Detection of Candida albicans in the screening of cervical cancer in rural population of Lucknow

Background Study of Candidal infection is very essential in rural women who being illiterate and financially weak are not aware of personal genital hygiene and thus harbour persistent vaginal infections due to poor availability of medical amenities. Method Rural cervical cancer screening is in progress in the western region of Lucknow, India since May 2013 through camp approach and till date, a total of 2949 women have been cytologically examined. Candidal infection has been observed in the 143 cervical smears of women and findings have been analyzed in relation to the different predisposing factor of cervical carcinogenesis. Result The incidence of Candida albicans seen in cervical smears of the total 2949 women examined was found to be 4.8% which is much higher than in their urban counterparts (1.2%). The Candida was seen more in the inflammatory smears (9.4%) and those showing squamous intraepithelial lesions of cervix (SIL). – (8.2%). The fungus was found more prevalent in the reproductive age group and women complaining of vaginal discharge and was result of persistent vaginal infections in the rural women which should be treated. The Candida was commonly seen in erosion cervix cases but its incidence was high in women with cervicitis and cervix bleeds on touch. Conclusions This persistent vaginal infections were seen in the illiterate and poor rural women who are not aware of personal genital hygiene. There is a need to create awareness for personal genital hygiene through health workers for making any cancer screening program meaningful and successful.

RELATIONSHIP OF PELVIC ALIGNMENT WITH BALANCE AND GAIT IN PATIENTS WITH STROKE: A SYSTEMATIC REVIEW

Background- Pelvis is the key structure that connects the spine and the lower limbs. Altered Pelvic Alignment and asymmetrical weight bearing on affected lower limbs is a common problem leading to pelvic instability which may have an effect on balance and gait in patients with stroke. Hence, it was aimed to investigate the interdependence of these three components in patients with stroke. Methods- Four databases (PubMed, Google Scholar, Cochrane, Science Direct) were searched to identify eligible studies using the keywords Pelvic Alignment, Gait, Balance, Stroke. Only observational studies published in last 10 years (2010-2020) were included in this review. Results- Thirteen studies were included in the review conducted on sub-acute and chronic stage. All studies investigated the affection of pelvic mal-alignment, balance and gait in combination of two variables except 3 studies which investigated the combined effect of pelvic inclination on both balance and gait. The abnormal pelvic tilt results in lateral displacement of the pelvis on affected side, altered Base of Support, reduced balance control, asymmetry in weight bearing leading to altered gait. Conclusion- Pelvic tilt, anterior and lateral has a significant impact on static balance, gait variables, weight bearing symmetry.

HYPOMAGNESAEMIA AND HYPOCALCAEMIA THE MAJOR MISSED OUT CLINICAL CONDITION IN THE MANAGEMENT OF DIABETES

Magnesium (Mg) and Calcium (Ca) is one of the essential factors for the insulin to get released from the pancreatic cell. To evaluate the relation of hypomagnesemia and hypocalcaemia in the glycaemic control and to analyse the importance of both Mg and Ca in the insulin secretion mechanism. The study was conducted in the laboratory department, Billroth hospitals. A total of 239 individuals were selected for this study, HbA1c level, serum magnesium and calcium were assessed for all the individuals and in addition to this serum electrolytes were also checked. Out of 239 individuals, 79 were found out as uncontrolled diabetic by calculating HbA1c as a gold standard, males are higher in ratio compared to female. By studying serum magnesium and calcium level, hypocalcaemia is present in more individuals and females (31%) are much prone to both than males (20%). The different correlation was also analysed for hypomagnesemia and hypocalcaemia. The electrolytes like sodium (Na) and potassium (K) was analysed, females are highly affected by electrolyte imbalance but in hypomagnesemia diabetic individuals the males are high in electrolyte imbalance. Since Mg and Ca plays a vital role in insulin synthesis, secretion, repair, and the alteration, along with the hypoglycaemic agents the supplementation of magnesium or calcium could be suggested via, dietary or drug supplements. In addition to this, regular monitoring of electrolytes is essential to maintain fluid balance.

Body composition in coronary artery disease in KONKAN region of India-Is non- obesity an indicator of Coronary Artery Disease?

Background India is witnessing a rising prevalence of non communicable diseases like diabetes, hypertension, coronary artery disease. This is attributed to rapid nutrition and lifestyle transition taking place since last 2 decades. Obesity is a well known independent risk factor but very little information is available about role of leanness (low BMI). We investigated whether non-obesity could be an independent risk factor for Coronary artery disease in a rural clinic in KONKAN. Methods In a cross sectional study we studied body composition of 300 patients (207 men) who underwent Coronary angiography in a rural hospital in KONKAN region. History of diabetes, hypertension and history smoking, tobacco chewing was recorded. Body composition was estimated using bio-impedance analyser. Based on results of coronary angiography, we generated a SYNTAX score derived by number of vessels involved and classified them into groups of severity of coronary artery disease (CAD). Results There were 95 (31 %) diabetes and 189 (63%) hypertensive patients in the sample and 60% of them smoked or chewed tobacco. There were 43 (28 males) patients with SYNTAX score of zero. Among those with coronary artery disease (n=257) increasing severity of CAD was associated with lower body weight, BMI, body fat percentage, and body fat mass and ejection fraction as against positive trend for lean mass and visceral fat. Conclusion BMI, fat mass decreased with severity of CAD while lean mass and visceral fat increased. We observed high proportion of CAD in underweight and lean KONKAN adults. These findings need further investigations

Comparative study of Negative Pressure Wound therapy Vs. Local antibiotic cream dressings in acute hand burns second-degree superficial to deep

Background: The hand is one of the most common parts of the body involved in burns, i.e., 80%. Even minor burns in the hand may result in severe limitations of function. Early initiation of physiotherapy, topical antibiotic cream treatment, collagen application, splintage, passive exercise for second-degree superficial burns. Materials and methods: A prospective comparative study was conducted in 10 patients with acute hand burns due to thermal burns (scald, flame). All patients with second-degree superficial to intermediate thickness burns were given Negative pressure wound therapy (indigenous NPWT Kit) to one hand and local antibiotic cream to the other hand or other parts of the body to study clinical profile and outcome. Results: A total of 10 patients were studied. The majority of patients were in 19 to 30 years of age group 6 patients (60%), five females, and one male. Pediatric patients account for 4 patients (40%), two female and two male children. Incidence of burns in females 70% and males’ group 30%. Significant reduction in postburn edema in NPWT hand compared to topical antibiotic cream dressing. Healing is fast in NPWT applied hand/part. Conclusion: Negative Pressure Wound Therapy for Acute second-degree superficial burns showed promising results in wound healing and reduced post-burn edema burn in hand in our study.

Pattern of Acute Organophosphorus Poisoning at a Tertiary Care Hospital of Western Maharashtra

Background: Every year, 3 million cases of pesticide, mainly O.P. poisoning, occurs all over the world. Therefore, statistics regarding O.P. poisoning in a specific region will aid in the early diagnosis and treatment of cases. The main objective of this research project is to find out the pattern of O.P. poisoning cases at the tertiary care center. Methods: We conducted a retrospective cross-sectional study, in which we analyzed data from 40 cases of O.P. poisoning, including patient information regarding gender, age, time of ingestion, type of poison, mode of poisoning, any first aid received, treatment given, duration of hospital stay and outcome of the treatment. Results: There were 16 females (40%) and 24 males (60%). The most common age group was 21 to 40 years, with 19 participants (47.50%). The majority of the participants were from the rural area, 38 cases (95%), while in 36 cases, the poisoning was suicidal (90%). 28 participants (70%) received some form of first aid. In addition, 21 of the participants received Atropine (52.50%), 13 received only gastric lavage (32.50%), 5 received both Atropine and Pralidoxime (12.50%), while one patient only received Pralidoxime (2.5%) as treatment. I.C.U. admission was required in 39 participants (97.50%), and ventilatory support was required in 2 participants (5%). Our study observed 4 deaths (10%) amongst our participants. The multivariate analysis of deaths in our study showed that specifically not receiving any first aid (p = 0.039) and requirement of the ventilator (p<0.001) were seen to have a significant association with deaths in our study. Conclusion: O.P. poisoning is the commonest cause of suicidal deaths in developing countries. Creating awareness regarding O.P. poisoning and legislative action on using hazardous poisons will help reduce the deaths.

Myoinositol with Metformin and Myoinositol alone in infertile PCOS women undergoing ovulation induction cycles: A comparative study

Background: This was a prospective observational study conducted over a twelve-month duration in our institute to compare the combined effect of metformin and myoinositol with metformin alone. Method: A total of sixty patients were included in the study, and they were divided into two groups depending on whether they were given the combination or the single drug. Group A (n=30) was given Myoinositol 600 mg+Metformin 500 mg thrice a day, and Group B ( n=30) was given only Myoinositol 600 mg thrice a day. The outcome measure was clinical pregnancy rate and improvement in clinical and hormonal parameters after drug therapy. Results: BMI (p<0.01), modified Ferriman Gallaway score (p>0.05), and the was a significant improvement in the hormonal parameters (LH,FSH) in both the groups and the levels were found to be comparable after a period of 6 months. The clinical pregnancy rate after six cycles of ovulation was significantly higher in Group A as compared to Group B. In Group A, the total clinical pregnancy rate was 43.33%, and in Group B, it was 26.67%, respectively, and the end of 6 months and the difference was statistically significant (p = <0.01) Conclusion: Equal response in reduction of hormonal levels and clinical and laboratory parameters were seen in both groups, while better results in terms of clinical fertility rates were observed in the group that was given a combination of myoinositol with metformin.

Comparison of electromyographic activity of quadriceps muscle in persons with unilateral traumatic transtibial amputation using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected limb in weight bearing positions.

Purpose: comparison of electromyographic activity of quadriceps muscle in persons with unilateral traumatic transtibial amputation using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected limb in weight bearing positions. Method: 30 individuals aged 18-60 years were assessed using surface electromyography with functional level K3 according to K-level functional assessment scale to compare the activity of quadriceps of affected side using patellar tendon bearing supracondylar endoskeletal prosthesis with the unaffected side. The data was analysed using paired t-test. Result: There was a significant difference in the activity of VMO and VLO muscles of the quadriceps in high sitting positions. There was also a significant difference in the activity of VMO muscle in single limb stance and bipedal stance. However, there was no significant difference between the activity of VLO muscle in bipedal stance but there was reduced activity of VLO muscle in the prosthetic limb in single limb stance. Conclusion: The quadriceps activity was reduced in the affected limb in high sitting position, single limb stance and bipedal stance. However, no difference in the muscle activity was noted in VLO muscle in bipedal stance. Keywords: trans tibial amputation, patellar tendon bearing supracondylar prosthetis, surface electromyography.

Evaluation of Phenotypic Variations in the Antibiotics Sensitivity of Escherichia Coli by Repeated Exposure

Enterobacteriaceae, in particular Escherichia coli, are habitual residents of the gastrointestinal tract, capable of causing a large number of infections. The MIC varies according to the bacterial strains and the antibiotics used, hence the need to carry out antibiotic sensitivity tests. The objective of this study is to evaluate the behavior of Escherichia coli after repeated exposure to the same antibiotic to demonstrate a possible correlation between excessive intake of antibiotics and bacterial resistance. A prospective and descriptive study was carried out in the Laboratory of Microbiology of Fundamental and Applied Biochemistry (Faculty of Sciences Antananarivo) during the month of November 2019. The strains studied were the reference strain Escherichia coli ATCC 25922 provided by the Laboratory and two clinical strains from the Microbiology Laboratory of the Joseph Ravoahangy Andrianavalona University Hospital Center (CHU JRA) Antananarivo. Repeated exposure to Tobramycin and Ofloxacin of these strains were performed. The results of our study showed that most E. coli is exposed to the antibiotic, the more it develops resistance. The evolution of E. coli's sensitivity is different in the presence of Tobramycin with MICs up to 4 times the starting value while in the presence of Ofloxacin, the MIC increases to 125 times the initial value. This difference may be due to the different target of the antibiotic which causes the bacteria to develop variable mechanisms to escape it. Key words: E. coli - MIC - antibiotics - repeated exposure

A cross-sectional study about socio-demographic factors and clinical characteristics of male patients with alcohol dependence syndrome

Background: Alcohol abuse is one of the major causes of death and disability globally; and a key risk factor for health, social, and economic problems in the communities. Consumption of alcohol by Indians has increased drastically due to various factors and in an unrestricted manner; and the age of initiation of drinking is progressively coming down. Objective: To determine the socio-demographic and clinical profile of the patients coming for treatment of alcohol dependence syndrome in the psychiatry department. Methods: A cross-sectional study was conducted on 50 male outpatients of alcohol dependence syndrome attending the department of psychiatry at a tertiary care hospital. Sociodemographic data and clinical details were recorded with the help of a pre-designed questionnaire. Results: Nuclear family, family history of alcoholism, unmarried status, higher educational level, unemployment, and peer pressure are the factors significantly associated with early age at first drink and age of dependence on alcohol (p < 0.05). Conclusion: Adolescents having a family history of alcoholism are a high-risk group for developing alcohol dependence and should be targeted for intervention strategies. Community based-longitudinal studies are needed to understand multiple factors influencing alcohol use and recommend targeted preventive measures. Keywords: Alcohol, Alcohol dependence syndrome, Peer pressure, Intoxication, Socio-demographic factors