Gluconeogenesis involves formation of glucose from the breakdown of protein to form glycogenic amino acid and lipid such as triglyceride to generate glycerol which is further utilized for the formation of glucose. Cashew (Anacardium occidentale) leaf has some non-scientific but traditional health benefit claims such as in the treatment of diabetes and hypertension. This work was designed to determine the evidence of Gluconeogenesis in rabbits given ypung cashew leaf extract using Plasma Value of Cortisol, Glycerol, Cortisol Binding Globulin Glucose, Total Triglyceride and Total Bile Acid. Materials and Methods: 10 rabbits of the same sex weighing 1.0-1.2Kg grouped into A1 (5 rabbits fed with normal meal and water only for 7 days), A2 (A1 rabbits given 500mg/KgBW of ethanolic extract for another seven days) and B1 (5 rabbits fed with normal meal and water only for 7 days), B2 (A1 rabbits given 500mg/KgBW of aqueous extract for another seven days). Plasma cortisol, glycerol, cortisol binding globulin, glucose, total triglyceride and total bile acid were measured biochemically using auto-analysis, ELISA and colorimetric techniques. The result obtained showed a significantly higher plasma value of cortisol, Glycerol and a significantly lower mean plasma value of Glucose and Total Triglyceride in rabbits (A2 and B2) given 500mg/KgBW of ethanolic or aqueous extract for seven days compared with the values of these parameters obtained in the same rabbits when they were fed with normal meal and water only for 7 days (A1 and B1) with p<0.05. This work reviled possible evidence of gluconeogenesis as indicated by the significant biochemical alterations the plasma values of cortisol, glycerol, glucose and total triglyceride with respect to changes in their plasma level before and after the supplementation of the extract of young cashew (Anacardium occidentale) leaf

Inflammatory response is a form of immune response which could be caused by infectious agents and toxic chemicals. Cnidoscolus aconitifolius leaf extract contains phytonutrients such as protein, vitamins, calcium, and iron; and is also a rich source of antioxidants which could be attributed to the traditional and scientific claims in the treatment of anaemia. This work was designed to determine possible pro and anti-inflammatory responses in the traditional application of raw liquid extract of Cnidoscolus aconitifolius leaf (iyana ipaja-chaya) in the treatment of anaemia. Twenty three (23) out of Thirty one (31)anaemic patients aged 12-32 years (including 2 females aged 12/15 years and 21 males aged 17 – 32 years) with PCV ≤ 20% receiving treatment at 5 traditional homes in Saki-west Local Government of Oyo State-Nigeria. Age matched 50 apparently healthy volunteers (Female-25; Male-25) with a PCV of 42±3.0% were recruited as control subjects. Thirty one anaemic patients initially volunteered themselves for the work but only 23 were successfully monitored. The patients were recruited before the commencement of the treatment. Each of the test and control subjects was subjected to stool microscopy for intestinal parasite, Giemsa thick staining procedure for plasmodium and Serological test for anti HIV, anti-HCV and HBsAg. All subjects who were negative to the aforementioned laboratory procedures were selected as subjects. Freshly prepared sixty milliliters (60ml) of the liquid was administered to each of the 23 anaemic patients and the 50 normal control volunteers 3 times on daily basis for 14 days when the PCV was found to have increased appreciably. Plasma ALT, IL-4, IL-6 , TNF-α (before and after the administration of the extract), HIV-1 p24 Antigen ELISA, anti-HCV, HBsAg were determined in all subjects by ELISA technique while whole blood was used to determine PCV by microhaematocrit and the identification of Plasmodium infection using Geimsa thick staining techniques.

Thyroid dysfunction is one of the most common endocrine disorder and its outcomes are social, psychological and medical burden to the world. This study is designed to determine the prevalence and pattern of thyroid dysfunctions and its association with different factors. In this hospital based cross-sectional study 809 women were enrolled (resident of Rupandehi District) during a period of August 2015 to September 2016. BMI was determined by measuring the height and weight to know the status of obesity and blood pressure was measured using sphygmomanometer. Other relevant information like age, sex and smoking habits were recorded by trained laboratory personnel through a comprehensive baseline questionnaire. Blood samples were collected and subjected for thyroid function test (TSH, fT3 and fT4). The studied population was categorized as euthyroid, subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism and hyperthyroidism on the basis of the level of thyroid hormones. SPSS version 16.0 was used for statistical analysis. The prevalence of thyroid disorders is nearly one third of the total studied population. The number of participants was higher in the subclinical hypothyroidism (17.18%) followed by the hypothyroidism, hyperthyroidism and the least in subclinical hyperthyroidism (7.96%). Study revealed higher prevalence of thyroid dysfunction. The screening of thyroid function test is recommended for high risk population in Nepal which will be helpful for the prompt diagnosis of the disease and the policy makers to formulate the national policies in order to minimize the disease burden and its consequences

Carrying angle has been studied by many researchers and it is being studied to correlate with different parameters like age, sex, height and side. The study is aimed to determine the normal carrying angle between right and left hands. A cross-sectional study was conducted among 130 medical students of Devdaha Medical College and Research Institute, Rupandehi district, Nepal from October 2016 to December 2016. Carrying angle of each individual was measured by using manual metal goniometer and height was measured by using measuring tape. The data was recorded in MS Excel 2007 and further statistical analysis was performed for the descriptive statistics and independent sample t-test was performed to compare the means of the study population by using SPSS 16. In the present study, participants were in the age group of 18-25 years with the mean age of 20.90 ± 1.45 years including 21.98 ± 1.45 years in male and 20.37 ± 1.12 years in female. The mean carrying angle in right hand was 10.64º ± 2.57 whereas 9.69 º ± 2.52 in the left hand with the significant differences between right and left hand. There were no significant differences between age, sex and height with the carrying angle in the study. The mean carrying angle value was higher in case of males than in females. This study is helpful for the anatomists, anthropologists, cosmetic surgeons and orthopaedic surgeon for the correction of the fractures and other associated elbow disorders.

High alcohol consumption is one of the most common causes of liver disease. Several markers have been studied for alcohol consumption such as carbohydrate deficient transferrin (CDT), gamma glutamyl transferase, alanine aminotransferase(ALT), aspartate aminotransferase (AST). An elevated serum AST in relation to serum ALT (alanine transaminase) has been proposed as an indicator that alcohol has induced organ damage. Thus when AST:ALT ratio is greater than 2, this is considered as highly suggestive that alcohol is the cause of the patient’s liver injury. The aim of this study was to assess the clinical utility of AST:ALT ratio in alcoholic and nonalcoholic liver disease. This study involved 148 subjects, out of which 74 were diagnosed cases of alcoholic liver disease (ALD) and remaining 74 were age and sex matched diagnosed cases of nonalcoholic liver disease(NALD). Blood samples were collected and plasma AST and ALT activity were determined in both groups(ALD & NALD) by colorimetric method using standard curve . Then the ratio of AST:ALT was calculated and compared in both groups. The plasma activity of AST and ALT was high in both alcoholic and nonalcoholic liver disease patients. Plasma AST, ALT activity and their ratio (AST:ALT ratio) were found to be significantly different in both groups(p < 0.05). AST:ALT ratio less than 2 was found in 95.94% and 29.72% of non-alcoholic liver disease and alcoholic liver disease respectively. The ratio was more than 2 in 4.05% of nonalcoholic liver disease and 70.27% of alcoholic liver disease cases. The ratio of AST:ALT was significantly increased in alcoholic liver disease as compared to nonalcoholic liver disease. Hence, the ratio of AST:ALT can be used as a parameter for the diagnosis of alcoholic liver disease and for the differentiation of alcoholic liver disease from nonalcoholic liver disease

Vitamin D deficiency is common in Indian population which has a high prevalence of cardiovascular disease. We aimed to find the association of serum 25-hydroxyvitamin D(25-OH-D) level with Carotid artery Intima Media Thickness(CIMT)-a marker of subclinical atherosclerosis, in type-2 diabetics, a high risk group for cardiovascular disease. Type-2 Diabetes Mellitus patients attending to OPD of PGIMER & Dr. RML Hospital, New Delhi, were enrolled in the study. Winter serum 25-OH-D levels were measured by enzyme immunoassay using IDS 25-OH-D EIA kit. Vitamin D deficiency was defined as serum 25-OH-D level less than 50 nmol/L.CIMT was measured by B-mode ultrasonography, on Philips HD 11 machine with transducer L12-3 MHz. CIMT >0.8 mm was considered abnormal. Multivariate linear regression analysis was used to identify independent predictors of increased CIMT.100 patients were studied (55 men and 45 women)with mean age 52.9 ± 11.1 years and mean duration of diabetes 9.2 ± 6.2 years. The prevalence of vitamin D deficiency was 71% in study group. Increased CIMT was seen in 25% patients. Serum 25-OH-D level was associated inversely with CIMT on univariate regression analysis (r2=0.61, p-value<0.001). On multivariate regression analysis, low serum 25-OH-D level was found to be independent predictor of increased CIMT (p-value<0.001) even after adjustment for risk factors showing association with CIMT on univariate analysis (p value<0.005,relaxed upto p value<0.2) which included serum 25-OH-D level, sex, smoking, HbA1c and HDL cholesterol. This regression model accounted for 65%(r2=0.65) of total variance in CIMT. Serum 25-OH-D level has an independent inverse association with Carotid Intima Media Thickness-a marker of subclinical atherosclerosis

Musculoskeletal pain is very common complaint in the workplace and about billions of dollars yearly are spending on work related musculoskeletal pain. Elbow pain is one of the common complaints in allied health providers today. Rare researches have been studied on musculoskeletal pain among allied health providers in Pakistan, but not specifically on elbow pain. The objective of study is to determine lifetime prevalence of work related elbow pain among allied health providers of Lahore. Cross-sectional study was conducted among allied health providers by using convenient sampling technique. Nordic Musculoskeletal Questionnaire (NMQ) of pain was used to assess the prevalence rate of work related elbow pain among allied health providers. The data was collected through a survey study of 105 participants from different healthcare setups in Lahore and was analyzed through statistical package for the social sciences (SPSS) version 21.There were total 105 participants who include 37 (35.2%) physiotherapist, 38 (36.2%) nurses and, 30 (28.6%) technologists. The prevalence of work related elbow pain among allied health providers was reported in 9 (8.6%) participants. Elbow pain was reported in physiotherapists 13.5%, nurses 2.6% and technologists 10%.Physiotherapists and technologists have much prevalence of elbow pain than nurses because of nature of their job in poor and uncomfortable posture

Fluoroquinolone antibacterial agents are broad spectrum molecules and may be co-prescribed with antimalarial drugs in co-presenting infections. This study aimed at assessing the intestinal permeability of piperaquine (PQ) from dihydroartemisinin-piperaquine (DP) co-formulated antimalarial co-prescribed with ciprofloxacin (CP), using ex vivoabsorption model. Excised intestinal segments (duodenum and ileum) of length 4 cm from New Zealand white albino male rabbits (n=2) loaded with DP suspension equivalent to PQ (100 mg/mL) and CP suspension (100 mg/mL) based on body weights of animals. Similarly, DP alone was loaded to serve as controls C1 and C2, respectively. The organ bath contained Tyrode solution (TS) 100 mL. Sampling (5mL) was taken at 0, 0.5, 1, 2, 4 and 6 h post immersion of tissue. PQ analysis was performed using high pressure chromatographic system with C8 ZorbactEclipse XDB (150 x 4.6 mm, 4.6 µm) column with UV detection at 220 nm and flow rate of 0.7 mL/min. Mobile phase contained acetonitrile: 10 mM ammonium acetate (70: 30 %v/v) and flow rate of 1.0 mL/min at ambient temperature. Area under the curve (AUC) ± SEM at 2 h and 6 h (AUC00-2 and AUC0-6) for tests and their respective control in duodenum were (0.2940±0.1055 versus 0.6198±0.0083 µg.mLh-1, P=0.009) and (1.9270±0.1287 versus 3.3975±0.3638 µg.mLh-1, P=0.006) and ileum (1.5300±0.1242 versus 1.5408±0.4275 µg.mLh-1, P=0.645) and (3.9500±0.0205 versus 5.6603±0.1073 µg.mLh-1, P=0.045), respectively. CP revealed lower permeability indices for PQ in duodenal but not in ileal intestinal barrier. Spacing out of drug regimen may be required for optimum PQ permeation

There are numerous kinds of centipedes present across the world. All species hold venom in their glands. However, a bite of each kind has its reactions. According to researchers, it has not been that bites of centipede killed people or pets. The symptoms of centipede stings vary depending on the degree of allergic reaction and the size of the centipede. Classically, bite victims have severe pain, swelling and redness at the site of the bite, with symptoms usually lasting less than 48 hours. Symptoms for those more sensitive to the venom’s effects may also include a headache, chest pain, heart tremors, nausea and vomiting. We are going to report and discuss a case of centipede bite or first dose of intravenous hydrocortisone complicated with a rare presentation of dystonic reaction

Cancer is a major public health problem and a cause of morbidity and mortality in many parts of the world. On the other hand radiotherapy is one of the cancer treatment methods available but it has many side effects. Hypoalbuminaemia and hypoproteinaemia are common effects of radiotherapy and are often used to assess nutritional status of patients but there are few published reports on albumin and total protein levels in cancer patients on radiotherapy in Zimbabwe. Hence this study was carried out to determine the levels of serum albumin and total protein and compare levels in radiotherapy-exposed patients at Parirenyatwa Radiotherapy Clinic by type of cancer. A total of 63 cancer patients took part in this cross-sectional study, 30 had breast cancer while 18 had cervical cancer and 15 had prostate cancer. Samples were analysed using the Beckman Coulter AU680 Chemistry Analyser based on Bromocresol Green (BCG) method for albumin and the Biuret method for total protein, respectively. One way ANOVA was used for comparison of normally distributed data while the Kruskal-Wallis test was used for skewed data. Out of all cancer patients who took part in this study, 18 (28.6%) were hypoalbuminaemic and 3 (4.7%) had hypoproteinaemia. There was no significant difference between albumin and total protein of patients with different types of cancer. Prevalence of patients with hypoalbuminaemia (28.6%) and hypoproteinaemia (4.7%) was comparable to studies from other countries. High prevelance of hypoalbuminaemia is worrying in this context as it worsens prognosis of cancer patients

Perinatal mortality rate is an important indicator of community health status. This study is to analyze the cause of perinatal death in Teaching Hospital, Batticaloa. A retrospective study was done over a period of last three and half years from January 2014 to June 2017, which included total 21,079 deliveries out of which 204 perinatal deaths occurred, hence perinatal mortality rate was 12.51 per 1000 birth on 2014, 15.11 per 1000 birth on 2015 and 13.28 per 1000 birth on 2016. The causes of perinatal deaths and risk factors were identified and analyzed. Out of 204 perinatal deaths, majority (53.4%) occurred due to pretermwith or without associated other factors, majority (87.2%) of perinatal death occurred in maternal age of 20-39 years, and found to be more common in (64.8%) multigravida patients and majority of perinatal deaths (58.3%) occurred during early neonatal period. Early identification of mothers at risk of pregnancy complications, especially intrauterine growth restricted fetuses, through antenatal care screening, educating pregnant women to recognize warning signs of pregnancy complications, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn resuscitation may reduce some of the categories of deaths. Fetal autopsy in future could detect many unknown causes. There should also be increased communication to work closelybetween neonatology team and obstetric team to bring down perinatal mortality

The rate of non-fatal deliberate self-harm (DSH) in Sri Lanka has increased in recent years, with associated morbidity and economic cost to the country. Pesticide ingestion is the commonest mode of suicide in Asia with an estimated loss of around 300,000 lives every year. We conducted a cross-sectional observational study in patients with 12 years of age and above who were admitted with deliberate self-harm (DSH) in Teaching Hospital Batticaloa, SriLanka. Of the 121 patients observed 83 (68.6%) females and 38 (31.4%) males. Among them, 119 (98.34%) cases (1.65%)) were of intentional poisoning and only two cases (1.44%) were of accidental poisoning. In this study, the majority of victims 47(38.84%) were young age group (20-29). Forty-two (34.71%) were teenagers.In the present study, the commonest poisoning agent was yellow oleander seeds 33 (27.3 %) followed by organophosphorus compounds 23(19%) and Paracetamol overdose 22 (18.2%). These findings support a strategy of limiting easy access to pesticides and oleander, and for improving the supply and effectiveness of antidotes, as a strategy for reducing fatal self- poisoning in rural SriLanka

The objective of this study is to determine the effect of progesterone antagonist, Mifepristone in perimenopausal women in decreasing the severity of symptoms like menorrhagia, dysmenorrhea, abdominal pain and urinary symptoms, in decreasing the fibroid volume and uterine volume, in improving the hemoglobin percentage, in increasing the endometrial thickness, to look for the side effects profile and to look for the effects which were present at the end of treatment persisted during post treatment follow up. It is a prospective and interventional study done among the perimenopausal women with symptomatic fibroid uterus who came to the Gynecological OPD in Gandhi Hospital, Secunderabad for a period of one and half year in a sample size of 50 patients. After taking a detailed menstrual history and calculating Pictorial Blood loss Assessment Chart (PBAC) score for menorrhagia and Visual Analogue Scale (VAS) score for dysmenorrhea and abdominal pain, baseline fibroid and uterine volumes, haemoglobin percentage and endometrial thickness were noted and endometrial biopsy was done when endometrial thickness crossed≥8mm. The drug mifepristone 25 mg was given orally for a period of 3 months.

Poisoning due to deliberate self-harm (DSH) with the seeds of yellow oleander (Thevetia peruviana) results in significant morbidity and mortality each year in South Asia. Yellow oleander seeds contain highly toxic cardiac glycosides including thevetins A and B and neriifolin. A cross-sectional observational study was conducted in Teaching Hospital Batticaloa, SriLanka among all DSH to see the prevalence of yellow oleander poisoning. Out of 121 DSH patients, 33(31.4%), 9 (27.3%) male and 24 (72.7%) female had seeds of yellow oleander poisoning. Among them, 3 (9.1%) patients got 1st-degree heart block while 2 (6.1%) got 2nd- degree heart block and 1(3%) patient got 3rd-degree heart block. Unfortunately, 2 (6.1%) patients have died. Though the numbers of suicide are already quite high, it is estimated that the real figures may be even higher in Sri Lanka. The under‐reporting is due to deaths not being recorded or being misclassified for different reasons such as stigma, legal harassment or insurance benefits. The main reasons for the oleander poisoning were a confrontation with their parents and siblings.

Atherogenic cardiovascular risk assessment is important in the management of dyslipidaemia associated with antiretroviral therapy (ART). Generally, Castelli’s Risk Index (CRI), Atherogenic Index of Plasma (AIP) and Atherogenic coefficient (AC) are becoming useful indices as risk predictors for cardiovascular disease (CVD). We studied the importance of these indices in identifying at-risk HIV individuals receiving treatment. Eighty (80) HIV-patients comprising treatment (n=40) and treatment-naïve (n=40) groups with age- and sex-matched were enrolled. Traditional lipid parameters {Total cholesterol (TC), Triglycerol (TG), and HDLc} were analyzed using spectrophotometry. The LDLc was calculated using Friedewald equation. Non-HDLc, CRI-I (TC/HDLc ratio) and CRI-II (LDLc/HDLc ratio), AIP {Log10 (TG/HDL-c)} and AC {(Non-HDLc)/HDLc} were also calculated. The CD4+ cell count was determined using flow cytometry. The correlations between atherogenic indices and lipid profile were determined using Pearson’s correlation.

Background: Pseudoexfoliation syndrome (PXF) is a well-known clinical condition associated with cataract and the more serious blinding secondary open angle glaucoma that lead silently if unilateral or asymmetrical to irreversible loss of vision as the condition will not diagnosed and treated early, so our objective is to estimate the size of the problem so we can plan to overcome the serious blinding outcome in the future. Objectives: 1-Assess the clinical condition frequency. 2-Assess associated complications as cataract and glaucoma (PXG). Settings and Design: Descriptive cross-sectional study of partially random sample. Patients and methods: Partially selected elderly Kurds patients aged 55 years or above those visited Aso eye hospital for any reason, we enrolled 252 patients, 128 female and 124 male patients in the survey, Full slit lamp examination, visual acuity, refraction, fundoscopy and intraocular pressure measurement by Applanation tonometer were done to the patients. Statistical analysis used: Microsoft excels 2010. Results: Of total 252 patients examined, we report 73 patients (146 eyes) have the syndrome; this represents a frequency or relative prevalence of about 29%. 30(44%) are females and 43 (56%) are males, so female to male ratio was about 2/3, of the affected 73 patients, 56 (76.7%) patients have the disease in both eyes (112 eyes) and 17 (23%) patients (34 eyes) of them was affected in one eye, of those affected 73 patients, 60 (82.2%) patient aged 65 years or above, 67(91.7%) of them were moderate to heavy smokers.

Odontogenic tumors represent a heterogeneous group of rare lesions accounting for about 1% of all jaw tumors. This work was carried out in order to evaluate the demographic and the histopathological characteristics of these tumors in Hassan II University Hospital, Fez, Morocco. This is a retrospective study including all cases of odontogenic tumors histologically diagnosed during a period of 10 years (2007-2016), in the department of pathology, Hassan II University Hospital, Fez, Morocco. Different demographic and histopathological characteristics have been analysed. A total of 31 odontogenic tumors were recorded. We noted a male predominance with a sex -ratio of 1.81. Mean age was 39.7 years (range, 7–87 years). The mandibular location was predominant with a maxillary/ mandibular ratio of 1: 1.21. Except one case of malignant odontogenic tumor, all other cases were benign. Ameloblastoma was the most common type (64.5%), followed by odontogenic myxoma/fibromyxoma and cementoma. In this series, odontogenic tumors have similarities and differences with those of previous series. We noted a male predominance, a more advanced age at diagnosis, and predominance of mandibular location and of ameloblastoma

Squamous cell carcinoma of the male urethra is an exceptional tumor. All types tumors of the urethra representing less than 1% of urinary tract tumors. The prognosis remains unfavorable. We report the ninth case observed which manifested by a transtumoral spontaneous breaking of squamous cell carcinoma of the urethra in a patient aged 58 years-old. He was treated by external irradiation associated with chemotherapy, and died after progression of the disease. The spontaneous breaking of tumor of the urethra is an exceptional discovery testifying to a local evolution unfavorable, making these tumors difficult to operate. However, current hope lies in therapeutic protocols combining radio-chemotherapy.

A simple and precise reversed-phase high performance liquid chromatography (HPLC) method for the determination of gliclazide in human plasma was developed and validated. Using glipizide as an internal standard (IS), separation was achieved on Atlantis dC18 column. The mobile phase consisted of acetonitrile and water (pH= 2.5±0.2 adjusted with phosphoric acid) (55:45, v:v), and delivered at a flow rate of 1 ml/min. 0.5 ml plasma samples were deproteinized with dichloromethane and centrifuged. 100 µl supernatant clear solutions were injected to HPLC system. The eluent was monitored spectrophotometricly at 230 nm. No interference in blank plasma or of commonly used drugs was observed. The relationship between the concentration of gliclazide in plasma and peak height ratio of gliclazide to the IS was linear over the range of 0.05-10.0 μg/ml. Intra-day and inter-day coefficient of variation (CV) and bias were 3.1% to 6.8% and 3.8% to 9.3% respectively. Mean extraction recovery of gliclazide and the IS from plasma samples was 94% and 87% respectively. The method was applied to assess the stability of gliclazide under various conditions generally encountered in the clinical laboratory. Stability for processed and unprocessed samples was ≥ 90% and ≥ 93% respectively

Head nurses are the important part of administration. The responsibilities of head nurses are to manage the nurses properly and provide the best quality of care to the patients. The provision of the supportive leadership can retain the employees in the long run and better health care services can be ensured. The purpose of the current study is to illuminate the effect of leadership styles of head nurses on staff nurses’ turnover. The study is of explanatory and quantitative study design. The cross-sectional survey technique was used. The 21 items questionnaire was used and distributed to 153 nurses of the Ittefaq hospital Lahore, Pakistan to assess the impact of head nurse’s leadership styles on staff nurse’s turnover intentions. The results show that 35.5% variation in the dependent variable is explained by the independent variables. However, the current study results indicate that transactional leadership style has significant positive relationship with turnover intentions and transformational leadership style has significant negative relationship with nurses’ turnover intention. Therefore, head nurses of the private hospitals should use the transformational leadership style to overcome the issue of nurses’ turnover