Multiple sclerosis (MS) is an important cause of neurological disability. Familial MS is uncommon in India and is seen mostly in the high prevalence countries like United States of America, Canada and New Zealand. In the present paper, two members of the same family were diagnosed as having MS. As the disease is uncommon, there was initial diagnostic difficulty in the first case. The clinical and radiological findings are described with a note on the treatment and follow up.

The study was conducted to assess the extent of seropositivity of Hepatitis C among HIV positive patients at tertiary care hospital in Rajkot from June 2016 to May 2017 and evaluate the need of routine screening for this infection among such patients. The samples were tested for HIV as per Strategy III of National AIDS control organization by using different system of testing to establish diagnosis of HIV. A total of 300 confirmed HIV-positive samples were tested for anti-HCV antibodies by using one step immunochromatographic assay based on the principle of the double antigen-sandwich technique. Out of total 300 HIV positive patients, 69.67% were male and 30.00% were female. Only one was transgender. Out of 300 samples tested, 5(1.67%) were positive for HCV with 2(0.96%) of male and 3(3.33%) of female patients. Highest prevalence was observed among age group 21–30yrs i.e 2(3.77%), while not a single anti-HCV positive case were recorded in age group ≤20 and ≥51 which implies that HIV and HCV infection is more common in younger generation. We believe our data could help health professionals to deal better with HIV infected patients. We also believe our data reinforces the need of prevention programs on HIV transmission, which also lead to reduction in prevalence of Hepatitis C.

To evaluate the serum lactic dehydrogenase (LDH) level as a marker of severity of preeclampsia. Antenatal mothers without complications were taken as controls and women with preeclampsia taken as cases. They were evaluated for serum LDH levels. All enrolled women were followed till delivery and their course of pregnancy and fetal outcome were noted. Mean value of LDH in the control group was 395.16+ 92.54IU/L. The LDH level in non severe type of preeclampsia was 566+ 219IU/L and in severe type of preeclampsia was >600 IU/L where it was highly significant (p<0.001). Antenatal complications and neonatal complications were 25% more in severe preeclampsia where serum LDH levels were >800IU/L. The severity of maternal and fetal complications was correlated well with increased LDH levels in preeclampsia.

Chikungunya Fever is one of the most important arboviral infections of medical significance. It is characterized by an abrupt onset of fever with severe arthralgia followed by constitutional symptoms and rash lasting for 1-7 days. The disease is almost self-limiting and rarely fatal. Chikungunya virus (CHIKV) is a RNA virus belonging to the family Togaviridae, Genus Alpha virus. Aim of the study is to know the seroprevalence of Chikungunya infection in a Tertiary Care Hospital in Jamnagar, Gujarat, India. A retrospective study was conducted at a Microbiology Department, Shree M.P. Shah Govt. Medical College, Jamnagar, Gujarat. Serum samples were collected from 382 suspected cases of Chikungunya fever and tested for Chikungunya IgM antibodies by ELISA over a 1 year period from July 2017 to June 2018. Of the 382 serum samples tested, 67 (17.54%) were positive for Chikungunya IgM antibodies. Out of these 67 positive samples, males were 30 (44.78%) and females were 37 (55.22%). The most affected age group was 31 to 45 years 22 (32.84%), followed by 16 to 30 years 17 (25.36%). From the present study it can be concluded that the Chikungunya cases are on rise. Hence, Chikungunya has become a major public health problem in India. Favorable mosquitogenic condition during monsoon period is primarily responsible for the rapid spread of Chikungunya. This requires continuous monitoring of the viral circulation in both endemic and nonendemic areas and rapid implementation of Chikungunya control programme. For these infections early detection and access to proper medical care will cause lower fatality rate.

Our aim was to formulation development and evaluation of herbal face pack without adding any preservatives. Face pack was formulated with different natural ingredients (sandal wood powder, multani mitti, china rose flower powder, turmeric, rose water) which are rich sources of vitamins and minerals that are essential for the health and glow of the skin. Evaluation methods were organoleptic, physico-chemical, rheological parameters and stability along with irritancy test. All prepared formulations were standardized by different parameters. Organoleptic parameters showed that the pack was smooth and rheological findings proved the flow properties of the pack as it was found to be free flowing and non-sticky in nature. The results showed that the formulation was stable on all aspects. Stability tests performed revealed the inert nature of the pack. Irritancy test was showed that no irritancy after use. Face packs are generally used to increase the fairness, glow and smoothness of the skin. They are non-toxic, non-allergic and having lesser side effects. Thus in the present work, it was a very good attempt to formulate and evaluate the herbal face pack containing natural herbal ingredients.

Temporomandibular ankylosis is defined as a permanent constriction of the temporomandibular joint. It can be an articular or juxta-articular origin, and includes various pathologies. We report here an unusual cause of temporo mandibular ankylosis which is an osteochondroma diagnosed by an anatomopathological study of the bone block. A 16-year-old patient who consults for a difficulty in opening the mouth. The clinical examination was without particularities. The cranian scan revealed the presence of a bony block at the right temporo mandibular joint with almost complete disappearance of the joint space.It was the histological examination of the osseous block that led to the diagnosis of osteochondroma.

Cutaneous larva migrans (CLM) is a tropical and subtropical parasitic infection caused by hookworm infection which inhabit in domestic pets such as cats and dogs. Larva found in infected soil, accidently penetrates the intact skin and causes lesions which are an erythematous, serpiginous, and extremely itchy. The reported case was clinically diagnosed as CLM had multiple lesions without complications and successfully treated with albendazole.

Acquired Immune Deficiency Syndrome (AIDS) is caused by lymphotropic retrovirus which was first recognised in 1981 and subsequently HIV was discovered in 1983. HIV infection causes derangement in hematopoietic system which directly results in lymphopenia with the progression of disease and leads to decrease in CD4 lymphocytes, which is directly related to prognosis of disease. It is said that other blood cells may also be deranged due to HIV infection leading to anemia, neutropenia or thrombocytopenia. The purpose of this study was to assess various haematological various haematological changes in HIV patients and to correlate the finding with CD4 counts. A total of 50 seropositive patients were studied over a period of 1 year. All patients diagnosed as HIV 1 and 2 were included in the study. Patients with no haematological study or CD4 count were excluded from the study. The hematological parameters included under this study were – Hemoglobin, Total Leucocyte count, Absolute Lymphocyte count, Platelet count, Mean Corpuscular Volume (MCV) and CD4 count. In this study 26 (52%) were male and 24 (48%) were females. Majority of cases (50%) were between the age of 30 – 44 years. Decrease in CD4 count correlated with lymphopenia with CD4 count less than 500/µl in majority (88%). Anemia was the commonest abnormality (62%), predominantly normocytic normochromic type. Thrombocytopenia was the least noted (14%). This study reiterated that absolute lymphocyte count is the best correlated parameter with CD4 count in seropositive patients.

Abstract: Polyhydramnios is an important obstetric complication with increased maternal morbidity. Undoubtedly, ultrasound is the best means to diagnose polyhydramnios USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. To determine the incidence and to assess the maternal outcome in patients diagnosed to have polyhydramnios in singleton pregnancies. The present study was conducted in Guahati Medical College for a period of one year from July 2017 to June 2018. All the patients were identified as having polyhydramnios using Largest pocket diameter method. The incidence of polyhydramnios in singleton pregnancy during the study period was 1.04 %. Majority of cases (76.61%) were mild, 14.03% moderate and 9.36 % severe polyhydramnios. Most common etiology was found to be idiopathic 69% followed by congenital anomalies19.8% and Diabetes Mellitus 10.52% Out of 171cases, 9 case was an abortion out of which 8 was induced due to fetal anomaly, 37 cases had preterm vaginal deliveries, 59 cases had full term vaginal deliveries, 66 cases had cesarean section. The most common maternal complication encountered was preterm labour and the most common malpresentations was breech. The study gives us the understanding of the impact of polyhydramnios on maternal outcome.

Macrocytosis in adults is defined as a red blood cell (RBC) mean corpuscular volume (MCV) >100 FL. Macrocytic anemia is generally classified into megaloblastic and non-megaloblastic anemia. The objective of this study was to assess haematological findings in patients of macrocytic anemia based on complete blood count and peripheral blood smear and to classify them based on clinical, serum vitamin B 12 and folic acid levels .The study was carried out over a period of one year at a tertiary care teaching hospital. 100 patients were selected on simple random sampling with MCV>99 FL and peripheral blood smear showing features of macrocytosis. Out of the 100 patients studied of macrocytic anemia, 55 percent had megaloblastic anemia and remaining 45 percent had non-megaloblastic anemia due to various causes. In our study, megaloblastic anemia was the most common cause of macrocytic anemia and among non- megaloblastic causes liver disorders like hepatitis was the most important cause.

Abstract: Sepsis is a clinical syndrome that complicates severe infection and is characterized by inflammation and widespread tissue injury. The clinical process usually begins with infection, which potentially leads to sepsis and organ dysfunction [1]. It is estimated that puerperal sepsis causes at least 75,000 maternal deaths every year, mostly in low-income countries [2]. To assess specific management of maternal sepsis in High Dependency unit (HDU) and its impact on maternal outcome. Prospective study carried out at HDU in Gauhati Medical College (GMCH) and Hospital from 1st June 2017- 30th July 2018.All patients with sepsis admitted to HDU during the period of study were studied for their response to management and outcome is evaluated. Out 74 patients with sepsis admitted to HDU, 42 expired due to severe sepsis, septic shock or MODS. The total number of maternal deaths during the study period was 148 due to various causes and the total number of live births was 15802. So maternal sepsis was responsible for 28 % of maternal deaths. The calculated MMR for the period of study was 936/ lakh live births and calculated MMR for maternal sepsis was 265 / lakh live births. From this study it can be concluded that sepsis is an important cause of maternal morbidity and mortality. A positive blood culture and the antibiotic susceptibility testing of the isolates are the best guide in choosing the appropriate antimicrobial therapy in treating sepsis. Blood and blood products, vasopressors also plays important role as adjunctive treatment of sepsis.

Acinetobacter has emerged as significant hospital pathogen involved in outbreaks of hospital infections, notoriously known to acquire antibiotic resistance to most of the commonly prescribed antimicrobials. Many risk factors are associated with Acinetobacter infections, especially in patients in intensive care unit (ICU). Acinetobacter species tend to be resistant to a variety of antibiotics and thus the infections are difficult to treat. This study aims to isolate Acinetobacter from various clinical samples and to determine its antimicrobial sensitivity pattern. The objectives of the present study were; 1) To isolate Acinetobacter species from various clinical samples. 2) To study their Antibiogram pattern of the Isolated Organisms. A total of 93 Acinetobacter species were isolated from various clinical samples. Identification of Acinetobacter was done on the basis of hemolysis on blood agar, growth at 42ºC, and oxidation fermentation test. Antibiotic susceptibility testing was done as per standard CLSI guidelines (2017). Maximum isolation of Acinetobacter species were from pus or wound swabs 57 (61.29%) followed by sputum and tracheal secretions 21 (22.58%) and urine 15 (16.12%) samples. Most of the strains were sensitive to imipenem (97%), piperacillin-tazobactam (91.39%), and getifloxacin (86%) whereas, maximum resistance was observed to co-trimoxazole (10.75%) and gentamicin (9.67%). Acinetobacter spp. has emerged as a major nosocomial pathogen. Broad-spectrum antibiotics should be used with caution and only after antibiotic susceptibility testing. Early identification and continued surveillance of prevalent organism will help prevent the spread of Acinetobacter in hospital environment. Empirical antibiotic policy should be determined for each hospital according to the resistance rates of that hospital setting.

In order to make full use of data of stroke and find the potential characters, we use computer algorithm to model the stroke so as to comply with the evolution of stroke disease. In order to visual express the complex reason of stroke, we use complex network to model the stroke so as to express the complex reason and describe the relation of stroke structure and function. Computer model and complex network model should be combined with stroke standard method and custom index, which are more direct for clinical index and practice. Hybrid methods for research of stroke are a test to model, prevention, control and serve for stroke and other clinical disease

Sclerosing rhabdomyosarcoma (SRMS) is a very rare subtype of rhabdomyosarcoma (RMS) and can lead to diagnostic difficulties especially if one is not advised of this variant. This entity was first described in 2000 by Mentzel and Katenkamp.Morphologically, it is characterized by an abundant hyalinized stroma that may erroneously lead to the diagnosis of extraskeletal chondrosarcoma, sometimes this stroma simulates a primary osteoid or vascular tumor. Thus, it can lead to confusion with osteosarcoma or angiosarcoma. We report here a case of SRMS mimicking a sclerosing epithelioid fibrosarcoma appearing in calves in a 55-year-old man. The tumor cells were arranged in nests, cords with sometimes a pseudovascular features. Immunostaining showed that the tumor was positive for Desmin, SMA and MyoD1, focally positive for myogenin and negative for CK, P63, EMA, S-100, H-caldesmon, CD34, CD31. Based on morphological discovery and immunostaining, he was diagnosed as an SRMS. This is the first case of SRMS to show a strong and diffuse α- SMA highlighting the risk of misdiagnosis as leiomyosarcoma.

Phenytoin is an Anticonvulsant mainly acts by promoting Na+ efflux or decreases Na+ influx from membranes in motor cortex neurons; stabilizes the neuronal membrane. Slows conduction velocity.Indicated in Seizures. A child of 12 years old of female patient came to pediatrics department with chief complaints of seizures not associated with fever. Generalised tonic clonic activity with loss of consciousness for 10 min and admitted in pediatrics department-II and his treatment chart was phenytoin 100mg PO OD and valproic acid 200mg – 200 mg – 200 mg Po 2tablets TID. During his second day of treatment child developed fever of 1020F and cough and to reduce the condition physician prescribed paracetamol 500mg Po BD and syrup chlorpheneramine maleate 5ml Po BD and increased the phenytoin dose 100 mg 2 tablets OD. On the 12th day of treatment child was irritable with hyperactive behaviour. Better vigilance is necessary for implementation of safe and effective treatment for each individual patient.in order to prevent serious adverse drug reactions of this drug, close monitoring drug treatment course, creating awareness, recognition of the problem and careful management of all the patients who receive medication are essential, because use of phenytoin causes Drowsiness, Fatigue, Ataxia, Irritability, Headache, Restlessness, Slurred speech, Nervousness, Nystagmus, Dizziness, Vertigo, Dysarthria, Paresthesia, Rash, Pruritus, Gingival hyperplasia (pediatric patients), Ataxia, Paradoxical seizure, Drug withdrawal seizure, Diplopia, Psychosis (high dose), Toxic amblyopia, Encephalopathy, AV conduction disorder, Ventricular fibrillation, Nausea, Vomiting, Constipation, Diarrhea, Megaloblastic (folate-deficiency) anemia, Hypocalcemia, Hepatotoxicity, Hypertrichosis, Lymphadenopathy, Purple glove syndrome, Rash, Allergic reactions in the form of rash or, rarely, more serious forms (drug reaction with eosinophilia and systemic symptoms, or DRESS) or anaphylaxis, Purpuric rash, Toxic epidermal necrolysis, Bullous dermatosis, Coarsening of facial features,Periarteritis nodosa,Immunoglobulin abnormalities, Altered taste sensation, including metallic taste, Peyronie disease