Neonatal screening for hypothyroidism by time - Resolved fluoroimmunoassay in Jharkhand

Objective: To screen newborns for congenital hypothyroidism by time resolved fluoroimmunoassay (TRFIA) (TRFIA meter by Perkin Elmer). Methods: Participants were randomly selected from the Department of Paediatrics/Obstetrics and Gynaecology, Rajendra Institute of Medical Sciences and Maternity Hospitals around 20 km of Rajendra Institute of Medical Sciences, Ranchi. Blood samples were obtained by heel prick for thyroid-stimulating hormone (TSH) estimation from newborns selected from abovementioned hospitals. Samples were collected from 3rd day of life to 7th day of life on a filter paper card and analyzed by TRFIAbased method. Results: 60% of the newborns were male and 40% were female among 150 newborns selected for study. Out ofthem, 65.33% were term, 28% were pre-term, and 6.67% were post-term. 92% newborns had TSH level <10 mIU/L, 8% had TSH between 10 and 20 mIU/L and none had TSH value >20 mIU/L. Conclusion: The prevalence of borderline TSH assay was 80/1000 newborns, which is significant. Screening studies for such conditions need larger sample size, stronger logistics to cover a larger area

A follow up study of postpartum intrauterine device insertion in a tertiary health care centre

Background: In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective and long-term contraception such as intrauterine device (IUCD) in post-partum women. This study was done to determine the efficacy and safety of Post-Partum Intrauterine Device (PPIUCD) and to compare the outcomes of PPIUCD insertion after vaginal delivery and caesarean section.Methods: This follow up study was carried out in the department of Obstetrics and Gynecology, Dr. R.M.L Hospital, PGIMER, New Delhi over a period of 7 month from January 2016 to July 2016. PPIUCD (cu T- 380 A) insertions were done in 136 women who fulfilled the inclusion criteria. Women having haemoglobin less than 8 gm%, rupture of membranes more than 18 hours, obstructed labour, Uterine anomalies, distorted uterine cavity by fibroid, significant postpartum haemorrhage, coagulation disorders, fever or clinical symptoms of infection during labour were excluded from the study. Post insertion counselling was done, and these women were advised to follow up at 6 weeks and then after 6 months postpartum in the family planning O.P.D. At the follow-up visit, the women were asked for any symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed.Results: Total number of cases that reported for follow up in family planning OPD was 118. Therefore, 18 patients were lost in the follow up. In 58.47% women, there was no complaint. Heavy menstrual bleeding was found in 17.79% women and pelvic pain in 16.10% women. The expulsion rate was 5.08% and IUCD removal was done in 12.71% women. Though, the incidence of expulsion and removal rate was more in vaginal insertions than in caesarean insertions but this difference was not statistically significant, while the incidence of missing threads were found more in intra caesarean insertion (28% vs. 11.76% with p value <0.05). Continuation rate at 6 month was 82.20%.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. Although the expulsion rate and removal rate was more in vaginal PPIUCD insertions, the benefits of providing highly effective contraception immediately after delivery outweigh this disadvantage, particularly in our country where most of the women do not come for contraceptive advice after delivery

Evaluation of oxidative stress in severe acute malnourished children at malnutrition treatment centre of Sardar Patel Medical College, Bikaner, Rajasthan, India

Background:Malnutrition represents one of the most severe health problems in India. Free radicals play an important role in immunological response, which induces the oxidative surplus in severe acute malnutrition. Severe dietary deficiency of nutrients leads to increased oxidative stress in cellular compartments. The goal of this study was to evaluation of oxidative stress in severe acute malnourished children at malnutrition treatment centre of S. P. Medical College, Bikaner, Rajasthan, India.Methods: The cross sectional study was conducted after the approval of ethical committee, in the Department of Biochemistry and Paediatrics at Sardar Patel medical College of Bikaner. The present study included 100 children between the age of 6 months to 5 years with the help of Paediatrician. Serum Lipid peroxide was measured by precipitating lipoproteins with trichloroacetic acid and boiled with thiobarbituric acid which reacts with Malondialdehyde to give pink colour as per Kei satoh's method.Results: Significantly increased levels of serum malondialdehyde (p <0.001) were found in the patients as compared to those in controls.Conclusion: Deficiency of various nutrients in severe acute malnutrition leads to generation of heavy oxidative stress

Time-to-death approach in revealing chronicity and severity of COVID-19 across the world

Background The outbreak of coronavirus disease, 2019 (COVID-19), which started from Wuhan, China,in late 2019, have spread worldwide. A total of 5,91,971 cases and 2,70,90 deaths were registered till 28th March, 2020. We aimed to predict the impact of duration of exposure to COVID-19 on the mortality rates increment. Methods In the present study, data on COVID-19 infected top seven countries viz., Germany, China, France, United Kingdom, Iran, Italy and Spain, and World as a whole, were used for modeling. The analytical procedure of generalized linear model followed by Gompertz link function was used to predict the impact lethal duration of exposure on the mortality rates. Findings Of the selected countries and World as whole, the projection based on 21st March, 2020 cases, suggest that a total (95% Cl) of 76 (65–151) days of exposure in Germany, mortality rate will increase by 5 times to 1%. In countries like France and United Kingdom, our projection suggests that additional exposure of 48 days and 7 days, respectively, will raise the mortality rates to 10%. Regarding Iran, Italy and Spain, mortality rate will rise to 10% with an additional 3–10 days of exposure. World’s mortality rates will continue increase by 1% in every three weeks. The predicted interval of lethal duration corresponding to each country has found to be consistent with the mortality rates observed on 28th March, 2020. Conclusion The prediction of lethal duration was found to have apparently effective in predicting mortality, and shows concordance with prevailing rates. In absence of any vaccine against COVID-19 infection, the present study adds information about the quantum of the severity and time elapsed to death will help the Government to take necessary and appropriate steps to control this pandemic

Bioremediation Techniques for Soil Pollution: An Introduction

Environmental pollution has been on the rise in the past few decades owing to increased human activities on energy reservoirs, unsafe agricultural practices and rapid industrialization. Soil pollution is one of the major worry among all because soil contamination can harm the humans by consumption of food grown in polluted soil or it can cause infertility to soil and lower the productivity, Among the pollutants that are of environmental and public health concerns due to their toxicities are: heavy metals, nuclear wastes, pesticides, greenhouse gases, and hydrocarbons. So this chapter will include; Sources of soil pollution and remediation of polluted sites using biological means has proven effective and reliable due to its eco-friendly features. Bio-remediation can either be carried out ex situ or in situ, depending on several factors, which include site characteristics, type and concentration of pollutants. It also seen as a solution for emerging contaminant problems

A study of thyroid dysfunction in dysfunctional uterine bleeding

Background: The objective of the study was to evaluate the prevalence of thyroid dysfunction in dysfunctional uterine bleeding and to assess the menstrual and endometrial pattern in women with thyroid disorders.Methods: The present study was conducted on 200 patients who presented with dysfunctional uterine bleeding in gynecology OPD.Results: Among the 200 women 39 (19.5%) had hypothyroidism, 2 (1%) had hyperthyroidism and 159 (79.55%) were euthyroid. Menorrhagia was the most common menstrual disorder in hypothyroidism and oligomenorrhoea in hyperthyroidism. In the present study 74.3% patients had proliferative endometrium,26.3% secretory endometrium, in hypothyroid patients and secretory endometrium in 2 (1%) hyperthyroid patients. A woman with hypothyroidism, commonly presents with anovulation and unopposed oestrogen activity causes endometrial hyperplasia which may outgrow the blood supply and may cause local areas of necrosis and breakdown and produces bleeding.Conclusions: The menstrual irregularities are significantly more frequent in patients with thyroid dysfunction and menorrhagia was the commonest menstrual abnormality. The study concludes that biochemical evaluation of thyroid function should be made mandatory in all cases of abnormal uterine bleeding and this would avoid unnecessary surgeries and exposure to hormones

Risk factors for low bone mass in healthy young adults from North India: studies on BMD and bone turnover markers

Background: Despite availability of adequate sunshine, Indian population has the highest prevalence of low bone mass and Bone Mineral Content (BMC). Risk factors for osteoporosis have been extensively studied in the west but poorly investigated in India. We studied BMD and Bone Turnover Markers (BTMs) among healthy young adults.Methods: Fifty one healthy young adults (28 Males, 23 Females) in the age group of 20-35 years were studied. Morphometric, biochemical parameters and BMD (whole body, spine, hip & wrist) were recorded. Anthropometric measurements included height, weight, BMI and Waist/Hip Ratio (WHR). BTMs studied included - serum Bone-Specific Alkaline Phosphatase (sBAP), serum Collagen cross-linked C-Terminal telopeptide (sCTx), serum Osteocalcin (OC) and human intact parathyroid hormone (hPTH) using standard ELISA kits.Results: Of 51 healthy volunteers 21.57% had normal BMD, 13.73% were frankly osteoporotic and 64.70% were osteopenic. Age, weight and BMI were the best predictors of total BMD and BMC at all sites. sCTX positively correlated with Total Bone Area (TBA), BMD at Hip and Forearm. Using multiple regressions - age, weight, and BMI were significant predictors of BMD in young adults. Percentage body fat had inverse correlation with BMC, BMD and TBA. Weight and height positively correlated with BMD at femoral neck, inter-trochanter and Ward’s triangle. Body weight was best predictor of BMD at femoral neck, Ward’s triangle, forearm UD, forearm MID and forearm1/3.Conclusion: Majority of healthy young Indians have poor bone health as evidenced by bone markers.

A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

Background: Caesarean section is most frequently performed surgery worldwide. Patients experience moderate to severe pain in the first 48 hours post-operatively. Aim of this study was to evaluate the efficacy of dexmedetomidine and dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block for postoperative analgesia in patients of caesarean section.Methods: A total 120 ASA I and II patients undergoing elective and emergency caesarean section under subarachnoid block were randomly divided into three groups B, BDM, BDX to receive bupivacaine alone or dexmedetomidine or dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block. Postoperatively, the patients were evaluated for pain level at rest and on movement with a 10 cm visual analog scale (VAS) pain score (0 = no pain and 10 = worst pain), time to demand of first analgesic request, number of analgesic requirements, nausea or vomiting, sedation and patient satisfaction at 0 hours and at 2, 4, 6, 12, 18, and 24 hours.Results: VAS score was significantly higher in group B in comparison to BDM and BDX, and higher in BDX in comparison to group BDM. Mean duration of analgesia was significantly higher in group BDM in comparison to group B and BDX. Total number of rescue analgesic demands were significantly lower in group BDM in comparison to group B and BDX. Sedation score and satisfaction score was higher in group BDM as compared to group B and BDX.Conclusions: Addition of dexmedetomidine and dexamethasone as an adjunct to bupivacaine reduces postoperative pain, prolongs analgesia, decreases demand for additional analgesics and provides better maternal satisfaction as compared to plain bupivacaine group in TAP block in patients undergoing caesarean section under subarachnoid block. Among dexmedetomidine and dexamethasone, dexmedetomidine had prolonged analgesia as compared to dexamethasone group

Study of psycho-social impairment in patients presenting with age related macular degeneration in a tertiary eye care hospital

Background: Age Related Macular Degeneration (ARMD) is an eye condition affecting old age people causing severe vision loss. This study was carried out to assess the psycho-social impairment in the ARMD patients and compare it with the normal eye patients.Methods: A Two study groups were made: 1. ARMD patients. 2. Control group patients. Patients of both the groups were made to fill “The validated Gujarati version of: General Health Quality Questionnaire-28 (GHQ 28)”. Self-scoring was done according to 0-1-2-3 lower to higher disability respectively.Results: Prevalence GHQ Mean score of ARMD patients was 34.27 and that of normal eye patients was 24.66. 80.85% of ARMD patients and 26.73% of normal eye patients were psychosocially impaired.Conclusion: ARMD patients are psychosocially more impaired as compared to control group patients (p value <0.001, highly significant).

HEPATIC DYSFUNCTION IN DENGUE: A TERITARY CARE HOSPITAL EXPERINCE

Objective: The objective of the study was to evaluate liver dysfunction in patients with dengue infections and corelation between liver function test and platelet count. Methods: Hospital-based case−control study conducted on 141 hospitalized with Dengue infection (NS 1 and IgM positive). Dengue seropositive patients are selected and subjected to complete blood count and liver function tests were analyzed. Results: The participants were found to have elevated levels of SGOT, SGPT levels, and lower levels of serum albumin and platelet count as compare to control on evaluation. The significant negative correlation was noted between SGOT/SGPT levels and baseline platelet counts levels. The Pearson correlation between platelet count and SGOT showed r=−0.185 and p&lt;0.01 which proves that when platelet count decreases, the SGOT levels increases. Similarly, for the correlation between platelet count and SGPT showed r=−0.166 and &lt;0.01 which proves that when platelet count decreases, the SGPT levels increase. Conclusion: Statistically significant corelation was observed between liver enzymes with platelet count. Furthermore, the severity of dengue infection predicted the severity of liver derangements. It is recommended that patients with dengue infections be screened for hepatic dysfunction. As hepatic dysfunction in dengue is transient and reversible, early identification of the same would help to reduce life threatening complications