Effect on serum potassium level in patients of diabetic nephropathy on spironolactone and ramipril over follow up period

Background: The study was conducted to evaluate the change in serum potassium level over follow up period in patients of diabetic nephropathy on spironolactone (25 mg) and ramipril (5 mg) and compare the results with diabetic nephropathy patients on Spironolactone (25 mg) alone.Methods: A comparative, prospective, non-randomized, non-blinded experimental study was conducted on 56 patients (30-70 yr.) of diagnosed type 2 diabetes mellitus showing proteinuria. Total duration of study was about one year from October 2017 to October 2018. Inclusion criteria followed in study were Age 30-70 years, diagnosed type 2 diabetes mellitus, serum potassium level <5 meq/l, estimated GFR >30 ml/min/1.73m2 and HbA1c <10%. Exclusion criteria were type 1 diabetes mellitus, impaired glucose tolerance secondary to endocrine disease, exocrine pancreatic disease, SBP >180 mmHg DBP >110 mmHg, UTI, hematuria, acute febrile illness, vigorous exercise, short-term pronounced hyperglycemia, obstructive uropathy, confirmed or suspected renal artery disease by USG doppler study, Serum potassium level >5.5 meq/l. Patients were divided in two groups, group A (n= 28, spironolactone 25 mg and ramipril 5 mg) and group B (n=27, spironolactone 25 mg). Subjects were followed over 12 weeks and baseline and 12-week serum potassium being compared. Other baseline base line laboratory investigation such as serum lipid profile, HbA1c, eGFR, fundus examination, ultrasonography (KUB), serum urea, serum creatinine, hemoglobin, were taken at the starting point.Results: Both the group after receiving respective drug were followed for 3-month duration and serum potassium level measured at end of 3 months. Mean values of baseline and follow up serum potassium for group A and group B were 4.24±0.59, 4.07±0.61 and 4.35±0.55, 4.16±0.61 respectively, p value found to be >0.05 at 95% CI.Conclusions: In the study it was concluded that p value found to be >0.05 at 95% C.I denoting that there is no significant difference between mean value of base line and follow up serum potassium value in both group. None of patients in either group had experienced hyperkalaemia over follow up period though serum potassium level were slightly higher in group A, but this difference was statistically not significant. Follow up period of study should be long enough to comment on safety profile of combining spironolactone and ACE inhibitors in diabetic nephropathy patients

Role of emergency bilateral internal iliac ligation in postpartum hemorrhage

ABSTRACTBackground: The aim of the study was to determine the effectiveness of emergency bilateral internal iliac ligation in intractable postpartum hemorrhage.Methods: A retrospective study was done on 33 women who have undergone emergency bilateral internal iliac ligation in obstetrics haemorrhage.Results: In all of 33 women under this study bilateral internal iliac ligation was performed in emergency. (11) of the cases were of atonic PPH, placenta previa (8), uterine rapture (7), extension of C-section scar (3), vaginal and cervical laceration (3) and uterine perforation (1). hysterectomy was not performed in any of the cases. internal iliac artery was injured in one case during the procedure and was managed successfully but two patients died during and after the BIIL.Conclusions: BIIL is an effective, less time consuming and life-saving procedure in intractable obstetrics hemorrhage if early decision is taken and performed by practiced surgeons

HEMATOBIOCEMICAL AND HISTOPATHOLOGICAL STUDIES ON THE EFFECTS OF RAJ NIRWAN BATI (A NOVEL ALLOVEDIC DRUG) IN WISTAR RATS

Objective: To see the effects of Raj Nirwan Bati (RNB) on the hematobiochemical parameters, coagulation tests, and histopathological changes in the lungs, liver, kidneys and spleen and also to evaluate the immunomodulatory activity of RNB in Wistar rats. Methods: A total of 24 adult albino Wistar rats (of bodyweight 200-250 g) of either sex were divided into 3 groups. In the normal control group (n=8), no drug was administered and in the rest of the groups (A and B), RNB@ 26 mg/kg body weight./day and 260 mg/kg body weight/day respectively were administered orally for a period of 14 d. The blood samples were collected from the jugular vein at zero d (before drug administration) and after the 14th d of drug administration in both groups (A and B). The organ samples (lungs, liver, kidneys, and spleen) were collected after euthanizing the rats using Ketamine anesthesia overdose intraperitoneally (IP) after the 14th d of drug administration. White Blood Cells (WBC), Red Blood Cells (RBC), Hemoglobin (Hb), Hematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin(MCH), Mean Corpuscular Hemoglobin Concentration(MCHC), number of platelets, Differential Leucocyte Count(DLC) i.e. the percentage of neutrophils, lymphocytes, eosinophils, monocytes and basophils, neutrophil adhesion percentage, Prothrombin test (PT), Activated Partial Thromboplastin Time (APTT), fibrinogen, D-dimer, Lactate Dehydrogenase (LDH), urea, creatinine, Aspartate Amino Transferase (AST), Alanine amino Transferase (ALT), Alkaline Phosphatase (ALP), C-Reactive Protein (CRP) were evaluated and histological examination of organs were done. Results: After statistical analysis, it was found that the decrease in TLC, RBC, Hb, HCT, and LDH in Wistar rats after RNB intervention in Group A as compared to that of before RNB intervention, was found to be statistically significant (P=0.001, P=0.002, P=0.001, P=0.039, and P=0.008). On the other hand, an increase was observed in MCV, Urea, Creatinine and ALT values in the Wistar rats after RNB intervention in Group ‘A’ as compared to that of before RNB intervention and this increase in values was statistically significant (P=0.007, P=0.001, P<0.001 and P=0.038). After RNB intervention in Group B, the increase in MCH, fibrinogen concentration, and monocytes percentage, was found to be statistically significant (P=0.004, P=0.033, and P=0.001) as well as the decrease in PT and APTT was statistically significant (P=0.007and P=0.002). After comparing the Mean Hematobiochemical and coagulation test parameters in the rats of Group A and Group B, after RNB intervention, it was observed that the concentration of Urea, Creatinine, APTT, and D-dimer were less in Group B as compared to that of Group A and this difference was statistically significant (P<0.001, P<0.001, P<0.001 and P=0.022). Histologically the findings in the lungs of group B were more distortion of lung architecture, most of the alveoli become collapse and make emphysematous changes, more diffuse inflammatory infiltrate within interalveolar septa and around bronchioles as compared to Group A. In the liver of group B rats, the histological findings were mild to moderate distortion of lobular architecture, healthy hepatocytes with more activation of kupffer cells as well as larger and more aggregates of inflammatory cells as compared to group A. Histological findings of kidneys in group A and group B rats were similar to that of control group rats. Conclusion: The results suggest that the RNB is having an immunomodulatory effect. It might be helpful in the restoration of coagulation factors and can help treat the COVID patients. No harmful effects on the lungs, liver, kidney, and spleen were seen. These findings may act as baseline data for planning further clinical trials in human study subjects to evaluate the effects on various comorbidities

KAP Study on Reproductive Tract Infections (RTIs) Among Married women (15-44 years) in rural area of Etawah, Uttar Pradesh

Background: High level of gynaecological morbidity, especially RTIs/STIs, if untreated, it can lead to adverse health outcomes such as infertility, ectopic pregnancy and increases vulnerability to transmission of HIV/AIDS. Sexually transmitted infections are worldwide major concern in developing countries.  The major aspect of the control and prevention of disease and health protection is health education. Since knowledge plays an important role in people attitude and behaviours. Aims & Objectives: To assess the Knowledge, Attitudes and Practices about RTIs among married women age 15-44 years in rural Etawah.   Material Methods:  A cross sectional study was done on 370 married women of rural area of Etawah district. Multi stage random sampling was adopted. A structured questionnaire was used to assess the knowledge, Attitudes and Practices about RTIs among married women. Chi -square test used for analysis. Data collection on morbidity pattern among married women was based only on symptoms. Result: In the present study 42.16 % were aware about RTIs. As per their knowledge about symptoms, mode of transmission and source of infections 35.41 % women told vaginal discharge as commonest symptom of RTIs, 40.0% women perceived sexual contact with multiple partner as the main route of transmission and 29.46% married women gained knowledge about RTIs from health worker followed by doctors 28.10%. Conclusion: Only 42.16% had knowledge of RTIs and only 61 infected women sought treatment out of 173 symptomatic women. There is need to educate women on preventive strategies as women are less likely to seek treatment for symptomatic infections because of stigma associated with RTIs

Household symptomatic contact screening of sputum smear positive tuberculosis patients at the DOTS clinic of SGT hospital, Gurugram

Background:  Contact screening was conducted under ICMR (REFERENCE ID: 2019-07811) programme in villages near SGT hospital, Gurugram.  Objective:  To evaluate risk factors, extent of spread of tuberculosis among household contacts of tuberculosis cases and to create awareness. Methods and Material: Address of TB cases were taken from RNTCP register at DOTS clinic, SGT medical college. Then all household contacts of positive cases were screened, counselled and advised to approach ASHA Workers if such symptoms appear. Data was analysed using appropriate statistical methods. Results:21 Index cases along with 94 household contacts were screened. 61.90% families still use chullahs for cooking. 76.1% families have overcrowding. 3) 61.90% families had inadequate ventilation 4) 19.05%families were aware about the spread of this disease. 5)Only 23.80% families practised adequate sanitation methods and precautions6) 42.8% Index cases had a history of smoking. 7) 44.4% 4 continue to smoke with infection. The association of adequate sanitation with presence of awareness was found to be statistically significant. (p-value<0.05). Other factors were not significantly associated with level of awareness regarding prevention of tuberculosis spread among study participants. Conclusions: Contact screening is an effective tool and it gives the real-time picture of TB in India

Incidence and Determinants of Low birth weight babies at rural tertiary care hospital in central Uttar Pradesh

Background: An infant’s birth weight is a reliable index of intrauterine growth and a sensitive predictor of newborn chances of survival, growth and long-term physical and psychosocial development. Low birth weight has been defined as birth weight <2.5 kg regardless of gestational age. The incidence of low birth weight (LBW) in India varies between 25–30% and of which 60–65% are because of intrauterine growth retardation. Aim & Objective: To determine the incidence and various determinants of low birth weight among babies delivered at rural tertiary care hospitals in central Uttar Pradesh. Methods and Material: The study was conducted at UPUMS, Saifai, Etawah, among pregnant women who delivered babies from 1st January 2018 to 31st December 2018. Details regarding age of the mother, gravida, parity, gestation period, presence of complications, the procedure for delivery and birth weight of the newborn were recorded and analyzed using SPSS software (version 23)   Results: A total of 7615 deliveries were conducted (53.2% were males, 46.8% were females). The mean birth weight of babies was 2.65 Kg with S.D ± 0.52. Preterm babies were 32% while 67% were term babies and 23% of babies were low birth weight. There was a statistically significant association between birth weight of babies and factors like age of mother, parity of mother, gestation period, and presence of complications during the antenatal period. Conclusions: Prompt identification of high-risk factors, prevention of premature delivery, increasing the use of health services during pregnancy and management of the risk factors would reduce the incidence of low birth weight

Prevalence of needle stick injuries, its associated factors and awareness among nursing staff at tertiary care hospital of North India

Background: Needle Stick Injuries (NSIs) are defined as accidental skin penetrating injuries caused by needles. It is the single greatest occupational hazard to a medical personnel. In developing countries, needle stick injury is associated with the highest global prevalence of HIV, Hepatitis B, and Hepatitis C. Aim & Objectives: To estimate the prevalence of needle stick injuries, its associated risk factors and assess the awareness regarding needle stick injuries among nursing staff. Material & Methods: A cross-sectional study was conducted among nursing staff who were working at a tertiary care hospital in Northern India during June 2019 to November 2019. The study commenced after taking prior approval from institutional ethics committee. A census method was used to include the participants. Results: Around 66.7% of the nursing staff was exposed to NSIs during their working hours at the hospital. There was significant association of needle stick injuries with place of working and education of nursing staff in multivariate binary logistic regression. About 26% of the nurses were unaware that recapping should be done or not for used needle, and 35% of staff nurses recapped the needle after the use. Conclusion: Needle stick injuries can be prevented by continued education, effective training, providing better safety devices, a positive work environment

Imatinib Inhibits GH Secretion From Somatotropinomas

Background: Imatinib, a tyrosine kinase inhibitor, causes growth failure in children with chronic myeloid leukemia probably by targeting the growth hormone (GH)/insulin like growth factor-1 (IGF-1) axis. We aim to explore the imatinib targets expression in pituitary adenomas and study the effect of imatinib on GH secretion in somatotropinoma cells and GH3 cell line.Materials and Methods: The expression pattern of imatinib's targets (c-kit, VEGF, and PDGFR-α/β) was studied using immunohistochemistry and immunoblotting 157 giant (≥4 cm) pituitary adenomas (121 non-functioning pituitary adenomas, 32 somatotropinomas, and four prolactinomas) and compared to normal pituitary (n = 4) obtained at autopsy. The effect imatinib on GH secretion, cell viability, immunohistochemistry, electron microscopy, and apoptosis was studied in primary culture of human somatotropinomas (n = 20) and in rat somato-mammotroph GH3 cell-line. A receptor tyrosine kinase array was applied to human samples to identify altered pathways.Results: Somatotropinomas showed significantly higher immunopositivity for c-kit and platelet-derived growth factor receptor-β (PDGFR-β; P < 0.009 and P < 0.001, respectively), while staining for platelet-derived growth factor receptor-α (PDGFR-α) and vascular endothelial growth factor (VEGF) revealed a weaker expression (P < 0.001) compared to normal pituitary. Imatinib inhibited GH secretion from both primary culture (P < 0.01) and GH3 cells (P < 0.001), while it did not affect cell viability and apoptosis. The receptor tyrosine kinase array showed that imatinib inhibits GH signaling via PDGFR-β pathway.Conclusion: Imatinib inhibits GH secretion in somatotropinoma cells without affecting cell viability and may be used as an adjunct therapy for treating GH secreting pituitary adenomas

Development and Commercialization of CMS Pigeonpea Hybrids

The role of heterosis in enhancing productivity in food crops is well known. Legume breeders have not been able, however, to take advantage of this genetic phenomenon for a long time, due to biological restrictions, such as the requirement of high seeding rate and the inability to produce large quantities of F1 hybrid seed. Recently, in pigeonpea (Cajanus cajan (L.) Millsp.), a breakthrough has been realized with the development and marketing of the world’s first legume hybrid, ICPH 2671. The key for this achievement was breeding and using a stable cytoplasmic nuclear male sterility (CMS) system obtained from the cross between C. cajanifolius, a wild relative of pigeonpea, and the cultivated type. The inherent partial natural out‐crossing of pigeonpea was knitted with this CMS system to facilitate economically‐viable large‐scale hybrid seed production. These developments provided opportunities to overcome the historic stagnant low yield (0.6–0.8 t ha–1) through heterosis breeding. Among hundreds of hybrid combinations tested, a cross between ICPA 2043 and ICPL 87119 (=ICPR 2671), designated as ICPH 2671, was the most promising, with >40% yield superiority (reaching yields above 3 t ha–1) over the prevalent cultivar ‘Maruti’, in multi‐location, multi‐year, on‐station trials, as well as on‐farm evaluations. The outstanding performance of ICPH 2671 led to its release in 2010 as the first medium duration commercial pigeonpea hybrid in India. Subsequently, two additional pigeonpea hybrids, ICPH 3762 and ICPH 2740 were also released for commercial cultivation in India in 2014 and 2015, respectively. According to recent estimates, in 2015 the CMS‐based pigeonpea hybrids were grown over 150,000 hectares in central and southern India. In this review, we summarize the research efforts that led to the milestone of developing the first commercial hybrid in food legumes