Prevalence of hepatitis B in pregnant women and management of babies born to Hepatitis B positive mother: A criterion based clinical audit

Introductions: This study aims at identifying the prevalence of Hepatitis B virus infection in pregnant women and adherence to the management of the newborns of these women as per the international guidelines. Methods: This is a cross sectional study conducted at Patan Hospital from January 1, 2008 to December 30, 2014. Prevalence of HBsAg in pregnant women and management of babies born to these women, immunization status, breast feeding status and follow up advise for the babies were studied.  These data were analyzed to see whether we were following international guidelines for preventing mother to child transmission of hepatitis B infection. Results: There were total of 58,917 deliveries and 59,438 births during the seven year study period. Total 148 cases of pregnant ladies with HBsAg positive status were recorded. Prevalence of HBsAg positive case was 1 in every 398 (0.25%) deliveries. Fifty four babies (87%) received hepatitis B vaccine (HBV) and hepatitis B immunoglobulin (HBIG) within 12 hours of birth. Eight babies (22%) failed to receive HBV and HBIG within 12hours of birth. Mother’s HBsAg positive status was not the reason for formula feeding in any of the babies. Follow up HBsAg status was not advised in any of the babies. Conclusions: At Patan hospital, we seem to be following most of the guidelines in the management of HBV infection, except for checking the HBsAg status of the babies at 9-18 months of age.Keywords: chronic liver disease, HBsAg positive, hepatitis B vaccine, Hepatitis B immunoglobulin, mother to child transferÂ

A study to determine the prevalence of urinary incontinence in antenatal women at a tertiary care centre in central India

Background: Urinary incontinence is a common condition in pregnancy and postpartum. There are more than a thousand articles on urinary incontinence (UI) in pregnancy but very limited literature from Indian subcontinent is available. Incidence and prevalence figures of UI in association with pregnancy vary substantially. Not many reviews have focused solely on incidence and prevalence of UI in association with pregnancy. Prevalence of UI in pregnancy ranges from 32% to 64%.Methods: A cross sectional observational study was conducted in the department of obstetrics and gynecology, MGM Medical College and M.Y. Hospital, Indore over the period of 6 months on 1000 pregnant women who were following antenatal care (ANC) clinic. Pregnant women, who were severely sick, diagnosed with kidney or urinary infection and vaginal infections women were excluded from the study. The data were collected using a structured questionnaire. After the purpose of the study was explained, written consent was obtained from each voluntary participant. This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA 12.1.Results: In the present study the prevalence of urinary incontinence reported is 16.4% of women during pregnancy.Conclusions: In this study the prevalence of UI during current pregnancy was found to be lower compared to previous studies conducted. The previous history of surgery, constipation, obesity and respiratory problems were found to be significantly associated with UI during pregnancy

An Overview on Patient-Centered Clinical Services

Drug-related problems (DRPs) had often been a concern in the system that needed to be detected, avoided, and addressed as soon as possible. The need for a clinical pharmacist becomes even more important. He is the one who can not only share the load but also be an important part of the system by providing required advice. They fill out the patient's pharmacotherapy reporting form and notify the medical team's head off any drug-related issues. General practitioners register severe adverse drug reactions (ADRs) yearly. As a result of all of this, a clinical pharmacist working in and around the healthcare system is expected to advance the pharmacy industry. Its therapy and drugs can improve one's health quality of life by curing, preventing, or diagnosing a disease, sign, or symptom. The sideshows, on the other hand, do much harm. Because of the services they offer, clinical pharmacy has grown in popularity. To determine the overall effect and benefits of the emergency department (ED) clinical pharmacist, a systematic review of clinical practice and patient outcomes will be needed. A clinical pharmacist's anatomy, toxicology, pharmacology, and medicinal chemistry expertise significantly improves a patient's therapy enforcement. It is now important to examine the failure points of healthcare systems as well as the individuals involved

A study of the risk factors and outcome in patients with upper gastrointestinal bleed presenting to a tertiary care center in Kumaon region of Uttarakhand

Background: Upper gastrointestinal (GI) bleeding refers to blood loss within the intraluminal GI tract from any location between the upper esophagi to the duodenum at the level of the ligament of Treitz. Bleeding from the upper GI tract may present as hematemesis, melena, hematochezia, occult GI bleeding, and anemia. Aims and Objectives: The aims of this study were to study the risk factors and outcome in upper GI bleed patients presenting to a tertiary care center in Kumaon region of Uttarakhand. The primary objective was to estimate the proportion of mortality in upper GI bleed patients attending a tertiary care center. The secondary objective was to study the risk factors associated with upper GI bleed and their effect on mortality. Materials and Methods: This was a hospital-based observational prospective clinical study, carried out in the Department of General medicine, Dr. Susheela Tiwari Memorial Hospital and associated Government Medical College, Haldwani, from January 2020 to September 2021 after obtaining ethical clearance from the Institutional Review Committee and informed consent from the patient or patient relatives. Statistical testing has been conducted with the Statistical Package for the Social Science software (SPSS version 20.0). Results: The factors associated with mortality using multivariate analysis were high international normalized ratio (INR), low albumin, raised serum glutamic oxaloacetic transaminas, high Child Pugh Score, and high model for end stage liver disease (MELD) score found to be significant. Conclusion: The mortality rate in our patients was 18% and factors associated with increased mortality were high INR, low Albumin, raised creatinine, high Child Pugh Score, high MELD score, and presence of spontaneous bacterial peritonitis

An application of ordinal regression to extract social dysfunction levels through behavioral problems

Psychological problems are complex in nature and accurate identification of these problems is important. For the identification of psychological problems, one of the preliminary tools is the use of interviews/questionnaires. Questionnaires are preferred over interviews if the group under study is large. A strengths and difficulties questionnaire (SDQ) is one of the most widely used and powerful questionnaires to identify behavioral problems and distresses being faced by the respondents, affecting their day-to-day lives (responsible for social dysfunction). This study was held on college/university students in India, with the objective of examining if the extent of social dysfunction as measured by an impact score can be extracted from behavioral problems which are the components of the difficulty score of SDQ. Two surveys were conducted during the COVID-19 pandemic period, between the months of May–June 2020 and October 2020–February 2021 for the study. Only those responses were considered who felt distressed (“yes” to item 26 of SDQ). The numbers of such responses were 772/1020 and 584/743, respectively, in the two surveys. Distress levels were treated as ordered variables and three categories of distress level, viz., “Normal”, “Borderline”, and “Abnormal” were estimated through behavioral problems using ordinal regression (OR) methods with a negative log-log link function. The fitting of OR models was tested and accepted using Cox and Snell, Nagelkerke, and McFadden test. Hyperactivity-inattention and emotional symptoms were significant contributors to estimating levels of distress among respondents in survey 1 (p < 0.05). In addition to these components, in survey 2, peer problems were also significant. OR models were good at estimating the extreme categories; however, the “Borderline” category was not estimated well. One of the reasons was the use of qualitative and complex data with the least wide “Borderline” category, both for the “Difficulty” and the “Impact” scores

Diagnostic utility of α-methylacyl CoA racemase (P504S) & HMWCK in morphologically difficult prostate cancer

<p>Abstract</p> <p>Background</p> <p>To evaluate the diagnostic utility of alpha-methylacyl CoA racemase (P504S) & HMWCK (34beta E12) in morphologically difficult prostate cancer.</p> <p>Methods</p> <p>A total of 1034 cases were reviewed and divided into benign (585) malignant (399) and suspicious (50). Immunohistochemistry with HMWCK and AMACR was done on the 50 suspicious cases along with controls.</p> <p>Results</p> <p>Forty nine suspicious cases were resolved by using both markers where as 1 case was resolved by further support with CD68. The original diagnosis was changed in 15 of 50 (30%) suspicious cases from benign to malignant, one case from benign to high grade PIN and in one case from malignant to benign. Change of diagnosis was seen in 17 of 50 (34%) suspicious cases with a significant p value of 0.002. The overall diagnosis was changed in 17 of 1034 cases (1.64%) of prostatic disease (p < 0.001).</p> <p>Conclusions</p> <p>A combination of HMWCK and AMACR is of great value in combating the morphologically suspicious cases and significantly increasing the diagnostic accuracy in prostate cancer. Although, in this study the sensitivity and specificity of HMWCK and AMACR were high, yet it should be used with caution, keeping in mind all their pitfalls and limitations.</p

Exploring possibilities of enhancing water use efficiency in potato: A review

Climate change threatens the global agriculture sustainability. Among different kinds of abiotic stresses, water stress is the most devastating component which curtails potato crop productivity. Our recent knowledge is limited concerning water stress tolerance and water use efficiency in potato. Many efforts are being made by the scientific community to reduce water use and to produce “more crop per drop”. This review elaborates quantitative and qualitative aspects of multiple stress mechanisms and their regulating system related to present scenario of water use efficiency (WUE) requirements. WUE can only be improved by using multidisciplinary promising research approaches like molecular breeding, high throughput genotyping, multi-gene transfer and bioinformatics applications to unleash the information needed to exploitation of required traits in potato

Phenolic and antioxidant capacity retention of potato peel waste as a function of cultivar, pretreatment and drying procedure

Drying procedures employed for potato peels (both raw and boiled) may adversely affect the useful bioactivecomponents present in them. This study envisaged the identification of a feasible drying procedure for handlingbulk potato peel waste for maximising the retention of phytochemicals in the peel powder. The total phenols (TP), flavonoids (TF) and antioxidant capacity (TAC) were assessed in peels of three commercial and one newly developed anthocyanin rich Indian potato cultivars in response to boiling pretreatment and varying drying procedures. Microwave drying (600W) was best in terms of drying rate for both raw and boiled peels. It yielded the greatest amount of TP and TF in the dried raw peel, irrespective of cultivar. Dried raw peels of an thocyanin rich Kufri Neelkanth cultivar exhibited maximum TAC. Retention of TF, metal scavenging activity and reducing power followed almost a similar pattern as TP irrespective of cultivar, pretreatment and drying procedure. Our study shows that potato peel from Kufri Neelkanth (raw) and Kufri Frysona (both raw and boiled) are best source of phenolics and flavonoids and can serve as a suitable matrix for extraction of bioactive compounds which holds promise for use in the food industry