum insulin and insulin- like growth factor-l in non-diabetic patients with skin tag. J Eur Acad Dermatol Venereol. 2010; 24:73-4.
36. Gupta D, Hess B, Bachegowda L. Granuloma Annulare. The Scientific World Journal. 2010; 1:384-6.
37. Dornelles SI, Poziomczyk CS, Boff A, Koche B, Dornelles Mde A, Richter GK, et al Generalized perforating granuloma annulare. An Bras Dermatol 2011; 86(2):327 -31.
38. Yamaoka H, Sasaki H, Yamasaki H, Ogawa K, Ohta T, Furuta H, et al. Truncal pruritus of unknown origin may be a symptom of diabetic polyneuropathy. Diabetes Care. 2010; 33:150-5.
39. Cantbell AR, Martz W. Idiopathic bullae in diabetics: bullosis diabeticorum. Arch Dermatol 1967; 96:42-4.
40. NamaziI MR, Jorizzo JL, Fallahzadeh MK. Rubeosis Faciei Diabeticorum: a Common, but Often Unnoticed, Clinical Manifestation of Diabetes Mellitus. Scientific World Journal. 2010; 1 0:70-1.
Study of ‘atd’ angle in myocardial infarction patients
Background: Myocardial infarction is the most important cause of mortality and morbidity in the world. Dermatoglyhics is the scientific study of skin creases and lines and has formed an important part of surface anatomy. The development of dermatoglyphics occurs at much earlier embryonic stage at which most of the organs and systems develop including the cardiovascular system. Hence in this study we evaluated the dermatoglyphics in patients of Myocardial Infarction as compared to normal counterparts. Materials and Methods: Study was carried out in Department of Anatomy, in D. Y. Patil medical college during January 2011 to June 2012. Finger prints and palm prints of 150 diagnosed cases of Myocardial Infarction 120 males (M) and 30 females (F) and 150 Control group120 males and 50 females were obtained. Standard ink method was used for data collection of both the hands. Written consent of the patients were obtained. Results: Significant increase in the mean value of ‘atd’ angle in both sexes in myocardial infarction patients was observed as compared to controls. Conclusion: From the present study, it appears that there exists a specific relation in the ‘atd angle’ and Myocardial infarction patients, as compared to normal subjects. It warrants further research in the same direction.
1. Mescher AL. Junqueira's Basic Histology. 12th ed. USA: McGraw-Hill Companies Inc; 2010.p. CD Chapter-Skin.
2. Kumbnani H. K.: Dermatoglyphics- A Review. Anthropologist Special Volume No. 3: 2007: 285-295.
3. Dorland’s Illustrated Medical Dictionary. 28th ed. Philadelphia: Saunders W B; Dermatoglyphics; 1994; 449.
4. Penrose L. S.: and P. T. Ohara: The development of epidermal ridges: Journal of Medical Genetics, 10, (2), 1973, 201-208.
5. Kasey Wertheim.: Embryology and morphology of friction ridge skin. The Fingerprint sourcebook. Washington, D C: U S department of justice, office of justice programs. Published by NIJ(National institute of juctice).2011, 1-22.
6. Namouchi I: Anthropological significance of dermatoglyphic trait variation: an intra-Tunisian population analysis. International Journal of Modern Anthropology 2011; 4 : 12 – 27
7. I. C. Fuller: Dermatoglyphics- A diagnostic Aid. Journal of medical genetics Volume No 10:1973, 165.
8. Gupta UK and Prakash S: Dermatoglyphics: a study of finger tip patterns in bronchial asthma and its genetic disposition. Kathmandu University Medical Journal (2003) Vol. 1, No. 4, Issue 4, 267-271.
9. Pratibha Ramani, Ahilasha P. R., Herald Sherlin and others: Conventional Dermatoglyphics-Revived concept. International journal of pharma and bio sciences,Vol 2, issue 3 sep 2011,446-458.
10. Fausi AS, Kasper DL, Longo DL, et al. Herrison's Principles of Internal Medicine Volume II. 17th ed. New York: McGraw-Hill; 2008.p.1532
11. Cummins H and Midlo. Finger Prints of palms and soles. An introduction to dermatoglyphics. 1961; Dover Pub. INC, New York.
12. Sadler TW. Langman’s Medical Embryology in integumentary system.10th edn. Baltimore, Maryland, USA: Lippincott Williamsand Wilkins.2006, p336.
13. Rathva Ashish, Baria Dipika, Rathod Hitesh, Maheria Pankaj,Mahyavanshi Darshan: A study of quantitative analysis of dermatoglyphic in Coronary Artery Disease patients. Indian Journal of Basic and Applied Medical Research; September 2013: Issue-8, Vol.-2, P. 831-840.
14. Manara A, Habib MA, Rahman MA, Ayub M, Begum N: Digital And Palmar Dermatoglyphics In Myocardial Infarction. AFMC Bangladesh, December 2011; Vol- 7, No- 2, P. 4-8
Bacteriological profile and antimicrobial susceptibilty of blood culture isolates from the patients of tertiary care hospital, Udaipur
Blood stream infection are major public health problem which leads to high morbidity and mortality of patients. So for on time diagnosis and appropriate treatment, total 214 blood samples received in microbiology laboratory from tertiary care hospital of R.N.T medical college, Udaipur over the duration of one year. Blood samples collected in BHI broth and the growth obtained was identified by colony morphology, grams staining of isolated colonies and by conventional biochemical tests as per the standard protocol followed in our laboratory and then antibiotic susceptibility test done of isolated colony. Positive blood cultures were obtained in 54.6% of total cases of which Gram-positive bacteria accounted for 61% of cases with staph. aureus predominance, gram negative bacteria accounted for 28% with the predominance of Escherichia coli, klebseilla sp. and pseudomonas sp. and 11.1 % were fungal isolates. The most sensitive drugs for Gram-positive isolates were Amikacin, Ciprofloxacin, Doxycycline, Levofloxacin, Tetracycline and for Gram-negative were Levofloxacin, Tetracycline, Doxycycline and Ciprofloxacin.
1. Wasihun AG, Wlekidan LN, Gebremariam SA, Dejene TA, Welderufael AL, Dejenie TD, and Muthupandian S:Bacteriological profile and antimicrobial susceptibility patterns of blood culture isolates among febrile patients in Mekelle Hospital, Northern Ethiopia: SpringerPlus. 2015; 4:314.
2. Patricia M. Tille: Bailey and Scott’s Diagnostic Microbiology Fourteenth Edition.
3. Diekema DJ, Beekmann SE, Chapin KC, Morel KA, Munson E, Doern GV:Epidemiology and outcome of nosocomial and community-onset bloodstream infection:J Clin Microbiol 2003;41:3655-60.
4. Mehdinejad M, Khosravi AD, Morvaridi A: Study of prevalence and antimicrobial susceptibility pattern of bacteria isolated from blood cultures: J Biologic Sci. 2009; 9:249-53.
5. Shrestha S, Amatya R: Frequency of blood culture isolates and their antibiogram in a teaching hospital:J Nepal Med Assoc.2014;52(193):692-6.
6. Garg A, Anupurba S, and Garg J: Bacteriological profile and antimicrobial resistance of blood culture isolates from a university hospital:J Ind Acad Clin Med.2007; 8(2):139–143.
7. Vanitha RN, Kannan G, Venkata NM, Vishwakanth D, Nagesh VR, Yogitha M et al:A retrospective study on blood stream infections and antibiotic susceptibility patterns in a tertiary care teaching hospital:Int J Pharm Sci.2012;4:543-8.
8. Clinical and Laboratory Standards Institute.Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Second Informational Supplement.Wayne, PA, USA: Clinical and Laboratory Standards Institute; 2012. M100-S22.
9. Tiwari P, Kaur S: Profile and sensitivity pattern of bacteria isolated from various cultures in a Tertiary Care Hospital in Delhi: Indian J Public Health. 2010; 54:213-5.
10. Oza SS, Mehta JS, kikani KM, Oza GS:Bacteriological profile and antibiogram of blood culture isolates from patients of rural tertiary care hospital: Int J Microbiol Myco.2016;4(3): 1-7.
11. 12.Lee,A,S.Mirrett,L.B.Reller and M.P.Weinstein:Detection of bloodstream infections in adults,How many blood cultures are needed?:J Clin Microbiol.2007;45:3546-3548.
12. China and Gupta V: Bacteriological profile and antimicrobial susceptibility pattern of blood isolates from a tertiary care hospital in North India:Int J Pharm Sci Res.2013;2: 24–35, 2013.
13. Kamga HLF, Njunda AL and Nde PF:Prevalence of septicemia and antibiotic sensitivity pattern of bacterial isolates at the University Teaching Hospital:Afr J Cln Exper Microbiol.2011;12(1):2–8.
14. Sharma R, Sharma R and Gupta S: Bacteriological Analysis of Blood Culture Isolates with their Antibiogram from a Tertiary Care Hospital:Int J Pharm Sci Res.2015;6(11): 4847-5.
15. Mehta M, Dutta P, and Gupta V: Antimicrobial susceptibility pattern of blood isolates from a teaching hospital in North India: J Infect Dis.2005; 58(3):174–176.
16. Roy, Jain A, Kumar M, and Agarwal SK:Bacteriology of neonatal septicemia in a tertiary care hospital of Northern India:Indian J Med Microbiol.2002;20:156–159.
17. Devi V, Sahoo B, Damrolien S, Praveen S, Lungran P, Devi M:A study on the bacterial profile of bloodstream infections in Rims Hospital:J Dent Med Sci.2015;14:18-23.
18. Karlowsky A, Jones ME, Draghi DC, Thornsberry C, Sahm DF, and Volturo GA: Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States: Ann Clin Microbiol Antimicrob.2004; 3(7).
19. Radji M, Fathni R, Fauziyah S: Evaluation of surgical antibiotic prophylaxis in tertiary care hospital in jakarta Indonesia:Experi J.2014;18(4):1292-6.
20. Vera VP, Igor F, Goran P, Novak S, Abram M, Ulf Bergman:Antimicrobial use at a university hospital: appropriate or misused? A qualitative study:Int J Clin Pharmacol Ther. 2007;45(3):169-74.
Comparative study of indications, complications and outcome of elective and emergency intubation
Objectives: Acute respiratory failure frequently necessitates the introduction of endotracheal tube to maintain airway patency and for mechanical ventilation. Intubation is a procedure in day today practice in EMS, medical wards, operation theatres. This is study done retrospectively of 200 patients to correlate the factors which affect outcome of intubation age, sex, nature of underlying disease. The purpose of this study is also to determine whether intubation alone or subsequent tracheostomy in previously intubated patients can prognosticate outcome and the complications of endotracheal intubation and tracheostomy as acquired either during the procedure, with tube in situ or on extubation. Methods: A retrospective study of 200 adult patients was conducted, who satisfied inclusion and exclusion criteria for intubation on elective or emergency grounds over a period of 18 months. Patient’s demographic data along with lab tests of Sr. Creatinine, Sr. K+, ABG analysis, chest X-ray, Mallampatti grade was noted. The indication for intubation as elective or emergency was based on ABG or severity of respiratory failure or for tracheal toileting. SOFA score, GCS score at Admission and 48 hrs was noted. Results: In this study, 200 patients were intubated. Out of which 137 were elective and 63 emergency and 146 were Males and 54 were Females. Major age group was 21- 40 years. Organ involvement in form of respiratory (168 patients), hepatic(19 patients), renal failure(44 patients) or MODS (18 patients) didn’t affect outcome in these patients. The overall mortality rate of the study was 37%. The disease specific mortality for sepsis patients was 100%, Coma was 56.2% and pneumonia was 52.4%. The elective intubated patients had lower mortality (32.1%) compared to that of emergency intubated patients (47.6%). Conclusion: Patients have to be intubated electively and early tracheostomy at 72- 96 hrs has improved survival.
1. Roger R.M., Waller C.: The impact of intensive care unit on survival of patient with acute respiratory failure, Chest 1978, 61 (1).
2. John. L. Stuffer, Daniel. L. Olson et al: Complication and consequences of intubation- A prospective study of 150 critically ill patients. The American Journal of Medicine, 70, 65-75, 1981.
3. Pinsky M.Z., Mutuschak G.M. et al: Multiple system organ failure, Critical care unit, Vol 5 (2), 195-198, 1989.
4. Gnanamuthu C, Ray D. outcome of patients with fulminant Guillain-Barre syndrome on mechanical ventilatory support. Indian J Chest Dis Allied Sci 1992, 34, 65-72.
5. Lawn ND, Fletcher DD, Henderson RD, Wolter TD, Wijdicks EFM. Anticipating mechanical ventilation in Guillain-Barre syndrome. Arch Neurol. 2001; 58: 893-8.
6. Wijdricks EF, Henderson RD, McDolland RL. Emergency intubation in Guillain-Barre syndrome. Arch Neurol. 2003, 69, 947-948.
7. Neuromuscular Respiratory Failure in Guillain-Barre Syndrome: Evaluation of Clinical and Electrodiagnostic Predictors : Uma Sundar, Elizabeth Abraham, A Gharat, ME Yeolekar, Trupti Trivedi, N Dwivedi. JAPI- Vol. 53, September 2005
8. AlÃa I, Esteban A, Anzueto A, Gordo F, ApezteguÃa C, Pálizas F et al. (2000). "How is mechanical ventilation employed in the intensive care unit? An international utilization review." Am J Respir Crit Care Med 161 (5): 1450–1458.
9. Esteban A, Anzueto A, Gordo F et al: Characteristics and outcomes in patients receiving mechanical ventilation. JAMA 2002, 287, 345-355.
10. Udwadia F.: Mechanical ventilation in critically ill- Principles of critical care, 2nd Edition, Page 311-338.
11. Price K J, Cardenas, Turanzas M, Lin H et al: Prognostic indicators of mortality of mechanically ventilated patients with acute leukemia in a comprehensive cancer center. Minerva Anestesiol 2013 Feb; 79(2):147-55.
12. Jaber, Samir, Jean-Yves, Charles, Robert, et al: Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: A prospective, multiple-center study. Critical Care Medicine: September 2006 - Volume 34 - Issue 9 - pp 2355-2361.
13. Donald E. G. Griesdale, T. Laine Bosma, Tobias Kurth, George Isac, Dean R. Chittock: Complications of endotracheal intubation in the critically ill. Intensive Care Medicine. Volume 34, Issue 10, pp 1835-1842.
14. Evans A, Vaughan R S, Hall J E, Mecklenburgh J, Wilkes A R: A comparison of the forces exerted during laryngoscopy using disposable and non-disposable laryngoscope blades. Anaesthesia: 2003, 58, 869-73.
Anthocyanin from red tamarind, Tamarindus indica var. rhodocarpa as a potential natural pigment for use in textile industry
L M Lenora, D Suresh Babu, R Sumathi, A Mayavel, S Murugesan, N Senthilkumar
Anthocyanin from red tamarind, Tamarindus indica var. rhodocarpa as a potential natural pigment for use in textile industry
1. Chandan Kumar Jha, Ratan Kumar, Venkat Kumar S and Devi Rajeswari V: Extraction of natural dye from marigold flower (Tageteserectal.) and dyeing of fabric and yarns: A focus on colorimetric analysis and fastness properties: Der Pharmacia Lettre. 2015; 7 (1):185-195.
2. Kundal J, Singh SV, Purohit MC: Extraction of Natural Dye from Ficus cunia and Dyeing of Polyester Cotton and Wool Fabric Using Different Mordants, with Evaluation of Colour Fastness Properties: Nat Prod Chem Res. 2016; 4: 214.
3. Mohammad Gias Uddin: Extraction of ecofriendly natural dyes from mango leaves and their application on silk fabric: Textiles and Clothing Sustainability. 2015; 1:7.
Significance of cerebral and umbilical artery doppler velocimetry in normal and growth restricted pregnancy
V S Prasannakumar Reddy, Aradhana Giri, N Bhavani, Togarikar
Background: Doppler velocimetry is a rapid non invasive test that provides valuable information about hemodynamic situation of the fetus and is an efficient diagnostic test of fetal jeopardy which helps in timely intervention and management of high risk pregnancy for better perinatal outcome. Material and Methods: This is a prospective study including 40 women with normal singleton pregnancy and 40 women with Intra uterine growth restricted pregnancy carried out over a period of 1 year from april 2015 to march 2016 at MNR Medical College and Hospital, Sangareddy. Results: Umbilical artery mean pulsatility index and resistive index were significantly greater in IUGR pregnancy as compared to normal pregnancy. Systolic/diastolic (S/D) ratios were comparable in both the groups. There was significant reduction in cerebroumbilical (C/U) ratio in IUGR pregnancy as compared to normal pregnancy suggesting presence of a brain sparing effect. 17.5% patients in study group had absent end diastolic volume (AEDV) and 2.5% had reversal of end diastolic volume. Conclusion: In normal pregnancy, there is gestational age related fall in impedance in umbilical and middle cerebral arteries. Doppler study of umbilical artery is highly sensitive in the detection of IUGR while Middle cerebral artery doppler is useful for the prediction of adverse perinatal outcome in small for gestational age.
1. Battalgia FC, Lubchenko LO. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967; 71:159-63. Level II-3.
2. Berkowitz GS, Chitkara U, Rosenberg J et al. Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of IUGR. A prospective study. Am J obstetrics and Gynaecology 1988; 158:1149-53.
3. Mari G, Moise KJ Jr, Deter RL et al. Doppler assessment of the pulsatility index in the cerebral circulation of the human fetus. Am J obstetrics and Gynaecology 1989; 160:698-703.
4. Mari G, Deter RL. Middle cerebral artery flow velocity waveforms in normal and small for gestational age foetuses. Am J obstetrics and Gynaecology 1992; 166:1262-70.
5. Rochelson BL, Schulman H, Fleischer A et al. The clinical significance of Doppler umbilical artery velocimetry in the small for gestation fetus. Am J obstetrics and Gynaecology 1987; 156:1223-6.
6. Harrington K, Thompson MO, Carpenter RG et al. Doppler fetal circulation in pregnancies complicated by pre-eclampsia or delivery of a small for gestational age baby: 2. Longitudinal analysis. Br J obstetGynaecol 1999; 106:453-66.
7. Wladimiroff JW, VdWijingaard JA, Degani S et al. Cerebral and umbilical arterial blood flow velocity waveforms n normal and growth retarted pregnancies. ObstetGynecol 1987; 69:705-9.
8. Lakhar BN, Ahamed SA. Doppler velocimetry of uterine and umbilical arteries during pregnancy. Indian J Radiol Imaging 1999; 9:119-25.
9. Khurana A, Chawala J, Singh K. Normal systolic/diastolic ratios of the umbilical artery flow velocity waveforms in Indian pregnancies. Indian J Radiol Imaging 1995; 5:25-8.
10. Narula H, Kapila AK, Kaur MM. Cerebral and Umbilical arterial blood flow velocity in normal and growth retarded pregnancy. J obstetGynaecol India January/February 2009; vol.59, 1:47-52.
11. Kirkinen P, Muller R, Huch R et al. Blood flow velocity waveforms in human fetal intracranial arteries. ObstetGynecol 1987; 70:617-21.
12. Gramilleni D, Folli MC, Raboni S et al. Cerebral umbilical Doppler ratio as a predictor of adverse perinatal outcome. ObstetGynecol 1992; 79:416-20.
13. Chandran R, Serra-Serra V, Sellers SM et al. Fetal cerebral Doppler in the recognition of fetal compromise. Br J ObstetGynecol 1993; 100:139-44.
14. Serag Y, Ozay O, Birgul G et al. Ratio of Middle cerebral to umbilical artery blood velocity in preeclamptic and hypertensive women in the prediction of poor perinatal outcome. Indian J Med Res 2004; 120:44-50.
Histopathological study of tumours of adipose tissue
Background: Tumours of adipose tissue form one of the largest single groups of soft tissue tumours. The benign, subcutaneous lipoma is the most common soft tissue neoplasm in adults, liposarcoma being the most common primary soft tissue malignancy. Objective: To study the morphological features of the various adipocytic tumours received in the Department of Pathology. Materials and Methods: Cases of adipocytic tumours were retrieved from the archives of the Department of Pathology. Results: The total number of cases numbered 155. Amongst these, 143 (92%) were benign and 12 (8%) were malignant. In benign cases, patients were in the age group 4-75 years, with 88 males and 55 females. Among the malignant cases, patients were in the age group 14-68 years, with 7 males and 5 females. The peak age distribution in both benign and malignant cases was in the fourth decade. The most common site of involvement was the nape of neck, followed by back and upper limbs. Conventional lipoma was the most common benign tumour. Variants of lipoma like angiolipoma, chondroid lipoma, dermolipoma etc was noted. Of the 12 malignant tumours, 6 cases were well differentiated liposarcoma, 2 cases variant of myxoid liposarcoma, and one case each of pleomorphic liposarcoma, lipoleiomyosarcoma and lipoma with sarcomatous changes. Conclusion: Conventional lipomas were the most common adipocytic soft tissue tumours. Malignant cases were rare, and among them, the most common malignant tumour was well-differentiated liposarcoma.
1. Marsden H B, Lawler W. Fletcher. Tumors Of Soft Tissue, In:Fletcher DM. Diagnostic Histopathology Of Tumors. 4th ed:Saunder Elsevier Inc; 2013: 1474-85.
2. Pathology and Genetics of Tumours of the Soft Tissue. In WHO Classification of Tumours. Hamilton.SR, Aaltonen.LA, eds. IARC Press Lyon 2016.
3. Ekanem VJ, Aligbe JU. Histopathological Analysis of Soft Tissue Sarcoma as seen in Benin City, Nigeria: A Ten Year Review (1995-2004). Nig J Gen Pract. 2006: 7:39-43.
4. Kransdorf JM. Benign Soft Tissue Tumors in a Large Referral Polulation: Distribution of Specific Diagnosis by Age, Sex and Location. AJR 1995; 164: 395-402.
5. Hameed M. Pathology and genetics of adipocytic tumors. Cytogenet Genome Res; 2007; 118: 138–47.
6. Angelo PD. Liposarcoma: New Entities and Evolving Concepts. Annals of Diagnostic Pathology. 2000; 4: 252-66.
7. Rydholm A, Berg NO. Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand.1983 Dec; 54: 929-34.
8. Mohammed U, Samaila O, Abubaker M. Pattern of adipose tissue tumors in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Annals of Nigerian Medicine. 2014; 8: 8-10.
9. Seleye-Fubara D, Etebu EN. Adipose tissue tumour in Port Harcourt: A
ten year review. Sahel Med J 2005; 8:92-4.
10. E I. Odokuma, V J. Ekanem, O E. Osemeke. Histopathologic Patterns of Adipocytic Tumours in University of Benin Teaching Hospital; a Twenty Year Retrospective Study. Annual Research and Review in Biology. 2015; 5: 553-62.
Bacteriological profile of Urinary Tract Infections in pregnant women – Future Challenges
Background: Pregnancy causes numerous changes in the woman’s body. Hormonal and mechanical changes increase the risk of urinary stasis and vesicoureteral reflux. These changes, along with an already short urethra and difficulty with hygiene due to a distended pregnant belly, increase the frequency of urinary tract infections (UTIs) in pregnant women. Indeed, UTIs are among the most common bacterial infections during pregnancy, Urinary tract infections remain one of the most common infections and a leading cause of morbidity in human population. Aims and Objectives: To study Bacteriological Profile of Urinary Tract Infections in Pregnant women at a Tertiary health care center Methodology: This was a cross-sectional study carried out in the department of Microbiology in association with department of Obstetrics and Gynaecology of a tertiary health care center during one year period i.e. March 2013 to March 2014 in 280 Samples of Suspected UTI in pregnant women. Fifty six samples were culture positive and were addressed for Antibiotic Sensitivity Testing (AST) as per the standard protocols. Results: The most commonly observed bacteria was E. coli (39.29%) and Staphylococcus aureus (19.64%), followed by Coagulase negative staphylococcus (16.07%), Klebsiella sp. (12.50%), Enterococci sp. (8.93%) and Acinetobacter sp. (3.57 %). Escherichia coli was most commonly sensitive to Nitofurantoin (77.27%), Klebsiella to Norfloxacin (71.43%), and Acinetobacter was 100% senstive to Amoxiclav, Amikacin, Tetracyclines and Norfloxacin. In Gram positive pathogens, Staphylococcus aureus was mostly sensitive to Cotrimoxazole and Erythromycin. Conclusion: It can be concluded from our study that commonly observed bacteria were E. coli and Staphylococcus aureus causing UTI in pregnant women. All pregnant women should be screened for UTI with a urine culture and treated with antibiotics if the culture is positive
1. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults.Clin Infect Dis. 2005 Mar 1. 40(5):64354
2. Rajan S, Prabavathy J. Antibiotic sensitivity and phenotypic detection of ESBL producing E. coli strains causing urinary tract infection in a community hospital, Chennai, Tamil Nadu, India. Webmed Central Pharml Sci. 2012;3(11):1-17
3. Kamat US, Fereirra A, Amonkar D, Motghare DD, Kulkarni MS. Epidemiology of hospital acquired urinary tract infections in a medical college hospital in Goa. Indian J Urol. 2009; 25:76-80
4. Kumar R, Dahiya SS, Hemwani K, Srivastava P. Isolation of human pathogenic bacteria causing urinary tract infection and their antimicrobial susceptibility pattern in a tertiary care hospital, Jaipur, India. Int Res J Med Sci. 2014;2(6):6-10
5. Syed MA, Ramakrishna PJ, Shaniya K, Arya B, Shakir VP. Urinary tract infections- an overview on the prevalence and the antibiogram of Gram negative uropathogens in a tertiary care centre in north Kerala, India. J ClinDiag Res. 2012;6(7):1192-5
6. Cheesbrough M. District laboratory practice in tropical countries second edition. Cambridge: Cambridge University press; 2006. pp. 62–143.
7. Acharya VN. Urinary tract infection- a dangerous and unrecognized forerunner of systemic sepsis. J Post Grad Med. 1992; 38:52-4.
8. ShaistaBano, Sarfraz A Tunio, AmeerAfzalMenom, Hakim Detho,RozinaBano, Kalpanakumari. Evaluation of antibiotic susceptibility patterns of uropathogens circulating in Hydrabad, Pakisthan. Khyber Med Univ J 2014; 6(3):110-115.
9. Rama Biswas, RaihanRabbani, HasanShahrear Ahmed, Mohammed Abdus Satter Sarkar, NahidaZafrin, Md. Motlabur Rahman. Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital. Bangladesh Crit Care J.2014 March;2(1):21-24
10. Humayun, T., Iqbal, A. 2012. The Culture and sensitivity pattern of Urinary Tract Infections in Females of Reproductive Age Group. Ann. Pak. Inst. Med. Sci.8(1): 19–22
11. McKenzie H, Donnet ML, Howie PW, Patel NB, Benvie DT. Risk of preterm delivery in pregnantwomen with group B streptococcal urinary infections or urinary antibodies to group B streptococcal and E. coli antigens. Br J ObstetGynaecol. 1994 Feb. 101(2):10713
12. Sibi, G., Devi, A. P., Fouzia, K., and Patil, B. R. 2011. Prevalence, microbiologic profile of urinary tract infection and its treatment with trimethoprim in diabetic patients. Research Journal of Microbioogy. 6: 543-551
13. Varsha Rani Gajamer, Hare Krishna Tiwari, PremDorjee Bhutia, SankhaSubra Sen, Ranadeep Ghosh, ArunabhaSarkar. Detection of antibiotic resistance pattern with ESBL producers and MRSA among uropathogens at tertiary health care centre, North Bengal. International Journal of Pure and Applied Bioscience.2015 April;3(2):522-533
14. Hooton, T.M., Roberts, P.L., Cox, M.E. and Stapleton, A.E. (2013) Voided Midstream Urine Culture and Acute Cystitis in Premenopausal Women. New England Journal of Medicine, 369, 1883-1891. http://dx.doi.org/10.1056/NEJMoa1302186
15. Naylor, G.R. (1984) A 16-Month Analysis of Urinary Tract Infection in Children. Journal of Medical Microbiology, 17, 31-36. http://dx.doi.org/10.1099/00222615-17-1-31 [6] Travis, L.B. and Bruhard, B.H. (1991) Infections of the Urinary Tract. In: Rudolph, A.M., Ed., Rudolph’s Paediatrics, 19th Edition, Appleton and Lange, Stamford
16. Warren, J.W. (1987) Catheter-Associated Urinary Tract Infections. Infectious Disease Clinics of North America, 1, 823-854. [8] Eghafona, N.O., Evbagharu, P.A. and Aluyi, H.A.S. (1998) Paediatric Urinary Tract Infection in Benin City, Nigeria. Journal of Medical Laboratory Sciences, 7, 59-61
17. Obiogbolu, C.H., Okonko, I.O., Anymene, C.O., Adedeji, A.O., Akanbi, A.O., Ogun, A.A., Ejembi, J. and Faleye, T.O.C. (2009) Incidence of Urinary Tract Infections (UTIs) among Pregnant Women in Awka Metropolis, Southeastern Nigeria. Scientific Research and Essay, 4, 820-824
18. Mamatha P Samaga. Bacteriological Profile of Urinary Tract Infections in Pregnant Women Indian J Microbiol Res 2016;3(1):17-21
19. C. M. Ogbukagu. Incidence of Urinary Tract Infections (UTI) amongst Patients Attending Primary Health Centres in Anambra State. Advances in Microbiology, 2016, 6, 537-547
20. Tazebew Demilie,Getenet Beyene, Selabat Melaku, Wondewosen Tsegaye. URINARY BACTERIAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN AMONG PREGNANT WOMEN IN NORTH WEST ETHIOPIA. Ethiop J Health Sci. 2012;22(2):121-128
21. Dybowski B, Bres-Niewada E, Radziszewski P. Pressure-flow nomogram for women with lower urinary tract symptoms. Arch Med Sci 2014; 10: 752-56
22. Carlet J, Jarlier V, Harbath, et al. Ready for a world withoutantibiotics? The Pensieres antibiotic resistance callto action.Antimicrob Resist Infect Control 2012; 1: 1-2
23. Sabharwal ER. Antibiotic susceptibility patterns of uropathogensin obstetric patients. N Am J Med Sci 2012;4: 316-19
24. McIsaac W, Carrol JC, Biringer A, et al. Screening for asymptomatic bacteriuria in pregnancy. J ObstetGynaecol Can 2005; 27: 20-24
25. Rizvi M, Khan F, Shukla, et al. Rising prevalence of antimicrobial resistance in urinary tract infections during pregnancy: necessity for exploring newer treatment options.J Lab Physicians 2011; 3: 98-103
26. Bojar I, Owoc A, Humeniuk E, Fronczak A, Walecka I. Quality of pregnant women’s diet in Poland – macro-elements. Arch Med Sci 2014; 10: 361-65
Issue details
Significance of glycemic status in patients of major depressive disorder with suicidal behaviour
Mahendra T Kamble, Prashant V Dharme, Prerna D Nandedkar, Arvind V Gaikwad, Kamalakar B Mane
Background: Suicidal ideation is common in major depressive disorder, and it is thought to be a strong contributing factor for completed or attempted suicide. Hyperglycemia and hyperinsulinemia may increase the risk of depression and also suicide risk. Therefore this study was conceived to explore the possible relationship between suicidal behaviour and impaired glucose metabolism in major depressive disorders. Materials and Method: This study was undertaken in Department of Biochemistry and Psychiatry, Government Medical College, Nagpur. 60 diagnosed cases of major depressive disorder in the age range of 21-60 years of either sex were enrolled. The diagnosis was determined by DSM IV criteria. HAMD scale was used to assess the severity of depression. Fasting and postprandial blood glucose along with HbA1c was determined in the study participants. Results: Out of 60 patients, nearly more than half of (53.33%, n=32) patients were having suicidal ideation and attempt. The male depressive cases (73.33%, n=22) outnumbered the female depressive cases (33.33%, n= 10) in having suicidal ideation and attempt. Statistically significant differences were found in fasting, postprandial blood glucose and HbAa1c of the major depressive cases with no suicidal ideation and behaviour, and with suicidal ideation and attempt. Conclusion: The observed association between blood glucose levels, HbA1c and suicidal behaviour suggests that disturbances in glucose metabolism are associated with suicidal ideation and attempts
1. Chadda RK. Social support and psychosocial dysfunction in depression. Indian J Psychiatry.1995; 37:119-23. 2. Chaudhary PK, Deka K, Chetia D. Disability associated with mental disorders. Indian J Psychiatry. 2006; 48:95-101. 3. Tharoor H, Chauhan A, Sharma PS. Across sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness. Indian J Psychiatry. 2008;50:24-9.s 4. Chakrabarti S, Kulhara P, Verma SK. Extent and determinants of burden among families of patients with affective disorders. ActaPsychiatr Scand. 1992; 86:247-52. 5. Gabrielle A, Carlson MD, Dennis P, Cantwell MD. Suicidal behaviour and depression in children and adolescents. Journal of American Academy of Child Psychiatry. 1982; 21:4:361-368. 6. CerettaLB,ReusGZ,Albelaira HM, Jordana LK, Schwalm MT, Hoepers NJ, et al. Increased prevalence of mood disordesr and suicidal ideation in type 2 diabetes patients. ActaDiabetol. 2012;49 suppl 1:S227-34 7. Bot M, Pouwer F, de jonge P, Tack JC, Geelhoed-Duijvestin PHLM, Snoek FJ. Differential associations between depressive symptoms and glycemic control in outpatients with diabetes. Diabet Med. 2013;30:e115-22 8. Kan C, Silv N, Golden SH, Rajala U, Timonen M, Stahl D, et al. A systemic review and meta-analysis of the association between depression and insulin resistance. Diabetes Care. 2013; 36:480-9. 9. American Psychiatric Association. Diagnostic and Statistical manual of mental disorders, fourth edition. 4thedn. American Psychiatric Association: Washington,DC (2001) 10. Hamilton, M. A rating scale for depression. J. Neurol Neurosurg.23,56-62 (1980) 11. Zimmerman M, Martinez J, H Young, D Chelminski I andDalrymple K. Severity classification on the Hamilton Depression Rating Scale. J Affect Disord. 150,384e8 (2013). 12. Sokero PT, Melartin TK, Rytsala HJ, Leskelä US, Lestela-Mielonen PS, IsometsaET. Suicidal ideation and attempts among psychiatric patients with majordepressive disorder. J Clin Psychiatry. 2003; 64:1094–100. 13. Nandi D N, Banarjee G, Boral GC. Suicide in west Bengal- A Century apart. Indian J Psychiatry.1978; 20:155-60. 14. Hedge RS. Suicide in rural community. Indian J Psychiatry. 1980;22:368-70. 15. Han SJ, Kim HJ, Choi YJ, Lee KW, Kim DJ. Increased risk of suicidal ideation In Korean adults with both diabetes and depression. Diabetes Res ClinPract. 2013; 101:14–7. 16. Dunn AJ, Swiergiel AH, de Beaurepaire R. Cytokines as mediators of Depression: What can we learn from animal studies? NeurosciBiobehav Rev. 2005; 29:891–909. 17. Banerjee M, Saxena M. Interleukin-1 (IL-1) family of cytokines: Role in Type 2 Diabetes. ClinicaChimicaActa. 2012; 413:1163–70. 18. Kressel G, Trunz B, Bub A, Hülsman O, Wolters M, Lichtinghagen R, et al. Systemic and vascular markers of inflammation in relation to metabolic Syndrome and insulin resistance in adults with elevated atherosclerosis risk. Athetosclerosis. 2009; 202:263–71. 19. Sublette ME, Galfalvy HC, Fuchs D, Lapidus M, Grunebaum MF, Oquendo MA, et al. Plasma kynurine levels are elevated in suicide attempters with Major disorder. Brain Behav Immun. 2011; 25:1272–8. 20. Brent DA, Perper JA, Goldstein JE, KolkoDJ,Allan MJ. Risk factors in adolescent suicide: A comparison of adolescent suicide victims with suicidal inpatients. Archives of General Psychiatry, 45, 581-588. 21. Stetler C, Miller GE. Depression and hypothalamic-pituitary-adrenalactivation: A Quantitative summary of four decades of research. Psychosomatic Med. 2011; 73:114–26. 22. Belvedere Murri R, Pariante C, Mondelli V, Masotti M, Atti AR, Mellacqua Z ,et al. HPA axis and aging in depression: Systematic review andmeta-analysis. Psychoneuroendocrinology. 2014; 41:46–62.
A study of the cutaneous manifestations in patients of diabetes mellitus
Yashdeep, Kishor Singh, Sanjay Kanodia, Parvesh
A study of the cutaneous manifestations in patients of diabetes mellitus
1. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997; 20(7):1183-97. 2. Park K. Epidemiology of chronic non communicable diseases and conditions. In: Parks Textbook of Preventive and Social Medicine. 21th ed. Jabalpur: Banarsi Das Bhanot publishers; 2011. p. 341-2. 3. Munichoodappa C. Epidemiology and burden of type 2 diabetes mellitus. In: Type 2 diabetes- The Indian Scenario, Jayaram BM (ed). Banglore: Microlabs Ltd. 2002; 13. 4. Davidson MB, Peters AL, Schriger DL. An alternative approach to the diagnosis of diabetes with a review of the literature. Diabetes Care. 1995; 8:1065-71. 5. Kalus AA, Chien AJ, Olerud JE. Diabetes Mellitus and Other Endocrine Diseases. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, editors. Fitzpatrick's Dermatology in General Medicine. 7th ed. USA (NY): McGraw-Hill; 2008. p. 1461-70. 6. Paron NG, Lambert PW. Cutaneous manifestations of diabetes mellitus. Prim Care. 2000; 27:371-83. 7. Dwivedi G, Dwivedi S. Sushruta-the Clinician-Teacher par Excellence. Indian I Chest Dis Al tied Sci 2007; 4V. 243-244 8. Bilous R, Donnelly R. History of Diabetes. In: Handbook of Diabetes. 4thed. Oxford : \Viley- Blackncll;20 I 0;5-8 9. Tattersall RB. The Histop’ of Diabetes Mellitus. In:Holt RIG, Corkrain CS, F-lyvbjerg A, Goldtsein JB, editors. Textbook of Diabetes. 4thed. Oxford:\Viley- BlackwclI;2010; 3-23 10. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012; 16(1):27 -36. 11. Graham PL, Lin SX, Larson EL. A U.S. population based survey of Staphylococcus aureus colonization. Ann Intern Med. 2006; 144:318-25. 12. Montes LF, Dobson H, Dodge BC, et al. Erythasma and diabetes mellitus. Arch Dermatol. 1969; 99:674-80. 13. Lai CF. Cutaneous manifestations in Diabetes Mellitus. Update article, social hygiene service, department of health, London, 2005. 14. Jelinek JE. Cutaneous manifestations of diabetes mellitus. Int J Dermatol. 1994; 33:605-17. 15. Lugo- Somolonos A, Sanchez JL. Prevalence of dermatophytosis in patients with diabetes. J Am Acad Dermatol. 1992; 26:408-10. 16. Sueki H, Fugisawa R. Pigmented pretibial patches with special references to the clinical classifications and the correlation to HbAlc which serves as an index of diabetic control. Nihon Hifuka Oakkai Zasshi. 1986 Mar; 96(3): 157-63. 17. Bhat R, Khaitan BK. Skin Manifestations in Internal Diseases. In: Valia RG, editor. IADVL Textbook and Atlas of Dermatology.3rd ed. Mumbai: Bhalani Publishing House; 2008.p.1369- 72. 18. Morgan AJ, Schwartz RA. Diabetic Dermopathy: A subtle sign with grave implications. J Am Acad Dermatol. 2008; 58:447-51. 19. Shemer A, Bergman R, Linn S, Kantor Y, Friedman Birnbaum R. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998; 37: 113-5. 20. Sibbald RG, Landolt SG, Toth D. Skin and diabetes. Endocrinol Metab Clin North Am. 1996; 25:463-72. 21. Muller SA. Dermatologic disorders associated with diabetes mellitus. Mayo Clin Proc. 1966; 41:689-703. 22. Jelinek J E. Cutaneous Manifestations of Diabetes Mellitus. Int J Dermatol. 1994; 33(9):605- 17. 23. Levy L, Zeichner JA. Dermatologic manifestation of diabetes. J Diabetes. 2012; 4(1):68-76. 24. Mutairi N. Skin diseases seen in diabetes mellitus. Bulletin of the Kuwait Institute for Medical Specialization. 2006; 5:30-9. 25. Libecco JF, Brodell RT, Finger Pebbles and Diabetes: A Case with Broad Involvement of the Dorsal Fingers and Hands. Arch Dermatol. 2001; 137(4):510-1. 26. Huntley AC. Finger pebbles: A common finding in diabetes. J Am Acad Dermatol. 1986; 14:612-7. 27. Cabo H, Woscoff A. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol.1995; 32(4):685. 28. Sreedevi C, Car N, Renar IP. Dermatologic lesions in diabetes mellitus. Diabetologia Croatica. 2002; 31 (3): 147-59. 29. Van Hattem S, Bootsma AH, Thio HB. Skin manifestations of diabetes. Cleve Clin J Med. 2008 Nov; 75(11):772-7. 30. Grandhe NP, Bhansali A, Dogra S, Kumar B. Acanthosis nigricans: Relation with type 2 diabetes mellitus, anthropometric variables, and body mass in Indians. Postgrad Med J. 2005; 81 :541-4. 31. Crook MA. Skin tags and the artherogenic lipid profile. J Clin Pathol. 2000; 53:873-4. 32. Kahn CR, Flier JS, Bar RS, Archer JA, Gorden P, Martin MM, et al. The syndromes of insulin resistance and acanthosis nigricans. Insulin-receptor disorders in man. N Engl J Med. 1976 Apr 1; 294(14):739-45. 33. Kahana M, Grossman E, Feinstein A, Ronnen M, Cohen M, Millet MS. Skin tags: A cutaneous marker for diabetes mellitus. Acta Derm Venereol. 1987; 67: 175-7. 34. Thappa DM. Skin tags as markers of diabetes mellitus: An epidemiological study in India. J Dermatol I 995; 22( 10):729-31. 35. Jowkar F, Fallahi A, Namazi MR. Is there any relation between serum insulin and insulin- like growth factor-l in non-diabetic patients with skin tag. J Eur Acad Dermatol Venereol. 2010; 24:73-4. 36. Gupta D, Hess B, Bachegowda L. Granuloma Annulare. The Scientific World Journal. 2010; 1:384-6. 37. Dornelles SI, Poziomczyk CS, Boff A, Koche B, Dornelles Mde A, Richter GK, et al Generalized perforating granuloma annulare. An Bras Dermatol 2011; 86(2):327 -31. 38. Yamaoka H, Sasaki H, Yamasaki H, Ogawa K, Ohta T, Furuta H, et al. Truncal pruritus of unknown origin may be a symptom of diabetic polyneuropathy. Diabetes Care. 2010; 33:150-5. 39. Cantbell AR, Martz W. Idiopathic bullae in diabetics: bullosis diabeticorum. Arch Dermatol 1967; 96:42-4. 40. NamaziI MR, Jorizzo JL, Fallahzadeh MK. Rubeosis Faciei Diabeticorum: a Common, but Often Unnoticed, Clinical Manifestation of Diabetes Mellitus. Scientific World Journal. 2010; 1 0:70-1.
Study of ‘atd’ angle in myocardial infarction patients
A V Salunkhe, U U Joshi, N R Mudiraj
Background: Myocardial infarction is the most important cause of mortality and morbidity in the world. Dermatoglyhics is the scientific study of skin creases and lines and has formed an important part of surface anatomy. The development of dermatoglyphics occurs at much earlier embryonic stage at which most of the organs and systems develop including the cardiovascular system. Hence in this study we evaluated the dermatoglyphics in patients of Myocardial Infarction as compared to normal counterparts. Materials and Methods: Study was carried out in Department of Anatomy, in D. Y. Patil medical college during January 2011 to June 2012. Finger prints and palm prints of 150 diagnosed cases of Myocardial Infarction 120 males (M) and 30 females (F) and 150 Control group120 males and 50 females were obtained. Standard ink method was used for data collection of both the hands. Written consent of the patients were obtained. Results: Significant increase in the mean value of ‘atd’ angle in both sexes in myocardial infarction patients was observed as compared to controls. Conclusion: From the present study, it appears that there exists a specific relation in the ‘atd angle’ and Myocardial infarction patients, as compared to normal subjects. It warrants further research in the same direction.
1. Mescher AL. Junqueira's Basic Histology. 12th ed. USA: McGraw-Hill Companies Inc; 2010.p. CD Chapter-Skin. 2. Kumbnani H. K.: Dermatoglyphics- A Review. Anthropologist Special Volume No. 3: 2007: 285-295. 3. Dorland’s Illustrated Medical Dictionary. 28th ed. Philadelphia: Saunders W B; Dermatoglyphics; 1994; 449. 4. Penrose L. S.: and P. T. Ohara: The development of epidermal ridges: Journal of Medical Genetics, 10, (2), 1973, 201-208. 5. Kasey Wertheim.: Embryology and morphology of friction ridge skin. The Fingerprint sourcebook. Washington, D C: U S department of justice, office of justice programs. Published by NIJ(National institute of juctice).2011, 1-22. 6. Namouchi I: Anthropological significance of dermatoglyphic trait variation: an intra-Tunisian population analysis. International Journal of Modern Anthropology 2011; 4 : 12 – 27 7. I. C. Fuller: Dermatoglyphics- A diagnostic Aid. Journal of medical genetics Volume No 10:1973, 165. 8. Gupta UK and Prakash S: Dermatoglyphics: a study of finger tip patterns in bronchial asthma and its genetic disposition. Kathmandu University Medical Journal (2003) Vol. 1, No. 4, Issue 4, 267-271. 9. Pratibha Ramani, Ahilasha P. R., Herald Sherlin and others: Conventional Dermatoglyphics-Revived concept. International journal of pharma and bio sciences,Vol 2, issue 3 sep 2011,446-458. 10. Fausi AS, Kasper DL, Longo DL, et al. Herrison's Principles of Internal Medicine Volume II. 17th ed. New York: McGraw-Hill; 2008.p.1532 11. Cummins H and Midlo. Finger Prints of palms and soles. An introduction to dermatoglyphics. 1961; Dover Pub. INC, New York. 12. Sadler TW. Langman’s Medical Embryology in integumentary system.10th edn. Baltimore, Maryland, USA: Lippincott Williamsand Wilkins.2006, p336. 13. Rathva Ashish, Baria Dipika, Rathod Hitesh, Maheria Pankaj,Mahyavanshi Darshan: A study of quantitative analysis of dermatoglyphic in Coronary Artery Disease patients. Indian Journal of Basic and Applied Medical Research; September 2013: Issue-8, Vol.-2, P. 831-840. 14. Manara A, Habib MA, Rahman MA, Ayub M, Begum N: Digital And Palmar Dermatoglyphics In Myocardial Infarction. AFMC Bangladesh, December 2011; Vol- 7, No- 2, P. 4-8
Bacteriological profile and antimicrobial susceptibilty of blood culture isolates from the patients of tertiary care hospital, Udaipur
Pratibha Mittal, Anshu Sharma
Blood stream infection are major public health problem which leads to high morbidity and mortality of patients. So for on time diagnosis and appropriate treatment, total 214 blood samples received in microbiology laboratory from tertiary care hospital of R.N.T medical college, Udaipur over the duration of one year. Blood samples collected in BHI broth and the growth obtained was identified by colony morphology, grams staining of isolated colonies and by conventional biochemical tests as per the standard protocol followed in our laboratory and then antibiotic susceptibility test done of isolated colony. Positive blood cultures were obtained in 54.6% of total cases of which Gram-positive bacteria accounted for 61% of cases with staph. aureus predominance, gram negative bacteria accounted for 28% with the predominance of Escherichia coli, klebseilla sp. and pseudomonas sp. and 11.1 % were fungal isolates. The most sensitive drugs for Gram-positive isolates were Amikacin, Ciprofloxacin, Doxycycline, Levofloxacin, Tetracycline and for Gram-negative were Levofloxacin, Tetracycline, Doxycycline and Ciprofloxacin.
1. Wasihun AG, Wlekidan LN, Gebremariam SA, Dejene TA, Welderufael AL, Dejenie TD, and Muthupandian S:Bacteriological profile and antimicrobial susceptibility patterns of blood culture isolates among febrile patients in Mekelle Hospital, Northern Ethiopia: SpringerPlus. 2015; 4:314. 2. Patricia M. Tille: Bailey and Scott’s Diagnostic Microbiology Fourteenth Edition. 3. Diekema DJ, Beekmann SE, Chapin KC, Morel KA, Munson E, Doern GV:Epidemiology and outcome of nosocomial and community-onset bloodstream infection:J Clin Microbiol 2003;41:3655-60. 4. Mehdinejad M, Khosravi AD, Morvaridi A: Study of prevalence and antimicrobial susceptibility pattern of bacteria isolated from blood cultures: J Biologic Sci. 2009; 9:249-53. 5. Shrestha S, Amatya R: Frequency of blood culture isolates and their antibiogram in a teaching hospital:J Nepal Med Assoc.2014;52(193):692-6. 6. Garg A, Anupurba S, and Garg J: Bacteriological profile and antimicrobial resistance of blood culture isolates from a university hospital:J Ind Acad Clin Med.2007; 8(2):139–143. 7. Vanitha RN, Kannan G, Venkata NM, Vishwakanth D, Nagesh VR, Yogitha M et al:A retrospective study on blood stream infections and antibiotic susceptibility patterns in a tertiary care teaching hospital:Int J Pharm Sci.2012;4:543-8. 8. Clinical and Laboratory Standards Institute.Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Second Informational Supplement.Wayne, PA, USA: Clinical and Laboratory Standards Institute; 2012. M100-S22. 9. Tiwari P, Kaur S: Profile and sensitivity pattern of bacteria isolated from various cultures in a Tertiary Care Hospital in Delhi: Indian J Public Health. 2010; 54:213-5. 10. Oza SS, Mehta JS, kikani KM, Oza GS:Bacteriological profile and antibiogram of blood culture isolates from patients of rural tertiary care hospital: Int J Microbiol Myco.2016;4(3): 1-7. 11. 12.Lee,A,S.Mirrett,L.B.Reller and M.P.Weinstein:Detection of bloodstream infections in adults,How many blood cultures are needed?:J Clin Microbiol.2007;45:3546-3548. 12. China and Gupta V: Bacteriological profile and antimicrobial susceptibility pattern of blood isolates from a tertiary care hospital in North India:Int J Pharm Sci Res.2013;2: 24–35, 2013. 13. Kamga HLF, Njunda AL and Nde PF:Prevalence of septicemia and antibiotic sensitivity pattern of bacterial isolates at the University Teaching Hospital:Afr J Cln Exper Microbiol.2011;12(1):2–8. 14. Sharma R, Sharma R and Gupta S: Bacteriological Analysis of Blood Culture Isolates with their Antibiogram from a Tertiary Care Hospital:Int J Pharm Sci Res.2015;6(11): 4847-5. 15. Mehta M, Dutta P, and Gupta V: Antimicrobial susceptibility pattern of blood isolates from a teaching hospital in North India: J Infect Dis.2005; 58(3):174–176. 16. Roy, Jain A, Kumar M, and Agarwal SK:Bacteriology of neonatal septicemia in a tertiary care hospital of Northern India:Indian J Med Microbiol.2002;20:156–159. 17. Devi V, Sahoo B, Damrolien S, Praveen S, Lungran P, Devi M:A study on the bacterial profile of bloodstream infections in Rims Hospital:J Dent Med Sci.2015;14:18-23. 18. Karlowsky A, Jones ME, Draghi DC, Thornsberry C, Sahm DF, and Volturo GA: Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States: Ann Clin Microbiol Antimicrob.2004; 3(7). 19. Radji M, Fathni R, Fauziyah S: Evaluation of surgical antibiotic prophylaxis in tertiary care hospital in jakarta Indonesia:Experi J.2014;18(4):1292-6. 20. Vera VP, Igor F, Goran P, Novak S, Abram M, Ulf Bergman:Antimicrobial use at a university hospital: appropriate or misused? A qualitative study:Int J Clin Pharmacol Ther. 2007;45(3):169-74.
Comparative study of indications, complications and outcome of elective and emergency intubation
Swati Chavan, Rupal Padhiyar, Aniket Mohite, Swapnil Dhampalwar
Objectives: Acute respiratory failure frequently necessitates the introduction of endotracheal tube to maintain airway patency and for mechanical ventilation. Intubation is a procedure in day today practice in EMS, medical wards, operation theatres. This is study done retrospectively of 200 patients to correlate the factors which affect outcome of intubation age, sex, nature of underlying disease. The purpose of this study is also to determine whether intubation alone or subsequent tracheostomy in previously intubated patients can prognosticate outcome and the complications of endotracheal intubation and tracheostomy as acquired either during the procedure, with tube in situ or on extubation. Methods: A retrospective study of 200 adult patients was conducted, who satisfied inclusion and exclusion criteria for intubation on elective or emergency grounds over a period of 18 months. Patient’s demographic data along with lab tests of Sr. Creatinine, Sr. K+, ABG analysis, chest X-ray, Mallampatti grade was noted. The indication for intubation as elective or emergency was based on ABG or severity of respiratory failure or for tracheal toileting. SOFA score, GCS score at Admission and 48 hrs was noted. Results: In this study, 200 patients were intubated. Out of which 137 were elective and 63 emergency and 146 were Males and 54 were Females. Major age group was 21- 40 years. Organ involvement in form of respiratory (168 patients), hepatic(19 patients), renal failure(44 patients) or MODS (18 patients) didn’t affect outcome in these patients. The overall mortality rate of the study was 37%. The disease specific mortality for sepsis patients was 100%, Coma was 56.2% and pneumonia was 52.4%. The elective intubated patients had lower mortality (32.1%) compared to that of emergency intubated patients (47.6%). Conclusion: Patients have to be intubated electively and early tracheostomy at 72- 96 hrs has improved survival.
1. Roger R.M., Waller C.: The impact of intensive care unit on survival of patient with acute respiratory failure, Chest 1978, 61 (1). 2. John. L. Stuffer, Daniel. L. Olson et al: Complication and consequences of intubation- A prospective study of 150 critically ill patients. The American Journal of Medicine, 70, 65-75, 1981. 3. Pinsky M.Z., Mutuschak G.M. et al: Multiple system organ failure, Critical care unit, Vol 5 (2), 195-198, 1989. 4. Gnanamuthu C, Ray D. outcome of patients with fulminant Guillain-Barre syndrome on mechanical ventilatory support. Indian J Chest Dis Allied Sci 1992, 34, 65-72. 5. Lawn ND, Fletcher DD, Henderson RD, Wolter TD, Wijdicks EFM. Anticipating mechanical ventilation in Guillain-Barre syndrome. Arch Neurol. 2001; 58: 893-8. 6. Wijdricks EF, Henderson RD, McDolland RL. Emergency intubation in Guillain-Barre syndrome. Arch Neurol. 2003, 69, 947-948. 7. Neuromuscular Respiratory Failure in Guillain-Barre Syndrome: Evaluation of Clinical and Electrodiagnostic Predictors : Uma Sundar, Elizabeth Abraham, A Gharat, ME Yeolekar, Trupti Trivedi, N Dwivedi. JAPI- Vol. 53, September 2005 8. AlÃa I, Esteban A, Anzueto A, Gordo F, ApezteguÃa C, Pálizas F et al. (2000). "How is mechanical ventilation employed in the intensive care unit? An international utilization review." Am J Respir Crit Care Med 161 (5): 1450–1458. 9. Esteban A, Anzueto A, Gordo F et al: Characteristics and outcomes in patients receiving mechanical ventilation. JAMA 2002, 287, 345-355. 10. Udwadia F.: Mechanical ventilation in critically ill- Principles of critical care, 2nd Edition, Page 311-338. 11. Price K J, Cardenas, Turanzas M, Lin H et al: Prognostic indicators of mortality of mechanically ventilated patients with acute leukemia in a comprehensive cancer center. Minerva Anestesiol 2013 Feb; 79(2):147-55. 12. Jaber, Samir, Jean-Yves, Charles, Robert, et al: Clinical practice and risk factors for immediate complications of endotracheal intubation in the intensive care unit: A prospective, multiple-center study. Critical Care Medicine: September 2006 - Volume 34 - Issue 9 - pp 2355-2361. 13. Donald E. G. Griesdale, T. Laine Bosma, Tobias Kurth, George Isac, Dean R. Chittock: Complications of endotracheal intubation in the critically ill. Intensive Care Medicine. Volume 34, Issue 10, pp 1835-1842. 14. Evans A, Vaughan R S, Hall J E, Mecklenburgh J, Wilkes A R: A comparison of the forces exerted during laryngoscopy using disposable and non-disposable laryngoscope blades. Anaesthesia: 2003, 58, 869-73.
Anthocyanin from red tamarind, Tamarindus indica var. rhodocarpa as a potential natural pigment for use in textile industry
L M Lenora, D Suresh Babu, R Sumathi, A Mayavel, S Murugesan, N Senthilkumar
Anthocyanin from red tamarind, Tamarindus indica var. rhodocarpa as a potential natural pigment for use in textile industry
1. Chandan Kumar Jha, Ratan Kumar, Venkat Kumar S and Devi Rajeswari V: Extraction of natural dye from marigold flower (Tageteserectal.) and dyeing of fabric and yarns: A focus on colorimetric analysis and fastness properties: Der Pharmacia Lettre. 2015; 7 (1):185-195. 2. Kundal J, Singh SV, Purohit MC: Extraction of Natural Dye from Ficus cunia and Dyeing of Polyester Cotton and Wool Fabric Using Different Mordants, with Evaluation of Colour Fastness Properties: Nat Prod Chem Res. 2016; 4: 214. 3. Mohammad Gias Uddin: Extraction of ecofriendly natural dyes from mango leaves and their application on silk fabric: Textiles and Clothing Sustainability. 2015; 1:7.
Significance of cerebral and umbilical artery doppler velocimetry in normal and growth restricted pregnancy
V S Prasannakumar Reddy, Aradhana Giri, N Bhavani, Togarikar
Background: Doppler velocimetry is a rapid non invasive test that provides valuable information about hemodynamic situation of the fetus and is an efficient diagnostic test of fetal jeopardy which helps in timely intervention and management of high risk pregnancy for better perinatal outcome. Material and Methods: This is a prospective study including 40 women with normal singleton pregnancy and 40 women with Intra uterine growth restricted pregnancy carried out over a period of 1 year from april 2015 to march 2016 at MNR Medical College and Hospital, Sangareddy. Results: Umbilical artery mean pulsatility index and resistive index were significantly greater in IUGR pregnancy as compared to normal pregnancy. Systolic/diastolic (S/D) ratios were comparable in both the groups. There was significant reduction in cerebroumbilical (C/U) ratio in IUGR pregnancy as compared to normal pregnancy suggesting presence of a brain sparing effect. 17.5% patients in study group had absent end diastolic volume (AEDV) and 2.5% had reversal of end diastolic volume. Conclusion: In normal pregnancy, there is gestational age related fall in impedance in umbilical and middle cerebral arteries. Doppler study of umbilical artery is highly sensitive in the detection of IUGR while Middle cerebral artery doppler is useful for the prediction of adverse perinatal outcome in small for gestational age.
1. Battalgia FC, Lubchenko LO. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967; 71:159-63. Level II-3. 2. Berkowitz GS, Chitkara U, Rosenberg J et al. Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of IUGR. A prospective study. Am J obstetrics and Gynaecology 1988; 158:1149-53. 3. Mari G, Moise KJ Jr, Deter RL et al. Doppler assessment of the pulsatility index in the cerebral circulation of the human fetus. Am J obstetrics and Gynaecology 1989; 160:698-703. 4. Mari G, Deter RL. Middle cerebral artery flow velocity waveforms in normal and small for gestational age foetuses. Am J obstetrics and Gynaecology 1992; 166:1262-70. 5. Rochelson BL, Schulman H, Fleischer A et al. The clinical significance of Doppler umbilical artery velocimetry in the small for gestation fetus. Am J obstetrics and Gynaecology 1987; 156:1223-6. 6. Harrington K, Thompson MO, Carpenter RG et al. Doppler fetal circulation in pregnancies complicated by pre-eclampsia or delivery of a small for gestational age baby: 2. Longitudinal analysis. Br J obstetGynaecol 1999; 106:453-66. 7. Wladimiroff JW, VdWijingaard JA, Degani S et al. Cerebral and umbilical arterial blood flow velocity waveforms n normal and growth retarted pregnancies. ObstetGynecol 1987; 69:705-9. 8. Lakhar BN, Ahamed SA. Doppler velocimetry of uterine and umbilical arteries during pregnancy. Indian J Radiol Imaging 1999; 9:119-25. 9. Khurana A, Chawala J, Singh K. Normal systolic/diastolic ratios of the umbilical artery flow velocity waveforms in Indian pregnancies. Indian J Radiol Imaging 1995; 5:25-8. 10. Narula H, Kapila AK, Kaur MM. Cerebral and Umbilical arterial blood flow velocity in normal and growth retarded pregnancy. J obstetGynaecol India January/February 2009; vol.59, 1:47-52. 11. Kirkinen P, Muller R, Huch R et al. Blood flow velocity waveforms in human fetal intracranial arteries. ObstetGynecol 1987; 70:617-21. 12. Gramilleni D, Folli MC, Raboni S et al. Cerebral umbilical Doppler ratio as a predictor of adverse perinatal outcome. ObstetGynecol 1992; 79:416-20. 13. Chandran R, Serra-Serra V, Sellers SM et al. Fetal cerebral Doppler in the recognition of fetal compromise. Br J ObstetGynecol 1993; 100:139-44. 14. Serag Y, Ozay O, Birgul G et al. Ratio of Middle cerebral to umbilical artery blood velocity in preeclamptic and hypertensive women in the prediction of poor perinatal outcome. Indian J Med Res 2004; 120:44-50.
Histopathological study of tumours of adipose tissue
Shilpa Premkumar, Prema Saldanha
Background: Tumours of adipose tissue form one of the largest single groups of soft tissue tumours. The benign, subcutaneous lipoma is the most common soft tissue neoplasm in adults, liposarcoma being the most common primary soft tissue malignancy. Objective: To study the morphological features of the various adipocytic tumours received in the Department of Pathology. Materials and Methods: Cases of adipocytic tumours were retrieved from the archives of the Department of Pathology. Results: The total number of cases numbered 155. Amongst these, 143 (92%) were benign and 12 (8%) were malignant. In benign cases, patients were in the age group 4-75 years, with 88 males and 55 females. Among the malignant cases, patients were in the age group 14-68 years, with 7 males and 5 females. The peak age distribution in both benign and malignant cases was in the fourth decade. The most common site of involvement was the nape of neck, followed by back and upper limbs. Conventional lipoma was the most common benign tumour. Variants of lipoma like angiolipoma, chondroid lipoma, dermolipoma etc was noted. Of the 12 malignant tumours, 6 cases were well differentiated liposarcoma, 2 cases variant of myxoid liposarcoma, and one case each of pleomorphic liposarcoma, lipoleiomyosarcoma and lipoma with sarcomatous changes. Conclusion: Conventional lipomas were the most common adipocytic soft tissue tumours. Malignant cases were rare, and among them, the most common malignant tumour was well-differentiated liposarcoma.
1. Marsden H B, Lawler W. Fletcher. Tumors Of Soft Tissue, In:Fletcher DM. Diagnostic Histopathology Of Tumors. 4th ed:Saunder Elsevier Inc; 2013: 1474-85. 2. Pathology and Genetics of Tumours of the Soft Tissue. In WHO Classification of Tumours. Hamilton.SR, Aaltonen.LA, eds. IARC Press Lyon 2016. 3. Ekanem VJ, Aligbe JU. Histopathological Analysis of Soft Tissue Sarcoma as seen in Benin City, Nigeria: A Ten Year Review (1995-2004). Nig J Gen Pract. 2006: 7:39-43. 4. Kransdorf JM. Benign Soft Tissue Tumors in a Large Referral Polulation: Distribution of Specific Diagnosis by Age, Sex and Location. AJR 1995; 164: 395-402. 5. Hameed M. Pathology and genetics of adipocytic tumors. Cytogenet Genome Res; 2007; 118: 138–47. 6. Angelo PD. Liposarcoma: New Entities and Evolving Concepts. Annals of Diagnostic Pathology. 2000; 4: 252-66. 7. Rydholm A, Berg NO. Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipoma and sarcoma. Acta Orthop Scand.1983 Dec; 54: 929-34. 8. Mohammed U, Samaila O, Abubaker M. Pattern of adipose tissue tumors in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Annals of Nigerian Medicine. 2014; 8: 8-10. 9. Seleye-Fubara D, Etebu EN. Adipose tissue tumour in Port Harcourt: A ten year review. Sahel Med J 2005; 8:92-4. 10. E I. Odokuma, V J. Ekanem, O E. Osemeke. Histopathologic Patterns of Adipocytic Tumours in University of Benin Teaching Hospital; a Twenty Year Retrospective Study. Annual Research and Review in Biology. 2015; 5: 553-62.
Bacteriological profile of Urinary Tract Infections in pregnant women – Future Challenges
Natasha Sawhney, Rahul Prabhas, Varsha A Singh
Background: Pregnancy causes numerous changes in the woman’s body. Hormonal and mechanical changes increase the risk of urinary stasis and vesicoureteral reflux. These changes, along with an already short urethra and difficulty with hygiene due to a distended pregnant belly, increase the frequency of urinary tract infections (UTIs) in pregnant women. Indeed, UTIs are among the most common bacterial infections during pregnancy, Urinary tract infections remain one of the most common infections and a leading cause of morbidity in human population. Aims and Objectives: To study Bacteriological Profile of Urinary Tract Infections in Pregnant women at a Tertiary health care center Methodology: This was a cross-sectional study carried out in the department of Microbiology in association with department of Obstetrics and Gynaecology of a tertiary health care center during one year period i.e. March 2013 to March 2014 in 280 Samples of Suspected UTI in pregnant women. Fifty six samples were culture positive and were addressed for Antibiotic Sensitivity Testing (AST) as per the standard protocols. Results: The most commonly observed bacteria was E. coli (39.29%) and Staphylococcus aureus (19.64%), followed by Coagulase negative staphylococcus (16.07%), Klebsiella sp. (12.50%), Enterococci sp. (8.93%) and Acinetobacter sp. (3.57 %). Escherichia coli was most commonly sensitive to Nitofurantoin (77.27%), Klebsiella to Norfloxacin (71.43%), and Acinetobacter was 100% senstive to Amoxiclav, Amikacin, Tetracyclines and Norfloxacin. In Gram positive pathogens, Staphylococcus aureus was mostly sensitive to Cotrimoxazole and Erythromycin. Conclusion: It can be concluded from our study that commonly observed bacteria were E. coli and Staphylococcus aureus causing UTI in pregnant women. All pregnant women should be screened for UTI with a urine culture and treated with antibiotics if the culture is positive
1. Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults.Clin Infect Dis. 2005 Mar 1. 40(5):64354 2. Rajan S, Prabavathy J. Antibiotic sensitivity and phenotypic detection of ESBL producing E. coli strains causing urinary tract infection in a community hospital, Chennai, Tamil Nadu, India. Webmed Central Pharml Sci. 2012;3(11):1-17 3. Kamat US, Fereirra A, Amonkar D, Motghare DD, Kulkarni MS. Epidemiology of hospital acquired urinary tract infections in a medical college hospital in Goa. Indian J Urol. 2009; 25:76-80 4. Kumar R, Dahiya SS, Hemwani K, Srivastava P. Isolation of human pathogenic bacteria causing urinary tract infection and their antimicrobial susceptibility pattern in a tertiary care hospital, Jaipur, India. Int Res J Med Sci. 2014;2(6):6-10 5. Syed MA, Ramakrishna PJ, Shaniya K, Arya B, Shakir VP. Urinary tract infections- an overview on the prevalence and the antibiogram of Gram negative uropathogens in a tertiary care centre in north Kerala, India. J ClinDiag Res. 2012;6(7):1192-5 6. Cheesbrough M. District laboratory practice in tropical countries second edition. Cambridge: Cambridge University press; 2006. pp. 62–143. 7. Acharya VN. Urinary tract infection- a dangerous and unrecognized forerunner of systemic sepsis. J Post Grad Med. 1992; 38:52-4. 8. ShaistaBano, Sarfraz A Tunio, AmeerAfzalMenom, Hakim Detho,RozinaBano, Kalpanakumari. Evaluation of antibiotic susceptibility patterns of uropathogens circulating in Hydrabad, Pakisthan. Khyber Med Univ J 2014; 6(3):110-115. 9. Rama Biswas, RaihanRabbani, HasanShahrear Ahmed, Mohammed Abdus Satter Sarkar, NahidaZafrin, Md. Motlabur Rahman. Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital. Bangladesh Crit Care J.2014 March;2(1):21-24 10. Humayun, T., Iqbal, A. 2012. The Culture and sensitivity pattern of Urinary Tract Infections in Females of Reproductive Age Group. Ann. Pak. Inst. Med. Sci.8(1): 19–22 11. McKenzie H, Donnet ML, Howie PW, Patel NB, Benvie DT. Risk of preterm delivery in pregnantwomen with group B streptococcal urinary infections or urinary antibodies to group B streptococcal and E. coli antigens. Br J ObstetGynaecol. 1994 Feb. 101(2):10713 12. Sibi, G., Devi, A. P., Fouzia, K., and Patil, B. R. 2011. Prevalence, microbiologic profile of urinary tract infection and its treatment with trimethoprim in diabetic patients. Research Journal of Microbioogy. 6: 543-551 13. Varsha Rani Gajamer, Hare Krishna Tiwari, PremDorjee Bhutia, SankhaSubra Sen, Ranadeep Ghosh, ArunabhaSarkar. Detection of antibiotic resistance pattern with ESBL producers and MRSA among uropathogens at tertiary health care centre, North Bengal. International Journal of Pure and Applied Bioscience.2015 April;3(2):522-533 14. Hooton, T.M., Roberts, P.L., Cox, M.E. and Stapleton, A.E. (2013) Voided Midstream Urine Culture and Acute Cystitis in Premenopausal Women. New England Journal of Medicine, 369, 1883-1891. http://dx.doi.org/10.1056/NEJMoa1302186 15. Naylor, G.R. (1984) A 16-Month Analysis of Urinary Tract Infection in Children. Journal of Medical Microbiology, 17, 31-36. http://dx.doi.org/10.1099/00222615-17-1-31 [6] Travis, L.B. and Bruhard, B.H. (1991) Infections of the Urinary Tract. In: Rudolph, A.M., Ed., Rudolph’s Paediatrics, 19th Edition, Appleton and Lange, Stamford 16. Warren, J.W. (1987) Catheter-Associated Urinary Tract Infections. Infectious Disease Clinics of North America, 1, 823-854. [8] Eghafona, N.O., Evbagharu, P.A. and Aluyi, H.A.S. (1998) Paediatric Urinary Tract Infection in Benin City, Nigeria. Journal of Medical Laboratory Sciences, 7, 59-61 17. Obiogbolu, C.H., Okonko, I.O., Anymene, C.O., Adedeji, A.O., Akanbi, A.O., Ogun, A.A., Ejembi, J. and Faleye, T.O.C. (2009) Incidence of Urinary Tract Infections (UTIs) among Pregnant Women in Awka Metropolis, Southeastern Nigeria. Scientific Research and Essay, 4, 820-824 18. Mamatha P Samaga. Bacteriological Profile of Urinary Tract Infections in Pregnant Women Indian J Microbiol Res 2016;3(1):17-21 19. C. M. Ogbukagu. Incidence of Urinary Tract Infections (UTI) amongst Patients Attending Primary Health Centres in Anambra State. Advances in Microbiology, 2016, 6, 537-547 20. Tazebew Demilie,Getenet Beyene, Selabat Melaku, Wondewosen Tsegaye. URINARY BACTERIAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN AMONG PREGNANT WOMEN IN NORTH WEST ETHIOPIA. Ethiop J Health Sci. 2012;22(2):121-128 21. Dybowski B, Bres-Niewada E, Radziszewski P. Pressure-flow nomogram for women with lower urinary tract symptoms. Arch Med Sci 2014; 10: 752-56 22. Carlet J, Jarlier V, Harbath, et al. Ready for a world withoutantibiotics? The Pensieres antibiotic resistance callto action.Antimicrob Resist Infect Control 2012; 1: 1-2 23. Sabharwal ER. Antibiotic susceptibility patterns of uropathogensin obstetric patients. N Am J Med Sci 2012;4: 316-19 24. McIsaac W, Carrol JC, Biringer A, et al. Screening for asymptomatic bacteriuria in pregnancy. J ObstetGynaecol Can 2005; 27: 20-24 25. Rizvi M, Khan F, Shukla, et al. Rising prevalence of antimicrobial resistance in urinary tract infections during pregnancy: necessity for exploring newer treatment options.J Lab Physicians 2011; 3: 98-103 26. Bojar I, Owoc A, Humeniuk E, Fronczak A, Walecka I. Quality of pregnant women’s diet in Poland – macro-elements. Arch Med Sci 2014; 10: 361-65