Manish Nigam, Preeti Nigam, Rakesh Kumar Paswan
In Indian culture maleness is matter of pride. The concept of maleness in India is preoccupied by various culturally reinforced false concepts. One of them is nocturnal emission induced physical weakness and sexual weakness. Despite of compelling scientific evidences that nocturnal emission is a normal physical process and has nothing to do with sexual or physical weakness, it is very difficult to treat psychopathology associated with nocturnal emission.
1. Kinsey, Alfred. 1948. Sexual Behavior in the Human Male. Philadelphia: W. B. Saunders 2. Meng, X et al "Fresh semen quality in ejaculates produced by nocturnal emission in men with idiopathic anejaculation". Fertility and Sterility. 3. LaBerge, S., Greenleaf, W., and Kedzierski, B. (1983). Physiological responses to dreamed sexual activity during lucid REM sleep. Psychophysiology, 20, 454-455. 4. Chris G. McMahon-Premature ejaculation a meta-analysis Indian J Urol. 2007 Apr-Jun; 23(2): 97–108.
Kanchana S Pillai, Trupti H Trivedi, Nivedita D Moulick
Aims: To study the age, sex, seasonal distribution and the clinical profile of different types of acute poisoning cases admitted to the ICU, and to determine outcome in the form of duration of stay and mortality and factors affecting it. Methods: This was a cross sectional observational study conducted in the MICU of a tertiary care hospital over a period of 12 months. Acute poisoning cases were studied. Outcome was measured in the form of duration of ICU stay and mortality. Results: There were a total of 714 admissions over 12 months, of which 149 were acute poisoning cases (20.8%). Among poisoning patients, males were 98/149 (65.7%). Age distribution: 12-19 yrs - 16.7%, 20-34 yrs - 44.9%, 35-49yrs - 26.1%, 50-69 yrs -10.7%, 70 yrs and above - 1.3%. Suicidal intent was the most common cause of poisoning (135/149, 90.6%). Pesticide is the most commonly used poison, majority being organophosphorus compounds OPC) (95/149 patients). Most common clinical features were vomiting, anxiety/ restlessness and cholinergic crisis. Most common ECG finding was bradycardia. Twenty two of 149 patients had a SOFA score of >11 (14.7%), 31 had score between 9 and 11 (20.8%) and 96 had score < 9 (64.4%). Most common complications seen were delirium due to atropinisation, electrolyte disturbance and intermediate syndrome. There were 22/ 149 deaths (Mortality of 14.7%), which was significantly less compared to mortality among non-poisoning group of patients (192/714,26.9%, p value < 0.01). Higher SOFA score significantly increased the risk of mortality among poisoning patients. (p- 0.01). Conclusion: Pesticides are the most common agents seen among the acute poisoning admissions in the MICU and young adult male population constitute majority. Mortality among the poisoning patients was significantly lower compared to the non-poisoning patients, and was mainly due to OPC. Higher SOFA score was associated with adverse outcome among the poisoning patients.
1. Gargi J, Rai H, Chanana A, Rai G, Sharma G, Bagga IJ. Current trend of poisoning-a hospital profile. J Indian Med Assoc. 2006 Feb; 104(2):72-3, 94. 2. K. N. Ramesha, Krishnamurthy B, H. Rao, Ganesh S. Kumar. Pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka, India. Indian J Crit Care Med. 2009 Jul-Sep; 13(3): 152–155. 3. Omender Singh, Yash Javeri, Deven Juneja, Manish Gupta, Gurpreet Singh, Rohit Dang. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth. 2011 Jul-Aug; 55(4): 370–374. 4. Kumar Shrinivasan. A profile of acute self drug poisoning: Our experience in a tertiary care medical college teaching hospital. International journal of biomedical and advanced research.Vol 7, No 8 (2016). 5. J hojer, S.Baehrendtz, L.Gustafsson. Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period. Journal of Internal Medicine. DOI: 10.1111/j.1365-2796.1989.tb01365.x 6. Mokhlesi B, Leikin JB, Murray P, Corbridge TC. Adult Toxicology in Critical Care Part II: Specific Poisonings. Chest. 2003 Mar; 123(3):897-922. 7. Srivastava A, Peshin SS, Kaleekal T, Gupta SK. An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. Hum Exp Toxicol. 2005 Jun; 24(6):279-85. 8. B. Maharani, N. Vijayakumari. Profile of poisoning cases in a Tertiary care Hospital, Tamil Nadu, India. Journal of Applied Pharmaceutical Science Vol. 3(01), pp.091-094, January, 2013. 9. Peter J, Sudarsan T, Moran J. Clinical features of organophosphate poisoning: A review of different classification systems and approaches. Indian Journal of Critical Care Medicine. 2014; 18(11):805. 10. Kim Y, Yeo J, Kang M, Lee J, Cho K, Hwang S et al. Performance Assessment of the SOFA, APACHE II Scoring System, and SAPS II in Intensive Care Unit Organophosphate Poisoned Patients. Journal of Korean Medical Science. 2013; 28(12):1822.
Megha Wani, Rajashree Purohit
Objective: To study category wise occurrence of breast lesions according to BIRADS mammography lexicon. To calculate age group wise occurrence of each category. To access usefulness of this lexicon to reduce the rate of unnecessary biopsies and histopathological examination. Materials and Methods: This is observational study of 2763 patients in age group of 20 to 80 years. Mammography findings were classified into various categories according to BIRADS mammography lexicon. Occurrence of each category and age wise distribution of each category done. Results: Majority of patients were found in 31 to 40 years age group. BIRADS category I is found to be commonest category followed by BIRADS category II. BIRADS category I and II are commonly seen in 31 to 40 years age group. Potentially malignant lesions that is BIRADS Category IV and V were found commonest in 31 to 50 years of age group. Conclusion: Commonest category of breast lesions is BIRADS category I and II. Categorising the lesion in these two categories defers the clinician from doing biopsies and histopathological examination. Category 4 and 5 are seen to be more common in younger patients in addition to older population.
1. SUSAN KLEIN, M.D., Southern Illinois University School of Medicine, Decatur, Illinois,Evaluation of Palpable Breast Masses,May 1, 2005 Volume 71, Number 9 www.aafp.org/afp American Family Physician 1] 2. Constance D. Lehman1,Amie Y. Lee,Christoph I. Lee, Imaging Management ofPalpable Breast Abnormalities, AJR:203, November 2014. 3. [Emine Devolli-Disha¹*, Suzana Manxhuka-Kërliu², Halit Ymeri¹, ArbenKutllovci, comparative accuracy of mammography and ultrasound in women with breast symptoms according to age and breast density, BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES 2009; 9 (2): 131-136] 4. [GHEONEA IOANA ANDREEA(1), RALUCA PEGZA(2), LUANA LASCU(3),SIMONA BONDARI(1), ZOIA STOICA(1), A. BONDARI, The Role of Imaging Techniques in Diagnosis of Breast Cancer, Current Health Sciences Journal Vol. 37, No. 2, 2011 5. [Expert Panel on Breast Imaging: Linda Moy, MD1 ; Samantha L. Heller, MD, PhD2 ; Lisa Bailey, MD3 ; Carl D’Orsi, MD4 ; Roberta M. DiFlorio, MD5 ; Edward D. Green, MD6 ; Anna I. Holbrook, MD7 ; Su-Ju Lee, MD8 ; Ana P. Lourenco, MD9 ; 6. Martha B. Mainiero, MD10; Karla A. Sepulveda, MD11; Priscilla J. Slanetz, MD, MPH12; SunitaTrikha, MD13; Monica M. Yepes, MD14; Mary S. Newell, MD.15,PALPABLE BREAST MASSES, American College of Radiology ACR Appropriateness Criteria® Palpable Breast Masses.] 7. [Nehmat Houssami1–3 Les Irwig2 Judy M. Simpson2 Merran McKessar1,4 Steven Blome1,5 Jennie Noakes4,Sydney Breast Imaging Accuracy Study: Comparative Sensitivity and Specificity of Mammography and Sonography in Young Women with Symptoms,AJR 2003;180:935–940] 8. Bellantone R, Rossi S, Lombardi CP, et al. Nonpalpable lesions of the breast. Diagnostic andtherapeutic considerations. Minerva Chir 1994;49:327–333] 9. Sachin Prasad N*, Dana Houserkova, a comparison of mammography and ultrasonography in the evaluation of breast masses, Biomed Pap Med FacUnivPalacky Olomouc Czech Repub. 2007, 151(2):315–322] 10. Elizabeth S. Burnside, MD, MPH, MSa, Edward A. Sickles, MDb, Lawrence W. Bassett, MDc, Daniel L. Rubin, MD, MSd, Carol H. Lee, MDe, Debra M. Ikeda, MDd, Ellen B. Mendelson, MDf, Pamela A. Wilcoxg, Priscilla F. Butlerg, and Carl J. D’Orsi, MDhThe ACR BI-RADS® Experience: Learning From History, J Am CollRadiol. 2009 December ; 6(12): 851–860. doi:10.1016/j.jacr.2009.07.023. ] 11. [11,12,13,14,17,18,19,20] D’Orsi CJ, Bassett LW, Berg WA, et al. Breast Imaging Reporting and Data System (BI-RADS). 5th ed. Reston, Va : American College of Radiology, 2013. [15, 22]Margaret M., MPH, Chester H. Fox, MD, Stephen B. Edge, MD, Cathleen A. 12. Carter, PhD, and Martin C. Mahoney, MD, PhD, FAAFP BI-RADS Classification for Management of Abnormal Mammogramsdoi: 10.3122/jabfm.19.2.161J Am Board Fam Med March-April 2006 vol. 19 no. 2 161-164] 13. Elizabeth S. Burnside, MD, MPH, MSa, Edward A. Sickles, MDb, Lawrence W. Bassett, MDc, Daniel L. Rubin, MD, MSd, Carol H. Lee, MDe, Debra M. Ikeda, MDd, Ellen B. Mendelson, MDf, Pamela A. Wilcoxg, Priscilla F. Butlerg, and Carl J. D’Orsi, MDh,The ACR BI-RADS® Experience: Learning From History,J Am CollRadiol. 2009 December ; 6(12): 851860.doi:10.1016/j.jacr.2009.07.023. 14. Janet K. Baum, MD Lucy G. Hanna, MS S uddhasatta A charyya, P hD M ary C. M ahoney, M D E mily F. C onant, M D L awrence W. B assett, M D Etta D. Pisano, MD AL Use of BI-RADS 3–Probably Benign Category in the American College of Radiology Imaging Network Digital 15. Mammographic Imaging Screening Trial. Radiology: Volume 260: Number 1—July 2011;Volume 260:61-67] [23,25] E.K. BRAKOHIAPA1, G.E. ARMAH2, J.N.A CLEGG-LAMPTEY3 and w.o. brakohiapa4,pattern of breast diseases in accra: review of mammography reports,ghana medical journal,Volume 47, Number 3 16. Catherine S. Giess, MD, Lisa Zorn Smeglin, MD, Jack E. Meyer, MD, Julie 17. A. Ritner, MD, Robyn L. Birdwell, MD,Risk of Malignancy in Palpable SolidBreast Masses Considered Probable Benign or Low Suspicion,©2012 by the American Institute of Ultrasound in Medicine J Ultrasound Med 2012; 31:1943–19490278-4297 |www.aium.org 18. web referencehttp://www.breastcancerindia.net/statistics/trends.html] 19. article18:Carey K. Andersa, Rebecca Johnsonb,JenniferLittonc, Marianne Phillipsd, and ArchieBleyer,Breast Cancer Before Age 40 Years,SeminOncol. Author manuscript; available in PMC 2010 June 29.
A B Fuzayel, Banasree Bhadra, N Choudhury, D J Shyam
Background: Hysterectomy is one of the most common surgery performed by Gynaecologist. As the time is passing trend is towards those approaches which are minimally invasive, less painful, have less complications, less blood loss and are more cosmetic. Thus total laparoscopic hysterectomy (TLH) and non descent vaginal hysterectomy (NDVH) has gained popularity. Laparoscopic surgeries requires high-tech Operation Theater (OT) setup, sophisticated instruments and surgical skills. Vaginal hysterectomy descent or non descent is a simple and effective technique for benign pathologies of uterus. Objective: This study was conducted to compare Total Laparoscopic Hysterectomy and Non Descent Vaginal Hysterectomy with reference to fall in blood haemoglobin level, duration of operation, weight of uterus, post-operative complication and post-operative ambulation. Material and Method: This is a prospective comparative (observational) study done among fifty patients who underwent total laparoscopic hysterectomy or non–descent vaginal hysterectomy for various indications in the Department of Obstetrics and Gynaecology in Silchar Medical College and Hospital, Silchar, Assam (India) from January to December 2015. The patients having at least two children, aged more than 35 years and size of the uterus less than 12 weeks size were included. The patients were monitored and data collected included indications of hysterectomy, type of hysterectomy, duration of operation ̦amount of blood loss weight of the uterus etc. Results: TLH cases had lesser blood loss than NDVH cases. NDVH took shorter operating time (96.8 min) than TLH (101.2 min). The Patients who underwent TLH ambulated early (22.4hrs) in comparison to NDVH group (27.24hrs). NDVH group had lesser complications in comparison to TLH. Conclusion: NDVH is better in its approach through natural orifice, faster and less expansive. In which way to approach the uterus shall depend upon skill of the surgeon, size and pathological nature of uterus, facilities available in the hospital and preference of patient as well as surgeon. In peripheral hospitals where resources are limited NDVH takes upper hand than TLH as it is more economic, takes lesser time, requires less surgical techniques in comparison to TLH.
1. Chattopadhyay S et al, A comparative study of total laparoscopic hysterectomy and non descent vaginal hysterectomy for treatment of benign diseases of uterus. Int J Reprod Contracept Obstet Gynecol.2017 Mar ;6 ( 3):1109- 1112 2. Singh AJ, Arora AK. Effect of uterine prolapse on the lines of rural North Indian women. Singapore. J Obstet Gynecol. 2003; 34:52-8. 3. Reena De, Goswami S. A Comparative study of Laparoscopic assisted vaginal hysterectomy and non descent vaginal hysterectomy. JSAFOG, May – August 2014; 6(2):101-103. 4. Roy KK, et al. A prospective randomized study of total laparoscopic hysterectomy, laparoscopically assited vaginal hysterectomy and non descent vaginal hysterectomy for the treatment of benign diseases of uterus. Arch Gynecol Obstet.2011 Oct; 284(4):907-912.Epub 2010Dec 8 5. Khanam NN, et al. Non descent vaginal hysterectomy is reasonable alternative to LAVH? South Asian Fed Obstet and Gynecol 2009 Jan – April; 1(1):47-52. 6. Drahonovsky J, Haakova L, Otcenasek M, Krofta L, Kucera E, Feyereisl J. A prospective randomized comparison of vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy, and total laparoscopic hysterectomy in women with benign uterine disease. Eur J Obstet Gynecol Reprod Biol. 2010; 148(2):172- 6. 7. Chang WC, Huang SC , Sheu BC,Cen CL, Torng PL, Hsu WC,et al. Transvaginal hysterectomy or laparoscopically assisted vaginal hysterectomy for non prolapsed uteri. Obstet Gynecol2005; 106:326-321. 8. Muller A, Thiel FC, Renner SP, Habenle, Beckmann MW. Hysterectomy-a comparison of approaches. Dtsch Arztebl Int. 2010; 107(20):353-9. 9. Candiani M,Izzo S, Bulfoni A, Riparini J, Ronjoni s, Marconi A , et al. Laparoscopy vs vaginal hysterectomy for benign pathology.Am J Obstet Gynecol 2009 April; 200(4):368. 10. Aniuliene R, Varzgaliene L, Varzgalis M. A comparative analysis of hysterectomies. Medicina (Kaunas). 2007; 43(2):118-24.
Anurup Sahu, K Kashi Viswanadham
Background: Systemic hypertension has been considered to be associated with adult population. But off late increase numbers of children are also being affected. Aims and Objectives: To Study prevalence of Hypertension and its associated factors in school children Methodology: This was a Cross -sectional study carried out among the School going children in the age between 7-16 with respect to Prevalence of Hypertension in the one month i.e. January 2016 to February 2016. Totally 1075 students after the consent of Parents were enrolled into study in all the students the basic anthropometric measurement were done and BMI in all of them was calculated, all the important history like family history of Hypertension, Diabetes. The statistical analysis done by Chi-square test/trend calculated by SPSS version 19. Result: The prevalence of Hypertension for Males in 7-10 was 3.47%, followed by in 10-13 was 12.65%, and in 13-16 was 23.36%, this increasing trend with increase in age of Hypertension was statistically significant ( 𝝌2 =33.64, df=1,< 0.0001 ) and also for Female 07-10 was 1.61%, 10-13 was 6.19%, in 13-16 was 6.40% for females also this increasing trend with increase in age of Hypertension was statistically significant (𝝌2 =4.267, df=1, P< 0.0389) Associated factors significantly associated with Hypertension in children’s were Obesity (𝝌2 =319.7, df=1, P< 0.0001 ), Family history of HTN and IHD (𝝌2 =464.8, df=1,P<0.0001). Family history of Diabetes (𝝌2 =392.1, df=1, P<0.0001) Conclusion: It can be concluded from our study that prevalence of hypertension was increased in students as their age increases also the significantly associated factor with Hypertension were Obesity, Family history of HTN and IHD, Family history of Diabetes.
1. Indian Pediatr 2010;47: 473-474, Hypertension in pediatric patients by Tej K Matto 2. Mitsnefes MM. Hypertension in children and adolescent. Pediatr Clin NorthAm 2006: 53:493-512. 3. Aglony M, Acevedo M, Ambrosio G. Hypertension in adolescents. Expert Rev Cardiovas Therapy. 2009; 7: 1595-603. 4. Buch N, Goyal JP, Kumar N, Parmar I, Shah VB, Charan J. Prevalence of hypertension in school going children of Surat city, Western India. J Cardiovas Dis Res. 2011; 2:228-32. 5. Rahman AJ, Qamar FN, Ashraf S, Khowaja ZA, Tariq SB, Naeem H. Prevalence of hypertension in healthy school children in Pakistan and its relationship with body mass index, proteinuria and hematuria. Saudi J Kidney Dis Transpl. 2013; 24:408-12. 6. Lu X, Shi P, Luo CY, Zhou YF, Yu HT, Guo CY, et al. Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai, China. BMC Public Health. 2013; 13:24. 7. Schiel R, Beltschikow W, Kramer G, Stein G. Overweight, obesity and elevated blood pressure in children and adolescents. European J Med Res. 2006; 11:97-101. 8. Acosta AA, Samuels JA, Portman RJ, Redwine KM. Prevalence of persistent prehypertension in adolescents. J Pediatr. 2012; 160:757-61. 9. Aggarwal R, Mandowara SL, Bhandari B, Garg OP. Prevalence of hypertension in apparently healthy school children. Indian Pediatr. 1982, 19: 779-784. 10. Gupta AK, Ahmad AJ. Normal blood pressures and the evaluation of sustained blood pressure elevation in childhood. Indian Pediatr 1990, 27: 33-42. 11. Londe S, Bourgoigine JJ, Robson AM. Hypertension in apparently normal children. J Pediatr 1971, 78: 569-577. 12. Levine LS, Lewy JE, New MI. Hypetension in high schoold students. NY State J Med 1976, 76: 40-44. 13. Whyte HM. Behind the adipose curtain Australia and New Guinea. Am J Cardiol: 1965, 15: 66-80. 14. Alexander JK. Obesity and circualtion. Mod Concepts Cardiovasc Dis 1963, 32: 799-803. 15. Dahl L, Silver L, Christie R. Role of salt in the fall of blood pressure accompanying reduction of obesity. N Eng J Med 1958, 258: 1186-1192. 16. Gupta AK. Influence of family history of morbid cardiovascular events on blood pressure levels of school children. Indian Pediatr 1991, 28: 131-139.
Lalit Krishna Gothecha, Rajesh Yadav
Background: Magnetic resonance imaging (MRI) is generally considered better than computed tomography (CT) for the diagnosis of Cerebral lesions but this belief has never been substantiated for the full range of patients in whom this diagnosis is suspected Aims and Objectives: To study of CT and MRI-Head for the Detection Acute Cerebral Haemorrhage. Methodology: After approval of institutional ethical committee this cross-sectional study carried out in the patients with suspected of intracranial bleeding at tertiary health center during the two year period i.e. January 2015 to January 2017 referred to the Radiology department of the tertiary health care centre. The details of information clinical history age was noted. All the patients gone through the investigations like MRI and CT consequently. Analyzed by Chi-square test calculated by SPSS 19 version software. Result: The majority of the patients were in the age group of >60 i.e. 57.5% followed by 50-60 were 22.5%, 40-50-13%, 30-40-6%, 20-30 -1%. The majority of the patients were Males i.e. 70.50% and Females were 29.50. For any Haemorrhage MRI positive in 71 ( 35.50%) and CT in 32 (16.00%) this difference is significant (P<0.0001,X2=47.73, df=1), For Acute haemorrhage MRI positive in 47 (23.50%) and CT in 9 (4.50%) but the difference is not significant ( P>0.75, X2=0.09, df=1), For Chronic haemorrhage CT positive in 28(14.00%) cases and in MRI 23 (11.50%) the difference is statistically significant (P<0.0001,X2=121.8, df=1). Conclusions: It can be concluded from our study that MRI was superior to CT in the diagnosis of all types and equal in acute but less superior CT in the diagnosis of chronic haemorrhage.
1. Fiebach JB, Schellinger PD, Gass A, et al. Stroke magnetic resonance imaging is accurate in hyperacute intracerebral haemorrhage: a multicenter study on the validity of stroke imaging. Stroke 2004; 35: 502–06. 2. Grotta JC, Chiu D, Lu M, et al. Agreement and variability in the interpretation of early CT changes in stroke patients qualifying for intravenous rtPA therapy. Stroke 1999; 30: 1528–33. 3. Kidwell CS, Chalela JA, Saver JL, et al. Comparison of MRI and CT for detection of acute intracerebral haemorrhage. JAMA 2004; 292: 1823–30. 4. Wardlaw JM, Mielke O. Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic treatment- systematic review. Radiology 2005; 235: 444–53. 5. Warach S, Gaa J, Siewert B, Wielopolski P, Edelman RR. Acute human stroke studied by whole brain echo planar diff usionweighted magnetic resonance imaging. Ann Neurol 1995; 37: 231–41. 6. Mohr JP, Biller J, Hilal SK, et al. Magnetic resonance versus computed tomographic imaging in acute stroke. Stroke 1995; 26: 807–12. 7. Bryan RN, Levy LM, Whitlow WD, Killian JM, Preziosi TJ, Rosario JA. Diagnosis of acute cerebral infarction: comparison of CT and MR imaging. AJNR Am J Neuroradiol 1991; 12: 611–20. 8. Fiebach JB, Schellinger PD, Jansen O, et al. CT and diff usionweighted MR imaging in randomized order: diff usion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002; 33: 2206–10. 9. Van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 2010; 9:167–176. 10. Shetty VS, Reis MN, Aulino JM, Berger KL, Broder J, Choudhri AF, et al. ACR appropriateness criteria head trauma. J Am Coll Radiol 2016; 13:668–679. 11. Orrison WW, Gentry LR, Stimac GK, Tarrel RM, Espinosa MC, Cobb LC. Blinded comparison of cranial CT and MR in closed head injury evaluation. AJNR Am J Neuroradiol 1994; 15:351–356. 12. Lee H, Wintermark M, Gean AD, Ghajar J, Manley GT, Mukherjee P. Focal lesions in acute mild traumatic brain injury and neurocognitive outcome: CT versus 3T MRI. J Neurotrauma2008; 25:1049–1056. 13. Altmeyer W, Steven A, Gutierrez J. Use of magnetic resonance in the evaluation of cranial trauma. MagnReson Imaging Clin N Am 2016; 24:305–323. 14. Da Rocha AJ, da Silva CJ, Gama HP, Baccin CE, Braga FT, Cesare Fde A, et al. Comparison of magnetic resonance imaging sequences with computed tomography to detect low-grade subarachnoid haemorrhage: role of fluid-attenuated inversion recovery sequence. J Comput Assist Tomogr 2006; 30:295–303. 15. Shimoda M, Hoshikawa K, Shiramizu H, Oda S, Matsumae M. Problems with diagnosis by fluid-attenuated inversion recovery magnetic resonance imaging in patients with acute aneurysmal subarachnoid haemorrhage. Neurol Med Chir (Tokyo) 2010; 50:530–537. 16. Julio A Chalela, Chelsea S Kidwell, Lauren M Nentwich et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007; 369: 293–98 17. Chelsea S. Kidwell, Julio A.Chalela, Jeffrey L. Saver. Comparison of MRI and CT for Detection of Acute Intracerebral Haemorrhage. (Reprinted) JAMA, October 20, 2004; 292(15):1823-1829.
Arunanchal Jha, SudhaBharti
Background: Thyroid gland plays a critical role in cell differentiation during development and health maintaining thermogenic and metabolic homeostasis in the adult. Hypothyroidism occurs in 1 to 2 percent of pregnant females and hyperthyroidism in 0.2%. Aims and Objectives: To monitor thyroid profile in healthy pregnant women. Material and Methods: 600 women of 18 to32 age group attending antenatal clinic and admitted as indoor patients was selected for study. Their thyroid hormone level was checked in all three trimesters. DISCUSSION: The women in this study ranged from 18 to 32 years. Majority of the patients were in the age group 24 to 26 years. Another study in India evaluated 124 pregnant women using Radioimmunoassay showed increase in TSH progressively with each trimester. Conclusion: it is important that thyroid function tests in pregnancy should be interpreted against gestational age related reference intervals and this can decrease the possibility of the misinterpretation of thyroid function tests in pregnant women.
1. ACOG practice bulletin. Clinical management guidelines for obstetrician-gynaecologists. Number 37, 2002. Thyroid disease in pregnancy. Obstetgynecol 2002 2. Bartalena L: Recent achievements in studies on thyroid hormones binding proteins. Endocor Rev 1990 3. BurroGN Thyroid function and hyperfunction during gestation Endochrin. Rev1993 4. Kumar A, Gupta N, Nath T, Sharma JB, Sharma S, Thyroid function tests in pregnancy Indian J Med Sci 2003 5. Lao TT. Thyroid disorders in pregnancy. Curropinobstetgynecol. 6. Mussey RD: Thyroid gland and pregnancy. Am. J obstet and gynecol 1938.
Arunanchal Jha, SudhaBharti
Study of postpartum complications in DMCH
1. IMPAC (Department of reproductive health and research) WHO 2000 2. One health organisation. The world health report 2005 3. Beucher G. J gynecolobstet Biol Reprod (Paris). 2008 Dec,37 suppl8:S244_259 4. Ottesen M. Placenta accreta. Bleeding and disseminated intravascular coagulation following caesarean section. UejeskrLaeger. 1998 Nov, 160(46):6659-60 5. Wisner K L, Parry B L, Pion Lake C M. Clinical practices, posrpartum depression. N Engl J Med. 2002 6. Sibai BM: preeclamsia-eclampsia Cur ProbObstetGynecolFertil 1990.
Sanjay Kumar Jha, Rajiv Ranjan
Background: A joint effusion is a common finding in patient with knee pain and swelling. USG is very much sensitive in detection of fluid. Role of ultrasound is multifaceted. Aims and Objectives: To re-establish the gradually increasing role of USG in detecting pathologies in patients presenting with pain and swelling of knee and also to establish its role in FNAC /Biopsy. Materials and Methods: Selected cases from orthopaedic OPD of Darbhanga Medical College and Hospital constituted the material of my study. A total number of 50 cases of swollen and painful knee joints were studied in these series. Result: In my study I found 23 cases of echo free effusion and 8 cases of echogenic effusion. Most cases of echo free effusion were either due to osteoarthritis or rheumatoid arthritis. Echogenic effusion was mostly related to traumatic injury to the knee. Conclusion: Ultrasound is the first choice of investigation in detecting and diagnosing peri-articular pathology and it is best choice for guidance of needle puncture or biopsy in peri-articular diseases.
1. Bianchi S et al : Sonographic evaluation of lipohaemarthrosis: clinical and in vitro study 2. Selvy B, et al: High resolution sonography of the menisci of the knee 3. Baker WM: On the formation of synovial cysts in the leg in connection with disease of knee joint. 4. Yasuda K, Majima J: Intra-articular gangalion blocking extension of the knee. 5. Miller TT et al : Sonography of patellar abnormalities in children
Background: Under-nutrition is one of the most common causes of morbidity and mortality among children throughout the world, more so in developing nations. Aims and Objectives: To Study Prevalence and Factor Associated with Protein Energy Malnutrion in Less than Six year Children at Tertiary health Centre. Methodology: This was a cross-sectional study carried out in the Pediatric department of a tertiary health care Centre during one year period from June 2014 to July 2015. All the Pediatric Patients were screened for nutritional status by WHO’s criteria to classify under six children into underweight The statistical analysis done by Chi-Square test. Result: Proportion of undernutrition was maximum in13-24 i.e. 70.21% month’s age followed by 25-36 i.e. 68.25; 37-48-69.00%; 49-60-55.26%; and minimum in 61-72-42.11%. Chi-square test was applied to test the difference in age groups of under six children and nutritional status which was highly significant (p<0.0001) proportion of girls suffered from under nutrition was more i.e. 61.87% than boys i.e. 56.96%. No significant difference was observed between boys and girls so far as under nutrition is concerned (p>0.05). Majority of the Factors associated with Underweight in Children were i.e. 59.85% of Lower Socio Economic Status, 55.19% were having In-adequate Immunization; 51.97% were having Frequent diarrheal infections in past one year; 49.46% were having Frequent ARI infections in past one year; 48.38% were having Delayed Colostrum Feeding; 45.87% were have Not –Exclusive Breast feeding ;44.80% were having Late Weaning; 44.08% were having Pre Lacteal feeding; 43.72% were having Inadequate Consumptions of IFA Tablets during ANC by mothers; 42.65% were having Low birth weight; 41.21% were delivered at Home. Conclusion: Overall prevalence found in our study was 58.61% and the risk factors most commonly associated with Underweight children were Lower Socio Economic Status; In-adequate Immunization; Frequent diarrheal infections in past one year; Frequent ARI infections in past one year; Not –Exclusive Breast feeding; Late Weaning; Pre Lacteal feeding; Inadequate Consumptions of IFA Tablets during ANC by mothers; Low birth weight ; deliveries at Home
1. World Health Organization. Management of severe malnutrition: a manual for physicians and other senior health workers; Geneva: 1999. 2. Amsalu S, Tigabu Z. Risk factors for severe acute malnutrition in children under the age of 5: A case-control study. Ethiopian Journal of Developmental Health. 2008; 22:21–25. 3. Progress for children, A Report Card on Nutrition, Number 4, Unicef (Online) 2006 May; Available from:http://www.unicef.org/media/files/PFC_Nutrition.pdf. [Accessed on 26.2.2011]. 4. The World Bank (Online) Malnutrition: prevalence, weight for age (% of children under 5) 2011 Available from: http://data.worldbank.org/indicator/SH.STA.MALN.ZS [Accessed on 04.09.2011]. 5. Unicef India - The Children - Nutrition (Online) Available from:http://www.unicef.org/india/children_2356.htm. [Accessed on 04.09.2011] 6. K. Park, Park’s Textbook of Preventive and Social Medicine,Jabalpur; 21st ed.; M/s BanarsidasBhanot Publishers; 2011:590,491,113. 7. Agarwal V: Integrated Management of Neonatal and Childhood Illness: Continuing Medical Education Module Public Health Department; Sept.2005: 6-8. 8. Harishankar, Dwivedi S, Darbal SB et al. Nutritional status of children Under 6 years of age. Ind J PrevSoc Med, 2004 July –Dec; 35(3and4):156-62. 9. Anna KA, The state of World’s children, UNICEF, 1988: 4. 10. Jeyaseelan L, Lakshman M, Risk factors for malnutrition in south Indian children. J BiosocSci.1997; 29(1):93-100. 11. Manishkumar G, Reshmi M, Ansuman D. Nutrition surveillance in 1 year Old children in urban slum of city Northan India, The Internet Journal Of Epidemiology [serial on the Internet]. 2007 [cited 2012 Oct 2]. (Availablefrom: http://ispub.com). 12. Joshi HS, Joshi MC, Singh A, Determinants Of Protein Energy Malnutrition (PEM) In 0-6 Years Children In Rural Community Of Bareilly. IndianJ.Prev.Soc.Med.2011 Apr; 42(2):154-158. 13. Ray SK, Haldar A, Biswas B, et al, Epidemiology of undernutrition. Indian J Pediatr 2001; 68(11):1025-1030. 14. Farooq A, Calcutti R, Bakshi S, Nutritional Status of Under Fives on Nationa Immunization Day in Srinagar, JK Science 2004Oct; 4(4):177-180 15. Ayaya SO, Esmai FO, RotichJ,Socio-economic factors predisposing under five-year-old children to severe protein energy maknutrtion at Moi Teaching and Referral Hospital, Eldoret, Kenya.EastAfr Med J2004 Aug;81(8): 415- 421. 16. Singh MB, Lakshminarayan J, Fotedar R, Childhood Illness And Malnutrition In Under Five Children In Draught Affected Desert Area Of Western Rajasthan, India.J.Commun.Dis 2006;38(1):88-96. 17. A Basit, S Nair, KB Chakraborthy, BB Darshan, and A Kamath. Risk factors for under-nutrition among children aged one to five years in Udupitaluk of Karnataka, India: A case control study. Australas Med J. 2012; 5(3): 163–167.
Devesh Pratap Singh, Kuldeep Kumar, Rakesh Kumar Paswan, Shweta Singh
There are various modalities like x ray, ultrasonography, CT, MRI, Laparoscopy etc that can be used for making sure and certain diagnosis of isolated abdominal tuberculosis. Among them when these were evaluated with each other using hospital data on abdominal tuberculosis miss rate with many of them was high even so much that the were seem to be un-reliable. Laparoscopic method proved to be more convincing than others.
1. Teh LB, Ng HS, Ho MS, Ong YY. The varied manifestations of abdominal tuberculosis. Ann Acad Med Singapore 1987;16: 488-94 2. Apaydin B, Paksoy M, Bilir M, Zengin K. Value of diagnostic laparoscopy in tuberculosis peritonitis. Eur J Surg 1999;165: 158-63 3. Wells AD, Northover JM, Howard ER. Abdominal tuberculosis: still a problem today. J R Soc Med 1986;79: 149-53 4. Wilairatana P, Wilairatana S, Lekhyananda S, Charoenlarp P. Does laparoscopy have a limited role in diagnosis of fibroadhesive tuberculous peritonitis? Southeast Asian J Trop Med Publ Health 1993;24: 762-5 5. Al Quorain AA, Satti MB, al Gindan YM, al Ghassab GA, al Freihi HM. Tuberculous peritonitis: the value of laparoscopy. Hepato-Gastroenterology 1991;38: 37-40 6. Badaoui E, Berney T, Kaiser L, Mentha G, Morel P. Surgical presentation of abdominal tuberculosis: a protean disease. Hepato-Gastroenterology 2000;47: 751-5 7. Jadvar H, Mindelzun RE, Olcott EW, Levitt DB. Still the great mimicker: abdominal tuberculosis. Am J Roentgenol 1997;168: 1455-60 8. Haddad FS, Ghossain A, Sawaya E, Nelson AR. Abdominal tuberculosis. Dis Colon Rectum 1987;30: 724-35 9. Rodriguez de Lope C, San Miguel Joglar G, Pons Romero F. Laparoscopic diagnosis of tuberculous ascites. Endoscopy 1982;14: 178-9 10. Semenovski AV, Barinov VS, Kochorova MN. Laparoscopy in the complex diagnosis of abdominal and genital tuberculosis. Problemy Tuberkuleza 1999;3: 36-9 11. Wolfe JH, Behn AR, Jackson BT. Tuberculous peritonitis and role of diagnostic laparoscopy. Lancet 1979;i: 852-3 12. Inadomi JM, Kapur S, Kinkhabwala M, Cello JP. The laparoscopic evaluation of ascites. Gastrointest Endosc Clin N Am 2001;11: 79-91 13. Bhargava DK, Shriniwas, Chopra P, Nijhawan S, Dasarathy S. Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy. Am J Gastroenterol 1992;87: 109-12 14. Lambrianides AL, Ackroyd N, Shorey BA. Abdominal tuberculosis. Br J Surg 1980;67: 887-9 15. Tacyilcliz I, Akgun Y, Boylu S. Abdominal tuberculosis: diagnosis and surgical therapy in 139 cases. Br J Surg 1997;84: 92. 16. Tison C, de Kerviler B, Kahn X, Joubert M, Le Borgne J. Video-laparoscopic diagnosis and follow-up of a peritoneal tuberculosis. Ann Chirurg 2000;125: 776-8 17. McLaughlin S, Jones T, Pitcher M, Evans P. Laparoscopic diagnosis of abdominal tuberculosis. Aust NZ J Surg 1998;68: 599-601 18. Kasia JM, Verspyck E, Le Boudec G, Struder C. Peritoneal tuberculosis: value of laparoscopy. J Gynécol Obstét Biol Reprod 1997;26: 367-73
A D Kannamwar, G L Maske, I V Ingole
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common pain relief medicines in the world. Every day lots of people use them for relief from headaches, sprains, arthritis symptoms, and other daily discomforts. In addition to reducing pain, NSAIDs also lower fever and reduce swelling. NSAIDs block the effects of enzymes, specifically Cox-1 and Cox-2 enzymes which play a key role in making prostaglandins leading to less swelling and less pain. But there are risks and side effects with NSAIDs which includes side effects associated with GIT, CVS and Kidney. In this study, adverse effect of Diclofenac sodium, which is one of the most commonly used NSAID, on weight and volume of kidneys of adult Swiss albino mice is demonstrated. It is studied in both, therapeutic as well as more than therapeutic doses, keeping in mind its inappropriate use because of over the counter availability. It is a case control study. In this, adult Swiss albino mice were divided into four groups; one group served as control ( Group D) while each of the remaining three groups were given Diclofenac sodium, 1 mg/ Kg( Group A); 2mg/ Kg (Group B) and 4mg/ kg (Group C) body weight of, for 15 days. All animals were kept in proper living conditions necessary for optimal growth. Weight of animals was recorded before giving medicine i.e. day 1 and again on day 15. Then animals were sacrificed and their kidneys were extracted. Weight and volumes of kidneys were recorded and change pattern in four sets was observed. This short term study showed one of the potential side effects of Diclofenac sodium in the form of increase in weight and volume of kidneys due oedematous changes and cellular toxicity.
1. Burke A, Smyth E M and Fitzgerald G A. Analgesic and Antipyretic agents; Pharmacotherapy of gout. In: Gudmann and Gilman’s the pharmacological basis of therapeutics (Publ. McGraw-Hill Medical publishing division, Edt. Brunton L L, Lazo J S and Parker K L) 2006; 11th edition: pp 671-716. 2. Williams D A, Lemke T N. Non-steroidal anti-inflammatory agents. In: Foye’s principles of medicinal chemistry (Publ. Lippincott Williams and Wilkins, Edt. Borne R F) 2002; 5th edition: pp751-790. 3. Dr. Kannamwar Archana, 2D. Dr. Maske Gajanan L., 3Dr. Ingole Indira V. Adverse Effect of Diclofenac Sodium On Body-Weight And General Behaviour Of Adult Swiss Albino Mice. Indian Journal of Basic and Applied Medical Research; March 2017: Vol.-6, Issue- 2, P. 225-233. www.ijbamr.com P ISSN: 2250-284X, E ISSN: 2250-2858. 4. M. M. Farag, M. Mikhail, R. Shehata, E. Abdel-Meguid And S. Abdel-Tawab. Assessment of gentamicin induced nephrotoxicity in rats treated with low doses of ibuprofen and diclofenac sodium. Clinical Science (1996) 91, 187-191. 5. Chatterjee T. K. The laboratory mouse. In: Handbook of Laboratory mice and rats (Publ. Chatterjee K. K., Calcutta) 1993; 1st edition: pp 3-12. 6. Committee for veterinary medicinal products. The European agency for the evaluation of medicinal products veterinary medicines and inspections. 2003; EMEA/ MRL/ 885/ 03- Final 7. Waggan I A. Effect of Diclofenac sodium (NSAID) on crown-rump length (CRL) of immature albino rats. Med channel 2004;10 (2):63-64. 8. Yasmeen T, Qureshi GS and Perveen S. Adverse effects of Diclofenac sodium on renal parenchyma of adult albino rats. J Pak Med Assoc 2007; 57 (7): 349-351. 9. Turan C, Kontas O, Bekerecloglum A, Kocaoglu C, Alper M and Kucukaydin M. The effect of Diclofenac sodium on the renal parenchyma during complete unilateral ureteral obstruction of the rats. Tr. J. of Medical Sciences 1998; 28: 247-251. 10. Aydin G, Gokcimen A, Cicek E, Karahan N and Gokalp O. Histopathological changes in liver and renal tissues induced by different doses of Diclofenac sodium in rats. Turk. J. Anim. Sci 2003; 27(5): 1131-1140. 11. Ahmed F A, Mohan P, Barua C C and Dutta D J. Effect of intramuscular Diclofenac sodium on pharmacokinetics of intravenous enrofloxacin in calves. Indian J Pharmacol 2005; 37 (3):189-190. 12. Taib N T, Jarrar B M and Mubarak M M. Ultra structural alterations in renal tissues of rabbits induced by Diclofenac sodium (Voltaren). Saudi Med J 2004; 25 (10):1360-1365. 13. Ragbetli C, Aydinlioglu A, Kara M, Ragbetli M C and IIhan F. Effects of Diclofenac sodium on the rat liver in post natal period. J. Anim. Vet. Adv.2009; 8(9): 1761-1764. 14. Yapar K, Atakisi O, Uzlu E, Uzun M and Erdogan H M. Protective effect of L carnitine against Diclofenac sodium toxicity in mice. Revue Med. Vet 2008; 159, 6: 363-367. 15. Cotran R S, Kumar V and Collins T. The Kidney. In: Robbins pathologic basis of disease (Publ. W.B. Saunder’s company) 1999; 6th edition: pp 930-996. 16. Schwarz A, Krause P H, Keller F, Offermann G and Mihatsch M J. Granulomatous interstitial nephritis after non-steroidal anti-inflammatory drugs. Am J Nephrol 1988; 8:410- 416. 17. Walter H. Hörl. Nonsteroidal Anti-Inflammatory Drugs and the Kidney. Pharmaceuticals (Basel). 2010 Jul; 3(7): 2291–2321.Published online 2010 Jul 21. doi: 10.3390/ph3072291. PMCID: PMC4036662. 18. C. M. Modi, S.K. Mody, H.B. Patel, G.B. Dudhatra, Avinash Kumar and Madhavi Avale. Toxicopathological overview of analgesic and anti-inflammatory drugs in animals. Journal of Applied Pharmaceutical Science 02 (01); 2012: 149-157
Sureshkumar T, Amruta Kadam
Background: Restless legs syndrome (RLS), a common sensorimotor disorder, has a wide range of severity from merely annoying to affecting sleep and quality of life severely enough to warrant medical treatment. Previous epidemiological studies, however, have failed to determine the prevalence of those with clinically significant RLS symptoms and to examine the life effects and medical experiences of this group. So further research is needed to find out the prevalence of RLS. Method: Cross-sectional study of a sample of 100 pregnant women between age group 20 to 30 years were assessed for the presence of RLS using the Revised International Restless Legs Syndrome Study Group criteria. Subjects were asked to rate the severity of RLS on this scale. Total score was taken. Result: A total of 100 subjects were undergone this study and 18 % of people are affected with Restless leg syndrome (n=18). In this 2% of subject are affected with mild RLS, 10% of subjects affected with moderate RLS and 6% of people affected with severe form of Restless leg syndrome. Conclusion: RLS is a frequent condition in pregnant women, and is commonly under diagnosed and undertreated. The study concludes that there is a significant prevalence of restless leg syndrome in Pregnancy.
1. Earley, Christopher J. (2003). "Restless Legs Syndrome". New England Journalof Medicine348 (21):2103–9. 2. Nomura T Nakashima K. prevalence of restless leg syndrome. Brain Nerve 2009 may, 61(5): 515-21 3. Rangarajan S, Rangarajan S, D’Souza GA. Restless legs syndrome in an Indian urban population. Sleep Med. 2007; 9:88–93 4. Nada Djokanovic, Medications for Restless leg syndrome in pregnancy .J obstet Gynaecol Can 2008; 30(6): 505-507. 5. Manconi M, et al. Pregnancy as a risk for restless leg syndrome. sleep med 2004; 5:305-8 6. Nada Djokanovic. Medications for Restless leg syndrome in pregnancy .J obstet Gynaecol Can 2008; 30(6): 505-507. 7. Haribabu et al. Restless legs syndrome.JITPS 2010; 1(1),1-8 8. Winkelman Jw Considering the causes of RLS Eur J Neurol 2006;13(suppl. 2):8-14. 9. Nada Djokanovic. Medications for Restless leg syndrome in pregnancy .J obstet Gynaecol Can 2008; 30(6): 505-507. 10. Manconi M, et al. Pregnancy as a risk for restless leg syndrome. sleep med 2004; 5:305-8. 11. RA Allen et al. Restless legs: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Medicine 2003 4: 101-119. 12. Nada Djokanovic. Medications for Restless leg syndrome in pregnancy .J obstet Gynaecol Can 2008; 30(6): 505-507. 13. Berger k et al Sex and the risk of restless legs syndrome in the general population. Arch InternMed. 2004 Jan 26; 164(2):196-202. 14. Mc Parland P, et al. Restless legs syndrome in pregnancy. Case reports. Clin Exp Obstet Gynecol. 1990; 17(1):5-6. 15. Hening WA, et al Circadian rhythm of motor restlessness and sensory symptoms in the idiopathic restless legs syndrome.Sleep. 1999 Nov 1;22(7):901-12
Sujatha S, Getrude Banumathi P, J Harikrishnan, Jaiganesh D, Ravishankar P
Background: There is an increasing discrepancy between the number of patients on the waiting list for organ transplantation and the available number of donors. Evaluation of college students’ awareness and attitude is of crucial importance to evaluate and develop educational programs to raise the students’ commitment to Organ Donation. Objective: To assess the awareness of organ donation and the attitude towards organ donation among the college students and to study the association of socio demographic factors with awareness and attitude. Methodology: A cross sectional study was conducted among the Arts and Science College students in Thiruvannamalai District, Tamil Nadu in December 2016 to January 2017. The sample size was 114. Multi stage sampling was done. Includes both male and female students above 18 years and who are willing to participate in the study. Excluded those who were absent on the day of visit. A semi-structured self administered questionnaire was used to know the socio demographic details and questions to assess the level of awareness and attitude. Official permission obtained from the Principal of the College, Institutional Ethics Committee, and Informed written consent from the students. The data entered in MS Excel. Analyzed using SPSS Version 16. Descriptive and Inferential analysis done by using Chi square test, Fisher’s exact test, p value less than 0.05 taken as significant. Results: In this study, 68.4% had heard about organ donation, 14.9% had pledged, 52.6% had inadequate awareness, 63.2% had poor attitude and 67.5% given willingness to donate. There was a statistically significant association between the age group less than or equal to 21years and adequate awareness (p 0.02), good attitude (p 0.00), and willingness to donate (p 0.00). There was a significant association of good attitude with willingness to donate (p 0.00). There was a significant association between Arts group students and good attitude (p 0.00). Conclusion: This study clearly revealed that there was a gap between the awareness and attitude towards organ donation. There is an unquestionable need to educate the college students regarding organ donation to bridge this gap.
1. www.notto.nic.in 2. Kaur Ramandeep, Begum Nilavansa S., Kaur Amritpal, A Quasi Experimental Study to assess the Effectiveness of Structured Teaching Programme on Knowledge and Attitude regarding Organ Donation among Young Adults in SelectedColleges of Jalandhar, Punjab,AJNER.,Jan2014-March2015; 5(1):140-145 3. www.organindia.org 4. Rakesh Shah, Alpesh Patel, Vaibhav Ramanuj, Nitin Solanki, Knowledge And Attitudes About Organ Donation Among Commerce College Students, National Journal of Community Medicine., Oct – Dec 2015; 6(4): 533 -535. 5. Nahida Khan, Zahid Masood, Nadia Tufail, Hina Shoukat, KTA Ashraf, Sumera Ehsan, Sabeeka Zehra, Nosheen Battol, Sadia Akram, Sehrish Khalid, Knowledge And Attitude Of People Towards Organ Donation, JUMDC., Jul-Dec 2011; 2(2): 15-21. 6. Annadurai K, Mani K, Ramasamy J, A study on knowledge, attitude and practices about organ donation among college students in Chennai, Tamil Nadu -2012, Progress in Health Sciences., 2013; 3(2): 59-65. 7. Sree T. Sucharitha, Ravi Siriki, Rajeshwara Rao Dugyala, Mullai, Priyadarshini, Kaavya, Roshini, Organ Donation: Awareness, attitudes and beliefs among undergraduate medical students in South India, National Journal of Research in Community Medicine., July-Sep. 2013; 2( 2):83-88 8. Dr. Saraswathi Ilango, Ms. M. Usha Nandhini, Dr. S. Manikandan, Dr. Prema Sembulingam, Awareness of Organ Donation among Fresh Students in Medical Field, International journal of medical science and clinical Invention., 2014; 1 (6) :274-283. 9. Ibrahim Tokalak, Altug Kut, Gokhan Moray, Remzi Emiroglu, Rengin Erdal, Hamdi Karakayali, Mehmet Haberal, Knowledge and Attitudes of High School Students Related to Organ Donation and Transplantation: A Cross-Sectional Survey in Turkey, Saudi J Kidney Dis Transplant., 2006;17(4): 491-496. 10. Aparajita Dasgupta, Bhaskar Shahbabu, Kaushik Sarkar, Ishita Sarkar, Sudipta Das, Malay Kumar Das: Perception of Organ Donation among Adults: A Community Based Study in an Urban Community of West Bengal, Sch. J. App. Med. Sci., 2014; 2(6A):2016-2021. 11. R. Naveen, V. Santosh Kumar, H. Praveen, C. Rajeswari, P. Seenivasan, K. Caroline Priya:Knowledge, Attitude And Practices Of Organ Donation Among College Students In Chennai, Stanley Medical Journal. , 2014; 1(1):11-16. 12. Saad Abdullah Alghanim, Knowledge and Attitudes toward Organ Donation: A Community-Based Study Comparing Rural and Urban Populations, Saudi J Kidney Dis Transpl., 2010;21(1):23-30 13. Dr. Saraswathi Ilango, Ms. M. Usha Nandhini, Dr. S. Manikandan, Dr. Prema Sembulingam: Awareness of Organ Donation among Fresh Students in Medical Field, International journal of medical science and clinical Invention.,2014;1(6) :274-283