A study on the clinical, biochemical and hormonal profile of polycystic ovary syndrome patients attending tertiary care hospital

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorder of reproductive age affecting 5% to 10% of women worldwide. It is a heterogenous, multifactorial, complex genetic disorder. PCOS receives a considerable attention because of its high prevalence and metabolic, reproductive and cardiovascular consequences.Methods: A cross sectional observation study of 100 PCOS patients was carried out between January 2014 to July 2015 in Gynaecology out-patient and Infertility OPD, Justice K. S. Hegde charitable hospital, Mangalore. The clinical, biochemical and hormonal profile of these patients were analysed and correlation was done between clinical features and biochemical and hormonal profile.Results: The prevalence of PCOS was 6.3% in the Gynaecology out-patient visits and 37.14% among infertile women. Menstrual irregularity was the most common complaint accounting for 31% followed by infertility (23%). Elevated leutinizing hormone and elevated LH: FSH was significant in irregular menstrual group. The prevalence of metabolic syndrome in our study was 21.3%. Spearmans correlation between various clinical and laboratory parameters showed menstrual cycle and body mass index(BMI) had a fair positive correlation and was significant. WHR (waist hip ratio) showed 21 times risk for metabolic syndrome.Conclusions: The study showed that most of our polycystic ovary syndrome subjects were hirsute, with central obesity and overweight or obese. Oligomenorrhea was the most common presentation. Among the various risk factors studied, WHR (waist hip ratio) showed 21 times risk for metabolic syndrome. Obese women with PCOS had more severe ovulatory dysfunction and need more attention for their appropriate management

Prevelance, risk factors and adverse perinatal outcomes of bacterial vaginosis in pregnancy

Background: Bacterial Vaginosis (BV) is the most common lower genital tract syndrome in women of age group 16 to 25years.BV is a disorder of the vaginal microbial ecosystem characterized by a shift in the vaginal flora, from the normally predominant Lactobacillus species to one dominated by a mixed flora. The prevalence of BV can be around 15-30% and upto 50% in pregnancy. This study aims to study the prevalence of BV and their adverse outcomes on pregnancy.Methods: It is a Cross Sectional Study at Department of Obstetrics and Gynecology, at a tertiary care hospital, for a period of one and half year from November 2016-April 2018.Pregnant women attending antenatal clinic were enrolled after obtaining an informed consent and vaginal swab examination done. The sample size was 200.Results: The prevalence of BV in pregnant females was 18%. The major risk factors for BV in pregnancy were young age, low socioeconomic status and recent sexual activity. All patients who took treatment for BV had good outcome. Amsel criteria had low sensitivity but very high specificity(95%).Individually vaginal PH had a very high sensitivity(91.6%) when compared to the gold standard Gram stain.Conclusions: Routine screening is recommended for all pregnant women with risk factors and with symptoms. Early diagnosis and treatment in pregnant women who are asymptomatic and with no risk factors can prevent adverse outcome

Zinc and copper levels in preeclampsia: a study from coastal South India

Background: Preeclampsia is one of the major causes of maternal and fetal morbidity and mortality. Though the etiology is obscure, studies indicate the role of oxidative stress and antioxidants may have a role in the prevention of preeclampsia. Micronutrients such as copper and zinc are involved in the antioxidant defense mechanism.Methods: The present study was undertaken in a medical college hospital in coastal South India to assess the serum levels of zinc and copper in women with preeclampsia and to compare them with normal pregnant women. The blood samples from 60 preeclamptic women and an equal number of controls were analyzed for zinc and copper levels. Outcome of pregnancy was analyzed and compared. Data were expressed as mean ± standard deviation. Comparison of levels of the elements between the two groups was performed by independent t test and Chi square test and P value of <0.05 was considered as statistically significant.Results: The serum zinc and copper levels were significantly lower in the preeclamptic group compared to the normotensives. Also preeclamptic women were older, their BMI was higher and birth weight of babies lower compared to normotensives.Conclusions: Increased knowledge about the importance of specific antioxidant micronutrients and their part in successful pregnancy outcome should be the focus for future health strategies. Low levels of maternal copper and zinc are related to preeclampsia and might have a causal role in this disease. Further investigation is needed to establish the role of these elements in this dangerous condition of pregnancy

CHOKING IN A PSYCHIATRIC PATIENT - A CASE REPORT

Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommon. The choking in children could be due toys, coins, marbles, nuts and any other small hard object or even sometimes due to stuffed in plastic bags whereas in adults most of the times food bolus or hard parts of food like bone pieces are responsible. It is mostly accidental in nature.&nbsp; It can cause coughing or sometimes airway obstruction leading to death. We present a case wherein a mentally ill person accidentally choked to death after consumption of food. KEYWORDS:&nbsp;Choking; Asphyxial deaths; Food bolus; Airway obstruction

CHOKING IN A PSYCHIATRIC PATIENT - A CASE REPORT

Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommon. The choking in children could be due toys, coins, marbles, nuts and any other small hard object or even sometimes due to stuffed in plastic bags whereas in adults most of the times food bolus or hard parts of food like bone pieces are responsible. It is mostly accidental in nature.&nbsp; It can cause coughing or sometimes airway obstruction leading to death. We present a case wherein a mentally ill person accidentally choked to death after consumption of food. KEYWORDS:&nbsp;Choking; Asphyxial deaths; Food bolus; Airway obstruction

Prevalence of Talon cusp in Indian population

Aim: To investigate the prevalence of the talon cusps in a sample of Indian dental patients and their distribution among different types of teeth. To determine the presence of other dental anomalies associated with the talon cusps. Methodology: 2740 out patients (1523 males and 1217 females) attending Oral Medicine department from November 2010 to January 2011 were screened for the presence of talon cusps and were subjected to Intra Oral Peri-apical (IOPA) radiograph to rule out any associated anomalies or peri-apical changes. Results: Talon cusps were detected in 16 out of 2740 patients (person prevalence 0.58%). Thirty one teeth were found to have talon cusp. Maxillary lateral incisors were the most commonly affected teeth (54.8%, 17 teeth), followed by maxillary central incisors and canines (16.12%, 5 teeth).Talon cusp was found in two mandibular central incisors (6.45%) and one each in mandibular second and third molar (3.22% each). Seventeen teeth in 7 patients (54.83%) were found to be associated with anomalies like dens invagination (6 teeth, 19.35%), impacted 13, 23 (6 teeth, 19.35%), partial anodontia (3 teeth, 9.67%), geographic and fissured tongue (2 teeth, 6.45%). Peri-apical granuloma was found in one tooth with talon cusp associated with dens invaginatus. None of the patients were found to be associated with any syndromes. Conclusion: Attention should be paid to the presence of the talon cusp and the associated anomalies. Early diagnosis of the talon cusp can help the clinician in preventing the further complications

Drinking Water in an Urban Area of South India

BackgroundGlobally, 1.1 billion people lack access to improved drinking water supply and drink water that is grossly contaminated. Hence, study of water treatment assumes utmost importance in order to ensure the safety of the water consumed especially in fast developing cities. This study would provide information of drinking water management practices in the study area. We studied the sources, the treatment and storage facilities of drinking water in households and assessed the free chlorine levels in the drinking water.Method  This community based cross sectional study was conducted in Mangalore - a city of Karnataka State in South India. Using convenience sampling, 100 households were visited in the area of Boloor. Information was collected regarding demographic profile, household drinking water sources, treatment and storage practices followed by testing for free chlorine in the drinking water using O-Toluidine.ResultsStudy population had high literacy rate and 83% had their main source of drinking water from municipality, 17% had private water source. Among these 6% households had bore wells, 10% had protected dug well. Overall 99% had improved source of drinking water. Sumps were present in 32% of the households.  Of these 34.4 % cleaned it once a month. Boiling was found to be the preferred choice of water treatment; but 5% of the population (lower socio economic status) did not use any method to treat water in their households. Overall, 43% households drank water by pouring to glass from storage vessel, 34% dipped glass into vessel using hands, 23% had tap system and 84.2% of the households cleaned their storage vessel daily. O-Toluidine test showed no free chlorine in drinking water in any of the homes.ConclusionStudy population had access to improved water. However households lacked appropriate storage and handling practices of drinking water which needs to be evaluated further

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe