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A review on role of essential trace elements in health and disease
Lingamaneni Prashanth, Kiran Kumar Kattapagari, Ravi Teja Chitturi, Venkat Ramana Reddy Baddam, Lingamaneni Krishna Prasad
April-June 2015, 4(2):75-85
Elements are present in different forms in the nature, and these elements are very essential for the body to perform different functions. Trace elements are very important for cell functions at biological, chemical and molecular levels. These elements mediate vital biochemical reactions by acting as cofactors for many enzymes, as well as act as centers for stabilizing structures of enzymes and proteins. Some of the trace elements control important biological processes by binding to molecules on the receptor site of cell membrane or by alternating the structure of membrane to prevent entry of specific molecules into the cell. The functions of trace elements have a dual role. In normal levels, they are important for stabilization of the cellular structures, but in deficiency states may stimulate alternate pathways and cause diseases. These trace elements have clinical significance and these can be estimated using different analytical method.
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Updated Kuppuswamy's socioeconomic scale for 2012
Shankar Reddy Dudala
July-September 2013, 2(3):201-202
  21 15,909 1,433
Prevalence of cognitive impairment and related factors among elderly: A population-based study
Deepak Sharma, Salig Ram Mazta, Anupam Parashar
July-September 2013, 2(3):171-176
Background: Older persons are at a risk of developing cognitive impairment, which is often considered a precursor to more serious conditions, such as dementia, depression or even Alzheimer's disease. Mini Mental State Exam (MMSE), a cognitive screening tests rated on a 30-point scale is most widely used to study cognitive measures. Aims and Objectives: The aim of our study was to determine the prevalence of cognitive impairment among older adults, to describe the pattern of cognitive impairment in rural and urban elderly population and to investigate the influence of socio-demographic and other variables on it. Materials and Methods: A cross-sectional study was carried out between January 2010 and July 2010, in urban and rural areas of Shimla district of Himachal Pradesh. Four hundred elderly people were included in the study. Cognitive levels were assessed with the MMSE scale (cut-off score 23). Data were analysed with SPSS 17.0 software for windows. Results: The prevalence of cognitive impairment was 3.5%. It was higher in rural (2.3%) than in urban population (1.3%), with a rural/urban prevalence ratio (PR) of 1.8 (95%CI 0.6-5.7). In the logistic regression model, old-old, illiterate and widowed showed a higher probability of cognitive impairment. It was not associated with use of alcohol, cigarette smoking or under nutrition. Conclusion: Knowing the prevalence rate of cognitive impairment in elderly, together with the associated factors may inform policy makers and aid in designing better geriatric friendly health services. When planning elderly health services priority should be given to the elderly who are old-old, widowed and those who are illiterate.
  14 7,277 914
Mounting media: An overview
Shamala Ravikumar, R Surekha, Rooban Thavarajah
March 2014, 3(5):1-8
Histological sections, which need to be examined for any length of time or to be stored must be mounted under a cover-slip. There are various types of mounting media available both commercially and also are prepared in one's own laboratory for mounting tissue sections. Some types of mounting media harden to hold the coverslip firmly in place and other types use different solvents such as water, glycerin and xylene because the stains in the sample preparation are sensitive to particular solvent. In order to prevent the of immonoflurescent slides, few mounting media contain antifade reagents. As less emphasis is given in the literature on mounting media, an attempt is made to review, venture and summarize on various types of mounting media and their uses in routine histopathologically and immunochemical staining.
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Antioxidant supplementation for health - a boon or a bane?
Uppala Satyanarayana, Amar Nagesh Kumar, Jupalle Nagaiah Naidu, Devavarapu Kasi Viswa Prasad
October-December 2014, 3(4):221-230
Antioxidants (vitamins E and C, β-carotene, superoxide dismutase [SOD], catalase etc.) are the substances that protect cells from the damage caused by free radicals, formed as a result of oxidative stress. Free radicals (O 2 , H 2 O2, OH , ROO etc.) are generated during the cellular metabolism and also due to environmental effects (cigarette smoke, ionizing radiations). Excessive production of free radicals has been implicated in the causation and progression of several diseases, e.g., atherosclerosis, cancer, rheumatoid arthritis, diabetes, and cataract. The general belief is that since free radicals are bad for health, antioxidants are good. This led to an indiscriminate use and supplementation of antioxidants, which is currently a controversial issue. This review gives an updated information on the effects of supplementation of antioxidants (vitamins E and C, β-carotene, SOD, catalase etc.). While some studies suggest that antioxidants are beneficial and protective, other interventional trials showed no health benefits. There are some interventional studies which demonstrated the deleterious effects of antioxidants (high risk of cancer, increased mortality). Further, antioxidant supplements were found to diminish the beneficial effects of certain drugs. It is suggested that indiscriminate use of antioxidant supplements should be avoided. Perhaps, antioxidants may be prescribed (not exceeding the recommended daily allowance) to the elderly, strict vegetarians or people who are on calorie-restricted diets. It is advisable that the antioxidants are consumed from rich natural dietary sources rather than supplements. Further, healthy individuals should exercise utmost caution while overdosing themselves with antioxidant supplements.
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High-dose hook effect
Rajendra Prasad Namburi, Vyshnavi Kancherla, Amaresh Reddy Ponnala
January-March 2014, 3(1):5-7
High-dose effect is a common phenomenon documented in various immunological and serological assays, which results in false-negative results. Due to limited amounts of reagent antibodies in the coated wells and extremely high concentrations of analyte in the sample leads to decrease in the formation of antigen-antibody complex and ultimately resulting in false low values of the analyte. High-dose hook effect has important medical implications, and simple methods of sample dilution helps in preventing false low concentrations.
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Morbidity profile of long distance truck drivers in Hyderabad city, India
Sharma Pawan Kumar, Enakshi Ganguly
October-December 2014, 3(4):234-237
Context: Truck drivers in India suffer from multiple health problems related to their long travelling and inadequate rest hours. Aims: The objective was to study the health problems and risk factors in a sample of truck drivers in Hyderabad city. Materials and Methods: A cross-sectional study was conducted during June 2011 among 59 truck drivers from a transport company, who were interviewed using a pretested proforma and examined by trained investigators. Lab results and medical consultations were provided the following day. Results were analyzed using Microsoft Access software. Results: The mean age of truck drivers was 28.46 ± 9.3 years. 54% suffered from low backache, 16.95% from visual problems, 45.76% had hypertension, 8.47% had anemia and 30.51% had high-risk body mass index. The prevalence of risk factors for metabolic disorders was lower compared to the general population. Conclusion: Proper road and job policies for truck drivers should be framed, aiming at subjecting them for periodic health evaluations to detect the diseases early.
  7 3,714 342
Epidemiological profile of mycotic keratitis in a tertiary care center of eastern Odisha
Bimoch P Paty, Pallabi Dash, Dharitri Mohapatra, Nirupama Chayani
January-March 2018, 7(1):23-25
Context: Mycotic keratitis presents as an ophthalmic problem causing visual disability due to its protracted course and unfavorable response. People of low socioeconomic classes who often come in contact with fungal spores during day to day activities suffer from this infection more often. Aims: To study the magnitude of fungal corneal ulcer, identify the risk factors, identify the predominant etiological agents in this region. Settings and Design: Type of study—observational study. This was a cross-sectional hospital based study. Materials and Methods: We collected 50 number of corneal scraping samples from patients clinically suspected to have fungal corneal ulcer within the age group 15–60 years. Direct microscopy of 10% potassium hydroxide (KOH) mount, gram staining, fungal culture on Sabouraud Dextrose Agar (SDA) media were performed. Results: Fungal isolates were obtained in 32% of cases of which 68.75% were male. Predominant age group was 30–45 years (56.25%). Majority of patients (68.75%) belong to low socioeconomic class. The most common risk factor was trauma with vegetative matter in 62.5% of cases. Predominant fungal isolate was Aspergillus spp. in 43.75% followed by fusarium, candida, and curvullaria spp. Conclusions: Because of the serious consequences of infectious keratitis, it is important to know the exact etiology to institute appropriate therapy in time. Laboratory confirmation should be under taken to rule out fungal infection before prescribing corticosteroid and antibacterial antibiotics.
  6 2,877 272
Elevated activities of serum lactate dehydrogenase in human immunodeficiency virus sero-positive patients in highly active antiretroviral therapy era
KV Ramana, Ratna Rao, Sabitha Kandi, Purna A Singh, Vankata Bharath P Kumar
July-September 2013, 2(3):162-166
Background: Monitoring HIV disease progression and deciding the time to initiate highly active antiretroviral therapy (HAART) requires evaluation of TCD4 + cell counts and HIV/RNA viral load at regular intervals. Considering the fact that it is the resource restrained developing countries that carry most of the burden of HIV, recently, studies have been carried out to evaluate the utility of low cost, easily performed alternate biomarkers that can be used for HIV disease management and in response to HAART. Unavailability of scientific technology and inadequate infrastructure makes it difficult for resource poor countries to manage HIV-infected individuals. Aim: Our study concentrated on evaluating LDH activities in HIV-infected individuals on HAART. Materials and Methods: The study was conducted between June 2011 to December 2011, and 36 HIV seropositive and antiretroviral therapy naive individuals and 21 HIV seropositive patients presently on HAART since past 3-6 months attending Integrated Counseling and Testing Centre (ICTC) situated at Area hospital Siddipet were enrolled in the study. Results: Our study concentrated on evaluating LDH activities in HIV-infected individuals (220.42 ± 79.04 IU/L) on HAART and showed that higher serum LDH activities were found when compared to controls (160.13 ± 47.11 IU/L). After 3–6 months of HAART, the serum LDH showed statistically significant decrease (188.76 ± 42.91 IU/L) (P < 0.002). Conclusion: LDH assay is useful in monitoring HIV disease progression and treatment response.
  5 8,013 439
Candidal carriage, isolation and species variation in patients undergoing radiotherapy and chemotherapy for head and neck tumours
Shoba Rani Bakki, Lalith Prakash Chandra Kantheti, Kiran Kumar Kuruba, Chandrasekhar Poosarla, Venkat Ramana Reddy Baddam, Raja Rajeswari Mulakaluri
January-March 2014, 3(1):28-34
Background: Opportunistic fungal infections, mainly candidiasis, is common in immunocompromised patients such as those undergoing chemo or radiatiotherapy and pose a great threat. Hence this study was done, attempting to find out the candidal carrier state and species variation, in such patients. Aims and Objectives: To determine the prevalence and speciation of Candida colonizing in the oral cavity of individuals attending to the cancer clinics in south India. Materials and Methods: Study groups comprised of 50 healthy, asymptomatic individuals as controls (Group I); 50 patients on : chemotherapy (Group - II) and 50 patients undergoing radiotherapy for head and neck cancers (Group - III). Mycological tests for the candidal isolation and speciation were done. Results: A total of 49 cases showed candidal culture positivity (32.67%). Candidal carriage was highest in Group II and Group III (38%). C. albicans was the most prevalent species (30%). The culture positivity and the colony forming unit/ml from the subjects of control group and the study group were highly significant, in pair-wise comparisons. Conclusion: Patients undergoing chemotherapy and radiotherapy for head and neck cancers are at a risk of developing oral candidiasis due to immunosuppression. C. albicans is the predominant isolate, but non-albicans species are also emerging as opportunistic pathogens. All may cause a similar spectrum of disease but differences in disease severity and antifungal susceptibility are noted. Hence, speciation can help to target the treatment of the disease in a much better way.
  5 3,007 371
Neonatal sepsis: A risk approach
Vijai Anand Babu Bangi, S Syamala Devi
October-December 2014, 3(4):254-258
Background: Neonatal sepsis continues to be a major cause of neonatal mortality in India. Incidence of neonatal sepsis in India was 30/1000 live births and is not changed much over the past decade. Aims and Objectives: The present study was intended to know the incidence and mortality rates of neonatal sepsis among hospital admission, whether there is any change in the risk factors over a decade and to evolve a risk approach in the management of neonatal sepsis. Patients and Methods: This was a cross-sectional study in a tertiary care teaching hospital. One hundred and twenty neonates with confirmed sepsis were enrolled. Cases were divided into early onset sepsis (EOS) (presenting in the first 72 h) and late onset sepsis (LOS) (presenting after 72 h). Information regarding risk factors was collected by questionnaire. All cases were started on ampicillin and gentamycin later upgraded based on culture and sensitivity. Cases were followed-up to discharge/death and the risk factors associated with fatal sepsis were analyzed using Chi-square test. Results: During 2003-2004, the incidence of sepsis was 6.04% of total pediatric admissions with EOS and LOS 3.08% and 2.96%. The same in 2013-2014 were 6.03%, 2.57% and 3.44%, respectively. Highly significant risk factors were inadequate antenatal care, assisted vaginal delivery, and premature rupture of membranes, low birth weight and associated complications. Klebsiella, Staphylococcus aureus and Escherichia coli were the most common organisms in both EOS and LOS. Conclusion: Overall incidence of sepsis and EOS is not changed much but the incidence of LOS has increased from 2.94% to 3.44%.
  5 5,123 599
Role of immunohistochemistry in diagnosis of brain tumors: A single institutional experience
Venugopal Madabhushi, Renuka Inuganti Venkata, Sailabala Garikaparthi, Satya Varaprasad Kakarala, Seshadri Sekhar Duttaluru
April-June 2015, 4(2):103-111
Background: Central nervous system tumors which constitute 1-2% of all tumors pose diagnostic challenges because tumors of varying histogenesis show divergent differentiation and overlap in morphological features. In problematic cases, immunohistochemistry is done in addition to the routine histopathologic examination to overcome the diagnostic difficulties, since an accurate histologic diagnosis helps in predicting the clinical outcome of various brain tumors. Materials and Methods: This study was carried out on a prospective basis in our institution from January 2009 to March 2012. During this period, a total of 246 neurosurgical specimens were received among which 118 brain tumors were diagnosed based on examination of Hematoxylin and Eosin stained sections of formalin-fixed and paraffin-embedded biopsy specimens. Immunohistochemical markers were applied in selective cases for an accurate diagnosis. Results: In adults, astrocytomas occurred most frequently in the study, followed by meningiomas, nerve sheath tumors, metastatic deposits, glioblastomas, and gliosarcomas. Primitive neurectodermal tumors occurred frequently in children. Other rare tumors included lymphomas and mesenchymal tumors. Age and sex incidence and anatomic distribution of various tumors were studied. Grading of the tumors was done as per the revised World Health Organization criteria. The results of immunohistochemical study in selective cases were analyzed. Conclusion: This study highlights the utility of immunohistochemistry as an adjunct in the histologic diagnosis of brain tumors in difficult cases.
  5 13,520 1,054
Perceptions of the introduction of objective structured practical examination (OSPE)/objective structured clinical examination (OSCE): A pilot study carried out in Government Medical College, Ananthapuramu, Andhra Pradesh, India
Gujjala Radhika, Aruna Kumari Dara, Kalyandurg Pujjari Varalaxmi, Chinnappagari Bhavani
July-September 2015, 4(3):145-149
Background: A uniform and reliable clinical and practical evaluation of medical students is always desirable. The method of objective structured practical examination (OSPE)/objective structured clinical examination (OSCE) tests the students on what they can do rather than what they know. This method is now believed to meet the deficiencies of the conventional system of practical/clinical examination. Aims: The aim of the present study is to take the perceptions and opinions of the medical education training (MET)-trained faculty regarding OSCE/OSPE, and their interest in introducing it as an assessment tool. Materials and Methods: This is a detailed, structured questionnaire study carried out in Government Medical College, Ananthapuramu, Andhra Pradesh, India in the period from May 2014 to July 2014 and was conducted on 50 members of MET-trained faculty. Results: Among the faculty, 96% agreed that it was a good and useful learning methodology; 98% agreed that it was a good assessment tool; 100% agreed that it assessed all the three domains; 80% agreed that it was a transparent, comprehensive, and fair assessment tool, 90% were of the opinion that it was mentally and physically taxing and required additional faculty hours to construct, review, and implement the arrangement of stations initially; 100% agreed that the combination with classical practical examination (CPE) produced good results; and 84% responded that it could partially replace CPE. Conclusion: We conclude that any change must first be thoroughly evaluated before it can uproot a well-defined and time-tested assessment methodology. OSCE/OSPE has several distinct advantages. In the current situation, it may be realistic to expect its inclusion in the evaluation schedule of universities and in day-to-day assessment of students to improve their clinical competence.
  5 13,750 552
Renal stone culture and sensitivity is a better predictor of potential urosepsis than pelvic or midstream urine culture and sensitivity
Rahul Devraj, Karthik Tanneru, Bhargav Reddy, Hasrhavardhan Amancherla, Ramreddy Chilumala
October-December 2016, 5(4):261-264
Background and Aim: Septicemia is a serious complication following percutaneous nephrolithotomy (PCNL) and can occur in spite of sterile preoperative urine culture and prophylactic antibiotics. The aim of the study was to analyze the utility of cultures of midstream urine (MSU), renal pelvic urine, and crushed stones for prediction of urosepsis. Materials and Methods: We performed a prospective clinical study in consecutive patients undergoing PCNL between April 2015 and October 2015. The samples collected for culture and sensitivity (C and S) were (1) MSU one day before surgery, (2) Urine from pelvicaliceal system during percutaneous puncture, and (3) Stone fragments collected during the procedure. All the patients were monitored during the postoperative period for symptoms and signs of urosepsis. The data collected were divided into 3 main groups, i.e., MSU C and S, pelvic urine C and S, and stone C and S, and were analyzed to determine association with urosepsis. Results: A total of 83 patients were included. The MSU C and S was positive in 10.8%, pelvic C and S in 13.7%, and stone C and S in 30.1% patients. Twenty patients had systemic inflammatory response syndrome (SIRS) and 3 patients had septic shock. Out of the 20 with SIRS, 17 cases were stone C and S positive, 6 were pelvic urine C and S positive, and 2 patients had positive MSU C and S. Conclusion: Stone C and S is a better predictor of potential urosepsis than pelvic urine and MSU C and S, which often fail to grow stone colonizing bacteria. We recommend routine collection of stone for C and S for the diagnosis and management of urosepsis after PCNL.
  5 4,386 368
Parasitic twinning - Varied presentations
Ramesh Reddy Kota, Srinivas Srirampur, Lavanya Kannaiyan, GM Irfan, Hariprasad Sharab, Subba Rao
July-September 2012, 1(3):174-176
Over a period of 5 years, 4 cases of parasitic twins with varied clinical presentations were treated. One case presented with an accessory limb near gluteal region with caudal duplication. Two cases presented as localized mass lesions; one in the epigastrium and another in the gluteal region. Yet another case presented with accessory limb and a mass in the dorsal paraspinal region. Histopathology of these cases revealed presence of mature teratomatous elements and representation from varied tissues suggestive of parasitic twinning. Management of these cases needs to be tailored as per the anatomy and may need staged correction.
  4 5,069 359
Lipoma in liver: A rare presentation
Onteddoo Joji Reddy, Jamkhana Abdul Gafoor, Balla Suresh, Polysetty Obuleswar Prasad
July-September 2015, 4(3):185-187
Liver lipoma is an extremely rare tumor. Its nature and behavior is not well-known since available information is based mostly on the individual case reports. This report presents a case of liver lipoma mimicking malignant liver tumor. Patient was a 76-year-old female patient with 5-month history of the right upper abdominal quadrant pain. Diagnostic work-up revealed a large liver tumor mass, suspicious of malignancy. However, histopathological analysis found it to be benign lipoma. Because of extremely low incidence of liver lipoma, especially large ones, appropriate diagnostic work-up is very important for its differentiation from malignant tumors.
  4 6,883 294
A finite element analysis of initial stresses and displacements in the tooth and the periodontium in periodontally compromised simulations: Labial versus lingual force application
Jayam Bharath Kumar, Gudimetla Jaisekhar Reddy, Moturi Sridhar, T Jayasimha Reddy, Pyata Jaipal Reddy, Sadam Srinivasa Rao
January-March 2016, 5(1):34-43
Introduction: Orthodontics a unique branch in dentistry is inter-related with biology, mathematics and engineering sciences. Biomechanics is fundamental to the practice of orthodontics. Stresses generated at any point during orthodontic treatment are critical in remodeling of bone and type of tooth movement. Aims and Objectives: The aim of the following study is to determine the initial stresses produced in the tooth, periodontal ligament (PDL) and bone when force is applied on the tooth for intrusion and tipping on labial and lingual sides in the presence of varying alveolar bone heights. Materials and Methods: A geometric model generated using AutoCAD (Autodesk, Inc.). Six three-dimensional finite element models of a maxillary central incisor were designed with PDL and varying alveolar bone heights after applying the boundary conditions of the model, force was applied on the tooth. Results: Results were obtained with color coded three-dimensional fringe patterns. Conclusion: Alveolar bone loss causes an increase in the maximum initial stresses relative to the bone heights.
  4 4,135 439
Evaluation of antimicrobial efficacy of neem and Aloe vera leaf extracts in comparison with 3% sodium hypochlorite and 2% chlorhexidine against E. faecalis and C. albicans
Sistla Datta Prasad, Prem Chand Goda, Kunam Sashidhar Reddy, Chennuru Sunil Kumar, Melpati Hemadri, Dappili Swamy Ranga Reddy
April-June 2016, 5(2):104-110
Aim: The aim of study was to determine the antimicrobial efficacy of alcoholic neem and Aloe vera leaf extracts against Enterococcus faecalis and Candida albicans in comparison with 3% sodium hypochlorite (3% NaOCl) and 2% chlorhexidine (2% CHX). Materials and Methods: In the present study, indigenously prepared neem and Aloe vera leaf extracts were serially diluted to determine the minimum inhibitory concentration (MIC) at which the E. faecalis and C. albicans were sensitive, and compared it with 3% NaOCl and 2% CHX by the agar-well diffusion method. Results: The MICs of the alcoholic neem extract to E. faecalis and C. albicans were determined as 0.94% and 1.88%, and for Aloe vera extracts they were 1.88% and 3.75%, respectively and the zones of diffusions that were formed around the extracts in the respective agar plates were significantly greater than with 3% NaOCl and 2% CHX within the groups when analyzed statistically by one-way analysis of variance (ANOVA). Conclusion: The antimicrobial efficacy of extracts was well demonstrated from the present in vitro observation of the agar-well diffusion method, and hence it may be advantageous if we use these extracts as irrigating solutions in endodontics. However, it requires further preclinical and clinical evaluation.
  4 7,044 572
Prevalence of Rotavirus diarrhea among under-5 hospitalized children in a Government tertiary hospital, Tirupati
Manohar Badur, Naramalli Madhavi Latha, Panabaka Ravi Kumar, Shankar Reddy Dudala, Shabbir Ali Shaik, Gagandeep Kang, Cheri Naveen Kumar
April-June 2015, 4(2):112-116
Context: Rotavirus is the most common cause of severe diarrhea requiring hospitalization among infants and young children worldwide. The prevalence of rotavirus diarrhea in India has been found to vary in the range 5-71% in hospitalized children aged under 5 years with acute gastroenteritis. The seasonal variation of rotavirus diarrhea in India varies across different geographical regions, with high incidence in the winter months at low relative humidity in northern India. Aim: This study aimed to estimate the prevalence of rotavirus diarrhea among hospitalized children aged under 5 years and to learn about the genotypic distribution of rotaviruses causing diarrhea. Settings and Design: Study design: hospital-based cross-sectional study. Study setting: the pediatrics department of a tertiary care Government hospital, Tirupati, India. Study period: September 20, 2012-September 19, 2013. Materials and Methods: Study units: children under 5 years of age presenting with diarrhea. Stool specimens from all hospitalized children aged under 5 years who had presented with acute watery diarrhea were collected and tested for rotavirus by the enzyme-linked immunosorbent assay (ELISA). Positive samples were tested for G and P typing by the reverse transcription-polymerase chain reaction (RT-PCR) technique. Statistical Analysis Used: Percentage and chi-square analysis. Results: Among the study sample, 68.7% of children were in the age group between 1-12 months and 25.6% children showed positive result for rotavirus by ELISA. Of the rotavirus positives, 50% were G1P8 viruses. Conclusion: Rotavirus is an important cause of diarrhea in hospitalized children.
  4 4,742 518
Giant pelvic hydatid cyst
Hari Charan Perigela, M Koti Reddy, B Vara Prasad, J Narahari
July-September 2013, 2(3):218-221
Hydatid disease, most commonly caused by the larval stage of Echinococcus granulosus, affects mainly human liver and lungs, and rarely other parts of the body. It is prevalent in most sheep-raising Mediterranean countries, Central Asia, the Middle East, Eastern Africa, and parts of South America. Peritoneal hydatid cyst, either primary or secondary, represents an uncommon but significant manifestation of the disease. The present case report describes a case of a giant secondary hydatid disease of the pelvic cavity with primary in the liver.
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An insight into HIV/AIDS epidemic in India and India's response
Turlapati L. N. Prasad
April-June 2012, 1(2):65-71
  3 4,324 483
Changing trend in the clinical distribution of Candida species in a tertiary care hospital
Jayapriya Sukumaran, Jeya Meenakshi Sundaram, Ranjith Raj Sivan
October-December 2012, 1(4):222-226
Aims: Candida albicans remains the most common species causing human infections but recent epidemiological data reveal shift from C. albicans to non C. albicans species. The aim of our study is to detect the clinical distribution of Candida species in a tertiary hospital. Materials and Methods: Fifty Candida isolates from clinical samples were studied. The samples were inoculated on Sabouraud's Dextrose Agar (SDA) and Hichrom agar and incubated at 37°C. Growth on SDA were identified and speciated by standard methods. Candida species were identified on Hichrom agar by morphology and color of the colony and were compared with conventional methods. Anti-fungal susceptibility was performed by disc diffusion method using commercially available anti-fungal discs (HiMedia). Results: Out of 50 Candida isolates collected 62% were from males and 38% from females. The distribution of the clinical samples was urine 44%, exudate 32%, respiratory 14% and blood 10%. C. albicans (54%) was the most common species isolated from these samples. The distribution of non C. albicans were C. tropicalis (18%), -C. krusei (12%), - C. glabrata (10%),- C. rugosa (6%). Among the non-albicans C. tropicalis was seen predominantly in urine and exudates. The specificity and sensitivity of Hichrom agar was 98%. Antibiotic susceptibility pattern shows that about 38% of C. albicans and 17% C. krusei isolates were resistant to fluconazole. Conclusions: Percentage of non-albicans species (46%) are increased in the prevalence with C. albicans (54%) as the predominant species from clinical samples. Anti-fungal profile shows an increased percentage of resistance to fluconazole.
  3 7,771 557
Quantitative and qualitative analysis of collagen in oral submucous fibrosis
Gannepalli Ashalata, Pacha Venkat Baghirath, Ayinampudi Bhargavi Krishna, Putcha Uday Kumar, Arun Tom
April-June 2012, 1(2):99-105
Background: Oral submucous fibrosis (OSMF) is considered as a potentially malignant disease, which is associated with betel quid and pan masala chewing. It is thought to be due to the defective collagen synthesis and degradation. The amount of collagen in the diseased varies with the functional stages and histopathological grades of the disease. Aims: The aim of the study was to assess the severity of the disease in oral submucous fibrosis, by correlating the functional staging with the histopathological grading and analyze the collagen distribution in different grades of OSMF using picrosirius red stain under polarizing microscope and also to assess the quantitative changes in collagen with respect to various histopathological grades of OSMF using spectrophotometry. Materials and Methods: The study conducted on 40 subjects, which included 30 subjects with different functional and histopathological grades of oral submucous fibrosis (OSMF), and 10 were in control group. Functional staging and histopathological grading was done based on the definite criteria. A Histopathological and quantitative analysis of collagen was conducted using picrosirius red stain, polarizing microscope and spectrophotometer, respectively. The results were analyzed using chi-square test, and the significance was tabulated. Results: The functional staging and the histopathological grading did not show statistical correlation, but as the histopathological grade of the disease increased; there was a shift in the polarizing color from yellow-green to orange-red. In the colorimetric estimation, the optical densities of the sample decreased as with increased grades of OSMF. Conclusion: In the present study, we observed that the histopathological grading of OSMF is not correlating with the functional staging of OSMF. Therefore, it mandates the proper correlation between the functional staging and the histopathological grading before the commencement of the treatment to render better outcome of the treatment.
  3 6,080 896
Study of pattern of blood sugar levels in low birth weight babies who are exclusively on breast milk
VSS Yerramilli Murty, Kethireddi Dinendra Ram
April-June 2012, 1(2):90-93
Background: Breast feeding of every newborn baby is being widely advocated in view of its undoubted and multiple benefits to both newborn baby and mother. But low birth weight (LBW) babies with several handicaps may not maintain blood sugar level. Adequacy of breast milk in maintaining euglycemia in LBW newborn babies is being studied. Aims: To study the pattern of blood sugar levels in LBW babies who feed exclusively on breast milk. Settings and Design: This is a prospective study conducted in postnatal ward and neonatal intensive care unit of a tertiary care centre. One hundred consecutive neonates with a birth weight less than 2500g when born, being fed exclusively with breast milk were studied. Materials and Methods: Estimation of blood sugar levels in LBW neonates with birth weight less than 2500g who were given direct breast feeding or expressed breast milk exclusively. Results: The present study revealed that 95% of LBW neonates maintained adequate blood sugar levels during the first 72 hours of life with breast milk irrespective of gestational age and birth weight studied. Single episode of hypoglycemia occurred in 5% of these LBW babies. Conclusions: There is a very low incidence of hypoglycemia in LBW newborn babies (including intrauterine growth retardation (IUGR) and preterm babies) on exclusive breast feeds. Breast milk is optimal feed in these LBW babies.
  3 6,260 1,202
Cytomorphometric analysis of exfoliative buccal cells in type II diabetic patients
M Suvarna, C Anuradha, K Kiran Kumar, P Chandra Sekhar, K Lalith Prakash Chandra, BV Ramana Reddy
January-March 2012, 1(1):33-37
Aim: To evaluate the quantitative and qualitative changes in cytological buccal smears of type II diabetic patients by using the parameters like nuclear area (NA), cytoplasmic area (CA), and cytoplasmic/nuclear ratio (C/N). Materials and Methods: The study was done in 40 known type II diabetic patients and 40 healthy individuals. Buccal smears were taken and subjected to Pap-stain. NA and CA of 20 integral cells in the smear were measured using Image Pro-Express Version 6.0 image analysis system by Media Cybernetics Inc., Bethesda, MD, USA. The C/N ratio was then calculated. For comparing cytomorphometric parameters (NA, CA, C/N ratio), t-test was used. Results: There was a statistically significant increase in average NA and significant decrease in the C/N ratio in diabetics when compared to non-diabetic healthy individuals. The average CA did not show any statistical difference between the two groups. The morphologic alteration seen in diabetic group was the presence of acute inflammation. Conclusion: Exfoliative cytology is an additional tool to aid in diagnosis of diabetes mellitus, apart from the regular standard tests.
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