Clinical and socio-demographic profile of substance abusing persons seeking treatment at a teaching hospital in Garhwal hills of Uttarakhand

Background: The substance abuse is gradually becoming one of the major public health issues of present day India. Many factors influence the pattern of substance abuse, including age, sex, educational level, social support, cultural factors, availability of drugs and the presence of cognitive or psychiatric problems. This study was planned to find out the clinical and socio-demographic profile of substance abusing persons.Methods: The study was conducted in the Out-patient facility of the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute Of Medical Science and Research, Srinagar (Uttarakhand), starting from 23 September 2015. One hundred consecutive treatment seeking subjects fulfilling International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), criteria for Mental and behavioural disorders due to psychoactive substance use were included in the study. All the participants were required to sign an informed consent approved by the institutional ethical committee before being enrolled in the study. All the subjects included in the study were administered a self-structured proforma to elicit the clinical and socio-demographic variables.Results: One hundred patients consisting of 95 men (95%) and 05 women (05%) were included. The average age of the sample was 39.68 years (SD=11.97). As for the socio-demographic variables other than age, 87% of the patients were married, 62% patients were living in nuclear families and 66% belonged to the rural areas. 79% patients were educated up to high school and above and only 06% were illiterate. Alcohol was the most frequently abused substance seen in 78% patients followed by tobacco smoking in 58% of the study subjects. Peer Pressure was cited as the most common reason for the initiation of substance abuse by 75 (75%) patients.Conclusions: Alcohol was the most commonly abused substance. Substance abuse was higher in married, educated males from rural areas living in nuclear families

Psychiatric comorbidity in substance abusing population in Garhwal hills of Uttarakhand

Background: Psychiatric morbidity occurs more frequently in patients with substance abuse than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving care of substance abusing population but such data are relatively meager from developing countries.Methods: This study was conducted in the Out-patient facility of the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute of Medical Science & Research, Srinagar (Uttarakhand), starting from 23 September 2015. One hundred consecutive treatment seeking subjects fulfilling international classification of diseases and related health problems, 10th Revision (ICD-10), criteria for mental and behavioral disorders due to psychoactive substance use were included in the study. All the participants were required to sign an informed consent approved by the institutional ethical committee before being enrolled in the study. All the subjects included in the study were administered a semi-structured Proforma to elicit the clinical and socio-demographic variables.  Results: One hundred patients consisting of 95 men (95%) and 05 women (05%) were included. The average age of the sample was 39.68 years (SD=11.97). As for the socio-demographic variables other than age, 87% of the patients were married, 62% patients were living in nuclear families and 66% belonged to the rural areas. 79% patients were educated up to high school and above and only 06% were illiterate. 36 % of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was significant higher in unmarried people with less education (primary or less) and those living in nuclear families.  Conclusions: Psychiatric comorbidity was found in 36% of the study subjects

A Comparative study between conventional method and the Bethesda system for reporting thyroid cytopathology (TBSRTC)

Background: FNAC is widely used for the diagnosis of thyroid lesions. TBSRTC was introduced to streamline the reporting of thyroid aspirates. Objectives was to study the spectrum of various thyroid lesions in and around Meerut and comparison of conventional method and TBSRTC.Methods: A total of 464 patients were evaluated both by conventional system and TBSRTC.Results: As per conventional system of reporting, maximum number of cases were diagnosed as benign (87%), followed by malignant (6.4%), follicular neoplasia (2.5%), equivocal (2.1%) and inadequate (1.7%). As per TBSRTC, maximum number of cases were reported as category 2, 86.2% followed by category 6, 6%, category 1, 2.5% and cat 3,2.5%, category 4, 1.5% and category 5, 1%. Among benign category, maximum number of cases were of colloid goiter/multinodular goiter (MNG) (65%) followed by Hashimoto`s thyroiditis (15%), Grave`s disease (6%). Among the malignant category, maximum number of cases were of papillary carcinoma thyroid (PCT) (5.3%) followed by medullary carcinoma thyroid (MCT) (0.43%), non-Hodgkin`s lymphoma NHL (0.21%), metastatic carcinoma (0.21%), and anaplastic carcinoma (0.21%) of each.Conclusions: In present study it was found that there is an excellent agreement between the conventional system and TBSRTC. Results of both systems of reporting are comparable. In some cases, TBSRTC is almost equivalent to the conventional system in the pattern of reporting (viz. benign and malignant cat) while in some cases, TBSRTC is better in reporting (viz. FN and equivocal cat). The sensitivity of TBSRTC (93%) is slightly more as compared to the conventional system (90%) while its specificity (86%) slightly less as compared to conventional system (88%). Thus, as compared to the conventional system, TBSRTC may be viewed as a better screening test for thyroid lesions, though at the cost of specificity

Evaluation of fungicides for the control of Sclerotinia stem rot of Indian mustard caused by Sclerotinia sclerotiorum (Lib.) de Bary

The current investigation was carried out under -in vitro and under sick plot conditions of the Department of Plant Pathology, CCS Haryana Agricultural University, Hisar to test the efficacy of different fungicides against Sclerotinia sclerotiorum. The experiment was carried out through poison food technique under in vitro conditions andthrough foliar sprays under sick plot conditions. Efficacy of fungicides in vitro against S. sclerotiorum showed that carbendazim and hexaconazole completely inhibited mycelial growth up to 100 per cent at 50 ppm concentration. Propiconazole inhibited 96.39 per cent mycelial growth at 50 ppm and 100 per cent at 1000 ppm, while tricyclazole failed to inhibit mycelial growth up to 100 ppm, however, at 1000 ppm concentration, there was 100 per cent mycelial inhibition. Mancozeb and captan completely inhibited up to 100 per cent mycelial growth at 500 ppm concentration. Copper oxychloride and pencycuron were not effective at lower concentrations but had inhibited 45.28 and 22.50 per cent mycelial growth at 1000 ppm. Field experiment was conducted to test the efficacy of those fungicides which were found best under in vitro conditions. All the four fungicides tested significantly controlled Sclerotinia stem rot disease and increased the seed yield as compared to untreated control. Two Foliar sprays with hexaconazole @ 0.05% at 45 and 60 days after sowing was found most effective in controlling disease incidence up to 78.3 per cent and increasing seed yield up to 37.6 per cent as compared to untreated control

Diagnostic spectrum of CSF involvement by malignant cells: three-year experience of tertiary care hospital in CSF cytology

Background: Cerebrospinal fluid (CSF) cytology is the diagnostic gold standard test for primary or metastatic involvement of central nervous system (CNS) by malignancy. It is a very important and routinely done test in the laboratory but its sensitivity is low due to many confounding factors and varies amongst type of malignancies. We did retrospective analysis of CSF cytology carried out at our center from January 2013 to December 2015 to find out about spectrum of malignancies being detected on CSF cytology.Methods: From January 2013 to December 2015, three hundred and seventy-five CSF samples were received and processed for presence of malignant cells at our center. The cytospin preparations stained with LG and PAP stains of these CSF samples were analyzed along with any special stain that was available in the records. Clinical details of the patients with positive cytology were correlated from records.Results: The diagnostic spectrum obtained through study of positive CSF cytology included cases of metastatic solid malignancies and hematolymphoid malignancies. Four cases out of ten were of Metastatic Adenocarcinoma with primary origin being Breast, Lung and Stomach. Out of six cases of hematolymphoid malignancies; five were known cases of lymphoma/leukemia and one was primarily diagnosed to have Non-Hodgkin’s lymphoma (NHL) on CSF cytology.Conclusions: Both Epithelial and Hematolymphoid malignancies can be diagnosed on CSF cytology and these are predominantly metastatic in origin; Hematolymphoid malignancies are more common in CSF than solid malignancies. Correlation with clinical details and Neuroimaging is a must

DESIGN AND EVALUATION OF EXTENDED RELEASE CEFUROXIME AXETIL FLOATING TABLETS WITH IMPROVED GI ABSORPTION

Oral drug delivery system represents one of the frontier area of controlled drug delivery system. Floating drug delivery system belongs to oral controlled drug delivery system group, which is capable of floating in the stomach for prolong period of time. The objective of the present research work is to provide a gastroretentive system for sustained release of therapeutically active agent, cefuroxime axetil in upper part of gastro-intestinal tract in the form of floating tablet. Cefuroxime axetil, an oral prodrug shows a bioavailablity of 30% to 40% when taken on fasting and 5% to 60% whentaken after food. The cefuroxim axetil esterase can hydrolyze cefuroximeaxetil to the nonabsorbable cefuroxim in the gut lumen and is therefore, suspected as a possible cause of incomplete bioavailability. Which suggests an absorption mechanism through the mucosa with limited capacity. Cefuroxime axetil had saturation kinetics that could be overcome by slow release of drug from the formulation, by incorporating cefuroxime axetil in sustained drug delivery system. Keywords: Floating drug delivery system, Cefuroxime axetil, Gastro-intestinal tractÂ

A toolset for complex decision making in analyze phase of Lean Six Sigma Project: A case validation

The analyze phase of Lean Six Sigma (LSS) project is an important phase where the project heads and organizational directors need to select the critical issues for further improvements. The present work is primarily focused on analyze phase of LSS project to prioritized the Critical to Quality (CTQs) in a particular case industry. The CTQs prioritization is being done based on the five evaluation criteria found from the literature. The weights of the criteria are determined through the Modified Digital Logic (MDL) method. The identified CTQs in assembly section of case industry have been ranked through the Grey Relation Analysis (GRA) under fuzzy environment. The results of the study have been validated using fuzzy VIKOR. It is found that the ‘cost’ criterion is the most significant among other criteria with MDL weight of 0.3. Through fuzzy-GRA, out of ten identified CTQs, non availability of rack system is found to be the most critical issue in assembly section of case industry. The perceptions of industrial manager and production head of case industry are strongly in favor of the obtained results and has implemented the suggested solutions.To sustain in the competitive environment and produce quality product at right time, organizations need to control their CTQs as per their criticality. For this, the decision making becomes quite complex to select the most critical factors due to the fascinating nature of various criteria and sub-criteria. The present study is the first attempt that has implemented the multi-criteria decision-making approach in analyze phase of LSS project

Can peripheral blood smear examination be totally replaced by automated hematology analyser - with special reference to anemia?

Background: The aims and objectives of present study was to correlate typing of anemia based on RBC indices obtained from an automated analyzer with peripheral blood smear (PBS) examination and also to find out whether the number of PBS examination can be reduced with the help of automated hematology analyzer.Methods: A total of 2500 blood samples showing anemia as per WHO reference range were collected in central pathology lab of SVBP Hospital attached to L.L.R.M. Medical College, Meerut, Uttar Pradesh, India over a period of one year. Samples were reported by auto-analyzer and PBS examination simultaneously.Results: Out of total 2500 cases, there were 1623 females (64.9%) and 877 males (35.1%) with male: female ratio 0.54:1. By auto-analyzer and PBS examination, MCHC anemia (49.8%) was the commonest anemia followed by NCNC anemia (36.5%) and Macrocytic anemia (4.2%). Discordant typing of anemia between two methods was found in 284 (11.4%) cases only. These cases were diagnosed as normocytic normochromic (NCNC) anemia with raised RDW by autoanalyzer while as Dimorphic Anemia (DA) on PBS examination. Also morphological changes such as RBC inclusions, spherocytes, RBC fragments, schistocytes, nucleated RBCs were seen only on PBS examination.Conclusions: The Study concluded that even today PBS examination is very important and cannot be totally replaced by automated analyzer and both methods are complementary to each other