A clinical study to determine metformin as a cause of serum vitamin B12 decrease and effect of combination of metformin and mecobalamin on serum vitamin B12 levels in type 2 diabetics

Background: Several evidences show metformin decreases vitamin B12. Diabetics are also at the risk of developing neuropathy which is treated with vitamin B12. metformin being initial therapy for diabetic patients, it becomes all the more important to know the extent of this decrease. The study was designed with the objective to compare the levels of vitamin B12 in patients on metformin vis-à-vis on antidiabetic drugs other than metformin and to evaluate the increase in vitamin B12 levels after prescribing a combination of metformin and mecobalamin, in T2DM patients.Methods: Of 500 enrolled, 321 patients completed the study for duration of 6 months, divided in two periods of 3 months each. At the end first period of 3 months the vitamin B12 levels were compared form Metformin vs. that of other antidiabetics. In second period of 3 months a combination of metformin and mecobalamin was given instead of plain metformin and vitamin B12 levels were repeated at the end of this period.Results: There was reduction in vitamin B12 levels with metformin with levels of 272.5pg/ml compared to 714.6pg/ml with other antidiabetics at the end of first period. The levels increased from 272.5pg/ml to 615.9 pg/ml at the end of second period after receiving the combination of metformin and mecobalamin.Conclusions: T2DM patients being treated with metformin had a greater risk of reduction in vitamin B12 levels and addition of vitamin B12 in the form of mecobalamin would decrease the reduction in vitamin B12 levels associated with Metformin therapy

Study of feto maternal outcome of teenage pregnancy at tertiary care hospital

Background: Teenage pregnancy due to changing social conditions, it’s important to study the implications of the maternal and fetal health. It is a serious health problem, more so in developing countries like India. Young mothers and newborns are at increased risk of anaemia, pre-eclampsia, increased rate of LSCS, PTVD, LBW, prematurity, NICU care, RDS, sepsis, IUGR. Hence, study is directed to identify the problems and their outcome.Methods: Teenage pregnant ladies between 18 to 20 years were taken up for the study. Study duration was 1 year from January to December 2016, at SDM Medical College Dharwad. During this period, all cases were included in the study, irrespective of their booking and unbooking statuses after 28 weeks of pregnancy are taken.Results: Study showed the incidence of teenage pregnancy is 10.26%. 79.2% of teenage mothers have varying grades of anaemia, 13.6% of women had eclampsia, 16.01% had preterm deliveries, LSCS rate were as high as 52%, 17.4% had instrumental deliveries, 12.5% were low birth weight neonates, 8.4% requiring NICU care and 2% were perinatal deaths due to prematurity, respiratory distress, sepsis.Conclusions: As teenage pregnancy is associated with high risk of anaemia, pre-eclampsia, eclampsia, PTVD, instrumental delivery, high rate of LSCS, prematurity, low birth weight, perinatal death. It’s important to reduce the teenage pregnancy by improving the socio-economic condition, education, public awareness, strict implementation of law, good ANC care, nutrition, access to contraceptive services, sex education

A retrospective study of 296 cases of intra uterine fetal deaths at a tertiary care centre

Background: To identify the risk factors and to streamline preventive and management protocols for IUD.Methods: This was a retrospective study from January 2011 to December 2012 which was conducted at G.S.V.M. Medical College, Kanpur. IUD was defined as fetal death beyond 20 weeks of gestation and/or birth weight > 500g. Maternal and fetal records were analysed. Mode of delivery and associated complications were studied.Results: Total number of deliveries were 7310.Incidence of IUD at our centre was 40 per 1000. 55.73% were antepartum and 11.06% were intra partum. In 33.44% cases, no causes were identified. Among the identifiable causes, very severe anemia (16.55%) and hypertensive disorders (10.81%) were most common followed by placental causes (12.16%).Congenital malformations were responsible for 9.45% cases .Induction was done in 151 patients,111 patients had spontaneous onset of labour and caesarean section was done in 34 patients. The most devastating complication of IUD was DIC found in 14 patients (3.71%).Conclusions: The present study is an effort to compile a profile of maternal, fetal and placental causes culminating to IUD at our centre. This emphasizes the importance of proper antenatal care and identification of risk factors and its treatment. Institutional deliveries should be promoted to prevent intrapartum fetal deaths .A substantial number of IUD are still labeled as unexplained, hence cannot be prevented. Decrease in the incidence of IUD would significantly reduce the perinatal mortality

PARVIMONAS MICRA AND FUSOBACTERIUM NUCLEATUM SEPTIC ARTHRITIS: A RARE ANAEROBIC DOUBLE TROUBLE

Septic arthritis is a condition initiated by pathogenic inoculation of joints either by direct or hematogenous route, necessitating immediate medical attention. Among aerobic bacteria, Staphylococcus aureus and Streptococcus spp. are commonly found in association with septic joints. Anaerobes are very rarely involved in the causation of septic arthritis with an estimated rate of <1%. We are presenting a case of septic arthritis of knee joint by Parvimonas micra and Fusobacterium nucleatum, both being constituents of microbial flora in the oral cavity and gastrointestinal tract. Gram stain and anaerobic culture incorporated along with the aerobic culture of synovial fluid have played an important role in the preliminary diagnosis of anaerobic septic arthritis in this case

Photodynamic Therapy – A Non-invasive Treatment Modality for Precancerous Lesions

Introduction: Oral premalignant lesions are conditions having high potential tendency for transformation into malignancy. The use of a conservative and effective treatment modality is one of the best strategies for cancer prevention. Photodynamic therapy (PDT) is a non-invasive method for topical and selective treatment of oral precancerous lesions. The present study was taken up to determine the efficacy of PDT in oral precancerous lesions.Methods: The study consisted 13 patients with 24 oral leukoplakia (OL) lesions and 8 with 20 oral lichen planus (OLP) lesions, divided into control and study groups. These lesions were affecting various intraoral sites, the buccal mucosa being the most common site followed by tongue and gingiva. The treatment regimen of PDT included 98% 5–aminolevulinic acid (5-ALA) which is topical applied and irradiated with light emitting diode (LED) of 420 nm wavelengths at several sessions.Results: In OL 16.6% of cases showed complete response, 66.6% partial response and 16.6% no response of the lesions to the treatment. In OLP 80% and 20% of the lesions showed partial and no response respectively. The differences with control groups for OL + OLP were found to be significant (P < 0.001).Conclusion: Based on the results of the present study, we can conclude that PDT appears to be a feasible alternative to conventional therapy for oral premalignant lesions

Frontoethmoid Mucocele causing Unilateral Proptosis

Introduction  Mucoceles occur most frequently in the frontal and ethmoidal sinuses, without gender prevalence. Presenting symptoms can include facial pain, headache, nasal obstruction, diplopia, decreased visual acuity, orbital globe displacement, facial swelling and meningitis, depending on the anatomic area involved. The gold standard in terms of diagnostic precision is computed tomography scan. Case Report The present study describes case of frontoethmoidal mucocele with orbital involvement that was treated by transnasal endoscopic approach obtaining good outcomes, demonstrating safety and efficacy of this surgical approach. Conclusion  Transnasal endoscopic management of mucoceles is preferred due to minimal trauma and less morbidity

Incidence of Mast Cells in Oral Squamous Cell Carcinoma: A Short Study

Mast cells are regarded as complex and multifunctional cells, playing a significant role in immunopathology and a substantial role in tumor angiogenesis. Angiogenesis is a complex process that is tightly regulated by various growth factors in which mast cells act directly by releasing angiogenic factors and henceforth promoting tumor growth and metastasis. The aim of this study is to evaluate the number of mast cells in tissue sections of oral squamous cell carcinoma (OSCC) in comparison with normal mucosa. A total of 40 cases (20 OSCC and 20 normal mucosa) were stained with 1% toluidine blue and the quantitative analysis was done by using light microscope under 400x magnification. A significant increase in the mast cell count was observed in the sections of OSCC when compared to normal mucosa suggesting their contributing role in tumor growth and progression

Simultaneous Determination of Rofecoxib and Tizanidine by HPTLC

Abstract: An innovative high performance thin layer chromatography method was developed and validated for simultaneous determination of rofecoxib and tizanidine from tablet dosage form. Rosiglitazone maleate was used as an internal standard. The separation was achieved using HPTLC plates (Merck #5548) precoated with silica gel 60F 254 on aluminum sheets and a mobile phase comprising of toluene: ethyl acetate: methanol: triethyl amine in volume ratio of 6:3:0.5:0.1 (v/v/v/v), with chamber saturation of 15 min. The plate was developed up to 8 cm and air dried. The plate was then scanned and quantified at 235 nm. The linearity of rofecoxib and tizanidine were in the range of 3.75 µg/spot to 11.25 µg/spot and 0.30 µg/spot to 0.90 µg/spot respectively. The limit of detection for rofecoxib and tizanidine was found to be 45.00 ng/spot and 30.00 ng/spot respectively. The limit of quantification for rofecoxib and tizanidine was found to be 135.00 ng/spot and 90.00 ng/spot respectively. The percentage assay was found between the range of 99.58% to 103.21% for rofecoxib and 98.73% to 101.55% for tizanidine respectively, whereas recovery was found between 99.97% to 100.43% for rofecoxib and 100.00% to 101.00% for tizanidine by standard addition method. The proposed method is accurate, precise and rapid for the simultaneous determination of rofecoxib and tizanidine in dosage form