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International Journal of Medical Studies

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1 LARYNGOTRACHEAL CLEFTS (LC) AS AN UNCOMMON CAUSE OF STRIDOR IN AN INFANT: CASE REPORT  , Dr. Seyedi javad  Dr. Elmi Saghi  Dr. Elmi Sam     Corresponding Author: Dr. Elmi Saghi 
Stridor is conventionally thought to be of inspiratory causes in nature and usually due to airway pathology which leads upper airway obstruction in infants. The present case report illustrates that stridor would be caused by Laryngotracheal clefts (LC) which can be resulted in respiratory distress, stridor, choking episodes, coughing and recurrent croup as well as recurrent aspiration and respiratory tract infections.  Keywords: stridor, Laryngotracheal clefts (LC), infants. 
2 AN UNUSUAL PATHWAY IN DIAGNOSIS OF IMMUNE DISORDER THROUGH INVASIVE PULMONARY ASPERGILLOSIS WITH HEMOPTYSIS: CASE PRESENTATION    , Dr. Seyedi javad Dr. Elmi Saghi   Dr. Elmi Sam  Dr. Zabolinejad Nona Correponding Author: Dr. Elmi Saghi 
Invasive pulmonary aspergillosis is a fungal infections caused by aspergillus fumigates that transmitted through inhalation of air conidia in most cases.  Since these conidia will removed by phagocytes, they cause rarely any diseases in people who are not immunocompromised; therefore normal and also sufficient function of macrophages and neutrophyles are necessary to prevent aspergillosis. On the other hand immunocompromised patients like CGD (Chronic Granulomatous Disease) can easily involved in such fungal infections through exposure to high amounts of these conidia.  In this article we will introduce a girl with interesting history of BCGitis, after awhile presented by hemptysis discovered as a begin sign of invasive pulmonary aspergillosis. Finally out evaluations showed immune disorder in this neglected child.  Regarding high  mortality of invasive aspergillosis as 30-50% ; effective  management  is achieved  by on time suspicion to fungal infection associated by  finding risky hosts  and also early initiation of antifungals for reduction of invasive aspergillosis .  
3 CHRONIC COUGH IN A 10- YEAR OLD BOY AS A FIRST PRESENTATION OF INFLAMMATORY MYOFIBROBLASTIC TUMOR (IMT): A CASE REPORT      , Dr. Seyedi javad   Dr. Elmi Saghi  Dr. Elmi Sam  Dr. Zabolinejad Nona  Dr. Erfani Sayyar  Dr. Hiradfar Mehran Corresponding Author : Dr. Elmi Saghi 
Inflammatory myofibroblastic tumor (IMT) is a rare benign tumor with an unknown origin. Its clinical and radiological manifestations are variable and non specific, also half of them are asymptomatic while cough, hemoptysis, dyspnea are possible to see. Therefore diagnosis is too hard to establish unless an exactly evaluation by an expert pathologist on a biopsy from surgical resection .The standard treatment for diagnostic and therapeutic reasons is a complete resection whereas incomplete resection increases the risk of recurrence. Here we report a 10-year old boy with prolonged cough and collapse-consolidation in his chest x-ray who referred to our pediatric center in north east of Iran.                 Key words: Inflammatory myofibroblastic tumor, cough, collapse, pediatric. 
4 The Relationship between Mean Platelet Volume and Coronary Collateral Vessels in Patients with Acute Coronary Syndromes     , Dr. Gaurav Singhal  
Background: Elevated mean platelet volume (MPV) has been proposed as a risk factor for coronary artery disease (CAD) and is associated with poor clinical outcome in acute coronary syndrome (ACS). However some studies have contradictory findings. Hence we aimed to evaluate the association of MPV with presence of coronary collateral vessel (CCV) in patients with ACS.  Objective: To find MPV value in ACS patients and to find predictive value of MPV in spectrum of CAD and to examine whether levels of MPV predict the presence of CCVs.  Methods:  A total of 180 patients with first ACS were included in the study.  Mean platelet volume (MPV) was measured. All patients underwent coronary angiography to know disease severity and coronary collateral vessels (CCVs). The CCVs are graded according to the Rentrop scoring system and According to coronary angiography  results, patients were divided into two groups as Group 1 (poor CCV) and Group 2 (good CCV).  Results:  The mean MPV was  10.74 ± 2 fl in poor collaterals group patients and 11.01 ±1.7 fl in good collaterals group (p value 0.421). Presence of CCV was not significantly associated with high levels of MPV. MPV value did not show any prediction of spectrum of coronary artery disease.  Conclusion: MPV on admission was not associated with development of CCV positively in patients with ACS. Also it is not associated with number of vessel involvements.     KEYWORDS: Acute coronary syndrome; coronary artery disease; mean platelet volume; Coronary collateral vessels; rentrop criteria.  
5 Hepatectomy In Children:  10 Year Experience In a Tertiary Care Hospital     , Dr. Sajad Ahmad Wani Dr. Gowhar Nazir Mufti Dr. Nisar Ahmad Bhat Dr. Aejaz Ahsan Baba    Corresponding Author: Dr. Sajad Ahmad Wani
Background: Hepatectomy can be safely performed in children with primary liver tumours, selected cases of metastatic tumours and traumatic liver injuries. However liver resections are associated significant morbidity and mortality even in advanced centers. The aim of this study was to evaluate the outcome of liver resections over a period of 10 years. Material and Methods: This was a prospective study of patients who underwent various types of hepatectomies for different indications from March 2005 to April 2015. Results: 15 patients underwent liver resections during the study period. The age of patients ranged from 8 months to 14 years with mean age of 3.7 years. The indications in our patients were hepatoblastoma in 9 patients, traumatic liver injury in 3 patients, abscess in 1 patient, liver extension of right wilms tumor in 1 patient and extension of left neuroblastoma to liver in 1 patient. Right and left hepatectomies were done in 8 (54.4%) and 5 (33.3%) patients respectively. Non anatomic/ wedge resection was done in 2 (13.3%) patients. Hemorrhage which needed transfusion occurred in 4 (26.7%) patients, bile leak in 1 (6.7%), wound infection in 1 (6.7%) and death in 1 (6.7%) patient.   Conclusion: Liver resection in children can be safely performed with minimal morbidity and mortality. Better results can be achieved with good per operative care, vigilant identification and good expertise in the management of complications.   KEYWORDS: Hepatectomy, Children, Outcome. 
6 CASE OF OPHTHALMOMYIASIS BY LARVAE OF CHRYSOMYIA BEZZANIA  , Dr Hariharan Swami 
Unique features of myiasis affects the eye, a rare disease caused by infestation of tissues by the larvae (maggots) of diptera (two-winged) flies. The condition though well recognised in animals is less frequently reported in humans. Our cases point to the importance of having high index of suspicion and early detection of Ophthalmomyiasis, as it is amenable to simple and effective treatment.  Keywords:  Ophthalmomyiasis, Maggots, Myiasis 
7 CHALLENGES AND RESTRICTIONS IN ASTHMA MANAGEMENT    , Dr Manish Rathore
Asthma is a complex disease and is no more considered as a single entity. It is an umbrella of term constituting many phenotypes, each varying in its clinical presentation and response to treatment1. Each phenotype requires specific approaches for control. But for an average clinician it is not practical to differentiate between phenotypes at least in the early stages of presentation. Hence all asthma patients pass through an ordeal of guideline based management.   
8 CASE REPORT: SYMMETRIC FLEXURAL EXANTHEMA TO DICLOFENAC      , Dr Paul Henry 
Symmetric intertriginous and flexural exanthema (SDRIFE) is a rare  self limiting drug reaction characteristically affecting the intertriginous areas.  The common offending drugs are aminopencillins, beta lactam antibiotics and chemotherapeutic agents. Here we report a 68 year old male  who developed  well defined  symmetric  erosions involving bilateral axilla, upper and inner thighs and  genitalia with  dusky hue of  the surrounding skin and mucosal lesions after twelve hours  of  intake of  diclofenac  sodium. One year later on re exposure to the same drug, he developed an exactly similar clinical picture. Patient recovered with hyperpigmentation during both the episodes   on   withdrawal of the offending drug and administration of systemic steroids. To the best of our knowledge, this is the first report of  recurrent SDRIFE to diclofenac sodium with unusual features of erosive lesions ,mucosal involvement and the striking resemblance to fixed drug eruption.     Key words: Symmetric intertriginous and Flexural exanthema, Fixed drug eruption, Diclofenac sodium. 
9 CASE REPORT: MALIGNANT TRANSFORMATION OF LUNG BULLA  , Dr. Namit Thapa
Cases of malignant transformation in bullous lung disease are not infrequent, and most of these cancers turn out to be non small cell lung cancer. However, they are often difficult to diagnose because of their uncertain appearance. Here we report a case of bullous lung disease, now presenting with an air – fluid level, in which a diagnosis of malignancy was made by ultrasound, guided fine needle aspiration cytology. Hence this possibility has to be kept in mind when a known case of bullous lung disease presents with worsening symptoms or new radiological shadows which is often treated as secondary infection of a preexisting bulla.    Key words: Malignant transformation, Bullous Lung Disease. 
10 AN EIGHTEEN YEAR STUDY OF INTESTINAL PROTOZOANS IN THE LOS ANGELES AREA BETWEEN 1996 AND 2013    , Dr. Omar M. Amin Dr. karim O. Amin Corresponding Author: Dr. karim O. Amin  
Seasonal and annual prevalence of intestinal protozoans were studied for a period of 18 years in an urban/suburban Los Angeles area. This is the first such study anywhere in the world. A total of 7766 fecal specimens from 3883 patients in the Los Angeles County, from 1996 to 2013 were tested at Parasitology Center, Inc. (PCI), Scottsdale, Arizona. During this period, 1629 (41%) of patients were found infected with one or more protozoan parasites. The most prevalent parasites were Blastocystis hominis (19%), Entamoeba histolytica/E. dispar (6%) E. hartmanni (6%), and Cryptosporidium parvum (5%). Blastocystis hominis made up 45% of all infections. Infections with Blastocystis hominis progressively declined through 2013 while those of C. parvum increased. Infections with B. hominis were more prevalent in colder weather and lowest in August and September. Infections with C. parvum were most prevalent from March to June and lowest in August. The overall monthly prevalence for all protozoan parasites varied between 34% in August and 51% in February. The composition of the parasitic fauna diagnosed, annual prevalence rates, and seasonality were discussed in comparison with other studies.     Key words:  Intestinal protozoans, Los Angeles, 1996-2013, Prevalence, Seasonality. 
11 THE AGGRESSIVE CLINICAL COURSE OF A PATIENT WITH BENIGN METASTASISING PLEOMORPHIC ADENOMA OF THE PAROTID GLAND  WITHOUT LOCAL RECURRENCE    , Dr. Fazli Yanik Dr.Yekta Altemur Karamustafaoglu  Dr. Fulya Oz Puyan Dr. Adem Karatas    Corresponding Author: Dr. Fazli Yanik
Benign metastasising pleomorphic adenoma (BMPA) is an extremely rare tumour that is classified histologically. A 58-year-old-woman presented with Pleomorphic adenoma originated from parotid gland with lung metastasis without local recurrence: There is no effective treatment except total excision and closely monitoring a benign PA with metastasis is important. Herein we report a rare case because of the several cases with metastasis without local recurrences have been reported in the literature.  Key words:  Metastasizing pleomorphic adenoma, Parotid gland, Surgery
12 PAPILLARY HIDRADENOMA OF VULVA: A RARE CASE PRESENTATION     , Dr. Kafil Akhtar Dr. Mohd Rafey Dr. Rana K Sherwani Dr. Zehra Mohsin  
Papillary hidradenomas in the vulva arises from specialized anogenital mammary-like glands in and around the intralabial sulcus. These are benign lesions, which present as slow growing, circumscribed cystic masses. Histologically, papillary hidradenomas are characterized by glandular structures and complex branching papillae with fibrovascular stalks. The glands are lined by myoepithelial cells and epithelial secretory cells with a surrounding fibrous stroma. Oestrogen and progesterone receptors are potential markers to differentiate between anogenital sweat glands and conventional sweat glands. We intend to present a case of excoriating papillary hidradenoma of vulva in a 23-year old female with review of literature.    Key words:  Papillary hidradenoma, Vulva, Benign Tumor. 
13 GLUCOSE AND LIPID PROFILE IN PREGNANCY INDUCED HYPERTENSION (PIH) IN A LOCAL POPULATION: A CASE CONTROL STUDY      , Dr. Arif Malik  Dr. Asia Parveen  Dr. Shahzad Ahmad  Dr. Sulayman Waquar  Dr. Kishwer Nawaz Dr. Rabail Alam Dr. Qurat-Ul-Ain Dr. Ayesha Zahid Dr. Mahmood Rasool Dr. Mahmood Husain Qazi     Corresponding Author:  Prof. Dr. Arif Malik
Objective: To estimate the lipid profile and glucose level in pregnancy induced hypertensive verses normal pregnant women in local population.  Design: Cross Sectional case control study.  Place & Duration of Study: All biochemical samples were analyzed in Institute of Molecular Biology and Biotechnology (IMBB), UOL from March to December 2012 and Gynecology department of Jinnah hospital Lahore.  Methods: Total of 60 individuals who consented was divided into case and control groups. The cases included 30 hypertensive pregnant women and controls included 30 normal pregnant women. Blood samples were collected from Gynecology department Jinnah hospital Lahore. Detailed physical examinations were performed. Blood pressure, age and weight were recorded.   Results: The glucose level was found to be slightly high in hypertensive pregnant women but no significant change was observed in hypertensive (Mean+/-SD: 95.93±14.268 vs. 87.86±17.83). The total cholesterol was found to be significantly higher in hypertensive pregnant women as compared to normal pregnant women (274.16±37.55 vs. 171.00±30.776). The TG level significant high in hypertensive then normal group (175.06±32.20 vs. 114.86±20.58) and HDL level low in hypertensive group (49.4±8.15 vs. 55.42±7.98). The LDL level (171.66±29.98 vs 105.60±19.66) and VLDL level (34.90±6.47 vs. 22.83±4.06).  Conclusions: The women with very high BP had higher Cholesterol, TG, LDL and VDL as compared to pregnant women. In normal pregnant women the level of cholesterol, TG, HDL, LDL and VLDL are normal or slightly raised. For glucose level, it is considered a non-significant risk factor for hypertension.     Key words:  Pre-Eclampsia, PIH, Lipid profile, Hypertension Pregnancy. 
14 METRONIDAZOLE INDUCED CEREBELLAR ATAXIA: A CASE REPORT    , Dr. N. S. Neki Dr. Satpal Aloona Dr. Bhupinder Singh   Corresponding Author: Dr. N. S. Neki
Metronidazole is a very commonly prescribed antibiotic for the treatment of anaerobic bacterial and protozoal infections. The most common adverse effects associated with it are nausea, dry mouth, vomiting, and diarrhea. Neurologic toxicity is very rare and if occur it includes peripheral neuropathy, headache, dizziness, syncope, vertigo, and confusion. Cerebellar toxicity is a very unusual, adverse event associated with its use. We are reporting a case of this very rare side effect, i.e. Reversible Cerebellar toxicity, in a patient who was on prolonged metronidazole therapy for multiple liver abscesses.    KEYWORDS:  Metronidazole, Cerebellar Ataxia, Multiple liver abscesses
15 A REVIEW ON ARTIFICIAL BLOOD     , Arjun Singh Solanki
Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available.   KEYWORDS: Blood, Artificial blood, Per fluorocarbons.  
16 JOB SATISFACTION AND ANXIETY AMONG SECONDARY SCHOOL TEACHERS IN ADO EKITI, EKITI STATE   , Dr. Olubukola Ajayi Dr. Samuel O., Oke Dr. Tafida A., Musa  
This study examined job satisfaction and anxiety among secondary school teachers in Ado − Ekiti, Ekiti State Nigeria. Two hundred teachers were randomly selected for the study. Five hypotheses were tested, result showed a significant negative relationship between job satisfaction and anxiety among secondary school teachers (r (198) =0.142, P >.05). It was also found out that there is no significant differences between male and female secondary school teachers in levels of job satisfaction (F (1, 196) =0.01, P>.05). Result also indicated that there is no differences between married and single secondary school teachers in levels of job satisfaction (F (1,196) = 1.13, P>.05). It was also found out that there is no significant differences between male and female secondary school teachers in levels of anxiety (F(1196)=0.02, P>.05). The study also revealed that there is no significant difference between married and single secondary school teachers in levels of anxiety. The implications of these findings were discussed and recommendations were suggested. KEYWORDS: Facial plexiform neurofibromatosis, Neurofibromatosis type 1, Ketotifen hydrogen fumarate.  
17 SOME IMPORTANT MEDICINAL PTERIDOPHYTES OF MANDSAUR DISTRICT (MADHYA PRADESH)   , Dr. Maya Pant Dr. Madhu Purohit  
Plants have been as a source of food, medicine and many other necessities of life since time immemorial. In the plant world, pteridophytes are said to be primitive vascular plants. They are the second largest component of this world flora. They have an important role in the earth’s diversity. They grow luxuriantly in moist tropical and temperate forest and their occurrence in different eco−geographically threatened regions from sea level to the highest mountain are of much interest. This fascinating group of Pteridophytes is distributed in the Himalaya, Western Ghats, Vindhya, hilly areas of Bihar, Orissa and other parts of Madhya Pradesh as well as in the Aravalli area. We reported 8 species of medicinally important pteridophytes, used by the tribes of Madhya Pradesh. Climatic conditions of Mandsaur district are suitable for the growth of pteridophytes. Actiniopteris radiata, (Sw.) Link is the most common plant of Mandsaur district and found in Gandhi Sagar Wild Life Sanctuary, Takhaji, Hinglajgarh and Navali. Dryopteris cochleata, (D. Don) C. Chr, Equisetum ramosissimum, Desf. ssp. debile (Roxb ex Vaucher) and Pteris vittata, Linn is found only in Takhaji. Cheilanthes farinosa, (Forssk) Kaulf, commonly known as Nanha was reported from Gandhi Sagar Wild Life Sanctuary.   KEYWORDS: Actiniopteris radiata, (Sw.) Link, Aravalli area, Cheilanthes farinosa, (Forssk) Kaulf, Climatic conditions, Diversity, Dryopteris cochleata, (D. Don) C. Chr, Equisetum ramosissimum, Desf. ssp. debile (Roxb ex Vaucher), Primitive, Pteris vittata, Linn, pteridophytes, Threatened, Vascular plants.
18 FACIAL PLEXIFORM NEUROFIBROMATOSIS IN A 30 YEARS OLD PATIENT WTH NEUROFIBROMATOSIS-1: A CASE REPORT   , Dr. Nugrohoaji Dharmawan Dr. Ancella Soenardi Dr. Prasetyadi Mawardi  
Background: Plexiform neurofibromatosis (PN) is a benign tumor that develops from peripheral nerve sheath, which can be found in 30% case of neurofibromatosis type 1 (NF1). PN which especially occur in face could cause disfigurement and functional problems. The main therapy for PN is surgery. Case: A 30 year old man came to the Department of Dermatovenerology of dr. Moewardi Hospital with a complaint of nodules in the face since 8 years ago which started as a little papule like a pimple which evolved into nodules that covers the left side of the face and the right chin and cheek. Other than these nodules, the patient also has brown spots since his birth that are spread all over his body. After a careful anamnesis, physical examination and a histopathological examination, the patient was diagnosed with plexiform neurofibromatosis in neurofibromatosis type 1. Therapy for this patient at the moment is ketotifen hydrogen fumarate 1 mg tablet twice daily, and is planned for a serial surgical resection of the nodules. Discussion: Plexiform neurofibromatosis is a benign nerve sheath tumor that is included as diagnostic criteria for NF1. The most common location is in the face and occurring hemifacially hence causing a disfigurement and cosmetic problem. The main therapy is surgical resection but because the tumor is often found along the nerve and the infiltrative nature of the tumor, surgery is often difficult and there is a chance of recurrence in the future. Other than surgery, we can give symptomatic medication with antihistamine such as ketotifen fumarate to reduce the pruritus.   KEYWORDS: Facial plexiform neurofibromatosis, Neurofibromatosis type 1, Ketotifen hydrogen fumarate.  
19 RELATION  SOIL  AMENDMENTS AND MICROBIAL ANTAGONISTS FOR BIOLOGICAL CONTROL OF NEMATODES     , Dr. Hamid Abbasi Moghaddam, Dr. Nasser Panjehkeh  
Plant parasitic nematodes are important factors affecting crop growth and yield in all agricultural production zones. However, chemical nematicides are now being reappraised in respect of environmental hazard, high costs, limited availability in many developing countries or their diminished effectiveness following repeated applications.  This  review  presents  progress  made  in  the  field  of  microbial  antagonists  of  plant−parasitic nematodes, including nematophagous fungi, endophytic fungi, actinomycetes and bacteria. A wide variety of microorganisms   are   capable   of    repelling,   inhibiting   or   killing   plant−parasitic   nematodes,   but   the commercialisation of these microorganisms lags far behind their resource investigation. One limiting factor is their inconsistent performance in the field. No matter how well suited a nematode antagonist is to a target nematode in a laboratory test, rational management decision can be made only by analysing the interactions naturally occurring among "host plant nematode target soil microbial control agent (MCA) environment". Organic soil amendments stimulate the activities of microorganisms that are antagonistic to plant parasitic nematodes. The decomposition of organic matter results in accumulation in the soils of special compounds that may be nematicidal. Amendments are mainly bio products and wastes from industrial, agricultural, biological and other activities. Control of plant parasitic nematodes can be by improvements of soil structure and fertility, alteration of the level of plant−resistance, release of nemato toxic compounds), parasites (fungi and bacteria) and other nematode antagonistic (biological control agents). The mode of action of organic amendments leading to plant disease control and stimulation of microorganisms is complex and dependent on the nature of the amendments.   KEYWORDS: Biological control, Microbial control, Plant parasitic nematode.  
20 IMPORTANCE  AND CONVERSATION OF ETHNOMEDICINAL PLANTS IN KHAMMAM DISTRICT, TELANGANA   , Dr. M. D Ghani
Around the globe, there are various traditionally used medicinal plants a source of relief in controlling various types of diseases. We have conducted an ethnobotanical survey to collect information about the use of traditional medicinal plants for various diseases by the tribes of Bhadrachalam forest areas of Khammam district in Telangana. Some medicinal plants were collected from Khammam forest area and planted in our research field for their growth. Various explants of these plants are used for future studies, micropropagation and conservation of germplasm. The herbal plants, fruits, seeds preserved by preparing the herbarium and museum.   KEYWORDS: Ethnomedicinal plants, Ethnic tribes, Koyas, Kondareddy, Sugali, Guttikaya, Bhadrachalam.
21 CHOLESTEROL LOWERING POTENTIAL OF SEABUCKTHORN   , Mr. Balveer Singh Chauhan Mr. Arjun Singh Solanki Mr. Rajendra Singh Sisodiya  
The present study was designed to investigate the effect of Seabuckthorn on lipid profile, its antioxidant potency and its effect on haemodynamic changes and baroreceptor mediated blood pressure regulatory mechanism in hypercholesterolemic rats. For induction of hypercholesterolemia rats were fed with fructose in drinking water and in vivo experiment had done to investigate the heamodynamic as well as biochemical profile of seabuckthorn. It is a natural product and investigations carried out so far do not report any apparent toxic effect. Based upon the results of the present study, it is recommended that seabuckthorn pulp oil may be supplemented with normal diet for providing protection against hypercholesterolemia. The fall in blood pressure of animals having a normal lipid profile suggests that it may have a hypotensive effect. Hence, its use as a lipid lowering agent needs to be carefully monitored especially in people with cardiac problems. Conclusive evidence shows that baroreceptor modulation of heart rate is impaired in animals and patients with atherosclerosis. It has been suggested that oxygen free radicals produced in atherosclerosis may contribute to baroreceptor dysfunction. Seabuckthorn prevented development of hypertension and reduced insulin resistance in chronically fructose fed rats and reduced vascular superoxide anion production through lowering the NAD (P) H oxidase activity in hypertensive rats.   KEYWORDS:    Hypercholestrolemia, Hypertension, Atherosclerosis, Baroreceptor dysfunction, Free radicals.  
22 DETERMINATION OF IMPURITY PROFILE OF DRUG SUBSTANCE (API) AND DRUG PRODUCT USING A MODEL DRUG PARACETAMOL     , Pankaj Suryawanshi Prakash Pant Milan Sankala
OBJECTIVE: Determination of impurity profile of drug substance (API) and drug product using a model drug paracetamol. MATERIALS & METHODS: Stock Solution, Paracetamol, HPLC. RESULTS AND DISCUSSION: Baseline was obtained a straight line, that show proper washing of previous sample. Then chromatogram was obtained with four different retention time of peak with good peak symmetry. Retention time of impurity peak in sample solution, standard solution and spike solution was obtained 7.587, 7.577and 7.687 respectively, Thus results and overlay view of standard and spike chromatograph shows the unknown impurity in the sample represent p−hydroxyacetophenone. CONCLUSION: The method for the determination of impurity profile using model drug paracetamol was optimized and developed. Two impurity chloroacetyanilide and p−hydroxyacetophenone was found in paracetamol by using optimized condition.   Keywords: Chromatogram, HPLC, Stock solution.  
23 IN VITRO ANTIMICROBIAL ACTIVITY OF HYDROALCOHOLIC EXTRACT OF PSIDIUM GUAJAVA L   , Omprakash Dayam Prakash Pant Surya Prakash Abhishek Bansal  
Aim: The present study aimed to evaluate the in vitro antimicrobial activity of hydroalcoholic and aqueous extracts from leaves of P. guajava on two bacterial samples to determine the range of minimum inhibitory concentration of the extracts. Material and Methods: The antimicrobial activity of extracts of different polarities was compared using the agar dilution method. Differences in susceptibility to the active ingredient could be observed. Result: The results showed that the hydroalcoholic extract was active against Escherichia coli (1024µ gƒml) and Bacillus cereus (900µgƒml). The aqueous extract showed no antimicrobial activity. Conclusion: Despite demonstrating antimicrobial efficiency, the P. guajava extract may be insufficient or may require a higher concentration to be fully effective. KEYWORDS: Ethnomedicinal, Antibacterial, Psidium guajava extracts  
24 BACTERIAL ETIOLOGY OF DIARRHEAL SYNDROME AND SUSCEPTIBILITY PROFILE OF ENTEROPATHOGENS AMONG PATIENT ATTENDING MTHATA GENERAL HOSPITAL     , Dr. Muringani, B.N.
The population of the Eastern Cape is largely non−urban and poor with inadequate water supply infrastructure (Mthata river systems 2008). Mthata has only 10% flushing toilet systems in the households and 90% is either bucket system or pit latrines with majority of 60% using the bushes around. Diarrheal infections have thus been shown to cause 20% of all deaths in children under 5 years of age living in settlements with no access to clean water. Objectives: To determine the frequency of isolation of Enteropathogens and emerging enterobacteria and their susceptibility profile to antibiotics. Methods: All stool samples submitted to the National health laboratory service Mthata general hospital from March−August 2012 from patients with acute ƒchronic diarrhea. Bacteria were isolated using standard microbiological procedures. Sensitivity testing was done on all isolates against a panel of 10 antibiotics while Campylobacter and Enterococcus against the panel of Six antibiotics. Results: Of the 150 stools , Escherichia coli was the most predominant with 32% isolates, 21% of these produced þ−lactamase enzyme and 42% were Enteropathogenic E coli . The isolates were resistant to most of the antibiotics and were only susceptible to meropenem, imipenem, ciprofloxacin and gentamicin. Enterobacter species followed at 20%, then 13% Enterococcus, 7% Citrobacter freundii, 5% Serratia marcesens, 4% Yersinia enterocolitica, while Campylobacter, Salmonella, Shigella, Morganella morganii were at an insignificant level of 1.3% respectively and were sensitive to all the antibiotic profiles while of the 150 patients, 40% were from 0−10 years patient and 60% from 11−80 years and 37% of this group were HIV positive. Conclusion: In the examined samples, E coli was the most  predominant, with notable resistance to þ−lactams and yet it is only considered in children less than 10 years and not considered as a pathogen in adults. The outcome therefore points at the need to assess patients individually to determine whether E coli is a cause for worry or not before ruling out infection.   KEYWORDS: þ−lactams, Diarrheal infections, Enteropathogens, Enterobacteria  
25 A REVIEW ON PLASTIC BIODEGRADATION   , Mayank Ameta
With more and more plastics being employed in human lives and increasing pressure being placed on capacities available for plastic waste disposal, the need for biodegradation plastics and biodegradation of plastic waste has assumed in increasing importance in the last few year. This review looks at the biodegradation of conventional plastic by microorganism. Thermostat plastics, such as aliphatic polyester and polyester polyurethane, are easily attacked by microorganisms directly because of the potential hydrolytic cleavage of ester or urethane bond in their structure. Plastics that are biodegradable can be considered environment friendly, they have increasing range of potential application and are driven by the growing use of plastics packaging. This paper attempt to make conclusion on potentially viable methods to reduce impacts of plastic waste on the environment.   KEYWORDS: Biodegradation, Plastics, Polyester, Polyurethane.  
26 IN VITRO ANTIPLASMODIAL ACTIVITY OF CINNAMOMUM TAMALA     , Abhishek Bansal
Malaria is a mosquito−borne infectious disease of humans and other animals caused by parasitic protozoan (a group of single−celled microorganism) belonging to the genus Plasmodium. Malaria causes symptoms that typically include fever, fatigue, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma or death. The disease is transmitted most commonly by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium can infect and be spread by humans. Most deaths are caused by P. falciparum because P. vivax, P. ovale, and P. malariae generally cause a milder form of malaria. The species P. knowlesi rarely causes disease in humans.   KEYWORDS: Plasmodium, P. vivax, P. ovale, and P. malariae, P. falciparum, Paroxysm, Quartan fever.  
27 OVERVIEW     OF     CHINESE     NEWBORN     SCREENING     FOR    CONGENITAL HYPOTHYROIDISM     , Dr. Juan Liu Dr. Yonglin Liu Dr. Xia Li
Neonatal screening has become one of the most successful public health policy since the start. The purpose of neonatal screening for congenital hypothyroidism disease is to find serious, treatable disease in newborn children and apply appropriate interventions, and when to avoid or ameliorate adverse outcomes. Neonatal screening is gradually popular today, with improvement in detection technology, systems technology to enhance and improve diagnosis and treatment. Chinese new born screening for congenital hypothyroidism thyroid level will rapidly increase. Currently, in most Chinese provinces to carry out newborn disease screening programs carried congenital hypothyroidism screening.   KEYWORDS: Neonatal screening, Congenital hypothyroidism, China  
28 EFFECT OF FRONT LINE SPRAY ON MANGE INFESTATION IN SHEEP AND GOAT       , Dr. Faiz Muhammad Khan Dr. Muhammad Ghiasuddin Shah Dr. Jameel Ahmed Gandahi Dr. Ghulam Murtaza Lochi Dr. Shakeel Ahmed Dr. Ahmed Tunio
Present study reveals that mites are prevailing in and around Tandojam. Sarcoptes scabiei var ovis is most predominant mite species infesting both sheep and goat. Frontline has excellent efficacy against mite infestation and only single topical application is sufficient to give total cure against mites in less than a week time. In the light of present study it may be suggested that use of Frontline spray may eliminate mite infestation in goat and sheep.  
29 COMPARISON OF THE RESULTS AND OUTCOMES OF THE DIFFERENT MODALITIES (CLOSED V/S OPEN) OF THE TREATMENT OF THE PROXIMAL HUMERUS FRACTURES   , Dr Rahul R Parmar Dr Kevin R Choksey Dr Yusuf A Bharmal    
Proximal humerus fractures are very common fractures occurring in the skeleton. They account for approximately 4 – 5% of the fracture attendance at the hospital. The preferred treatment depends on various factors including the patient's age, bone quality, the patterns of fracture and the patients' expectations and physical demands. In this study, we have studied the results of different modalities of operative treatment, their advantages & disadvantages, complications & outcomes in terms of functional and radiological results. Material & Methods: This study was carried out in CIVIL HOSPITAL, AHMEDABAD between May 2012 to April 2013; we have studied forty four patients of proximal humerus fractures. Observation & Results: The study consists of 44 cases of proximal humerus fractures in adult patients treated surgically. The data analysis of these patients received as, the material for the study was analyzed to the following findings. Mean constant score [2] in percutaneous method is 73 (SD=20.54) and ORIF method is 80.26 (SD=14.23) (P value <0.05). Total 12 (29.54%) fractures showed varus collapse at final follow up. Among them 7 (33.33%) of the patients were operated by percutaneous method and 5 (26.87%) of the patients were operated by open method showed varus collapse. Conclusion: Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply should be applied.   KEYWORDS: Proximal humerus, Orif, Percutaneous method, Varus collapse, Constant score               Proximal humerus fractures are very common fractures occurring in the skeleton. They account for approximately 4 – 5% of the fracture attendance at the hospital. The preferred treatment depends on various factors including the patient's age, bone quality, the patterns of fracture and the patients' expectations and physical demands. In this study, we have studied the results of different modalities of operative treatment, their advantages & disadvantages, complications & outcomes in terms of functional and radiological results. Material & Methods: This study was carried out in CIVIL HOSPITAL, AHMEDABAD between May 2012 to April 2013; we have studied forty four patients of proximal humerus fractures. Observation & Results: The study consists of 44 cases of proximal humerus fractures in adult patients treated surgically. The data analysis of these patients received as, the material for the study was analyzed to the following findings. Mean constant score [2] in percutaneous method is 73 (SD=20.54) and ORIF method is 80.26 (SD=14.23) (P value <0.05). Total 12 (29.54%) fractures showed varus collapse at final follow up. Among them 7 (33.33%) of the patients were operated by percutaneous method and 5 (26.87%) of the patients were operated by open method showed varus collapse. Conclusion: Principle of fixation is reconstruction of the articular surface, including the restoration of the anatomy, stable fixation, with minimal injury to the soft tissues preserving the vascular supply should be applied.   KEYWORDS: Proximal humerus, Orif, Percutaneous method, Varus collapse, Constant score
30 TUBERCULOSIS CONTROL: PERSPECTIVE AND PROGRAMMES     , Prakash Pant Dr Ramniwas
Tuberculosis continues to be major adversary of human health and life since time immemorial. The expanding AIDS pandemic has gravely boosted incidence, prevalence and severity of tuberculosis. Two decades earlier therefore, the WHO has proclaimed tuberculosis as emergency in health care. The disease is integrated with weak spots of human living, environment, habits and socioeconomic profile. Mycobacteria are essentially fought with drugs and development of resistance to antitubercular drugs is great medical challenge. The traditions of prevention and control of tuberculosis are historically established and continue to progress in parallel to unending disease burden. Perpetual adaptations of strategies for control exemplify holistic understanding in medicine and particularly tuberculosis. In the scientifically advanced but economically modest national context, tuberculosis control programmes remain major frontier of medicine. This article attempts to briefly overview the context.   KEYWORDS: Antitubercular drugs, HIVƒTB comorbidity, RNTCP, Tuberculosis  
31 THE SOCIAL BRAIN: NEUROPHYSIOLOGICAL FOUNDATION AND ENVIRONMENTAL CHALLENGES   , Abhay Kumar Pandey
Human asset of social brain is evolved system that draws upon focal as well as global connected brain mechanisms. These are dynamic and flexible anatomical routes operated for co−operation and co−ordination in intelligent behaviors. Divers cues and inputs from interaction, specially human social interaction are processed with reference to innate and acquired mental assets for inference and consequent generation of appropriate output (response).The focal and global connections are now subject to view with functional neuroimaging technology. Brain mapping approaches are now adding to the comprehensive understanding of neurophysiology. The technology driven scientific advances have disclosed serious threat of environmental pollutants for the complex, dynamic but delicate neural architecture operating the social brain. The dreads are worst at early developmental stages and later in aging phase of population. It is very huge challenge of quality of human beings, society and life. There is myth also that Hitler’s hatred arose in such very contexts. The need for befitting response to the challenge by medical fraternity is urgent. This narrative attempts to briefly introduce neurophysiological and neurotoxicological perspectives in this context for general reading among medical basic science and clinical educators and students. The interdisciplinary perspectives also indicate the research vistas and development of preventive and corrective interventions.   KEYWORDS: Cognitive neuroscience, Environmental toxicology, Neuronal networks, Neurotoxicology, Social cognition.
32 A REVIEW PAPER ON HEALTH BENEFITS FROM PROBIOTICS   , Mayank Ameta
Bacteria have a reputation for causing disease, so the idea of tossing down a few billion a day for your health might seem — literally and figuratively — hard to swallow. But a growing body of scientific evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of live bacteria. Northern Europeans consume a lot of these beneficial microorganisms, called probiotics (from pro and biota, meaning “for life”), because of their tradition of eating foods fermented with bacteria, such as yogurt. Probiotic−laced beverages are also big business in Japan. Probiotics are organisms such as bacteria or yeast that are believed to improve health. They are available in supplements and foods. The digestive system is home to more than 500 different types of bacteria. They help keep the intestines healthy and assist in digesting food. The most compelling evidence for use of probiotics is in reducing the duration of infectious infant viral diarrhea, a frequent cause of infant morbidity in developing countries. Usually managed by rehydration therapy, there is growing evidence to support the use of probiotics as a complementary therapy. Specific probiotic strains or mixtures have been shown to reduce the disease time frame by as much as two days, a significant effect.  
33 THE AFFECT OF NUTRIENTS OVER ECOTOXICOLOGICAL RESPONSES OF AQUATIC SPECIES (CANDIDA ALBICANS AND PHAEODACTYLUM TRICORNUTUM)   , Prakash Pant Milan
Study shows a primary evaluation on the effect of nutrient loads and toxicant exposure on cell growth of aquatic  species  comparing  results  obtained  by  a  well−standardized  test  on  algal  specie  (Phaeodactylum tricornutum) and yeast, using a recent specie of ecotoxicological interest (Candida albicans). Results obtained suggest a significant effect due to nutrient loads on cells growth in both species affecting toxicity of the tested chemical. Furthermore, yeast responses are faster and comparable to results obtained on algae species.  
34 IMPLICATIONS OF BURNOUT ON INTENT TO LEAVE   , Patricia J. Beck Toni DiDona  
The past 35 years have included a rise in research on burnout and its implications for employees and organizations. Among the many causes of burnout, work overload results in exhaustion, disengagement, and employee turnover, which is expensive for companies. The intent of this study was to confirm previous research studies by exploring the antecedents, symptoms, and consequences of burnout. Therefore, we measured the variables of work overload, burnout, and intent to leave, using the Quantitative Workload Inventory, Oldenburg Burnout Inventory, and Intention to Quit Scale. We used convenience snowball sampling and an online survey to acquire men and women (N=108) living in the United States who were 18 years of age or older. We hypothesized that there is a positive correlation between burnout and intent to leave. Furthermore, we expected to find a positive correlation between work overload and burnout. Correlationƒregression tests supported these hypotheses, revealing positive and statistically significant correlations. Combined, these findings suggest that people who are subject to a high workload tend to experience burnout; and people who are experiencing burnout are likely to harbor the intent to leave their job. For employers, the consequences of burnout are damaging and expensive; further implications are discussed.     KEYWORDS: Burnout, Work over load, Intent to leave, Correlation, Regression  
35 QUORUM SENSING-A    COMMUNICATION PATHWAY FOR BEHAVIOURAL SYNCHRONIZATION IN BACTERIA     , Dr. Nida Tabassum Khan
Quorum sensing is a communication pathway in bacteria that allows them to regulate their gene expression in accordance to their population density. This pathway is initiated due to the secretion of signal molecules, also called as autoinducers by the bacteria. Quorum sensing benefits bacteria by allowing it to survive better through the help of mechanisms such as virulence, conjugation, colonization, sporulation etc.   KEYWORDS: Conjugation, Sporulation, Motility, Streptococcus pneumoniae, Cyclization, Oligopeptides.
36 ASSESSING LIFESTYLE STATUS AND ADIPOSITY AMONG HEALTH PERSONNEL IN BUEA HEALTH DISTRICT, CAMEROON   , Dr. Tinyami Tandi Dr. KyungHee Kim Dr. Sanghoo Kim Dr. JaeWook Choi  
Introduction: Obesity is at the centre of public health concern in both developed and undeveloped settings. We assessed the relationship between lifestyle status and adiposity based on physical activity, dietary habits, occupation and income levels among public health care personnel (HCP) working within the Buea health district in Cameroon. Method: Using a questionnaire, a cross−sectional study was performed among a total of 212 public HCP of the Buea health district who consented and participated in the study. Using appropriate statistical analyses, weight, height, waist circumference (WC) and leisure time physical activity were measured and categorised. And dietary habits were measured based on food frequency questionnaires. Results: Of the 212 HCP sampled, 43% of the women and 15.4% male were obese at p<0.01, and overweight was 33.6% for women and 20.5% for male at p<0.05. Also, abdominal obesity was observed among 16.4% of women and 6.4% of men at p<0.05. Fats and oil, milk and animal products and grains and cereals were positively associated in both genders. Also, by using multivariate analyses and after adjusting for age groups, leisure time physical activity quartiles, dietary group, tobacco smoking and alcohol consumption, in men, based on professional category, there was a significant difference for overweight (AOR=2.1; 95% CI:1.3−2.8), obesity (AOR=3.5; 95% CI:0.6−3.2), abdominal obesity (AOR=2.5, 95% CI:1.9−2.8) for those with higher occupation category than those with lower category. Smoking tobacco was significantly associated with abdominal obesity in men, while education had no significant association with the various risk factors based on gender but was significantly associated for Mean METS of leisure time physical activity and alcohol consumption. Conclusion: After adjusting for confounding factors, lifestyle status is positively associated with adiposity among HCP in Buea health district. KEYWORDS: Lifestyle status, Health care personnel, Overweight, Obesity, Abdominal obesity, Cameroon
37 THE EFFICACY OF LAPAROSCOPIC HELLER’S MYOTOMY IN ACHALASIA PATIENTS-A UNIVERSITY HOSPITAL EXPERIENCE   , Dr. Sami AI−Nassar  Dr. Nouf AIbaIIa Dr. Afaf AImutairi Dr. Sarah AIjabri Dr. Munira AImehsen Dr. KhoIoud Dr. AIdawsar Dr. Iftikhar Ahmed Dr. Waseem Hajjar  
Objectives: To determine the impact of Laparoscopic HeIIer Myotomy on patient’s symptoms by evaIuating pre−operative and post−operative Eckardt's score. Method: The patients invoIved in this study were diagnosed with AchaIasia and underwent Laparoscopic HeIIer Myotomy between 2008 and 2015 in King Saud University MedicaI CityƒSaudi Arabia. A twenty five patients who underwent LHM were reviewed. FinaIIy, 19 patients who met the incIusion criteria were incIuded to conduct a retrospective cohort designed study. Patient’s demographic data, time of admission, hospitaI stay and surgicaI compIications were obtained through HospitaI Information System (HIS). CIinicaI symptoms were assessed using the Eckardt’s score which is the sum of the individuaI symptom score for dysphagia, regurgitation, and retrosternaI pain and weight Ioss. The pre−operative score was coIIected before the time of the  surgery  in  the  surgicaI  cIinic.  The  post−operative  score  was  coIIected  by  contacting  the  patient  via teIephone. The post−operative Eckardt’s score has been taken in two time periods. First 3 to 6 months after the surgery and second, at the time of the caII (January 2016). ResuIts: A totaI of 19 patients were incIuded, with a mean age of 36.6 years and 68.4% of them were maIes. The mean of the pre−surgicaI Eckardt score was 6.2 which dropped to (1.3, 2.5) after Laparoscopic HeIIer Myotomy (P<0.01) with a cIinicaI remission of 84.2% after the surgery and a totaI faiIure in 3 patients (15.2%) after the surgery. ConcIusion: Laparoscopic HeIIer Myotomy is an effective procedure in AchaIasia patients with cIinicaI remission of 84.2%.   KEYWORDS: AchaIasia, HeIIer myotomy, Esophagus, Eckdart score.  
38 ADENOVIRUS NEPHRITIS IN A 44 YEARS OLD MALE POST KIDNEY TRANSPLANT: A CASE REPORT   , Dr. Riyadh Alsehli  Dr. Afaf Almutairi  Dr. Sarah Aljabri  Dr. Sufia Husain  
With the rising number of solid organ transplantations and the use of immunosuppressants; it will have the patient at the risk of opportunistic infections, especially viral infections. The most common cause of fever of unknown  origin  in  post−transplant  patients  is  adenovirus.  We  report  the  case  of  end  stage  renal  disease secondary to diabetes underwent a live renal transplant from an unrelated donor. The patient presented after two years of renal transplant with two weeks history of fever, dysuria, and generalised fatigue. The patient was treated with 40 grams of IVIG for two days as an immunomodulator to reduce the risk of rejection.   KEYWORDS: Renal transplantation, Adenovirus, Nephritis.  
39 FACTORS CAUSING INFECTION IN SPINE SURGERY–A CROSS SECTIONAL STUDY BETWEEN SURGICAL TIME AND BLEED VOLUME   , Dr. Suhasish Ray  
Hospital acquired infection is responsible for long hospital stays, increased cost, and mortality. Of the myriad factors associated with postoperative infections in spinal surgery a descriptive, retrospective, cross−sectional study was conducted in the spine surgery facilities under the aeges of spineservices−india (a teaching, research and spinal treatment facility in the city of Kolkata). India Pearson’s and Spearman’s correlation was calculated and all p < 0.05 values were considered significant. In this study the correlation between time of surgery and bleeding amount had the highest importance and relevance.   KEYWORDS:  Hospital  acquired  infection,  Spine  surgery,  Cross−sectional  study,  Surgical  time  bleeding amount.  
40 Editorial on IMMUNITY , Dr Maya Pant
Our immune system is essential for our survival. Without an immune system, our bodies would be open to attack from bacteria, viruses, parasites, and more. It is our immune system that keeps us healthy as we drift through a sea of pathogens. Keywords: Immune, Bacteria, Viruse, Parasite, Pathogens.
41 Editorial: HONEY AS MEDICINE , Dr Maya Pant
Indeed, medicinal importance of honey has been documented in the world's oldest medical literatures, and since the ancient times, it has been known to possess the most important nutriment of honey is carbohydrates present in the form of monosaccharides, fructose and glucose. Honey plays an important role as an antioxidant, anti-inflammatory, anti-bacterial agent and augments the adherence of skin grafts and wound healing process. The antimicrobial activity in most honeys is due to the enzymatic production of hydrogen peroxide. The role of honey has been acknowledged in the scientific literature and there is convincing evidence in support of its antioxidant and antibacterial nature, cough prevention, fertility and wound healing properties. Keywords: Honey, Antioxidant, Anti-inflammatory, Anti-bacterial, Fertility.
42 HOME BASED MANAGEMENT OF DIARRHEA AMONG MOTHERS OF UNDERFIVE CHILDREN IN JIMMA, ETHIOPIA , 1 Ebissa Bayana, 2 Adugna Olani, 3 YonasBiratu, 4 Bikila Taresa  
Background: Diarrhea is the passage of three or more loose or watery stools in a 24-hour period. It is one of the major causes of morbidity and mortality in under -five children in developing countries. It is caused by multiple viral, bacterial, and parasites. Objective: The aim of this study is to assess home based management of diarrhea among mothers having under-five children in Jimma, Ethiopia. Method: Community based cross sectional study design was conducted among 360 samples and systematic sampling technique was used to collect data from respondents. Data were entered using Epi Data version 3.1 and exported to Statistical Package for Social Sciences version 23 for analysis. Binary and multiple logistic regression analysis were done to see association between variables. Finally, Variables having p value <0.05 at 95% confidence interval were considered as statistically significant. Result: Out of all participants, 90 (25.6%) of them were in the age group of 25-29 years and the mean age of the respondents were 30.17±7.443. Out of ten practice questions asked to caregivers of under-five children about home-based diarrhea management, 191 (54.3%) of them had a good practice. Age, educational status, marital status, family size and attitude of mother’s/care givers were significantly associated to home based management of diarrhea. Conclusion: More than half of the study participants have a good practice of home-based diarrheal management. Jimma health bureau and health extension workers should take responsibility on demonstrating the community on how to manage children with diarrhea at home. Keywords: Home-Based, Management, Diarrhea, Under-Five, Mothers, Jimma.
43 PREVALENCE OF AUTOIMMUNE HEMOLYTIC ANEMIA IN HIV INFECTED ANEMIC ADULTS, AT TIKUR ANBESSA SPECIALIZED TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA , 1 Mignot Taye, 2 Mintewab Hussein, 3 Jemal Alemu, 4 Tsegahun Asfaw
Background: A high prevalence of anemia was observed in HIV-infected individuals. Presence of auto-antibody also contributes for the development of anemia in HIV positive individuals. Few studies are conducted to show the prevalence of anemia in HIV positive individuals, but there is no documented data that rule out the prevalence of autoimmune hemolytic anemia (AIHA) in HIV positive individuals in Ethiopia. Objective: Determine the prevalence of autoimmune hemolytic anemia in HIV-infected adult patients at Tikur Anbessa Specialized teaching Hospital, Addis Ababa, Ethiopia. Methods: Hospital based cross sectional study was conducted on 384 HIV positive individuals using convenient sampling method from June 5, 2018 to September 10, 2019. Participants’ soco-demographic data, CD4 result and some important information was extracted from participants’ recorded data. Venous blood (5 ml) was collected for determination of HGB, RBC count, RBC indices, reticulocyte count and CBC results. After all, DAT was performed and blood film examination was done to confirm hemolysis. Finally data was analyzed using SPSS version 21 statistical soft ware package, and Descriptive statistic and Chi-square tests were used. Result: Of 384 study participants, 9 (2.34 %) patients are found to be AIHA positive. Of these, 6 (66.7 %) were females and 3 (33.3 %) were males. Nineteen patients had positive DAT result; 10 (52.6 %) had mild anemia, 4 (21 %) moderate and 5 (26.3 %) severe anemia respectively. 37 (9.6 %) patients showed reticulocytopinea, while 31(8.1 %) patients had shown reticulocytosis. From 26 patients who showed evidence for the presence of hemolysis in their blood film, two individuals showed +2 graded hemolysis whereas 24 patients showed +1 graded hemolysis. Conclusion: Prevalence of AIHA in HIV patients is not common. But it can be cause of anemia, most of the time in patients with severe-moderate ranged anemia and in patients with low CD4 count. Keywords: Autoimmune hemolytic anemia, HIV, Anemic Adult, Ethiopia.
44 Anti-Allergic Drugs: A Review , Milan kumar
Allergies, also known as allergic diseases, are a number of conditions caused by hypersensitivity of the immune system to something in the environment that usually causes little problem in most people. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, runny nose, shortness of breath, or swelling. Food intolerances and food poisoning are separate conditions. An allergy is a reaction by your immune system to something that does not bother most other people.
45 A REVIEW ON MODERN TECHNIQUES OF PHARMACEUTICAL ANALYSIS , Mr Karan Gupta
Traditionally, pharmaceutical analysis referred to the chemical analysis of drug molecules. However, over the years, modern pharmaceutical analysis has evolved beyond this to encompass combination techniques, highthroughput technologies, chemo metrics, micro dosing studies, miniaturization and nanotechnology. These analytical advances are now being employed in all stages of drug discovery and the focus of this review will be on how these technologies are being employed within this process. With new, improved and evolving technologies, as well as new applications for existing technology, the search for new drugs for the prevention and treatment of human diseases continues Keywords: Chromatography, Pharmaceutical Analysis, Constructive Technologies.
46 A REVIEW ON SMOKING , Karan Gupta
Cigarette smoking is a kind of psychic addiction, Nicotine in the cigarette causes addiction. It tends forces smokers to smoke again & again. When once smoker's nicotine enters the blood stream through lungs, it quickly reaches the brain where it affects certain chemical that make one feel normal. Eventually the brain becomes addicted or dependent on nicotine. 90% of smokers are aware that smoking is harmful. Zyban is the first nicotine free fill that can help stop smoking.
47 FACTORS INFLUENCING ATTRITION OF NURSES IN ROYAL VICTORIA TEACHNG HOSPITAL, THE GAMBIA , Dr. Haddy Tunkara-Bah
Background: Human resources are the foundation of a health system and a key prerequisite for improving health outcomes. In recent years, there is a crisis in human resources for health in The Gambia due to high attrition rate of trained health care professionals. As employees leave an organization, they take with them much-needed skills and qualifications that they developed during their tenure. However, understanding the factors that satisfy or dissatisfy nurses can guide the development of interventions that can improve the working conditions and discourage attrition among them. Therefore, the purpose of this study was to determine the factors influencing the attrition of nurses in the Royal Victoria Teaching Hospital (RVTH). Methods: A descriptive study design was used and information was obtained through self –administered questionnaire from a simple randomly selected sample of 75 nurses. Data was analyzed with SPSS version 15 using descriptive and inferential statistics and the significant level was set at 0.05. Results: Findings from the study indicate that 24% of the respondents already left the hospital and 67% of those working with RVTH during the time of data collection reported that they had the intention to leave. Among those who left the hospital, most of them were trained midwives and had working experience of 10 years or more. The study respondents rated the hospital low in meeting their basic human needs. The main factors reported to be contributing to their attritions were low opportunity for promotion, management and financial problems, lack of self-esteem and self-actualization and low sense of love and belonging. Conclusion: The high rate of attrition among nurses in RVTH calls for urgent interventions that will include reviewing the remuneration of nurses and management reform that targets their human needs.
48 DEVELOPMENT AND VALIDATION OF STABILITY INDICATING RP-HPLC METHOD FOR DETERMINATION OF OLANZAPINE IN PHARMACEUTICAL DOSAGE FORMS , Sunil Yadav, prakash pant, Vaibhav Verma
Background: Spectrophotometric analysis fulfils requirement where the simultaneous estimation of the drug combination can be done with similar effectiveness as that of chromatographic methods. Simultaneous estimation of drug combination is generally done by separation using chromatographic methods like HPLC, GC and HPTLC etc. These methods are accurate and precise with good reproducibility, but the cost of analysis is quite high owing to expensive instrumentation, reagent and expertise. Hence it is advisable to develop simpler and cost-effective method for simultaneous estimation of drugs for routine analysis of formulation. Methods: A descriptive study design was used and information was obtained through various literature reviews. RP-HPLC method was used and data was analyzed. Conclusion: The developed stability indicating HPLC method for quantitative estimation of olanzapine in bulk and pharmaceutical dosage forms is fast, simple, accurate, and more precise. Validation of this method was accomplished, getting results meeting all requirements. Thus, the developed HPLC method can be used for routine quality control test.   Keywords: Chromatography, RP-HPLC, Spectrophotometric, Simultaneous estimation.
49 OPTIMIZATION OF METHODS FOR DIAGNOSTIC AND TREATMENT OF PATIENTS WITH HEPATIC ABCESSES , S.G. Ali-Zade
The article presents the results of 24 clinical observations of patients with liver abscess. The possibilities of the integrated and effective use of modern minimally invasive surgical technologies in the diagnosis and treatment of patients with this pathology are shown. Keywords: liver abscesses, ultrasound, CT scan.
50 GENETIC ENGINEERING AND FARMING IN ANIMALS: A REVIEW , Milan Sankala
Availability of animal protein for human consumption is very low in the developing countries mainly because of low productivity of existing livestock; ways and means to improve productivity through breeding are discussed and some basic issues requiring further research pointed out. Human beings have been altering the characteristics of farm animals through selective breeding since the beginning of domestication thousands of years ago. In recent decades, selective breeding has been aided by a number of assisted reproductive technologies such as artificial insemination and embryo transfer. Within the globalized animal breeding industry, a small number of large multinational companies control the vast majority of livestock and poultry breeding. Increasingly, specialized breeds have been developed that produce very high yields of a single commodity (such as meat, milk or eggs). The drive to increase productivity has, in many cases, had serious consequences for the health and welfare of the animals.
51 PREVALENCE OF DYSLEXIA AMONG UNDERGRADUATE STUDENTS AT BUITEMS , Nida Tabassum Khan, Nousheen Hussain
Dyslexia is identified in adults as a reading difficulty who faces phonological issues when reading though they possess the normal intelligence required for correct and fluent reading. Dyslexia is quite common with an incidence rate of approximately 5 to 10 % in adults. Dyslexic adult students struggle in reading and writing, mispronounces words, faces difficulty in remembering dates, names, etc. and verbal instruction, poor recall of conversations or events, etc. These verbal problems may create issues for them in carrying out their studies and thus their academics will be affected.
52 THE RISE OF DRUG-RESISTANT TUBERCULOSIS IN SOUTHERN AFRICA: ARE WE LEARNING FROM HISTORY OR REPEATING IT? , T Apalata
Background and Objective The tuberculosis epidemic has reached astronomic and emergency proportions, particularly in Southern Africa, despite efforts by key stakeholders in implementing necessary control strategies. The diagnosis of TB is still based on smear microscopy in many parts of Africa while the emergence of drug-resistant TB is increasing. We are reporting on the outcomes of samples received in a TB reference laboratory in Swaziland and results from an assessment of non-clinical staff’s knowledge, attitudes, and beliefs towards TB and IPC related issues in public health facilities in South Africa. Methods A self-administered close-ended questionnaire was used to collect cross-sectional data among non-clinical staff in 5 public hospitals in KwaZulu-Natal between April 2011 and November 2011. In a TB reference laboratory in Swaziland, using   MGIT automated instrument, sputum samples were screened for TB from June 2011 to December 2011. Positive cultures were confirmed as MTB complex using ZN smears and TB Ag MPT64 and then, the drug susceptibility testing was done on RIF, INH, Streptomycin, and Ethambutol using the 1% proportion method. Results Of the 79 non-clinical staff, 67.4% were of the opinion that a surgical face mask protects the wearer from contracting TB while 44.3% did not understand the rationale behind triage and fast-tracking of patients in the TB control program. Of great concern, 25% of non-clinical respondents perceived no risk of contracting TB in the hospital environment and believed that TB was caused by drinking and smoking. Whilst 10% of these respondents desperately felt that there is no means of protection against TB; they also expressed that there is no need to implement a screening program for staff. Samples were obtained from 6163 patients of which 22.3% were culture positive and of these culture positives, 90% were MTB complex and 10% were NTM.  Among patients diagnosed with TB, 52% were smear-positive and 48% were smeared negative. Sixty-six percent of these cases were MDR follow up cases with 3.4% relapse cases, and 4.5% failure to convert. Conclusion While knowledge of staff about TB Infection Control is still very low, DR-TB cases are increasing. The study underlines the need to prevent DR-TB by bridging knowledge gaps among HCWs and the necessity to improve laboratory capacity to support TB control efforts.
53 FENOFIBRATES FOR SERUM LIPID ABNORMALITIES , Dr. Shah Murad
Allopathic drugs used as hypolipidemic agents have a number of unwanted effects. Herbal therapy for Hyperlipidemia is getting attention due to their less frequent side effects. In this study we have compared hypolipidemic effects of Fenofibrate 40 mg with Nigella sativa. Seventy-five hyperlipidemic patients from National Hospital Lahore were enrolled for the study. Consent was taken from all enrolled participants and were divided in three equal numbers i.e.; twenty-five in each group. Group 1 was on Nigella sativa, group 2 was on Gemfibrozil and third group was on placebo therapy. They were advised to take drugs for two months. After completion of the study pretreatment and post-treatment values of LDL cholesterol were analyzed statistically. In 25 patients who were on Nigella sativa, their LDL cholesterol decreased from 191.14±3.45 to 159.40±2.98 mg/dl. 31.7 mg/dl LDL reduction was observed when compared with the placebo group. In 25 patients who were on Fenofibrate 40 mg, their LDL cholesterol decreased from 197.77±3.91 mg/dl to 159.62±2.20 mg/dl. LDL reduction in this group was 38.2 mg/dl. These changes are highly significant with p-values of <0.001. We concluded from this study that the hypolipidemic characteristic of Nigella sativa is comparable and therapeutically as effective as traditionally used hypolipidemic medication Fenofibrate.
54 Clinical study of abdominal tuberculosis , Mr. Jashwant Shrivash, Mr. Shubham Chaurasia
This is a clinical study of 101 cases of abdominal tuberculosis admitted to the district hospital during May 2016-August 2018. Majority of abdominal tuberculosis patients presented in 21-30 years age and 11-20 years age groups which were 34.65% and 21.78% respectively. The majority of patients were females, which found to be 62 (61.39%) patients, while male 39 (38.61%) patients. The ratio of male to female was 1: 1.59. The majority of patients were from lower socioeconomic group i.e. 66 (65.35%) patients. The most common complaint was abdominal pain, which in all i.e. 100% patients. Followed by the next complaints were loss of weight and loss of appetite which were present in 77.23% and 73.27% patients. Past history of tuberculosis present in 8.91% of patients. The most common sign was pallor which was present in 67.33 patients and abdominal tenderness, which was present in 39.60% of patients. Anaemia was found, 69.31% of patients. Mantoux test was positive in 25.74% patients and ESR was raised in 67.33% patients. X-ray chest showed a positive finding of tuberculosis in 24.25% of patients. HIV was reactive in 4.95% of patients. Biopsy and CT abdomen pelvis have a maximum sensitivity of 100%. In all ascites patients, the Ascites ADA level was increased. Surgical Management was done in 66.34% of patients and 33.66% managed with chemotherapy alone. The most common surgical procedure was resection and anastomosis done in 26.87% of patients, followed by right hemicolectomy done in 23.88% patients. Diagnostic laparoscopy was done in 16.42% of patients. The most common operative findings were Ileocecal mass. The most common complication was wound infection. Mortality occurred in 1.49% of patients. In follow up 80% of patients completed 6 months of AKT and 20% were on AKT.
55 “Communication in the health sciences for the prevention of parasitic diseases in the community”: A critical analysis , Dr. Osvaldo Batista Rojas
Research on the theoretical basis of communication points to the fact that nowadays, the process is, from a social point of view, a means of achieving interpersonal relationships and it has strategic potential toward men’s social and cultural construction. A bibliographic review was carried out in order to approach the study of subject matters related to social communication in health and disease prevention in the community. Therefore, this paper aims to establish the theoretical basis that support the study of the relationship between communication in health and the implementation of precautionary work from the community. It is defended that social communication in health promotes dialogue and information exchange and it is an essential element in all health services. Key words: Social communication in health sciences, Parasitism, Infectious disease, Prevention, and control.
56 Celastrus paniculatus, Willd. from mandsaur district ,
Celastrus paniculatus, Willd. is an important medicinal plant of India, commonly found in Himalayan Tracts, Central India, Western and Eastern Ghats, Bihar, Orissa and Middle and South Andaman’s. C. paniculatus is commonly known as malkangani, kangani, jyotishmati, climbing staff plant and oriental bitter sweet tree, used by various tribes of India for the treatment of various diseases. Owing to the ever-increasing demand from the pharmaceutical industries and also the traditional systems, this plant is at high risk in India. Malkangani was reported as vulnerable in Amarkantak and Kerar ghati area, Bandhavgarh and Panpatha area Madhya Pradesh, Chhattisgarh and Orissa, Kerala and in Western Ghats. It was reported as critically endangered in Uttar Pradesh and Uttarakhand while near threatened in Karnataka, Tamil Nadu and Andhra Pradesh and least concerned in Maharashtra. We found this plant growing wildly in “Takhaji” and “Hinglajgarh” forest area of Mandsaur district of Madhya Pradesh. This plant was not reported earlier by any researcher or even forest department inspite of the fact that the reported areas come under reserve forest. The present study was aimed to: -Survey of medicinal plants available in the area. -Medicinal plants used by local people and tribes of the area. -Special attention was given to those plants which had already reported endangered from Madhya Pradesh and other states.   Keywords: Celastrus paniculatus, Willd., Critically Endangered, Last Concerned, Medicinal Plant, Near Threatened, Pharmaceutical Industry, Traditional System, Vulnerable
57 Phytochemical investigation and in-vitro anti-oxidant and in-vivo anti-diabetic evaluation of Berberis aristata , Mr. Shubham Chaurasia, Dr. Anil Kumar Chaurasia, Mr. Prashant Gupta, Miss. Priyanka Chaurasia
Antioxidants usually used to protect the food material from deterioration or deleterious effects of oxidation. Antioxidants are the defensive agents produced by the body to neutralize the effect of ROS (Reactive Oxygen Species). Diabetes mellitus is a chronic metabolic disease that affects the human body in terms of physical and mental health. It is becoming the third “killer” health of human beings along with cancer, cardiovascular, and cerebrovascular disorders. The prevalence of Diabetes mellitus is growing quickly global and the World Health Organization (2003) has predicted that by 2030 the number of adults with diabetes would have almost doubled worldwide, from 177 million in 2000 to 370 million. Current research on Berberis Aristata is directed towards finding naturally occurring anti-oxidants & Anti-diabetics activity of plant origin by preventing the progression of the free radical-mediated disorder.
58 A review on medicinal plants used by various tribes of india for the treatment of snakebite , Dr. Maya Pant
Tribal and rural populations face various medical emergencies due to remote locations. Among them, snakebite is a common acute medical emergency. It is very common in district Mandsaur of Madhya Pradesh with heavy rainfall and humid climate. The present review deals with various plant species used traditionally by bhil and bhilala tribes and rural people of the district for the treatment of snakebite. Keywords: Acute Medical Emergency, Climate, Humid, Plant, Snake Bite, Species, Tribes
59 Are strength and aerobic training responses mutually exclusive? Discuss , Dr. Ahmud Minhas General Practitioner, United Kingdom Dr. Mohammed Zubair Bhutta Family Consultant, United Kingdom  
The detailed review and study is suggesting whether strength and aerobic training responses mutually exclusive. Some studies suggest that concurrent endurance training leads to a decline in strength-like adaptations in training programmes. This is mainly due to the interference of the molecular signaling pathways as a result of both exercise stimuli. Training regimes need to be designed specific to the athlete including rest and nutritional intake, finding the optimal combination of strength and aerobic training required. Keywords: Aerobic training, Concurrent endurance, Molecular signaling, Stimuli
60 Effect of educational program on pressure ulcer prevention intervention among nurses of intensive care units at public hospital, pakistan , Nasira Hassan
Background: Localized damage of skin tissue due to elongate and extensive weight on bony eminences is called pressure ulcer. Study Purpose: The purpose of this study to evaluate the effect of an educational program on pressure ulcer prevention intervention among nurses in intensive care units at public hospitals, Pakistan. Research Methodology: A quasi experimental study proposal was used to explore the effect of an educational session of pressure ulcer prevention intervention among nurses of intensive care units. Results: There was a major difference between the mean knowledge score about the pressure ulcer preventive measures among nurses before (5.73±1.488) and after (12.01±.908) education sessions. P value is 0.000 which was less than .001 shows a significant difference in mean knowledge score before and after the education.  Keywords: Intensive care units (ICU), Pressure ulcer (PU)
61 Clinical decision making in midwifery practice: a concept analysis , Betty SakalaUniversity of Malawi, Kamuzu College of Nursing, Post Office Box 415 Blantyre, Malawi Ruth MwaleUniversity of Malawi, Kamuzu College of Nursing, Post Office Box 415 Blantyre, Malawi Esnath KapitoUniversity of Malawi, Kamuzu College of Nursing, Post Office Box 415 Blantyre, Malawi Veronica MaluwaUniversity of Malawi, Kamuzu College of Nursing, Post Office Box 415 Blantyre, Malawi Elizabeth GwazaUniversity of Malawi, Kamuzu College of Nursing, Post Office Box 415 Blantyre, Malawi Clara HaruzivisheUniversity of Zimbabwe, College of Health Sciences, Department of Nursing Sciences.
Aim: The aim of this concept analysis is to explore the concept clinical decision making in relation to midwifery care. Methods: The Walker and Avant, (2005) model of concept analysis was used to conduct the analysis by following steps used in the model from the purpose, definitions of the concept, antecedents, consequences, empirical reference and attributes. Results: Clinical reasoning was found to be an important element in clinical decision making as it helps to boost midwives’ level of confidence and competence to save lives of mothers and their babies. Conclusion: Labour wards may be associated with high stress levels due to staff shortages to manage obstetric emergencies. Despite all these problems, midwives are expected to make quick accurate decisions regarding patient management to save life of mothers and babies. Therefore, it is necessary for midwives to utilise clinical decision making to guide them in linking theory, practice and research. Keywords: Clinical Decision Making, Concept Analysis, High Stress Levels, Obstetric Emergencies, Midwives
62 Factors affecting birth weight at the jos university teaching hospital, jos, plateau state, north central nigeria , Dr. Obikili Chinedu GeorgeJos University Teaching Hospital, P. M. B. 2076, Lamingo, Jos, Plateau State, Nigeria. Prof Ocheke Amaka NJos University Teaching Hospital, P. M. B. 2076, Lamingo, Jos, Plateau State, Nigeria.
Background: Birth weight is one of the most easily assessed parameters in the new born. It can be used as an assessment of intra uterine fetal life and as a predictor of neonatal and later life. There are various factors both maternal and fetal that have been shown to be determinants of birth weight. The objective of this study was to assess the factors that affect birth weight at the Jos University Teaching Hospital. Materials and method: A 3 year retrospective observational study was conducted looking at the 4279 babies born during this period and evaluating which factors could lead to heavier babies and some immediate obstetric consequences of such babies to their mothers. The required data was collected from the labour ward records and analysis using Excel 16.0. Results: The results showed that fetal sex, parity, maternal age and educational level all have a role to play in the eventual weight of babies. It also showed that higher birth weights did not lead to worse perineal tears. Conclusion: The conclusion was that the factors affecting birth weight in this study reflect similar studies with additional factor of educational level and buttressing the thinking that larger birth weight does not predispose to more severe perineal tears.   Keywords: Birth Weight, Outcome, Jos, Determinants, Nigeria
63 Characterization of lung diseases using computed tomography in burydah city , Abdelmoneim Saeed AhmedCollege of Applied Medical Science, Qassim University, Burydah, KSA. P. O. Box: 6800. & Postal code 51452
Background: This study was designed to characterize the chest diseases using MSCT. To determine the diagnostic value of MSCT in the chest diseases and to know their prevalence in Qassim region. Methods and materials: A retrospective review of medical records from 19 February 2017 to 12 May 2018 was carried out of patients, who had undergone chest CT with and without IV contrast, were reviewed. A total of 55 patients with lung diseases were analyzed 30 (55%) were males and 25 (45%) females. Their age ranged from 20-80 (mean±41years) in Burydah central hospital and King Saud hospital, who are complaining from lung diseases and they have clinical evidence. Data recorded with the variables of interest; the gender, age, smoking habits residential states, types of pathology, the symptoms and breathing rate. The collected data have been analyzed using statistical package for social science SPSS version 21 and the data have been shown in bars, percentage % and correlations. Results: This study revealed that most of the cases had airway diseases which represent 14.5 %, with average age 41 years. Most of the affected cases were males, their ages above 30 years. Followed by multi metastasis which represents 10.9% of all cases their ages above 51 years and it is common in male patients. Conclusion: It concluded that MSCT imaging is best imaging technique that allows for non- invasive evaluations of chest diseases with a high diagnostic precision and well characterized, and have remarkably improved disease outcomes as well. Strongly significant link was observed between respiratory rate and age, P value (0.001). Although chest radiographs are still useful as an initial test. Keywords: Computed tomography, Chest, X-ray diseases
64 Acute oral toxicity study of a polyherbal formulation immunofree in wistar albino rats , Mr. Puneet MittalMittal Global Clinical Trial Services Dr. Amit Kumar PalInstitute for Industrial Research & Toxicology Sonakshi ChaudharyMittal Global Clinical Trial Services Dr. Abhijit MunshiMittal Global Clinical Trial Services
The acute oral toxicity study of Immunofree tablets was done on wistar albino rat species. The study was done under the OECD Guideline-423. The healthy wistar albino rats of body weight 190±20 gm were selected for the study after acclimatization to standard laboratory conditions and were divided into test compound three animals. COVID-19 affects the respiratory tract. It causes flu in the initial stage while severe pneumonia and breathlessness in late stages. The Immunofree tablet or the test product is an Ayurvedic proprietary medicine and is a combination of the polyherbal mixture. The components of this formulation are known for their anti-viral and immunomodulatory effects.   Keywords: Acclimatization, Antiviral, Ayurvedic, COVID-19, Immunofree, Immunomodulatory, OECD Guideline, Polyherbal, Toxicity, Wistar Albino Rat