Rare incidence of yolk sac tumor in pregnancy posing management challenge: a case report

Yolk sac tumor of the ovary, although rare but highly malignant, when diagnosed in a pregnant woman is difficult to manage because of risks involved to the fetus but with the advent of surgery and chemotherapy prognosis has greatly improved.A G3P2L2, 35 years old, woman got admitted at 8 months amenorrhea with absent fetal movements since two days with labor pains. She carried an ultrasound report, done at a private clinic which showed intrauterine death of fetus along with a pelvic tumor. Her CT done at our hospital confirmed a pelvic tumor mass posterior to the uterus and in close proximity with the rectum. A laparotomy was planned for her as the pelvic mass was preventing the descent of fetal head thus hindering vaginal delivery. Biopsy from the tumor mass revealed yolk sac tumor of the ovary. Her general condition was poor with low Hb levels and deranged LFT and KFT and was shifted to ICU for intensive care but she could not survive despite the best efforts.Early diagnosis of ovarian yolk sac tumor in pregnancy leads to timely intervention in the forms of surgery and chemotherapy which greatly improves the survival rates

Assessment of nitric oxide and uric acid in patients of leprosy

Background: Leprosy is an old, dreaded infectious disease caused by the obligate intracellular bacterium mycobacterium leprae. Leprosy still continues to be a significant public health problem in few countries including India. Oxidative stress caused by derangement in the balance between ROS and natural antioxidants plays a crucial role in the pathogenesis of leprosy. Hence this study attempts to assess the oxidative stress and antioxidant status in terms of Nitric oxide and uric acid.Methods: A case control observational study was carried out in100 untreated leprosy patients and compared with 50 healthy controls.  Leprosy patients were divided as paucibacillary and multibacillary. Serum Nitric oxide and uric acid levels were estimated in both groups to find out correlation of Nitric Oxide with uric acid.Results: There was a significant rise in serum NO in both PB and MB leprosy as compared to controls. The uric acid level was significantly decreased in both PB and MB leprosy patients as compared to controls.Conclusions: Elevated NO levels indicate oxidative stress in leprosy patients, denoting its crucial involvement in the pathogenesis and nerve damage in leprosy. Low uric acid indicates decrease defence of antioxidants in leprosy

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study

The Burden of Obstructive Lung Disease (BOLD) study was established to assess the prevalence of chronic airflow obstruction, a key characteristic of chronic obstructive pulmonary disease, and its risk factors in adults (≥40 years) from general populations across the world. The baseline study was conducted between 2003 and 2016, in 41 sites across Africa, Asia, Europe, North America, the Caribbean and Oceania, and collected high-quality pre- and post-bronchodilator spirometry from 28 828 participants. The follow-up study was conducted between 2019 and 2021, in 18 sites across Africa, Asia, Europe and the Caribbean. At baseline, there were in these sites 12 502 participants with high-quality spirometry. A total of 6452 were followed up, with 5936 completing the study core questionnaire. Of these, 4044 also provided high-quality pre- and post-bronchodilator spirometry. On both occasions, the core questionnaire covered information on respiratory symptoms, doctor diagnoses, health care use, medication use and ealth status, as well as potential risk factors. Information on occupation, environmental exposures and diet was also collected

A survey of knowledge of interns about the instructions given to the patients while prescribing various dosage forms

Introduction: Education of health care providers regarding the proper use of dosage forms is inadequate, contributing to prescription errors. Objectives : The objective of this study is to assess the knowledge of interns regarding the dosage forms and their administration techniques. Materials and Methods: Interns ready to solve questionnaire were allotted to Arm A (n = 153). For each correct multiple choice question (MCQ) answer scored "1" and each incorrect or unanswered MCQ was given "0" mark. The percentage marks obtained was calculated and re-allotted grade as per 10 point grade scale. The participants in Arm B (n = 93) had to perform demonstrations. Demonstrations which included metered dose inhaler (MDI), insulin injection, eye drops, and nasal drops were performed. Score "1" for correct step and score "0" for incorrect step was given. Percentage of interns solved each step in a demonstration was calculated. Both Arm A and B analyzed separately. Results: Analysis of the questionnaire (Arm A) showed the following grades: 6.54%, 24.18%, 28.10%, 22.88% 13.73%, and 4.57% i.e. interns scored grades as excellent, very good, good, satisfactory, sufficient to pass, and fail, respectively. In demonstration techniques (Arm B) for use of MDI, nasal drops, eye drops, preparation of 40 U of 10 U humulin-R and 30 U humulin-N in one syringe and subcutaneous administration of premixed insulin were assessed and it was observed that respectively 13.98% (13/93), 10.75% (10/93), 2% (2/93), 1% (1/93), and 27.96% (26/93) interns could demonstrate correctly. Conclusion: This study suggests theoretical knowledge is not sufficient. Very Few interns could demonstrate correctly this explains the need for emphasis on such exercises in curriculum