A study of thyroid disorders in females attending obstetrics and gynecology outpatient department of a tertiary care institute of central India

Background: The study was conducted with an objective to study the spectrum of thyroid dysfunction and to correlate clinical symptoms with abnormal thyroid function.Methods: A total no. of 1010 women, attending the Gynecology and Medicine OPD of M.Y. Hospital, Indore, MP were subjected to screening with TSH levels estimation. The women with abnormal TSH values were then evaluated for various clinical symptoms.Results: Out of total 1010 women, 120 had abnormal TSH. The prevalence was high (11.88%). Hypothyroidism (71.66%) was more common than hyperthyroidism (28.33%). The incidence of thyroid disorders was higher with advancing age. Abnormal TSH levels had a linear correlation with increasing BMI. Majority of the patients presented with vague symptoms commonest being weight changes (24.15%). Abnormal uterine bleeding (5.8%) and infertility (5.8%) were the chief gynecological complaints. Hypertension was strongly associated with thyroid dysfunction.Conclusions: Thyroid dysfunction is a highly prevalent problem in female population. Estimation of TSH level is a good screening tool; however complete thyroid profile is required before initiating treatment. The incidence increases with advancing age, hypothyroidism being the more common variant. Classical symptoms may not be present in majority of patients who have a vague clinical picture. This study recommends universal screening of women for thyroid dysfunction in view of high prevalence, vague and varied presentation.  

Advances in the Diagnosis and Treatment of Acanthamoeba Keratitis

This paper aims to review the recent literature describing Acanthamoeba keratitis and outline current thoughts on pathogenesis, diagnosis, and treatment as well as currently emerging diagnostic and treatment modalities

Protuupalno i analgetsko djelovanje ekstrakta cijele biljke Fumaria indica na eksperimentalnim životinjama

The 50% ethanolic extract of Fumaria indica was investigated for its anti-inflammatory and antinociceptive potential in animal models. Oral administration of F. indica dry extract (100, 200 and 400 mg kg1) exhibited dose dependent and significant anti-inflammatory activity in acute (carrageenean and histamine induced hind paw oedema – p < 0.05) and chronic (cotton pellet granuloma models of inflammation – p < 0.01). The extract (400 mg kg1) exhibited maximum anti-inflammatory effects of 42.2 and 42.1% after 3 h with carrageenean and histamine respectively. The same dose of extract showed 38.9% reduction in granuloma mass in a chronic condition. A significant anti-nociceptive activity was evidenced in mice; 6.6–67.7% (p < 0.01) protection in mechanical, 33.9–125.1% (p < 0.05) protection in thermal induced pain and 22.2–73.9% (p < 0.05) protection in acetic acid-induced writhing.Na animalnom modelu ispitivano je protuupalno i analgetsko djelovanje ekstrakta biljke Fumaria indica sa 50%-tnim etanolnom. Peroralna primjena suhog ekstrakta F. indica (100, 200 i 400 mg kg1) pokazuje značajno i o dozi ovisno protuupalno djelovanje na akutni (edem šape uzrokovan karagenom i histaminom – p < 0.05) i kronični upalni proces (granulomi uzrokovani pamučnim peletama – p < 0.01). Najveći protuupalni učinak u karagenskom, odnosno histaminskom testu od 42,2 i 42,1% dobiven je s dozom 400 mg kg1 nakon 3 h. Ista doza ekstrakta pokazala je 38,9% smanjenje mase granuloma. Značajno analgetsko djelovanje dokazano je pokusima na miševima: 6,6–67,7% (p < 0,01) zaštita od mehanički izazvane boli, 33,9–125,1% (p < 0,05) zaštita od termički izazvane boli i 22,2–73,9% (p < 0,05) zaštita od kemijski izazvane boli octenom kiselinom

Negative pressure wound therapy for open traumatic wounds

BACKGROUND: Traumatic wounds (wounds caused by injury) range from abrasions and minor skin incisions or tears, to wounds with extensive tissue damage or loss as well as damage to bone and internal organs. Two key types of traumatic wounds considered in this review are those that damage soft tissue only and those that involve a broken bone, that is, open fractures. In some cases these wounds are left open and negative pressure wound therapy (NPWT) is used as a treatment. This medical device involves the application of a wound dressing through which negative pressure is applied and tissue fluid drawn away from the area. The treatment aims to support wound management, to prepare wounds for further surgery, to reduce the risk of infection and potentially to reduce time to healing (with or without surgical intervention). There are no systematic reviews assessing the effectiveness of NPWT for traumatic wounds. OBJECTIVES: To assess the effects of NPWT for treating open traumatic wounds in people managed in any care setting. SEARCH METHODS: In June 2018 we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: Published and unpublished randomised controlled trials that used NPWT for open traumatic wounds involving either open fractures or soft tissue wounds. Wound healing, wound infection and adverse events were our primary outcomes. DATA COLLECTION AND ANALYSIS: Two review authors independently selected eligible studies, extracted data, carried out a 'Risk of bias' assessment and rated the certainty of the evidence. Data were presented and analysed separately for open fracture wounds and other open traumatic wounds (not involving a broken bone). MAIN RESULTS: Seven RCTs (1377 participants recruited) met the inclusion criteria of this review. Study sample sizes ranged from 40 to 586 participants. One study had three arms, which were all included in the review. Six studies compared NPWT at 125 mmHg with standard care: one of these studies did not report any relevant outcome data. One further study compared NPWT at 75 mmHg with standard care and NPWT 125mmHg with NPWT 75 mmHg.Open fracture wounds (four studies all comparing NPWT 125 mmHg with standard care)One study (460 participants) comparing NPWT 125 mmHg with standard care reported the proportions of wounds healed in each arm. At six weeks there was no clear difference between groups in the number of participants with a healed, open fracture wound: risk ratio (RR) 1.01 (95% confidence interval (CI) 0.81 to 1.27); moderate-certainty evidence, downgraded for imprecision.We pooled data on wound infection from four studies (596 participants). Follow-up varied between studies but was approximately 30 days. On average, it is uncertain whether NPWT at 125 mmHg reduces the risk of wound infection compared with standard care (RR 0.48, 95% CI 0.20 to 1.13; I2 = 56%); very low-certainty evidence downgraded for risk of bias, inconsistency and imprecision.Data from one study shows that there is probably no clear difference in health-related quality of life between participants treated with NPWT 125 mmHg and those treated with standard wound care (EQ-5D utility scores mean difference (MD) -0.01, 95% CI -0.08 to 0.06; 364 participants, moderate-certainty evidence; physical component summary score of the short-form 12 instrument MD -0.50, 95% CI -4.08 to 3.08; 329 participants; low-certainty evidence downgraded for imprecision).Moderate-certainty evidence from one trial (460 participants) suggests that NPWT is unlikely to be a cost-effective treatment for open fractures in the UK. On average, NPWT was more costly and conferred few additional quality-adjusted life years (QALYs) when compared with standard care. The incremental cost-effectiveness ratio was GBP 267,910 and NPWT was shown to be unlikely to be cost effective at a range of cost-per-QALYs thresholds. We downgraded the certainty of the evidence for imprecision.Other open traumatic wounds (two studies, one comparing NPWT 125 mmHg with standard care and a three-arm study comparing NPWT 125 mmHg, NPWT 75 mmHg and standard care)Pooled data from two studies (509 participants) suggests no clear difference in risk of wound infection between open traumatic wounds treated with NPWT at 125 mmHg or standard care (RR 0.61, 95% CI 0.31 to 1.18); low-certainty evidence downgraded for risk of bias and imprecision.One trial with 463 participants compared NPWT at 75 mmHg with standard care and with NPWT at 125 mmHg. Data on wound infection were reported for each comparison. It is uncertain if there is a difference in risk of wound infection between NPWT 75 mmHg and standard care (RR 0.44, 95% CI 0.17 to 1.10; 463 participants) and uncertain if there is a difference in risk of wound infection between NPWT 75 mmHg and 125 mmHg (RR 1.04, 95% CI 0.31 to 3.51; 251 participants. We downgraded the certainty of the evidence for risk of bias and imprecision. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence for no clear difference between NPWT and standard care on the proportion of wounds healed at six weeks for open fracture wounds. There is moderate-certainty evidence that NPWT is not a cost-effective treatment for open fracture wounds. Moderate-certainty evidence means that the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. It is uncertain whether there is a difference in risk of wound infection, adverse events, time to closure or coverage surgery, pain or health-related quality of life between NPWT and standard care for any type of open traumatic wound

A study of thyroid disorders in females attending obstetrics and gynecology outpatient department of a tertiary care institute of central India

Background: The study was conducted with an objective to study the spectrum of thyroid dysfunction and to correlate clinical symptoms with abnormal thyroid function.Methods: A total no. of 1010 women, attending the Gynecology and Medicine OPD of M.Y. Hospital, Indore, MP were subjected to screening with TSH levels estimation. The women with abnormal TSH values were then evaluated for various clinical symptoms.Results: Out of total 1010 women, 120 had abnormal TSH. The prevalence was high (11.88%). Hypothyroidism (71.66%) was more common than hyperthyroidism (28.33%). The incidence of thyroid disorders was higher with advancing age. Abnormal TSH levels had a linear correlation with increasing BMI. Majority of the patients presented with vague symptoms commonest being weight changes (24.15%). Abnormal uterine bleeding (5.8%) and infertility (5.8%) were the chief gynecological complaints. Hypertension was strongly associated with thyroid dysfunction.Conclusions: Thyroid dysfunction is a highly prevalent problem in female population. Estimation of TSH level is a good screening tool; however complete thyroid profile is required before initiating treatment. The incidence increases with advancing age, hypothyroidism being the more common variant. Classical symptoms may not be present in majority of patients who have a vague clinical picture. This study recommends universal screening of women for thyroid dysfunction in view of high prevalence, vague and varied presentation.  

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Not AvailableFrom very ancient times, fish is regarded as as an important source of food, which plays vital role in fighting hunger and malnutrition. Fish is a very good source of cheap protein, good fat, highly unsaturated omega-3 fatty acids, vitamins and minerals. Due to the highly perishable nature of fish, it undergoes a series of changes immediately after caught, the major reasons for which are autolysis, microbial activity and rancidity and in some cases physical damages. Increased risk of perishability coupled with poor post- harvest handling has to led to high losses of fish, in both marine and inland fisheries. Therefore aquatic resources need to be properly managed and all those involved in fish processing, distribution and marketing should be encouraged to reduce post-harvest losses and waste, improve the use of by-catch to the extent that this is consistent with responsible fisheries management practices, if their contribution to the nutritional, economic and social well- being of the growing world's population was to be sustained.Not Availabl

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