International Archives of BioMedical and Clinical Research
International Archives of Biomedical and Clinical Research (IABCR) is an open access, international, peer-reviewed, quarterly multidisciplinary medical research journal that focuses on communicating high quality research articles, reviews, Short communications, case reports, Letter to Editor, Drug News and updates in the field of Medical, Dental and other allied health and BioMedical Sciences. The Journal publishes 4-four issues in a year. Connecting Researchers Globally IABCR offer Researchers, Academicians a better option when it comes to Open Access Journal publishing. Our platform vies to become the standard for all open access publications, irrespective of subjects or branches and aims to bring together researchers from all over the world and under a single global organization to form a community that actively creates new data and shares it with everyone with the utmost ease and simplicity. Ethical guidelines for journal publication The Editor-in-Chief/Editor of International Archives of BioMedical and Clinical Research (IABCR) is responsible for determining which of the research papers/articles submitted to the journal should be printed. The publication decision is based on the recommendation of the journal's reviewers. The Editor-in-Chief /Editor may be maneuvered by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief/Editor may consult with other editors or reviewers in getting to this determination.
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Prevalence of Hepatitis B and Hepatitis C Virus Infection in Patients with Advanced Renal Failure: A Tertiary Care Centre Study from North Indian Population
Background: Viral hepatitis (Hepatitis B Virus (HBV) & Hepatitis C Virus (HCV)) related liver disease is a leading cause of morbidity and mortality especially in the patients with advanced renal failure who are treated with dialysis, and this is due to high number of blood transfusion sessions and/or cross contamination from the dialysis circuits. Aims & Objectives: This study aimed to determine the prevalence of HB and HCV infections in patients with advanced renal failure (ARF). Materials & Methods: A cross-sectional study was done in collaboration with the department of Nephrology and department of Gastro-enterology, KGMU, Lucknow, from June 2018 to June 2020 among, CRF patients. Clinical data such as age, gender, duration of dialysis; number of transfusions, Serum sample was collected from each patient. Serological markers for HBV and HCV were determined with ELISA by using commercial diagnostic kits. HCV-RNA and HBV-DNA were determined quantitatively by polymerase chain reaction (PCR) assay. Results: A total 934 patients with advanced renal failure attended the nephrology OPD. Out of 934 patients, 65 (6.96%) patients screened positive for HBV/HCV infection. The results of this study also showed that the prevalence of viral hepatitis infection in the haemodialysis (HD) and without HD patients is 8.25% and 6.3% respectively. Conclusion: It has been found that viral infections, particularly HBV and HCV infections are common in advanced renal failure patients who are on HD.
Hepatitis B, Hepatitis C, Non-Fatty liver disease
Copyright (c) 2025 R. S Sehgal, Pradeep Kumar Choudhary (Author) https://creativecommons.org/licenses/by-nc/4.0
Prevalence of Metabolic Syndrome in Infertile Women
Background: Prevalence of Metabolic syndrome is increasing rapidly among the infertile women over the last few years. Objective: to evaluate the prevalence of metabolic syndrome (MBS) among the infertile women. Methods: A prospective cross-sectional study was conducted of all infertile women in a tertiary care centre in southern India. These women underwent screening for MBS according to the modified AHA/NHLBI (ATP III 2005) definition. These women were categorized as PCOS and Non-PCOS based on Rotterdam criteria (2003). Results: Among 1030 infertile women. The prevalence of MBS among the infertile women was 35.3% and among PCOS and Non PCOS women were 44.7% and 28.9% respectively. Conclusions: The prevalence of MBS among infertile women was 35.3%. Itis showing an upward trend among infertile PCOS and Non PCOS women. So early screening for MBS can reduce the long term sequale.
Copyright (c) 2024 RS Sehgal, Pradeep Kumar Choudhary (Author) https://creativecommons.org/licenses/by-nc/4.0
State of oxidative stress: Lethal phenomenon for heart and vessels
Hyperglycemia, hypertension, and hyperlipidemia are known as metabolic syndrome. In presence of high levels of blood LDL particles, free radicals (ROS), macrophages, cytokines, platelets, histamine, 5HT get involved in LDL oxidation, leading to formation of atherosclerotic plaques which get deposited in endothelium of coronary arteries causing coronary artery disease (CAD). Psyllium fibers and Ficus Carica (FC) are being considered to be useful in treating hyperlipidemia, hypertension, and hyperglycemia. This study was conducted to determine hypotensive, hypolipidemic, and hypoglycemic potential of Psyllium husk and FC. Study was conducted in National hospital, Lahore, Pakistan from January to April 2020. Seventy five hyperlipidemic, hypertensive and diabetic patients were enrolled selected from the hospital with their consent. They were divided in three groups ie 25 patients in each group. Group-1 was on placebo, group-2 was on 15 grams psyllium husk to be used in three divided doses. Group-3 was on 12 grams FC to be taken in three divided doses daily for two months. Their Lipid profile, FBS, and hypertension were determined before and after two months therapy by these two agents. Two analyze data we used SPSS version 10.01.001 2015 and t test was applied to determine changes in the tested parameters. In two months therapy by psyllium husk in 24 patients TG, TC, LDL-c was reduced 21.48, 10.09, 24.17 mg/dl respectively. HDL was increased 12.38 mg/dl in this group. FBS reduction was 28.66 mg/dl, systolic BP 6.30, and diastolic BP reduced in this group 7.52 mm of mg. We then concluded that FC and PH have good enough potential to normalize lipid profile, reduce BP, and FBS in patients suffering from metabolic syndrome.
Hyperglycemia, hypertension, and hyperlipidemia
Copyright (c) 2025 Zafar H Tanveer, Sajida Zafar, Ali Abuzar Raza, Rabia Zafar, Jamil Ahmed Lakhair, Shah Murad, Shaheena, Ajaz Fatima (Author) https://creativecommons.org/licenses/by-nc/4.0
Neurological Manifestations of Covid-19: A Comprehensive Review
The COVID-19 pandemic causing virus, SARS-CoV-2 emerged in the year 2019 from China. Since then, it has inflicted millions of people globally. Common presentations include cough, fever, body ache, fatigue, and shortness of breath, whereas few people might not develop any symptom. The main target of this virus is respiratory system; precisely it attacks the ACE-2 receptors of alveolar cells of lungs. ACE-2 receptors are also found in heart, gastrointestinal tract, kidneys, testis, and brain; hence involvement of these organs is also seen with this disease. An emerging discovery of invasion of nervous system by this virus has impelled researchers to investigate and understand the neurological mechanisms and features of COVID-19. The virus can affect Central as well as Peripheral Nervous System. Peripheral nervous system implications are not critical and include hypersomnia, ageusia, Guillain barre syndrome, paresthesia, skeletal muscle injury and cranial nerve involvement, whereas in central nervous system, dizziness, headache, acute cerebrovascular disease, altered level of consciousness, transverse myelitis, acute hemorrhagic necrotizing encephalopathy, encephalopathy, encephalitis, epilepsy and ataxia can develop. Neurological manifestations are particularly seen with severely ill COVID patients. In this article, we present a comprehensive review of prevalence of various CNS and PNS symptoms in COVID-19, risk factors, investigations, management, and prognosis related to these. This will aid the physicians and neurologists in better understanding the course of this illness and the current statistics of neurological presentations, crucial for handling the disease.
Neurological complications, SARS-Cov-2, Neurological signs, Neurological symptoms, Covid-19, Novel Coronavirus.
Copyright (c) 2025 Naseem Ahmad, Lahiba Rasheed, Rabia Rasool, Amna Imran, Maria Noor (Author) https://creativecommons.org/licenses/by-nc/4.0
Outcome of short segment pedicular instrumentation with intermediate screw and fusion in thoracolumbar fracture
Study design: In this prospective randomized study, The results of Treating Unstable thoracolumbar burst fracture by pedicle instrumentation with fracture level screw combination were given. Objective: To evaluate the effectiveness of short-segment pedicle fixation with intermediate screws. Methods: A prospective study was done of 30 patients with thoracolumbar Fractures who were treated with posterior short segment pedicular fixation with intermediate screw fixation. Anterior vertebral body height compression percentage (AVBCP), regional kyphosis angle and local kyphosis were measured and analysed preoperatively, post-operatively, and at last follow-up period. Neurological findings (Frenkel classification) and pain score (Denis pain score) were evaluated at serial follow up. All patients were followed up for a minimum of 6 months. Results: No patients exhibited an increase in neurological deficit. A statistically significant difference existed between the patient’s preoperative, postoperative and follow up anterior body compression, vertebral kyphosis and regional kyphosis. The mean immediate post-operative Corrections of AVBCP, vertebral kyphosis and Regional kyphosis was 42 %, 11.43º±1.06º and 12.01º±0.87º, respectively. The mean losses of correction at follow-up period were 0% , 1.5°and 1º for AVBCP , vertebral kyphosis, and regional kyphosis respectively. At the last follow-up, there was no significant loss of correction of kyphosis, whereas loss of correction of AVBCP was not significant . The final parameters at the latest follow-up period compared to the preoperative value were significantly improved (p<.001). There were 2 cases of screw loosening which did not progress to angulation. Conclusions: Although long-term follow–up evaluation needs to be verified, the short-term follow-up results suggest a favourable outcome for short-segment pedicular fixation with intermediate screws is safe and effective in the surgical treatment of thoracolumbar and fractures who were co-operative with 3 -4 months bracing. It provides significant correction of Vertebral body height, vertebral kyphosis, and regional kyphosis angle
pedicle, screw instrumentation Thoracolumbar fracture, Intermediate screw, short segment fixation
Copyright (c) 2021 Deepak Kr Tanwar , Brejesh Prasad, Vishesh Verma , Varun Garg, Abhishek Kashyap (Author) https://creativecommons.org/licenses/by-nc/4.0
Comparison of computed tomography and magnetic resonance imaging based target delineation in radiotherapy planning of central nervous system tumors ( High grade gliomas).
Aim of study : The study was designed to assess and analyze the difference in tumor volumes depicted on computed tomography (CT) and magnetic resonance (MRI) and their effect on the treatment planning. Materials and methods: twenty -five patients with high grade glioma who had underwent surgical resection and reffered for radiation treatment were taken in the study. CT and MRI imaging were done for all the patients with 1.25 mm thickness. the CT and MRI tumor volumes were delineated and comparision was done between them. Results: The mean and median of GTV on CT scan were 70.82 and 65.65 respectively. The mean and median of GTV on MRI were 91.11 and 76.54 respectively. A linear relationship between CT and MRI volumes with correaltion coefficient of r=0.93 and MRI shows 1.19 times more volume when comparedwith CT volumes. Conclusion : The study shows that MRI is an important modality to delineate the brain tumor to avoid the geographical miss and under dosage of the tumor. key words: high grade glioma, computed tomography, magnetic resonance imaging.
Copyright (c) 2025 karuna singh, NIHARIKA MITTAL, pardeep sharma, sheetal sachdeva (Author) https://creativecommons.org/licenses/by-nc/4.0
Clinical Significance of Microbial Flora in Middle Ear Infections and its Implications
Background: In pre-antibiotic era, complications related with CSOM were frequent, but, the antibiotics is important to clinicians as a tool to be used even without the specific etiological diagnosis. However, if the antibiotics used wide in range so it leads to the emergence of multi-drug resistant bacterial strains and complication of disease. In the last decade, variations in microbial flora in middle ear infection have been confirmed by many researchers. Methods: This study was carried out in 110 cases who had middle ear infection. This study was conducted in the Department of Microbiology and Otolaryngology, Government Medical College, Shahdol. This study duration was six month. Results: We found that from the 53.6% cases had infection with Gram positive bacteria followed by gram negative bacteria. Conclusions: This is suggested that ear infection should be treated when the causative agents as well as the drug sensitivity patterns are known and properly administered.
Microorganism, CSOM, Antibiotic susceptibility test
Copyright (c) 2025 Abhishek Gaur, Md. Izhar Khan (Author) https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of Vitamin D level in Patients who had Sleeve Gasterectomy Surgery for Morbid Obesity; Retrospective Clinical study
Background: Obesity is associated with various comorbidities in addition to increased mortality. Indeed, a modest 3-5% weight loss results in an improvement in various health outcomes. Various treatment options are currently available for weight management, including surgical and non-surgical approaches. Weight loss varies widely between interventions and is highest following bariatric surgery. Body mass index, and particularly fat mass, is a known determinant of Vitamin D deficiency is common in individuals with obesity. Such a deficiency is multifactorial. Low vitamin intake and supplements, poor dietary habits and low sun exposure are important risk factors. In addition, changes in the activity and expression of enzymatic pathways involved in vitamin D metabolism have been observed, including a decrease in the expression of hydroxylation enzymes, namely 25-hydroxylase and 1α-hydroxylase in adipose tissue, and a decrease in hepatic 25-hydroxylation. The aim of this study is to evaluate the relationship between vitamin D level and weight loss in patients after Laparoscopic sleeve gastrectomy, a Bariatric Surgery. Methods: The files of all patients who had bariatric surgery between January 2017 and January 2021 were reviewed. All patients who underwent sleeve gastrectomy were retrospectively evaluated for weight loss and Vitamin D levels in the specified time period. We see very good results in 6 months, maximum excess weight loss in one year, lower weight loss between one year and three years. Results: Eighty-five patients who managed to be evaluated for weight loss at 6 months, 1 year, and 3 years after surgery during the analyzed period were included in the study. Of 85 patients, 65 (77%) were female, 20 (23%) were male, and the mean age was 43 (27-51 years). The mean preoperative BMI was 46.7 kg/m2 (range 44.6-57.4). Conclusion: Despite the increase in vitamin D levels due to weight loss in the early period in patients who have undergone bariatric surgery, patients need vitamin D support after a certain period of time. The effect of this vitamin D supplement on weight loss is not clearly understood. Double-blind randomized clinical studies are needed to obtain clearer results.
Sleeve gastrectomy, vitamin D level, obesity
Copyright (c) 2024 International Archives of BioMedical and Clinical Research https://creativecommons.org/licenses/by-nc/4.0
Prevalence of JAK2 V617F mutation in BCR::ABL negative classical myeloproliferative neoplasm along with a comparison of two mutant allele burden detection techniques
Background: JAK2V617F mutation is the main driver mutation identified in BCR::ABL1 negative classical myeloproliferative neoplasm (MPNs), which includes Essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF). The aim of this study was to evaluate the prevalence of JAK2V617F mutation in these MPNs and to compare the measurement of mutant allele burden using commercial q-PCR kit and ARMS-PCR followed by fragment analysis. Methods: JAK2V617F mutation status using ARMS PCR was analysed for all consecutive cases of BCR::ABL1 negative MPNs over a period of 6.5 years. Eighteen randomly selected JAK2V617F mutated samples, across all the three disease groups, were taken for JAK2V617F quantitation using Ipsogen JAK2 RGQ-PCR Kit and ARMS-PCR followed by fragment analysis. Prevalence of mutation, allele burden among different disease groups and the two detection methods were compared. Results: Out of 378 cases studied, JAK2V61F mutation was noted in 113/124 (91.1%) cases of PV, 92/133 (69.2%) cases of PMF, and 74/121 (61.1%) cases of ET. The median allele burden in ET, PV and PMF were 37.8%, 77.3% and 88.9%, respectively. There was a good concordance rate between the two methods of JAK2V617F quantitation (r = 0.851). The cost per test with ARMS-PCR followed by fragment analysis was lower as compared RGQ PCR (INR 2400 vs INR 3600). Conclusion: JAK2V617F mutation is seen in majority of BCR::ABL1 negative classic MPNs. In-house validated method for quantitation using ARMS-PCR followed by fragment analysis is a reliable and cheaper alternative
Effect of red blood cell lysing agent in leukemia/lymphoma immunophenotyping by flow cytometry
Background: Getting rid of the red blood cells (RBC) is an integral part of flow cytometry (FCM)-based leukemia/lymphoma immunophenotyping. It is routinely done using an RBC lysing agent. RBC lysing has numerous consequences for the physical and immunophenotypic characteristics of the cell. We aimed to analyse the effect of different RBC lysing agents (with or without paraformaldehyde) on the antibody staining pattern. Methods: Three different RBC lysis preparations were used, namely BD FACSLyse (FL) and BD PharmLyse (PL), and a laboratory-prepared (home-brewed, HB) ammonium chloride-based reagent. A lyse-stain-wash protocol was used to prepare the cells, which were stained using a single tube of five-color antibodies (CD20-BV605, CD8-BV510, CD3-FITC, CD4-CD19-PeCy7, and CD45-APCR700). The effects of different lysings on different cellular characteristics, including the median fluorescence intensity (MFI) of CD45 in lymphocytes, CD3 in T lymphocytes, CD19 in B lymphocytes, CD20 in B lymphocytes, CD4 in T helper cells, CD8 in cytotoxic T cells, and CD4 in monocytes, were noted. Results: The duration needed for the RBC lysis using PL and HB was longer than that with FL (15–20 minutes vs. 10 minutes). The morphology of leukocytes was better preserved with the FL as compared to the HB and PL. The MFI of most of the antigens was similar for the HB and PL, but it was significantly lower for the FL. Conclusion: We should be aware of the changes that these agents may bring to the physical or immunophenotypic properties so as to choose the appropriate agent.
Role of Vitamin D in Prediabetic Individuals – Update
Vitamin D deficiency and diabetes have one common trait of being pandemic. Association between insulin sensitivity and serum 25-OHD levels is clear. Patients with diabetes and Vitamin D deficiency have increased insulin resistance. Vitamin D supplementation may decrease the incidence of diabetes mellitus and may improve the metabolic control in the diabetes state
Gossypiboma: To Err is Human – A Case Report
Gossypiboma (retained surgical sponge) is one of the identities that can be a disaster not only to the carrier of operating surgeon but also for the hospital as far as the financial burden and the reputation is concerned. The patient may have severe morbidity and in worst of the event can have mortality. The aim of this article is to highlight the fact that the incidence is not as rare as has been reported in different literatures and to discuss its various –clinico-radiological features, predisposing factors, measures to avoid it and how to manage when such a calamity has occurred. This article increases the awareness about the problem thus avoiding unnecessary morbidity/mortality to the patient as well as save the surgeon from malpractice law suits, great psychological trauma and negative publicity.
Mixed Medullary and Papillary Carcinoma Thyroid in a Young Female- A Rare Case Report
The medullary thyroid carcinomas (MTC) comprise 5-10% of all thyroid carcinomas. It is known to show many cyto-architectural variations. The WHO classification of thyroid tumors includes an entity called mixed medullary-papillary carcinoma, a rare malignancy known to represent <1% of all thyroid malignancies. Fewer than 40 such cases have been reported so far and include tumors showing morphological features of both medullary carcinoma and papillary carcinoma with immunoreactivity for calcitonin and CK19 &thyroglobulin respectively. We report a case of a 27-year-old female with complaints of gradually increasing neck swelling for 2 years, with difficulty in swallowing in the last 2 months. The swelling was more localized towards left. Ultrasound neck revealed a nodule in the left lobe of thyroid with benign features most likely nodular colloid goiter. Thyroid profile of the patient was normal. FNA revealed sheets and follicles lined by both hyperplastic and involutional follicular cells. Few micro follicles showed pleomorphic cells having hyperchromatic nuclei and mild anisonucleosis. A diagnosis of colloid goiter was given on cytology; however, on grounds of suspicion of a neoplastic process, histopathology was advised. The patient underwent total thyroidectomy. Hematoxylin & Eosin stained sections showed features of mixed medullary-papillary carcinoma of the thyroid which was further confirmed on Immunohistochemistry and raised serum calcitonin levels. It is important to know about this entity due to its prognostic implications, association with other endocrine disorders and to prevent any diagnostic dilemmas.
A Rare Case of Salbutamol Induced Tetany Pooja Shukla1*, Mohd Tariq Salman1, R K Dixit2, Shiv Sagar Gupta3, V K Verma1, Ali Ahmad1
A 25-year-old female, housewife, Nonsmoker, with complains of Dysnoea and pain in chest was diagnosed with Bronchial asthma in the Out Patient Department of Pulmonary Medicine of our institute. As per the GINA guidelines she was prescribed nebulization with Salbutamol 5 mg for confirming the diagnosis of bronchial asthma. Within minutes of nebulization she started to have involuntary contraction involving all four limb and developed hand posture associated with tetany. The nebulization was stopped and symptoms were relieved after 15 minutes of the calcium administration. The causal relationship between the suspected drug and the adverse event was assessed to be probable and thus clinicians should always be aware of the possibility of tetany due to salbutamol
A Prospective Study on the Diagnosis of Cysticercosis through High resolution ultrasonography
Introduction: Cysticercosis is mainly seen in developing countries. Here, the extraneural tissues are usually involved synchronously or metachronously with the brain. Isolated infestation of soft tissue and muscle in the absence of neural involvement is more common than previously thought. High resolution ultrasonography has advanced now as an examination of decision with demonstrated sonological examples of delicate tissue cysticercosis which can totally discredit the requirement for obtrusive intercessions. Materials and Methods: Therefore, this Prospective study was conducted on 6 cases of extraneural cysticercosis over a period of 5 months. HRUSG analysis of 6 cases was done to evaluate and classify the various classic sonomorphological features of isolated cysticercosis involving soft tissue and muscles. FNAC was done only in 3 cases. Results: Around 6 patients were selected on the basis of inclusion and exclusion criteria. Among 6 cases, 2 were male and 4 were female patients. Two individuals were vegetarian and four were non vegetarian. Mean age was 38 years. All cases were diagnosed on HRUSG. Intramuscular lesion was identified in 4 cases and 1 case had subcutaneous involvement with anterior abdominal wall in muscular plane as the commonest site in three patients. FNAC was done in 3 cases confirming the cysticercosis and was treated surgically. Conclusion: With the advent of high resolution ultrasonography and increased clinical awareness of the isolated soft tissue-intramuscular cysticercosis especially in endemic zone, a more conservative non-invasive approach can be applied both in diagnosis and treatment of these isolated cases of cysticercosis.
Prescription Auditing of Patients Admitted at Psychiatry ward of a Tertiary Care Hospital of Western UP
Introduction: The World Health Organization (WHO) proposed core-prescribing indicators for prescription audit and drug utilization studies. The focus of Indian studies has mainly been on the WHO core-prescribing indicators such as the range and number of drugs per prescription. Critical evaluation of prescriptions including rational auditing of prescriptions of patients admitted at Psychiatry Ward of Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh, from the period of 31/05/2013 to 30/05/2015. Materials and Methods: Permission for retrospective study to access medical records of the past 2 years of all patients admitted in the Psychiatry ward from 31/05/2013 to 30/05/2015 was obtained from the competent authority. Prescriptions of 44 patients (26 female, 18 male) were available in the Central Record Section during this period. The following parameters were taken to analyse and audit prescriptions as per WHO prescribing indicators: 1) Patient details, 2) Mention of diagnosis, legibility & spelling mistakes, 3) Details of the consultant, 4) Use of antibiotics/antipsychotics by various routes, 5) Provision of proper instructions to patients and 6) Additional parameters - Percentage of prescriptions with nutritional supplements and antacids. Results: Only 36% of prescriptions contained the full names of patients, while age, sex and address were present in 84.09% of the prescriptions. 100% prescriptions were found written with complete diagnosis and contained the signature of the concerned doctor. None of the prescription had the doctor’s contact number. A mean number of 3.18 drugs were written per prescription. All prescriptions were legible and 2.27% contained spelling mistakes. Insufficient instructions for both oral and injectable drugs were mentioned on all prescriptions. Conclusion: As per WHO laid guidelines, study related to drug use indicators are simple as a supervisory tool to assess prescribing patterns by individual doctors. These prescription studies provide scope to improvement in prescribing patterns and promotion of rational use of drug among practitioners.
Exploring Demographic Factors Influencing Acceptance of Family Planning Methods in Aligarh
Introduction: Population of India has jumped to 1,290,974,613 (1.29 billion) on Dec 07, 2015. There are certain demographic factors, which affect the acceptance of family planning methods. Therefore this study was conducted to determine the extent of felt need of family planning methods and to assess the demographic factors influencing the contraceptive acceptance. Materials and Methods: This cross-sectional study was conducted in J.N. Medical College, AMU, Aligarh, for a period of two and half year. Only the mothers in the post partum period were interviewed. Those mothers who had already accepted family planning methods were not included in the study. 1383 mothers were interviewed. Data were tabulated and analysed using SPSS version 20. Chi-square test (χ2) was applied to know the statistical significance. Results: Significant number of mothers (39.6%) had planned to adopt family planning methods. Majority of the mothers (71.4%) were in the age group of 21-30 years. In this age group, 39.7% mothers wanted to adopt family methods. As the age of the mothers increased, the acceptance rate also increased. Majority of mothers (52.9%) admitted in the hospital were Hindus. Among Muslims, 40.3 per cent mothers had felt need of family planning methods. Mostly the mothers were illiterate (50.8%). 30.8 per cent of these illiterate mothers wanted to accept family planning methods. Similar felt need (36.4%) was observed in mothers with education up to primary level (V standard). As the birth order increased, felt need also increased. Conclusion: It may be concluded that significant number of mothers had planned to adopt family planning methods. Though the campaign to promote family planning methods in our country is being carried out, the message should be given more vigorously through information, education and communication (IEC) activities and involvement of non-governmental organisations (NGO). Concerted efforts are needed to find out the reasons for unmet need and its solution
Indicator Based Assessment of Medicine Storage and Inventory Management Practices in various Public Sector Hospitals of District Srinagar
Introduction: The role and relevance of medicines, vaccines and other health supplies are critical, as they are considered important building blocks of the health care system. Well-located, well-built and secured storage facilities are an essential component of a pharmaceutical supply system. Methodology: This study was carried out at various public sector hospitals of District Srinagar using a set of 138 assessment indicators to study the drug storage and inventory management practices in terms of storage facilities and procedures, inventory and stock management practices and daily, monthly, yearly storage and inventory related activities. Results: Indicator based assessment for drug storage and inventory management practices revealed highest percentage adherence of 80% in managing expired drugs followed by 55.4% in daily, monthly, yearly storage and inventory control activities, 48% adherence in storage procedures, 46.1% in receiving supplies, 42.5% in stock positioning, 40.9% in storage space, 38% in stock management, 26% in stock-outs and the lowest percentage adherence of 22.9% was observed in inventory management. Facility-wise assessment revealed highest overall percentage adherence of 64.1% at Children’s Hospital (CH) followed by 54.3% at District Hospital (DH), 49.3% at Medical College (MC), 29.6 % at Sub-District Hospital (SDH) and 24.4% at Primary Health Centre (PHC). Overall percentage availability of indicator medicines was found to be 32.5% (CH=56.2% & DH=18.6%). Stock cards were not found in any of the health care facility and no expired products were found stocked in CH, MC and DH. Average indenting frequency was found to be 31 days (PHC=60; MC=10) whereas average numbers of medicines indented in one go were found to be 24. Average lead time was found to be 15 days (CH=15; MC=60) whereas average no of stock out days was found to be 66.6 days (CH=10 & PHC=115). Conclusion: Overall adherence towards various storage conditions was found to be less than 50% and lack of adherence to the basic inventory management principles was found to be common
Predicting the prognosis of Conservative Treatment in Acute Cholecystitis using an Artificial Neural Network
Introduction: In majority of the cases clinicians usually choose the conservative mode of treatment as the first line of treatment in case of acute cholecystitis. But studies have shown that in most of the cases patients do not show any significant improvement and eventually are referred to cholecystectomy. This delay in referral catalyses complications like septic conditions and development of gangrenous cholecystitis. Computational structures like artificial neural networks are excellent tools for predicting outcomes apriori. So a neural network was employed to predict the prognosis of conservative treatment mode in cholecystitis and avoid the otherwise imminent complications. Materials and Methods: A neural network was developed and trained on clinically significant data from a set of 150 medical records pertaining to patients who presented themselves with diagnosis of acute cholecystitis at a tertiary care hospital. The performance of the network was tested on this training set and a separate validation set comprising of data from 100 such patients. Results: The developed network demonstrated excellent prognostic capabilities with respect to the success/failure of conservative treatment in acute cholecystitis. Conclusion: A neural network can predict the outcome of conservative treatment in cholecystitis with significant accuracy and could prove to be an indispensable tool to clinicians
Management of Nutoo-E-Rahm (Uterine Prolapse) by Pelvic Floor Exercises
Uterine prolapse is defined as when the uterus slips down into the vagina from its normal position, and in severe cases, outside the vagina. It is one of the most distressful gynaecological problem commonly seen among the menopausal and post-delivery women mainly due to the weakening of pelvic floor muscles. Pelvic floor muscles provide support or act as a “ floor” for the abdominal viscera including the rectum and constrictor or continence mechanism to the urethral, anal and vaginal orifices (in females). Weakening of these muscles not only lead to uterine prolapse, but may also lead to the prolapse of other pelvic organs as a complication that is Cystocoele (prolapse of Bladder) and Rectocoele (prolapse of Rectum). Pelvic floor exercises also called as Kegel exercises mainly works on strengthening the muscles and the ligaments that support the female genital tract which become slack and atonic, and improves their general muscular tone. It also increases the thickness of the vaginal wall and lubrication after menopause. Here, I will discuss briefly about the uterine prolapse, and mainly the importance and process of doing pelvic floor exercises, since it has been mentioned that initial degrees of uterine descent can be managed by it. Need of this paper is to spread the awareness about the conservative treatment, rather than looking for surgery.
Roflumilast therapy in COPD − Update and Trials
Chronic Obstructive Pulmonary Disease (COPD) represents an important public health challenge that is both preventable and treatable. Pharmacological treatment regimen for COPD needs to be patient specific. Hence management of COPD should be based on strategy considering both disease impact and future risk of disease progression ( especially of exacerbation ). Risk of exacerbations significantly increases in GOLD 3 and GOLD 4 COPD. Exacerbations increase the decline in lung function , deteorriation in health status and risk of death. Roflumilast is a phosphodiesterase-4 (PDE4) inhibitor. It reduces risk of moderate to severe exacerbations in patients of GOLD 3 & GOLD 4 COPD. It has no direct bronchodilator activity, although it has been shown to improve FEV1 in patients treated with inhaled long-acting bronchodilator. Adverse effects may occur early during the treatment but these are reversible and diminish overtime with continued treatment .
Phenytoin induced Stevens-Johnson syndrome in a 38 year male patient: A Case Report
Adverse drug reactions (ADRs) are one of the leading causes of death among hospitalized patients and occur in 0.3 to 7 per cent of all hospital admissions. These may vary from mild rashes to severe reactions such as Stevens-Johnson syndrome (SJS). Antiepileptic drugs-induced SJS is a life-threatening severe cutaneous adverse reaction. We report here a case of phenytoin induced SJS in a 38 year old male patient presenting at emergency room. The patient responded to the treatment and was prescribed tab. Levetrecitam and remained symptom free since then.
A Comparative Study between Intranasal Midazolam and Intravenous Midazolam In Control Of Seizure In Children
Introduction: Seizures are one of the important reasons for children visiting the hospital. Febrile seizures are the most common type of seizures found in childhood. Earlier Diazepam was widely used for treating all types of seizures but due to short duration of action, newer drugs were tried and found better than diazepam. Aims: To compare midazolam given intranasally with midazolam given intravenously for the treatment of febrile seizures in children. Methods: This prospective study was conducted in children suffering from seizures at the Paediatric Emergency Department of Teerthanker Mahaveer Medical over a period of 12 months. 84 children between the ages of one months to fourteen years with febrile seizures lasting for at least 10 minutes were eligible for inclusion in our study. Treatment was considered successful if the seizure ceased within one hundred twenty seconds Results: In group A out of 44 patients, 20(45.5%) patients were responded to Intranasal Midazolam, whereas in group B 40 patients who were treated with IV Midazolam as first line treatment, 36 patients (90%) had responded to it. Time recorded for the commencement was more in IV Midazolam group (1.598 min) than IN Midazolam group (0.379 min), but average response time was lesser in group B (1.009 min) than group A (3.001 min). Conclusion: Midazolam given intranasally is a safe and effective treatment for prolonged febrile seizures in children and may be used in general practice and, with appropriate instructions, by the parents of children with recurrent febrile seizures at home.
Ofloxacin and Nitrofurantoin sensitivity pattern In Patients of Urinary Tract Infection (UTI) at a tertiary care teaching hospital
Introduction: UTIs are the second most common bacterial infection in present population. Women are more prone to UTI than Male. Uropathogenic Escherichia coli is responsible for >80% of community acquired UTIs. Aims: The present study was carried out to compare sensitivity / Resistance between Ofloxacin and Nitrofurantoin in UTI patients. Methods: This was a prospective, cross-sectional, observatory study conducted on patients (n = 200) suffering from Urinary Tract Infection from March 2014 to February 2015 at the Department of Microbiology and Department of Pharmacology, Teerthanker Mahaveer Medical College and Research Centre (TMMC & RC), at a tertiary care teaching hospital, in Moradabad, Uttar Pradesh, India. Results: UTI was much more common in females (61%, n=122) than in males (39%, n=78). The most common organism isolated was E. coli, 47%(n=94), followed by Klebsiella 34.5%(n=69), staphylococcus 7.5%(n=15), Proteus, pseudomonas 4%(n=8) and enterococcus 3%(n=6). E. coli was highly sensitive to the Ofloxacin 18% (n=36). Conclusion: Sensitivity pattern of the antimicrobial was found to be more in Nitrofurantoin (57%) was found to be more sensitive than Ofloxacin (40.5%) for the treatment of UTI.
Role of Topical Acetic Acid in Comparison to Gentamicin for the Management of Chronic Suppurative Otitis Media
Introduction: Chronic Suppurative Otitis Media (CSOM) is one of the diseases resistant to current antibiotics; persisting for more than two week; and capable of causing severe discharge, tympanic membrane perforation and deafness. This may cause distress and affect their quality of life and productivity. Aims: To assess the role of topical Acetic Acid in comparison to Gentamycin for management of CSOM. Methods: It was a Randomized, open label study. Patients diagnosed as CSOM (safe type) were randomly divided into two groups, group I - topical 1.5% Acetic acid and group II - topical 0.3% Gentamicin sulphate in a dose of three otic drops thrice daily. Follow up was done every week for two weeks and was compared on the basis of otological symptoms score. Results: The mean difference of otological symptom score at day 7 and day 14 from baseline in Group I was 1.90±1.01 and 3.40±1.08; and in Group II 1.96±0.57 and 3.12±0.74; p<0.05. Among the study groups, reduction of otological symptom scores at day 7 (Group I =3.22±1, Group II=2.66±1.76; p=0.14) and at day 14 (Group I = 1.72±1.76, Group II= 1.50±1.79; p=0.56) respectively. Also, “Treatment success” seen in 46 (92%) patients in the Acetic acid group and 44 (88%) patients in Gentamicin sulphate group. Moreover, cost of the treatment for Acetic acid was 102.94 and for Gentamicin sulphate was Rs.160.25 per person. Conclusion: Topical Acetic acid was found to be equally effective to Gentamicin sulphate for the treatment of CSOM.
Prevalence and pattern of Hypothyroidism in patients attending the Outpatient department of a tertiary care teaching hospital.
Introduction: Among the endocrine disorders, Hypothyroidism is now believed to be the worldwide problem next to Diabetes. Aims: This study was carried out to ascertain the prevalence and pattern of Hypothyroidism. Methods: This prospective, epidemiological study was conducted in patients aged ≥20 years suspicion of thyroid disorders at a tertiary care teaching hospital from Jan 2012 to Dec 2013 in Bhuj, Gujrat. Thyroid abnormalities were diagnosed on the basis of laboratory results (serum FT3, FT4 and Thyroid Stimulating Hormone [TSH]). Results: Out of 425 patients enrolled in our study, only 345 patients completed left. Out of the 345 analysable subjects, Female [n=217 (62.89%)] predominance is seen. Around n=72 cases were confirmed having thyroid abnormalities, Out of n=72 cases, only n=32 (9.27%) participants were found to have Hypothyroidism, Subclinical hypothyroidism was detected in n=28(8.11%) cases. Only n=12 (3.47%) cases had signs and symptoms of Clinical hyperthyroidism. Conclusion: The prevalence of hypothyroidism was high, affecting approximately 9.27% study population. Hypothyroidism is found to have close association with Female gender and older age. Iodine intake ceases to be the sole etiological contender for thyroid disorders in urban areas.
Intraperitoneal Drainage Under Local Anaesthesia In Patients Of Perforation Peritonitis Before Definitive Management: Is It Justified?
Introduction: Perforation peritonitis is one of the most frequently encounter surgical emergency around the world. In spite of advances in diagnosis, antimicrobial therapy, surgery, it remains a fatal affliction with high mortality rate. This high mortality rate makes way for innovation in techniques in addition to the persisting knowledge for a better outcome. Aims: A pilot study was conducted, to evaluate the efficacy of intraperitoneal drainage in patients of perforation peritonitis during the resuscitation period before definitive surgical treatment. Methods: This was a prospective control study, conducted on the patients of perforation peritonitis with gastro-intestinal perforation for a period of 2 years w.e.f. January, 2011 to November 2012. 100 patients were included in this study and were divided into two groups (50 each). Group I- patient with preoperative intraperitoneal drainage under local anaesthesia, group II- patient without preoperative intraperitoneal drainage, before definitive surgery. Results: The overall morbidity and mortality of the patients in group-I were comparable with those in group-II Conclusion: Intraperitoneal drainage under local anaesthesia, in patients of gastrointestinal perforation peritonitis seems to be effective in decreasing morbidity and mortality.
Psychosomatic Disorders Pertaining To Dental Practice
Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Psychosomatic disorders represent impaired adaptation or deficiencies that limit the capacity to adapt successfully to the demands of everyday life. The symptoms are thought to be a response to stress. Appropriate health consultation should be considered for further evaluation and treatment.
Do we really need multiple terms for a single concept in the field of Environmental Pharmacovigilance?
Environmental pharmacology is an emerging specialty of pharmacology. It is defined as the effect of pharmaceuticals and house care products on the environment and ecosystem. It involves the study of gene-environment interaction, drug-environment interaction and toxin-environment interaction, for which specific terminologies have been used very appropriately i.e. ‘Ecogeneology’, ‘Ecopharmacology’ and ‘Ecotoxicology’, respectively.
Steven Johnson Syndrome – A Triad of Mucosal Lesions, Cutaneous Involvement and History of Recent Drug Exposure
Steven Johnson Syndrome is relative a rare but yet an acute life-threatening condition. A middle aged lady presented to us in an emergency condition with high grade fever (104oF), oral mucosal ulcers, purulent discharge from both eyes, photophobia, generalized skin rashes, flank bruises, dyspnea, severe odynophagia along with dysphagia and blisters on both hands and feet. Because of extensive oral thrush, mouth ulcers and purulent discharge from eyes, the patient was initially suspected to be a case of oral candidiasis and bacterial conjunctivitis. However, due to wide spread muco-cutaneous involvement and after obtaining detailed drug history and getting opinion from dermatology and ophthalmology department, a diagnosis of Steven Johnson Syndrome was established. The treatment was started accordingly and the patient responded dramatically to the treatment, got improved and was subsequently discharged.