This complete enumeration, cross-sectional descriptive study was conducted on 62 students (females=29; 46.77%; males=33; 53.23%) at Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra State, India, to determine the effect of objective structured practical examination on student scores. After the examination procedure and the check-list based marking system was explained to first-year medical students, written informed consent was taken from willing participants. The mean conventional practical examination score (out of 60) was 38.03  8.62 (95% CI: 35.89 – 40.18), while that for objective structured practical examination (out of 60) was 52.19  4.56 (95% CI: 51.06 – 53.33). The difference in overall scores was highly significant (Z=11.433; p<0.00001). But, the gender differences in mean scores were not significant. The results of this study indicate that objective structured practical examination was more objective, measured practical skills better, eliminated examiner bias and significantly enhanced student scores and can be used for formative assessment to improve students’ competence (psychomotor component). Students with lower scores may need remedial educational intervention

Liver cirrhosis is a life-threatening disease and quick diagnosis of liver cirrhosis is important. Liver Biopsy is considered a gold standard method for the diagnosis of liver cirrhosis. However, it is an invasive method. Basic imaging and non-invasive methods have been developed over the last few decades for the detection of liver cirrhosis. The aim of our research is to compare shear wave elastography with greyscale and Doppler ultrasonography for better treatment and diagnosis of Liver Cirrhosis. One-ninety-five (195) patients were selected at INMOL Hospital, Lahore radiology department suffering from cirrhosis. On Shear Wave Elastography (SWE) Elasticity and Stiffness were mean 21.76±9.00 Kpa (10.50 to 72.3 Kpa) and Shear-wave Velocity Mode was mean 2.578±0.4766 cm/s (2.08 to 4.86) cm/s. This study showed that the greyscale and Doppler ultrasonography alone is not enough for the detection of Liver cirrhosis and Shear wave elastography (SWE) is the more accurate and best method for the detection of Liver Cirrhosis

Aim: The present articles involves the investigation of anticlastogenic activity of ethanolic extract of bael fruit (Aegle marmelos). Acute toxicity study was conducted as per OECD guidelines up to 2000mg/kg body weight. Methodology: Anticlastogenic activity was investigated by two models viz, micronucleus test and chromosomal aberration method using mice. In micronucleus assay model the bone marrow was extracted form various groups of animals, staining was performed and the slides were scanned under oil immersion(100X) in LAbomed-Digi 2 microscope (90V-260V), for the presence of micronucleus in PCE (Polychromatic Erythrocytes) and NCE (Normochromatic Erythrocytes). Results: In chromosomal aberration model the animals has been sacrificed from all the groups and bone marrow was collected, processed and different types of aberrations like chromosome breaks, exchanges, rings and minute were recorded. In micronucleus assay, there was a significant (P<0.001) increase in the % MNPCE and decrease in P/N ratio in cyclophosphamide (50 mg/kg, i.p.) treated animals when compared with normal control animals. In chromosomal aberration test, there was a significant increase in total no. of chromosomal aberrations (rings, exchanges, breaks and minute) in cyclophosphamide treated animals when compared with normal control animals and it was time dependent. Bael fruit extract were found to be non mutagenic and significantly (P<0.001) decreased the cyclophosphamide induced formation of chromosomal aberrations. Conclusion: Based on the present empirical evidences the ethanolic extract of bael fruit was found significant anticlastogenic activity

Ultrasonography is a widely used imaging technique that has many clinical applications. Most hospitals will offer women at least 2 ultrasound scans during their pregnancy. The first is usually at around 8 to 14 weeks and is sometimes called the ‘dating scan’ because it can help to determine when the baby is due. Anomaly scan is an ultrasound scan that is carried out around weeks 19 to 20 of your pregnancy. Neural tube defects are abnormalities that occur in the development of the spinal cord and brain in the fetus. This scan aims to identify any physical problems with the baby. During the anomaly scan, we can identify the neural tube defects. Exorbitant choice sonography has improved it practical to picture the developing embryo and analyze fetal anomalies previously the twentieth week of pregnancy. Contingent upon the kind of neural tube defects distinguished, early end of the pregnancy might be thought about. The sonographer, just as the whole obstetric gathering, should be cognizant that there's a range of conditions with different discoveries related to a neural tube defect. Learning and awareness of these conditions will make an examination and control less demanding

Background: Stroke is a leading cause of neurological disability and death in adults. Carotid atherosclerosis represents major aetiopathogenesis of stroke. Ultrasonography is affordable, safe and relatively available imaging modality. The aim of this study was to determine the intima-media thickness (IMT) of common carotid arteries (CCA) in adult stroke patients in Maiduguri, North-Eastern Nigeria. Materials and Methods: This was a cross-sectional prospective study carried out on 100 adult stroke patients that attended neurology clinic and wards at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria. All patients had neuroimaging (Brain CT/MRI) for confirmation of diagnosis. The examination was performed using Logic P5 GE ultrasound scanner equipped with linear transducer. The IMT of CCA of the patients was measured using grey scale ultrasonography and was correlated with age and sex. Results: There were 62 males and 38 females aged 30-85 years (mean ± SD of 59.15 ± 4.20 years). Ischaemic stroke was the major subtype of stroke (73% of the study population). The overall mean CCA IMT was 1.03 ± 0.29 mm. Forty five percent (45%) of the stroke patients had increased CCA IMT (>1.0 mm). The relationship between increased CCA IMT with stroke was statistically significant (p = 0.02). There was significant correlation between increased CCA IMT with increasing age (p = 0.01). However, the IMT was higher in men than the women but their correlation was not statistically significant. Conclusion: Increased CIMT was significantly associated with stroke. There was positive correlation between increased CIMT with advancing age

Increased morbidity and mortality has been recorded from diseases such as HIV/AIDS, tuberculosis, hypersensitivity reactions, autoimmune disorders, and graft versus tissue rejections. Therefore, immunomodulation can be beneficial depending on the desired immune status. The aim of this study was to determine the effect of aqueous extract of leaves of Ocimum gratissimum on immune response in albino Wistar rats. Albino Wistar rats were administered the following extracts/drugs by oral administration for 21 days: Group 1 (40 mg/kg extract), Group 2 (80 mg/kg extract), Group 3 (60 mg/kg extract), Group 4 (Levamisole 0.5 mg/kg) positive control, Group 5 (no drugs, no extract) negative control. After 21 days, blood samples were collected for the estimation of plasma IgG level and absolute WBC count. There were statistically significant reductions in plasma IgG levels in the test groups compared to controls (p value 0.052). Multiple comparisons (Dunn’s) of the group values further revealed statistically significant p values of 0.022 (group 2 vs group 1), 0.023 (group 2 vs group 4), and 0.011 (group 5 vs group 2). There were also statistically significant reductions in total WBC in the test groups compared to controls (p value 0.043). Multiple comparisons (Dunn’s) of the group values further revealed statistically significant p values of 0.013 (group 2 vs group 5), and 0.010 (group 3 vs group 5). At the doses and concentrations used in this study, the aqueous leaf extract of O. gratissimum produced dose dependent inhibition of plasma IgG concentration and total WBC count in albino Wistar rats

A comparative analysis of endothelial cell loss was done after manual small incision cataract surgery and phacoemulsification with 50 patients in each group in a tertiary care eye hospital in India. Follow up was done upto 8 weeks for visual acuity, mean endothelial cell density, corneal thickness and change in hexagonality. Analysis was done on TOPCON- 3000P specular microscope. Males and females were equally distributed mainly in 51-60 years of age group. The visual acuity in group A (phacoemulsification) was 6/6 in 68% patients while in group B it was 6/6 in 40% patients. There was more decrease in mean endothelial cell density in group A (phacoemulsification) 4.24% vs 3.87%. Corneal edema occurred in both the groups initially but was not statistically significant. The overall loss of hexagonal cells is not statistically significant between phacoemulsification and manual small incision cataract surgery. All through our study, there was more corneal edema, endothelial cell loss and decrease in hexagonality in phacoemulsification group. However, the difference was not statistically significant. Hence, both the surgeries are safe pertaining to corneal endothelial health

Aim: To evaluate muscle relaxant property of Cuminum Cyminum in albino rats. Methodology: This is an experimental study conducted at Department of Pharmacology, Dr. S. N. Medical College, Jodhpur (Rajasthan) on albino rats to find out the muscle relaxant property of Cuminum Cyminum standard drug was diazepam. Adult albino rats of either sex (100-150g) were divided into 3 groups. Group I consisting of 6 animals, served as control and received distilled water. Group II subdivided into three groups II-A, II-B, II-C, consisting of six animals each, received Cuminum cyminum in three doses of 300mg, 750 mg, 1000mg per orally respectively. Group III subdivided into three groups III-A, III-B, III-C, consisting of 6 animals each, received the standard drug in three doses per orally. Result: Cumin were tested as muscle relaxant and compared with diazepam as standard drug. P- value for fall-off time was not significant in all the three doses of Cuminum cyminum. Fall-off time was decreased by 0.70%, 0.91%, 2.40%, respectively with all the three doses of Cuminum cyminum. Conclusion: Skeletal muscle relaxant property of Cuminum cyminum aqueous solvent extract was not significant. It may be because extract got heat thermal degradation so it may be lost some of its property. According to some studies and animal models cumins alcohol solvent extract is having muscle relaxant property while it is having relaxant property for tracheal smooth muscle

Fungal corneal ulcers usually difficult to diagnose and treat especially in primary and secondary hospital level and abrupt use of antibiotics and steroids lead to resistance to treatment. Our study realized that while treating a recalcitrant deep fungal keratitis in combination with intrastomal injection of voriconazole along with use of topical voriconazole eye drop increases the healing rate and hastens the resolution period without significant complications leading to severe visual loss as compared to the treatment with use of topical voriconazole eye drop alone

As the age increase the comorbidities also increases and also chance of polypharmacy. Polypharmacy is termed as the concurrent use of multiple medications (5 or more drugs), whether prescription or over-the-counter, by a single patient. The use of multiple drugs increases the risk of inappropriate pre¬scribing and significantly lowers adherence to drug regimens and results in DDIs. The main aim of study to find drug interactions in elderly patients as a result of polypharmacy and also determine the drug use. A retrospective, observational study was carried out to find among elderly in-patients age above or equal to 60 years for over a period of 3 months. Data was collected from medical record department (MRD) in a pre-designed format which includes demographic details, drugs prescribed, drug per prescription and drug- drugs interactions (DDIs) encountered, DDIs are calculated using drugs.com. during the study we found that average number of drugs are 8.9 (±5.6) and mean age was 70.69 ± 6.89 year between the range 60 -88 years. Drugs involving moderate drug interaction (66.95%) were predominately seen when compared to minor (20.87%) and major (12.18%) drug interactions. The study reveals that there is statistically significant (p<0.05) between the number of drugs per prescription and frequency of drug interactions. Highest number of inappropriate drug combinations are seen between aspirin and anticoagulants like enoxaparin and heparin. Polypharmacy is a risk factor in elderly which will results in serious consequences like ADRs and DDIs. These problems can be overcome by strictly monitoring which will helps in maintaining the quality of life in elderly

Vernal conjunctivitis is a bilateral, recurrent inflammation of conjunctiva that tends to occur in children.The prominent features are itching, photophobia, redness, tearing, mild ptosis and thick ropy yellow mucoid discharge. The main clinical signs are cobblestone papillary hypertrophy, hyperemia of upper tarsal conjunctiva localized edema and Trantas dots. The three forms of vernal conjunctivitis are palpebral, limbal and mixed. Wide range of treatment modalities are now available for vernal keratoconjunctivitis.This study included 80 patients of both sex in the age group 5-25 years with any form and severity of vernal keratoconjunctivitis. Patients were randomly divided into two groups A and B. Group A patients were given cyclosporine (0.05%) eye drops and group B patients were given fluorometholone (0.1%) eye drops. The results were statistically analyzed by Mann Whitney Test and p value of <0.05 was taken as statistically significant. Maximum numbers of patients were below 15 years of age in both the groups and, in both groups; males were more than females.Most of the eyes presented with palpebral type of disease in both groups.Patients had maximum symptomatic relief at the end of fourth week in both the groups. Response to fluorometholone (0.1%) was significantly better than cyclosporine (0.05%)

Introduction: Von Hippel-Lindau disease (VHL) is a multi-systemic disease characterized by abnormal multiplication of blood vessels, with haemangioblastomas and cysts, as well as other neoformations in the blood Several organs. We report the case of a patient; we try to put the point on this pathology. Case Report: 14-year-old patient, consults for a BAV of the OD whose examination finds an intra vitreous haemorrhage,retinal capillary haemangioma and a lower exudative retinal detachment. The patientreceived an IVT of anti VEGF initially followed by an endocular surgery. Postoperative visual acuity was not improved with a follow-up of 6 months. Discussion: The clinical definition of VHL disease is based on the presence of two major lesions, one of which is hemangioblastoma. The absence of family history, or a single injury in the presence of a family history. Complementary examination is based on angiographyto fluorescein. Complications can range from simple exudates to DR or even phtyse of the globe. The treatmentis essentially based on argon laser coagulation, cryotherapy, anti-VEGF and retinovitealstage of complications. Conclusion: VHL is a hereditary disorder with multi-systemic involvement, hence the interest of an examination complete follow-up, regular monitoring and genetic counseling in any patient suspected of having the diseaseas well as his family

Objective: This study was carried out to determine awareness and willingness to eye donations among undergraduate medical students. Methods: A cross sectional survey was done at Al-Nafees Medical College Islamabad during the months of March to July 2018. Total 250 students were enrolled by applying simple random sampling. A self administered structured questionnaire was applied for data collection. Data was entered and analyzed by using statistical package for social sciences (SPSS version 23). Results: Out of the selected 247 students, 124(50.2%) were male and 123(49.8%) were female. 234(94.7%) knew about eye donations and 106(51.8%) knew that cornea is transplanted into the receiver’s eye. Only 32(13%) knew about eye banks in Pakistan whereas only 67(27.1%) students were agree to donate their eyes. Conclusion: From the current study it was concluded that most of the medical students were aware of eye donations but they did not know the further detail of eye donation and majority was not ready to bestow their eyes

Behçet’s disease is a systemic vasculitides, characterized clinically by recurrent mucocutaneous lesions but vital organs may by affected like central nervous which can increased the morbi-mortality especially among young patients. Infliximab, is a promising therapeutic approach for this disease especially in those with manifestations refractory to the standard immunosuppressive therapy. We report 3 cases of refractory neuro-Behçet’s disease with a dramatical clinical improvement under infleximab

Although each drug causes unique physiological and neurological effects, all drugs overlap in one important way, All drugs cause changes in the brain, some in ways that may be long-lasting or even permanent. These brain changes can have significant effects on mood and cause depression, ultimately lessening a person's ability to lead their best and healthiest life. Your brain regulates all the body's basic functions, including every breath and each heartbeat, while enabling you to interpret and respond to experience. It shapes thoughts and emotions and determines your behavior. Despite some commonality, the short- and long-term health effects of drugs are distinct, with each one potentially affecting life spans in a different way. Opioids include heroin and prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine and fentanyl. All members of the same chemical family, these drugs interact with the opioid receptors on nerve cells in both the body and the brain. Out of everyone who tries heroin for the first time, nearly one in four become addicted. Repeated heroin use changes the physical structure Wang, X et al., (2012) and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed Ignar, D. M et al., (1990) & Kreek, M. J et al., (1984). Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations Li, W et al., (2013), Qiu, Y et al., (2013) & Liu, J et al., (2011). Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects