Background & Objectives: Breast cancer is the most common cancer in women and the second most common cancer worldwide. It is also the second leading cause of death due to cancer. Breast cancer is less frequent in the younger age group but have a poorer outcome in contrast to the breast cancer arising in the older age groups. There is a lack of awareness and due to this, majority of patients present late. The aim of this study is to know the incidence and clinicopathological features of breast cancer in young females under the age of 40 years. Methods: This is a retrospective study done over a period of one year at a tertiary care hospital in south India. The hospital and lab records were searched for histologically confirmed breast cancer cases in female patients under the age of 40 years. A total of 14 breast cancer cases were identified and hematoxylin and eosin stained histopathology slides were retrieved from the histopathology archives and were reviewed. The available slides of immunohistochemistry markers were also reviewed. Results: The most common histological type was infiltrating ductal carcinoma (IDC) seen in 13 (92.8%) cases with 1 case of invasive lobular carcinoma. Half of cases were of stage III at the time of diagnosis. 4 (28.57%) cases presented as stage II and 3 (21.4%) cases were stage I. There was a predominance of higher grade with 7 (50%) cases having grade II and 5 (35.7%) of cases were grade III. On IHC, 4 cases (28.57%) were negative for estrogen receptor, progesterone receptor and Her 2 neu. Conclusion: Young breast cancer patients present with higher stage, higher tumor grade and hormonal receptor negative status. More studies are needed to investigate survival and post treatment recurrence in young females with breast cancer.

Catharanthus rosea is an important ethno medicinal plant rich in bioactive compounds mainly alkaloids used widely in treatment of cancer disease. The aim of present study was to determine the total phenol, flavonoid, tannin and alkaloid content in leaf stem and root parts of Catharanthus rosea in benzene, methanol, aqueous, chloroform and petroleum ether extracts by spectrophotometric method. Phytochemical analysis showed presence of saponin, tannin, terpenoid, flavonoid, cardiac glycoside, alkaloid, steroid, quinones and phenolic compounds whereas protein was found absent. The total phenol, flavonoid, tannin, and alkaloid content of plant in different extracts were determined in comparison to standard gallic acid, rutin, tannic acid and quercetin respectively. The higher concentration for phenol was found in benzene leaf extract (0.65±0.02) µg/ml, flavonoid in chloroform leaf extract (0.62±0.02) µg/ml, tannin in methanol root extract (21±0.01) µg/ml and alkaloid in benzene leaf extract (0.61±0.03) µg/ml. The presence of such metabolites indicates therapeutic importance of plant.

Staphylococcus aureus is a dangerous human pathogen and one of the leading causes of infections worldwide While S. aureus toxin production is highly strain-specific, because most toxins of S. aureus. Some of the genetic diseases that directly associated to the lysis of the cells of the blood. One of the diseases that associated to the genetic level included the sickle cell anemia. This is particularly useful in classifying streptococcal species. A substance that causes hemolysis is a hemolysin. Different effects appeared due to more hemolysis of the cells of the blood by different microbes. β-Hemolytic streptococci are also detected in laboratory rats but rarely cause disease. Streptococcus pneumoniae and a group of oral streptococci as Streptococcus viridans or viridans streptococci display alpha hemolysis. This is sometimes called green hemolysis because of the color change in the agar. Bacteria are often divided into different families and groups. This division is based in part on the physical appearance of the bacteria as well as some of their chemical and biological characteristics. The organism does not induce hemolysis, the agar under and around the colony is unchanged, and the organism is called non-hemolytic or said to display gamma hemolysis (γ-hemolysis).

From the literature it is seen that graphene oxide nano filler possess exceptional mechanical properties and it is being used for enhancing mechanical properties in polymer composite. The effect of inclusion of graphene oxide nano filler on dynamic properties in fiber reinforced polymer composite has not been fully investigated. The objective of this experimental work is to investigate the dynamic properties of graphene oxide based nano-modified symmetric Glass/Carbon interlayer hybrid laminates. Ultra-sonification has been used for dispersing graphene oxide (0.5%wt) nano filler into the epoxy. The unidirectional carbon fibers are placed into the composite laminate at various stacking sequence. The modal parameters like frequency, mode shape and damping ratio were determined experimentally using traditional ‘strike method’ using FFT analyzer and Data Acquisition System. Experimental modal analysis of the composite laminates was conducted for fiber orientations of 45 and for two boundary conditions ( ie F-F-F-F and C-F-F-F). The effect of hybridization using graphene oxide nano filler in symmetric glass/carbon interlayer composite on frequency and modal damping are discussed in this paper. This research work provides basic understanding of the dynamic behavior of interlayer hybrid composites with incorporation of Graphene oxide.

Background: Histopathology remains the key to diagnosis and management of bone lesions and the present study focuses on the relative frequencies of the various causes of bone lesions with respect to age and gender. Methods: The study was conducted as a combined retrospective and prospective study spanning over a 2 year period from 2018 to 2020. Consecutive bone specimens received in the Pathology Department were subject to histopathological examination and correlated with the demographic characteristics of the patient population. Results: Among the 105 specimens examined histopathology, non-neoplastic lesions were more common than neoplastic lesions (67 vs 38). Tuberculous osteomyelitis (n=22, 32.8%) was the most common non-neoplastic lesion. Osteochondroma (30.8%) and osteosarcoma (50%) are the commonest begin and malignant tumours respectively. Conclusion: Histopathology remains a gold standard for the diagnosis of bone lesions. Knowledge of the relative frequencies of various lesions with respect to age and gender is of paramount importance. This when combined with clinical and radiographic data helps in arriving at correct diagnosis.

For every child, early moments matter. Children’s lives have been turned upside down by COVID19. For some children, with the right support and resources, the situation will be manageable, but for others the effects of the pandemic will cast a long shadow over their lives. The response to coronavirus already is exposing the fragile situation that many children and young people live in (UNICEF, 2020). Hundreds of thousands of children who rely on school, health and social systems and the support of the voluntary sector are being left unprotected as these systems are weakened. The risks to children’s health, wellbeing and future opportunities are serious and need immediate intervention. Hundreds of thousands of children will face hunger, violence, ill-health and lost opportunities that could follow them into adulthood. This review article aims to highlight the impact of COVID 19 on children.

The aim of this study was to evaluate the sensitivity of Fecal Occult Blood (FOB) strips in the diagnosis of Pulmonary Tuberculosis (PTB) isolated from sputum of tubercles patient. The study was carried out in Omdurman Teaching Hospital-Abu Anga-Tuberculosis ward. From 27th of August to 25th of September 2007. A total of 67 sputum samples collected from the suspected people. The samples examined by FOB test and Z.N techniques. Ten out of the enrolled samples, which showed positive FOB and negative Z.N techniques selected confirmed by using PCR techniques. The result showed that there were 12 (17.9%) of cases were Z.N (+ve), while 55 (82.1%) of cases were Z.N (-ve). It was also showed that there were 53(79.1%) of cases were FOB test (+ve), while 14(20.9%) of cases were FOB test (-ve). According to PCR techniques, after performed 10 samples that showed Z.N (-ve) and FOB test (+ve), it was noted that there were 4(40%) of cases were PCR (+ve), while 6(60%) of cases were PCR (-ve).

Introduction: Anaemia in pregnancy is emerging as one of the most important causes of maternal complications, morbidity and offspring mortality in almost all the developing countries of the world including India. Haemolytic anaemia is the anaemia which results from increased rate of red cell destruction. The haemolytic anaemia resulting from intra corpuscular defects are predominantly hereditary in nature. Material and Methods: This is a prospective and descriptive study was carried out on pregnant women with hemolytic anaemias conducted in the Department of Pathology at Tertiary care Teaching Hospital. Inclusion Criteria: Antenatal women (age 18 to 40 years) and Irrespective of gestational age and parity. Anaemias due to other causes (nutritional, blood loss, microangiopathic hemolytic anaemia, acquired hemolysis) were excluded. Hematological parameters were studied using an automated blood cell counter. Result: In our study, 31 women (44.2%) out of 70 persons were within 21-30 year and least were 12 women (17.1%). Of whom 38 were detected to have hemolytic anaemias, 19 had Beta-Thalassemia; 11 had Sickle cell anaemia, 2 had Haemoglobin E Trait. The frequency of Mild to severe anaemia was recorded to be 27.2% to 36.3% sickle cell anaemia, 10.5% to be 39.4% haemolytic anaemia, 47.3% to be 15.7% (β -thalassemia trait), and 100% severe (Haemoglobin E Trait) in pregnant women. Conclusion: Successful outcome in pregnancies complicated with hemolytic anaemias can be achieved with prompt diagnosis, patient education, screening, genetic counselling and prenatal diagnostic testing of foetus and management in a tertiary care hospital by a multidisciplinary approach.

Background: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. Methods: This is a prospective, descriptive and observational study conducted at Department of Microbiology, Surabhi Institute of Medical Sciences over a period of 1 year included 410 patients. Patients of either sex of any age who have been admitted inward and on antibiotic therapy were included. Outdoor patients were excluded in our study. Conducted from various clinical Departments such as Medicine wards, Surgical wards, Paediatric wards and Orthopaedics wards. All data was be documented and reviewed periodically. Any deviations from the agreed criteria were communicated, discussed, and documented. Results: On the basis of gender, frequency of Male patients were recorded little bit higher (62.6%) than female (37.4%). So, the hospital attendance rate of this study was male predominant. Majority of subjects belonged to 21-40 years (32.1%) followed by 1-20 years (29.5%) of age range. When it is categorized according to ward, in Medicine ward was recorded 34.8%, and for Orthopaedics it was 20.0%, while 30.9% for surgery and 14.1% paediatrics wards. For this study, subjects were categorised in eighteen groups on the basis of their diagnosis. Out of which, majority of the population (20.50%) were found with diagnosis of carcinoma followed by orthopaedic diseases (19.90%), while least number of patients (0.9%) were diagnosed with ophthalmological as well as thyroid diseases. Beta lactam and Cephalosporin were found the most frequent used first antibiotic even after surgery. Even for the each wards, Beta lactam and Cephalosporin were recorded highly significant and most desirable choices among all the antibiotics. Conclusions: Implementation of a multidisciplinary antibiotic stewardship program in this academic, large, Indian hospital demonstrated feasibility and economic benefits.

Introduction: A urinary tract infection (UTI) is an infection in any part of urinary system namely kidneys, ureters, bladder and urethra. UTIs are caused by both Gram-negative and Gram-positive bacteria, as well as by certain fungi. The most common causative agent for both complicated and uncomplicated UTIs is uropathogenic Escherichia coli (UPEC). Materials and Methods: This is a prospective study and observational study conducted in the Department of Microbiology, Surabhi Institute of Medical Sciences. A total of 200 consecutive urine samples were screened from patients with symptomatic UTI. Clean-catch midstream urine samples were collected in sterile disposable container and processed within one hour. Semi quantitative loop measuring 2.2 mm diameter with a holding capacity of 0.004ml was employed to culture urine on CLED agar and MacConkey’s agar. The inoculated plates were incubated over night at 370C Isolates in significant number (colony count ≥ 105 CFU/ml) were identified by standard procedures. Results: A sum of 200 patients who satisfied the inclusion principles during the investigation were enlisted. The present study shows the pathogens causing UTIs and their antibiotic susceptibility pattern. Escherichia.coli 48.5% was the predominant pathogen followed by Klebsiella pneumoniae 23%, Proteus spp. 13.5%, Staphylococcus aureus 7.5%, Pseudomonas aeruginosa 2.5%, Citrobacter spp. 3%, Staphylococcus saprophyticus 0.5%, Enterococcus faecalis 1% and Acinetobacter spp. 0.5%. In our study, high susceptibility of meropenem (76.2%) and imipenem (72.1%) was seen and least were Ciprofloxacin 13.5%. Conclusion: Infections caused by ESBL- producing bacteria often limits therapeutic options, leading to high disease burden. Therefore, diagnostic laboratories are in need of reliable, cost efficient and less labour-intensive methods to use in the detection of ESBL- producing bacteria. The public health implications of this are disturbing thus the need to rapidly detect these pathogens in the laboratory.

Introduction: Breast cancer is regarded as the most common cancer among women, and about 6.6% of cases are diagnosed among women 40 years old or younger. Inflammatory cells can regulate the tumor microenvironment and are clearly implicated in tumor development by facilitating proliferation, migration, and survival. Several cytokines, including interferon-a, interleukin (IL)-2, IL-6, IL-8, IL-10, and tumor necrosis factor-a, have essential and coordinated functions in breast carcinogenesis. Materials and Methods: This is a prospective study and observational study conducted in the Department of Pathology, Dr. V.R.K. Women’s Medical College Teaching Hospital & Research Centre over a period of 1 year with a sample of 40 patients. Two to five grams of tumour tissue and another sample from the normal peri-tumoural breast tissue were taken from the resected breast immediately after surgery. Specimen were fixed in 10 % buffered formalin, processed and embedded in paraffin. Paraffin section was stained with hematoxylin and eosin staining for histopathology and grading of the tumour. Immunohistochemistry was done for detection of cytokine IL 10 following a standardized protocol described earlier. Results: The mean patient age was 50 years (range 30-70years). Even though either side of the Breast can be affected in Ca. Breast, for the reasons not known there is slight preponderance to left side breast. Most of the gross tumours were of size 4-5 cms (n=17 i.e, 42.5%) followed by 5- 6 cm (n=10 i.e, 25%). Majority of the patients are categorized as grade-II i.e. 47.5% of cases and next is grade-I tumours i.e. 30.0% cases. All grade 3 tumours expressed strong expression of IL-10 indicating that probably IL-10 expression is more in high grade tumours. Conclusion: IL-10 may serve as a useful biomarker with potential prognostic value as there is statistically significant association of high IL-10 mRNA levels and the breast tumour tissue when compared with peri-tumoral tissue. Evidence from various studies suggests that IL-10 within tumour tissue has an important role in initiation and progression of breast carcinoma. This is also supported by high serum IL-10 levels noticed in such patients, although the mechanisms involved in the process are not exactly known.

Introduction: Meningiomas are the most common primary benign tumors of the central nervous system (CNS) as well as intradural part of the spinal cord. The prevalence of expression of progesterone receptor (PR) among patients with meningioma has been reported to be determined by different clinicopathologic factors particularly tumor grade as it was established by the WHO. Ki-67 is a nuclear non histone protein. It is used as a marker of proliferative activity and as a prognostic indicator in many tumors like breast carcinomas, neuroendocrine tumors, prostate, brain, nephroblastomas and lung. Materials and Methods: This is a Prospective study conducted in the Department of Pathology at Dr. V.R.K. Women’s Medical College Teaching Hospital & Research Centre. The study included histopathologically diagnosed cases of different histological variants of all intracranial and intraspinal meningiomas. A total number of 50 cases were studied over a period of 1 year. All intracranial and intraspinal meningiomas received at the Upgraded department of Pathology with adequate pre-operative, intra-operative and post-operative information, were included in the study. Results: The maximum number of cases were seen in the age group of 40-49 years (26.6%) followed by 50-59 years (23.3%). In the present study, out of 60 cases, 47 (78.3%) were females and the remaining 13 (21.6%) cases were males. Among the total 60 cases of Meningiomas, it was observed that intracranial location was more commonly involved comprising of 56 (93.3%) cases followed by Intraspinal location observed in 04 (6.6%) cases. Overall including the both grades total 51 cases out of 60 i.e. 85% were positive for PR, and 9 cases (including both the grades) i.e. 15% were negative for PR. Most of the grade I meningiomas (50 out of 56 cases i.e. 89.2% of grade I tumors) were positive for PR and few (6 out of 56 i.e. 10.7% of grade I tumors) were negative. Conclusion: Present study concluded that meningiomas will express PR. And this expression of PR has a significant inverse relationship with Ki- 67 i.e. as the Ki-67 expression denotes grade of meningioma, with increasing grade PR expression is reduced. So, Immuno histochemical staining with Ki-67 and PR antibody will help in deciding the grade of meningioma and helps to select the cases for which hormonal therapy can be employed.

Background: Oligohydramnios, characterized by an amniotic fluid index (AFI) of ≤5 cm, is associated with increased maternal and perinatal risks, including fetal growth restriction, abnormal labor patterns, and higher rates of operative delivery. Timely identification and intervention are essential to improving outcomes. Aim of the study: To evaluate maternal outcomes in pregnancies complicated by oligohydramnios, with a particular focus on delivery methods, antepartum complications, and the effect of L-arginine supplementation. Methods: This prospective observational study included 115 pregnant women diagnosed with oligohydramnios at Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Data on maternal demographics, obstetric history, antepartum complications, labor characteristics, and delivery outcomes were collected. Management included hydration, rest, fetal surveillance, and in selected cases, L-arginine therapy. Statistical analysis was performed using SPSS version 26. Result: Most participants were aged 20–34 years (92.17%) and had normal BMI (53.91%). Common complications included anemia (37.39%) and hypertensive disorders (31.30%). Induced labor was required in 75.65% of cases. The most frequent mode of delivery was vaginal (55.65%), followed by emergency cesarean section (33.91%). Emergency cesarean indications were mainly non-reassuring fetal heart rate patterns (79.13%). Conclusion: Oligohydramnios significantly increases the risk of emergency interventions and adverse maternal outcomes. Early detection and close monitoring, along with supportive therapies such as L-arginine, may help optimize maternal and fetal well-being.

The study was done to determine distribution and frequencies of ABO and Rh blood groups among blood donors and to establish the existence or widespread of this hepatitis B virus among this group of people in FMC Owo. The study was carried out in Owo and the analysis of the samples was done in the Department of Haematology and Blood Bank, Federal Medical Centre, Owo, Ondo State. After an informed consent was obtained 120 blood donors (110 male and 10 females) volunteered to participate in the exercise. Demographic data forms which carried all the information, personal details such as occupation, educational back ground, age, sex, medical history e.t.c were filled by each donor. All the donors were apparently healthy, age 18 to 60 years with body weight 50kg. About 5ml of blood was collected from each donor with the donor in a sitting position. The blood was transferred into plain bottles and allowed to clot, centrifuged at 1500rpm for 3 minutes to obtain serum. The serum samples were transferred to vials for use and preserved at -20C until use. ABO and Rh grouping were determined using tiles methods by the agglutination of red cell in the presence of the corresponding antigen after a drop of antisera was placed on a clean tile. Hepatitis B surface antigen was determined by the Rapid Response TM Hepatitis B Surface Antigen (HBsAg) test strip. Simple percentage distributions and tables were used to represent the results. Phenotypic frequencies were calculated and expressed as percentage. Table-1 shows the age distribution and ABO blood group among various occupations of 120 subjects that participated in the research. The artisans were 26(12.6) with their age range 31-40. Their ABO blood group number and their percentages were as follow: A 2(1.66), B 5(4.17), AB 1(0.83) and O 8(5). Other groups of people % frequency, age range and ABO distributions were as shown in the table. Table-2 shows the occurrence of hepatitis B virus among the various groups of people that participated in this project work. The total number of people that were positive and negative and their percentages were 13(10.83) and 107(89.17). Artisans group showed the highest number 6(5) and Civil servants were the group with the least number 1(0.83). The ABO, rhesus (D) blood group and Hepatitis B virus distribution among the Owo blood donors were shown in Table-3. Out of the 120 donors only 4(3.3%) were rhesus (D) negative belonging to blood ABO blood group O. Other ABO blood groups were rhesus (D) positive. Blood group O also has the highest number of hepatitis B virus 13(10.9) while AB has the least (0). The Government should intensify and encourage the artisan to surrender themselves to be immunized against HBsAg and also encourage the adults to participate in voluntary blood donation in order to safe life.

Background: There is an increasing burden of care for chronic noncommunicable diseases on the health care system, in particular, in mixed urban-rural districts where resource constraints and limited health workers threaten continuity of care. Nurse practitioners (NPs), who have received clinical training to assess, diagnose, and educate patients, are coming to play an increasingly important role in the care of people with chronic diseases. Thrown into the limelight of chronicity, NPs and their roles and practice barriers are less documented, at least in some Indian settings. Objectives: This study was to describe the extent of the NP practice in managing chronic disease and examine self-perceived competency across core clinical and educational domains, and activity options, in addition to exploring the regulatory, organizational, and interprofessional factors that make possible or hinder the NP effectiveness in Osmanabad district, Maharashtra. Methods: A descriptive cross-sectional survey was carried out among 80 conveniently selected NPs employed in primary and community health centres of Osmanabad. A self-assessment questionnaire was validated and used to assess five domains: clinical assessment, treatment and medication management, patient education and self-management support, care coordination, and system roles. The Likert-scale items were analysed using descriptive statistics (means, standard deviations, frequencies), and open-ended responses were subjected to thematic analysis between two independent researchers to identify the barriers and facilitators. Results: NPs performed history-taking (mean 4.6 ± 0.5) as well as initiating pharmacotherapy according to guidelines (4.4 ± 0.6) with high competence, indicating their good clinical basis. Adverse-event monitoring (3.9 ± 0.9) and telehealth follow-up (3.9 ± 0.9) scores were below average for continued education. A high degree of commitment to patient empowerment for self-management was indicated for patients' understanding of the disease process (4.5 ± 0.6) and for showing them how to perform self-monitoring (4.3 ± 0.7) (domains of patient education). Regulatory and restricted diagnostic authority and restricted diagnostic authority were primary barriers, and supportive interdisciplinary teams and access to decision-support tools were key facilitators, as revealed by thematic analysis. Conclusion: Nurse practitioners in Osmanabad are significant providers of care for chronic disease, but need further training in the management of adverse events and telehealth delivery. And so, policy reforms that are providing NPs with diagnostic and prescriptive autonomy, that are being combined with structured capacity-building interventions, will maximize the impact and influence of their contributions.