Anorectal manometry profile among elderly patients with chronic constipation in a tertiary health center

Background: Constipation is a common condition in elderly in India. High resolution anorectal manometry (HRAM) is an essential tool in the evaluation. In this context, studies from south India are sparse regarding the motility data of elderly patients with functional constipation. We aimed at studying anorectal pressure patterns in this population of this part of the country. Methods: Manometric data of 50 elderly patients (≥60 year), who underwent the procedure for chronic constipation (Rome IV), was retrospectively collected. Manometric parameters were compiled and observations tabulated. Results: Among 50 patients, 35 were (70%) males and 15 (30%) females with mean age of 66.5±3.2 years. In HRAM study, the mean resting pressure was 90.2±27.5 mmHg (range 43-153 mmHg) and mean squeeze pressure was 136.9±39.76 mmHg (range 88-223 mmHg). In present study 23 patients had abnormal HRAM suggestive of dyssynergic defecation (46%). Conclusions: The present study showed that 46% of the elderly constipation patients had defecation disorder. Defecation disorders are common in our population and there is a need to diagnose it as treatment perspectives differ from other causes of constipation

Prevalence of metabolic syndrome in a rural population- a cross sectional study from Western Uttar Pradesh, India

Background: Prevalence of non-communicable diseases like hypertension, diabetes mellitus and coronary artery disease is on the rise due to the change in lifestyle, unfavourable dietary habits and obesity. Metabolic syndrome is a simple tool by which we can predict the future risk of diabetes mellitus and cardiovascular disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population, but majority of them were done in urban population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among a population of 2982. Each participant was subjected to clinical examination, anthropometric measurements and necessary laboratory investigations. Metabolic syndrome was diagnosed based on modified NCEP: ATP III criteria.Results: The prevalence of metabolic syndrome was found to be 11.7% and was higher among female population (13.8%) as compared to males (9.6%). The prevalence of metabolic syndrome increased with increasing age. 28.3% of the participants over the age of 50 years had metabolic syndrome whereas it was only 0.4% below the age of 20 years. Nearly half (47.1%) of the obese individuals were suffering from metabolic syndrome implicating obesity as one of the most important risk factors in the etiopathogenesis of metabolic syndrome. The prevalence was only 1.1% among the underweight group.Conclusions: Present study has shown moderate prevalence of metabolic syndrome among the rural population of Western Uttar Pradesh, India with a more female predisposition

Prevalence of type 2 diabetes mellitus in rural population of India- a study from Western Uttar Pradesh

Background: Diabetes is a major challenge for a resource-limited country like India. Majority of the patients are diagnosed late in the course of illness with presence of complications. There is limited data on diabetes from rural India. Present study is an attempt to provide data on diabetes in rural India. The overall objective of present study was to estimate the prevalence of Type 2 diabetes mellitus in rural population above 25 years age in district Etawah and neighbouring areas of Uttar Pradesh, India.Methods: The study was planned to determine the prevalence of diabetes mellitus in rural community by health camp and door to door approach. Fasting capillary blood glucose was first determined using a glucose meter (SD check code free, SD biosensor Inc. Korea). All the adults were given 75gm of glucose dissolved in 200ml water which was drunk over a period of up to 5 minutes and the 2-hour post load capillary blood glucose was estimated. Diabetic status was confirmed by taking blood samples for fasting and postprandial blood sugar levels in a fluoride vacutainer. Fasting plasma glucose ≥126mg/dl and or 2-hour postprandial glucose ≥200mg/dl were taken as the diagnostic criteria for diagnosis.Results: Prevalence of type 2 diabetes in the rural population was found to be 8.03%. Prevalence was higher in female population (9.91%) as compared to males (6.79%). 19.74 % of participants over 70 yrs of age were diabetics while diabetes was present only in 2.95% of participants in the age group of 25-39 year. The maximum number of diabetes were in the age group of 50-59 years. 10.04 % of participants were diagnosed to be Prediabetics. 35.77% of the diabetics were newly diagnosed.Conclusions:Present study shows there is high prevalence of type 2 diabetes in rural area of western Uttar Pradesh, India.

Prevalence of non-alcoholic fatty liver disease in patients of metabolic syndrome in a rural population attending tertiary care centre

Background: Non-alcoholic fatty liver disease and steatohepatitis now constitute the major etiology of chronic liver disease. Prevalence of non-alcoholic fatty liver disease is rising due to the change in lifestyle habits, diet and obesity. Metabolic syndrome is closely related with the pathogenesis of non-alcoholic fatty liver disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among patients attending General Medicine OPD. Each participant was subjected to clinical examination, anthropometric measurements, laboratory investigations and abdominal ultrasound. NAFLD was diagnosed by ultrasound and metabolic syndrome was diagnosed based on modified NCEP:ATP III criteria.Results: The prevalence of NAFLD was found to be 18.78% and was higher among male population (20.05%) as compared to females (17.32%). The prevalence of metabolic syndrome among NAFLD and control groups were 42.74% and 17.91% respectively.Conclusions: Present study has shown moderate prevalence of NAFLD and metabolic syndrome among the rural population of western Uttar Pradesh with a more male predisposition.

Prevalence of hypertension in rural population of Central India

Background: Hypertension is an important public health problem in both rural and urban areas of economically developed as well as developing nations. It is a chronic medical condition and is one of the most common life threatening non-communicable disease. It is an asymptomatic condition, symptoms do not arise unless the complications develop which result in delayed diagnosis and treatment especially among the uneducated and unexplained social groups such as rural population. Present study was an attempt to provide data on hypertension in rural area of central India. The objective of present study was to estimate the prevalence of hypertension in rural population above 18 years of age in Etawah and neighbouring districts of Uttar Pradesh, India.Methods: The study was planned to determine the prevalence of hypertension in rural community by health camp and door to door approach. BP measurements were made after the subject had rested for at least 5 minutes in a seated position using mercury sphygmomanometer. The first blood pressure measurement was taken after obtaining socio-demographic information from the study subject, while the second was recorded after 5 minutes.Results: The prevalence of hypertension was found to be 17%, which was observed to be higher among female i.e. 170 (18.3%) individuals than males 153 (15.8%) individuals. The prevalence of hypertension was observed to be higher among the older individuals. It was found to be 5.26 times higher in older (>50 years) than the younger (<30 years) age group. We found prehypertension in 65.74%, Stage I hypertension in 11.33% and stage II hypertension in 5.69% individuals.Conclusions: Present study showed that high prevalence of hypertension in rural area of Western Uttar Pradesh, Central India

Bacteriological profile of patients with biliary obstruction in tertiary care center

Background: Bile ducts are usually kept sterile by bacteriostatic and flushing effects of bile. Patients presenting with biliary obstruction especially due to benign etiology have either single or multiple bacterial organisms. Acute cholangitis carries significant morbidity with variable mortality rate. The serious presentation of such toxic patients signifies the requirement of appropriate antibiotic treatment.  Choledocholithiasis followed by neoplasm and benign biliary strictures are the common predisposing factors for obstruction. Widespread use of antibiotics over years lead to change in sensitivity pattern of organisms which necessitates change in empiric antibiotic usage. Methods: This retrospective study was conducted in department of medical gastroenterology. We studied 50 patients with biliary obstruction (clinical and demographic data were recorded). The diagnosis of cholangitis was made according to TG2018. While undergoing therapeutic ERCP, bile aspirate was collected by biliary cannulation and sent for microbiological analysis. The antibiotic susceptibility pattern and rest of the data were analyzed by appropriate statistical tests. Results: Mean age of the study group was 49 years. Majority were female in study (60%). Overall, 74% had benign etiology, 32% had cholangitis. Bile cultures were positive in 64% patients 75% of them had benign etiology (gallstone being most common; 56%) and 25% had malignant etiology. Bacterobilia in cholangitis patients was statistically significant in comparison to patients without cholangitis (p-0.01). Organisms grown are mainly aerobic gram negative, most common being E. coli, Klebsiella and Pseudomonas species. Patients having bacterobilia had mortality of 6.25% during hospital stay. Conclusions: In this study we found higher sensitivity to colistin (90.6%), tigecycline (81.25%), amikacin (75%) and least sensitivity was noted for ampicillin (6.25%) followed by cefixime (12.5%). Sensitivity to previously commonly used ciprofloxacin antibiotic was 31.25%. Study confirms the significance of obtaining routine bile sample during ERCP in obstructed biliary system to prevent dreaded complications of cholangitis

The prevalence of hypertension among young adults in a rural population of North India

Background: Most of the studies on hypertension provided the data on older age group. Most of the times, younger population remains unaddressed as they are assumed to be at a lower risk of developing the disease. So, the study on prevalence of hypertension among younger age group and their socio-demographic variables provides the guide for requirements of any intervention. Objective of present study is to estimate the prevalence of Hypertension among young adults in a rural population of central India.Methods: We collected data on socio-demographic characteristics and hypertension status from 1061 subjects aged 18–40 years. Relevant clinical parameters were collected (blood pressure recordings and anthropometric measurements).Results: Hypertension was detected in 188 of the 1061 subjects (17.7%). Prevalence among men was higher (18.8% compared to 15.2% among women). A total of 40.2% of the subjects was found to have pre-hypertension. Higher prevalence of hypertension was seen among those with a history of smoking.Conclusions: Most of the young adults with raised blood pressure were previously undiagnosed. A large number of subjects had prehypertension. Their early identification facilitates early, active management of blood pressure and formulation of preventive strategies thereby decreasing morbidity and mortality due to cardiovascular diseases and hypertension.

Physics Potential of the ICAL detector at the India-based Neutrino Observatory (INO)

The upcoming 50 kt magnetized iron calorimeter (ICAL) detector at the India-based Neutrino Observatory (INO) is designed to study the atmospheric neutrinos and antineutrinos separately over a wide range of energies and path lengths. The primary focus of this experiment is to explore the Earth matter effects by observing the energy and zenith angle dependence of the atmospheric neutrinos in the multi-GeV range. This study will be crucial to address some of the outstanding issues in neutrino oscillation physics, including the fundamental issue of neutrino mass hierarchy. In this document, we present the physics potential of the detector as obtained from realistic detector simulations. We describe the simulation framework, the neutrino interactions in the detector, and the expected response of the detector to particles traversing it. The ICAL detector can determine the energy and direction of the muons to a high precision, and in addition, its sensitivity to multi-GeV hadrons increases its physics reach substantially. Its charge identification capability, and hence its ability to distinguish neutrinos from antineutrinos, makes it an efficient detector for determining the neutrino mass hierarchy. In this report, we outline the analyses carried out for the determination of neutrino mass hierarchy and precision measurements of atmospheric neutrino mixing parameters at ICAL, and give the expected physics reach of the detector with 10 years of runtime. We also explore the potential of ICAL for probing new physics scenarios like CPT violation and the presence of magnetic monopoles.Comment: 139 pages, Physics White Paper of the ICAL (INO) Collaboration, Contents identical with the version published in Pramana - J. Physic

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis