This is an award-winning study of its kind first time conducted in the rural areas of Indore Madhya Pradesh with the aim of evaluating the subclinical morbidity and mortality pattern of the chronic hematological and neurological effect of organophosphate pesticide exposure in children of farmers. Poison is any substance which if introduced into the living body could cause ill health or death. Among children, the commonest culprits include kerosene, pesticides, household chemicals, drugs. In rural areas of developing countries, children of agricultural workers have high probabilities for exposure to OP pesticides. This puts them at an increased risk of damage. A community-based cross-sectional study was carried out in 64 children aged 7-14 years in adjoining villages of khudel, Indore, Madhya Pradesh. Various neurological symptoms like muscarinic (diarrhea, urinary incontinence, lacrimation, excessive salivation), nicotinic (tremors, muscle weakness, tachycardia) and general symptoms (a headache, insomnia, numbness in legs, fatigue, anorexia, nausea, vomiting, dizziness, lethargy) were assessed by doing a clinical examination. Exposure index (EI) was calculated by multiplying the number of hours exposed to OP pesticides and the number of years of exposure. Various CBC parameters, metabolic panel (liver function test, kidney function test, FPG, vitamin B 12, electrolyte level) were calculated. The statistical evaluation was done using SPSS version 24.0 analysis of variance (ANOVA).

A polyherbal suspension was formulated from the extracts of roots of Cyperus rotundus (CRR) and leaves of Azadirachta indica (AIL) and Bryophyllum pinnatum (BPL). The suspension had very good redispersibility and was very stable without agglomeration, caking or microbial growth. Study of diuretic activity was done on individual plant extract as well as formulation. There was a significant increase in the volume of urine and electrolytes Na+, K+, Cl- which was similar to the standard drug furosemide. The formulation had much better activity as compared to the individual drug extracts which may be due to the synergistic effect of the herbs used. There was no significant change in pH. The loss in electrolytes Na+, K+, Cl- may lead to a reduction in supersaturation of calcium in urine thereby preventing the formation of kidney stone. The PHF have good diuretic activity and can be used to reduce hypertension, kidney problems and urolithiasis.

We have two ways for coping: the way of avoidance or the way of acceptance. The present study aimed to determine the most adaptable coping strategies of patients with diagnosed somatoform disorder. Along with, we elicited whether patients preferred problem focused or emotional focused coping strategy. The present study was a cross-sectional and observational study on patients referred by psychiatrists, who presented with persistent, medically unexplained, physical symptoms in pure psychiatric setup of a medical college and hospital. Study consisted of 72 somatoform disorder patients those who were diagnosed and were willing to undergo the psychological assessment. Patients were divided into two groups on the basis of symptom frequency and duration, as determined by the Diagnostic Interview Schedule: somatic syndrome group (N=49) and somatic sub-syndrome group (N=23). Both the groups were gone through eight emotion‐ and problem‐focused strategies, as used by the coping strategy inventory. Average age among participated was 49.1±15.8years. 74% of patients were women and 26% was men who reported unexplained physical symptoms. With respect of coping strategy, multi variate logistic regression prominent that sociodemographic factors positively correlated with the adaptations of different types of coping strategy. Group I and Group II was negatively associated with seeking of coping strategies. The findings of the present study elicited that patients with somatoform disorder patients tends to follow emotional focused coping strategies rather than problem focused one. The results are basis for further research to evaluate psychological intervention for breast cancer patients with that also to evaluate operationalize psychobehavioural factors in this patients group

Snakebite is a major socio-medical problem affecting many communities globally, especially African and Asian countries. It is still depending on the usage of antisera as the major source of treatment, which has its limitations. In many rural communities, health care facilities are inadequate and victims of snakebites mostly depend on traditional healers for herbal antidotes as an alternative treatment. This review has focused on the mechanisms of action of the animal derived anivenoms (antisera or antivenins) as well as those derived from plant resources (phyto-antivenoms). Antigen-antibody reaction is the basic mechanism of snake venom neutralization by the antivenins, but for the phyto-antivenoms, there are many hypotheses proposed on how the herbal compounds neutralize the toxic venom constituents. These include; protein precipitation, enzyme inactivation, chelation activity, adjuvant action, antioxidant activity, combination of these activities, etc. The review might be a stepping stone in establishing an effective and widely acceptable future therapy against snakebite treatment and management

Aminoglycosides antibiotics have been in use for a long time. They are bactericidal in nature and are used to treat infections by Gram-negative bacteria. Studies have revealed their dangerous effect on human body that is the Ototoxicity. Aminoglycosides-induced ototoxicity has resulted in permanent hearing loss. Different agents are being examined for their activity against aminoglycosides-induced ototoxicity. These agents govern mostly on the principle of antioxidant capacity

A colorimetric method was used for the determination of vitamin K1 phylloquinone in different plant extracts (Alchornea cordifolia, Aspilia Africana, Chromolaena odorata, Vernonia amygdalina). Benzene was used to extract the plants after drying and milling. The method of vitamin k determnation utilizes the coupling of 2,4-dinitrophenylhydrazine, in which a hydrazone of vitamin K, forms acid-salts in basic media giving blue coloured solutions that absorbs maximally at 635 nm. The results showed that Aspilia Africana 2.43 ± 1.56, Vernonia amygdalina 2.12 ± 1.11, Chromolaena odorata 6.36 ± 2.09, Alchornea cordifolia 8.31 ± 1.23 ug/g dry extract

A 59-year-old male with primary sclerosing cholangitis (PSC) presenting with a suspected dominant biliary stricture suspicious for cholangiocarcinoma developed acute cholecystitis following cholangioscopy. This is the first case report of this rare complication that may have been related to the irrigation occurring during the procedure. Early recognition of this rare complication will likely lead to timely antibiotic therapy.

Prostate cancer became a major public health problem on the threshold of the third millennium. The trilogy rectal touch, PSA-iso forms and biopsy is the pillar of the diagnostic approach and a pragmatic reflection. This is a retrospective study including the analysis of the medical records of 1053 patients admitted between 2000 and 2015. The inclusion criterion is a rate of PSA-T between 4 and 10 ng / ml which corresponds to 783 patients (74.3%) constituting two groups, one of 253 (prostate cancer), the other of 530 (adenomas = control group). The aim of our study is to evaluate the interest of the PSAL / T ratio in the North African population. The median age of patients was 63 years, 70.3% were symptomatic. The median PSA-T is 6.9ng / ml with a PSAL / T ratio ranging from 7% to 32% with an average of 19%. The mean prostatic volume is 57 cm3. 32, 3% with prostate cancer. The sensitivity and specificity of the PSA L / T ratio according to the cut-offs were studied at the time of diagnosis of prostate cancer and the value of 17% was retained with the best compromise between specificity (68%) and sensitivity (57%). A PSAL / T ratio <15% is the best detection rate for prostate cancer (52%). The contribution of the PSA-L / PSA-T report is indisputable since the first contact with the patient in consultation; the results in the Maghreb are comparable to those found in the literature. This iso PSA form reduces many unnecessary biopsies when it is greater than 25%.

Umbilical/Epigastric hernia is a rather common surgical problem. Approximately 10% of all primary hernias comprise umbilical and epigastric hernias. In this study the complication rates of different mesh types which were used to repair umbilical/epigastric hernias were investigated. A retrospective chart review was performed of 86 patients who underwent ventral herniorrhaphy with either Composite Mesh ( CM, Group-1) or Dual Sided Mesh (DM, Group-1), were included in the study. Mean duration of follow-up was 22 months and no significant difference was demonstrated between groups in respects of hernia recurrence , wound complications ,mesh infection, infection requiring removal, development of bowel obstruction, or persistent pain or discomfort. On subgroup analysis there was no significant difference between complication and recurrence rates in respect of meshes of different trademarks. This study showed no significant difference between dual sided and composite meshes in respect of mesh-related complications

A new stability indicating RP-HPLC method was developed and validated for the simultaneous estimation of Sofosbuvir and Daclatasvir in pharmaceutical dosage form and bulk drug. The optimized conditions for the simultaneous estimation of drug includes Discovery C18 (150mm x 4.6 mm, 5m) column, 0.01N potassium dihydrogen phosphate and Acetonitrile (50:50%v/v) as mobile phase run on isocratic mode at a flow rate 1.0ml/min. The column is maintained at 30ºC temperature and the drugs are detected at a wavelength of 254nm. The retention time for Sofosbuvir and for Daclatasvir were found to be 2.47 min and 3.31 min respectively. The %RSD for Sofosbuvir and Daclatasvir were found 0.8 and 0.5 respectively. The % Recovery for Sofosbuvir was found to be 99.90% - 100.03% and % recovery for Daclatasvir was found to be 99.90% - 99.93%. A linear response was found in the concentration range of 100µg/ml – 600µg/ml for Sofosbuvir and 15µg/ml – 90µg/ml for Daclatasvir, with correlation coefficient of 0.999 for both the drugs. The method was found to specific, accurate, precise, robust, rugged and stable in solution for 24 hours. The forced degradation studies indicated that the drugs are stable in various stress conditions as the net degradation was found to be within the limits. The developed method can be used for the quality control for simultaneous estimation of Sofosbuvir and Daclatasvir in pharmaceutical dosage form.

The objective of this study was to evaluate the anti-inflammatory and antioxidant activities of Phragmanthera capitata stems widely used by traditional healers. Acute toxicity according to the OECD Guideline 423 showed that the LD 50 of ethanolic extract was greater than 5000mg/kg body weight. Anti-inflammatory capacity was evaluated by hind paw oedema model using carrageenan-induced inflammation in rat. It has showed that ethanolic extract possess a dose-dependent anti-inflammatory activity at the first hour with 16.95 % and 28.21 %, respectively, as a percentage inhibition for the 200 and 300 mg / kg body weight extract. The phenol dosage by the Folin-Ciocalteu method showed that ethanolic extract had 14420 mg mg EAA/g of dry extract. The antioxidant capacity was evaluated by the diphenyl-picryl test (DPPH), and the EC 50 was 0.0085 mg / ml for ethanolic extract when EC 50 of the ascorbic acid (reference) was 0.033 mg/ml. Phragmanthera capitata stems ethanolic extract is non toxic and have inflammatory and antioxidant activity that could justify its traditional use

Chronic supportive otitis media is highly prevalent in the developing countries like India. The present study was conducted for duration of three years in two Medical Colleges of West Bengal, India, to find the prevalence of bacterial infections in otorrhoea. Chronic suppurative otitis media was more common in the rural population (66.8%) than in the urban population (33.2%). Out of the 226 patients in the study, 144 cases (63.7%) of purely bacterial, 59 cases (26.1%) of mixed (bacterial and fungal), and 23 cases (10.2%) of purely fungal infections were isolated. Out of the total 226 cases of chronic suppurative otitis media, the number of bacterial infections was 203 (89.8%). The most common age group observed was 1-10 years (32.3%). There was no significant difference between male and female preponderance, with a male, female ratio of 1.17:1. Pseudomonas aeruginosa was found in 87 (38.50%) cases and was the most common organism, followed by Staphylococcus aureus in 51 (22.57%) cases. Other bacteria found in our study were Klebsiella species in 20 patients (8.85%), Enterococcus species in 18 patients (7.96%), and Proteus species in 16 patients (7.07%), Citrobacter species in 9 patients (3.98%) and Serratia marcescens in 2 patients (0.88%). We found that antibiotics effective against most of the organisms were gentamicin, followed by ciprofloxacin. Coamoxyclav was found to be effective mainly against Staphylococcus aureus (94.1%) but ineffective against the Gram negative bacteria. Ciprofloxacin is recommended as a first line antimicrobial for chronic suppurative otitis media, as it has no ototoxicity, has lower cost and is available both in topical and oral preparations

Stress is a stimulus or a stressful situation. If the situation is a stressful job situation, then stress on work can be caused by several factors, including workload and working conditions. The ICU nurse must monitor the patient's critical condition carefully and continuously. Hospitals are one form of health facilities, both organized by the government and society that serves to make efforts of basic health or referral health and supporting health efforts. Hospitals in carrying out their functions are expected to pay attention to social functions in providing health services to the community. ICU is one of the work environment that has high-stress tendency. It is possible since ICU nurses are exposed to patients with unsafe mental conditions, requiring particular attention for 24 hours/day. This condition requires greater physical energy with special nursing care as well. Also, critical patients demand the speed and accuracy of performing actions that are not always required in other nursing situations. Another opinion says that inadequate knowledge and skills are seen as a stress source of ICU nurses. A nurse in charge of ICU performs three main tasks, life support, monitoring the patient's condition and preventing possible complications. The type of research is observational with the quantitative approach, while the research design used is cross-sectional that is by examining the dependent variable, free and variable between simultaneously. With a sample of nurses 11 people. Data analysis method by univariate analysis and bivariate analysis. The workload of nurses who work in the ICU area of the majority "Medium" are five people (45.5%). The working conditions of nurses working in ICU areas of the majority "Medium and Hard" are four people (36.4%). The stress levels the work of nurses working in the ICU area of the majority "Medium" are five people (45.5%). There is Workload Relation with Stress Level of Respondent in ICU is p <0,05 (p = 0.032), no Relation of Working Condition with Stress Level Respondent in ICU Year 2017 is p> 0.05 (p = 0.775). The hospital has to give counseling, education and training of emergency and the use of supporting tools available in ICU room so that they can anticipate the obstacles faced during the working period.

Tuberculosis of the temporalis muscle is a rare clinical entity. Diagnosis is difficult because there are no specific clinical, radiological or biological signs of the disease. Only bacteriological and histopathological findings can confirm the diagnosis. Treatment is based on anti-tuberculous drugs and allows usually a favourable evolution. The aim of this paper is to report a case of primary tuberculosis of the temporalis muscle in a 67-year-old female, and to stress the corresponding diagnostic pitfalls.

In the present study, different extracts of leaves of Myrica esculenta were prepared and evaluated their membrane stabilizing and antioxidant effects. All extract were tested for presence of phytoconstituents i.e., alkaloid, carbohydrate, sterols, proteins, amino acids, saponin, and phenolic compounds. Membrane stabilizing effect was studied by hypotonic solution induced haemolysis of erythrocyte and Antioxidant activity was studied by DPPH method at a different concentration. From the study, Phytochemical analysis showed that methanol extract was the richest extract for the tested phytoconstituents. Maximum membrane stabilizing activity of leaves of Myrica esculenta showed in Methanol extract (61.11±1.10) at a concentration of 1000 μg/ml in comparison to standard drug aspirin. From antioxidant studies, methanol extract showed maximum antioxidant activity (91.36±1.27) at a concentration of 1000 μg/ml than other extract and comparison to standard drug ascorbic acid. From above studies it could be concluded that methanol extract showed maximum membrane stabilizing and antioxidant activities.

Recurrent respiratory papillomatosis is a rare benign disease of the upper airway caused by HPV, primarily affecting the paediatric age group. A retrospective analysis of 11 cases of recurrent respiratory papillomatosis was done in the present study extending for 30 years in three Medical Colleges of India. The presenting age of the patients was 2 to 7 years. Around 73% of recurrent respiratory papillomatosis cases had been diagnosed within 5 years of age. In our study, we did not find any case of adult onset recurrent respiratory papillomatosis and all the cases were of juvenile onset. Both males and females were affected equally with a male to female ratio of 1.2: 1. The incidence was more in the population with lower socio-economic conditions. Out of the total 11 cases, 6 patients required emergency tracheostomy for obstruction of the airway due to extensive involvement of the larynx. Microlaryngoscopic removal of the lesions with microdebrider was the primary treatment combined with adjuvant nonsurgical/medical treatments to contain the virus and growth of the tumours. In the case of the 5 (45%) patients presenting with hoarseness of voice without respiratory distress, complete microlaryngoscopic excision of the lesions were possible. However there were recurrences in 3 of these 5 cases, requiring further surgeries. In the case of the 6 (55%) patients, who required emergency tracheostomy for acute respiratory distress, complete microlaryngoscopic excision of the lesions were not possible in the first surgery, due to extensive pathology and there were recurrences in all these cases. Collectively, there were recurrences in 9 cases out of the total 11 cases.

Human taeniasis was found from more than 50 provinces in Vietnam, and in which the highest prevalences have always been observed in the highland and mountainous areas. In addition, Cysticercus cellulose infection of pigs is considered as one of the most risk factor that contribute to taeniasis in human. Therefore, our study investigated both of the prevelence of Cysticercus cellulose in pigs and Taenia solium in human in the 3 communes of Son La, a moutainous province, in order to identify if there is such kind of correlation between the infected rates of pigs and human. Our results show that the prevelences of Cysticercus cellulose in pigs and Taenia solium in human in the 3 communes were high when comparing to other ares of Vietnam, however, they are within the range of the disease infected rates in Vietnamese mountainous ares. In addition, we observed that infectionof Cysticercus cellulose in pigs was closely associated by infection of Taenia solium in human, and also vice versus. In addition, because although cysticerci of Taenia solium occur primarily in pork, they also occur in humans, so humans can have both taeniasis and cysticercosis (including neurocysticercosis), which are dangerous and health-damaged in many cases. Therefore we suggest that in order to eliminate this meat-borne parasitoses, the effective prevention and treatment are required to applied simutanously on both pigs and humans of the areas

Onychomycoses are fungal infections that affect hands and feet nails and are caused by several genera of filamentous and yeast fungi. The knowledge of the etiology is fundamental to establish the appropriate therapeutic conduct. Most fungi genera are free living, but some have adapted to parasitism and others depend on predisposing factors for implantation in the host. The objective of this research was to perform an epidemiological survey to identify the genera of fungi etiological agents of onychomycosis in patients attending in Rio de Janeiro dermatology clinics. After cleaning the nails with 70% alcohol, scraped scales with a sterilized scalpel were collected and seeded in Sabouraud-dextrose-agar and Mycosel culture media at room temperature. The colonies of filamentous fungi were identified by the cultural characteristics and the yeasturiformes by the staining of Gram method and biochemical tests. Among the 1290 cultures examined, 362 (28.06%) were positive for the following fungi: Candida spp. 335 (92.54%), Trichophyton rubrum 12 (3.31%), Epidermophyton floccosum 8 (2.21%), Microsporum canis 6 (1.66%) and Aspergillus niger 1 (0.28%). The fungal etiology of the nail lesions had an incidence of 28.06% of the samples from 1290 patients, being the genus Candida the most prevalent cause of onychomycosis

Hydrogels have high affinity to absorb water due to the presence of hydrophilic group; Hydrogels can be prepared from both natural and synthetic polymer. Though the synthetic polymers are preferred more due to their less risk of immune response and less chances of viral and bacterial attack With increasing efforts devoted to controlled release of drug molecules, the application of hydrogels will continue to grow in future with its more relevantly and more efficiently applications, The success of hydrogels as delivery systems can be judged by several marketed preparations.

The wound stress is applied to leaves of P. foetida and ethyl actetate extracts is optimized using mobile phase: ethyl acetate: chloroform: glacial acetic acid: benzene (25:15:2:10) and TLC bioautographic depict two antimicrobial compounds at Rf 0.46 and 0.73. The extract shows antimicrobic activity 12 mm against S. aureus at 5 mg/ml and 14 mm against E. coli at 10 mg/ml. Their HR-LCMS chromatogram elucidates the structure of two possible antimicrobial compounds as nitrofurazone (RT: 0.644 min) or 4-tridecynoic acid (RT 7.616 min) and dihydrodeoxystreptomycin (RT:9.22min). The HPLC-DAD detected dihydrodeoxystreptomycin at 254 nm and ibuprofen at 220 nm. The GCMS confirmed 4-chloro 7-nitrobenzofurazan (RT: 18.39), methyl jasmonate (RT: 18.84), 10.03 PPM and 12-hydroxy dodecanoic acid (RT: 23.79), 82.65 PPM in 96 extract. These compound's viz 4-tridecynoic acid and dihydrodeoxystreptomycin, ibuprofen, 4-chloro 7-nitrobenzofurazan, methyl jasmonate and 12-hydroxy dodecanoic acid could be possible raised as antimicrobial drugs in pharmaceutical industries.

Tornwaldt’s cyst is an uncommon midline nasopharyngeal cyst that arises from the pharyngeal bursa on the posterior nasopharynx. They represent as a communication between notochord remnants and the pharyngeal endoderm. Occlusion of this communication results in the formation of Tornwaldt’s cyst. Development of these cysts has been linked to scarring from prior adenoidectomy and nasopharyngeal inflammation. It is usually small and accidentally diagnosed on rhinoscopy, computerized tomography (CT) or magnetic resonance imaging (MRI). Clinical symptoms of nasopharyngeal cysts may include fullness in the ear, tinnitus, nasal obstruction, dysphagia, dysarthria, dysphonia, odynophagia, halitosis, cephalgia, or stiffness of cervical muscles. We report a case of a 24-year-old male with as an isolated nasal obstruction and discuss the clinical, radiological features, and the differential diagnosis of these cysts

This cross-sectional, community-based study was conducted in the area of the Urban Health Training Centre of a municipal medical college, located about 30 kms from Mumbai (India). The participants were 57 females (mean age: 63.91±8.91 years) and and 47 males (mean age: 62.13±10.16 years) with type-2 diabetes mellitus for five or more years preceding the study period but who did not have symptoms related to complications of diabetes mellitus, who gave written informed consent. The participants were interviewed using a semi-structured questionnaire. Their records of follow-up pattern were correlated with the occurrence of manifestations suggestive of early onset of common and morbid complications. Nine participants revealed maternal history of diabetes mellitus while four had a paternal history. 35 females and 38 males had no other diabetic in their families, while four patients revealed that three or more of their family members were affected. 55 (52.88%) were asymptomatic. Among the symptomatic, the complaints were weakness (18.27%), spells of fainting or giddiness (11.54%), loss of body weight (7.69%), polyuria and polydipsia (7.69%). The gender difference in the mean body mass index was statistically significant (Z=2.348; p=0.019) while that for mean systolic (Z=0.942; p=0.3472), diastolic blood pressure (Z=0.596; p=0.549), mean fasting (Z=0.399; p=0.689) and post-prandial blood sugar levels (Z=1.364; p=0.174) was not significant. As per available medical records and responses given by participants to the questionnaire, regular follow-ups were inadequate and a significant proportion was not on specific anti-diabetic medications

Fine needle aspiration cytology (FNAC) is a valuable adjuvant to preoperative assessment in patients with salivary tumors. The study aimed at studying the cytological features of benign and malignant salivary gland tumors, improving the diagnostic accuracy by using immunocytochemistry and correlating it with histopathology. A total of 46 salivary gland tumors including twenty three cases each of benign and malignant tumors with available histology were included in the study. We studied 23 benign tumors, Pleomorphic Adenoma comprised 86.7% of all benign tumors and rest three cases were diagnosed as Warthin’s tumors. Positive correlation with histology was obtained in 95% in Pleomorphic adenoma and 100% in Warthin’s tumors. Twenty three malignant salivary gland tumors comprised 11 Mucoepidermoid carcinoma,10 Adenoid cystic and 2 Acinic Cell Carcinoma. Positive cytohistological correlation was established in eight out of eleven Mucoepidermoid carcinoma (Diagnostic Accuracy=72.7%) and all cases of Adenoid cystic and Acinic cell carcinoma. Diagnostic accuracy of FNAC for malignant tumors was 95.65%. Our study shows that FNAC is a highly sensitive and specific technique for diagnosis of salivary gland tumors. Immunocytochemistry can act as adjuvant in diagnosing salivary gland tumors, however it did not help in improving the diagnostic accuracy of FNAC in our study .Kappa value of 0.88 in our study indicated an excellent agreement between typing of salivary gland tumors on FNAC and histopathology

In this present study minimum inhibitory concentration of Moxifloxacin hydrochloride is determined by using cup plate method. Moxifloxacin Hydrochloride belongs to fourth generation fluoroquinolone antibiotic which is effective against both gram positive and gram negative microorganisms. Since moxifloxacin hydrochloride is a broad spectrum antibiotic Staphylococcus aureus and Escherichia coli is selected as test organisms. Serial dilution of Moxifloxacin Hydrochloride were made in the concentration ranging from 5000 µg/ml to 2.43µg/ml. Minimum inhibitory concentration of Moxifloxacin Hydrochloride was found out at 312.5µg/ml when seeded with S aureus and 19.5µg/ml when seeded with E coli