Background: As agriculture is the major occupation of Indian subcontinent; as an occupational hazard most of our farmers are exposed to the risk of poisonous snake bites every single day and night. After the occurrence of snakebite snake venom is injected into the body and has so many deleterious effects in the form of local swelling and intense pain, haematotoxicity, neurotoxicity, myotoxicity, nephrotoxicity. Aim of this study was to observe clinical manifestations of neurological manifestations and to study the outcome of the patients with respiratory paralysis after giving them the proper management in the form of antisnake venom and cardio-respiratory support. Material and Methods: Present prospective study has been conducted in emergency ward and intensive care unit of Medicine department of K. R. Hospital, Mysore, India during the period from July 2003 to June 2005. Results: In the present study, maximum number of patients belonged to the age group of 3rd to 5th decade. There were 106 patients studied among them males were 79 (74.53%) and female were 27 (25.47%). Most of them i.e.75 (70.75%) were from agricultural background. Though the distal part of body was the commonest site of snake bite, three patients had unusual site of snake bite (over external ear, scalp and body trunk). About 22 (20.75%) patients had neurological manifestations, out of them 8 (7.55%) patients had respiratory paralysis and required mechanical ventilation. Conclusions: Emergent treatment of neurovascular manifestations of snakebite with anti snake venom and mechanical ventilation is important for better outcome such patients.
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An inventory control model for deteriorating items with shortage under time varying holding cost for instantaneous replenishment
In this paper, an Economic Order Quantity (EOQ) model has been developed. An item deteriorates with three parameter Weibull distribution where shortages are allowed. The optimal cycle time, optimal holding cost and total optimal cost has been derived for the model. The optimal Holding cost has been derived by minimizing the total inventory cost. A numerical example and sensitivity analysis are presented to illustrate the proposed model.
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Comparison of intra ocular pressure changes in third trimester of normal pregnancy and pregnancy induced hypertension
Pitta Paramjyothi, Battu Vijayalaxmi, A N R Lakshmi
12-17% pregnant women face various problems related to pregnancy and child birth. The alarming symptoms of eye with Pregnancy Induced Hypertension are blurring, dimness of vision and at times complete blindness. 60 pregnant women with third trimester of normal pregnancy and PIH were selected for the study. There was a significant increase in third trimester IOP in PIH women when compared to normal pregnant women. Along with routine Blood Pressure monitoring and antenatal check up Intra Ocular Pressure measurement by Schiotz tonometry is advised to prevent the complications of PIH and ocular problems.
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Evaluation of balance related tasks in hearing impaired children
Aim: to find out most affected tasks related to balance in hearing impaired children. Objectives: To identify and compare the balance related tasks in hearing impaired children. To find out the most affected balance related tasks in hearing impaired children. To find the effect of gender and Age on balance in hearing impaired children. Procedure: 100 Subjects fulfilling the inclusive criteria were selected. Informed Consent was taken from respective principals to conduct the study. Subjects were assessed by pediatric balance scale (pbs). Mean and standard deviation was calculated. To find out the balance related tasks in hearing impaired children ANOVA test was done. For multiple comparison Tukey’s test was applied. Result: The most affected component of balance in hearing impaired children is component standing with one foot in front. The balance is minimum at the age of 7 years and maximum at age of 12 years. And there is no relation between balance and gender in hearing impaired children. Conclusion: The most affected component of balance in hearing impaired children is standing with one foot in front. Other components which are affected are standing on one foot, standing with eyes closed, turning 360 degrees and turning to look behind. The balance changes according to the age in hearing impaired children. The balance is minimum at the age of 7 years and maximum at age of 12 years. There is no relation exists between balance and gender in hearing impaired children.
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A rare case of skin metastasis from soft palate cancer
Distant metastasis from soft palate cancers usually occur in the lung, liver or bone. We present here a case of skin metastasis from primary cancer of the soft palate in 51 year old male initially at stage IV A. After completion of definitive chemoradiation, the patient was in disease free locoregionally but developed skin nodule which was confirmed as metastatic deposits. Skin metastasis from soft palate cancers are very rare and need careful evaluation because they portend a poor prognosis.
Background: Malnutrition and undernutrition among mothers in developing countries is a major problem and is closely associated with impaired, maternal, foetal and infant health .The usual diet of women in India is found to be nutritionally inadequate. The state of physiological stress during pregnancy may aggravate chronic dietary inadequacy, and thus adversely influence the course and outcome of pregnancy, foetal growth and composition of lactation. Hence this study was taken up to find out if maternal nutritional status influences the important biochemical constituents in colostrum of mother. Methods: 100 mothers were enrolled in the study after obtaining prior informed consent. They were divided into 2 groups - Group I had 50 malnourished mothers and group II had 50 well-nourished mothers. The pre-fed milk sample which was collected was stored at - 20℃ until it was processed. It was thawed and analysed for total lipids, lactose and proteins. Results: The colostrum content for well-nourished mothers was significantly higher for lipid, protein, and lactose content as compared to malnourished mothers. Conclusions: The parameters of weight, height weight/height ratio and hemoglobin varied significantly between the well-nourished and malnourished mothers. Total protein levels in colostrum of malnourished mothers are significantly lower than those in well-nourished mother. Total lipid levels in milk of malnourished mothers are significantly lower than those in well-nourished mothers. Total lactose levels in colostrum of malnourished mothers are significantly lower than those in well-nourished mothers. Hence this study suggest that the nutritional status of women influences the composition of breast milk and as well as the growth and development of her neonate.
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A study on association of Eustachian tube function with graft uptake in chronic suppurative otitis media (tubotympanic) patients in tertiary level care hospital
Yoganandh M, Balasubramani J, Getrude Banumathi P, Sujatha S, Jaiganesh D
Background: Normal Middle Ear functioning relies on Eustachian tube patency and its proper functioning. Eustachian tube has three functions with respect to middle ear (i) Protection from Nasopharyngeal sound pressure and secretions (ii) Drainage into the Nasopharynx of middle ear secretion (iii)Ventilation to equilibrate the air pressure in the middle ear with atmospheric pressure. The aim of our study is to assess the Eustachian tube patency in chronic suppurative otitis media (Tubotympanic type) and to evaluate the treatment outcome of CSOM (tubotympanic type) in relation to Eustachian tube dysfunction. Materials and Methods: In our study 50 patients with CSOM (tubotymnpanic type) were subjected to assess ETF by Impedance audiometry and Dye Instillation test. The patients were grouped into normal ETF and Impaired ETF. Patients with dry ear were planned for myringoplasty and with wet ear were planned for cortical mastoidectomy. The patients were followed up at 1 month and 3 months post operatively and then the results were analyzed. Successful outcome defined as healed graft with good middle ear function. Graft failure or perforation secondary to otitis media during follow up is considered as failure. Results: In our study done in 50 patients 44 (88%) had normal ETF, 6 (12%) patients had impaired ETF by impedance audiometry. The Dye Instillation test revealed that 6(12%) patients had obstruction, 5 (10%) patients had hypofunction and 39 (78%) patients had normal ETF Conclusion: In our study the correlation between ETF and graft uptake was statistically analysed (p value 0.015) and was found to be highly significant. Hence there is a strong association between ETF and graft uptake. The pre operative test of tubal function is therefore of great interest, especially if such provides a possibility of estimating the chance of achieving a satisfactory result of tympanoplasty
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Study of association of MTHFR 677 C→T gene polymorphism in coronary artery disease
Shetty Prithviraj Manohar Vijaya, Qadri Zareeful Huda, Murarka Arpith, Mittal Honey, David Mary, Vidhate Deepali Amarsin, Thomas James
Coronary Artery Disease (CAD) continues to be a major cause of mortality, globally for the last few decades. Hyperhomocysteinemia (HCA) resulting from MTHFR 677 C→T polymorphism as a reason for CAD in India has been debatable. The purpose of this study was to analyze the possible association between MTHFR 677C→T polymorphism with CAD by performing a case control study in subjects from Navi Mumbai. Subjects with CAD (n=49) below the age of 65 were compared with a similar number of age and gender matched controls without CAD. According to genotypic analysis, 46 and 48 individuals with CC genotype; 3 and 1 individual with CT genotype were found in cases and controls respectively. No individuals with TT genotype were found in either group. Statistical analysis of biochemical parameters revealed significantly higher levels of plasma homocysteine (Homocysteine) in cases than in controls (p= 0.00), which was statistically significant. However the analysis did not show a significant difference in the Homocysteine levels of CC and CT genotypes within the cases (or in controls). The T allele presents a higher relative risk (OR= 3.0632) in susceptibility to CAD, however, this is not statistically significant (p = 0.3361). Although our study failed to find any association between the existing polymorphisms of MTHFR gene and CAD, it did find an association between HCA and CAD.
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22. Nasiri, M., Roostaei, A., Ehsanian, Z. (2014) Association of Methylene tetrahydrofolate Reductase (MTHFR) Gene C677Tand A1298C Polymorphisms with Myocardial Infarction from North of Fars Province. Research in Molecular Medicine, 2(3), 36-40.
23. Dhar, S., Chatterjee, S., Sengupta, B., Chakrabarti, S., Ray, S. and Dutta, A. (2010). Polymorphisms of methylene tetrahydrofolate reductase gene as the genetic predispositions of coronary artery diseases in eastern India. Journal of Cardiovascular Disease Research, 1(3), pp.152-157.
24. Tripathi, R., Tewari, S., Singh, P. and Agarwal, S. (2010). Association of homocysteine and methylene tetrahydrofolate reductase (MTHFR C677T) gene polymorphism with coronary artery disease (CAD) in the population of North India. Genetics and Molecular Biology, 33(2), pp.224-228.
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A clinical study of neurotoxic manifestations following snake bite in a tertiary care centre of south Karnataka
Anitha M S, Lade V V
Background: As agriculture is the major occupation of Indian subcontinent; as an occupational hazard most of our farmers are exposed to the risk of poisonous snake bites every single day and night. After the occurrence of snakebite snake venom is injected into the body and has so many deleterious effects in the form of local swelling and intense pain, haematotoxicity, neurotoxicity, myotoxicity, nephrotoxicity. Aim of this study was to observe clinical manifestations of neurological manifestations and to study the outcome of the patients with respiratory paralysis after giving them the proper management in the form of antisnake venom and cardio-respiratory support. Material and Methods: Present prospective study has been conducted in emergency ward and intensive care unit of Medicine department of K. R. Hospital, Mysore, India during the period from July 2003 to June 2005. Results: In the present study, maximum number of patients belonged to the age group of 3rd to 5th decade. There were 106 patients studied among them males were 79 (74.53%) and female were 27 (25.47%). Most of them i.e.75 (70.75%) were from agricultural background. Though the distal part of body was the commonest site of snake bite, three patients had unusual site of snake bite (over external ear, scalp and body trunk). About 22 (20.75%) patients had neurological manifestations, out of them 8 (7.55%) patients had respiratory paralysis and required mechanical ventilation. Conclusions: Emergent treatment of neurovascular manifestations of snakebite with anti snake venom and mechanical ventilation is important for better outcome such patients.
1. Gordon Cook. Manson's Tropical Diseases. Animal Toxins by Warrel D A. 21st edition. Saunders Publications 2005.Pg 581-611. 2. Park K. Park's Textbook of Preventive and Social Medicine.17th edition.Jabalpur 2002. 3. Weatherall, Leningham, Warrel. Oxford Text book of Medicine, 4th edition.Oxford 2004.Pg 923-936. 4. Mishra M. P., Mishra S. C. Snake bite Quarterly Medical Review. Oct 1982; 33(4). 5. David A Warrell. Guidelines for the management of snake-bites. WHO SEA RO 2009 6. Bhattacharya P,Chakraborty A, Neurotoxic snake bite with respiratory failure. Indian J Crit Care Med 2007;11:161-4[serial online] 7. Udwadia FE. Critical care in envenomation.In: Principles of critical care.Udwadia FE.Oxford University press:Delhi;1995.p607-11 8. Banerjee R N, Poisonous snakes of India, their venom, symptomatology and treatment of envenomation-Progressive Clinical Medicine, Arnold Heumann Publishers; 1985. 9. Reid H A, Theakston R D G, The Management of Snake Bite, Bulletin of WHO; 1986 61 (6): 885-895.
An inventory control model for deteriorating items with shortage under time varying holding cost for instantaneous replenishment
Pravin B Bansode, Sunil V Kawale
In this paper, an Economic Order Quantity (EOQ) model has been developed. An item deteriorates with three parameter Weibull distribution where shortages are allowed. The optimal cycle time, optimal holding cost and total optimal cost has been derived for the model. The optimal Holding cost has been derived by minimizing the total inventory cost. A numerical example and sensitivity analysis are presented to illustrate the proposed model.
1. B.C.Giri, A. Goswami and K.S. Chaudhuri(1996), An EOQ model for deteriorating items with time varying demand and costs. Journal of the Operational Research Society, 47, 1398-1405. 2. N. Ghasemi and B.A. Nadjafi(2013), EOQ models with varying holding cost. Journal of Industrial Mathematics, article id-743921, 7 pages. 3. N.H. Shah and K.T.Shukla(2009), Deteriorating inventory model for waiting time partial backlogging. Applied Mathematical Sciences, vol.3, no. 9, 421-428. 4. P.N. Ghare and G.P. Schrader (1963), A model for exponentially decaying inventory. Journal of Industrial Engineering, 14, 238-243. 5. R. P. Covert and G.C. Philip (1973), An EOQ Model for Items with Weibulldistribution deterioration. A I I E Transactions, 5:4, 323-326. 6. S.V. Kawale and P.B. Bansode (2012), An EPQ model using Weibull deterioration for deterioration item with time varying holding cost. International Journal of Science, Engineering and Technology Research, vol.1, issue 4, 29-33. 7. S. Kawale and P. Bansode (2013), An Inventory Model for Time Varying Holding Cost and Weibull Distribution for Deterioration with Fully Backlogged Shortages, International Journal of Mathematics Trends and Technology, Volume 4 Issue 10, 201-206. 8. T. Chakrabarty, B.C. Giri and K.S. Chaudhuri (1998), An EOQ model for items with Weibull distribution deterioration, shortages and trended demand: an extension of Philip’s mode.Computers and Operations Research, vol.25, no.7–8, 649-657. 9. V.K. Mishra, L.S. Singh and R. Kumar (2013), An inventory model for deteriorating items with time-dependent demand and time-varying holding cost under partial backlogging. Journal of Industrial Engineering International, 9:4.
Comparison of intra ocular pressure changes in third trimester of normal pregnancy and pregnancy induced hypertension
Pitta Paramjyothi, Battu Vijayalaxmi, A N R Lakshmi
12-17% pregnant women face various problems related to pregnancy and child birth. The alarming symptoms of eye with Pregnancy Induced Hypertension are blurring, dimness of vision and at times complete blindness. 60 pregnant women with third trimester of normal pregnancy and PIH were selected for the study. There was a significant increase in third trimester IOP in PIH women when compared to normal pregnant women. Along with routine Blood Pressure monitoring and antenatal check up Intra Ocular Pressure measurement by Schiotz tonometry is advised to prevent the complications of PIH and ocular problems.
1. Quershi IA, IOP and Pregnancy; A comparison between normal and ocular hypertensive subjects. Arch Med Res.1997, Autumn: 20(3)397-400. 2. Quershi IA, XI XR, Yaqob T, The ocular hypertensive effect of late pregnancy is higher in multi-gravidae than in primi gravidae. Graefer Arch clin Exp ophthalmol, 2000 Jan. 288 (1): 56-7. 3. Quershi IA, XI XR, WU XD, Intraocular pressure trends in pregnancy and in the third trimester hypertensive patients. Aota Obstet Gynecol Soand 1996 Oct.75 (9); 816-9. 4. Ziai N, Ory SJ, Khan AR, B rubaker RF, Beta- human chorionic gonadotropins, progesterone and aqueous dynamics during pregnancy. Arch Ophthalmol, 1994 Jun; 112 (6); 801-6. 5. Bill A. Blood circulation and fluid dynamics in the eye. Physiol Rev 1975; 55: 383-417. 6. De Alvarez RR, Pre eclampsia, eclampsia and other hypertensive disorders of pregnancy. In Aladjem S (ed): Obstetrical practice. St. LOUIS Mosby Year book, 1980; pp 576-611. 7. Davis EA, Dana MR, Pregnancy and the eye, In; Albert DM, Jacobbiek FA. Editors. Principles and practice of Ophthalmology- Second edition. Vol 5, W. B.Saunders Co. Philadelphia. 2000; 4767-83. 8. Sunness Js. The pregnant woman’s eye. Surv. Ophthalmol 1988; 32: 219-38. 9. Imre J. The influence of the endocrine system on intraocular tension. Endocrinology 1922; 6:213-7. 10. Aota Obstet Gynecol Scand.IOP trends in pregnancy and in the third trimester hypertensive patients.1996 Oct.75 (9): 816-9.
Evaluation of balance related tasks in hearing impaired children
Tejas Borkar, Pradeep Borkar
Aim: to find out most affected tasks related to balance in hearing impaired children. Objectives: To identify and compare the balance related tasks in hearing impaired children. To find out the most affected balance related tasks in hearing impaired children. To find the effect of gender and Age on balance in hearing impaired children. Procedure: 100 Subjects fulfilling the inclusive criteria were selected. Informed Consent was taken from respective principals to conduct the study. Subjects were assessed by pediatric balance scale (pbs). Mean and standard deviation was calculated. To find out the balance related tasks in hearing impaired children ANOVA test was done. For multiple comparison Tukey’s test was applied. Result: The most affected component of balance in hearing impaired children is component standing with one foot in front. The balance is minimum at the age of 7 years and maximum at age of 12 years. And there is no relation between balance and gender in hearing impaired children. Conclusion: The most affected component of balance in hearing impaired children is standing with one foot in front. Other components which are affected are standing on one foot, standing with eyes closed, turning 360 degrees and turning to look behind. The balance changes according to the age in hearing impaired children. The balance is minimum at the age of 7 years and maximum at age of 12 years. There is no relation exists between balance and gender in hearing impaired children.
1. Darcy Umphred :Neurological Rehabilitation-5th edition,Ch-23; Lesile Allison, Kenda Fuller.732-773. 2. Susan O’sullivan Physical Rehabilitation-, 5th edition, vestibular rehabilitation; Michael C. Schubert, 1000-1029. 3. Susan K. Effugen :effect of exercise program on static balance of deaf children J Physical Therapy vol 61, no 6, June 1981; 873-877. 4. Motor control 3rd edition, Anne Shumway- Cook, Marjorie Woollacott; Lippincott Williams and Wilkins. 2000 Ch-8: Development of postural control,187-211. 5. Terry K. Crowe and Fay B. Horak : Motor Proficiency Associated with Vestibular Deficits in Children with Hearing Impairments ; J Physical Therapy Volume 68, Number 10, October 1988, 1493-1499. 6. Report by Royal college of Physicians, London ;Hearing and balance disorders Achieving excellence in diagnosis and Management, 2007 7. P. L. Dhingra Diseases of ENT 3rd Edition Elsvier 2004, Ch 3 physiology of ear, pg 19-22 8. P. L. Dhingra Diseases of ENT 3rd Edition Elsvier 2004, Ch 6 Hearing loss pg.38-52, Ch 20 The deaf child, pg 148-152 9. A. Davis, K. Davis and G. Mencher Paediatric : Epidemiology of Permanent childhood hearing impairment; Paediatric Audiological Medicine) 10. Arnvig J: vestibular function in deafness and severe hardness of hearing.Acta Otolaryngeology 4:283-288, 1955. 11. Cyntia N. Potter and Lyn Newman Silverman: Characteristics of Vestibular Function and Static Balance Skills in Deaf Children, J Physical Therapy vol 64, no 7 July 1984 1071-1075. 12. Rapin I: Hypoactive labyrinths and motor development. Clin pediatrics(Phila) 13:922-937, 1974 13. Linsey D, O’Neal J: static and dynamic balance skills of eight year old deaf and hearing children, Am Ann deaf 121:49-55, 1976 14. Kimitaka Kaga , Yukiko Shinjo , Yulian Jin and Hideki Takegoshi :Vestibular failure in children with congenital deafness International journal of Audiology; 2008, Vol. 47, No. 9, Pages 590-599. 15. Janet Collins Siegel, Maria Marchrtti, Jan Stephen Tecklin: Age relate balance changes in hearing impaired children J of physical therapy, vol 71(3); March1991,183-189 16. Ewa Raglan , Paul Radomskij , John Veness , Kaukab Rajput : ‘An audio- vestibular study of 128 children presenting to a specialized paediatric audio-vestibular clinic: Should every child with hearing impairment have vestibular function assessed?’J Audiological medicine 2009, Vol. 7( 3), Pages 143-147. 17. Fay B. Horak Anne Shumway-Cook Terry K. Crowe F. Owen Black:Function and motor proficiency of children with impaired hearing or with Learning disability and motor impairments: J Developmental medicine and child neurology, 1988(30):64-79. 18. Franjoine MR, Gunther JS, Taylor MJ: Pediatric balance scale: a modified version Of the berg balance scale for the school-age child with mild to moderate motor impairment. J Paediatric physical therapy 2003 Summer;15(2):114-28. 19. Rine, Rose Marie, Rubish Kimber Chrrisopher : Measurement of sensory system effectiveness and maturational changes in young children, J of Paediatric Physical Therapy,1988 vol 10(1). 20. Cumberworth VL, Patel NN The maturation of balance in children, Journal of Laryngology Otol 2007 May,121(5):449-54 21. Peter selz vestibular deficits in deaf children otolaryngology, head neck surgery vol 113,(2) 22. Beck DL, Petrak MR, Bahner CL. Advances in vestibular diagnosis and rehabilitation. Hearing Review. 2010;17(11):12-16. 23. Anne Shumway Cook. Motor Control: Theory and Practical Applications.2nd Edition Lippincott Williams and Wilkins. 2000.chapter 3: physiology of motor control pg 46-82 ; ch10: abnormal postural control, 233-256 24. Suarez H et al. Balance sensory Organization in children with profound hearing loss and cochlear implants. Int J Pediatric otorhinolaryngology, 2007Apr,71(4):629-37 25. An MH, Yi CH, Jeon HS, Park SY :Age related changes of single limb standing balance in children with and without deafness, Int J Pediatric otorhinolaryngology 2000;73(11): 1539-44 26. Dolores B. Bertoti: functional neurorehabilitation through life span, F.A. Davis 2004, Ch-3; 49-88 27. Rine, Rose Marie(2009) 'Growing evidence for balance and vestibular problems in children',Audiological Medicine, 7(3), 138 –142 28. Hale, Sheri Anne :Postural control in children and young adults, 2004 29. O’Reilly et al: Prevalence of vestibular and balance disorders in children, Otol Neurotol. 2010 Dec; 31 (9): 1441-4 30. Medeiros IR et al : Vestibular rehabilitation therapy in children, Otol neurotolol, 2005 Jul; 26(4): 699-703 31. Freja Gheysen, Gerrit Loots, HildeVan Waelvelde :motor development of deaf children with and without cochlear implants Journal of deaf studies and deaf education2008,13(2);215-223
A rare case of skin metastasis from soft palate cancer
Meenu Gill, Reeti Saini, Rajeev Sen
Distant metastasis from soft palate cancers usually occur in the lung, liver or bone. We present here a case of skin metastasis from primary cancer of the soft palate in 51 year old male initially at stage IV A. After completion of definitive chemoradiation, the patient was in disease free locoregionally but developed skin nodule which was confirmed as metastatic deposits. Skin metastasis from soft palate cancers are very rare and need careful evaluation because they portend a poor prognosis.
1. Hussein MR. Skin metastasis: a pathologist's perspective. J Cutan Pathol. 2010; 37(9):e1-20. 2. Yoskovitch A, Hier MP, Okrainec A, Black MJ, Rochon L. Skin metastasis in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck. 2001; 124(3):248-52. 3. Lookingbill DP, Spangler N, Sexton FM. Skin involvment as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol. 1990; 22(1):19–26. 4. Léon X, Quer M, Orus C, Venegas M, Lopez M. Distant metastases in head and neck cancer patients who achieved loco-regional control. Head Neck. 2000; 22(7):680-6. 5. Pugliano FA. Tumours of the Oropharynx. In: Watkinson JC, Gaze MN, Wilson JA editors. Stell and Maran’s Head and Neck Surgery. Oxford: Butterworth-Heinemann, 2000.p. 319-35 6. Pitman KT, Johnson JT. Skin metastases from head and neck squamous cell carcinoma: incidence and impact. Head Neck. 1999; 21(60):560-5. 7. Fletcher OH. Textbook of Radiotherapy. Philadelphia: Lea - Febiger, 1980: 315-7. 8. Pugliano FA. Tumours of the Oropharynx. In: Watkinson JC, Gaze MN, Wilson JA editors. Stell and Maran’s Head and Neck Surgery. Oxford: Butterworth-Heinemann, 2000.p. 319-35. 9. Berger DS, Fletcher OH. Distant metastasis following local control of squamous cell carcinoma of the nasopharynx, tonsillar fossa and base of tongue. Radiology. 1971; 100(1):141-3. 10. Vikram B, Strong EW, Shah JP, Spiro R. Failure at distant sites of following multimodality treatment for advanced head and neck cancer. Head Neck Surg. 1984; 6(3):730-3. 11. Berger DS, Fletcher GH. Distant metastases following local control of squamous cell carcinoma of the nasopharynx, tonsillar fossa and base of the tongue. Radiology. 1971; 100(1):141-3. 12. Rao R, Balachandran C, Rao L. Zosteriform cutaneous metastases: a case report and brief review of literature. Indian J Dermatol Venereol Leprol. 2010; 76(4):447. 13. Schwartz RA. Cutaneous metastatic disease. J Am Acad Dermatol. 1995; 33(2 Pt 1):161-82. 14. KY Hari Kishan, GRR Rao. A rare case of zosteriform cutaneous metastases from squamous cell carcinoma of hard palate. Ann Med Health Sci Res. 2013; 3(1):127–30. 15. Dequanter D, Mboti FB, Lothaire P, Andry G. Skin metastases from a head and neck carcinoma: a prognostic factor? B-ENT. 2005; 1(3):113-5. 16. Kotwall C, Sako K, Razack MS, Rao U, Bakamjian V, Shedd DP. Metastatic patterns in squamous cell cancer of the head and neck. Am J Surg. 1987; 154(4):439-42.
The study of biochemical composition of breast milk in malnourished mothers versus well-nourished mothers
Sharmila M Mane, Neelam J Patil, Alka V Nerurkar, Sachin Patharkar
Background: Malnutrition and undernutrition among mothers in developing countries is a major problem and is closely associated with impaired, maternal, foetal and infant health .The usual diet of women in India is found to be nutritionally inadequate. The state of physiological stress during pregnancy may aggravate chronic dietary inadequacy, and thus adversely influence the course and outcome of pregnancy, foetal growth and composition of lactation. Hence this study was taken up to find out if maternal nutritional status influences the important biochemical constituents in colostrum of mother. Methods: 100 mothers were enrolled in the study after obtaining prior informed consent. They were divided into 2 groups - Group I had 50 malnourished mothers and group II had 50 well-nourished mothers. The pre-fed milk sample which was collected was stored at - 20℃ until it was processed. It was thawed and analysed for total lipids, lactose and proteins. Results: The colostrum content for well-nourished mothers was significantly higher for lipid, protein, and lactose content as compared to malnourished mothers. Conclusions: The parameters of weight, height weight/height ratio and hemoglobin varied significantly between the well-nourished and malnourished mothers. Total protein levels in colostrum of malnourished mothers are significantly lower than those in well-nourished mother. Total lipid levels in milk of malnourished mothers are significantly lower than those in well-nourished mothers. Total lactose levels in colostrum of malnourished mothers are significantly lower than those in well-nourished mothers. Hence this study suggest that the nutritional status of women influences the composition of breast milk and as well as the growth and development of her neonate.
1. Chi-Ren Tsai B, Jiin-Tsae Liang E, Teh-Ming Wang B et al. Changes in Preterm Breast Milk Nutrient Content in the First Month Pediatrics and Neonatology (2014)55, 449 e 454. 2. Jacqueline Bauer A, Joachim Gerss. Longitudinal analysis of macronutrients and minerals in human milk produced by mothers of preterm infants Clinical Nutrition 30 (2011) 215-220. 3. Roseli Souza Santos Da Costa et al. Trace Elements Content of Colostrum Milk in Brazil Journal of Food Composition and Analysis (2002) 15, 27–33. 4. Dror Mandel et al. Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation Pediatrics Vol.116 no.3 Sep 2005. 5. Olivia Ballard, J Da, Ardythe L. Morrow. Human Milk Composition: Nutrients and Bioactive Factors Pediatr.Clin. N Am 60 (2013) 49–74. 6. Cesar G Victoria et al. Breast feeding and growth in Brazilian infants Am. J. Clin. Nutr. (1998) 67; 452-458. 7. C. Manjrekar, M.P.Vihalakshi, J.A.Begum, G.N.Padma Breast feeding ability of undernourished mothers and physical development of their infants during 0-1 year IndPaed. (1985) Nov; 22 801-809. 8. Cheirici R, Saccomandi D, Vigi V. Dietary supplements for the lactating mothers: Influence on the trace element content of milk ActaPaeditrSuppl (1999) Aug;88(430):7-13. 9. D.V. Mavalankar et al. Maternal weight, height and risk of poor pregnancy outcome in Ahmedabad, India Indian Pediatrics (1994)31:1205-1212. 10. Emmett PM, Rogers IS. Properties of human milk and their relationship with maternal nutrition Early Hum Dev.(1997) Oct 29;49 Suppl;S7-28. 11. Folin& Wu H. Estimation of lactose from milk J of Biol Chem. (1920) 41:367-369. 12. Forsum et al. Effect of protein intake on protein and nitrogen composition of breast milk Am. J. Clin. Nutr.(1980) 33:1809-1813. 13. GerdHarzer et al. Changing patterns of human milk lipids in the course of the lactation and during the day Am. J. Clin. Nutr. (1983) 37; 612-621. 14. Herra M.G., J.O. Mova et al Maternal weight/ height and the effect of food supplementation during pregnancy and lactation pp-252-263 in H Albi and R. whitehead eds : Maternal nutrition during pregnancy & lactation Hans. Huber publishers, Bern (1980). 15. Jafer Ali et al Changes in human milk Vitamin E and total lipids during the first twelve days of lactation Am. J. Clin. Nutr. (1986) 43; 925-930. 16. Karmarkar M.G. & Ramakrishnan C.V. Studies on human lactation: Relation between the dietary intake of lactating women and the chemical composition of milk with regard to the principle and certain inorganic constituents Acta.Paed.Scand (1969) 49: 599-604.Karmarkar et al. 17. Studies on human lactation Ind. J. of. Med. Res.(1959) 47. 18. Lindblad BS Rahimtoola A. A pilot study of the quality of human milk in a lower socioeconomic group in Karachi, Pakistan Acta.Paediat.Scand. (1974)63:125-8. 19. Lonnerdal B. Biochemistry and physiology function of human milk proteins Am. J. Clin. Nutr. (1985) 42:1299 20. Lonnerdal B. Effect of maternal dietary intake on human milk composition J. Nutr. (1986) 116:499. 21. Miranda et al. Effect of maternal malnutritional status on immunological substances in human colostrum and milk Am. J. Clin. Nutr. (1983) 37; 632-640. 22. Nancy F. Butte et al. Human milk intake and growth in exclusively breast-fed infants J. Paediatrics (1984) 104:187-195 23. Nancy F. Butte et al. Effect of maternal diet and body composition on lactational performance Am. J. Clin. Nutr. (1984) 39; 296-306. 24. N.D. DattaBanik et al. The influence of maternal factor on birth-weight of the new born Indian. J. Paediat. (1969) 36:278-283. 25. N.D. Patil, M.S. Phadke. Proximate principle and energy content of human milk in well-nourished urban mother Indian Paediatrics (1986) 26: 1211-1213. 26. N. Thilothammal, R. Sujaritha, K.G. Kamala et al. Maternal nutritional status and neonatal head circumference Indian Paediatrics(1993) 30:1130-1133. 27. Picciano M.F. The composition of human milk in malnutrition: Determinants and consequences (White, P.L &Selvey, N., eds.) (1984) pp. 111-122. 28. Reinhardt MC, Lauber E. Maternal diet breast-feeding and infant growth J. Trop. Pediatr. (1981) 27: 229-236. 29. Roberto Frisancho, Jorge Matos, Pam Flegel. Maternal nutritional status and adolescent pregnancy outcome Am. J. Clin. Nutr.(1983)38:739-746. 30. Ruth. A. Lawrence. Biochemistry of human milk Breast feeding (third Edition) (1989) 73-117. 31. S. Gopalan, R.K. Puri. Breast feeding and infant growth. Indian Paediatrics(1992) 29; 1079-1085. 32. Saleha Qureshi et al. Effect of maternal nutrition supplementation on the birth-weight of the newborn Indian Paediatrics (1973) 9; 541-544. 33. Sushma Malik et al.Maternal biosocial factor affecting low birth weight Indian Paediatrics(1997)64:373-377. 34. Lowry O.H. and Daughaday W.H. J.LabClin Med.(1952) 39:663 35. Frings C.S., Fendly .J.W.,Dunn R.T. and queen C.A. Clin.Chem(1972)18:673.
A study on association of Eustachian tube function with graft uptake in chronic suppurative otitis media (tubotympanic) patients in tertiary level care hospital
Yoganandh M, Balasubramani J, Getrude Banumathi P, Sujatha S, Jaiganesh D
Background: Normal Middle Ear functioning relies on Eustachian tube patency and its proper functioning. Eustachian tube has three functions with respect to middle ear (i) Protection from Nasopharyngeal sound pressure and secretions (ii) Drainage into the Nasopharynx of middle ear secretion (iii)Ventilation to equilibrate the air pressure in the middle ear with atmospheric pressure. The aim of our study is to assess the Eustachian tube patency in chronic suppurative otitis media (Tubotympanic type) and to evaluate the treatment outcome of CSOM (tubotympanic type) in relation to Eustachian tube dysfunction. Materials and Methods: In our study 50 patients with CSOM (tubotymnpanic type) were subjected to assess ETF by Impedance audiometry and Dye Instillation test. The patients were grouped into normal ETF and Impaired ETF. Patients with dry ear were planned for myringoplasty and with wet ear were planned for cortical mastoidectomy. The patients were followed up at 1 month and 3 months post operatively and then the results were analyzed. Successful outcome defined as healed graft with good middle ear function. Graft failure or perforation secondary to otitis media during follow up is considered as failure. Results: In our study done in 50 patients 44 (88%) had normal ETF, 6 (12%) patients had impaired ETF by impedance audiometry. The Dye Instillation test revealed that 6(12%) patients had obstruction, 5 (10%) patients had hypofunction and 39 (78%) patients had normal ETF Conclusion: In our study the correlation between ETF and graft uptake was statistically analysed (p value 0.015) and was found to be highly significant. Hence there is a strong association between ETF and graft uptake. The pre operative test of tubal function is therefore of great interest, especially if such provides a possibility of estimating the chance of achieving a satisfactory result of tympanoplasty
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Study of association of MTHFR 677 C→T gene polymorphism in coronary artery disease
Shetty Prithviraj Manohar Vijaya, Qadri Zareeful Huda, Murarka Arpith, Mittal Honey, David Mary, Vidhate Deepali Amarsin, Thomas James
Coronary Artery Disease (CAD) continues to be a major cause of mortality, globally for the last few decades. Hyperhomocysteinemia (HCA) resulting from MTHFR 677 C→T polymorphism as a reason for CAD in India has been debatable. The purpose of this study was to analyze the possible association between MTHFR 677C→T polymorphism with CAD by performing a case control study in subjects from Navi Mumbai. Subjects with CAD (n=49) below the age of 65 were compared with a similar number of age and gender matched controls without CAD. According to genotypic analysis, 46 and 48 individuals with CC genotype; 3 and 1 individual with CT genotype were found in cases and controls respectively. No individuals with TT genotype were found in either group. Statistical analysis of biochemical parameters revealed significantly higher levels of plasma homocysteine (Homocysteine) in cases than in controls (p= 0.00), which was statistically significant. However the analysis did not show a significant difference in the Homocysteine levels of CC and CT genotypes within the cases (or in controls). The T allele presents a higher relative risk (OR= 3.0632) in susceptibility to CAD, however, this is not statistically significant (p = 0.3361). Although our study failed to find any association between the existing polymorphisms of MTHFR gene and CAD, it did find an association between HCA and CAD.
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