International Journal of Recent Trends in Science and Technology

Research Articles

1. Evaluation of treatment of fracture neck fermur with uncemented bipolar prosthesis

   Abdul Naser, Sarang Vyawahare

   • » Abstract Background: The Incidence of Femoral Neck Fracture is On an Increase. Despite Marked Improvement in Implant Design, Surgeon technique and Patient Care, This Fracture Still remains the Unsolved Fracture. In the elderly replacement arthroplasty is better option in View of critical blood supply of femoral head, osteoporosis, prolonged immobility in elderly patient Considering the social economic status, cost factor, demand of squatting and sitting cross legged, operating conditions, Bipolar arthroplasty whereas can be conducted even in remote areas, is cost effective, result even at the hand of general orthopedic surgeons are good and does not change much the life style of Indian population. Material and methods: All patent above the age of 55 years suspected of having an intracapsular fracture of the femoral neck coming to the casualty were considered for this. Detailed history of the mechanism of the injury, associated injuries Anteroposterior X- rays of the hip and lateral x-rays were taken presence of absence of osteoporosis were noted. Also the part of the neck remaining above the lesser trochanter was noted, Bipolar Prosthesis was used, Lateral Position was given and Moore’s approach was used. Results: In the Presence Series total no of cases were 50 of which mean age of patient were 60 years and mean follow-up was 2 years, The mean post operative Harris hip score was 84 points, 50% of cases were excellent out come with no pain no limp with normal life style. Conclusion: Bipolar prosthesis could be used as replacement arthroplasty in intracapsular fracture neck femur on a larger scale ensuring early mobilization and ambulation of elderly patients.
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2. Pattern of road traffic accident cases in Karad - Three years retrospective study

   Sunil C Aramani, Shakuntala S Aramani, Vijay Kumar A G, Patil D T, Anand Patil

   • » Abstract Introduction: A traffic collision, also known as a traffic accident, motor vehicle collision, motor vehicle accident, car accident, automobile accident, road traffic collision, road traffic accident, wreck (USA), car crash, or car smash (Australian) occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction, such as a tree or utility pole. Material and Methods: In this 3 years retrospective study done from Jan 2010 to Dec 2012, totally 2698 road traffic accident cases which have been registered in the casualty of Krishna Institute of Medical sciences were analyzed at the Department of Forensic Medicine and Toxicology, KIMS, Karad. During this study several epidemiological observations and their results were considered. Results and Discussion: In the present study, maximum number of cases belongs to 21-30 years age group, with male: female ratio is 2.1:1. According to study done by Badrinarayan M, among 360 RTA victims, most cases 138 (38.33%) were in the age group of 15–30 years. A high percentage of both fatal 30 cases out of total 66 (45.45%) and non-fatal 108 out of total 294 (36.73%) cases were observed from the same age group. Mobile males (85%) outscored the domicile females (15%) with a ratio of 5.66:1. Conclusions: Research suggests that the driver's attention is affected by distracting sounds such as conversations and operating a mobile phone while driving. Many jurisdictions now restrict or outlaw the use of some types of phone within the car.
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3. Climate change and adaptation concepts: an indispensable curriculum innovation at higher and basic levels of education in developing countries of Africa

   Ezugwu J J O

   • » Abstract Introduction: This paper presents the outcome of an investigation that considered the current global changes in climate and discussed “climate change and adaptation concepts” for inclusion as innovations in curriculum planning, revision and implementation at both basic and higher levels of education in countries in Africa. This investigation was carried out in Nigeria, an African country and therefore considers African countries’, especially Nigerian educational system as possible areas where the suggested “climate change and adaptation concepts” could best be infused as innovations in curriculum provisions, curriculum revision, and implementation at both Basic and Higher levels of education. In this context, Africa countries are assumed to have approximately similar climatic conditions and can be considered together. The design employed in the investigation was a survey that involved the opinions of a randomly composed sample of one hundred and twenty (120) respondents to a questionnaire instrument developed by the researcher. The sample was made up 30 (thirty) higher education (University lecturers, 30 (thirty) College of Education lecturers, 30 (thirty) basic education (secondary education tutors) and 30(thirty) literate adult members of the public, all drawn from University of Nigeria town in Nsukka, Ehamufu College of Education, Secondary School in Nsukka and Adult members of the public within the metropolis. A total of 5(five) research questions were posed, a total of 20 (twenty) questionnaire items were used and 3(three) research hypotheses were formulated to guide the study. Data collected were analysed using some descriptive statistics like frequencies of the responses obtained on a 4-point likert scale, weighted average responses, as well as z-test statistic for answering the hypotheses formulated. Results obtained showed that all the items of the five research questions posed were considered acceptable by the three categories of respondents used in the study. Results also showed that there was no significant difference in the mean opinions of University lecturers, college of education lecturers, secondary education tutors and the literate adult members of the public that served as respondents to the questionnaire items. Recommendations made include that the performance objectives; content areas to be used; instructional methods for teaching and learning of the concepts; as well as evaluation techniques suggested be infused in the curriculum at both levels of education as innovations in Africa countries, especially in Nigeria.
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4. Towards achieving millennium development goals in Nigeria: development and validation of an instrument for assessing e-learning acquisition in a learner

   Ezugwu J J O, Onugha I U

   • » Abstract Introduction: This paper focused on the development and validation of an instrument for assessing extent of e-learning acquisition by learners in tertiary institutions in Nigeria. Two designs were employed namely: documentary and instrumentation research design. Documentary design was employed because many Information and Communication Technology (ICT) documents were consulted for the content validity of the instrument. Instrumentation is also justified because the paper is tailored on development and validation of an instrument for assessing extent of acquisition of the ICT facilities e-learning skills in learners. Area of the study is principally university of Nigeria, Nsukka. Sample and sampling techniques were not carried out since the entire academic staff of the university who are currently battling with the acquisition of e-learning skills was used in the study. Items of the instrument were framed based on Information and Communication Technology (ICT) plat form. The assessment instrument was content and non-referenced validated by three experts: two computer and one measurement and evaluation experts in this university. Its reliability coefficient was found to be 0.71 using the rates of three (3) expert judges that rated the adequacy of the assessment instrument out of fifty (50) items presented while fifty (50) approved as appropriate as shown in the final drafting of the assessment instrument.
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5. Influence of divorce on children’s up brought and education in afikpo north local government of ebonyi state: Remedial measures for sustainable life styles

   Oko Emelda Chinasa, Ezeugwu J J O

   • » Abstract Introduction: This study presents the results of an investigation on the major causes of divorce in Afikpo North Local Government Area of Ebonyi State, the influence of divorce on children’s upbringing, educationally, socially and emotionally and suggested measures for the eradication of divorce which is a notable problem in Afikpo North Local Government Area of Ebonyi State. Seven clustered research questions with a total of 60 the following items and hypothesis guided the study. The design employed was the descriptive survey involving a questionnaire instrument. Purposive sampling technique was used in the study in order to use schools that have divorced cases in the study. A random sample of 480 SS 3 students 40 secondary school teachers, as well as 21 school guidance counselors, all drawn from 21 secondary schools in the L.G.A, was used as respondents. On the whole there were 260 males, 260 females respectively taking all males and females together well as data collected were analyzed analyses using some descriptive statistics like frequencies, percentages, weighted average responses, as inferential statistics like t-test statistics for testing the hypothesis stated in the study. Major findings in the causes of divorce include sterility, importency, adultery, neglect of wives by husbands; influences of divorce on children include of education of children for trading and other, forms of petty business, exhibition of deviant behaviours like theft, prostitution, aggression, development of low self-esteem and feeling of rejection. Some suggested remedial measures include complete eradication of early and forceful marriages, unfaithfulness, neglect of wives and exhibition of true love and respect on the part of couples. Some recommendations made include that would-be-partners should be biologically harmonious through adequate testing of their genotypes, and avoidance of marriages arranged by relatives or friends without the consent of both parents.
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6. Influence of divorce on children’s up brought and education in afikpo north local government of ebonyi state: Remedial measures for sustainable life styles

   Oko Emelda Chinasa, Ezeugwu J J O

   • » Abstract Introduction: This study presents the results of an investigation on the major causes of divorce in Afikpo North Local Government Area of Ebonyi State, the influence of divorce on children’s upbringing, educationally, socially and emotionally and suggested measures for the eradication of divorce which is a notable problem in Afikpo North Local Government Area of Ebonyi State. Seven clustered research questions with a total of 60 the following items and hypothesis guided the study. The design employed was the descriptive survey involving a questionnaire instrument. Purposive sampling technique was used in the study in order to use schools that have divorced cases in the study. A random sample of 480 SS 3 students 40 secondary school teachers, as well as 21 school guidance counselors, all drawn from 21 secondary schools in the L.G.A, was used as respondents. On the whole there were 260 males, 260 females respectively taking all males and females together well as data collected were analyzed analyses using some descriptive statistics like frequencies, percentages, weighted average responses, as inferential statistics like t-test statistics for testing the hypothesis stated in the study. Major findings in the causes of divorce include sterility, importency, adultery, neglect of wives by husbands; influences of divorce on children include of education of children for trading and other, forms of petty business, exhibition of deviant behaviours like theft, prostitution, aggression, development of low self-esteem and feeling of rejection. Some suggested remedial measures include complete eradication of early and forceful marriages, unfaithfulness, neglect of wives and exhibition of true love and respect on the part of couples. Some recommendations made include that would-be-partners should be biologically harmonious through adequate testing of their genotypes, and avoidance of marriages arranged by relatives or friends without the consent of both parents.
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7. Efficacy of dexmedetomidine infusion of two different doses in patients undergoing laparoscopic surgeries

   Tanmay Tiwari, Rajni Gupta, Ajay Chaudhary, Monica Kohli, Jaishree Bogra

   • » Abstract Introduction: Dexmedetomidine is an α-adrenoceptor agonist with dose dependent α2-adrenoceptor selectivity. Clinical trials indicate that patients treated with dexmedetomidine required either no additional sedative medication or only small doses of add-on medications. This was significantly different from the add-on medication requirements of patients who did not receive dexmedetomidine. Aims and objectives: to study the Efficacy of dexmedetomidine infusion of two different doses in patients undergoing laparoscopic surgeries. Materials and method: in the present study three groups were compared (control, dex 0.3 and dex 0.6). Sedation using Ramsay sedation score, pain using Visual analogue score (VAS), incidence of post operative nausea and vomiting and use of any drug for pain, vomiting and any other side effect were measured and compared. Results: It was observed that duration of surgery, duration of infusion and use of Fentanyl (μg) was statistically insignificant in all the three groups. The mean time of eye opening in Control, Dex 0.3 and Dex 0.6 was 2.83 ± 0.67 min, 4.35 ± 0.68 min and 4.71 ± 0.61 min respectively. The mean time to follow verbal commands in Control, Dex 0.3 and Dex 0.6 group was 3.32 ± 0.70 min, 4.84 ± 0.68 min and 5.29 ± 0.69 min respectively. The mean time to extubate was maximum (5.94 ± 0.66 min) in Dex 0.6 group as compare to control (3.87 ± 0.62 min) and Dex 0.3 (5.25 ± 0.73 min). The use of antiemetic and analgesics was highest in Control followed by Dex 0.3 and least in Dex 0.6. Conclusion: The perioperative infusion of dexmedetomidine has good efficacy during laparoscopic surgery as it, offered decreased postoperative pain level and better sedation scores, decreased the total amount of analgesic and antiemetics requirements as compared with control. Continuous infusion at 0.3µg/kg/hour is recommended over the 0.6µg/kg/hour.
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8. A Rare Case of Calcified Non-Parasitic Splenic Abscess

   S. Pani1, Harpriya Kar, Sujit Prasad, Lisha Suraj, Vishal Yadav, Gautam Agarwal, Anuraddha Koli, Reshma Bhoir

   • » Abstract Primary splenic abscess is a relatively rare disease. Here we present a case of a 40 year old female who is a case of a calcified non-parasitic splenic abscess.
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9. Petrographic and Chemical studies of Tertiary Lignite of Ratnagiri Coast of Maharashtra, INDIA

   R A Suryawanshi

   • » Abstract Tertiary Lignite of western Maharashtra is trapped in basalt and laterite and at places between laterite. These deposits are 50mts above MSL and 500mts away from sea coast. Lignite of Ratnagiri are studied petrographicaly, chemically and with SEM studies for their genesis, depositional environment and quality. The microlithotypes of lignite are recognized on the basis of shape and nature of maceral. The properties of the coal are mainly dependent on the relative abundance and the degree of mixing of maceral. From the study it has been observed that huminite maceral is present in abundance (72 to 90%), followed by irrtertinite and exinite which is very rare to absent. Lignite of Jaigarh is close to peat with high ash, low carbon and calorific value, more mineral matter. While lignite of Golap-Pawas area have distinct maceral content, high carbon and sulphur, low ash and mineral matter with high calorific value. Pyrite nodules concentration indicate reduced environment of deposition. Present study indicates lignite is deposited in estuarine to marine environment.
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10. Spatial verification of SCS-CN and Φ-Index methods in correlation to land use/land cover and Soil characteristics

    Varsha Mane, Y B Katpatal, K R Aher

    • » Abstract Groundwater recharge planning in microwatersheds is based on realistic information on infiltration characteristics. The present paper focuses on identification of infiltration characteristics within Mini watersheds by estimating runoff parameters and Φ-index. For this, the landuse /land cover and hydrological soil groups of the study area have been generated in GIS environment. By using landuse and soil classes, curve number has been generated. In the process, the SCS- CN method has been used to estimate runoff depth, peak discharge, and potential maximum retention, time of concentration and time to peak discharge for individual ten micro-watershed of the study area. For computation of infiltration rate from rainfall runoff data, infiltration indices i.e. Φ -index has been used. The study reveals that the SCS-CN method can be significantly used to determine the runoff estimation with input of LU/LC from RS data in comparison to the rational method. The study also verifies the fact that the Φ-index is related to the landuse, especially vegetation intensity and soil type of the micro-watershed. Result shows that WGK-2, 1/10 micro-watershed having highest Φ–index (2.29 mm/day) value, lower runoff (711.3) and Curve number value (64.33), has 70% forest area and gravely sandy loam type of soil. WGK-2, 10/10 micro-watershed having lowest Φ–index (0.81 mm/day) has higher runoff (807.29 mm) and Curve number value (84.7).
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11. Evaluation of portal vein anatomy and variations in a south Indian population group on routine abdominal multi-detector computed tomography

    Thomas B, Basti Ram S, Xavier Joseph V, Kumbar Vishwanath G

    • » Abstract Introduction: The portal venous system is associated with a wide range of congenital variations and its preoperative detection is imperative for hepatobiliary surgical and percutaneous procedures. Aims: The purpose of this study is to study the normal anatomy and to determine the incidence of the types of variations and clinical implications of intrahepatic portal vein anatomy detected on routine MDCT multiphase scan of abdomen among Indian adults. Methods and Material: This is a retrospective study done on 200 patients who underwent MDCT of the abdomen, at our institution, for various indications. All scans were done using GE Bright speed 16 –slice MDCT, according to standard abdominal multiphase CT protocols. Main PV variations and right portal vein variations were investigated as 5 separate groups. All cases were assessed by a single radiologist, for the existence of, type, and number of PV variations. Results: In our study of 200 patients, with almost equal sex distribution (males 103/ 200 and females 97 /200), the standard portal venous anatomy was seen in 81.5% and the prevalence of portal vein variation was 18.5 %. Type 2 accounted for (23 /200) 11.5% and was the most common variant followed by type 3 (9 /200) 4.5%. The prevalence of right portal vein variations in our study was 2.5 percent. No significant association was seen between sex distribution and the presence of portal vein variations. Conclusions: Radiologist and surgeons need to be aware of portal vein variations, especially in cases pertaining to liver interventions. Our study shows a relatively smaller incidence of portal vein variation in the Indian study group compared to that of recent literature. However a study on a larger group is imperative to unravel the true extent of portal vein variations in the Indian population.
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12. factors of type 2 diabetes: a study among high risk adults in a tribal area of western Maharashtra

    Kunde Pallavi B, Zade Dnyaneshwar C

    • » Abstract Background: The recent World Health Organization report suggests that number of diabetic subjects in India is projected to increase to nearly 80 million by 2030. Behaviour change communication is one of the strategy to prevent type 2 diabetes. Objectives: To study the effect of Behaviour Change Communication on behavioural risk factors of type 2 diabetes. Materials and Methods: This is an interventional study carried out during December 2010 to November 2012 in a field practice area under Rural Health Training Centre (RHTC) attached to the Department of Community Medicine of a tertiary care municipal hospital in Mumbai. Forty one tribal adults in 25 - 64 yrs age group having 3 or more risk factors for type 2 diabetes were included in this study. Data was collected at baseline and 12 months after behaviour change communication. Data was analyzed in SPSS Version 15.0 using Paired t test. Results: Thirty five participants completed the study. Significant reductions in both the tobacco and alcohol use occurred between baseline and 12 months after intervention. Improvement in fruit and vegetable intake was observed at 12 months but it was not statistically significant. Conclusion: Behaviour Change Communication is effective strategy to reduce the behavioural risk factors of type 2 diabetes among high risk tribal adults.
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13. A study of assessment of dyslipidemia in hypertensive patients

    Laxmikant Chavan, Abraha Hailu

    • » Abstract Introduction: The metabolic syndrome is a constellation of interrelate risk factors of metabolic origin—metabolic risk factors that appear to directly promote the development of atherosclerotic cardiovascular disease. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Aims and objectives: To assess the Dyslipidemia in hypertensive patients as per ATP-3 guidelines. Material and Method: In the present study two groups were formed (hypertensive and control group). Lipid profile of all the selected patients was done and compared. Results: 48% and 32% of hypertensive patients were having borderline high to high cholesterol level. 40% hypertensive subjects were having elevated serum triglyceride levels. 54% of patients belonging to control group had optimal LDL Cholesterol level.44% hypertensive were having VLDL >30. In control group only 6% were having VLDL >30. 92% hypertensive had levels more than 40 whereas in control group 38% had levels more than 40. Conclusion: thus we conclude that there is significant association of Hypertension and Dyslipidemia.
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14. Role of MRI in lumbar intervertebral disc prolapse - a clinico- radiologic correlation study

    Ram Shenoy Basti, Rishi Philip Mathew, Abdunnisar M, Hadihally B Suresh

    • » Abstract Objective: To describe degenerative changes involving intervertebral discs of lumbar spine in correlation with symptoms of the patients. Materials and Methods: Patients with clinically suspected lumbar intervertebral disc prolapse referred for MRI to the Radiology Dept. of our institution over a period of one year from Jan 2013 to Jan 2014 were included in the study. This retrospective analytical study included 100 patients who presented with low back and/or radiating leg pain and other symptoms suggestive of intervertebral disc prolapse. All the patients have undergone MRI on 1.5 T MRI (Philips Achieva 16 Ch.) scanner. The images were correlated with clinical symptoms and level of disc prolapse as well as neurological signs and symptoms. Statistical analysis included percentage frequency and chi square test. Results: 100 patients were included in the study with age ranging from 18 to 73. Disc bulge was most frequent finding seen in 74 patients (74%), disc herniation was seen in 25 patients (25%) and was commonest in patient with acute history of backache while disc bulge was common in patients with chronic symptoms. 77 patients (77%) had MR evidence of nerve or thecal compression. Nerve compression (P Value= 0.013) and disc herniation (P value= 0.004) were significantly associated with pain distal to the knees. Conclusion: Nerve compression or Disc herniation was strongly associated with distal leg pain. Nerve compressions were commonest in patients presenting with acute onset of backache. Disc bulge/ degeneration showed no significant association with specific pain patterns.
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15. Clinico-pathological study on role of frozen section in ovarian lesions at a tertiary care hospital in south India

    Nisha J Marla, Athulya C, Hilda Fernandes, Jayaprakash C S

    • » Abstract Background: Ovarian neoplasms are an important cause of morbidity and mortality in women. Frozen section (FS) is an integral component in the assessment of ovarian neoplasms at laparoscopy or laparotomy. This study was undertaken to study and correlate FS with permanent histopathological sections in ovarian lesions. Materials and Methods: Intra-operative FS performed for ovarian lesion was analyzed prospectively and retrospectively in 45 patients who underwent surgery at our institution from January 2009 to July 2013.This was compared with the final histopathologic diagnosis on permanent paraffin sections. Results: Among 45 cases of ovarian lesions, the final histopathological diagnosis showed 31 benign tumors, 5 borderline tumors and 9 malignant tumors. The FS diagnosis correlated with the final histopathology in 43 cases (95.5%) and was discordant in 2 cases (4.4%). The overall sensitivity, specificity, positive predictive value and negative predictive value of FS was 97.2%, 88.8%, 97.2% and 88.8% respectively. The sensitivity of FS diagnosis for benign, borderline and malignant lesions was 96.7%, 100% and 88.8%; respectively and the specificities were 92.8%, 100% and 97.2% respectively. Conclusion: Intraoperative FS has high accuracy in the diagnosis of suspected ovarian neoplasms. It is a valuable tool to guide the surgical management of these patients and should be routinely used in all major oncology centres.
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16. Study of Intravenous Drug Analgesia for first stage labour pain relief: a descriptive study

    Sanjaykumar B Pagare, Nimisha Pagare, Deshpande S S, Yelikar K A

    • » Abstract Pain relief in labour is among the most common problem encountered by treating doctors. Various methods are being increasingly employed for pain relief during labour. Present study describes the effect of Intravenous Drug Analgesia in relief of first stage of labour pain. 100 cases of full term (37 to 42 weeks) singleton pregnancy with cephalic presentation in active phase of labour with cervical dilatation of ≥ 3cm but ≤ 5 cm were included in the study. VAS was used to assess the pain before administering labour analgesia and repeated at 1 hour, 2 hour, 4 hour and at full dilatation of cervix. Overall effect of labour analgesia in relief of pain was categorized as: Excellent, Good, Fair and Poor. Duration of labour was recorded from time of administration of labour analgesia to delivery of baby. Mode of delivery was also noted and categorized as Normal, Assisted- Ventouse/Forceps or Caesarean. Assessment of neonatal outcome was done using APGAR score in all babies at 1 minute and 5 minute. Side effects or complications were also noted. The results indicate that Intravenous Drug Analgesia is as an effective mode of management of labour pain.
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17. Assessing hand grip strength and screening of performance related upper limb injuries experienced by Indian musicians

    Ajay Malshikare, Tushar Palekar, Parag Narayankar

    • » Abstract The objective of this study were to assess Hand Grip Strength and screen for performance related upper limb injuries experienced by Guitar, Sitar, Keyboard, Harmonium, and Tabla players.100 Musicians from age group of 20-60 years participated in this survey. Every musician was given a questionnaire to fill as per their experience about performance related symptoms and problem faced in past or present in upper limb. After this, Hand grip strength (B/L) was measured in sitting position with elbow flexed in 900, shoulder adducted, forearm in mid prone position with wrist in neutral position and cuff of Modified Mercurial type Adult Sphygmomanometer inflated to 20 mmHg. Every participant musician was told to press the cuff as hard as possible for 3 times. Rest period of 5 minutes was given in-between every trail. The Mean score among 3 trails was recorded. The result showed, 66 Musicians out of 100 were having performance related symptom or problem experienced in upper limb. The information about musician`s hand grip strength, showed significant difference between the dominant and non-dominant hand grip strength (p = 0.034). Musicians participated in survey experienced symptoms like significant pain in musculoskeletal system, abnormal sensations in finger tips, weakness in muscles and loss of sensation in fingers. Assessment of grip strength is an essential evaluation method and it’s useful to keep normative data of hand grip strength for musicians and also for physiotherapist.
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18. Evaluation of anatomical variations in aortic arch branching pattern in south Indian population using computed tomography

    Ram Shenoy Basti, Sanjay Kumar

    • » Abstract Background and Purpose: Anatomical variations can occur in the aortic arch branching pattern and the frequency of various types vary in different population groups. These are likely due to alterations in the development of aortic arch arteries during embryonic period. These variations are significant for diagnostic and surgical procedures in head and neck. The purpose of this study is to determine the frequency of the aortic arch branch variations on CT in the local population and thus provide useful data to intervention radiologists, vascular, head and neck and thoracic surgeons. Materials and Methods: CT scans of the chest of a total of 306 patients performed in our hospital were analyzed retrospectively and assessed for the origin of the major aortic branches. Axial images are primarily used for assessment. Thereafter necessary reformatted multiplanar and curved reformatted images, MIP, VR images were used to assign each patient is assigned into a particular type of the branch variation. Results: The most common aortic arch branching pattern - type 1 was found in 274 of 306 cases (89.5%). In this pattern three major branches - Brachiocephalic trunk (BT), Left common carotid (LCC) and Left subclavian (LS) originated independently from the arch of aorta. Second commonest branching pattern was type 2 which was found in 16 of 306 cases (5.2%). This pattern had only two branches - The first was a common trunk designated as great trunk (GT) which gave the brachiocephalic trunk and left common carotid artery. The other was the left subclavian artery. Third common branching pattern was type 3 which was seen in 14 of 306 cases (4.6%), which had four branches: Brachiocephalic trunk, left common carotid artery, left subclavian artery and left vertebral artery (LV). Two rare variants were found, 1 case each (0.3%). One had four branches: right common carotid, left common carotid, left subclavian and aberrant right subclavian artery (ARSC). This has been called the type 4 variant. The other had three branches: great trunk, left vertebral artery and left subclavian artery ( type 6 variant).
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19. Perimenopausal bleeding: evaluation of various treatment modalities

    Sanjay Bansode, Vinit Dhadke

    • » Abstract Introduction: Perimenopause is defined as, the years prior to menopause that encompasses the change from normal ovulatory cycles to cessation of menses, marked by irregularity of menstrual cycles. Management consists of a stepwise evaluation of all possible organic causes of uterine bleeding. A patient's degree of menorrhagia, associated pain, desire for pregnancy, concurrent medical conditions, treatment side effects and her physician's comfort level should be taken into account when deciding on management. Aims and objectives: to study the various treatment modalities used to treat perimenopausal bleeding. Materials and method: Women attending gynecology department with perimenopausal bleeding were enrolled in the study. Detail history, clinical finding were recorded. Treatment was decided using standard criteria. And the outcome was measured. Results: Maximum 66 i.e. 82.5% cases had dysfunctional uterine bleeding followed by fibroid. Majority of the cases (13.75%) had hypertension as associated disorder. 42 cases received Norethisterone acetate which cured 35 i.e. 83.33% cases, while 14 cases received Tranexamic acid which cured 12 i.e. 85.71% cases. In 12 cases dilatation and curettage was performed which cured 9 i.e. 75% cases, while in 12 cases hysterectomy was done which cured all the cases. 16.25% women required blood transfusion to correct the anemia. Conclusion: In medical management low cost tranexamic acid (85.75%) is almost as effective as high cost hormone therapy, norethisterone acetate (83.33%).Low cost minor surgical procedures like dilatation and curettage is effective in 75% cases while high cost major surgery like hysterectomy is effective in all the cases as it removes the causative organ.
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20. Preparation, characterization and luminescent properties of LiBO2:Tb3+ green emitting phosphor for solid state lighting

    V R Panse, N S Kokode, S J Dhoble

    • » Abstract Introduction: In our work we report the preparation, characterization and luminescence mechanism of Tb3+ activated LiBO2 green emitting phosphor for solids state lighting. Tb3+ has been extensively used as green-emitting activator for luminescent phosphor materials; the excitation and emission spectra indicate that the prepared lithium borate based phosphor can be effectively excited by 353 nm, to showing a bright green emission at 545 nm corresponding to the f→f transition of Tb3+ ions. All the characteristics indicated that LiBO2:Tb3+ is an excellent phosphor for solid state lighting.
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21. A rare case report -Lipoid proteinosis with laryngeal and oral manifestations

    Poonam Khairnar, S. K. Nagle, Kartik Parelkar, Shubhangi Kedar, Bandu Nagarale

    • » Abstract Introduction: Lipoid proteinosis is a rare autosomal recessive disorder, characterized histologically by infiltration of periodic acid Schiff-positive hyaline material into the skin, upper aerodigestive tract, and internal organs. Classical clinical features include skin scarring, beaded eyelid papules, and laryngeal infiltration leading to hoarseness. Usually, the hoarse voice is present at birth or in early infancy, as the first manifestation. In more severe cases, diffuse infiltration of the pharynx and larynx might cause respiratory distress, at times requiring tracheostomy. This paper reports a classical case of lipoid proteinosis with laryngeal and oral manifestations.
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22. A comparative study of platelet counts by manual and automated methods in platelet poor plasma

    J B Leena, Mrudula, Sumanth Devaraju, Crysle Saldhana, Veronica

    • » Abstract Introduction: Reliable platelet count is crucial for minimizing errors in coagulation studies. Platelet poor plasma is routinely used for coagulation studies as platelets interfere with coagulation. In this study randomly collected 30 samples of platelet poor plasma for routine coagulation studies received in haematology laboratory of Father Muller Medical College Hospital, Mangalore for a period of 3 months were analysed and counts were done by both manual method and automated methods. Platelets were analyzed by using Neubauer chamber and were compared with automated method. The study analysis showed that there was no significant difference between manual and automated platelet counts in platelet poor plasma. The intraclass correlation between automated and manual method showed significance with p value 0.00, and also showed an excellent agreement (ICC: 0.868) with a positive correlation between the two methods. Hence this study shows that both methods can be used to asses platelets in platelet poor plasma as a part of quality control procedure. Manual method is thus recommended even at places where automation is unavailable to improve quality of coagulation studies.
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23. Obstetric outcome of teenage pregnancy

    H C Savitha, Sanjay Kumar C2, Deepthi H R

    • » Abstract Background: Teenage pregnancy is a social problem worldwide with a serious implication on maternal and child health. The objective of this study is to compare the maternal and perinatal outcomes between teenage girls (age between 13 to 19 years) and pregnant adults (age between 20-29 years). Methods: We performed a retrospective analysis of case records on teenage pregnancies from January 2013 to June 2013 in the department of Obstetrics and Gynaecology, Mandya Institute Of Medical Sciences, Mandya, Karnataka, India, a referral tertiary care centre and teaching hospital with over 6000 deliveries annually. Pregnancy outcomes in girls aged 13-19 years were compared with those in women aged 20-29years. Results: The incidence of teenage pregnancy was 6.56%, majority of teenagers were primigarvida. The study showed that teenage mothers are at increased risk of having abortions, preeclampsia, low birth weight babies and perinatal mortality. Conclusion: Our study showed that risk of obstetric complication was no higher in adolescents than in adult women, but adolescent tended to have higher incidence of abortion, pre-eclampsia, low birth weight babies and perinatal mortality. Early booking and good antenatal care should improve the obstetric and perinatal outcome in teenage pregnancies
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24. A histopathological review of scalp tumors: Hospital based study

    J B Leena, M B Sandeep, Crysle Saldanha, Megha, Krishnaprasad H V

    • » Abstract Background: Lesions of the scalp are rare comprise a heterogeneous assemblage varying from benign to malignant. The clinical experience regarding these rare lesions is limited .Hence there is corresponding paucity of data in the medical literature regarding the incidence and prevalence of scalp lesions with an extremely wide range of pathology appearances. This study is intended to determine the distribution of both benign and malignant lesions. Materials and Methods: This is a 2 year (2010 2012) retrospective study of all scalp lesions received at our referral teaching hospital, Father Muller medical college, Mangalore, India. All the histopathologically proven cases of scalp lesions were reviewed and clinical details were obtained from the archives. Age, gender, and histology of all the specimens were evaluated Results: Among the 45 cases, 39 (87%)) cases were benign lesions and remaining 6 (13%) were malignant lesions. Most common clinical presentation was a scalp swelling or a nodule. The male to female ratio among the benign tumors was 1.5:1. Age distribution in benign lesions was 20-40 years whereas malignant lesions were seen in the elderly. Trichelemmal cyst was the most common benign lesion and basal cell carcinoma was the most common malignant lesion. Conclusion: Scalp lesions are rare, benign tumors are more common and malignant tumors are not uncommon. In each case of a scalp lesion a broad differential diagnosis has to be considered. Improved clinical experience and hospital attendance with more comprehensive reporting would yield more representative data.
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25. Delayed death in hanging – a rare case report

    Khetre R R, Bansude M E, Dode C R, Umbare R B, Chormale D

    • » Abstract Hanging is very common mode of suicide particularly in young adults. Its incidence in India is approximately 25% of total cases of suicide. It is a painless method of committing suicide and death is instantaneous. However, a few cases have been reported in literature in which death has occurred after certain period of time or patient has survived after prolonged resuscitative measures. Here we present two cases of delayed deaths in hanging with the victims eventually succumbing to one or more of the fatal complications after surviving for different time duration.
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26. The study of incidence of maternal anaemia in various age groups of women going to labour in Orissa

    Rajeshwari K., Ashok Kumar Behera

    • » Abstract Introduction: Anaemia is the commonest medical disorder in pregnancy and has a varied prevalence, aetiology and degree of severity in different populations. Anaemia during pregnancy has been shown to be associated with a two-fold risk for preterm delivery and a three-fold risk for low birth-weight as well as maternal mortality. The World Health Organization (WHO) estimates that anaemia contributed to approximately 20% of the 515,000 maternal deaths worldwide in 1995. Keeping these facts in view, the present study embodies the observation of 250 cases among 400 cases attending labour room of S. C. B. Medical College, Cuttack (Orissa), giving an incidence of 62.5%, which is quite high in comparison to developed countries.
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27. A study of radial nerve and its deep branch in the cubital fossa

    Vaishali P. Ahire, Lakshmi Rajgopal

    • » Abstract Introduction: The radial nerve anterior to the lateral epicondyle divides into superficial and deep terminal branches. Entrapment or compression neuropathy of the deep branch of radial nerve (DBRN) or posterior interosseous nerve (PIN) leads to radial tunnel syndrome or PIN syndrome. It may also be one of the differential diagnoses of lateral epicondylitis. This study was performed on 38 upper limbs of 19 formalin-fixed cadavers. In most of the instances it was found that the radial nerve divided 1.4 cm above the interepicondylar line (IEL). The nerve to extensor carpi radialis brevis (ECRB) arose at 1.2 cm from the IEL. We also observed the nature of some of the important structures which may compress deep branch of radial nerve. This knowledge is important for exploring elbow region during surgical decompression of DBRN.
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28. A prospective autopsy based study of sudden natural non-traumatic deaths in a rural district

    Khetre R R, Batra A K, Shrigiriwar M B, Kuchewar S V, Jambure M P

    • » Abstract Introduction: Sudden natural death, especially when it occurs in an apparently healthy person, can have a great impact on society. Sudden natural deaths undoubtedly constitute a significant portion of deaths which undergo autopsy for investigation of death. Therefore, a prospective autopsy based study of sudden natural non-traumatic deaths (SNND) was decided to determine age, sex and system wise involvement. Aims and Objectives: The study was aimed to find out the burden (percentage) of sudden natural non-traumatic deaths and also to determine age, sex and body system wise involvement. Material and Methods: This prospective autopsy based study was conducted in the Department of Forensic Medicine and Toxicology, Shri V. N. Government Medical College, Yavatmal, Maharashtra, India. During study period from 1st October, 2010 to 31st August, 2012, total 1711 medico-legal autopsies were conducted in the department, of which those cases which were turned out to be sudden natural non-traumatic deaths (SNND) were studied. Observations and Results: The burden (percentage) of SNND cases was 7.3% (125/1711). Total SNND cases were 125, out of which maximum number of cases i.e. 72 (57.6%) were seen in the age group of 21 to 50 years. The average age of SNND was 37.5 ± 18.5 years for both sexes. Amongst 125 cases, maximum i.e. 92 (73.6%) were males and 33 (26.4%) were females. The male to female ratio was 2.8:1. Out of total 125 cases of SNND, maximum i.e. 41 (32.8%) cases were of cardiovascular causes followed by 32 (25.6%) due to respiratory causes. 17 (13.6%) cases were of central nervous causes, 20 (16%) were of gastrointestinal causes, 05 (04%) due to genitourinary causes and 10 (08%) were of miscellaneous causes. System wise differences in male and female cases was found to be statistically significant (χ2=17.22, p= 0.004105). An age group wise difference in male and female cases was found to be statistically significant (χ2= 21.38, p= 0.003246) Conclusion: Sudden death was the most common indication in natural deaths for medico-legal autopsy. Burden of sudden natural non-traumatic death (SNND) cases was 7.3%. So, it is the need of time to implement necessary steps to reduce this burden. SNND cases had male preponderance and target age group for maximum SNND cases was 21 to 50 years. Cardiovascular system was most vulnerable. Survival period, rapidity of death and their frequent occurrence must be considered in planning emergency referral, transport and emergency and super speciality medical services to cope with immediate events prior to death.
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29. Evaluation of Oxidative stress markers and antioxidant status in diabetic retinopathy

    Shilpashree Y D, Suma M N, Devaki R N, Prashant V

    • » Abstract Introduction: Oxidative stress resulting from enhanced free-radical generation and/or a decrease in antioxidant defenses has been implicated in the pathogenesis of diabetic retinopathy. This study was conducted to evaluate oxidative stress and antioxidant balance in diabeticretinopathy and to correlate this with glycemic control Method: Thirty patients with diabetic retinopathy and thirty age matched healthy controls were included in the study. Fasting blood glucose and glycosylated hemoglobin (HbA1C) were estimated to assess the severity of diabetes and the glycemic control respectively. Serum malondialdehyde (MDA) levels were assessed as a marker of lipid peroxidation and hence oxidative stress. Erythrocyte glutathione peroxidase (GPx) levels were assessed for antioxidant status. Results: HbA1c in patients with diabetic retinopathy compared to healthy control was statistically highly significant (p<0.000). Significant positive correlation was found between serum MDA levels and HbA1c (r = 0.387, p < 0.0001) in patients with diabetic retinopathy. There was statistically significant reduction in the Glutathione peroxidase levels. Further, MDA levels were inversely correlated with GPx (r = - 0.90, p < 0.0001) levels. Conclusion and summary: oxidative stress is greatly increased in patients suffering from diabetic retinopathy and is inversely related to glycemic control. This may be due to depressed antioxidant enzyme levels and may also be responsible for further depletion of antioxidant enzyme GPx. This worsens the oxidative stress and creates a vicious cycle of imbalance of free radical generation and deficit of antioxidant status in these patients which may lead to nervous system damage causing diabetic retinopathy. A good glycemic control is essential for prevention of diabetic retinopathy.
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30. Effect of suryanamaskar on handgrip strength in healthy volunteers in the age group of 20-40 years

    M. S. Bhonde, A. H. Bagade, A. D. Dhanavijay

    • » Abstract Introduction: Yoga helps in improvement of physical strength and neuromuscular co-ordination. Suryanamaskar (Sun Salutation) is an integral part of Yogic exercises. It involves exercising almost all the muscles and joints of the body. Hand grip strength (HGS) is not only a measure of the strength of muscles of the upper limb but also neuromuscular co-ordination. The objective of the study was to evaluate the effect of suryanamaskar on HGS in healthy adult subjects. 120 newly enrolled healthy volunteers (62 females) in the age group of 20 to 40 years were selected from a reputed Yoga canters in Mumbai. HGS was measured using hand grip dynamometer set at second handle position at 0º and 90º elbow flexion before the start of study. The subjects were then instructed to practice suryanamaskar for 30 minutes daily for 12 weeks. HGS was measured after completion of study period. Paired t test was used for analysis of data. It was observed that the mean HGS before study was 27.73 which increased significantly to 30.28 after the practice of suryanamaskar (p< 0.001). We conclude that the increase in hand grip strength is probably due to strengthening of the muscular system of the body also involving upper limb muscles due to stimulation of muscles during the isometric contraction maintained during the steady state of yogic postures and improved co-ordination as a result of practice of suryanamaskar.
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31. Platelet aggregation, plasma fibrinogen level and euglobulin clot lysis time in male hypertensive patients

    Shekhar P Shiradhonkar, Aradhana Arvind Deshmukh, S M Handergulle

    • » Abstract Introduction: The present study was conducted at S. R. T. R. Medical College, Ambajogai. Fifty hypertension cases and 50 controls were taken according to different age groups. Platelet aggregation, plasma fibrinogen level and euglobulin clot lysis time were compared with age matched control and also cases were compared amongst themselves depending upon the duration of hypertension. Analysis of results showed a statistically significant increase in platelet aggregation and plasma fibrinogen level in all the hypertensive cases when compared with age matched control. Euglobulin clot lysis time showed a statistically significant decrease (increase in fibrinolysis) in all the hypertensive cases when compared with age matched control. When the increase in Euglobulin clot lysis time (decrease in fibrinolysis) was correlated with duration of hypertension, it was found that the decrease in fibrinolysis varies directly with increase in duration of exposure.
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32. Role of Renal Biopsy in Systemic Lupus Erythematosis (SLE)

    Nisha J Marla, Ramesh Naik, Hilda Fernandes, Jayaprakash C S, Kirana Pailoor

    • » Abstract Aims and Objectives: 1)To evaluate histopathological findings in Lupus Nephritis and to classify it according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS 2003) classification system for Lupus Nephritis. 2) To correlate the histological findings with the disease process. Materials and Methods: Renal biopsy performed at a tertiary care centre and Hospital in South India, for duration of 2 years was collected along with relevant clinical data. Ultrasound guided renal biopsy was performed and tissue were processed routinely and the slides were stained with Hematoxylin and Eosin. Special stains that is per iodic acid Schiff (PAS) and Methanamine silver (PASM) were performed for all cases. All the cases were correlated with Immunofluroscence (IF) study. 30 Renal biopsies were performed, 21 cases were of Primary Glomerulonephritis and 9 cases were Secondary Glomerulonephritis out of which 6 were cases of Systemic Lupus Erythematosus. Renal Biopsy of all the cases of SLE was classified according to ISN/RPS classification system. Results: Out of 30 cases (n=30), Primary glomerulonephritis (GN) accounted for 70% and secondary GN accounted for 30%. Among secondary glomerulonephritis predominant lesion were systemic lupus nephritis (66.7%) followed by diabetes mellitus (22.2%) and Amyloidosis (11.1%). In secondary GN the predominant lesion was Systemic Lupus Nephritis, Out of 6 (100%) cases of Lupus Nephritis, 4 (66.7%) cases were class IV, 1(16.7%) case was class II and 1(16.7%) case was class V. Conclusion: Management goals in patients with Lupus Nephritis include early diagnosis and appropriate therapy whilst preserving overall Kidney function without undue side effects and prevent irreversible damage. ISN/RPS 2003 classification tends to correlate with clinical syndrome and provide valuable information regarding prognosis and guideline for treatment. ISN/RPS classification system also intends to facilitate a higher degree of reproducibility, resulting in a better patient care. A renal biopsy examined by routine light microscopy, Immunofluroscence and electron microscopy contributes toward diagnosis, prognostic information, and appropriate management.
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33. Effect of single dose of Di isobutyl Phthalate on hepatic development in Wister rats treated prenatally

    Shetty PN, Ray B, D’Souza AS, Sushma RK, Nayak D, Rao ACK, Chakraborti S

    • » Abstract Phthalate esters are plasticizers widely used in the manufacture of plastics. Di iso butyl phthalate (DIBP) is used as a plasticizers, ranging from the plasticization of PVC to the production of paints, printing inks and adhesives. Therefore, DIBP exposure in people in adhesive industries and pharmaceutical industries are higher in comparison to general population where it is low. Major route of excretion of DIBP is through urine, with some excretion in the faeces, presumably due to biliary excretion. Aim of this study was to determine the effect of single dose of DIBP on developing liver of Wistar rat. One hundred and eight adult pregnant Wistar rats were divided into control and experimental groups. Rats in experimental group were given DIBP on10, 12and 14day of gestation at 0.375, 0.75 and 1.25ml/kg body weight doseintraperitoneally in a single dose.Sections of liver collected on day 21of gestation were stained with haematoxyline and eosin and examined histologically.The remarkable histo-pathological changes were not observed, when exposed to above dose of DIBP.But, there was a significant reduction in the weight of foetalrat liver, when mother rat exposed to DIBP on 10thday of gestation compared to 12th and 14th days. As pregnant women are constantly exposed, effect of DIBP on the liver of a developing fetus would denote the consequence in future generation.
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34. A clinical study of neurotoxic manifestations following snake bite in a tertiary care centre of south Karnataka

    Anitha M S, Lade V V

    • » Abstract 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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35. An inventory control model for deteriorating items with shortage under time varying holding cost for instantaneous replenishment

    Pravin B Bansode, Sunil V Kawale

    • » Abstract 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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36. Comparison of intra ocular pressure changes in third trimester of normal pregnancy and pregnancy induced hypertension

    Pitta Paramjyothi, Battu Vijayalaxmi, A N R Lakshmi

    • » Abstract 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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37. Evaluation of balance related tasks in hearing impaired children

    Tejas Borkar, Pradeep Borkar

    • » Abstract 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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38. A rare case of skin metastasis from soft palate cancer

    Meenu Gill, Reeti Saini, Rajeev Sen

    • » Abstract 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.
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39. 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

    • » Abstract 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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40. 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

    • » Abstract 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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41. A phantom study on the influence of viscosity of blood, percentage diameter stenosis, length of stenosis and cross-sectional area of blood vessel on blood flow dynamics in peripheral (brachial and femoral) artery models using Doppler ultrasound spectral analysis

    Sudha Pattan, Santhosh Joseph, Venkata Sai P. M., Aruna P., Ravishankar P.

    • » Abstract Objectives: To study the influence of viscosity of blood, percentage diameter stenosis, length of stenosis and cross-sectional area of blood vessel on blood flow dynamics in peripheral (brachial and femoral) artery models using Doppler ultrasound spectral analysis. Methods/Analysis: An experimental study was carried out using an indigenously fabricated Doppler ultrasound compatible blood flow phantom. Doppler frequency spectral analysis was the method used for the study. To study the influence of various factors on blood flow dynamics, brachial and femoral artery models with 25%, 50%, 75% diameter stenosis of 5mm, 10mm lengths and 2cP, 3cP, 4cP viscosity blood mimicking fluids (BMF) were used. To study the influence of the parameters, the change in ratios of Pre and Post stenotic Peak Systolic Velocities (PSV ratio) obtained with respect to change in the parameter were assessed. Findings: The magnitude and pattern of change in the PSV ratio with respect to pre-destined values of viscosity, percentage diameter stenosis, length of stenosis and cross-sectional area of the blood vessel were analysed. Novelty: As the analysis of flow dynamics under such conditions of variability cannot be exercised clinically (as a patient-based study), a model-based experimental study was performed with a cost-effective indigenously fabricated Doppler ultrasound blood flow phantom.
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42. Isolation and characterization of thermostable lipases from themophilic bacteria isolated from hot water spring

    R J Pungle, S G Sapkal, B D Vyawahare, P R Bhandwalkar, S B Bedwal, R S Pise, S A Rathod

    • » Abstract Twelve isolates were screened for lipases production from hot water spring, Vajreshwari, Thane, Maharashtra on a Nutrient agar and nutrient broth medium consisting of olive oil. The isolate showed highest lipase activity was VIII which later was identified as Sphingomonas paucimobilis. The effect of pH, temperature and substrate concentration was studied on partially purified lipases by ammonium sulphate precipitation from Sphingomonas paucimobilis. The partially purified lipase had maximal activity at pH of 7.The optimum temperature for the hydrolysis of olive oil at 60°C.The lipases has ability to hydrolyse used fried oil. The transesterification activity of lipases was used to synthesis biodiesel. The analysis of synthesized biodiesel was performed by FTIR( Fourier transform infrared spectroscopy) and free fatty acid content.
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43. A study to assess the effectiveness of cranberry juice on urinary tract infection among post natal mothers in selected hospitals

    Shwetha Shamlal Kayasth, Nilima R. Bhore

    • » Abstract Background: Urinary tract infections are the second commonest infections in community practice. UTI’s are the foremost common microorganism infections throughout physiological condition. Therefore, Cranberries have been used to prevent urinary tract infections (UTIs). Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. Aims and Objectives: To assess the signs and symptoms of urinary tract infection among post natalmothers. To assess the effectiveness of cranberry juice on urinary tract infection among post-natal mothers. Materials and Methods: A quantitative research approach and a descriptive research design was used. Quasi experimental research study was conducted on 80 postnatal mothers during august and September 2017. Non probability purposive sampling technique was adopted. Results and Conclusion: Cranberries contain 2 compounds with antiadherence properties that prevent fimbriated Escherichia coli from adhering to uroepithelial cells in the urinary tract. The findings of present study have been discussed as per the objectives of the study. Cranberry juice was significantly effective on urinary tract infection among post natal mothers. Hence it is concluded that there is significant effect of Cranberry juice on urinary tract infection among post natal mothers.
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44. Radiographic study of anatomical basis of Coracoacromial arch impingement due to varied morphology of acromion process

    Aruna Y Yadav, A D Patil

    • » Abstract The purpose of this study to know the different shapes of acromion process according to Beglani and Edelson and Traitz on radiographs. For this study 260 radiographs were taken - 200 radiographs of patients having shoulder pain due to impingement and 60 Radiograph of normal patients without shoulder pain. In this study according to Beglani, there were 33 radiographs of Type I, 137 radiographs of type II and 30 radiographs of Type III, Type II radiographs being more in number than Type I and Type III in case of symptomatic patients. In case of normal patients, there were 7 radiographs of Type I, 52 radiographs of type II and 1 radiographs of Type III, Type II radiographs are more in number than Type I and Type III and anatomically Type III acromion process is responsible for impingement. According to Edelson and Traitz classification, 56 radiographs of Cobra shape, 109 radiographs of Intermediate shape and 35 radiographs of Square tip were found in case of shoulder pain patients and in case of normal patients, 4 radiographs of Cobra shape, 47 radiographs of Intermediate shape and 9 radiographs of Square tip were found. In majority of cases Cobra shape acromion is responsible for impingement, also Cobra shape acromion gets rapidly converted into Type III acromion than Square tip and intermediate Shape acromion. Also, we see the Coracoacromial arch distance is very less in Type III acromion than other Type of acromion. According to Beglani, P value is 0.000. According to Edelson and Traitz also P value for coracoacromial arch is 0.001 which ishighly significant. In normal radiographs of patients without shoulder pain p value is not significant.
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45. The impact of patient’s pre operative characteristics on post operative health status in THR patients

    Jaywant Nagulkar, Samiksha Talreja

    • » Abstract Aim: To observe quality of life in THR patients. Objectives: To observe the quality of life before THR To observe quality of life after THR. To compare pre operative and post operative quality of life in THR Material and Methods: In this study 50 subjects were included as sample size. List of THR subjects was collected from local super specialty hospital. Subjects were communicated through telecommunication media and survey was done. Two questionnaires that are WOMAC and EQ-5D (VAS) were asked of pre and post health status. Results: Before the THR, the mean score of WOMAC was found to be 86.3 and After the THR, the mean score of WOMAC was found to be 39.82 respectively. It also shows extremely significant difference between pre and post scores of WOMAC as the p value is found to be less than 0.05. Before the THR, the mean score of EQ-5D (vas) was found to be 4.18 and After the THR, the mean score of EQ-5D (VAS) was found to be 5.82 respectively. It also shows extremely significant difference between pre and post scores of EQ-5D (VAS) as the p value is found to be less than 0.05. Conclusion: As the post operative scores of WOMAC and EQ-5D(VAS) showed significant improvement in the health outcomes, it can be said that the quality of life improves after THR.
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46. Recent developments in anticancer applications of the Schiff bases and their metal complexes

    Madhuri Chaurasia, Sulekh Chandra

    • » Abstract Metal complexes of Schiff base signify a class of compounds that have become a field of huge interest for chemists all over the world because of their immense therapeutic applications. They show versatile bonding behaviour because of easy variation in steric and electronic structure of Schiff bases by taking appropriate aldehydes/ ketones and amines. This review highlights the up-to-date research on transition metal complexes of Schiff bases emphasizing mainly on their anticancer applications. We present a complete study of structural factors that are responsible for their activity against particular cancer cell lines and the methods used for such study that includes both experimental and theoretical approach. Contemporary strategies will be helpful to the development of new drugs based on the moiety and interactions with various cancer cell lines which lead to the apoptosis.
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47. Ayurvedic importance of the process of anulepana in sanskrit plays

    Anjali Oak

    • » Abstract Ayurveda has been a part of Indian culture since ages. We often tend to ignore the hidden secrets bestowed on us by our ancestors. There are many amazing Ayurvedic herbs for skin available that helps in improving the texture of skin. It can be used to treat many skin problems like acne, pimples, burns, infections, allergies, rashes, skin wound, insect bites etc. they have anti-fungal, healing, anti-inflammatory and cooling properties. Anulepana is one of the important beauty treatment which helps to reduce skin problems. This paper deals with the references of this Anulepana process in Sanskrit dramas.
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48. Nanoparticles coupled with microorganisms mediated photocatalytic mineralization, detoxification and disinfection of phenolic waste water

    Bholay A D, Khairnar Sayali, Bhagwat Ayushi

    • » Abstract Solarphotocatalysis is an important aspect of AOPs for the treatment of organic pollutants in industrial wastewater. The photocatalytic activity of Zinc Oxide nanoparticles also prove to be an efficient method for degradation of organic compounds and also have their lethal activity on microbial species. This study aimed at mineralization of phenol in wastewater, its disinfection and detoxification using the photocatalytic activity of ZnO andthe biodegrading ability of phenol degrading organisms. This had been successful in decreasing treatment time, cost effective, environment friendly and increased efficiency. The ZnO nanoparticles were synthesized chemically and characterized by UV-VIS spectroscopy and FTIR. Phenol degrading organisms were isolated and screened from soil sample. The coupled action of synthesized ZnO nanoparticles and phenol degrading microorganisms was studied under solar radiations for five consecutive days. The concentration of phenol analysed was degraded upto 93.4%. The COD and BOD were reduced upto 90.84% and 81.15% respectively. The reduction in TOC from 585 to 137mg/L represents mineralization of phenol and the by-products formed during its degradation. Pot culture and seed germination bioassays showed the reduction in toxicity of phenol after treatment by 60%. Reduction in TVC of coliforms during treatment confirmed lethal effect of ZnO and solar radiations.After treatment the photocatalyst was recovered, regenerated and reused effectively showing no significant reduction in photocatalytic activity and photodegradation of phenol.
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49. A comparative study of lipoprotein (a) level in young adults with and without family history of hypertension/diabetes mellitus

    Muhammed Ashraf K, Pradeep Kumar K M, Geetha P A, Bhaskaran Chalil

    • » Abstract Non communicable chronic diseases like diabetes mellitus (DM), hypertension and cardio vascular diseases are increasing among the adult population all over the world. In India there is increased susceptibility to diabetes mellitus and these patients are at increased risk to develop coronary heart disease (CHD). Hypertension is also one of the major cause for myocardial infarction and congestive heart failure and cerebrovascular accidents. Dyslipedimia is one of the strong risk factor for CHD. Among the dyslipidemia, lipoprotein (a) [Lp (a)] is strongly associated with myocardial infarction and it is genetically linked also. In this study serum Lp (a) level was compared in 50 young adults with family history of hypertension /diabetes mellitus (group 1) and 50 young adults without family history of hypertension /diabetes mellitus (group 2). Result: Lp(a) level was significantly elevated(p value = 0.000) in group 1 subjects when compared to group 2. Conclusion: This present study indicates the importance of lipoprotein (a) estimation and follow up study to identify the risk of dyslipidemia and development of CHD in our population.
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50. Greywater treatment by vermifilter: A low-cost option for rural sanitation in India

    Patil Y. M., Munavalli G. R.

    • » Abstract Recycle and reuse are the best options to deal with water scarcity. An attempt is made to reuse greywater after giving low cost effective treatment with the help of vermifilter. Vermifilter is an emerging technology in which combined action of earthworm activity and the adsorption properties of material like soil, sand and gravel particles on the organic pollutants applied for greywater treatment. The present study addresses performance evaluation of a laboratory scale vegetated vermifilter system comprising of settling tank, sand-gravel filter (SGF), Laterite soil vegetated filter (LSVF) and laterite soil vegetated vermifilter(LSVVF) for the treatment of greywater. The sequential batch experiments were conducted in a pilot scale experimental set-up. The Organic loading rate (OLR) was varied from 20 to 140 kg BOD/ha/d and the hydraulic retention time (HRT) used was from 0.50,1,2 and 3 d. The BOD5 removal efficiency was found to be in the range 15–30%, 48–60 %, and 70-80 for 3 d HRT in SGF, LSVF and LSVVF respectively. The efficiency of the system for BOD5 removal was observed to be 75–85% at 3 d HRT. The effluent can be recycled and used for non-potable purposes in a household. The developed system is a potential option for the decentralized wastewater treatment in developing country like India.
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51. Risk and prevalence of thyroid disorder among Indian population: A meta-analysis

    Ankita Sharma, V. K. Shivgotra

    • » Abstract Thyroid disorders are common in India population. This study aimed at synthesized population based studies on prevalence of thyroid diseases in India. General database and subject’s specific database were searched for primary studies. Manuscript of appropriate studies was retrieved. Based on some criteria, only eligible studies were included in this study. Combined estimate and confidence interval of the result were obtained by Mata analysis. The prevalence of thyroid diseases was 18.75% and with the 95 % confidence interval of (CI: 21.20%-16.32%). This study showed that prevalence of thyroid diseases is high in India. There is need to developed strategies to prevent, treat and control the thyroid diseases effectively in India
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52. Biochemical effects of two phytochemical mixture Eugenol with (+)-O-Methylarmepavine during the morphogenetic development of Blattella germanica

    Anand Konkala, Sabita Raja

    • » Abstract The German cockroach, Blattella germanica, is an important sanitary pest. It is cosmopolitan and abundant in homes and other human installations. Besides contaminating the places they live in with their excrements and exuviae, they are the mechanical vectors for a number of human pathogenic microorganisms and also produce allergens. The food items are contaminated by the in and around movements of German cockroaches which become unsuitable for the human consumption. Proteins are the characteristic components of the tissues which play a major role in morphogenetic events. The quantitative estimation of the proteins in the fatbody, haemolymph and ovary of nymphs and the adult was carried out to show their interrelationship. Anti gonadotropic action of Eugenol with (+)-O-Methylarmepavine on Blatella germanica was studied in the fatbody, haemolymph and the ovarian proteins during the morphogenetic development.
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53. Phenotypic characterization of coagulase negative staphylococci from various clinical isolates

    Mamta Gour, Kalpana Date, V. R. Thombare, K. K. Gour

    • » Abstract Background: Despite their frequency as contaminants, coagulase-negative staphylococci (CNS) have become important nosocomial pathogens, accounting for 9% of all nosocomial infections. These infections are difficult to treat because of the risk factors and the multiple drug resistance shown by these organisms. Material and Methods: One hundred and forty CNS were isolated from various clinical samples like blood, pus, urine body fluids, urine, catheter tip, gastric lavage and wound swab. After confirming the isolates as CNS, species level identification was performed by simple, nonexpensive conventional methods and antibiotic sensitivity testing was also carried out. Result: 140 isolates could be identified to species level. Among these 140 identified CNS isolates, S. saprophyticus was the most frequently isolated 58 (41.43%) from various clinical sample, followed by S. epidermidis 45 (32.14%), S. lugdunensis 23 (16.43%), S. hemolyticus 11 (7.86%), S. schleiferi 3 (2.14%). In the present study, the susceptibility pattern of CNS species against antimicrobial agents showed that 65.71 % of the isolates were Methicillin Sensitive (MSCNS). Majority of the CNS species were sensitive to Amikacin, (94.29%), Nitrofurantoin (85.71%), Tetracycline (75.71%), and clindamycin (75%). None of the CNS species showed resistance to vancomycin and Linezolid. Conclusion: The increased pathogenic potential and multiple-drug resistance demonstrates the need to adopt simple, reliable and non-expensive methods for identifying and determining the antibiotic sensitivity of CNS.
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54. Glycosylated proteins (fructosamine) and albumin levels in diabetic patients after multi-vitamin multi-mineral supplementation

    Bhushan Mahajan, S. K. B. Patil, Vaishali Mahajan

    • » Abstract Introduction: Prolonged hyperglycemia is known to cause an increase in levels of non enzymatically glycosylated proteins which is thought to contribute to long term complications of disease by enzyme inactivation, inhibition of binding of regulatory molecules, decreased proteolysis and cross-linking of glycated proteins. In present study, fructosamine and albumin levels were measured in normal healthy controls and Diabetic patients before and after supplementation of Multi-vitamin multi-mineral tablets. Serum fructosamine level was decreased significantly in diabetic patients after multi-vitamin multi-mineral supplementation.
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55. 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

    • » Abstract 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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56. Hydrogeochemical characteristics of shallow and deep aquifers and its suitability for drinking and irrigation use in Uttar Mand sub-basin of Krishna river basin, Maharashtra, India

    Gaikwad M R

    • » Abstract Groundwater is the most important water resources in modern water supply and its quality is the determining factor, especially for the groundwater supply under extreme events. Groundwater quality survey was carried out in Uttar Mand sub-basin of Krishna River Basin, Maharashtra, India, which is a famous for sugarcane cultivation. The result shows that the distribution of major ions in the groundwater as Ca2+ > Mg2+ > Na+ > K+ and HCO3- > SO42- > Cl- > B. The influences of agricultural fertilizers and irrigation practices are the reason for increasing trends of NO3- ions in the groundwater from studied area. According to the drinking water quality standards, the groundwater is not suitable for drinking with reference to the concentrations of total hardness, Ca2+, Mg2+ and B in many locations. Based on the parameters mentioned above (Sodium Adsorption Ratio, Residual Soluble Carbonate and Permeability Index), the groundwater quality is assessed and the overall irrigation qualities of wells are demarcated as suitable for irrigation.
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57. Extended Spectrum Beta - Lactamase Producing Escherichia coli at a Tertiary Care Hospital in Maharashtra, India: Phenotypic Detection and Antimicrobial Sensitivity Pattern

    N.M Suryawanshi, A.P Pichare,M.S. Davane, K.D.Deshpande

    • » Abstract Extended spectrum beta lactamases (ESBLs) are rapidly evolving plasmid mediated; TEM and SHV derived enzymes, capable of hydrolyzing oxyimino- cephalosporins and monobactams. Bacteria producing ESBLs remain an important cause for failure of therapy with cephalosporins and other antibiotics. ESBL testing is useful for epidemiological or infection control purposes.Aims: The present study was conducted to detect ESBLs in strains of Escherichia coli isolated from various clinical samples in a tertiary care hospital. Material and Methods: A total of 272 non enteric randomly chosen non repetitive E.coli isolates obtained over the period of one year from both outpatient and hospitalized patients were studied. Out of 272 isolates, 191 (70.22%) were screened as ESBL producing. They were further studied for ESBL production by phenotypic confirmatory disc diffusion test (PCDDT). Results: It was observed that not all screen positive isolates were confirmed as ESBL producers. Of the total 191 ESBL positive isolates, the PCDDT method detected 168 (87.95%) cases. Overall prevalence of ESBL in E.coli was found to be 61.76%. Only 4 strains (1.47%) were found resistant to imipenem and 11 strains (4.04%) were found resistant to meropenem. Conclusions: The present study shows that any of the three screening agents can be used to detect potential ESBL producers. The routine antibiotic sensitivity test may fail to detect ESBL mediated resistance. Therefore, screening for detection of ESBL and confirmation of the same should be carried out by PCDDT method as it is simple, reproducible, cost effective and sensitive method. ESBL detection studies help to formulate an empirical antibiotic policy to treat Gram negative infections in respective hospitals.
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58. ANTIBIOGRAM OF GRAM NEGATIVE UROPATHOGENS IN HOSPITALIZED PATIENTS

    K.D. Deshpande, A.P. Pichare, N.M. Suryawanshi, M.S. Davane

    • » Abstract Background: Urinary tract infections (UTIs) are caused by variety of microorganisms. The frequency of different bacterial isolates and their susceptibility to antibiotics may differ widely, particularly in hospitalized patients. The study of susceptibility pattern becomes obligatory for a proper selection of antibiotics. Aim: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures in hospitalized patients. Material and Methods: The present study was conducted in Yashwantrao Chavan Rural Hospital, Latur over a period of one year from June 2010 to May 2011. A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 296 (59.2%). Commonest organism found was Escherichia coli 252 (50.2%) followed by Klebsiella spp. 123 (24.6%), Pseudomonas spp. 49 (9.8%), Proteus spp. 42 (8.4%), Citrobacter spp. 27(5.4%) and Acinetobacter spp. 8 (1.6%). Majority of the strains were found sensitive to nitrofurantoin 404 (80.8%) followed by amikacin 357 (71.4%), piperacillin-tazobactam 325 (65.2%) and co- trimoxazole 254 (50.8%). Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in 169 (67.33%) E.coli and 87 (70.73%) in Klebsiella spp. Conclusions: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing empirical antibiotic therapy.
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59. Absence of Musculocutaneous Nerve Along With Accessory Head of Biceps Brachii

    U.W. Mane, S. R. Pandhare

    • » Abstract Musculocutaneous nerve is one of the terminal branches of lateral cord of brachial plexus. This nerve is responsible for innervation of flexor compartment of arm and for cutaneous innervation on lateral surface of forearm. Its absence has been described previously but its real prevalence is unknown. A case of absence of Musculocutaneous nerve along with presence of accessory head of biceps brachii was observed during routine undergraduate dissection of right arm of a male cadaver. In this case the muscles which are usually innervated by musculocutaneous nerve were innervated by median nerve. Medical concerns related with these variations include, anaesthetic blocks, surgical approaches, interpreting tumour or traumatic nerve compressions having unexplained clinical symptoms. There is also possibility of injury to the muscular branches of median nerve in arm by surgeon as usually this nerve does not give branches in arm. Hence this case report was studied and reported.
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60. Limberg Transposition Flap in the Treatment of Pilonidal Sinus – Our Experience

    K. Senthil Kumar, R. Anantharamakrishnan

    • » Abstract Introduction: Pilonidal sinus disease is a common surgical condition usually seen in young adults. Although several techniques have been described each one has its own merits and demerits. This study was carried out to evaluate the advantages of primary excision and Limberg flap reconstruction in the management of pilonidal sinus disease. Materials and Method: This study was done in a surgical unit at a tertiary care hospital, Chettinad Hospital and Research Institute from June 2009 to June 2012..During the study period 25 patients were enrolled and the duration of operation, postoperative pain, duration of hospital stay, postoperative complications, time until to return to work and recurrence rate were noted. Results: In our study the mean age of presentation was 23 years with male predominance. Average operating time was 81 minutes with postoperative hospital stay of 6 days. Of all the complications, flap necrosis and seroma formation were common with no recurrence in any of our patients during the one year follow up period. Conclusion: When compared with the available data Limberg flap is very effective for pilonidal disease with short hospital stay, earlier healing and shorter time off-work, low complication rates, low recurrence rates,. The surgery can be mastered easily. The results of this study favour rhomboid excision and Limberg flap reconstruction for pilonidal disease over excision with primary closure.
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61. Clinical Study of Patients of Chronic ear Discharge attending OPD in Govt. Medical College Hospital

    Jagdalpur, Bastar Shukla S K

    • » Abstract Objective: Clinical study of the patients suffering from Chronic ear discharge. Material and Methods: Patients attending O. P. D. of a Govt. Medical College Hospital Jagdalpur, were taken in to consideration for study .Detail history and clinical examination were carried out of all selected patients. Thus 128 ears of one hundred cases included in the study. Statistical analysis: Statistical analysis was expressed in terms of simple proportion. Results: Otorrhoea was present in most of the sampled cases followed by deafness, tinnitus, headache, earache and vertigo. Recurrent nasal and throat infection was the most common associated factors responsible for chronic ear discharge. Conclusion: There is an urgent need to bring awareness among the masses about various aspects of the disease; similarly consulting doctors must be motivated for rational use of drugs, by keeping in mind the development of resistance against antibiotics.
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62. An Effort to Domesticate Wild Edible Mushrooms Growing in the Forest of Jharkhand

    Ajay K Srivastava, Fr Prabhat Kennedy Soreng s.j

    • » Abstract Abstract: Jharkhand has a rich biodiversity of wild edible mushrooms. A number of edible mushrooms growing in their natural habitats are being collected by the local people during the rainy season for their consumption or sale. Some of the common wild edible mushrooms of Jharkhand are Macrolepiota procera , Termitomyces clypeatus,T. heimii, Lycoperdon, Calvatia, Geastrum, Boletus edulis, Russula, Termitomyces microcarpous, Amanita, Clitocybe, Armillaria etc.They are rich in protein and can easily fit into all’s platter, being a vegetarian product. The villagers are acquainted with them, but they just collect them and consume. The idea to conserve and cultivate them is still eluding them. The ongoing study is an effort to domesticate some of these wild edible mushrooms in an artificial condition that they can be conserved and grown all throughout the year and standardize a package of practice for these mushrooms so that villagers could find some avenues to generate income through mushroom cultivation and marketing.
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63. Glucose and Total Sugars Content and Changes therein in the Seeds of Schleichera oleosa (Lour.) Oken.(kusum) due to Bioterioration by Pathogenic Fungi during Storage

    AK Srivastava, GK Pandey

    • » Abstract Abstract:Seeds of one of the non-edible oilseed, kusum(Schleichera oleosa f . Sapindaceae) are of great significance in Jharkhand area and its oil is used in burning lamps, varnishing, massage and medicine. Its oil-cake is a good manure. The unsanitary and humid condition makes it prone to a faster biodeterioration due to several fungal inhabitants during storage. The colonising fungi in the seeds use up some of the glucose and sugars as carbon sources for meeting energy requirements in their prolonged association with the seeds. In the span of one year the glucose level dropped by as much as 50.2 percent of its initial value. Similarly, total sugar also registered a loss of 40.4 percent due to the association of the mycodwellers.
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64. Antifungal Properties of Gamma-Irradiated Chitosan from Sea Crab Shells

    F.C.K. Ocloo, A. Adu-Gyamfi, E. A. Quarcoo, Y. Serfor-Armah, D.K. Asare

    • » Abstract Abstract: Chitosan extracted from sea crab shells was used to determine antifungal properties against Aspergillus niger. Chitosan powder irradiated at 100 kGy and dissolved in 1 % acetic acid (v/v) with pH adjusted to approximately 6.0 was used in preparing chitosan concentrations of 2 %, 1.5 %, 1 % and 0.5 %. The agar dilution method was used to test the antifungal activity of the various chitosan solutions at concentrations of 0.20 %, 0.15 %, 0.10 % and 0.05 %. Both media containing irradiated and unirradiated chitosan inhibited the mycelial growth of Aspergillus niger and the degree of inhibition was dependent on the concentration of the chitosan in the fungal growth medium. Results show that the media containing irradiated chitosan inhibited the mycelia growth of Aspergillus niger to a greater extent than the media containing unirradiated chitosan.
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65. Hydrochemical Characteristics and Quality Assessment of Groundwater in Parts of Kannad, District Aurangabad (MS) INDIA.

    G.D. Mahajan

    • » Abstract Abstract: An attempt has been made to appreciate the quality and the suitability of groundwater for drinking and irrigation. In order to attend this objective, a total of 20 representative water samples were collected from dug wells; and analyzed for pH, total dissolved salts, electrical conductivity, total hardness, calcium, magnesium, sodium, potassium, chloride, sulphate, bicarbonate and nitrate. Based on the physicochemical analyses, irrigation quality parameters like sodium absorption ratio (SAR) and residual sodium carbonate (RSC), was calculated. The suitability of the water from the groundwater sources for drinking purposes was evaluated by comparing the values of different water quality parameters with WHO and BIS guideline values for drinking water. A preliminary hydrochemical characterization shows that most of the samples are within permissible limit for drinking water standards. The correlation of the analytical data has been attempted by plotting graphical representations such as U.S. Salinity Laboratory, which are employed to critically study the geochemical characteristics of groundwater which indicates that groundwater is suitable for irrigation purpose.
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66. Assessment of Knowledge and Practices about Menstrual Hygiene amongst Rural and Urban Adolescent Girls –A comparative Study

    S.B.Salve, R.K. Dase, S.M.Mahajan, S.A.Adchitre

    • » Abstract Abstract: Adolescence is the period of transition from childhood to adulthood, spanning the age between 10 to 19 years. In girls Menarche starts during this period, and girls feel shy to discuss the topic openly, So to assess the knowledge and practices amongst rural and urban adolescent, present study was carried out in Study area comprises Z.P. High school Ambelohale form rural area and Sharda Mandir Girls High School Aurangabad from Urban area. In the field practice area of MGM Medical College Aurangabad. (M.S.). During the period January 2011 to April 2011. A total of 189 rural and 132 urban girls of 8th to 10th standard were included in this study. Pretested questionnaire was used to collect the information. Post test health Education was given about reproductive health, menstrual hygiene by Gynecologists. Findings were analyzed and statistical relationship was determined by using chi-square test. Results:- 93(49%) rural & 94(71%) urban girls had started menarche ,regularities of menstruation was better in rural girls i.e. 87(94%) compared to urban girls, 53(56%). Percentage of using market available sanitary napkins was more in urban girls 56(60%) compared to rural girls 6 (06%) whereas homemade sanitary napkins were used by 87(94%) rural girls & 38 (40%) urban girls and this difference was statistically significant .amongst rural girls ,female teacher was the main source of knowledge 89(47%) while it was mother in urban area 48(36%).knowledge about reproductive system, determination of foetal sex, age of marriage etc. was better amongst urban girls. Social taboos like separate sitting, restriction on attending school & social functions were more amongst rural girls while sanitary facilities like attached toilet , full wall bathroom ,sufficient water etc were less in rural areas. Differences came out of study were statistically significant. Conclusion: - knowledge, practices, sanitary facilities were less amongst rural girl compared to urban girls. Recommendation:-1) sanitary facilities should made available to each house under NRHM. 2) Sanitary napkins should made available at lowest cost with AWW/ANM/ASHA 3) Health education in small groups of girls, to increase health awareness and healthful practices should be given regularly
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67. School Children as ‘Messengers’ for Improving Vitamin A Knowledge and Practices in Urban Slums.

    Pradip Sawardekar, Gopa Kothari, Madhavi Marathe

    • » Abstract Background: Vitamin A deficiency (VAD) is still a significant public health problem in India among children. Deliberate and sustained nutrition education has been recognized as a potent tool for prevention and control of VAD. Children being future parents need to be aware of good nutrition and therefore it is important to provide nutrition education to them. Objective: To educate school children to initiate change in knowledge and practices with a specific focus on vitamin A deficiency. Materials and Methods: The study was carried out in selected slums in Mumbai. Western India. 50 school going children and their mothers were selected for the study. Questionnaire, individual interviews and focus group discussions were employed to collect data from both the groups at the baseline. Participatory learning techniques and group dynamics approach were used during education the sessions. Results: The knowledge scores of the children showed a significant change (P<0.001) after the intervention. There was significant increase in weekly frequency of consumption of YOVs (P<0.5). The mothers were aware of vitamin A foods (87.5%) and its deficiency (68.8%) after the intervention. Conclusion: Children can be used as messengers for spreading nutritional messages and promoting vitamin A foods. Involvement of mothers in nutrition education has compounding effect.
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68. Role of Ultrasonic Bone Surgery Device (Piezosurgery®) in Harvesting Intraoral Autogenous Bone Graft – A Case Report

    Pooja M Pharne, Dinesh Hingorani, Ulhas S.Mali, Smita Vitthal Patil

    • » Abstract Abstract: Piezosurgery® is a sophisticated ultrasonic device (Mectron,Italy) invented by Dr.Tomaso Vercellotti. Present study was conducted to see the efficacy and safety of ultrasonic bone surgery device in harvesting intraoral autogenous bone graft and to compair it with manual and rotary instruments. It is concluded that piezosurgery is very easy and safe to use for harvesting intraoral autogenous bone graft as compared to manual and rotary instruments.
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69. Ethnomedicinal Plants Used by the Tribal’s in Cure of Wounds in Buldhana District (MS) INDIA

    A. N. Korpenwar

    • » Abstract Abstract: Buldhana District of Maharashtra state (India) has a rich biodiversity of medicinal plant species. An ethnobotanical survey was carried out in Buldana district, Maharashtra during July, 2008 to March, 2010 for documentation of wound healing knowledge acquired by the tribal communities. The tribal communities possess rich knowledge about medicinal plants and its uses as they are far away from modern facilities. Therefore, we have done an exhaustive ethnobotanical survey in this area. A list of 72 wound healing plants species are recorded, which are in practice by traditional healers of tribal communities. The traditional healers in this area use the wild as well as cultivated plants in the treatment of wounds. Documenting the indigenous knowledge through ethnobotanical studies is important for the conservation and utilization of biological resources and for the wale fare of human being. The plants were identified with relevant information and are documented alphabetically with their botanical name, family, local name, parts used, mode of preparation and uses.
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70. Assessment of thickness of the temporalis muscle in orthodontic patients with various growth pattern using ultrasound imaging system

    Joe Joseph, Gokulakrishnan Periakaruppan, Arun B Chitharanjan, P M Venkata Sai

    • » Abstract Introduction: Wolff’s law states that, “Every change in the form and function of bone or of their function alone is followed by certain definite changes in their internal architecture, and equally definite alteration in their external conformation, in accordance with mathematical laws.” Based on cephalometric values the dentofacial growth pattern has been divided into three namely, average, vertical and horizontal. Aims and Objectives: To assess the thickness of temporalis muscle in orthodontic patients with various growth pattern using ultrasound imaging system. Materials and Method: The study consisted of 75 subjects undergoing orthodontic treatment in the Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Sciences, Sri Ramachandra University. All the subjects were divided in three groups (viz. average, vertical and horizontal growth group) containing 25 patients each. Utrasonagraphy was used to calculate the thickness of temporalis muscle. The thickness was measured in relaxed and contracted state on both sides. Results: It was observe that the thickness of temporalis was more in average growth group in relaxed and contracted state but the difference was not statistically significant. The thickness of temporalis muscle in contracted and relaxed state was more in horizontal growth group but the difference was not statistically significant.The thickness of temporalis muscle in contracted and relaxed state was more in horizontal growth group as compared to vertical group and the difference was also statistically significant.Conclusion: The thickness of the temporalis muscle was greatest in horizontal growth pattern, followed by average growth pattern and vertical growth pattern.
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71. Adult type ureterocele in lower moiety of duplicated draining system- case report

    S R Kulkarni, Ashar Shaikh, Ronak Chaudhari, Sandeep Gupta, Tejas Chincholi, Kishor Bandagar

    • » Abstract Ureterocele is dilatation of lower ureter at its entry into urinary bladder. It is classified as single or duplex system and acquired or congenital. Acquired type is commonly seen in adults.Duplicated ureters are often associated with an obstructed upper pole moiety and a refluxing lower pole moiety. In our case report adult type simple ureterocele is presented in lower moiety of duplex system with impacted calculus. Because of rarity of the presentation and diagnosis of the condition, urologist needs to be aware of etiology and appearance. Treatment options depend on the extension of the ureterocele, obstruction to draining system.
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72. Electrophysiological study of changes in retinal function following pan retinal photocoagulation in patients with diabetic retinopathy

    C Biju John,P S Girija Devi

    • » Abstract Purpose:To Quantify the loss of Retinal Function due to Pan Retinal Photocoagulation in Diabetic Retinopathy patients using Full Field Electroretinography.Methods: This was a prospective observational study of 53 patients (105 eyes) with Diabetic Retinopathy selected for Pan Retinal Pan Retinal Photocoagulation (PRP) in a tertiary eye care centre. In all these patients Full Field ERG were done prior to PRP and then at 1 month and 3 months after PRP. The mean amplitudes and implicit times for different wave parameters at each visit (pre laser, 1 month and 3 months) were calculated. The values were paired as pre and 1 month, Pre and 3 month and 1month and 3 month and the mean differences of the pairs were calculated. Paired t test was used to calculate the significance of the variations. Results:It was found that the PRP produced a global loss of retinal function which was variable and was reflected in the statistically significant reduction in amplitudes of the Full field ERG waves. The average loss of amplitudeat 3 months was 27.2% for “A” waves and 14.4% for “B” waves. The changes to the implicit time were not of much significance. As far as the visual results are concerned, Stabilisation (defined as no change in vision or a loss of vision less than 2 lines) or improvement of visual acuity could be achieved in 95% of the eyes. Conclusions:The amplitudes of the different waves of the Full Field ERGs can be used effectively in order to quantify the loss in Global Retinal function as a result of PRP. The implicit times however did not prove to be a reliable parameter to measure the change in retinal function.
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73. Comparison among intrathecal fentanyl and nalbuphine in combination with bupivacaine and plain bupivacaine for lower limb surgeries

    Ravikiran J Thote, Prashant Lomate, Shilpa Gaikwad, Jyotsna S Paranjpe, Manohar Mane

    • » Abstract Background: Nalbuphine, kappa agonist/partial mu antagonist and potent analgesic is less explored for analgesia. Aims and Objectives: To compare intrathecal addition of Nalbuphine verses Fentanyl to local anaesthetic on quality and duration of analgesia. Material and Methods: This study compared the effects of intrathecally administered, preservative-free Fentanyl and Nalbuphine in combination with bupivacaine and plain Bupivacaine in 60, ASA I or II patients of either sex who underwent lower limb surgeries with spinal anesthesia. Patients were divided into three groups (n=60). Fentanyl group (Group I) received 2.5 ml of 0.5% bupivacaine with 25mcg of fentanyl, Nalbuphine group (Group II) received 2.5 ml of 0.5% bupivacaine along with 500mcg of Nalbuphine, Control group (Group III) received 2.5ml of 0.5% bupivacaine along with 0.5 ml of CSF, Group I and II are study groups. Results: There is prolongation of sensory block in fentanyl and nalbuphine group as compared to control group, but there is more prolongation of sensory block duration in nalbuphine group than fentanyl group. Addition of fentanyl or nalbuphine to intrathecal bupivacaine does not prolong the motor block. The perioperative sedation was present in only nalbuphine group but all the patients were arousable and it was not associated with respiratory depression. Request for postoperative pain relief was significantly present in control group. Sedation was noticed in the Nalbuphine treated group only. Conclusions: Intrathecal Nalbuphine-Bupivacaine combination is better than Fentanyl-Bupivacaine combination in respect to the duration of sensory block. There was more sedation in nalbuphine treated group. Both Fentanyl and Nalbuphine reduced the analgesic requirement in the early postoperative period
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74. Hepatotropic effects of acute heavy metal poisoning in rats

    R Jayashree

    • » Abstract Introduction: Increasing technologic use of metals has posed hazards to health of humans as well as animals. Excessive concentration of metals occurs in water, air and soil as results of natural deposits as well as technologic use of non biodegradable materials. Further metals released into the environment may be biocentrated and thus enter the food chain. In Industrial Toxicology, Occupational exposure to Lead, Cadmium fume, Chromic acid and Chromates is significant. Aims and Objectives: To study the Hepototropic effects of acute heavy metal poisoning in rats Materials and Methods: In the present study 24 rats were divided in four groups (Cadmium group, Chromium, Lead and Control group) containing 6 rats each. The rats were exposed to respective heavy metal salt by two daily injections. The acute doses have been chosen based on previous studies in literature. On the third day the entire animals were weighed and sodium pentobarbitone 30 mg/kg body weight was administrated intraperitoneally. The time off administration of drug, the time of loss of righting reflex and the recovery of the animals were noted. 1ml blood sample was withdrawn by retroorbital puncture from all the animals for the blood assay. Results: Onset of sleeping time and duration of sleeping was increased in all the group but the difference was not statistically significant. The difference in SGOT levels of control and lead group was statistically insignificant. The SGPT levels were increased with statistically significant difference in cadmium group as compared to control group. The rise in alkaline phosphatase was statistically significant in cadmium and lead group when compared with control group. Serum proteins were also increased with statistical significance in cadmium and lead group. Conclusion: It may be stated that acute heavy metal exposure is associated with some changes in enzymic activity of liver and significant decrease in serum proteins.
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75. Optical, lower microwave and radio frequency response of binary mixtures of organic liquids - A dielectric approach

    Ashvin N Prajapati

    • » Abstract Background:Each material displays an unique complex permittivity spectra in the radio/ microwave frequency domain because of their different structures and varying dynamic responses to an external electromagnetic field. These spectra usually include one or more dispersions. A dielectric dispersion is mainly characterized by two parameters, dielectric decrement (ε0 – ε) and relaxation time (0). Complex permittivity of various concentrations 1-Propanol (1-PrOH) and its mixtures with N,N Dimethylformamide (DMF) were obtained in the radio and lower microwave frequency range using Vector network analyzer (VNA). Furthermore to have more insight the dielectric constant (ε’) and dielectric loss (ε”) of these samples were also determined using standard X-band microwave test bench operated at 9.1 GHz. Optical dielectric constant (ε= n2) of these liquids samples were measured using Abbe’s refractometer. These data points of different frequencies were fitted into Debye model to evaluate dielectric parameters like, a relaxation time (0), static dielectric constant (ε0). Excess of static dielectric constant (ε0)E and excess inverse relaxation time (1/0)E are determined and fitted with Redlich-Kister polynomial equation to derive the binary coefficients and standard deviations. Kirkwood correlation factor (g) and Bruggeman factor (fB) were also evaluated for this system. These parameters were used to interpret the molecular interaction between the molecular species of the liquid mixtures.
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76. Evaluation of relation betweendysmenorrheaandbody mass index in rural adolescents girlsandits impact on quality oflife

    Shashikant G Somani, Sonali Rathi Somani, Vrunda Choudhary, P Sudhir Babu, A Vijay Laxmi

    • » Abstract Objective: To evaluaterelationbetweendysmenorrheaandbody mass indexandits impacton health-related quality of life (HRQoL). Method: Study wasconducted in rural areaatKamineniInstituteofMedical Sciences, Narketpally. Thorough menstrual history was taken from 100adolescentpatientswith dysmenorrhea.Severityof dysmenorrhea wasdetected byverbal multi-dimensional scoring. Body mass index was calculated. Their absenteeism from school or class were assessed. SF-36 scalewas used to determinate HRQoL.Results: In present study, 38%, 44%and 18% patients weresuffering from mild, moderate and severe dysmenorrhea. Majority of girls (51%) were severly underweight having BMI <16.5kg/m2, 26 % underweight. This indicatespoor nutritional status of Indian adolescent girls, in rural setup. Majority ofgirls with moderate and severe dysmenorrhea had BMI <16.5Kg/m2which wassignificant (p <0.05). 30% patientshad symptomssevere enough to be absent from schooland31%from classes. 18% patientsreported social withdrawal. Scores received from many of SF-36 domains (physical functioning, role–physical, bodily pain, general health perception, vitality and social functioning) were significantly low. Also, withincreasing severity of dysmenorrhea, scores were decreasing in these domains. Conclusion:Dysmenorrhea is important publichealth problem.Ithasnegative effects on day today activities and health-related quality of life.Thereis a positive correlation between dysmenorrheaandlow BMI. Present study was conducted forbetterment of society for creating awareness ofdiet and health educationto assist in improvingquality of life.
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77. Mucopolysaccharidosis type I-Hurler’s syndrome

    A M Deodhar, Vedprakash Biradar, Rushikesh M Patwardhan, Parikshit Mule, Pallavi Rawal, Rajeshri Ekale

    • » Abstract Mucopolysaccharidosis I (MPS I) is a rare inherited disorder that belongs to a group of clinically progressive disorders and is caused by the deficiency of the lysosomal enzyme, α1 -iduronidase. MPS I has been recently classified into a severe (Hurler syndrome) and an attenuated type (Hurler-Scheie and Scheie syndromes).
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78. Dynamic temporalis muscle transfer revisited – aTechnique for correction of lagopthalmos in leprosy patients

    Manish Singhal, Rupnarayan Bhattacharya, Shilpi Jain

    • » Abstract Background: Leprosy is the most common cause of facial paralysis in India. Lagophthalmos is its most common manifestation. The temporalis muscle transfer ensured a good functional eyelid closure thus preventing corneal exposure and progression to impairment of visual acquity. Patients and Methods: 20 patients of leprosy who presented with lagophthalmos were included in the study. All cases underwent dynamic temporalis myofascial sling transfer for correction of lagophthalmos.Change in appearance of the eye and function of the eyelids was assessed post operatively. Results: All cases underwent dynamic temporalis myofascial sling transfer for correction of lagophthalmos. Temporalis Muscle transfer for bilateral cases were done in the same sitting. Anderson’s modification of Gillies procedure was done in 13 cases and Johnson’s operation was done in 7 cases. Mean lid gap reduced to 9.09 mm in straight gaze, 1.59 mm in gentle closure and 0.5 mm in tight closure. Conclusion: The temporalis muscle transfer ensured a good functional eyelid closure thus preventing corneal exposure and progression to impairment of visual acquity.
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79. Clinical profile and outcome of organophosphate poisoning cases in a tertiary care hospital in central Kerala

    Edwin J George, Jayaraj K, John J Manjaly, Raghunath M

    • » Abstract Background and objective: DSH is a major problem in the developing world. Poisoning is one of the most common methods employed for the act of DSH. As far Asia is concerned, the wide availability and lack of rules and regulations for the sale of agrochemical pesticides resulted in widespread use of organophosphate as one of the most common poison used for DSH. The delay in attaining medical care and the lack of facilities in the rural areas have resulted in increased number of death due to OP poisoning. In this study, we aim to find out the clinical profile with respect to different OP compounds, prognosis and outcome o f each patient in relation to the delay in getting medical attention. Our objective is to find out if there is any specific clinical finding which can predict bad outcome. Methods: 50 patients admitted to this hospital were enrolled into the study. After getting informed consent, detailed clinical examination was carried out. The incidence of complications and other measures of outcome were compared with respect to the clinical profile. Results: 33 males and 17 females were studied. 74% of the patients survived following poisoning while 26% expired. Chlorpyriphos was the compound consumed by most of the patients, followed by quinalphos. 50% death is due to chlorpyriphos poisoning. The most common symptom was vomiting followed by frothing. 12% patients had history of psychiatric illness. Crackleswas the most common clinical sign which was seen in 66% of the study population Interpretation and conclusion: From this study it is revealed that more the delay in getting medical care, higher the mortality is. Also altered sensorium, especially drowsiness may point towards grave prognosis. Majority of the patients who required mechanical ventilation had gross lung crackles at the time of presentation. The incidence of intermediate syndrome seemed to be a very important factor in the survival of the patient. In this study, all patients who developed IMS expired. Lung crackles, drowsiness and ventilator assistance were all high in the chlorpyriphos group when compared to other OP compounds.
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80. Zinc oxide nano thin film for solar cell device applications

    Sarika Jadhav, Limbraj Ravangave

    • » Abstract Background: Zinc Oxide (ZnO) thin film was deposited using simple low cost spray pyrolysis technique. The deposited film was characterized by X-ray diffractometer (XRD), Scanning Electron Microscope (SEM) and UV-Visible spectroscopy. XRD Spectra revealed that ZnO film represents polycrystalline wurzite crystal structure. Full Width at Half Maximum (FWHM) was estimated using Lorentz Fit of XRD data. The crystallite size calculated was to be 26.31 nm. The SEM image of ZnO thin film shows whole surface was uniformly coated with spherical ZnO grains of average size 111.55 nm. Purity of the deposited sample was investigated by using Energy Dispersive X-ray Analysis (EDX). The deposited ZnO film shows 78% transmittance. The optical band gap estimated by Tauc plot was 3.76eV.
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81. Comparative prospective study of outcome between aggressive and expectant management of premature rupture of membranes

    Shivamurty H M, N Spandana, Y Anusha Sunkara, Ahswini Konin, V Sridivya Chowdary

    • » Abstract Background: Premature rupture of membranes (PROM) is the loss of integrity of membranes before onset of labor. PROM occurs in approximately 5–10 % of all pregnancies.and is a significant obstetric problem and is important cause of maternal and neonatal morbidity. When PROM occurs at term, labor typically ensues spontaneously or is induced within 12 to 24 hoursObjectives: To compare the expectant and aggressive management and its neonatal and maternal outcomes.Material and Methods:This is a prospective study carried out in the Obstetric and Gynecology Department of J.J.M Medical College, Davangere, Karnataka.Results: There were 573 cases of PROM giving incidence of 8.15%. The incidence was found to be higher in case of rural, young, primigravida. Out of thesePROM cases 81.5%were managed aggressively (group A),18.4%were managed expectantly (group B). Mode of delivery was as follows.Group A (Expectant management) Vaginal delivery in 70.75%, LSCS in 29.25 %.Group B (Aggressive management)Vaginal delivery 83.7% LSCS 27%. Perinatal mortality, Group A 7.54 %, Group B1.28%. Perinatal morbidity, Group A 7.54 % group B 4.49%. Maternal morbidity, Group A was 18.86% Group B 1.07%,Matrenal mortality Group A 0.94% one, Group B was zeroConclusion: Aggressive management by induction of labor within 12 hours in PROM reduced the time of delivery and the rates of chorioamnionitis, endometritis, and admission to the neonatal intensive care unit. A proposed plan of "Aggressive management" is the final answer to decrease maternal and neonatal morbidity and mortality.
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82. Correlation between pathological staging, histological grading, ER/PR and Her2neu status in breast cancer

    Pereira Carlsen Bernard, Sheldon G Mathias

    • » Abstract Introduction: Breast cancer is the 2nd most common cause of cancer among women worldwide. Women in India it presents at a younger age who present themselves at an advanced stage with poorer prognosis compared to western counterparts. Estrogen and Progesterone play a key role in the growth kinetics of the breast. Tumors that are positive for both estrogen and progesterone receptors have a better possibility of remission following Hormonal therapy (70%). Objectives: Hence this study was done to correlate the histological grading, tumor size and Nodal status with ER/PR and HER2neu status in women undergoing Modified Radical Mastectomy for breast cancer. Results and Discussion: 50 female patients who underwent Modified Radical Mastectomy for breast cancer proved by FNAC from Jan 2013 till September 2014 evaluated for correlation. Among 50 patients 25 had ER (+) receptor status, with tumor size of 2-5cm was seen in 19 patients. 9 patients with ER (+) status had zero lymph node status. 20 patients were SBR grade 2.16 patients had PR (+) status, among these patients 12 had a tomor size of 2-5 cm, 6 patients had 0 lymph nodes and 14 patients were SBR grade 2. 26 patients had HER2neu (+), 8 patients with HER2neu + status had a tumour size of more than 5 cm. 6 patients with HER2neu +receptor status had more than 10 lymph nodes, 21 patients were SBR grade 2. Conclusion: Study concludes presence or absence of estrogen, progesterone and HER2 neu receptor status can help to decide on further plan of treatment and prognosis in breast cancer patients.
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83. Transgenic plants as sole source for biopharmaceuticals

    Mukund Joshi, Kuldip Singh Sodhi, Rajesh Pandey, Jasbir Singh, Subhash Goyal

    • » Abstract Within a very short time period, the use of genetically modified plants for the production of therapeutic compounds has moved from being an experimental system with significant potential to a commercially viable process poised to deliver products useful in animal and human therapies. In roads have been made not only in more traditional areas of therapeutic development (e.g., the identification and isolation of bioactive secondary metabolites), but also in relatively uncharted areas such as the production of novel bioactive peptides and proteins, antibody production for passive immunization therapy, and edible oral vaccines. The rapid pace of development witnessed thus far is likely to accelerate in the very near future as additional, novel uses of transgenic plants as production systems for human therapeutics are explored. The limitations for the use of genetically modified plants will likely arise from our still somewhat unsophisticated knowledge of how plant gene expression is controlled and how various metabolic pathways within a plant interact and regulate themselves. The use of plants as production factories is already seen as an economically attractive alternative for the production of clinically important compound.
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84. Study of serum enzymes Lactate dehydrogenase (LDH) and Gamma-glutamyltransferase (GGT) in patients of cervical cancer

    Trupti D Ramteke, Sucheta Ghule, Rajesh Jambhulkar, Avinash Jadhao

    • » Abstract In patients of cervical cancer, a simple and easy blood based tumor marker system might be an additional tool to derive tumor status and to correlate with the response to anticancer treatment and disease recurrence. Being simple, rapid, inexpensive, easily assayable, serum levels of LDH and GGT were measured in 50 histopathologically diagnosed cases of cervical cancer and compared with age matched healthy controls in the age group of 35-75 years and analysed by unpaired Student’s ‘t’ test (2- tailed) for parametric analysis. The cases of cervical cancer were further divided into study subgroups i.e. stage I, II, III. The comparison was also done among study subgroups. The biochemical parameters were compared among three study subgroups using one way analysis of variance (ANOVA). Results of the study showed significant higher levels of serum Lactate dehydrogenase, Gamma-glutamyltransferase in cases of cervical cancer as compared to their age matched controls. Interstage comparison between study subgroups was also significant.Thus it is concluded that Serum LDH and GGT may be better indicators of cervical cancer and may help in early detection of the disease and assist in assessing the extent and therefore prognosis of this malignancy along with clinical findings.
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85. Study of awareness and impact of training on STI/RTI towards capacity building of medical officers in the district of Vizianagaram, Andhra Pradesh

    Dash Satyanarayan, Ukey Ujwala U

    • » Abstract Introduction: Introduction: Health care providers (HCPs) are considered to play a pivotal role in reducing the burden of STI/RTI and stemming the spread of STI through effective preventive and curative services to individuals suffering from HIV/AIDS and STIs. Aims and Objectives: To assess awareness of the medical officers about the STI/ RTI and to judge the impact of the training in capacity building towards improvement of their awareness. Materials and Methods: Observational cross sectional study was conducted in 30 medical officers attending the training. A structured questionnaire containing 30 close ended questions on the various aspects of awareness about STI /RTI was administered to them for pre and post tests. Chi square test and Z test were applied as the tests of significance. Results: During pre-test, 13 (43.33%) of the participants were aware that STI/RTI can exist without any symptoms or signs. The correct response to the same question rose to28 (93.33%) in the post-test. During the pre-test it was observed that 15 (50%) of the study participants had the correct awareness that asymptomatic carriers can pass infections to their partners during sexual contact. The correct response was given by 24 (80%) study participants during post-test. Mean score for all the questions considered together increased from 17.5 during pre test to 26.2 during post test with a Z of 15.67 and p value of < 0.0001. Conclusion: Medical officers were found to have sufficient awareness about STI/RTI. The significant increase in the post test scores showed that the training was also proved to be effective in improving the awareness on STI/RTI.
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86. Study of various characteristics of Pulmonary and extra pulmonary tuberculosis patients enrolled for DOTS under RNTCP

    Sanjiv Zangde, Anjali Deshmukh

    • » Abstract Introduction: India has nearly 30% of global tuberculosis burden. With an estimated burden of new smear positive tuberculosis of 85 per 1 lakh population, nearly one million new smear positive case and about 2 million total new cases are added every year. More adults die from tuberculosis than from any other infectious disease in India, one every minute more than 1,000 every day. Aims and objective: To study of various characteristics of Pulmonary and extra pulmonary tuberculosis patients enrolled for DOTS under RNTCP. Material and method: All the newly diagnosed cases of pulmonary and extra pulmonary tuberculosis attending OPD/IPD of Govt. Medical College Nanded and residing in area under coverage of RNTCP centre of GMC Nanded were included in this study. Name, age, sex, address, occupation, income, number of family members, presenting complaints in chronological order, past history, personal history, through general and systemic examinations, investigations were carried out and the findings were recorded. All the standard definitions defined by Central TB division of Directorate General of Health Services were used. Results: 57.01% patients were having pulmonary Tuberculosis and 42.99% patients were having extra pulmonary tuberculosis. Among the cases of extra pulmonary tuberculosis TB Lymph Nodes contributes 23.08%, followed by pleural effusion 13.57%. It was seen that 84.13% parinets were subjected to category I (sputum positive and seriously ill sputum negative) and only 15.87%patients i.e. sputum negative and not seriously ill were subjected to category III. Maximum number of patients enrolled in present study were between15- 44 i.e. economically productive age group of life. Cough was the most common symptom observed and next was fever Conclusion: Sputum positive pulmonary tuberculosis was the most common type of tuberculosis as compared to extra pulmonary and sputum negative pulmonary tuberculosis. Young male belonging to lower socioeconomic class was most common group suffering from tuberculosis.
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87. Utility of thyroid peroxidase autoantibodies as risk marker of thyroid dysfuction in pregnant women

    Jayaram Swati, Krishnamurthy U

    • » Abstract Undiagnosed thyroid diseases in pregnant women can result in miscarriage, preterm birth and gestational hypertension. Autoimmunity has been implicated as one among the causes for thyroid illness in pregnancy. This study intended to define the prevalence of autoimmune thyroid disease by measuring thyroid peroxidase autoantibodies (ATPO) in pregnant women which can aid in predicting the hypothyroidism and early intervention. Pregnant women (n=107) were screened for Thyroid Stimulating Hormone (TSH) and ATPO. This study revealed that the prevalence of thyroid illness in pregnant women by TSH as 14.1% and the prevalence increased to 29.9% on combining TSH with ATPO. The sensitivity and specificity of positive ATPO for the thyroid illness was 26.6% and 81.5% respectively. Hypothyroid subjects had high levels of ATPO which was statistically significant by one-way analysis of variance. Therefore, detection of raised ATPO in pregnant women may be of use in early diagnosis of thyroid illness and help in preventing adverse out comes.
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88. Prevalence of asymptomatic bacteriuria in pregnant women in a rural tertiary care hospital at Jalna

    Sufia M Siddiqui, Arvind B Deshmukh, Prasad L Bhanap

    • » Abstract Aims and Objectives: A total 206 women attending the antenatal clinic at our rural hospital were evaluated for asymptomatic bacteriuria over a period of 3 months. Direct smear examination with wet mount examination, gram staining of uncentrifuged urine, and then culture and sensitivity testing to detect significant bacteriuria was carried out. Results: Of these 8.7% (18 women) showed significant bacteriuria. and the maximum incidence was found to be in the <25 age group(83.3%).Prevalence was found to be higher in second gravid (38.9%) and in second trimester of pregnancy(44.4%).Gram stain was found to be more sensitive and specific than wet mount examination. Eschrechia coli was found to be the predominant isolate (38.88%) followed by coagulase negative staphylococcus (33.33%) Conclusions: It is advised to screen all ANC women for asymptomatic bacteriuria repeatedly in all the three trimesters of pregnancy and to advocate treatment only if repeated samples show significant bacteriuria.
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89. A study of thyroid profile in primary infertility

    Sarika Munghate, Vinita Belsare, Bhushan Mahajan, Sandip Lambe

    • » Abstract Infertility is defined as inability of a couple to achieve conception after 1 year of unprotected coitus. 10 to 15% of marriages contracted by men and women prove to be childless. Hormonal conditions like hypothyroidism are one of the etiological factors responsible for female infertility. The aim of the present study was to determine the incidence and prevalence of thyroid dysfunction in patients seeking treatment of infertility. 50 women subjects and 50 controls were selected for the study in the age group 19 years to 35 years. Serum T3, T4 and TSH levels were estimated in both population. It was found that the levels of serum TSH were increased significantly and serum T4 levels were decreased significantly in the study group compared to the controls.
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90. A comparative study of pulmonary function in chronic kidney disease patients pre and post hemodialysis

    Tanmoy Banerjee, Nataraj S M, Suhas Y Shirur

    • » Abstract Introduction: Chronic kidney disease(CKD) is a multisystem disorder, the major pulmonary alterations seen in CKD patients are obstructive disorders such as air flow limitation in distal airways and reduced pulmonary diffusion capacity. Hemodialysis can reduce the incidence and severity of many of these disturbances so much so that the overt and florid manifestations of uremia have largely disappeared in modern health setting. Aims and objective: The present study was undertaken to assess the changes in pulmonary function in CKD patients following dialysis. Material and Methods: The study was conducted on 30 patients within age group of 20-50 years suffering from ESRD undergoing regular hemodialysis for more than 3 months. Spirometry was performed on subjects before dialysis and was repeated after dialysis. Results: There was a significant improvement of pulmonary function, Forced Vital Capacity(FVC), Forced Expiratory Volume in first second (FEV1) and Maximum Expiratory Pressure(MEP) from pre to post dialysis. Conclusion: Uremia in ESRD patients causes obstructive pulmonary dysfunctions such as pulmonary edema, small air way obstruction and decreased diffusion capacity of the alveoli. Hemodialysis by removing and reducing uremic products improves the obstructive changes in the lungs. It reduces pulmonary edema (residual edema), improves pulmonary capillary permeability and elevates respiratory muscle functions.
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91. Hydrogeochemical Assessment of Groundwater Quality in Parts of Phulambri Block, Aurangabad, INDIA

    Salve P L

    • » Abstract Detailed hydrogeochemical analysis of twentytwo samples of groundwater collected from parts of Phulambri block of Aurangabad district, has been carried out in an effort to assess the quality of groundwater in the area. These samples were analysed for pH, EC, TDS, TH, Ca, Mg, Na, K, Total Alkalinity, Cl NO3 and SO4. The suitability of the water from the groundwater sources for drinking purposes was evaluated by comparing the values of different water quality parameters with Bureau of Indian Standards and World Health Organization guideline values. The result of the analysis shows that the Water chemistry of Phulambri block is deteriorated at some places. The Suitability of groundwater for irrigation was determined by analyzing sodium adsorption ratio (SAR), Kelly’s ratio (KR), Sodium percentage (Na%), Magnesium Ratio (MR) and study reveals that most of the samples of the study area falls below the permissible limit indicating groundwater is suitable for irrigation purpose. The geochemical characteristics of the groundwater’s are impeded by natural geology and anthropogenic activities, and a proper groundwater management strategy is necessary to protect sustainably this valuable resource.
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92. Study of relationship between cardiorespiratory fitness and blood pressure in young obese individuals

    Suhas Y Shirur, Rajeshwari L, Swathi H N

    • » Abstract Introduction: The prevalence of hypertension amongst children and young adults in India is increasing nowadays, increased adiposity is considered to be one of the major factors implicated in the pathogenesis of hypertension and is associated with low cardiorespiratory fitness levels. Aims and Objective: To study the relationship between cardiorespiratory fitness and blood pressure among young obese individuals. Material and Methods: Sixty young obese individuals in the age group of 20 to 25 years were included in this study group. Body mass index was measured as weight in kilograms divided by height in meters square. Resting blood pressure was recorded. Cardio respiratory fitness in terms of VO2max was predicted by standard Bruce Treadmill protocol. Pearson’s correlation test was used to find out correlation between VO2max and blood pressure. Results: VO2max showed significant negative correlationship with the blood pressure in both male and female subjects. An important finding was that there was a gender difference in the association of VO2max with blood pressure profile. While in females, VO2max showed a significant negative correlationship with DBP, in males, it showed a significant negative correlationship with PP. Regarding the correlationship with SBP and MAP, VO2max showed significant correlationship in both gender, but again a stronger correlationship was found amongst females as compared to male subjects. Conclusion: It may be concluded that a correlation exists between cardio respiratory fitness and blood pressure. In order to have higher fitness profile and to avoid cardiovascular complications, young adults should take care of their food habits and physical activity to maintain optimal body weight.
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93. Study of relationship between cardiorespiratory fitness and obesity in young individuals

    Suhas Y Shirur, Rajeshwari L, Swathi H N

    • » Abstract Introduction: Obesity and cardiorespiratory fitness are considered as modifiable and independent risk factors for cardiovascular mortality. Aims and Objective: The current study was designated to evaluate cardio respiratory fitness in terms of VO2max in young healthy males and to correlate between obesity and cardio respiratory fitness. Material and Methods: Sixty young healthy male subjects in the age group of 20 to 25 years were included in this study group. Body mass index was measured as weight in kilograms divided by height in meters square. Cardio respiratory fitness in terms of VO2max was predicted by standard Bruce Treadmill protocol. Results: There was a highly significant negative correlation between obesity and VO2max, r= -0.84 p<0.05. In contrast, obesity shows a highly significant direct correlation with maximal heart rate, r=0.82 p<0.05. Conclusion: The result proved that cardiorespiratory fitness was significantly affected by obesity. In view of current obesity trend and increasing cardiovascular diseases, it’s advisable to decrease the daily calorie intake and also to improve cardiorespiratory fitness in young individuals by methodical and scientifically validated exercise regimen.
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94. Effect of yogic practices on cardiovascular risk factors in postmenopausal woman

    Shrinivas S Chitta, Prerna D Nandedkar, Prashant T Tayade, Piyush M Kherde

    • » Abstract Background: In postmenopausal women Coronary heart disease is one of the most important causes of death. Obesity, hypertension and dyslipidemia are modifiable risk factor of this disease. The yogic practices are important for prevention and treatment of dyelipidemia. Therefore, the present investigation is focused at efficacy of SKY practices on cardiovascular risk factors like obesity, hypertension and lipid profile in postmenopausal woman within 6months. Aim: To estimate lipid profile and to measure BMI, WHR and BP in postmenopausal women who are at risk of CAD on 0 day and 6 months after regular SKY yogic practices. Settings and designs: This cross sectional study was undertaken in the Department of physiology and Department of Biochemistry of Government Medical College and hospital Akola, Maharashtra. Material and method Statistical Analysis: BMI, WHR and BP measured and lipid profile were analyzed and compared between 30 age matched postmenopausal women who are on risk of CAD study group and normal healthy control group of age group 40‐55 years using unpaired two‐tailed Student‘t’ test. Results: Values of BMI (p<0.05), WHR (p<0.05), Systolic BP (p<0.05) and diastolic BP (p<0.05) were significantly lower in both study and control group. Values of TG (p<0.05), TC (p<0.05), LDL-C(p<0.05), VLDL-C(p<0.05) were significantly lower in control group expect HDL-C which is not significantly increased while all parameters of lipid profile are improved in study group. Conclusion: Regular Yogic practices are more effective in postmenopausal women who are at risk of CAD.
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95. Groundwater quality studies of Kamlapur village industrial area of Aurangabad, India

    S M Deshpande, R A Suryawanshi, K R Aher, G D Gaikawad, R K Aher

    • » Abstract The present paper deals with the assessment of variation in the groundwater samples and its suitability for drinking purposes. Spatial distribution of pH, electrical conductivity (EC), total dissolved solids (TDS), Calcium, Magnesium, Total hardness, chloride, and total alkalinity content of 30 ground water samples collected from the kamlapur village, near industrial area of Aurangabad has been studied. In the study area majority of samples shows high content in parameters such as electrical conductivity (EC), total dissolved solids (TDS), Calcium, Total hardness and Chloride. The degradation of water quality can be attributed to the use of agricultural fertilizer, urbanization and industrial discharges in the study area.
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96. Dyslipidemia in hemodialysed patients of chronic renal failure

    Fating Prasanna M, Tadas Arun K, Katore Sarika D, Tadas Swati A

    • » Abstract Background: Cardiovascular disease (CVD) is major cause of mortality and morbidity among patients with Chronic kidney disease (CKD). More than 50% of patients with CKD die due to cardiovascular complication and dyslipidemia is an independent risk factor for CKD. The incidence of coronary artery disease is seen in 28 percent of dialysis patients. So we considered to study this relation of chronic renal failure (CRF) and lipid profile in dialysed patients. Aim: To estimate lipid profile in hemodialysed patients of chronic renal failure. Settings and Designs: This cross sectional study was undertaken in the Department of Biochemistry and kidney Unit, Department of Medicine and Department of Nephrology of Government Medical College and superspeciality hospital Nagpur, Maharashtra (India). Material and Methods: Total cholesterol (TC), Triglycerides (TG), High density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), atherogenic ratio i.e. TC/HDL, LDL/HDL, was assessed in hemodialysed CRF patients (n=50) and healthy individuals (n=50). Mean of biochemical parameter were compared by performing student’s t-test. Results: Values of triglyceride, LDL-C and TC/HDL, LDL/HDL were significantly higher in hemodialysed patients of CRF but values of HDL-C (p<0.001) were significantly lower in hemodialysed patients of CRF as compared to controls. Conclusion: Atherogenic dyslipidemia was more pronounced in hemodialysed patients as compared to normal patients.
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97. Diseases of the vulva- a clinicopathological study

    Hilda Fernandes, Lovely George, Jacintha Martis, Nagaratna

    • » Abstract Background: Vulval lesions may present in a variety of ways ranging from asymptomatic to chronic disabling conditions. The differential diagnosis may include a wide range of diseases. This study was undertaken to find out the distribution and type of diseases affecting the vulva. Materials and Methods: All the vulval lesions encountered in the histopathology section for a duration of 3 years were included in this retrospective study. Results: A total number of 35 cases of vulval lesions were encountered in the study .The age group of patients ranged from 21 to 86 years .Majority of the women had ithching or mass as a presenting complaint. Out of the 35 cases ,28 cases ( 80% ) were found to be benign and 7 cases ( 20 % ) were found to be malignant . Bartholin’s cyst was the commonest benign lesion which was found in the reproductive age group. Squamous cell carcinoma was the next common lesion in our study which was seen in older age groups. Conclusion: The vulval lesions are one of the most neglected especially by the Indian women. Since the vulva can harbour lesions starting from a benign bartholin’s cyst to aggressive malignancies, more importance should be given to the timely detection , diagnosis and appropriate treatment of these lesions .
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98. A Study of Factors like Immunization, diarrheal and respiratory infections Responsible for Protein Energy Malnutrition in rural Maharashtra

    Balaji V Ukarande, A S Nagaonkar

    • » Abstract Introduction: Death in children constitutes more than 34% of total death in India. Seven out of ten of these deaths are due to respiratory infection, diarrhea and malnutrition. There is high under five morbidity and mortality in India. Methodology: Present study is cross-sectional, observational study infield practice area snd sample size was selected by simple random sampling method. Result: Proportion of undernutrition was more i.e. 92.86% in un- immunized children followed by 91.92% in partially immunized and 22.03% in completely immunized children. The problem Undernutrition was more i.e. 65.13% among children who had history of persistent diarrhea in past 12 months compared to 55.56% of undernutrition among whom there was no history of persistent diarrhea in past 12 months. Undernutrition was more i.e. 77.87% among children who had history of persistent febrile illness in past 12 months compared to i.e. 51.98% of undernutrition among children who did not have history of persistent febrile illness in past 12 months. Conclusion: All children should be fully immunized and early treatment of the children suffered from diarrheal and respiratory infections should done.
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99. Significance of measuring of dimensions of lumbar spinal canal on plain radiographs in narrow spinal canal

    Shastrakar Rupali Sureshrao, Kasote Arunkumar P

    • » Abstract The present study was carried out on 200 subjects with 100 asymptomatic control and 100 symptomatic cases of low backache, sciatica and neurogenic claudication of more than 6 months duration of age group 30 -80 years. The aim of the study was to find out the dimensions of the lumbar spinal canal on plain radiographs of the lumbar spine in normal and symptomatic subjects and to compare them. It was found that the lower normal limit of the transverse diameter of the lumbar spinal canal was 20 mm and antero-posterior diameter was 15.2 mm on plain radiographs of asymptomatic healthy subjects. Anteroposterior diameter was found to be more adversely affected in narrow spinal canal.
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100. Micro-organisms and their sensitivity pattern in acute otitis media from a developing country

     Wagh Kailash B, Ghule Shubhangi B, Mohite S T

     • » Abstract Objective: Acute otitis media (AOM) has been associated with much morbidity including economic burden. Many bacterial organisms were identified to be the causative agents and several risk factors have been identified to increase the incidence of AOM. Considering the differences in the etiological agents and their susceptibility pattern, it becomes necessary to have up-to-date information on microbial resistance to guide the rational use of the existing antimicrobials. Hence, the present study has been envisaged to evaluate the spectrum of micro-organisms causing AOM and their antimicrobial susceptibility pattern in a tertiary care hospital. Methods: The present study was a cross-sectional study and was initiated following approval from the institutional ethics committee and written informed consent was obtained from all the study participants. Patients who have been diagnosed to have AOM by clinical symptoms and signs were enrolled in the study. Demographic details (age, sex), history associated with risk factors (unhygienic mopping, past history of antibiotic use/ear infection/surgery in the ear or head) were collected from each study participant. Three cotton swabs were used to collect the discharge and were subjected to Gram stain; aerobic culture and direct examination (KOH Preparation) for fungal elements and fungal culture were done. Results: A total of 106 consecutive AOM patients were identified of which, 76 (71.7%) were males and 30 (28.3%) were females. Majority [94/106 (88.7%)] had unilateral and one-third of the individuals (32%) were less than 10 years old. Majority of the study participants [79/106 (77.5%)] had purulent discharge and a total of 84/106 (82.4%) had history of unhygienic mopping of the ear discharge with sticks and 51/106 (50%) reported of having applied oil or hot water in the ears. Culture was positive in 102/106 (96.2%) patients. A total of 118 organisms have been grown in the culture, of which 117 were bacterial isolates and the remaining one was Candida albicans. Of the 117 bacterial isolates, 51 (43.6%) was Staphylococcus aureus and 42 (35.9%) was Klebsiella pneumoniae. Many of the isolated organisms [80/117(68.4%)] were sensitive to ciprofloxacin, 69/117 (59%) were sensitive to Amikacin, 63/117 (53.9%) to Piperacillin and 60/117 (51.3%) to Gentamicin. Conclusion: We found that majority of the patients of AOM had clinical presentation similar to other parts of the world. Even the growth and sensitivity of the isolated micro-organisms were similar to previous studies.
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101. Adsorptive removal of methylene blue dye from aqueous solution by limonia acidissima rind biomass

     N Ramulu, V Thirumurugan, R Rajajeyaganthan

     • » Abstract Adsorptive removal of Methylene blue from aqueous solution was studied by adsorption on Wood apple rind (WAR- Limonia acidissima rind) Wastes. Kinetics study was carried out to observe the effects of various process parameters. The results follow kinetics of pseudo second order rate equation for the removal of Methylene blue by WAR. The suitability of the WAR adsorbent for removal of Methylene blue from aqueous solution was tested by fitting the adsorption data with two isotherms, namely Freundlich and Langmuir isotherms. The characteristic parameters for each isotherm have been determined. The Langmuir equation represented the best fit for the experimental data of WAR in removal of Methylene blue than the Freundlich isotherm equation. It was observed that WAR adsorbent is suitable for removal of Methylene blue from aqueous solution.
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102. A rare case of primary disseminated abdominal hydatidosis

     Sandip Pattanshetti, Nishith Shetty

     • » Abstract Primary peritoneal hydatidosis is rare and accounts for 2% of all abdominal hydatidosis. Very few cases are reported in literature so far. We report a case of a 46 year old woman presented with complaints of pain abdomen and recurrent fever of one month duration. On physical examination abdomen was distended and a mass was palpated in the lower abdomen and left lumbar region. Contrast-enhanced CT scan of the abdomen showed multiple intra peritoneal cystic lesions with minimally enhancing walls and similar lesions in liver and spleen. Cysts were excised and pathological analysis was consistent with hydatid cysts.
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103. Spermatocytic seminoma masquerading as chronic orchitis

     R Sujitha, Sowmya S

     • » Abstract Spermatocytic seminoma is an uncommon germ cell neoplasm found in elderly male patients, which carries excellent prognosis. It usually presents as a slow growing painless testicular swelling. Clinical history, physical examination, and ultrasound provide important clues as to the nature of testicular swellings in general. Rarely the diagnosis of testicular tumours in patients may be missed because testicular swelling is attributed to orchitis, as indeed happened in our case. Histopathological examination is confirmatory in such cases.
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104. Post operative wound infection in clean and clean contaminated surgery

     Gaurav Salunke, Maria Jose Wiseman Pinto, Savio Rodrigues

     • » Abstract Introduction: Surgical Site Infections are one of the most important causes of healthcare associated infections and are associated with considerable morbidity and mortality. This study was conducted to analyze postoperative wound infection in clean and clean contaminated surgeries, to determine spectrum of bacteria responsible, study their antimicrobial sensitivity pattern and to identify various factors responsible for them. Materials and Methods: Patients suffering from post operative wound infection during the period from January 2013 to December 2013 were included in the study. Patients were randomly selected. Pus samples were collected and processed in Microbiology department for aerobic and anaerobic organisms, according to standard procedures. Results: Cases were well spread in all age groups above 31 years. The male: female ratio was 1.4: 1. Clean contaminated cases accounted for more than half the number of cases. Staphylococcus aureus was the single most commonly isolated pathogen, followed by Acinetobacter baumanii and Pseudomonas aeruginosa. Most gram positive organisms were sensitive to Vancomycin, Amikacin and Linezolid, while gram negative organisms showed maximum sensitivity to Imipenem and Cefoperazone - sulbactum. An increase in the isolation of most bacterial species was observed when the duration of surgery and duration of pre operative stay increased. Conclusion: Despite intensive attempts at eradication during last 20 years, MRSA continues to be the major nosocomial pathogen worldwide. Antimicrobial prophylaxis is a critically timed adjuvant used to reduce microbial burden of post operative contamination. There is pressing need to reduce indiscriminate use of antibiotics and develop alternatives to reduce SSI.
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105. Serum lactate: an independent predictor of severe sepsis in obstetric patients

     Alveera, Prema D’ Cunha

     • » Abstract Objectives: to determine the utility of serum lactate as an effective and independent indicator of severe sepsis in patients with obstetric related sepsis. Methods: the study was conducted on 40 patients admitted to our hospital on in patient basis with 2 or more signs and symptoms of infection, along with a suspected source of infection. Once sepsis was diagnosed, a baseline serum lactate was done in these patients and further evaluated over a period of time. Results: out of the 40 patients studied, it was found that not all patients with sepsis had an elevated serum lactate levels. During the study, it was found that patients with an initial raised lactate level (>2.2mmol), needed more aggressive treatment and a closer follow up during their period of stay in the hospital. Although all patients with elevated serum lactate had severe sepsis, lactate was not the only determining factor, patients in whom other laboratory parameters were altered, and where lactate was normal were also found to be in severe sepsis. Conclusion: Serum lactate is an independent and effective predictor of obstetric related sepsis.
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106. Correlative study of fine needle aspiration cytology and histopathology in intraabdominal lumps

     Saroj A Bolde, Smita S Pudale, Smita S Shette, Ashwini Raut, Nitin Kole

     • » Abstract Introduction: Intra-abdominal masses always remain an enigma in surgical practice. Fine needle aspiration cytology (FNAC) preferably ultrasonographically guided (USG) of 50 cases of intraabdominal lump was performed and co-rrelated with histopathology. Aims: To co-rrelate the study of cytology with histopathology in cases of intraabdominal lumps. Material and Methods: This study included 50 intraabdominal lesions which were detected clinically.USG guided FNAC was done in 40 cases. Under light microscopy the lesions were reported, cytohistopathological correlation was done in 36 cases. Hematoxylin, eosin and papanicolau’s stains were used. Results: Cases from all age group were included. Maximum number of cases14 (28%) were in age group of 51-60 yrs, with Male: Female ratio of 1.63:1.The diagnostic yield was higher in USG guided FNAC. There were 24(48%) malignant, 09 (18%) inflammatory, 09 (18%) suggestive of malignancy,02(4%) nonneoplastic and06(12%) unsatisfactory smear. Hepatic lesions were most common. Hepatocellular carcinoma and Adenocarcinoma were the most common malignant lesions. Accuracy rate for cytohistopathological correlation was90% as out of 40 cases 36 cases were showing same diagnosis histologically. We found various lesions of liver, gastrointestinal tract, kidney and few cases of pancreas, gall bladder, spleen , mesenteric lymph nodes. We have came across a rare lesion of Gaucher disease (2 cases) diagnosed successfully both by cytology and histopathology. Conclusion: Intra abdominal FNAC is a simple, economical and safe procedure with high sensitivity, specificity and diagnostic accuracy. It can be utilized as pre- operative procedure for the management of intra- abdominal lump.
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107. Environmental hazards due to rate of siltation in the Wular Lake (Jammu and Kashmir), India

     Kulkarni U.D., Khan Asiya

     • » Abstract The siltation rate in the Wular Lake shows abnormality in space and time, as evidenced from preliminary geological survey of its catchment. The Panjal traps, limestones (with scanty intercalations of black shales) and Karewas form the major provenance for the silt which drains into the lake. The lineament fabric suggests a strong structural control over the formation of the lake. The Tertiary uplift, as well as, the pulses of seismicity have been instrumental in modifying regional geomorphological relief and the resultant changes in the rate of siltation. The climatic changes have also influenced the varied rate of erosion and subsequent siltation. The topographic relief appears to have fluctuated in the recent geological past, as is evidenced from the silt deposits in and around the lake. The environmental significance lies in the fact that such a rate of siltation would result in shallowing of the lake floor and may prove disastrous during higher degrees of runoff (either due to excess precipitation or melting of ice). The present state of human interference, in the form of settlements around the lake and farming practices on the reclaimed and / or acquired land of the lake, are beyond permissible limits of the environmentally safety zones.
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108. Kuttner’s tumour: a rare case report

     Nanda Patil, Alok Kumar Yadav, Shrutika D. Dhawan

     • » Abstract Kuttner’s tumour, also known as chronic sclerosing sialadenitis predominantly involves the submandibular gland. Though described more than a century ago, the entity remains under diagnosed and is commonly mistaken for carcinoma. The diagnosis is done by histopathological examination of excised salivary gland which reveals dense lympho-plasmacytic infiltration with acinar atrophy and periductal fibrosis. We present a case of Kuttner’s tumour in a 50 year old male patient to highlight its histopathological features and to increase the awareness about this under diagnosed entity.
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109. Contributory geochemical factors for variation in groundwater quality along confluence of Mula-Mutha and Bhima River, Dist. Ahmednagar, Maharashtra

     U. D. Kulkarni, Y. M. Nandurkar, R. R. Sangpal

     • » Abstract Sixty groundwater samples were collected in different seasons from the study area. The water soluble products of congruent weathering reactions such as Na, K, Ca, Mg, HCO3, and SiO2 have been probed. Apart from these, anthropogenic parameters such as Cl, NO3, PO4, and SO4 have also been analyzed. The mathematical and graphical tools are used to assess the groundwater quality for drinking and irrigation purpose. The study reveals that the concentration of major ions is controlled by the water-rock interactions. The water is not at all suitable for drinking purpose. As per pH, TDS, SAR, chloride and sulphate concentration water is suitable for irrigation purpose. Critical verification of hardness, EC, RSC, salinity hazard compels to assign water quality doubtful for irrigation purpose. Such doubtful zones need special care and suggested to adopt alternative salt tolerance cropping pattern. Also it is advised to avoid excessive use of artificial fertilizer and excessive irrigation.
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110. Anomalous muscle bellies in the flexor compartment of forearm - a case report

     Sunita U Sawant, Sunil M Kolekar

     • » Abstract Introduction: The muscular variations of upper limb are common. Their importance becomes apparent with regard to surgical approaches for various clinical conditions involving the upper limb. During routine dissection classes to undergraduate medical students, we came across two additional muscle bellies in the flexor compartment of the left forearm of a male cadaver arising from the under surface of flexor digitorum superficialis (FDS) and were found to be inserted into flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) separately. The above two accessory muscle bellies are also called Gantzer's muscles. In another male cadaver, an accessory muscle belly arising from the flexor digitorum superficialis of the right forearm was found to be inserted into the flexor digitorum profundus (FDP). Muscle anomalies of the upper extremity are recognized causes of peripheral nerve disorder. Awareness of these variations is necessary to avoid complications during radio-diagnostic procedures or surgeries in the upper limb.
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111. Effect on sexual dysfunction in depressed females after treatment with SSRI antidepressants

     Abhivant Niteen N., Sawant Neena S.

     • » Abstract Introduction: Depression is associated with sexual dysfunction. As the depression improves sexual dysfunction also improves. There are not many studies on female sexuality. Aims and Objectives: To find out the changes in sexual functioning in depressed females after treatment with anti-depressant drugs. Method: 41 female patients diagnosed to have depression were included in study. Becks Depression Inventory, Arizona Sexual Experience Scale and Female Sexual Functioning Index scales were applied at the beginning and after 6 weeks to assess the improvement in sexual dysfunction and depression. Results: When scores were compared after 6 weeks of antidepressant treatment then a highly significant difference was seen on all the scores of BDI ( p< 0.000***), ASEX ( p< 0.027***)and FSFI. (p< 0.01**). On the various domains of FSFI a highly significant difference was seen on the domains of Arousal (p< 0.03**), Lubrication (p< 0.051**), Orgasm (p< 0.028**) and Satisfaction (p< 0.06**). Desire and pain domains did not show any significant changes. Conclusions: This study showed significant improvement in sexual dysfunction and different aspects of sexual dysfunctions after treatment with antidepressants for 6 weeks.
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112. Schizencephaly: a case report of a rare developmental disorder of brain

     Kapil S. More, Vijaykumar R. Kapse, Sonali Kagne, Deepak Kubde

     • » Abstract Introduction: Schizencephaly is an extremely rare developmental disorder of the brain. Its prevalence in Indian data is 1.5: 1,00,000 population. It is a triad of hemiplegia, seizure disorder and mental retardation. Hence we are reposting a case of 28 yrs. old female who presented with intractable seizures and altered sensorium for 2 days. She is a known case of epilepsy since the age of two months. She also had left sided hemiparesis since the same duration. She had delayed developmental milestones and mental retardation. Her, CT brain was done. It showed large fluid filled cavity occupying right frontal, temporo- parietal region lined by grey matter communicated with right ventricle. These findings are constistent with right sided unilateral open-lip schizencephaly.
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113. Comparative study of glycosylated hemoglobin and lipid profile in gestational diabetic women and normal pregnant women

     B. J. Pradeep Kumar, Sudhir Modala, Parimala P., Manisha Baghel

     • » Abstract Aim: Lipid profile and glycosylated hemoglobin level changes in gestational diabetes. The extent to which this alteration takes place is still not clearly documented. Materials and Methods: To add a clear answer to this question, lipid profile parameters, and glycosylated hemoglobin status were determined in patients with gestational diabetes mellitus and compared to healthy pregnant women (controls). Results: Fasting plasma glucose levels, plasma glucose levels 1 hour, and plasma glucose levels 2 hours after 75 gm oral glucose administration (oral glucose tolerance test) were significantly higher in patients with gestational diabetes as compared to controls. Glycosylated hemoglobin was significantly higher in gestational diabetes than in controls. It was observed that there was a significant increase in serum cholesterol and serum triglyceride level in cases with gestational diabetes when compared to healthy pregnant women. Conclusion: The results of our study suggest that abnormal glucose levels, glycosylated hemoglobin, serum cholesterol, and serum triglycerides play an important role in pathophysiology of gestational diabetes, and therefore, extensive studies are required. Early diagnosis of gestational diabetes will decrease adverse neonatal and maternal outcomes
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114. Inducible clindamycin resistance in Staphylococcus aureus isolatedfrom clinical samples

     K. Vidyasagar, R. Ravikumar

     • » Abstract Purpose: Clindamycin is commonly used in the treatment of erythromycin resistant Staphylococcus aureus causing skin and soft tissue infections. In vitro routine tests for clindamycin susceptibility may fail to detect inducible clindamycin resistance due to erm genes resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D test on routine basis. Materials and Method: 100 Staphylococcus aureus isolates from various clinical samples subjected to routine antibiotic susceptibility testing by Kirby Bauer disc diffusion method. Inducible clindamycin resistance was detected by D test, as per CLSI guidelines on erythromycin resistant isolates. Results: 42 (42%) isolates showed inducible clindamycin resistance, 13 (13%) showed constitutive resistance while 10(10%) showed MS phenotype. Inducible resistance was found to be higher in Methicillin resistance Staphylococcus aureus (MRSA) as compared to Methicillin sensitive Staphylococcus aureus (MSSA) (56.6%, 13.2% and 25.53%, 12.7% respectively) Conclusion: Study showed that D test should be used as a mandatory method in routine disc diffusion testing to detect inducible clindamycin resistance.
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115. Evoked response audiometry in high risk infants

     Lakshmi T., Zaheera Sultana S., S. V. Brid

     • » Abstract Background: Hearing is the means by which the newborn comes into contact with the world of sound and with language. The first three years of life are the most important period for speech and language acquisition. Reduced hearing acuity of any severity in infancy or early childhood may prevent the child from receiving adequate auditory, linguistic and social stimulation required for speech and language development. Hearing loss is one of the most common abnormalities present since birth. The prevalence of hearing loss is reported to be 1.5 to 6 per 1000 newborn in the well baby nursery population. Several risk factors associated with hearing loss during early infancy have been described by Joint Committee on Infant Hearing which includes hereditary cause, inutero infection, prematurity, asphyxia, hyperbili-rubinemia and ototoxic medications. Objectives: To assess the degree of hearing impairment in high risk infants by using BERA and to analyse and compare BERA responses in high risk infants with age matched controls. Methods: 100 high risk infants having one or more risk factors attending Pediatric OPD of Bapuji hospital and Chigateri General Hospital and 30 age matched controls satisfying the inclusion criteria were randomly selected from immunization centre were subjected to BERA. Parameters such as absolute latencies of waves I, III, and V, Interpeak latencies I-III, I-V and III-V were assessed and analysed by using unpaired t-test. Results: The high risk infants had increased wave V threshold when compared to the control group. Absolute latencies of wave III, V, interpeak latencies of I-III and I-V were prolonged in the cases. The incidence of hearing impairment was 64.9% in the high risk infants.
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116. Study to find the efficiency of multi-detector computed tomography in evaluation of renal masses

     Shailender Singh N, Satishchandra H

     • » Abstract Introduction: Detection of malignant renal masses and their differentiation from their benign counterparts is extremely important, especially when these masses are small. Although the effectiveness of conventional axial renal CT is well established, a variety of problems can be encountered. The major advantages of the multiple detector-row computed tomography (MDCT) technology over conventional CT is that it allows for acquisition of different image thicknesses from the same acquisition data set. Thus the present study was undertaken to study the efficiency of MDCT in diagnosing renal masses. Aims and Objective: To find out the efficiency of Multi-detector Computed Tomography in the evaluation of renal masses. Materials and Method: The study was conducted over a period of two years on 50 patients with clinically suspected Renal mass or patients who were diagnosed to have renal mass on ultrasound and were referred to CT for further characterization. Results: Overall there were 33 (66%) males and 17 (34%) females; the male to female ratio was 1.9:1.thus renal neoplasm was seen more commonly in males. MDCT was able to differentiate a benign from malignant lesion with Sensitivity of 100, Specificity of 71 %, and Accuracy of 96 %. When the images were assessed in unenhanced, corticomedullary and nephrographic phases. Conclusion: Multi-detector Computed Tomography can be used as an efficient tool with high degree of accuracy in diagnosing renal masses.
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117. Prescription pattern of antihypertensive drugs and life style practices of hypertensive patients in an urban locality of Mysore

     Kalabharathi H L, Mohammed Sibgatullah, Pushpa V H, Satish A M, Suresha R N

     • » Abstract Objective: To determine the prescription pattern of antihypertensive drugs in Narsimharajamohalla of Mysore. To determine the lifestyle practices of hypertensives. Materials and Methods: Around 165 patients were enrolled in the survey after obtaining their consent. Prescription pattern of antihypertensive drugs was noted. Lifestyle practices such as exercise habits, dietary salt intake; compliance to medication was enquired through a questionnaire. Results: majority of patients are on combination therapy. Diuretics were the commonly prescribed antihypertensives. Reduction in salt intake and exercise habits were poor among majority of the patients. Few patients were noncompliant to the prescribed medication. Conclusion: With the obtained data showing a large amount of patients on combination therapy with poor life style practices, there should be an emphasis on health education. The prescribing doctor, paramedics, media, government should do their best in educating the masses.
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118. Effectiveness of the First Antiepileptic Drug in the Treatment of Epilepsy in Children

     Sangeeta Basu, C D Aundhakar, Jitendra Kumar, Amit Galgali, Rakesh Patil, Sharanabasav Kirdi

     • » Abstract Abstract: Seizures are the most common pediatric neurologic disorder, with 4% to 10 % of children suffering at least one seizure in the first 16 years of life. 3 If the response of the first antiepileptic drug trial is a powerful marker of outcome, then the early identification of patients who are at risk to fail the initial antiepileptic drug trial should be a priority. The AED chosen for the initial therapy should be one that is for the highly effective for the particular seizure type or syndrome and that is safe and well tolerated. We conclude that presence of history of seizures in family members and the presence of microcephaly can have a significant role to play in the outcome of the trial with the first AED. Good seizure control can be achieved by using mono therapy with the standard first line AED drugs in moderate doses.
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119. Study of Effect of Meditation on BMI

     Sangeeta J. Sarkate, Sangita R. Phatale, P. S. Bhakare

     • » Abstract Background and Objective: Meditation is described as condition of inner tranquility and attaining of higher state of consciousness. The present study was undertaken to find out the effect of meditation on BMI. Material and method: The study was conducted on 74 subjects in the age group of 45 to 55years of either sex. BMI was recorded before and after two months training of meditation. Results: BMI was decreased and was statistically highly significant. Conclusion: Meditation practice found to reduced the BMI.
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120. Pseudocyst of Pancreas Presenting in Respiratory Failure Due to Myasthenia Crisis

     Mohammad Hafiz Deshmukh, Ashish Deshmukh, Sunil Jadhav, Shivprasad Kasat, Sandeep Dandin

     • » Abstract Abstract: We report a case history of a 43 yr old lady, who presented with acute abdominal pain and then went into respiratory failure. The patient was not a known case of myasthenia gravis. The Chest X-ray was normal, blood gas analysis showed respiratory acidosis, CT scan of abdomen showed pseudocyst of pancreas with necrosis in tail of pancreas. Myasthenia crisis can be triggered by a variety of factors, in this case by acute pancreatitis. In our case myasthenia gravis was diagnosed since we had difficulty in weaning her off from the ventilator. Myasthenia crisis with pseudocyst of pancreas and acute pancreatitis is rare. After putting her on ventilator, there was improvement in blood gas, but she could not be weaned off the ventilator even after repeated attempts because of poor respiratory muscle activity. Serum Acetylcholineesterase receptor auto antibodies were found to be high, and she was then diagnosed as having Myasthenia gravis. Myasthenia gravis should be suspected in a patient with unexplained respiratory failure.
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121. Association between Periodontitis and Cardiovascular Diseases: A Clinicobiochemical Study

     Kalpana U. Rakshit, Neelima Rajhans, Pankaj Kamble, Nilkanth Mhaske, Nikesh Moolya, Sudeep HM

     • » Abstract Introduction: The periodontal tissues mount an immune inflammatory response to bacteria and their products and the systemic challenge with these agents also induce a major vascular response. Oral infection models have emerged as useful tools to study the hypothesis that infection is a cardiovascular disease (CVD) risk factor. Periodontal infections are a leading culprit, with studies reporting associations between periodontal disease and CVD. Material and Methods: The study was conducted on a group of 50 individuals aged 30 to 65 years, divided in five different groups depending on the type of cardiovascular disease diagnosed. These five groups were: Ischemic heart disease, bacterial endocarditis, Congestive cardiac failure, valvular heart disease and cardiomyopathies. The dental investigations comprised of Ramjford’s periodontal disease severity index and clinical attachment level Laboratory investigations were done for lipid profile analysis. Observations and Results: Ramjford’s disease severity index showed a significant difference (p<0.05) between Bacterial endocarditis and Valvular heart disease. This index also showed significant positive correlation with total cholesterol, triglycerides and VLDL and showed negative correlation with HDL. Attachment level was not significant between Valvular heart disease and Cardiomyopathies. However, it showed positive correlation with total cholesterol. Lipid profile showed dyslipidaemia with Ischemic Heart Disease. Conclusion: The study concludes that Bacterial endocarditis and Ischemic heart diseases have severe degree of periodontitis as compared to Valvular heart diseases, cardiomyopathies and congestive cardiac failure.
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122. A Comparative Study of Lipoprotein Levels in Normal and Hypothyroidism Patients

     Kedar Joshi, Deepak K. Bokankar, Hardas V. M.

     • » Abstract Introduction: Thyroid hormones influence all the major metabolic pathways. Their most obvious and well known action is increase in basal energy expenditure obtained acting on protein, carbohydrate and lipid metabolism. With specific regards to lipids, thyroid hormone affects synthesis, mobilization and degradation of lipids, although degradation is influenced more than synthesis. Aims and objectives: To study changes in lipoprotein levels in overt and subclinical hypothyroidism patients and compare it with matched healthy controls in population. Material and method: The present study was conducted in Government Medical College and Hospital, Aurangabad from October 2005 to October 2007. Lipid profile of patients of hypothyroidism was compared with control group. Results: Thus among the patients with overt hypothyroidism, we found highly significant increase in TC, LDL and HDL values and no significant change in TG and VLDL when compared with controls. Among the patients with subclinical hypothyroidism, we found significant increase in TC and LDL while no change in TG, HDL and VLDL when compared with controls. Conclusion: that in overt and subclinical hypothyroidism patients, the lipid profile is clearly atherogenic.
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123. Causative Microorganism for Sepsis in NICU

     Kiran B Bhaisare, Sunil S Holikar, L. S. Deshmukh

     • » Abstract Introduction: As many as 2% of foetuses are infected in utero, and up to 10% of infants have infections in the 1st mo of life. Infections are a frequent and important cause of neonatal and infant morbidity and mortality. nosocomial infection rates are increasing with an incidence inversely proportional to the gestational ages of the infants populating the NICUs. Causative organisms, Group B Streptococci or Escherichia coli that are most likely acquired perinatally. The reported incidence of nosocomial sepsis in India ranges from 1.5-37%. Klebsiella emerging as an important cause of nosocomial sepsis. Outcome depends upon weight and marturity of neonate, type of etiologic agent, antibiotic sensitivity and adequacy of specific and supportive therapy. Material and Methods: All babies admitted in NICU showing clinical features of sepsis, in whom laboratory investigation support the diagnosis of sepsis. Study Period: January 2008 to October 2010.Study design: Observational study. Methods: Babies enrolled in the study were subjected to laboratory investigations Blood culture and Sensitivity was sent in all babies admitted and if sepsis was suspected. Conclusion: Total 1580 neonates were admitted during the study period. Out of these 223 were enrolled in study, Seven neonates were lost during follow up. Fifty neonates of neonatal infection died during the study period. Septic screen was positive in 91.92%, CRP (84.75%), blood culture ( 74.88%), meningitis(18.8%). Most common organism isolated was Klebsiella pneumoniae (28.7%) and least was streptococcus species (5.3%).Mortality due to neonatal sepsis was 24.4%.
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124. A Study of Prevalence of HIV Infection in Children Attending Pediatric Department

     Vikas N. Solunke, Milind B. Kamble, Amol R. Suryawanshi, Pallavi Saple, Manish M. Tiwari, Bhete S. B., Garad S. B.

     • » Abstract Introduction: The increase in pediatric HIV infection has had a substantial impact on childhood mortality both in industrialized countries and developing countries. Pediatric HIV is a major world health problem which is progressing at an alarming rate. Aims and objectives: a) To study the prevalence of HIV infection in children. b) To study various presenting signs and symptoms in pediatric HIV patients. Methodology: The present study was carried out in the department of pediatrics from January 2008 to June 2009. All the patients attending the pediatric department i.e. OPD and IPD were enrolled in the study. Out of these patients suffering from HIV were diagnosed. The study population included was patients who were already HIV positive or diagnosed later on investigation on suspicion of the clinical features. Results: A sum of 24828 children attended pediatric department during study period. Amongst those 144 were found to be HIV reactive. Hence the prevalence of HIV infection during the study period was 0.58%. Vertical transmission was seen in 98.62% and infection via blood transfusion in 1.38%. Male to female ratio was 1.93:1. On first presentation fever was the most common symptom. On examination severe malnutrition (PEM Gr III and IV) was the most common finding (59.02%) followed by pallor (51.38%), respiratory signs (47.22%). Conclusion: prevalence of HIV in children attending pediatric department was 0.58%. Fever was the most common complaint reported by the study population and malnutrition was also most commonly associated finding in pediatric HIV patients.
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125. Assessment of Ground Water Quality in Bachigudam Village near Patencheru in Medak District in Month of July

     Baby Abrarunnisa Begum, N. Devanna, Md. Sibgatullah, Asma

     • » Abstract Abstract: Rapid industrialization has resulted in pollution of ground water recourses. Patencheru in Medak district is one such industrial hub near Hyderabad. The treated industrial waste in released into stream nakkavagu which joins river manjeera a tributary of river Godavari. Bachigudem village was selected for ground water assessment as it lies in the nakkavagu catchment area. Parameters from eight sources were analyzed for parameters such as color, turbidity, pH, total alkalinity, total dissolved solids, total hardness, chlorides, sulphates, nitrates, fluorides and electrical conductivity. The sampling was done in month of july which is a peak rainy season. The results showed gross contamination of the ground water in bachigudem village. Fresh water is one of the essentials for life on earth. The Indian subcontinent is one of the wettest places on the earth with annual precipitation of over 4000 km3 with a river flow of 1880 km3 and potential ground water resources of about 431 km 3 besides water glaciers, ponds and lakes. But still we have the demand for good quality water because of growing population and use and abuse of existing resources.
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126. Association of Serum Apolipoprotein in Patients with Coronary Heart Disease – An Observational Study

     Deepak Kishan Bokankar, Kedar Balwant Joshi, Patil V. P.

     • » Abstract Introduction: Incidence of coronary heart disease (CHD) has shown an upward trend in Indian in the last decade. Estimation of serum lipids like Cholesterol and triglycerides were used to assess the risk of CHD. However, the correlation between serum Cholesterol and CHD is not ideal. Apoplipoprotein play an important role in many disorders of lipid metabolism. Indeed, it has become increasingly clear that while the lipids in lipoproteins are the transported moieties, the protein moieties of lipoproteins - the apoproteins - perform the crucial roles of transporting the lipids, and apoproteins can determine the levels of lipoprotein lipids. Therefore, attempts have been made to assess the relationships between plasma apoprotein concentrations and CHD. Aim and Objectives: To see the association of serum apolipoprotein A-I and B in patient with Coronary Heart Disease. Materials and Methods: The present study was conducted at Government Medical College and Hospital, Aurangabad. Levels of Apolipoprotein A-I and B in 60 Coronary Heart Disease patients admitted with first episode of coronary heart disease in ICCU were compared with 60 healthy apparently normal age, sex matched individuals. Results: it was observed that levels of apolipoprotein A-I and the ratio of apolipoprotein A-1 and B were decreased in CHD patients where as levels of apolipoprotein B was increased in CHD patients as compared to control group. And the difference was also statistically significant. Conclusion: concentration of apo A-I, apo B and its ratio can be a useful summary index of risk of CHD.
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127. Histopathological Pattern of Skin Diseases in a Teaching Hospital Puducherry

     Sandhya Panjeta Gulia, Swati Anil Wadhai, Lavanya M , Roshni Menon, Madhusudan Chaudhary, SP Arun Kumar

     • » Abstract Aims: This study is conducted to study the prevalence of various skin lesions attending the outpatient department of dermatology over a period of one year dec2012-dec2013. Materials and Methods: A total of 125 cases of skin lesions for over a year were taken for the study. Diagnosis was confirmed by histopathological examination with Hand E stain. Special stains were done wherever required. Results : Out of 125 cases, 30(24%)were reported under the category of non-infectious erythematous papulosquamous diseases, 20(16%) cases of leucocytoclasticvasculitis, 6(4.8%) cases of vesiculobullous and vesiculopustular diseases, 15 (12%)cases were reported as connective tissue disorders amongst which morphea, 12(9.6%)was the commonest, granuloma annulare 1 case(0.8%), erythema nodosum 2 (1.6%), 5(4%) cases of cutaneous drug toxicities, infectious etiology was reported in 15(12%) cases, pigmentary disorders of the skin was reported in 5(4%), 2(1.6%) cases of tumors arising from epidermal appendages, 5(4.0%) cases of tumors and cysts of epidermis and miscellaneous category,15(12%) cases. Conclusion : Among skin infections papulosquamous lesions were more common in our region with psoriasis being the most common lesion.
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128. Study of Fetal and Maternal Outcome in Eclampsia

     Kuljit Kaur, R. D. Shrivastav, Veena Rahatgaonkar, U. T. Bhosale

     • » Abstract Aim: To Study the fetal and maternal outcome in patients with eclampsia. Background: In modern Obstetrics, the prevalence of eclampsia and its complication is high, so we decided to study pregnancy outcome in all eclampsia patients. Methodology: A Retrospective study carried out in department of Obstetrics and Gynecology in Bharati Medical College and Hospital, Sangli. Cases of eclampsia from May 2008 to May 2012 included in study. Analysis done regarding age of women, parity , gestational age, number of convulsion, time of convulsion, mode of delivery and fetal outcome. Results: 84.6% patients are primigravidas.88.4% came with antepartum eclampsia. Only 15.3% patients had postpartum eclampsia. Fetal outcome being intrauterine death in 46.1 % and preterm delivery in 26.9 %. Conclusion: Our observation states Antepartum eclampsia is more common in primigravidas between age group 20-25 years. With gestational age between 24-28 weeks and 32 to 36 weeks with poor fetal and maternal outcome. In our study we found all cases were unbooked and not received Antenatal care indicating the failure of adequate health care delivery in rural areas of western Maharashtra. Fetal outcome is better in patients with early intervention by lower segment caesarean section.
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129. A Rare Presentation of Sternal Tuberculosis with Pulmonary Tuberculosis in an Immunocompetent Adult

     V. R. Lokhande

     • » Abstract Abstract: The case of a 30 years old male presenting with pain and swelling over the manubrium sternii with no constitutional symptoms is presented here. The patient was immunocompetent and found to have tuberculous affection of sternum with lung involvement as well based on imaging and histopathology. He was treated with anti tuberculous therapy for 9 months and responded well with complete resolution of the lesions. A one year follow up has revealed no recurrence so far. This case highlights the importance of rare presentations of TB in immunocompetent individuals.
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130. Study to Assess the Awareness and Perception of Eye Donation among Medical Students

     Venukumar Lachmaya Rangu, Rupali Venukumar Rangu, Nitin Akhade

     • » Abstract Abstract: Corneal transplantation remains a major treatment option for restoring sight among those suffering from corneal blindness. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate numbers of corneas collected. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counseling for donating eyes. The aim of the study was to assess the perception and willingness of 400 first-year medical students towards eye donation in Maharashtra. They were administered a pretested semi-structured questionnaire on eye donation. Data were analyzed using Epi-Info software package 6.04 version. The majority (99.6%) of students knew that eyes can be donated after death but only 40% knew that the ideal time of donation was within six hours of death. Most participants (83.5%) were willing to donate eyes, 89.5% students were aware that there is shortage of donated eyes in India. Nobility in the act of eye donation was the main motivational force for eye donation according to 86.2% of students. Perceived reasons for not pledging eyes by the people were: lack of awareness (31.8%), objection by family members (27.7%), unsuitability to donate because of health problem (16.6%) and the unacceptable idea to separate the eye from the body (15.1%). Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. Perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community.
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131. Analysis of Stevens-Johnson’s Syndrome and Toxic Epidermonecrolysis Patients in a Rural Based Medical College with an Emphasis on Steroid Therapy

     Venkateshwarlu Nandyala, Gandiah P., Govind Das, Harish Kumar J., P Anand G. Reddy, Sandeep Kumar G

     • » Abstract Abstract: Thirty cases of SJS-TEN were reported during a seven year period between 01-01-2007 and 31-12-2013 were analysed. Eighteen were males, anti-epileptics were the culprits in 11 cases (Phenytoin sodium was responsible in 6, carbamazepine in 4 while sodium valproate was responsible in 1 case. Ofloxacin was responsible in 4 ciprofloxacin and cefixime in one each case whereas another 8 cases it was NSAIDs. Two ayurvedic medications were also noted in our study. 12 patients received 3 days therapy of pulse dose dexamethasone therapy, 6 patients received pulse dose Methyl Prednisolone 7 patients received regular dexamethasone treatment while remaining 5 did not get any steroid. All cases received supportive therapy, barrier nursing and prophylactic antibiotics. Cases who received Pulse dose steroid treatment recovered fast and hospital stay was reduced, while two patients in non-steroid group died and remaining 3 recovered very slowly. Short term (3 days) pulse steroid therapy is well tolerated and recovery is very fast as compared to regular steroid therapy or therapy without steroid. However as the sample size is small we recommend a large study preferably a double blind study.
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132. Spontaneous Pancreatico-Cutaneous Fistula: a Rare Case Report and Review

     Jaykar R.D., Jadhav S.C., Agrawal S.G

     • » Abstract Background: The frequency of pancreatic fistulas is low. Only 0.4% of patients develop this complication after an acute episode. However, the incidence of these complications increases in patients with other complications after acute pancreatitis—4.5% in patients with pancreatic pseudocysts (4.5%) and 40% in patients with infected necrosis after surgical debridement. Treatment is conservative for most patients.1 Case: We report a case of Spontaneous Pancreatico-cutaneous (Pancreatico-umbilical) Fistula in a 30 year male complaining of pain in abdomen in epigastrium, lump in abdomen and spontaneous discharge of pus from umbilicus followed by disappearance of lump. Patient was known case of Acute Pancreatitis with pseudocyst formation since 4 months. Abdominal ultrasound contrast CT scan abdomen revealed. “Severe acute pancreatitis with focal necrosis in tail region with multiple peripancreatic collection. Multiple organised intra-abdominal infective collection. Organised collection in anterior abdominal wall with sinus tract formation in umbilical region”. Review CT scan abdomen with Fistulogram revealed “Small fistulous tract in midline extending from umbilicus and communicating with peritoneal cavity”. The patient was treated conservatively with higher antibiotics and patient recovered uneventfully and discharged.
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133. Tropical Pulmonary Eosinophilia – A Rare Presentation of a Common Disease in Tropics

     Venkateshwarlu Nandyala, Gandiah P., Indira G., Anand Gopal Reddy P.

     • » Abstract Abstract: Tropical pulmonary eosinophilia is one of the many pulmonary infiltrates with eosinophilia. We are presenting a case with features of lung abscess in left lung field. The diagnosis was suspected and proved retrospectively after successful treatment with diethyl carbamazine (DEC). There was an elevation of gamma-glutaryl transpeptidase levels in our case, which may have a role in pulmonary infiltrates in tropical eosinophilia.
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134. Study of Surgical Intervention in Patient of Meningocele with Hydrocephalus: Simultaneous V/S Sequential Group

     D. B. Katikar, R. D. Jaykar, Mahendra Kamble, Sumeet

     • » Abstract Background: Meningocele is sac protruding from the spinal column, Myelomeningocele is most severe type of spina bifida, which is commonly encountered by surgeon in new born due to failure of caudal neurulation. The incidence of meningocele is 0.2-2/1000 live births, and 15-25% of neonates with myelomeningocele have hydrocephalus at birth. Hence required significant amount of medical intervention, about 80-90% of them need shunt procedure. Methods: For all patients evaluation plan was as follows: Detail clinical history followed by thorough clinical examination. Investigations: Routine laboratory investigation required for pre anesthetic checkup such as Hemogram, Blood sugar level, Serum electrolytes, Blood urea level, Serum creatinine, Serum bilirubin; Ultrasonography (local, abdomen and pelvis, cranium); CT scan head. Consent: A written informed consent for surgery as per the risk was obtained from parents of patients. Pre-Operative Treatment: One dose of pre-operative antibiotic i.v Ceftriaxone 100mg/kg before operation. Anaesthesia: General anaesthesia Procedure: a) Low pressure V.P Shunt was used. b) Skin closure with 2-0 Nylon in both the procedures. Post-operative Treatment: All the patients from both the study groups were given- Antibiotics - I.V Ceftriaxone 100mg/kg x 5 days I.V Amikacin 15mg/kg x 5 days Local care -dressing on day 3, 5 and on wards if required Postoperative: Each patient’s operative time requirement for both study groups was recorded. The operative time was considered as the time from skin incision to the application of dressing. Patients were discharged after the operation as per their comfort and instructed to follow up on for suture removal. Patients were followed up at every week for two week, then on fourth week, eighth week and three months after discharge on outpatient department basis. Problems expected during postoperative period were: 1. Local wound infection. 2. Non healing of the wound. 3. Dehiscence of the wound. 4. Meningitis. 5. Ventriculitis. 6. Shunt failure. Local infection leading to septicaemia: In our comparative study, we had compared 40 patients of meningocele with hydrocephalus operated in one stage group and in two stage group. All patients were infants with age less than seven days. The meningocele sac was more commonly situated in lumbosacral region in our study groups. Our average operative time for single stage group was 105 min and average operative time for two stage group was 135 mins. The average hospital stay for single stage group was 10 days and two stage group was 22 days. We had two mortalities in our study, one each for both groups. Both the children developed septicemia and meningitis in spite of aggressive antibiotics treatment, they succumbed. We had complications like fever, local wound dehiscence and cerebrospinal fluid leak, none of which were life threading and all got corrected with appropriate treatment. The incidence in both group was almost similar. Both the procedure appeared to be equally safe and the complication rates were similar. The operative timing and hospital stay was less in one stage procedure which makes it economical and emotional burden lessens for the patients family. If the child appears to be fit and undergoes one stage procedure, it appears to be safe economical and without additional complication. Conclusion: Our comparative study revealed as 1. Mean operative time was less in one stage procedure than two stage procedure. 2. Hospital stay in one stage procedure was less than two stage procedure. 3. Complications rate in both the group were comparable. 4. One stage procedure enhanced flap survival and prevented CSF leakage. 5. It can be safely done, 6. It is economical and shortens hospital stay. 7. It avoided need for second aneasthetic administration. 8. It leads to reduction in hospital burden and patient morbidity. 9. Complication such as CSF leakage, wound dehiscence and shunt infection were comparable. Children who are having meningocele and hydrocephalus can be operated by either one stage procedure or two stage procedure. Both the procedures appear to be equally safe and the complication rate was similar. The operative timing and hospital stay was less in one stay procedure which makes economical and emotional burdens less for the patient’s family. If the child appears to be fit, and undergoes one stage procedure, it appears to be safe, economical and without additional complication. A bigger sample size would be needed to validate their finding. Simultaneous surgery had the advantages of exposing these children to ones rather than twice for anaesthesia.
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135. Study on the Diagnostic Efficacy of Clinico-Laboratory Parameters in Serologically Diagnosed Cases of Dengue Fever

     Sreejith M. G., Peter George

     • » Abstract Background: Dengue fever (DF), is the most common mosquito borne arbo-viral infection in humans. The high mortality associated with DF mandates early diagnosis and therapeutic interventions. Aims: To study the utility of clinic-laboratory parameters in serologically diagnosed cases of DF and to correlate with serological tests with the progression of disease. Material and methods: This is are prospective study done among patients, admitted to a tertiary care facility in South India between 1rstMarch and 31rst August 2013, with the diagnosis of Dengue fever (DF) either by dengue NS1 or Ig-M positive test. Their clinical and laboratory parameters were compared for the diagnostic utility withthat of NS1 or Ig-M dengue tests in relation to the day of performing the tests. Results: 200 serologically diagnosed DF patients were evaluated with 145 positive for NSI antigen and 55 for Ig-M antibody. 114 patients were male and 86 females. Clinical features of fever with headache, body ache and myalgia were present in 90%, whereas retro-orbital pain in only 40 % of cases. High grade fever and headache were the most specific clinical feature(92%). Almost 94% of NS1 positive cases presented within 4 days of onset of fever. Among NS1 positive cases leucopoenia alone had a sensitivity of 55% and specificity 48% with PPV 73%. Thrombocytopenia had sensitivity 89% with PPV 70.45%. Anicteric hepatitis had sensitivity of 75% and specificity 40%. Combination of clinical features with 2 out of four laboratory parameters (high haematocrit, leucopenia, thrombocytopenia, anicteric hepatitis) increased sensitivity to 94%. The chances of developing complications were very less during the first 4 days (3%) and the sensitivity of NS1 was 0-40% after 5 days of symptom, but IGM was 70-100%. Conclusion: During the early stages of disease we observed the diagnostic efficacy of clinico-laboratory parameters is similar to NS1 antigen. In a developing country with limited resources, were DF is endemic the routine use of expensive serological investigations is questionable.
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136. Study of Engine Performance and Emission with Neem Oil (NOME) Based Bio-Diesel

     Tejaswita Kajale, Abhay Pawar, Channapatana

     • » Abstract Abstract: The world is getting modernized and industrialized day by day. As a result vehicles and engines are increasing. But energy sources used in these engines are limited and decreasing gradually. This situation leads to seek an alternative fuel for diesel engine is biodiesel. Biodiesel is a non-toxic, biodegradable and renewable alternative fuel that can be used in diesel engines with little modification. Biodiesel is currently expensive. It could be produced from low-cost Neem seed oils. The objective of this study was to investigate the effect of the biodiesel produced from high free fatty acid feed stocks on engine performance and emissions. Biodiesel performance and testing is done in C.I. engine. Neem oil was extracted from neem seed by solvent extraction. Refractive index, density, viscosity, ash content, Saphonification value, iodine number was studied. Biodiesel has been prepared from NEEM oil by esterification and transesterification. It was examined for physical and chemical properties and chemical properties. HC, CO, NOx, SOx, and particulate matter was studied. The conversion of the biodiesel fuel's energy to work was equal to that from diesel fuel. The results also clearly indicate that the engine running with biodiesel and blends have higher NOx emission by up to 20%. However, the emissions of the CI engine running on neat biodiesel (B100) were reduced by up to 15%, 40% and 30% for CO, CO2 and THC emissions respectively, as compared to diesel fuel at various operating conditions.
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137. An Analysis of Indications for Caesarean Section at Government Medical College, Latur

     Prashant Bade, Varsharani Kendre, Yallapa Jadhav, Atul Wadagale

     • » Abstract Background: According to WHO, the optimal caesarean delivery rate is 10-15%.However the caesarean rate is much higher in India. The increased caesarean rate has resulted in increased economical burden on health care and possibly increased maternal morbidity. Objectives: To study various indications for caesarean sections performed at Govt. Medical College and Hospital, Latur. To suggest recommendations to reduce the caesarean section rate. Materials and Methods: This study is a record based cross sectional study, conducted at Government Medical College and Hospital, Latur. All women who underwent caesarean section from March 2013 to august2013 were included in the study .Data was entered in MS Excel and analyzed with percentages and chi square test using SPSS ver.21. Results: Caesarean section rate observed in our study was 23.97 %. It was significantly more common in the age group of 21-30years, women with parity 2 and rural women. The primary LSCS rate was 41.99% and that of repeat LSCS was 58.01%.The Emergency LSCS rate was significantly higher (74.22%) than elective LSCS rate. The commonest indication for LSCS was previous LSCS (24.8%) followed by, cephalopelvic disproportion (17.6%), failure to progress (16.6%), and fetal distress (11.7%). Conclusions: In this study, caesarean section rate is higher than WHO standard and previous LSCS was the most common indication. So reduction in overall caesarean section rate can be met through reduction of elective LSCS with the promotion of trial of labour and by improving maternal health. Interpretation: Though the benefits of the caesarean section cannot be denied, unnecessary caesarean sections should be avoided.
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138. Palmaris Longus - Upside Down!!!!

     K. S. Nemade, M. M. Meshram

     • » Abstract Abstract: Palmaris longus muscle is a very well known muscle for variations. It can be absent, digastric, duplicated, having proximal tendon. These variations are important in grafting surgeries like tendon transfer, ptosis correction, lip augmentations which use the muscle as a graft. Here, we reported a rare variation of palmaris longus in the form of proximal tendon, middle belly and distal tendon which is continuous with palmar aponeurosis. In the same cadaver, plantaris muscle also dissected to note the variation.
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139. Kuppuswamy’s Socio-Economic Status Scale – A Revision of Income Parameter For 2014

     Gururaj, Maheshwaran

     • » Abstract Socioeconomic status (SES) refers to an individual’s position within a hierarchical social structure, which is one of the important determinants of health status. Composite scales are generally used to measure the SES, which has a combination of social and economic variables. Several studies namely hospital and community based require assessment of socio-economic status of an individual / family. This reflects the affordability of health services, necessities and purchasing power of the same. Several methods or scales have been proposed for classifying different populations by socioeconomic status: Rahudkar scale 1960, Udai Parikh scale 1964, Jalota Scale 1970, Kulshrestha scale 1972, Kuppuswamy scale 1976, Shrivastava scale 1978, Bharadwaj scale 2001.1-7 However, social transformation and fast growing economy have rendered these scales ineffective in measuring the SES over the years. The Kuppuswamy scale proposed in 1976, measures the SES of an individual based on three variables namely, education and occupation of the head of the household and income of the family.5 Of the three variables, education and occupation of the head of the household do not change frequently with time. However, the steady inflation and the resultant devaluation of the rupee necessitate periodic revisions of the income variable. The previous revisions of the scale were done in the years 1998 and 2007.8,9
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140. Drug Prescription Practices among Paediatric Patients in Yavatmal, Central India

     Ajapuje P., Dhengre P., Giri V.C., Khakse G.M

     • » Abstract The rational use of drugs requires the patient to receive medicines appropriate to their needs in doses that meet their individual requirement for adequate period of time and at lowest cost. Rational use of drugs forms the corner stone of successful implementation of rational use of medicines(1). Medically inappropriate, ineffective, non-economical use of pharmaceutical product is commonly observed in health care system throughout the world and especially so in developing countries (2). Inappropriate prescription not only increases the cost of medical treatment but also increases the morbidity and mortality. Third world population spends 30-40% of their total health budget on drugs many of which are prescribed irrationally. These countries double their expenditure on drugs every 4 years while GNP double every of 16 years. (3). Thus there is an urgent need to ensure that the patients are always given evidence based cost effective & rational treatment. Children constitute 40% of Indian population. Infant and children are the most vulnerable group of population suffers from frequent but usually non serious illness. Most of these are self limiting (4) and treated not only inappropriately but also reporting to polypharmacy (5). Compared to adult medicines drug use in paediatrics is not extensively researched and range of licensed drug in appropriate dose form is limited (6). One significant study has shown that potentially harmful medication error can be three times more common in paediatric population than in adults (7). Prescriber and consumer are flooded with vast array of pharmaceutical preparation with innumerable trade names, available often at unaffordable prices. Considering these facts, the present study was planned to understand the prescription pattern of paediatric patient in Yavatmal, Central India.
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141. Comparative Analysis of Prescription Writing by Teaching and Non-Teaching Clinicians in and around Guntur

     G. B. Simpson, G. Naveen Choudary

     • » Abstract Aim: To study the prescribing patterns of clinicians working in two different settings. i.e. a) Teaching clinicians (clinicians working in teaching hospital) and b) Non-teaching clinicians (clinicians involved in private practice). Materials and methods: Comparative cross sectional study was carried out for a period of 6 months in 2 different settings. The study is confined to a) Qualified medical practitioners in Katuri medical college and hospital (Teaching clinicians) b) Qualified medical practitioners in Private health sector(PMPs) or (Non-teaching clinicians).450 prescriptions were collected from clinicians belonging to various departments of KMC &H and 450 prescriptions from private practitioners of Guntur city. Data were coded and entered with the help of a statistician to minimize data entry errors. Data were analysed on EPINFO version 3.5.4 and MS EXCEL. Results: It was found that non-teaching clinicians prescribed in average number of drugs for prescription (3.28) more than teaching clinicians (2.82).Teaching clinicians prescribed 73 drugs (5.75%) by generic name, whereas non-teaching clinicians prescribed 62 drugs (4.18%). Number of drugs prescribed from essential drug list was compared in both the settings. Teaching clinicians prescribed 860 drugs (67.76%) from the essential medicines list, whereas non-teaching clinicians prescribed only 574 drugs (38.78%) from the essential medicines list. Number of injectables prescribed by both categories of clinicians is compared. Non-teaching clinicians prescribed 130 drugs (8.78%) compared to 52 drugs (4.09%) by teaching clinicians. Teaching clinicians prescribed 283(28.30%) drug combinations compared to 462(31.21%) drug combinations prescribed by non-teaching clinicians. Among the total drugs prescribed in different categories by teaching clinicians more than 46% (46.48%) were from two major groups, antimicrobials 24.11% and NSAIDs 22.37%. Non-teaching clinicians prescribed about 54% (54.04%) Antimicrobials 29.52% and NSAIDs 24.52%. Conclusion: The results indicate a considerable scope for improving the prescribing patterns of drugs in both the settings.
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142. A Clinicomicrobiological Study of Enterococcus Species with Special Reference to Its Virulence Factors

     Sharma Revati, Pai (Bhat) Chitra, Urhekar A.D

     • » Abstract Abstract: Clinical samples were screened for enterococcus species. 215 enterococcal isolates were biochemically characterized. Seven species of enterococcus could be identified. The isolates were further screened for the presence of virulent factors such as hemolysin, gelatinase, enterococcal surface protein (esp) and aggregation substance (Agg) both phenotypically and genotypically. Virulent factors are known to cause an increase in the severity of the infection in animal models. The isolates produced 54 (25%), 77 (36%), 122 (57%) and 2(1%) of hemolysin, gelatinase, enterococcal surface proteins and aggregation substance respectively. The hemolysin (cylA) and gelatinase (gelE) genes did not correlate with their respective phenotypic expression indicating the presence of silent genes. The urine isolates had the maximum number of virulence factors.
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143. Role of Neonatal Foot Length as Alternative Predictor of Low Birth Weight

     Holambe V. M., Kakrani V. A. , Godale L. B.

     • » Abstract Introduction: LBW is the major public health problem in India. The perinatal mortality in LBW babies is 8 times higher than that in infants weighing more than 2500gms. 74% of India’s population lives in rural areas. Most of the deliveries in rural areas conducted at home by untrained relatives and dais where weight recording is a problem. Aim and objective: To overcome the logistic problems associated with weighing the newborns in the field, a study was undertaken to assess the usefulness of neonatal foot length (FL) as an alternative to birth weight in identifying low birth weight babies specially below 2000 gms. Methods: nine hundred and thirty four live born neonates having weight below 2500 gms were studied at Sassoon general hospital, block no 20, the postnatal wing where the neonates are kept with their mothers. Birth weight and FL were recorded within 24 – 48 hrs of birth by standard procedures. Results: results showed significant correlation between birth weight and FL (r=0.70). The correlation was significant in preterm neonates (r=0.54). Mean weight of LBW babies was 2183.88 ± 255.04 gms. the mean birth weight of preterm newborn was 1856.8 ±249.4 gms. The mean FL was 6.67 ± 0.47 cm. the mean FL of preterm newborns was 6.21 ± 0.28 cm. sensitivity and specificity of FL at cut off point of < 6.75 cm for identifying low birth weight babies specially below 2000 gms was 92.8% and 65% respectively. Conclusion: Measurement of FL being simple alternate,low cost, reliable, and practicable method for identification of LBW babies specially below 2000 gms can be used by a person with little training in community.
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144. Comprehensive Eye Care with Community Development in Rural Area

     Pradeep Sawardekar, Sunita Thorat, Gopa Kothari

     • » Abstract Abstract: Dang is the smallest, poorest and backward tribal District of Gujarat state in India.It is one of the underdeveloped district of the country. The goal was to develop comprehensive eye care with community development in 73 villages with active community participation. The objective of the programme was explained with various community groups. To identify the urgent needs, it was decided to do the community assessment. Problems faced by community were tackled. Training imparted to various Health workers. The programme was implemented from year 2001 and yearly monitoring and evaluation was done. The reviewing of results showed satisfactory results. Comprehensive eye care programme with active community participation leading to improvement in general health, control of avoidable blindness, development of referral system, networking and linkages with Govt. and NGO’s has helped in achieving Millennium Development Goals and sustainable eye care programme along with community development is develop in tribal area.
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145. Detection of Mediastinal Masses in Adult Patients Using Spiral Computerised Tomography

     Sartaj S Pathan, Minhaj S Pathan

     • » Abstract Introduction: Since, its advent, Computerised Tomography (CT) has emerged as the main technique to evaluate mediastinum. CT has become the imaging method of choice in the evaluation of mediastinal widening or suspected mediastinal abnormalities. CT has the ability to distinguish density differences as well as provide a 3 dimensional cross sectional view of anatomic relations. A variety of imaging modalities are available for investigating the mediastinum, but CT and Magnetic Resonance Imaging (MRI) are undoubtedly the most versatile radiological investigation for evaluating an abnormality demonstrated on high kv chest radiograph.
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146. Synthesis And Characterization Of Lanthanum Doped Mg-Zn Ferrite Nanoparticles Prepared by SOL-GEL Method

     R. U. Mullai, P. Priyadharsini Pradeep, G. Chandrasekaran

     • » Abstract Abstract: The Ferrite compositions of La substituted Mg0.5Zn0.5LaxFe2-xO4 (x=0.0, 0.025, 0.05, 0.075, 0.1) are prepared using sol-gel citrate-nitrate. The as prepared powders are annealed at 600Ëš c to improve structural and magnetic properties. The thermal behavior of ferrite from its gel is studied by using DSC and the structural and morphological studies of the ferrites have been investigated by using XRD, SEM-EDAX and FAR-IR respectively. The magnetic properties of the samples are studied using VSM at room temperatures. The samples are found to exhibit saturation magnetization. Lanthanum doped Mg-Zn ferrites are found to exhibit large relaxation which make them useful for microwave applications.
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147. A Study to Assess Pattern of Migration across India Based on Census Data

     Radha Taralekar, Prasad Waingankar, Pandurang Thatkar

     • » Abstract Introduction: Migration is an important demographic event and needs to be studied by Public Health Experts. As migration is a facet of population growth & development assessing patterns helps understand the dynamics of society.In this study, the pattern of interstate & international migration in different zones is compared and various socioeconomic factors influencing migration are assessed along with their reasons for migration.Materials and Methods: The study is based on the secondary data of 1991, 2001 Census of India. Zone wise comparison was studied for patterns & reasons for migration among interstate&international migrant (based on last place of residence, for all duration).The official census data was analyzed using SPSS version 17.Results:The study findings show that, North Zone of India has highest interstate migrants, amounting to 11 % of the total population as per Census 2001 data. The work & business have been found as main causes for interstate migration in Western zone while education as the major cause for interstate migration in southern zone of India, excluding marriage and other reasons for migration. Looking at data from 1971 to 2001, there is significant correlation (Pearson Correlation 0.752) between Gross National Income per capita and Internal Migration (P < 0.01).On Further analysis of Census 2001 data it was noted that there is significant correlation (Pearson Correlation 0.388) between literacy rate of states receiving in-migrants and education as a reason for migration (P < 0.05) among interstate migrants. Similarly ‘work’ as the reason for migration among International migrants was observed to be more in states with higher GDP (Pearson’s Correlation 0.411) Conclusion: Higher the literacy rates, GDP, urbanization, all favors migration. More research is required to know the educational levels of migrants who mention education as reason for migration.
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148. Giant Retroperitoneal Lipoma: a Case Report and Review

     Jaykar R.D., Kasabe P., Bhushan C., Kamble P.H

     • » Abstract Abstract: Retroperitoneal lipomas have remained the essentially rare tumors seen in clinical practice. There are very few reported cases in surgical literature worldwide.Case: The authors report a case of giant retroperitoneal lipoma in a 35-year-old female, with a history of pain and abdominal distension. Abdominal ultrasonography and CT scan of abdomen showed a large mass located in the retroperitoneal space. Laparotomy showed a large encapsulated tumor measuring 40 x 30 x 10 cm and weighing 8kg. The histological study revealed a benign neoplasm of fatty cells. The patient had a good postoperative performance status. Conclusion: Lipomas should be considered in the differential diagnosis of a solid tumor in the retroperitoneal space and treatment of retroperitoneal lipomas is eminently surgical.
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149. Plasma Osteopontin Level in Ischemic Heart Disease

     Sudhir P. Sase, Jayshree V. Ganu, Ashok N. Bhupali, Pramod Shinde

     • » Abstract Abstract: The aim of the present study was to evaluate the association between plasma Osteopontin (OPN) levels and ischemic Heart disease (IHD).OPN is a bone related protein present within the atherosclerotic plaque. OPN is 44kDa glycoprotein which is implicated in the regulation of biological phenomenon including atherosclerosis. Plasma OPN level was measured from 115 patients (age36 to 66 years) who underwent coronary angiography OPN level of patients with IHD is not significantly different than that of non IHD patients. Hence plasma OPN cannot be considered as an independent risk factor for development of IHD.
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150. Clinical Profile, Etiological Factors and Outcome of Acute Renal Failure in Children: A Clinical Study

     Sk Mohammed Ajaz, Minhaj S Pathan, Khaled Mohsin Badaam

     • » Abstract Abstract: Acute Renal failure is a syndrome characterised by acute decline in glomerular filtration rate leading to retention of nitrogenous wastes such as urea and creatinine. 56 Acute Renal Failure patients were included in the study who attended our hospital during the study period. Out of the total 56 patients included for the study analysis, 34 patients were males and 22 were females’ indicating that frequency of acute renal failure was more in males as compared to females with a male: female ratio of 1.54:1. Children in the age group of 5-8 years were most commonly affected followed by children between 9-12 years, 1-4 years and less than one year in decreasing order. Oliguria was the most common presenting complaint in the patients. Vomiting, haematuria, fever were other common complaints. Intrinsic renal pathology was the commonest cause of acute renal failure in enrolled patients, followed by pre-renal and post-renal causes. Acute glomerulonephritis was the commonest etiology of intrinsic renal failure. Age less than one year, female sex, Acute Tubular Necrosis, Obstructive Uropathy, Haemlytic Uremic syndrome, presence of CNS complications and prolonged oligoanuria were associated with poor prognosis. The mortality rate was 25% in the present study.
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151. A Prevalence Study of Risk Factors for Chronic Diseases among Police Personnel in a Metropolitan Area

     Nikhil N. Tambe, Vivek Singh, Kiran Narang, Vikrant Tambe, Rajesh B. Goel

     • » Abstract Abstract: Police are backbone for maintaining law and order within the limits of city. Their motto is ‘to protect the good and punish the evil’; but they are themselves punished by the evil- CHRONIC LIFESTYLE DISEASES. They suffer from stress related to their work-uncertain duty hours, transferable jobs, inadequate sleep, addiction to alcohol and tobacco. Hypertension, diabetes, acute coronary syndromes, obesity and even cancer are some of the major chronic health diseases commonly observed due to their hectic and stressful lifestyle. This study was carried out to assess the risk factors among police personnel, contributing to chronic diseases like obesity, hypertension, diabetes and creating awareness of the same. It emerged that almost 49% of police personnel in study population of 443 were overweight, alcohol and tobacco consumption accounted to 28%, 20% were hypertensive, 11% diabetics and smoking observed in 8%. This study provided us with data about the health status in police community and will help us in devising new strategies to bring about a healthy change in their life style. Such study if carried out periodically will help reduce the rampant problem of chronic health diseases in police community at primordial level.
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152. Protein-Protein Interaction-Yeast two Hybrid System

     Ajay K Srivastava, Preety Prasad

     • » Abstract Abstract: Many proteins recognize and bind to other proteins. The total of all protein-protein interactions is sometimes referred to as the protein interactome by those enthusiastic about “omics” terminology. Mass screening of such interactions has proved possible by means of the “Two hybrid” system. It is assumed that the binding of a novel protein to one that is well characterized may provide some hint as the function. Two hybrid analyses depend on the modular structure of transcriptional activator proteins. Many of these proteins contain two factor domains -DNA Binding Domain (DBD) and Activation Domain (AD). The DBD recognizes a specific sequence in the DNA upstream of a promoter and the AD stimulates transcription by binding to RNA polymerase. Provided that the two domains interact, they will activate transcription. The whole experiment is based on this principle of Yeast two Hybrid system.
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153. Anatomy Post Graduation as Career Option: A Situational Analysis

     Sunita Bharati, Praful Nikam, Ujwal Gajbe, Vivekanand Giri

     • » Abstract Abstract: Medical graduates often have confusion after PG entrance while selecting Branch for Post graduation. Large numbers of medical colleges facing difficulty in getting anatomy faculty. Situational Analysis is one method to understand situation in simpler manner. Research Question: What is the present scope of Anatomy Post-graduation as career option? Aims & Objectives: 1. To carry out situational Analysis of Anatomy PG Seat in Medical colleges, 2.To Suggest suitable recommendation based on study findings. Methodology: Present situational analysis based on data of official web page of Medical Council of India (On March 2012) www.mciindia.org. in which we use PG college database and faculty database, All these data were entered in Microsoft excel sheet and analyzed by using statistical software SPSS version 16.Situational Analysis: Total number of Medical colleges in India 335(till March 2012) of which only 198(59.1%) colleges having PG seat in Anatomy Discipline. Annual Anatomy PG seat intake in all colleges was found to be 610.Total MBBS seat intake Yearly 40525, the ratio of MBBS to Anatomy PG seat is 100: 1.5. Karnataka is having highest number of anatomy PG seat annually 92(15.1%), followed by Maharashtra 91 (14.9%), Andhra Pradesh 70 (11.5%). These three state namely Maharashtra, Karnataka, A.P is contributing about 42.7% PG seat in India. In Last Five year 42.8% colleges are in process of increasing PG seat. Till now 21% college PG seat intake permitted in 10(A) section of MCI. Total numbers of Anatomy faculty in India are 3774.
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154. Anomalous Anterior Cerebral Artery

     Kardile Poorwa Baburao, Ughade Jaideo Manohar, Ughade Manohar Namdeo, Sudhir Vishnupant Pandit

     • » Abstract Abstract: The variation in the anterior part of the circle of willis is quiet rare and finding multiple variation in single case is still rare. During routine dissection we noted multiple anomalies in form of hypoplasticity, duplication and persistence of embryonic pattern in the form of azygous artery in the right anterior cerebral artery. Any variation in the vessels of circle of Willis influences the change in the haemodynamics of blood supply to the brain. such variations also play a great role in the decision of line of management of the patient. The awareness of this rare anatomical variant is important considering today advanced imaging modalities and give consideration to its potential serious complications with fellow clinicians.
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155. Effect of Pranayama Training on Cardiovascular Parameters

     S.P. Surwase, D.N. Deore, U.S. Zingade, P.R. Deshmukh, A.K. Zombade, Shazia

     • » Abstract Objectives- To study the effect of pranayama training on cardiovascular parameters. Design- Longitudinal study. Settings/Location- Government Dental College, Aurangabad. Subjects- 60 Normal healthy females and males volunteers in the age group of 30 to 50 years ready to give consent. Subjects were divided randomly into two groups of 30 individuals act as subjects and control. Trial was registered under WHO and CTRI trial registry systems. CTRI registration no. is CTRI/2012/03/002512 and WHO registry no. is UTN- U1111-1129-2155. Interventions- Pranayama training camp will be conducted 45 minutes daily for 1 month. The exercises include slow and fast breathing exercises like ‘nadishuddhi’, ‘mukh-bhastrika’, ‘pranav’ and ‘savitripranayama’. Outcome Measures- Cardiovascular efficiency will be tested by using parameters like 1. Systolic blood pressure 2. Diastolic blood pressure 3. Heart rate and Systolic time intervals involving pre-ejection period (PEP), left ventricular ejection time (LVET), total mechanical systole (QS2) & PEP/LVET ratio. Results- Pranayama training for 1 month resulted in significant decrease in systolic blood pressure (<0.0001) & LVET (<0.0001) whereas QS2 (<0.0001) and PEP (<0.0001) were increased significantly.PEP/LVET ratio which is a sensitive index of cardiac performance was significantly increased after the training. Conclusion- Our study shows that pranayama training improves ventricular performance by increasing parasympathetic activity.
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156. Allopurinol in Inflammatory Arthritis (probably Gout): Indian Perspective in Light of EULAR Recommendations

     Amit R Burande, Amit Kale, Meeta A Burande, Nitin Deshpande

     • » Abstract Introduction-Hyperuricemia (solubility point of Mono Sodium Urate Crystal i.e. 7.1 mg/dl) is associated with gout and present in 0.2 to 2% of Indian popultion. EULAR has published the guidelines for the diagnosis of gout based on evidences. In this study, we tried to evaluate clinical correlation of arthralgia with serum uric acid level in Indian patients and benefit from Allopurinol treatment. Material and Methods-Study design - Prospective, open labeled single arm Study carried out in Hospital attached to Medical University. Exclusion Criteria were Patients having definitive diagnosis for the etiology of arthralgia or Definitive Gout by clinical diagnosis as per EULAR recommendation. Inclusion criteria were Patients having the history of use of analgesic with persistent symptoms, having less than 4 EULAR criteria for gout and willing to be enrolled in the study. Intervention - Allopurinol 100 mg twice a day was given to patients and clinically assessed on day 1, day 10 and at 4 week Sample size: 28 patients were included in the study and follow up. Results – In elderly age group incidence is same in both sexes. Purine rich diet increases the risk five times with more risk of precipitation of symptoms at lower level of uric acid. Most common site of presentation was knee pain i.e. 50%. Serum Uric acid at enrollment was 6.76+0.99 that reduced to 3.74+0.63 at four week with dissolving of symptoms. Conclusion–There is a subset of Gout in elderly Indians, which is more prone to precipitation of symptoms at lower level of serum Uric acid and equal gender distribution. Hyperuricemia in patients may be defined on 5.0 mg% and target level should be kept less than 4.0 mg in Indians.
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157. Influence of Certain Factors on Overweight and Obesity among Undergraduate Medical Students at Vizianagaram

     Dantu Padmasree, Ukey Ujwala U

     • » Abstract Introduction: In recent years, developing countries like India have been experiencing a nutritional transition in food choices from typically starchy (mainly carbohydrate diets) to fast food pattern and as a result, the dietary habits of young adults like medical students have been affected. Obesity is associated with a large number of debilitating and life-threatening disorders, such as increase in associated cardiovascular, metabolic and other non-communicable diseases. Aim and Objectives: To determine the influence of certain dietary habits and life style on body weight of medical students. Materials and Methods: Descriptive cross sectional study was conducted in 263 MBBS students. The study questionnaire covered demographic details, eating habits, types of food, exercise and lifestyle. The Body mass index (BMI) was calculated from weight (kg) & square of height (m). Various factors influencing overweight and obesity were analyzed. Results: Overweight and obesity was detected in a total of 41 students. Significant difference was observed between mean BMI of normal weight(21.23±1.71kg/m2) and overweight-obese (27.08±2.51kg/m2) students. Factors such as irregular diet (OR=2.79), restaurant visits (OR=2.96), family history of diabetes (OR=1.99) and obesity (OR=3.48) were associated with significantly higher risk of overweight and obesity. Conclusions: Obesity per se was detected as an uncommon occurrence as compared to overweight or pre-obesity which may turn to obesity in future life. Prevalence of overweight and obesity in young adults similar to national figures is alarming and warrants the need for regular risk factor screening and young adult-based approaches such as changes in life style and health education.
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158. Unilateral Merging of Musculocutaneous Nerve with Variant Branching of Median Nerve

     Kardile Poorwa Baburao, Ughade Jaideo Manohar, Joshi Rajani A, Herekar Narsimh G, Jadhav Asmita S, Katti Anupama S, Ughade Manohar Namdeo

     • » Abstract Abstract: Variations of brachial plexus in different ways are very often detected in upper limb. During our study, in a 75 years old cadaver we found the musculocutaneous nerve communicating with median nerve in the left arm. The musculocutaneous nerve gave a branch to coracobrachialis then the nerve merged with the lateral root of median nerve. Later the area of innervations of musculocutaneous nerve was replaced by Median nerve. The Median nerve originated normally from the union of medial and lateral root but gave two muscular branches in the arm, to Biceps brachii, Brachialis & a sensory branch which continued as lateral cutaneous nerve of forearm. The course of Median nerve in the forearm was normal. The Musculocutaneous nerve of right side was present with normal course & routine branches.
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159. Impact of Health Intervention on Cancer Awareness of Mumbai Urban Slum Population

     Sarang Pedgaonkar, GD Velhal, Hemant Mahajan, Bhuwan Sharma

     • » Abstract Objectives: 1) To assess the awareness about Cancers in an Urban Slum population of Mumbai. 2) To assess the impact of health intervention on awareness of slum population about various Cancers. Materials and Methodology: A community based descriptive epidemiological interventional study was conducted at Cheetah Camp urban slum which is a field practice area of Department of Preventive and Social Medicine, of TN Medical College Mumbai during January 2008 to October 2009. Population above 40 years of age were included in this study. Sample was selected using cluster sampling method. The information was gathered by personal interview using semi-structured questionnaires. Results: Out of 525 study participants Out of 525 study participants, males were 50.48%. 169 (32.2%) participants thought that cancer is a disease; whereas 109 (20.6%) participants were not able to describe cancer. Regarding general initial symptoms of cancer, 272 (51.8%) don’t knew any symptom. Commonest risk factor known to participants (450, 85.7%) was tobacco consumption. Awareness of participants about prognostic factors, screening facilities, screening centres of cancers, treatment centres of cancer was very poor. After health intervention improvement in the knowledge of study participants about various cancers was seen. Conclusion: Awareness of study participants about cancers was very poor. There is a need for awareness generation programs to educate population about various common cancers. Propagation of correct messages and promotion of early detection of cancers should be stressed.
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160. Effect of Specific Stabilization Exercise versus Conventional Back Extension in Management of Chronic Herniated Pulposus

     Sucheta Golhar, Amit V. Nagrale, Tanpreet kaur Bagga

     • » Abstract Background: Local stabilizing musculature activation occurs automatically in a preparatory manner prior to movement. Failure of this preparatory stabilizing mechanism is identified as primary cause of persistence low back pain. The aim of this study was to investigate whether specific stabilization exercises or conventional back extension exercises are effective in people with Chronic Herniated Pulposus (HNP). Materials and Methods: 20 patients with Chronic Herniated Pulposus (HNP) were randomized into two groups. 10 patients in Group A received Specific stabilization exercise while 10 patients in Group B received conventional back extension exercise. Pain perception was measured using the Visual Analogue Scale (VAS). Disability was measured using the Ronald – Morris Disability Questionnaire (RMDQ). Both the intervention periods were delivered at 5 times/week for 4 weeks. Results: Training of the specific stabilization exercise in group A showed a significant improvement in decreasing pain and in improving functional ability when compared to strengthening exercise in group B at p <0.05 (t-test). Conclusion: There was decrease in the pain intensity and improvement in functional level in patients who were given conventional back extension exercise but there was a more marked relief in patients who were given Specific stabilization exercises after a treatment protocol of four weeks.
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161. Why and How Aerobic Mesophilic Composting is Effective? A Comprehensive Study on Aerobic and Anaerobic Composting of Green Waste under Mesophilic and Thermophilic Conditions

     D.Anand, V.Veerakumar, JagdishGabhane, SPM Prince William, V.P.Bhange, A.N.Vaidya, M.P.Patil, J.K.Bhattacharyya, S.R.Wate

     • » Abstract Abstract:The relative advantage of aerobic-mesophilic(ARM) condition forgreen waste composting over other conditions such as aerobic-thermophilic(ART), anaerobic-mesophilic (ANM) and anaerobic-thermophilic (ANT) is evaluated in the present investigation. A perusal of results indicated that ARM is the most favorable condition for green waste composting as it facilitates the growth and development of cellulolytic microbesand increasing their cellulose activity required for lignocellulosic degradation. Although, aerobic thermophilic condition (ART)was found to increase the rate of cellulose degradation, it was not mediated through cellulase activity. The effect of thermophilic phase on lignocelluloses wasmere physical in nature. The quality assessment studies on finished compost also confirmed ARM as the most favorable condition for composting.
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162. Maternal Risk Factors Determining Birth Weight of Newborns: A Tertiary Care Hospital Based Study

     P. S. Thomre, A. L. Borle, J. D. Naik, S. S. Rajderkar

     • » Abstract Introduction: Globally, more than 20 million infants are born with low birth weight. The number of low birth weight babies is concentrated in two regions of the developing world: Asia and Africa. 72% of low birth weight infants in developing countries are born in Asia where most births also take place, and 22% are born in Africa. India alone accounts for 40% of low birth weight births in Asia. . The reduction of low birth weight also forms an important contribution to the Millennium Development Goal (MDG) for reducing child mortality. The factors associated with intrauterine growth retardation are multiple and interrelated to mother, placenta and foetus. Objectives: 1) To study the ‘Birth weight’ pattern among study group. 2) To identify the maternal factors associated with low birth weight of newborns. Material and Methods: The present cross sectional study was carried out in Government Medical College & Hospital, Miraj amongst all the mothers and newborns delivered at institution during the period of one calendar year from January 2007 to December 2007. The data was collected with the help of interview technique using predesigned and pretested questionnaires followed by the thorough clinical examination and anthropometric measurements of mother and newborn. Interview was followed by thorough clinical examination and necessary investigations. Results & Conclusion: Low birth weight was found to be present in 92 (18.1%) newborns. The internal comparison was made among the study subjects with normal birth weight babies and those with low birth weight babies using the bivariate analysis and multiple logistic regressions. The factor found significantly associated were gestational age at delivery, number of antenatal visits, anemia, gestational age at 1st ANC visit, bad obstetric history, mothers weight, socio-economic status, birth interval, type of work, iron and folic acid supplementation, religion, sex of new born and gravida.
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163. Congenital Dyserythropoitic Anemia Type I Presenting as Congestive Cardiac Failure in Neonatal Life

     Anilkumar M. Khamkar, Manish M. Tiwari, Pallavi P. Saple, Amol Suryawanshi, P.M.Zadke, Manisha Surwade

     • » Abstract Abstract: Congenital Dyserythropoietic Anemias (CDAs) constitute a heterogeneous group of rare inherited disorders, characterized by moderate to severe anemia due to a markedly ineffective erythropoiesis with an erythroblastic bone-marrow and specific erythroid morphological anomalies. Three major types of CDA and a number of variants have been described. The diagnosis and categorization of these disorders are facilitated by microscopic examination of the blood and bone marrow and by serologic testing. The severity of Anemia varies considerably within and between families. We report a case of CDA type I in a neonate who presented as congestive cardiac failure secondary to severe Anemia who also had PPHN due to LVF. Baby succumbed to death on day 1 of life itself. Clinical profile and laboratory investigations were consistent with CDA type I.
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164. Risk Factors for Nosocomial Sepsis in NICU

     Sunil S. Holikar, Kiran B. Bhaisare, L. S. Deshmukh

     • » Abstract Abstract: Nosocomial infection is defined as an infection occurring at any site, which was acquired during a hospitalization and results from inoculation with an organism that was not present or incubating in a patient at the time of admission. Patients with sepsis requiring mechanical ventilation in form of bag and tube, endotracheal tube tip culture was sent, angiocath tip culture were also done . The study was conducted to evaluate risk factors for nosocomial sepsis in neonates admitted in NICU. Total 1580 neonates were admitted during the study period. Out of these 223 met the inclusion and exclusion criteria and either of their parents gave consent to participate in the study. Seven neonates were lost during follow up. Fifty neonates of nosocomial infection died during the study period.
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165. Study of Pneumoconiosis in Thermal Power Station Workers

     K. D. Garkal, Shete Anjali N.

     • » Abstract Aims and Objectives: The study was carried out with the aim of finding respiratory parameters for detecting early impairment in thermal power station workers. The extent of damage caused by exposure to substances was also assessed. Material and Methods: The pulmonary function tests were carried out in 121 coal handling plant workers in Parli, Thermal power station. Biometric parameters were recorded along with family history, smoking history. The PFT was recorded by MEDSPIROR machine. Results: The PFT parameters were seen to be decreased in thermal power station workers. The study showed restrictive type of pulmonary impairment in the workers. The impairment was seen to be increasing with increase in the duration of exposure.
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166. A Crossectional Study of Glycosylated Haemoglobin (HbA1c) Values in Type II Diabetes Mellitus & its Relationship with Lipid Profile and Diabetes Complications

     Ahmed Munibuddin, Khaled M Badaam, Zingade U. S.

     • » Abstract Abstract: The present study was carried out with an objective to find out the correlation of glycosylated haemoglobin with blood sugar, serum cholesterol and triglyceride levels in patients having type II diabetes with and without complications. In this study 30 diabetic patients without any complication and 40 diabetic patients with microangiopathies, in which 20 were having diabetic retinopathy and 20 having diabetic nephropathy with retinopathy were compared with 30 normal subjects of same age group acting as a control group. Blood glucose levels (Fasting & Post meal), glycosylated haemoglobin, serum cholesterol and triglyceride were estimated in these three groups. In diabetes with microangiopathy the fasting blood glucose level was 232.92 ± 20.03, post-meal blood glucose level was 267.96 ± 25.68, HbA1c % was 10.48 ± 1.22, serum cholesterol 262.0  11.30 and triglyceride 174.60  7.87. In diabetes without any complications the fasting blood glucose level was 163.07 ± 20.31, post-meal blood glucose level was 208.33 ± 18.50, HbA1c % was 7.62 ± 0.69, serum cholesterol 213.66  11.51 and triglyceride 151.08  10.86. And in non-diabetic control subjects the fasting, post-meal blood glucose levels, HbA1c% serum cholesterol and triglyceride were 95.12 ± 9.31, 140.15 ± 9.43, 4.99 ± 0.98, 164.75  13.39 and 120.0  9.21 respectively. It was observed that the glycosylated haemoglobin % is more in diabetics and much more in diabetics with complications, and this increase in glycosylated haemoglobin % has a positive correlation with fasting, post-meal blood glucose, serum cholesterol and triglyceride levels.
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167. Correlation of Alpha-1 Antitrypsin and Smoking in Chronic Obstructive Lung Disease: An Observational Study

     Deore Deepmala, Yogesh B. Gavali, Zingade Urjita, Badaam Khaled

     • » Abstract Setting- The present study was carried out in the Department of Physiology, Biochemistry & Medicine Govt. Medical College, Aurangabad, Maharashtra, India. Objective- To correlate serum AAT levels in smoker and non smoker COPD patients with controls. Design- An observational study carried out in 314 subjects in the age group 40-70 years from medicine department of our college divided into three groups. Group 1- Normal healthy individuals without history of smoking (controls).Group 2- Patients with COPD for 5 years or more without history of smoking in present or past. Group 3- Patients with COPD for 5 years or more with history of smoking of at least 10 pack years. Pulmonary function tests were used for COPD diagnosis as per GOLD criteria and Serum AAT levels done by turbidimetric method. Analysis was done by ANOVA, Pearson’s correlation coefficient and Tukey’s test. Results- The results indicate that serum AAT levels were decreased in non smoker COPD patients (187.7 ± 55.42) & smoker COPD patients (133.37 ±19.36) when compared to controls (251.5 ± 47.73). Smoker COPD patients show lowest values of serum AAT. Conclusion- So serum AAT levels can act as predictor for future development of COPD in smokers & in non smokers.
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168. A Crossectional Study of VO2max and Plasma Lactate Values in Football Players

     Khaled Mohsin Badaam, N.D. Somwanshi, U.S. Zingade, Ahmed Munibuddin

     • » Abstract Introduction: Football is the most popular sport played all over world. There is scarce published data on football players from India, although there are numerous published reports for American, European and Australian players. Study was conducted to determine VO2max and plasma lactate values of football players. Objective: To evaluate aerobic capacity (VO2max) and anaerobic capacity (lactate) in professional football players and compare it with controls. Methods: 60 males, aged 21 to 24 years were included. Thirty were professional football players and thirty were controls with sedentary lifestyle. Queens College Step Test was used to determine predicted VO2max. An all-out effort of running for 60 seconds was performed by both groups and immediately after that; venous sample was collected for plasma lactate estimation. Unpaired t test was used to test statistical significance. Results and Conclusion: Mean predicted VO2max was 59.53 ± 2.96 ml/kg/min in players, and 42.61 ± 3.45 ml/kg/min in controls, mean plasma lactate 104.03 ± 9.55 mg/dl in players and 65.13 ± 7.6 mg/dl in controls. The difference in VO2max and lactate is statistically highly significant with ‘p’ value less than 0.001. Thus, football players showed superior aerobic and anaerobic capacity. VO2max of local professional players fall in the range reported for elite soccer players from various countries. The coaches may get help in improving performance of players by proper designing of training programs in accordance with research studies. Maybe, this will contribute to put India ahead in international Soccer rankings.
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169. Assessment of Groundwater Quality and its Suitability for Drinking Uses in Warora tehsil, District Chandrapur, India

     S.M.Deshapnde, K.R. Aher and , G.D.Gaikwad

     • » Abstract Abstract: In order to evaluate the quality of groundwater in study area for its suitability for drinking purposes, sixty groundwater samples were collected during pre-monsoon period of the year 2011 and analyzed for various parameters. Physical and chemical parameters of groundwater such as electrical conductivity, pH, total dissolved solids, Ca2+, Mg2+, Na+, K+, Cl−, CO32−, HCO3− and SO42− , NO3−, PO4−, and F − were determined. The value of TDS, Cl− and SO4 − ion concentration is within the limits in majority of the samples. The excess amount of Ca++, Mg++, TH and NO3− and F − in the groundwater is due to anthropogenic factors and geological characteristics of the aquifer. Assessment of groundwater samples indicated that groundwater in study area is chemically not suitable for drinking uses. Total hardness (25%), Calcium (59%), Magnesium (13%), fluoride (50%) and nitrate (17 %) are crosses the maximum permissible limits for human consumption as per the drinking water standards.
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170. Self-Health Care Practices Among Type 2 Diabetes Patients Attending Diabetes Clinic in India: A Descriptive Cross-Sectional Study

     Priya D., Hiwarkar P.A., Khakse G.M., Wahab S.N

     • » Abstract Abstract: The prevalence of diabetes in adults worldwide is expected to rise to 5.4% by 2025. The best person to manage a disease that is affected so markedly by daily fluctuations in diet, exercise and infections are the patients themselves. As such there is need to investigate the practice among the people with Diabetes so the present descriptive cross-sectional study was carried out to assess the practice regarding self health care among all diabetics patients served by Govt. Medical College and Hospital, Nagpur. All the patients of type -2 Diabetes Mellitus attending Diabetes Clinic in a first fortnight of June were enrolled in the study. Total 952 patients attended the Diabetes clinic during this period. Knowledge and practice of self-health care was asked to each study subject with predesigned and pretested proforma. Out 0f 927 study subjects, maximum were in the age group of 61-70 years. Only 406 (43.8%) study subjects were aware about and only 357 (38.5%) study subjects were taking small and frequent meals. 106 (11.4%) study subjects were knowing about food items to be restricted. 407(43.9%) study subjects were aware about the effects of exercise. 558 (60.2%) study subjects were not doing any type of exercise. Patients should be educated about various aspects of self health care so that they can effectively participate in prevention of development of complications.
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171. An Integrative Approach towards Conceptual Frameworks for Injury Prevention.

     Nikhil N. Tambe, Rajesh B. Goel

     • » Abstract Abstract: Globally more than 9 people die every minute from injuries or violence. According to WHO’s World Health Report, injury will be the third leading cause of death in India by year 2020. Many people accept injury as ‘fate’, ‘destiny’ or as ‘part of life’; but the fact is most injuries are predictable hence preventable. Injury prevention is an effort to prevent or reduce severity of bodily injuries caused by external mechanisms such as accidents, before they occur. Injuries are preventable and do not occur randomly. This fact has enabled many researchers to create conceptual frameworks which can help describe magnitude of problem and groups at risk; identify factors that increase or decrease the risk for injury; explore ways to prevent them by designing, implementing and evaluating interventions and promote the wide spread adoption of effective strategies, programs, policies and practices. Ideas presented in 8 different conceptual frameworks for injury prevention were studied and integrated. A complimentary approach was maintained to understand the important risk factors and preventive strategies against all types of injuries. This integrative study will help us to create an action plan towards injury free environment.
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172. Study of CNS Infections in HIV Positive Patients

     Hemant Mahajan, Deepak Bhutkar, Naresh Gill, Maya Padvi

     • » Abstract Objective: 1) To study proportions of various central nervous system infections in HIV positive patients. 2) To study the correlation between central nervous systems infections and CD4 counts. Material and Methods: A cross sectional observational study was conducted at TN Medical College Mumbai. Total 50 HIV positive patients having neurological manifestations were included in this study. The information was gathered by personal interview using semi-structured proforma. Results: shows majority of the patients 37 (74%) were males and 33 (66%) of patients were from 30 to 49 years of age group. Maximum patients had TB meningitis followed by tuberculoma. Only 10 (20%) of patients had CD4 counts more than 200 of which 9 (90%) were males. Patients’ on anti-retroviral therapy had more mean CD4 count. Patients diagnosed with Toxoplasmosis and Neurocysticercosis had minimum CD-4 cell count of 50 to 100. 42 (84%) HIV patients with neurological complication had other opportunistic infections and most of these patients had CD4 count less than 200. Total42 (84%) of 50 patients had associated opportunistic infections of which 17 (40.5%) had pulmonary tuberculosis, 13(30.9%) had abdominal tuberculosis. Of these 42 patients having associated opportunistic infection 26 (61.9%) patients were not taking ART. Opportunistic infections were more common in patient’s not taking ART. Summary and Conclusion: In our study it was found that opportunistic infections were the most common cause of neurological involvement in HIV infected patients. The mean CD4 count was significantly low in all neurological manifestations suggesting severe immunosuppression. Thus neurological manifestations can serve as a good predictor of the advanced HIV infection. Hence CD4 count can serve as an indicator for initiation of chemoprophylaxis of certain opportunistic infections.
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173. Control of rat population through Bhelwa oil in Panch -Pargana area of Jharkhand

     Srivastava AK, Sudhanshu Kumar

     • » Abstract Abstract: Rat has always been a problem for agricultural fields. Farmers of Jharkhand are always troubled by these rodents who damage grains in fields or in store. The cost of various chemicals to kill or repel rat is beyond the affordable limit of the poor tribal farmers in Jharkhand. Farmers of Panch-Pargana area of Jharkhand have developed an indigenous way to get rid of rats from their fields and prevent damage caused by them below economic injury level. Bhelwa (Semicarpus anacardium) seed oil is used for this purpose. Though the practice is quite old and time tested it is still not known to modern scientific world. The aim of this communication is to study the detailed method of rat population management through the Bhelwa seed oil.
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174. Morphology, Occurrence, Natural habitat, Structure and Texture of Geastrum

     Srivastava A K, Fr. Prabhat Kennedy Soreng s.j.

     • » Abstract Abstract: Geastrum is a genus of fungi belonging to class: Basidiomycetes, order: Lycoperdales, family: Lycoperdaceae and sub-family: Geastrae. This genus includes a number of edible and inedible species. Geastrum coronatum and Geastrum entomophilum are inedible. Two species of Geastrum are found in Jharkhand, both of them are edible. They taste delicious; they are sold in the market with high price. One species occurs as the rainy season starts in the months of June-July which is locally known as jaitputu or rugra. Second species appears a bit later locally known as kherputu. Many species of Geastrum are commonly known as earthstars because when its fruiting body is young and unopened resembles small spheres lying in the soil but as it matures the thick leathery outer layer of tissue called peridium splits star-like to form a number of fleshy arms, which curves downward to reveal the inner spore sac which contains the fertile tissue known as the gleba. The network of fertile tissue inside the inner peridium, the capillitium arises from the columella. The spore sac has a narrow grooved opening at the top from which the spores are released. The fungus is saprobic and grows on the ground, in leaf litter, or on decomposing wood. In Jharkhand it is found abundantly in the Sal (Shorea robusta) forest.
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175. Food Selection Acceptance: Activities for Promoting Pro-Vitamin A Foods among Young Children in Urban Slums

     Madhavi Marathe, L.I. Bhattacharjee, Pradeep Sawardekar, Sunita Thorat, Gopa Kothari

     • » Abstract Introduction: Dietary and eating habits are largely formed during early childhood and healthy eating habits acquired at this age will provide sustainable nutrition and dietary benefits. Educating children to eat, enjoy, and ask for foods that meet their needs becomes an integral part of improving the nutritional status of young children. Objective: To study the food selection acceptance for providing Pro-Vitamin A Foods among Young Children in Urban Slums. Subjects and Methods: The subjects for the study included 250 pre-school children aged 3 to 6 years. The spontaneous preferences of vegetables and fruits and acceptance for various preparations were studied among these young children. Results: Bright coloured fruits and vegetables were preferred over light to dull coloured ones by the children. A strong preference was observed for the bright coloured pro-vitamin A foods over the more familiar and commonly purchased and prepared other vegetables and fruits. Colours have shown to influence the spontaneous selection of the vegetables and fruits to a large extent. Conclusions: Children preferred deep orange and red coloured pro-vitamin A foods over light and dull coloured ones.
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176. Growth and Development of Cleft Lip and Cleft Palate Children Before and After Reconstruction Surgery

     Nitin S. Mehkarkar, C.G.Chaudhari

     • » Abstract Abstract: Birth of baby brings happiness in the lives of parents and family .But what could be more tortuous for parents to see their baby with the deformity of cleft lip and palate .Along with cosmetic defect, the deformity puts enormous psychological, emotional and financial burden to parents .The anatomical defects suffered by children with cleft lip and cleft palate are known causes of early difficulties with feeding which can lead to under nutrition and compromised growth. The basic reason behind choosing this topic is lack of such studies in India.
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177. Progesterone Hydrotherapy in Management of Small, Mid and Lower ureteric calculi

     Mandar Tilak, Nikhil Bhamare

     • » Abstract Aim: To study efficacy of pcrogesterone utilizing its smooth muscle relaxant action for augmenting hydrotherapy for medical management of small mid and lower ureteric calculi. Materials and methods : Patients of mid and lower ureteric calculi in age group 20 t0 50 were selected. They were evaluated for size of calculus, kidney function tests, serum electrolytes as well as cardio-respiratory fitness assessment was done. 80 patients with calculi of size 6mm-1.5 mm, with normal kidney functions, normal lipid profile as well as normal cardio-respiratory fitness were selected for the study. These were randomly divided into two groups; labeled control and test group such that each group had 40 pts with ; 20pts with mid and 20 with lower ureteric or vesico-ureteric junction.(VUJ) calculi .After written informed consent, patients in test group were given following therapy: Inj depot medroxy-progesterone acetate 300mg i.m single dose hydrotherapy : (1pint normal saline + inj Lassix 20 mg ) such 3 times daily for 5 days.In control group Plain Hydrotherapy as mentioned above was given.Patients were observed for 7 days in hospital and for 2 weeks on O.P.D basis after discharge and results were tabulated. Results: The expulsion rate was significantly higher in group-2 i.e test group where progesterone was used for calculus expulsion (65 & 80 % for mid & lower urtereic calculi) as compared to control group of plain hydrotherapy (30 & 45 % respectively). Average time of extrusion of the calculi for test group was 4 days while for the control group was 10 days.Extrusion with progesterone therapy occurred more for lower ureteric calculi and V.U.J calculi and more so in females as compared to males.Average size of urtereric calculus expelled by progesterone therapy was 9.5mm with largest size being 1.4cm.Conclusion : Progesterone due to its smooth muscle relaxant action can be effectively used in medical management of small mid, lower and vesico-ureteric junction calculi up to 1.4mm size. This is an economical and can be practiced at peripheral centers.
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178. Improving Outcome in Tracheostomy: Our Study

     Girish Thakur, Vinod Kandakure, Amit Thote, Ayesha Kausar, Anup Gilada

     • » Abstract Abstract: Tracheostomy is most valuable and life saving operation in which a surgical airway in the cervical trachea is created. Timing of tracheostomy is most important before anoxic damage results. The aim of study is to study various indications and management of the tracheostomy. If managed efficiently during postoperative period, morbidity and mortality can be reduced in the tracheostomy.
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179. Health Education: an Effective Intervention in Hypertensive Patients.

     Hemant Mahajan, Yasmeen Kazi, Bhuwan Sharma, GD Velhal

     • » Abstract Objective: Assessment of impact of health intervention on KAP and hypertensive status of patients in an urban slum of Mumbai. Material and Methods: A cross-sectional study was conducted at Shivaji Nagar urban slum which is a field practice area of Department of Preventive and Social Medicine, of TN Medical College Mumbai. Hypertensive patients above 40 years of age were included in this study. The information was gathered by personal interview using semi-structured proforma. Results: Out of 340 subjects 176 (51. 76%) were males. Before intervention 83.42%, 69.11%, 73.24% patients had poor knowledge, attitude and practices respectively which decreased to 25%, 21.76%, 33.81% respectively. Mean systolic BP, Diastolic BP, Body mass index and weight was also decreased as practices of patients improved to after health intervention. There was improvement in self care practices and life style modification factors. Conclusion: People have to be educated through mass media on hypertension and its risk factors. The health workers have to play part by educating the people and also themselves being an example in avoiding the risk factors for hypertension like consumption of fatty food, alcohol and smoking. People have to be educated on the importance of physical exercises and have to be encouraged to do them.
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180. Dermatoglyphics in Children Having Congenital Talipes Equino Varus

     Amit R. Burande, Meeta A. Burande, Vasudha Nikam, Asha D Patil, Anita R. Gune

     • » Abstract Introduction: Dermatoglyphics is study of integumentary features showing skin patterns on fingers. It is important for medicolegal purpose as well as in clinical medicine due to its association with genetic disorders. CTEV is one of the common disorder with single gene mutation and dominant inheritance. Hence in this study we evaluated the dermatoglyphics in CTEV children as compared to normal counterparts. Material and Methods: Material required for standard ink method was collected and implemented for data collection of both the hands. Oral consent of the parents was obtained. Study was carried out in Department of anatomy, in D Y Patil medical college during January 2008 to June 2009. Total 50 CTEV and 50 normal children were included in study.Results:In CTEV whorls were highest while in normal children Ulnar loop were maximum. Hypothenar pattern is more while thenar pattern is less in CTEV children. Simian lines and Sydney lines were seen only in CTEV male children. Additional lines were less in CTEV male while more in CTEV female children. CTEV female has less frequency of t and higher frequency of t’ while CTEV male children shows decreased frequency of t and increased frequency of t’ as compare to normal counterparts. CTEV children have higher TFRC count, AB Ridge count and Atd angle as compare to normal counterparts. Conclusion: Dermatoglyphics in CTEV shows significant variation as compare to normal children. It strengthen the family and genetic association in the disease and warrant further research in the same direction.
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181. An Action Plan towards Injury Free India from Womb to Tomb

     Nikhil N. Tambe, Rajesh B. Goel

     • » Abstract Abstract: With the decline of communicable diseases, injuries are becoming one of the highest causes for death in India. According to WHO’s World Health Report, injury will be 3rd leading cause of death in India by year 2020. Health and safety is a fundamental right of every human being and it can only be maintained and improved if preventive measures are taken against risk factors. Ideas presented in different conceptual frameworks for injury prevention were studied and put together to create an action plan for injury prevention in India targeted at different age groups. This study gives an age-specific approach towards finding out risk factors and devises interventions. It targets wide spectrum of population i.e. from foetus to old age and is suitable for all kinds of unintentional injuries. The present statistics of injuries in India suggests that it is high time to take prompt action in field of injury prevention. This study is an initiative towards subject of injury prevention in India and highlights the method to do so. This study will not only create awareness among public with regards to injury prevention but also help government devise effective policies and legislations.
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182. Acute Gall Bladder Volvulus; an Unexpected Abdominal Emergency

     Ashish Motewar, Mandar Tilak, Nikhil Bhamare

     • » Abstract Abstract: Gallbladder Volvulus is a very rare pathology in a patient presenting to the emergency with acute abdominal pain with only 500 cases reported worldwide [1]. The volvulus occurs along the axis of the cystic artery and cystic duct causing infarction and obstruction at the same time and if not diagnosed and treated promptly will lead to gangrenous perforation of the gall bladder, acute septic biliary peritonitis, morbidity and even mortality. Though it can occur in any age group most cases occur in elderly people with a female preponderance [2]. There is no classical clinical as well as radiologic sign for prompt diagnosis. But if a high index of suspicion is maintained and prompt diagnostic laparoscopy is done this acute condition can be satisfactorily treated with laparoscopic cholecystectomy with minimal intra operative difficulty and minimal post operative morbidity.
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183. Nanoparticle and Stem Cell Nanotechnology: Interdisciplinary Research Area Involving Pharmacology and Anatomy

     Meeta A. Burande, Amit R. Burande

     • » Abstract Introduction: Nanoparticles are the particles of nanometer size that are used in various applications while stem cells are pluripotent cells having capacity to proliferate and differentiate in desired manner. Interaction of nanoparticles with stem cells i.e. stem cell nanotechnology has opened the new area of research and application in medical sciences. Objective: In this review we aimed to search the pharmacological aspect of nanoparticles in stem cells. Method: We searched pubmed, medline, google scholar and other online as well as offline data base with key words of nanoparticle, stem cells, nanotechnology to find the information. Articles were further sorted out regarding the availability of content. Only those articles, which were available by open access either abstract or full paper or both were included in the review. Result & Conclusion: We conclude the stem cell nanotechnology is upcoming branch of study in pharmacology. Different pharmacokinetic and pharmacodynmic aspect of nanoparticles as nanodrug has to be explored before using them on wide scale. These data warrant the establishment of new area of studies i.e. Stem Cell Nanophrmaceutics to deal with nanodrugs.
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184. Geochemistry and Assessment of Groundwater Quality for Drinking and Irrigation Purposes: A Case Study of Sukhana River Sub basin, District Aurangabad, Maharashtra, India

     K.R. Aher

     • » Abstract Abstract: An attempt has been made to check the quality of groundwater of Sukhana river sub basin of Aurangabad district, Maharashtra, India for drinking and irrigation purposes. Thirty five groundwater samples were collected from different dugwells and borewells. The quality assessment is made through the estimation of pH., EC, TDS, total hardness as CaCO3, Ca2+, Mg2+, Na+, K+, Cl−, CO32−, HCO3− and SO42− and Based on these analyses, parameters like sodium adsorption ratio, sodium soluble percentage and residual sodium carbonate were calculated. The value of TDS, Cl− and SO4 − ion concentration is within the limits in majority of the samples. The excess amount of Ca++, Mg++, TH and Na+ in the groundwater is due to anthropogenic factors and geological characteristics of the aquifer. The correlation of the analytical data has been attempted by plotting different graphical representations such as Wilcox and US Salinity Laboratory for the classification of water, and results show that most of the samples are fit for irrigation
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185. Efficacy of Saccharomyces boulardii strain in acute diarrhoea in children: An Indian Perspective

     Meeta A. Burande, Amit R. Burande

     • » Abstract Context: There are different probiotic preparations are available in Indian market, but the efficacy & superiority over each other or ORS & zinc only is not established with certainty. At the same time whatever information is available none is conducted over Indian children so far. Hence, there is a need to study the efficacy of Saccharomyces boulardii in diarrhoea in Indian children. Aims: To compare the efficacy of ORS + Zn verses ORS + Zn + Probiotics Saccharomyces boulardii strain in treatment of acute diarrhoea in Indian children. Settings and Design: prospective, parallel, single blind randomized controlled clinical trial in Hospital attached with Medical College. Methods and Material: 75 children up to 5 years of age suffering from acute diarrhoea (three or more unformed stools within last 24 hrs) of less than 48 hours with CBC and stool microscopy negative for infection. All children were given ORS ad lib till resolution of diarrhoea and Zinc 10 mg per day in child of less than 6 month and 20 mg per day for child above 6 month a day for 14 days. While intervention arm (n=35) were also given Saccharomyces Boulardii 250 mg orally two times a day for 5 days. Main Outcomes Measured were duration of diarrhoea and duration of vomiting in days. Statistical analysis used: Z test and student t test Results: Mean duration of diarrhoea for study group was 3.4 days + 1.4 days and for control group was 5.5 days + 2.1 days (Z value 4.9). Average time of recovery from vomiting was 2.5 +1.2 days for study group & for control were 3.3 + 1.2 days (t17 = 3.3, P< 0.01). Conclusions: Saccharomyces boulardii in the treatment of acute diarrhoea significantly reduces the duration of diarrhoea as well as vomiting.
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186. A study of caustic injury of upper gastro intestinal tract

     Babu Elangovan, Sreenevasan K, Sankar S

     • » Abstract Introduction: Ingestion of corrosive substances remains an important public health issue in Western countries despite education and regulatory efforts to reduce its occurrence. These injuries are still increasing in developing countries, related to the social, economic, and educational variables and mainly to a lack of prevention. This is record based study to see various clinical characters and differences in the two groups. Aims and Objective: To study the various clinical characters of Cauticinjuiry of upper Gastrointestinal tract, and to see any differences observed in early (<5yr) and Late Group (>5Yr) Methodology: This is ten years retrospective study in this all the patients (N=65) ( of caustic injury within 10 years were studied , in that these patients were divided into two group based upon within 5yrs –Early group and more than 5yrs –Late group Result: significantly more number males and female were there from early group, Significantly more no of co-morbid conditions like Diabetes, Depression, No any Co-morbid condition, Other social illness were found in Early ingestion group. While no any significant difference found in Co-morbid conditions like Hypertension, Other medical illness. In purpose of ingestion of caustic in that there was significantly more trend of suicide by caustic ingestion in late group as compared to early group, but other purposes in early and late group were not significantly different. Conclusion: The caustic injury is mostly due to suicidal tendency, so early detection of this tendency and proper psychiatric counseling can reduce the incidence of this poisoning.
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187. Radiological Analysis of Sella Turcica

     S. R. Chavan, M. A. Kathole, A. S. Katti, N. G. Herekar

     • » Abstract Abstract: The exact dimensions of sella turcica are an important consideration in the diagnosis, prognosis and treatment of diseases related to pituitary gland and brain. Present study was aimed to present a set of baseline measurements of sella turcica by studying the various dimensions by radiographs In the present study, lateral radiographs of skulls of four hundred and forty seven subjects of known age (between 13 to 55 years) and sex (two hundred and thirty seven males; two hundred and ten females) were studied. The various parameters of sella turcica were studied in present study these were greatest anteroposterior diameter, depth & area of sella turcica It was found that greatest anteroposterior diameter of sella turcica, depth of sella turcica showed statistically no significant difference in their mean values of males and females indicating no sexual dimorphism. The area also showed no sexual dimorphism. Careful study of these parameters can help in radiological detection of pituitary tumours, suprasellar or parasellar tumours etc. The normal dimensions of sella turcica and shape can be used as reference values for evaluating various pathological (clinical) conditions related to sella turcica in Western Maharastra population.
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188. Outcome of External Dacryocystorhinostomy

     M J Venkatesan, M Loganathan

     • » Abstract Aim: To analyze the various factors affecting the outcome of external dacryocystorhinostomy (DCR). Materials and methods: Prospective study of forty five cases of chronic dacryocystitis, underwent planned external DCR without silicon tube intubation under local anesthesia (LA) by single surgeon. All the patient followed up post operatively for one and half years. During follow up periods patients were evaluated by syringing. Results: Syringing was freely patent in all the cases. Two patients developed post operative bleeding which was effectively controlled by fresh adrenaline soaked nasal pack. Conclusion: Proper pre operative evaluation and medications, investigations, ideal size bony ostium, adequate size flaps and suturing of both the flaps, surgeon skills and post operative medications are the main factors which influences the outcome of the external DCR.
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189. Study of Student’s Feedback on Present Teaching and Learning Patterns

     Usha Patil, Surekha Vaidya, Smita Jore, Meena Parekh, M.S. Patwardhan

     • » Abstract Aim and Objectives: To study student’s views on various teaching methods used at present and to make necessary improvements in teaching learning methods after analysis of feedback for better understanding of the subjects.
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190. Green Waste As a Resource for Value Added Product Generation: A Review

     Vivek P. Bhange, SPM. Prince William, A.N.Vaidya, A.R.Chokhandre

     • » Abstract Abstract: Green waste includes foliage, plant residues, fallen flowers, garden refuse, leaf litter, cut grass, residues of pruning, weeds and other organic matter discarded from gardens and greeneries but exclude organic waste of the type obtained from municipal collections. These green wastes would land in dumping sites, or will be burned, if not collected and processed contributing to the large scale contamination of land, water and air. Leaves accumulating in the urban and suburban locations such as sidewalks, lawns, and playgrounds are not only an unseemly sight but adds to the overall problem of municipal solid waste (MSW) disposal. In India and several other countries, foliage is often piled-up and set on fire. The resulting ash returns some of the NPK content of the foliage to the soil but much of nitrogen, phosphorous, and organic carbon gets lost. The burning of leaves also adds to air pollution and global warming. Green waste when decomposes in soil may release methane and foul odors, before getting converted into humus. However green waste can be a potential resource for energy and other value added products, if properly processed. The present review aims at summarizing different processing options for green waste towards energy production and value added product generation. Green waste is mostly dealt with aerobic treatment (composting), anaerobic treatments, incineration, biomass briquetting, cellulosic ethanol from biomass, biohydrogen production, bioplastics etc.
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191. Pattern of adverse drug reactions of anticancer drugs used in patients with oral cancer

     R Lenin, G Rajaram, P Sugirda

     • » Abstract Aim: Adverse Drug Reactions are a global problem. The incidence of oral cancer is 2% worldwide. In India, the higher incidence (30% of all cancers) of oral cancer is due to tobacco, betal chewing and alcohol. Cancer chemotherapy is more helpful in advanced stages of oral cancer. But, these drugs themselves can cause adverse drug reactions affecting the patients’ health. Objective: To study the pattern of adverse drug reactions of anticancer drugs used in patients with oral cancer in a tertiary care hospital. Materials and Methods: This study was conducted in Stanley Medical College Hospital, Chennai-01 from August’2014 to February’2015 among 60 oral cancer patients receiving anticancer drugs in Dept of Oncology. This was a hospital based, prospective, observational study. ADRs were documented in suspected ADR reporting forms designed by CDSCO; causality assessment was done using Naranjo’s algorithm and severity assessment by Modified Hartwig Siegel Scale. Result: Cisplatin, 5-Fluorouracil, Paclitaxel, Gemcitabine were the common anticancer drugs used in various combinations. The most common combinations used are 5FU + Cisplatin, Gemcitabine + Cisplatin, 5FU+ Paclitaxel+Carboplatin. ADRs were reported among 54 patients taking treatment. Causality assessment – Probable 5.6% ,Possible 94.4% ; Severity assessment – Mild 94.4%,Moderate 5.6%. Conclusion: The anticancer drug combinations used in the treatment of oral cancer were associated with varied adverse effects. But, the early detection of drug toxicity may be helpful in modifying the doses to minimize the toxic effects.
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192. Legalising Medical Abortion...Where We Stand?

     Deepa Kala, Rajesh B. Goel, Dipti Khedekar

     • » Abstract Aim: This study was undertaken to know if the availability of medical abortifacients can legitimately be considered a public health success in our country or is it a curse to the medical society by increasing the burden of unsafe and septic abortions. Methods: A group of hundred general practitioners were voluntarily asked to fill a proforma. Their answers were graded on a scale of minimum “1” to maximum “2” score. The whole data was then analysed for statistical significance. Result: Almost 63% of GP’s are offering Medical Abortion, out of which 40% have poor knowledge about it. The quality of medical abortion services offered by various GP’s does not correspond to the type of degrees they hold. The maximum quality of skills offered by GP’s is average. Conclusion: By modifying a few current MTP policies, medical abortion can be safely merged into the existing Indian health care infrastructure.
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193. A study of segmental vitiligo treatment with hair follicle auto graft

     Shankar R Savant, Sunil Patel

     • » Abstract Introduction: Vitiligo is an acquired pigmentary disorder presenting as hypopigmented or depigmented macules and affects 0.5-2% of the population worldwide. Segmental vitiligo has depigmented macules arranged in a dermatomal or quasi-dermatomal distribution, which does not cross the midline and is usually unresponsive to medical treatment. There are two clinically recognized distinct variants of vitiligo based on distribution of depigmented areas; generalized and localized. Generalized or bilateral symmetrical form of vitiligo is a disease that destroys skin and mucosal membranes melanocytes progressively, and in some cases could involve ears and eyes Aims and Objective: To study effect of follicle auto graft in the treatment of segmental vitiligo. Methodology: After approval from Institutional Ethical committee This clinical trial was carried out at tertiary care hospital in 30 patients Diagnosed of segmental vitiligo who suffered from persistent form of segmental vitiligo for more than 3 years in the year 2014. The patients were not in the progressing phase of their disease at the time of enrollment. Patients were enrolled after their informed written consent. Result: In this study was no re pigmentation around the segmental vitiligo but this re pigmentation after the treatment goes on increasing at, 2 wks. Mean repigmentation area was 1±0.93mm, 4 wks. -2±1.12mm,8wks-4±1.23mm,12wks-5±1.54mm,16wks-6±.94,20wks-8±1.21,24wks-9±1.32 which were highly significant if compared between previous and after weeks mean re-pigmentation area. (P<0.001,t=9.78,df=29, P<0.001, t=6.585,df=57, P<0.001, t=3,df=47, P<0.001,t=7.14,df=54 respectively) Conclusion: As repigmentations was significantly higher at the end of six month and more than the before the treatment so this method is useful for regimentation in segmental vitiligo, so this method should be used whereEver possible in the treatment of segmental vitiligo.
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194. A Study of Microbial Flora and MRSA Harboured by Mobile Phones of Health Care Personnel

     Nikhil N. Tambe, Chitra Pai

     • » Abstract Abstract: Mobile phones are increasingly being used by health care workers in day today life. They come incontact with various surfaces while carrying out health care activities and are thus likely to get contaminated by variety of organisms. This study was carried out to know the microbial flora harboured by mobile phones of health care personnel and to know the antibiotic resistance patterns of pathogenic bacteria. Mobile phones of health care personnel were swabbed and inoculated on enriched and selective media, incubated for 24 hours and a variety of biochemical tests were carried out to know the bacterial and fungal species. Antibiotic sensitivity tests were done for pathogenic bacteria using K irby Bauer disc diffusion method. It was found that out of 120 mobile phones of health care personnel, 99 (82.5%) were contaminated, while 85 (70.8%) harbored pathogenic bacteria. Out of 120 mobile phones; 65 (54.16%) harbored S. aureus, 25 (20.83%) Micrococci, 9(7.5%) Diphtheroids, 5 (4.1%) Enterococci, [4 (3.3%) each] Pseudomonas, Citrobacter and Bacillus, [2(1.6%) each] Acinetobacter, Enterobacter and Streptococcus viridians. S. aureus was resistant to methicillin, amoxicillin, augmentin, erythromycin and lincomycin. [11/65 (16.9%)] Methicillin Resistant Staphylococcus Aureus were isolated from health care providers. Fungi isolated were Candida 8 (6.66%), Aspegillus 6 (5%), Mucor 1 (0.8%) and Trichophyton 1 (0.8%).
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195. Clinico-epidemiologcal study of gallbladder lump

     Tridip Dutta Baruah, Chetan Anand

     • » Abstract Introduction: Gallbladder disease represents a major health problem worldwide and has been known since the time of the Egyptian dynasty. More than 98% of all gallbladder and biliary track disorders are one way or another connected to cholelithiasis, and calculus diseases constitutes most of the cases that seek surgical attention. It may present as acute chole-cystitis which many progress to empyema, chronic calculus cholecystitis or mucocele. Carcinoma of the gallbladder (GBC), although it has a low overall prevalence, is the most common cancer of the biliary tree and one of the most highly malignant tumors with poor prognosis Aims and Objective: To study the clinico epidemiological factors responsible for gall bladder disease presenting as lump. Methodology: All the cases presenting with gall bladder disease over the period of 12 months from 30 June 2007 till 29 June 2008 in the Surgery Out patient Department and Casualty at Gauhati Medical College And Hospital, Guwahati were included in this prospective study. Out of 149 cases, 56 were included in this study. Result: Overall the presentations of acute cases of gall bladder was more, than chronic and malignant, 29 (44.62%), 23(41.07%), 4 (40%). Maximal incidence in females was seen in the fifth decade, whiles the maximum incidence in males was seen in the fourth decade. The male to female ratio was 1:4.09 but in the malignant group the ratio is 1:3. Gallbladder disease with palpable lumps was maximally seen housewives, which is around 66.07%. Next common occupation was male cultivators constituting 10.71%. 32.2% of the case belonged to the lower middle class of society Conclusion: As the cases were more common in Females in forty and in middle and low socio economic groups patients so special attention should be given for prevention and in the diagnosing these cases.
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196. Determinants of Exclusive Breast Feeding in a Rural Community of Maharashtra.

     Wadde Satish K., Yadav Vallabh B

     • » Abstract BACKGROUND: - The breast feeding practices adopted in terms of duration, frequency and exclusiveness of breast feeding and weaning have great impact on complete physical, mental and psycho-social development of the child. Exclusive breast saves many lives by preventing malnutrition and infections. It gives the babies the best start in life. It is essential for the health growth of child. OBJECTIVES:- 1. To study the exclusive breast feeding practices in rural community. 2. To study some factors related to exclusive breast feeding. MATERIAL & METHODS:- The present cross sectional study was conducted in three adopted villages of Department of P.S.M., S.R.T.R. Medical College, Ambajogai, Maharashtra. 306 mothers with youngest child in age group of 4-24 months were included in the study. The information was collected by interviewing the mothers with the help of pretested, predesigned proforma. RESULTS:- All the mothers’ age ranged between 18 to 35 years. Out of 306 mothers enrolled in the study 66.01% were illiterate. Only 87 (28.43%) mothers followed exclusive breast feeding. Very less no. of illiterate mothers followed exclusive breast feeding as compared to literate mothers. Exclusive breast feeding was less prevalent in mothers of lower socioeconomic status than the upper one. Significant number of mothers from nuclear and joint families followed exclusive breast feeding as compared to mothers from third generation families. 61 (34.46 %) of 177 hospital delivered mothers practiced exclusive breast feeding as compared to 26 (20.16%) of 129 home delivered mothers where chi square was significant. CONCLUSION: - Only 28.43 % mothers followed exclusive breast feeding which shows a very less. All the mothers should be encouraged to follow exclusive breast feeding practice as it is very beneficial for the physical, mental and psychosocial developmental of the child
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197. Clinico-epidemiologcal study of gallbladder lump

     Tridip Dutta Baruah, Chetan Anand

     • » Abstract Introduction: Gallbladder disease represents a major health problem worldwide and has been known since the time of the Egyptian dynasty. More than 98% of all gallbladder and biliary track disorders are one way or another connected to cholelithiasis, and calculus diseases constitutes most of the cases that seek surgical attention. It may present as acute chole-cystitis which many progress to empyema, chronic calculus cholecystitis or mucocele. Carcinoma of the gallbladder (GBC), although it has a low overall prevalence, is the most common cancer of the biliary tree and one of the most highly malignant tumors with poor prognosis Aims and Objective: To study the clinico epidemiological factors responsible for gall bladder disease presenting as lump. Methodology: All the cases presenting with gall bladder disease over the period of 12 months from 30 June 2007 till 29 June 2008 in the Surgery Out patient Department and Casualty at Gauhati Medical College And Hospital, Guwahati were included in this prospective study. Out of 149 cases, 56 were included in this study. Result: Overall the presentations of acute cases of gall bladder was more, than chronic and malignant, 29 (44.62%), 23(41.07%), 4 (40%). Maximal incidence in females was seen in the fifth decade, whiles the maximum incidence in males was seen in the fourth decade. The male to female ratio was 1:4.09 but in the malignant group the ratio is 1:3. Gallbladder disease with palpable lumps was maximally seen housewives, which is around 66.07%. Next common occupation was male cultivators constituting 10.71%. 32.2% of the case belonged to the lower middle class of society Conclusion: As the cases were more common in Females in forty and in middle and low socio economic groups patients so special attention should be given for prevention and in the diagnosing these cases.
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198. Starch and Glucose Content and Changes therein in the Seeds of Schleichera oleosa(kusum) due to Bioterioration by Pathogenic Fungi during Storage.

     AK Srivastava, GK Pandey

     • » Abstract Abstract:: Seeds of one of the non-edible oilseed, kusum(Schleichera oleosa f . Sapindaceae) are of great significance in Jharkhand area and its oil is used in burning lamps, varnishing, massage and medicine. Its oil-cake is a good manure. The unsanitary and humid condition makes it prone to a faster biodeterioration due to several fungal inhabitants during storage. The colonising fungi in the seeds use up some of the glucose and starch as carbon sources for meeting energy requirements in their prolonged association with the seeds. In the span of one year the glucose level dropped by as much as 50.2 percent of its initial value. The starch in the stored seeds reduced steadily from 2.55 percent of dry seed weight to 1.25 percent due to the association of the mycodwellers.
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199. Anaesthetic management of a child for surgical ligation of patent ductusarteriosus with severe valvular aortic stenosis with ventricular septal defect

     Ajita Annachhatre, Suhrid Annachhatre, Nagesh Jambure

     • » Abstract Patent ductusarteriosus is one of the most common congenital heart disease1and is often associated with other cardiac defects e.g. ventricular septaldefect, Tetrology of Fallot, Transposition of Great Vessels. An isolated PDA is usually corrected by either surgical interruption or coil embolisation in cath lab. PDA with severe valvular stenosis and VSD is very rare. A review of literature revealed very few articles stating information on anaesthetic management of a large PDA with severe aortic stenosis with VSD.
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200. Hydrogeochemistry of Sukhana River subbasin of Aurangabad district, INDIA

     G.D. Mahajan

     • » Abstract Abstract: Water quality has significant role in human health and sustenance of human, animals and plants. The quality of groundwater within a region is governed by both natural processes such as precipitation rate, weathering processes and soil erosion and anthropogenic effects such as urban, industrial and agricultural activities and the human exploitation of water resources. This paper deals with the drinking water quality of the Sukhana river sub-basin of Aurangabad districts. Twenty groundwater samples collected and were analyzed for major physicochemical parameter such as pH, Electrical Conductivity (EC), Total Disolve Soilids (TDS),Calcium (Ca2+),Magnesium(Mg2+),Total Hardness (TH), Sodium (Na+),Potassium (K+), Bicarbonate alkalinity (HCO3−),Sulphate (SO4−),Chloride (Cl−) and Nitrate (NO3−) in order to understand the different geochemical processes affecting the groundwater quality. The analytical data were interpreted with World Health Organization and Indian Standard Institution drinking water standards. The analytical results indicate the majority groundwater samples are suitable for drinking purposes except few which indicates signs of deterioration in the study area. The aquifers of Sukhana river subbasin are subject to contamination at same places due to sewage effluents, industrial discharge and excessive use of fertilizers and pesticides in agriculture.
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201. A comparative study of once intraoperative versus intraoperative plus two post-operative injections of triamcinolonein wedge excision of keloid

     Sunil Patel, Shankar R Savant

     • » Abstract Introduction: It is well known that keloids are “Confused scars that do not know when to stop growing”. The basic pathology is an imbalance between anabolic (proliferation) and catabolic (apoptotic) phases of the healing process. The various treatment modalities so far described in managing keloids aresurgical excision, intraregional steroidal injections, compression therapy with silicon sheets, cryotherapy, laser, α-2b interferon and chemotherapeutic agents like 5 fluorouracil. Surgical excision totally eliminates the lesion but the main disadvantage is ≥50% recurrence if used alone. Aims and Objective: To study the effectiveness of Intraoperative Plus Two Post-Operative Injections of Triamcinolone versus Once Intraoperative Triamcinolone in Wedge Excision of Keloid. This was a randomized controlled trial was conducted at the Department of Plastic Surgery at tertiary care health Centre. All the patients diagnosed and want operations or treatment during the complete year 2014 was included into the study those who does not give consent were excluded from the study. There were 70 patients in this study. The study protocol was approved by the institutional ethics committee. Patients fulfilling the inclusion criteria were picked up using consecutive sampling. Patients were randomly allocated into two groups by using computer-generated random number table; Group A having patients who were given single per-operative injection of triamcinolone, and Group B. Result: Most common site affected was Ear pinna followed by Chest, Wrist, Back, Buttock, and Face. Mean size of Keloid Preoperatively was 2.54 ±0.516 and 2.61±0.569 respectively in Group A and Group B but the observed difference was not statistically significant (t=0.539,df=68,p>0.05). But the Recurrence was 10 (28.57%) in Group A was significantly higher than that of the Group B i.e. 3(8.57%) (z= 2.15.p<0.03). Mean size of Keloid Post-operatively was 2.64± 0.495 significantly higher in Group A as compared to Group B i.e. 1.23±0.521 (t=11.60,df=68,p<0.001). Conclusion: It is better to use Two Post-Operative Injections of Triamcinolone in Wedge Excision of Keloid than single use of injection Triamcinolone alone to prevent the not only the recurrence but the size of keloid those in who it was recurred.
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202. A study of retrohepatic segment of inferior vena cava and hepatic vein openings

     D Malar

     • » Abstract The retrohepatic segment of inferior vena cava and hepatic vein openings were studied in 30 adult livers. Altogether 322 hepatic vein openings were observed .The openings were classified into large, medium and small according to the size of the opening. The position of the ostia was studied by dividing the posterior wall of retrohepatic segment of inferior vena cava into 16 areas. The large openings were right, left and middle hepatic veins. The large openings showed different pattern of combinations. The anatomical knowledge of retrohepatic segment of Inferior vena cava and hepatic vein openings are important in preoperative evaluation, in liver resections and transplantation procedures.
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203. Etiological factors and clinical courses of birth asphyxia

     Dilip Kumar Mandal, Prasant Kumar, Uday Shankar Prasad, Shyamali Datta

     • » Abstract Introduction: perinatal asphyxia, neonatal asphyxia partum factor or birth asphyxia is a medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the process to cause physical harm, PROM, Cord accidents usually to the brain. And it is almost all neonatal deaths occur in our rural and urban area, where the majority is delivered at homes with negligible antenatal care and poor prenatal services. Methods: In this collaborative study conducted prospective, descriptive study. As a case of 150 newborn babies and as a control 1190 newborn babies are fulfilled the selection criteria for prenatal and birth asphyxia. Results: Incidence of birth asphyxia in relation to ante partum and intra partum factors. And shows that mother with complication like eclampsia, APH, PROM, cord accidents, failed progress of labor, obstructive labor and prolong 2nd stage of labor, etc were more likely to deliver asphyxiated baby, and analysis of maternal risk factors for birth asphyxia. Many pathological, biochemical and metabolic changes occurs as a result of birth asphyxia. And the data were analyzed by slandered statistical test, namely, Z test, Chi square test, and uniovariate and ultivariate logistic regression analysis of risk factor. Conclusion: In our study it was observed that, Pregnancy related complication in rural and urban population of Kishanganj district was mostly Eclampsia, pre-eclamptic toxaemia, Oligohydramnios, PROM(M24hr) etc.To prevent birth asphyxia trained personal and neonatal resuscitation equipment should be mandatory in all maternity home/hospital because prevention is the best and be only option to reduce the Pre natal andbirth asphyxia.
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204. Urinary tract infections in intensive care unit of a tertiary care hospital

     A Mohankumar, J Kaur, M Deb

     • » Abstract Introduction: Nosocomial infections are threat to patients, especially in high-risk areas such as intensive care units (ICU). Urinary tract infections are the most common among them. Aim: To study the occurrence, spectrum and antibiotic resistance profile of urinary tract infections in high risk areas. Methods: A study was carried out for six months during Feb-July, 2012 in 819 urine samples received from ICU department. Allurinary samples were collected under sterile conditions. Culture was done on Blood agar and MacConkey Agar. Isolates were identified by standard biochemical tests. Antibiotic sensitivity testing was done on Muller Hilton Agar (MHA) by disk diffusion method and interpreted using CLSI guidelines. Results: Out of 819 urine samples from ICU patients, 93(11.4%) had significant bacteriuria. Candida spp. 30(32.3%), was the most common followed by Enterococcus spp. 19(20.4%), and Escherichia coli 12(12.9%). Nitrofurantoin (66.7%) and Piperacillin-tazobactum (58.3%) was mostly sensitive and second generation Cephalosporins, Ampicillin and Amoxicillin clavulanate were the most resistant among all. ThreeImipenem resistant bacteria were isolated. Above 90% resistance was seen in aminoglycosides and fluroquinolone group of drugs. Vancomycin was resistant in 8(42.1%) isolates of Enterococcus spp. whereas all isolates were sensitive to Linezolid. Conclusion: The Spectrum of uro-pathogens and their resistant pattern to common antimicrobial agents is changing and must be taken into account when selecting treatment strategies.
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205. Distribution of cases and outcome at dermatology and venereal disease inpatient department of tertiary care hospital

     Nilesh Ramesh Bhirud, Prakash Narayan Patil

     • » Abstract Introduction: There are numbers of people in India suffering from common skin Problems. They are found in children, young and adults as well as in old persons. The common skin problems are Acne, Burn scars, Hyperhidrosis, Psoriasis, Scabies, Skin grafting, Vitiligo, Pediculosis, Herpes simplex infection, Varicella, Herpes Zoster, Erythema, Urticaria etc. Dermatological problem in India manifests as primary and secondary cutaneous complaints. Among them, allergy and itches are widely observed in most of the patients. Aims and Objectives: To study Distribution of Cases and Outcome at Dermatology and Venereal Disease Inpatient Department of a Tertiary Care Hospital Methodology: This was cross sectional, hospital based study during the period of Jan 2013 to Jan 214 in All the patients with dermatological illness admitted to tertiary care hospital . All the information necessary was collected by using pretested, semi-structured questionnaire. During this year total 296 patients were included into the study. Result: Overall the Scabies, Skin infections like Fungal ,Bacterial and Viral, Auto-immune, Auto-immune UTI/STDs are more common in Males but Acne found to be more common In Female .Also it is clear that Scabies was more common in <10 and 10-20 years age group, Skin infections like Fungal, Bacterial and Viral were more common in 20-30, 30-40 yrs., age group, Acne was more common in the 20-30 and 30-40 years age group. Auto immune diseases were common in 30-40 and 40-50 yrs. age group. UTI/STDs were more common in 30-40 and 20-30 yrs. age group. mean duration of time to improvement required was highest for UTI/STDs 12±4.5 followed by Acne 9±2.1, Skin infections like Fungal ,Bacterial and Viral 6±3.1, Auto-immune 5±3.1, Scabies3±2, Others,4.5±3.1. Conclusions: Knowledge of various prevalence patterns of specific dieses of Dermatology and Venereology as per the age, sex, should be considered while diagnosing and management of patients.
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206. Comparative study of temporalis fascia and fascia lata graft in type I tympanoplasty

     A A Mohite, R S Mane, J K Watve, B C Patil

     • » Abstract Hearing outcome in tympanoplasty depends on many variables, one of them being the type of graft used. A number of materials like skin, vein, periosteum, perichondrium and fat have been used as grafts to seal the perforation, each having some advantages as well as disadvantages. Over past three decades temporalis fascia continues to be the graft of choice for tympanoplasty. However with the advent of endaural/endomeatal incision and cosmetic awareness, fascia lata an autologous free fascia graft from the thigh is gaining importance as graft in tympanoplasty. At Dr. D Y Patil Medical College Hospital, Kolhapur, we conducted a prospective randomized controlled trial on 100 subjects with inactive mucosal type of chronic suppurative otitis media and central perforation, with the aim to evaluate the comparative efficacy of temporalis fascia and fascia lata graft in type I tympanoplasty. In 50 patients temporalis fascia was used as a graft and in remaining 50 fascia lata was used. In this study surgical success was evaluated in terms of intact drum, average gain in hearing threshold and average hearing gain in audiometric frequency spectrum (low frequency-250, 500 and 1000Hzand high frequency-2, 4 and 6 kHz) at 3 months post-operatively. Temporalis fascia and fascia lata both achieved a graft uptake of 96%. Statistical analysis was done by using Z-test for proportion by using Graph pad quickcal software. The means of threshold gains, high frequency gains were significantly better at specific frequencies in the fascia lata group, and low frequency gains were better in temporalis fascia group and significantly much better in fascia lata group. However by Z-test for proportion this difference was statistically not significant. Except for residual perforation in two patients of each group and thigh wound infection in two patients of fascia lata group, no other complications were encountered. Thus we conclude that fascia lata may also be a preferred graft material in tympanoplasty.
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207. Morphometric study of foramen magnum in human skulls

     Zuberi Hussain Riyaz, Azhar Ahmed Siddiqui

     • » Abstract Aim: The objectives were to study the morphology of the foramen magnum in dry skulls and to evaluate its antero-posterior diameter, transverse diameter and morphological variants of the shapes of foramen magnum. Materials and Methods: The foramen magna of 61 dry human cadaver skulls that were obtained from Department Anatomy IIMSR Warudi, Badnapur Different shapes of the foramen magnum were macroscopically noted and classified. The antero-posterior and transverse diameters were measured. Results: The foramen magnum shapes were determined as a round shape in 29.50% of cases, tetragonal in 18.03%, oval in 31.14%, irregular in 11.47%, hexagonal in 8.19% and pentagonal in 1.63% of the cases. The mean antero-posterior and transverse diameter of the foramen magnum was determined as 39± 2.2 mm and 37.5 ± 2.5 mm respectively. Conclusion: The present study has determined the various shapes of foramen magnum and its morphometry. The data obtained may be of useful to the neurosurgeon in analyzing the morphological anatomy of craniovertebral junction. The findings are also enlightening for the Anthropologists, morphologists and clinical anatomists.
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208. A study of clinical profile of elderly hypertensives in a medical college hospital in Kerala

     Sundeep S, Arun Raj C N

     • » Abstract Aims: To study the common symptoms at presentation, prevalence of target organ damages and the effect of risk factors like obesity, alcoholism, smoking, diabetes mellitus and dyslipidemia in producing these complications among elderly hypertensives. Methods: This was a cross sectional study conducted in two hundred adult patients with hypertension who were aged above or equal to60years, admitted to the medical wards of Travancore Medical College hospital, Kollam. Statistical analysis was done using chi square test and Gaussian test wherever required. Results: In our study, among the elderly hypertensives, headache was the chief commonest complaint (36%).The commonest target organ damage involved were of cardiovascular system (35%).The prevalence of target organ damage among elderly hypertensives with risk factors like obesity, alcoholism, smoking, diabetes mellitus and dyslipidemia were higher, compared to elderly hypertensives without these risk factors. Conclusion: Headache was the common symptom of presentation among the elderly hypertensives. Of the target organ damages, those involving cardiovascular system were the most common. Although the prevalence of target organ damage among elderly hypertensives with risk factors, were higher thanelderly hypertensives without these risk factors, statistical significance was present only for dyslipidemia
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209. A study of diagnostic accuracy of ultrasonography in breast disease

     Ryan Denis Fernandes, Syed Aezaz Quryshi

     • » Abstract Introduction: Breast cancer is one of the commonest cancers in females and causes extensive morbidity and mortality. The incidence of carcinoma breast is high in USA, North America and Northern Europe and is low in most Asian and African Countries. Breast health awareness has resulted in increasing detection of early breast cancer and corresponding decrease in breast cancer morbidity. About 80% of breast biopsies result in benign pathology. Symptomatic breast lesions are traditionally evaluated by clinical, radiologic and cytological methods. Aims and Objectives: To evaluate the diagnostic accuracy and value of ultrasonography in as assessment of breast disease Methodology: All the cases underwent a thorough clinical examination followed by anultrasonography of both breasts and fine needle aspiration cytology(FNAC).If surgery was indicated, Histopathology of the specimen was done and there port compared with the ultrasonography reports SOURCE OF DATA: This study was a prospective study from October 2011 to October 2013 done at YMCH, Deralakatte and Mangalore. Result: Most common way of presentation of the tumor was Lump i.e. 90% and Pain 10%. Most common diagnosis by USG were Ca-breast, Fibroadenosis, Indeterminate. Most common diagnosis by Histopathology were Infiltrating lobar carcinoma, infiltrating ductal carcinoma with Neuroendocrine differentiation, Fibroadenoma. The sensitivity of the test (USG) is 90%, the specificity of the Test is also 90% and Positive predictive value is 85.71%. Conclusion: However from this study it can be concluded that ultrasonography can be highly accurate in differentiating benign from malignant disease. Ultrasound may even avoid unnecessary FNAC’s which in turn reduces the pain and the cost burden to the patient.
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210. Clinico-epidemiological study of gallbladder lump

     Tridip Dutta Baruah, Chetan Anand, Arun V K

     • » Abstract Introduction: Gallbladder disease represents a major health problem worldwide and has been known since the time of the Egyptian dynasty. More than 98% of all gallbladder and biliary track disorders are one way or another connected to cholelithiasis, and calculus diseases constitutes most of the cases that seek surgical attention. It may present as acute chole-cystitis which many progress to empyema, chronic calculus cholecystitis or mucocele. Carcinoma of the gallbladder (GBC), although it has a low overall prevalence, is the most common cancer of the biliary tree and one of the most highly malignant tumors with poor prognosis. Aims and Objectives: To see the clinic epidemiological factors responsible for gall bladder disease. Methodology: All the cases presenting with gall bladder disease over the period of 12months from 30 June 2007 till 29 June 2008 in the Surgery Outpatient Department and Casualty at Gauhati Medical College And Hospital, Guwahati were included in this prospective study. Out of 149 cases, 56 were included in this study. Result: Overall the presentations of acute cases of gall bladder was more, than chronic and malignant i.e. 29 (44.62%), 23 (41.07%) and 4 (.40%) respectively. Maximal incidence in females was seen in the fifth decade, whiles the maximum incidence in males was seen in the fourth decade. The male to female ratio was 1:4.09 but in the malignant group the ratio is 1:3. Gallbladder disease with palpable lumps was maximally seen in housewives, which is around 66.07%. Next common occupation was male cultivators constituting 10.71%. 32.2% of the case belonged to the lower middle class of society. Conclusion: As the cases were more common in Females in fourth decade and in middle and low socio economic groups patients so special attention should be given for prevention and diagnosis these groups.
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211. A study of skin prick in patients with chronic urticaria

     Meryl Sonia Rebello, Ramesh Bhat M, Sukumar D, Geethu F Alapatt

     • » Abstract Background: Chronic urticaria can be caused by a number of known and unknown allergens. Some of these allergens can be identified by prick tests. Objectives: To assess the positivity of skin prick test (SPT) in patients with chronic urticaria Patients and Methods: Forty patients diagnosed with chronic urticaria attending Skin department of our institute were included in the study and evaluated by prick testing. Results: Among the 40 patients, 33 patients showed positive reactions to various allergens tested i.e 82.5%. The mean age of the patients was 30 years. Female to male ratio was 1.6:1. On SPT, number of patients with 1-5 positive reactions were13, 6-10 were 15 and more than 10 were 5 patients. Ten most common allergens in order of their frequency include mite D-farinae (52), mite D-pteronyssinus (48), cockroach (32), prawn(28), housefly (25), chicken (22), cyanodon (22), parthenium (20),mosquito (20), crab (16). The five most common food allergen positivity include prawn (29%), chicken (24%), wheat (18%), crab (16%), black pepper(13%). Conclusions: A greater proportion of patients with chronic urticaria demonstrate sensitivity to house dust mites, cockroach, pollens along with food. Thus, SPT is an important diagnostic procedure in cases of chronic urticaria, It is also important to perform SPTs among patients suffering from chronic urticaria not only for food allergens but also for pollens, house dust mites.
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212. Knowledge, attitude and practice (KAP survey) of contraception among women seeking termination of pregnancy at a tertiary care hospital in Maharashtra

     Savita Khiste, Gauri Dank, Lakshmi Rachkonda, Gautam Shroff, Swati Shiradkar

     • » Abstract Objective: To determine the awareness and use of contraception by women seeking termination of pregnancy in MGM Medical College, Aurangabad. Materials and Methods: The study is a cross sectional opinion survey of patients attending OBGY OPD of MGM Medical College, Aurangabad using a pretested questionnaire. Results: Mean age of respondents was between 20-30yrs. 86% women were Hindus. Most of the women were multiparous.42% women were not aware of contraceptives.2% were aware of emergency contraception Conclusion: Among users, most common method of contraception was condom. Females in young age group were more vulnerable to unwanted pregnancy. More than 3/4th (84%) of females had completed their family. These unwanted pregnancies which were getting terminated had real need of awareness of contraception.
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213. Primary closure of common bile duct after choledocotomy over feeding tube as a stent – A prospective study

     Dhiraj Agarwal, Abhisek Gupta, Tanmay Jain, K K Dangayach

     • » Abstract In the era of laparoscopic management of Cholelithiasis, chloledocholithiasis is not routinely managed by laparoscopically because laparoscopic management of CBD stones demands skills and equipment, and is therefore used by few surgeons. Therefore open surgery is still a treatment of choice in many hospitals. The classical performance of bile duct exploration is associated with the problem of an incised bile duct closure. Choledochotomy followed by T-tube drainage is a traditional surgical treatment for chloledocholithiasis but it is not exempt from complications, which are present in up to 10% of patients. The most frequent of these is bile leakage after removal, which is reported to occur in 1–19% of cases. Primary closure of the CBD after exploration is not new. Halstead first described the advantages of primary closure. In our hospital, open CBD exploration is still the treatment chosen for CBD stones. In this study, our aim was to assess the outcome of primary closure of common bile duct over feeding tube after choledochotomy.
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214. Efficacy and safety of erbium-doped yttrium aluminium garnet fractional resurfacing laser for treatment of facial acne scars

     Geethu F Alapatt, Ramesh Bhat M, Sukumar D, Meryl Sonia Rebello

     • » Abstract Background: Acne scarring has lifelong sequelae and are extremely disturbing to patients, both physically and psychologically. The use of ablative fractional lasers for the treatment of acne scars is becoming increasingly popular. But studies regarding the efficacy and safety of the same in the Indian skin is limited. Objective: To evaluate the efficacy and safety of Erbium-doped Yttrium Aluminium Garnet (Er: YAG) 2940 nm fractional laser resurfacing in the treatment of acne scars in 10 patients at a tertiary care teaching hospital Methodology: All 10 patients received four treatment sessions with Er: YAG fractional laser at 1-month interval. Subjective assessment in percentage of improvement was documented after four sessions. Subjects were instructed to report any cutaneous side-effects including erythema, oozing, crusting, dyschromia, scarring or secondary infection and about interference with daily activities in the post-treatment period. Photographs were taken before each treatment session and 1 month after the final session. A clinical assessment by comparing the photographs was done. Patient's satisfaction of improvement was noted at the end of four sessions. Conclusion: Er- YAG laser resurfacing is both effective and safe in the treatment for acne scars.
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215. Profit-function of two- identical cold standby satellite system subject to failure due to unexpected large disturbance at the second stage separation resulting in a sub-orbital flight of the vehicle and failure due to developmental flight, payload placed into lower than planned orbit

     Ashok Kumar Saini

     • » Abstract Background: In this paper we have taken failure due to unexpected large disturbance at the second stage separation resulting in a sub-orbital flight of the vehicle and failure due to Developmental Flight, payload placed into lower than planned orbit, and did not have sufficient fuel to reach a usable orbit. When the main unit fails then cold standby system becomes operative. Failure payload placed into lower than planned orbit, and did not have sufficient fuel to reach a usable orbit cannot occur simultaneously in both the units and after failure the unit undergoes Type-I or Type-II or Type-III repair facility immediately. Applying the regenerative point technique with renewal process theory the various reliability parameters MTSF, Availability, Busy period, Benefit-Function analysis have been evaluated.
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216. Etiology and management of pubertymenorrhagia in adolescent girls

     Manaswini Khuntia, Ritanjali Behera

     • » Abstract Introduction: Puberty menorrhagia is a real trouble among adolescent girls mostly due to problem in hypothalamic-pituitary-ovarian axis. Aims and objectives: To understand the various causative factors in puberty menorrhagia and to evaluate the role of hormones estrogens, progesterones or combination of both in controlling the excessive menstrual bleeding. Materials and methods: It is a study conducted in the Department of Obstetrics and Gynaecology at MKCG medical college, Berhampur, Odisha from Oct 2012 to Oct 2014. Study included a total of 112 adolescent girls presenting with complains of menorrhagia. Assessment of each case with thorough history, physical examination and laboratory investigations was done. Results: About 78.2% patients had menorrhagia due to immaturity of hypothalamic-pituitary-ovarian axis, 7.1% patients had bleeding diathesis, 5.3% had polycystic ovarian disease and 5.3% had hypothyroidism. Other rare causes were genital TB (1.8%), Leukemia (0.9%), polyp (0.9%). 3(2.6%) patients needed surgical intervention in the form of DandC and polypectomy. Hormonal management were given in 104(92.9%) and only non-hormonal management were given in 8(7.1%) of cases. Conclusion: Most abnormal bleeding in adolescent is caused by immaturity of hypothalamo-pituitary-ovarian axis resulting in anovulation. Majority of the patients showed good response to combined oral contraceptive pills.
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217. Critical alert values in cytopathology

     Subalakshmi Balasubramanian, S Rajendiran, J Thanka

     • » Abstract Introduction: Critical values (CVs)in clinical pathology is a well known entity that necessitates immediate notification of the physician to initiate rapid and prompt treatment. This concept has gained significance in cytopathology recently. Aim: 1. To evaluate the CVs in cytology reports from January 2011 to June 2013 and its utility in the health care delivery. 2. Perceptions of clinicians about the utility of Critical Values in cytology. Materials and Methods: We reviewed the documented cases of CVs among 23000 cytopathology reports. Cases considered CVs included bacteria and fungi in fluid cytology, Pneumocystis fungi or Cytopathic changes in Pulmonary cytology specimens, Unexpected malignant cells in cytology and Polymorphs in Synovial fluid. A survey was conducted among clinicians to rate the usefulness of critical alert values on a scale of 1 to 4 as follows 1. No need of phone call. 2. A phone call should be done but no change in treatment. 3. Stat phone call needed not sure if change in treatment. 4. Stat phone call needed for prompt treatment. Another survey was also conducted on the mode of communication of critical alerts and most of the clinicians favoured a need of stat phone call to their cellular phones rather than land line phone. Results: We identified 58 CVs documented in our cytology specimens of 23000 during the study period. Among these 78.3% were Non-Gynecology specimens. Most common CV was AFB positive smears (n=26) 44.8%. The next common was unexpected malignancies 23cases (39.6%) .6 cases (15.7%) were polymorphs in synovial fluid. CSF showed polymorphs in 3 case (5.2%).Among the gynaecology specimens no Herpes in Pap smears of near term pregnancies were identified. Survey among clinicians were done most of them voted for a immediate phone call for prompt treatment and the best mode of communication preferred was call to the mobile phones. Conclusion: Though the overall number of CVs in cytopathology is low but we feel that practise of CVs in cytology is very important in preventing the undesired delay in patient management.
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218. Efficacy of external fixation in high risk intertrochantric fracture of femur patients

     Pawan Jadhav

     • » Abstract Introduction: Hip fractures are a leading cause of death and disability among the elderly. Treatment goals for this patient include early rehabilitation, restoration of the anatomic alignment of the proximal part of the femur and maintenance of the fracture reduction. Various treatment modalities have been explained by various authors. But the treatment of choice in high surgical risk elderly patients is not clear. Aims and objectives: To study the efficacy of external fixation in a group of high surgical risk elderly patients. Materials and methods: 20 cases of intertrochantric fracture of femur with ASA grade more than 2 were studied. First the fracture reduction was achieved using standard procedure. The reduction was confirmed in two planes that is, anteroposterior and lateral view on x-ray or c-arm. Schanz screws and connecting AO clamps were used as external fixators. The surgical time blood loss was recorded. Average hospital stay and post operative complications were recorded. Results: Majority of the patients were in grade III and IV of Tronzo fracture grading. According to the ASA grading majority (55%) of the patients were in ASA III grade. Superficial infection was the most common complication. In 7 cases malunion was observed. One case was reported as delayed union for which continuation of the fixator was needed for 14 weeks. There was no case of nonunion. The neck shaft angle in 13 patients was excellent (between 125 to 135 degrees). In two patients it was fair (between 110 and 125 degrees). In one patients it was poor (<110 degrees). The final outcome was not measured in 4 cases because they lost to follow-up. Two patients died in the curse of treatment. The cause was unrelated to the fracture fixation. Conclusions: External fixation can be used as method of choice in high-risk geriatric patients with interochanteric fractures.
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219. Effect of temperature on dielectric parameters of ferroelectric materials at microwave frequency

     Bhagwan K Bongane, Prashant G Gavali

     • » Abstract Background: The composite materials of ST and BT ceramics were prepared by using solid state reaction method. The dielectric parameters of ST and BT ceramics of particle size 125 micron like dielectric constant (ε'), loss (ε"), quality factor (QxF), relaxation time (Ï„) and conductivity (σ) has been studied at different temperatures i.e. -10oc, +10oc, +30oc and +50oc. the values of dielectric parameters are found greeter of ST then BT but the relaxation time of ST is found smaller than BT.
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220. Managing ingested foreign bodies – not a piece of cake

     B Selvaraj, K Senthil Kumaran, G P Sekar

     • » Abstract Foreign body ingestion into gastrointestinal tract is a common problem in pediatric age group and in mentally retarded adults. In this article we have presented three patients from three age groups depicting the entire spectrum of the problem. Majority of these foreign bodies will be excreted without any problem but some sharp objects and impacted ones need emergency removal by endoscopy. We have also reviewed the literature for guidelines to manage this problem.
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221. MRSA and MRSE: Its prevalence, antibiotic sensitivity and correlation with biofilm formation observed in various clinical isolates

     Deepika Atray, Anshu Sharma, Meena Atray

     • » Abstract Biofilm formation has become a major factor in enhancing the antibiotic resistance of staphylococci. In the present study, we observed methicillin resistance and further biofilm production by two methods – Congo red agar method and Christenson’s test tube method and compared the antibiotic resistance pattern between biofilm producers and non biofilm producers. 102 S. aureus and 168 S. epidermidis were isolated from various clinical samples with 70.5% and 79.7% methicillin resistance resp.51.4% MRSA and 61.2% MRSE were biofilm producers. Antibiotic sensitivity was observed in biofilm producing S. epidermidis and S aureus for Vancomycin (63%/85%), Doxycycline (48%/61%), Tetracycline (41%/52%), Cephalexin (19%/15%), Cefotaxime (41%/43%), Ceftrioxone (31%/37%), Cotrimoxazole (10%/11%), Ciprofloxacin (45%/52%), Amoxicillin (34%/35%), Ampicillin (4%/2%), Amoxyclave (26%/17%), Erythromycin (6%/14%), Amikacin (71%/76%), Gentamycin (66%/65%) and for urinary isolates Norfloxacin (9%/11%) and Nitrofuranoin (57%/78%) which was significantly less as compared to non biofilm producers.
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222. An unusual case of uterine inversion: A case report

     Shreyaa A Shriram, U T Bhosale

     • » Abstract Uterine inversion is a rare obstetric emergency. The incidence varies considerably and can range from 1 case in 2000 to 1 case in every 50,000 births. This postpartum complication has an academic importance due to its rarity and severity. When not immediately identified, the massive and often underestimated blood loss can lead to hypovolemic shock and maternal death that can reach 15% in some series. The best management options for this condition are not fully known, given the worldwide scarce experience of each obstetrical team managing this type of situation. There are several therapeutic strategies described in the literature, including drugs, manual maneuvers and surgical interventions. The aim of this article is to describe a case of complete acute uterine inversion after a normal delivery, and provide a literature review of uterine inversion, its definition, etiology, predictive and risk factors, diagnosis and treatment.
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223. Role of early laparoscopic cholecystectomy in acute cholecystitis – A retrospective analysis

     Loganathan Mannu, Habeeb Mohammed Shajahan, Balakrishnan Varadharajan, Karunanithi Ramaiah, Natarajan Ramalingam

     • » Abstract Background: Various studies have proposed conflicting opinion about first-line management of patients with Acute Cholecystitis. Results from these studies have evidences for and against the early Laparoscopic Cholecystectomy. The aim of this study is to retrospectively analyse the results of our practise in managing acute Cholecystitis with early Laparoscopic Cholecystectomy. Methods: Data collection from the case records of patients who underwent initial Laparoscopic approach for Acute Cholecystitis. Various parameters assessed are conversion rate, operating time, length of hospital stay, bile duct injury and port site infection as predictors of efficiency of early laparoscopic approach. Results: The analysis included 95 patients, 57 females and 38 males, average age was 52 years. Mean duration of symptoms before intervention was 64 hours. Mean operating time was 96 minutes. Over all conversion rate was 16.8%, which decreased substantially from year 1 through till the end of study period. Length of hospital stay was 3-7 days (Mean =4.6 days). Postoperative complication occurred in 7 patients (2 cases of cystic duct leak and 5 cases of port site infection). Conclusion: Early laparoscopic approach has yielded comparable results in terms of operating time, conversion rate, and complication rates, while the total length of hospital stay was substantially reduced when compared with total hospital stay in delayed approach from other studies
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224. A cadaveric study of variations in branching pattern of brachial plexus

     Smita K Balsurkar, Surwase Ramdas G, Ferozkhan J Pathan, Ugale Mahesh, Reddy Anand

     • » Abstract Aims and Objectives: The aims of present study are 1) to study the variations in branching pattern of the brachial plexus 2) to study the communication of median nerve with other nerves of upper limb. Materials and Methods: In present study 30 brachial plexuses from 15 well embalmed human cadavers were studied in anatomy department. In depth study was done on the communications of median with the musculocutaneous nerve and the different types were classified. Communication between ulnar nerve and median nerve was studied. Results: Out of 30 upper limbs, we found communication between musculocutaneous nerve and median nerve in 6 cases. In such cases, the communicating branch run from musculocutaneus nerve towards median nerve. Four upper limb shows communication between ulnar nerve and medial root of median nerve. Conclusion: It is concluded that knowledge of such variations is essential in evaluation of unexplained sensory and motor loss after trauma and surgical interventions to upper limb. Knowledge of these variations is important to anatomists, radiologists, anesthesiologists and surgeons.
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225. Evaluation of lipid profile in patients with liver cirrhosis and their association with severity of the disease

     Vijay laxmi Nangliya

     • » Abstract The study was conducted to determine the Lipid profiles in Patients with Liver Cirrhosis and to assess their association with severity of the disease. In an analytical cross sectional study, 150 Cirrhotic subjects of either sex ranging in age from 25-65 years were included in the study and the results were compared with 50, age and sex matched healthy control subjects. All Cirrhotic subjects were assessed for severity of disease as Mild (Child A), Moderate (Child B) and Severe (Child C) as per Child Pugh classification. Total Cholesterol, HDL, LDL and triglycerides were measured. The results of this study showed that all the serum lipid profile parameters (Total Cholesterol, LDL and HDL) were significantly (p <0.05)decreased in cirrhotics as compared to control group and the concentration of these study variables decreased with Severity of liver disease and the mean level difference was statistically significantly (p <0.01) with the exception of serum triglyceride levels. Triglyceride levels rather showed a decline in Cirrhotic patients but it was not statistically significant. Dyslipidemia exists in patients with liver cirrhosis. Serum Lipid profile is routinely measured parameters, which may have independent prognostic value in patients with liver cirrhosis thus assessment of the serum lipid profile is important for an effective treatment and prognostic evaluation of patients with chronic liver disease.
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226. Study of gram negative septicemia in cases of neonates admitted in neonatal intensive care unit at tertiary care hospital

     Preeti M Huggi, Sanjeev B Navadagi

     • » Abstract Background: Septicemia in neonates is one of the four leading causes of neonatal mortality in India. The pattern of causative agents has been constantly changing and there has been a frequent emergence of resistant bacteria. The antibiotic misuse has resulted in emergence of drug resistant bacterial strains in the neonatal units with grave sequelae. Objectives: to describe the spectrum of aerobic gram negative bacterial isolates and study the sensitivity pattern in cases of neonatal septicemia. Methods: Blood samples were collected aseptically from 200 clinically suspected cases and inoculated into BHI broth and incubated at 370 C for 7 days. Repeated subcultures were made on 1st, 3rd and 5th days onto Blood agar and Mac Conkey agar. Any growth was identified by colony characteristics and appropriate biochemical tests. Antibiotic susceptibility was done by disc diffusion method as per CLSI guidelines. Results: Of the 200 cases, 31.5% were found to be culture positive. Gram negative isolates were predominant 73% and Gram positive isolates were obtained in 27% of the cases. Out of the Gram negative, Klebsiellaspp was the commonest (44.4%) followed by Pseudomonas aeruginosa (17.5%), Escherichia coli (9.5%), Proteus vulgaris (1.6%). Gram negative isolates were most sensitive to Imipenem and Meropenem (98%), followed by Cefoperazone /Sulbactum (75-80%), Amikacin and Gentamycin (70-75%) and least sensitive to third generation cephalosporins. Conclusion: Therefore uncertainty regarding the choice of antibiotics can be minimized by regular survey of etiological agents and their antimicrobial susceptibility pattern.
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227. Effect of modulation of environment of learning by ‘Mantra-Meditation’ in MBBS students

     Santosh C Gursale, Mohankrishna Ghanta

     • » Abstract Introduction: Learning is a multidimensional and dynamic process requiring a stress free and relaxed environment. There is some evidence in literature that meditation could positively influence memory and help medical students in reducing stress. Chanting of mantra is basically mind oriented with minimum body activity involvement, passive method of meditation Aims: At the end of ‘Mantra-Meditation’ technique, for three lectures, to assess the effect of ‘Mantra Meditation’, just prior to a learning session, on the students’ concentration towards lecture, academic performance, relaxation of mind and pulse rate. Material and Methods: Institutional Ethical Committee approval was taken. 69 students were included in the study, after taking their written informed consent. Test group- 34 Students were asked to chant mantra (Mantra-Meditation) for 8 min. at the start of the lecture, then lecture was delivered. Control group- Without Mantra-Meditation, same lecture was delivered to 35 students. Evaluation was done after three lectures by i) Students’ feedback questionnaire- ii) Multiple choice question test- was carried out before and after third lecture in both groups . iii) Discussion with students iv) ‘Pulse rate per minute’ of each student was recorded, before and after entire session. Statistical analysis used: Analysis of the difference in the performance in MCQ tests between two groups was done using independent samples t test. The change in pulse rate was analysed using paired t test. Results: In MCQ tests, difference in students' post MCQ test scores between control and test group was not statistically significant. But pre MCQ test score of meditation group was significantly better than control group. Significant number of students of mantra meditation group reported to be more attentive, relaxed, increase in concentration towards lecture, reduction in thoughts and in wandering of mind. There was significant reduction in mean pulse rate in mantra meditation group. Conclusions: This simple and easy mantra meditation could be adopted to enhance student learning.
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228. A comparative study of symptomatic and radiologic findings in cases of gall bladder disease undergoing cholecystectomy

     Sushant Kumar, Pranaya Kunal, Deepak Kumar Yadav

     • » Abstract A prospective clinical study of 100 selected cases admitted in the Department. Of General Surgery, M.G.M Medical College and L.S.K. Hospital, Kishanganj during the period of July, 2012 – September, 2014 was undertaken to assess the mode of clinical presentation, laboratory and radiological impressions and finally their management. A brief review of available literature was also made. Majority cases (35%) belonged to age group of 31-40yrs with a female preponderance (F:M- 3:1) with most of the women in their child bearing age. Pain abdomen over the right hypochondrium with referred pain to the inferior angle of scapula and positive Murphy’s sign were the commonest clinical presentation followed with nausea, vomiting, flatulence and dyspepsia. Only 1 case had jaundice during the first clinical presentation. Ultrasonography of abdomen not only revealed evidence of gall stones with impressions of acute or chronic cholecystitis in 95% cases but also revealed some changes in common bile duct, liver, pancreas etc. Total WBC count was found to be elevated (mild to moderate) in 100% cases. Liver function test results- 16% cases was with elevated serum bilirubin, 24% cases with elevated alkaline phosphatase and 6% with elevated liver enzymes was observed. All cases were managed conservatively in acute phase of which 20% cases needed early operation being refractory to conservative means. Rest underwent interval cholecystectomy after 4-6 weeks. Open Cholecystectomy through right subcostal Kocher’s incision were carried out in all cases out of which Choledocholithotomy and Choledochoduodenostomy were done in 5% cases. 80% cases revealed multiple stones, 14% solitary stone and 3% sludge only. Macroscopically 60% cases showed mixed stones, 22% pigment stones and 6% cholesterol stones. Macroscopically 72% revealed gross thickening with fibrosis, 28% with congestion. Microscopically chroniccholecystitis was found in 100% cases. Bacteriological examination of gall bladder contents showed 56% to be sterile, Klebsiella sp. And Staphylococcus aureus predominant in infected cases (42%). E. coli, Enterococcus, Enterobacter were also detected. The post operative period of all cases were uneventful except pain abdomen and wound sepsis in few. There was no mortality and significant morbidity.
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229. A comparative study of phosphate binders in patients of end stage kidney disease undergoing haemodialysis

     Manjuprasad M S, Padmaja Udaykumar, Shreya Hegde

     • » Abstract Introduction: Hyperphosphatemia is one of the complication in patients with chronic kidney disease on long term haemodialysis which will add on to the morbidity and mortality of the patient. This study was conducted in an attempt to compare the efficacy of phosphate binders prescribed to the patients of end stage kidney disease undergoing haemodialysis. It was a retrospective study in which medical records of patients with ESKD who received phosphate binders over past 2 years (2013 and 2014) were included in the study and divided into groups receiving sevelemer, calcium carbonate and calcium acetate and their baseline serum phosphate levels were compared with serum phosphate levels after 8weeks of treatment and found that at the end of 8th week the difference in control of phosphate levels in sevelemer group compared with control group was highly significant with a p value of 0.003. The difference in control of phosphate levels in the calcium carbonate group compared with control group also had a significant result with p value 0.039. There were no significant differences in calcium acetate and control group with respect to serum phosphate level difference at the end of 8th week. There were no statistically significant differences between individual groups. Conclusion: Our study confirms that phosphate binders significantly control the serum phosphate levels over a period of eight weeks treatment in ESKD patients on haemodialysis. However sevelemer was found to be more effective in controlling the serum phosphate levels but its high costs limits its use for the poor socioeconomic population.
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230. Potential drug interactions in chronic kidney disease patients - A cross sectional study

     S Hegde, P Udaykumar, M S Manjuprasad

     • » Abstract Chronic kidney disease (CKD) is a major systemic condition whose prevalence is rising in India. Presence of comorbid conditions like hypertension, diabetes mellitus, metabolic bone disease and electrolyte disturbances along with the deteriorating renal function makes the management of CKD complex .The aim of this study was to assess the pattern of drug drug interactions in CKD patients. This was a prospective cross sectional study conducted in a tertiary care medical hospital in India. A total of 120 patients were enrolled and the list of drug interactions in them was analysed using drug interaction software. The mean age of the study group was 58.53±8.38 years. Hyperphosphataemia, hypertension and diabetes mellitus were among the frequently associated comorbid illnesses.146 potential drug drug interactions (PDDI) were found with an average of 2.39 interactions per patient. Of these 38.14% were mild, 45.36% were moderate and 16.41% were severe. Hypotension, hypertension, hyperkalemia, hypokalemia, anemia, hyperphosphatemia, hyperuricemia were among the commonest outcomes of interactions. Sodium bicarbonate, ferrous sulfate, calcium carbonate, aspirin, pantoprazole, allopurinol were the drugs commonly involved in PDDI. There was a positive correlation between the age and number of interactions (Karl Pearson correlation coefficient: 0.607; p value<0.001) and the number of tablets and number of interactions (karl pearson coefficient: 0.876; p value<0.001). The prevalence of PDDI among CKD patients in this study was high (80.83%). Hence, rational prescription, early detection of harmful drug combinations and careful monitoring of these patients can prevent the occurrence of drug interactions.
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231. Urinary tract infection in children in Chennai- Mangadu area

     Inayath Ali Badusha, Sumathi

     • » Abstract Urinary tract infections are the most frequent bacterial infections. They occur most frequently in female children and uncircumcised male children.10% of female getting an infection yearly and 60% get infection in some point of their life. Recurrences are common. Infection occurs four times more frequently in female than male sex. Urinary tract infection affects 10% of people during childhood. It is necessary to have the spectrum of infecting bacteria and antibiotic sensitivity pattern in the particular area, so that the treating physician is capable of treating the disease easily. That is the reason the author has taken this topic. Introduction in United States of America, urinary tract infection accounts for nearly seven million office visits, and one million emergency department visits. One hundred thousand hospitalisation every year. The cost of these infections is significant in terms of lost time at work and cost of medical care. In united states, the direct cost of treatment is estimated at 1.6 billion U.S. Dollars yearly. Urinary tract infections have been described since ancient times with first documented description in the ebers papyrus to 1550 b. c., it was described by egyptians as: sending forth heat from the bladder”. Effective urinary tract infection treatment did not develop until the discovery of antibiotics in 1930. Before which time herbs, bloodletting and rest were re commended.
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232. Single incision two ports and two slings technique of laparoscopic cholecystectomy – A retrospective analysis of our practise

     Loganathan Mannu, Habeeb Mohammed Shajahan, Balakrishnan V, Karunanithi Ramaiah, Natarajan Ramalingam

     • » Abstract Background: Since the advent of Single incision laparoscopic surgery, there has been genuine effort from the Laparoscopic fraternity to improvise the technique and make it safe, lesser discomfort and cost effective for the patients. One such effort is the use of standard laparoscopic trocars and instruments in accomplishing Single incision laparoscopic surgery. Various modifications have been introduced by various surgeons all over the world. Our modification is the first instance in literature, where cholecystectomy using standard laparoscopic instruments in single incision, has been done with only two ports. Here we analyse the expediency, safety, benefits, and drawbacks of our practice. Methods: For a duration of 2 years, 65 patients with cholelithiasis without any complications were operated upon by our modified single incision laparoscopic technique. Results were analysed. Results: All 65 patients were successfully operated upon by SITPS (Single incision two ports and two slings) technique. VAS score <4 in 64 patients and >5 in one patient. There was no significant postoperative complications. Seven patient had port site edema. No patient had port site infection. There was no incidence of port site hernia after one year follow up. Conclusion: SITPS technique of laparoscopic cholecystectomy is a technically feasible and safe alternative to standard laparoscopic approach, with reduced postoperative pain, with no visible scar and hence cosmetically superior.
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233. Does hypovitaminosis D have a role in lipid profile alteration among non-obese diabetics?

     Hariharan A, Asmathulla S, Suresh S

     • » Abstract Objective: The prevalence of hypovitaminosis D among diabetics is very high with it being an adjuvant causative factor. It has been shown in few studies that hypovitaminosis D has an impact on lipid profile of diabetic patients but most of the studies haven’t excluded the confounding factor viz. obesity. It is a known fact that obesity has a major role in development of hypovitaminosis D. So in our study, we try to find out whether the association between hypovitaminosis D and lipid profile exists even after excluding obesity in diabetics. Materials and Methods: It is a cross section study conducted in 55 Non-obese diabetics. We had measured serum FBS, vitamin-D, urea, creatinine, lipid profile and urinary microalbumin. Results: We found a negative correlation between vitamin-D with that of TGL (r: -0.337; p<0.012) and VLDL (r: -0.190; p<0.011). There was no association found between hypovitaminosis D with that of cholesterol, HDL and LDL. Conclusion: From our study it’s clear that hypovitaminosis D is associated with TGL and VLDL even after excluding obesity.
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234. A rare case of kimura’s disease presenting as posterior auricular swelling

     S Deivanayagam, Vinod Balaji, Jawahar, Yeshwanth Kumar

     • » Abstract Kimura's Disease is a chronic inflammatory disorder of unknown etiology commonly seen among people who live in the Middle and Far East countries; characterised lymphatic follicles, vascular proliferation, and marked eosinophilic infiltration by histologically. It is mainly seen on the head and neck region. The lesion is benign but might be confused with malignant lesions. Kimura's Disease is often seen in the second and third decades of life. This disease is characterised by a blood and tissue eosinophilia, markedly elevated serum IgE levels, painless subcutaneous mass and regional lymphadenopathy on the head and neck region. In this report, we present a 14 yr old boy who was admitted to our hospital with bilateral post auricular swelling for 4 yr duration. Bilateral postauricular masses were excised under general anaesthesia and Kimura's disease was diagnosed by histopathological examination of these lesions.
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235. A rare case of maxillary central incisors with two root canals

     Rosamma George, Kavyashree G, Jayalakshmi C

     • » Abstract Maxillary central incisors usually have one root canal. The cases with two root canals with type IV vertucci canal configuration are extremely rare. Internal morphology of the root canals is variable and often complex. Better understanding of root canal complex is very essential for a clinician to ensure proper treatment. Computed tomography plays an excellent role in diagnosing such anatomical variations.
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236. Comparative study of RR, PR and JT intervals during the different phases of menstrual cycle

     Rajeshwari L, Uma R, A R Gorkal

     • » Abstract Aim: Cardiac functions are influenced by gender and gonadal steroids. Ventricular arrhythmias are more common in women and seem to exhibit during the menstrual cycle. JT interval is major component of QT interval. It measures ventricular repolarization. According to literature, estrogen lengthens the JT interval. Hormonal changes during menstrual cycle may cause changes in ECG intervals. Objective: The objective of the present study is to evaluate the effect of different phases of menstrual cycle on the RR, PR and JT intervals of ECG. Methods: This is a prospective study among a cohort of 30 healthy female students, who were aged 18-22 years and had regular menstrual cycles over past six months. Subjects were monitored on three separate occasions during two consecutive menstrual cycles. ECG was recorded for 5 minutes in Lead –II using Power lab multichannel polygraph instrument, once during every phase. The computerized recordings of RR, PR and JT intervals thus obtained were analyzed statistically using pooled t test, probability < 0.05 to assess if any significant difference existed in these parameters during the different phases of menstrual cycle. Results: This study did not show any statistically significant variation in RR, PR and JT intervals between the menstrual, follicular and luteal phases of the menstrual cycle. Conclusion: It may be concluded that there was no statistically significant variation in RR, PR and JT intervals during different phases of the menstrual cycle which may be due to the small sample size.
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237. A study of effect of injection drotaverine hydrochloride in agumentation of labour

     Maya Narayan Arvikar, Prashant C Patil, Shubhangi Choudhari

     • » Abstract Background: The common cause of prolonged first stage of labour is cervical dystocia. Many a times inspite of good utrine contractions cervix fails to dilate or dilates very slowly. In modern obstetrics the passive concept of watchful expectancy has long been abandoned and replaced by intensive care. Objectives: To study the effect of injection drotaverine hydrochloride in augmentation of first stage of labour. Material and Methods: Study was conducted in Dr. Ulhas Patil Medical College and Hospital Jalgaon, Kh, Maharashtra. Total uncomplicated 140 full term patients were studied, 70 patients with injection drotaverine hydrochloride and 70 controls. In both the groups 35 primigravidas and 35 multigravidas each. Results and Conclusion: Injection Drotaverine Hydrochloride during active phase of labour increases rate of cervical dilatation and decreases duration significantly.
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238. A study of knowledge on osteoporosis among peri –menopausal women in an urban slum area of Berhampur

     Gurukrushna Mohapatra

     • » Abstract Background: Osteoporosis, a condition characterized by decreased bone strength, is prevalent among perimenopausal women as a major risk factors. world wide it causes more than 8.9 million fractures annually. Aims and Objectives: aimed to assess the knowledge on osteoporosis among peri menopausal women in urban slum area of southern Odisha Material and Methods: It was a cross-sectional study carried out in slum area of Berhampur, Odisha between September 2013 to February 2014. The study population include all the peri-menopausal women in the slum area. Sample size taken as 369. data was collected from a structured pre tested and pre designed questionnaire. The data was analysed SPSS version 16.0. p value less than 0.05 was taken to be statistically significant. Results and Conclusion: majority of the women (75%) were in the age group 51-60yr and (42%) of women had no formal education. By occupation 32% were daily labourer. As per average family income, 24% belonged to the income group of more than Rs.5000/- per month. regarding source 36% had known about osteoporosis from health personnel. About 48% opined that osteoporosis is a disease of bone. 72% women agreed old age to be a risk factor for it. 44% knew that back pain as a major symptom of the disease. Only 28% knew that calcium rich foods can prevent osteoporosis. The study shows limited knowledge on understanding of osteoporosis and it’s preventive measures suggested this as a evidence to be used for future correspondence. In the community : knowledge on osteoporosis among peri-menopausal women is very low and it is significantly associated with factors like age, occupation. The symptoms of osteoporosis submerged in the population like a tip of ice berg which is expressed only in the form of fracture or serious complications. Also the literacy does not make any difference as per our observation
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239. Intrathecal block for breast augmentation surgery in poland’s syndrome: A case report

     Abhirup Samanta, Shama Shikalgar, Prashant Lomate

     • » Abstract Breast augmentation is an increasing popular day case procedure. Local infiltration anaesthesia with sedation is routinely used for it’s ease of application as compared to more complex and potentially riskier intrathecal block. We hypothesized that intrathecal isobaric ropivacaine by experienced anaesthetist was more effective than local anaesthesia with sedation, in view of adequate sensory blockade. Intrathecal Isobaric ropivacaine which is less cardiotoxic produces more sensory blockade over motor blockade as compare to intrathecal hyperbaric bupivacaine which is most popular anaesthetic drug for spinal anaesthesia. Moreover ropivacaine needs less dose and does not require head low position to achieve higher level of blockade as compare to bupivacaine since it is isobaric in nature. we present a case of unilateral breast augmentation of a women, successfully performed by the application of intrathecal block without any complication.
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240. Cytodiagnosis of Gouty Tophi – Case report

     A D Jungare, S A Jungare, U D Suryawanshi, B B Sonawane

     • » Abstract Gout is a clinical syndrome which is characterized by hyperuricemia and recurrent acute arthritis. Accumulation of tophi in joints triggers the inflammatory response of gouty arthritis. We report here a case of gouty tophi diagnosed by fine needle aspiration, along with review of literature. A 53 year old male presented with multiple subcutaneous nodules on both feet. The nodules were firm and nontender. Fine needle aspiration was diagnostic as it revealed granular amorphous material and scattered stacks and sheaves of slender needle shaped crystals few histocytes and chronic inflammatory cells. Radiographs of both feet showed extensive soft tissue swellings with underline bone erosion. The serum uric acid levels were found to be raised confirmed diagnosis. Fine needle aspiration is an effective tool in the diagnosis of gouty tophi. Difficulties in management can be avoided by using the fine needle aspiration technique.
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241. Breakage of the tip of a flipcutter during ACL reconstruction: A rare complication of the knee arthroscopy

     Mozimul haq siddiqui

     • » Abstract We report a case of broken tip of the reprocessed flipcutter guide pin (arthrex, Naples, FL ) while drilling the tibial socket for the ACL reconstruction. The complication was identified immediately and the broken instrument removed piece meal. We have not come across such a case in the literature and it is the first report of its kind to our knowledge. Repeated use of flip cutter is to be avoided to prevent such hazards. Also care should be taken to lock the blades properly before starting to drill the sockets. Although instrument breakage is a rare complication during knee arthroscopy, orthopaedic surgeon should be aware of this complication and methods to deal with it.
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242. Screening of Glucose-6-Phosphate Dehydrogenase deficiency in Neonates

     Raviraj Naik, Sarita Dakhure, Rittu Chandel, Leela Abichandani

     • » Abstract Introduction: Glucose – 6 – phosphate dehydrogenase (G-6-PD) is an enzyme that participates in the first step of Hexose monophosphate pathway of glucose metabolism. Deficiency of this enzyme is most common genetic disorder in India. Its deficiency causes hemolysis which eventually lead to acute haemolytic anemia and neonatal jaundice. The hemolysis in these deficient patients are triggered by bacterial, viral infections, drugs like aspirin and chloroquine, foods like fava beans Period from after birth to first 4 weeks is the neonatal period and the child is called a neonate. There is no cure for G-6-PD.Early detection and prevention of hemolytic episodes by avoiding the triggers is the only cure for this deficiency. Aim: To screen the neonates for glucose -6-Phosphate dehydrogenase deficiency so as to prevent the morbidity and mortality occurring due to this deficiency. Material and Methods: One Thousand neonatal blood sample were obtained from the Labour room, of the civil Hospital of vasai. The samples were analysed by Dye Decolourization method. Results: Of the 1000 samples, 10 was found to be G-6- PD deficient and 20 were found to be G-6-PD deficiency carriers. Conclusion: G-6-PD deficiency is common in Adivasi Population.G-6-PD deficiency testing should be done as a screening procedure at least in Adivasi residing areas as early diagnosis and prevention is the only way of treating this deficiency disorder and avoiding its complications.
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243. Serum cortisol levels in critically Ill versus non-critically Ill patients

     Chandrashekar M, Shivaraj B M, V P Krishna

     • » Abstract This case control study was undertaken to compare the early morning venous serum cortisol levels between 40 cases of critically ill (group A) vs non critically ill (group B) patients admitted to a tertiary teaching hospital for a duration of one year. It was found that there was significant increase in the serum cortisol levels among critically ill (mean 33.68 μg/dl ±15.93) as compared to non critically ill (mean 15.93 μg/dl ± 5.93) patients.
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244. Non invasive prediction of esophageal varices using right lobe of liver to albumin ratio

     Sanjay Raj, Chandrashekar M

     • » Abstract Studies have shown that biochemical, clinical and ultrasonographic parameters alone or together have good predictive power for non-invasively assessing the presence of esophageal varices. Here we studied the correlation of right liver lobe diameter to albumin ratio as a predictor of esophageal varices in 50 patients of cirrhosis admitted to medicine wards of tertiary teaching hospital. Considering the right liver lobe/albumin ratio cut-of value of 4.425 as suggested by Tamara Alempijevic et al., our study yielded a sensitivity of 83.3% and specificity of 29.5%
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245. Ethnomedicinal Plants Used by the Tribal’s in Cure of Wounds in Buldhana District (MS) INDIA

     A. N. Korpenwar

     • » Abstract biodiversity of medicinal plant species. An ethnobotanical survey was carried out in Buldana district, Maharashtra during July, 2008 to March, 2010 for documentation of wound healing knowledge acquired by the tribal communities. The tribal communities possess rich knowledge about medicinal plants and its uses as they are far away from modern facilities. Therefore, we have done an exhaustive ethnobotanical survey in this area. A list of 72 wound healing plants species are recorded, which are in practice by traditional healers of tribal communities. The traditional healers in this area use the wild as well as cultivated plants in the treatment of wounds. Documenting the indigenous knowledge through ethnobotanical studies is important for the conservation and utilization of biological resources and for the wale fare of human being. The plants were identified with relevant information and are documented alphabetically with their botanical name, family, local name, parts used, mode of preparation and uses.
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246. Study of Glutathione S-Transferase in gastrointestinal cancer

     N R Hazari, V S Hatolkar

     • » Abstract Glutathione S-Transferase(GST) distributed widely in tissues such as liver, lung, skin, brain, intestine and placenta. Levels of enzyme detection in serum are useful for diagnosis and prognosis of human disease. Recently GST may be useful in monitoring pathogenesis of liver disease. In the present study of serum GST was significantly higher in patients with esophagus and stomach cancer as compared to those obtained from normal healthy group. Our results showed a significant increased activity of GST in stage III patients than stage II patients of both cancers; which may trigger the progression of cancer.
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247. Introduction of project as a learning tool in forensic medicine

     Sachin Janbaji Gadge, Alka Rawekar

     • » Abstract Project Based Learning is a teaching method in which student gains knowledge and skills by working for an extended period of time to investigate and respond to a complex question, problem, or challenge. The aim of our study was to improve learning of Forensic Medicine in under graduate students. A batch of 100 under graduate students were given didactic lecture on injuries. After that 50 were divided into 5 batches of 10 each and allotted projects on injuries. Pretest and post test were conducted for all 100 students. The pre and post test were evaluated by student ‘t’ test. Learning gain of the project subjected group was more as compared to traditional teaching (p = 0.000). The absolute learning gain was much higher (228.80%).
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248. Sympathetic cardiovascular function integrity in children with parental history of diabetes mellitus

     Amruta Nitin Kumbhar, Lalit H Nikam

     • » Abstract Introduction: Type 2 DM has a strong genetic component. Individuals having parents with type 2 DM have an increased risk of diabetes; if both parents have type 2 DM, the risk approaches 40%. The autonomic nervous system regulates the electrical and contractile activity of myocardium via interplay of sympathetic and parasympathetic activity. Sympathetic nerves of heart are derived from the upper thoracic 5 segments of the spinal cord. In general, sympathetic stimulation increases the overall activity of the heart. This is accomplished by increasing both the rate and force of heart contraction. Amis and Objectives: To study Sympathetic cardiovascular Function Integrity in children with parental history of diabetes mellitus. Materials and Method: The study procedure was carried out on healthy volunteer medical students of age group 18 to 25 years. They were first categorized into two groups, control (without parental history of diabetes mellitus) and subject (with parental history of diabetes mellitus). The sample size was 70 in the control group and 70 in the subject group. All participants were examined after explaining the study procedure. The cardiovascular tests to measure cardiovascular autonomic response were performed. These tests were explained and demonstrated to the participants before performing on them. Tests Done For Assessing Sympathetic Activity were Blood pressure response to standing (Orthostasis) test, Hand grip test and QTc interval test. The mean and standard deviation (S D) was calculated for all the parameters. The data was entered using Microsoft Excel (2007). Statistical analysis was done using SPSS version 10.The statistical test used were (as per the requirement of the data). Results: The age distribution and sex distribution was nearly same in the study and control group. Mean resting pulse, mean SBP and DBP was slightly more in study group as compared to control group and the difference was not significant statistically. While assessing sympathetic activity Orthostasis and Mean QTc interval test showed no statistically significant difference in study and control group whereas sustained handgrip test showed statistically significant difference in study and control group. Conclusion: Early subclinical sympathetic autonomic neuropathy may develop in children of type 2 diabetic parents without the presence of long term hyperglycemia. It could be due to inherited susceptibility genes for sympathetic autonomic neuropathy which could be expressed before or even without development of diabetes mellitus.
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249. An unusual case of prominent duct of accessory parotid gland

     Anil Joshi, Rajani Joshi

     • » Abstract Accessory parotid glands are an occasional islet of parotid tissue separate from the main parotid gland, lying anteriorly just above the commencement of the parotid duct. They are found in 20% of general population. Though accessory parotid gland draining by a ductule in to the main parotid duct is a common finding, accessory parotid gland draining by a separate duct is a rare occurrence. We present the imaging findings in a case of left accessory parotid gland with a prominent duct of its own which was communicating with main parotid duct with a calculus at their junction
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250. A study of factors associated with disabilities of hands and feet among leprosy patients

     Shivani Ranjan, Devraj Dogra, Naina Dogra

     • » Abstract Introduction: Leprosy (Hansen’s disease, hanseniasis) is a chronic infectious disease caused by Mycobacterium leprae, affecting the peripheral nervous system, the skin, mucous membranes and occasionally other tissues. In leprosy patients, disabilities involving hands, feet, eyes, face are seen. Deformities of hands include ulcers, cracks, scars, blisters, claw hand, wrist drop, dactylitis, contractures of fingers, resorption of fingers, stiff joints. Defomities of feet include ulcers, cracks, scars, blisters, foot drop, claw toes, resorption of toes, contracture of tendo achilles, equinovarus deformity. Aims and Objectives: To study the various factors associated disabilities of hands and feet among leprosy patients reported in a tertiary care center. Material and Method: The present study was conducted in the Post Graduate Department of Dermatology, Venereology and Leprology, Government Medical College, Jammu from November 2012 to October 2013. All patients clinically diagnosed as cases of leprosy both old and new registered in the hospital were included in the study. A detailed history was taken regarding the age, sex, occupation, education, duration of disease, reactional states, treatment status, past history and family history. Complete clinical examination of each patient was performed with respect to skin lesions, nerve involvement and distribution, site, symmetry, type and grading of disability of hands and feet. Results: It was observed that out of total 150 patients, 93 (62%) were diagnosed to be with disability. Among the newly diagnosed patients, 57.97% were disabled whereas among the on treatment patients 64% were disabled. Mean age was 40.22±13.15 years. The male to female ratio for disability was 4.2:1. Maximum number of disabled patients was seen among manual labourers (farmers and labourers) and housewives. Disability was more common among illiterates (73.33%) as compared to literate patients (45%). It was observed that as the duration of disease increases and registration was delayed, the proportion of disabled was increased. Disability rate was increased with increasing number of nerves involved. All the patients with histoid and polyneuritic leprosy were disabled. Disability among lepromatous leprosy and borderline lepromatous leprosy was seen in 89.29% and 75.61% respectively. Conclusion: Thus from the above results we conclude that increasing age, male sex, manual labourers and illiterates were common demographic factors associated with disabilities of hands and feet among leprosy patients. It was also seen that delay in registration, increase in duration of disease and increasing number of nerves involved were common reason for disability. Disability is common in lepromatous leprosy and borderline lepromatous leprosy.
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251. Comparison of upper lip bite test and modified mallampati test in prediction of difficult endotracheal intubation

     Babu Isaac, Sharma Monika

     • » Abstract 150 patients of either sex scheduled for elective surgery were included in the study. All patients were aged more than sixteen years and belonging to ASA PS- 1/ 2. All the patients were assessed preoperatively by modified mallampati test and upper lip bite test. Difficult tracheal intubation was graded on Cormack Lehane scale. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Conclusion: Modified Mallampati test is a better test at predicting difficult endotracheal intubation when compared to upper lip bite test.
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252. A study of diagnostic categories in prisoners with psychiatric disorders

     S R Suryavanshi, I S Netto, A V Pawar

     • » Abstract Background: There are very few recent studies regarding the diagnostic categories in prisoners with psychiatric disorders in the Indian setting. Methodology: The study was conducted on 50 prisoners admitted to a closed prisoner’s ward. The patient’s history was recorded and their mental status examination was done. The Kuppuswamy’s socio-economic scale and the MINI Plus were administered to the patient. The diagnostic categorization of the prisoners was done according to ICD-10 research criteria. Results: There were 46 males and 4 female prisoners. Out of the 46 male prisoners, 14 were convicted and 32 were under-trial and all the four females were under-trial. 46 males and 4 female prisoners were evaluated and most were from the lower socioeconomic class and rural areas. Schizophrenia, bipolar affective disorder-mania, major depressive disorder, and psychotic disorder NOS, psychotic disorder due to general medical condition and psychosis with mental retardation were the main diagnostic categories observed. The most common diagnostic category was schizophrenia in both males and females prisoners. Murder, attempt to murder, rape, kidnapping, grievous injury and theft were the crimes committed by the prisoners. Murder was the most common crime committed by both male and female prisoners. Most prisoners with violent crimes (murder) had a diagnosis of schizophrenia. Conclusion: This has implications for mental health services, training of mental health professional research and policy in forensic psychiatry in the Indian setting.
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253. A study done using pulmonary function test as a tool in health assessment among individuals with different lifestyle

     C Indira Devi, Mohd Rasheeduddin Imran, Sayeeda Anjum, Mohd Abrar Hassan

     • » Abstract Background: Pulmonary function tests are of significance in assessing the functional status of lungs in different individuals exposed to varied conditions and to predict the clinical outcome. Aims: The study has been conducted to evaluate and explain the effects of different lifestyle conditions including the sedentary life style, smoking and yoga exercises on the functioning of the lungs and to signify the importance of regular exercise and to quit smoking to improve the health. Settings and Design: This study was conducted in clinical lab of physiology department on 30 healthy male sedentary non-smoker subjects, 30 healthy male sedentary smoker subjects and30 healthy male ex-smoker Yogis in the age range of 21 to 30 years. Materials and Methods: Five spirometricparameters were used to evaluate the pulmonary function and differences between groups. Lung Function Test was performed using– computerized spirometer“Medspiror”. All the values were recorded and comparison tables were derived after statistical analysis using SPSS statistical software version 20.0 and the results were analyzed. Results and Conclusion: The Pulmonary Function values derived were compared between the study groups. In the present study the ex-smoker Yogis group was having higher mean value of FVC, FEV1, FEV1/FVC, PEFR, and MVV as compared to sedentary smoker and sedentary non-smoker group. Smoker group has significantly less mean values for the lung function variables compared to other two groups. The ex-smoker yogis has higher mean values than sedentary groups suggesting that regular Yoga exercises has improved lung function after cessation of smoking.
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254. Pattern of disabilities of hands and feet among leprosy patients reported at tertiary care centre

     Shivani Ranjan, Devraj Dogra, Naina Dogra

     • » Abstract Introduction: In leprosy patients, disabilities involving hands, feet, eyes, face are seen. Deformities of hands include ulcers, cracks, scars, blisters, claw hand, wrist drop, dactylitis, contractures of fingers, resorption of fingers, stiff joints. Defomities of feet include ulcers, cracks, scars, blisters, foot drop, claw toes, resorption of toes, contracture of tendo achilles, equinovarus deformity. Aims and Objectives: To study the pattern of disabilities of hands and feet among leprosy patients reported at tertiary care centre. Material and Method: The present study was conducted in the Post Graduate Department of Dermatology, Venereology and Leprology, Government Medical College, Jammu from November 2012 to October 2013. All patients clinically diagnosed as cases of leprosy both old and new registered in the hospital were included in the study. A detailed history was taken regarding the age, sex, occupation, education, duration of disease, reactional states, treatment status, past history and family history. Complete clinical examination of each patient was performed with respect to skin lesions, nerve involvement and distribution, site, symmetry, type and grading of disability of hands and feet. Results: It was observed that out of total 150 patients, 93 (62%) were diagnosed to be with disability. Disability among lepromatous leprosy and borderline lepromatous leprosy was seen in 89.29% and 75.61% respectively. Both hands and feet were involved in 70.97% of disabled patients. Bilateral involvement of hands and feet was seen in 83.87% of disabled patients. Grade II disability was seen in 62.37% of disabled patients whereas grade I disability was diagnosed in 37.63% of disabled patients. In hands, 62.07% of patients had wasting in form of flattening of thenar or hypothenar eminence or guttering as the commonest deformity followed by clawing in 51.72% and ulceration in 18.97%. In feet, 24.14% of patients had ulceration as the commonest deformity followed by wasting. Disability increased with increasing number of nerves involved. This finding is statistically significant (χ²=61.28; p=0.0005). Conclusion: Thus we conclude that wasting and clawing was most common disability in hand whereas ulceration and wasting was common disability in feet. The most common pattern of disability was bilateral involvement of both hands and feet with grade II class of disability. Increasing age, male sex, lepromatous and borderline lepromatous leprosy was the common factors associated with disability.
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255. Preliminary study on the influence of moringa seed extracts supplementation on the yield and quality of cottage cheese

     T. Mahami, F.C.K. Ocloo, S.T. Odonkor, C. Owulah, S. A. Coffie

     • » Abstract Abstract: Variability of quality of product makes cottage cheese production unattractive to urban populations. Meanwhile demand for value-added dairy products is on the increase in the urban areas. This study investigated the effect of moringa seed extract (0.5%, 1%, 1.5% and 2%) supplementation on the yield and quality of cottage cheese prepared from fresh cow milk coagulated with latex from Callotropis procera. Yield, milk coagulation time, pH, moisture content, percentage protein, percentage fat, phosphorous and ash content of cottage cheese were determined. The pH of cottage cheese increased with increase in moringa seed extract. The control sample gave a pH of 6.52, whiles 0.5%, 1%, 1.5% and 2% concentrations of moringa seed extract gave pH values of 6.54, 6.55, 6.56 and 6.62 respectively and their difference were significant (p<0.05). Yield of cottage cheese also increased significantly (p<0.05) with increase in concentration of moringa seed extract. The 500mls of milk yielded 18.19% cheese in the case of the control whereas 0.5% moringa seed extract yielded 19.75%. Also, 1%, 1.5% and 2% concentrations of moringa seed extract gave outputs of 22.55%, 23.66% and 24.42% cheese respectively. Protein content of cheese increased from 14.50± 0.00% to 14.96 ± 0.00% when 0.5% moringa seed extract was added, to 16.01 ± 0.00% after the addition of 1% moringa seed extract, to 18.31 ± 0.00% when 1.5% moringa seed extract was added and to 18.50± 0.00 following an addition of 2.0% moringa seed extract. The differences were statistically significant (p<0.05). This study also revealed that phosphorous content, ash content and fat of cheese all increased significantly (p<0.05) with increase in moringa seed extract concentration. Effect of moringa seed extract on moisture content was however not clear. Moringa seed extract enrichment resulted in significant increases in the yield, protein content and mineral content of cottage cheese and therefore has the potential to be used in improving the yield and quality of cottage cheese
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256. A role of ultrasonography in right iliac fossa pain and avoidance of unnecessary removal of normal appendix

     Sanjeeva Kumar Choudhary, Ved Rajan Arya, Bhaskar Kumar

     • » Abstract Numerous diseases mimic appendicitis, and it is often difficult to rule it out on the basis of clinical presentation. Based on the clinical, laboratory and radiological findings can help in the diagnosis of acute appendicitis. A prospective, single centre based observational study carried out at our Rural Medical College. 100 patients were admitted with preliminary complains of pain Right iliac fossa. Clinical examination along with the laboratory and radiological findings was able to differentiate patients who came with pain Right iliac fossa but were having normal appendix from the patients who were actual cases of acute appendicitis. In patients with histologically confirmed acute appendicitis taking as the standard. The WBC count ,Ultrasonography and CT Scan when combined with reliable clinical signs and symptoms is an excellent diagnostic marker of the disease is so that proper handling of the patient can be done and we can prevent unnecessary appendectomies in pain Right iliac fossa.
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257. Correlation of birth weight with placental weight in pregnancy induced hypertension and normal pregnancy

     Kailash Balkund, Uddhav Mane, Vijay Nayak, Utkarsh Srivastava

     • » Abstract Pregnancy induced hypertension is one of the threatening problem among pregnancy related health problems. Complications arising from it are also common which leads to several maternal and foetal deaths. During pregnancy, examination of mother and foetus done properly but what is overlooked is placenta, as it cannot be measured directly until after birth. Foetal distress, intrauterine foetal death and placental abnormalities are common in pregnancy induced hypertension. Rate of preterm birth ranges from 5 to10 percent of deliveries in developing countries (Hsleh TʼSang- TʼSang 2005). About two third of preterm deliveries are due to spontaneous onset of preterm labour or preterm premature rupture of membranes. Approximately one third follow induction of labours or caesarean section performed for maternal or foetal indication such as preeclampsia, haemorrhage, non-reassuring foetal heart rate or intrauterine growth retardation. Thus, pathologists are frequently called on to evaluate preterm placenta, to determine the cause of the spontaneous preterm birth and/or correlate placental finding with the clinical history (O. M. Faye-Petersen 2008). The risk is increased if placental function has been impaired by pre-eclampsia, post maturity and threatened abortion. The margin may be narrow and hazard may be greater if the placenta is unusually small. Weight of placenta is “functionally significant” because it is related to villous surface area and to total foetal metabolism (Udainia A, Bhagwat S). Pregnancy complicated by hypertension is commonly associated with placental insufficiency, there by resulting in foetal growth retardation. Again reduced utero-placental blood flow has been recognized in cases of severe preeclampsia with hypertension. As stated above, foetal growth is retarded in preeclampsia and that a small infant has usually a small sized placenta. In previous studies it has been revealed that there is clear relationship between pregnancy induced hypertension and morphometric changes in placenta and which ultimately reflects foeto-maternal status. Placental weight is one of placental measure by which placental growth can be characterised. So the present study is carried out on placentae from mothers with pregnancy induced hypertension and placentae from mothers without any materno-foetal complication (normal placentae). Two hundred and one placentae, 101 from normal pregnancies and 100 from pregnancy induced hypertension pregnancies, were examined. Weight of placenta was taken in gram by using standard weighing machine after removing membranes and cutting cord leaving 2.5 cm attachment. Weight of new born baby was taken on standard weighing machine immediately after cord tying and cutting. In present study the mean placental weight in normal group is 469.50gm. And in pregnancy induced hypertension group is 420.98gm., from this finding it is concluded that the placental weight in pregnancy induced hypertension cases is significantly less than the placental weight in normal group. The mean birth weight in normal group is 2556.9gm. and in pregnancy induced hypertension it is 2192.50gm. So the birth weight in pregnancy induced hypertension is significantly low as compared to normal group. The ratio between birth weight and placental weight in pregnancy induced hypertension group is significantly lower than normal. It is concluded that correlation between birth weight and placental weight in normal group is moderately correlated (r=0.484), where as in pregnancy induced hypertension is strongly correlated(r=0.836).
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258. Immunization status of 1-5 year children and factors affecting it: A hospital based study

     Vinod Chaudhary, Anil Khamkar, Manish Tiwari, Manoj Ghoghare

     • » Abstract Objective: We attempted to determine the immunisation status of children as per national immunisation schedule admitted in paediatric ward. Design: Hospital based Descriptive, Cross-sectional study conducted from January 2014 to June 2014. Setting: Tertiary referral teaching hospital. Patients: All patients admitted in paediatric ward satisfying inclusion criteria were included in the study. Information regarding immunisation status was taken from the primary care giver preferably mother and available medical records of immunisation status were verified. Children were classified as completely immunised as per age and national immunisation schedule or partially immunised or unimmunised. Results: Out of total 840 children 520 (61. 91%) were completely immunised, 312 (37.14%) were partially immunised and 8 (0.95%) were unimmunised. Fully immunised percentage of male was 61.40% and that of female was 62.69%. The ratio of fully immunized children was 38.2%, 52.63%, 70.72% and 100% in illiterate, primary educated, HSC educated and graduate mother respectively. Conclusion: The observed percentage of fully immunized children 1-5 years of age was 61.91%. Dropping out trend in immunization increases as the age advances. Among the routine vaccines under 1 year of age, OPV/DPT 3rd dose and Measles vaccine were the least to be received. Mother's education significantly influences the immunization coverage among the under-fives. Sex of a child had not significant association with immunization coverage in 1-5 year.
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259. A comparative study of different predictive severity scoring system for acute pancreatitis in relation to outcome

     Sanjeeva Kumar Choudhary, Ved Rajan Arya, Bhaskar Kumar, Md Sarfaraz Nawaz

     • » Abstract Acute pancreatitis has wide spectrum of clinical illness that ranges from mild self-limited symptoms to early severe acute pancreatitis (ESAP), rapid deterioration and death. Prior assessment of severity allows the managing physician to identify those patients who are most likely to have a severe episode early administration of therapies to reduce severity. The present study was intended to compare the predictive accuracy of 04 different severity scoring systems for acute pancreatitis- Ranson’s score, Acute Physiology and Chronic Health Evaluation [APACHE] II, Balthazar CT Severity Index (CTSI) and Goris Multi Organ Failure(MOF) scale for prediction of severe pancreatitis. This prospective study has been conducted by selecting 30 consecutive CECT confirmed patients of acute pancreatitis admitted during the period October 2012 to June 2014 in MGM Medical College, Kishanganj, Bihar. Patients have been evaluated, examined and investigated as per the study proforma. Severity assessment was done for every patient on admission and at 48 hrs using clinical, hematological, biochemical and radiological parameters by calculating severity scoring points in respect to Ranson’s, APACHE II on admission, APACHEII after 48 hrs, Balthazar CT severity index score, Goris MOF score (at cut off>0), (at cut off ≥2) on admission and after 48 hrs .All cases were followed up for a period of next 06 months. In this study, out of 30 patients 24 (80%) cases were in the age group of 20-59 yrs. However only 6 (20%) cases were in the age group >60 yrs. Sex ratio was Male: female = 27:3. Alcohol and Gall stone disease was aetiology of pancreatitis in 17 (56.67%) patients and 7 (23.33%) patients. There was one case of hyperlipidemia and the remaining 5 cases were of idiopathic pancreatitis. 80% of the cases presented with upper abdominal pain and repeated vomiting. Classical presentation of radiation of pain to back and relief on leaning forward was present only in 09 (30%) and 6 (20 %) cases respectively. 20 (50%) patients presented with history of obstipation and about 44% patients presented with abdominal distension misleading the diagnosis initially towards intestinal obstruction on admission. In 8 patients amylase was not elevated and basis for a diagnosis of pancreatitis was characteristic pain, strong clinical suspicion and evident pancreatitis in CECT abdomen. In this study out of total 30 patient 11(37%) developed severe pancreatitis whereas 19(63%) developed mild pancreatitis. Out of 11 severe pancreatitis cases one patient died due to sepsis and multi organ failure during 5th week of hospital admission .Incidence of organ failure and MODS in this study was 83.33% and 10%. Hepatic dysfunction was present in all patients who developed organ failure. The sensitivity, specificity, Positive predictive value, Positive Likelihood Ratio and negative likelihood ratio of Ranson’s score was found to be 73%, 63%, 53%, 1.97 and 0.43 respectively. There is no significant difference in median APACHE II score on admission and after 48 hrs in our study. CTSI score had almost equal AUC under ROC curve (0.653), NPV (79%) and equal specificity (73%) as of Ranson’s score. However about 50% cases who had necrosis in CECT did not develop clinical severe pancreatitis This demonstrate a very low PPV (50%) for CTSI score. Goris MOF score (at cut off >0) on admission and after 48 hrs had the highest sensitivity (82%) of all scores. In this study, all patients who were predicted to develop severe pancreatitis due to persistence or progression of organ failure during first week actually developed severe pancreatitis later on. Also, all the patients who did not develop severe pancreatitis were correctly predicted as mild pancreatitis by the absence of persistent/progressive organ failure during first week. Thus a specificity and PPV of 100% were obtained by persistent organ failure criterion. Persistence or progression of organ failure during the first week of admission was also found to have the greatest area under the curve (AUC=0.727) under the receiver operating characteristic (ROC) curve and specificity (100%) denoting its highest predictive accuracy in comparison to other scores. However, the drawback of this score was that it takes one week observation of the patient prior to prediction of severity. Whereas APACHEII or Goris MOF score can be obtained as early as on admission making them more useful.
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260. Accessory spleen - a case report

     Ruta Bapat, R A Joshi, V G Sawant

     • » Abstract During routine dissection, in one of the female cadaver, the accessory spleen was found in the lieno-renal ligament. This variation is important for the radiologists and surgeons.
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261. Cytohistopathological correlation of head neck and face lesions

     Nishant Bawankule, Shubhangi Jibhkate

     • » Abstract Atropa belladonna is a topical agent used in the treatment of skin wounds in Slovak folk medicine. The aim of this study was to assess the effect of A. belladonna extract on wound tensile strength and collagen maturation in wistar rats. Wistar rats of either sex were divided into 2 groups. Group I: Animals served as wounded control, treated with normal saline. Group II: Animals were daily administered Atropa belladonna extract (0.3ml /100gm /rat) orally once daily from day 0 to 9 via intragastric tube. Dead space wound model was used for this study and granulation tissue was used to analyze the biochemical parameters of wound healing such as hydroxyproline, hexosamine and hexuronic acid. Significant increase in hydroxyproline and glycosaminoglycans content in granulation tissue were observed in rats treated with the extracts of Atropa Belladonna. The mean tensile strength of both A. belladonna extract treated groups was significantly higher than the untreated group. Present result shows that Atropa extract has significant wound healing promoting activity indicating collagen maturation as indicated by increase in hydroxyproline, hexosamine and hexuronic acid levels in the granulation tissue. The wound breaking strength also increased significantly.
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262. Effect of Atropa belladonna on wound healing in rats

     Alaya Laxminarayana Udupa, Harish Naik, U P Rathnakar, Sudarshan Reddy C

     • » Abstract Atropa belladonna is a topical agent used in the treatment of skin wounds in Slovak folk medicine. The aim of this study was to assess the effect of A. belladonna extract on wound tensile strength and collagen maturation in wistar rats. Wistar rats of either sex were divided into 2 groups. Group I: Animals served as wounded control, treated with normal saline. Group II: Animals were daily administered Atropa belladonna extract (0.3ml /100gm /rat) orally once daily from day 0 to 9 via intragastric tube. Dead space wound model was used for this study and granulation tissue was used to analyze the biochemical parameters of wound healing such as hydroxyproline, hexosamine and hexuronic acid. Significant increase in hydroxyproline and glycosaminoglycans content in granulation tissue were observed in rats treated with the extracts of Atropa Belladonna. The mean tensile strength of both A. belladonna extract treated groups was significantly higher than the untreated group. Present result shows that Atropa extract has significant wound healing promoting activity indicating collagen maturation as indicated by increase in hydroxyproline, hexosamine and hexuronic acid levels in the granulation tissue. The wound breaking strength also increased significantly.
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263. A study of non invasive cardiac output and other cardiorespiratory parameters in various neurosurgical positions

     Nishant Bawankule, Shubhangi Jibhkate

     • » Abstract Neurosurgical patients are operated in supine, prone, lateral and sitting positions, which cause physiological changes in cardiorespiratory parameters. Various monitors, both non invasive and invasive are used to monitor these changes. NICO monitor developed by Novametrix Medical System Inc is a non-invasive cardiac output monitor, which also measures and displays various other parameters like stroke volume, cardiac index, pulmonary capillary blood flow, alveolar and dead space ventilation, peak flow rates, airway pressures and respiratory volumes. We felt that a study using the NICO monitor in anaesthetised patients being operated in different positions would provide a complete characterization of cardiopulmonary function, help in defining risk factors and improve intraoperative management. Hence, forty consecutive patients undergoing neurosurgical procedures- twenty in prone, sixteen in lateral and four in sitting position were studied. The haemodynamic and cardiorespiratory parameters were noted in supine position about 15 minutes after induction of general anaesthesia using standard protocol and 15 minutes after giving surgical position using NICO monitor. We concluded that under anaesthesia, while the respiratory parameters are not significantly affected, the prone and sitting position negatively affect derived cardiac parameters like cardiac output, cardiac index and stroke volume and lateral position tends to improve these parameters.
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264. Profile of medico-legal cases at tertiary care centre

     Raju K, Hemanth Raj M N

     • » Abstract The casualty department is backbone of every Hospital because almost all cases of Medical emergencies reported first to Casualty Department of Hospital, and apart from these Medical emergencies, Casualty Department also deals with the Medico legal cases more frequently than any other department of Hospital The study was conducted in a retrospective manner and all the Medico-legal cases which came to the emergency department of the hospital between Jan 2014 to Dec 2014 were studied. The males were the dominant group (67.6%). The most of the victims were of the age group 21-30 years (45.1%). The Road traffic accident cases had the highest incidence in relation to the cause of admission (36.9%), followed by poisoning. Most of the patients (53.2%) reported in the hospital within one hour of sustaining the injury/other causes. In simple language it is a medical case with legal implications for the attending doctor where the attending doctor, after eliciting history and examining the patient, thinks that some investigation by law enforcement agencies is essential.
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265. Oxidative stress in patients with beta thalassemia major

     Vinita Belsare, Hrishikesh Belsare, Sarika Munghate, Sandip Lambe

     • » Abstract Thalassemia major is cause of severe anemia. Anemia is treated with repeated blood transfusion. All this leads to ineffective erythropoiesis and hemochromatosis. The present study was conducted to assess the severity of anemia and iron overload due to repeated blood transfusion leading to oxidative stress.
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266. In vitro propagation of ayurvedic important plant Tinospora cordifolia (willd.) Miers

     Megha Tupe, Narayan Pandhure

     • » Abstract Tinospora cordifolia (Willd.) Miersis an important medicinal plant belongs to family Amaranthaceae found in India. The plant has medicinal properties like treat convalescence from severe illness, arthritis (or joint diseases), liver disease, eye diseases, urinary problems, anemia, cancer, diarrhea, and diabetes. It also helps to remove toxins from the body. The successful protocol for in vitro propagation has been achieved for the medicinal important plant T. cordifolia by using nodal and apical shoot tip segments as explants. In vitro plantlets raised on Murashige and Skoog (MS) medium containing 0.5–3.00 mg/l BAP in combination with 0.2-1.00 mg/l IAA, 3% sucrose, and 0.3% clerigar. After 21 days maximum percentage of shoot organogenesis was obtained on medium containing 2.0 mg/l BAP and 0.2 mg/l IAA. The regeneration protocol developed in this study provides an important method of micropropagation of this plant. Furthermore, this protocol may be used for a large scale production of its medicinally active compounds and genetic transformations for further improvement.
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267. Comparative study of serum magnesium and copper levels in type 2 diabetes mellitus patients and non diabetic healthy subjects

     Deepali Tonde, Bhushan Mahajan, Manohar Muddeshwar, Sandip Lambe

     • » Abstract Diabetes mellitus is a common complication of chronic pancreatitis, can disturb the metabolism of zinc, copper, magnesium and selenium1. The serum magnesium and copper levels were estimated in sixty patients admitted in medicine department in GMC, Nagpur and in non diabetic healthy subjects. The result of study showed that serum copper were increased and magnesium level were decreased significantly in diabetic group compared to non-diabetic group. Thus it is concluded that these changes play an important role in the pathogenesis of type 2 DM by the involvement of these elements in the oxidative stress and may have a contributory role in the progression of DM and later development of complications.
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268. Study of auditroy reaction time in autism

     Prafullata S Bhakare, Sangita R Phatale, Aruna Vinchurkar

     • » Abstract Background and objective: Autism spectrum disorders are behaviourally defined disorder affecting 1 in 88 individuals. It is a complex neurodevelopmental disorder. The reaction time is an indirect index of processing capability of central nervous system and also a simple means for sensory and motor performance. Material and methods: The present study was conducted in Dept. of Physiology, MGM’S Medical College and Aurangabad. The study included 20 autistic children from “Arambh” autistic school and 20 normal children in the age group 10 to 15 years were taken for the control match. Auditory reaction time was determined by using an instrument reaction time apparatus designed by Anand agency, Pune. The data was statistically analyzed by using students paired “t” test. Result: Auditory reaction time was significantly increased in ASD children as compared with control. Conclusion: There is significant increase in auditory reaction time. Also delay in MSI in autism.
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269. Mesentric fibromatosis presenting as a giant intra abdominal tumor - a case report

     S S Quadri, Mohd Ghouse Mohiuddin, Fakeha Firdous, Zohra Fatima

     • » Abstract Mesentric fibromatosis a predominantly histological diagnosis has been linked to the mesentry because of its anatomic location. Giant abdominal masses from the mesentry are uncommon. A case of mesenteric fibromatosis presenting as giant intra abdominal tumor is being reported here.
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270. Unwanted pregnancy and care seeking behaviour in social perspective: An experience from eastern India

     Subhrajyoti Naskar

     • » Abstract Background: Adverse health outcomes like maternal mortality and morbidity due to abortion could be drastically brought down if the women have access to safe abortion services. Abortion is one of the most fundamental health care needs of women. Aims: To assess care seeking behavior of currently married women in case of unwanted pregnancy and its social correlates. Settings: 12 Villages and 4 wards of Paschim Midnapur District of West Bengal. Participants: 2000 currently married women of reproductive age groups (15-49 yrs). Methods and Materials: Community based cross-sectional study was carried out among 2000 currently married women (15-49 yrs) in Paschim Midnapur district of West Bengal during May to October 2009 by stratified multistage random sampling and interviewed eligible women through pre-designed and pre-tested proforma by house to house survey. Statistical analysis: Proportions, Chi-square test. Results: Out of total study population, majority were in the age group of 24-29 yrs (31.5%). Most of the respondents belonged to illiterate and just literate group (46.9%), 87% were Hindu by religion. Regarding providers choice , majority (43.3%) were in favour of government hospital followed by nursing home (32.7%). 11.3%, 10.5% and 2.2% were in favour of Quacks, others group of providers and unaware respectively. 14.7 % of the educated women (secondary andabove) still preferred quacks. Preference of others group of providers was more (15.7%) among Low socio-economic group (BPL) than APL group (3.8%). So 24% of the study subjects having proper lack of knowledge either wrong perception (21.8%) or unawareness (2.2%) for safe abortion procedure. Preference of quacks was more among Muslims than Hindus as well as the women belonged to nuclear families and rural community. Conclusion: Awareness generation about safe abortion practice to be enhanced through mass media advocacy and interpersonal communication. Utilization of safe abortion services through more effective behavior change strategy.
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271. Exploring ototoxicity of aminoglycosides

     B G Patil, Alka B Patil

     • » Abstract Any drug with potential to cause toxic reactions to structures of the inner ear, including the cochlea, vestibuler, semicircular canals, is considered ototoxic. The evidence for the ototoxicity of aminoglycoside antibiotics is overwhelming. Drug induced damage to the structures of the auditory and balance system can result in hearing loss, tinnitus and disequibrium. Fetal ototoxicity have been described after maternal exposure to aminoglycoside toxicity, are evaluated. There is susceptibility and genetic predisposition for Aminoglycoside ototoxicity. Relative oxygen species (ROS) participate in the cellular events leading to aminoglycoside induced hearing loss. Monitoring and challenges to hearing loss discussed. Prevention and future prospects explored.
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272. A study of COX-2 expression in prostatic adenocarcinoma and its clinical relevance

     Rukzana Fathima S

     • » Abstract Objective: The purpose of the present study was to determine the expression of cyclooxygenase-2 (COX-2) in patients with carcinoma of prostate and its clinical significance in relation to clinical pathological parameters. Materials and Methods: A total of 100 cases of prostatic tissue specimens consisting of 88 adenocarcinoma prostate and 12 Benign Prostatic Hyperplasia (BPH) were included in the study. Formalin-fixed paraffin-embedded tissue samples were initially stained using Hematoxylin and Eosin stains and graded according to Gleason scoring system. Immunohistochemistry for COX-2 were performed on these blocks. The expression pattern was determined and correlated with clinicopathological parameters. Results: A majority of well differentiated prostate carcinoma and BPH cases showed strong COX-2 expression. In contrast poorly differentiated and most of the moderately differentiated cases showed weak positivity. COX-2 expression pattern for different grades were found to be statistically significant (p=0.03). Clinically proven metastatic samples showed negative COX-2 expression. Correlation between serum PSA level with COX-2 expression did not show any significant relationship. Conclusion: COX-2 expression was found to be strong in well differentiated carcinoma of prostate irrespective of the PSA levels. Inhibitors of COX-2 may prove useful as a alternative therapeutic adjunct for the treatment of low grade prostatic carcinoma.
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273. Bilateral undescended testes: its embryological and clinical importance

     Bashir Khan, Navid Shah

     • » Abstract During routine cadaveric dissection of lower abdomen and groin region for first M.B.B.S students in department of anatomy, Shri Bhausaheb Hire Government Medical College, Dhule, a case of bilateral undesended testes was found in formalin fixed male cadaver. Cryptorchidism is a condition in which testes fail to move down to scrotum. In some children testes reach to scrotum but later on rise above, these are known as acquired undescended testes. Although exact cause of undescended testis is not known but failure of formation of androgens is important cause. If both testes are undescended, they may remain immature and results in infertility. Uncorrected cases may develop germ cell tumor.
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274. The role of thrombocytopenia in the clinical course of leptospiral infection

     Linda Rose Jose, M N Sumana

     • » Abstract Aim: This study is aimed to find out the incidence of thrombocytopenia in leptospirosis patients and to correlate thrombocytopenia with other parameters like hepatorenal failure, lung involvement and bleeding manifestations. Material and Methods: This study was conducted at Department of Microbiology, JSS Medical College and Hospital, Mysore, India from September 2014 to February 2015. Ethical approval was obtained from the Institutional Ethics Committee. The medical records of all serologically confirmed leptospirosis patients were retrospectively reviewed. Thrombocytopenia was then categorized as mild, moderate and severe and then correlated with renal dysfunction, hepatic dysfunction and haemorrhagic manifestations along with the course of infection. Results: A total of 60 patients were serologically positive for leptospirosis during this study period. Thrombocytopenia was observed in 52/60 cases, bleeding manifestations were seen in11, 43 had hepatic failure, 22 had renal failure. Conclusion: Thrombocytopenia in patients with Pyrexia of Unknown Origin (PUO) should alert physicians to the differential diagnosis of leptospiral infection and prompt the institution of appropriate therapy. It is important to recognize thrombocytopenia early in the course of leptospirosis so that appropriate steps can be taken to prevent further complications associated with thrombocytopenia in such patients.
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275. To find out treatment outcome between HIV positive and HIV negative tuberculosis patient in a rural hospital of Wardha district Maharashtra

     Rajesh C Sambutwad, V S Rathod, Vasant Wagh, A Mudey, Sanjay Chaudhary

     • » Abstract Background: It is caused by Mycobacterium Tuberculosis (MTB), the causative organism of TB is spread almost exclusively by the respiratory route. Tuberculosis is the leading cause of death among HIV infected people; Rates of HIV-related tuberculosis have risen in countries in Europe, United States and South America, and the rates have increased so rapidly in India. Aim: find out treatment outcome in both HIV positive and HIV negative tuberculosis patients Objective: 1) find out treatment outcome in HIV positive TB patients 2) Find out treatment outcome in HIV negative TB patients. 3) Compare both result and give the summary. Method: A community based longitudinal study was conducted. All the participant who visit to hospitals Tb & chest department and register for the tuberculosis treatment. We are conducting three visits to collect the result of TB treatment. Result: Out of 206 Tb patient 42 patients was HIV patient & 164 HIV negative patient. In HIV positive patients we are found 50% cure rate, 11.9% of failure & 0% defaulter. About HIV negative cure rate was 82.9%Failure rate 7.9% and defaulter 2.4%. Conclusion: Cure rate was not up to RNTCP data because we contain both HIV positive patient and HIV negative patient. We are work for decrease the deflators in HIV negative group.
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276. The study of seroprevalence of HIV in pregnant women from rural area

     Lamture Alka

     • » Abstract The present study is six years retrospective analysis (2008-2013) to find out the seroprevalence of HIV in pregnant women in a tertiary care hospital in rural area of Latur, Maharashtra. A total of 9763 pregnant women were screened for HIV as per the NACO (National AIDS Control Organization) guidelines out of which 22 (0.22%) were found positive for HIV. Highest number of HIV positive cases (nine) was found in the year 2008 and only one case was found positive in the year 2013. A significant decline from 0.38% in 2008 to 0.09% in 2013 was observed in last 6 years. These results indicate that there is an overall decline in HIV prevalence rate in ANC attendees.
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277. Role of various parameters of sacrum in determination of sex

     Uttama U Joshi, Medha Puranik, Manisha R Dhobale, Nitin Mudiraj

     • » Abstract Introduction: The identification of sex in human skeleton is important for many anthropologists, anatomists and forensic experts. Pelvis remains the most reliable region for assessing sex. Sacrum, as a part of pelvis also demonstrates differences. The most useful aspect of such studies is to determine appropriate standards of parameters for sexual dimorphism in different populations. Hence this study was undertaken to evaluate the role of different parameters of sacrum in sex determination. Materials and Methods: Study was carried out in Department of Anatomy, BVDU Medical College, Pune. Adult, dry sacra were collected randomly from Anatomy department of different Medical colleges of Maharashtra, with the kind permission of the concerned authorities.141 sacra were classified in to male and female bones by observing parameters like length of sacrum, width of sacrum, transverse diameter of body of S1, anteroposterior diameter of S1, length of ala of sacrum. Results: As a part of univariate analysis, demarcating point (D.P.) was obtained for each of the parameter. The % of bones identified beyond D.P. was found for each of them. The accuracy of this method varied from parameter to parameter. Ventral straight length of sacrum, mid-ventral curved length, anteroposterior and transverse diameter of body of S1 were more in male than female sacra with statistically significant difference in them. Whereas values for the parameters like sacral width (breadth) and length of ala of sacrum were more in female than male sacra with statistically significant difference. Conclusion: For different populations based on geographic areas different anthropometric criteria should be applied which could be specific to that particular population. It can be concluded that to identify the sex of sacrum with 100 % accuracy, single parameter was not sufficient instead it requires multiple parameters and indices to reach at the most accurate result.
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278. Variation in the termination of common facial vein – a case report

     Pathan Ferozkhan Jafarkhan, Surwase Ramdas Gopalrao, Smita Balsurkar, Rubeena Hashmi

     • » Abstract During routine dissection of 50 year old male cadaver in the department of anatomy for undergraduate students we found variation of common facial vein, in which it was draining into external jugular vein of same side instead of internal jugular vein. This is rare isolated anomaly of common facial vein. Many other investigators also reported similar findings in previous studies.We are reporting here, the rare occurrence of the common facial vein draining into the external jugular vein unilaterally.Variation in the venous drainage of veins of the neck is having clinical importance for surgeon for the success of procedures in the neck also to avoid the complication during the procedures. This variation is also having embryological basis that will be discussed in this paper.
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279. Mifepristone: A conservative approach for Retained products of conception and placenta accreta

     Divya Pandey, Sudha Salhan

     • » Abstract patient was a post natal day 5 case with severe anemia(Hb 5 gm%) after home delivery who presented with grade 3 dyspneoa. Examination showed subinvolution of uterus. Ultrasound revealed POC of 5*4 cm .She was chosen for conservative management after informed consent in view of her high risk status due to severe anemia. She received 2 packed cell transfusions followed by parenteral Iron therapy in view of her iron deficiency picture as per investigations report.
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280. Morphometric study of radial artery

     Nitin R Mudiraj, Manisha R Dhobale

     • » Abstract Radial artery has been used in coronary artery bypass grafting, in forearm flap surgeries and in renal dialysis by making an autogenous fistula. In present study, ninety upper limbs from 45 formalin-fixed cadavers were dissected meticulously to expose the radial artery from its origin to its termination. The morphometric parameters like distance between interepicondylar line and bifurcation of brachial artery, length of radial artery and internal diameter of radial artery at various levels were measured. In cases of usual bifurcation of brachial artery, mean distance between interepicondylar line (IEL) and bifurcation of brachial artery on right side was 3.56 cm and on left side it was 3.49 cm and the mean length of radial artery on the right side was 26.73 cm and on left side it was 26.58 cm. Average distance of high bifurcation of brachial artery above the interepicondylar line was found to be 5.1 cm on the right side and 4.9 cm on the left side. The length of radial artery from its origin to the first dorsal interosseous space in the cases of high bifurcation of brachial artery was found to be in the range of 27.0 - 46.5 cm on the right side and 28.0 – 47.0 cm on the left side. The length of radial artery from its origin to the first dorsal interosseous space in the cases of high origin of radial artery was found to be in the range of 40.0 - 45.0 cm. The mean diameter of radial artery on right side was 2.35 mm and on left side it was 2.30 mm.
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281. Traditional demonstration versus modified demonstration in the department of anatomy

     Surwase Ramdas Gopalrao, Ferozkhan J Pathan, Smita Balsurkar, Mahesh Ugale, Prity Solanke

     • » Abstract Aim and Objectives: 1) To compare learning gain between traditional demonstration and modified demonstration. 2) To implement better method throughout the year. 3) Application of knowledge of anatomy for the better patient care. Methodology: Ist MBBS (100) students 2014-15 batch pretest on bones of upper extremity was taken and evaluated. Students are divided into two groups Group-A and Group-B50 students each. For the one Group-A demonstration is done by routine demonstrations and for the Group –B teaching was started with modified method that is with bones and showing the video clips of respective bones. After the completion of demonstration of bones of upper extremity posttest was taken and evaluated. Statistical analysis was done with the help of excel program. Results: For the bones of upper extremity demonstration, mean score of the Group- B is more as compared to Group A. The calculated Z-value is three times greater than standard error value. Hence the observed difference in mean score of two groups is real in 99% students and is due to the intervention given to the students. Conclusions: The learning gain for the group-B is more than Group-A. More learning gain for this group is because of intervention that is video clip.
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282. Lung cancer misdiagnosed as sputum negative pulmonary tuberculosis can we avoid this pitfall with the investigations available today

     B Selvaraj, K Senthil Kumaran, G P Sekar

     • » Abstract Early lung cancer can masquerade as pulmonary TB especially an endemic area like India. Many early lung cancers have been treated wrongly as pulmonary TB because the clinical and the radiological features for both conditions are similar. We present 2 cases of early lung cancer who were treated wrongly as pulmonary TB. In the first patient we did ultrasound guided Trans Thoracic Needle aspiration(TTNA) and in the second patient we did CT of upper abdomen which revealed the metastasis in Rt adrenal gland. We also review the literature.
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283. Distribution of preventable otological diseases among school going children

     D M Ambekar

     • » Abstract Introduction: ENT disorders are common in the school going age. Sometimes these disorders can remain undetected and affect the academic as well as overall personality development of the child. The objective of this study was to determine the percentage of different types of hearing disorders in school going children by simple clinical and audiological assessment. Materials and Methods: In the present study school children within age group of 6-15 years were included. About 289 children of both sexes were selected randomly from the school located in Nerul, Navi Mumbai. Children were examined in detail by an otorhinolaryngologist. Results: In the present study sample (n=289) the otological disorders were observed in132 (45.67%) children. Wax was the commonest hearing disorder (93.18%) seen. Otitis media with effusion was found to be the second commonest disorder (3.03%).Less common disorders were Chronic suppurative otitis media (1.51%) followed by otomycosis(0.75%),foreign body in the ear(0.75%) and acute suppurative otitis media (0.75%). Conclusion: Regular health checkups by otorhinolaryngologists and increasing awareness in parents and teachers can help in early diagnosis of ear disorders in children. Early diagnosis will help in their effective treatment and rehabilitation. Simple ENT examination and audiological assessment when and where required can help in improving prognosis of most of the preventable hearing disorders in children.
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284. IoT based object sorting and portable skin tone meter system

     V A Chaudhari, P Girgaon, P Sutar, P D Rupanwar, T H Mujawar

     • » Abstract Background: There is an extensive convention of numerous products in our daily life and built-up of this products are completed in various big scale and petite scale industries. Arranging causes class uniformity problem. Currently the major intricacy explicitly faced subsequent to the manufacture is of categorization. Arranging of objects in an industry is a tedious contemporary procedure, which is done actually. Consistent physical necessitate of this variety of machine in the industries will assist in arrangement the machine according to their load, bulk, color, shape, etc. This paper gives succinct information regarding the categorization of objects according to their color using TCS3200 sensor, Arduino UNO and servo motors. The recognition of color is made by frequency scaling of color detection.
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285. Juvenile myelomonocytic leukemia

     88-90

     • » Abstract Juvenile myelomonocytic leukemia (JMML) is a rare pediatric malignancy, which presents in infancy or early childhood with myeloproliferative features and hepatosplenomegaly. JMML is Philadelphia chromosome negative with aggressive clinical course. We report a case of JMML in a three year old female child with recurrent fever, anemia and hepatosplenomegaly. Her blood examination showed leucocytosis, monocytosis and elevated HbF without increase in blasts. Philadelphia chromosome was negative. The disease progressed with worsening anemia, leucocytosis and thrombocytopenia and patient expired due to intracranial bleed within two months of diagnosis.
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286. Clinical case of conjunctival intraepithelial neoplasia presented as pterygium

     V H Karambelkar, D K Sindal, Smita Javadekar, Vaishali Pawar, Supriya Patil

     • » Abstract Conjunctival intraepithelial neoplasia is rare neoplasia resembling pterygium. It is important to understand Conjunctival intraepithelial neoplasia because it casues disfigurement and it can progress to invasive squamous cell carcinoma. The following case report describes its clinical presentation, histopathological findings and management of patient.
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287. A cross – sectional study on factors associated with tobacco use among adolescents in an urban slum area of South India

     Pravin N Yerpude, Keerti S Jogdand

     • » Abstract Introduction: Worldwide, the second major cause of death is use of tobacco. Throughout the world, 5 million people are killed each year due to use of tobacco products. According to WHO estimates for the year 2020, about 10 million deaths will be caused by use of tobacco and most of these deaths will occur in developing countries. Use of tobacco in various forms is increasing in urban slum area. The present study was undertaken to find out prevalence of tobacco use in adolescents of urban slum area of South India and various factors associated with its use. Materials and Methods: The present community based cross sectional study was conducted during September –December 2009 in an urban slum area of South India. All adolescents in the age group of 10-19 were included in the study. The study subjects were interviewed by predesigned and pretested questionnaire. Data in respect of age, sex, tobacco use by them, tobacco use by other family members was collected. Results: Total no of study subjects included in the study were 287.68.99 % study subjects were males. Most of the study subjects were in the age group of 10-13 yrs (39.72%).Most of the study subjects were literate (81.18). The overall prevalence of tobacco use in the slum area was found to be 31.71%. 20.88 % of adolescents initiated tobacco before adolescence (before 10 years) and 52.75 % adolescents initiate tobacco in early adolescence period (10 to 13 years).Curiosity (67.03%) and peer pressure (42.86%) were the main reasons behind starting and continuing tobacco use. Conclusion: Curiosity and peer pressure were the main reasons behind using tobacco so simple stray knowledge about harmful effects of tobacco was not enough to bring about any change in behavior. Strong motivation with informatory knowledge is likely to change such behavior. Behavior Change Communication activities among adolescents and their family members should be carried out in the slum area as well as in the schools.
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288. Complications and Outcome of Lower Extremity Amputations at Tertiary Care Hospital in Aurangabad District of Maharashtra: An Observational Study

     Junaid M Shaikh, Ansari Mohammed Abdul Muqtadir, Sarojini P Jadhav, Anagha S Varudkar

     • » Abstract Introduction: Although an ancient surgical procedure, amputation has retained its relevance in modern time to save life or remove a dead or useless limb. The physical disability associated with it has been partly overcome by sophisticated modern prosthetic technology, which unfortunately is poorly available and often non-affordable in the developing countries. Knowledge of indications and complications of amputation is helpful in instituting preventive strategies. Present study describes the complications and outcome of Lower Extremity Amputations in surgical cases at Government Medical College and Hospital (GMCH), Aurangabad which is a well known tertiary referral centre in Marathwada region of Maharashtra. Methods: This is a study of 174 patients who had visited GMCH, Aurangabad for treatment during the period of February 2004 to October 2006. The lower extremity amputation done in the patients was either elective or an emergency procedure. Complications and outcome of the cases was described. Results and Conclusions: Observations show that in our study primary closure was achieved in 53% cases whereas 47% underwent Guillotine Amputation. Total of 29 patients from our study required re-amputation. The most common complications were Infection and Phantom pain which were found in 17.2% and 16.09% cases respectively. Mortality was 11.4% in the study group. Crutches were used as the most form of rehabilitation method. Present study gives valuable information regarding the complications and outcome of patients undergoing lower limb amputations from the Marathwada region of Maharashtra.
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289. Profile of suicidal poisoning in Puducherry area

     Naveen N, Madhuvardhana T, Arun M, Balakrishna Rao A J, Kagne R N

     • » Abstract Introduction: Any substance irrespective of its quality or quantity when given with an intention to endanger, injure or kill a person, will be called poison. In India intentional, occupational and accidental poisoning is a major public health problem. Manner of poisoning is mainly suicidal and accidental, whereas even few cases of homicide are reported. In Puducherry region during 2013, the suicidal rate was 35.6 per one lakh populations and suicidal poisoning deaths were 12.3%. Knowing the pattern of poisoning cases in a region helps in suggesting proper earliest preventive measures and also in early management of cases.This study will aim at determining sociodemographic profile, pattern of poisoning and the outcome of cases reporting to Sri Manakula Vinayagar Medical College and Hospital during the study period. Aims and Objectives: To study the socio demographic profiles of the poisoned individuals and type of poisoning. Materials and Methods: This present study was conducted in the Department of Casualty and Forensic Medicine, Sri ManakulaVinayagar Medical College and Hospital, Puducherry for a period of one year from June 2013 to May 2014.All the cases who have consumed poisons reported to Casualty, during the study period were included. The victims profile like name, age, sex, marital status, education and occupational status are obtained and two identification marks are recorded. History about the poisoning regarding, time, date, type of poison were recorded in the proforma. Data collected will be entered in the computer database, analysis done. Results: A total of 322 cases reported to during the study period were recorded. Out of this the majority of the victims were female (55.60%), married (53.41%) and the most commonly affected age group was between 21-30 years. Most of the victims were unemployed (77.63%), illiterate (19.25%). Nuclear family (86%) and from low economic class (70.6%). Insecticides and Pesticides (41. 92%) were the most common type of poison. Conclusion: Information gathered from this study can be used in formulating regulations which will help society from the hazardous effects of poisoning. Therefore the findings of this study will be helpful for the government authorities and planning bodies, to plan and implement strategies towards prevention of poisoning.
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290. Impact of lifestyle changes and dietary habits oncardiovascular risk factors amongobese and non-obese children-A comparative study

     Anantha Narayana Gowda B L, Arun Daniel J, Yamuna B N

     • » Abstract Background: The prevalence of overweight and obesity in childhood and adolescence is high, lifestyle and dietary habits has major impact in developing obesity. Excessive body fat at young age is likely to persist into adulthood and is associated with physical and psychosocial morbidities, with increase in incidence of cardiovascular risk factors. Objectives: To compare the dietaryhabits and lifestyle patterns and their association with cardiovascular risk factors among the obese and non-obese children. Materials and Methods: Study was conducted in 112 children aged 5-15 years, who had presented with complaints of obesity to pediatric outpatient department in a tertiary care hospital, Tumkur, Karnataka from December 2013 to September 2014. Prevalence of childhood obesity was calculated based on BMI using NCHS guidelines. Cardio vascular risk factors like blood pressure, lipid profile and fasting blood sugar were evaluated. Dietary pattern, physical activity and behavioral patterns were record edonapre-tested proforma informed by parents. Results: Out of 112 children included in the study28 (25%) children were obese, 28 (25 %) children were overweight, 56 (50 %) children were normal. Pre- hypertension (18.9%) and Hypertension (24.5%) were found to be statistically significantintheobesegroupwhencomparedtothenon-obesegroup.Obesegroup had higher levels of total cholesterol, LDL-C and low levels of HDL-C compared to non-obese group. Obese children had higher significant risk factors like excess caloriein take and sedentary activities compared to non-obese group. Conclusion: Childhood obesity was associated with excess calorie intake and certain behavioral changes like TV watching habit. These children are at a higher risk of “childhood onset of adult diseases” especially hypertension and dyslipidemia. This demands a timely intervention to decrease the adulthood morbidity and mortality due to obesity in these children.
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291. Study of acute poisoning cases in and around chitradurga, a retrospective study at district hospital

     Raju K, Hemanth Raj M N, V Chandan

     • » Abstract Introduction: Acute poisoning is a major public health issue in many countries around the world. The nature of poison used varies in different parts of the world and may vary even in different parts of the same country depending on the socioeconomic factors and cultural diversity. In developing countries such as India the reported mortality of 10% is significantly higher than the 0.5% reported in developed countries. Materials and Method: The present study was a retrospective study conducted over a period of twenty-four months at district hospital, Chitradurga. Case records of poisoning cases from January 2011 till December 2012 were reviewed retrospectively. Results: A total of 408 patients of various poisoning cases were studied. Incidence was more common among males (74.6%) compared to females (25.4) with a ratio of 3:1. Most cases of acute poisoning presented in the age group between 20 and 29 years (31.2%) followed by 12 to 19year age group (30.2%). By occupation, 44.8% of the cases were farmers and laborers (183) followed by housewives (13.2%, 54), students (12.5%, 51), unemployed (10.2%, 42) and businessmen (8.8%, 36).A majority of the poisoning cases (36.0%) were due to organophosphorus compound (OPC) followed by snake bite (16.2%), drugs (11.0%), rat poison (7.3%) and others. Conclusions: Incidences of intentional poisoning are rising day by day due to social, emotional and professional stress. Most commonly used agents for intentional poisoning are pesticides or medicines by the people. The findings of the study conclude that intentional poisoning was more in male adults and in female adolescent group. The mortality and morbidity due to poisoning can be reduced by conducting educational programs in rural areas and providing counselling services and poison information services to the needy people.
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292. Profile of Road Traffic Accident cases in a Tertiary care Hospital, Puducherry

     Madhuvardhana T, Naveen N, Arun M, Balakrishna Rao A J, Kagne R N

     • » Abstract Introduction: Road traffic accidents are one of the major causes of death in developed as well as developing countries. India accounts for about 10% of road accident fatalities worldwide and more deaths are recorded due to traffic crashes than due to cardiovascular diseases or neoplasms. A very high number of road traffic accidents were reported in rural Puducherry and Areas around Puducherry such as Cuddalore and Villupuram. Materials and methods: The present study was a done in the casualty, Sri Manakula Vinayagar Medical College and Hospital, Puducherry. The Study included 781 Cases of Road Traffic Accident victims. The basic information’s like name, age are obtained followed by History of the accident Regarding, time, day, date, type of road, type of vehicle, road user status of the victim were collected. A meticulous clinical examination of injuries was done and the type, site, size and other features of the injuries were noted. Results: The majority of road traffic accident victims were male comprising of 85.02% and the male: female ratio is 6.67: 1.The age group commonly involved in accidents in both the sexes is 20-29 years (34%and21.4%).Accidents are more on Sundays (15.5%). Most of the accidents happen in the evening hours (44.6%). Accidents are more during the month of November (10.2%). Most of the accidents happen on semi urban tar roads (85.8). Two wheelers are the most common vehicles involving in accidents (41.3).The percentage of alcohol users involved in accidents is 16.1%. Head injury is the most common site to be injured (24%).Abrasion is the commonest type of injury (41.3%). A reasonable reduction in the number of accidents and injuries resulting from them can be achieved by making certain road safety measures. Conclusion: Awareness and health education regarding various traffic rules to the general population will help in reducing the frequency of road traffic accidents.
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293. Serum zinc, copper and selenium level in inflammatory bowel disease patients and their relation with metabolic bone disease

     Anjali

     • » Abstract Bone metabolism changes in patients with inflammatory bowel disease (IBD) awoke a growing interest in the past few years mostly because of their high prevalence, with estimations around 40-50% for osteopenia and 5-30% regarding osteoporosis. Contributing factors including inadequate nutrition, corticosteroid, and decreased physical activity. Trace elements play an important role in the growth development and maintenance of bones. The aim of our study was to assess the Bone mineral indexes and serum Zinc, Copper, Selenium levels in Inflammatory Bowel Disease patients and their correlation with bone mineral density. One hundred newly diagnosed patients of Inflammatory Bowel Disease and 50 healthy Controls of both gender ranging in age from 19-50 years were included in the study. Fasting blood samples were processed for all baseline parameters. Serum Zinc, Copper and Selenium assessed by Atomic Absorption Spectrophotometry. The subjects were evaluated for Bone Mineral Density (g/cm2) using Dual Energy X-ray Absorptiometry scan and T score was calculated to assess Osteoporosis. Student’s unpaired t-test, one way ANOVA and Pearson correlation tests were used for statistical analysis. Inflammatory Bowel Disease patients had significantly lower Bone Mineral Density than the Controls. Bone Mineral Density values were not different between the subtypes Crohn’s Disease and Ulcerative Colitis. Though Ulcerative Colitis and Crohn’s Disease patients had significantly lower Bone Mineral Density than the Controls. Significantly Low Zinc and selenium level was observed in Inflammatory Bowel disease patients however Copper was found significantly high. Zinc, Copper and Selenium level was significantly correlated with Bone Mineral Density(r=0.24,-0.25,0.22). Patients with Inflammatory Bowel Disease are more prone to develop metabolic bone disease. Along with other nutrients supplement Zinc, Copper and Selenium should be added to prevent bone loss as well as oxidative stress in Inflammatory Bowel Disease patient.
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294. Studies on the Synthesis, Growth and Physico-chemical properties of a New Single NLO crystal: Potassium L-threoninate

     S Anna Venus, S Anbarasu, Prem Anand Devarajan

     • » Abstract Potassium L-threoninate (PLT), a New Second order non linear optical crystal was grown by slow evaporation method for the first time. The unit cell parameters of as the grown crystal was estimated by single crystal X-ray diffraction technique. The as grown crystal was subjected to X-ray Powder diffraction studies to identify the crystalline nature. The UV-Vis absorption spectra was recorded to estimate the cut-off wavelength. The presence of functional groups was ascertained by FTIR analysis. The thermal stability of the crystal was determined by TG/DT analysis. The hardness of the crystal was studied by Vickers micro hardness tester. The SHG efficiency was tested by Kurtz Powder method. Dielectric measurements were carried out at various temperatures in the frequency range 20 Hz to 1 MHz. The AC conductivity measurements done on PLT reveals that PLT crystal has a sharp electrical conductivity with an increase of temperature.
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295. Purification and characterization of L-asparaginase from Salinicoccus sp. M KJ997975

     Bhat M R, T Marar

     • » Abstract L-asparaginase has been a major research subject worldwide because of its use as effective therapeutic agent against lymphocytic leukemia and lymphosacoma. Apart from its medical use it finds applications in food industry as well. The objective of the study was to purify, characterize L-asparaginase extracted from Salinicoccus sp. M KJ997975. The enzyme was purified to near homogeneity by ammonium sulphate precipitation (40-60%), followed by dialysis, gel filtration on Sephadex G-75 column and DEAE Cellulose A-50 ion exchange column. The enzyme was purified to 64 folds and showed specific activity of 105 IU/mg of protein with 3.55 % recovery. SDS-PAGE and gel filtration of the purified enzyme suggested that the protein may be a homotetramer of approximately 56 kDa with each subunit of approximately 14 kDa. The purified enzyme showed maximum activity at 37°C and pH 7 after incubation period of 30 minutes. Mg2+, Ca2+, K+ activated the enzyme whereas EDTA and Hg 2+ inactivated it.
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296. Microstrip patch antenna for x-band medical-stereotactic radio surgery applications with coaxial fed

     Supriya Jana, Sudeshna Dey

     • » Abstract The Microstrip Patch Antenna for X-Band is one of the most preferred antenna structures for low cost and compact design for wireless system and microwave application. Multiband antenna is a relative interest since they can support multiple communication system. In this paper we represent the design of a compact size, single feed, single layer and dual frequency microstrip patch antenna for X-Band Medical Stereotactic Radio Surgery applications. A novel design of small sized, low profile coaxial fed patch antenna with unequal slots with wang edges is proposed for the frequency of X- Band application with the substrate. With the introduction of slots at the edges of the microstrip patch antenna has been reduced to 53.26%. The characteristics of the designed structure are investigated by using method of moment based EM simulation software IED. The simple configuration and low profile nature of the proposed antenna parameters such as return loss, bandwidth, gain, directivity, VSWR are calculated and leads to easy fabrication and multi frequency operation makes it suitable for the applications in X-band wireless communication systems.
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297. Status of serum potassium in patients with type 2 diabetes mellitus with and without complications

     Badyal Ashima, Pandey Rajesh, S. Sodhi Kuldeep, Singh Jasbir

     • » Abstract Accumulating evidence that metabolism of several essential elements is altered in diabetes mellitus (DM) and might have specific roles in the pathogenesis and progress of this disease.1 Data underscore the adverse effects of glucose and insulin on potassium levels and the high incidence of cardiovascular and renal complications in patients with diabetes mellitus. Chronic hyperglycemia of diabetes mellitus is associated with long term damage and dysfunction of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. These findings have not been comprehensively evaluated in critical reviews.2 Aim: To estimate the serum potassium levels in type 2 diabetes mellitus with and without complications. Setting and Design: A hospital based cross sectional study in the rural setting of Haryana. Material and Methods: 250 subjects were selected, 50 were healthy controls and 200 were taking the treatment for T2DM, including patients with and without complications were recruited from Medicine OPD of MMIMSR, Mullana, Ambala (Haryana), and their potassium levels were measured and compared. Statistical Analysis: By SPSS version 12{SPSS v12 (Spss Inc; Chicago, IL)}. Results and Conclusion: Subtle changes in serum potassium levels in T2DM as they might have a bearing with disease complications.
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298. Aquifer level groundwater management through community participation in district Jalna, Maharashtra

     P L Salve

     • » Abstract Groundwater is an important natural resource, crucial to rural and agricultural development in Maharashtra. In the State about 70% of the rural population depends on groundwater for drinking and agricultural use. The incidences of crop failure and decline in agriculture production are common in the State. Development of groundwater resources is mainly for agriculture use and uncontrolled extraction of groundwater has resulted in severe scarcity of water, both for drinking and irrigation. In absence of any effective policy measures, groundwater in many parts of the State are plagued with water scarcity, in-equitable distribution of water and environmental degradation. Presently groundwater rights are attached to the land of the farmer and as such there is no control on groundwater extraction. It has been recognized that farmers need to be provided with knowledge on the availability of groundwater resources and decide how to manage it through self regulatory measures. The Aquifer Level Groundwater Management has focused on the management of groundwater by the community and has achieved the behavioral change leading to voluntary self regulations for reducing extraction and misuse of groundwater. In the present case, government agencies and non govt. organizations has shared the technical data with the community and provided input to improve their skill to collect technical data such as rainfall and groundwater level and has nurtured the community institutions for local governance of groundwater use.
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299. Evaluation of serum uric acid levels in type 2 diabetes mellitus: complex interplay with demographic and clinical parameters

     Amruta Bakshi

     • » Abstract Introduction: Type 2 Diabetes Mellitus presents potential risk factor for development of macro and microvascular complications because of certain metabolic as well as clinicodemographic variables. The association of uric acid with such parameters in diabetic environment is highly complex and inconclusive, which forms the basis of our study. Materials and Methods: OPD based cross sectional study including 100 cases of T2DM and 100 controls evaluated in a stepwise manner. Results were assessed by appropriate statistical software. Observations and Results: Significant difference was noted in mean values of age, SBP, BMI WHR, BSL and UA between cases and controls (P< 0.05); while DBP was not significant high compared to controls (P =0.12). The number of males, smokers, alcoholics, physically inactive and mixed dietarians was high in cases compared to controls. Mean duration of diabetes was 6.7+1.1 years. Hyperuricemia was observed 51 cases, with a mean level of 8.8+1.7 mg%. Cases in hyperuricemic group were comparatively aged, with high BP, BMI and WHR than those with normal/ low UA. WHR showed strongest positive correlation with UA, while BSL and duration of diabetes showed negative correlation. The impact of central obesity shown by WHR is profound than general obesity shown by BMI. Inverse relationship of uric acid with duration of diabetes and blood glucose level shows uricosuric effect of glucose on kidneys. Conclusion: Impact of demographic and clinical variables on metabolic parameters like uric acid in diabetic settings often remains underevaluated in practice. Uric acid level in a patient is rather an ultimate outcome of several factors which must be taken into consideration before any precise causality is established.
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300. A rare case of neurofibromatosis type I involving the right upper eyelid

     Smita Javadekar, D K Sindal, Sagar Petkar, V H Karambelkar, Vaishali Pawar

     • » Abstract Neurofibromatosis is a rare genetic disorder primarily affecting the tissues developed from the neural crest. It has two distinct types, Neurofibromatosis type I and Neurofibromatosis type II (NF1 and NF2). Bilateral Lisch nodules (iris hamartomas), cafe au lait spots over the extremities and a history of first degree relative with the same disease are some of the characteristics of NF1. Secondary glaucomas along with ectropion uvea is also common. NF type II is characterized by bilateral acoustic neuromas and cataracts. Here we report a case of a 25 yr old female having neurofibromatosis type I involving the right upper eyelid, the extremeties and the iris of both eyes.
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301. A Case Report of Scrub Typhus with ARDS in Pregnancy- A Therapeutic Challenge

     R B Sudagar Singh, K Vengadakrishnan, J Damodharan

     • » Abstract Scrub typhus is an endemic disease in tropical countries. Acute respiratory distress syndrome (ARDS) in scrub typhus carries a high mortality. Scrub typhus in pregnancy is an uncommon occurrence which carries a significant risk to the mother and fetus. Drug of choice for scrub typhus is Doxycycline or Chloramphenicol, however these drugs are contraindicated in pregnancy. The drug of choice in pregnancy is Azithromycin. Here we are reporting a case of 22 weeks primigravida admitted with scrub typhus (Confirmed by ELISA) and ARDS who did not adequately respond to Azithromycin. However she made complete recovery with addition of Rifampicin and continued her pregnancy.
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302. Endometriosis following episiotomy: a case report with review of literature

     N Lavanya Kumari, Valluvan Manimozhi, K Hari Prasad, P Viswanathan, RehanaTippoo

     • » Abstract A 30 years old women presented with painful nodule in the 8’o clock position of the labia majora. There was a history of episiotomy 12 months back. The nodule was subsequently developed and there is history of cyclic pain. Treated successfully with complete excision
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303. Diabetic ketoacidosis and acute myeloid leukemia predisposing mucormycosis in a middle aged lady

     R B Sudagar Singh, J Damodharan, Siva Prakash

     • » Abstract Mucormycosis is a rare but rapidly progressive opportunistic fungal infection. It is most often reported in patients with diabetes mellitus especially in the setting of ketoacidosis, but growing number of cases of mucormycosis are reported in patients with hematological malignancies such as leukemia and lymphoma. We report a case of a 43 year old diabetic lady who presented with Diabetic ketoacidosis and was found to have sino-orbital mucormycosis and acute myeloid leukemia. In spite of the unusual combination of two confounding risk factors, we managed to successfully treat both mucormycosis and acute myeloid leukemia in this patient.
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304. A rarity in itself an osseous neurilemmoma – a case study

     Nitin Patil, Ravindra Gunki, Mandar Shaha, Himanshu Kulkarni

     • » Abstract Schwannomas or neurilemomas are relatively less frequent benign tumors; however, intraosseous schwannomas are even rarer benign tumours of the bones with characteristic radiological and histological features. Though the most common site for intraosseous neurilemmoma is the mandible, we hereby present a case of 18 year old male having femoral diphyseal neurilemmoma managed with wide excision, grafting and internal fixation.
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305. Profile of RTA cases attending a tertiary health care centre in Kanchipuram district of Tamil Nadu

     Ruma Dutta

     • » Abstract Road Traffic Accidents (RTAs) have emerged as a major global public health problem of this century and are now recognised as a veritable neglected pandemic. The problem is so severe that, by 2020, it is projected that road traffic disability-adjusted life years (DALYs) lost will move from being the ninth leading cause to the third in the world and the second leading cause in developing countries. Accidents occur not only due to ignorance but also due to carelessness, thoughtlessness and over confidence. Human, vehicular and environmental factors play a role before, during and after RTAs. Road traffic injuries are partially predictable and hence preventable1. The World Health Organization’s Global Status Report on Road Safety highlighted that more people die in RTAs in India than anywhere else in the world, including the more populous China2. A better understanding of the common factors implicated in RTAs is the need of the hour owing to its dreadful nature. The present study attempts to describe the pattern of road traffic accidents and the various factors influencing it in a tertiary care hospital in Kanchipuram district of Tamilnadu.
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306. Estimation of Height (Stature) From Inferior Extremity Length and Foot Length in Children.

     Swati Ramakant Pandhare, Anjali D. Patil, A. Kasote, M. M. Meshram

     • » Abstract Abstract: Personal identification is an integral part of the investigation in cases of mass disasters where disintegrated and amputated body organs are found very frequently. Estimating stature from various parameters based on the above mentioned evidences becomes one of the most important and essential exercise for personal identification. Different anthropometric parameters have been measured of 1120 children (576 male children, 544 female children) of the age group ranging from Birth to 5 years. Among these findings, height, inferior extremity length and foot length have been evaluated for sexual dimorphism as well as subjected to statistics to study the correlation of inferior extremity length and foot length with that of height. There is scarcity of literature suggesting stature estimation in this age group hence, further the regression equations have been drawn from the data collected. It has been observed that stature can be estimated from the inferior extremity length and foot length. The Technical Error of Measurements was within the accepted limits. It is determined that there was significant differences (p<0.05) in stature, inferior extremity length and foot length between sexes. Stature, inferior extremity length and foot length are positively and significantly correlated with each other (p<0.01).
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307. Musculoskeletal morbidities among bus drivers in city of Central India

     Amod Borle, Sandeep Gunjal, Ashok Jadhao, Suresh Ughade, Arun Humne

     • » Abstract Introduction: Bus drivers must successfully balance the competing demands of safety, customer – focused service and company operating regulations. Driving frequently involve many risk factors such as prolonged sitting and motor vehicle driving, tight running schedules, reduced rest breaks, rotating shift patterns, traffic congestion, the sedentary nature of job etc. These risk factors are specially important when work demands exceed the physical capacity of the worker. Objectives: 1) To study prevalence and pattern of musculoskeletal morbidities amongst M.S.R.T.C. bus drivers. 2) To study some epidemiological factors related with these morbidities. Material and Methods: The present cross sectional study was carried out among 581 bus drivers of M.S.R.T.C. bus depots in Nagpur city. Data gathered with the help of interview technique using predesigned questionnaire. Information regarding musculoskeletal disorders was gathered with the help of Standardized Nordic Questionnaire. Interview was followed by thorough clinical examination and necessary investigations. Results & Conclusion: Commonest morbidity was backache present in 340 (58.5%) study subjects, followed by joint pain among 268 (46.1%) and commonest site being lower back in 318 (85%). Musculoskeletal discomfort was found significantly related with age, duration of service, daily average driving (km) and duration of driving (hrs/wk). It was also significantly higher in study subjects with BMI ≥ 30 kg/m2. Musculoskeletal discomfort increased significantly with increase in age, duration of service, daily average driving.
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308. A Study of Demographic Pattern among Geriatric Population in the Field Practice Area of Rural Health Training Centre, Paithan of Govt. Medical College, Aurangabad.

     Jadhav V.S, Mundada V.D, Gaikwad A.V, Doibale M.K, Kulkarni A.P

     • » Abstract Abstract: 1. Research Question: What is the demographic pattern of geriatric population in rural area? 2. Objectives : i) To study the demographic profile of elderly ii) To study the Socio-economic problems of elderly. 3. Study design: Cross - Sectional Study 4. Settings: Field practice area of R.H.T.C, Paithan of Govt. Medical College, Aurangabad. 5. Participants: Elderly above 60 years of age. 6. Sample size: 625 which was 20 % of total elderly at RHTC, Paithan. 7. Statistical analysis: Chi - Square 8. Results: Total elderly subjects were 625 of which females were 328 (52.48 %) and males were 297 (47.52 %) studied. 339 (54.24%) elderly were from the age group of 60- 69 years. 459 (73.44%) elderly belonged to Hindu religion, 111(17.76%) were Muslims and 47(7.52%) were Buddhist.108 (36.36%) elderly males and 223(67.98%) elderly females were illiterate.199 (67%) males and 143(54.72%) females were economically productive in their life. 437(69.92%) elderly belonged to Class- IV and V of socio-economic classification.161 (49.08 %) females were widowed and 13(3.96%) were separated from their partners
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309. Hydro Geochemical Processes in the Groundwater Environment of Vemula area, Kadapa District, South India

     L. Chandra Sekhar Reddy, S.M. Deshpande, K.V. Ramana Reddy, K.R. Aher

     • » Abstract Abstract: Groundwater is the most precious gift of nature to living beings, particularly to the mankind and is essential for life. In recent years, rapid development has created an increased demand for drinking water, which is increasingly being fulfilled by groundwater abstraction. Groundwater constitutes one of the principal sources of fresh water. Hence it assumes enormous importance in domestic as well as Industrial activities. In view of the groundwater being used for potable purpose, its quality remains one of the issues of concern. The present study was undertaken to assess major ion chemistry of ground water to understand geochemical evolution of groundwater and water quality for promoting sustainable development and effective management of groundwater resources. Sampling procedures and chemical analysis were carried out as per the standard methods. A total of 19 water samples were collected and the water chemistry of various parameters viz. pH, EC, Total Hardness (TH), Total Dissolved Solids (TDS), calcium (Ca++), sodium (Na+), potassium (K+), carbonate (CO3-), bicarbonate (HCO3-), chloride (Cl-), nitrate (NO3- ), and fluoride (F-) are carried out. A comparison of groundwater quality in relation to drinking water quality standards revealed that most of the samples are suitable for drinking purpose.
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310. Sexually Transmitted Diseases (STDS) Among Adolescents In Second Cycle Institutions In Accra, Ghana: Trends In Sexual Behaviors

     Stephen T. Odonkor, Justice Nonvignon, Joseph Adu, Mavis Okyere, Tahiru Mahami

     • » Abstract Abstract: Adolescents and youth form the vast majority of sexually active individuals. Many of these young people are at risk with the consequences of unexpected pregnancies and sexually transmitted infections (STI). The objective of this study was to assess the sexual behaviors of adolescents. Questionnaires were used to obtain data from 250 adolescents between the ages of 15-25 years in a second cycle institution in Accra. As much as 92.1% of the respondents’ have had sex education before. About 49.2% have had sex between the ages of 13 and 18. Also 38.1% were led into having sex because they fell in love. 42.1% of respondents had more than one sexual partner. 35.7% of those who had sex said they used condom to protect themselves, 15.9% used vaginal foaming tablet and 41.3% used condom sometimes during sex. Fifty nine respondents who have had sex education had sex between ages of thirteen and eighteen and only one had sex below 12 years. Forty five percent of respondents who have had sex education protected themselves with condoms when having sex. 78.6% of respondents were aware they can get a sexually transmitted disease from having sex unprotected sex and 77.8% knew that sexually transmitted diseases can lead to infertility. In conclusion, sex education does not really have an effect on adolescent sexual behaviours. Knowledge on of sexually transmitted diseases did not reflect on how and when adolescents get involved in sex.
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311. Effect of Combined Slow & Fast Pranayamic Breathing Exercises on Autonomic Nervous System

     S. B. Jore, T. B. Bhutada, U.S. Patil, S. V. Patil, P. B. Gaikwad

     • » Abstract Background- Pranayama is well known breathing exercise which is known to be improving cardiac autonomic status. This effect mainly depends on type & duration of Pranayama for which it is carried out. Objectives - This study was undertaken to access the effects of both fast & slow type pranayama done for short duration on autonomic parameters. Materials & Methods - The study was conducted on 60 healthy M.B.B.S. students. Pranayama practice was carried out daily for 12 weeks which included slow as well as fast breathing exercises. Autonomic nervous system parameters reading were taken before & after pranayama practice. The autonomic status was studied with non-invasive cardiovascular autonomic function tests which included Resting Heart Rate, Basal Blood Pressure, and HRV with deep breathing i.e. E: I Ratio, Cold Pressor Test. Results - There was statistically significant decrease in heart rate, systolic blood pressure, rise of blood pressure after CPT, increase in E: I Ratio after 12th week of Pranayama practice. Also there was decrease in diastolic BP, but this change was not statistically significant. Conclusion - Thus results of study showed a significantly improved vagal tone and reduced sympathetic activity after pranayama training. Thus the regular practice of pranayama has beneficial effect on body as it reduces harmful effect of sympathetic nervous system on cardiovascular system. This can be applied in day today life to reduce incidence of stress related disorders mainly hypertension, stroke, peptic ulcer.
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312. Radiation sensitivity of Listeria monocytogenes planktonic and biofilm-associated cells

     T. Mahami, A. Adu-Gyamfi, S.T.Odonkor

     • » Abstract Abstract: Biofilms of Listeria monocytogenes were formed on sterile glass slides in a coincubation apparatus, using inoculated tryptic soy broth, incubated at 37°C for 48 h. The planktonic and biofilm cultures were subjected to incremental gamma radiation doses (0, 0.5, 1.0, 1.5 , 2.0 kGy) from a Cobalt-60 source. The D10 values were calculated from the linear regression model for the logarithm of the surviving fraction and irradiation dose. The survivors and surviving fraction of planktonic and biofilmassociated cells decreased with increased irradiation doses. The D10 value of L. monocytogenes planktonic cells (0.476KGy) was higher than that of biofilm-associated cells (0.379KGy) indicating biofilm cells were more sensitive to ionizing radiation than planktonic cells. The antimicrobial efficacy of ionizing radiation is therefore preserved or enhanced in the treatment of biofilm-associated bacteria.
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313. Ethnomedicinal Plants Used To Cure Skin Diseases In Ambabarwa Wild Life Sanctuary Area Of Buldhana District (M.S.), India

     A. N. Korpenwar

     • » Abstract Abstract: Plants are used by tribals and folklore traditions in India in the treatment of skin diseases, like leprosy, scabies, rash, wound, psoriasis, swelling, eczema, dandruff. The traditional healers are on the decline because the younger members of the tribe have started moving towards the towns and cities and are not willing to practice this form of medicine. There is danger that the knowledge of these medicinal plants will also die with them. Some of useful species are under serious threat due to unsustainable activities. Hence, a proper documentation of useful plants with their present status and local traditional knowledge as well as practices is urgently needed. The paper enumerates the traditional uses of 55 plant species belonging to 52 genera representing 39 families, which are used by the tribal communities of Amba-barwa wild life sanctuary area of Buldhana district for the treatment skin diseases.
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314. Antibacterial Activity Of Azadirachta indica A. Juss. Leaves Extracts Against Skin Pathogens

     Mule Gajanan

     • » Abstract Abstract: Azadirachta indica A. Juss. is an indigenous medicinal plant used to cure skin diseases in traditional healthcare system. The present study was carried out to evaluate antibacterial activity of Azadirachta indica A. Juss leaves extracts against certain skin pathogens. Disc diffusion method was used to assess the antibacterial activity of these extracts against skin pathogens. Streptococcus pyogenes and Staphylococcus aureus shows zone of inhibition. The growth of Streptococcus pyogenes was remarkably inhibited by chloroform extract of the Azadirachta indica A. Juss leaves than the other solvents used. Key Words: Streptococcus pyogenes and Staphylococcus aureus Azadirachta indica A. Juss.
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315. Effect of Mutagenesis on Germination, Survival and Pollen sterility in M1 Generation of Soybean [Glycine max (L.) Merill]

     Rajendra A. Satpute and Rajendra V. Fultambkar

     • » Abstract Abstract: M1 generation of soybean [Glycine max (L.) Merill] was raised by treating the dormant seeds of variety of MAUS-71 and JS-335 with varied concentration of chemical mutagen (EMS) and physical mutagen (Gamma rays). A dose dependant decrease was noticed in most of the characters in M1 generation. The results indicated that the reduction in germination percent over control was noticed in all mutagenic treatments in both the cultivars, while increased pollen sterility was associated with corresponding increases in dose/ concentration of mutagens. Results indicate that higher doses were more effective.
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316. A Longitudinal Study of Attitudes and Adverse Reactions of Influenza Vaccination among Health Care Personnel

     Kriti A Patel, J.D. Naik, S.S. Rajderkar, Sanjay K Jathar

     • » Abstract Abstract: Influenza (Flu) pandemics are caused by emergence of, Re-assorted Novel Influenza A H1N1 viruses that have recently adapted to humans. It continues to be a significant cause of morbidity and mortality globally. Health Care Personnel (HCP), the backbone of health care delivery system, have been identified as an important source of influenza for patients. Vaccination is a useful but underused means of preventing the illness and deaths but the coverage is lower than expected among HCP. Influenza vaccination programs for HCP have not met wide acceptance and it is important to explore their attitudes behind vaccine uptake. Objectives: To study the attitudes/beliefs behind vaccination. To study the frequency and pattern of adverse reactions following influenza vaccination in HCP. Materials and Methods: A longitudinal study was conducted in 130 HCP, working in Govt. Medical College & Hospital (Miraj & Sangli), participating voluntarily, who had taken influenza vaccine (Nasovac or Injectable). They were followed for 1 year period (Aug‘2010 to July ‘2011) from the day of vaccination. The relevant information was recorded in predesigned proforma, after informed consent. Results: Mean age group of the participants was 33.8±10.2 years. 87(67%) of the total subjects had procured the vaccine from private source but 91(70%) preferred Govt. hospital for vaccination. 78(60%) of the total subjects gave the reason for vaccination as personal protection. 71.5% participants took nasal vaccine, of which 52(56%) subjects told the reason for its selection being the ease of administration. The overall incidence of side reactions after vaccination was 40%. No significant difference was found between adverse reactions following Nasal or Injectable vaccine. Most of the reactions were mild & seen during first 3 days of vaccination which was statistically significant. Conclusion: Govt. hospital was the preferred place for vaccination by HCP. Vaccination of both types of vaccine is associated with mild adverse reactions during first 3 days with declining frequency over 1 year. The uptake of influenza vaccine is poor among HCP.
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317. Distribution of Ambient Suspended Particulates and Volatile Organic Carbon in a Fast Developing Metropolis in the Niger Delta, Nigeria

     Emerhi, E.A., Ideriah, T.J.K., and Trinya, W.

     • » Abstract Abstract: The concentrations of various sizes of suspended particulates and volatile organic carbons along selected roadsides and control sites in the fast developing city of Port Harcourt in the Niger Delta were determined at 0m and 50m from roads during the dry and rainy seasons. The parameters were determined using portable hand held air monitors which include an Industrial Scientific Corporation ITX Multi Gas Monitor and Aerosol Mass Monitor by Met One Instrument INC. The results showed highest concentrations of PM1 (0.004mg/m3), PM2.5 (0.19 mg/m3), PM7 (0.715 mg/m3), PM10 (0.829 mg/m3), TSP (0.946 mg/m3) and VOC (4.2ppm) in the dry season and PM1 (0.004mg/m3), PM2.5 (0.28 mg/m3), PM7 (0.226 mg/m3), PM10 (0.109 mg/m3), TSP (0.129 mg/m3) and VOC (1.2ppm) in the rainy season. The differences between the dry and rainy season values were significant at P≥0.05. The concentrations of the pollutants measured at the high density areas were generally higher than the concentrations measured at low density areas; however PM1, PM2.5, PM10 and VOC showed significant differences with traffic density at P≥0.05. There was no significant difference between the mean concentrations measured at 0m and 50m. The results showed very strong relationship between PM10 and TSP in both season, PM7 and TSP in the dry season as well as PM1 with PM2.5 and PM7 in the rainy season implying similarity in sources of the particulates. The pollutants in the study area do not originate from the same sources as the correlations between PM2.5 and other fractions as well as between the suspended particulates and VOC were very low with decreasing mean r = 0.2174PM1, 0.2052 PM2.5, 0.0591 PM7, 0.0386 PM10 and 0.0209 TSP. The levels of VOC call for serious environmental concern as their concentrations at the high density stations exceeded permissible limit recommended by the Federal Environmental Protection Agency of Nigeria and United States. The levels of the pollutants were influenced by traffic density, seasonal variations and distances from major roads, therefore farming activities and consumption of exposed foodstuffs should be discouraged in the study areas. Key words: Suspended Particulate Matter, Volatile Organic Carbon, Traffic density, Distance, Seasonal variation, Port Harcourt, Niger Delta
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318. A Prevalence Study of Intestinal Parasitic Infections in a Rural Hospital

     M.S. Davane, N.M. Suryawanshi, K.D. Deshpande

     • » Abstract Abstract: Survey on prevalence of various intestinal parasitic infections is prerequisite to obtain an accurate understanding of burden of cases of intestinal parasitic infections in particular area. The aim of present study was to determine the prevalence of intestinal parasitic infections among all age group of people in Latur district, India. Material and Method: A total of 211 stool samples were collected from all age groups and examined by routine naked eye and microscopic examination. Results: 14(6.63%) stool samples showed presence of ova/cysts of protozoa or helminths. Protozoal cysts or trophozoites were found in 3(32.4%) while helminthic eggs were found in 11(78.5%) of positive samples. Conclusion: The prevalence is very low as compared to other studies. These findings suggest that there is increased awareness of personal hygiene and sanitary practices among people in this area.
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319. Morphometric Study on Anterior Papillary Muscles of Human Tricuspid Valve

     Harsha B. R., Dakshayani K .R.

     • » Abstract Background: Aim of the present study was to observe the measurements of anterior papillary muscles present in tricuspid valve of human heart. Measurements of anterior papillary muscles in tricuspid valve gains utmost importance in cardiac surgeries because they are the causes of myocardial infarction in recent times because of its variations and detection of these causes by advent in modern technologies which will help in treatment of tricuspid valve diseases. Materials and Methods: This study was carried out on 96 normal formalin fixed human heart specimens. Dissection was performed according to standard techniques. Anterior papillary muscles were observed and length, width and thickness of each muscle were measured and documented. Results: In the present study, numbers of anterior papillary muscles were present with a frequency of 1-3, with most common appearance of 1 muscle in 66 hearts (68.8%) and least common incidence of 3 muscles in 6 hearts (6.3%). Anterior papillary muscles were present in all 96 hearts. In measurements, anterior papillary muscles mean height was 1.49±0.44 cm; mean width was 0.82±0.21 cm and mean thickness was 0.64±0.15 cm respectively. Conclusion: We hope this study will serve to understand the morphometry of anterior papillary muscles better and will help in various surgical procedures and cardiac treatment done on tricuspid valve.
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320. PMNL Status in Type-II Diabetic Patients with Multi-Vitamin Multi-Mineral Supplementation

     Bhushan Mahajan, S. K. B. Patil, Manohar Muddeshwar

     • » Abstract Introduction: We have studied the effect of multi-vitamin multi-mineral supplementation on polymorphonuclear leukocyte(PMNL) membrane status in Type II Diabetes Mellitus patients. Material and Methods: The study was divided into four groups. Group A- Diabetic patients (DM0). Group B consisted of normal healthy controls (NHC), Group C of Diabetic patients given multi-vitamin multi-mineral supplementation capsules for 30 days (DM30). Group D consisted of diabetics withdrawn from multi-vitamin multi-mineral supplementation for next 30 days (DM60). Fasting blood samples were collected from the respective groups. PMNL Phospholipid phosphorous (PLp), cholesterol, triglyceride lipase, triglycerides, vitamin C, Magnesium and Zinc were estimated by standard methods. Analysis of variance was calculated by applying students “t” test. Results and discussion:- The PMNL cholesterol, triglycerides, phospholipids phosphorous were significantly high (p<0.05) whereas PMNL triglyceride lipase, vitamin C, Zinc and magnesium were significantly low (p<0.05) in DM without multi-vitamin multi-mineral supplementation as compared to NHC . The levels of Cholesterol, triglycerides, Phospholipid phosphorus significantly decreased after 30 days supplementation. Withdrawal of supplementation for next 30 days showed a slight increase in PMNL PLp. A significant increase in PMNL TG lipase activity was seen after multi-vitamin multi-mineral supplementation in diabetic patients. Supplementation of multi-vitamin multi-mineral capsules to diabetic patients showed significant elevation in PMNL Vitamin C, PMNL Mg and PMNL Zn. A significant change was observed in the levels of PMNL Vitamin C, Mg and Zn after withdrawing multi-vitamin multi-mineral supplementation for next 30 days.Conclusion:-This suggests that multi-mineral multi-vitamin supplementation in combination with conventional hypoglycemic treatment may modulate the PMNL function and provide better metabolic control in Type II Diabetes Mellitus patients.
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321. Utility of Leukocyte Esterase Dipstick test in bed side diagnosis of Spontaneous Bacterial Peritonitis in Patients of Cirrhosis of Liver with Ascites

     Anurag Lavekar, Tanuja Manohar, Aniket Saoji, Gajanan Gondhali

     • » Abstract Background: Spontaneous bacterial peritonitis (SBP) is commonest and severe complication of decompensated cirrhosis. SBP is defined as the infection of ascitic fluid (AF) in the absence of a contiguous source of infection and/or an intra-abdominal inflammatory focus. An AF polymorphonuclear (PMN) leucocyte count ≥ 250/mm3 -irrespective of the AF culture result- is universally accepted nowadays as the best surrogate marker for diagnosing SBP. Without early antibiotic treatment, this complication is associated with high mortality rate, so early diagnosis and treatment of SBP is therefore necessary for survival. Leukocyte esterase dipstick test can rapidly diagnose the SBP. Aim: Objective of our study was to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis. Methods: This cross-sectional study was conducted from January 2013 to August 2013 at a tertiary care center in central India . All the Patients with cirrhosis and ascites of either gender were included in this study. A total of 104 patients were enrolled for the study. Patients with secondary bacterial peritonitis and those who have received antibiotic therapy during past 10 days of hospital admission were excluded from the study. All the patients underwent abdominal paracentesis. Urine dipstick (Piramal10x test-India) was used as screening test and the results were compared with manual cell counting and ascitic fluid culture. A cut-off of 4+ on dipstick test was considered as positive for SBP. Results: The manual cell count using the above criterion diagnosed 28.9% patients as having SBP. The dipstick results were compared with the PMN counts. Sensitivity, Specificity, Positive predictive value, Negative predictive value and accuracy was 83.3%, 95.9%, 89.3%, 93.4% and 92.3% respectively. Conclusion: Leukocyte esterase dipstick test emerged out as an effective tool for rapid, bedside diagnosis of SBP.
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322. Rhinolith - A Rare Case

     Suresh Palukuri, Koteswar Nalluri

     • » Abstract Rhinoliths are uncommon clinical entities reported in practice presenting as unilateral foul smelling nasal discharge and nasal obstruction. These are mineralized foreign bodies in nasal cavity. A case of 43 year old female with left side foul smell nasal discharge and nasal obstruction for the past 10 years diagnosed as rhinolith after thorough clinical examination and confirmed by endoscopy and radiological examination. Endoscopic surgical removal was done. A high index of suspicion is required.
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323. Bacteriological Screening of Hands and Mobile Phones of Healthcare Workers and Its Management

     Raghavendra M. P., Shruthi K. C., Shivalingaiah B.

     • » Abstract Introduction: The hands and cell phones can harbor various potential pathogens and become an exogenous source of nosocomial infection among hospitalized members. The present study highlights the need of continuous screening of pathogens carried through hands and cell phones and also its proper management. Aims and Objectives: To determine nosocomial infections carried through hands and cell phones of healthcare workers and its management through surface sterilization. Material and Methods: Fifty samples collected from both hands and cell phones of healthcare workers, working in various departments at government hospital, Mandya were subjected to bacteriological analysis. Using sterile cotton tipped applicator moistened with nutrient broth samples were collected from both hands and front, back and the sides of the cell phones. Collected samples were cultured and the resulting isolates were identified. The above procedure was repeated after decontamination of cell phones using 90% alcohol. Results: Out of 50 nursing staff screened, hands swab showed 22% of Staphylococcus aureus, 3% of Streptococcus spp. and 3% of Enterobacter aerogenes where as on mobile phones swab showed 52% of Staphylococcus aureus, 34% of Streptococcus spp. and 4% of Bacillus spp. After decontamination with 90% alcohol only 4 mobile phones showed growth of bacteria which are nonhaemolytic, thus proving the efficacy of decontamination to be nearly 83%. The bacterial isolates were further subjected to antibiotic sensitivity test by disk diffusion as well as well diffusion methods on Muller Hinton agar medium. It is quite interesting to observe that different strains of Staphylococcus aureus recorded varied response to the same antibiotic used in the study. Conclusions: This is an important study carried out to report the varied response of different strains of Staphylococcus aureus against already available/used antibiotics and need of regular checking of hands and handset as a source of inoculum of potential pathogenic bacteria. The difference in genetic set up among the strains can be worked out by further molecular studies.
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324. Disseminated Cysticercosis: Uncommon Presentation of a Common Disease

     Sonkamble Siddharth, S. J. Pednekar, Dharmendra P., Nishita S

     • » Abstract Introduction: Cysticercosis is a common tropical disease. One of the uncommon manifestations of cysticercosis is its disseminated form. This is the report of a case of disseminated cysticercosis, with simultaneous involvement of the brain, eyes, muscles and subcutaneous tissues. Such an extensive involvement of cysticercosis is extremely rare. Case Presentation: A 24 year old male presented with a history of abdominal and back pain, one brief episode of tonic clonic seizure and headache. He had multiple asymptomatic pea-sized subcutaneous nodules over the trunk. Serological test for cysticercal antibodies was positive. In Ultrasonography multiple small cystic area seen in muscles of anterior abdominal wall s/o muscular cysticercosis. In Contrast Enhanced CT Scan extensive foci of calcification with non enhancing pea sized hypodense areas seen in abdominal muscles, Psoas, pelvic and thigh muscles s/o cysticercosis. In CT brain multiple hyperdense foci and few hypodense small sized tiny lesions were seen. The patient was treated with albendazole, steroids and phenytoin, and showed improvement during follow up. Conclusion: Wide spread dissemination is a rare complication of cysticercosis. A planned approach to therapy is required.
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325. Working and Short Term Memory Status of Male and Female Patients in Type 2 Diabetes Mellitus

     Sanjay B. Bhagoji, Mahesh Patil2, Mrutyanjay Mirje, Mallikarjun Biradar

     • » Abstract Background and objectives: Working and short term memory loss is common in diabetic patients. Though cognitive deficits affect daily activities and differences between genders are not given much importance to assess working and short term memory at bedside. Hence this study was undertaken to compare working and short term memory in type 2 diabetics with gender matched normal subjects. Methodology: Present study was conducted in Al-Ameen Medical College and Government district Hospital, Bijapur on 114 diabetics (male=72, female=42) and 119 normal subjects (male=79, females=40) aged (40-60 yrs.). Cognitive function assessment was done for short term and working memory by using 5 memory tests-AVLT, VFT, VRT, WDST and VST were used. The results were expressed in average total scores (%). χ2 test was used for statistical analysis. Results: Memory scores of all 5 tests decreased in male diabetic patients when compared to normal male subjects and this decrease was statistically significant (P<0.0001). When female diabetes patients were compared with normal female subjects out of 5 memory tests memory scores in 4 tests were decreased (except VRT) and this decrease was found to be statistically significant (P<0.05). Male diabetic patients when compared with female diabetic patients, decrease in memory scores in male diabetic patients was found to be statistically significant in all tests (except in WDST). Interpretation and conclusion: The short term and working memory status in the present study decreased significantly in the male diabetic patients, which may be due to hyperglycemia, hypoglycemia, vascular dementia and insulin resistance, type of diabetes, age of onset, duration and type of therapy. Therefore these observed effects of gender are of potential clinical importance because working and short term memory loss may interfere with day today activities.
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326. Hematological Profile in Patients of Sickle Cell Anemia and Sickle Cell Trait in Relation to Blood Gas Analysis—Revisited

     Kulkarni R. A., Gangane N., Sharma S. M

     • » Abstract Several works in different parts of the world have contributed to the etiological and hematological aspects of sickling disorders. The work in this study was planned to correlate hematological profile with blood gas analysis in cases of sickle cell anemia and sickle cell trait .Sickling disorders are associated with an abnormal hemoglobin, vascular obstruction by sickled cells and a resultant shunting of blood across the pulmonary circulation without access to ventilation. An important aspect of the pathophysiology of sickling disorders lies in the maintenance of adequate oxygen delivery in the face of anemia and vascular obstruction, confounded by compensated pulmonary function. Some of the contemporary works on pulse oximetry have thrown light on various other parameters that need to be considered.
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327. A Comparative Evaluation of the Frictional Resistance between Stainless Steel, TMA and Low Friction TMA Orthodontic Archwires – An In-Vitro Study

     P. Premanand, S. Saravana Kumar

     • » Abstract Aim: To understand the frictional forces between the orthodontic brackets and orthodontic wires and to evaluate the frictional resistance of different orthodontic wires. Materials and method: The test was divided into six groups comprising of fifteen samples each. Group I - stainless steel wires, Group II - TMA wires, Group III- low friction TMA wires, Group IV - colored low friction TMA wires aqua, Group V - colored low friction TMA wires purple, Group VI - colored low friction TMA wires honey dew. The measurements of friction between bracket and arch wire were done with the Instron Universal testing machine (model no.4701). The results were subjected to statistical analysis. Results: On analyzing the mean values of Groups I to VI it was clearly evident that the Group II (TMA) has the maximum frictional resistance and Group VI (colored low friction TMA - honey dew) has the lowest frictional resistance. Conclusion: The frictional resistance is highest in TMA, The frictional resistance is lowest in colored low friction TMA honeydew, and the frictional resistance of colored low friction TMA aqua is similar to that of stainless steel.
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328. Persistent Mullerian Duct Syndrome - Case Report

     Pramila, Balakrishnan, Sivaelangovan

     • » Abstract Persistent Mullerian duct syndrome (PMDS) refers to the presence of a uterus and sometimes other Mullerian duct derivatives in a genetically male. We report a case of male with right side cryptorchidism and left inguino scrotal mass with Mullerian duct derivatives (uterus).
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329. A Study of New Technique of Loop Stoma Bridge in Tertiary Care Hospital Hosamath

     Vijaykumar, Sreekar Agumbe Pai, Harish K., Basti Sunita Devendra

     • » Abstract Background and Objectives: Delay in the application of stomal appliance till the removal of the conventional supporting glass or plastic rods resulted in leakage of faecal matter. The objective of the study was to know the efficacy, safety and compliance of the new technique of loop Stoma Bridge. Methods: Subcutaneously, a closed suction drain tube of 16 or 18 F was placed with the help of trocar .The points of entry and exit of the tube are just beyond the circumference of the flange. Results: Out of the 45 patients studied no major complications were encountered. Emergency and elective procedures were done in 23 and 22 patients respectively. Complications like pain in 14 patients were noticed and in 4 patients serous discharge was seen. None had pain for more than 10 days. Interpretations and Conclusion: It is a safe, cheap method and can be performed easily with low morbidity. The colostomy flange can be applied immediately without faecal leakage.
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330. Efficacy of Klemm and Borner Criteria in Evaluating the End Results of Management of Closed Diaphyseal Fracture of Tibia Treated by Closed Interlocking Nailing

     Saurabh Chandra, Mukesh Tiwari

     • » Abstract Background. The tibia is the most common fractured long bone, because of its exposed anatomical location and inadequate muscular envelope. Objectives: Evaluate fracture healing and union time with closed Interlocking nailing with reaming in regards to its functional outcome (klemm and borner criteria) with respect to knee and ankle joint movements, deformity, muscle atrophy and radiological union aiming at early mobility of patients. We report a randomized analysis of 30 patients treated in one center in rural area. Methods: Study done at Orthopaedic Department of NIMS Medical College, Jaipur (Rajasthan) between May 2011and May 2013. The patients included were more than 18 years, only closed diaphyseal fractures considered. Fractures of tibia other than diaphysis and unfit patients were excluded. Mean age was 32.4 years.29 patients had road traffic accident,1patient had history of fall:16 had ipsilateral fibula fracture,6 had contralateral tibia shaft fracture ,3 had head injury,3 had metacarpal fracture,2 had fracture clavicle and one had floating knee. Results: Average union time 4.7 months Complications encountered were 3 delayed union,1 malunion,1superficial infection,1 deep infection and 15 developed anterior knee pain. Conclusion: 90%of the total cases had excellent results,6.66% had good results and 3.33% had fair results.
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331. Incidence of Postoperative Wound Infection in Orthopaedic Surgery - An in Vivo Study

     Vivian D’Almeida, John Benny, Raghuveer Adiga, Vivek Mahajan, Karen D’sa, Rohit Jhamnani

     • » Abstract Objectives: Therefore, the present study was planned with an objective to analyze the incidence of postoperative wound infections. An additional objective was to evaluate the efficacy of different measures taken by surgeons prior to Surgery to prevent infection. Methods: Hundred individuals between 18-50 years of age were evaluated based on the surgery’s they underwent at Father Muller Medical College, Mangalore between 2010 – 2012. The data received was recorded in individual patient proform as obtained on admission and on outpatient basis. Results: The overall incidence in this study was 4%. Maximum incidence was observed in 41-50 age group (96%), followed by in the age group of 21-30 yrs (94%).Out of 56 patients with spinal anaesthesia, the incidence of infection was noted in 4 cases. The mean preoperative stay in infected cases was 4.50 days, when compared to 3.06 days in non infected cases whereas mean post operative stay in infected cases was 7.75 days, when compared to 10.16 days. Conclusions: Prophylactic regimens should be recommended for a wide variety of surgical procedures. Marked variations exist in the spectrum of infecting pathogens and in the degree of antimicrobial resistance.
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332. A Comparative Analysis: SILS over Conventional Laproscopic Procedures

     S. Pradhaban

     • » Abstract Objectives: To report our experience with single-incision laparoscopic surgery (SILS) and to perform a comparison with conventional laparoscopic surgeries. Study Design: Data were prospectively collected for all patients undergoing SILS(n = 23) and compared with data of those undergoing conventional laparoscopic procedures (n = 42) at Lifeline Hospital, Perungudi, Chennai. This included patient demographic data and intraoperative and postoperative outcomes. Interventions: conventional laparoscopic surgeries and SILS. Main Outcome measures: Operative time, conversion to open operation, and length of hospital stay. Results: Operative time was longer with SILS compared with conventional laparoscopic surgeries (P < .001). A correlation was seen between reducing SILS operative time and increasing experience (Pearson’s correlation coefficient, −0.27). Two patients in the SILS group required the addition of extra laparoscopic ports. No patients in the SILS group required conversion to open surgery compared with 4 patients in the standard laparoscopic group. Patients stayed an average of 0.67 days following SILS and 1.62 days following conventional laparoscopic procedures. Conclusions: Single-incision laparoscopic surgery may be equal to conventional laparoscopic surgeries in terms of safety and efficacy. Further randomized studies are required to investigate any significant advantages of this new and attractive technique.
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333. Study of Malondialdehyde (MDA) As a Marker of Oxidative Stress in Obese Male Individuals

     Dhananjay Vasantrao Bhale, Dhanashri Shashikant Patil, Roshan Kumar Mahat

     • » Abstract Background: Obesity is associated with enhanced lipid peroxidation. Malondialdehyde (MDA), one of several by-products of lipid peroxidation process, is a biomarker that provides an indication of lipid peroxidation level. The objective of the present study was to estimate the level of MDA in obese individuals. Methods: 30 obese men with BMI between 25-30 Kg/m2 and 30 non-obese men with BMI <25 Kg/m2 were enrolled in the study. Malondialdehyde (MDA) was assessed in both the groups. Results: Plasma MDA activity was significantly increased in the obese subjects when compared with controls. Conclusion: This finding suggests that obesity is an important factor for enhanced oxidative stress in individuals.
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334. 23 Gauge Transconjunctival Vitrectomy-Short Term Visual Outcomes and Complications

     Biju John C.1, Apuca Susan Mathew

     • » Abstract Purpose: To report the initial experience, complications and short term visual outcomes of patients undergoing 23 Gauge Transconjunctival Pars Plana Vitrectomy. Methods: This was a Retrospective non comparative case series evaluating the first 50 consecutive cases of 23 Gauge Transconjunctival Pars Plana Vitrectomy done by a single surgeon in a Tertiary Eye Care centre. The outcome measures included best corrected visual acuity at 6weeks compared to the Pre Operative Visual acuity, Intraoperative complications and difficulties and Post Operative complications. The relevant information was retrieved from the case records and follow up records of these patients. Results: Out of the 50 eyes studied, Visual Acuity at 6 weeks improved in 39 (78%); remained unchanged in 8 (16%) and worsened in 3 (6%). Suturing of at least one of the ports was done in 18 eyes (36%).Intraoperative Retinal breaks occurred in 2 eyes. The Post operative complications noted in the post operative period up to 6 wks were vitreous hemorrhage (8%) ,cataract formation (6%),post operative uveitis (6%) and retinal redetachment (2%). 1 case had to be converted into a 20 Gauge vitrectomy due to the development of choroidal effusion. Conclusion: 23 Gauge Transconjunctival Vitrectomy is an effective surgical technique for a variety of Vitreoretinal surgical indications. The safety and efficacy compared well with that in the published literature.
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335. Sacral Fractures: Various Modalities of Treatment and outcomes

     Nilesh Keche, Sanjay Khairnar, Abhang Khairnar, Kedar Jagtap, Kiran Patil, Harshal Kalambe

     • » Abstract Introduction: Sacral fractures occur in approximately 45% of all pelvic fractures. From conservative to surgical, various treatment modalities are available to treat sacral fracture. The post treatment outcome also depends on various factors. Aims and Objectives: To study the modalities of treatment employed in the management of sacral and sacro-iliac joint injuries (Conservative and Operative) and to compare the results and outcomes of conservative vs. operative interventions employed in the management of sacral factures and sacro-iliac joint injuries. Materials and methods: total 32 patients were selected during the study period and were followed for 6 months post treatment to study the outcome. Majeed Scoring system was used to study post treatment functional assessment. Results: post injury displacement was seen in Denis type 3 fracture and vertical shaer fractures. And the displacement ids much reduced after treatment (both surgical and conservative). Mean ambulatory time in patients managed surgically and conservatively was nearly equal. In surgical procedure plating was required in most of the patients as compared to iliosacral screw and external fixator. It was also observed that patient managed surgically scored better Majeed score as compared to conservatively managed patients. But the difference was not significant. Conclusion: sacral fracture can be managed conservatively and surgically depending upon the post injury displacement. Outcome can be improved by selecting appropriate treatment modality.
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336. A Prospective Study of Blood Transfusion Practice in Elective Orthopaedic Surgeries

     Suresh Chandra Dulara, Pooja Jangid, Rinku Jain, Ashish Jangid

     • » Abstract Aims and Objectives: To assess the practice and trends of blood transfusion services at our institute in elective orthopaedic surgeries, and to work out Surgical Blood Order Schedule at our institute by means of Cross Match Transfusion Ratio (C/T ratio), Transfusion Index (TI), Transfusion Probability (%T) and Mead’s criteria and to develop suggestions to improve the efficiency of blood utilisation and reduce the unnecessary cross matching as well as wastage of blood bank resources. Materials and Methods: Patients (male and female) of the age group of 20- 80 years under elective orthopaedic surgery were enrolled in the study. Patients, who received blood transfusion during intraoperative period and within 24 hours postoperatively, during one year duration, were included in the study and frequency of utilization of blood in different elective orthopaedic surgeries was noted. Results and Conclusion: A total of 159 patients with an age group of 20-80 years were evaluated in one year duration. Two hundred forty two units of blood were cross matched and only seventy eight units were transfused to seventy one patients. Sixty eight percent of the units cross-matched were not transfused. Five out of six elective procedures had a C/T ratio higher than 2.5 and all of the procedures under study had a low Transfusion Index (TI<0.5).
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337. A Prospective Study of Blood Transfusion Practice in Elective Orthopaedic Surgeries

     Suresh Chandra Dulara, Pooja Jangid, Rinku Jain, Ashish Jangid

     • » Abstract Aims and Objectives: To assess the practice and trends of blood transfusion services at our institute in elective orthopaedic surgeries, and to work out Surgical Blood Order Schedule at our institute by means of Cross Match Transfusion Ratio (C/T ratio), Transfusion Index (TI), Transfusion Probability (%T) and Mead’s criteria and to develop suggestions to improve the efficiency of blood utilisation and reduce the unnecessary cross matching as well as wastage of blood bank resources. Materials and Methods: Patients (male and female) of the age group of 20- 80 years under elective orthopaedic surgery were enrolled in the study. Patients, who received blood transfusion during intraoperative period and within 24 hours postoperatively, during one year duration, were included in the study and frequency of utilization of blood in different elective orthopaedic surgeries was noted. Results and Conclusion: A total of 159 patients with an age group of 20-80 years were evaluated in one year duration. Two hundred forty two units of blood were cross matched and only seventy eight units were transfused to seventy one patients. Sixty eight percent of the units cross-matched were not transfused. Five out of six elective procedures had a C/T ratio higher than 2.5 and all of the procedures under study had a low Transfusion Index (TI<0.5).
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338. Correlation of Blood Glucose Level with Working and Short Term Memory Status in Type 2 Diabetes Mellitus

     Sanjay B Bhagoji, Mrutyanjay Mirje, Mahesh Patil, Mallikarjun Biradar

     • » Abstract Background and Objectives: Working and short term memory loss is common in poorly controlled diabetic patients. Though cognitive deficits affect daily activities much importance is not given to assess working and short term memory at bedside. Hence this study was undertaken to correlate blood glucose level with working and short term memory in type 2 diabetics compared with age and gender matched normal subjects. Methodology: Present study was conducted in Al-Ameen Medical College and Government district Hospital, Bijapur on 114 diabetics aged (40-60 yrs.) and 119 normal subjects aged (40-60 yrs.). Cognitive function assessment was done for short term and working memory by using 5 memory tests. For short term memory- AVLT, VFT and VRT and for working memory – WDST and VST were used. The results were expressed in average total scores(%). T test and Correlation-regression analysis were used for statistical analysis. Results: Significant decrease in working and short term memory was observed in diabetic patients. In diabetes patients mean FBS was found to be 146+29.2mg% compared to the mean FBS levels of normal subjects (97.9+12.6mg %). In diabetes patients mean PPBS was found to be 194+39mg % compared to the mean PPBS levels of normal subjects (133+11.1mg %). Memory scores in all 5 tests were found to be decreased correlating negatively with the FBS and PPBS levels. Interpretation and Conclusion: The short term and working memory status in the present study decreased significantly in the diabetic patients, which may be due to hyperglycemia, hypoglycemia, vascular dementia and insulin resistance. Therefore these observed effects of FBS and PPBS levels are of potential clinical importance because working and short term memory loss could interfere with day today activities.
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339. A Study of the Extent of Neurological Involvement and Neurological Deficit in Different Types of Sacral Fractures

     Nilesh Keche, Sanjay Khairnar, Abhang Khairnar, Kedar Jagtap, Kiran Patil5, Harshal Kalambe

     • » Abstract Introduction: Sacral fractures occur in approximately 45% of all pelvic fractures. Neurological deficit has been reported in some cases of sacral fracture. Aims and Objectives: To study the extent of neurological involvement and neurological deficit in different types of sacral fractures in accordance with the Gibbons classification. Materials and method: present study was conducted in tertiary care institute with total 32 patients of sacral fracture. Gibbons grading system was used to assess neurological deficit. Results: 15.7%% patients had neurological deficit. In Denis classification fractures neurological deficit was found in type 2 and 3 patients. Neurodeficit found in 37.5% of vertical shear type of sacral fracture. Conclusion: neurodeficit occours in some cases of sacral fracture. And it is common in sever grade of Denis classification and vertical shear fracture.
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340. Evaluation of Hypoglycemic Activity of Tramadol in Streptozotocin Induced Diabetic Rats

     Totagi Vinod Gangadhar, A. M. Satish, M. K. Jayanthi, M. Brahadeesh, Lokraj Subedee, Suresha R. N

     • » Abstract Objective: To evaluate the hypoglycemic activity of Tramadol in streptozocin induced diabetic rats. Methods: In this study, 18 albino rats (Three groups each containing six rats)were included for the study. After 4 days of streptozocin injection those rats that develop fasting blood sugar >200mg/dl will be selected for the study. The study groups will be divided as follows, Group-1 (CONTROL): Distilled water 0.5ml (oral), Group-2 (STANDARD): Streptozocin (60mg/kg) i.v. and Group-3 (TEST): Streptozocin(60mg/kg) i.v.+ Tramadol(0.45mg/kg). Fasting blood glucose levels from experimental animals will be measured on 1, 3, 7, 14 and 28th day by capillary blood glucose method by using glucometer(ACUCHEK). Results: In this study after inducing diabetes with streptozotocin(60mg/kg) diabetes was induced and test drug has showed significant hypoglycemic activity comparing to standard drug Glimepiride.
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341. The Clinical Manifestation and Outcome of Scorpion Sting Envenomation in Children Admitted to Tertiary Care Hospital

     Srinivasa K., Vishwanath B.

     • » Abstract Objective: To study the clinical profile, the pattern of presentation, treatment and the outcome in scorpion sting envenomation at a tertiary care hospital. Methods: A total of 120 children were prospectively studied. The data included demographics, the time of presentation to the hospital, the clinical features, and the premedication which was given before the arrival of the subjects at the hospital, response to the oral Prazosin and the hospital outcome. Results: Local pain, sweating and peripheral circulatory failure were the common clinical presentations. Complications like acute pulmonary oedema, myocarditis, shock and encephalopathy were also seen. These were treated with a combination of Prazosin with either inotropes or vasodilators. Mortality was seen in 3(2.5%) children. Oral Prazosin, a postsynaptic alpha –1 blocker, is a highly effective drug for scorpion sting envenomation. Conclusion: Scorpion sting envenomation is an acute life threatening emergency and an early presentation to the hospital and an early intervention with proper medication( Prazosin) can hasten the recovery in the scorpion sting victim.
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342. Case Report of Delayed Presentation of Congenital Diaphragmatic Hernia

     Sangeeta Basu, Jitendra Kumar, Basaveshwar Patil, C. D. Aundhakar

     • » Abstract Congenital diaphragmatic hernia (CDH) usually presents immediately in neonatal period with respiratory distress. However, delayed presentation has been reported. The morbidity and mortality of congenital diaphragmatic hernia is related to the severity of lung hypoplasia, pulmonary hypertension and associated anomalies. This report highlights the importance of high index of suspicion through clinical examination and noninvasive diagnostic modalities. CDH presenting after neonatal period if diagnosed early, and treated appropriately poses less challenges in management.
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343. The Study of the Pattern of Maternal Vaginal Flora in Labour and Its Association with Neonatal Sepsis

     Sangeeta Basu, S. Y. Ingale, V. R. Potdar, Basaveshwar Patil, C. D. Aundhakar

     • » Abstract Infection continues to account for a major proportion of maternal, fetal and neonatal mortality and morbidity worldwide. The shared relationship between mothers and their newborns leads to common risk factors and etiologies of infectious diseases. Neonatal sepsis continues to be one of the leading causes of neonatal mortality in India. Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life. The present study has been undertaken to understand the pattern of maternal vaginal flora in labour and its relation with neonatal sepsis. Knowledge of the significant organisms in the genital tract of the pregnant woman and the peripartal risk factors can help us to develop strategies to control the transmission from mother to child or from environment to the neonate. Prevention of these infections could be practiced through screening programs for mothers vaginorectal colonization, identification of pathogenic organisms and administration of antibiotic prophylaxis to mothers or high risk neonates. Early treatment with appropriate antibiotics would minimize the risk of severe morbidity and mortality besides reducing the emergence of multidrug resistant organisms in intensive care units by rational antibiotic use.
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344. Acute Physiological and Chronic Health Examination Scoring System in Prediction of Mortality in Critically Ill Patients and It’s Comparison with Other Scoring Systems

     Bhargava Reddy N., Swaroo Phegde, Neha Athale, Jaishree Ghanekar

     • » Abstract Predicting the severity of critically ill patients is as essential as management of the patient in intensive care unit . Several scoring systems have been tried in the past with regular modifications. Acute physiological and chronic health examination scoring system (APACHE IV) was used in predicting the mortality and outcome in critically ill patients. APACHE IV scoring system was compared with the older scoring systems, LODS, MPM II0 and MPM II24, . Various statistical tools were used to assess the correlation, significance, and predictability. A total of 181 patients were included in the study. APACHE IV score had the best calibration and discrimination MPM II0 score had good calibration and fairly good discrimination MPM II24 score had the least significant discrimination and calibration.
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345. Chronic Alcoholism and its Effect on Nerve Conduction Velocity

     Sangita.R.Phatale, Anjali Shete

     • » Abstract Background and objective: Alcoholism is common and serious problem. Alcohol most commonly consumed in the form of ethanol. The effects of alcohol are mainly caused by altering the function of membrane proteins in many different cell types especially cells of GIT, urinary tract, cardiovascular and nervous system. Alcohol also causes alcoholic peripheral neuropathy. Material and Methods: The study was conducted in the department of physiology MR Medical College Gulbarga. The study was conducted in chronic alcoholic’s subject and there age matched control and in three groups of 30 subjects in each groups. Group I – Normal healthy control, Group II – chronic alcoholic without neuropathy, Group III – chronic alcoholic with neuropathy. Nerve conduction study was carried out by using RMS- EMG,EP machine manufactured by Recorders and Medicare System (P) Ltd. The data was statistically analyses by using student unpaired’ test. Result: Motor and sensory nerve conduction velocity was compared with chronic alcoholic and healthy aged matched controls. The both sensory and motor nerve conduction was significantly decreased in chronic alcoholic without neuropathy and with neuropathy. Conclusion: From our study we conclude that alcohol addiction has adverse effect on the NCV Thus helps in early diagnosis as well as prognosis of alcoholic neuropathy
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346. The Study of Pulmonary Function Tests in Chronic Alcoholics

     Sangita R. Phatale, Boramma S

     • » Abstract Background and objective: The present study was undertaken to assess the pulmonary function tests in chronic alcoholics. Alcohol has multitude of effects on many organ systems producing distinct clinical entities, particularly in lung, heart, liver and central nervous system. Material and Methods: The study was done using computerized medspiror. It includes 50 male chronic alcoholics of 20 - 60 years age and 50 normal male healthy subjects who served as age matched controls. The following lung function viz FVC, FEV1/FVC ratio, PEFR was carried out and subjected for statistical significance. Analysis was carried out by ‘t’ unpaired test. Result: The results of the study revealed statistically significant (P<0.05) decline in FVC and FEV1/FVC ratio, PEFR in chronic alcoholics as compared to normal control group, suggesting chronic alcoholism definitely affects pulmonary functions with the manifestations of both obstructive as well as restrictive pattern. Conclusion: Thus we conclude that alcoholism adversely affects pulmonary functions. (1).
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347. Situs Inversus with Dextrocardia Associated with Complex Congenital Heart Disease: A Case Report

     Tungikar Sudhir, Kulkarni Pratima, Kawle Deepak

     • » Abstract Situs inversus is rare congenital anomaly, in which there is general transposition of viscera due to reverse rotation including heart which rotates to right side and all abdominal - thoracic viscera are laterally transposed i.e. all viscera normally on right are seen on left and vice versa. The heart is structurally normal in 90-95% of cases. Incidence of cardiac anomalies in dextrocardia with SI is low (3%), while in isolated dextrocardia it is high. Dextrocardia with situs inversus occurs in 2 per 10,000 live births. Establishment of body axis antero-posterior, dorso-ventral and right-left axis is during embryogenesis at the time of gastrulation.Gene expression patterns are responsible for establishing right-left axis, mainly hox code that specify segmental position. Recent research on mice suggests that situs inversus is caused by the absence of a single protein due to particular mutation on chromosome 12. We came across a 30 year old lady having this rare anomaly of situs inversus with dextrocardia associated with complex congenital heart disease.
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348. Profile of Suspect Adverse Drug Reactions in a Teaching Hospital

     Shubhatara Swamy, Pratibha Nadig, Bhanuprakash, Muralimohan, Manjula Shetty

     • » Abstract Purpose: The present study was carried out to analyse the profile of suspect adverse drug reactions (ADRs) reported to the Pharmacovigilance unit. The primary objective was to identify the common drugs implicated and the pattern of the reactions, which would ensure a judicious prescription and further prevention. Methods: An awareness building lecture on voluntary reporting of ADRs was conducted after which ADR forms were distributed to various departments. They were assessed for the type of reaction based on Rawlins and Thomson criteria; severity based on Hartwig’s scale; seriousness as per Centre for Drugs Standards Control Organisation; expectedness as defined by International Conference on Harmonisation and causality based on Naranjo’s algorhythm. The common group of offending class of drugs were also identified. The results were analysed using descriptive statistics. Results: Out of 75 reactions 74 (98.67%) were type B and 1 reaction (1.33%) was type A. There were 5 unexpected reactions. Sixty four reactions (85.3%) were mild, 4 (5.33%) moderate and 7 (9.33%) were severe in nature. Seven (9.33%) out of 75 were considered serious as they required hospitalisation. The causality assessment for 154 drugs from 75 forms showed 118 (51%) to be possibly related, 36 (49%) as probably related and none were definitely related. The major group of drugs implicated were Antimicrobials followed by Non-steroidal anti-inflammatory drugs. Conclusion: ADRs were mostly due to antimicrobials and Non-steroidal anti-inflammatory drugs. It is necessary to create more awareness to curb irrational polypharmacy which helps in prevention and an accurate diagnosis of the reactions.
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349. Screening of the Drug Sumatriptan for Its Antiinflammatory Potential in Albino Rats

     Brahadeesh M., Suresha R. N., Satish A. M

     • » Abstract Objective: To study the anti-inflammatory activity of sumatriptan in acute and sub acute experimental animal model. Methods: Adult albino rats of either sex weighing 150-200 grams were randomly divided into 3 groups of 6 each. The control, standard and test group received Gum acacia 2g%, indomethacin 10 mg/kg and sumatriptan 1.28 mg /kg respectively .Acute inflammatory activity was assessed by carageenan induced paw oedema, Turpentine induced arthritis model and sub acute activity was assessed by cotton pellet induced granuloma model. Results: The anti-inflammatory activity was expressed as percentage of inhibition. In carageenan induced paw oedema, percentage of inhibition of paw oedema by indomethacin and sumatriptan respect to control were 51%and25% respectively. Hence the anti-edema effect of the test group was good and comparable with standard.The percentage of inhibition of paw oedema by the test group considering the percentage of inhibition of standard as 100 % was 65.5%.Thus sumatriptan showed good anti-inflammatory activity compared with the standard drug indomethacin in carageenan induced rat paw oedema model. The percentage of inhibition of knee arthritis with respect to control by standard and sumatriptan were 60% and 23%respectively.Hence the test group showed moderate antiarthritic effect in comparision to indomethacin .The percentage of inhibition of knee arthritis by the test group considering the percentage of inhibition of standard as 100% was 52.3%.Thus sumatriptan showed anti-inflammatory activity of moderate degree compared with the standard drug indomethacin in Turpentine induced arthritis animal model. The percentage of inhibition of granuloma. by standard and sumatriptan were49% and 13%respectively.The antigranuloma effect of test group was good as compared with standard.The percentage of inhibition of dry granulation tissue of the test group considering the percentage inhibition of standard as 100% was 58.2%.Thus sumatriptan shows moderate anti-inflammatory effect compared with the standard drug indomethacin in cotton pellet induced granuloma animal model. Conclusion: As sumatriptan showed considerably good antiinflammatory effect in acute models and in sub acute model ,it can be used as a promising antiinflammatory agent .
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350. Effect of Chitosan and Mordants on Dyeability of Cotton Fabrics with Natural Dye from Barks of Ficus Religiosa Linn

     P. Saravanan, G. Chandramohan, J. Maria Jancy Rani, P. Shanmuga Sundaram

     • » Abstract Natural dyes can be anything that comes from natural sources such as barks, flowers, leaves, roots, insects, shells, and mineral substances. They are used for food coloring, painting and textile dyeing. Using natural dyes in textile processing have been shown a greater interest because they are more eco-friendly than synthetic dye and show a variety of colors from one natural dye depending on dyeing process and types of mordants. In present study, the cotton fabric was treated with chitosan at different concentrations to finda suitable concentration on dye ability with natural dye from barks of Ficus Religiosa Linn. The influence of dyeing methods with mordants, i.e. pre-mordanting, post-mordanting and simultaneous mordanting was determined. The light and wash fastness of chitosan treated samples were measured compared with untreated samples. Chitosan-treated cotton fabric improved both dyeability and fastness compared with untreated cotton fabric. The cotton fabrics treated with chitosan not only provided better depth of shade but also provided better wash fastness and light fastness than those of the untreated fabrics. The use of different mordants and mordanting methods affected the dye shade and depth of shade differently on the dyed fabrics both with and without chitosan. The range of colour developed on dyed materials were evaluated in terms of (L*a*b*) CIELAB coordinates and the dye absorption on the cotton was studied by using K/S values.
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351. Anaesthethic Management of a Case of HOCM Posted for Rt. # IT Femur (DHS Plating)

     Pramod V. Bhale, Medha Kulkarni, Radhika Ruhatiya, Selva Kumaran

     • » Abstract Hypertrophic Cardiomyopathy is most common genetic cardiovascular disease with a prevalence of 1:500 and is transmitted as autosomal dominant condition with variable penetrance (1, 2). It can affect patients of all ages. The disease is characterised by LV hypertrophy most commonly septal and anterolateral free wall hypertrophy. Surgery poses a very high risk for these patients because of several complications (1, 2) that can occur in the perioperative and post operative period. We present a case of 67yr old male a diagnosed case of HOCM posted for #Rt. IT Femur(DHS plating) under Epidural anaesthesia.
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352. Study of Serum Prostate Specific Antigen (PSA) Levels in Patients of Benign Enlargement of Prostate and Prostatic Cancer

     Dhananjay Vasantrao Bhale

     • » Abstract Prostate specific antigen (PSA), neutral serine protease secreted exclusively by prostatic epithelial cells, has a number of applications in the management of men with prostatic carcinoma. While it is widely recognized that elevated PSA correlates with the presence of carcinoma, little data exist regarding the use of PSA as the initial test in the early detection of prostatic cancer Prostate-specific antigen (PSA) is a protein produced by the prostate and this protein may be elevated for several reasons, including prostatitis, benign prostatic hypertrophy and cancer. The value of the PSA test varies when used for screening, diagnosis, prognosis and as indicator of recurrence of prostate cancer. AIMS and Objectives: To study levels of Serum PSA in patients of Benign prostatic hypertrophy and prostatic carcinoma and comparing them with normal healthy individuals above 55 years of age. Material and Methods: The study was performed on 100 consecutive male patients (mean age 68 ± 10.8 years SD) comprising of 80 patients with benign disease (80%) and 20 prostate carcinoma patients (20%), who had histologically proven prostate cancer. Patients with total PSA between 2-25 ng/ml were included in the study. 30 normal healthy males with age 55 ± 10 years, served as control. Serum total PSA were analyzed using CLIA method.The mean total PSA in normal healthy control subjects was 1.72 ± 1.06 ng/ml. It was increased significantly in diseased condition. Its mean concentration in carcinoma patients was 12.6 ± 5.3 ng/ml and in benign patients it was 6.3 ± 4.6 ng/ml. Conclusions: Markedly increased PSA levels in serum suggests a cancer. This information may aid patients and clinicians in management of prostate cancer, such as selecting patients for watchful waiting. However, more research is needed to determine the performance characteristics of PSA in clinical practice. It is recommended that the use of PSA and Digital Rectal Examination in combination is important as a diagnostic procedure for the early detection of prostate cancer.
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353. Comparative Study of Blood Glucose and Glycosylated Hemoglobin Levels and Clinical Profile in Low Body Weight (lean), Nonobese and Obese Type 2 Diabetes Mellitus

     Dhananjay V. Bhale

     • » Abstract Background: Diabetes has emerged as a major public health problem in our country Insulin has important effects on key steps in metabolism of lipids and lipoproteins and altered lipid metabolism is common in diabetic population. As far as diabetes in India is concerned, the vast majority are found to be nonobese. More peculiarly prevalence is rising in lean and underweight persons. Very little data is available on Nonobese type 2 diabetes and especially on those who have low body weight BMI< 18.5 Kg/m2. Materials and Methods: Present study was carried out in MGM Medical College, Aurangabad. Total 90 known cases of type 2 diabetes mellitus were taken from OPD, Medicine wards of above institute and were divided into three groups as follows: Lean (B.M.I.< 18.5) Nonobese (B.M.I.= 18.5-25) and obese( B.M.I.>25). B.M.I.(Body mass index): Weight in kg/height in m2. Following biochemical parameters were done 1. Fasting and Postprandial Blood glucose measured by glucose oxidase method on RA 1000 fully automated Biochemistry Analyser 2. Glycosylated Hemoglobin was estimated by Flukinger and Winterbalter’s colorimetric method. Conclusion: The increase in glycosylated haemoglobin in lean i.e. Group I diabetics as compared to nonobese and obese is statistically significant (P<0.05). This shows that low body weight type 2 diabetics had a poor glycemic control as compared to nonobese and obese type 2 diabetics.
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354. Effect of Medium-dose Gamma Irradiation on Microbial Quality of Cut-cabbage (Brassica oleracea): A case study in Greater Accra Region of Ghana

     G. K. Frimpong, V. Appiah, J. Nketsia-Tabiri, W.Torgby-Tetteh

     • » Abstract Consumption of fresh and fresh-cut fruits and vegetables has increased every year in the past decade because of their convenience and nutritional benefits. Unfortunately, the increasing consumption of fresh produce has been accompanied by an increase in the number of outbreaks and recalls due to contamination with human pathogens. Irradiation of this kind of ready-to-eat product is a feasible alternative treatment to be considered in order to improve the microbiological quality and to extend the shelf life. The objective of this study was to explore the effect of medium-dose gamma irradiation on the microbial quality of cut-cabbage. Cut-cabbage was irradiated and its microbial quality determined. The initial total viable count (TVC) for unirradiated or control cut cabbage samples was 9.11 log10 cfu/g and that of irradiated samples (1-3kGy) at 0 day ranged from 7.39 to 8.95 log10 cfu/g. However, total coliform count for cut-cabbage irradiated at 2kGy was not significantly different from the rest of irradiated samples. The effective irradiation dose of 2kGy was able to reduce the bioburden of by up to 4 log cycles in fresh pre-cut cabbage.
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355. Comparison of Suxamethonium with Rocuronium for Endotracheal Intubation

     Pramod Bhale, Narender Bhandari, Selva Kumaran P., Rashmee Joshi

     • » Abstract Background: In the present day practice, muscle relaxation is used for facilitation of endotracheal intubation and to provide muscle relaxation throughout the surgery. Rocuronium bromide is a nondepolarizing aminosteroidal, vecuronium derivative drug with intermediate duration Side effects of suxamethonium are not observed with rocuronium bromide. Present study is aimed at determining the efficacy of rocuronium for routine endotracheal intubation within 60 seconds in general population. Objective: To compare the intubating conditions of rocuronium bromide with suxamethonium chloride. Methods: Patients were premedicated with inj. midazolam 0.05mg kg-1, inj. Pentazocine 0.5mg kg-1 and inj. glycopyrolate 0.005 mg kg-1, after which patients were preoxygenated for 03min with 100% oxygen. Induction was done with inj.thiopentone at the dose of 5mg kg-1. After loss of eye lash reflexes, muscle relaxant (rocuronium bromide/ suxamethonium chloride) was given as iv bolus. Intubating conditions were assesed at 60 seconds after injection of muscle relaxant, if intubating conditions were unsatisfactory, then repeat scopy was attempted after every 30sec interval (90, 120, 150 and 180 sec). Bag mask ventilation with 100% oxygen was continued till the repeat scopy was attempted. Monitoring of pulse rate, oxygen saturation, systolic and diastolic blood pressures, electrocardiogram were recorded immediately after laryngoscopy, at 5 and 10min after intubation. Results: Suxamethonium showed acceptable intubating conditions in 100% of cases at 60 Sec. out of which 93.24% were excellent. In rocuronium Group 100% of cases had acceptable intubating conditions at 60 sec. out of which 77.7% excellent and 22.2% good intubating conditions were observed. Conclusion: Rocuronium bromide at 0.9 mg kg-1 is a safe and good alternative for suxamethonium 1.5mg kg-1 for endotracheal intubation at 60 seconds. We advice rocuronium bromide 0.9 mg kg can be used for Rapid Sequence induction and Intubation, if there is no prediction of difficult intubation.
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356. The Rheological Profile of Cereal Flour Composites as affected by Gamma Irradiation

     B. Darfour, S. Annan, E. A. Ayeh

     • » Abstract Abstract: Retrogradation of starch occurs when the amylose in starch-containing products returns to a less soluble, crystalline state over time. Irradiation has been shown to be a useful method for producing modified starch since it generates free radicals that can alter the structure of starch molecules. The aim of this work was to enhanced cereal flour composite using gamma irradiation to be used as breakfast meal. Cereal flour composites were prepared from three local cereals wheat, sorghum and rice in a certain ratio and gamma irradiated for subsequent analysis. Pasting properties and moisture were analyzed. The irradiated flour composite showed decreases in maximum viscosity temperature, maximum viscosity, cooling and final holding viscosities, setback viscosity, breakdown viscosity and retrogradation. The irradiation and the composite ratio had significant effect on all the pasting parameters studied except the beginning gelatinization torque. Cereal breakfast meal could be preferably prepared from irradiated wheat, sorghum and rice flours in the ratios of 25 % wheat: 25 % sorghum: 50 % rice or 100 % each of wheat, sorghum and rice or 25 % wheat: 50 % sorghum: 25 % rice.
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357. Study of Serum Ferritin Levels in Anemia of Pregnancy

     Dhananjay Vasantrao Bhale, Pramod Vasantrao Bhale, Shubhangi Arun Mande, Sanjay Guddetwar

     • » Abstract Abstract: Anemia in pregnancy is a global problem and is associated with increased maternal morbidity and mortality (WHO, 1992). Iron deficiency anemia is defined as anemia accompanied by depleted iron stores and signs of a compromised supply of iron to the tissues. The objectives of this study were to determine the serum ferritin in anemic pregnant women and to compare them to that of normal healthy non-pregnant women. Materials and Methods: Present Cross sectional study was carried out in the Department of Biochemistry MGM Medical College, Aurangabad during March 2011 to March 2013. A total of 50 pregnant women of 15-35 yrs age with hemoglobin level < 10.5 g% were compared with 50 non-pregnant healthy women. Serum ferritin levels were done by Chemiluminescence assay (Immulite 1000).Mean and standard deviation were calculated for Hb%, Serum Ferritin. Statistical analysis was done using SPSS. In the present study mean hemoglobin level and serum ferritin level was low in test group as compared to control group. Low level of hemoglobin and serum ferritin was noted in 2nd trimester as compared to 1st and 3rd trimester of pregnancy which was statistically significant.
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358. Biosorption of Reactive Red 198 from an Aqueous Solution Using Morinda Tinctoria

     R. Vijayalakshmi, R. Venkatachalam, T. Periyathambi, P. Saravanan

     • » Abstract Abstract: Morinda tinctoria seed used for the removal of reactive red 198 from an Aqueous solution was studied by batch biosorption system process The equilibrium dye uptake capacity of Morinda tinctoria was determined with the influence of various environmental parameters such as sorbent dosage (0.02–0.1 g 100mL-1), initial pH (1–6), and initial dye concentration (10-50 mg L-1). Batch experiments were carried out for biosorption kinetics and isotherm studies. The results showed that dye uptake capacity was found to increase with decreases in biosorbent dosage. Equilibrium uptake capacity was found to be more at pH2, when compared with all other pH values studied. The equilibrium data was analyzed with the use of Freundlich and Langmuir adsorption isotherm models. The equilibrium data was found to be fitted very well with the Freundlich isotherm model when compared with the Langmuir isotherm model. Adsorption kinetics data modeled with the application of pseudo-first order and pseudo-second order models revealed that the pseudo-second order model was the best fitting model. The biosorbent characteristics were observed by SEM and FTIR analysis.
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359. Primary Multicentric Hepatocellular Carcinoma An Incidental Finding at Autopsy

     Arun M., Reddy A., Kagne R. N., Sowmya S., Balaraman R

     • » Abstract Abstract: Multicentric hepatocellular carcinoma is relatively a rare malignant condition usually presenting without symptoms. It is commonly seen in hepatitic or cirrhotic liver as an incidental finding at autopsy. In non hepatitic liver multicentricity is associated with secondary metastasis rather than primary hepatocellular carcinoma. Medicolegal autopsy was conducted on a 56 year old male who died due to septicemic complications of burns. On gross examination of the liver secondary metastasis was suspected because of the presence of multiple nodules seen on the surface of both the lobes. After histopathological examination of the lesion the diagnosis of primary multicentric hepatocellular carcinoma was established. Thus a case of multicentric hepatocellular carcinoma was detected as an incidental finding on medicolegal autopsy.
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360. Unilateral Ectopic Kidney with Associated Anomalies: A Case Report

     Bashir Khan, Bipin Khade, Gajanan Patil

     • » Abstract Abstract: Present study is a case observed in the department of anatomy at Shri Bhausaheb Hire Government Medical College, Dhule. During routine cadaveric dissection of first M,B.B.S students in department of anatomy, a case of unilateral ectopic kidney with non rotation and vascular anomaly was found in an adult male cadaver. An accessory artery to inferior pole may obstruct the ureter leading to hydronephrosis. During operative procedures, a surgeon should be careful about accessory renal arteries because these are end arteries, consequently, if an accessory artery is damaged or ligated, the part of kidney supplied by it will become ischemic.
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361. Unmarried Adolescent Pregnancy: a Learning Lesson!

     Archana Rokade, R. P. Patange, D. P. Javadekar

     • » Abstract Objective: To determine risk factors and explore the socio-behavioral context of pregnancyin the unmarried adolescent girls. Methods: This is cross-sectional observational study over period of one year from August 2012 to July 2013. Total 90 unmarried pregnant girls were included in study. All unmarried adolescent girls seeking abortion were given questionnaire and data that collected was analyzed. This study was conducted in Obstetrics and Gynecology Department of Krishna University of medical sciences karad. Study variables: age, relation with partner, age of partner, literacy and education, socioeconomic class, parenting, type of family and parenting, family problems, awareness of sexual and reproductive health, involvement in productive activities, awareness regarding STD and AIDS, knowledge of contraception, gestational age, methods used for MTP. Results: 90 unmarried adolescent girls undergoing abortions included in the study.60% were from rural area and 44.4% were in age group of 17-18 years. More than 57.7% of unmarried girls had a friend or fiancée as their sex partner who were also in adolescent age. 42% sought abortion in the second trimester of pregnancy. Single parenting with irrational strictness or negligence and family disputes are independent risk factor for adolescent unmarried pregnancy. Contraceptive awareness was low, awareness regarding AIDS (though low at 47%), was higher than that for STDs in general (31%).lack of awareness regarding sexual and reproductive health and noninvolvement in productive activities are important risk factors.
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362. Effect of Lipodystrophy on Quality of life of HIV/AIDS patients: A cross sectional study in South India

     Sudhir, Deepa.K., Ashok N.C., Murali Dhar

     • » Abstract Background: Introduction of ART has initially improved the quality of life (QoL) of HIV positive patients, however body fat redistribution and metabolic disorders associated with long-term ART use may attenuate this improvement. As access to treatment improves in India, the disfiguring nature of lipodystrophy (peripheral atrophy and/or central adiposity) may deter treatment adherence and decrease QoL. Objective: To study the relation between lipodystrophy and QoL in ART-treated HIV+ patients. Methodology: The study was conducted in January 2012 to August 2012. This cross sectional study was done in 1000 HIV/AIDS patients out of which 255 had lipodystrophy at ART centre K.R Hospital, Mysore. WHO-QOL-Brief a summarized quality of life questionnaire was used to assess the Quality of life. Physical examination was done to assess lipodystrophy. Statistical analysis was done using SYSTAT 13 software. To test the significance, t test was applied. Results: Out of 255 patients, who had lipodystrophy, 163 of them were male and 92 of them were females. Facial atrophy was more common among males and abdominal enlargement was found more commonly associated with females. The Quality of life score was found significantly less among HIV patients with lipodystrophy than those without. However CD4 count was found to be significantly higher in patients with lipodystrophy than those without. Conclusion: Body fat alterations negatively affect quality of life. These symptoms may result in stigmatization and marginalization and adversely affect ART adherence and treatment initiatives. Efforts to evaluate self-perceived body fat changes may improve patient’s wellbeing, ART adherence and treatment outcomes can contribute towards stability in quality of life continuum.
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363. Comparison of Dexmedetomidine, Fentanyl and Magnesium Sulfate as Adjuvants with Hyperbaric Bupivacaine for Spinal Anesthesia: A Double Blind Controlled Study

     Sunil B. V., Sahana K. S., Jajee P. R

     • » Abstract Background: Intrathecal adjuvants has gained popularity with the aim of prolonging the duration of block, quality of block and decreased resource utilization compared with general anaesthesia. The purpose of this study was to evaluate the onset and duration of sensory and motor block as well as adverse effects of adding exmedetomidine, fentanyl or magnesium to hyperbaric bupivacaine for spinal anesthesia. Design: randomized double blind trail. Setting: hospital based study during the period, march-june 2013. Method: 90 Patients were randomly allocated to three groups of 30 each to receive intrathecally either 15 mg hyperbaric bupivacaine plus 10 µg dexmedetomidine ( group D) or 15 mg hyperbaric bupivacaine plus 25 µg fentanyl (group F) or 15 mg hyperbaric bupivacaine plus 50 mg magnesium (group M). The onset time to reach T10 sensory and Bromage 3 motor level, the regression time for L1 sensory and Bromage 0 motor block, Sedation scores, hemodynamic changes and side effects were recorded. Statistical analysis: Performed using computer statistical software system SPSS version 16. Data were expressed as either mean and standard deviation or numbers and percentages. Continuous covariates (age, height, weight and duration of surgery) were compared using analysis of variance (ANOVA). For categorical covariates (gender, ASA class, blood transfusion, nausea/vomiting, hypotension, bradycardia, use of ephedrine, additive analgesia, atropine and type of surgery) a Chi-square test was used, with the p value reported at the 95% confidence interval. For the time to reach T10 dermatome, Bromage 3 scale, and the regression of the sensory block to L1 dermatome and Bromage scale 0, ANOVA test was used to compare the means. The level of significance used was p<0.05. The total sample size was calculated to be 90 (30 patients in each group). Results: Onset of bromage 3 motor block and time to reach T10 sensory dermatome level was statistically significant between group D, group M and group F .onset time for sensory and motor block was significantly earlier in group D but delayed in group M .(P<0.001, DvsM. P<0.05, DvsF and FvsM). The time for regression of sensory block to L1 dermatome and bromage 0 motor block was significantly prolonged in group D compared to group M, which was greater then group F . (p <0.001, F vs D,M and DvsM). Conclusion: addition of dexmedetomidine prolonged the sensory and motor block significantly when used with hyperbaric bupivacaine for spinal anesthesia. Onset of both sensory and motor block was earlier and significant in Dexmedetomidine group. In magnesium sulfate group although onset of sensory and motor block was delayed, the regression was significantly prolonged then fentanyl group, good haemodynamic stability was observed and there was no significant side effects in three groups during study period.
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364. Computerized Tomographic Measurement of Thoracic Vertebral Morphology in South Indian Population

     Latheesh Latheef, Mrinal B Shetty, Vivian D’ Almeida, Rajesh Wilson, Tinu Joseph

     • » Abstract Abstract: Knowledge of the vertebral morphology has been seen to be crucial for the safe placement of screws in pedicle screw fixation of the spine .An analysis of the morphometric parameters of the thoracic vertebrae was done in 229 patients using computed tomography scans in south Indian population .The results show significant variation in the morphology of the vertebral body and the pedicle in Indian population when compared to other races. The measurements were seen to be greater in males than in females with the exception of the transverse angle of the pedicle. The vertebral body height was found to be progressively increasing from T1 to T12 levels and ranged from 5.8mm(cumulative) at T1 to 22.3mm (cumulative) at T12.The vertebral body width was found to decrease from T1 to T5 and again increase from T6 to T12.The cephalo-caudal height of the pedicle ranged from 7.8mm at T1 to 13mm at T12.The medio-lateral width of the pedicle was found to decrease from T1 to T5 and increase from T6 to T12; the smallest cumulative value being 4.4 mm at T4 and the largest being 6mm at T12.The cord length ranged from 30.8mm at T1 to 40.4mm at T12.The mean transverse angle of the pedicle was observed to reduce from 26.80 at T1 to 1.80 at T12.The pedicle sagittal angulation was seen to be lowest at T12 with a cumulative value of 11.570 and highest at T3 with a cumulative value of 17.580. The study shows that medio-lateral width of the pedicle is smaller from T4 to T7 levels for the use of standard pedicle screws, thus making their use difficult and risky. The cord length measurements according to the study allow the use of standard screws ranging from 25mm to 35mm.A wide variation in the dimensions is also observed between different individuals, demonstrating the need for computed tomography as a preoperative evaluation tool in each patient for choosing the appropriate implant and also to prevent complications.
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365. Detection of Macrolide-Lincosamide-Streptogramin B Resistance in Staphylococci Isolated from Ear Discharge of Patients of Chronic Suppurative Otitis Media in a Tertiary Care Hospital

     Chetana I. Wahane, Vanita A. Kulkarni

     • » Abstract Staphylococci act as major aerobic pathogens in the causation of chronic suppurative otitis media (CSOM). Clindamycin is one of the alternative agents used to treat CSOM and accurate identification of clindamycin resistance is important to prevent therapeutic failure. Inducible clindamycin resistance cannot be detected by standard susceptibility tests. This study aimed to detect macrolide-lincosamide-streptogramin B (MLSB) resistance in staphylococcal isolates causing CSOM in order to assist clinicians in treatment of CSOM by thesegroup of antibiotics. MLSB resistance in the present study was detected in 59 staphylococcal isolates (41 S. aureus and 18 CONS) isolated by standard procedure from ear discharge in CSOM. D-test was performed on these isolates to detect MLSB resistance. Inducible clindamycin was detected in 5% Methicillin susceptible staphylococcus aureus (MSSA), 0% Methicillin resistant staphylococcus aureus (MRSA) and 5.5% Coagulase negative Staphylococci (CONS). Constitutive resistance (8.4%) was found more common than inducible clindamycin resistance (5%) in the present study. Detection of inducible clindamycin resistance can help in using clindamycin safely and effectively in patients with true clindamycin susceptible isolates and thus helps to avoid treatment failure while high prevalence of constitutive resistance makes D-test essential when clindamycin is an option for therapy of staphylococci in CSOM.
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366. A Case of Central Venous Line Insertion in Severe Scoliosis

     Sunil B. V., Sahana K. S., Jajee P. R

     • » Abstract We are presenting a case of central venous catheter (CVC) malposition which was introduced under ultrasound (USG) guidance and its tip position was evaluated by transesophageal echocardiography (TEE), in a patient with severe scoliosis posted for cardiac surgery. CVC insertion is difficult and complications are more common in such cases due to distorted anatomy. Our aim was to avoid major complications related to central venous catheter insertion. We recommend USG guided insertion of central line in scoliosis which decreases complications during insertion, number of attempt, and failure rate.
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367. A study of Assessment of Prevalence of Tubercular Infection and Tubercular Cervical Lymphadenitis in Rural school children of Nagamangala Taluka of Mandya District, Karnataka State

     Suresh Lankeshwar, Usha Ramachandra, Prabhu N. B

     • » Abstract Background: Tuberculosis is one of the common communicable infections in our country. The present study reveals the status of Tubercular infection and Cervical Tuberculosis lymphadenitis in rural school children of Nagamangala Taluka of Karnataka State in the year 2004-2005. Objectives: Assessment of prevalence of Tubercular infection and Tubercular Cervical lymphadenitis in school children of Nagamangala district of Karnataka state. Materials and methods: data was collected from sample size of 693 school children using simple random technique. Tuberculin test to assess prevalence of Tubercular infection and FNAC test to confirm tubercular cervical lymphadenitis. Results: Tubercular infection was found to be 3.17% and Tubercular Cervical lymphadenitis o.58%. Conclusion: Tuberculosis infection is still common in school children and so is tubercular cervical lymphadenitis (extra pulmonary tuberculosis). Tuberculin test in children and FNAC test are cost effective in assessing status of TB infection and Tubercular cervical lymphadenitis.
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368. Histogenesis of Endodermal Component of Human Fetal Thymus

     Bashir Khan, Vinaram Rukhmode, Sanobar Shaikh, Chhaya Diwan

     • » Abstract The present study is conducted to observe the early cellular events and histological maturity endodermal component of thymus. After ethical approval from institutional ethics committee 53 human fetuses were obtained from department of Obstetrics and Gynaecology with permission of head of department and written informed consent from respective parents. The gestational age was determined by menstrual history and Crown Rump length (CRL). The specimen were dissected through parasternal incision and processed in paraffin. The sections were taken by rotary microtome. The slides were stained by Haematoxylin and eosin and Periodic acid-Schiff (PAS) stains. Endoderm of thymus differentiate into epithelial cells which from cytoreticulum and Hassall’s corpuscles in medulla. Epithelial cells are first observed at 10th week. Hassall’s corpuscles appeared PAS positive. They are first observed at 12th week and increased in size and number with increase in gestational age.
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369. Study of Socio-Demographic Factors Associated with Protein Energy Malnutrition in Less than Six Year Children in Field Practice Area of Rural Health Training Centre

     Balaji V. Ukarande1*, A. S. Nagaonkar2, Nazia Khan

     • » Abstract Study objectives: In spite of a large number of national programmes related to nutrition such as ICDS, mid-day meal, etc., about 6600 under-five children die every day, accounting to 46% child deaths due to protein energy malnutrition (PEM) in India, so considering the PEM , important nutritional problem and as ICDS, programme render the services to children less than six years of age, present study was undertaken to assess the nutritional status of children ageing less than six years of age residing in rural field practice area of Rural Health Training Centre of medical college. Methodology: Present study is cross-sectional, observational study in field-practice area and sample size was selected by simple random sampling method. Results: Overall prevalence of undernutrition in 0-72months (0-6 yrs) age group was 58.61%. Undernutrition was more in 49-60 months age group (70.21%) than other age group. Undernutrition was more among children whose mothers were illiterate or primary-secondry educated and less in higher and graduated, this difference was highly significant (χ25=362.93, p<0.001). Undernutrition was highest among children belonging to unemployed fathers, least in children whose fathers were owner and cultivators (χ24=272, p<0.0001).Proportion of undernutrition was highest in class V socio-economic-category children, where as lowest in children belonging to class I category. It is also clear that as socio-economic-status increases proportion of undernutrition decreases which was statistically highly significant. (χ24 =141, p<0.001). Conclusion: In spite of various schemes for children to decrease malnutrition, still the PEM is high in the study area; an integrated approach is required to curb this problem.
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370. Electromyographic Activity of Masticatory Muscles in Different Skeletal Profiles

     Srikanth Gunturu, Sushmitha R. Tauro

     • » Abstract Introduction: Effects of activity of facial and masticatory muscles on facial morphology is important to understand the normal growth and morphological abnormalities If muscle function plays a role in the development, abnormal muscle function explain’s certain abnormalities of facial morphology and certain forms of malocclusion. The present study is designed to know the activity of masticatory muscles in different skeletal facial profiles. Method: Fifteen subjects were selected who have acceptable occlusion and classified into Class I, Class II , Class III groups based on their cephalometric landmarks. Electromyographic recording of Masseter, Temporalis and Orbicularis Oris muscles were carried out and the activity of the muscles was correlated with their skeletal profiles. Results: Activity of the right and left muscles have not differed much. Postural EMG activity for masseter and Temporalis muscles were higher in class II subjects than in class I and class III subjects. Activity was lower in class I when compared to class II and class III. Orbicularis oris muscle activity is least in class II subjects during swallowing. High correlations between electromyographic activity and ANB angle were observed. Conclusion: Clear correlations were found between the shape of the face and the activity of the masticatory muscles.
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371. A Prospective Study on Efficacy of Oral Iron in Comparison with Intravenous Iron Sucrose in the Treatment of Iron Deficiency Anemia in Pregnant Women in a Rural Scenario

     Badveli Manasa, Indranil Dutta, Vijayalakshmi S

     • » Abstract Objectives: To determine the current prevalence and severity of iron deficiency anemia in a rural scenario and to document the response to oral iron supplementation in comparison to intravenous iron sucrose for better efficacy, compliance and safety in treatment of iron deficiency anemia in pregnancy. Methods: This comparative study was conducted at rural medical hospital in Karnataka, India during the period November 2010 to October 2012. 80 patients who fulfilled the inclusion criteria were randomized into either of the two groups, 40 to the oral iron group and 40 to the IV iron group and the improvement of hemoglobin was recorded meticulously. Comparison between the two groups was done based on the initial Hb, the total dose of iron required, the side effects and the final Hb. Statistical analysis was done using Chi-square test. Results: The following observations were made from this study age of patients ranged from 19-35years. Samples are age matched with P= 1.000. Majority of the anemic women in this study belonged to the age group of 20-25years.Majority of the women belonged to SE class II. SES distribution is statistically similar in two groups with p=1.000. In this study, anemia was equally common in Primi-gravida and multigravidas. Parity distribution is statistically similar in both groups with P=0.369. Majority of anemic patients in this study belonged to gestational age of 14-29weeks. Mean Gestational age is statistically similar in two groups with P = 0.408. Mean body weight is statistically significantly less Oral Rx group P = 0.017*. Levels of initial hemoglobin is statistically similar in two groups studied with P=0.624. MCV <70 is more associated with IV Rx group of patients with P=0.096+. Majority of the women in this study had a microcytic hypochromic smear picture. Distribution of PS is statistically similar in both groups with P=0.845. Mean total drug required(TDR) is significantly more in IV Rx group (881.50) when compared to Oral Rx Group (856.98) with P=0.149. Levels of Final Hb is statistically significantly less in Oral Rx group of patients than in the IV group with p=0.001**. Conclusion: This study was attempted to analyze the safety and efficacy of oral iron in comparison to IV iron on the hematological parameters in pregnant women with iron deficiency anemia. This study confirms that IV iron caused a rapid and effective improvement in the hematological parameters when compared to oral iron. In our country, with a higher incidence of iron deficiency anemia in pregnancy, especially in a rural scenario, this type of treatment may be helpful in management of these patients in a cost-effective manner. Following a rigorous research and evaluation iron sucrose has established its full place and potential and may be the solution.
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372. Evaluation of Amiodarone for Its Effect on Glucose Metabolism in Euglycemic Albino Wistar Rats

     Mohammed Sibgatullah, Suresha R. N.

     • » Abstract Objective: To evaluate the effect of amiodarone on glucose levels in albino wistar rats. Materials and Methods: Albino wistar rats were divided in to test group (amiodarone) and control group (distilled water) of six animals each. They were given test drug i.e amiodarone 180mg/kg and distilled water 5ml/ rat respectively for a period of 5 days. On 5th day OGTT (slightly modified) was performed and cbg values were recorded at 0 min, 60min and 150 min respectively. Results and Discussion: The cbg values were significantly higher (p<0.05) in test group at all the time intervals thereby indicating that amiodarone has hyperglycemic activity in the albino wistar rats. Conclusion: Further studies are required to evaluate the effect of amiodarone in humans and it should be used with caution in diabetics patients.
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373. Auditory and Visual Reaction Time in Taekwondo Players

     A. A. Asia, A. B. Warkar2

     • » Abstract Background: Excellence in a combat sport like Taekwondo relies on the ability to execute a technique with enough force in as little time as possible. Hence reaction time, speed and agility are essential in these practitioners. Objectives: The purpose of this study was to find out the Auditory and Visual Reaction time in Taekwondo players and compare it with non athletes. Method: Reaction time was measured with the response analyzer in trained taekwondo practitioners and non athletes. Results: The practitioners of Taekwondo responded significantly earlier to both auditory and visual stimuli. Conclusion: It can be concluded that shorter reaction time in these players is beneficial as it would prevent them from opponent attacks and help them to score better. Training to achieve a suitable reaction time can significantly influence performance especially during competitions.
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374. Uterine Artery Embolization in the Management of Undiagnosed Genital Bleeding

     Sangeeta Chippa, Dipti Vaidya, Shubhangi Mande, Swati Shiradkar

     • » Abstract This is a case report of a case of post abortal bleeding with hepatic dysfunction with coagulopathy. The lady presented primarily as uncontrollable post abortal bleeding with severe anaemia and coagulopathy. The recent history of her check curettage in view of her having incomplete abortion was the only clinching factor for the diagnosis. She had AV malformation in the uterus which got stimulated for bleed due to the check curettage which was done. Hence as life saving procedure uterine artery embolization was performed on this lady successfully. This is exceptional case where uterine artery embolization was performed in a clinically unstable patient.
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375. Retrospective Study of Eclampsia in a Teaching Hospital

     Pradeep M. R., Lalitha Shivanna

     • » Abstract Eclampsia is one of the major cause of both maternal and perinatal mortality in India. Retrospective study of eclampsia was done in our hospital from Jan-2011 to Jun-2013 Over a period of 2 ½ year to know the incidence, clinical profile and current management of eclampsia patients along with maternal and perinatal outcome. Analysis of case records of all eclampsia patients admitted to our hospital from Jan-2011 to Jun-2013 was done. Incidence of eclampsia was found to be 2.19/1000 deliveries. Eclampsia is a disease of young women between 19-24 years (79%) and primigravida (67%). Majority of them had convulsions before the onset of labour (87%). Eclampsia occurs most commonly at term gestation. Most of them had mild-moderate hypertension at the time of convulsion. Majority had vaginal delivery (63%) with current intervention, there were no maternal deaths. Perinatal mortality was 300/1000 live births. The current intervention for eclampsia is effective in reducing maternal mortality but management of perinatal outcome still needs improvement.
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376. Effect of Alpha-Methyl-P-Tyrosine Pretreatment on Stereotyped Behaviour Induced by Lamotrigine, Apomorphine, Dexamphetamine in Rats

     Shinde A. R., Thorat V. M., Jadhav S.A., Balsara J. J., Shinde R. V.

     • » Abstract Alpha-methyl-p-tyrosine by inhibing tyrosine hydroxylase, decreases the synthesis of dopamine (DA) in the nigrostriatal DAergic neurons so less DA is available for release from these neurons. Lamotrigine(LTG), Dexamphetamine(DAM) and Apomorphine (APO) produce SB directly by stimulating DA receptors or indirectly by releasing DA from nigrostriatal DAergic neurons .Our aim is to study the effect of pretreatment of alpha methyl P tyrosine(AMT) on SB induced by LTG,DAM and APO in rats. Albino rats of either sex (120-180 g) were used by random distribution in group of 10 animals each. Intensity of SB is assessed by Costall and Naylor scoring system. Our results indicate that pretreatment with 100 mg/kg AMT significantly antagonised the SB induced by 5, 10, 20 and 40 mg/kg lamotrigine. Pretreatment with 200 mg/kg AMT abolished the SB induced by 5 mg/kg lamotrigine and significantly antagonised the SB induced by 10, 20 and 40 mg/kg lamotrigine. Pretreatment with 100 and 200 mg/kg AMT significantly antagonised the SB induced by 5 and 10 mg/kg dexamphetamine. Pretreatment with 100 and 200 mg/kg AMT did not significantly influence the intensity of SB induced by 1.5 and 3 mg/kg apomorphine.
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377. Protein carbonylation, Lipid peroxidation and serum alpha Tocopherol activity in Preeclampsia

     N. Asha Rani, J. N. Naidu

     • » Abstract Hypertensive disorders are the most common medical complication of pregnancy and are important cause of maternal and perinatal morbidity and mortality. The etiology of preeclampsia has always remained elusive. More recently, antioxidants have been proposed as a potential preventive strategy on the basis of data suggesting that endothelial dysfunction is fundamental to the development of preeclampsia as a result of increased oxidative stress and deficiency of antioxidant protection. In this context the present study was undertaken to evaluate the intensity of oxidative stress and to investigate a possible correlation between oxidative stress, antioxidant status and severity of preeclampsia. A case control study was performed on 50 normal pregnant and 50 diagnosed preeclamptic women age and trimester matched. Malondialdehyde (MDA), Protein Carbonyls (PCO)and Vitamin E(Vit E) were estimated in the serum of all subjects. Statistically significant increase in levels of PCO (p< 0.0001), MDA (p <0.0001) and decrease in Vit E (p<0.0001) were observed in preeclamptic women as compared to normal controls. A negative correlation between oxidative stress markers (MDA, PCO) and Vit E and positive correlation between oxidative stress markers (MDA, PCO) and blood pressure was observed in preeclamptic women. Increased MDA, PCO and decreased Vit E suggests an imbalance between the oxidative stress and antioxidant status which supports the hypothesis that the oxidative stress is an important causative factor in pathogenesis of preeclampsia and supplementation with antioxidant vitamin may benefit the preeclamptic mothers.
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378. Doppler Study of Uterine and Cubital Artery in Normal Pregnancy, Pre-eclampsia and Intrauterine Growth Restriction – Evidence for Systemic Vessel Involvement

     P. L. Bhanap, Prashant Ingole

     • » Abstract Hypertensive disorders are among the commonest medical disorders during pregnancy and continue to be a major cause of maternal and perinatal morbidity and mortality. In this study, 30 women with no pregnancy complication, 30 with preeclampsia and 30 with intrauterine growth restriction were included. The present study included 90 cases over a period of one year. Doppler sonography of placental uterine, non – placental uterine and cubital artery was carried out. It was observed that, the mean pulsatality index at the placental uterine artery, non placental uterine artery and cubital artery is significantly higher in preeclampsia and intrauterine growth restriction group. Key words: Pregnancy induced hypertension, intrauterine growth restriction, Doppler velocimetry.
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379. Effect of Sudarshankriya Yoga on Cardiorespiratory Parameters

     Somwanshi S. D., Handergulle S. M., Adgaonkar B. D.3, Kolpe D. V.

     • » Abstract Objective: The present study is done to determine the effect of Sudarshankriya Yoga on heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and respiratory rate. Material and Methods: About 30 subjects (cases) underwent the practice of Sudarsharkriya Yoga for 12 weeks. Above cardio respiratory parameters were measured before and after the practice of Sudarshankriya Yoga. Comparative analysis is done for the effect of 12 weeks of yoga practice on these parameters. Results: Sudarshankriya yoga showed statistically significant decrease in the values of heart rate, systolic blood pressure, diastolic blood pressure as well as respiratory rate after 12 weeks of practice. Conclusion: The mechanism involved is by creating balance in autonomic nervous system functions by parasympathetic dominance and decreased sympathetic drive.
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380. Normative Values for Nerve Conduction Study among healthy subjects from Aurangabad, INDIA

     Shaikh Shahabuddin, DaimiSayad Badar, Khan Md Moizuddin, L. B. Sami3, Solepure A. B

     • » Abstract Aim: The aim of our study is to establish the normal electrophysiological values of the common nerves in upper and lower limb and to study the influence of age and height on conduction velocity in healthy adult subjects. Material and Method: The study was conducted in MGM Medical College, a tertiary care center in city of Aurangabad, India. A total of 90 healthy volunteers, 45 males and 45 females aged 20 years and above were selected after clinical evaluation to exclude systemic or neuromuscular disorders. Anthropometric measurements were done using a standard protocol. Nerve Conduction Study was carried out according to a standardized protocol. Motor NCS included the Median, Peroneal and Tibial nerves. Sensory NCS included the Ulnar, Median, and Sural nerves. Results: The NCS data was separately analyzed for males and females. The mean along with standard deviation (SD) for latencies, amplitude and velocities of Sural sensory, Ulnar sensory and Median sensory nerves for males and females is obtained. Similarly the means with SD of the latencies, amplitudes and velocities of the Ulnar motor, Median motor, Peroneal motor and Tibial motor nerves were obtained. Also the NCS parameters at various percentiles were obtained. Linear regression models show the inverse association of Age and Height with NCS parameter in males and females. The model also gave the coefficient by which the NCS parameters change for unit change in Age (Year) or Height (Cm). Conclusion: The study will be helpful in establishing normative values of nerve conduction parameters of the commonly tested nerves in the upper and lower limb for our region. The mean nerve conduction parameters for all the nerves were similar with the existing data from different Indian studies. In general Age and Height had inverse relation with NCS parameters.
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381. Epidemiological Study of Dog Bite Cases Reported at ARV Clinic of Rural Hospital Panvel in Raigad District of Maharashtra, INDIA

     Virendra Wankhede, Prasad Waingankar, Seema Anjenaya, B. T. Telang

     • » Abstract Introduction: Rabies is almost always fatal in animals or in humans those do not receive post-exposure prophylaxis (PEP). Thedog-bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. The present study has been conducted at a Rural Hospital Panvel (India) situated in rapidly urbanizing are aimed to know the epidemiology of dog bites. Methodology: All the patients who reported at Anti Rabies Vaccine (ARV) clinic with complaints of dog bite during the period of three months (September - November 2012) were included in this study for data collection by exit interview method.The data was analysed using Microsoft Excel, Epiinfo and SPSS. Results and Discussion: Total 318 dog bite cases were reported to ARV clinic during the period of 3 months. Majority were males (80.2%). More than 30% patients were in the age group of 26 to 45 years while 27.8% patients were children below 15 years. More than 70 % dog bites have taken place while victims were walking on the road. More than 97% of the bites were unprovoked and by stray dogs. Out of 318 victims, 164 (51.6 %) had knowledge about benefit of immediate cleaning of the wound. Proportion of using home remedies is negligible compared with other earlier studies. More than 88 % patients reported within 24 hours. Most of the study findings are consistent with earlier studies conducted in India with some variations. Conclusion and Recommendations: It is necessary to improve knowledge level in the local population further, about the immediate cleaning of the wound by using the means of behaviour change communication methods. The civic authorities need to resort to control of stray dogs. The establishment of surveillance for dog bite cases will definitely help.
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382. A Perception of Maternal Mortality among Women in an Urban Slum Area of South India

     Keerti S. Jogdand, Pravin N. Yerpude, Mohini Jogdand

     • » Abstract Introduction: Every pregnant woman hopes pregnancy to be a smooth process and expect to give birth safely as pregnancy and child birth is considered a normal physiological process. But, this is not happening at least in developing countries including India.In the year 2010, global maternal deaths per 100,000 live births i.e. maternal mortality ratio (MMR) was estimated to be 210. Objective: To determine perception of maternal mortality among women in an urban slum area of South India. Materials and methods: a descriptive cross-sectional study was carried out in an urban slum area of south India among 378 women above 20 yrs of age. Using semi-structured questionnaire answers to questions on perception of maternal mortality in the community were elicited from the study participants. The data was analysed using the SPSS program 14. Results: The majority (35.98%) of the study subjects were in the age group 31-40 years followed by 28.31% study subjects in the age group of 21-30. 34.14 % study subjects were educated upto intermediate and 22.22 % were educated upto secondary level. 95.50 % of the study subjects aware that death can occur from pregnancy-related problems. 73.81% subjects stated that excessive vaginal bleeding was a possible cause of death followed by high BP as possible cause of death in 21.96% study subjects. Conclusion: In order to reduce the high rate of maternal mortality, health education programs on prevention of maternal deaths and morbidities directed towards at risk women need to be improved.As most of the decisions in families were taken by the men,their participation is also very important.
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383. Results of Defect Augmentation with Tricalcium Phosphate in Tibial Plateau Fractures

     Supradeeptha C., Sudhir M. Shandilya, Siva Reddy, Vikram Kumar Kadiam

     • » Abstract Reduction of the depressed joint surface in tibial plateau fractures leaves large cancellous bone defects. These metaphyseal defects are usually filled with autogenous bone grafts that cause significant donor site morbidity. The use of injectable tricalcium phosphate gives the opportunity to support the reduced joint surface without bone grafting. Objective: The aim of this study was to evaluate the functional and radiological outcomes of closed/open reduction and internal fixation, augmentation with injectable tricalcium phosphate in tibial plateau fractures. Methods: This prospective study includes 20 patients, with mean age of 44.4 years. According to the Schatzker’s classification, there were 12 fractures of type II, one fracture of type III, five fractures of type V, and two of type VI. Intervention: All the patients underwent closed/ open reduction, osteosynthesis with screws or plate, and injection of tricalcium phosphate injection in the subchondral bone defect. The patients were reviewed at an average follow up of 15.35 months (range 6-28 months). Rasmussen’s clinical and radiological score was used to assess the patients post-operatively and during follow-up period. Results: Union was achieved in all patients. Rasmussen's radiologic score was excellent in 2 patients (10%), good in 17 patients (85%), and fair in 1 patient (5%). Rasmussen’s clinical score was excellent in 6 patients (30%), good in 13 patients (65%), and fair in 1 patient (5%). Conclusion: The results show that injectable tricalcium phosphate is a safe and useful alternative to bone grafting in tibial plateau fractures which have high compression strength and allows early partial and full weight bearing.
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384. A Study of Pulmonary Function: ‘Children versus Young Adults’ in Guntur, Andhra Pradesh, INDIA

     Madhu Babu K, Venkata Venu Gopala Raju S

     • » Abstract Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and young adults. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and young adults, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FVC of 153.49%, FEV1 of 133.33%, FEF25-75% of 80.54%, ERV of 84.78% and PEFR of 94.35% was observed in young adults, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC and FEV1 showed a greater increase in young adults than the remaining parameters, when compared with children. Conclusion: In the current study, pulmonary function test values of children and young adults, a marked increase was observed in all the five parameters, from childhood to adulthood as per the body needs of oxygen. It is important to understand the improvement of pulmonary function test values with age among young adults, in interpretation of pulmonary function variations in different physiological and pathological settings.
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385. Clinical Study of Complications in Twin Gestation

     P. L. Bhanap, A. R. Mahale

     • » Abstract A retrospective study of twin pregnancies was done for a period of 6 months from 1st July 2001 to 31st December 2001 at labor and delivery ward admissions at Government Medical College, Nanded. Total 185 cases analyzed for obstetric and neonatal complications studied.Anemia was found universal. Prematurity was common. Dreaded complications like undelivered second twin was also encountered.Low birth weight and prematurity were less common in unregistered pregnant women.
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386. The Effect of Ramadan Fasting on the Body Composition, Blood Pressure, Heart Rate of Healthy

     Young Adults B. Shruthi, Abrar Hassan, B. V. Reddy

     • » Abstract During the month of Ramadan, Muslims refrain from drinking and eating between sunrise and sunset. This study is aimed to understand the effect of this long intermittent fasting schedule during Ramadan on body composition, and cardiovascular system in healthy young adults. Fifty healthy adults were included and were all tested before and on the 28th day of the Ramadan fast. The parameters studied were body composition, blood pressure and heart rate before and towards the end of the fasting. Significant changes were observed in the form of decreased body weight, Body Mass Index, Waist to Hip Ratio, body fat percentage, blood pressure and heart rate. Dominance of the sympathetic nervous system over the parasympathetic nervous system has been shown to be a strong risk factor for cardiovascular disease. Weight loss has a positive effect on this balance and is associated with significant improvement in autonomic cardiac modulation through enhancement of parasympathetic effect. This increase in vagal tone has shown its effects on the blood pressure and heart rate in this study. At the cellular level fasting reduces the levels of oxidative stress at the same time it acts as repeated mild stress that induces expression of genes that enhance the ability of cells to cope with more severe stress. The effect of fasting on cardiovascular function should be further explored to recognize fasting as a potential non-pharmacological intervention for improving cardiovascular health.
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387. Determination of Various Sociodemographic Factors Affecting Anemia in Pregnancy

     Leela Khatod, Shruti Chidrawar, Santosh Bhangadia, Jivan Chakurkar, Shital Bhattad, Susheel Bhattad

     • » Abstract Objective: Many sociodemographic factors are responsible for anemia in pregnancy such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family. We studied socio-demographic factors affecting anemia in pregnancy. Design: a cross sectional study. Setting: tertiary-care referral hospital. Participants: All the pregnant patients admitted in the hospital whose hemoglobin less than 10gm% were included in the anemic group and whose hemoglobin above 10 gm% were included in non anemic group. Intervention: detailed history which included various sociodemographic factors was taken; their association with anemia in pregnancy was studied. Outcome Measures: factors such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family and association with anemia in pregnancy. Results: 144 patients with hemoglobin <10gm% were included in the anemic group. 122 patients with hemoglobin more than or equal to 10gm% were taken as non anemic group. In Anemic group 90.97% of the patients were from lower socioeconomic class 3 and class 4. Only 09 (06.25%) patients from anemic group had more than 4 antenatal checkups, whereas in non anemic group 118(96.72%) cases out of 122 had more than 4 antenatal checkups. Conclusions: we found that anemia in pregnancy was more common in multiparous women, less birth spacing, lower income, number of ANC visits <4, low educational status, poor calorie intake and with vegetarian diet, but some factors like age, occupation and type of family had no correlation with anemia in pregnancy.
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388. Correlation of Diabetic Retinopathy with Serum Lipids

     Smita Dileep Javadekar, Sindal Deokrishna, Karambelkar V. H., Pooja Agrawal

     • » Abstract Aim: To find out the Correlation of Diabetic retinopathy with serum lipids in Type 2 diabetic subjects. Settings and Design: Cross sectional nonrandomized study. Materials and Methods: 311 patients with more than 5 years of Type 2 diabetes were assessed for presence and severity of retinopathy and were co related with age, sex, duration of DM and serum lipids. Diabetic Retinopathy was diagnosed by fundus examination and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. Results: Overall 76.5% (238) had DR and 23.5% (73) had no Diabetic Retinopathy. The mean serum cholesterol (P<0.05), serum triglycerides (P <0.05) and non-high-density lipoprotein (HDL)-cholesterol (P <0.05) concentrations were higher in subjects with Diabetic Retinopathy compared with those without Diabetic Retinopathy. Significant association of triglycerides (P< 0.05) and LDL-cholesterol with clinically significant macular edema (CSME) (P< 0.05). Conclusion: Significant association is found of dyslipidaemia with Diabetic Retinopathy and CSME.
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389. Orbital Cysticercosis Presenting as Proptosis

     Vikas Chennamaneni

     • » Abstract Orbital cysticercosis is a less common presentation of cysticercal infestation. Diagnosis is primarily by CT and MRI investigations. High resolution ultrasound is rarely used in the diagnosis. Patients can be managed conservatively with antihelminths and steroids. We present the case of a 10 years old girl presenting with proptosis of left eye and was diagnosed as extraocular orbital cysticercosis involving the inferior rectus muscle on high-resolution ultrasound and managed conservatively with antihelminths.
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390. Variations of Dermatoglyphic Features in Non Insulin Dependent Diabetes Mellitus

     Feroz khan J. Pathan, Rubeena N. Hashmi

     • » Abstract Background: Man has always wondered about the significance of the peculiar arrangement of ridges on the volar aspect of palm and sole. The knowledge of dermatoglyphics is thousands of years old as evident from the stone carvings found at the edge of Kejimkoojik Lake in Nova Scotia and the walls of Neolithic burial passages found on the island of Brittany. The ancient Indian literature also describes various patterns as Chakra, Shankh and Padma. With the emergence of civilization, this interest was replaced by methodological and scientific study of these patterns.As dermatoglyphic features are strongly affected by genetic and environmental factors, the idea of using it as supportive evidence in the diagnosis of hereditary disorders becomes a reality. Objective: Present study intends to evaluate the relationship between dermatoglyphic features and non-insulin dependent diabetes mellitus. Material and method: Dermatoglyphic prints of one hundred non-insulin dependent diabetes mellitus patients ( 50 male and 50 females) were taken for studyand compared with equal number of prints of healthy controls (50 males and 50 females). In this study fingertip patterns, Atd angle, a-b ridge count and C line type parameters were studied. Result: In diabeticpatientsfrequency of whorls is significantly increased;while frequency of ulnar loops is significantly decreased in cases as compared to controls. Arches and radial loops showed no significant changes.Atd angle showed no significant difference. A-b ridge count is significantly decreased in diabetics. C line type also showed significant difference in cases and controls.
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391. Thyroid Hormone Status of Normal Pregnant Women

     Swati Tadas, Arun Tadas, Nilam Mishra, Aniruddha Jibhkate

     • » Abstract Objectives: To study thyroid hormone status of normal pregnant women in each trimester and compare it with non-pregnant women. Materials and Methods: This was a longitudinal type of study. Serum levels of T3, T4 and TSH were estimated by ELISA technique in normal pregnant women (n=60) in each trimester and compared with age matched control (n=60). Results: We found significant increase in T3 and T4 level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further (P<0.01) and in 3rd trimester increase was statistically highly significant (P<0.001). We observed decreased TSH level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further but difference was not statistically significant (P>0.05). In 3rd trimester there was statistically significant rise in values when compared to control group. Conclusion: Interpretation of thyroid function test in pregnancy needs care and separate reference intervals should be used.
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392. Risk Factors for Myopia in Medical Students

     N. S. Wakode, S. L. Wakode, D. D. Ksheersagar

     • » Abstract Aim and introduction: Today in India, with increasing level of education and living standard, the prevalence and severity of myopia appear to be an upward trend. High incidence and progression rates of myopia have been reported in individuals who spend long hours in near work activity. Besides several other factors, possible genetic factor and occurrence of myopia was also determined. Material and method: The present study was carried on 222 MBBS students of NKP Salve Medical Collage and government medical collage Nagpur. Student completed questionnaire that include age, sex, age of appearance of refractive error, parent history, reading hours, computer using, television watching, playing videogame, scoring in common entrance, extra achievement in carrier and sport. Data was analyzed using SPSS frequency, percentage, mean and standard deviation was calculated accordingly. Chi-square test was applied wherever applicable and P value <0.05 was considered statistically significant. Result: Assessing genetic component, 81(66.39%) myopic student parent show positive family history whereas 41 myopic student parent, (33.60%) did not have positive family history. Statistically it showed strong significant relationship. (P= 0.001). Average continuous reading hours of myopic student were about 25hrs/ wk and 10hrs/ wk for emmetropic student. It was statistically significant (P=0.001). Strong significant association was found in myopic student for scoring achievement in carrier other than regular study as compared to emmetropic (P=0.001). Total hours of work on computer, watching television and playing video games were statistically significant for myopic. Conclusion: Myopia is a predominant refractive error among the first year medical students. Majority of myopic students score highest marks in common entrance, achievement in carrier other than syllabus study. The prevalence of myopia shows association with computer, videogame and TV. Majority of the parents of myopic medical students are also found to be myopic.
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393. A Study of Efficacy of Misoprostol in Early Pregnancy Loss

     R. P. Patange, Dileep P. Javadekar, Archana Rokade

     • » Abstract This study aims to assess the efficacy of misoprostol in the management of missed miscarriage and anembryonic pregnancy. Data of 123 consecutive women with early pregnancy loss treated with medical method were collected prospectively in rural medical college hospital. Each woman received 600µg of misoprostol vaginally. Three hours following the first dose second dose was given if necessary. Women that failed to pass products of conception or had incomplete abortion on ultrasound scan were offered surgical evacuation. Success was defined as complete uterine evacuation within 12 hours on ultrasound scan, without need for surgical evacuation. Results: The overall success rate of medical management was 89.43%.the median dose of misoprostol required was 1200µg.and the median induction miscarriage interval after first dose of Misoprostal was 7.1±3.5 hours (range 6-10hrs) In 13 women medical method failed. Side effects were less common and mild.
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394. Double Inlet Left Ventricle - A Case Report

     Vrushali V. Nikade, Saurabh P. Kulkarni, Sanjay K. Shivapuje†, M. V. Ambiye

     • » Abstract Double inlet left ventricle is a very rare congenital anomaly which occurs in about 5 - 10 of 100,000 live births. Only the left ventricle of heart is developed properly and both atrial chambers carry blood into this ventricle. This means that oxygen-rich blood mixes with oxygen-poor blood. The mixture is then pumped into both the body and the lungs. The problem most likely occurs early in the pregnancy, when the baby's heart develops. However, the exact cause of DILV is unknown. We are presenting here a case of 2 year old child with single ventricle having left ventricular morphology diagnosed by echocardiography. Great vessels were transposed and pulmonary artery was stenosed.
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395. A Comparative Study of Pulmonary Function Tests in Children and Adolescents, in a Rural Area of Guntur District, Andhra Pradesh, India

     Venkata Venu Gopala Raju S., Madhu Babu K., Chaitanya G.

     • » Abstract Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and adolescents. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and adolescents, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age, who are in good health and without any signs and symptoms of disease. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FEV1 of 93.58%, FVC of 105%, ERVof 67.39%, FEF25-75% of 52.03%, PEFR of 46.19% was observed in adolescents, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC showed a greater increase (i.e. 105%) in adolescents than the remaining parameters when compared with children. Conclusion: In the current study, Pulmonary function test values of children and adolescents, a marked increase was observed in all the five parameters, from childhood to adolescence as per the body needs of oxygen. It is important to understand the improvement of Pulmonary function test values with age among adolescents, in interpretation of PFT variations in different clinical settings.
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396. Study of Sutures: Anatomical Variations in the Fusion of Sutures

     Divyesh Kapadia, Ajay Rathva, Dharati M. Kubavat, Shaileshkumar K. Nagar

     • » Abstract Background: The cranial sutures are the fibrous tissues uniting the skull bones as they approximate one another during development. The coronal, sagittal and lambdoid sutures were analyzed for quantifying the sutural patency as maintenance of suture patency depends on various factors in skull. Metopic sutures are a vertical sutures occurring as a result of failure of ossification between the two halves of frontal bone. It is very often mistaken for fracture of the frontal bone in the A-P view X-Ray of skull. Objective: The goal of the study was to evaluate the gross morphology of the coronal, sagittal, lambdoid and metopic sutures in human adult dried skulls and to determine if any difference exists in terms of fusion. Material and methods: The study included 150 human dry skulls of Indian population were selected from the museum of anatomy department of GMERS Medical College Gotri, Vadodara, and Government Medical College Bhavnagar. Result: the study shows the patency of the lambdoid suture is more compared to the other sutures and incidence of metopism was 2%.
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397. Association of Chakra Personality Type and Obesity

     Sachin M. Patel, Pradeep R. Jadhav, L. N. Joshi

     • » Abstract Personality is thought to affect risk for Obesity. Studies have shown a possible linkage between personality/personality trait and obesity. Aim: To assess the Chakra personality types in normal and overweight/obese individuals and to determine the association between chakra personality types and obesity. Study design and method: Observational cross sectional study conducted in Physiology department. One hundred and fifty enrolled participants` body mass index (BMI) was calculated and dichotomized into normal weight and overweight/obese group based on BMI. Chakra personality types were analyzed using chakra personality questionnaire in both the groups. Results: Out of the total one hundred and fifty subjects , 24 were Satvik, 107 were Rajsik and 19 Tamsik using the Chakra personality test. There was a strong association between chakra personality type and overweight/obesity (P value of <0.01). There was significant difference in the proportion of Tamsik in overweight /obese group. Conclusion: Study suggests that Tamsik chakra personality type may predispose to overeating behaviour and physical inactivity leading to obesity.
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398. Study of Cephalic Index in South Gujarat

     Kanan Uttekar, Deepa S. Gupta, Rashida Andani, Dharati M. Kubavat, Shaileshkumar K. Nagar, Padma Varlekar

     • » Abstract Cephalic Index is race and sex specific parameter. Cephalic Index is different in various racial groups. The present study was determined to identify Cephalic Index of South Gujarat population and compare it with the available data of various Indian populations. The study revealed that Mean Cephalic Index for South Gujarat was 81.2. Cephalic Index shows sexual dimorphism. Mean Cephalic Index for males was 80.88 and for females it was 82.48. We also found that in all available data as well as in our findings Cephalic Index was higher in females compared to males. Such data is of great medico legal and forensic importance which indicates that Cephalic Index can be used as marker of ethnicity, sex and race.
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399. Physico - Chemical Study of Groundwater near Holy Place Khuldabad Region of Aurangabad (M.S.)

     B. R. Agrawalc, Vidya Pradhanb, Rashmi Pathrikarb, Mohammad Mohsina

     • » Abstract Physico-Chemical study of groundwater near Khuldabad area is carried out in the year 2009-10. For the study different five stations were selected. Different parameters like pH, Conductivity, TDS, Hardness, Sodium, Potassium, Iron, Total Alkalinity, Carbonate, Bicarbonate, Chloride, Flouride, Nitrate and Sulphate are analyzed. Mahismal station having the values within the permissible limit and good for human consumption.
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400. Comparative Study of Single Layer versus Double Layer Closure of Lower Transverse Uterine Incision at Cesarean Delivery

     Manisha M. Laddad, Sanjay Kumar Patil, Nitin S. Skirsagar, Neha Gupta

     • » Abstract Objective(s): To assess intraoperative and postoperative outcome following single layer closure of lower transverse uterine incision at cesarean section as compared to double layer closure. Method(s): In this prospective randomized controlled study, 200 women scheduled for lower segment cesarean section through Pfannenstiel or sub umbilical midline incision were randomized to either single layer (n = 100) or double layer (n=100) closure of uterine incision. Primary outcome measures studied were operating time, intraoperative blood loss, febrile morbidity, and endomyometritis. Secondary outcome measures studied were number of additional hemostatic sutures needed, postoperative pain, perioperative hemoglobin fall, cystitis, wound infection, and hospitalization period. Student t test was used for comparing continuous variables. Categorical variables were compared by Chi square test or Fisher exact test. Results: The maternal demographic factors, indications for cesarean sections and high risk factors were similar between the two groups. There was significant reduction in operating time (P=0.022), intraoperative blood loss (P=0.04), febrile morbidity (P=0.024, OR 0.41, 95% CI (0.17-0.95), perioperative hemoglobin fall (P=0.044), endomyometritis (P=0.03, OR 0.36, 95% CI 0.16-0.90, and period of hospitalization (P=0.00005) in the subjects as compared to controls. There was no significant difference between the two groups regarding number of additional hemostatic sutures needed, postoperative pain, and cystitis or wound infection. Conclusion(s): Single layer closure of lower transverse uterine incision at cesarean section is associated with lesser operating time, intraoperative blood loss, febrile morbidity, endomyometritis, and hospitalization period, as compared to double layer closure.
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401. Ruptured Intracranial Sellar-Suprasellar Dermoid -A Case Report

     Jagdish Aher, A. P. Oak, B. H. Kombade, M. M. Kadam, U. M. Dhumal

     • » Abstract Intracranial dermoids comprise less than 1% of all intracranial lesions. These are slow growing benign congenital ectodermal inclusion cysts containing varying amounts of ectodermal derivatives. They usually found in midline in contrast to epidermoids. Teratomas, although similar in some respects, are a separate entity. Intracranial dermoid cysts show variable presentation usually cause symptoms because of mass effect and due to rupture with spillage of its contents into subarachnoid space and/or ventricles is a potentially serious complication that can lead to aseptic meningitis, seizures, cerebral ischaemia, hydrocephalus and rarely olfactory ischaemia. Occasionally they are incidentally detected.[1,3,4]. Summary: Rupture of intracranial dermoid is very uncommon occurrence with significant mortality. We present a case of ruptured sellar-suprasellar dermoid with subarachnoid and intraventricular dissemination of its contents causing hydrocephalus.
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402. Effect of Deep Breathing Test on Female Patients of Iron Deficiency Anemia

     Aniruddha Jibhkate, Richa Lath, Sonali Pande, Swati Tadas

     • » Abstract The present study was conducted to find out whether the deep breathing test and thus the autonomic nervous system are affected in female patients of iron deficiency anemia. Material and Method: In this study the change in heart rate was recorded with the help of ECG machine during inspiration and expiration phases of deep breathing maneuver. The change in heart rate was compared between 60 women with iron deficiency anemia and 60 age and socioeconomically matched women. Result: it was found that the change in heart rate was significantly altered in women with iron deficiency anemia (P<0.0001) when compared to controls. Conclusion: altered deep breathing test suggestive of altered autonomic function in iron deficiency anemia.
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403. A Study on Awareness and Practice about Preventive Methods against Mosquito Bite among Households in an Urban Slum Area of South India

     Pravin N. Yerpude, Keerti S. Jogdand, Mohini Jogdand

     • » Abstract Introduction: In India, Mosquito borne diseases constitute a major public health problem in the list of communicable diseases. The most important are malaria, dengue fever, chikungunya fever. One of the important components of Vector borne disease control programme is to impart awareness about mosquito bite prevention in the general community. The present community based study was conducted to assess the awareness and practices of mosquito bite prevention methods amongst households in an urban slum area of South India. Materials and methods: The present community based study was conducted in Guntur district of Andhra Pradesh. All households of Urban Health Training Center, Shrinavasrao Thota which is urban catchment area of department of Community Medicine, Katuri Medical College, Guntur were selected for the study. Results: 91.50 % of the study participants had knowledge about breeding places of mosquito. 22.29 % of study population still had myths that garbage was the breeding place for mosquito. Only 33.72% of the study population knew that dengue, chikungunya was transmitted by mosquito. Conclusion: The study found that knowledge about causes of malaria and mosquito breeding places was satisfactory in study subjects, but some myths were still prevalent. The people should be made aware that mosquito bite causes other diseases also.
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404. Knowledge and Attitude of School Girls about Reproductive Health

     P. L. Bhanap, Ajay Mane

     • » Abstract Increased awareness about reproductive health amongst young girls is expected given the rate of growth of print and electronic media in India. Does availability of modern communication make us wise or we are just literate? Adolescent girls constitute about 22 % of the population. These would be mothers should know about reproductive health. This study was carried out during seminars for their reproductive health education. A pretest was carried out before seminars for family education. During time span of 2003 to 2012 many schools were visited in Marathwada region and this study is sample of 980 girls. A standard questionnaire was given to them before seminars and their knowledge and attitude evaluated. Many girls were well aware of these issues and at the end of seminars they were empowered with more knowledge.
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405. Effect of Sudarshankriya Yoga on Cardiorespiratory Parameters

     Somwanshi S. D., Handergulle S. M., Adgaonkar B. D., Kolpe D. V.

     • » Abstract Objective: The present study is done to determine the effect of Sudarshankriya Yoga on heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and respiratory rate. Material and Methods: About 30 subjects (cases) underwent the practice of Sudarsharkriya Yoga for 12 weeks. Above cardio respiratory parameters were measured before and after the practice of Sudarshankriya Yoga. Comparative analysis is done for the effect of 12 weeks of yoga practice on these parameters. Results: Sudarshankriya yoga showed statistically significant decrease in the values of heart rate, systolic blood pressure, diastolic blood pressure as well as respiratory rate after 12 weeks of practice. Conclusion: The mechanism involved is by creating balance in autonomic nervous system functions by parasympathetic dominance and decreased sympathetic drive.
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406. Normative Values for Nerve Conduction Study among healthy subjects from Aurangabad, INDIA

     Shaikh Shahabuddin, DaimiSayad Badar, Khan Md Moizuddin, L. B. Sami, Solepure A. B.

     • » Abstract Aim: The aim of our study is to establish the normal electrophysiological values of the common nerves in upper and lower limb and to study the influence of age and height on conduction velocity in healthy adult subjects. Material and Method: The study was conducted in MGM Medical College, a tertiary care center in city of Aurangabad, India. A total of 90 healthy volunteers, 45 males and 45 females aged 20 years and above were selected after clinical evaluation to exclude systemic or neuromuscular disorders. Anthropometric measurements were done using a standard protocol. Nerve Conduction Study was carried out according to a standardized protocol. Motor NCS included the Median, Peroneal and Tibial nerves. Sensory NCS included the Ulnar, Median, and Sural nerves. Results: The NCS data was separately analyzed for males and females. The mean along with standard deviation (SD) for latencies, amplitude and velocities of Sural sensory, Ulnar sensory and Median sensory nerves for males and females is obtained. Similarly the means with SD of the latencies, amplitudes and velocities of the Ulnar motor, Median motor, Peroneal motor and Tibial motor nerves were obtained. Also the NCS parameters at various percentiles were obtained. Linear regression models show the inverse association of Age and Height with NCS parameter in males and females. The model also gave the coefficient by which the NCS parameters change for unit change in Age (Year) or Height (Cm). Conclusion: The study will be helpful in establishing normative values of nerve conduction parameters of the commonly tested nerves in the upper and lower limb for our region. The mean nerve conduction parameters for all the nerves were similar with the existing data from different Indian studies. In general Age and Height had inverse relation with NCS parameters.
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407. Epidemiological Study of Dog Bite Cases Reported at ARV Clinic of Rural Hospital Panvel in Raigad District of Maharashtra, INDIA

     Virendra Wankhede, Prasad Waingankar, Seema Anjenaya, B. T. Telang

     • » Abstract Introduction: Rabies is almost always fatal in animals or in humans those do not receive post-exposure prophylaxis (PEP). Thedog-bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. The present study has been conducted at a Rural Hospital Panvel (India) situated in rapidly urbanizing are aimed to know the epidemiology of dog bites. Methodology: All the patients who reported at Anti Rabies Vaccine (ARV) clinic with complaints of dog bite during the period of three months (September - November 2012) were included in this study for data collection by exit interview method.The data was analysed using Microsoft Excel, Epiinfo and SPSS. Results and Discussion: Total 318 dog bite cases were reported to ARV clinic during the period of 3 months. Majority were males (80.2%). More than 30% patients were in the age group of 26 to 45 years while 27.8% patients were children below 15 years. More than 70 % dog bites have taken place while victims were walking on the road. More than 97% of the bites were unprovoked and by stray dogs. Out of 318 victims, 164 (51.6 %) had knowledge about benefit of immediate cleaning of the wound. Proportion of using home remedies is negligible compared with other earlier studies. More than 88 % patients reported within 24 hours. Most of the study findings are consistent with earlier studies conducted in India with some variations. Conclusion and Recommendations: It is necessary to improve knowledge level in the local population further, about the immediate cleaning of the wound by using the means of behaviour change communication methods. The civic authorities need to resort to control of stray dogs. The establishment of surveillance for dog bite cases will definitely help.
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408. A Perception of Maternal Mortality among Women in an Urban Slum Area of South India

     Keerti S. Jogdand, Pravin N. Yerpude, Mohini Jogdand

     • » Abstract Introduction: Every pregnant woman hopes pregnancy to be a smooth process and expect to give birth safely as pregnancy and child birth is considered a normal physiological process. But, this is not happening at least in developing countries including India.In the year 2010, global maternal deaths per 100,000 live births i.e. maternal mortality ratio (MMR) was estimated to be 210. Objective: To determine perception of maternal mortality among women in an urban slum area of South India. Materials and methods: a descriptive cross-sectional study was carried out in an urban slum area of south India among 378 women above 20 yrs of age. Using semi-structured questionnaire answers to questions on perception of maternal mortality in the community were elicited from the study participants. The data was analysed using the SPSS program 14. Results: The majority (35.98%) of the study subjects were in the age group 31-40 years followed by 28.31% study subjects in the age group of 21-30. 34.14 % study subjects were educated upto intermediate and 22.22 % were educated upto secondary level. 95.50 % of the study subjects aware that death can occur from pregnancy-related problems. 73.81% subjects stated that excessive vaginal bleeding was a possible cause of death followed by high BP as possible cause of death in 21.96% study subjects. Conclusion: In order to reduce the high rate of maternal mortality, health education programs on prevention of maternal deaths and morbidities directed towards at risk women need to be improved.As most of the decisions in families were taken by the men,their participation is also very important.
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409. Results of Defect Augmentation with Tricalcium Phosphate in Tibial Plateau Fractures

     Supradeeptha C., Sudhir M. Shandilya, Siva Reddy, Vikram Kumar Kadiam

     • » Abstract Reduction of the depressed joint surface in tibial plateau fractures leaves large cancellous bone defects. These metaphyseal defects are usually filled with autogenous bone grafts that cause significant donor site morbidity. The use of injectable tricalcium phosphate gives the opportunity to support the reduced joint surface without bone grafting. Objective: The aim of this study was to evaluate the functional and radiological outcomes of closed/open reduction and internal fixation, augmentation with injectable tricalcium phosphate in tibial plateau fractures. Methods: This prospective study includes 20 patients, with mean age of 44.4 years. According to the Schatzker’s classification, there were 12 fractures of type II, one fracture of type III, five fractures of type V, and two of type VI. Intervention: All the patients underwent closed/ open reduction, osteosynthesis with screws or plate, and injection of tricalcium phosphate injection in the subchondral bone defect. The patients were reviewed at an average follow up of 15.35 months (range 6-28 months). Rasmussen’s clinical and radiological score was used to assess the patients post-operatively and during follow-up period. Results: Union was achieved in all patients. Rasmussen's radiologic score was excellent in 2 patients (10%), good in 17 patients (85%), and fair in 1 patient (5%). Rasmussen’s clinical score was excellent in 6 patients (30%), good in 13 patients (65%), and fair in 1 patient (5%). Conclusion: The results show that injectable tricalcium phosphate is a safe and useful alternative to bone grafting in tibial plateau fractures which have high compression strength and allows early partial and full weight bearing.
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410. A Study of Pulmonary Function: ‘Children versus Young Adults’ in Guntur, Andhra Pradesh, INDIA

     Madhu Babu K, Venkata Venu Gopala Raju S.

     • » Abstract Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and young adults. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and young adults, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FVC of 153.49%, FEV1 of 133.33%, FEF25-75% of 80.54%, ERV of 84.78% and PEFR of 94.35% was observed in young adults, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC and FEV1 showed a greater increase in young adults than the remaining parameters, when compared with children. Conclusion: In the current study, pulmonary function test values of children and young adults, a marked increase was observed in all the five parameters, from childhood to adulthood as per the body needs of oxygen. It is important to understand the improvement of pulmonary function test values with age among young adults, in interpretation of pulmonary function variations in different physiological and pathological settings.
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411. Clinical Study of Complications in Twin Gestation

     P. L. Bhanap, A. R. Mahale

     • » Abstract A retrospective study of twin pregnancies was done for a period of 6 months from 1st July 2001 to 31st December 2001 at labor and delivery ward admissions at Government Medical College, Nanded. Total 185 cases analyzed for obstetric and neonatal complications studied.Anemia was found universal. Prematurity was common. Dreaded complications like undelivered second twin was also encountered.Low birth weight and prematurity were less common in unregistered pregnant women.
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412. The Effect of Ramadan Fasting on the Body Composition, Blood Pressure, Heart Rate of Healthy Young Adults

     B. Shruthi, Abrar Hassan, B. V. Reddy

     • » Abstract During the month of Ramadan, Muslims refrain from drinking and eating between sunrise and sunset. This study is aimed to understand the effect of this long intermittent fasting schedule during Ramadan on body composition, and cardiovascular system in healthy young adults. Fifty healthy adults were included and were all tested before and on the 28th day of the Ramadan fast. The parameters studied were body composition, blood pressure and heart rate before and towards the end of the fasting. Significant changes were observed in the form of decreased body weight, Body Mass Index, Waist to Hip Ratio, body fat percentage, blood pressure and heart rate. Dominance of the sympathetic nervous system over the parasympathetic nervous system has been shown to be a strong risk factor for cardiovascular disease. Weight loss has a positive effect on this balance and is associated with significant improvement in autonomic cardiac modulation through enhancement of parasympathetic effect. This increase in vagal tone has shown its effects on the blood pressure and heart rate in this study. At the cellular level fasting reduces the levels of oxidative stress at the same time it acts as repeated mild stress that induces expression of genes that enhance the ability of cells to cope with more severe stress. The effect of fasting on cardiovascular function should be further explored to recognize fasting as a potential non-pharmacological intervention for improving cardiovascular health.
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413. Determination of Various Sociodemographic Factors Affecting Anemia in Pregnancy

     Leela Khatod, Shruti Chidrawar, Santosh Bhangadia, Jivan Chakurkar, Shital Bhattad5*, Susheel Bhattad

     • » Abstract Objective: Many sociodemographic factors are responsible for anemia in pregnancy such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family. We studied socio-demographic factors affecting anemia in pregnancy. Design: a cross sectional study. Setting: tertiary-care referral hospital. Participants: All the pregnant patients admitted in the hospital whose hemoglobin less than 10gm% were included in the anemic group and whose hemoglobin above 10 gm% were included in non anemic group. Intervention: detailed history which included various sociodemographic factors was taken; their association with anemia in pregnancy was studied. Outcome Measures: factors such as age, parity, spacing, percapita income, number of ANC visits, educational status, dietary habits, occupation, type of family and association with anemia in pregnancy. Results: 144 patients with hemoglobin <10gm% were included in the anemic group. 122 patients with hemoglobin more than or equal to 10gm% were taken as non anemic group. In Anemic group 90.97% of the patients were from lower socioeconomic class 3 and class 4. Only 09 (06.25%) patients from anemic group had more than 4 antenatal checkups, whereas in non anemic group 118(96.72%) cases out of 122 had more than 4 antenatal checkups. Conclusions: we found that anemia in pregnancy was more common in multiparous women, less birth spacing, lower income, number of ANC visits <4, low educational status, poor calorie intake and with vegetarian diet, but some factors like age, occupation and type of family had no correlation with anemia in pregnancy.
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414. Correlation of Diabetic Retinopathy with Serum Lipids

     Smita Dileep Javadekar, Sindal Deokrishna, Karambelkar V. H., Pooja Agrawal

     • » Abstract Aim: To find out the Correlation of Diabetic retinopathy with serum lipids in Type 2 diabetic subjects. Settings and Design: Cross sectional nonrandomized study. Materials and Methods: 311 patients with more than 5 years of Type 2 diabetes were assessed for presence and severity of retinopathy and were co related with age, sex, duration of DM and serum lipids. Diabetic Retinopathy was diagnosed by fundus examination and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system. Results: Overall 76.5% (238) had DR and 23.5% (73) had no Diabetic Retinopathy. The mean serum cholesterol (P<0.05), serum triglycerides (P <0.05) and non-high-density lipoprotein (HDL)-cholesterol (P <0.05) concentrations were higher in subjects with Diabetic Retinopathy compared with those without Diabetic Retinopathy. Significant association of triglycerides (P< 0.05) and LDL-cholesterol with clinically significant macular edema (CSME) (P< 0.05). Conclusion: Significant association is found of dyslipidaemia with Diabetic Retinopathy and CSME.
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415. Orbital Cysticercosis Presenting as Proptosis

     Vikas Chennamaneni

     • » Abstract Abstract: Orbital cysticercosis is a less common presentation of cysticercal infestation. Diagnosis is primarily by CT and MRI investigations. High resolution ultrasound is rarely used in the diagnosis. Patients can be managed conservatively with antihelminths and steroids. We present the case of a 10 years old girl presenting with proptosis of left eye and was diagnosed as extraocular orbital cysticercosis involving the inferior rectus muscle on high-resolution ultrasound and managed conservatively with antihelminths.
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416. Variations of Dermatoglyphic Features in Non Insulin Dependent Diabetes Mellitus

     Feroz khan J. Pathan, Rubeena N. Hashmi

     • » Abstract Background: Man has always wondered about the significance of the peculiar arrangement of ridges on the volar aspect of palm and sole. The knowledge of dermatoglyphics is thousands of years old as evident from the stone carvings found at the edge of Kejimkoojik Lake in Nova Scotia and the walls of Neolithic burial passages found on the island of Brittany. The ancient Indian literature also describes various patterns as Chakra, Shankh and Padma. With the emergence of civilization, this interest was replaced by methodological and scientific study of these patterns.As dermatoglyphic features are strongly affected by genetic and environmental factors, the idea of using it as supportive evidence in the diagnosis of hereditary disorders becomes a reality. Objective: Present study intends to evaluate the relationship between dermatoglyphic features and non-insulin dependent diabetes mellitus. Material and method: Dermatoglyphic prints of one hundred non-insulin dependent diabetes mellitus patients ( 50 male and 50 females) were taken for studyand compared with equal number of prints of healthy controls (50 males and 50 females). In this study fingertip patterns, Atd angle, a-b ridge count and C line type parameters were studied. Result: In diabeticpatientsfrequency of whorls is significantly increased;while frequency of ulnar loops is significantly decreased in cases as compared to controls. Arches and radial loops showed no significant changes.Atd angle showed no significant difference. A-b ridge count is significantly decreased in diabetics. C line type also showed significant difference in cases and controls.
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417. Thyroid Hormone Status of Normal Pregnant Women

     Swati Tadas, Arun Tadas, Nilam Mishra, Aniruddha Jibhkate

     • » Abstract Abstract: Objectives: To study thyroid hormone status of normal pregnant women in each trimester and compare it with non-pregnant women. Materials and Methods: This was a longitudinal type of study. Serum levels of T3, T4 and TSH were estimated by ELISA technique in normal pregnant women (n=60) in each trimester and compared with age matched control (n=60). Results: We found significant increase in T3 and T4 level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further (P<0.01) and in 3rd trimester increase was statistically highly significant (P<0.001). We observed decreased TSH level in 1st trimester (P<0.01) when compared to control group. In 2nd trimester values increased further but difference was not statistically significant (P>0.05). In 3rd trimester there was statistically significant rise in values when compared to control group. Conclusion: Interpretation of thyroid function test in pregnancy needs care and separate reference intervals should be used.
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418. Risk Factors for Myopia in Medical Students

     N. S. Wakode, S. L. Wakode, D. D. Ksheersagar

     • » Abstract Aim and introduction: Today in India, with increasing level of education and living standard, the prevalence and severity of myopia appear to be an upward trend. High incidence and progression rates of myopia have been reported in individuals who spend long hours in near work activity. Besides several other factors, possible genetic factor and occurrence of myopia was also determined. Material and method: The present study was carried on 222 MBBS students of NKP Salve Medical Collage and government medical collage Nagpur. Student completed questionnaire that include age, sex, age of appearance of refractive error, parent history, reading hours, computer using, television watching, playing videogame, scoring in common entrance, extra achievement in carrier and sport. Data was analyzed using SPSS frequency, percentage, mean and standard deviation was calculated accordingly. Chi-square test was applied wherever applicable and P value <0.05 was considered statistically significant. Result: Assessing genetic component, 81(66.39%) myopic student parent show positive family history whereas 41 myopic student parent, (33.60%) did not have positive family history. Statistically it showed strong significant relationship. (P= 0.001). Average continuous reading hours of myopic student were about 25hrs/ wk and 10hrs/ wk for emmetropic student. It was statistically significant (P=0.001). Strong significant association was found in myopic student for scoring achievement in carrier other than regular study as compared to emmetropic (P=0.001). Total hours of work on computer, watching television and playing video games were statistically significant for myopic. Conclusion: Myopia is a predominant refractive error among the first year medical students. Majority of myopic students score highest marks in common entrance, achievement in carrier other than syllabus study. The prevalence of myopia shows association with computer, videogame and TV. Majority of the parents of myopic medical students are also found to be myopic.
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419. A Study of Efficacy of Misoprostol in Early Pregnancy Loss

     R. P. Patange, Dileep P. Javadekar, Archana Rokade

     • » Abstract Abstract: This study aims to assess the efficacy of misoprostol in the management of missed miscarriage and anembryonic pregnancy. Data of 123 consecutive women with early pregnancy loss treated with medical method were collected prospectively in rural medical college hospital. Each woman received 600µg of misoprostol vaginally. Three hours following the first dose second dose was given if necessary. Women that failed to pass products of conception or had incomplete abortion on ultrasound scan were offered surgical evacuation. Success was defined as complete uterine evacuation within 12 hours on ultrasound scan, without need for surgical evacuation. Results: The overall success rate of medical management was 89.43%.the median dose of misoprostol required was 1200µg.and the median induction miscarriage interval after first dose of Misoprostal was 7.1±3.5 hours (range 6-10hrs) In 13 women medical method failed. Side effects were less common and mild.
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420. Double Inlet Left Ventricle - A Case Report

     Vrushali V. Nikade, Saurabh P. Kulkarni, Sanjay K. Shivapuje, M. V. Ambiye

     • » Abstract Abstract: Double inlet left ventricle is a very rare congenital anomaly which occurs in about 5 - 10 of 100,000 live births. Only the left ventricle of heart is developed properly and both atrial chambers carry blood into this ventricle. This means that oxygen-rich blood mixes with oxygen-poor blood. The mixture is then pumped into both the body and the lungs. The problem most likely occurs early in the pregnancy, when the baby's heart develops. However, the exact cause of DILV is unknown. We are presenting here a case of 2 year old child with single ventricle having left ventricular morphology diagnosed by echocardiography. Great vessels were transposed and pulmonary artery was stenosed.
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421. A Comparative Study of Pulmonary Function Tests in Children and Adolescents, in a Rural Area of Guntur District, Andhra Pradesh, India

     Venkata Venu Gopala Raju S, Madhu Babu K., Chaitanya G

     • » Abstract Introduction: Pulmonary Function Tests are used to measure base¬line status of respiratory function, to monitor treatment and to estimate prognosis. The present study was aimed to determine pulmonary function tests values and to compare the different parameters like FVC, FEV1, ERV, FEF25-75%, PEFR in children and adolescents. Materials and Methods: A cross sectional study was conducted to determine the pulmonary function tests in selected children and adolescents, belonging to rural area of Guntur district. Fifty male subjects were considered for the study and divided them into two groups basing on the age, who are in good health and without any signs and symptoms of disease. Pulmonary function tests were done with the help of Computerized Spirometer. Different parameters like FVC, FEV1, ERV, FEF25-75% and PEFR were recorded. Results and Discussion: Increase of FEV1 of 93.58%, FVC of 105%, ERVof 67.39%, FEF25-75% of 52.03%, PEFR of 46.19% was observed in adolescents, when compared to children. Statistical significance was obtained by using t test (P<0.001). Among the parameters studied, FVC showed a greater increase (i.e. 105%) in adolescents than the remaining parameters when compared with children. Conclusion: In the current study, Pulmonary function test values of children and adolescents, a marked increase was observed in all the five parameters, from childhood to adolescence as per the body needs of oxygen. It is important to understand the improvement of Pulmonary function test values with age among adolescents, in interpretation of PFT variations in different clinical settings.
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422. Study of Changes in Cardiovascular and Cerebrovascular Risk Factors Due to Stress Using Physiological and Biochemical Profiles in Professional Urban Bus Drivers

     Mohd. Rasheeduddin Imran, B. Syamala Devi

     • » Abstract Background: Driving bus in urban area is a demanding job and requires lot of physical and mental stability to perform the task with minimal hazards. The bus drivers are under continuous stress during the working hours and are prone for many diseases related to the changes induced by the stress, especially the cardiovascular and cerebrovascular diseases. Aims: To examine the hemodynamic and biochemical changes in urban bus drivers which are the markers of increased cardiovascular and cerebrovascular risk and to signify the importance of rest and avoidance of long driving hours resulting in stress. Settings and Design: This study was conducted on 50 healthy male professional drivers and 50 healthy male conductors in the age range of 21 to 40 years weighing 50 – 70 Kg. The drivers were compared with conductors of the same bus. Methods and Material: The variables were recorded on Sunday and on next working day in morning 0600 hours and in evening 1800 hours. Blood Pressure was measured using a mercury sphygmomanometer; heart rate was measured using ECG. Blood and urine sample were collected for measurement of serum lipid profile and urine catecholamines. All the values were recorded and comparison tables were derived after statistical analysis using SPSS statistical software and the results were analyzed. Results and Conclusions: The results indicate that there is a significant hemodynamic change including an increase in heart rate and blood pressure in the case group after driving hours compared to the values at rest and also when compared to the controls at the end of working hour. There were no significant changes in serum total cholesterol levels in the case group during the study period but the levels were significantly higher compared to the controls. The urine catecholamines levels showed highly significant elevation in levels in cases compared to levels at rest and to the controls at end of working hours though the first urine samples of the morning on both the study days did not show any significant difference. The study concludes that there are multiple risk factors that are significantly elevated in the bus drivers and can have cumulative effect to cause acute cardiovascular or cerebrovascular event which can be fatal to the driver and also dangerous to the others.
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423. Factors Influencing Animal Bite Cases and Practices among the Cases attending the Anti Rabies Clinic DMCH, Darbhanga (Bihar)

     Abhay Kumar, Rishabh Kr. Rana, Sunil Kumar, Veena Roy, C. Roy

     • » Abstract Introduction: Rabies is an enzootic and epizootic disease caused by a RNA virus (Genus: Lyssavirus, Family: Rhabdoviridae), is of worldwide importance, and is a practically 100 percent fatal disease even today, if not treated appropriately and in a timely fashion but easily preventable. There are many myths and false beliefs associated with animal bite and its management. This study is undertaken to highlight the factors influencing animal bite cases and practices regarding animal bites. Objective: 1. To determine the factors influencing the Animal Bite cases attending ARC, DMCH Darbhanga, Bihar. 2. To find out the practices related to animal bites among the cases attending ARC, DMCH Darbhanga, Bihar. Material and Methods: Study design: This is a hospital based descriptive cross sectional study conducted among 822 animal bite victims attended Anti Rabies Clinic, DMC Darbhanga. Duration: The duration of the study was 6 months, from May 2012 to November 2012 including data collection, data analysis and report writing. Study Population: The patients attending Anti Rabies Clinic DMCH, Darbhanga (Bihar) during the specified period. Tools: Semi structured proforma. Data Collection: The data collection was done through in-depth interviews with the animal bite victims attending OPD. Results: Animal bite cases attending ARC, Darbhanga are mostly male, Hindu, rural people those provoked the animal and they belonged to category III. Among all 9 cases were admitted with frank symptom of Hydrophobia. Conclusion: Wound toileting after a bite was lacking in most of the subjects. Many myths and false beliefs associated with animal bites and its management were present.
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424. A Comparative Study of Physical Growth in Urban and Rural School Children from 5 to 13 Years of Age

     Sunil M Kolekar, Sunita U Sawant

     • » Abstract Abstract: A cross-sectional study was conducted to compare the physical growth amongst healthy school children from the urban and rural areas of Sangli district, Maharashtra, India. A total of 2300 school children were taken for study, out of which 1390 were urban school children and 910 were rural school children. The anthropometric measurements like height and weight were taken. Height and weight of urban school children were statistically (p<0.05) higher than those of rural school children. This was due to differences in nutritional and socio-economic environment in urban and rural areas. This was also due to better understanding of nutritional requirements, availability of different foods, and prevention and treatment of recurrent diseases, state of hygiene and parental literacy in urban areas as compared to rural areas.
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425. A Cross Sectional Study of Domestic Violence in Married Women in Asudgaon Village of Raigad District

     Drushti Parikh, Seema Anjenaya

     • » Abstract Abstract: Domestic violence is a wide spread, deeply ingrained health and social problem among women, which is silently borne by the victims. Domestic violence constitutes willful intimidation, assault, battery, sexual assault or other abusive behavior perpetrated by one family member, household member, or intimate partner against another. According to NFHS-3 (2005-06), the prevalence of domestic violence in ever-married women who have ever experienced spousal violence is 37.2%.1 Domestic violence has major implications on a woman’s health and victims hardly take recourse to law. Being a confidential, intimate and sensitive issue, women tend to hide or provide incomplete information, thereby making it crucial to understand the extent of domestic violence and its determinants. With this background, a community based, cross-sectional study on domestic violence was conducted during June to August 2010, among 250 randomly selected married women in Asudgaon village of Raigad district. The study endeavors to assess the prevalence of domestic violence, its causes including the demographic and socio-cultural determinants thereby helping the healthcare personnel in formulating comprehensive and effective strategies towards tackling this problem. A house to house visit was done and the women were interviewed personally using a pre-designed, pre-tested and structured questionnaire, designed to determine whether they were subjected to domestic violence and if yes, to assess its causes, including the demographic and socio-cultural determinants. The data collected on the day to day basis was compiled, tabulated and analyzed. Statistical analysis was done using Mean and Percentages. Out of the 250 married women, 83 women gave a positive history of domestic violence, thereby reporting a prevalence of 33.2%. The various causes for domestic violence, as reported by the affected females were conflict over cooking and household work (38.55%), wife’s nagging or arguing (32.53%), children related issues (30.12%) and economic distress (26.5%). Slapping (46.98%) was the commonest form of physical violence, followed by pulling hair (14.46%), twisting arm (13.25%) and having things thrown at her (13.25%). Experiences of sexual violence included marital rape (12.05%), being forced to have sex without protection (against pregnancy and STDs) (10.84%), being forced to perform unnatural sex (6.02%) and being forced to imitate acts as shown in pornographic films (4.82%). The most common socio-cultural risk factor for domestic violence, as reported by the respondents, was addiction (42.11%), followed by poverty (38.55%), husband brought up with the idea that wife-beating is acceptable (36.14%) and visiting brothels (16.86%). Among the reasons given by battered women to stay in violent relationships, most common cause was that the women were unaware about legal provisions (61.45%), followed by the fear of being looked down upon by the society (59.03%), for the sake of their children (54.22%) and the fear of complaining due to the threats received from the batterer (43.37%). 80.72% abused females were reported to have tolerated the violence. Only 5.26% of the affected females sought legal help to deal with the violence, while 15.66% females tried to convince the perpetrator. A comprehensive health sector response to this problem is needed whereby health sector can play a vital role in preventing violence against women, helping to identify abuse early, providing victims with the necessary treatment and referring women to appropriate care.
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426. Cryptorchidism - A Case Report

     Sadiqali Abbasali Syed, N. G. Herekar

     • » Abstract Abstract: Cryptorchidism is a condition in which one or both the testes have not passed down the scrotal sac. It may be unilateral or bilateral. It is categorized as true undescended testes in which testes are present in the normal path of descent, and ectopic testes in which testes are present at abnormal site. Common complications of Cryptorchidism are testicular cancer, sub fertility, testicular torsion, and inguinal hernia. In a male cadaver, the right testis was found in the inguinal region. It was dissected properly and the scrotal ligament was observed to be attached to the pubic region. The left testis was descended normally. On doing pathological examination of both testes only senile degenerative changes were observed. Patient had lived a life for 78 years without complication and was died of acute peritonitis.
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427. Sturge- Weber Syndrome: Case report with Ophthalmic Manifestations

     U. S. Mohite, Mahesh Thikekar, K. R. Jadhav

     • » Abstract Sturge Weber Syndrome sometimes referred to as encephalotrigeminal angiomatosis, is rare phakomatosis consisting neurological, skin, ocular manifestation. Ophthalmological features of this disease can vary greatly most relevant characteristic is represented by the glaucoma and is associated with vascular malformations of conjunctiva, episclera, choroid and retina. The goal of present paper is to report a case of 17 yrs old male patient with Sturge Weber Syndrome presenting its inherent clinical features and to underline the importance of its diagnosis in the clinical ophthalmological practice.
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428. A Comparative Study of the Acute Effect of Tobacco Smoking on Cardiovascular System in Smokers to the Non-Smoking Individuals

     Mohd. Rasheeduddin Imran, P. Sambasiva Rao

     • » Abstract Background: Smoking is a serious global public health hazard and has already emerged as a major cause of death due to heart diseases. It is not recognized because of inadequate programmes to deal with it. Aims: The study has been conducted to evaluate and explain the acute cardiovascular effects of tobacco smoking in the habitual smokers and the benefits of quitting the habit of smoking to avoid the complications. Settings and Design: This study was conducted in human lab of physiology department on 100 healthy male smokers and 50 healthy male non-smoker subjects in the age range of 21 to 40 years. Based on duration of exposure to cigarette smoking the smokers were again classified as short term smokers and long term smokers. The smokers were compared with non-smokers. Methods and Material: The smokers were given standard cigarette to smoke while the non-smokers did sham smoking using a cool drink straw. The variables were recorded at rest and immediately after smoking. Blood Pressure was measured using a mercury sphygmomanometer, heart rate was measured using ECG and Stroke volume and Cardiac Output were derived using Echocardiography. All the values were recorded and comparison tables were derived after statistical analysis using SPSS statistical software and the results were analyzed. Results and Conclusions: The results indicate that there is a significant hemodynamic change including an increase in heart rate, blood pressure, stroke volume and cardiac output in both long term and short term smokers immediately after cigarette smoking compared to the non-smoking group after sham smoking. The study concludes that the acute effects can lead to acute cardiovascular events which are more important risk than long-term effects of tobacco smoking and especially in heavy smokers who are always in a state of constant abnormal hemodynamic state.
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429. A Comparative Study of the Acute Effect of Tobacco Smoking on Cardiovascular System in Smokers to the Non-Smoking Individuals

     Mohd. Rasheeduddin Imran, P. Sambasiva Rao2

     • » Abstract Background: Smoking is a serious global public health hazard and has already emerged as a major cause of death due to heart diseases. It is not recognized because of inadequate programmes to deal with it. Aims: The study has been conducted to evaluate and explain the acute cardiovascular effects of tobacco smoking in the habitual smokers and the benefits of quitting the habit of smoking to avoid the complications. Settings and Design: This study was conducted in human lab of physiology department on 100 healthy male smokers and 50 healthy male non-smoker subjects in the age range of 21 to 40 years. Based on duration of exposure to cigarette smoking the smokers were again classified as short term smokers and long term smokers. The smokers were compared with non-smokers. Methods and Material: The smokers were given standard cigarette to smoke while the non-smokers did sham smoking using a cool drink straw. The variables were recorded at rest and immediately after smoking. Blood Pressure was measured using a mercury sphygmomanometer, heart rate was measured using ECG and Stroke volume and Cardiac Output were derived using Echocardiography. All the values were recorded and comparison tables were derived after statistical analysis using SPSS statistical software and the results were analyzed. Results and Conclusions: The results indicate that there is a significant hemodynamic change including an increase in heart rate, blood pressure, stroke volume and cardiac output in both long term and short term smokers immediately after cigarette smoking compared to the non-smoking group after sham smoking. The study concludes that the acute effects can lead to acute cardiovascular events which are more important risk than long-term effects of tobacco smoking and especially in heavy smokers who are always in a state of constant abnormal hemodynamic state.
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430. Study of Serum Uric Acid and its Correlation with Intelligence Quotient and Other Parameters in Normal Healthy Adults

     Usha Patil, Sandhya Divekar, Surekha Vaidya, V. M. Ruikar, M. S. Patwardhan

     • » Abstract Abstract: The study of serum uric acid and its relationship with the intelligence of a person is quiet interesting. We have tried to find out correlation of serum uric acid and general intelligence in healthy medical students between age group of 17 to 20 years. We have also studied correlation of serum uric acid with type of food and difference in values in males and females. For present study 100 medical students in the age group of 17 to 20 yrs were selected. All the subjects were thoroughly examined. Standard IQ was determined by IQ test prescribed by M. C. Joshi.¹ the questionnaire comprised of 100 multiple choice questions with time limit of 20 minutes. I.Q. was determined by Weschsler’s² formula and as per marks they were grouped from genius to superior, above normal, normal, feeble minded, borderline and mentally deficient. The serum uric acid estimation was done by enzymatic method. Statistical analysis was done. It was observed that in male’s serum uric acid level was more than in females. No difference was found between vegetarians and non-vegetarians. There was highly significant positive correlation between serum uric acid and IQ. Higher serum uric acid level was found in those categorized under genius and superior, as compared to those having normal or borderline IQ. Whether IQ of a person and serum uric acid participate common gene loci has to be determined by further study.
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431. Analyzing the Dreams Coming True for Young Undergraduates of DMCH, Laherisarai ,Darbhanga using DREEM Score

     Rishabh Kumar Rana, Sunil Kumar, Abhay Kumar, Veena Roy, C. Roy

     • » Abstract Introduction Poor maintenance, unclean surroundings, and lots of other issues are a sine qua non with majority of Government Medical Colleges across the state. Majority of times it is seen that hasty decisions are made in the 1st Professional Year i.e. in the 1st Semester itself. As the students start to live, learn and imbibe in the local culture and atmosphere their concerns are minimized and number of students leaving the course midway in 3rd semester lessens. This study aims to measure the reasons for this in, statistical terms using DREEM1 ( Dundee Ready Educational Environment Measure) Score. Objective: Analyze the level of satisfaction of undergraduate students after getting in the Medical College by assessing their Perception of the Educational Environment in the medical college through the DREEM Score. Methodology – A cross sectional study conducted in Darbhanga Medical College, Laheriasarai, Darbhanga Bihar. Data was collected using 50 item Dundee Ready Educational Environment Measure. . Total number of students was 170, 80 from 1st Semester and 90 from 3rd Semester. Study period was from September 2012- November 2012. The data obtained was analyzed using Medcalc . Results: According to DREEM Score, items having a mean score of ≥3.5 are positive points, ≤2 indicate problem areas, and between 2 and 3 are aspects of the study environment that could be improved. The 1st semester students scored less than 2 for 10 items (4, 9, 14, 25, 27,39, 42, 43, 48, and 49) and above 3 for 3 items (2, 10, and 19). 3rd semester students scored less than 2 for 10 items (3, 4, 9, 14, 17, 25, 27, 42, 48, and 49) and above 3 for 2 item (2 and 19). Scoring patterns in both the groups were similar except for 2 items (10 and 39). Conclusion - Considerations of climate in the medical school, along the lines of continuous quality improvement and innovation, are likely to further the medical school as a learning organization with the attendant benefits.
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432. Derivation of Demarcating Points for Sex Determination from Skull

     Mohammad Laeeque, Vivek Kishanrao Nirmale, Chaya Vijay Diwan

     • » Abstract Abstract: Craniometry is a branch of anthropometry through which cranial dimensions can be estimated. The study of sexual dimorphism is important clinically as well as in forensic anthropology. Head circumference and maximum biparital diameter were measured in a total of 98 skulls (60 males and 38 females) from the bone bank of the Department of Anatomy, Govt. Medical College Aurangabad. All the measurements were expressed in descriptive statistics i.e. mean; SD, range and mean ± 3S.D. are calculated. The p value of both parameters i.e. Head Circumference and Maximum Biparital diameter are found to be highly significant. (P value <0.001). Demarkating points were derived for the male and female skulls and these demarcating points were cross validated from the available samples. Accuracy of the demarcating points was established. A comparison of the data with the earlier works demonstrated the identical outcomes and highly significant results. The values are a reference tool for the evaluation in Indian race especially of Maharastra. This study is recommended to forensic anthropologists, craniofacial surgeons and medical practitioners and also serves as the basis for future studies on other ethnic group.
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433. A Study of Branching Pattern of Femoral Artery in Femoral Triangle in Cadavers

     Kulkarni Saurabh P, Nikade Vrushali V

     • » Abstract Abstract: Femoral artery is an area of interest for interventionalists. This study of 60 femoral arteries reveals posterior origin of profunda femoris from femoral artery more frequently. Medial circumflex femoral artery found to be arising more proximally than lateral. This artery more commonly originates from femoral artery than its lateral counterpart. It is also found absent in 2 cases.
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434. The Study of Variation of Structures in Hepatoduodenal Ligament and Its Co-Relation with Surgical Anatomy of Liver Transplantation

     Kalyankar A. G., Shingare P. H., Diwan C. V., Kawale D. N.

     • » Abstract Abstract: Variations in biliary tree and its associated vascular elements are very frequent, hence it is important to identify major structures in this area before surgery is attempted, because injury to these structures may result in troublesome hemorrhage and subsequent injury to common bile duct or hepatic ducts or even the inadevarant ligation to the right or common hepatic arteries results into hepatic infarction, necrosis or so called liver death. Similarly variations in duct system can be basis of serious and fatal complications. Hence the study of variations in hepatic pedicle is of interest to both surgeons and anatomist.The present study was undertaken to evaluate the presentation of types and frequency of variations of structures in hepatic pedicle. Aim was to study hepatoduodenal ligament for its morphology, contents and variation of its contents and to co-relate its importance in liver transplantation.A total of 100 cadavers were dissected as per the routine method with routine instruments. The hepatoduodenal ligament was dissected and its contents were followed towards the portahepatis. The branching pattern of hepatic artery and portal vein as well as morphology of extra hepatic biliary system was noted. After collecting the data, statistical analysis was done.Results showed the normal branching pattern of proper hepatic artery in 86% cadavers and remaining 14% cadavers had variations were of 3 types. The branching pattern of portal vein was normal in 56% cadavers while a variation in branching pattern of portal vein was seen in 44% cadavers.The draining pattern of extra hepatic biliary drainage system was normal in 90% cadavers and its variants were seen in 10% of cadavers. The number of cadavers having all 3 structures in normal pattern was 43% of cadavers only.The study shows significant frequency of variations in the anatomy of contents of hepatoduodenal ligament. Hence a detailed study of these structures is warranted before and during hepatic transplant procedures to avoid post operative complications such as biliary ischemia, stricture or hemorrhage.
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435. Congenital Unilateral Renal Agenesis in Association with Genital Anomalies: A Case Report

     Sudhanshu kumar Das, Sidharth S. Maharana

     • » Abstract Congenital unilateral renal agenesis occurs in a incidence of 1 in 450 to 1000 birth, and diagnosed incidentally during imaging examination. Genital anomalies occur in 37–60% of females and 12% of males and 25% of them have associated cardiovascular, gastrointestinal, skeletal abnormalitise. Here we present one case of congenital unilateral renal agenesis in association with genital anomalies.
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436. Epidemiological Study of Oral Submucous Fibrosis in Yavatmal District

     Kalbande A. B., Khakse G. M., Priya D., Tamgadge P. B.

     • » Abstract Introduction: Oral submucous fibrosis (OSF) is now accepted globally as an Indian disease, having highest malignant potential than any other oral premalignant lesions. The understanding of the exact role of alkaloids and other etiological agents with respect to pathogenesis will help the management and treatment modalities. Material & Methods: 370 patients of Oral Submucous Fibrosis attending the Dental out-patient clinic of S.V.N. Govt. Medical College, Yavatmal, over a period of one year, were selected for study. A detailed case history and clinical examination was done in visible light. The diagnosis of OSMF was difficulty in opening the mouth and associated blanched oral mucosa with palpable fibrous bands. Results: Of the 370 cases of OSMF studied, 223 (60.3%) cases were males and 147 (39.7%) cases were females. 547 (39.9%) patients chewed gutkha, 30% chewed betel nut and the remaining 27% chewed betel quid.
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437. Congenital Miliaria Crystallina Associated With Right-Sided Diaphragmatic Eventration: A Rare Case Report

     Sudhanshu kumar Das, M. Amarendra, P.V. Subbarao

     • » Abstract Miliaria crystallina (MC) is a transient, self-limiting, superficial obstruction of the eccrine sweat ducts resulting in rapidly surfacing, tiny, clear, noninflammatory vesicle,which is frequently seen in hot, humid, tropical climates. Congenital occurrence is rare but appearance in the neonatal period is most likely due to lack of maturation of the sweat duct. Here we report a case of congenital MC in a baby with right sided diaphragmatic eventration.
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438. Hemosuccus Pancreaticus Upper GI Bleed: In a Child, a Rare Case Report

     Sujata Devi, Rabindra Kumar Sahoo

     • » Abstract Hemosuccus pancreaticus is a rare but potentially life threatening upper GI bleed via ductus pancreaticus major and ductus pancreaticus minor . The intensity of bleeding varies from intermittent occult bleeding to massive acute bleeding causing even death . We report a rare case of a 10-year old girl who presented with hematemesis and melena. The source of bleeding was pseudo aneurysm of splenic artery, bleeding into GIT via pancreatic duct. Though there are more than 100 cases reported in adults [1], reports in children are limited[2] [3]. There is a report from India with calcific pancreatitits induced gastroduodenal artery aneurysm[4] but none with splenic artery aneurysm.
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439. Acute Diarrhoea in a Child: Fish Tape Worm Infestation- We All May Miss!

     Rabindra Kumar Sahoo, Sujata Devi

     • » Abstract Diphyllobothrium latum is a platyhelminth otherwise called as fish tape worm. It is endemic in areas where humans frequently consume raw or pickled fish. Diphyllobothrium latum infection is typically an asymptomatic condition. Patients do not usually observe passage of segments in the stool as noted in other tapeworm infections. A few reports have documented patients who presented after vomiting a ball of worms that were determined to be fish tapeworms. We report a rare case of Fish Tape Worm Infestation that occurred in India.
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440. Need of Evaluation of the Present Status of Environmental Conditions of Completed River Valley Projects – Jayakwadi Project a Case Study

     Ujwal G. Patil, S. N. Patil

     • » Abstract Abstract: Every dam causes partly temporary and partly permanent submergence of land in the upstream and displacement of resident persons and their property, along-with submergence of plant life and disruption to animal life. It is necessary to evaluate and monitor the post project impacts and whether the envisaged benefits are achieved. Hence it is essential to evaluate the impacts, adverse or beneficial in order to minimise the adverse impacts and maximise the beneficial impacts for equitable distribution of water resource. The effect of a project of this magnitude has never been studied. An in depth analysis will identify the long-term positive and negative impacts on environment, socio-economic development and on physical factors such as soil, water and air. This evaluation will also result in providing a measurement criteria and yardsticks for carrying out EIA for future water resources projects.
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441. Comparison of Environmental Impact of Barrages and Large Dam by Checklist Method

     Ujwal G. Patil, S. N. Patil

     • » Abstract Abstract: This article focuses on the environmental & social impacts of the River Valley Projects, while pinpointing the vital need of large storage water resources projects in India. The water is becoming scarcer in India due to increase in population; on the other hand due to creation of large dams it is resulting environmental impacts. The paper aims at clarifying implementation of the minor & medium projects on the river with minimizing the environmental impacts & leading towards a sustainable growth.
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442. Comparison of Fine Needle Aspiration Cytology (FNAC) and Histopathology in the Diagnosis of Neck Masses

     G. G. Swamy, B. Chandrasekhar, J. Parameswari, S. Madhuravani

     • » Abstract Objective: Neck masses are a common clinical finding, affecting all age groups. These lumps may be extremely worrying for both physician and patient, as a wide variety of pathological conditions. Accurate cytological analysis has played a major role in evaluation and planning for surgery. We attempted to evaluate the role of Fine Needle Aspiration Cytology (FNAC) in diagnosing lump lesions of the neck region and to review the diversity of lesions in the patients attending the hospital. Material and Methods: The study was conducted prospectively in the Department of pathology at Great Eastern Medical School- Teaching Hospital, Srikakulam, India a tertiary health care centre. The target population comprised patients presenting with palpable masses at neck region during the period of December 2010 to December 2012. The accuracy of FNAC was verified by histological examination in this final study group of (n=136) patients. Results: In these (n=136) patients, twenty were males and hundred were females. Thyroid gland (60%) was the commonest site aspirated, followed by lymph node (35%), and soft tissue lesions (5%). In our study the sensitivity was 87.5%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 98.50% and false negatives were 12.0%. Summary and Conclusion: We concluded that FNAC is a safe, cost-effective, sensitive and specific technique in the initial evaluation of head and neck masses. A correct cytological diagnosis can be achieved in a majority of cases, avoiding the need for surgical interventions.
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443. Classifying Gait Patterns of Older Adults by Movement Control and Biomechanical Factors: Validation by Gait and Physical Performance Measures

     Shyam D. Ganvir, Suvarna S.Ganvir, Amit V Nagrale, Abhijit D.Diwate

     • » Abstract Background: While gait patterns of older adults with mobility problems vary, the patterns are rarely used to plan interventions. The purpose of this study was to establish concurrent validity of a clinically useful classification system using gait and physical performance measures. Methods: Community-dwelling male veterans (n=106; mean 76 ± 7.1) referred for mobility problems were videotaped for evaluation. Gait patterns have been classified using structured clinical observation and along movement control factors (consistent, inconsistent) & biomechanical factors (posture: usual, flexed, extended, crouched). Pair wise comparisons across various groups were performed to validate the gait classification using gait parameters (gait speed, step length, width and variability), lower extremity range of motion and muscle strength, physical function in ADL (Physical Performance Test, PPT) and gait abnormalities (GARS-M). Results: Consistent and inconsistent groups were different in gait speed (0.66 and 0.49m/s, respectively; p=0.003), step length (0.46 and 0.38m; p=0.008), step length variability (7.47% and 12.74%; p=0.043), the PPT (15.80 and 11.73; p<0.001) and GARS-M (5.83 and 10.66; p<0.001). Within both consistent and inconsistent groups, four groups defined by postural patterns, also differed in gait speed, step length, PPT and GARS-M scores (p<.05). Conclusion: Gait pattern classification based on movement control and biomechanical factors has good concurrent validity with respect to gait and physical performance measures of mobility.
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444. A Qualitative Assessment of the Perceptions towards Mandatory Pre-Marital HIV Testing Among Unmarried Youths in Dakar

     P G Sow, A. B. Tall, O. Ka, A. A. Ndiaye, A Tal Dia, I Traore

     • » Abstract Abstract: Mandatory premarital HIV testing is gaining more ground especially among youths in Dakar but the perceptions of the young persons affected by this request have not been adequately explored. This study used a qualitative approach to assess the perceptions of unmarried youths regarding mandatory pre-marital HIV testing. Six focus group discussions were conducted among male and female youths in Dakar areas. Many of the participants were aware of mandatory pre-marital HIV testing and majority had a positive perception of the practice. Though participants were of the view that a positive HIV status at that stage would signify the end of the relationship, most of the female participants were against the cancelation of intending marriages by religious organizations because of sero-discordance. Even though majority wanted the results to be given to the couple, most would like the religious leader to disclose the result. The need for post-test counselling was stressed by many of the participants.
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445. Study of hematological parameters in patients with diabetic retinopathy

     Anjali

     • » Abstract Bonedemineralization is a significant problem in Inflammatory Bowel Disease. Contributing factors including inadequate nutrition, corticosteroid, and decreased physical activity .Trace elements play an important role in the growth development and maintenance of bones .The aim of our study was to assess the relationship between the serum Zinc level and the bone Mineral indexes in Inflammatory Bowel Disease patients. Forty two newly diagnosed patients of Inflammatory Bowel Disease and forty healthy Controls of both gender ranging in age from 19-50 years were included in the study. Fasting blood samples were processed for following biochemical parameters– Serum Calcium, Phosphorus, Vitamin D, Parathyroid Hormone and Zinc. The subjects were evaluated for Bone Mineral Density (g/cm2) using Dual Energy X-rayAbsorptiometryscan and T score was calculated to assess Osteoporosis. Student’s unpaired t-test, one way ANOVA and Pearson correlation tests were used for statistical analysis .Inflammatory Bowel Disease patients had significantly lower Bone Mineral Density than the Controls. Bone Mineral Density values were not different between the subtypes Crohn’s Disease and Ulcerative Colitis. Though Ulcerative Colitis and Crohn’s Disease patients had significantly lower Bone Mineral Density than the Controls. Low Zinc level was observed in 50% of Osteopenic and 80% of Osteoporotic subjects. Zinc level was positively correlated with Bone Mineral Density(r=0.24) and Vitamin D (r=0.25) . Patients with Inflammatory Bowel Disease are more prone to develop metabolic bone disease. Along with other nutrients supplement Zinc should be added to prevent bone loss.
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446. Study of hematological parameters in patients with diabetic retinopathy

     A Sowmya Devi, T B Uma Devi, Erli Amel Ivan, G Ramya

     • » Abstract Background: Diabetic Retinopathy (DR) is the major cause of blindness among the working population and is the most common microvascular complication of diabetes. Diabetes Mellitus (DM) is a complex disease characterized by chronic hyperglycemia, metabolic abnormalities, and long term macro and micro vascular complications involving the blood vessels, eyes, kidneys, and nerves. The majority of morbidity and mortality associated with diabetes are due to hyperglycemia leading to diabetic complications. Larger platelets contain denser granules which are metabolically and enzymatically more active and have higher thrombotic potential. Mean Platelet Volume (MPV) indicates the activity and average size of platelets and increase in MPV is linked to increased thrombotic potential. Several studies have shown relation between platelet parameters like Platelet count and MPV with presence of vascular complications. Objectives: To study the hematological parameters in patients with diabetic retinopathy and to evaluate the association of platelet parameters with glycemic control and vascular complications in patients with diabetic retinopathy. Materials and Methods: This was a case control study carried out for 18 months in a tertiary care hospital in patients with diabetic retinopathy. Results and Discussion: Patients with DR had low normal hemoglobin level of 13.5 (+/- 1.1) gm/dl. The Red cell Distribution Width was increased in patients with DR (15.4). The ESR in patients with DR was increased. The platelet count had a positive correlation with fasting blood sugar, postprandial blood sugar and HbA1C in patients with DR. Conclusion: For identification of vascular complications in patients with Type 2 diabetes, platelet parameters can be used only as an accessory tool but not as a single reliable marker. It is recommended that hematological parameters should be analyzed along with glycemic index and fundus examination to look for retinal changes to rule out impending microvascular complication of diabetes mainly diabetic retinopathy.
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447. Study of hematological parameters in patients with diabetic retinopathy

     A Sowmya Devi, T B Uma Devi, Erli Amel Ivan, G Ramya

     • » Abstract Background: Diabetic Retinopathy (DR) is the major cause of blindness among the working population and is the most common microvascular complication of diabetes. Diabetes Mellitus (DM) is a complex disease characterized by chronic hyperglycemia, metabolic abnormalities, and long term macro and micro vascular complications involving the blood vessels, eyes, kidneys, and nerves. The majority of morbidity and mortality associated with diabetes are due to hyperglycemia leading to diabetic complications. Larger platelets contain denser granules which are metabolically and enzymatically more active and have higher thrombotic potential. Mean Platelet Volume (MPV) indicates the activity and average size of platelets and increase in MPV is linked to increased thrombotic potential. Several studies have shown relation between platelet parameters like Platelet count and MPV with presence of vascular complications. Objectives: To study the hematological parameters in patients with diabetic retinopathy and to evaluate the association of platelet parameters with glycemic control and vascular complications in patients with diabetic retinopathy. Materials and Methods: This was a case control study carried out for 18 months in a tertiary care hospital in patients with diabetic retinopathy. Results and Discussion: Patients with DR had low normal hemoglobin level of 13.5 (+/- 1.1) gm/dl. The Red cell Distribution Width was increased in patients with DR (15.4). The ESR in patients with DR was increased. The platelet count had a positive correlation with fasting blood sugar, postprandial blood sugar and HbA1C in patients with DR. Conclusion: For identification of vascular complications in patients with Type 2 diabetes, platelet parameters can be used only as an accessory tool but not as a single reliable marker. It is recommended that hematological parameters should be analyzed along with glycemic index and fundus examination to look for retinal changes to rule out impending microvascular complication of diabetes mainly diabetic retinopathy.
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448. Effect of various mulches on the growth and yield of strawberry cv. chandler under sub tropical conditions of Punjab

     Pawandeep Kaur, Amarjeet Kaur

     • » Abstract A field study was conducted in the Department of Horticulture, Khalsa College, Amritsar during 2016-2017 to study the effect of various mulches on performance of strawberry cv. Chandler. The runners of strawberry cv. Chandler were planted in the second fortnight of October with spacing of 45 × 30 cm. The investigation was laid out in RBD replicated thrice. There were treatments were seven treatments including T1(Black polyethylene), T2(Silver polyethylene), T3 (Sugarcane trash), T4(Paddy straw), T5(Grass), T6 (Saw dust) and T7 (Control). Results of the study showed that black polyethylene mulch increased the vegetative growth parameters of strawberry. The maximum plant height (21.43 cm), number of leaves per plant (37.66), leaf area (89.36cm2), number of flowers (27.52), number of fruits (22.46), fruit set per cent (82.99) were recorded in the treatment T1 (black polyethylene mulch).It also increased the yield(145.43g/plant). Hence application of black polyethylene mulch enhanced the vegetative and yield characters of strawberry fruits than other mulches respectively.
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449. 16S rDNA based identification of culturable bacteria from highly polluted Varthur and Bellandur lakes of Bangalore, India

     Smitha Murthy, Venkata Narasimha Kadali, Sheji Chandran N

     • » Abstract This study investigated the microbial population of highly polluted Varthur and Bellandur lakes, the largest freshwater lakes of Bangalore, Karnataka. A motivation for this study was the numerous reports about these polluted lakes and the occurrence of pathogenic microorganisms in drinking water and the associated diseases. Water samples were collected from both the lakes in July 2017. PCR assay of 16S rRNA genes showed that the bacterial compositions of both lakes are largely similar. The present study identified 36 bacterial strains which include highly pathogenic bacterial species like Klebsiellapneumoniae, Escherichia coli, Staphylococcus aureus, Citrobacterfreundii, Enterobacteraerogenes, and industrially important bacterial species such as Pseudomonas aeruginosa, Micrococcus luteus, Bacillus amyloliquifaciensand Bacillus subtilis. This is the first report of molecular study ofbacteria from these lakes. This study has clearly revealed that currently, the microbiological quality of Varthur and Bellandur lakes water makes them unfit for drinking and recreational activities due to contamination by bacteria. The water analyzed in this study has clearly shown that they are loaded with the contaminants indicator organisms which are the indication of feacal pollution. This study helps to assess its usefulness as portable/ recreational water and to recommend control measures where necessary. Key Words: Bacterial identification, lake water, 16S rDNA sequencing, Varthur and Bellandur lakes, water pollution, pathogenic bacteria, lakeeutrophication
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450. Role of oxidative stress in thyrotoxicosis

     Geetha P A, Ajaykumar B, Parvathi K, Sreejayan M P

     • » Abstract Thyrotoxicosis is a clinical syndrome that results when excessive levels of active thyroid hormones T3 and T4 are secreted into the circulation. In thyrotoxicosis oxidative stress is implicated in the causation of clinical features like myopathy, myocardial insufficiency and ophthalmopathy. Oxidative change in thyrotoxicosis was assessed by measuring level of lipid peroxidation product malondialdehyde (MDA) and activity of antioxidant enzyme superoxide dismutase (SOD) in the blood of 18 thyrotoxic patients and 22 healthy euthyroid controls. Serum MDA level was significantly increased and serum SOD activity was very significantly decreased in the cases when compared to controls. Conclusion: The present study confirms the presence of oxidative stress in thyrotoxicosis. This warrants nutritional support with antioxidant agents in thyrotoxicosis.
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451. Dharmendra Jena, Somya Choubey

     Dharmendra Jena, Somya Choubey

     • » Abstract The study demeanor to comprehend an assortment of extraction that impinge on the rural population of Gujarat to access eye care services and understand the need of outreach eye camps to be conducted in the remote and rural areas of Gujarat. The study investigate a variety of factors that protect them to available various eye care services available by various service provider like government, NGOs, corporate and others. Patients attend the eye camps from different villages have been interviewed of different age group. Total 110 people attended the camp were elected through cluster sampling method from the registration sheet of the camp. 110 patients from different villages of Sabarkantha and Aarvali district in the state of Gujarat have been interviewed for the purpose of the study. The staff of outreach team of Blind People’s Association along with field workers and counselors conducted the interview for the study purpose.
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452. Localisation of the gap junctions in the trigeminal ganglia of the rat using various techniques

     Sanjay Kumar Sharma, Vishwajit Ravindra Deshmukh, Pranav Prasoon, Subrata Basu Ray

     • » Abstract Background: Gap junctions form the important connecting channels among the neurons and the surrounding cells. Various neurotransmitters pass through them. Gap junctions were made up of Connexons. These connexon subunits of two cells joined with each other to form the gap junctions. In the present study, localization of gap junctions was done in trigeminal ganglia using various techniques. This ganglion consists of neurons of varied sizes, which were surrounded by satellite glial cells. Satellite glial cells from the envelope like structure around the glial cells and in turn responsible for controlling the internal homeostasis of the neuron. Increase activity of these cells were seen in many of the pathological conditions such as trigeminal neuralgia Material Methods: The present study was done on the adult male wistar rats (n=18). These rats were randomly divided into three groups, depending upon the procedure performed. Group I (n=6) was utilized for the cresyl violet staining to identify various sizes of neurons, group II (n=6) had undergone immunohistochemistry for the connexin-43 antibody and the group III, electron microscopic study was done to identify and confirm the location of gap junctions Results: In the present study, trigeminal ganglia from both the left and right sides were examined for morphological, immunohistochemical and electron microscopic localization of gap junctions. Morphological studies showed that ganglia were composed of neurons surrounded by satellite cells, nerve fibers along with Schwann cells and connective tissue containing blood vessel. Immunohistochemistry showed prominent gap junctions between the neurons and satellite glial cells of the ganglia. Electron microscopy revealed the presence of gap junctions in the trigeminal ganglion. No difference was noted between the trigeminal ganglia of the left and right sides. Conclusion: Gap junctions forms the important channels for the transmission of various neurotransmitters. Cresyl violet staining did identification of cells in the trigeminal ganglion. After identification, further confirmation was done by the immunohistochemistry and electronmicrosopic study. Localization of the gap junctions is important to identify the sites for exchange and in future these sites can be utilized for various gap junction blocker studies.
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453. Additional role of sertraline prescribed for treatment of pre mature ejaculation in control of nightfall (nocturnal emission) - A multicenter study

     Manish Nigam, Preeti Nigam, Rakesh Kumar Paswan

     • » Abstract 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.
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454. A review of acute poisoning cases admitted in the MICU of a tertiary care hospital

     Kanchana S Pillai, Trupti H Trivedi, Nivedita D Moulick

     • » Abstract 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.
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455. Category wise occurrence of breast lesions according to BIRADS mammography lexicon: An observational study

     Megha Wani, Rajashree Purohit

     • » Abstract 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.
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456. Total laparoscopic hysterectomy versus non–descent vaginal hysterectomy: An observational study

     A B Fuzayel, Banasree Bhadra, N Choudhury, D J Shyam

     • » Abstract 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.
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457. A study of prevalence of hypertension and its associated factors in school children

     Anurup Sahu, K Kashi Viswanadham

     • » Abstract 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.
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458. A comparative study of CT, MRI-Head for the detection of acute cerebral haemorrhage

     Lalit Krishna Gothecha, Rajesh Yadav

     • » Abstract 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.
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459. Thyroid profile in pregnancy

     Arunanchal Jha, SudhaBharti

     • » Abstract 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.
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460. Study of postpartum complications in DMCH

     Arunanchal Jha, SudhaBharti

     • » Abstract Study of postpartum complications in DMCH
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461. Role of high resolution sonography in symptomatic knee joint

     Sanjay Kumar Jha, Rajiv Ranjan

     • » Abstract 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.
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462. A study of prevalence and factor associated with protein energy malnutrition in less than six year children at tertiary health centre

     Hemant Kumar

     • » Abstract 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
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463. Laparoscopy as method of choice for diagnosing and treating peritoneal and intestinal tuberculosis: A multicentric study

     Devesh Pratap Singh, Kuldeep Kumar, Rakesh Kumar Paswan, Shweta Singh

     • » Abstract 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.
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464. Adverse effect of Diclofenac sodium on weight and volume of kidneys of adult swiss albino mice

     A D Kannamwar, G L Maske, I V Ingole

     • » Abstract 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.
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465. Prevalence and severity of restless leg syndrome in pregnant women of Latur district

     Sureshkumar T, Amruta Kadam

     • » Abstract 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.
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466. A study on awareness and attitude of organ donation among arts college students of Thiruvannamalai district, Tamil Nadu 2017

     Sujatha S, Getrude Banumathi P, J Harikrishnan, Jaiganesh D, Ravishankar P

     • » Abstract 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.
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467. 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

     • » Abstract 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
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468. A study of the cutaneous manifestations in patients of diabetes mellitus

     Yashdeep, Kishor Singh, Sanjay Kanodia, Parvesh

     • » Abstract A study of the cutaneous manifestations in patients of diabetes mellitus
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469. Study of ‘atd’ angle in myocardial infarction patients

     A V Salunkhe, U U Joshi, N R Mudiraj

     • » Abstract 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.
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470. Bacteriological profile and antimicrobial susceptibilty of blood culture isolates from the patients of tertiary care hospital, Udaipur

     Pratibha Mittal, Anshu Sharma

     • » Abstract 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.
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471. Comparative study of indications, complications and outcome of elective and emergency intubation

     Swati Chavan, Rupal Padhiyar, Aniket Mohite, Swapnil Dhampalwar

     • » Abstract 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.
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472. 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

     • » Abstract Anthocyanin from red tamarind, Tamarindus indica var. rhodocarpa as a potential natural pigment for use in textile industry
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473. Significance of cerebral and umbilical artery doppler velocimetry in normal and growth restricted pregnancy

     V S Prasannakumar Reddy, Aradhana Giri, N Bhavani, Togarikar

     • » Abstract 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.
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474. Histopathological study of tumours of adipose tissue

     Shilpa Premkumar, Prema Saldanha

     • » Abstract 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.
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475. Bacteriological profile of Urinary Tract Infections in pregnant women – Future Challenges

     Natasha Sawhney, Rahul Prabhas, Varsha A Singh

     • » Abstract 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
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476. A rare case report of anaesthetic management in a paediatric patient with Christ-Siemens-Touraine syndrome

     Sonali Khobragade, Leena Ingle, Amol Jatale, Jitendra Bhagat

     • » Abstract Ectodermal dysplasia (ED) is a heterogeneous group of disorders which may involve teeth, skin and appendageal structures including hairs, nails, eccrine and sebaceous glands. As ED is very rare in occurrence, the available literature is scarce. We are describing a case of 3 year old male child with suspected foreign body (nose) posted for emergency nasal endoscopy. Anticipating difficult airway, frequent pulmonary infections, temperature monitoring are important considerations in anaesthesia management in a case of patient with Ectodermal Dysplasia. Thorough knowledge about Ectodermal Dysplasia is important to an Anaesthesiologist to tackle related complications in emergency scenarios.
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477. Placental thickness an estimator of fetal growth variables

     Shantha A, Kesavsingh, Arumugam P, Kasthuri A, Rajendran A K

     • » Abstract Objectives: 1.To find out the relationships between fetus growth variables with placental thickness.2.To estimate the growth variables through the regression analysis models. Methodology: 240 III trimester ante-natal mothers were selected as first 20 singleton pregnant mothers through the months of January to December 2016. The Ultra Sona Graphed statistics like Abdominal Circumference (AC), Biparietal diameter (BPD), Femer length (FL), LMP based gestational age (GA) and Placental Thickness (PT) were collected. The study subjects 240 singleton Ante Natal mothers fetal growth of above variables were analyzed and interpreted accordingly. Results: The placental thickness determined the BPD as 60.1%, AC as 64.8%, FL as 67.7% and 66.7%. Based on this, four regression equations were being computed for estimating the BPD, AC, FL and GA. Discussions: The main function of the placenta is exchanging nutrients, metabolic products and gases to the fetus. The placental thickness can be an indicator of IUGR. Conclusions: Early detections of fetal growth may prevent the perinatal, neonatal and maternal mortalities.
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478. Incidence of coronary artery disease in asymptomatic obese individuals

     Neelima S Deshpande, Vaibhav Lade, S A Sangle, H D Prasad

     • » Abstract Aims: To find out evidence of coronary artery disease in asymptomatic obese individuals by treadmill stress test -modified bruce protocol. To study left ventricular function in these individuals by 2D Echocardiography Obesity being one of the major risk factor for coronary artery disease present study was undertaken to find out evidence of coronary artery disease in asymptomatic obese individuals. 50 asymptomatic obese individuals were studied both males and females having Body Mass Index more than 30. Treadmill stress test was performed in each case by using modified Bruce protocol. Test was positive in 22% individuals. Left ventricular hypertrophy was found in 32% and diastolic dysfunction in 10% individuals. Thus there is rise in cardiovascular risk like hypertension and incidence of coronary artery disease as BMI increases.
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479. Autoimmune status and the morphological disease in the thyroid gland

     Priakshi Baruah, Sheereen Tarannum, Aniruddha Mukherjee

     • » Abstract Problem Statement: Thyroid gland is one of the parts of our body which is constantly active metabolically and is one of the most responsive organs of the body. The thyroid gland turns out to be the endocrine organ in which the auto reactive processes have been known the longest. Anti thyroid antibodies are found in 3 – 8 % of individuals with no clinical evidence of Thyroid disease possibly signifying a subclinical focal thyroiditis. In the different thyroid disorders, the presence of anti-thyroid antibodies has been reported as 50 – 60%. Methods: 62 patients with different thyroid disorders (Colloid Nodular Goiter, inflammation and tumours) attending the various Medicine and surgical wards and the ENT dept. for their problems and who were subsequently sent to the pathology and biochemistry department of M.G.M. Medical College and L.S.K. Hospital, for investigations, were evaluated simultaneously for their autoimmune status and the morphological disease in the thyroid gland. Results: There are three primary antithyroid antibodies, the peroxidise antibodies (TPO), anti thyroglobulin antibodies (Tg) and anti (TSH) receptor antibody. While it was found to be 23% in the thyroid disorder group. Anti- TPO antibody alone was found to be positive in 5 patients(8.06%). Two of them had sub acute granulomatous thyroiditis. Conclusion: Strongly positive anti Tg and anti TPO antibody levels are diagnostic of Autoimmune thyroid disease. Retrospective review of all the antibody positive cases in other thyroid disease. All of the antibody positive cases need to be followed up. In the light of the clinical utility of the tests for anti thyroid antibodies in the diagnosis and prognosis of AITD.
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480. Relationship of inflammatory markers with metabolic and anthropometric variables in obese individuals

     Bindu Gopinathan Nair, Saleena Prameela Chinnaiah Rajadas

     • » Abstract Bindu Gopinathan Nair, Saleena Prameela Chinnaiah Rajadas
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481. Physio-chemical studies of some irrigation water sources from Ogbia, Bayelsa state and their effects on elemental composition of Zea mays L

     M M Etukudo, R A Ukpe, Ikechukwu Nyenwe

     • » Abstract The physico-chemical characteristics of four different water sources and their effects on the elemental composition of Zea mays L. were evaluated in the laboratory for two (2) weeks. Standard procedures were used to determine the physico-chemical characteristics (pH, salinity, conductivity, turbidity, TDS, TSS, COD, BOD, DO, Mg, Ca, Na, K, Pb etc) of the water samples. Seedlings of the test crop were raised and irrigated with varied sources of water samples alongside a control treatment (distilled water). Mineral nutrient composition of the plant (Pb, Cd, Cr, Ca, Mg, Na, K, NO3-, PO4, Fe, Cu, Zn, and Mn), were estimated. The results showed that there were marked differences (P < 0.05) in the physico-chemical characteristics of the four water samples. The highest content of potassium, sodium and phosphate were recorded in decreasing order from stream, tap, rain and distilled water, while, the Mg, and Mn contents in the test crop were in the decreasing order from stream, rain, tap and distilled water. In addition, there were significant differences (P < 0.05) in the content of Ca among the four water sources, with values higher than that of the control. This study suggests that there is need for appropriate environmental pollution control measures, in order to keep some water parameters within optimum range for proper metabolism in the test crop in the study area.
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482. Impact of pre–natal diagnostic technique (PNDT) act implementation on child sex ratio in India

     Keshav Singh, Shantha A, Rajendran A K, Kasthuri A, Arumugam P

     • » Abstract Aim and Objectives 1. To determine the major state wise net decrease of CSR from 1991 to 2001 and from 2001 to 2011.2.To determine the relationship of feticide during 2005 to 2010 on the 2011 CSR. Methodology: The CSR net decrease of major states for the census years 1991, 2001, and 2011 was calculated and average decadal net decrease compared for significance. The total reported feticide crimes during 2005 to 2010 were collected and correlated with 2011 CSR. Results: The mean net reduction of CSR from 1991 -2001 was 23.2 ± 22.4. And from 2001to 2011 was 6.3±17.6. The reduction between the two decades was significant (P<0.05). The reported feticide crimes were negatively correlated with 2011 CSR. (r = -0.469, n = 19, P = 0.043). Discussion: The association between feticide and CSR shows negative correlation. The significant reduction of CSR is attributed to the impact of implementation of PNDT Act 1994.Conclusion: The study reveals that the illegal practice of sex selective abortions has been curtailed by enforcement of PNDT Act 1994 as feticide is negatively correlated with CSR.
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483. Clinical profile of mononeuritis multiplex in a tertiary care hospital

     Rohit Pai, Srilakshmi Prabhu, Raghavendra B S

     • » Abstract Clinical profile of mononeuritis multiplex in a tertiary care hospital
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484. Assessment of present status of plant species in Otuoke macro habitat of Ogbia in Bayelsa state, Nigeria:A checklist of plant species in the study area

     B L Nyananyo, M M Etukudo, M I E Roberts

     • » Abstract This study was carried out to assess the qualitative parameters of native species in Otuoke terrestrial habitat in view of the need for monitoring of plant species and enhance sustainability of the important services provided by plants. Random sampling with line transect was used to collect plant specimen from the study area. Preservation and identification of plant species were carried out using standard taxonomic procedures. Vast number of plant species ranging from herbs, shrubs to trees were identified in the study area. Eighty six (86) plant species that cut across different families were identified and preserved in the herbarium unit of the Department of Biological Sciences, Federal University Otuoke, Bayelsa State, Nigeria. This study provides an excellent overview of the present status of plant species in the study area. This study suggests that Otuoke terrestrial habitat is endowed with great diversity of flora, hence, appropriate conservation strategies should be adopted for sustainable exploitation and management of plant species in the area.
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485. Ultrasonographic correlation of abnormal uterine bleeding at perimenopusal stage

     Jaideep M Palwade, Charushila S Borole

     • » Abstract Aims and Objectives: To study Ultrasonographic correlation of abnormal uterine bleeding at perimenopausal stage. Methodology: This was cross-sectional study carried out in 150 patients gynaecology OPD with the complaints of excessive per vaginal bleeding and who were in the age group between 37 to 51 years were considered. This study was carried out during year 2016. Total 150 females admitted in obstetrics and gynaecology department in MIMER Medical College were included into study. Clinical diagnosis and ultrasonographic findings were correlated. Results: Most of the patients in the present study were between 37-41 years i.e. 56%. Followed by 42-46 i.e. 25.33% and in 47-51 were 18.67 %. Majority of the patients on Ultrasonographic findings Showed no obvious pathology in 62 % patients, Leiomyoma in 21.33 %, followed by Adenomyosis in 5.33%, s/o PID in 2%, s/o Carcinoma growth in 2%. Respective percentage of Clinically diagnosed patients and Ultrasonographically diagnosed patients for Leiomyoma was 21.33 % , 21.33%, followed by DUB, PID, Carcinoma cervix was 2% , 2%; 7%, 3%; 44%, 7.33%. Conclusion: Except DUB, all other cases of AUB correlated well clinically and ultrasonographically. Leiomyoma and cervical growth were the only entities, which correlated well clinically, ultrasonographically. Whereas DUB, adenomyosis, polyp, PID did not correlate well clinically, ultrasonographically.. Adenomyosis was a histopathological diagnosis. DUB was an overestimated diagnosis clinically.
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486. Carcinoma cervix: Prevalence and risk factors in patients from rural India

     Balaji P Nalwad, Rajesh V Darade, Chate Preshit

     • » Abstract Aims and Objectives: To know prevalence and risk factors of carcinoma cervix in patients from rural India. Methodology: This study was conducted in tertiary care institute over period of 2 yrs. from May 2005 to Sep 2007. Cases included were all gynecological cases of carcinoma cervix diagnosed on histopathological examination denovo in our hospital or private hospital with established diagnosis. Total 18278 cases were studied. Cases excluded from study were all pregnant patients with carcinoma cervix. The data is presented in the form of Table and percentages. Result: Incidence of carcinoma cervix in tertiary care institute in our study is 2.7 per 1000 women per two years and in an average 1.35 per 1000 annually. Mean age of presentation was 48.4 years in our study. Out of 50 patients 38(76%) are from rural areas where as 14% are from semi-urban and 5% from urban areas. Maximum number of patients belong to lower socioeconomic status. group i.e. 72% Commonest age at menarche as per our study is between 12-13 years in 58%Maximum number of patients 22 out of 50(44%) in our study are peri-menopausal 50% of women married before age 18 years. All 50 patients are married, commonest duration of married life found to be 25 to 29 years Frequency of Coitus (FOC) per week is found more than 3 in 44 out of 50 patients (88%). Most of the patients were having marriage before 19 years of age. 90% of patients in our study are with parity 3 or more. The most common symptom was vaginal bleeding i.e. in 70 % Most common sign in growth on cervix i.e. 68% followed by cervix that bleeds on touch 62%. However normal looking cervix is found in 3 out of 50 patients. Conclusion: The incidence of carcinoma cervix in our institute was 2.29/1000 OPD cases incidence was maximum in 4thand 5th decade in rural areas and in lower socioeconomic, strata of society. Important risk factors associated with carcinoma of cervix were early age of menarche, prolonged duration of menstrual activity early age of marriage, prolonged duration of sexual activity, increased frequency of coitus, early age of first pregnancy and multiparty. Vaginal discharge was the commonest presenting symptoms and cervix that bleeds on touch was commonest sign.
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487. Auto immune pancreatitis - A case report

     Remya Baburaj, Prabhu Radhan, Rajoo Ramachandran, Subramanian Ilanchezhian, Praveen Kumar

     • » Abstract It is a type of chronic pancreatitis characterized by a heterogeneous autoimmune inflammatory process associated with fibrosis of the pancreas causes organ dysfunction. There are three recognized radiological patterns of autoimmune pancreatitis: diffuse, focal, and multifocal. Diffuse disease is the most common type, with a diffusely edematous sausage - like appearing pancreas with well demarcated sharp margin and absence of the surface undulations. Focal disease is less common and manifests as a focal mass mimic pancreatic malignancy. We had a 52 year old male with history of epigastric pain and fever for a duration of 2 weeks referred to our department for MRI abdomen with contrast. The MRI of the patient revealed diffuse form of Autoimmune pancreatitis which will be discussed in detail.
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488. A study of perinatal outcome in meconium stained amniotic fluid

     Priti Singh, Surendra Nath Soren

     • » Abstract Aims and Objectives: To find out the incidence, study the mode of delivery, relation between meconium staining and fetal heart rate abnormality and clinical correlation of perinatal outcome with thin and thick meconium stained amniotic fluid. Materials and Method: Study was carried out in the department of Obstetrics and Gynaecology of MKCG Medical College Hospital, Berhampur from December 2014 to September 2016. Study included 912 patients with meconium stained amniotic fluid detected during labour and their perinatal outcome will be analysed keeping the type of meconium as the principal variable. Results: Out of 912 cases, thin meconium staining was seen in 63.82% and thick in 36.18%. 66.43% cases of MSAF were associated with high risk factors. Fetal heart rate abnormality was seen in 32.24% cases, more in cases of thick meconium. The mode of delivery in majority of 46.5% were spontaneous vaginal, 11.18% were assisted by forceps or ventouse and 42.77% needed LSCS. At 1 minute, 65.79% babies had Apgar score >7. At 5 minute, 80.92% babies had Apgar score >7. When heart rate abnormality was present along with meconium, 71.43% had Apgar score <7. 35.53% required NICU admission. 19.74% developed perinatal morbidity. MAS was the leading cause of death in 3.95%.Conclusion: There was significant association between heart rate abnormalities and mode of intervention. Low Apgar score was mainly observed when meconium was associated with abnormal heart rate pattern. Thick meconium stained amniotic fluid was associated with increased rate of intervention, neonatal morbidity and mortality compared with thin MSAF.
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489. Seroprevalence of transfusion transmitted infections among voluntary blood donors at a tertiary care teaching hospital in Kolhapur, India

     Chougale R A, Shinde P J

     • » Abstract Background: Transfusion of blood is life saving but also has life-threatening hazards and far-reaching consequences for the recipients themselves as well as for their families and their communities. The present study is based on the seroprevalence of human immunodeficiency virus, hepatitis b virus, hepatitis c virus, syphilis and malaria in voluntary donors. This gives information regarding safety associated with blood transfusion and an accurate measurement of risk versus benefits of blood transfusion. The data generated will help clinicians for judicious use of blood as well as awareness regarding the transfusion transmitted infections (TTIS). Objectives: The objective of the present study was to assess the seroprevalence and trend of TTIS among blood donors in the blood bank of D. Y. Patil Medical College, hospital and research centre, Kolhapur, India. Methods: A total of 5178 samples were screened during a period of seven years from January 2010 to December 2016. Data analysis was done by quickcal software by chi square test. p<0.05 is considered significant. The prevalence of TTIS was expressed by donation years and donors’ characteristics (age, gender, geographical distribution). Results: The overall prevalence of HBV, HIV, HCV, syphilis and malaria was 1.31%, 0.54%, 0.54% and 0.08% respectively, with no reported case of malaria.
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490. A study of correlation between preoperative provisional diagnosis and intra operative findings in the patients with non traumatic acute abdominal pain

     Anil Shriram Mundhe, Tushar S. Agrawal

     • » Abstract Introduction: Abdominal pain is one of the most common reasons for an emergency department (ED) visit, accounting to about 5% to 10% of all ED visits. Aims and Objectives: To Study Correlation between Preoperative Provisional Diagnosis and Intra Operative Findings in the Patients with Non Traumatic Acute Abdominal Pain. Material and Methods: After approval form the Institutional ethical committee a records based, cross-sectional study was carried out in the Department of General Surgery at tertiary health care center during one-year period June 2014-June 2015. All details about clinical history, Clinical diagnosis, Ultrasongraphic findings, CT-Scan findings and Intraoperative findings was extracted from the case records. There were 100 patients were included into the study. 62 pt managed operatively and 38 patients managed conservatively. Result: The majority of the Patients were from the age group of 30-40 i.e. 33%. The majority of the patients were Males i.e. 56% and Females were 44% As per Preoperative Provisional Diagnosis the most common diagnosis found was Acute appendicitis in 44% followed by; Urolithiasis in 14%, Gastritis in 13%, Hollow viscus perforation in 12%, Intestinal obstruction in 06%, Acute cholecystitis in 6%, Acute Pancreatitis in 5%. As per Intraoperative findings in patients with preoperative provisional diagnosis of acute Appendicitis intra op finding was inflamed appendicitis in 63.46% followed by Perforated appendicitis in 20.46%, Gangrenous appendicitis in 13.64%, Normal appendicitis in 2.27%. For preoperative diagnosis in 12 patients as Hollow viscus perforation incidence of Duodenal perforation 58.4% followed by Gastric perforation in 33.3%, Ileal perforation in 8.3% . For total 6 patients as preoperative provisional diagnosis as intestinal obstruction the intraop finding were Postoperative adhesive band 50.1%, Sigmoid volvulus 16.7%, Superior mesenteric artery thrombus 16.7%, Obstructed hernia 16.7.The compatibility of intraoperative findings was highest with USG Diagnosis i.e. 89.00% followed by CT-Scan was 81% and of the Clinical diagnosis was 59%. Conclusion: As per Preoperative Provisional Diagnosis the most common diagnosis found was Acute appendicitis in followed by Urolithiasis, Gastritis, Hollow viscus perforation, Intestinal obstruction, Acute cholecystitis, Acute Pancreatitis etc . The compatibility of intraoperative findings was highest with USG Diagnosis i.e. 89.00% followed by CT-Scan was 81% and of the Clinical diagnosis was 59%.
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491. Ipsilateral compound GR 2 femoral neck and shaft fracture in a 2 year old children- A case report

     Karan Chopra, Suman Dhar, Mangesh Panat, Pratik Israni

     • » Abstract Introduction: Concomittant Ipsilateral Fractures of Neck And Shaft of femur are rare in children of age group 2 years. there are only 11 reported cases till now. These injuries occur in children due to high velocity trauma and there is no accepted method of treatment. Case Report: We had compound grade 2 mid shaft femur with bone loss and ipsilateral neck femur. After fixation it resulted in no limb length discrepancy and no varus deformity. we advocate operative stabilisation of femoral shaft fracture to reduce the risk of further displacement and simplify the fiation of femoral neck. The common complications we see have poor progonosis resulting in avascular necrosis, coxa vara and limb length discrepancy. But in our case report we had nothing of them despite of being compound grade 2 with bone loss. Conclusion: To Conclude, Case Of This Sort In Paediatric Age Group Are Rare, But If Managed Properly Gives A Satisfactory Outcome With Minimal Or Nil Complications.
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492. Post-operative pain and analgesic requirements in breast surgery: Comparative study of combined general anaesthesia with paravertebral block versus general anaesthesia alone

     Nilambari S Adke, Pravin C Jadhav

     • » Abstract Background:Patients undergoing breast cancer surgery frequently experience chronic postoperative pain. The primary objective of this randomized study was to determine if thoracic paravertebral block (TPVB) reduced the incidence of chronic pain after a modified radical mastectomy (MRM) when compared with general anesthesia (GA).This study was undertaken to compare analgesic efficacy and complications of combined general anaesthesia with paravertebral block versus general anaesthesia alone in breast surgery. Material and Methods: A total of 60 patients for elective breast surgery were grouped as Group A (General anaesthesia with paravertebral block) and Group B (General anaesthesia alone) and compared for analgesic efficacy and complications. Results: Duration of postoperative analgesia in group A was 17.63 ± 2.34 versus 5.47 ± 1.63 in group B. Patients in group A (PVB + GA) didn’t required any rescue analgesics as compared to group B (GA) where 28 patients received rescue analgesics. Incidence of PONV was significantly lower in group A as compared to group B. Conclusion: Para vertebral block when used with general anaesthesia induces excellent anaesthesia and greater postoperative pain relief and lower incidence of PONV and other complications.
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493. Study of fine needle aspiration cytology in the diagnosis of ovarian masses

     Delux V Godghate, Arvind Bhake

     • » Abstract Background: Earlier the technique of aspirating ovarian masses was mostly unguided imaging technique. The ovarian masses were located by palpation and were approached transrectally, transvaginally and transcutaneously for fine needle aspiration cytology. The advancement of imaging technique has enabled many workers to undertake fine needle aspiration cytology of ovarian masses as it helped in correct localization and sampling from suspected area of cancerous and noncancerous lesions. Objectives: To study cytomorphological features of benign and malignant conditions of ovarian masses obtained at ultrasound guided fine needle aspiration cytology. To determine sensitivity and specificity at ultrasound guided fine needle aspiration cytology in diagnosis of ovarian masses. To draw value of comparison between cytodiagnosis and histomorphological diagnosis; rate of accuracy, false positive, false negative, positive predictive value and negative predictive value. Material and Methods: The present prospective study was carried out in the Department of Pathology, Jawaharlal Nehru Medical College, Sawangi (M), Wardha during two years duration from July 2009 to June 2011.FNAC was performed on cases with suspected ovarian masses with plan for surgical treatment. The material obtained at aspiration was wet fixed in 95 % ethyl alcohol and stained with papanicolaou stain while few were dry fixed and stained with May Grunwald Giemsa stain. Result: The false positive rate was 0 and false negative rate was 4.34%. The sensitivity and specificity of FNAC in diagnosis of ovarian masses was found to be 95.65% and 100% respectively. Negative predictive value was 96.77% and positive predictive value was 100% of FNAC in diagnosis of ovarian masses. Overall rate of accuracy of FNAC in diagnosis of ovarian masses was 98.11% in present study. Conclusion: FNAC over lesion of ovary carried out under USG guidance is a safe preoperative diagnostic modality. USG guided FNAC in the ovarian lumps has a definite ability to distinguish between a non neoplastic and neoplastic lesions of ovary with confidence.
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494. A study of prevalence and clinical profile of the patients having hypertensive disorders of pregnancy

     Vidya Jadhav, Supriya Waydande

     • » Abstract Introduction: Hypertensive disorder in pregnancy is a condition in which the pregnant woman presents with an elevated blood pressure during pregnancy or puerperium as defined in 1986 by the American College of Obstetricians and Gynecologists and adopted by the World Health Organization (WHO). Hypertensive disorder of pregnancy is seen after 20weeks of pregnancy. It affects almost 6-10% of all pregnancies worldwide. Systolic blood pressure above 140 and diastolic blood pressure above 90mm of Hg with associated proteinuria. Eclampsia means patients with severe preeclampsia develop tonic-clonic convulsions. Material and Method: It was prospective hospital based observational study of patients of hypertensive disorders of pregnancy conducted at Bharti Hospital, Sangli in the department of Obstetrics and Gynecology. In this study patients with essential hypertension and chronic hypertension, patients with known renal disease prior to pregnancy were excluded. Results: The prevalence of Hypertension overall was 29.20 i.e. 125 out 428 ANC registered women. As per age wise in 10-16 years age group it was 29.26% in 17-19 years was 15.00 in 20-24 years. Conclusion: The overall prevalence of PIH in our study was Hypertension overall was 29.20. And associated factors were Obesity, H/o Hypertension, Family H/O of PIH, Diabetes, Primipara, H/O Exposure to Smoking
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495. Trends of poisoning in Vidarbh region of Maharashtra

     Shankar Dakhankar, Bipin Tirpude

     • » Abstract Poisoning is mysterious, dangerous, and reliable method of dying. it is most common method of suicide and homicide since ancient time. Trends of poisoning are different in different parts of India. Present study was conducted at Kasturba Hospital of MGIMS Sevagram, Wardha. This hospital drains patients from the whole Vidarbh area. This study was conducted during period January 1997-December 1998. Durinng this period 364 cases of poisoning were reported at MGIMS Sevagram. Out of them 268 cases of poisoning were admitted for treatment and 49 died during treatment. 78 cases of poisoning directly brought for postmortem. Study showed male predominance in age group of 21-30 years. Organophasphorus poisoning was most common.
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496. A clinico-demographic study of reproductive tract infections at tertiary health care center

     Birajdar Annasaheb Gulabrao, More N V, Suwarna Dahitankar

     • » Abstract Introduction: the maximum cases of Bacterial vaginosis, Trichomonasvaginalis and Candidiasis were in the age group of 20-29 yrs. and least in the age group of ≤ 19 yrs. As parity increases, the no. of cases of each one become less and most of the cases were having parity 1 to 2. Aims and Objectives: To Study Clinico -Demographic profile of patients with Reproductive Tract Infections at tertiary Health care center. Methodology: Patients attending tertiary health care center with complaint of abnormal vaginal discharge of age group 15 to 40 years were selected for the study. This study was conducted at tertiary health care centre from January 2009 to September 2010. During the study period the total number of gynaec O.P.D attendees were 19,270. Presuming the equal distribution of cases on all days the no. of attendees (symptomatic and asymptomatic) with findings of RTI were 6,423. Data presented in tables and in percentages. Result: Vaginal discharge was the commonest complaint among the study group. Prevalence increased with increase in Parity. RTI was more among the Muslims. Prevalence was higher among non-working women. Prevalence of RTI cases was higher in Illiterate. The prevalence of RTI was highest in non-users of Contraceptives (41.26%) as compared to other groups; it was lowest in the women who were dependent on their spouse for the use of condom as a contraceptive. Out of 64 cases of Bacterial vaginosis, 43.75% complained of vaginal discharge, 37.5% complained of pain in abdomen, 15.62% patients complained of backache, 20.31% complained of itching at genital area, 23.43% complained of increased frequency of micturation and 10.93% complained of dyspareunia. Among 40 cases of Trichomonasvaginalis, vaginal discharge was present in 40% cases, pain in abdomen in 20%, backache in 22.5%, Itching in 45%, increased frequency of micturation in 27.5%, dyspareunia in 12.5% of cases. Among 36 cases of Candidiasis vaginal discharge was present in 59.45% cases, backache in 37.83%, pain in abdomen in 40.54%, itching at genital area in 51.35%, increased frequency of micturition in 29.72 % and dyspareunia in 24.32%. Conclusion: It can beconcluded from study that Majority of cases with suggestive symptoms of RTI were in the age group of 20-29 years, asymptomatic cases were highest in the parity group > 4. Prevalence of RTI cases was high among Muslims nonworking (housewife), in illiterate and in non-users of contraceptives.In the study population cases were having multiple symptoms of which in overall vaginal discharge was the most common complaint.
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497. A study of different treatment modalities for carcinoma of breast at tertiary health care center

     Koustubh Mench, T Phira

     • » Abstract Introduction: The World Cancer Report issued by the International Agency for Research on Cancer (IARC), tells us that cancer rates are set to increase at an alarming rate globally. Aims and Objectives: To Study Different Treatment Modalities for Carcinoma of Breast at tertiary health care center. Material and Methods: After approval from Institutional ethical committee a cross-sectional study carried out in all Cases of Carcinoma of Breast that has undergone treatment from April 2012 to April 2014 at Department of General Surgery of CPR hospital attached to RCSM Government Medical College Kolhapur. All the patients were treated as per the protocol by Surgically, Radiology and Chemotherapy and Neo-adjuvant therapy as per necessary in one-year duration such a way 50 patients were selected. Result: 38 patients (76%) of the total 50 patients underwent modified radical mastectomy (MRM). Simple mastectomy (SM) was done in 4 patients (8%) post-operative complication was lymphedema in 10 patients (23.8%) out of 38 patients. post-operative complications were Flap necrosis 2(4.76%) and wound infection 1 patients (1.19%) out of 38 patients. In treatment of stage IV disease NACT+MRM+ post-operative adjuvant therapy required in 8 % and Adjuvant therapy only required in 67% and Simple Mastectomy and Post-operative adjuvant therapy required in 25 % individuals. Out of the total 50 patients neo-adjuvant CT(NACT) was given in 6 patients (12%), post-operative / adjuvant therapy 3 i.e. 6% patients. CT was given as CT only 20%, T+RT-30% CT+HT-16% CT+RT+HT-16 %. Of the total 47 patients of chemotherapy, CT was delayed in 10 patients (21%). CT was not stopped in any patients.46 patients (92%) remained disease free, two patients with previously diagnosed stage III disease developed metastasis to bone. One patients with stage IIIB disease developed local chest wall recurrence. One patients in stage IV died after 10 months of diagnosis. Conclusion: It can be concluded from our study that; mortality of the patients after adequate treatment in our study was found very less i.e. 2% so proper and adequate treatment of the patients as per the standard protocol should be given for increasing survival of the breast cancer patient.
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498. An observational study to evaluate direct obstetric causes of maternal mortality at a tertiary care centre in Mumbai, Maharashtra

     Niranjan N Chavan, Smurti Kamble, Neha Raj, Pradnya Changede

     • » Abstract Background: To evaluate direct obstetric causes of maternal mortality at a tertiary care centre in Mumbai, Maharashtra Methods: A total of 206 cases of maternal deaths due to direct obstetric causes from January 2011 to December2015 were analysed in a tertiary care centre. Information was extracted from the patients' case-notes from Medical Record Office, the labour ward registers, the antenatal and postnatal ward registers. Results: Majority of mortality occurred in age group of 21 -29, multiparous women belonging to urban Hindu community. Most of the cases were ANC registered as the study was carried out in a tertiary care centre, however 83 % of these were referred to our hospital. Most of the mortality occurred in postpartum period in ICU set up. Most common cause was found to be haemorrhage followed by eclampsia Conclusions: Multiple and frequent deliveries in already anaemic young women is the major underlying cause of maternal mortality. Antenatal care starting early in pregnancy, detection and managing pregnancy complications, detection and treatment of associated medical disorders, institutional deliveries, proper referral facility and emergency transport, timely intervention, access to contraceptives and safe abortion services can prevent most of the deaths.
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499. The prediction of delivery date by ultrasonic measurement of fetal crown – Rump length in first trimester

     Arati Mane, L L Pujari

     • » Abstract Introduction: The establishment of pregnancy dates is important not only for the mother who wants to know when to expect the delivery, but it is also important to calculate the gestational age. Accurate dating decrease the number of labour inductions for postterm pregnancies, prevent iatrogenic prematurity Aims and Objectives: To study prediction of delivery date by ultrasonic measurement of fetal crown – rump length in first trimester. Material and Methods: This was a cross-sectional study at OBGY department of tertiary health care center during 12 months. Sample size was 200.EDD is calculated by Naegele’s rule Obstetric ultrasonography will be performed using Philips ultrasound scanner using a 3.5MHZ convex probe. Data was analyzed statically by chi square test, paired t test and other appropriate statistical tests using SPSS version. P value of <0.05 will be considered statistically significant. Result: The maximum cases studied were in age group of 20-24 years i.e., 124 cases (62%) . In EDD of USG, out of 200 cases 22(11%) delivered on predicted day, 61(30.5%) delivered 7 days before, 95(47.5%) delivered after 7 days, 1(0.5%) delivered 8-10 days before, 13(6.5%) delivered 8-10 days after, 0(0%) delivered 11-14 days before, 4(2.0%) delivered after 11-14 days, 1(0.5%) delivered before 15-21 days and 3(1.5%) delivered after 15-21 days in according with EDD calculated by CRL . In LMP-ED Dout of 200 cases, 88(44%) delivered before 5 days, 85(42.5%) delivered from 4 days before to 7 days after, 27(13.5%) delivered after days. Prediction of USG EDD is significantly differed from LMP EDD (Chi –Square =69.7, df =2, P Value =<0.0000001). Conclusion: 89% (178) women delivered within + or – 7 days EDD estimated from LMP 98%(196) women delivered within + or – 14 days of EDD estimated from CRL to conclude, ultrasonographic measurement of CRL (crown Rump Length) between 6-14 weeks of pregnancy is more accurate predictor of EDD as compared to LMP. We recommend the routine use of CRL estimate in the prediction of EDD even if the patient recalls her LMP certainly.
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500. Clinicopathological study of splenomegaly in pediatric age group

     Pore Shubhajyoti N, Patil Sunita P, Bindu Rajan S

     • » Abstract The study is based on 100 cases in pediatric age group with splenomegaly carried out in the Government Medical College and Hospital, Aurangabad. The study group showed slight male predominance. Clinical grading of splenomegaly was done with conventional method. Majority of cases (87%) had either Grade I or II splenomegaly. Hackett’s method for grading of splenomegaly was also employed. Majority of cases (70%) had Grade I or II splenomegaly. The most common presenting complaint was fever followed by pallor. The other complaints were lump in abdomen, history of bleeding, pain in abdomen and symptoms of general ill health. The associated clinical findings were hepatomegaly (85%) and lymphadenopathy (33%). Hematological evaluation including bone marrow examination revealed diagnosis in the majority of cases (62%). These tests are safe, easy to perform and cost effective investigations. Other investigations like histopathology, biochemistry, serology, radiology proved helpful in the diagnosis in 16% cases. Anemia including hemolytic anemia and hematological malignancies were the common etiologies (28%) in the causation of splenomegaly. The Grade I and Grade II splenomegaly was the most common. Hemolytic anemia was the most common anemia (53.6%) followed by megaloblastic anemia (21.4%). The hematological malignancies also encountered frequently (28%). The most common malignancy was acute lymphoblastic leukemia (46.4%) followed by chronic myeloid leukemia (17.8%). The infectious etiologies included malaria, hepatitis, dengue fever, enteric fever etc. Malaria was the most common among them (46.1%). Infiltrative diseases mainly encountered in Grade III (conventional) and Grade 5 (Hackett’s method) splenomegaly.
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501. Anatomical variations of the chorda tympani nerve observed during middle ear surgeries-an institutional study

     Rahman Abdul Aman, Raja Premnath, Subramanian Kulasekaran

     • » Abstract Objectives: The aim of this study is to describe observed variations in the middle ear anatomy of the chorda tympani nerve during middle ear surgeries in our institution. Study Design: A prospective study of 2 years covering 100 middle ear surgeries analyzing the course of the chorda tympani nerve in the middle ear. The surgeries were subdivided into myringoplasty (78 cases) and mastoidectomy with tympanoplasty (22 cases). Results: Chorda tympani nerve anatomy was observed based on its entry into the middle ear from the junction of the posterior and lateral walls of middle ear at the level of the tympanic sulcus. The variations observed were based on its entry at either three levels 1) Iter chordae posterius (35 cases) 2) Inferior toiter chordae posterious (63 cases) 3) Lateral to the tympanic sulcus (2 cases). Conclusion: Variations in the middle ear course of chorda tympani nerve were commonly seen in our case series. The most common variation being its entry into the middle ear inferior to the iter chordae posterious at the level of tympanic sulcus and the least common being its entry lateral to the tympanic sulcus.Understanding the middle ear anatomical variations in the course of chorda tympani nerve is surgically significant in preventing post-operative taste and salivary morbidity following middle ear surgeries. The present study highlights the varied course of the chorda tympani nerve in the middle ear and minor anatomical variations are not very rare.
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502. Magnetic resonance imaging diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome

     Shaurya Thakran, Hemant Mishra, Sunilagrawal, Ravindrakumar

     • » Abstract Mayer- Rokitansky-Kuster-Hauser (MRKH) syndrome is an uncommon variation in the prenatal development of the female genital tract. It is a congenital malformation of the female genital tract. Its features include partial or complete absence (agenesis) of the uterus with an absent or hypoplastic vagina normal fallopian tubes, ovaries, normal external genitalia and the typical 46, XX, female chromosome pattern. Breast development and growth of pubic hair are also normal. Associated renal and/or skeletal abnormalities are common. Mayer-Rokitansky-Kuster-Hauser syndrome is also known as Mullerian Agenesis. The incidence is one in 4000–5000 female births1,2. The normal external appearance of MRKH females makes it difficult to diagnose until puberty, typically diagnosed in mid-adolescence. The average age of diagnosis is between 15 and 18 years, although occasionally a girl may be diagnosed at birth or during childhood because of other health problems. A pelvic ultrasound may be used to see the presence or absence of the uterus and its condition.
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503. A study of clinical profile of respiratory distress syndrome(RDS) in preterm babies

     Sambhaji S Wagh, Deepa S Phirke, Sudhakar Bantewad

     • » Abstract Objective: Study of clinical profile of Respiratory Distress Syndrome in preterm babies. Design: Prospective observational study. Settings: Neonatal Intensive Care unit at tertiary care hospital. Outcome measures: To study role of antenatal steroid, surfactant and assisted ventilation in RDS and outcome in terms of morbidity and mortality in preterms with RDS. Results: 150 neonates with gestational age <37wk with diagnosed as RDS as per clinical investigational guidelines were included.97.3% babies received antenatal steroid while 2.7% did not. Out of the babies who received antenatal steroid 80% survived and 20% died. All (100%) who did not receive antenatal steroid died. Out of them 57.3% received surfactant and 42.7% did not receive. Out of babies who received surfactant 88% survived 12% died. Out of babies who did not receive surfactant 64% survived 36% died. All babies (100%) receiving only CPAP (SA score <4) survived. Out of babies receiving both CPAP and surfactant (SA score 4–7) 98.6% survived and 1.4% died. All babies receiving only assisted ventilation for >10 days died. Morbidity in RDS was sepsis 14.66%, PDA 14%, NEC 8.66% and pulmonary hemorrhage 5.33%. At the end of study 118 (78.66%) babies survived while 32(21.33%) died. Conclusion: We conclude that administration of antenatal steroids in pregnant women during preterm delivery significantly improves lung maturity. CPAP was safe and effective treatment modality. Early institution of CPAP reduced need of ventilation. Early use of surfactant improved the survival and shortened duration of assisted ventilation.
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504. Study of serum uric acid and erythrocytic superoxide dismutase levels in gestational diabetes mellitus and normal pregnancy

     Amol D Shinde, Archana Dhotre, Suresh Ghangle, Mangesh Tekade, Sucheta Ghule

     • » Abstract Level of non-enzymatic antioxidant like serum uric acid and enzymatic antioxidant like superoxide dismutase is found to be deranged in patients of gestational diabetes mellitus. Serum uric acid and superoxide dismutase levels were estimated in sixty patients of gestational diabetes mellitus admitted in obstetrics and gynecology department of G.M.C., Nagpur and sixty normal healthy pregnant controls. The result of the study showed that serum uric acid levels were increased significantly in the gestational diabetes mellitus group compared to the normal pregnant group and serum superoxide dismutase levels were decreased significantly in the gestational diabetes mellitus group compared to the normal pregnant group. Furthermore when levels of serum uric acid and superoxide dismutase were correlated with the fasting and post meal blood glucose in gestational diabetes mellitus patients, significant positive and negative correlation was observed respectively.
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505. Clinico biochemical abnormalities in Thalassemia

     Suman Ghosh, Sheereen Tarannum, Monidipa Ghosh

     • » Abstract Problem statement: Thalassemias are a group of inherited disorders of Hb synthesis characterised by a reduced rate of production of one or more globin chains of Hb resulting in an anaemic state. Blood transfusion which both elevates the anaemia and suppresses the compensatory mechanism is the basis of therapy. But the inevitable consequence of prolonged transfusion therapy is the hemosiderosis. This causes complications like endocrine abnormalities along with hepatic and myocardial siderosis. The group with regular blood transfusion has the more chance of iron excess. The patients with inadequate transfusion are not free from the danger of iron overload because in them the anaemia causes excessive iron absorption. The endocrine glands are not also free from the burnt of hemosiderosis The excess iron in the storage form of ferritin get deposited in endocrine organs like pituitary, pancreas, parathyroid, and thyroid. Methods: It was performed on selected patients with diagnosis of Thalassemia disease, who were attending in both institution (Malda Medical College and M.G.M Medical College and L.S.K Hospital,)The 30 patients were included in our study. In the present study maximum number of cases were in the age group of 5-15 years (68%) and 32% of patients were in the age group of 16-25 years. Results: Dysfunction of the thyroid gland is less frequent than other endocrinopathies in thalassemia patients. Results are Distribution of Cases in Different Types of Thalassemia: Growth Hormone Study, Gonadotrophins Study. In our study no patient had yet developed hypothyroidism but possibilities of hypothyroidism in future specially of the sub-clinical hypothyroid patients remain.
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506. Hodgkins lymphoma presenting as a solitary bone tumor: A case report

     Manimaran Karthikeya Pandian, Varaprasad Sagiraj, Indhumathy K

     • » Abstract Abstract: Primary lymphoma of the bone is the bone involvement by malignant lymphoid infiltrate without the involvement of lymph nodes or other tissues. Differential diagnoses for the primary bone lymphomas include chronic osteomyelitis, primary bone sarcoma, Ewing’s sarcoma, metastatic sarcomas, leukemic infiltrate and carcinoma. Lymphomas of the bone are commonly misdiagnosed as Ewing’s sarcoma. We report a case of 16 years old male, who presented with pain in the Right hip and difficulty in walking that had persisted for 2 months with no history of trauma. The patient was initially diagnosed as a case of PLB of the right acetabulum confirmed by open biopsy but the FDG-PET-CT examination was done which showed an abnormally high uptake of F-FDG in the cervical, mediastinal, retroperitoneal, iliac lymphnodal groups, skeletal system, liver and spleen and Immunohistochemistry favoured the diagnosis of Classical Hodgkins lymphoma, mixed cellularity type. He was classified as stage IV B Cell lymphoma and referred to oncology department for favour of chemotherapy and radiotherapy.
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507. Comparison of phenotypic methods for the detection of extended spectrum beta lactamase production among enterobacteriaceae

     M Anitha Raj, V Abarna, E Arthi

     • » Abstract Introduction: Extended-spectrum β-lactamases (ESBLs) are enzymes which hydrolyse extended-spectrum Cephalosporins and are more common in recent times. Aim: We aimed to compare Chrome agar, double disk synergy test (DDST) and potentiated combined disk diffusion test (PCDDT) with ESBL E test for their sensitivity in ESBL detection. Materials and Methods: The study was a cross-sectional prospective analytical study involving 100 isolates of Enterobacteriaceae family between May 2014 and December 2014. All the isolates were subjected to ESBL detection by Chrome agar, double disk synergy test (DDST), Phenotypic confirmatory disk diffusion test (PCDDT) and ESBL Estrip method. Results: Among the 100 isolates tested, 61 isolates were resistant to one of the third generation Cephalosporins. Among them potentiated disk diffusion test (PCDDT) detected 30/61 isolates (49.18%), DDST detected26 (42.62%) and E strip detected detected35 (57.37%) isolates. Chrome agar showed growth on 42 samples. Conclusions: In resource poor settings, Chrome agar along with Phenotypic confirmatory disk diffusion test (PCDDT) can be taken as an effective screening method for ESBL detection.
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508. Study of serum CRP and malondialdehyde levels in gestational diabetes mellitus and normal pregnancy

     Amol D Shinde, Archana Dhotre, Suresh Ghangle, Mangesh Tekade, Sucheta Ghule

     • » Abstract Introduction: Markers of inflammation and oxidative stress like C Reactive Protein and Malondialdehyde may provide information about risk of developing Type II DM, cardiovascular disease and hypertension in future in patients of Gestational diabetes mellitus. Serum C Reactive Protein and serum MDA level were estimated in sixty patients of gestational diabetes mellitus admitted in obstetrics and gynecology department of G.M.C., Nagpur and sixty normal healthy pregnant controls. The result of the study showed that serum C Reactive Protein and Malondialdehyde levels were increased significantly in the gestational diabetes mellitus group compared to the normal pregnant group. Furthermore when levels of serum C Reactive Protein and Malondialdehyde were correlated with the fasting and post meal blood glucose in gestational diabetes mellitus patients, significant positive correlation was observed.
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509. A retrospective study of prescription pattern and cost analysis of selected drugs used in coronary artery disease and angioplasty patients

     Tamilselvan T, Hesly Rajan, Sabith T, Anand Kumar S, Kumutha T

     • » Abstract Coronary Artery Disease (CAD) is a condition wherever the vascular supply to the heart is obstructed by fatty tissue, occlusion or spasm of coronary arteries. There is increasing importance of prescription pattern monitoring studies (PPMS) due to a lift in promoting of latest medicine, variations in pattern of prescribing and consumption of medication, growing concern regarding drug interactions, price of medication and pattern of prescription. The present study was planned to assess the prescription pattern and cost of selected drugs used in Coronary Artery Disease and Angioplasty patients. The drug prescription pattern was noted from cardiology department of multi specialty tertiary care hospital and cost analysis was performed for the selected drugs. The data was collected by using structured data collection form. A total of 107 prescriptions were analysed from 240 patient records. Most of the patients diagnosed with coronary artery disease were in the age group of 61-70 years (41.12 %). The cost difference between Atenolol and Metoprolol were statistically significant (P<0.01). The most common classes of drugs prescribed were antihypertensives, antiplatelets, antianginals and antihyperlipidemics. The study results showed that the inappropriate use of drugs in CAD increases the cost of treatment and in long term this may even contribute to drug related problems. Interventions are necessary to improve rational drug use of drugs.
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510. Study the association of midtrimester insulin resistance with development of pre-eclampsia among primi gravidae

     05-08

     • » Abstract Study the association of midtrimester insulin resistance with development of pre-eclampsia among primi gravidae
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511. Diversity in the spectrum of malignant soft tissue tumors

     Naseem Noorunnisa, Prema Saldanha, Syed Ahmed Hussain, Senthil N. Ganesh

     • » Abstract Soft tissue tumors are a highly heterogenous group of tumors that are classified on a histogenetic basis. Benign tumors far outnumber the malignant ones which form less than 1 % of all cancers. The most common sites are extremities, chest wall, mediastinum and retroperitoneum and as in the case of other malignancies, occur mainly in the older age group except rhabdomyo sarcoma. These tumors present a varied histomorphological pattern. Our study has included the different patterns, with specific site, gender and age distribution.
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512. To study the effect of tricep strengthening in lateral epicondylitis

     Meenakshi Vairagade, Pradeep N Borkar, Tanuja Chhotwani

     • » Abstract Aim: “To Study the effect of tricep strengthening in lateral epicondylitis” Objectives: To study the effect of tricep srtenghthening on pain relief. To study the effect of tricep strenghthening in functional activities. To study the effect of conventional therapy on pain relief. To study the effect of conventional therapy on functional activities. To compare the effect of tricep strength thening and conventional therapy on pain and functional activities. Procedure: 30 Samples were collected according to inclusion and exclusion criteria. Then Consent was taken from the respective subjects to conduct the study. Respective protocol was followed for Group A and Group B; and treatment protocol was followed for 2 weeks. Pre and post values of subjects was assessed by numerical pain rating scale, strength of elbow flexors with 10 RM, isometric strength of triceps was reassessed by Jamar dynamometer, and pain and functional assessment with patient rated tennis elbow evaluation questionnaire. Data was collected and analyzed statistically. Results: t value for NPRS comparion between group A and B is 0.871. At p value 0.391: considered Significant at p≤ 0.05 with 95 % confidence interval. t value for 10RM in group A and B in pre and post treatment is -1.169. At p value 0.252: considered Significant at p≤ 0.05 with 95 % confidence interval. t value for isometric strength of right triceps with jamar dynamometer is-0.561. At p value 0.579: considered Significant at p≤ 0.05 with 95 % confidence interval. t value for isometric strength of left triceps with jamar dynamometer is 0.469. At p value 0.643: considered Significant at p≤ 0.05 with 95 % confidence interval. t value for comparison between PRTEEQ in group A and B is 0.871. At p value 0.391: considered Significant at p≤ 0.05 with 95 % confidence interval. Conclusion: This study concludes that triceps strengthening along with conventional physiotherapy program has shown better improvement on NPRS,10RM, (Triceps) Isometric strength with JAMAR DYNAMOMTERE score as compared to conventional physiotherapy alone over 2 week of training program.
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513. A clinical study of effect of transcutaneous nerve stimulation (TENS) in labour analgesia

     Bharati Rajani, Hemlata Chaudhary, Bhavna V Panchmatiya, Ravi Agrawal

     • » Abstract Objective: Objectives are to observe the onset, effectiveness, extent of labour analgesia using TENS and cardiovascular and respiratory changes in mother. Effect of TENS on the progress of labour on fetal heart rate and adverse effect of TENS, if any.
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514. Development of indigenous innovative visual reinforcement system for hearing screening among young children

     Shradha S, Daisy E, Gladys Prathiba D, Krithika K

     • » Abstract Visual reinforcement audiometry (VRA) is the gold standard hearing assessment procedure. It is a combination of both visual and auditory stimuli uses conventional toys and speakers to estimate hearing. The aim of the study is to develop digital animated VRA instrumentation and to test the feasibility of the tool in screening young children. The study was carried out in two phases, wherein the development of the age appropriate digital video animated clips and the VRA system as a part of phase I. Phase II focused on exploring the feasibility of the newly developed instrument with digital images. Two groups of 21 typically developing children underwent VRA hearing testing in a sound treated room. Children of three different age groups (7-12 month, 13-24 months, 25-36 months) were included in the study. Results indicates that older children (13 to 36 months) demonstrated greater interest and anticipation for the newly developed system of VRA. It is evident that the newly developed VRA system is a clinically plausible option for testing hearing in young children.
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515. In-Vitro cultivation of mycobacterium leprae and confirmation by molecular method

     D Pal, K Ghosh

     • » Abstract Mycobacterium leprae was the first organism described as the causative agent of an infection. It was described by Dr. G. Armaner Hansen as the causative agent of leprosy in 1874. Thereafter, numerous agents/bacteria have been described as causative agents of disease like Mycobacterium tuberculosis, Vibrio cholera, etc. Almost all bacteria discovered till now have been grown in artificial culture in chemically defined media (in-vitro cultivation) in the laboratory. However, Mycobacterium leprae though first described as a causative agent still remains uncultivable in the laboratory in artificial culture media. Numerous attempts have been made by different workers to grow this organism in the laboratory but all attempts at cultivation have been unsuccessful till date. As it would be too extensive to list all the unsuccessful attempts at cultivating this organism on artificial culture media, only a few important references are cited here (see References 1-10 below).
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516. Morbidity pattern among elderly population at tertiary care hospital: A retrospective study

     Chinte L T, Andurkar S P, Kendre V V, Dixit J V

     • » Abstract In general, “elderly” age group is defined as persons aged 65 years and above. The two extremes of life child and elderly need special care. Elderly life is full of problems – physical, social and economic. While ageing of the population is essentially a simple phenomenon, its consequences are multiple and not always well recognized Methodology: A hospital based retrospective study was undertaken during the period of1 April 2014 to 31 March 2015 to know the morbidities in geriatric population admitted in Government Medical College Latur. Results: Mean age of geriatric patients was 72 years and maximum age of patient admitted was 106 years. common morbidity seen is cataract and diminished vision (62.92%), followed by Injury and various fractures(19.53), Diseases of circulatory system ;Diseases of blood and blood forming organs (4.52), Diseases of respiratory system (2.71), Infectious and parasitic diseases (2.44), Diseases of digestive system (2.26). Conclusion: There is a growing need for interventions to ensure the health of this vulnerable group and to create a policy to meet the care and needs of the disabled elderly. Further research, especially qualitative research, is needed to explore the depth of the problems of the elderly.
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517. Effect of rehablitation on muscle imbalance in upper cross syndrome

     Chhotwani Tanuja, Vairagade Meenakshi, Borkar Pradeep

     • » Abstract Aims and Objective: To assess the effect of exercise, stretching and postural correction on neck Imbalance and To assess the effect of exercise, stretching and postural correction on forward head posture Design: Experimental Study Setting: Dr.D.Y.Patil I.P.D. and O.P.D. Participants: Twenty four patients with the complain of neck pain in the age group of 20-40 years and history of working in same posture for 6 to 8 hours participated in the study. Intervention: All the patients were conveniently selected from the OPD of Physiotherapy clinic in our institution and after signing of consent form they were given 2 week rehabilitation protocol of stretching and strengthening (based on Sherrington law) and posture correction exercise. Craniovertebrtal angle, NDI and VAS were used to assess the pain discomfort and disability caused by neck pain. Outcome Measures: VAS (visual analogue scale), Neck Disability Index, CV angle. Result: 24 participants completed the study. Comparison of pre and post Neck disability index, Neck pain (VAS) and craniovertebral angle were found to be statistically significant (p<0.05) at the end of 2 week rehabilitation protocol of stretching, strengthening and posture correction Conclusion: This study concludes that the effect of exercise, stretching and postural correction was there on Pain, neck Imbalance and also on the forward head posture. There was significant decrease in pain and neck disability.
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518. Manual small incision cataract surgery (MSICS) under topical anesthesia

     Bhalchandra S Joshi, V H Karambelkar, Vikrant A Narwade

     • » Abstract Introduction: Manual small incision cataract surgery under topical anesthesia with 0.5% proparacaine hydrochloride and 1% preservative free intracameral lignocaine is a reasonably well tolerated procedure and is absolutely safer alternative to surgery under peribulbar or retrobulbar anesthesia with excellent outcome. Aim: To evaluate the patient’s and surgeon’s experience in MSICS using topical anesthesia with 0.5% proparacaine hydrochloride eye drops andpreservative free intracameral 1% lignocaine in terms of pain, surgical complications and outcome.
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519. A study of gentamicin level in CSF of the pediatric patients with meningitis

     Sham D Kulkarni

     • » Abstract Introduction: Paediatric clinical pharmacology is well established in western countries, but in our country. Bioavailability of a drug is altered in paediatric age group especially due to many variable factor, like, larger body surface in proportion to body-wt., changes in haematocrit values and phases of maturation of organs like kidney, liver etc. Hence clinical response, to a drug would depend on varieties of factors and, would decide the ultimate outcome in, especially, a sick child. Aims and Objectives: To Study Gentamicin level in CSF of the Pediatric Patients with Meningitis Methodology: This was prospective clinical trial at tertiary care hospitalthe children admitted in pediatric ward of a general hospital constituted the material for the present study. Only those children, for whom diagnostic L.P. was considered necessary on admission, were included in this study and hence no child was subjected to L.P. only for the purpose of this study. Out of the selected children, those who did not have any clinical and laboratory evidence of intracranial infections, constituted the group of normal children. Whereas those, who had clinical and Laboratory evidence of intracranial infections, constituted the another group under study. Both the group of children was subjected for similar work-up. Total 28 children were included into the study. Result: In Children Without Meningitis There are wide fluctuations is the serum concentration at 11/2 hrs. C.S.F. did not show any detectable concentration of drug. Fluctuation in serum concentration same as in group one. Most of the children show detectable concentration of drug in C.S.F. Serum levels after 5 doses have shown marked variation. None of them had any detectable level in C.S.F. Conclusion: Presence of detectable in c.s.f. is in marked variation. With absence of detectable levels in children without meningitis. This does show the effect of altered blood-brain barrier in meningitis
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520. Synergistic effects of intrathecal magnesium sulphate to the combination of bupivacaine and fentanyl spinal anaesthesia in patients undergoing lower abdominal surgeries

     Mallikarjuna

     • » Abstract Background: Local anesthetics are extremely useful drugs for anaesthesiologists. All modern local anesthetics are amides. Esters are unstable in its solution. Lignocaine, Prilocaine, Bupivacaine etc all shares a common basic structure termed aminoacylamide. The current study aims to evaluate the effects of intrathecal supplementation of magnesium sulphate to bupivacaine-fentanyl in patients undergoing lower abdominal surgeries. Methodology: The patients were randomly assigned into two groups of 40 patients each, to receive an intrathecal injection in sitting position of either 15mg of 0.5% hyperbaric bupivacaine + 20mcg i.e 0.4ml of fentanyl + 0.1mg (0.1ml) 50% of magnesium sulphate or 15mg of 0.5% hyperbaric bupivacaine + 20mcg i.e. 0.4ml of fentanyl + 0.1ml normal saline. Duration of motor blockade, time taken for two segments regression are noted. Results: Duration of motor blockade was higher in Group A compared to Group B (279.25+53.33 vs. 249.75+45.11, p<0.001). Regression of sensory block to S1 was significantly earlier in Group B compared to Group A (240.13±58.99 vs. 271.25±56.78, p<0.001). Conclusion: Longer time for two segment regression, longer duration of motor blockade,decrease incidence of adverse effects.
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521. Comparison of sample and re-sampling techniques in the estimation of third trimester obstetric parameters

     Arumugam P, Keshav Singh, Rajendran A K, Kasthuri A

     • » Abstract Background: Obstetricians interested in estimating the third trimester parameters, can find the outliers by estimating the crucial boundaries of these parameters. The estimation may be made by two approaches namely random sampling and re-sampling techniques (bootstrap sampling). AIM: Comparison between random sample and Bootstrap sample parameters Objectives: To calculate the statistics of the two procedures by means of averages. To estimate the population parameters by both methods. To interpret the difference statistically. Methodology: A random sample of 240 III trimester ante-natal mothers was selected as first 20 singleton pregnant mothers through the months of January to December 2014and among them 154 and 86 mothers were primi para and multi para respectively obtained from the records of a teaching hospital in Tamil Nadu. The Ultra Sona Graphed statistics like Head Circumference (HC), Abdominal Circumference (AC), and Placental Thickness (PT) were collected. The statistics and parameters of primi mothers (154) were computed by both techniques and the difference between the variance was inferred by variance ratio test with the help of IBM SPSS Version 20. Results: The following obstetric statistics viz. mean median SD and SE calculated by sample and Bootstrap methods are furnished. Discussion: The difference between the variances were not statistically significant (P>0.05). Hence the difference between Std. errors were also not statistically significant (P>0.05). And thus the parameters will also be not statistically significant (P>0.05). Conclusion: As the sample size of 154 was large, the estimated parameters of both techniques may not be significant. The Bootstrap sample parameter may be a more appropriate estimation in respect of small samples.
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522. Study of gender differences in polysomnographic profile of obstructive sleep apnea patients

     Mrutunjay M Mahindrekar, Sanjiv V Zangde, Vikas R Patel, Sanjay Muttyepod, Manish Meshram

     • » Abstract Mrutunjay M Mahindrekar, Sanjiv V Zangde, Vikas R Patel, Sanjay Muttyepod, Manish Meshram
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523. The effect of circuit resistance training on upper limb muscle strength in volleyball attacker players

     Pradeep Borkar, Bhavika Keswani, Meenakshi Vairagade

     • » Abstract Aim: To find out effect of circuit resistance training on upper limb muscle strength in volleyball attacker players. Objectives: To study effect of circuit Resistance Training on strength of triceps, deltoid, shoulder internal rotator muscles and on workout volume in volleyball attacker players. Procedure: 30 Subjects were collected according to inclusion and exclusion criteria. Consent was taken from respective subjects to conduct the study. Respective protocol was followed for Group A (Controlled Group) and Group B (Experimental Group); over 5 weeks, with 3 sessions per week .Pre and post values of Subjects were assessed by using 10 RM and Push up test. The statistical tests used for analysis of result were: Paired t-test and unpaired t- test. Mean standard deviation and standard error was carried out for both groups. Result: After 5-weeks of training period, the B group showed more improvement in Strength of Triceps (P< 0.050) considered significant, Deltoid (p< 0.040) considered significant, Shoulder internal rotators(p<0.030) considered significant and Push up performance (p<0.000) Considered extremely significant. Conclusion: This study concludes that Circuit Resistance Training is more effective in improving the strength of shoulder internal rotators, deltoid and triceps Muscles as compare to regular Training in volleyball players.
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524. Ileo -colic Intussusception in Adults due to Lipomatous Polyp: A rare case

     Harpreet Singh, D G Mote

     • » Abstract Adult Intussusception is a rare but challenging condition. The condition is usually secondary to definitive lesion. The aetiology, clinical presentation and management of this condition are different in adults than in children. Preoperative diagnosis is usually missed or delayed because of non specific or sub acute symptoms. We present a case of ileo -colic intussuscepton in a 78 year old male patient.
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525. Depression associated with cardiac surgery and the probable risk factors- A randomised observational clinical study

     Davan K R, Bindu, Mallikarjuna, Sowmia Mammen, Sumaiya Sabreen

     • » Abstract Introduction: Cardiovascular surgery can trigger depression; counselling and medications can easily beat it. The earlier we identify people who have depression, complicating their ability to get back to normal life, better is the chances of recovery. We conducted a prospective randomized observational study to assess incidence of depression in patients undergoing cardiac surgery and risk factors which can trigger depression. Materials and Methods: A prospective randomized double blind controlled Observational clinical study was conducted in 250 patients who underwent open heart surgery with and without assistance of cardio pulmonary bypass (CPB) from May 2013 to July 2014. All patients were screened for depression with Patient Health Questionnaire (PHQ-9) preoperatively (Q1), at hospital discharge (Q2), 3months (Q3) and 6months (Q4) postoperatively. At each interval patients were identified as ‘‘not depressed’’ (PHQ-9 score 0), minimally depressed (score 1-4), mild(score5-9), moderate (10-14), moderately severe(15-19), severe depression(20-27). Multiple regression analysis was used to identify variables associated with depression. Results: On regression analysis, preoperative depression for depression at discharge (OR 88.5, p<0.0001), depression at discharge for incidence of depression at three months (OR 4004, p<0.0001) and 6 months (OR 1194, p<0.0001) had significant Odds ratio (OR) with statistical significance. Patients who had depression at discharge were older, had lower preoperative ejection fraction (EF), prolonged waiting period, ICU stay, hospital stay. Other risk factors identified were higher NYHA class , history of prior CCF, abnormal lipid profile, pre-existing hypertension, diabetes mellitus, peripheral vascular disease and patients on beta blockers. Conclusion: Depression is common after cardiac surgery. Among all the risk factors, preoperative depression was associated with the highest risk for postoperative depression.
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526. Comparative study of efficacy of per rectal misoprostol, intravenous methylergometrine and intramuscular carboprost in active management of third stage of labour

     Sonal Agrawal, Vimal Kumar Agarwal

     • » Abstract Introduction: Postpartum haemorrhage (PPH) during the third stage of labour is the most common cause of maternal deaths in developing countries. Active pharmacological management of this stage to prevent haemorrhage with an uterotonic drugs leads to a decrease in postpartum vaginal haemorrhage. The aim of this study was to assess and compare the effectiveness of rectal misoprostol compared with an intravenous oxytocin and intramuscular carboprost in active management of third stage of labour. Material and Methods: A total of 400 women in labour were randomized into four groups (100 women in each). Within 1 minute of delivery of the anterior shoulder participants in group A received 800g of rectal misoprostol; group B received 0.2mg of methylergometrine intravenously; group C received 125g of carboprost intramuscularly and group D served as control and had not received any prophylactic uterotonics. Results: All groups were compared regarding the need for excessive uterotonics, amount of blood loss, and hematocrit drop. Per rectal misoprostol was found to be equal or better to rest of the drugs in the study with lowest duration of third stage of labor (mean =8.69 mins), lowest amount of blood loss (mean=149.90 ml), haematocrit drop (0.51±0.32) and lowest incidence of PPH. There was no significant difference in the duration of third stage of labor amongst the four groups. Conclusions: Per rectal Misoprostol is equal or better as compared to injection methyl ergometrine or carboprost and can prove to be better alternative because of several advantages.
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527. A Clinical profile and Factors associated with Migraine in Pediatric patients

     Shivakumar R

     • » Abstract Introduction: The epidemiology of pediatric headache is described in numerous articles of international origin. Aims and Objectives: To Study Clinical profile and Factors associated with Migraine in Pediatric patients. Methodology: This was a cross-sectional study carried out at the Pediatric department of a tertiary health care center during one-year period from January 2015 to December 2015. All the Pediatric patients were screened except less than 3 yrs. as it was expected that children below this age might not be able to express their symptoms clearly. Prensky's criteria for migraine was used to diagnose the Patients the patients associated with other reasons of headache like sinusitis, refractive errors, hypertension, chronic renal illness, neurological disorders and neoplasms were excluded from the study. All detail clinical and associated or precipitating factors history was asked. Result: The majority of the Patients were from age group of 3-6 i.e. 10.25% followed by 7-10-35.89%; 11-12 -53.84%. The majority of the patients were females i.e. 58.97% followed by Males 41.03%. The most common symptoms were Pulsating or throbbing headache which shifts to a unilateral or to temporal location were 53.84% followed by bi-temporal/bi-frontal/Retro-orbital headache in 46.15% patients; Nausea /Vomiting in 41.02% of patients; Photophobia in 35.89% patients; Abdominal Pain in 30.76% patients and Sweating in 25.64% patients; Visual Disturbances in 25.64% of patients. Giddiness (Vertigo) in 23.07% patients. Tingling sensation in hands or Perioral area were present in 12.82% of patients. The most common associated or Precipitating factors were Sunlight -64.10%; Mental stress- 53.84%; Physical strain -48.71%; Family history -46.15%. Watching TV -43.58%; Exposure to unpleasant smell -33.33%. Hunger -28.20%; Winter season -23.07%. Conclusion: Migraine was having late childhood onset; the majority of the patients were females Most common clinical features were Pulsating or throbbing headache which shifts to a unilateral or to temporal location, The most common associated or Precipitating factors were Sunlight, Mental Stress Physical strain etc.
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528. Study of weaning practices in rural area of Latur

     Vidyadevi D Kendre, Varsharani Kendre

     • » Abstract We know that large number of children in both wealthy and poverty stricken region suffer malnutrition. Optimal infant and young child feeding is an evidence based measure for improving child nutrition and child survival. According to the World Health Organization (WHO), Ninety nine per cent of all under-five deaths occur in developing countries. Most common causes of deaths are due to malnutrition, pneumonia, diarrhoea, malaria. So weaning at proper time and with proper food is very important for growth of child. Aim -To know weaning practices in rural area of latur .Objectives -1) To determine factors related to early and delayed weaning. 2) To study various factors regarding weaning and association of weaning with malnutrition. Materials and method- A cross sectional observational study was conducted in the Dept of Paediatrics MIMSR medical college Latur. A pretested questionnaire was introduced to mother and feedbacks were taken. Mothers having infant from 6months to 2yr old who attended Pediatrics outpatient department or ward were included in study. Statistical test-chi square test was used. Results and conclusion- In only 50% children, weaning was started at proper time. Factors affecting early weaning were feeling insufficient amount of milk, working mothers, family members forcing to start gutti at 2 months, television. Factors affecting delayed weaning were lack of knowledge to mother regarding weaning, family’s decision etc. Malnutrition was significantly associated with time of weaning. Weaning should be started at proper time to prevent malnutrition. Health education should be given to mothers regarding weaning.
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529. A Study of Outcome of cranio-maxillofacial soft-tissue injuries at tertiary care health Centre

     Priyesh Patil, Vaibhav Mirajkar

     • » Abstract Introduction: Soft-tissue injuries of the cranio-maxillofacial region still remain one of the common disease encountered in the casualty department of every health-care facility. Aims and Objectives: To Study Outcome of Maxilo-facial soft-tissue injuries at tertiary care health Centre. Methodology: This was a Cross-sectional study carried out at the Department of Dentistry of Government Hospital of Tertiary Health care Centre during the period from June 2007 to June 2014 in 7 yrs. Period in all the patients Reported to Government Hospital for the injuries with the various reasons. The patients of Hard tissues except (Dento-alveolar) and head injury, were excluded from the study. Total 126 patients were reported during the time period. The outcome of these patients were noted. Result: In our study we have seen that The majority of the patients were form the age groups (Yrs.) of 30-40- were 45 (35.71%); followed by 20-30 were 35 (27.77%); 40-50 were 19 (15.07%); 50-60 were 15(11.90%); >60Yrs were- 12 (9.52%) respectively. The majority of the patients were Male- 95(75.30%) followed by Female-31 (24.70%)The most common cause was RTA- 62 (49.20%) followed by Assault 21 (16.66%); Fall -41(32.53%); Animal assault injuries -2 (1.58%). The most common pattern of injury was Soft tissue only was 55 (43.65%) followed by Soft tissue + Dentoalveolar was 38(30.15%); Soft tissue + Dentoalveolar + Tongue was 13 (10.31%); Soft tissue + Tongue only was 20 (15.87%). The majority of the patients were improved i.e. 120 (95.23%) followed by Referred to Higher Centre due to neurological problems were 6 (4.77%). Conclusion: The most common cause was RTA followed by Assault, Fall, Animal assault injury The most common pattern of injury was Soft tissue only was followed by,Soft tissue plus Dentoalveolar and in outcome the majority of the patients were improved and remaining referred to higher Centre for the neurological problems.
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530. Hypothyroidism as a sequelae following treatment of head and neck cancer

     S Suresh

     • » Abstract Background: Hypothyroidism is one of the late side effects seen after curative radiotherapy in the head and neck region encompassing part or whole of the thyroid gland. Still thyroid function tests are not a part of routine follow up of head – neck cancer patients treated with radiotherapy with or without surgery and / or chemotherapy. Aim of this study was to to find out the incidence of hypothyroidism in head – neck cancer patients treated with radiotherapy with or without chemotherapy and influence of concomitant chemotherapy. Materials and Methods: Of the 112 patients, 57 (50.8%) were planned to receive radiotherapy alone, 42 (37.5%) to receive neo-adjuvant chemotherapy with Cisplatin and 5-FU and the rest 13 (11.6%) patients to receive concurrent chemo-radiation. Thyroid function tests were done at the beginning of treatment, at six weeks after completion of radiotherapy and thereafter at six weeks’ interval for two years. Results: After 24 months follow up, overall incidence of clinical hypothyroidism of our reported patients was 31.03% and of sub-clinical hypothyroidism was 37.93%. Conclusion: As a significant number of patients develop hypothyroidism following radiotherapy to the neck, thyroid function tests should be included in the routine follow up protocol of such patients.
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531. Study of dental caries in primary school children of rural area

     Arun Bansode, Sayyad Tajmul, N S Inamdar

     • » Abstract Dental health diseases such as dental caries are among the most widespread diseases in the world. Dental caries will eventually lead to pain and tooth loss if untreated. The present study was carried out to find prevalence of dental caries and its relationship with some epidemiological factors. The present study was cross sectional study which included 916 school children from 3 villages. Prevalence of dental caries in the present study was 48.14%. Higher prevalence of dental caries was associated with low education status of mother, consuming sweet articles in between meals, cleaning teeth once daily or occasionally. Due to high prevalence of dental caries in school children, health care system should ensure periodic dental health checkup and early detection and promt treatment of dental caries
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532. A clinicopathological study of colorectal carcinomas

     Farzana T

     • » Abstract Objectives: To study the clinicopathological correlation of colorectal carcinoma and its histopathological typing. Materials and Methods: Retrospective study of one year duration from Jan 2013-Dec 2013 was done in Yenepoya Medical College Hospital, Mangalore. Hematoxylin and eosin stained slides were retrieved from pathology archives and light microscopic diagnosis and typing was done according to the WHO classification. Correlation was done with the clinical findings obtained from clinical records. Histochemistry and immunohistochemistry were done wherever indicated. Results: There were a total of 24 cases of colorectal cancer, majority being adenocarcinomas (87.5%), with age range of 26 to 75 years and almost equal sex ratio. One case was associated with familial adenomatous polyposis coli (FAP). Majority were well differentiated (66.6%) followed by moderately differentiated (28.6%) and poorly differentiated type(4.8%) About 67% of adenocarcinomas occurred in the rectum followed by rectosigmoid junction (17%) and sigmoid colon(8%). Other three rare tumours (12.5%) were neuroendocrine tumour of transverse colon, leiomyosarcoma and mixed adenocarcinoma and neuroendocrine tumour. Conclusion: The diagnosis and management of colorectal carcinomas require a team perspective. The pathological assessment of colorectal carcinoma is of critical importance to know the type and extent of tumour, grade and stage, and important prognostic factors, which are of crucial value in patient treatment and predicting the prognosis.
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533. Head and neck cancer in Bihar

     Rajat Rohan, Damandeep Kaur Mundi, Arup Sengupta

     • » Abstract Head and neck cancer in Bihar has distinct demographic profiles, risk factor, food habits and personal family history. The term head and neck cancer refers to a group of biological similar cancers originating from the upper aerodigestive tract, including lip, oral cavity, nasal cavity, paranasal sinuses, pharynx and larynx. Head and neck cancers can cause varying degree of structural deformities and functional handicaps, depending on site, size and patterns of spread, thereby compromising well being and self esteem.
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534. Study of nutritional status of primary school children in an urban field practice area of Pune

     Sayyad Tajmul, Arun Bansode, Akshay Salgar, N S Inamdar

     • » Abstract Childhood years constitutes the most crucial period in life, when the foundations are laid for cognitive, social and emotional language, physical and motor development and cumulative lifelong learning. The young child is most vulnerable to the vicious cycles of malnutrition, infection and resultant disability all of which influence the present condition of a child at micro level and the future human resource development of the nation at the macro level. The present study was a cross sectional study which was carried out in two randomly selected municipal schools of an urban area. The Study consisted of 400 school children from 6 - 9 yrs age group, in which 75 (18.75%) children were found to be stunted and 114 (28.5%) children were underweight. Prevalence of Malnutrition in the form of stunting, and underweight significantly associated with socioeconomic status, educational status of mother, type of family and high birth order. Health education, personal hygiene education, nutrition education may be made as part of the school curriculum.
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535. A cross sectional study on iodized salt usage at household level in Ulagankulam Panchayat of Tirunelveli district Tamil Nadu

     P Getrude Banumathi, D Jaiganesh, P Parameshwari, R Dharani Sri, P Ravishankar

     • » Abstract Background: Iodine deficiency disorders (IDD) still remains a major public health problems in many countries including India. Thus the Iodised salt is most economical, convenient and effective means of mass prophylaxis against Iodine Deficiency Disorders. Objectives: To estimate the prevalence of iodized salt usage at household level and to find out the iodine content of edible salt with MBI spot testing kit among women at household level in Ulagankulam panchayat of Tirunelveli. Materials and Methods: A community based cross sectional study among 306 women in households of Ulagankulam Panchayat, Thirunelveli District. A standardized, semi-structured questionnaire was applied to the women household who is in charge of kitchen to estimate the usage regarding iodized salt. Cooking salt was tested with MBI Spot testing kit for iodine content. Iodine content ≥ 15ppm was considered as adequately iodised salt. Appropriate statistical tests used and analysis done using SPSS 18 software. Results: Among the 306 salt samples tested, 123 (40.2%) were using adequately iodized salt (> 15ppm), 66 (21.6%) – inadequate iodized salt, 117 (38.2) – uniodized salt. 135 (44.1%) were buying salt from street vendors, 102 (33.3%) from nearby petty shops, 66 (21.6%) from General provisional store and 3 (1%) from Public distribution system (PDS). 54 (52.9%) and 54 (78.3%) of salt samples from nearby Petty shops and General provisional store were adequately iodized. Conclusion and recommendation: Based on this study, only 40.2% were using adequately iodised salt. This is well below the WHO recommended level (90%). Iodized salt should be manufactured in small pockets and made available at low cost even in petty shops and public distribution systems of rural areas and legal measures to ban crystallized non iodized salt to be strengthened. Increased awareness and frequent inspection by health staffs to be done.
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536. A study of rhinolith as detected by CT scan paranasal air sinuses at tertiary health care centre

     Anil G Joshi

     • » Abstract Introduction: Rhinoliths are calcareous concretions around calcinated intranasal foreign bodies within the nasal cavity. They are commonly seen in the anterior part of the nasal cavity. The incidence of adult rhinolith is very low. Rhinoliths are generally single, exogenous or endogenous, unilateral, and asymptomatic. Aims and Objectives: To Study Rhinolith as Detected by CT Scan Paranasal Air Sinuses at tertiary health care center. Methodology: It was a retrospective study of 2860 CT scans of paranasal sinuses during the period of June 2013 to August 2015 was done to detect Rhinoliths. The observations of CT scan were made and the results were statistically analyzed. Result: The majority of the Patients were from 30-40 age group i.e. 50.00% followed by 20-30-33.33% and 40+- 16.67%. Majority of the Patients were Female i.e. 66.67% followed by Male 33.33%. Conclusion: Rhinoliths are quite rare cases of the nose, which may show clinical and radiological similarities with each other and benign and malignant diseases of the region so in the nose diseases clinical suspicion of a rhinolith should always be considered, in order to lead to the right diagnosis
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537. Study of comparison of yield of bronchial brushing and broncho-alveolar lavage in diagnosis of lung cancer

     Vijaykumar R Kapse, Dilip G Mhaisekar, Dattatray Totewad, Mithilesh Kulkarni

     • » Abstract Flexible fiber-optic bronchoscope revolutionized respiratory cytology, as techniques like bronchial brushings, broncho-alveolar lavage and bronchial biopsy became more easy, accessible and popular, shifting the emphasis from diagnosis of advanced malignancy in operable patients to the use of cytology as a first line diagnostic and management tool. Objective: To compare the yield of bronchial brushing and bronchoalveolar lavage cytology in lung cancer. Methodology: the present study was carried out at dr. S.C.G.M.C. Nanded, Maharashtra. In patients having lung cancer, bronchoscopy done and bal, bronchial brushing and endobronchial biopsy samples were collected. Comparison of yield of bronchial brushing and bronchoalveolar lavage cytology was done, in patients, in whome biopsy samples are positive for malignant cells. The statistical test( chi-square test) was applied to test the significance. Results: out of 56 patients bronchial brushing yielded 45 (80.35%) to be malignant as compared to bal cytology which yielded 15(26.78%) to be malignant. the difference in yield by both techniques was found to be statistically significant (p < 0.05). Conclusion: bronchial brushing has better diagnostic yield as compared to broncho Alveolar Lavage cytology in patients having lung cancer.
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538. Laryngeal tuberculosis and its outcome

     Ashok Purohit, Shashikant Dorkar

     • » Abstract Introduction: Tuberculosis is still one of the most common granulomatous diseases of the larynx. In the past, it commonly followed pulmonary tuberculosis. Among the risk factors identified are the consumption of tobacco, alcohol, malnutrition, immunodeficiency and being homeless. Aims and Objectives: To study Laryngeal Tuberculosis and its Outcome. Methodology: This was a hospital based cross- sectional study carried out at tertiary health care Centre with the patients diagnosed as Laryngeal tuberculosis by Otolaryngology department were admitted to ward and managed accordingly medical and necessary surgical management like tracheal dilation and Tracheostomy procedure were performed as per the protocols during the year June 2014 to June 2015 there were 45 patients studied during this time. Tabulations and Percentages used for the Presenting the Data. Result: We have found that the majority of the Patients were from >50- 35.55% followed by 40-50-20.00%, 30-40-15.55%, 20-30-13.33%, 10-20-8.88%, 1-10- 6.66%. Majority of the patients were Male 75.55% and Female 24.45%.The majority of the Patients presented with Stridor-35.55% followed by Dysphonia -17.77%. Dysphagia and odynophagia -15.55%, Throat pain -13.33%, Otalgia-8.88%, Fever-8.88%.The Majority of the Patients improved i.e. of 77.78% and 17.77% referred to Higher Centre for the further surgical management and prosthetic surgeries and Death occurred in 2 patient i.e. 4.44% mortality the reasons for the death was severe stridor. Conclusion: The majority of the Patients presented with complaining of Stridorfollowed by Dysphonia, Dysphagia and odynophagia, Throat pain, Otalgia, Fever. The Majority of the Patients improved i.e. of 77.78% and 4.44% mortality found in our study the reasons for mortality was severe stridor.
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539. Alvarado score and ultrasonographic criteria to diagnose acute appendicitis: A clinical study of 100 cases

     Arvind

     • » Abstract Acute appendicitis is one of the most common surgical emergencies around the world with a life time prevalence of approximately one in seven. It's incidence is 1.5-1.9/1000 in male and female population. Scoring systems are valuable and valid instruments for discriminating between acute appendicitis and nonspecific pain abdomen. Alvarado scoring is one of them and is purely based on history, clinical examination and few laboratory tests and is very easy to apply. Advent of cross sectional computer based imaging modalities (USG, CT and MRI) in early eighties opened up new methods for diagnosis of acute appendicitis. It was also found that ultrasound was able to establish alternative diagnosis in up to one-third cases of right iliac pain like ureteric colic and gynaecological disorders. Statistical analysis of data in our study gave sensitivity of Alvarado score as 94.9%, specificity 61.9%, positive 90.3% and negative predictive value 76.4% while sensitivity of ultrasonography was 91.9%, specificity 85%, positive 95% and negative predictive value 77.2%.When both modalities were positive for acute appendicitis, no false positive result obtained. So it is concluded that the combination of Alvarado score and ultrasonography increases the sensitivity and specificity for the diagnosis of acute appendicitis.
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540. A study of metabolic syndrome in newly diagnosed patients of type 2 diabetes mellitus in the tertiary care centre of Kumaun region

     Taukeer Ahmad, Sangeeta Singh, Basant Joshi, Suman Pandey

     • » Abstract Introduction: Diabetes mellitus is the commonest metabolic abnormality in the world. Prevalence of type 2 diabetes is especially increasing in developing countries. The metabolic syndrome (Syndrome X) consists of a constellation of metabolic abnormalities that increase the risk of micro and macrovascular complications of type 2 diabetes mellitus. The major features of metabolic syndrome include central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycaemia, and hypertension. The metabolic dysregulation associated with diabetes mellitus and metabolic syndrome cause secondary pathophysiologic changes in multiple organ system that impose a tremendous burden on the individual with diabetes and on the health care system. Material and Methods: - 100 Patients of age group 20-60 years with newly diagnosed type 2 diabetes mellitus were included in the study. Detailed physical and anthropometric examinations were done in all patients. Estimation of extended lipid profile including Apo B, KFT and microalbuminuria were done. Results: Of the 100 patients studied, 58 patients had metabolic syndrome according to the International Diabetes Federation criteria 2006. 85% of the patients with metabolic syndrome were either overweight or obese (calculated by their body mass index) as compared to 15% of patients without metabolic syndrome. Waist hip ratio was increased in 33% of males with metabolic syndrome and 100% of females with metabolic syndrome. Serum triglyceride (p< 0.009), VLDLc (p< 0.007) and microalbuminuria (p< 0.01) levels were significantly elevated in patients of metabolic syndrome as compared to those without metabolic syndrome. Conclusion: The present study shows that metabolic syndrome is increasingly present in patients with type 2 diabetes mellitus in the Kumaun region of Uttarakhand. Physicians treating type 2 diabetics should consider metabolic syndrome with greater emphasis in their patients and advice early intervention, to delay the development of micro and macrovascular complications of diabetes mellitus.
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541. Use of psychological principles of management for improved performance in patients care in a tertiary care centre - A randomised control study

     Nasir Mahmood Khan

     • » Abstract Patient care in a tertiary care centre is a holistic and comprehensive task and cannot get desired outcomes if various aspects of patient care like physical, psychological, mental, social and personal are not properly integrated. The study was planned to provide necessary awareness to the patients and caregivers regarding their illness and treatment outcomes. This was supposed to alleviate unnecessary apprehension and help in healing of patients. By using psychological tools of management in improving patient care, study derives various results that help in understanding the intricate mechanism of patient’s response on treatment. Study demonstrates comparatively better response on added psychological interventions of study group as compared to control group.
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542. A comparative study of venous and capillary blood glucose levels by semi auto analyser and glucometer

     Supriya Shete, Humaira Khan, A M Siddiqui, Amol Shinde

     • » Abstract Introduction: Diabetes Mellitus(DM) is a non communicable disease and most common metabolic disorder reaching epidemic proportions globally. Both type 1 and type 2 diabetes show direct relationship between the glycemic control and the risk of systemic complications. Blood glucose estimation is the mainstay of diagnosis and management of diabetes mellitus. Aim: To compare the blood glucose estimation methods from capillary blood by glucometer and venous plasma glucose estimation by Semi auto analyser and to find out variation percentages in results. Material and Methods: 80 patients attending Outpatient department of a tertiary care level hospital who were advised blood glucose estimation were selected. Finger prick (capillary) blood glucose was measured by glucometer and venous plasma glucose estimation was measured by Semi auto analyser in central laboratory. Results and Conclusion: Capillary blood glucose estimation by glucometer is better alternative to venous plasma glucose estimation for diagnosis follow up and in emergency conditions in diabetic as well as non- diabetic patients.
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543. HLA-A association with psoriasis in a south Indian population

     Ashwin Anandan, Krishnamoorthy R, Ravindra Prasad T, Panicker V K, Murugan S

     • » Abstract Background: Psoriasis is a common skin disorder affecting around 3% of the population worldwide.HLA association with psoriasis is well established with very little information about Indian Population. Aim: To determine the HLA-A pattern and its association in psoriasis patients. Materials and Methods: 50 cases and 50 controls were enrolled in the study. HLA-A typing was done by PCR-SSP method and the results was analysed and interpreted. Results: The alleles that was found in higher frequency in the cases than in the controls – HLA-A*02(36%), HLA-A*11(32%), HLA-A*03 and HLA-A*24(30%). Conclusion: HLA-A*11 shows a strong association with psoriasis and HLA-A*01 shows decreased association with psoriasis in the present study.
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544. A study of the role of insulin resistance and iron in NAFLD associated with HFE gene mutation

     K Ponsuganthi, R Sudha

     • » Abstract Introduction: NAFLD is becoming a major public problem worldwide. NAFLD is an emerging problem in the Asia-Pacific region and its overall prevalence at present is broadly similar to west. Based on surveys using ultrasonography, the prevalence of NAFLD in the general population across Asia varies from 5% to 40% Aims and Objectives: To Assess the risk of NASH with clinical predictor score associated with HFE gene mutation. Materials and Methods: The work embodied in this study was conducted at tertiary care Hospital. All the type 2 diabetic patients attending the OPD irrespective of their sex and treatment protocol were taken; it includes both old and new cases of type 2 diabetes. All the type 2 diabetic patients were subjected to ultrasonography to rule out the fatty liver. Type 2 DM with NAFLD was taken as cases and Type 2 DM without NAFLD was taken as controls. Biochemical parameter analyzed are fasting glucose, fasting insulin, serum iron, T.I.B.C and ALT.DNA was extracted from frozen whole blood to detect Cys282Tyr mutation. Based on HAIR score, the NASH was assessed in our NAFLD patients. Result: In our study population out of 100 type 2 diabetes patients, 54 of them had fatty liver. In our study population, cases had more female patients (59.2%) than controls (36.9%) and it was statistically significant (Chi square value x2= 4.94 and p<0.02). Fasting insulin and insulin resistance were significantly higher in cases (p< 0.05).Serum Iron and transferrin saturation were significantly raised (p<0.01) in cases when compared to controls. NAFLD patients had significantly higher ALT levels. In our study, 27.8% of patients had NASH based on HAIR score. HFE gene C282Y mutation was not found in our study population. Conclusion: Based on HAIR score, 27.8% of NAFLD patients might have NASH. NAFLD patients had significantly increased serum iron and transferrin saturation when compared to controls. None of our patients had HFE mutation.
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545. Dukes treadmill score and myocardial perfusion scintigraphy - A comparative study in patients

     Harish B, Sowmya H E

     • » Abstract Radionuclide myocardial perfusion imaging (MPI) can be used to demonstrate the presence of coronary heart disease and to risk stratify and guide management of patients with known disease. Treadmill test which is commonly used as screening test for CAD, and with help of DTS can to some extent accurately risk stratify the patients as well. Aim of the study was to compare Duke treadmill score and MPI in risk stratifying the patient with CAD. 130 patients were considered in the study. Most of the patients fell in moderate Dukes score (78 patients, 60%). MPI could further stratify those patients into high (28 patients, 36%) and low risk (50 patients, 64%) groups. Low and high Dukes scores correlated well with normal and severe defects in MPI respectively. Hence it is advisable to perform MPI in moderate Dukes Score patients for further risk stratification.
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546. Assessment of the insulin resistance- insulin sensitivity and β cell function in type 2 diabetes with NAFLD associated with HFE gene mutation

     K Ponsuganthi, R Sudha

     • » Abstract Introduction: Diabetes mellitus has reached pandemic proportion and in 2030, there will be approximately 366 million diabetics; of these 79 million will be from India. Diabetes mellitus is a group of metabolic diseases that includes hyperglycemia resulting from defects in insulin secretion, insulin action or both. Type 2 diabetes is characterized by insulin resistance and insulin deficiency (often relative rather than absolute). Aims and Objectives: To study Assessment of the insulin resistance- insulin sensitivity and β cell function in type 2 diabetes with NAFLD associated with HFE gene mutation. Materials and Methods: The work embodied in this study was conducted at tertiary care Hospital. It is a hospital based case control study. All the type 2 diabetic patients attending the OPD irrespective of their sex and treatment protocol were taken; it includes both old and new cases of type 2 diabetes. All the type 2 diabetic patients were subjected to ultrasonography to rule out the fatty liver. Type 2 DM with NAFLD was taken as cases and Type 2 DM without NAFLD was taken as controls. Biochemical parameters analysed were glucose, insulin, serum iron and total iron binding capacity. DNA was extracted from frozen whole blood to detect Cys282Tyr mutation.Result: In our study population out of 100 type 2 diabetes, 54 patients had fatty liver. The prevalence of fatty liver in our study group was 54%.In our study population, majority of the patients were in the age group of 51- 60 years in both cases and controls. Age distribution between cases and controls were matched (Chi square value 2.45 degree of freedom (df) is 3, p value = 0.48).NAFLD cases had more female patients (59.2%) than controls and it was statistically significant (Chi square value x2= 4.94 and p<0.02). In our study population, mean fasting glucose in cases and controls (147.8 ± 44.6 and 138.5 ± 33.9 respectively) were not significantly different (p<0.5). Whereas post prandial glucose, fasting insulin, HOMA-IR and HOMA-β were significantly(p<0.5) higher in NAFLD patients. In comparison to controls, Insulin sensitivity index (QUICK) was statistically low(p< 0.05) in NAFLD patients. Conclusion: We observed significant increase in fasting insulin, beta-cell function (HOMA-β) and insulin resistance along with decreased insulin sensitivity in NAFLD patients
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547. A comparative study of two different doses of Gabapentin in attenuating the cardiovascular response to direct laryngoscopy and intubation

     V B Gowda, Manjunath K S, Henjarappa K S, Namrata Ranganath, Arathi B H

     • » Abstract Introduction: Direct laryngoscopy and endotracheal intubation is an integral part of anaesthesia which offers tremendous safety to administration of general anaesthesia but is associated with hemodynamic changes, due to reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Aims and Objectives: Tostudy the effect of two different doses of Gabapentin in attenuating the cardiovascular response to direct laryngoscopy and intubation. Materials and methods: Prospective, randomized, double blind and placebo controlled clinical study involving90 patients of kidwai memorial institute of oncology,Banglore visiting pre anaesthesia clinic scheduled for elective surgery under GA with ASA I and ASA II was designed after approval from institute ethics committee. Statistical analysis was done by Analysis of variance (ANOVA) to find the significance of study.Student t test (paired) has been used to find the significance within the same group. Result: Laryngoscopy and intubation caused a significant increase in heart rate and blood pressure in controlled group. Gabapentin can be used to attenuate pressor response to laryngoscopy and intubation. Gabapentin 800mg and 400mg attenuated the pressor response to laryngoscopy and intubation. SBP, DBP, MAP and HR were all attenuated by Gabapentin in comparison to control group. Gabapentin 800mg is more effective than 400mg for attenuation of pressor response to laryngoscopy and intubation (Statistically significant p<0.05) Conclusion: SBP, DBP, MAP and HR were all attenuated by Gabapentin in comparison to control group. Gabapentin 800mg is more effective than 400mg for attenuation of pressor response to laryngoscopy and intubation.
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548. A study of the efficacy of mifepristone with misoprostol over misoprostol alone in medical termination of pregnancy

     Pushpee Sinha

     • » Abstract Introduction: Misoprostol has proven its efficacy as an effective abortifacient for the second trimester termination of pregnancy. It is being successfully used through all the routes i.e. sublingual, oral and vaginal and in different regimens with the induction abortion interval varying from 12 h to as high as 33 h. Aims and Objectives: To Study the Efficacy of Mifepristone with misoprostol over misoprostol alone in medical termination of Pregnancy Methodology: This was a hospital based study in patients attending the department of Obstretics and Gynecology of teaching hospitals attached to Bangalore Medical College, Bangalore (viz. Bowring and Lady Curzon Hospital and Vanivilas Hospital) who needed MTP. Out of 100 Pregnant Women 50 pregnant women given oral mifepristone 200mg followed by vaginal misoprostol 400 microgram after 48 hours and one hour of that 200 microgram of oral misoprostol. 50 pregnant women given 600 microgram vaginal misoprostol alone at a time The statistical analysis done by unpaired t-test. Result: Complete abortion was achieved in 88% (44) of the patients in misoprostol alone regimen. Complete abortion was achieved in 96% (48) of the patinets in combination regimen. Overall complete abortion was achieved in 92 patients in our study. Failure rate was observed more in Misoprostol alone group i.e. 12.0% as compared to Misoprostol+Mifepristone group i.e. 4.0%. Mean Time to Induction to Abortion was significantly less in Mifepristone with misoprostol than misoprostol alone group. Conclusion: From our study it can be concluded that the combination of Mifepristone with misoprostol is superior to misoprostol alone with respect to less failure rate and Mean Time to Induction to Abortion in both Primi and Multi Gravidity.
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549. Comparative study of bone marrow aspiration and bone marrow clot sections in various haematological disorders

     Upasana Uniya, Yogesh Patle, Hanisha Jain

     • » Abstract Introduction: During the last two decades, bone marrow examination has become an indispensable adjuvant to diagnose the malignant diseases of the blood and other body systems. This will obviate the need for many other expensive and time-consuming investigations. When both the procedures for bone marrow examination i.e. aspiration and clot section done simultaneously, can yield a good diagnostic material which will be helpful for more accurate diagnosis. Aims and Objectives: This study was aimed to assess the diagnostic value of the BMA and Bone Marrow Clot Sections and role of both the procedures to reach final diagnosis when done simultaneously. Methods: The present study was done on 80 cases in which complete peripheral blood smears, bone marrow and cell blocks was available were included in the study. Bone marrow aspiration was performed, Cell block was prepared and stained with hematoxylin and eosin stain, smears were stained with Leishman stain. Results: Comparison was done between bone marrow aspirate smears stained by Romanowsky group of stains i.e. Leishman and paraffin embedded cell block section stained by Hematoxylin and Eosin stain. Out of 80 cases, there were 60 cases (75%) of anaemias, 9(11.2%) platelet disorders, 6(7.5%) Acute Leukaemias, 2(2.5%) Lymphoproliferative disorders, 1(1.2%) MDS, 1(1.2%) Leishmaniasis and 1(1.2%) hyperspleenism. Conclusions: The advantage of both the procedures done together provided more material and enabled us to study the cytomorphology of the cells, with the pattern of distribution of the cells depending on the cases and help in more accurate diagnosis.
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550. Phenotyphic Determination of Urinary Virulence Factors in Escherichia coli

     Vidhya J, Senita Samuel, Kennedy Kumar P, KopulaSridharan S, Uma Sekar

     • » Abstract Aim: To determine the virulence factors haemolysin production, hemagglutination and serum resistance in Escherichia coli (E.coli) of urinary isolates and Escherichia coli isolated from the other sites like blood, exudate and stool. Materials and Methods: A cross sectional study was conducted in the Department of Microbiology, Sri Ramachandra Medical College and Research Institute. A total of 120 strains of E. Coli isolated fromthe following specimens urine (50), Exudate (25), Blood (25) and Stool (20) were included in the study and assessed for the presence of Uropathogenic virulence factors such as Haemolysin production, Hemagglutination property both the Mannose Resistant Hemagglutination (MRHA) and Mannose Sensitive Hemagglutination (MSHA) and Serum Resistance factor. Results: Among the 50 urinary isolates haemolysis was observed in 10%, hemagglutinating property was seen in 20 %( MRHA 7 and MSHA 3 n=10)) and 88 % of them had serum resistance factor. Out of the 25 E.coli strains isolated from the exudate samples none of them was found to be haemolytic, 12% of them were hemagglutinating (MRHA 67% and MSHA 33%) and serum resistance factor was seen with 24% of isolates. Among the 25 E. coli isolates from the blood 8% were haemolytic, 28% of them were hemagglutinating (MRHA 100%) and serum resistance factor was observed in 72. Out of 20 E.coli strains isolated from stool, haemolysis was not seen in any of the them, 20% of them were hemagglutinating property (MRHA 100%) and serum resistance factor was positive in 20% of them. Summary and Conclusion: A total of 50 E.coli reported as significant bacteriuria (>105) was included in this study and at the same time 70 isolates of E.coli reported from other specimens (Blood, Exudates and Stool) were taken as control group. Uropathogenic virulence factor was exhibited by 45 out of 50 urinary isolates (90%). Serum Resistance is the commonest virulence factor observed in our study (88%) followed by Hemagglutination property (20%) and Haemolytic property (10%). The entire 3 virulence factor is exhibited by 3 strains of urinary isolates (6%) only. In the control group Haemolysis was observed in 2 isolates, Hemagglutination with 24 isolate, Serum Resistance in 28 E.coli isolates.
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551. Comorbidity of recurrent depressive disorder with thyroid dysfunction and altered lipid metabolism in postmenopausal women: A case-control study

     Aditi Ranawat, Maheep Sinha, Ram Kumar Solanki

     • » Abstract The transition to menopause represents the passage from reproductive to non-reproductive life. Most women during the menopause experience irregular menstrual periods along with fluctuation of ovarian hormones secretion during this time. Usually during the menopause and after menopause i.e. post-menopause women face physical and emotional changes. Since years various investigators have already documented an association between depression and menopause. Post-menopausal period is accompanied in a majority of women with significant somatic and psychiatric symptomatology. Objective: Since psychiatric symptomatology is a growing concern in post-menopausal women, hence we tried to examine whether a comorbidity of metabolic and psychiatric disorders occurs in this patient population or whether these disorders occur independently. The study was planned to examine comorbidity of recurrent depressive disorder with thyroid dysfunction and altered lipid metabolism in post-menopausal women (PMW). Method: To conduct this study a cross sectional, case-control study was planned. The experimental group consisted of PMW with recurrent depressive disorder (ICD-10 criteria) (n=100), and was compared with a control group (n=100) of PMW without recurrent depressive disorder. Subjects were assessed through Beck’s depressive self-rating inventory and their blood level of Thyroid Stimulating Hormone (TSH) and lipid profile was assessed. Group comparison was done with chi square test and z test. Correlation analysis was undertaken using Pearson correlation coefficients (r). Result: Results obtained depicted that serum total cholesterol, triglyceride, TSH levels were significantly higher and HDL levels were significantly lower in the depressed group.Highly significant positive correlation was found between Beck’s score and TSH levels in depressed PMW. Conclusion: Taken together, these data demonstrated that comorbidity of recurrent depressive disorder with Thyroid dysfunction and lipid metabolism abnormality in post-menopausal women is common and needs clinical attention.
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552. Incidence, risk factors and microbiological profile of Surgical Site Infections in cardiac surgery patients

     A K Baburajan, T S Shailaja, C K Shibu

     • » Abstract Objective: To find out the incidence of surgical site infections(SSI) in cardiac surgery patients, the organisms responsible and the risk factors associated with such infections. Materials and methods: The study is conducted in 1000 consecutive adult patients who underwent cardiac surgeries between January 2011 and August 2015 in a cardiac surgical department attached to a teaching hospital in Central Kerala, India. Results: SSIs were diagnosed in 1.8% of the patients (18 of 1,000). Of these, 15 were superficial wound infections and three were mediastinitis and all got cured with conservative management without any mortality. Culture was positive in 13 cases and the most commonly isolated pathogen was Staphylococcus spp. Though age > 60 years and male sex predisposed to SSIs, these were not statistically significant. 13 of our 18 SSI patients were diabetics. Conclusion: The incidence of surgical site infections in this centre is comparable with other studies from India as well as abroad which range from 0.53% to 18.7% [1, 2, 3, 4].
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553. A study of the analgesic efficacy of Intravenous paracetamol versus intravenous diclofenac for the postoperative pain following modified radical mastectomy

     Namrata Ranganath

     • » Abstract Background and aims: Post operative pain relief is important for decreased morbidity and mortality. It would be easy to compare analgesic efficacy of iv Paracetamol and iv Diclofenac postoperatively in two groups of patients undergoing similar surgeries Modified Radical Mastectomy experiencing similar pain. Methods: After Ethical committee approval, 70 patients undergoing modified radical mastectomy were randomly allocated to one of the two groups, each receiving IV Diclofenac and IV Paracetamol. Each group received the respective analgesic after axillary dissection, 30 minutes prior to reversal. IV Paracetamol 1 Gm. was administered as 100mL (10 mg/mL) proprietary solution over 20 minutes. IV Diclofenac 75 mg was administered in 100 mL saline as an infusion over 20 minutes.After surgery patients were shifted to Post-operative ICU. Analgesia was assessed postoperatively at the following intervals – immediate postop (time 0), 30 minutes, 1 hour, 2 hour from extubation and then at 2 hourly interval for first ten hours after surgery. Fentanyl was administered when the VAS scores crossed 4 and/ or the patient demanded the rescue analgesic. The time when the patient demanded the dosage of rescue analgesic was noted. Results: Pain scores changes during a 6 hour period between two groups were similar, 6 hours after surgery, pain scores were significantly higher with Paracetamol compared to Diclofenac (p<0.05),At 8hrs, 10hrs post extubation pain scores were significantly higher with Diclofenac. Group P patients received rescue analgesic 60-90 minutes prior to the group D (± minutes).The total number of patients demanding rescue analgesic in each of the groups was found to be statistically similar. Conclusion: Both Intravenous Paracetamol and Intravenous Diclofenac have equal efficacy for post operative analgesia following Modified radical mastectomy except duration of analgesia which is longer for Intravenous Diclofenac, as inferred from VAS scores and time of need for rescue analgesic. It appears from our study that IV Paracetamol is good alternative to IV diclofenac for post operative analgesia following Modified radical mastectomy.
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554. Evaluation of analgesic effect of Atorvastatin in rats

     Bhete S B, Pandit P R, Satpute Sachin, Vikas N Solunke

     • » Abstract Aim: The aim of this study is to evaluate the analgesic activity of atorvastatin in tail clip model of rat. Methods and Material: Analgesic activity of atorvastatin 3mg/kg and 8mg/kg were assessed in in tail clip model of rat where they were compared with control and ibuprofen group. Results: In tail clip method of rats, Atorvastatin 8 mg/kg group showed significant analgesic activity as compared with control group on day 3 and 6. However, atorvastatin 3 mg/kg group did not show any analgesic effect. Analgesic activity of both group of atorvastatin showed improvement as the study progressed from day 3 to day 6. Conclusion: The result of this study if substantiated by further experimental and clinical research suggest that atorvastatin may play important role in treating painful condition like osteoarthritis and rheumatoid arthritis specially when there is coexisting hypercholesterolemia.
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555. In hypertensive patients – measurement of left ventricular mass index by echocardiography and its correlation with current electrocardiographic criteria for the diagnosis of left ventricular hypertrophy

     A Manjula, Krishnappa R Havanur, Riaz Ahamad, Ravichetankumar, Srinivas

     • » Abstract Left ventricular hypertrophy has emerged as a powerful non invasive indicator of increased vulnerability to the occurrence of major Cardiovascular disease outcomes in hypertension. Electrocardiography and Echocardiography are the two very common modalities used to detect Left Ventricular Hypertrophy. The question is which among the two is better in terms of efficacy. So the present study was undertaken, because in the Indian population, due to lack of resources, expensive investigations like Echocardiography may not be within the common man’s reach. A total of 50 patients were included in this study between the age group of 31-65 years after satisfying the inclusion and the exclusion criteria. All these patients who had Echocardiographic evidence of Left Ventricular Hypertrophy were compared with the Electrocardiographic Criteria using the Romhilt-Estes scoring system and Sokolow-Lyon voltage criteria system. Our study confirms that Romhilt and Estes point score is specific but insensitive and showed that the sensitivity of both the Electrocardiographic criteria for diagnosing Left Ventricular Hypertrophy increased with increasing body mass index. Our findings suggest that Echocardiography is a better modality for the detection of Left Ventricular Hypertrophy when compared to Electrocardiography because of lack of sensitivity of the Electrocardiographic criteria, even though it is slightly more expensive. In view of its’ prognostic implication, routine use of Echocardiography for” the detection of Left Ventricular Hypertrophy could be justified. However, Electrocardiography should keep its place in the detection of Left Ventricular Hypertrophy as an initial modality because of its easy availability. Hence the two procedures be regarded as complementary to each other rather than mutually exclusive.
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556. Retrospective study of determinants of caesarean section in a tertiary referral hospital

     Shivamurthy H M, Ashwini Konin, Sri Divya Choudhary, Madhav Gopal, Navroze M Jassawalla

     • » Abstract Background: Caesarean Section is the second commonest surgery done on women in India after tubectomy and have great impact on maternal and neonatal health. Increasing Caesarean rates have raised the need to study its influencing factors. The overall Caesarean section rate in our set up is about 31.26%. of which 45.68% were primary sections. Objectives: To analyse the various clinical and non-clinical influencing factors of Caesarean Section. Materials and methods: We did a retrospective study consisting of 200 cases of caesarean sections conducted in Chigateri General Hospital, attached to JJMMC, Davangere during 2014. We analysed factors like age, Educational level, BMI, Parity, Co-morbidity, type of CS, Indications and fetal birth weight and Neonatal performance. Data was collected from the Hospital records. Results: In this study, 74.5% were unbooked, 74% were educated, 62.5% had more than normal BMI,16.5% were associated with hypertensive disorders, 58% were primary and 42% were repeat sections. There were 86.5% emergency and 13.5% were elective CS. The commonest indications were not willing for VBAC (70%), fetal distress (52%) and CPD (19%).Majority of the fetal weight among the study group were more than 2.5kg. Conclusions: According to our study, higher educational level, unbooked status and BMI more than normal were the significant factors determining CS. Nearly three-fifth of the patient underwent primary CS. Being a tertiary and referral Hospital we had a very high Caesarean rates.
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557. Utility of small bowel feces sign and string of beads sign in diagnosing small bowel obstruction

     Ammu Anne Mathew, Rishi Philip Mathew, Binston Thomas, H B Suresh

     • » Abstract CT has an important role in the workup and treatment of patients with small bowel obstruction. The diagnosis of small bowel obstruction on C.T is made when there is a discrepancy between the calibers of proximal and distal small bowel loops. If a distinct point of transition between the dilated proximal and collapsed distal bowel is detected, the diagnosis is more certain. Two secondary signs that has been reported to be helpful in confirming small bowel obstruction is the “small-bowel feces” sign and “string of beads” sign. This study was done to assess the role of these “small-bowel feces” sign and “string of beads sign” in the diagnosis of clinically suspected small-bowel obstruction. We assessed 62 patients in the study who were suspected to have intestinal obstruction and was referred for CT scan of the abdomen. Of the 62 patients 34 had small bowel obstructionand 28 had no obstruction.10 of them had small bowel feces sign and it was absent in the remaining 24.8 of them had string of beads sign and it was absent in the remaining 26. All those who had the above mentioned signs had small bowel obstruction on laparotomy suggesting a specificity of 100 %. However sensitivity was only 29% for small bowel feces sign and 23.5% for string of beads sign, indicating that these signs are not very sensitive for obstruction, but when present they are very specific.
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558. Clinico radiological correlation of psoriatic arthropathy- A prospective study

     K Parimalam, R Subha, M Ananthi, V Suganthi, B Karpagam

     • » Abstract Psoriatic arthropathy [PsA] is one of the common seronegative spondyloarthropathies. It was in the mid-19th century that an association between psoriasis and joint involvement first made when, apart from the clinical findings, diagnosis of PsA was based mainly on conventional radiography. In the recent times, imaging techniques like magnetic resonance imaging [MRI] and ultrasonography [USG] have been increasingly used in the diagnosis and management of PsA. . The interpretations provide additional clues to the pathogenesis of this progressive and sometimes mutilating disease. A positive radiological finding using X ray means an advanced disease, and hence the need for better imaging studies which can detect the pathology much earlier. As is well agreed upon, early detection of articular and peri-articular inflammation will help timely initiation of appropriate therapy to prevent further progression of the inflammation and thereby prevent joint destruction. USG ismore effective than X ray and less expensive than and having more or less equal diagnostic potential as MRI. USG is areliable investigatory tool freely available in many canters and should be made use of in the diagnosis and follow up of patients with PsA
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559. A study on the effectiveness of ketamine gargle in postoperative sore throat

     Namrata Ranganath, Tejashwini, Syed Mudassar, Sumitha C S, Arathi B H, V B Gowda

     • » Abstract Background and aims: Postoperativesore throat (POST) is a complication in patients undergoing endotracheal intubation for general anaesthesia Avoiding POST symptoms is a major priority for these patients. This study was done to primarily assess the incidence and severity of POST in the distilled water gargle group and compare it with Ketamine gargle group in patient undergoing elective surgical procedures performed under GA with tracheal intubation. Methods: Patients were randomly allocated in to two groups of 30 Patients each.GroupKFor30 patients, 50mg Ketamine diluted in 29 ml of distilled water was given. Group C-For 30 patients, 30 ml of distilled water was given. all Patients were made to gargle for 30 seconds, 5minutes before induction. In the postoperative period the incidence, duration and severity of sore throat was evaluated at 4, 8 and 24 hours. Results: Demographic characteristics such as age, height, sex, weight, duration of surgery were comparable, Incidence of postoperative sore throat was higher in control group at all the time compared to the Ketamine group. Most of the patients were complaining of mild sore throat in both the groups at 4hr, 8hr and 24 hr. But none had severe sore throat in Ketamine group where as in control group 23.3% at 4hr, 10% at 8hr and 3.3% at 24hr complained of severe sore throat. At 24th hour the incidence and severity of sore throat was significantly reduced in both the groups 4 (13.3) in group K and 14(46.7%) in group C. Conclusion: The incidence of POST in the patients undergoing GA with endotracheal intubation for routine surgical cases is quite common and this throat discomfort remains for next 24 hrs and Ketamine gargle significantly reduces the incidence and severity of POST.
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560. Observation on oxidative stress, liver function of subjects in various socio-economic and nutritional status

     Debjit Mitra

     • » Abstract Problem statement: In this study initially an attempt has been taken to draw the demography of alcoholic and non-alcoholic liver disease. With the help of anthropometry and biochemical investigation, an attempt has been made to give an idea on nutritional status of the patients. Malnutrition refers to under nutrition, over nutrition and nutrient deficiency. The distribution of the malnutrition occurs in a society due to different public health outcomes and policy formulation. Body mass index (BMI) is the main indicator of malnutrition. Low social status and poor social relationship are strong determinants of poor health. Methods: It was performed on unselected patients(outdoor) with diagnosis of different kinds of liver disease, who were attending in this institution (M.G.M Medical College and L.S.K Hospital,)The adult patients (50) were included for this study. They were aged 18- 65 yrs. Results: Results are expressed; it has been observed that BMI decrease in ALD and Cirrhosis in Comparison to normal and in Malnutrition II in comparison to normal showed a depressed value. Biochemical parameters – LFT, MDA, GSH value were compared both case and control group and statistical analysis were calculated by the help of SPSS software. Conclusion: Malnutrition in the condition that develops when the body does not get the right amount of the vitamins, minerals and other nutrients in need to maintain healthy tissues and organ function. Malnutrition is a health problem with multiple facets. The ecological factors related to malnutrition are conditioning influences. Socioeconomic practices, food production, health services, mother education and type of family. Nutritional disorders can affect any system in the body and senses of sight, taste and smell. They also produced anxiety, changes in mood, abnormalities and organ malfunction followed by illness and death.
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561. Synthesis and characterization of gallium (III) derivatives of sterically hindered heterocyclic β-diketone

     Jyoti Bhomia, Jyoti Sharma, Yashpal Singh

     • » Abstract Some new organic derivatives of heterocyclic β-diketone [4-chlorobenzoyl-3-methyl-1-phenyl-2-pyrazolin-5-one (CMPPOH)] of the type Ga(OPri)3-n (CMPPO)n (where n=1,2and 3) have been synthesized by the reactions of Ga(OPri)3 and heterocyclic β-diketone in different molar ratios. These derivatives were characterized by elemental analyses, mol. wt. measurements and their probable structures have been proposed on the basis of IR and 1H NMR spectral studies.
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562. Acute stemi presenting with fragmented QRS complex: A small cohort study from North India

     Kunal Mahajan

     • » Abstract Background: Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non–Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSR’ patterns, without a typical bundle-branch block are markers of altered ventricular depolarization owing to a prior myocardial scar. We postulated that the presence of fQRS might be associated with a poorer outcome in patients of acute acute ST Elevation Myocardial Infarction (STEMI). Methods and Results: The study included 255 consecutive patients of acute ST Elevation Myocardial Infarction. After excluding 31 patients, the remaining 214 patients were divided into two groups, one consisting of patients who developed fragmented QRS during hospital stay (GROUP A with 139 patients) and the other group consisting of those who did not(GROUP B with 75 patients). In comparison Q wave appeared in 137 patients (64.01%). In 77 patients who did not develop a Q wave on ECG post MI, fragmented QRS developed in 57 of them (74 %), thus making it a valuable tool in identifying a non-Q wave MI. Significantly increased levels of cardiac biomarkers on presentation and increased rates of post MI angina, congestive heart failure, and major tachyarrhythmias were observed up to 30 days of follow up in patients of group A as compared to group B patients. Conclusion: This study of 255 patients highlighted the usefulness of fragmented QRS in identifying patients at higher cardiac risk with larger areas of ischemic jeopardized or necrotic myocardium, and it can provide very useful information in the risk stratification of acute STEMI patients. It also helps to identify the evidence of infarction in patients without a Q wave on surface ECG. These all features make fragmented QRS an area to explore in the field of electrocardiography in the near future in large randomized clinical trials.
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563. Comparative study of skin closure with adhesive skin glue, staplers and conventional suture materials for skin incisions in clean elective surgeries with respect to efficacy, cosmesis and cost effectiveness

     Debasis Ray, Dipmalya Chatterjee, Sunny Khanna, Sarbarthakumar Pratihar

     • » Abstract The scar is the signature of the surgeon. Apart from cosmetically good scars it is also necessary that the skin closure technique should be technically easy, acceptable, speedy and economical. The choice of wound closure after surgery has always been a matter of debate. Wound closure techniques have evolved from the earliest development of natural suturing materials through synthetic sutures (absorbable and non-absorbable), staplers, and tapes to the newest modality of adhesive compounds. This prospective randomized study compared time efficacy, post-operative pain, wound complication rate, cosmesis and cost-effectiveness between sutures, staplers and 2-octyl cyanoacrylate skin adhesive in closure of skin incisions of different sizes (1-10cm) in 150 patients who underwent clean elective surgery between January 2011 and January 2012 in our department.
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564. Efficacy of honey as a dressing agent in lower limb ulcers

     Santosh B Dalavi, P D Gurav, Navnath E Avhad

     • » Abstract Objectives: To study efficacy of honey, as a dressing agent, in lower limb ulcers. Methods: This was a prospective study comprises 53 patients of all the age groups with lower limb ulcer were admitted in the department of surgery and treated with local application of honey to the ulcer. Observations and Results: Observations noted in view of reduction in ulcer size, reduction in slough and discharge, culture results, and decrease in pain. In 42 patients duration of symptoms is less than 1 month, 18 patients were suffering from diabetes mellitus, 38 patients were having ulcer size less than 5cm, At the end of 14 days 100% wounds became free of slough and discharge. At the end of seven days only 6 patients were having pain at the ulcer site. On day 14 there was no associated pain. All the 53 ulcers became bacteria free within 14 days. On admission, 44 patients undergone debridement, 47 patients progressed to healthy granulation tissue in 1st week and 100% in two weeks. After 14 days ulcer of nine patients completely healed 50 patients had complete healing of the lower limb ulcer after 1 month evaluation. The mean healing time estimated was 19.98 days. Conclusion: Honey made the wounds bacteria free within 14 days, honey removes offensive smells and has a desloughing action, stimulates rapid granulation tissue formation, stops further infections and the moist environment very suitable for wound recovery. Honey reduces the need for amputations.
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565. Is rectal diclofenac sodium analgesia better than oral tramadol analgesia for perineal pain relief following vaginal delivery?

     Shivamurthy H M, Hirani Madhav Gopal, Navroze Jassawalla, Ashwini Konin, Divya Chowdhary

     • » Abstract Background: To compare the efficacy of rectal Diclofenac sodium suppository with orally administered Tramadol for relief of perineal pain following vaginal delivery. Objective: To determine the efficacy of Diclofenac rectal suppository and oral Tramadol tablets for perineal pain relief following vaginal delivery. Materials and Methods: In this randomized control cross sectional study, 300 subjects were divided in two groups. Group A (150 subjects) received rectal Diclofenac sodium suppositories and Group B (150 subjects) received oral Tramadol tablets. First suppository was inserted immediately after episiotomy suturing, and second offered 12-24 hours after first dose if the lady complained of pain still. Women in group B were given oral Tramadol tablets 0 and 8 hourly. Women were evaluated for pain relief using validated short form of McGill pain questionnaire, Wong-Baker facial pain rating scale and numeric pain rating scale. Results: There was statistically significant difference between the two groups for sensory, affective and total pain scores at rest or with movement after 24 hours of childbirth indicating rectal suppository was superior to oral tramadol tablets. Pain scores were significantly lower in Diclofenac sodium suppository group (p value ≤ .0001) when compared to Tramadol group. The difference was not sustained 48 hours after birth. Conclusion: The use of rectal Diclofenac sodium suppositories is simple, faster acting, effective and safe method of reducing the perineal pain experienced by women following normal vaginal delivery within 24 hours of normal vaginal delivery.
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566. Patients choices for cesarean delivery: Enhancing C-section rate

     Dilip Kumar Das

     • » Abstract Introduction: Caesarean section is one of the most common surgeries performed in modern obstetrics. At the beginning, the process was started for the interest of the mother but now it is frequently performed for fetal indications. Though, it was introduced in clinical practice as a life saving procedure for the mother and the child, as time elapsed, this procedure also developed some health care inequity in the world like other procedures of complexities. Under use in low income setting and adequate or even unnecessary use in middle and high income setting. Enhancing C- section Rate: In India the rate of caesarean delivery has increased from 3 per cent to 10 per cent between 1992-93 and 2005-06 (IIPS, 2007), are lower in comparison to some developing nations like Brazil and China. But, as India is the second most populous country in the world, a small percentage increase in rate affects huge number of population. In India, family members sometimes demand that the baby be born on an auspicious date and time by C-section for horoscopic/astrological preferences. Conclusion: Patients choice for the caesarian delivery is one of the major factors for rising trends in the C-section rate. Barring genuine indications, Obstetricians convenience and financial considerations are other major factors. With the prevailing situations patients must be informed about the later consequences like placenta previa, repeat C- section, postpartum hemorrhage and other morbidities.
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567. A study of incidence and pattern of organ injury and management of blunt trauma to abdomen

     Meghraj J Chawada, Utkarsh V Ghavghave

     • » Abstract Introduction: Blunt trauma to abdominal is one of the leading causes of morbidity and mortality among all age groups. Identification of serious intra abdominal pathology is often challenging. Intestinal disruptions can be due to a variety of types of blunt trauma, with automobile being the most common etiologic agent. Aims and objective: To study the incidence and pattern of various organ injury due to blunt trauma to Abdomen and its Management. Materials and Method: Total 40 cases of blunt abdominal trauma were enrolled in the present study. Diagnostic laproscopic was performed in all the patients using standard guidelines. Hemodynamic parameters were watched meticulously during the procedure. Postoperatively, the patients were observed for vital parameters, hemoglobin level and return of bowel functions and wound complications. The patients who underwent spleenectomy were given vaccination against meaningful, pneumococcal, and H. influenza type B infections. The patients were discharged after return of normal bowel functions, drain removal and ruling out complications if any. The collected data was analyzed and presented with appropriate table and graphs. Results: Majority of the patients (75%) in the present study were less than 40 years of age. Majority of the patients were male (80%). The most common mode of injury was road traffic injury (60%) followed by fall (15%) and assault (20%). The incidence of liver trauma was 70% followed by spleen injury (35%). The incidence of small bowel injury was 20% whereas kidney and colon injury was 10% each. 75% patients were managed successively by conservative management. Explorative laprotomy was required in 25% patients. Conclusion: Thus we conclude that the highest incidence of blunt abdominal trauma was seen in males in 2nd and 3rd decade of life and was most commonly due to RTA. The liver, spleen and small bowel were the most commonly injured organs. By using diagnostic laproscopy majority of the patients were managed efficiently by conservative management.
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568. Clinical study of complications of cholecystectomy, an analysis of 50 patients

     P D Gurav, A V Ingale, Sachin V Mahadik

     • » Abstract Laparoscopic Cholecystectomy (LC) has lot of proven advantages over open cholecystectomy but some of its complications are always to be kept in mind for better results. This study was undertaken to study the complications of laparoscopic cholecystectomy and analyze them with regard to, conversion rate, intra-operative complications, post-operative complications, mortality and their management. This prospective study was conducted in the Department of Surgery, Government Medical College of Miraj, Maharashtra. The study included 50 patients who underwent elective laparoscopic cholecystectomy. Patients with age > 80 years, pregnant females, portal hypertension, and severe cardiac or pulmonary disease and pancreatic malignancies were excluded from the study. The complications which were noted include conversion to open cholecystectomy (12%), hematoma (16%), hemorrhage (6%), bile duct injury (2%), vascular injury (2%), visceral injury (2%), wound infection and wound pain (32%), pancreatitis (16%), retained stones (4%), subhepatic collection (2%), Port site and incisional hernia (16%).Guidelines for prevention for operative injury are similar to those of any open procedure namely, adequate training and experience, accurate identification of anatomy and identification of risk factors preoperatively leading to conversion of laporoscopic cholecystectomy to laparatomy.
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569. Clinical study of sutureless and glue free conjunctival autograft in pterygium surgery

     Satish Desai, Amol T Wanjari

     • » Abstract In this paper we study outcome of sutureless and glue free conjunctival autograft in pterygium surgery. To study pattern of astigmatism induced due to primary pterygium. To study the different complications after sutureless and glue free conjunctival autograft in pterygium surgery. To study change in astigmatism after pterygium surgery by sutureless and glue free conjunctival autograft.
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570. The effect of topical 0.05% cyclosporine on recurrence following pterygium surgery

     Anjali D Patil, D K Sindal, V Karambelkar

     • » Abstract : To investigate the role of postoperative topical 0.05% cyclosporine A (CsA) eye drops in the prevention of recurrence among patients with primary pterygium treated with bare-sclera technique. Methods: In this prospective randomized controlled study, 36 eyes (34 patients) with primary pterygium were randomized into two groups: Group I comprised 40 eyes (40 patients), and Group II comprised 40 eyes (39 patients). Bare sclera technique was performed in both groups. In Group I, 0.05% CsA was administered postoperatively at 6-hour intervals for 6 months, and Group II did not receive any cyclosporine treatment. The patients were assessed for recurrence, side effects, and complications at postoperative 1 and 7 days as well as each month during the following year. Conjunctival advances which showed a limbus higher than 1 mm were recognized as recurrence.
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571. Vitamin D deficiency and coronary artery disease

     P Gandiah, N Venkateshwarlu, K Bharat Nandan Reddy, Najma Farheen, G Sandeep Kumar

     • » Abstract Background: Recent evidence supports an association between vitamin D deficiency and hypertension, peripheral vascular disease, diabetes mellitus, metabolic syndrome, coronary artery disease, and heart failure. Materials and Methods: 100 consecutive cases of acute myocardial infarction and angina pectoris were included in this study. Another 100 otherwise age and sex matched healthy individuals formed the control group. The study was a prospective observational study. Observations: There was not much difference between the two groups as per the age and sex. 56 patients were obese while 38 were in the control group. Physical activity was slightly more in control group as 12 in patient group and 24 in control group were optimally active. 74% cases were smokers as against 46% in the asymptomatic group. There was no difference in alcohol consumption amongst the groups. Diabetes mellitus was more prevalent in study group (48 vs 22). 75% of patient group did record low Vitamin D levels, while 45% of the control individuals showed lower than 30 ng/ml. Without adjustment, the chance of being affected by coronary artery disease in individuals with vitamin D deficiency is 4.12 (1.64-8.04) times in comparison with those with normal vitamin D and after adjustment with risk factors, i.e., blood pressure, diabetes, smoking, obesity, physical activity and high blood cholesterol, this chance becomes 6.08 times (1.76-18.83). Discussion: The results of our study demonstrate that vitamin D deficiency increases the chance of coronary artery disease due to ischemic heart disease and the association between ischemic heart disease and vitamin D deficiency remains significant even after adjustment for cardiovascular risk factors such as diabetes, smoking, obesity, physical activity, high blood cholesterol.
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572. Relationships between dietary habits and the incidence of obesity in Indian medical students

     Usha Patil, Mervin Israel

     • » Abstract Dietary habits play a major role in the healthy wellbeing of and individual and may be the key intervention for treatment of overweight and obesity and the chronic disorders along with it. The study to know the incidents of obesity in medical students and its correlation with dietary habits is of great significance as students in general are highly inclined to irregular and unhealthy dietary habits. On the other hand medical students, with irregular and prolonged study schedules tend to be further inclined to such dietary habits. Obesity is well known disorder of the 21st century which is constantly on the rise, carrying with it the vast Variety of health related factors. The study included 200 medical students of the ages 18-24. The students were examined thoroughly, so as to exclude those suffering from major diseases, psychological problems and those on medication. Obesity was determined by calculating the BMI according to the American journal of clinical nutrition. And the grading of obesity into various grades between 18.5 to 24.9 kg/m, was done according to WHO. Dietary habits was determined by a self admitted questionnaire on dietary and exercise habits, (extracted from) “A Survey of Dietary and Exercise Habits and Perceived Barriers to Following a Healthy Lifestyle in a College Population by Kathryn Silliman, Kathleen Rodas-Fortier, Michelle Neyman California State University, Chico2. After appropriate statistical analysis and assessment it was observed that 47 (23.5%) students belonged to the overweight category with BMI ranging from 30.0 to 39.9.Maximum number of students i.e. 89 (44.5%) were found to be inclined to snacking while studying Majority of the students 85 (42.5%) snacked on food items such as chips, crackers and nuts. While 42 (21%) students snacked on ice cream, candy and cookies. There is significant concern about the regularity of consumption of fruits and vegetables, as Maximum number 80 (40%) of students consumed vegetables a mere 2-6 times a week, while only 33 (16.5%) students consumed vegetables daily. Fruits were consumed by majority of students 123 (63%) only once a week or less. while only 11 (5.50%) students consumed fruits on a daily basis.
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573. Endovenous laser ablation gold standard for varicose veins of lower limbs

     Bhosale Dattatray, Sawant Sharad

     • » Abstract Endoveinous laser ablation (EVLA) of the great saphenous vein (GSV) is thought to minimize postoperative morbidity and reduce work loss compared with high ligation and stripping (HL/S). Patients with varicose veins due to GSV insufficiency were randomized to either EVLA (980 nm) or HL/S in tumescent anesthesia. In our clinics, 50 varicose patients were treated between August 2013 and September 2016. EVLA was applied in 25 cases and HL/S was applied in 25cases. Clinical features and demographic characteristics of the patients were summarized. EVLA procedure was done by 980 nm diode laser (Ceralas D 980, Biolitec) at continues mode with 15 W energy. Patient visits were done at post-operative 10th day, 6th month, 1st year and 2nd year. Routine physical examination and Doppler USG assessments were performed at these visits. EVLA and HL/S procedures were done in complete success in all cases at both groups. All cases were invited for control visits. When complications developed after procedures were evaluated; no infection, hematoma or paresthesis were observed in EVLA group. However in HL/S group; infections, hematomas and paresthesis were observed in 6, 4 and 2 cases respectively. In terms of treatment success, there was no recurrence in EVLA procedure while recurrence rate after conventional surgery found in 3 cases. In terms of post-op complication, EVLA method was associated with significantly less paresthesis, hematoma and pain. EVLA method is a method as effective and safe as standard treatment. However, when a long term result of this method is shown completely, its effectiveness will be cleared and its clinical utility will be established.
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574. Statistical methods for the analysis of increased access to emergency contraception

     Irene Elizabeth Joy, Anil C Mathew

     • » Abstract Survival analysis encompasses investigation of time to event data in clinical research. In survival analysis, it is common to have truncated data due to limited time span of the study or drop out of the subject for various reasons. The estimation of survivor function under left truncation was first discussed by Kaplan Meier by extending the well known product limit estimator of the survivor function. Later several parametric models are used for modelling survival data. The focus of this paper is to compare the models and their application in the study on increased access to emergency contraception by Raymond, E. et al. (2006) and their adverse impact on risk of sexual transmitted infections. Various models are computed using SAS (Statistical Analysis System) program. The findings are presented and discussed.
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575. Bowel wall calcification secondary to meconium peritonitis- A rare entity

     Nilofar Khudbuddin Mujawar, Pradeep Kulkarni

     • » Abstract Meconium peritonitis is an aseptic chemical peritonitis that follows perforation of intestines in fetal life. Bowel wall calcification in such cases is rare. It should be emphasized that correct diagnosis can be made on basis of characteristic roentgenographic findings.
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576. Malrotation of gut - A case report

     Alok Yadav

     • » Abstract Intestinal Malrotation is a congenital anatomical anomaly which results from an abnormal rotation of the gut as it returns to the abdominal cavity during embryogenesis.
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577. Study of hypothyroidism in adult population

     Chivate C G, Deshmukh S V, Patil R V, Kumbhar S S, Bhanu P

     • » Abstract Background: Hypothyroidism is the most frequently encountered health problem in India, especially among women population. Aims and Objectives: To study the occurrence of hypothyroidism in adults with male to female ratio, its age of onset, to see for drug induced hypothyroidism. To see for co-morbid conditions associated with hypothyroidism. Material and Methods: Total 100 patients were included in this study. All adults attending medicine OPD/IPD who fulfill the criteria for suspect hypothyroidism were included in the study. Results: A female preponderance with an alarming ratio of 24:5 (female: male) was observed. Average age of onset of hypothyroidism was 33 years. Subclinical hypothyroidism was observed in 37% cases. Hypertension was present as a comorbid state in 70 % cases. Hypertension and Diabetes mellitus coexistedin 17 % of the cases.
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578. A prospective comparative study in the management of Seinsheimer type IIB and type IIIA subtrochanteric fracture with proximal femoral nail (PFN) versus proximal femur locking compression plate (PF-LCP)

     Ramesh R, Ajeet Hundekar

     • » Abstract Introduction: Subtrochanteric femur fractures have demanded special consideration in orthopaedic traumatology, given the high rate of complications associated with their management. 10%–34% of all hip fractures occur in the subtrochanteric region. Purpose of the study: To compare the clinical outcome of Seinsheimer type IIB and type IIIA subtrochanteric fractures treated with PFN versus LCP – PF. Materials and Method: A prospective study of 40 patients with Seinsheimer type IIB and type IIIA subtrochanteric fracture among which 20 were treated with Proximal Femoral Nail and 20 with Proximal Femoral-Locking Compression Plate at two Hospitals attached to J.J.M Medical College Davangere, Karnataka, India between June 2014 to October 2016.. At final follow up results were assessed with Modified Harris Hip score. Result: In the PFN group, 9 patients (45%) showed excellent outcome, 9 patients (45%) showed good outcome and 2 patients (10%) showed fair outcome. Among the PF-LCP group, 12 patients (60%) showed good outcome, 4 patients (20%) showed fair outcome and 04 patients with poor outcome. Conclusion: Proximal Femoral Nail for subtrochanteric fractures has better results compared to Locking Compression Plate-proximal femur with less failure rates and restoring better hip biomechanics.
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579. Self revealing of HIV positive serostatus by people living with HIV – a cross sectional study

     Sivakkumar Shanmugasundaram, Premamalini Thayanidhi

     • » Abstract This article emphasizes the importance of self revealing and analyzes various reasons related to hospitals, work place and family for not revealing of serostatus. The study was conducted at a Non Government Organization in Chennai among 61 people living with HIV. In this study, it was observed that about 14 (22.95%) patients out of total 61 PLWH had undergone discrimination in hospitals mainly by qualified doctors(57.14%), nurse (28. 57%) and paramedical staff (14.28%). Majority of the patients i.e about 42( 85.71%) did not reveal the HIV status at work place out of which, 30 (71.42%) had fear of discrimination and the rest 12 (28.57%) had fear of losing job. Most of the PLWH 50(82%) had revealed their HIV status to family members among which 40 (80%) got support from them and only 10(20%) had been discriminated by family members after revealing the status. Hence it can be concluded from this study that most of them have not revealed their status because of fear of discrimination at various levels.
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580. A study of accessory mandibular foramina in north Indian mandibles

     Archana Singh, Syed Hasan Hyder Zaidi, Rakesh Gupta

     • » Abstract Introduction: The surgeon who is going to perform a surgery in oral cavity e.g. a dental surgeon performing tooth extraction should be aware of accessory mandibular foramina for planning anaesthesia at an appropriate anatomical site as the branches of the facial nerve, mylohyoid nerve, buccal nerve and transverse cervical cutaneous nerve are known to pass through these foramina. Another applied use of morphological situation of accessory mandibular foramina may be utilized by the oncologist in planning radiation therapy as these foramina also provide an easy route for the spread of infection and tumor cells following radiotherapy. Since the positions of these foramina in the mandibular bones are highly variable with the races, region, and ethnicity and if this information of position of foramina can be made available freely for particular region with the help of such types of studies like the present one. Thus we can increase utilization to enhance accuracy especially in the above mentioned areas of medical field. Aims and Objectives: To evaluate the incidence of variations regarding the position and number of accessory mandibular foramina in human dry mandibles of north Indian population irrespective of gender and specific age in the light of similar studies in other global region and to draw significant conclusions. Material and Methods: Twenty eight dry human mandibles of Rohilkhand Medical College and Institutes of Dental College, Bareilly, UP, were studied to find out the incidence of accessory mandibular foramina, a mandibular variant. Results: Out of total 28 mandibles this variant (accessory mandibular foramina) was present in 39.28% of mandibles. The commonest pattern of this variant was bilateral in 21.43% of mandibles. Out of these in 14.29% mandibles the variant was single and in 3.57% mandible it was double while in remaining 3.57% of mandibles it was triple. In 17.86% mandibles the pattern was found to be unilateral.
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581. Primary adenocarcinoma of lung in a 24 year old never smoker

     Sumanta Jha, Soumya Kundu, Falguni Mandi, Souvik Ray, Sudipta Sil, Saumen Nandi

     • » Abstract Lung cancer is the commonest cancer in the world. Tobacco smoking is by far the most predominant risk factor of lung cancer. However a variety of genetic and environmental risk factors, occupational exposure to asbestos, arsenic, nickel, silica and polycyclic aromatic hydrocarbon also plays a role in lung cancer. Lung cancer is rare in young age. We report a case of a young man 24 year old, never-smoker, with no family history of malignancy, and no past history of tuberculosis or chronic obstructive bronchitis, who presented with cough, right sided chest pain and shortness of breath for 1 month duration. Patient was a manual labourer for 6 years. Clinicoradiologically, he was diagnosed as a case of right sided pulmonary consolidation with parapneumonic pleural effusion. CT guided FNAC from consolidation of right lung revealed adenocarcinoma. Chemotherapy was started and the follow-up is uneventful till now.
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582. Ocular perfusion pressure response to short term moderate isotonic exercise in obese young adults

     Ramya C M, S M Nataraj

     • » Abstract Objective: To study the effect of moderate isotonic exercise on Ocular perfusion pressure in healthy obese young adults. Method: 100 healthy young adult volunteers comprising 50 obese and 50 non-obese in the age group of 18-19 years were selected among MBBS Phase I students of JSS Medical college, JSSU, Mysuru. Subjects were asked to perform moderate Isotonic exercise on Treadmill. Heart rate, Intra-ocular pressure (IOP) and arterial blood pressure (BP) were recorded at rest and post- exercise period. Mean arterial pressure (MAP) and Ocular perfusion pressure (OPP) were calculated. Results: There was a significant increase in MAP & OPP and a decrease in IOP in post-exercise period in obese group compared to non-obese group [(Obese: MAP=93.93±4.75 to 105.37±4.91; OPP=51.48±3.27 to 61.23±3.25; IOP=16.71±1.08 to 13.53±1.01). (Non-obese: MAP = 91.37±2.71 to 104.41±4.44; OPP = 50.14± 1.57 to 61.05± 2.86; IOP =16.17±0.97 to 12.82±1.24)]. The OPP was significantly high in males (53.49±1.87) than female group (49.47±3.14) at rest. Following exercise OPP was significantly raised in females as compared to males. Conclusion: Moderate isotonic exercise proves beneficial to ocular health by increasing the perfusion levels, which may be helpful for glaucomatous patients.
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583. A rare case of thoracic extramedullary hematopoiesis associated with myelofibrosis: a diagnostic dilemma

     Priyaranjan Chattopadhyay, Soumya Kundu, Apurba Ghosh, Aditi Bhattacharyya, Manatosh Mandal

     • » Abstract Extramedullary hematopoiesis (EMH) is the production of hematopoietic precursors outside the bone marrow cavity which may cause mass effects according to its localization. A 50-year-old male presented with non-specific symptomatology and a mass in both paravertebral regions and posterior mediastinum on chest X-ray and in the chest computed tomography (CT) scan. A CT guided percutaneous needle aspiration from the mass showed hematopoietic cells with fat spaces. A bone marrow biopsy revealed a hypercellular marrow with an increased fibrosis. The final diagnosis was myelofibrosis leading to extramedullary hematopoiesis in paravertebral region. Keywords: Extramedullary hematopoiesis, paravertebral region mass, myelofibrosis.
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584. Clinical profile of snake patients in tertiary care centre

     Bhurke D P, Farooqui Mohd Abdulrafe

     • » Abstract Background: In India snakes are worshipped since ancient times, and it occupies important place in the field of medicine and medical emblems. Out of 216 species which are found in India only 52 (24.07%) species are poisonous. Approximately 2,00,000 persons are reportedly bitten by snakes out of which 35000 to 50000 persons meet death in India. Aims and Objectives: Several studies reported in the Indian literature state that there is variability of the clinical profile of snake bites. Aims and Objectives: This prospective study to clinical profile of patient admitted with history of snake bite was carried out. Materials and Methodology: Patients with history of snake bite were included in the study, 200 cases satisfied the criteria for inclusion. Patients transferred to other hospitals and could not be followed were excluded. Depending on clinical features, the patients were divided into two groups. Ineffective and effective bites. Effective bites were sub-classified as a local swelling, neurotoxicity, nephrotoxicity, cardiotoxicity and combined. The patients who had signs of envenomation were subjected for detailed hematological, biochemical, electrocardiogram and other investigations. Results and Observations: The male to female ratio was 1.29:1.00. In the age group of 21 to 30 years there was maximum number. The higher number of cases was from rural area. The highest number of bites occurred in lower limb 117 (59.70%). Out of 200 snake bite cases 77 (38.5%) were ineffective and remaining 123 were effective. Amongst them there were 101 (82.11%) patients had local reaction, 66 (53.65%) neurotoxicity, 19 (15.44%) nephrotoxicity, 5 (2.5) combined toxicity and 13 (10.56) had cardiotoxicity. Out of these 123 cases 19 (15.44%) cases developed renal failure who were treated conservatively or dialysis, out of these 4 (3.25%) patients died of uremia. Respiratory paralysis was developed in 15 (12.19%) patients who were given respiratory assisted ventilation, out of these 1 (0.81%) patients died. Conclusion: Low mortality in cases of snake bites is due to availability of independent dialysis unit, ventilator support and proper early anti snake venom treatment free of cost to the patients available in the institute.
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585. Profile of adolescent girls with obstetrics problems of illegitimate pregnancy

     Sujata Mane, Vasanti Munot

     • » Abstract Introduction: Adolescence is a formative period of life. It is a crucial period because major physical, psychological and behavioral changes take place. It is a period to undertake major decisions; including responsible parenthood Adolescents constitute a great human resource for the society. Amis and Objectives: to study the profile of adolescent girls with obstetrics problems. Materials and Method: All the adolescent girls (age between10-19 years) attending the institute with obstetrical complaints were enrolled in the study. Detail history and complete clinical examination was done in all the girls. All the adolescent girls were followed up till the termination of pregnancy. Counselling of parents and girls was done wherever required. Results: 50% of the adolescent girls were in the age group 18-19 years. 63.64% of adolescent girls were belonging to lower socioeconomic class. Majority of the adolescent girls reporting to the institute were more than 14th week of gestational age. Out of the total 22 pregnant adolescent girls 14 were managed by inducted abortion. Preterm delivery was observed in 3 cases and third degree perineal tear was observed in one case. Conclusion: Thus from the above study, it can be concluded that Comprehensive sex education and establishment of adolescent clinics id desirable to prevent unwanted early pregnancies in adolescent girls.
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586. Study of effects of different methods of pre-operative skin preparation on post-operative wound infection

     Kalpesh A Parmar, Pankaj Pandor, Himanshu Soni

     • » Abstract This study was carried out in 150 cases to make a comparative study of different methods of preoperative skin preparation to find out the best possible and feasible method out of the many available methods influencing the rate of postoperative surgical site infection.
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587. A study of various gynecological problems in adolescent girls

     Sujata Mane, Vasanti Munot

     • » Abstract Introduction: Adolescence in girls has been recognized as a special period which signifies the transition from girlhood to womanhood, which are formative years when maximum amount of physical, psychological and behavioural changes take place most notable being the onset of menstruation. Aims and Objectives: To study the various gynecological problems of adolescents. Materials and Method: All the adolescent girls (age between10-19 years) attending the institute with gynecological complaints were enrolled in the study. Detail history and complete clinical examination was done in all the girls. All the adolescent girls were treated using standard protocol and followed up regularly. Counseling of parents and girls was done wherever required. Results: Majority (30.38%) of the adolescent girls attending gynecology department were having menstrual disorders followed by primary amenorrhea (22.78%) and sexual assault (29.11%). Menorrhagia was observed in 17 cases. Among the primary amenorrhea cases; Cryptomenorrhea and true amenorrhea was seen in 9 cases each. 23 cases of sexual assault were in the present study. Conclusion: Thus in the end we conclude that menstrual abnormalities are the most common problems of adolescents.
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588. A study on Maternal Mortality – At BRIMS Bidar

     Jayashree, Asha Hanamshetty

     • » Abstract Objectives: To study the maternal mortality and the common causes and complications leading to maternal death over a period of 7 years from 2008 – 2014. Methods: Prospective study of maternal death in Brims Bidar over a period of seven years was carried out. Results: Maternal Mortality Rates (MMR) of 157.16 to 53.6 were observed over a period of 7 years. Of the women who died 85.29% were from rural areas, 67.6% were unbooked for delivery. 82.35% were in 20 to 30 years age group. Hemorrhage was the commonest cause of death followed by sepsis. Anaemia was the major indirect cause of maternal mortality. Conclusion: Hemorrhage and sepsis were the major cause of death. Anaemia was an important indirect cause of death.
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589. Verruca vulgaris in a case of benign fibrous histiocytoma – a case repor

     Mutharasu A, Sowmya S, Ramya G

     • » Abstract Benign fibrous histiocytoma is a fairly common soft tissue neoplasm composed of storiform pattern of spindle cells and histiocytes, usually seen in the dermis rarely infiltrating the sub cutis. Verruca vulgaris is another common skin lesion caused by human papilloma virus which affects only the epidermis at any site in the body. Both these lesions favor the extremities and are mostly common in female population. Verruca vulgaris coexisting with benign fibrous histiocytoma is rarely documented. We document here a case of 43 year old male presenting with elevated lesions in his skin all over the body, clinically suspected to be neurofibromatosis but the biopsy proved otherwise.
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590. A comparative study of single layer closure and conventional layered closure of laparotomy wounds in a rural setup

     Namitha D, Murali Mohan R, Yashas H R, Srinath R, Sushruta M S, Akshai C K

     • » Abstract Introduction: Many of the operations performed by the general surgeons take place within the abdomen and consequently incision and suturing of the abdominal layers is the most common exercise in operative surgery. Abdominal closure is very important with regard to incision, technique of repair and use of newer suture material, and has created a great interest to surgeons. Recent data suggests that technical factors are crucial and can be manipulated by the surgeon. Different suture techniques are used for closure of laparotomy wounds and each has its strong proponents. But the ideal method of abdominal wound closure is modified frequently. Commonly followed methods of abdominal closure are conventional layered closure and single layer closure. Aim: To compare the techniques of single layer closure and conventional layered closure of laparotomy wounds in a rural setup. Objectives: To study 60 cases of laparotomy, dividing them into two groups of 30 each. Patients of one group will undergo closure of the laparotomy wound by conventional methods and the other group will undergo closure in a single layer. The objectives being to: Compare the operative time and healing time for single layer closure and conventional layered closure of laparotomy wounds. Compare the post-operative complications after performing single layer closure and conventional layered closure of laparotomy wounds, like seroma, wound infection, wound gaping, burst abdomen and incisional hernia. Result: Comparing both the closures, single layer closure had reduced operative time than conventional layered closure, and hence, lessens anaesthetic hazards, reduces cost of anesthetic agents and saves the surgeons time. Incidence of postoperative complications like seroma, wound infection, wound gaping; burst abdomen and incisional hernia are significantly less in single layer closure technique.
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591. Comparison of non communicable diseases and its risk factors prevalence between Tamil Nadu and Kerala

     Arumugam P

     • » Abstract Background: Tamil Nadu (TN) and Kerala, the two states of Indian constituency are located in the Indian Peninsula and divided by Western Ghats. Both states are having similarities in custom and culture. Kerala and Tamil Nadu had achieved the goals of Health for All by 2000 AD well in advance by 1987 and 1991respectively. The IDSP-NCD Risk Factors Survey Phase-I revealed risk factors which were influencing the prevalence of NCD in both states. Aim: To compare the prevalence of NCD and its risk factors between two states. Methodology: The demographic characteristics, risk factors of NCD and prevalence of hypertension and diabetes data were selected from the IDSP Survey Phase-I results. The participants of Tamil Nadu and Kerala were 5105 and 4838 persons respectively. Appropriate test of significance was applied for comparison. Results: Mean ages of study subjects of Tamil Nadu and Kerala were 39.5±13.5years 41.6±13.8 years respectively. Prevalence of Diabetes in Tamil Nadu and Kerala were 4.5% and 9.2% respectively and hypertension prevalence were 3.0% and 6.9% respectively in both states. Risk factors prevalence (%) between the states was Smoking 29.0 and 30.3%, Smokeless tobacco 22.5 and 11.5, Alcohol 28 and 32.8, Physical activities 4.3 and 7.1, Obesity 22.5 and 27.1 and Coconut oil consumption was 3.1 and 87.2 respectively. Discussion: In Kerala age and literates were significantly greater than Tamil Nadu. Except tobacco usage; other risk factors were significantly greater than Tamil Nadu. Smoking was not significant and smokeless tobacco was significantly less in Kerala. The prevalence of HT and Diabetes were significantly more in Kerala than Tamil Nadu. Conclusion: High Prevalence of HT and Diabetes in Kerala compared to Tamil Nadu may be attributed to the high rate of consumption of Coconut oil (87.2%) and Alcohol (32.8%) in spite of having more physical activities (7.1%).
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592. Studies on the synthesis, growth and physic -chemical properties of a new single NLO crystal: potassium L-threoninate

     S Anna Venus, S Anbarasu, Prem Anand Devarajan

     • » Abstract Potassium L - threoninate (PLT), a New Second order non linear optical crystal was grown by slow evaporation method for the first time. The unit cell parameters of as the grown crystal was estimated by single crystal X-ray diffraction technique. The as grown crystal was subjected to X-ray Powder diffraction studies to identify the crystalline nature. The UV-Vis absorption spectra was recorded to estimate the cut-off wavelength. The presence of functional groups were ascertained by FTIR analysis. The thermal stability of the crystal was determined by TG/DT analysis. The hardness of the crystal was studied by Vickers micro hardness tester. The SHG efficiency was tested by Kurtz Powder method. Dielectric measurements were carried out at various temperatures in the frequency range 20 Hz to 1 MHz. The AC conductivity measurements done on PLT reveals that PLT crystal has a sharp electrical conductivity with an increase of temperature.
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593. Atypical squamous cells of undetermined significance (ASCUS) for papanicolaou smears in perimenopausal and postmenopausal women and its significance: a retrograde study

     Dolly Sharma, Ajit Saluja, Santosh Gupta, R. Hazari, Yogesh Patle

     • » Abstract The diagnostic category of atypical squamous cells of undetermined significance (ASCUS) varies in threshold and significance among individual pathologists and among cytology laboratories. The rate of concurrent and subsequent squamous intraepithelial lesions (SIL) in patients with ASCUS found on Papanicolaou (Pap) smears shows a wide range in the literature.1–8 The significance of this diagnosis in perimenopausal and postmenopausal women is particularly unclear.4, 9, 10 We therefore compared the ASCUS-to-SIL ratio and the rate of subsequent SIL diagnoses in premenopausal, perimenopausal, and postmenopausal women.
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594. Surface Water Quality Index of Ujjani Reservoir and its Assessment, Solapur District, INDIA

     U D Kulkarni, R R Sangpal

     • » Abstract This study was aimed at evaluating surface water parameters of Ujjani reservoir to identify major pollutant sources using multivariate statistics. Hydrochemistry of surface water in Ujjani reservoir was used to assess the quality of surface water for determining its suitability for drinking purposes. In two consecutive years along 20 stations of Ujjani reservoir, water parameters such as Temperature, pH, Turbidity, Electrical conductivity (EC), Total Dissolved Solids (TDS), Total Hardness (TH), Total Alkalinity (TA), Ca++, Mg++, Na+, K+, Cl-, HCO3-, CO3--, SO4--, NO3-, SAR, PO43-, DO, BOD and COD were determined in two seasons i.e. pre-monsoon and post- monsoon. Based on the Piper trilinear diagram it was confirmed all the water samples are alkali type excepting three samples which are away from the dam wall which are alkaline earth. In both seasons i.e. pre and post-monsoon, there is a good correlation between the electrical conductivity and elements Ca++, Mg++, K+, Cl-, SO4--, HCO3- and BOD. Total Hardness and elements Ca++, Mg++, HCO3- and TA. The range of values for WQI from different sampling stations showed variations from 44.90 to 189.53. It was inferred that the water quality of Ujjani dam varied from moderately to severely polluted (WQI method). Our findings highlighted the deterioration of water quality in the dam due to industrialization, urbanization and modern agricultural practices.
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595. Efficacy and safety of conjunctival auto graft and amniotic membrane graft after primary pterygium excision

     Dhuwadhapare Pravinkumar Gangadhar, Choudhary Kashinath G, Khaire Bhaskar Shankar

     • » Abstract Introduction: Pterygium is a degenerative condition of sub-conjunctival tissue which proliferates as vascularised granulation tissue to invade cornea, destroying the superficial layers of stroma and Bowman’s membrane; the whole being covered by conjunctival epithelium. The mainstay of treatment is surgical. There are numerous surgical procedures that have been advocated for the surgical management of pterygia and each has advantages and disadvantages. Aims and Objectives: To study the efficacy and safety of Conjunctival auto graft and Amniotic membrane graft after primary pterygium excision. Material and Method: fifty cases of primary pterygium were enrolled in the study and were divided in two groups of 25 patients each. After receiving institutional ethical committee approval and informed consent from patients the study was conducted. Group A patients underwent pterygium excision with conjunctival auto-grafting whereas Group B patients underwent pterygium excision with amniotic membrane grafting. All the patients were observed keenly for any intra operative and post operative complication. Postoperative follow up was done To find any recurrence. Results: Mean age of patients in group A was 43.16±12.60 years whereas in group B mean age was 42.48±12.20 years. Majority of the patients in both groups were having nasal pterygium (96% each). No patient had intra-operative complications in group A. In group B one patient had intra-operative graft tear. In group A, 5 (20%) patients had subconjuctival hemorrhage, 4 (16%) patients had immediate post operative graft edema, 2 (8%) patients had foreign body granuloma, 1 patient (4%) had graft infection and in group B, 1 (4%) patient had intraoperative graft tear at the time of suturing, 3 (12%) patients had subconjuctival hemorrhage, 2 (8%) patients had foreign body granuloma. None of these had any long term effect on outcome of surgeries. there was recurrence of pterygium in 1 (4%) case each in both groups. Conclusion: Both amniotic membrane grafting and conjunctival autografting are equally safe and effective procedures for the management of primary pterygium. And Amniotic membrane grafting is viable alternative to conjunctival autografting.
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596. Prevalence and associated risk factors of Diabetes Mellitus in Age group 20 and above in the rural area attached to our medical college

     S Mangal, M Khatri, M Mangal, A Nagar

     • » Abstract Background: Diabetes in adults is now a global health problem, Projections related to diabetes are often based on one or two available studies. To make these figures more robust, it is necessary to have more studies. This paper contributes new data on the prevalence of diabetes and IGT. This was a cross sectional study involving 600 subjects aged 20 years and above (300 males and 300 females) conducted in the rural field practice area of the concerned medical college. To assess the prevalence and the associated risk factors for DM (in the age group 20 and above). Result: The total prevalence of diabetes was 4.67% and was higher among males as compared to females. (4 % females and 5.3 % males). Prevalence of Pre-diabetes in our study is 3%. The prevalence of diabetes increased significantly with advancing age and this difference was found to be statistically highly significant. The prevalence of obesity was highest in diabetics, and further decreased among pre-diabetics and non-diabetics. This difference was found to be statistically highly significant. Similar results were obtained with central obesity also. Family history of diabetes was present in 12% subjects, being more common in patients with diabetes and high risk subjects i.e. pre-diabetic. This difference was found to be statistically highly significant. Diabetes was more prevalent in higher social class, higher percentage of them were addicted to alcohol while tobacco addiction was similar in diabetics and non diabetics. Diabetic subjects were involved less in moderate activity as compared to non diabetics and more of light activity was seen among diabetics as compared to non diabetics. Conclusion: The study suggests that prevalence of diabetes is on an increase even in rural areas with occurrence even in the younger age group. There are associated risk factors as obesity, addiction to alcohol, and physical activity which are modifiable risk factors and if taken care of can help in controlling this epidemic of diabetes. Besides we have certain non modifiable risk factors contributing to this disease as family history of diabetes and social class.
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597. Thyroid hormones - its influence on the level and activity of nitric oxide and inflammatory marker among women with hypothyroidism

     Uma Sudhan E, Rajagovindan D, Sumathi S

     • » Abstract Background: Hypothyroidism is associated with hypo metabolic state and endothelial dysfunction; it results in the activation of nitric oxide synthase enzyme, which releases nitric oxide. Nitric oxide synthase derived peroxynitrite has a central component of inflammation. Inflammatory and autoimmune conditions cause synthesis of hs-CRP by liver. This study was done to compare and evaluate the correlation between thyroid function, nitric oxide and inflammatory status in hypothyroid subjects. Material and Methods: 50 cases each of Euthyroidism and Hypothyroidism were included in this study. Blood samples were drawn for the estimation of nitric oxide (NO), hs-CRP and thyroid profile in all the study subjects. Results: No values were significantly decreased in hypothyroid patients (n=50) compared to controls. (n=50) (p<.000) hs-CRP values were significantly increased in hypothyroid patients (n=50) compared to euthyroid controls (n=50). (p<.000) hs-CRP had a significant negative correlation with ft3 and ft4 and positive correlation with TSH.NO had a significant positive correlation with ft3andft4and negative correlation with TSH. Conclusion: These findings suggest that raised hs-CRP and reduced NO levels in hypothyroidism could cause subclinical inflammatory state which could be a risk factor for atherosclerosis and CVD.
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598. Clinical anophthalmia and microphthalmia: a clinical case in a baby infected with TORCH

     V Pradhan, S Javadekar, V Pawar, D K Sindal, V Karambelkar

     • » Abstract Anophthalmia is a very rare condition. Clinical anophthalmia is a term to describe cases of severe microphthlmia when the eyeball is severely hypoplastic or absent. Anophthalmos is complete absence of ocular tissue and is a histopathological diagnosis. The preciseaetiology of anophthalmos unknownbut is considered to be multifactorial. They include genetic mutations and environmental factors like viruses including the TORCH group of viruses. It may also occur as a part of a syndrome.This case report discusses a 2 days old child with clinical anophthalmia. It delves into the possible causes of this condition.
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599. A case report - goldenhars syndrome

     Bindu C B, Srinivasa B S, Bhagawan

     • » Abstract A boy aged 2 years 6 months was reported to our district hospital with a rare syndrome of goldenhar having multiple symptoms. He had facial asymmetry, scoliosis, eye problems like limbaldermoid, hypoplastic mandible with bilateral preauricular skin tag and there is history of delayed dentition and the baby was operated during neonatal period for tracheoesaphagialfistulla. Child also had absent Right Kidney.
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600. Sero- prevalence of HIV and Hepatitis B surface antigen (HbsAg) among voluntary blood donors in a tertiary care centre of Puducherry

     Shanmugasamy K, Anandraj Vaithy K2, Vaishali Dhananjay Kotasthane, Dhananjay S Kotasthane4

     • » Abstract Background: Transfusion of blood and blood components remains the main stay of treatment for hematological and co-morbid conditions. They also serve the purpose of saving life during accidental blood loss and also during elective and emergency circumstances. Aims and Objectives: The main objective of the present study was to find the prevalence of HIV and HbsAg among the voluntary blood donors in a tertiary care hospital [SBV UNIVERSITY] and to find its association with age, gender, and alcohol consumption. Materials and Methodology: The prospective study (prevalence study) included 100 voluntary blood donors with inclusion and exclusion criteria with a standard protocol. Blood grouping was performed in the blood samples obtained through this voluntary blood donation and were screened for HbsAg and HIV serology using ELISA. Data analysis was done by SPSS software. Results and Observations: Among 100 voluntary blood donor studied, 92 were male donors and 8 were female donors. Out of the 100 voluntary blood donors, 65 were in the age group of 16-25 while 25 were in the age group of 26-35 years of age.78 donors were found to be non alcoholics. Only 22 of the voluntary blood donors gave history of alcohol consumption. Out of the 100 voluntary blood donors, 31 had O +ve blood group and 29 had B +ve blood group. 81 of the voluntary blood donors had Rh +ve blood group while only 19 had Rh-ve blood group. Of the 100 voluntary blood donors, only 4 were found to be sero-positive for HbsAg while there were no donors who were found to be sero-positive for HIV. All 4 HbsAg positive cases were found to be male with age group of 16-25 years. Of the 4 HbsAg positive donors, 3 were non alcoholics and only one was an alcoholic. During the course of the present study, HbsAg positive donors were found to be distributed among different blood groups. Hence an analysis was done. It was found that of the 4 HbsAg positive donors, 2 belonged to ‘B’ blood group, 1 belonged to ‘O’ blood group and 1 had ‘A’ blood group. All 4 HbsAg positive donors had Rh +ve blood group. Conclusion: This study emphasizes the importance of donor screening among voluntary donors in all blood banks of hospitals. Significant association was found between HbsAg positivity and Rh blood grouping. HbsAg positivity was significantly high in Rh +ve blood groups. The study also show alcohol consumption has no impact on HbsAg positivity.
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601. Student assessment on learning based on powerpoint versus chalkboard

     S M Chavan Swati, S R Tankhiwale Suresh, S G Damke Sachin

     • » Abstract Aim and Objectives: To assess learning gain and learning preference of students based on PowerPoint versus chalkboard for department of Microbiology. Material and Methods: Students were divided into two groups of 80 each. Two didatic lectures were delivered. In lecture 1, Group A was taught on PowerPoint, while the group B on chalkboard on the same topic. In lecture 2, Groups were interchanged. Learning gain of the student was assessed from the pre test and post test. Result: In lecture 1, mean absolute learning gain score for group A was 42.1 and group B 45.7. Average normalized gain (g) for group A was 49.6% and group B 54.88%. Impact of students pass in group A was 73.77% versus 66.19% for group B. In lecture 2, mean absolute learning gain score for group A was 57.8 and group B 26.4. Average normalized gain (g) for group A was 64.10% and group B 27.56% .Impact of students pass in group A was significantly higher than group B, 79.63% versus 15.07 %. Students’ preference for PowerPoint was 70% and 78% versus 23% and 14% for chalkboard, in lecture 1and2 respectively. Conclusion: Difference in learning gain of student for simple topic was of no significance for PowerPoint and chalkboard. Learning gain of student for complex topic was significantly more for chalkboard than PowerPoint. Student’s preference for learning is by PowerPoint.
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602. Unique differential diagnosis for a gluteal mass

     Pervez Ahmed, Apurva Arora, Narayanan Cunnigaiper Dhanasekhar

     • » Abstract Introduction: Non hodgkins lymphoma (NHL) of soft tissue and particularly the lower trunk are rare. We report a 67 year old female with a mass and pain in the left buttock. Computerized tomography (CT) and Magnetic resonance imaging (MRI) revealed it as a soft tissue mass infiltrating left gluteus minimus and involving the left iliac bone. Fine needle aspiration cytology (FNAC) was inconclusive. Incision biopsy revealed small cell non hodgkins lymphoma of B variety with CD45+ and high Ki67 activity. It is a systemic disease which is chemotherapy and radiotherapy sensitive.
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603. A retrospective study of hemoglobin levels in children with febrile seizures between the age group 6 months to 6 years

     Vitus D’silva, K Shreedhara Avabratha

     • » Abstract Introduction: Febrile seizureis the leading cause of convulsive disorder in paediatric age group with incidence varying from 2-14 %.Iron deficiency anaemia is one of the risk factors known to be associated with febrile seizures. The incidence of iron deficiency anemia among children 6 to 59 months in India is79% and the age for peak incidence of febrile seizure is 14 to18 months, which overlaps with that of iron deficiency anemia which is 6 to 24 months. Iron deficiency is the commonest micronutrient deficiency causing anemia and is a preventable and treatable condition. Objectives: To find the prevalence of low hemoglobin in children presenting with febrile seizures and its correlation with the type of febrile seizures. Results: Sixty four children diagnosed with febrile seizures over a period of 1 yearin a tertiary care hospital were included, out of which 39 were males and 25 females. The prevalence of Simple febrile seizures was 43 (67.2%) and Complex febrile seizures 21 (32.8%).Complex febrile seizure was significantly higher in males compared to females. The prevalence of anemia was 42 % and among the total 27 children with anemia 19 (70.4%) had simple febrile seizures and 8 (29.6%) had complex febrile seizures. However these findings were not statistically significant, probably because the study involved small sample size and was conducted in a tertiary care hospital. Conclusion: This study concludes that there is no statistically significant relation between low hemoglobin, febrile seizures and type of febrile seizures. Further studies are needed to correlate anemia, febrile seizures and type of febrile seizures and establish possible role of anemia as a risk factor.
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604. Efficacy of hydroxyapatite granules in bone regeneration following periradicular surgery

     Sahadev C K, M J Bharath, Praveen Kumar M R, Sandeep R, Rosamma George

     • » Abstract The indications for surgical Endodontics have become fewer with the advancements in non surgical endodontic techniques and material. However, there are some cases, which definitely required an apical surgery. The success of apical surgery depends on regeneration of the periapical tissues and filling of the osseous defects. For this purpose, different grafts are used. One such allogenous bone graft is the bioresorbable, bioactive hydroxyapatite: Biograft-HA. The effects of this graft on bone regeneration are evaluated in this study. This graft was used in three cases with osseous defects by a simple procedure. The cases with three months, six months follow up are presented here.
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605. A school based study on assessment of age by third molar space in an urban area of Tamil Nadu

     Sivakkumar Shanmugasundaram

     • » Abstract Aim: Estimation of the age in living individual by using the third molar space as a criteria was attempted and also the female preponderance in the development of third molar space was verified. Materials and Methods: 151 school students between the age group of 14 and 17 years were selected based on the availability of their birth certificates. Their oral cavity was examined for the development of third molar space behind second permanent molar. Observations and Results: It has been observed that third molar space developed in the students between the age group of 14 and 17 years in various percentages and female preponderance is present in 14 and15 year group and male preponderance is Present In 16 and17 Year Age Group of Students.
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606. A comparative study of hyperglycaemic response in well controlled diabetic patients undergoing general and regional anaesthesia

     Suneeth P Lazarus

     • » Abstract Hyperglycaemic response in diabetic patients can be well controlled with adequate depth in general anaesthesia and it can be totally eliminated in the regional anaesthesia. In group I [general anaesthesia] the hyperglycaemic response was not clinically significant. The haemodynamic response measured as rise in heart rate and blood pressure were also not clinically significant. Where as in group II [Regional Anaesthesia] the differentiation of sympathetic nervous system eliminates hyperglycemic response.
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607. Reconstructive procedures in orofacial malignancies at tertiary care hospital in Aurangabad district of Maharashtra: an observational study

     Ajay K Boralkar, Ansari Mohammed Abdul Muqtadir, Pankaj S Vairagad

     • » Abstract Present study describes the various types of reconstructive procedures undertaken and its outcome in the Orofacial cancer patients at the tertiary care hospital in Aurangabad district of Maharashtra during the study period. Total of 40 cases with squamous cell carcinoma were studied. The procedures done were Split Thickness Skin Graft in 2 cases, Naso-labial flaps in 12 cases, Myocutaneous flaps in 23 cases and free flaps in 3 cases. Pectoralis Major Myocutaneous (PMMC) Flap repair was the most common type of reconstructive procedure employed and it was done in 17 cases. On analysis of complications in PMMC Flap repair, we found partial Flap necrosis in one case, Flap Dehiscence in 2 cases, Infection in 3 cases, Seroma in one case, orocutaneous fistula in 2 cases, restricted jaw movement in 3 cases and Donor site morbidity in one case. Overall outcome analysis in PMMC repair showed good functional outcome in the form of oral diet in 85.5% cases, good speech intelligibility as well as mouth opening in 82.6% patients and good aesthetic outcome in 86.95% patients. Overall functional and aesthetic outcome was found to be best in patients with Free Flap reconstruction and Split Thickness Skin Graft.
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608. Counselling and disclosure of HIV status to retropositive patients by various health regulatory bodies

     Sivakkumar Shanmugasundaram, Premamalini Thayanidhi

     • » Abstract Introduction: HIV counselling and disclosure of status play a vital role in care, treatment and support of retropositive patients. This ensures that people have the right to know their HIV status with confidentiality, and benefit from increased access to antiretroviral treatment. The study was conducted in a Non Government Organization among 61 retropositive patients. It was observed that for majority of the patients (52.5%) pre and post test counselling was not done, and also written consent was not obtained from them (55.7%) before HIV testing, at both government hosiptals, private hospitals and laboratories. This kind of practice should be curtailed. Qualified medical practitioners should be trained in this regard which will motivate people to come forward for testing voluntarily.
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609. Recent trends in the prescribing pattern of anti-hypertensive drugs in a suburban teaching hospital

     S T Balamurali, S Sivakkumar

     • » Abstract Background: Raised Blood pressure is an important modifiable risk factor for cardiovascular diseases, cerebrovascular diseases, Pheripheral vascular diseases etc. The prescribing pattern of drugs used for treating hypertension changes from time to time in response to changes in recommended guidelines and innovations of new drugs. Therefore it is necessary to find out the prescribing pattern of anti-hypertensive drugs by medical practitioners in current medical practice. Aims and Objectives: To evaluate the recent trends in prescribing pattern of anti-hypertensive drugs, the different combinations being prescribed and the commonly prescribed dosage of individual drugs. Methodology: This study was carried out for a 3 months’ time period. The patients selected were in the age group of 25 to 70 years, diagnosed to have mild to severe systemic hypertension and on treatment, who were attending the OPD of General Medicine, without any other complications or co-morbid diseases. Result and Conclusion: The most common anti-hypertensive agents used were CA channel blockers 75 % (n=90) followed by β blockers (BBS) 30% (n=36), Angiotensin receptor blockers 25% (n=30), Angiotensin converting enzyme inhibitors 15 % (n=18) and Diuretics 15 % (n=18). Among those, most commonly prescribed drug for Monotherapy was calcium channel blockers (55%).Of the respondents 52.5 % were receiving at least 2 anti-hypertensive agents. Among them the most common agents used in combination were CA channel blockers + β blockers (40%) followed by AR blockers + CA channel blockers (20 %) and Diuretics + AR blockers (17.5 %). CA channel blockers were the most commonly used drug for combination therapy.
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610. Annular pancreas – a case report and review of the literature

     B Selvaraj, K Senthil Kumaran, G P Sekar

     • » Abstract Introduction: Annular pancreas is a very rare congenital problem that can manifest clinically from neonatal age to adulthood. Here we present a rare case of Annular pancreas which presented in neonatal period. The child presented with bilious vomiting and the AXR revealed classical Double bubble appearance. Laparotomy revealed the diagnosis and we did Kimura’s diamond shaped Duodeno-duodenostomy. Postoperatively we gave peripheral TPN for 10 days.
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611. Tight tendoachilles as etiological factor in plantar fasciitis

     Terence Derryl L. Dsouza, Ronald Menezes, Arun Mathew Cyriac

     • » Abstract Introduction: Plantar fasciitis is a commonly encountered problem and could be secondary to a plethora of causes. Among the various causes suggested, tight TA is one of the frequently implicated etiology in many previous studies. Our study was to test this hypothesis of tight tendoachilles in cases with Plantar fasciitis using a foot pressure plate analysis.Among the 33 patients clinically diagnosed as PF only 5 had Point of Maximum Pressure anteriorly suggesting the co existence of tight TA in these cases. However overall results showed no staitsically significant association of tight tendoachilles with plantar fasciitis.
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612. Trichoblastoma: an unusual visitor to a surgeon

     Mahendra Bendre, Nandkishore Narwade, Abhijit Bagul, Abid Raval

     • » Abstract Trichoblastoma is a rare, benign adnexial tumour arising from follicular germinative cells, presenting as a solitary mass of brown/black nodule usually on head or neck in adult males. It is a dermal, epithelial and stromal neoplasm consisting of proliferation of basaloid cells in a stroma resembling perifollicular fibrous structures. A biopsy is essential for diagnosis as it may closely resemble a basal cell carcinoma or rarely undergo malignant transformation. Complete surgical excision is the treatment of choice. We present herewith a rare case of a giant trichoblastoma on thigh along with a a comprehensive review of the whole subject.
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613. Clinicopathological study of viral skin lesions

     V Sriram, S Sowmya

     • » Abstract Introduction: Many viral infections have prominent skin manifestations. Most commonly encountered are herpes simplex, molluscum contagiosum and human papilloma virus which causes verruca vulgaris, condyloma acuminatum, deep palmoplantar wart and verucca plana. They are of increased significance in immunocompromised patients. Most of the viral lesions are diagnosed clinically and serologically, some require biopsy confirmation. Aims and objectives: To identify the specific histological changes in individual viral lesions. To differentiate the lesions that can clinically mimic as bullous lesion or soft tissue mass. Materials and Methods: The skin biopsies received in the department of pathology, SMVMCH for a period of 3 years from 2011 to 2013 were taken for this study. Results: Out of 2160 skin biopsies studied, 31 patients were diagnosed to have skin manifestations of various viral infections. The most commonly encountered entity was Verruca vulgaris (14), followed by condyloma accuminatum (6), deep palmoplantar wart (4), molluscum contagiosum (4), herpes (2) and verucca plana (1). The most characteristic histological findings that helped in the diagnosis were, intranuclear inclusions in herpes; cytoplasmic viral inclusion bodies in MC, deep palmoplantar wart; koilocytes in Verruca and condyloma .These were also associated with other epidermal changes. Conclusion: Virus can produce warty, bullous and mass like lesions which can mimic non infectious conditions. Histopathological evaluation serves as a valuable tool for identification of virus induced skin changes and aids in appropriate management of these lesions. In our study most common infection was HPV.
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614. Screening for microalbuminuria as an early marker of diabetic nephropathy in type 2 diabetic patients

     Satyajeet Giri, Ben S Ashok, Rakesh Kumar Saroj

     • » Abstract Background: One of the early complications of type 2 diabetes mellitus is diabetic nephropathy which is reported as the leading cause of premature deaths due to renal failure. This study was conducted to see the prevalence of microalbuminuria in type 2 diabetic patients. Materials and Methods: This cross sectional study was carried out in the Diabetic Clinic of Sri Ramachandra Medical Centre, Chennai, India. Subjects were selected based on a detailed questionnaire. Blood and urine sample of 95 type 2 diabetic patients and 30 normal subjects between the ages of 45-63 years were collected to analyze fasting plasma glucose, post prandial glucose, Glycated hemoglobin, Blood urea nitrogen, creatinine and microalbuminuria. Results: There were 38 microalbuminuria positive cases out of 95 diabetic patients (p<0.001). The prevalence of microalbuminuria was higher in older patients and increased with increase in duration of diabetes. Conclusion: There is significant association between the duration of diabetes and microalbuminuria in type 2 diabetic patients.
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615. Effect of BMI and nutritional status on physical fitness index in response to short term moderate intensity exercise in sedentary young adults

     Mona Kharbanda1*, G Indra Kumar2, Shweta Kumari Shah

     • » Abstract Introduction: The current study was conducted to see the relationship between nutritional status of an individual, its body mass index and its physical performance so as to improve the physical fitness of low body mass index subjects bringing their better performance. The study was carried out in 58 young healthy sedentary medical students who were asked to perform short term limited duration exercise on bicycle ergograph. Each subject served as its own control. Subjects were introduced a pretested questionnaire for assessing nutritional status, Cardiorespiratory profile, status of nervous system, physical activity and related problems, history of past and present illness to find out any condition affecting physical performance of the subject. Physical activity level was assessed by different tests assessing their flexibility, coordination, Equilibrium, agility, strength and endurance. Physical activity Rating scale and VO2 max was used to assess the physical fitness. Physical fitness index was calculated using the formula. Pearson’s correlation coefficient was to determine the relation between BMI and Nutritional status score. Pearson’s correlation coefficient also determined the relation between nutritional status score and physical fitness index. Observed data revealed that subjects with poor nutritional status and obese subjects had lower level of physical fitness score. Physical fitness score was found to have a significant negative correlation with BMI in underweight and overweight subjects. It could thus be concluded that population having normal body mass index showed greater improvement in aerobic work capacity of study population which shows that sedentary medical students need proper nutrition, education and physical exercise to go a long way.
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616. Histopathological study of xanthogranulomatous reaction in various sites

     Ronald J Bosco, S Sowmya

     • » Abstract Introduction: Xanthogranulomatous inflammation is a chronic inflammatory disease. Histologically characterized by collection of foamy macrophages admixed with polymorphonuclear leukocytes, plasma cells and lymphocytes in a mosaic like pattern along with marked fibrosis and organ destruction. Most common sites are gall bladder, kidney, followed by lymph nodes and urogenitial tract. They mimic malignant neoplasm both radiologically and clinically. Usually they are incidental findings in the histopathological sections. They can be induced or associated with neoplastic and inflammatory processes. Materials and Methods: Histopathologically diagnosed cases of xanthogranulomatous reaction from the department of pathology, SMVMCH for a period of 2 years from 2012 to 2013 were taken for this study. Observation and Results: Totally 16 patients were diagnosed to have xanthogranulomatous reaction in various sites. It was found in association with various conditions like radicular cyst, anal fistula, cholecystitis, synovitis, pyelonephritis, mastitis, serous cystadenoma of ovary, vaginal wall mullerian cyst, epididymo-orchitis and ruptured epidermal cyst. PAS showed diffuse granular cytoplasmic staining which differentiates it from malakoplakia. Conclusion: Most xanthogranulomas present as a mass lesion extending to adjacent structures and can mimic infiltrating carcinoma. It may also accompany inflammatory signs like pain, fever, leukocytosis due to delayed type hypersensitivity reaction. Therefore distinguishing infections from neoplasm for further management is important. So histopathology is essential for confirmation of the lesion.
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617. A Comprehensive Study of Epidemiological Pattern of Dengue and Comparison of Dengue Rapid Diagnostic Tests verses Dengue ELISA Tests

     R Patel et al.

     • » Abstract Background: Dengue is the most important arthropod-borne viral disease of public health significance. It has become endemic in India with outbreaks occurring almost every year. Aim and Objectives: To analyze the epidemiological pattern of dengue disease along with clinical study and to compare the result of the dengue rapid diagnostic test with standard ELISA test. Materials and Methods: The laboratory records of dengue positive cases of year 2013were analyzed retrospectively for epidemiological data & dengue diagnostic tests. Results: The study shows predominant younger age group involvement with male predominance. Among the positive dengue rapid diagnostic tests, only 80% tests were positive when compared to standard ELISA tests. Conclusions: The epidemiology pattern of dengue is changing in some areas with predominant younger age group involvement. Though rapid diagnostic tests shows false positive results sometimes, it can offer early detection of outbreak.
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618. Comparative prospective study of outcome between aggressive and expectant management of premature rupture of membranes

     Shivamurty H M, N Spandana, Y Anusha Sunkara, Ahswini Konin, V Sridivya Chowdary

     • » Abstract Background: Premature rupture of membranes (PROM) is the loss of integrity of membranes before onset of labor. PROM occurs in approximately 5–10 % of all pregnancies. and is a significant obstetric problem and is important cause of maternal and neonatal morbidity. When PROM occurs at term, labor typically ensues spontaneously or is induced within 12 to 24 hours Objectives: To compare the expectant and aggressive management and its neonatal and maternal outcomes. Material and Methods: This is a prospective study carried out in the Obstetric and Gynecology Department of J.J.M Medical College, Davangere, Karnataka. Results: There were 573 cases of PROM giving incidence of 8.15%. The incidence was found to be higher in case of rural, young, primigravida. Out of these PROM cases 81.5% were managed aggressively (group A), 18.4% were managed expectantly (group B). Mode of delivery was as follows. Group A (Expectant management) Vaginal delivery in 70.75%, LSCS in 29.25 %. Group B (Aggressive management) Vaginal delivery 83.7% LSCS 27%. Perinatal mortality, Group A 7.54 %, Group B 1.28%. Perinatal morbidity, Group A 7.54 % group B 4.49%. Maternal morbidity, Group A was 18.86% Group B 1.07%, Matrenal mortality Group A 0.94% one, Group B was zero Conclusion: Aggressive management by induction of labor within 12 hours in PROM reduced the time of delivery and the rates of chorioamnionitis, endometritis, and admission to the neonatal intensive care unit. A proposed plan of "Aggressive management" is the final answer to decrease maternal and neonatal morbidity and mortality.
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619. Atypical spinal tuberculosis– extra-osseous extra dural tuberculoma: a retrospective study

     Jayant Jain, V Shanmugam

     • » Abstract Introduction: Extra-osseous, epidural tuberculoma are extra-pulmonary manifestations of tuberculosis involving the central nervous system. Material and methods: We are reporting 5 patients of extra-dural tuberculoma ranging in age from 21yrsto 64 yrs. All patients had varying degree of paraparesis at the time of presentation. Only two patients had spinal tenderness and bone involvement could not be seen in plain radiographs in all five cases. All patients underwent magnetic resonance imaging and only three had no osseous involvement. Exploration through posterior approach by laminectomy with posterior instrumentation done in all cases and the epidural mass had been sent for histo-pathological examination which confirmed the diagnosis. Results: All patients healed clinico-radiologically with anti tubercular therapy and been followed for minimum 2 years. Conclusion: Extra-dural tuberculoma should be considered as a differential diagnosis in compression myelopathy due to spinal tumor syndrome.
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620. Quantification and evaluation of garden biomass in municipal solid waste of Nagpur city: A case study

     Vivek P Bhange, SPM Prince William, Sanvidhan G Suke, A N Vaidya

     • » Abstract Garden biomass (GB), a potential cellulosic resource for bio energy is commonly found in urban waste. Quantification and characterization of GB would help in disposing this waste properly besides opening avenues to reap energy from it. In this context, the present investigation was carried out in Nagpur, India to quantify and characterize GB in urban waste and to assess its potential as a substrate for bioenergy production. 25 samples were collected from different locations in Nagpur city. Physical and chemical parameters were analyzed in the laboratory. The result showed that the average quantity of GB generation in the urban waste of Nagpur city as 1.68 % with a moisture content of 50.77%. The major (61.17%) portion of garden biomass was fallen leaves followed by cut grasses and small twigs. The characterization of GB samples revealed that it contained 37.33% of cellulose, 26.02% of hemicellulose and 28.39 % of lignin in it. The quantity of biomass in its cellulosic content in the urban waste of Nagpur city warrants its suitability as a promising feedstock for energy generation.
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621. Quantification and evaluation of garden biomass in municipal solid waste of Nagpur city: A case study

     Vivek P Bhange, SPM Prince William, Sanvidhan G Suke, A N Vaidya

     • » Abstract Garden biomass (GB), a potential cellulosic resource for bio energy is commonly found in urban waste. Quantification and characterization of GB would help in disposing this waste properly besides opening avenues to reap energy from it. In this context, the present investigation was carried out in Nagpur, India to quantify and characterize GB in urban waste and to assess its potential as a substrate for bioenergy production. 25 samples were collected from different locations in Nagpur city. Physical and chemical parameters were analyzed in the laboratory. The result showed that the average quantity of GB generation in the urban waste of Nagpur city as 1.68 % with a moisture content of 50.77%. The major (61.17%) portion of garden biomass was fallen leaves followed by cut grasses and small twigs. The characterization of GB samples revealed that it contained 37.33% of cellulose, 26.02% of hemicellulose and 28.39 % of lignin in it. The quantity of biomass in its cellulosic content in the urban waste of Nagpur city warrants its suitability as a promising feedstock for energy generation.
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622. Awareness knowledge and attitude regarding eye donation in Thiruvananthapuram district south India

     Simon George, Prashob Mohan

     • » Abstract Objective: To study the awareness, knowledge and attitude to eye donation among the residents of Thiruvananthapuram, Kerala State, India. Materials and Methods: After obtaining informed consent, subjects aged 16 or above selected from the residents of Thiruvananthapuram district were asked to fill up a validated objective type questionnaire on eye donation. Data was analyzed using appropriate computer statistical software tools. Results: A total of 557 subjects participated in the study. The awareness of eye donation was 90.5%. The awareness was significantly less among the illiterate (63.6%) (p<0.05), those with monthly income less than 1000 rupees (79.3%) (p<0.05) and females (78.4%) (p<0.05). Only 70.6% were willing to donate their eyes or have already pledged their eyes. Among those who were unwilling to donate eyes, 48.2 % believed that their body would be disfigured (p< 0.05). 25% thought that persons with cataract could not donate eyes. Audiovisual and print media were the major sources of information (58%). Government publicity measures accounted for only 1.8%. Conclusion: Although Thiruvananthapuram has a high level of awareness about eye donation, significant number of people are unwilling to donate their eyes mainly due to their misconceptions. To increase the availability of corneas for transplantation, more effective publicity measures are needed to properly educate the residents about eye donation.
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623. Body adiposity index in metabolic syndrome

     Ayesha Almas, Vanitha Gowda M N

     • » Abstract Background: Obesity is a chronic and complex disease defined as an excess of body fat. Adipose tissue accumulation increases the incidence and risk of adverse metabolic events and diseases. Many techniques have been developed for assessing and/or determining body fat or adiposity. A new index of adiposity, namely the body adiposity index (BAI) has been developed. Metabolic syndrome is a group of abnormalities that confers an increased risk of developing atherosclerotic cardiovascular diseases and type 2 diabetes mellitus. Aim: To determine BAI levels in metabolic syndrome, to analyse correlation of BAI with metabolic risk factors and to determine what appropriate cut-off value of BAI would be most closely predictive of the metabolic syndrome. Materials and Methods: A cross-sectional study was undertaken in M S Ramaiah Medical College and Hospitals, Bangalore. A detailed personal and clinical history, blood pressure, anthropometric measurements were recorded and a fasting blood sample was drawn from each of the 90 subjects selected. The serum samples were analyzed for Fasting Blood Sugar and lipid profile. Results: BAI levels in subjects with metabolic syndrome was 30.29% ±4.36 and 27.97 %±3.72 in controls without the presence of a single risk factor for metabolic syndrome. BAI showed a significant positive correlation with Serum triglycerides, Systolic and diastolic blood pressure in both the cases and controls and a significant negative correlation with Serum High Density Lipoprotein (HDL). A cut-off of 26.76% for BAI had an optimal sensitivity and specificity to be most closely predictive of the metabolic syndrome. Conclusion: BAI can be used as an additional marker in screening populations for metabolic syndrome in field studies; however its validity needs to be demonstrated in field studies with larger populations, before accepting it as a new marker to predict cardiovascular and other health risks.
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624. A preliminary report on hand preference with hand length, hand breadth and shape indices and its role in sexual dimorphism

     Tarsem Kumar, Vishram Singh

     • » Abstract The hand is the most used and versatile part of body is of great scientific importance to investigators in the field of anthropometry, forensic pathology, orthopedic surgery and ergonomics. The aim of the present study is to provide an authentic data database on right and left hand length, hand breadth and hand shape indices of two different ethnic groups of a particular age and sex. And study its correlation with handedness and sexual dimorphism. The study was conducted on 300 Haryanvi Brahmins (150 each of either sex) and Kashmiri Pandits (150 each of either sex) of age group 18 year and above. The values for hand-length, hand breadth and hand shape indices were calculated for both the hands. Hand preference was established according to Edinburg inventory and five hand-preference determination groups were constituted after calculation of laterality score. The result were tabulated and subjected to statistical analyses. Mean values for hand-length handbreadth and hand shape indices in males are more, when assessed by sex. These values were found statistically significant (p≤00.1). when relationship between laterality score(indicator of hand preference) and hand-length, handbreadth, and shape indices were examined, the values were found to be positively correlated for right hand-length, left hand-length, left shape index but the correlation was no statistically significant. Laterality score was negatively correlated with right hand breadth, left hand breadth and right shape index in Haryanvi Brahmins where as in Kashmiri Pandits it was positively correlated with right hand length, left hand length and left hand shape index. But the correlation was statistically significant in case of right hand breadth (p≤0.01) and right shape index (p≤0.01).
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625. Intra operative management of a case of pheochromocytoma excision by thoracic approach - a nightmare for the anaesthesiologist

     Debashish Paul, Col Manu Tandon, Maj Bhupendra

     • » Abstract Pheochromocytoma is a potentially lethal catecholamine containing tumor of chromaffin tissues.The classic triad of headache, palpitation and diaphoresis is present in up to 70% of the cases and only 50% have sustained hypertension. The best approach for pheochromocytoma treatment is surgical excision of the affected adrenal gland. Although uncommon type of tumor, pheochromocytomas present a great challenge to the Anaesthesiologist, since it has unspecific clinical symptoms, complex detection tests and possibility of unfavorable results, including death when not previously diagnosed. The perioperative course and anesthetic management of patients with catecholamine-secreting pheochromoytoma has typically been reported only in small case series because of the infrequent incidence of these tumors. In this report, we describe a successful management of a case of Normetanephrine secreting bilateral adrenal and Rt Subhepatic region & Lt Paravertebral region pheochromocytoma that underwent excision with favorable outcome. Because of surgical approach for excision by thoracotomy, one lung ventilation (OLV) was established which is itself a challenge for the Anaesthesiologist.
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626. A case report of antenatal bartter syndrome

     Roshini Kasi Viswanathan, Sheila K Pillai, Ravi Kumar Barva

     • » Abstract Bartter syndrome is a rare renal tubulopathy first described by Frederic Bartter in 1962. The primary pathogenic mechanism is defective transepithelial chloride reabsorption in the thick ascending limb of loop of Henle (TALH). The disease is characterized by hypokalemia, metabolic alkalosis, and secondary hyperaldosteronism with normal to low blood pressure due to renal loss of sodium and hyperplasia of juxtaglomerular apparatus. The two distinct presentations of Bartter syndrome are antenatal bartter syndrome (ABS) and classical Bartter syndrome.We present a rare case of antenatal bartter syndrome.
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627. Incidence of polycythemia in with high risk antenatal and natal history

     R C Mahajan, Lalit Une, Sharad Bansal

     • » Abstract Introduction: Polycythemia in Newborns is well known now a day to pediatricians. It is not uncommon and is a potentially serious disorder of newborns. By definition, it is an increase in the circulating red blood cells above normal values and corresponding increase occurring in hemoglobin and hematocrit or packed cell volume. Alternatively it is an increase in red cell mass per unit of body weight. Various risk factors such as birth asphyxia, toxemias of pregnancy (preeclampsia/eclampsia), twin pregnancies, hypertension, postmaturity, suspected intrauterine growth relation, maternal diabetes etc have been reported by various authors. Aims and Objectives: To study the incidence of polycythemia in newborns with high risk antenatal history and various factors associated with it. Materials and Methods: In the present study newborn with various high risk antenatal factors were enrolled. A detailed antenatal (medical and obstetric), intrapartum history of mother was recorded on a prestructured proforma. Complete clinical examination was done in newborns. Cord blood hematocrit determined was done by Wintrobe's hematocrit method from each of the newborns. Results: The incidence of polycythemia was found to be 10.5% at sea level. Birth asphyxia, twin pregnancy, toxemias of pregnancy and intrauterine growth retardation are the commenest risk factors which predispore for the development of polycythemia and hyperviscosity syndrome. Polycythemia is more common in small for gestational age babies than appropriate for gestational age babies. Out of total 21 newborn with polycythemia, 19 were delivered by spontaneous vaginal delivery. Conclusion: The incidence of polycythemia in newborn with high risk antenatal history was 10.5%. Birth asphyxia, twin pregnancy and IUGR were the most common risk factors associated with polycythemia.
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628. Study of management of superficial burn wounds (up to 30%), using camphor and coconut oil, in 2000 patients

     S P Jadhav, Ritvik Jaykar, Shrikant Makam, S P Patankar

     • » Abstract The authors report their experience with Management of Burn wound with Camphor and Coconut Oil in 2000 Patients, From January 2000 to January 2014. The patients having superficial burns involving 30% or less than 30% were selected for the study. There were no major complications and no mortality in the series. The advantages exceed that of conventional dressing methods. Advantages like decreased duration for wound healing, decreased pain, decreased hospital stay with early return to routine activities and finally better cosmesis were seen. It also decreased the cost compared to other methods which needs costly dressing materials.
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629. Preliminary phytochemical evaluation of bambusa arundinacea seeds

     Thamizharasan S, Umamaheswari S, Rajeswari Hari, Ulagaratchagan

     • » Abstract Bambusa arundinacea belongs to the family poaceae is highly reputed ayurvedic medicinal tree commonly known as Bamboo. It plays a significant role in human civilization since ancient times and still contributing to the subsistence of over two billion people living in tropical and subtropical belts in Asia, latin America and Africa. Traditionally bambusa leaves, stem and root were used as astringent, laxative, diuretics and also it has anti-inflammatory, anti microbial, antifertility, antispasmodic, antidiabetic and antiulcer activity. Leaf buds are used to treat menstrual problems. Roots are used to treat cirrhosis and tumors of liver, spleen and abdomen.. The information on the phytochemicals of bambusa arundinacea seed is limited. The objective of this research work was to evaluate phytochemicals of Bambusa arundinacea seeds. Preliminary phytochemical evaluation of seed extract bambusa arundinacea reveals the presence proteins, carbohydrates, flavanoids, phenols and tannins.
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630. Awareness regarding rabies and its prevention among final year medical students in a tertiary health care institute in Mandya, Karnataka

     Shashikantha S K, Vishma B K

     • » Abstract Introduction: Rabies continues to be a major public health problem in India, with an estimated 20,000 people dying of this disease every year. Rabies is an almost 100% fatal disease and at the same time it is almost 100% preventable. Medical graduates constitute a key source of medical care for antirabies treatment to the victims of animal bites. Aims and Objectives: To assess the knowledge among the medical students in a rural tertiary care institute regarding awareness of rabies and its prevention. Materials and Methods: A cross sectional study was conducted during January 2015 among 96 final year medical students to assess the knowledge regarding rabies and its prevention. A pretested structured questionnaire was administered after obtaining the consent. The data were entered and analyzed using Microsoft excel. Results: Our study found that less than half of the study subjects were aware of the mode of transmission and incubation period of rabies. Two third of them knew soap and water should be used for cleaning the wound after a bite and 36.5% of the subjects were of the opinion that bandaging has to be done in selective cases of uncontrolled bleeding. The knowledge regarding intramuscular and intradermal schedule, dose and site was 28.1% and 9.4% respectively. Conclusion: There is a need for emphasizing the public health importance of rabies and its prevention which can be done by sensitizing the students during internship and Continued Medical Education programmes at regular intervals.
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631. Routine urinalysis-predictor of urinary tract infection

     A C Pinto, S Devaraju, V K Basavaraju, B M Thomas

     • » Abstract Introduction: Urinary tract infection (UTI) is one of the most common problems warranting medical attention. The purpose of this study was to determine the usefulness of routine urine analysis in predicting UTI, to facilitate presumptive treatment. Data of 500 culture positive urine samples were collected. The colony counts were correlated with physical, chemical and microscopic parameters of the urine sample. Of particular interest were tests for nitrites (NIT) and leukocyte esterase (LEU). Sensitivity, specificity and predictive values were calculated with regard to NIT, LEU and a combination of both (NIT+LEU). Chi square test was used to calculate p-value and thereby association of culture positivity with various above mentioned parameters. Most parameters showed significant correlation with colony count (p value <0.05). Sensitivity of NIT, LEU and (NIT+LEU) to detect infection was 22.33%, 66.1% and 50% respectively. Specificity of NIT, LEU and (NIT+LEU) was 90.9%, 54.3% and 92.7% respectively. In our study (NIT+LEU) had higher specificity and positive predictive value and are therefore useful in predicting the presence of UTI.
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632. Study of intravenous clonidine Vs intravenous dexmedetomidine to attenuate the response to laryngoscopy and intubation

     Anand Subramaniam, Shalini G Anand

     • » Abstract Introduction: Laryngoscopy and intubation is associated with sympathoadrenal stimuli and heightened cardio respiratory and neurological reflexes such as tachycardia, hypertension, bronchospasm and increased intracranial pressure. These reflexes are potentially harmful for the patients more so in patients with hypertension, ischemic heart disease or associated neurological problem. Clonidine and dexmedetomidine are alpha 2 agonists acting in the central nervous system to reduce the sympathetic outflow. Aim: To compare clonidine and dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation when given as a infusion before induction. Material and Methods: A prospective double blinded randomized study involving patients coming to the operation theater for surgery under general anesthesia. Patients were divided into two groups, group C n=30 received clonidine 1µgm/kg intravenously 10 minutes as infusion before intubation and group D n=30 received dexmedetomidine 1µgm/kg intravenously 10 minutes as infusion before intubation. The hemodynamic variables were noted at 1, 3 and 5 minutes after intubation. Statistical Analysis: The obtained data were analyzed using the independent sample t-test. Results: There was no statistically significant difference between the two groups with respect to the heart rate, systolic and diastolic blood pressure, mean arterial pressure or the rate pressure product. Conclusion: Clonidine and dexmedetomidine are equally effective in reducing the stress response to Laryngoscopy and intubation.
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633. Prevalence of childhood obesity and associated risk factors: a cross sectional study in schools of Jaipur

     Amit Saini, Chaman Verma, B S Tomar

     • » Abstract Purpose: To determine the Prevalence of obesity in school children aged 6 to 15 years in co-educational schools of Jaipur and Evaluation of risk factors associated with obesity. Materials and Methods: The present study was conducted on 1250 school children of either sex aged 6 to 15 years in four schools of Jaipur. The height and weight of each child was measured and BMI was calculated. Children with BMI more than 95th percentile for that age and sex were considered as obese and from this prevalence of obesity was calculated. Various risk factors causing obesity were also evaluated. Results: The prevalence of obesity was found to be 7.6%. Overall prevalence among girls and boys was 9.34% and 5.69% respectively. The prevalence of obesity among those with positive family history, obesogenic diets, high socio-economic status, who did not exercise, was found to be 22.85%, 12.09%, 11.82%, 8.19% respectively. Conclusion: The sex, socio-economic status and physical activity have a bearing effect on obesity while family history and dietary habits have no effect. Obesity is an emerging health problem in school-age children belonging to affluent families in Jaipur.
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634. Intravenous methergin versus intramuscular oxytocin in active management of third stage labour

     Ramya K S, Shilpa Shivanna, Gopal N

     • » Abstract Abstract: Post partum haemorrhage is the single most significant cause of maternal death worldwide. More than half of all maternal deaths occur within 24 hours of delivery, most commonly from excessive bleeding. It is estimated that worldwide 1,40,000 women die of postpartum haemorrhage each year—one every 4 minutes1. Objectives: To assess and compare the efficacy of intramuscular oxytocin 10 IU and intravenous methergin 0.2 mg during active management of third stage of labour. Methods: 210 women delivering either vaginally or by caesarean were included and randomised into two groups. In Group I 100 women were given injection oxytocin 10 IU IM and in group II 110 women were given injection methergin 0.2 mg IV within one minute of delivery of the baby prophylactically. The main outcome measures were amount of blood loss, duration of third stage, need for MRP, incidence of PPH, need for repeated oxytocics and its side effects. Results: The mean blood loss at vaginal delivery in Group I was 354 ml and in group II was 162.72 ml with P value 0.00046, which was statistically significant .The mean blood loss at caesarean delivery in Group I was 741.66 ml and Group II was 492.7 ml with P value 0.036, which was statistically significant. The mean duration of third stage of labour in Group 1 was 7.35 min and Group 2 was 6.21 min. Conclusion: In the active management of third stage labour intravenous methergin is a better uterotonic when compared to intramuscular oxytocin to reduce the amount of blood loss at delivery and prevent complications like atonic PPH.
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635. Late steroid intervention in traumatic optic neuropathy

     Vinod Sharma, Kalpana Sharma, Himanshu Goyal, Suresh Kumar, Kulbhushan Prakash Chaudhary

     • » Abstract Traumatic optic neuropathy after craniofacial injury was first described by Hippocrates. The optic nerve is vulnerable to indirect and direct trauma causing functional impairment of vision. Optic nerve injuries occur in the setting of head injury which is often a consequence of road traffic accidents or falls. The diagnosis of optic nerve injury may be delayed by the presence of other life-threatening injuries .We report a case of 60 yrs old male patient who met with a road side accident and reported to us with sudden painless loss of vision left eye after 15 days. On MRI brain and optic nerve he had small Extradural haemorrhage (EDH) along left anterior frontal lobe and there was enlargement of left optic nerve sheath. Currently, there is no validated approach to the management of traumatic optic neuropathy. Thus, with numerous conflicting reports on the management of traumatic optic neuropathy, there is little world consensus on the optimal management of this condition. Keeping this in view we devised high dose steroids to the patient to which he regained his vision in left eye 6/60. The main aim of this article is to review the treatment modalities in a case traumatic optic neuropathy.
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636. Prevalence and risk factors of obstetric anal sphincter injuries: analyses of eight thousand vaginal deliveries

     Wanwadee Sapmee, Pattaya Hengrasmee

     • » Abstract Introduction: Obstetric anal sphincter injuries (OASIS) following vaginal childbirth are a major cause of fecal incontinence which can have tremendous impact on women’s quality of life. Unfortunately, these are often missed at the time of delivery. Recognition of potential risk factors may help increase awareness and detection rate of OASIS in routine obstetric practice. The objective of this study was to determine the prevalence of OASIS and associated risk factors in women undergoing vaginal childbirth Materials and Methods: This was a retrospective chart review of 8,475 women undergoing vaginal delivery at Department of Obstetrics and Gynecology, Siriraj Hospital during 2010 and 2012. Inclusion criteria were singleton, cephalic presentation, gestational age≥ 20 weeks, live births, no history of cesarean section and complete medical record. OASIS was defined as third- and fourth-degree perineal tears. Women’s baseline characteristics and factors potentially associated with OASIS were recorded. Chi-square and Student T-tests were used to demonstrate the correlation between OASIS and non-OASIS groups. Univariate and multiple logistic regression analyses were performed to determine significant predictors of OASIS. Observations and Results: Overall prevalence of OASIS was 5.4%. With two-step analyses, birth weight over 3,500 g was confirmed as the strongest predictor for OASIS (OR 6.26; 95% CI 3.79–10.32).Other risk factors included occiput posterior position (OR 5.54), instrumental delivery (OR 3.54), primiparity (OR 3.22), prolonged second stage of labor (OR 2.23), and short stature(OR 1.8) respectively. Conclusion: Preventive strategies and proper management during intrapartum and postpartum period are essential for all women at risk in order to avoid anal sphincter injuries.
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637. Comparison of intubating conditions with two doses of rocuronium at 60 and 80 seconds

     Anand Subramaniam, Ashok Kulasekhar, Shalini G Anand

     • » Abstract Introduction: Rapid sequence induction and intubation involves securing the airway rapidly in the shortest possible time using a rapidly acting muscle relaxant in patients who present for emergency surgery with full stomach. succinylcholine is the drug which has been commonly used for this purpose because of its quick action in spite of few drawbacks. Rocuronium bromide a new muscle relaxant, an analogue of vecuronium is rapidly replacing succinylcoline. Aim: To compare the intubating conditions using two doses of rocuronium 0.6mg/kg and 1mg/kg at both 60 and 80 seconds. Material and Method: It is a prospective and double blinded study involving 80 patients who presented for the operation theater to undergo surgery under general anesthesia. Patients were divided into four groups group A n=20 were given 0.6mg rocuronium and intubated in 60 seconds, group B n=20 were given 0.6mg/kg rocuronium and intubated at 80 seconds, group C n=20 were given 1 mg/kg rocuronium and intubated at 60 seconds and group D n=20 were given rocuronium 1 mg/kg and intubated at 80 seconds. The intubating conditions were assessed using the scale followed by cooper et al. Statistical Analysis: the obtained data was analyzed using the one way analysis of variance test and chi-square test. Results: Group A produced excellent intubating condition in 50% of patients, group B 90% and group C and D 100%. Conclusion: Rocuronium at 1 mg/kg produced excellent intubating condition within 60 seconds.
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638. Agenesis of isthmus of thyroid gland - a case study

     Sandhyarani M Patil, Rajani A Joshi, M D Raval

     • » Abstract This paper presents and describes a case of agenesis of isthmus of thyroid gland.It was found in an old aged male cadaver during routine dissection in the department of anatomy . There was no glandular tissue in the region of isthmus of thyroid gland. There was levator glandulae thyroidae extending from right lobe upto the lower border of hyoid bone.
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639. Effectiveness of silver dressings in treatment of diabetic ulcer

     Saurabh Mishra, John Joseph S Martis

     • » Abstract Background and objective: With the increase in the life expectancy, the incidence of diabetic ulcers is inevitable. In this study we compare the efficacy of topical silver preparation with conventional wound dressing in healing of diabetic ulcers, in terms of days required for healing, rate of granulation tissue formation, quality of graft bed, graft uptake, effect on bacterial growth and side effects of silver preparations. Method: 58 patients with diabetic ulcers were selected by purposive sampling technique in Father Muller Medical College and Hospital between august 2012 to September 2014. Data related to the objectives of the study were collected. Result: this study has shown better granulation tissue formation, graft uptake, negative bacterial growth and decreased hospital stay in patients receiving silver dressings than patients receiving conventional dressings. Conclusion: The study concludes that silver preparations are better than conventional preparation. They are also cheap, readily available and easy to use alternative with no side effect.
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640. Reduction en masse in a strangulated direct inguinal hernia

     M L Sankar Narayanan, S Surya, K Balaji Singh, T Mohanapriya, T Manuneethimaran, K Arunkumar, E Premanandh, N Nitesh, T R Karthikhaeyan

     • » Abstract Background: Direct or Internal Inguinal Hernia is quite commonly encountered in elderly people due to laxity of posterior wall following repeated distention and straining. It is uncommon to undergo complication such as obstruction, strangulation, perforation in a direct , complete inguinal hernia. Hernial Reduction En Masse is rare to encounter and requires high degree of clinical suspicion, more likely to be unnoticed and can end up being fatal to the patient. We report a case of a strangulated, direct, complete inguinal hernia which perforated following spontaneous En Masse reduction.
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641. Role of P16INK4a immunoexpression in diagnostically difficult cases in cervix

     Leena Dennis Joseph, C N Sai Shalini, Pavithra V, Lawrence D’Cruze, Rajendiran S

     • » Abstract Background/Aims: Cervical biopsies harbouring inflammatory and reactive conditions showed similar histology as that of early Cervical intraepithelial neoplasia (CIN) lesions making it difficult to distinguish both of them. This scenario paved the way for experimenting new specific biomarkers for high risk cervical lesions. p16INK4a is a cell cycle regulatory protein that has a negative influence on cell proliferation by sharing a reciprocal relationship with tumor suppressor protein, retinoblastoma gene product (pRB).This pRB is inactivated by human papillomavirus (HPV) oncoprotein E7 leading to inappropriate shifting of cell cycle directly into S phase. This results in reciprocal overexpression of p16INK4a which can be demonstrated immunohistochemically using monoclonal antibodiesMethods: A total of 100 cases of cervical lesions including inflammatory lesions(n=23),CIN I(n=5),CIN II(n=5),CIN III(n=31) and invasive carcinomas(n=36)were selected. For immunohistochemistry the CIN Tec Histology kit(Mur and Mur)was used.Strong nuclear and cytoplasmic positivity was considered a positive reaction.Results: Of the 23 cases of chronic cervicitis, 22 cases (95.6%) were negative for P16INK4a staining. Only one case was positive (4.3%)Of 5 cases of CIN I, 2 cases(40%)were positive for the stain whereas 3 cases(60%) were negative. Of the 5 cases of CIN II, 2 cases were positive (40%) and 3 cases (60%) were negative. In the CIN III group of 31 cases, 26 cases (83.8%) were positive for P16INK4a staining, but 5 cases (16.1%) were negative. All the 26 cases showed a100% full thickness positivity. In the category of Invasive squamous cell carcinoma, 29 cases(80.5%),out of the 36 showed a 100% full thickness positivity but 7 cases (19.4%) were negative. Statistical analysis was done and CHI SQUARE VALUE=45.05;P value <0.001Conclusions: The use of P16INK4a immunostain is a useful adjunct with Hematoxylin and Eosin(H&E) stained slides,as it aids to increase diagnostic accuracy and interobserver agreement in the diagnosis of high grade cervical intraepithelial neoplasia and carcinoma
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642. A clinical profile and factors associated with age related macular degeneration

     Vijay Kumar Srivastava

     • » Abstract Introduction: Age-related macular degeneration (AMD) is the leading cause of blindness among people aged 55 years and older in the U.S and other Western countries. Aims and Objectives: To study Clinical profile and factors associated with Age related macular degeneration. Material and Methods: After approval from institutional Ethical committee a cross sectional study was carried out in patients with age related macular degeneration at Ophthalmology department of tertiary health care center during the year 2014. For the diagnosis of age related macular degeneration all the persons with age >45 with the signs and symptoms of AMD were Ophthalmoscopically examined and fundus examination was done by Ophthalmologist and confirmed by OCT or fluoresce in angiography or both. So, during the study period total 30 patients were diagnosed as AMD were included into study. All the data is presented in the tabular form and arranged in percentages. Result: The majority of the patients were in the age group of 75-85 and were 40.00%. The most common clinical features observed were Difficulty in recognizing the Faces i.e. in 73.33% followed by C/o Distorted images in center in 60%; Need brighter light than normal for reading in 56.66%; C/o Blurry Text in 53.33%; C/o Blind spot in the middle of visual field in 43.33%; Impaired depth perception in 33.33%; Difficulty in Reading and Driving in 30% of the patients respectively. The most common risk factor associated with Age related macular degeneration patients were H/o Hypertension in 70% followed by H/o Smoking in 63.33%; H/o Alcoholism in 56.66%; Female Sex in 53.33%;C/o Cataract in 43.33%; H/o Hyperopia in 33.33%; Atherosclerosis in 30%; Obesity (BMI >30)in 30 and Diabetes in 23.33 % of the patients respectively. Conclusion: It can be concluded from our study that the most common clinical features observed were Difficulty in recognizing the Faces, Distorted images in center, Need brighter light than normal for reading and the most common risk factors associated were H/o Hypertension followed by H/o Smoking, H/o Alcoholism. Female Sex, Cataract and H/o Hyperopia; Atherosclerosis; K/c/o Obesity (BMI >30) and K/c/o Diabetes etc.
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643. A study of various complications and factors associated with primary trabeculectomy

     Vijay Kumar Srivastava, Leena Lawrence

     • » Abstract A study of various complications and factors associated with primary trabeculectomy
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644. A study of time interval between thrombolytic treatment and Outcome in Patients with myocardial infraction

     Pankaj Bohra, Eshan Sharma, Kamal Kumar Jain

     • » Abstract Introduction: The time-related effect of treatment on survival and myocardial salvage in patients with acute myocardial infarction (MI) has been demonstrated in thrombolysis trials Aims and Objectives: To study Time interval between thrombolytic treatment and Outcome in Patients with Myocardial infraction. Methodology: This was a hospital based cross-sectional study of the Patients who were admitted to tertiary health care Centre with diagnosis of Myocardial Ischemia diagnosed by ST-Elevation Myocardial Infarction during the Period of One year from June 2014 to June 2021 at tertiary health care Centre. Total 120 patients were enrolled into the studyThe statistical analysis done by Chi-square test calculated by Graph Pad Prism software. Results: The majority of the Patients were from 40-50 -26.67% followed by 50-60- 25.00%, >60- 19.16%30-40- 19.16%, 20-30- 10%. Majority of the Patients were Male i.e. 58.33% and 41.67% were Female Majority of the Patients who recovered completely from the illness were the patients who received treatment <2 Hr. from onset of the Symptoms i.e. 66.67% as compared to 31.95% who received treatment >2Hr. This observed difference is statistically significant. (X2 = 13.99, df=1, P<0.0002.) Conclusion: In our study the Recovery among the MI patients were significantly higher if the treatment is started within 2 hrs. duration.
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645. Implications of serum urea and creatinine estimation in prostate cancer

     Mukund Joshi, Suvarna Prasad, Kuldip Singh Sodhi, Rajesh Pandey, Jasbir Singh, Subhash Goyal

     • » Abstract Demographic and epidemiological transitions in developing countries like India have shown an increasing trend in burden of non communicable diseases like cardiovascular disease, diabetes as well as cancer. Previously, it was thought that the prevalence of prostate cancer in India is far lower as compared to the western countries but due to various reasons it is becoming clear that we are not very far behind the rate from western countries. Since prostate disorders have an association with end stage renal disease and is also age related, this study focuses on the utility of blood levels of urea, creatinine, as a possible aid in the diagnosis of prostate cancer. The study was conducted in the Department of Biochemistry in collaboration with the Department of Surgery in MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana. The clinical and laboratory findings of 100 subjects (age ≥ 30 years) with biopsy-confirmed prostate related disorders as BPH, carcinoma of prostate, prostatomegaly were taken from hospital records dated January 2013 to September 2014. Out of 100 subjects, 7 (7%) had elevated serum urea, 17 (17%) had elevated serum creatinine and 7 (7%) had elevated levels of both. 29 (29%) patients had elevated serum PSA levels out of which 2 (6.8%) had elevated serum urea, 9 (31%) had elevated serum creatinine, and 2 (6.8%) had elevated serum levels of both. Majority of subjects were in the age group of 61-70 years whereas serum PSA levels were highest in the age group of 71-80 years. Therefore, increased serum urea and/or creatinine could be an early hint towards prostate cancer and it is recommended that males ≥40 years of age should undergo screening for serum PSA levels every 5 years.
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646. A Study of clinical profile of the patients with myocardial ischemia at tertiary health care centre

     Pankaj Bohra, Eshan Sharma, Kamal Kumar Jain

     • » Abstract Introduction: In 2003, the prevalence of CHD in India was estimated to be 3-4 per cent in rural areas (two-fold higher compared with 40 year ago), and 8-10 per cent in urban areas (six fold higher compared with 40 year ago), with a total of 29.8 million affected Aims and Objectives: To study clinical profile of the patients with myocardial ischemia at tertiary health care Centre Methodology: This was a hospital based cross-sectional study of the Patients who were admitted to tertiary health care Centre with diagnosis of Myocardial Ischemia diagnosed by ST-Elevation Myocardial Infarction during the Period of One year from June 2014 to June 2021 at tertiary health care Centre. Total 110 patients were enrolled into the study. All the Socio-demographic information and Clinical information were recorded and the associated Risk factors have also studied. Result: The majority of the Patients were from 40-50- 25.45 % followed by 50-60- 23.63 %; 30-40- 20.90 %; >60- 19.09 %; 20-30- 10.90 % Majority of the Patients were Male i.e. 56.36% and 43.63% were Female Most common associated factors with MI patients were H/o Smoking - 52.72% followed by H/o- Hypertension -48.18%; Obesity (BMI >30) -39.09%; H/o Tobacco Chewing -34.45%; H/o Diabetes - 22.72%; Hyper-cholestremia -21.81%Out of the Total 110 Patients 82.72%- Recovered; 10.90%- Discharge Against medical Advise; 6.36%- Died.Conclusion: The most common age of presentation of Myocardial infarction observed in our study is 40-50 and was associated with risk factors like Smoking, Hypertension, Obesity, Tobacco Chewing, Diabetes, Hyper-cholestremia.
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647. Breast carcinoma in men - it’s rare but there

     Ravi Kumar Mathur, Vineet Choudhary, Brijesh Kumar Singh, Akhilesh Shekhawat

     • » Abstract Background: Male breast carcinoma is a very rare disease. It accounts for less than 1% of malignancies in men. This study reviews the male breast carcinoma cases with regard to its incidence, presenting characteristics, risk factors, diagnosis, management and survival. Methods: We present a series of 5 consecutive cases seen at a single centre tertiary care teaching NIMS hospital over a period of from 2007 to 2013. We searched the paper charts of all male patients with a histologically confirmed diagnosis of breast cancer. A study of various epidemiological factors/clinical presentation and metastasis (local and distant) was done. Results: Mean age of diagnosis was significantly higher in males; mean survival after diagnosis was significantly lower in men because cancer was found at a more advanced stage in men at the time of diagnosis. Conclusion: Men have a delayed diagnosis, older age at diagnosis and shorter survival after the diagnosis of male breast cancer. There is a need for creating awareness of possibilities of breast cancer in men which would help in earlier diagnosis and potentially better outcome after treatment.
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648. Does mode of delivery of second twin influence the neonatal outcome?

     Shivamurthy H M, Y Anusha Sunkara, N Spandana, Ashwini Konin, V Sridivya Choudary

     • » Abstract Background: The incidence of twin pregnancies account is about 3% of all gestations. The second twin is generally considered at higher risk of severe morbidity and mortality because of obstetric complications. There is general consensus that vaginal delivery for twins is safe when both are in vertex presentation, whereas planned caesarean section is typically indicated for breech presentation of the first twin. Planned vaginal delivery has been associated with an increased risk of perinatal mortality and morbidity of the second twin compared with the first twin. The purpose of this study was to examine the association between mode of delivery and NICU admission, neonatal mortality in term and preterm twin pregnancies, particularly for second born twins. Objectives: To study the influence of various methods of delivery of the second of the twins on the neo natal outcome of the second twin. Material and Methods: We analyzed 50 cases of twin pregnancies delivered in hospitals attached to JJM Medical College, Davangere (from July 2013 to July 2014) where the first twin was vertex and delivered vaginally. Pregnancies with ante-partum complications were excluded. Three groups of twin pairs were selected and included in the study. Group A: Twin pairs with the second twin delivered by caesarean section. Group B: Vaginally delivered second twin. Group C: Version and breech extracted second twin. Twin pairs were excluded if the mother was assigned a diagnosis suggesting any ante-partum pathology: congenital malformations, immunization or hydrops, intrauterine growth restriction, chorioamnionitis, maternal infection or fever, ante-partum bleeding or placenta praevia, preeclampsia or eclampsia, diabetes, twin-to-twin transfusion syndrome, or intrauterine fetal death. Results: Total number of 50 cases were studied where the first twin was vertex and delivered vaginally. Out of 50 cases, 62% had a non-vertex second twin. 64% of babies delivered vaginally were admitted into NICU with 24% mortality. All cases of IPV and breech delivery were admitted into NICU with 50% mortality where as only 52.63% of babies delivered by caesarean sections were admitted into NICU with 15.78% mortality. The neonatal outcome in the three study groups were shown in Table 1 and 2. Second born twins in Group A (second twin delivered by caesarean section) was at lower risk of NICU admission (p=0.109) or neonatal death (p=0.232) compared to second born twins in group B (vaginally delivered second twin) and group C (version and breech extracted second twin). Conclusion: Neonatal mortality is lower for the second twin after caesarean delivery compared to Vaginal and IPV-breech but it is not statistically significant. The present results support that, caesarean delivery may be associated with a better chance of neonatal survival in otherwise uncomplicated twin pregnancies.
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649. Genital tuberculosisan important cause of infertility needing high index of suspicion

     Bhumija, Girija Wagh

     • » Abstract Objective: To report association between genital tuberculosis and infertility. Summary of Background Data: The incidence of genital tuberculosis varies widely with social status and environment of the patient. The incidence is around 1% amongst the gynaecological patients in developing countries. The incidence rises to 5-10% amongst patients with infertility.Tuberculosis specially affecting the female genital tract has been identified as the most difficult diagnostic challenge. Genital tuberculosis is a chronic disease with a low grade symptomology and a very few specific complaints. Methods: Prospective review of the patient’s lab reports and histo-pathological findings. Results: We reviewed records of 3 patients who presented to us with complaints of infertility. On basis of various investigation modalities and pathological studies, we found out that genital tuberculosis was the cause of infertility in these patients. Conclusion: We report that female genital tract tuberculosis poses a diagnostic challenge. The commonest clinical manifestation is infertility. Hence, a high degree of suspicion aided by intensive investigations is important in the diagnosis of the disease
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650. Modes of presentation of acute myocardial infarction and circadian, circaseptan, circannual rhythms

     Rajshekhar I Koujalgi

     • » Abstract Background and Objectives: To study the Modes of presentation of MI along with Circadian, Circaseptan, Circannual pattern of onset in local population and the effect of time delay on mortality. Methods: Presentation of 316 patients (October 2006 to September 2009) of acute myocardial infarction (AMI) with typical chest pain and atypical symptoms were studied. The circadian, circaseptan and circannual rhythm of onset noted along with risk factors and delay in treatment and outcome. Results: 273 (86.39%) patients presented with chest pain, mean age (51.5) and 43(13.60%) with atypical symptoms, mean age (56.3) had proportionately more females. A larger (115 patients) morning peak (1st quarter) of onset of AMI and lesser (85patients) evening peak was noted. 12.97% mortality in patients presenting <6 hours and 24.75% in >6 hours. More onset of AMI on Friday and Sunday (circaseptan). 109 patients had onset of AMI in monsoon. Conclusion: 13.60% of individuals had atypical presentation of MI. Delay of arrival was associated with increased mortality rate and decreased thrombolysis there was significant morning peak in the onset of MI and seasonal peak onset in monsoon. But least onset in winter and no significant circaseptan pattern.
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651. A study of clinical profile of patients with dengue fever with thrombocytopenia

     Pankaj B Palange, R B Kulkarni, R K Shrawasti, Nikhil A Kharat, Atul Jankar

     • » Abstract This study was done on 68 patients of dengue fever who were admitted in Bharati Hospital, Sangli during the period Jan. 2012 to Dec. 2013. All the patients require hospitalization due to one or the other complications of dengue fever like bleeding manifestations, shock, organ dysfunction etc. 57 patients recovered completely without any complications. While 11 patients expired due to severe dengue in spite of intensive management. These patients suffered from dengue haemorrhagic fever and dengue shock syndrome. It was observed that mortality was mainly due to plasma leak leading to shock, severe haemmorhage and multiorgan failure. Platelet count was not found to be a predictor of severity of disease or outcome. Effective fluid resuscitation by colloids, crystalloids and blood
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652. A Retrospective Study of Secondary Postpartum Haemorrhage at BRIMS, Bidar

     Uma Deshmukh, Meenal Vardhan

     • » Abstract Objectives: To assess the incidence, clinical features, investigations and management of secondary postpartum Haemorrhage (PPH). Methods: A retrospective analysis of 50 cases who presented at BRIMS, Bidar with secondary PPH was carried out. Results: The incidence of secondary PPH was 0.71%. Eight of these women also had primary PPH due to atonic uterus. In 0.14% of cases secondary PPH occurred during the second postpartum week. Sonography findings were suggestive of retained products of conception in 10 cases. Eighty-six percent of women responded to conservative line of management and 14% required surgical evacuation. Only in 50% of cases, the ultrasound diagnosis of retained products was confirmed by histology. Conclusion: Complete blood count should be done for all secondary PPH patients. Midwifery training for third stage of labour is must. Per speculum examination is must in developing country like INDIA. Role of ultrasound is debatable. Unnecessary operative procedures on the puerperal uterus should be avoided. Curettage material should be sent for histopathology.
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653. Pecoma of the ischiorectal fossa presenting in pregnancy - a rare presentation of a rare tumor

     S Shameema, R N Visweswara, V Saradha

     • » Abstract Perivascular epitheloid cell tumor (PEComa) is an uncommon entity composed of distinctive perivascular epitheloid cells with variable immuno reactivity for melanocytic and muscle markers. They are recently described tumors, and in the last decade there have been reports of similar tumors in various sites, such as uterus, retro peritoneum, breast, cardiovascular and central nervous system. However in our opinion, such a tumor has not been reported in pregnancy till now. Here we report a case of PEComa occurring in a 22 year old pregnant lady in the ischiorectal fossa, and describe the diagnostic and surgical challenges faced. We also highlight the peculiar clinical and morphological features of the case. The importance of considering PEComas in the differential diagnosis even in pregnancy, the need to arrive at a conclusive preoperative diagnosis and the requirement for immune histochemical work up have been discussed, with a revision of the concerning scientific literature.
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654. A double blind randomised controlled clinical trial of Isoamyl-2-cyanoacrylate with N-butyl cyanoacrylate

     S T Balamurali

     • » Abstract Introduction: Closure of wounds with bioadhesives was proved to be efficacious and well tolerable. It also produces scar thinner than the sutures. Now it is require comparing the efficacy of various bioadhesives available in the market by a phase III clinical trial. Aim: To compare the efficacy and tolerability of Isoamyl-2-cyanoacrylate bya control clinical trial using n-Butyl cyanoacrylate as the control. Methodology: it is a double blind, randomised controlled clinical trial of Isoamyl-2-cyanoacrylate with n-butyl cyanoacrylate in patients of inguinal hernia in the age group of 18 – 40 years who were admitted in the surgical ward of Government General Hospital, Chennai. Result and Conclusion: The scar was of better quality in the 3rd month for the test group. The increase in the scar scale was statistically significant for Isoamyl and n-butyl cyanoacrylate using paired student ‘t’ test p<0.05. The difference in the scar quality between the two groups using unpaired ‘t’ test was not statistically significant.
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655. Circadian, circaseptan and circannual onset in stroke

     Rajshekhar I Koujalgi

     • » Abstract Background and Objective: This study was done to evaluate circadian, circaseptan, and circannual rhythms in onset of stroke subtypes along with influence of risk factors, in local population. Subjects and Methods: 294 stroke patients, subtyped as Ischemic Stroke (IS), Intracerebral hemorrhage (ICH) and Subarachnoid hemorrhage (SAH) with Circadian (time in a day), circaseptan (day in a week) and circannual (season in a year) onset and risk factors were studied between January 2009 and December 2010 Results: 229 (77.89%) had IS, 63(21.42%) ICH and 2(0.68%) SAH. Bimodal peak of stroke onset noted, with bigger (51.7% patients) morning peak (4:01 am to 8:00 am), smaller (19.38% patients) evening peak (4:01 pm to 8:00 pm).Stroke subtypes and risk factors had similar pattern except diabetics (34 patients), had bigger peak in evening than morning. Stroke onset (circaseptan) was, on Wednesday (24.01%), Monday (21.83%), least on Sunday (14.87%) and similar in stroke subtypes. Seasonal (circannual) onset of stroke was highest in monsoon (34.01%), summer (33.67%), post monsoon (17%) and least in winter (15.30%) for all subtypes of stroke. Conclusion: Stroke onset has bimodal circadian peak (morning and evening), and attenuation of morning peak in diabetics and Circannual (seasonal) onset in monsoon and summer in local population.
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656. Assessment of role of Uterine Volume in Decision Making for the Route and Technique of Hysterectomy

     Smitha Surendran, Jyotsna R Himgire

     • » Abstract Objective: To assess the value of uterine volume estimated by ultrasound sonography in decision making for route and technique of hysterectomy. Methods: Uterine volume was measured by ultrasound sonography in 50 cases posted for hysterectomy. Intra operative difficulties, accessibility and ease of surgery were noted. Also, uterine weight postoperatively was compared with the volume. Results: Vaginal hysterectomy was done without difficulty up to 300cm³. With uterine volume more than 300cm³, debulking was more frequently required. In patients with uterine volume greater than 500cm³, i.e., approximately more than 16 weeks pregnant uterus size the surgeons preferred abdominal rather than vaginal route. Uterine volume correlated well with the uterine weight measured post operatively. Conclusion: Uterine volume measured by ultrasound sonography was found to correlate with uterine weight measured post operatively. It played an important role in assessing the feasibility of vaginal hysterectomy.
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657. To assess the knowledge of Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) among medical interns at tertiary care hospital in Raigad district, Maharashtra

     Roza Bhaisare, Madhavi Mankar, Rajesh Goel, Seema Anjenaya, Pradeep Sawardekar, Pandurang Thatkar, Rupali Guja

     • » Abstract The Maharashtra government has launched Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) in the state since July 2012 for below poverty line patients. In this scheme, all procedure from registration of patient to the discharge is done online. The present study was conducted to assess the knowledge of Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) among medical Interns and find out the technical difficulties faced by them while working with RGJAY at tertiary care hospital. All MBBS interns (96) who have completed 6 months of internship were selected for the study. A predesigned and pre-tested, questionnaire was given to interns when they come in RGJAY OPD and asked to fill the form after written consent. The data was analysed using Microsoft excel and SPSS. Total 96 interns were participated in the study. Most of the interns (97.9%) were aware about Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY). Main source of information was RGJAY OPD. About 91.70% interns told that they didn’t get any pre internship training for these technical procedures under RGJAY. About 80% interns were properly guided by Aarogyamitra. Majority of interns (91.70%) had experienced technical difficulties and about 76.14% interns responded that their difficulties had been resolved in RGJAY OPD. Out of all procedures, interns stated that, to fill online pre-auth registration (35.40%) and Discharge update (43.80%) were the most complicated procedure. Majority of interns (82.3%) reported that there should be separate staff for RGJAY on line procedures, 90 % interns reported that RGJAY OPD needs upgraded infrastructure; about 87.5% interns reported that pre-training should be given. There are many medical insurance schemes are operating in the country but for effective implementation and utilization of schemes, proper information, training, education and communication is needed at programme level as well as community level.
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658. Childhood asthma - a detailed review article

     Inayath Ali Badusha

     • » Abstract Diagnosis of bronchial asthma in children poses great difficulty up to five years. The moment the pediatrician makes a diagnosis of bronchial asthma there is a lot of stress, anxiety and worry in the minds of parents. There are many causes of wheeze in children other than bronchial asthma. So it is difficult for the physician to make a concrete diagnosis of childhood asthma .so the author has taken a decision to review the topic in detail.
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659. Evaluation of effectiveness of labour analgesics in programmed labour

     Shivamurthy H M, Durgadas Asaranna, Giridhar S A, Aparna Madhavan, Ashwini Konin, V Sridivya Chowdary

     • » Abstract Background: Management of labour is an art and science and many a times achallenge in the present scenario with the advent of many modifications in labour science and the increasing demand of the clients for a safe and not so painful experience. “Programmed labour is an indigenously developed protocol for labour management developed with dual objective of providing pain relief during labour and reaching the goals of safe motherhood by optimizing obstetric outcome”1. I this direction the current study was undertaken to examine the effectiveness of analgesics used in the management of Programmed labour. Objectives: To study the efficacy of Obstetric analgesics in programmed labour. Materials and Methods: This prospective study includes two hundred women in active phase of labour who underwent management of labour by programmed labour protocol assessed for effectiveness of labour analgesia. Two patients went for caesarean section in the beginning itself due to non-reassring Foetal status. Labour pain scoring was done when the patient was set into active labour in three distinct groups. Then the analgesic medication was administered as per the protocol in programmed labour. The postmedication pain relief scoring was done. Efficacy of the analgesic in relation to the cervical dilatation and duration of labour was examined and analysed statistically. Results: Of the 198, parturients 2 patients had bearable pain (pain score 1), 177 had severe pain (score 2) and 21 had unbearable pain (score3).Of the group with unbearable pain (score 3) 12 (57.2%) had complete pain relief. Out of 135 patient who had cervical dilatation of 3-4 cms, 75% had substantial relief of pain. Those who had 1-2 hrs of active labour, 73% had substantial pain relief after medication. Conclusions: Programmed labour protocol proved to be efficient in pain relief, shorter duration of labour, reduction in incidence of dystocia, reduction in instrumental deliveries and caesarean sections with a good maternal and neonatal outcome in both primi and multigravidae.
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660. Intravenous metoprolol in severe hypertension

     Pravin N Soni, Seema P Soni

     • » Abstract Introduction: To study the effect of intravenous metoprolol in severe hypertension. The use of betablockers in the management of severe hypertension was not considered for the fear of paradoxical rise in blood pressure, but it has been found that IV metoprolol is safe and effective in the management severe hypertension with careful clinical monitoring even in the absence of ICU facility. (Khokhani 1993) Materials and Methods: Patient presenting with severe hypertension of unknown etiology were taken for the study. The study has been carried out at GMC, Aurangabad for about three years. Metoprolol (Betaloc) was given intravenously at the rate of 1mg/min.Systolic, diastolic blood pressure and heart rate recorded at various intervals. Adverse reaction if any noted Result: The study has been carried out for three years on 34 cases of severe hypertension, admitted at GMC Aurangabad. After giving IV Metoprolol the fall in systolic, diastolic blood pressure was statistically significant The fall starts at the end of five minutes and continued up to ninety minutes. Our study compared with this study, (Kokhani et al 1993), it is observed that results in both studies are same. No side effect observed during the study. Conclusion: After the administration of IV Metoprolol the fall in blood pressure and heart rate was statistically significant. A safe diastolic blood pressure (≤ 110 mm of hg) effect were observed during the study and does not require scrupulous monitoring was achieved. It is thus concluded that IV Metoprolol is a safe and effective drug in patient of severe hypertension. No side effects were observed during the study and does not require scrupulous monitoring.
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661. Management inputs for strengthening health System through public private partnership with reference to National Rural Health Mission

     R R Shinde, B S Nagaonkar, R D Anerao

     • » Abstract Background: It was proposed to study the scope of PPP as a strategic management policy to improve standards of health services in hospital to IPHS (Indian Public Health Standards) level. Objectives: The objective of this study is to assess the scope and feasibility of specific managerial inputs to promote Public Private Partnership of National Rural Health Mission in emphasizing qualitative aspect of services by identifying components where Public Private Partnership can be evolved for hospital services development and probable modalities for the sustainability of the same. To study and compare outcome of select indicators in study and control groups, implementing Public Private Partnership strategies in the domains of “Outsourcing’’ of Clinical services, Nonclinical services, Paramedical services, Civil works, Hospital accreditation under Janani Suraksha Yojna. To review public-private partnership practices in Public Health Department and to recommend strategies of Public Private Partnership in implementing quality health services in hospitals based on study findings. Material and Methods: The present study adopts an experimental epidemiological study design involving study and control group, in which study group of 6 hospitals receives an intervention package and control group of 14 hospitals does not receive an intervention package. Results and Impact: In Present study output indicators are found statistically different at 90% C.I. level, while outcome indicators are not found statistically different at 90% C.I.level. So it is needed to institutionalize outcome quality indicators. All these Outcome quality indicators are included in grading criteria of empanelled Public and Private hospitals under Rajeev Gandhi Jeevandayee Yojna of state which is a Health insurance scheme.
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662. Evaluation of complications of abdominal and vaginal hysterectomy in non decent cases

     Shreyaa Sriram, U T Bhosale, Ramchandra Shriwastav

     • » Abstract Introduction: Abdominal and vaginal hysterectomies are the two prominent operative modalities for various uterine conditions. However the indications for selecting a particular procedure in any setting may not be optimally defined. This study was undertaken to evaluate the appropriate route of hysterectomy in a hospital population for women with benign disease by comparing peri operative and post operative complications. Method: This experimental study was undertaken at the department of OBGY Bharati Hospital, Sangli, from Jan 2014 to June 2014. 50 subjects were equally divided into vaginal and abdominal hysterectomy groups by convenience sampling. The primary outcome measures were operative time, primary haemorrhage, wound infection, post operative analgesia, febrile morbidity, hospital stay and secondary haemorrhage and secondary outcome measures were estimated
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663. Groundwater development in chevella basin, Ranga reddy district, Andhra Pradesh, India

     Penumaka Ramesh, Srinu Naik, P Sankara Pitchaiah

     • » Abstract Groundwater is one of the fresh water sources which are neither unlimited nor protected deterioration. In most of the times due to excess usage of groundwater resulted in drying up of the open and tubular wells, increasing the salt concentration, causing sea water intrusion near coastal areas and depletion of the water resource. Now a days most of the people recognized water quality as one of the important aspect in their life as its quantity. Present study is an attempt to analyse the impact of rainwater harvesting structures on groundwater quality in the Chevella basin. pH, TDS, Hardness, Bicarbonates, Chlorides, Sulphates, Nitrates, Fluorides, Calcium, Magnesium, Sodium, Potassium and Iron are measured/estimated for the years 2010-2013 (Pre and Post-monsoon periods) using standard analytical techniques. The study supports that the rainwater harvesting has improved the quality of groundwater in Chevella basin.
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664. Effects of music on patients undergoing caesarean section under spinal anaesthesia

     Dhrubajyoti Sarkar

     • » Abstract Introduction: Most caesarean sections are performed under epidural or spinal block and women undergoing caesarean section often experience anxiety in anticipation of the event to which one may be unfamiliar, uncomfortable or have undesirable results. Methods: This randomized controlled clinical trial was conducted for a period of one year. 100 pregnant with American Society of Anesthesiologists (ASA) physical status I–II scheduled to undergo cesarean section surgery under spinal anaesthesia were taken up for the study and were randomly divided into two equal groups. The objective of the study was to evaluate the effect of music on self-reported anxiety and hemodynamic parameters in the intraoperative phase in patients who underwent caesarean section under spinal anaesthesia. Patients of study group were subjected to listen preoperatively self chosen music with the help of headphone with the volume label as acceptable by the patient. Music listening started on completion of successful spinal anaesthetic procedure and lasted till the end of the surgery. The Visual Analogue Scale (VAS) was explained in detail to the patients and was used to measure the preoperative & postoperative anxiety, and maternal satisfaction score (MSS), and haemodynamic parameters was recorded. Results: There was no statistically significant change in the SpO2 (P=.782), systolic (P=.405) and diastolic blood pressure (P=.513) but there was significant change in the respiratory rate (P=.004) and pulse rate (P=.017) on completion of the surgery in the music group. A statistically significant difference was also recorded in the VAS for anxiety score (VASA), P=.000 and MSS (P=.000) in the postoperative period in the music group. Conclusion: Music therapy is an example of a non-pharmacological aid that can be used on patients undergoing surgical under spinal anaesthesia, empowering the patient to develop own ability to gain control over negative effects of the surgical stress.
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665. Rhinoliths

     Anil Joshi, Rajani Joshi

     • » Abstract Rhinoliths are mineralised foreign bodies in the nasal cavity and may be discovered during routine radiographic exam. The incidence of adult rhinolith is very low. Rhinoliths are generally single, exogenous or endogenous, unilateral, and asymptomatic. They can cause nasal obstruction, fetid odour and purulent discharge. Though infrequently observed, rhinoliths can be the source of bad smell from the nose and therefore a social concern for the patient. The CT Scan of paranasal sinuses is the radiological investigation of choice in this condition. We report four patients with rhinoliths presenting with diverse clinical findings.
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666. Premedicant in children: efficacy of oral Midazolam Vs. Triclofos

     Maya Rose Jose, SanjanaVinod

     • » Abstract Hospital admission, anesthesia and surgery are stressful experiences for children which may lead to psychological trauma and personality changes. The increasing use of day care surgery, the avoidance of parental separation and the use of sedative premedication may reduce the stress of hospitalization in children and the risk of adverse psychological sequel. Search for an ideal premedicant drug for children is still on. Aims and objectives: To compare and evaluate the efficacy of midazolam and triclofos when given orally as premedicants in children. Materials and methods: In the present study 50 children were selected and were divided in two groups (midazolam group and triclofos group). Preoperative assessment was performed one day before the surgery by an observer.Evaluation of post-premedication sedation (thirty minutes post-premedication in the Midazolam group and sixty minutes post-premedication in the Triclofos group) was recorded. Level of sedation at the post premedication and level of sedation at the time of separation from parents was recorded. Behavior at the time of separation from parents and behavior during mask acceptance was recorded and analyzed. Results: On Post Premedicant it was observed that in midazolam group majority children (22) had sedation score of two whereas in triclofos group majority of the children (21) had sedation score four. Evaluation of the level of sedation at the time of separation from parents showed that majority of the children (22) in the Midazolam group had a sedation score of two whereas in triclofos group majority of the children (20) were having score four. The comparison of sedation scores between the two groups was done using the Fisher’s exact probability test. The difference between the two groups was very highly significant statistically. While studying behavior at the time of separation from parents, it was observed that majority of the children in midazolam and triclofos were having score four (21 and 23 children respectively). In the Midazolam group, 14 children had a mask acceptance score of four and in the triclofos group, 20 children had a mask acceptance score of four. Conclusion: Even though the children are less sedated with oral midazolam as compared to triclofos, if produces an equally satisfactory separation from parents and satisfactory mask acceptance.
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667. A comparative study of Isoamyl-2-cyanoacrylate with sutures

     S T Balamurali

     • » Abstract Introduction: Closure of wounds with bioadhesives was proved to be efficacious and well tolerable. Therefore it is necessary to do a study which should compare the bioadhesives and sutures. Aim: To compare the efficacy of Isoamyl-2-cyanoacrylate with sutures in patients with bilateral inguinal hernia. Methodology: it is a comparative study of Isoamyl-2-cyanoacrylate with sutures in patients of bilateral inguinal hernia in the age group of 18 – 65 years who were admitted in the surgical ward of Government General Hospital, Chennai. Result and Conclusion: The scar obtained with bioadhesive is of better quality in the 3rd month and 6th month for the test group than that of suture. Though more expensive than sutures where economically feasible Isoamyl 2 cyanoacrylate offers a well acceptable alternative to suture.
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668. Phimosis in children: Conservative treatment using a topical steroid

     Anita Jagdish Kandi, Venkat Arjunrao Gite, Anagha S Varudkar

     • » Abstract Introduction: Phimosis or inability to retract the foreskin in the majority of neonates is because of natural adhesions exist between the prepuce and the glans. Circumcision is often regarded as a minor surgical procedure but there is probably more complication associated with this operation. In cases of pathologic phimosis, surgical correction is the standard treatment. However, in recent years, the topical application of steroids provides an alternative to the management of this disease. Aims and objectives: To evaluate the efficacy of topical steroid betamethasone (0.05%) in management phimosis. Materials and methods: 50 pediatric patients of phimosis attending the surgery outpatient department and patients referred from pediatric outpatient department as well as Indoor ward were included in the study. The phimosis was graded by using Kikiros grading system. All patients underwent treatment with application of topical steroid betamethasone 0.05% thrice daily after washing or bathing for 4 weeks to the foreskin. After the foreskin become retractable, patients / parents were asked to retract the foreskin gently without causing any pain. When the phimosis didn’t resolve then patients were offered another course of two weeks. A final assessment of the grading was done at completion of 6 weeks course. All patients were followed up at 8, 10, and 12 weeks respectively after completion of treatment. Results: The mean age of children in the study was 6.3 ± 0.43 years. Majority of the children were having grade V phimosis (86%) and it was followed by grade IV (14%). Response rate of topical steroid betarnethasone 0.05% at 4th week was 80%. Out of 8 patients who did not respond at 4th week were given additional 2 week treatment and 6 patients responded. First follow up was done at 8th week and the treatment response rate was maintained (92%). The response rate was maintained at 92% till the follow-up was done at 12th week. Conclusion: Thus in the end we conclude that topical treatment of phimosis with corticosteroids is simple and efficient treatment modality.
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669. Awareness of pharmacovigilance among medical students

     Deepak P, Jayashree V Nagaral

     • » Abstract Objective: To assess the awareness of Pharmacovigilance among Medical students. Materials and Methods: The study was conducted by Department of Pharmacology of Hassan Institute of Medical Sciences, Hassan among II year medical students after obtaining permission from Institutional Ethical Committee. A questionnaire containing 14 questions with 2 – 5 options were given to each student and they were asked to tick one best suitable option. The questionnaire was based on previous study about Pharmacovigilance and was suitably modified for students. The completed questionnaire was analysed and frequency is expressed as percentage. Results: A total of 96 students who were in II MBBS participated in the study. Most of the students had correct understanding regarding Pharmacovigilance and knew the role of Pharmacovigilance in identifying the safety of drugs. 94% of the students were well aware of activities involved in Pharmacovigilance. 50% of the students haven’t come across any article about adverse drug reaction (ADR). 81% felt that all unwanted events are not due to medicine alone.73% were aware of drugs banned because of ADR. 92% were aware of the measures to be taken when an ADR is suspected. Majority of the participants agreed that all health care professionals are responsible for reporting ADR and it is a professional obligation. Conclusion: The study results revealed that students were aware of Pharmacovigilance, but there was lack of professional obligation towards reporting ADR. Though Pharmacovigilance is being taught as part of Undergraduate curriculum, the students should be involved in more activity based and problem based learning.
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670. Epidemiology and injury pattern of road traffic accident cases

     RajnishBorkar, BaliramChikte

     • » Abstract Injury and deaths due to road traffic accidents are a major but neglected public health problem in developing countries. This ever expanding epidemic targeting the young and productive generation is likely to take heavy burden on quality of life and economy of the nation. The present studywas conducted in Rajiv Gandhi Institute of Medical Sciences, Adilabad to study epidemiology and injury pattern of Road Traffic Accident (RTA) cases. The present study wasaretrospectiverecordbasedstudyanddata wascollectedusingquestionnairemethod. A total of 504 RTA cases were studied from thecaserecordsofthe medicalrecordssectionof Rajiv Gandhi Institute of Medical Sciences, Adilabad during the period of October 2010 toSeptember2011. The results revealed that (i) out of total 504 RTA cases, 395 (77.3%) of the victims were males and the rest 109 (22.7%) were females. (ii) Thehighestnumberofvictims186(36.90%) werefrom21-30yearsofagegroup.(iii) The highestnumberof Accidents took place in February (11.71%) and on Sunday (18.06%) during 6 p.m. to 9 p.m. (27.58 %) (iv) Head, neck and face was involved in 219 (32.93%) cases while out of total 161cases of fractures, the commonest site of fracture was lower limb in 75 (46.58%) cases.
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671. Gravid uterus: unusal content of incisional hernia – case report

     Agarwal Vimal K, Agrawal Sonal

     • » Abstract A 23 year old woman presented in outpatient Department in obst. and gynecology her 3rd pregnancy at 32 weeks of gestation age in labour with an unusual bulge of her lower abdomen. Abdominal bulge was her gravid uterus herniating through anterior abdominal wall. Incisional hernia is though not rare, but potentially serious condition due to its antecedent complications. Initially these hernias may be reducible, but delay in recognition can lead to incarceration and subsequent strangulation of gravid uterus. In this case Caeserean section and bilateral tubal ligation were done with repair of incisional hernia with nonabsorbable suture with uneventful post operative recovery. Even for emergency operations like caesarean section surgical principles must be followed.
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672. A rare cause of intestinal obstruction: ileal squamous cell carcinoma - a case report

     Debasish Bhattacharya, Subhadip Khatua, Abhijit Banerjee

     • » Abstract Introduction: Small bowel obstruction caused by metastatic lesion from other primary cancer is a rare event. The most common types of tumor metastasizing to the small bowel are malignant melanoma, carcinoma from lung, breast, and ovary, and choriocarcinoma Idelevich et al. reviewed the literature and found that between 1988 and 2005, only 36 cases have been reported. Interestingly, the most common primary cancer in these cases was lobular breast carcinoma (47%), followed by lung cancer (11%) and malignant melanoma (8%), most of which are adenocarcinoma.. Rarely however, does it selectively affect the small bowel in the form of an isolated metastatic stricture. We are reporting such a case of terminal ileum obstruction due to metastatic deposit of invasive cervical squamous cell carcinoma, 8 months after total abdominal hysterectomy, emphasizing role of meticulous searching of lymph nodes during surgery of cervical carcinoma to avoid such fatal complication.
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673. Low visual aids, the boon for improving visual functions of the visually handicap students of SarwaShikshaAbhiyan (education for all) of Nagpur district

     Rahul Dagwar, NileshGaddewar, Ashok Madan

     • » Abstract Context: Many students of various government schools, having eye problems are referred to tertiary eye care hospital underSarwaShikshaAbhiyan (Education for all).Aim: To study the causes of blindness and functional vision improvement in visually impaired students (BCVA<6/60) by providing optical low vision aids (LVAs).Setting and design: Students of various government schools of Nagpur district are referred to government medical college, Nagpur for various eye problems under SarwaShikshaAbhiyan (education for all). Prospective series was conducted among the students who are advised visual handicap certificate (BCVA<6/60) after complete evaluation. Materials and Methods: Ocular evaluation of these students was done using World Health Organization's eye examination protocol by slit lamp examination, ophthalmoscopy, retinoscopy and visual acuity estimation with the log MAR chart at a distance of 4 m and reduced Snellen's acuity charts. LVAs were prescribed.Results: Study includes two hundred and thirty students who were advised handicap certificate (BCVA <6/60). ; Their mean age was 12.6 years (S.D. 3.3 years, range 5-20 years) and 123 (53.5%) were males. Two hundred and seven (90%) were visually handicap since birth. The students were handicap due to microphthalmos, anophthalmos and coloboma 121 (52.60%), diseases of cornea 30 (13%), lens 39 (16.9%), uvea 5%, retina 21 (9.13%) including retinopathy of prematurity (ROP) and optic nerve lesions 6%. LVA for distance was prescribed to 30 students (13%) who improved >1 line and for near was prescribed to 72 students (31.3%) of whom 68 attained N6-N12 acuity. Conclusion: LVA prescription improved visual acuity of visually handicap students and allowed them to learn and read print.
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674. Students’ perception of effective learning experiences in government medical college

     Sahana G N, Deepak P

     • » Abstract Objective: To obtain students feedback on teaching methodologies and evaluation methods for the betterment of teaching and learning pharmacology. Material and Methods: The study was done by Department of Pharmacology, Hassan Institute of Medical Sciences, Hassan. A questionnaire containing 14 questions were given to second MBBS students who were due to appear for examination. They were supposed to tick one suitable option. Descriptive statistics is used for analysis of data. Frequency expressed as percentage. Results: Total response of 93.33% was observed. Most of the students preferred blackboard as the teaching media which imparts knowledge (65.3%) and better interaction between student and teacher (81.6%). Majority of students felt that cardiovascular system (47.9%), Hormones (32.6%), Autonomic Nervous system (31.6) and Clinical pharmacology (27.55%) as most interesting topics in Pharmacology. Central nervous system (40%) was mentioned as the most difficult topic to understand. 69% mentioned Tutorials and 52% Group discussion as most useful method in preparing for University exams. Students preferred textbooks and class notes (41.8%) for studying pharmacology. As a part of pharmacology practicals, Clinical pharmacology (44.9%), Prescription writing and Problem solving exercises (26.5%) was preferred. Most of the students felt that special topics like Emergency drugs (57%) and Rationale use of drugs (23%) should be discussed in lectures/ practicals. 65% of students felt Pharmacology to be integrated with other subjects. Conclusion: Collaboration of various teaching methods if adopted will ensure in depth knowledge acquisition and improved performance in exam. Incorporation of clinically oriented teaching program will guide students to study the subject from futuristic point of view. Frequent feedback from students may help teachers plan the curriculum and improve the teaching.
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675. Efficacy of oral fenofibrate in the management of unconjugated hyperbilirubinemia in neonates- A prospective study

     B L Anantha Narayana Gowda, H M Viswanathakumar, Yamuna B N, Arun Daniel J

     • » Abstract Background: Fenofibrate is one of the commonest drugs to treat hyperlipidemia in adults. It also has the ability to induce bilirubin conjugation apart from its hypolipidemic action. Objective: To study the efficacy of oral fenofibrate in reducing bilirubin levels in neonates with significant unconjugated hyperbilirubinemia. Materials and methods: A prospective study was conducted ina tertiary care hospital at Tumkur, Karnataka between June 2013 and April 2014 following up a cohort of 100 neonates. Efficacy of oral fenofibrate was determined by comparing 50 neonates who received oral fenofibrate as well as phototherapy (exposed group) with those who received phototherapy alone (unexposed group), by measuring direct and indirect bilirubin levels at 12, 24, and 48 hours. Results: There was no significant difference in bilirubin levels at 12 (p=0.22), 24 (p=0.08) and 48 hours (p=0.07) respectively among the two groups. Conclusion: Oral fenofibrate did not prove efficacious in reducing bilirubin levels in neonates with significant unconjugated hyperbilirubinemia.
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676. Bacterial colonization of endotracheal tubes in intubated patients

     Mayuri K S, VinodKumar C S, Arun Kumar A, Jayasimha V L, Basavarajappa K G

     • » Abstract Background: Ventilator associated pneumonia (VAP) is one of the most important form of hospital acquired infections which is associated with increased mortality and morbidity. VAP occurs in about 9 to 27% of all intubated patients. Intubation is associated with 3 to 10 fold increase in the incidence of VAP among all patients receiving mechanical ventilation. In contrast to other nosocomial infections, the crude mortality rate occurring due to VAP ranges from 24% to 76%. ICU patients with VAP have a 2 to 10-fold higher risk of death when compared with patients without pneumonia. Aim: The present study is undertaken to find out the frequency of occurrence of VAP in clinically suspected patients who are mechanically ventilated for more than 48 hours and the major pathogens causing VAP and their antibiotic sensitivity pattern. Methods: A total of 392 patients who are mechanically ventilated for more than 48 hours with clinical suspicion of VAP were included in the study. Endotracheal aspirate was collected and subjected to Grams stain and culture. Culture was performed by quantitative culture technique. Growth on the culture plate was identified by standard microbiological techniques and subjected to antibiotic sensitivity testing by Kirby Bauer disc diffusion method and CLSI guidelines. Results: Among the 392 clinically suspected VAP patients enrolled in the study 52.8% patients were diagnosed with VAP as per the CPIS score. The most common age group affected was 28- 40 years with male preponderance. 18% of the infections were categorized as early onset VAP while 72% as late onset VAP. Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii were the most common isolates.78.5% of Gram negative bacteria were β lactamase producers.89.6% of the Pseudomonas aeruginosa and 96.2 % of Acinetobacter baumannii were meropenem and 84.6% of Staphylococcus aureus strains were methicillin resistant. Conclusion: Staphylococcus aureus was the most common organism causing early onset and Pseudomonas aeruginosa in late onset VAP.
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677. Aberrant Right Renal Artery- A Case Report

     S G Kawale, G L Maske, A D Kannamwar, S E Shaikh, S V Pandit

     • » Abstract During routine undergraduate dissection of abdomen in middle aged male cadaver we encountered an unusual variation. This was aberrant right renal artery arising from superior mesenteric artery. There were no variation on left side and other branches of abdominal aorta and there courses were normal. Clinical implication and embryological basis of this type of variation will be discussed
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678. Occult carcinoma of breast presenting as axillary nodal metastasis – a case report

     Jawahar Krishnaswamy, Deivanayagam Shanmugam, Vijay Kalimuthu, Sanjai Venkatesh Somasukumar

     • » Abstract We report the case of a 50-year-old woman with occult breast cancer who presented with a hard metastatic nodule in the left axilla. Histology identified a metastatic ductal carcinoma deposits in the lymph nodes, but mammography of left breast showed only diffuse thickening of skin and subcutaneous tissue.Left modified radical mastectomy was performed and histopathology revealed invasive ductal carcinoma 1mm x 1mm size with multiple axillary node metastasis.
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679. Clinical evaluation of Isoamyl 2- cyanoacrylate: a novel tissue adhesive

     S T Balamurali

     • » Abstract Even in present day surgical practice, closure of wounds with sutures consumes more time. With advancement of surgical methods like staples and tapes which are used in closure of wounds leave a disfigured scar. Therefore it is necessary to minimise the scar as well as the time consumption with use of newer methods like bioadhesives. Aim: To study the effect of Isoamyl-2-cyanoacrylate on patients with surgical wounds (combined phase I and II) Methodology: it is a combined Phase I and II clinical trial conducted in patients of inguinal hernia in the age group of 18 – 40 years who were admitted in the surgical ward of Government General Hospital, Chennai. Result and Conclusion: the wound closure using bioadhesive is excellent with minimal scar formationand the difference is significant at 95% level of confidence. It is well tolerated.
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680. Peri-operative hemodynamic stability in patients undergoing laparoscopic procedures using dexmedetomidine

     Sanjana Vinod, Maya Rose Jose

     • » Abstract Peri-operative hemodynamic stability in patients undergoing laparoscopic procedures using dexmedetomidine
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681. Comparison of efficacy of isobaric ropivacaine and bupivacaine with morphine in spinal anaesthesia for perineal surgeries

     Priyanka V, Dayanand V P, Bhaskara B

     • » Abstract Introduction: In the present study we compared ropivacaine and bupivacaine with adjuvant morphine for perineal surgeries. Aims: The aim of this study is to compare isobaric 3ml of 0.5% Ropivacaine and 3ml of isobaric 0.5% Bupivacaine with 100µ morphine in both the group sintrathecally for elective Perineal surgeries. Onset and duration of sensory block, onset and duration of motor block, maximum height of sensory block, quality of anaesthesia, time of request for analgesia, time for ambulation, time for urination, sedation score, VAS score, hemodynamic parameters and adverse effects if any were studied. Methods: This study was conducted in 120 patients scheduled for elective Perineal surgeries were randomly divided into two groups of 60 each. Group B received isobaric 3ml of 0.5% Bupivacaine and Group R received 3ml of 0.5% Ropivacaine with 100µ morphine intrathecally in both groups. Onset and duration of sensory block, onset and duration of motor block, maximum height of sensory block, quality of anaesthesia, time of request for analgesia, time for ambulation, time for urination, sedation score, VAS score, hemodynamic parameters and adverse effects if any were studied Results: There was significant difference between the two groups in mean time to onset of sensory block,duration of sensory block, duration of motor block and time to walk in mins. Total duration of sensory block was 155.50±4.19 min in group R and 199.83±11.12 min in group B, which is significant. (P Ë‚0.001). Duration of motor block was 159.83 min in group R and 182.83min in group B which is clinically and statistically significant (P<0.001). Conclusion: Ropivacaine 3 ml of 0.5% with 100µ morphine provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to Bupivacaine.
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682. Polycythemia Vera with Janus Kinase2 mutation

     N V Naren, P Giridhar, K P Rashmi, S N Sadia

     • » Abstract Polycythemia vera (PV) is a chronic myeloproliferative disorder characterised by panmyelosis, splenomegaly, and predisposition to venous and arterial thrombosis. Our case was a 54 year male patient who presented with massive splenomegaly, eryhtrocytosis and bone marrow panmyelosis and positive JAK2V617F mutation. Sensitive and relatively cost effective test of JAK2V617F mutation helped in early diagnosis and treatment of PV with certainity. Patient responded well with phlebotomy. Polycythemia vera is a uncommon myeloproliferative neoplasm which is asymptomatic in majority of patients thus needs early identification and treatment to prevent serious complications of haemorrhage and thrombosis.
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683. Survival of truncus arteriosus in 5th decade - a case report

     Kalyan Munde, Nagesh Waghmare, Ashish Amaldi, Anil Kumar

     • » Abstract Persistent Truncus arteriosus is congenital cyanotic heart disease characterised by a single great artery that leaves the base of heart and gives rise to coronary, pulmonary and systemic arteries. Majority of patients die of congestive heart failure before their first birthday .Only occasional patients survive in adulthood. We are presenting such a case
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684. Correlation of hyponatremia in children presenting with acute lower respiratory tract infection in a tertiary care hospital

     Guruswamy N T, Habeeb Khan, Pavan Hegde

     • » Abstract Background: Hyponatremia(serum sodium<135mEq/L)has been found to be the major electrolyte abnormality in children admitted with pneumonia in various studies throughout the world. Hyponatremia increases morbidity and mortality of children if not evaluated and treated appropriately. Hyponatremia in pneumonia was found to be mainly dilutional and secondary to Syndrome of Inappropriate secretion of Antidiuretic Hormone(SIADH).Objectives: This is a prospective study to know the incidence of hyponatremia and SIADH in children with severe pneumonia, morbidity and mortality due to hyponatremia and its management in children with severe pneumonia. Materials and Methods: The study group comprised of 60 children in the age group of 2 months to 5 years admitted with severe pneumonia as defined by modified WHO-BTS guidelines and confirmed radiologically. Investigations were done on the day of admission for serum electrolytes. In patients who were clinically euvolemic and had an initial serum sodium value <135mEq/L, work up for diagnosis of SIADH was done. Renal function tests were also done. Statistical analysis was done to know the frequency of hyponatremia, morbidity and mortality associated with hyponatremia. Results: Of the 60 children enrolled in the study, 28(46.7%) children had hyponatremia. Of the 28 hyponatremic children, 18(64.3%) had dilutional hyponatremia secondary to SIADH. The duration of hospitalization was significantly prolonged in children who had hyponatremia. There were 3 mortalities and all the 3 had hyponatremia, of which 2 were found to have SIADH. Conclusion: Almost half of the children with severe pneumonia developed hyponatremia which was predominantly due to SIADH. Hence careful fluid management is needed in children with pneumonia.
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685. A study on contraceptive knowledge, attitude and practice (KAP) among women attending family planning clinic of a private hospital of Western INDIA

     Rahul Rokade

     • » Abstract Background: The widespread adoption of family planning, in a society, is an integral component of modern development and is essential for the integration of women into social and economic life. Objectives: To assess the knowledge, attitude and practice regarding usage of contraceptive methods among women attending family planning clinic Material and Method: A cross sectional study was conducted in 100 urban women. They were allotted to two groups – Group A of 76 women consisted of those who came for Medical termination of pregnancy (MTP) and Group B of 24 women who came with incomplete abortion following induced abortion. A pretested semi structure questionnaire was used as study tool to assess the contraceptive knowledge, attitude and practices. The data was analyzed using appropriate statistical methods (SPSS ver. 20). Result: Though 82% women were aware of the existence of a contraceptive method, only 44% ever used one. The most commonly used contraceptive was condom (34%). 82% were willing to undergo tubectomy in future whereas only 20% were willing to accept an intrauterine contraceptive device. Conclusion(S): The study highlights that although there is high level of awareness, contraceptive use is not very high. New ways of motivating people to adopt contraceptives should be considered.
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686. Reconstruction of Depositional environment of Tertiary deposits occurring along west coast of Maharashtra using paleontological techniques

     R A Suryawanshi

     • » Abstract Tertiary sediments along west coast of Maharashtra (India) are about 60 m. above the present sea-level and occurrence of lateritic gravel beds and bouldery, pebbly gravels below the sea-level suggest sea level changes around Ratnagiri (Rajguru and Marathe, 1984). Occurrences of lignite bed over laterite, developed on Deccan basalt clearly indicate that the lignite is younger than the laterite of early Tertiary age. Sedimentlogical and pollen studies revel creek or estuarine environment of deposition. The angiosperm pollens and their modern equivalent conform non marine environment of deposition.
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687. Digital and palmar dermatoglyphics patterns in myocardial infarction

     A V Salunkhe, N R Mudiraj

     • » Abstract Introduction: 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. This is the same period when 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. Materials required for standard ink method was collected and used for data collection of both the hands. Written consent of the patients was obtained. Results: It was observed in our present study that there was significant increase in whorls and decrease in percentage loops and arches in Myocardial Infarction as compared to controls. The frequency of total palmar pattern in Myocardial Infarction Group is decreased in both sexes and both sides as compared to the controls. There was increase in frequency of position of axial triradii at t’ and t’’ in both hands of myocardial Infarction group in both sexes. Conclusion: Dermatoglyphics in Myocardial Infarction showed significant variation as compare to normal. Presence of above dermatoglyphic features will help us to predict that these individuals may be susceptible for myocardial infarction. It warrants further research in the same direction.
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688. Correlation between clinical and angiographic findings in patient underwent angiography

     Pankaj Palange, Ravikant Patil, R B Kulkarni, Atul Jankar

     • » Abstract Introduction: Cardiovascular diseases are account for approximately 12 million deaths annually and are commonest cause of death globally. The progressive evolution in cardiac catheterization technique coupled with the development of effective treatment options for coronary artery disease, diagnostic coronary angiography has become one of the primary components of cardiac catheterization. Objective: To study correlation between clinical and angiographic findings in patient underwent angiography. Material and Methods: A cross sectional study was carried out for the period of one Year in Department of Cardiology, Bharati Vidyapeeth Medical College and Hospital, Sangli. 100 patients above 20 years of age, symptomatic patient, asymptomatic patient with electrocardiogram changes, patients who are willfully opting for coronary angiography were included in the study. Patients with previously diagnosed ischemic heart disease and underwent PTCA or CABG are excluded. Coronary angiography either from femoral or radial artery was done. The results of coronary angiography were carefully interpreted. Patients were grouped as Single Vessels Disease (SVD), Double Vessel Disease (DVD) or Triple Vessel Disease (TVD). According to the percentage of stenosis; the patients were expressed as <50% and >50% stenosis. Statistical analysis was done using Microsoft excel and necessary statistical analysis software was used where necessary. Results: The majority of patients were male with mean age was 60.19± 11.73 years and 57.70± 9.19 years in females. The clinical characteristics showed that chest pain was common clinical feature (96%). The coronary angiography revealed that majority of patients were having SVD (36%) with involvement of LAD artery (82%). 15% showed normal coronary arteries. The correlation between clinical presentation and stenosis of coronary artery showed no statistical significant. Conclusion: The clinical assessment is a good predictor for CAD but it can’t be correlated directly to the coronary angiography findings.
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689. Uncommon diffuse dense masses on X-ray mammogram, uncurtained by sonomammogram, confirmed on histopathology: A Case series

     Rajani Gorantla

     • » Abstract Unilateral enlargement of the breast can occur due to various diffuse infiltrative breast lesions, including normal physiological changes, infective, inflammatory, benign etiology and malignant tumors. In this article we present a series of cases with history of unilateral enlargement of breast and appearing as diffuse dense mass on x ray mammogram. Ultrasound findings made appropriate diagnoses which are confirmed on histopathology further.
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690. Study of Intrauterine fetal death

     Sangeeta Chippa, V S Prasannakumar Reddy, N Bhavani, Bijan Mukhopadhyay, Aaradhana Giri, Avanthi Sathineedi

     • » Abstract Objective: To study the epidemiodemiological factors related to intrauterine fetal death and to study the associated maternal and fetal risk factors. Methods: This observational study was carried out at M. N. R. Medical college and Hospital, Sangareddy over a period of 2 years. All pregnant women diagnosed as singleton intrauterine fetal death with gestational age more than 20 weeks were included in the study. Women with Multiple pregnancy and intrapartum fetal deaths were excluded from the study. Data was analysed with respect to age, parity, gestational age, blood group, previous history of intrauterine fetal death and associated risk factors. Results: 41 patients were included in the study. 90% of fetal deaths were seen in young women between 20 to 30yrs age. Majority (51.2%) women were primigravida and 56% were diagnosed as having intrauterine fetal death at 26 to 31 weeks of gestation. Preeclampsia, severe oligohydramnios, antepartum haemorrhage and congenital anomalies were the major associated risk factors. Other less common risk factors seen in the study were Rh isoimmunisation, eclampsia and hand prolapse. In 19.51% women no risk factor was identified and the cause remained unexplained. Conclusion: majority of risk factors associated with intrauterine fetal death are preventable. Although congenital anomalies remain unavoidable, prenatal diagnostic tests and early detection of anomalies by antenatal screening tests may reduce the prevalence of late fetal death and associated psychological trauma to the parents. Early detection and treatment of high risk women may reduce the risk of unexplained fetal deaths.
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691. Dengue: platelet and immature platelet dynamics a study done at a tertiary care centre from South India

     Febe R Suman, Lawrence D’Cruze, Rithika Rejendran, Suresh Varadarajan

     • » Abstract Background: Thrombocytopenia is a common haematologic abnormality in dengue which demands platelet transfusion. Platelet transfusion though life saving has its own hazards so that unnecessary usage is to be avoided. There is a need to find out a laboratory parameter which can predict platelet recovery. Aims and objectives: We aim to study the platelet and immature platelet dynamics and the immature platelet fraction Methods: This is a observational descriptive study done in 2012 on all the dengue patients who were positive for NS1 antigen or IgM antibody or both and treated at Sri Ramachandra Medical Center. The values of platelet and IPF were retrieved for day 1st, 3rd, 5th and 7th day of admission Association between values of IPF and significant clinical change in platelet values during the subsequent 48 hrs is done. A sensitivity analysis was carried out to ascertain the cut-off of IPF on the corresponding days which yielded increase in platelet values of over 20,000 in the subsequent 48 hours. Results: There is statistically significant (P < 0.01) improvement in platelet values within 48 hours when the IPF is more than 6.1% If the IPF value is more than 6.25% and10.6% there is 67% and100% chance of platelet recovery within 48 hours respectively. Conclusion: IPF is an additional parameter to predict platelet recovery, so that prophylactic platelet transfusion can be deferred and also the hazards associated with it.
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692. Bombay blood group in a female child with congenital anomalies and recurrent infections – a rare case report

     Priya Subashchandrabose, Vasudevan Kasturirengan, Monica Vincent Bonipace, Sarada Venkatesan

     • » Abstract Bombay blood group is a very rare phenotype within ABO group and is inherited in an autosomal recessive pattern. This phenotype necessitates extreme caution while blood transfusion as these individuals can be given either autologous transfusion or blood from other Bombay group individuals only. Review of literature reveals that Bombay blood group is reported to be associated with congenital disorder of Glycosylation Type 2c, leukocyte adhesion deficiency type 2 and Rambam–Hasharon syndrome. To the best of author’s knowledge, there are no other syndromic associations described so far. We report a case of incidentally identified Bombay blood group in a 12 year old female child during routine pre operative evaluation for drainage of cerebellar abscess. She had a constellation of clinical findings which include Bombay blood group, congenital anomalies (Bilateral Microtia with Supra aural fistula), history of mild delay in developmental milestones and recurrent infections (Mastoiditis).
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693. Usefullness of dexmedetomidine as an adjuvant to local anaesthetics in infraclavicular brachial plexus block for prolongation of postoperative analgesia

     Prashant Lomate, Divakar Patil, Vasudha Jadhav, Trupti Deshpande, Manisha Patil

     • » Abstract Background and Objectives: The infraclavicular brachial plexus block is a safe and reliable approach to provide intraoperative and postoperative analgesia of upper limb. We evaluated the efficacy of dexmedetomidine added to local anaesthetics in infraclavicular brachial plexus block to hasten the onset of sensory and motor block and to prolong the postoperative analgesia. Methods: A prospective randomized double-blind study was carried out in 60 patients aged 18-60 years of ASA grade I and II, who were scheduled for various upper limb surgeries in orthopedics. The patients were divided into two groups of 30 each i.e. Control Group (group C) received 20 ml of inj. Bupivacaine + 10 ml of inj. Xylocaine + 10 ml of Normal Saline and Dexmedetomidine Group (group D) received 20 ml of inj. Bupivacaine + 10 ml of inj. Xylocaine + 10 ml of Normal Saline + 1 µg/kg of inj. Dexmedetomidine. Both groups were compared for the time of onset of sensory and motor blocks, postoperative analgesia and haemodynamic changes. Results: The onset of sensory and motor blockade (2.9 ± 1.0 Vs 8.8 ± 2.22 min and 5.23 ± 1.14 Vs 10.86 ± 2.41 min, respectively) were significantly more rapid in the D group than in the C group (p = 0.0001). The duration of sensory and motor blockade (825 ± 133.83 Vs 412 min ± 74.17 and 878.33 ± 166.23 Vs 409.33 ± 72.01 min respectively) were significantly longer in the D group than in the C group (p = 0.0001). The duration of analgesia (1448.66 ± 288.33 Vs 499 ± 78.79 min) was significantly longer in D group than in the C group (p = 0.0001). Systolic and diastolic blood pressure were lower in D group than C group during the period of anaesthesia from 30 to 120 minutes (in this period patients can be closely monitored and managed) (p < 0.05). Heart rate levels were also low in D group than C group during the period of anaesthesia from 15 to 120 minutes (p < 0.05). Conclusion: We conclude that the addition of dexmedetomidine to local anaesthetic mixture in infraclavicular brachial plexus block hastens the onset and prolong the duration of sensory and motor blocks, as well as the duration of postoperative analgesia.
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694. Leiomyosarcoma of somatic soft tissue origin in the leg - a case report

     Jawahar Krishnaswamy, Deivanayagam Shanmugam, Vijay Kalimuthu, Vinod Balaji Baskar

     • » Abstract Leiomyosarcoma of soft tissue is thought to arise from the smooth muscle cells lining small blood vessels. Most common site of involvement is retroperitoneum, accounting for approximately 50% of occurrences. Leiomyosarcoma of somatic soft tissues presents as an enlarging, painless mass. Although these tumours are generally associated with small blood vessels they usually do not present with signs or symptoms of vascular compression. However, when leiomyosarcoma arises from a major blood vessel, symptoms of vascular compromise or leg edema may be present, as well as neurologic symptoms such as numbness from compression of an adjacent nerve. We report a case of leiomyosarcoma of somatic soft tissue of the leg of a young male presented to us with swelling in the upper one-third of left leg which was associated with severe pain on extension of the joint. Patient was diagnosed as leiomyosarcoma of the somatic soft tissue origin by clinical, pathological and immunohistochemistry methods.
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695. Study of relationship between serum adenosine deaminase and lipid profile and type 2 diabetes mellitus

     Karunashree, Padma Vijayashree, Bijan Kumar Mukhopadhyay, Sangeeta Chippa4, N. Bhavani, Prasanna Kumar Reddy, Chitra Patil

     • » Abstract Introduction: Diabetes mellitus type -2 is one of the common metabolic disorder we face in our day to day life. it is characterized by high blood glucose level. Adenosine deaminase (ADA) is the enzyme which catalyses the irreversible deamination of adenosine to inosine. Objective: To estimate the level of serum adenosine deaminase (ADA), fasting blood glucose and lipid profile in patients with uncomplicated type -2 diabetes mellitus through case control study and also to know any correlation between plasma glucose values with ADA and lipid profile. Method: This study was conducted in Dept. of Obstetrics and Gynaecology, MNR Medical College and Hospital, Sangareddy, Medak. We took total 50 patients in our study, out of which 25 patients were with uncomplicated type-2 diabetes mellitus and other 25 were as healthy control group. Blood sample were taken and Adenosine deaminase levels were measured colourimetrically, based on the method described by Giusti and Galanti. Other routine investigation like- FBS,PPBS,lipid profile, Blood urea, Serum creatinine were also measured. Results: elevation of the serum ADP were found in diabetic patients as compared to controls and also strong correlations were found between serum ADA, lipid profile and plasma glucose levels. Conclusions: ADA level is significantly related with the type -2 diabetes mellitus. Any change of ADA level is an indirect expression of tissue adenosine levels. In pathophysiology of diabetes, ADA has its multimetabolic effects.
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696. Acrania: a case report

     Satish Prasad B S, Lakshmi Paragannavar

     • » Abstract Acrania is a rare lethal congenital anomaly characterised by an absence of the calvarium. Ultrasound allows early diagnosis of this anomaly. Although acrania associated with anencephaly is a well recognized entity with an incidence of about 10:10,000 births, isolated acrania is a rare anomaly, and its incidence is unknown. We report a 25 year old female patient referred to our ultrasound department for antenatal scan. The fetus was found to have a completely formed brain, base of the skull and facial structures but lacking a cranium.
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697. A study of profile of poisoning cases in and around Hassan district, Karnataka

     Shivakumar K T, Deepak P

     • » Abstract A study of profile of poisoning cases in and around Hassan district, Karnataka
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698. A Comparative Study on Effect of Moderate and heavy Intensity Exercise Priscription in Moderate COPD Patients on Haemodynamics and Functional Capacity

     Virendra K Meshram

     • » Abstract Patients with COPD have reduced functional capacity due to deconditioning. Various studies have found that endurance exercise training is single most important aspect of rehabilitation for patients with chronic pulmonary disease. However, there are conflicting views about the intensity for exercise prescription in stable COPD patients. The optimal specific exercise prescription guidelines in terms of intensity prescription have not been well documented. The purpose of this study was to compare the effect of two training intensities in stable COPD patients, which would help in formulating a comfortable and efficient exercise program in this population. 60 male subjects with moderate COPD were selected through purposive sampling and randomly allocated into two groups, group A and group B, each group having 30 subjects (n=30). Group A subjects were trained with moderate intensity and Group B subjects with heavy intensity exercise. Subjects were trained with the prescribed intensity exercise for respective groups for 10 min per day, 4 times a week for 4 weeks of duration. Outcome of interest include Resting Heart rate, Respiratory rate, Distance covered in 6-min walk test, % predicted FEV1 value, % predicted FEV1/FVC ratio. Data were analysed using paired and unpaired t test. Group B showed significant improvement in RHR, RR. Improvement is found in both groups for 6-MWD, whereas group B subjects showed more significant improvement. However, there was no improvement found in FEV1 and FEV1/FVC ratio in either group. The result of this study revealed that heavy intensity exercise training provides benefits to patients with moderate COPD than moderate intensity exercise training in terms of improvements in functional status if done with permissible interval training during the training. There was 18% of improvement in 6-MWD in group B.
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699. Influence of age, body fat distribution, alcohol consumption and smoking on liver enzymes activity in apparently healthy western Indian males

     Shalini N Maksane, Sucheta P Dandekar

     • » Abstract This prospective study was conducted to assess the effect of demographic and clinical parameters on liver enzymes in apparently healthy western Indian male population. The study population consisted of 669 males attending blood donation camps during 2011 to 2013. Anthropometric measurement was taken and history for alcohol consumption and smoking was noted. Biochemical parameters including AST, ALT, and GGT activities were determined using auto analyzer (AU-400 by Olympus). Mann-Whitney Test and Kruskal-Wallis One Way ANOVA on Ranks Test applied. P value of < 0.05 was considered to be statistically significant. All analyses were conducted using the SPSS-13.0. According to alcohol habit, 97 (14.5%) were alcoholic and 572 (85.5%) were non-alcoholic. According to smoking habits, 171 (25.6 %) were smokers and 498 (74.4 %) were non-smokers. Median activity of serum AST, ALT and GGT were 27.00 IU/L, 17.00 IU/L and 18.80 IU/L respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body mass index, and waist and hip circumferences, Waist-Hip ratio (p < 0.05). AST and GGT activity were significantly higher in alcoholic men compared to non alcoholic (p < 0.05). BMI, AST, ALT and GGT were significantly higher in smokers compared to non-smokers (p < 0.05). These data suggest that slight to moderate increase in BMI and light alcohol intake and smoking affected liver enzymes levels in apparently healthy western Indian males. These factors should be considered in the definition of normal limits for liver enzymes.
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700. Antioxidants: the defense mechanism against free radicals

     Runki

     • » Abstract Introduction: Metabolism refers to biochemical processes that occur within any living organism - including humans - to maintain life. It is sum of all anabolic (synthesis) and catabolic (break down) reactions occurring in our body. Metabolism can also be aerobic (O2 dependent) or anaerobic (in absence of O2). These biochemical processes allow us to grow, reproduce, repair damage, and respond to our environment. Oxidants are formed as a normal product of aerobic metabolism. This aerobic metabolism does not come without cost. “Free radicals” are formed as a by product of this metabolism which is capable of attacking the healthy cells of the body. They are responsible for causation and progress of many diseases like Atherosclerosis, Cataract, Cancer, degenerative diseases, inflammatory diseases, etc. Antioxidants are the first line of defense for these free radicals and are vital in maintaining optimum health and well being. These anti oxidants can be obtained from natural dietary sources or can be taken as nutritional supplements.
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701. Biochemical assessment of dysfunction of liver and brain in alcoholic liver disease patient

     Bharati V Nalgirkar, Shubhangi S Pathak, Sanjeev Kale, Vivek V Nalgirkar

     • » Abstract Total Serum Sialic acid has been suggested as a new marker of alcoholic liver disease. The synthesis and the catabolism of Sialic acid takes place in the liver and therefore the status of liver can influence the serum levels of Total Sialic acid (TSA). Increased capacity of transferrin deficient in SA to selectively deposit iron in the hepatocytes might be of significance for the development of hepatic siderosis observed in alcoholism. Estimation of serum sialic acid level may be of help in early diagnosis of alcoholic liver disease and prevents the progression of the disease to terminal stages and complications. However, the role of TSA as a marker of liver disease and its association with cognitive changes has not been clearly elucidated. Material and methods: A total of 68 cases and 50 age matched healthy controls were recruited. These patients were further categorized into 3 groups; fatty liver, alcoholic hepatitis and alcoholic cirrhosis. Enrolled patients were followed for 6 months. The study was approved by the institutional ethical committee. Global cognitive functions were assessed periodically with Mini Mental State Examination (MMSE).Serum TSA levels were determined by Biovision’s Sialic acid assay kit. Result: The serum TSA levels (34.74±11.25 nmol/µl) were significantly higher in the alcoholic liver disease than in the healthy controls (2.21±1.01 nmol/µl). Significantly higher TSA levels were observed in patients with alcoholic cirrhosis (36.46±7.66 nmol/µl, p<0.001) compared with alcoholic hepatitis (31.14±9.69 nmol/µl, p<0.001) and alcoholic fatty liver (35.17±10.9 nmol/µl, p<0.001). MMSE Scores were found to be lowest in alcoholic cirrhosis (10.60± 5.32) followed by hepatitis (12.36 ±5.48) and fatty liver (18.28±3.43). Conclusion: Serum TSA is significantly elevated in alcoholic cirrhosis. Serum TSA levels can be used as a marker of alcoholic liver disease and may correlate with cognitive dysfunction among ALD patients.
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702. Relationship between acylated ghrelin and uric acid in prediabetic obese individuals

     Ankita Sharma, G G Kaushik, Sonali Sharma, J S Broca

     • » Abstract Objective: To evaluate acylated ghrelin and uric acid in prediabetic subjects and compare it with type 2 diabetics and healthy subjects and to examine the relationship between plasma acylated ghrelin and uric acid concentrations. Method: The study was conducted on 100 subjects: 50 subjects of prediabetes (Group - I) and 50 subjects of type 2 diabetes (Group - II). 50 healthy non-diabetic control subjects (Group-III) of same age of either sex were selected. All subjects with BMI > 30 kg/m2 were considered. Blood samples were analyzed for fasting blood glucose, insulin, HbA1c, uric acid and acylated ghrelin. Result: Acylated Ghrelin and uric acid increases in group -I when compared with group -III and decreases in group-II when compared to group –I. The strongest positive association of acylated ghrelin was observed between acylated ghrelin and Homa- β in prediabetic subjects while the strongest association of uric acid was observed between uric acid and acylated ghrelin in prediabetic subjects. Conclusion: Although the mean values of both acylated ghrelin and uric acid are high in prediabetic subjects as compared to obese control yet the mechanism related to prediabetes i.e. impaired insulin secretion has strong positive association with acylated ghrelin while it shows negative association with uric acid. Hence, acylated ghrelin and uric acid shows inverse relationship in prediabetic obese individuals.
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703. Case report on systemic lupus erythmatosus in pregnancy

     Priti Bagade, Anagha Jinturkar

     • » Abstract Background: Systemic Lupus erythmatosus is a autoimmune disease mostly affecting Women of child bearing age. SLE are at higher risk for exacerbations of the disease during pregnancy, spontaneous abortions, intrauterine foetal death, pre-eclampsia and eclampsia, preterm delivery and intrauterine growth retardation. Objective: pregnancy is a challenge for lupus patients and their physicians. This case report is focused on the disease course, gestational outcome and management of patients with SLE during pregnancy. Methods: Here we describe the successful management of patient with SLE, registered at second trimester of pregnancy, with antinuclear antibody and antiphospholipid antibody positive, with intra uterine growth restriction with good maternal and fetal outcome. Conclusion: As the treatment of systemic lupus erythematosus (SLE) improves, and with better understanding of the disease more women with this disease are able to become pregnant. Pregnancy outcomes have improved dramatically over the last 40 years. However, fetal and maternal complications still exist. Careful planning of pregnancy coupled with multidisciplinary monitoring and treatment substantially decreases the risks for the mother and the infant.
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704. Study of biochemical parameters in beta thalassemia major patients

     Vinita Belsare, Hrishikesh Belsare, Sandip Lambe

     • » Abstract Children with thalassemia have various skeletal changes and effect on liver, lungs and kidneys. All these effect are due to ineffective erythropoiesis and hemochromatosis. All this leads to impairment of functions of various organs. The present study was conducted to assess the kidney functions with blood urea, serum creatinine, serum phosphates, serum sodium, serum potassium ,urinary total protein and urine specific gravity in children’s with beta thalassemia major.
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705. Laproscopic repair of inguinal hernia by trans-abdominal pre- peritoneal repair (tapp) technique

     Jaykar R D, Ubale B P, Shende P Shweta, Vikram Ramamurthy

     • » Abstract Background: The evolution of scientific knowledge in microbiological field has provided an opportunity to explode new methods of therapy, which have changed and improved surgical practice remarkably during 20th century. Surgical infection, particularly surgical site infection (SSI), has always been a major complication of surgery and trauma and has been documented for 4000-5000 years. Cases: 800 patients have been studied in this study. Department of microbiology helped us in conducting this study. Every Patient who underwent clean and clean contaminated surgery was studied.
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706. Spontaneous "true" ileal perforation of tuberculous origin: a report of two cases

     B Easwaran, N Sivaprahasam, G P Sekar, B Selvaraj

     • » Abstract Majority of the tuberculous intestinal perforation are associated with a distal stricture and are considered to be blow outs due to distension. Perforations not associated with strictures or adhesive bands which can cause proximal dilatation are only considered as true perforations. Some of the perforations are associated with initiation of antituberculous therapy. Herewith we report 2 cases of tuberculous ileal perforation which are associated with neither strictures nor antituberculous therapy. Hence these are considered as spontaneous and true.
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707. Clinical profile of wound infection in postoperative patients in the department of general surgery

     Jaykar R D, Jadhav S C, Ganakwar R G, Lakhpatre S B

     • » Abstract Background: The evolution of scientific knowledge in microbiological field has provided an opportunity to explode new methods of therapy, which have changed and improved surgical practice remarkably during 20th century. Surgical infection, particularly surgical site infection (SSI), has always been a major complication of surgery and trauma and has been documented for 4000-5000 years. Cases: 800 patients have been studied in this study. Department of microbiology helped us in conducting this study. Every Patient who underwent clean and clean contaminated surgery was studied.
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708. Complications of rigid bronchoscopy in pediatric foreign body aspiration: 3 rare case reports

     Salma Shaziya

     • » Abstract The severity of complications in pediatric foreign body aspiration is often underestimated as they are rarely reported. Complications are more severe in patients who have tracheo-bronchial aspiration for prolonged time. Rigid bronchoscopy is a common procedure in pediatric age group. Pneumothorax and tracheo-broncheal stenosis are rare complications noticed after rigid bronchoscopy done for pediatric foreign body aspirations. Here are 3 case reports of complications noticed after bronchoscopy. First two cases developed pneumothorax post bronchoscopy and intercostal tube drainage was sufficient in their management. Third case had undergone 3 repeat rigid bronchoscopic procedures in one month duration. At 6 months follow up he had developed mild bronchial stenosis manifesting as intermittent wheezy respiration without respiratory distress . The case was managed conservatively.
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709. The clinical study of antepartum haemorrhage

     Laxmi Rachkonda, Suresh Rawte, Surabhi Ruiwale

     • » Abstract Introduction: Antepartum Haemorrhage (APH) is defined as bleeding from or into the genital tract after 28th week of pregnancy till the end of 2nd stage of labour. APH is a grave obstetrical emergency and is one of the leading causes of maternal and perinatal morbidity and mortality. APH can be due to placenta praevia, abruptio placentae, indeterminate causes or local causes of genital tract. This study is carried out to have a statistical impression of the consequences of antepartum haemorrhage on mother and foetus in a tertiary care center (MGM Hospital, Aurangabad, India). Objectives: This is a prospective observational study carried out in MGM Medical College, Aurangabad, India from January 2014 to June 2014. Results: During the study period, there were 1211 deliveries, out of which complete data from 50 diagnosed patients with antepartum haemorrhage were studied. In my study the incidence of antepartum haemorrhage was 4.1%. Out of 50 deliveries, 21 (42%) were diagnosed with placenta praevia, 29 (58%) had abruptio placentae as causes of antepartum haemorrhage. The mean age was 25 years. 76% of the patients were registered. During the antenatal period 52% had anaemia, 30% had oligohydramnios, 18% had malpresentation, 28% had hypertensive disorder in present pregnancy.80% have delivered by LSCS. 70% were preterm LSCS. The postnatal complications were PPH (16%), HELLP syndrome (6%), DIC (6%), Shock (4%). 66% required blood transfusion.53% of the live babies were low birth weight.46% were admitted to NICU. 16% had birth asphyxia 13% had IUGR. The perinatal mortality was 40%. Conclusion: From this study it was evident that, Antepartum Haemorrhage has serious life threatening complications and if diagnosed earlier in pregnancy and proper antenatal care is provided the maternal and perinatal outcome is surely to improve.
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710. Morphometric analysis of urmodi basin of bamnoli range of western Maharashtra dissecting lateritic terrain

     R V Desai, R A Suryawanshi

     • » Abstract Attempt of this study is to use GIS for drainage analysis of Urmodi river basin of Satara district of Maharashtra. This river is tributary of Krishna, which originates at Kas Lateritic plateau of Bamnoli range. The aim of this paper is to understand a geomorphological change that has been taken place and to understand the geological role in these changes. GIS is a tool which is very useful and important in this case for assessment of drainage analysis. With the help of rosette diagram we tried to find out the structural control of different order streams of this basin for which Geo Rose software is used. All the parameters indicate steep slopes at higher altitude with high stream frequency on hard laterite and compact non porous basalt at lower level. There is structural, geomorphological and lithological control on basin development.
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711. Bilateral lobular breast cancer in a pregnant woman with bilateral krukenberg tumor - a very rare case report

     Sibaprashad Pattanayak, Subrata Pramanik, Sanjit Kumar Nayak, Sivashankar Behuria

     • » Abstract Background: Krukenberg tumors in pregnancy are relatively very rare and their management can present a great dilemma for the obstetrician and oncologist. The situation becomes further complicated when the primary is bilateral lobular breast cancers. Case Report: We present the case of a G2P1 who presented to us at 34 weeks of gestation with bilateral massive Krukenberg tumors. She also had bilateral lobular cancers of breasts. Despite at surgery and chemotherapy she died 3 months postpartum. Conclusion: Early detection followed by surgery and chemotherapy could possibly result in a favorable outcome with such patients.
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712. Knowledge and practice of breast feeding among mothers

     Mamatha S

     • » Abstract Objectives: 1) To study the knowledge of breast feeding among mothers. 2) To study the practice methods of breast feeding followed among mothers. Materials and Method: Observational study done over 3 months at Sri Adichunchangiri institute of medical sciences, B.G. Nagara. Study period: January 2009 till April 2009. Cases studied: 300. Using simple questionare regarding knowledge of breast feeding and practices followed to mothers who delivered at Sri Adichunchangiri institute of medical sciences, B.G. Nagara, in the study period. WHO BFHI Guidelines were used in the questionnaire. Results: In my study of all mothers who delivered at Sri Adichunchangiri institute of medical sciences, B.G. Nagara in the study period, 60% of mothers had NO knowledge, 43.3% with average knowledge and 16.6 % with good knowledge of breast feeding. About breast feeding practices, 33.3% of mothers followed good practices, 16.6 % of the mothers were average and 50% of the mothers were not following good breast feeding practices. Morethan hospital staff, elderly person at family and neighbours influence the practice of breast feeding among mothers. Conclusion: Large proportion of mothers are still lacking the knowledge of good breast feeding and practice methods. Antenatal counselling and demonstration of breast feeding advantages and techniques ante natally and post natally would help to achieve WHO goals in a long run.
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713. Predictive value of mannheim peritonitis index (MPI) for mortality in perforated peptic ulcer

     N Sivaprahasam, S Vijayalakshmi, S Kalitathinam, R Balasubramaniam

     • » Abstract Introduction: Perforated peptic ulcer is a life threatening emergency and a means to predict severity of disease is welcome. Many scoring systems to predict outcome in patients with peritonitis are available. Materials and Methods: To evaluate the usefulness of Mannheim Peritonitis Index, in patients with perforated peptic ulcer a prospective study was done from June 2003 to May 2004 at Govt. Rajaji Hospital attached to Madurai Medical College, Madurai. 37 patients were studied. Results: No patient with a score <15 died, whereas 3 out of 4 (75%) with a score >25 died. Conclusion: MPI is useful in prediction outcome in patients with perforated peptic ulcer. Increasing MPI score indicates poor prognosis and higher mortality.
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714. Unusual presentation of subglottic foreign body in pediatrics: two case reports

     Salma Shaziya, Mozimul Haq Siddiqui

     • » Abstract History of foreign body aspiration presumably is as old as mankind. 90% of foreign bodies aspirated are bronchial and only 10% foreign bodies are laryngeal or tracheal. Our first case is unique in sense aspiration was due to fruit gel chocolate which clinically presented as a catastrophic event due subglottic obstruction and child’s life was saved with tracheal aspiration following intubation. The second case was unique in sense unlike usual severe symptoms following subglottic foreign body aspirations this child presented with time lapse of seven days after aspiration and only stridor as symptom.
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715. A case of anaphylactic/anaphylactoid reaction to ondansetron injection

     S G S Rajesh Reddy V, Shiddalingesh Salimath, Torvi Janaki R

     • » Abstract This case report illustrates anaphylactic/anaphylactoid reaction in form of generalized rash and laryngospasm after administration of a single dose of 1mg ondansetron intravenously. It was used as a preanesthetic medication in a 7yr old female child with left sided pyothorax/fibrothorax posted for minithoracotomy (decortitectomy). Awareness on this rare but fatal adverse reaction to this commonly used drug helps in early recognition and prompt management of event
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716. Obstetric and neonatal outcome in gestational diabetes mellitus

     Savitha H C, Usha D, Sanjay Kumar C, Deepthi H R

     • » Abstract Objective: To assess the maternal, neonatal complications and outcome in pregnancy with gestational diabetes mellitus. Materials and Methods: A total of 72 GDM cases were studied retrospectively at MIMS Mandya over a period of 3yrs. Antenatal and perinatal data were obtained from patient’s medical records. All diabetic pregnant women also suffering from other disorders which directly or indirectly may affect the outcome of pregnancy were excluded from the study. Results: Out of total 20,468 deliveries, GDM was seen in 72cases(0.35%). 62% of the patients were above 25yrs of age and 68% were multiparous. 69% of the patients required insulin for glycemic control. Higher incidence of preeclampsia (44.4%), polyhydramnions(23.6%), PROM(8.3%) and preterm delivery(8.3%) was noted. Common neonatal complications were macrosomia (29.17%) and hypoglycaemia (9.7%). Increased rate of caesarean section was also noted (62%). Conclusion: GDM is recognised to be associated with increased rates of adverse maternal and neonatal outcomes, which are supported by the findings of our study. Even mild form of GDM seems to have significant consequences for women and their offspring and is recommended to be aggressively treated. Early diagnosis and strict control of blood sugar levels throughout the pregnancy can significantly reduce maternal and neonatal complications.
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717. Finding the treatment result of tuberculosis patient according to their socioeconomic class and area of leaving

     Rajesh C Sambutwad, Vasant Wagh, V S Rathod, A Mudey

     • » Abstract Background: Tuberculosis (TB) is a contagious disease. Like the common cold, it spreads through the air. Only people who are sick with TB in their lungs are infectious..The last two-three decades have seen increasing interest in the quantitative study of socioeconomic factors and health system factors as determinants of health outcomes in the field of public health. Aim: Correlation between TB result and socio economic class and area of leaving Objective: 1) finding the treatment outcome according to the socio economic group. 2)to find out the area wise treatment outcome of tuberculosis patient Method: Community based longitudinal study was conducted. All the participant are tose who visit to hospitals Tb and chest department and register for the tuberculosis treatment. Social economic class we uses for rural area Modified Prasads classification and urban area Kuppuswamis method of classification. Result: Most of the patients are from rural area 81.5% of total participant and urban area only 18.4% .cure rate also higher in urban area that was 78.9%.Defolter rate was higher in rural area 2.3%. According to social class most patient belong to class IV 64.5%, cure rate was 100% in SEC I. Conclusion: The area and SEC class where we work hard for the better result of Tb treatment outcome.
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718. Comparative study of various types of reconstructive procedures in facial and oral malignancies at tertiary care hospital: an observational study

     Abdul Rafe Abdul Qadeer, Sharad S Sawant, Vikas Gosavi, P D Gurav

     • » Abstract The goal of therapy of patient with oral cavity malignancy is not only to cure the tumour, but also provide rehabilitation and try to preserve or restore some reasonable quality of life. Oral cavity reconstruction is not simply based on closure of the wound. Present study describes the various types of reconstructive procedures undertaken and its outcome in the patients at the tertiary care hospital in Miraj district of Maharashtra during the study period. Total of 52 cases were studied. The procedures done were Primary closure in 11 cases, Split Thickness Skin Graft in 2 cases, Local flaps in 11 cases, Myocutaneous flaps in 23 cases and free flaps in 5 cases. Recipient site morbidity in terms of infection was highest in Pectoralis Major Myocutaneous flaps (22%) followed by local flaps (18%) and free flaps (20%). Incidence of orocutaneous fistula was maximum in Pectoralis Major Myocutaneous flaps (13%) followed by free flap (13.3 %). Overall morbidity in terms of duration of operation, hospital stay, and return to operation theatre for evacuation of hematoma was more in free flaps. There was no peri-operative mortality. Post operative mortality was 5 % mainly due to cardiovascular and respiratory causes. Functional and aesthetic results were excellent in patients of free flap repair as compared to other procedures.
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719. Study of various factors associated with septic abortion

     Asha Hanamshetty, Sarita M Hattarki

     • » Abstract Introduction: Unwanted pregnancy has been a problem of mankind from time immemorial. The WHO has estimated that on the Indian subcontinent 15-24 unsafe abortions take place in every 1000 women aged 15-49, even after 40 years of the implementation of medical termination of pregnancies in India Aims and objective: to study the incidence and various factors associated with septic abortion. Materials and method: The present study was conducted in department of obstetrics and gynecology at Government General Hospital and Sangameshwer Hospital. Gulbarga. All the cases of abortion reported were enrolled in the study. Cases of septic abortion were studied in detail. After stabilization of patients’ detailed history regarding name, age, parity, marital status and gestational period were inquired and record. Results: Out of the total 327 cases of abortion septic abortion was observed in 36 cases thus the incidence of septic abortion was 11.01%. Majority (61.11%) of the patients suffering from septic abortion were 21 to 30 years old. 27.78% were from Urban and 72.22% were from rural area and 72.22% were married. Septic abortion incidence was highest in less than 8 weeks of gestation (47.22%). Incidence of septic abortion was more common among multipara (30.56%), followed by Grand multiparas (27.78%) and nullipara (25%). Conclusion: The incidence of septic abortion in Government General Hospital Gulbarga was 11.01%. Septic abortion was common in younger married women residing in rural area and seen most commonly in first trimester and multi parous women.
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720. Laparoscopic management of rectal carcinoma

     Mitra A S, Memane S S, Chandak U, Ghuge D B

     • » Abstract Background: Surgical resection is the mainstay of treatment of rectal cancer with curative intent. Laparoscopic surgery for rectal cancer is much more challenging than that for colon cancer because of the confined space within the pelvis. Further, because of the tumour's location in the pelvis, maintenance of resection margins is of greater concern. Aims and Objectives: To assess the feasibility of a laparoscopic resection for rectal carcinoma with emphasis on perioperative and short-term oncological outcomes. Materials and Methods: It was a hospital based nonrandomised prospective study. From July 2011 to November 2013, 37 patients underwent laparoscopic surgery for the rectal cancer. Results: Total 37 patients were operated for rectal carcinoma, 26 laparoscopic anterior resection and 11 laparoscopic abdominoperineal resection. There were 05 cases of conversion to open surgery and 02 procedures were abandoned. The average operative time was 237.5 minutes. The average hospital stay was 9.7 days. The most common postoperative complication was wound infection in 04 patients. The postoperative mortality was seen in 2 patients. The average number of lymph nodes harvested from specimen was 11. There was only one case of positive distal resection margin. The most common Astler Collar stage and tumour grade was stage B and grade 2. Conclusion: The laparoscopic surgery was safe and feasible for treatment of rectal cancer and associated with shorter hospital stay, less morbidity and reduced blood loss.
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721. A statistical analysis of static water level trend and rainfall data in PTW-1watershed, Buldhana district, INDIA

     P V Kathane, Suryakant M Patil, K R Aher

     • » Abstract Groundwater is a dynamic resource and it varies from place to place quantativaly and qualitatively. Its quantity is mostly depends on the rainfall data of that particular region, Geological terrain, Rock type i.e. Aquifer, Geomorphology and drainage pattern. In India especially in Maharashtra state drinking and irrigation water demand is rapidly increases last few years, to cope up this problem, it is necessary to evaluate the existing trend and availability of groundwater in time and space for proper planning in near future. Pre and post monsoon ground water record and its trend, rainfall pattern, and geological especially hydrological study is very useful technique for judicious future planning of groundwater utilization. Proper utilization of available surface water and Ground water quantity it is necessary to manage the watershed concept. For this manners, this paper discuss to analyze the long term (2002-2012) trend of pre- and post-monsoon water level of watershed PTW-1 of Malkapur and Motala Taluka of Buldhana district first time. Trend of Pre and Post Monsoon static Ground water level indicate that there is depletion of static ground water level with the passage of time.
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722. A comparative study of outcome of caesarean delivery in rural obstetric referrals with elective caesarean delivery

     Sowmya M1*, Indranil Dutta2, Vijayalakshmi S

     • » Abstract Objectives: To study the obstetric outcome of rural referrals who undergo emergency caesarean delivery versus elective caesarean delivery in a tertiary care hospital in rural scenario and to evaluate the risks and complications associated with it. Methodology: This comparative study was conducted at Rural Medical Hospital in Karnataka, India over a period of 18 months. Among the total of 100 patients who fulfilled the inclusion criteria 50 patients referred to us, who underwent caesarean delivery are emergency group and 50 patients admitted in our hospital who were posted for elective caesarean delivery were the other group in the study period. The various parameters, maternal morbidity, neonatal outcome, morbidity and mortality were compared in both groups using a semi structured Performa. The comparison was done by using Chi-square test and p-value< 0.05was considered statistically significant. Results: During our study period the referred cases constituted of 19.8%. Caesarean delivery rate among referred Cases was 40.7%. Statistically significant association was found between emergency CS and younger patients, low parity, irregular attendance at antenatal clinics, intra operative complications, postoperative morbidity and low Apgar score, NICU admission and also mortality as compared to elective caesarean section group. The commonest indication for caesarean delivery in emergency was obstructed labour (34 %), previous caesarean delivery (36%) being the commonest in elective group. Perinatal mortality was 12.5% Conclusions: The present study has shown that improper intranatal, an emergency care for a pregnant women being responsible for most of the referral cases undergoing caesarean section on emergency which caused increased maternal morbidity and perinatal deaths in our institution. It was concluded that every effort should be directed to effect-planned CS, as determined during the antenatal period, if possible, so as to reduce the various problems associated with emergency CS.
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723. Pericolic abscess due to large bowel perforation by fish bone – a case report

     Vijay Kalimuthu, Jawahar Krishnaswamy, Anitha Samraj, Ravishankar Jayavelu

     • » Abstract A diagnosis of large-bowel perforation, caused by a sharp or pointed foreign body, is rarely made preoperatively because the clinical symptoms are usually nonspecific and can mimic other surgical conditions, such as appendicitis and diverticulitis. Less than 1% of ingested foreign body results in perforation from mouth to anus mostly by sharp objects. Of these sharp objects, chicken bone and fishbone account for half of the reported perforations. The most common sites are the ileo-caecal junction and sigmoid colon. In our case the patient presented late with pericolic abscess following the perforation by a fish bone in proximal ascending colon and the fish bone found extramurally making it as first case for that site of large bowel perforation by a fish bone with localized late presentation.
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724. Comparative study of PFN and DHS in proximal femoral fractures

     Gourishankar D

     • » Abstract Introduction: The operative treatment of proximal femoral fractures has been a matter of discussion ever since internal fixation was advocated to prevent the complications of long-term confinement to bed for the elderly. Aims and objective: To compare the Dynamic Hip Screw and the Proximal Femoral Nail method of fixation in intertrochanteric fracture of femur. Materials and method: total 50 cases of intertrochanteric fracture of femur were enrolled in the study. 25 patients were treated by Proximal Femoral Nail method and 25 were treated by Dynamic Hip Screw method. All the patients were observed meticulously intra operatively and post operatively. Duration required for surgery, blood loss and complications were recored. Results: The mean age of the study patients was 64.25years. It was observed that 64% patients in the sturdy were male. In 68% patients cause of fracture was domestic fall. Mean duration of surgery was 58±12 min whereas in DHS group was91±8. Mean blood loss during surgery in PFN group was 100±16ml whereas in the DHS group was 250±50ml. Limb shortening was observed in 10 cases in PFN group whereas 24% in DHS. Nonunion was seen in one case of DHS group. In PFN group infection was seen in 6% patients and 14% in DHS group. Implant failure was seen in one case of PFN group whereas in two cases in DHS group. Death was observed in one cases of DHS group. Conclusion: thus we conclude that the Proximal Femoral Nail method for fixation in intertrochanteric fracture of femur is better as compared to the Dynamic Hip Screw.
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725. Palynological studies of tertiary sediments of west coast of India to decipher provenance and environment of deposition

     R A Suryawanshi

     • » Abstract Tertiary sediments are deposited along the west coast in study area on basalt and covered by laterite. These sediments include carbonaceous shale, lignite and sandstone, which are rich in micro fossils and pollens. The Fungal remains, Pteridophyte spores and Angiosperm pollens are studied. The modern equivalents of these fossil pollen and spores are presently found in diversified ecologic habitats ranging from deltaic to fresh water swamps and low altitude ever green to open forests. Ecological distribution of the modern equivalents of these micro fossils indicates deltaic to swampy depositional environment. The source of pollen and lignite coal is in the Western Ghats and source rock is basalt for shale and sandstone.
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726. A study of Clinicopathological aspects of Pilonidal Sinus

     Anilkumar M Talwade, Sanjay Baswaraj Chanda

     • » Abstract Introduction: Pilonidal Sinus is a painful condition usually occurring in the intergluteal region, which consists of a Sinus or fistula, situated a short distance behind the anus and generally containing hair. Pilonidal Sinus has its peak incidence between 16-20 years of age and it decreases after age of 25 years it is rare after 45 years. Pilonidal Sinus occurs predominantly in men 80%. All races can develop the disease, but it seems more common in those with dark, stiff hair and hirsute individuals. However, Pilonidal Sinus can also occur in relatively hairless types. Aims and objective: to study the Clinicopathological aspects of Pilonidal Sinus. Materials and Method: In the present cross sectional study 30 patients of pilonidal sinus were enrolled. Detail history containing age, sex and occupation of the all the patients was noted in prestructured proforma. The main presenting symptoms were also noted. Routine general physical examination was done with special attention towards body hair distribution. On local examination site of the Pilonidal Sinus was confirmed, number of sinuses, presence of tenderness, discharge, any hair protruding from the sinuses and the condition of the surrounding area for indurations was examined. All patients also underwent digital rectal examination and proctoscopy. Results: 56.66% of patients were between 16-25 yrs of age. 70% were males. Labourers form the most common group constituting 40% of our patients followed by students. 24 (83.33%) of our patients were hairy individuals of which 18 were males and only 6 patients were hairy females. Discharge was the most common symptoms in the study being present in all patients. It was followed by pain (56.67%). Most common presentation being swelling and discharge from intergluteal region present in 20 (66.66%) of patients. Sinus was present in all patients (100%) and some form of discharge was seen in 86.7% patients. Conclusion: thus we conclude that pilonidal sinus is often very painful and associated with discharge and typically occurs in young hairy males.
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727. Comparison of surgically induced astigmatism (SIA) and postoperative astigmatism with superior, superotemporal and temporal incisions in phacoemulsification surgery

     Snehal P Gade, Bhaskar S Khaire

     • » Abstract Introduction: Cataract is defined as any opacity of lens or capsule which is either developmental or acquired. Cataract surgery is the commonest procedure performed in ophthalmology. Astigmatism prevention and control is one of the biggest challenges for a surgeon after cataract surgery. Since postoperative astigmatism is the major determinant of visual outcome, a comparative study is essential to ascertain the difference in induced astigmatism, if any between different sites of incision in Phacoemulsification keeping the size of incision same. Aims and Objectives: To compare postoperative astigmatism and surgically induced astigmatism (SIA) with superior, superotemporal and temporal incisions in phacoemulsification surgery. Materials and Method: This prospective study comprised of 150 patients of cataract operated by using phacoemulsification using superior, superotemporal and temporal incisions. All the patients were divided in three groups containing 50 patients each depending upon the type of incision used. The outcome measures were post operative and surgically induced astigmatism (SIA) post operatively. Results: The pre-operative astigmatism in all three groups was measured it was in the range of 0 to 1.5D with no statistical significant difference. Majority of the patients were having post operative astigmatism between 0.75 to 1.25D. i.e. 44% in group A, 60% in group B and 58% in group C. Surgically induced astigmatism less than 0.75D in group A was seen in 78% patients whereas in group B was 92% and in group C was 90%. According to the Tukey’s multiple comparison test, post operative and surgically induced astigmatism was statically significant in group A and C. Whereas the difference in group A and B and group B and C was not significant. Conclusion: temporal and superotemporal incision leads to significantly less amount of mean post-operative astigmatism as well as Surgically Induced Astigmatism (SIA) as compared to superior incision.
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728. Surgical and functional outcome of lateral canthal tarsorrhaphy in unilateral paralytic lagophthalmos

     Kavita A Dhabarde, A H Madan

     • » Abstract Ten patients having unilateral infranuclear 7th nerve palsy with lagophthalmos of different age group and different aetiology underwent lateral canthal tarsorrhaphy to prevent progression of and treatment of severe exposure keratitis in tertiary eye care centre at Govt. Medical College and Hospital, Nagpur. Patients were advised local lubricants, antibiotics. Nearly all pts showed improvement in lid closure, epiphora and keratitis. Lat. tarsorrhaphy supported the lower lid with not much cosmetic disfigurement of the eyeball. Only in a single case the ulcer perforated. Lateral tarsorrhaphy is a good option for poor patients having infranuclear Bell’s palsy with severe exposure keratitis who cannot afford to go for temporalis transplant.
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729. Comparative study of serum and aqueous humour electrolyte levels in cataract patients

     Tasneem A F, Shwetha B A, Mamata N

     • » Abstract Background and Objectives: There are about 50 million blind people in the world, a third of them being due to cataract. In India alone, cataract accounts for 80% of treatable blindness. Many factors such as ageing, altered blood electrolyte levels, nutrition and family history are involved in cataractogenesis. Aim: Comparative study of serum and aqueous humour levels in cataract patients. Objectives are to compare serum Na+, K+, Ca+2 and PO4 -3 levels with that of aqueous humour levels in patients with cataract and to establish a correlation between altered serum and aqueous humour electrolyte levels with the type of cataract. Methods: The study undertaken includes a total of one hundred cataract patients who visited VIMS and RC, White field, Bangalore between January 2012 and June 2013. It considered cataract patients of both sexes above the age of 40 years and excluded patients with any systemic disease, past ocular disease, or any drug intake known to cause electrolyte changes in the body. The patients were all routinely subjected to a detailed ocular examination including visual acuity, slit lamp examination to stage the type of cataract, fundoscopy, intraocular pressure recording. Serum and aqueous humour samples were collected intraoperatively in cataract patients and sent for Na+, K+, Ca+2 and PO4 -3 level measurement by Beckman Coulter Unicel DxC 600 and Synchron CX5PRO.The serum and aqueous humour electrolyte levels were compared with each other. Results: The aqueous humour, though a secretion of serum; shows a considerable difference in the electrolyte levels as compare to serum which is statistically significant (p<0.001). Conclusion: Aqueous sodium levels as compared to serum sodium levels were higher in patients with cataract. Aqueous potassium, calcium, phosphate levels were low compared to serum levels. Aqueous levels of potassium in cataract patients (50 % of cases) were raised when compared to normal aqueous levels.
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730. A rare case of uterine didelphys

     Sudha R, Sunanda N, Babitha M C

     • » Abstract Uterus didelphys is one of the congenital uterine anomalies due to defective medial fusion of Mullerian ducts. Often remains asymptomatic and hence undetected. Women with congenital uterine alformation usually have higher incidence of complications during pregnancy and delivery. Although pregnancies can occur in patients with Mullerian duct anomalies, most of them have been linked to infertility, recurrent pregnancy loss, pre term deliveries, fetal mal-presentations and other obstetrics complications, making successful pregnancy outcome a rare situation in this condition. We report a case of successful pregnancy outcome in a case of uterus didelphys bicollis. A 25year old P2L2 with 2 previous LSCS, failed LS, with 2 months of amenorrhea, continued her pregnancy till term and underwent cesarean section with concurrent sterilization.
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731. Study of incidence of ischemic stroke due to intracranial, extracranial and combined vascular lesions and associated risk factors

     Anjali Deshmukh, Sanjiv Zangde

     • » Abstract Introduction: Ischemic Cerebrovascular disease (ischaemic stroke) is a leading public health problem. Stroke is defined as an abrupt neurologic deficit that is attributable to focal vascular cause. Risk factors for stroke include hypertension, carotid stenosis, atrial myxomas, smoking, hyperlipidemia, diabetes, myocardial infarction and atrial fibrillation. Aims and objectives: To study the incidence of ischaemic stroke due to intracranial, extracranial and combined vascular lesions. Material and Method: in the present study 104 cases of ischemic stroke were included in the study. All these patients were studied clinically and radiologically to study the nature of lesion (intracranial or extracranial vascular lesion). Neuroimaging- MRI-Brain or CT-Brain was done in each patient to see site of infarct. Results: It was observed that out of 104 patients included in our study, 28.84% patients were having intracranial vascular lesion, 31.73% patients were having extracranial vascular lesion and 7.69% patients were having combined intracranial and extracranial vascular lesions. 31.73% patients were having normal angiographic study. Incidence of stroke increases with increasing age and has male preponderance. Hypertension was found in 76.92% of total patients. 41.35% of patients in our study were having diabetes mellitus. History of smoking was observed in 33.65% of patients. Conclusion: The incidence of stroke due to intracranial, extracranial and combined vascular lesion was 28.84%, 31.73% and 7.69% respectively. Increasing age, male sex, HTN, DM, IHD, past history of stroke and smoking were important risk factors for ischaemic strokes.
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732. Computed tomographic prevalence of intracranial calcification of pineal gland in apparently normal individuals

     M S Ugale, P R Kulkarni, R G Surwase, G M Ugale

     • » Abstract Introduction: This study was undertaken to know the prevalence of pineal calcification in normal individuals of south central Maharashtra with the objective to study the age related variation, the sexual variations in the prevalence of normal pineal gland calcification. It increased from 2.22% in the first decade to 57.5% in seventh decade with statistically significant rise from 13.33% to 26.66% from second to third decade. Considering the process of calcification, endocrine activity of pineal gland and the significant rise in the prevalence of calcification after second decade, it was concluded that secretions of pineal gland may influence sexual hormone and the gland is more active in second and third decade of life.
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733. A study of etiological factors in ascities - a cross sectional study

     Bindu C B, Uday B Nayak, Sydney D Souza

     • » Abstract Introduction: Ascites is a known complication in cirrhosis of liver and ascites can develop in many other conditions in adults like cardiac, infectious, autoimmune, renal, malnutrition and many others clinical conditions. Ascites along with abdominal distension presents with other salient features depending on the etiology. This study was focused on evaluating variuos aetiological facors involved in ascites. Methods and Materials: It was a cross sectional study done among 60 patients with ascites in K M C Hospital Mangalore from September 2006 to September 2008. Patients were clinically assessed and subjected to various biochemical tests of blood and ascitic fluid. Results: Among the 60 patients of ascites majority of the patients are males85% probably related to alcohol, and cirrhosis of liver was the leading cause for ascites66.7% followed by HBV infection10% and tubercular peritonitis8.3% and nearly33.3% were of the age group between 40 to 50years. In our study anorexia and pain abdomen were common presenting symptom along with distension of abdomen and pedal oedema was seen in 88.3% of patient’s pallor and spleenomegaly are the other common signs. Conclusions: Cirrhosis was the common aetiology for ascites when compared to other causes probably seen in chronic alcoholics as it is shown in our study that males in mid age group are more affected.
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734. Study of awareness about diabetes mellitus among undergraduate medical students

     Rashmi Amans Flora Nazareth, Arunachalam R, Sudeep K

     • » Abstract Introduction: Diabetes mellitus (DM) causes significant morbidity and mortality. The importance of proper diagnosis and management of this non communicable disease is being increasingly recognized. This study was conducted to assess the knowledge about DM among medical students who are the future health care providers. Materials and Methods: The data was collected from a questionnaire filled by medical students studying in Final year MBBS and internship in Father Muller Medical College Hospital, Mangalore. Results: From this study it was found that 81.25% of the interns and 78.75% of the final year students were aware of the classical symptoms of DM. The interns (65.4%) were more knowledgeable than the final year students (48.3%) about the biochemical parameters. The awareness about diabetic ketoacidosis (DKA) and its management was poor. Conclusion: There were gaps in knowledge of both the final year students and interns. Education programs teaching in detail about diabetes mellitus, its complications and management are needed to be incorporated more effectively in the medical curriculum.
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735. Metabolic syndrome in an adult population of rural Karnataka

     Vanitha Gowda M N, Krishnamurthy U, Shalini C N, Pruthvish S, Shalini P, Dinesh R6, Murthy N S

     • » Abstract Background: Metabolic syndrome is a group of abnormalities that confers an increased risk of developing atherosclerotic cardiovascular diseases and type 2 diabetes mellitus. Aim: To determine the prevalence of metabolic syndrome in adults aged ≥18 years in a rural population, to find the prevalence of various risk factors of metabolic syndrome and to determine the factors significantly contributing to metabolic syndrome in the same population. Materials and Methods: A cross-sectional study was undertaken in Jangamsheegehally village of Chintamani taluk in Karnataka. A detailed personal and clinical history, blood pressure, anthropometric measurements were recorded and a fasting blood sample was drawn from each of the 188 subjects. The serum samples were analyzed for Fasting Blood Sugar and lipid profile. Results: the prevalence of metabolic syndrome in adults aged ≥18 years, using the updated AHA/NHLBI statement criteria was 42 (22.3%). At least one metabolic abnormality was seen in 87.23% subjects (90% of females and 84% of the males). The commonest abnormality in females was low HDL (79%), Central obesity (29%) and hyperglycemia (12%). In males, low HDL (67%) was also the most common abnormality followed by high triglycerides (40.9%) and hyperglycemia (18.1%). The most significant independent risk factors for developing metabolic syndrome were found to be Hypertriglyceridemia (OR 21.07, CI 8.48-52.35, p<0.001), Low HDL levels (OR 20.71, CI 1.78- 101.0, p= 0.001) and Central obesity (OR 15.75, CI 7.40-38.69, p<0.001). Conclusion: The prevalence of metabolic syndrome was highest in the age group of 31-40 years with low HDL levels, hypertriglyceridemia and central obesity being independent risk factors. Efforts should be aimed at educating the rural masses regarding lifestyle modifications including suggestions on improving eating habits, the importance of a regular exercise regimen, social support and stress management strategies in order to alleviate the metabolic abnormalities that could increase the risk of Metabolic syndrome.
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736. Effect of diet and exercise on improvement of anthropometric variables and BSL in prediabetic study subjects of urban slum area

     Chandrashekhar M Gedam, Pravin N Yerpude, P B Sawant, Keerti S Jogdand

     • » Abstract Introduction: Subjects with IGT and IFG have an increased risk of type-2 diabetes therefore form an important target group for interventions aimed at preventing diabetes. Approximately one third of the individuals with either IFG or IGT and two third of individuals with both will develop diabetes within six years. Present study was planned to focus attention on prediabetes and to see the effect of the intervention measures such as diet change and increasing level of physical activity to control the blood sugar level in prediabetics. Materials and Methods: The present hospital based interventional study was conducted in urban slum area. The outpatient department attendees of the Urban Health Centre, comprises the study population for the present study. If blood sugar levels fits in the definition of pre-diabetes (either IFG or IGT or both) then subjects were assigned to the groups, either in the intervention group or control group by randomization. Subjects in the intervention group were advised regarding diet change and exercise. All the subjects in both the groups were followed-up for 9 months. Results: Total 288 study subjects undergo investigation for pre-diabetes, out of which 104 (36.11%) found to have pre-diabetes. So prevalence of pre-diabetes was 36.11%. Majority of the participants i.e. 34 were in the age group of 40 to 49 yrs. Majority of the participants had completed their education up to graduation (39 %) and post-graduation (17 %). Anthropometric variables like BMI and waist hip ratio were not found significant before intervention but after intervention there is significant variation in anthropometric variables between control and intervention groups. Similarly fasting and post prandial blood sugar level among control and intervention groups were found to be significant after intervention. Conclusion: The study shows that intervention measures like diet change and exercise are effective to decrease and maintain the blood sugar levels among prediabetics by decreasing and maintaining their bodyweight.
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737. Lineament Fabric of South Baluchistan (Iran) and its Impact on Geomorphic Landforms

     U D Kulkarni, Yousefi Hamidoddin, Ravindra G Jaybhaye

     • » Abstract Lineament analysis of South Baluchistan region in Iran using sensors of Landsat 8 (Landsat Data Continuity Mission, LDCM)) suggests orgoenic uplift of the region brought about deformation of mesoscopic structures. The lineament fabric showed prominent lineament directions along E-W and NW-SE. The study also revealed that the Alpine Himalayan orogenic uplift has been responsible for the structural fabric of the south Baluchistan. This deformation is documented in the form of reverse and normal faults.
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738. Do spontaneous separation of placenta reduce blood loss during caesarean delivery?

     Shivamurthy H M, Durgadas Asaranna, Giridhar S A, Ashwini Konin, Jyotsna R Himgire

     • » Abstract Background: Blood loss during a caesarean section is of great concern for the surgeon, especially in an anaemic patient and where facilities are not available for blood transfusion especially at the peripheral hospitals. Also majority of our pregnant women (nearly 80%) are anaemic. Again there is a lot of demand for blood transfusion due to non-comparable conditions like APH, PPH etc which may further lessen the availability of blood for transfusion. Such being the situation the technique of bloodless caesarean proves to be a boon in our setup .So also blood transfusion has its own complications. Objectives: To compare the blood loss after spontaneous separation of placenta with the blood loss associated with manual removal of placenta during caesarean section deliveries. Materials and Methods: In this study, estimation of blood loss in the placental delivery ,was done on 100 consecutive women undergoing caesarean section due to various indications excluding those who are likely to bleed by the virtue of their pathology like APH .Of the 100 cases 50 cases were managed by waiting for placental separation ,and alternative cases were managed by manual removal placenta without waiting for spontaneous separation .The blood loss was assessed by using preweighed cotton mops and weighing them again after the use to mop the blood loss. Care was taken to not allow the mixing of amniotic fluid and all the clots were weighed and computed for the loss of blood (by multiplying the weight of the clot by1.05) Results: Shapiro wilks test showed that the data was normally distributed, thus parametric test was employed. There was a statistical significance between the study and control groups for placental delivery interval, blood loss and drop in Hb levels at p < 0.05. There was no difference in the morbidity levels in study and control groups as shown by the Chi square test p (< 0.05) Conclusion: The spontaneous placental separation and delivery during caesarean section is associated with less blood loss than that of manual removal of placenta.
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739. Variant arterial pattern in upper limb with persistant median artery

     A D Kannamwar, G L Maske, I V Ingole

     • » Abstract During routine dissection classes we observed bilateral anatomical variations of the brachial and ante brachial arterial pattern and along with variant superficial palmar arch formation. We will be reporting this case with its embryological correlation and clinical implications.
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740. Sertoli leydig cell tumour - a rarity in reality

     Vembu Radha, Narayanan Palaniappan

     • » Abstract Introduction: Sertoli Leydig Cell Tumour of the ovary is an extremely rare tumour that belongs to a group of Sex Cord Stromal tumours of the ovary. It accounts for less than 0.5% of all primary ovarian neoplasms. Very few cases are documented in the literature so far. Hence we report a case of Sertoli Leydig Cell Tumour of intermediate grade differentiation involving the left ovary in a 26 years old nulliparous woman who presented with menstrual irregularity and virilizing features.
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741. Laparoscopy assisted management of vaginal evisceration

     Jayanth Leo, Parimuthukumar, Vishwanath Pai, A. Rekha, Bhuvana

     • » Abstract Introduction: Evisceration is an uncommon surgical emergency. A vaginal evisceration is a rare occurrence following hysterectomy. The risk factors of having an evisceration are obesity, sudden increase in intra abdominal pressure, vaginal surgeries and post menopausal age group. This is a case report of a 58 year old lady who presented to the emergency room with evisceration through the vaginal vault. This mandates an early diagnosis of the condition, start the patient on broad spectrum antibiotics on admission and plan emergent surgical intervention. In our case we did a combined vaginal and laparoscopic approach. The use of minimally invasive surgery had saved the patient the morbidity of a laparotomy especially when done as an emergency procedure. The outcome of having managed this patient this way was rewarding.
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742. Bilatral absence of musculocutaneous nerve – a case report

     A D Kannamwar, G L Maske, I V Ingole

     • » Abstract During routine undergraduate dissection in Anatomy department, bilateral variations were found in the anterior compartment of the arm in male cadaver of approximately 58 years age. The musculocutaneous nerve was absent on both sides. The muscles in the anterior compartment of the arm except coracobrachialis, which are normally supplied by musculocutaneous nerve, were receiving fibers from lateral side of median nerve. Coracobrachialis was supplied by thin nerve arising directly from lateral chord. We will be reporting this case with its clinical significance.
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743. Uroflowmetry Evaluation of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia an institutional study

     Chikkaraddi Manjunath L, Manjunath Shetty

     • » Abstract BPH is one the common conditions found in an ageing man, presenting with LUTS. This study focused on comparison of IPSS score with prostrate size and uroflowmetry. We found the age group of 61-70 years were most commonly affected. Symptom score collected, co-related well with uroflowmetry than prostrate size obtained from ultrasound. The average flow rates co-relates well with IPSS score and also co-relates weakly with post void residual urine. Based on this study, the severity of BPH has nothing to do with prostratic size. IPSS score and uroflowmetry should be used to predict the severity of BPH.
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744. Role of colour doppler evaluation of middle cerebral and umbilical arteries in intrauterine growth restriction and prediction of adverse perinatal outcome

     Vishwanath G Kumbar, Vijayalakshmi N, Vinod Xavier Joseph, Richard Thomas, Tessa N Kaneria, Sandeep M B, Gouri B Kaveriappa

     • » Abstract Background and Objectives: Objective of our study was to evaluate the usefulness of middle cerebral artery (MCA) and umbilical artery (UA) Doppler in the diagnosis of intrauterine growth restriction (IUGR) and its prediction of adverse perinatal outcome in clinically suspected IUGR pregnancies and to establish the role of Doppler ultrasound in the management of IUGR pregnancy. Materials and Methods: Data were analysed from 40 cases with clinical suspicion of IUGR between 31 to 40 weeks of gestation from June 2011 to June 2013. Pulsatility index (PI) was used as the Doppler index. The UA and MCA PI was considered abnormal if the value was >95th percentile and <5th percentile of previously published values for gestational age, respectively. Cut-off value of 1.08 was used for MCA/UA PI ratio; velocimetry above 1.08 was considered normal and if below abnormal. The fetus was considered IUGR if the estimated fetal weight (EFW) was <10th percentile of previously published values for gestational age. Pregnancies with documented major congenital abnormality and multiple gestations were excluded from the study. Findings of Doppler studies were correlated with the EFW and the following adverse perinatal outcomes: perinatal death, emergency caesarian section for fetal distress, low Apgar score (5min Apgar <7), and admission to neonatal intensive care unit for complications of IUGR, pregnancy outcome was considered favourable when these were absent. Results: Cerebroplacental ratio (MCA/UA PI) was the most sensitive parameter (95.8%) to predict adverse outcome. It was more sensitive than UA PI (91%) and MCA PI (87.5%). Diagnostic accuracy of cerebroplacental ratio (90%) was better than UA PI (88%) and MCA PI (66%) in predicting adverse outcomes. MCA/UA PI had less diagnostic accuracy (65%) in diagnosing IUGR than predicting its adverse outcome (90%). Conclusion: Cerebroplacental Ratio (MCA/UA PI) is a better predictor of adverse perinatal outcome than an abnormal MCA PI or UA PI, however has less diagnostic accuracy in the diagnosis of IUGR compared to prediction of adverse perinatal outcome.
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745. Splints are an overall better alternative to casting for torus fractures in children in rural hospitals

     Midhun Krishnan, Cherian Jacob

     • » Abstract The aim of the study was to compare the functional outcome, patient satisfaction and cost of two methods of treatment, namely plaster of Paris cast and a removable splint, for Torus or buckling fractures of the distal forearm in a rural teaching hospital setting. Methods: The study was done on71 consecutive patients with torus fracture presenting to the emergency department. The functional outcome was assessed using Mayo’s wrist score and patient satisfaction with Verhaar scale. Results: Functional results were satisfactory in 95% of the splint group and in 89% of the plaster group. Patient satisfaction was good to excellent in 97% of the splint group and 91% of the plaster group. The splint group had approximately 61% reduction in overall costs in monetary terms. Conclusion: Removable splinting as opposed to plaster casting has an overall better functional outcome, patient satisfaction and lower cost and may be the preferable treatment option for these simple fractures.
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746. Detection of ESBL (extended spectrum β lactamases) from urinary isolates of multi drug resistant enterobacteriaceae in a tertiary care hospital in Mangalore

     Lumbeni Kithan, Thomas S Kuruvilla, Tina Damodar

     • » Abstract Introduction: The incidence of Extended Spectrum β Lactamase (ESBL) producing strains is increasing over the years. ESBL producing organisms pose problem for treatment. ESBL producers are also higher in uropathogens and baseline knowledge of ESBL organisms is mandatory for formulating control measures hence an attempt was therefore made to study ESBL production from urinary samples at a tertiary care hospital at Mangalore. Aim: To detect the number of ESBL producers among uropathogens in our centre and to compare two methods of ESBL detection. Materials and Methods: 1121 urinary samples were processed, of this 319 were Multi-drug resistant and were tested for ESBL production by Double Disc approximation and CLSI Confirmatory Test. Results: Out of 319 MDR samples, 153 were Enterobacteriaceae 93 were positive for ESBL i.e., 60.78% .Inpatients were more than outpatients and the two methods of ESBL detection were comparable. In this study ESBL was 60.78% among MDR enterobacteriacea and enterobacteriacea being the commonest organism in UTI, an attempt to contain ESBL organism may have some impact on decreasing the load of MDR organism. Conclusion: The burden of ESBL's among Enterobacteriacea uropathogens continues to pose a challenge in treatment. Carbapenems were a mainstay in treating these cases and either methods of ESBL detection may be conviently used. However attempts to minimize ESBL spread through hygiene, contact precautions, suitable antibiotic policy to include cheaper and more effective antimicrobials are the need of the hour.
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747. Systematic geochemical exploration of stream sediments for gold-bearing deposits in shurchah area (SE Zahedan)

     Mohammad G Kahrazeh, Hamidoddin Yousefi, Kulkarni U D

     • » Abstract Shurchah area is located 60 kilometers to the southeast of Zahedan. Zahedan granitoides and dioritic dykes have intruded in flysch sediments of Eocene age. After collating of factors such as stratigraphy, lithology, tectonics and topological gravity of drainage patterns, 82 stream sediment samples have been taken from streams. Samples were analyzed using ICP-MS and AAS analytical methods. For eight elements Au, Ag, Cu, Pb, Zn, As, Sb and Hg factors such as error, frequency distribution, amount of sensored, background, threshold, anomaly, mean, mode and standard deviation, calculated individually. Among these elements, Sb with an average value of 10 ppm has been considered as anomaly regarding the spatial situation of the anomaly; it was determined to be in the central part of the study area. In addition, strong positive correlation was observed between gold- arsenic and gold- antimony.
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748. Diabetes mellitus in pulmonary tuberculosis

     P S Gawali, Sudhir Tungikar

     • » Abstract Introduction: To study a) Prevalence of Diabetes Mellitus in Pulmonary tuberculosis. b) Radiological picture in Pulmonary Tuberculosis when it is associated with diabetes Mellitus. c) Co-relation between extent of Pulmonary Tuberculosis and severity of Diabetes Mellitus. Material and Methods: sputum positive pulmonary tuberculosis patients admitted in medical college hospital for about one year irrespective of age and sex constituted material for this study. All 100 sputum positive tuberculosis patients were screened for diabetes mellitus. Extent of tuberculosis was decided by national tuberculosis association of USA criteria which were also adopted by national tuberculosis association of India. Severity of diabetes was decided by criteria used by Deshmukh et al (1966) and Nanda and Tripathi (1984). Results: out of 100 tuberculous patient studied 17 patients were found to have diabetes mellitus. However 5 patients were already known to have diabetes mellitus Thus, Prevalence of diabetes mellitus in pulmonary tuberculosis was 12.6 % (12 out of 95). Prevalence in Male was 13.7% and in Females was 10 %. Prevalence below age of 40 was 9.3 % and it was 15.1% above the age of 40 years of T.B. patients. Amongst 17 diabetes patients 47% had far advanced tuberculous lesions. Of those 35.53% had cavitatory lesions. Bilateral involvement of lungs was found in 70.6%. Of these patients 29.7% had far advanced tuberculosis and severe diabetes. Conclusions: The prevalence of diabetes mellitus is significantly high i.e. 12.6% in this study. Radiological lesions in patients of pulmonary tuberculosis complicated diabetes mellitus are bilateral, cavitatory, confluent and far advanced. The association of advanced pulmonary tuberculosis and severe diabetes millitus is far more common then association of minimal lesion pulmonary tuberculosis and mild diabetes mellitus.
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749. Signal intensity features of intracranial lesions on diffusion weighted magnetic resonance imaging

     Richard Thomas, Ravi Hoisala

     • » Abstract Introduction: Diffusion weighted imaging is an essential sequence to be included in any ptotocol for magnetic resonance imaging of the brain and therefore it is essential to study the signal intensity features of intracranial lesions in this sequence. Aims: To describe the signal intensities of intracranial lesions on diffusion weighted imaging and to compare this with apparent diffusion coefficient maps. Methods and Materials: Images of 115 patients who underwent magnetic resonance imaging at our hospital from March 2010 to March 2011 were prospectively studied. The signal intensities of various lesions on diffusion weighted images, apparent diffusion coefficient maps were studied. Statistical analysis used: Percentages of individual intra and extra cranial lesions that showed diffusion restriction, increased diffusivity or isointense signal relative to gray matter were calculated. Results: All cases of acute infarcts, hypoxic ischemic injury, abscesses and extradural empyemas showed diffusion restriction. 50% of subacute infarcts, 33% of tuberculomas, 40% of GBM, 75% of medulloblastomas, 33% of meningiomas, single case of epidermoid cyst and 50% of lymphomas showed true restriction of diffusion. The remaining cases showed increased diffusivity or intermediate signal intensity. Conclusion: Intracranial lesions show a varied appearance on diffusion weighted imaging and this sequence is an important tool in establishing an accurate diagnosis.
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750. Accidental ingestion of mosquito repellent liquid vaporizer

     Bhavana Tiwari, Sushil Kumar

     • » Abstract Background: Accidental poisoning of mosquito repellent liquid vaporizer. Case Characteristics: A 3 yrs old male child accidently ingested liquid of mosquito repellent vaporizer. Observation: Child was immediately brought to emergency department of our hospital with urticarial rash all over the body. Outcome: Child was managed conservatively with antihistaminic injection and kept under observation for any respiratory or other complications. Message: Potentially poisonous things should be kept away from the children.
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751. Variation in the origin of lateral circumflex femoral artery

     Asharani S K, Vasantha Kuberappa, Divyalatha

     • » Abstract The lateral circumflex femoral artery arises from the lateral side of the profundafemoris artery, passes horizontally between the divisions of the femoral nerve and behind the Sartorius and rectus femoris, and divides into ascending, transverse and descending branches. During routine dissection of cadavers allotted for first MBBS students, variation in the origin of lateral circumflex femoral artery was observed unilaterally in an old aged female cadaver. In the present study, the lateral circumflex femoral artery was taking origin directly from the lateral side of femoral artery. The branches of lateral circumflex femoral artery are used in making anterolateral thigh flap for reconstruction of defects in face, aorto-popliteal bypass, coronary artery bypass grafting. As the femoral artery is the main artery of the lower limb and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical importance.
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752. Study of mental health status among medical post graduate aspirants

     Shrihari Bharsakle, T B Bhutada, Afshan Kausar

     • » Abstract Background: After completing graduation students has to prepare for post graduate entrance exam. The pursuit of higher medical education is expected to be stressful, which may be hazardous to physical and mental health status among these students. Objectives: To assess prevalence of psychological disorders (anxiety and depression) among post graduate aspirants and to determine if there is any gender difference. Materials and methods: General Health Questionnaire (GHQ-28), a self-administered instrument, rated on a four point Likert-type scale (0-1-2-3) giving a potential score of 0-84, participations with higher scores representing greater distress. Results: Among 300 students responded to questionnaire, 125 were females and 175 were males. 36.12 % (110) had psychological disorder among these 48% were females (60) and 28% were males (50). The gender difference was significant. Conclusion: In present study, there was high prevalence of psychological disorder among students preparing for post graduate entrance examination. Factors like exercise, sports and yoga should be encouraged to practice regularly for releasing stress and reducing depression.
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753. Lipid profile and homocysteine levels in patients with chronic periodontitis with and without cardiovascular disease

     Madhur M Gupta, Suresh N Chari, Abhay P Kolte

     • » Abstract Common risk factors such as smoking, diabetes, hyperlipidemia, aging and male gender place an individual at risk for both periodontitis as well as cardiovascular disease. A Case control study was carried out in 50 subjects with chronic periodontitis aged 30-65 years (group II) and age matched with 50 control subjects (group I) .Group III (n=30) patients included patients of periodontitis with cardiovascular disease (CVD) and group IV(n=40) included patients with cardiovascular disease. Blood samples collected was assessed for lipid profile and homocysteine levels. Total cholesterol, LDL-cholesterol, triglycerides and homocysteine are significantly increased (p<0.001) in periodontitis patients with and without CVD and patients with CVD when compared with normal healthy controls. Significant positive correlation was found when total cholesterol and triglycerides are compared with homocysteine in periodontitis with and without CVD and patients with CVD alone. Hence, homocysteine assessment is useful in predicting the future risk of cardiovascular disease in chronic periodontitis patients
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754. HIV and severe malaria: a case report

     Rashmi P Mahale, Sumana M N, Tejashree A, Usha H C, Eshwari R

     • » Abstract Introduction: We report a case of severe malaria with HIV infection. The patient had parasitemia with Plasmodium falciparum and the patient was also reactive to HIV. Patient presented with multiorgan dysfunction including renal impairment, altered liver functions along with altered sensorium.
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755. Computed tomography evaluation of acute pancreatitis, its complications and CT severity index

     Nitin Bhutada, Sunita Zanwar, Anup Wakodkar

     • » Abstract Aims and objectives: 1) Morphology of pancreas in various grades of Acute pancreatitis 2) Complications of pancreatitis like pseudocyst, abscess, phlegmon formation and vascular complications (pseudoaneurysm and venous thrombosis) etc. 3) Grading the severity of disease using CTSI and Modified CT severity index (CTSI) Materials and Methods: This prospective study of 100 patients suspected of pancreatitis will be evaluated with two slice spiral CT scanner, somatom, Siemens (Germany) at Tertiary care centre, from August 2012 to October 2013.The series consists of patients of pancreatitis which were clinically diagnosed and sent directly for CT examination and the patients in whom abdominal ultrasound examination was suggestive of pancreatitis. Helical CT is an effective modality for imaging the pancreas with faster scanning time and no respiratory misregistration. Pancreas if scanned during the peak parenchymal enhancement phase, helps in better morphological characterization of pancreas and detection of pancreatic necrosis. Helical CT effectively detects the different non vascular and vascular complication of pancreatitis. Grading of acute pancreatitis according to the severity of the disease in the form of Modified CTSI which will predict the clinical outcome of the disease could be done effectively with helical CT.
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756. Cost benefit analysis in closure versus non-closure of peritoneum in open appendicectomy

     Rakesh K Janna, Rakesh Rai

     • » Abstract Aims and Objectives: To assess the cost benefit ratio in non-closure of the peritoneum at open appendectomy as compared to suture peritonization. Materials and Methods: The study population comprised of 100 in-patients who underwent open appendicectomy in Father Muller Medical College, Mangalore selected by purposive sampling method. To treat the patients with minimal pain and in the cheapest way. Results: Mean for VAS for closure was 8, 5 and 3 on day 0, 1 and 2 respectively. And that for non-closure was 5,3 and 2 on day 0, 1 and 2 respectively. Conclusion: Non-closure of peritoneum was better than closure of peritoneum in open appendicectomy because of short duration of the procedure, less postoperative pain, less analgesic requirement and less number of days of hospital stay. Also the cost was less in non-closure overall.
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757. Acute ischemic stroke following viper bite

     Bindu C B, Suresh R M, Venkatesh

     • » Abstract Reporting a case of snake bite. Viper bites are important venomous snakes in srilanka and south India. We report a 55 year old male bitten by viper on right dorsum of foot later he developed severe pain and swelling at the site of bite and he was shifted to our hospital 6 hours after the bite. His leg was swollen, having severe pain and tenderness at bitten site, anxious with tachycardia tachypnea with normal neurological examination and other systems being normal. Blood investigation showed deranged coagulation which was corrected after giving 40 vials of antisnake venom. He developed right sided hemiperesis36 hours of bite even after giving antivenom treatment and his CT brain showed acute infarct in left frontal lobe (anterior division of MCA). His wound started healing by seventh day and his hemiparesis completely recovered by 6 weeks.
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758. Awareness of insulin and factors contributing to its avoidance in patients with type 2 diabetes mellitus

     Prashanth kumar P, Smitha Bhat, Steffi Sapeco

     • » Abstract Introduction: The incidence of Diabetes Mellitus is increasing rapidly. Patients of Type 2 Diabetes Mellitus can be managed with oral hypoglycaemic agents initially, however many require insulin therapy later in the course of the treatment due to secondary resistance to oral hypoglycaemic agents. Indian Diabetic patients tend to be wary about the use of insulin. This refusal to use insulin militates against achievement of ideal glycaemic control in conditions mandating insulin therapy. This study was aimed at determining the logistic and psychological factors contributing to the refusal or avoidance of insulin therapy and the initial barriers to the use of insulin as a treatment option for Diabetes management. Materials and Methods: This study was a Cross-Sectional Observational study involving 50 patients with Type 2 Diabetes Mellitus attending OPD and inpatients admitted to FMMCH. A Questionnaire was framed, prevalidated, piloted and the questionnaire was administered in the local language and the data collected was analysed. Results: From this study it was inferred that 88% diabetic patients were aware of insulin as a treatment modality for diabetes. It was found that 80% cases avoided insulin due to difficulty in administration and remembering dosage of insulin. It was found that 76% cases had inhibitions to initiate insulin injections in view of fear of pain and 60 % diabetic subjects were wary of insulin therapy fearing that once started, it would need to be continued lifelong. Conclusion: Exploring patient concerns and beliefs about insulin is crucial to assist physicians in counselling and motivating patients to take insulin.
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759. Comparative Study of Laparoscopic Versus Open Incisional Hernia Repair

     Brijesh A Panchal, Kirit D Parmar, Yogesh Modiya

     • » Abstract Introduction: Incisional hernia is a frequent complication of abdominal operations. The object of this study is to compare laparoscopic repair to open repair of incisional hernia regarding hospital stay and complications. Material and Methods: This study compares total 22 cases of incisional hernia repairs performed during December 2011 and May 2013, of which 10 were laparoscopic and 12 were open surgeries. Composite mesh (polypropylene, cellulose ORC) was used for laparoscopic intraperitoneal placement. Observations and Results: Both the groups were comparable regarding age. Mean operative time was 163.2 minutes for laparoscopic group (LG), 125.6 minutes for open group (OG). Mean hernia diameter was 6.1cm for laparoscopic group, 6.4cm for open group. Mean length of stay was 3.6 days for laparoscopic group, 7.33 days for open group. Mean follow up was 11.2 months for laparoscopic group, 12.1 months for open group. Complications occurred in 10% of laparoscopic and 41.66% open group. There was no recurrence and mortality in both groups. Conclusion: Results for laparoscopic incisional hernia repair seem to be superior to results for open repair in terms of shorter hospital stay, lower infection rate, earlier return to work and comparable recurrence rate and better cosmetic results.
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760. Management of swine flu epidemics

     Inayath Ali Badusha

     • » Abstract Swine flu was pandamic in 1918 and 1989-90 in the year 2009 the disease was wide spread throughout the world. All the governments are worried that they have to safe guard the population. there was travel restriction in the air and train-rail routes etc. at the airport and railway stations all the travellers were screened for symptoms of H1N1 by the specially trainne medical personnel. H1N1 was the cause of loss of many lives. During the 2009 epidemic the author has screened about 450 cases out of this 395 were positive for H1N1. he treated all the positive cases with the drug tamiflu and broad spectrum antibiotic when needed. He shares his experience for future guidance.
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761. Efficacy of allopurinol in decreasing proteinuria and hyperuricemia in Indian patients with type 2 diabetes: prospective, placebo controlled, randomized double blind study

     Meeta Amit Burande, Amit Burande, Anil Jain

     • » Abstract Introduction: Diabetic Nephropathy affects up to 30% of the population with ACE-I and ARB as mainstay of treatment but associated with side effect of hyperkalemia. Allopurinol has been studied to reduce the proteinuria in randomized double blind prospective trial for 1 month. Allopurinol has significantly reduced serum uric acid (P = 0.002) and urine protein (P = 0.0003) in study group as compare to control group.
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762. Study of vitamin D receptor polymorphisms (FokI, TaqI, ApaI) in acute lower respiratory infections among hospitalised Indian children

     Deepa Haldar, B C Kabi, Pankaj R Kamble, Manish Tripathi, J N Mohapatra

     • » Abstract Background: Acute Lower Respiratory Infections (ALRI) is the most common cause of global child mortality, with the incidence almost 10 times higher in developing countries in under-5 children. Many in vitro studies have shown the role of vitamin D in promoting and regulating immune response via binding to vitamin D receptor (VDR). In this study, we aimed to find the association between vitamin D receptor polymorphism and ALRI. Methods: Three vitamin D receptor (VDR) polymorphisms (FokI, TaqI, ApaI) were studied by the method of PCR-RFLP in 78 hospitalised cases of acute lower respiratory infections (ALRI) and were compared with 75 age and sex matched apparently healthy children below five years of age. Serum vitamin D levels were also measured. Results: TaqI tt genotype and independent t allele were found to confer a significant protection against ALRI. FokI and ApaI genotypes had no significant association with the risk of ALRI in our study population. Vitamin D levels were found to be significantly low in children suffering from ALRI. No statistically significant difference in vitamin D levels was found among the three genotypes in FokI, TaqI and ApaI polymorphisms. Conclusions: The present study demonstrates that presence of tt genotype confers a significant protection against ALRI of bacterial origin.
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763. Comparison of four malignancy risk indices in the preoperative evaluation of patients with adnexal masses

     Dhara, Sujaya V. Rao

     • » Abstract Background: Adnexal masses are the fourth most common gynaecological causes for hospitalization with differential diagnosis varying from benign masses to malignant tumors. As amount of tumor left after the primary cytoreductive surgery is one of the most important prognostic factors in ovarian cancers, preoperative determination of whether a mass is benign or malignant is very important for timely referral to a gynaecologic oncologist. Objectives: The aim of this study was to evaluate the ability of four malignancy risk indices (RMI 1, RMI 2, RMI 3 and RMI 4), incorporating menopausal status, serum CA125 levels, and ultrasound findings, to discriminate a benign from a malignant pelvic mass. Materials and Methods: This is a descriptive correlative study of 100 women admitted to Department of Obstetrics and Gynaecology, Father Muller Medical College, Mangalore, Karnataka, India from September 2012 to August 2013 for surgical exploration of pelvic masses. The sensitivity, specificity, and positive predictive value of serum CA 125 levels, ultrasound findings, and menopausal status were taken separately and combined into the RMI 1, RMI 2, RMI 3 and RMI 4 to diagnose ovarian cancer. The histopathological diagnosis was considered as the gold standard for defining the outcomes. Data was analysed using the Statistical Package for the Social Sciences, and Pearson’s Chi square test was used to compare the individual RMI scores between the benign and malignant cases. Results: In this study we found that there is no statistically significant difference in the performance of the four different RMIs in discriminating malignancy. Individual variables that were analysed showed significant differences in ultrasound score of ≥2 and mean serum CA-125 level (p <0.001and p = 0.001, respectively) between the benign and malignant cases. Conclusions: We concluded that the risk of malignancy index is able to identify malignant and benign pelvic masses efficiently to optimize therapy and any of the four malignancy risk indices described can be used for selection of cases for optimal therapy. These methods are simple techniques that can be used even in less-specialized gynaecology clinics to facilitate the selection of cases for referral to an oncological unit.
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764. Bacteriological profile and antibiotic susceptibility pattern of neonatal sepsis at tertiary care hospital in Sangli district of Maharashtra, INDIA: a descriptive study

     Haseeb M, Khan S T, Shoeb Khan, Wagh S S, Khaled Badaam

     • » Abstract Neonatal sepsis remains a significant cause of morbidity and mortality in newborns, more so in developing countries like India due to delivery and post natal care taking place in an unclean environment having more chances of contamination with infective organisms. For the effective treatment of sepsis it is essential to have periodic review regarding the causative organisms and its susceptibility to available antibiotics. Present study was undertaken to describe the bacteriological profile and antibiotic susceptibility pattern of culture isolates from Neonatal sepsis patients at a tertiary care centre in Sangli district of Maharashtra, India. Study was carried over a period of one year at the Department of Paediatrics of PVPGH Sangli and Govt Medical College, Miraj. One hundred and five neonates (0 to 28 days) with clinical diagnosis of sepsis were included in the study. Patients who underwent surgery and those who were older than 28 days were excluded. Blood culture reports were studied in 105 cases of clinically suspected septicaemia in neonates using the standard technique of Mackie and McCartney. The antibiotic sensitivity was performed by Kirby-Bauer's disc diffusion method. Blood culture was positive in 19 cases (18.09%). Klebsiella pneumoniae and staphylococcus aureus were the most common isolated organisms. Resistance to antibiotics was very common in isolated organisms. Gram positive organisms isolated were found to be sensitive to ciprofloxacin, amikacin, chloramphenicol and gram negative organisms were found to be sensitive to vancomycin.
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765. Status of serum nitrate levels in type II diabetic patients with hypertension

     Zaheera Sultana S, Lakshmi T, Abdul Shabeer, Mohammed Zaheer Pasha

     • » Abstract Background and objectives: Diabetes mellitus is a long term disease with variable clinical manifestation and progression. The prevalence of diabetes mellitus in India was found to be 2.4 % in rural and 4 - 11.6 % in urban. It leads to number of complications like cardiovascular, renal, neurological, ocular and others such as intercurrent infections. Therefore understanding the pathophysiology of hypertension and diabetes is important.Hence this study is taken up to estimate Serum Nitrate levels in Type II Diabetic Patients with Hypertension compared with healthy individuals. Methodology: The present study was conducted in the Department of Physiology, Al-Ameen Medical College, Bijapur and District Hospital, Bijapur. Thirty five Type II Diabetic Patients with Hypertension (35) between 35 to 65 yrs age and Thirty nine (39) healthy individuals, controls between 38 yrs to 65 yrs age visiting Al-Ameen Medical College Hospital, Bijapur and District Hospital Bijapur were selected. Serum Nitrate was estimated by GRIESS METHOD. Statistical analysis was done by ANOVA and unpaired t test. Results: Statistically significant variations were found in parameters like age, Ht, Wt, BSA, BMI, PR, SBP, DBP, Serum Nitrate levels in controls and Primary Hypertension patients. Interpretation and conclusion: In the present study the mean ± SEM of Serum Nitrate in controls was found to be 49.93 ± 1.01 μ mol / lt, and Type II Diabetic patients with Hypertension was 29.36 ± 1.29 μ mol / lt. It was found Serum Nitrate levels of Type II Diabetic patients with Hypertension was lower when compared with the controls, these difference were found to be statistically significant (t =15.324, p= 0.0000). Mechanism which can reduce NO levels in Diabetic patients with Hypertension are decreased eNOS activity and thus reduces the bioavailability of NO and also increased oxidative stress. ADMA is an endogenous inhibitor of eNOS thus elevated ADMA will further decrease the bioavailability of NO. Elevated CRP has been reported to decrease the stability of mRNA for eNOS, thus further reducing the synthesis of NO.
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766. A study comparing non-closure and closure of visceral and parietal peritonium during caesarean section

     Supriya Waydande, Vidya Jdhav, U T Bhosle

     • » Abstract Objectives: To find out the short term morbidity of non-closure of the visceral and parietal peritonium during caesarean section compared to suturing of visceral and parietal peritonium. Method: A prospective study of two hundred women undergoing caesarean section was done. Perioperative, intraoperative and postoperative details were observed. Results: Operating time, anaesthesia time and time of ambulation were significantly shorter in non-closure group. There was less postoperative pain, analgesic requirement and febrile requirement in non-closure group. However, it was not statistically significant. Conclusion:Non-closing the visceral and parietal peritonium at caesarean is associated with lesser operating time, decreased febrial morbitity and lesser need for postoperative analgesic. Hence, routine closure of peritoneum at caesarean can be avoided.
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767. A study of visual field changes for diagnosis of glaucoma on humphreys perimetry

     Abhijeet Dhavale, Nitin Akhade

     • » Abstract Aim: To study visual field changes in patients with raised intraocular pressure and optic disc changes suspicious of glaucoma. Methodology: This was a cross sectional studies of 100 patients with disc changes suspicious of glaucoma or IOP≥21 mm Hg were included. Patients of both sexes and all age groups were included. Anterior chamber angle was examined with Goldmann 3 mirror gonioscopic lens. IOP was measured with applanation tonometer. Fundus examination was performed to document the degree of optic disc cupping. Results: The prevalence of visual field defects in the present study was 36%. 36 patients showed glaucomatous field defects. Mean age of patients with field defect was 48 years ± 10.6. Majority of patients with field defects were above 50 years of age, only 20% of patients had a positive family history of POAG .The mean IOP of 51 eyes with visual field defects was found to be 28.02 ± 7.65 mm Hg.50% of patients with asymmetrical C:D ratio ≥ 0.2 had visual field defects. Conclusions: Glaucoma suspects patients with F/H/O glaucoma, IOP ≥ 21 mm Hg, C:D> 0.5 & a symmetrical cupping are more prone for glaucoma& also constitute an important group that would benefit from energetic screening for glaucoma by Visual field analysis.
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768. Thyroid carcinomas and associated benign lesions- a hospital base study

     Namita Hegde Katte, Umashankar T, Amanda Christina Pinto, Archana Bhat, Subhan Ali R

     • » Abstract Introduction: Thyroid cancers are fairly uncommon neoplasms, the annual incidence of which ranges from 0.5 to 10 cases per 1,000,000 population. The commonest thyroid malignant tumours are those of papillary carcinoma and follicular carcinoma followed by medullary, malignant and undifferentiated carcinoma. Aims/ Objectives: To determine the most common malignancy encountered and to identify the most common associated benign lesion. Materials and Methods: Fifty histopathologically diagnosed cases of thyroid malignancies were analysed retrospectively for the associated benign condition. A statistical analysis was done to determine the common association and the common malignancy encountered. Observation/ Results: of the fifty cases studied, 45 cases were papillary carcinoma, 4 cases follicular carcinoma and one case of medullary carcinoma. Among the 45 cases of papillary carcinoma 12 of them were papillary microcarcinoma. While thirty five cases of papillary carcinoma were associated with multi-nodulargoiter, 9 cases were associated with Hashimoto’s thyroiditis and in one case the rest of the thyroid was normal. Among the 4 cases of follicular carcinoma 3 were associated with multi-nodular goitre and one with Hashimoto’s thyroiditis. Medullary carcinoma was associated with Hashimoto’s thyroiditis. Conclusion: Since most of the thyroid malignancies in our study were associated with multi-nodulargoiter and, as a significant number of cases were papillary microcarcinomas a vigilant sectioning of the specimen is to be done to identify the presence of neoplastic foci grossly. The findings of the study also warrants for a follow up of the patients who have under gone hemithyroidectomy for nodular goiter, as most of thyroid malignancies have indolent clinical course.
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