New Indian Journal of Surgery

 Non communicable diseases are major , emerging and growing public health threats which have been silently creeping down our public health care system. If the current trend continues NCD’S are expected to account for 73% of the deaths and 63% of the global disease burden ,thus becoming a leading cause for mortality and morbidity .so a systematic approach towards these modifiable risk factors and their assessment is required.

 At some point in a medical curriculum, students are taught how to handle emergencies in a hospital emergency setting where all facilities are available. But the adequate knowledge required for handling an emergency without hospital setting at the site of the accident or emergency may not be sufficient. Keeping this view in mind, the present study was planned to determine the level of knowledge among the undergraduate students of KMC, Mangalore regarding first aid measures. Data were collected from 152 students of 4th, 6th and 8th Semester Students of KMC, Mangalore (Manipal University, Manipal) through pre-tested questionnaire in May, 2011. Each question has certain options which carry some marks based on the appropriateness of the option in the particular situation. The maximum and minimum scores were 207 and 007, respectively. The score between 147-207 was regarded as good; 67-146 as moderate; and 7-66 as poor. The results were compared by ?2 test with significance set at 5.00% level.Out of 152 students, 13.8% had good level of knowledge on first-aid; 68.4% had moderate and 17.8% had poor level of knowledge on first aid. Gender-wise, 11.5% of males and 15.4% of females had good level of knowledge on first-aid measures while 69.0% of males and 68.0% of females had moderate level of knowledge on first-aid measures. About 19.7% of males and 16.5% of females had poor level of knowledge on first-aid. Gender differences were, however, non- significant. The knowledge regarding first-aid measures was good amongst most of the students of 8th semester (16.7%) followed by those of 4th semester (15.6%) and 6th semester (7.70%), the differences being statistically significant. Most of the students had poor knowledge regarding first aid measures in the field of road traffic accidents, heat stroke, dog/cat bites, heart attack, acid reflux and insect in the ear.Because of very low number (13.8%) of undergraduate students having good level of knowledge on first-aid, courses related to first-aid should be included in the curriculum.

 Among the wide array of human neoplasms, tumor of bone and soft tissue are not very common and account for only less than 1 percent of all neoplasms.Central Institute Of Orthopaedics is a referral centre for musculoskeletal pathology where a large amount of bone and soft tissue tumours are seen.We are presenting eight rare variants of bone & soft tissue sarcomas with their clinico-pathological and radiological features, reported in the department of orthopaedics, VMMC & SJH. The variants to be presented are as follows:

• Bone neoplasms:

1. Malignant fibrous histiocytoma of bone

2. Clear cell chondrosarcoma

3. Clear cell sarcoma of bone

4. Parosteal osteosarcoma

5. Telangiectatic osteosarcoma

6. Chondroblastic osteosarcoma

• Soft tissue neoplasms

1. Low grade fibromyxoid sarcoma

2. Soft tissue sarcoma

 Organ transplant programs are increasing in India with the major barrier to transplantation being a shortage of organs. The majority of Indian Nationals are reluctant and unwilling to donate or consent for donation. This study was undertaken to determine the knowledge, attitudes and practices regarding organ donation in a selected student population in Bellary.

 Anemia is considered as a severe public health problem by World Health Organization (W.H.O), when anemia prevalence is equal to or grater than 40% of population. According to W.H.O, in developing countries anemia averages 56%, ranging between 35% to 100%. In India, anemia is the second most common cause of maternal deaths, accounting for 20% of total maternal deaths.

 Polycystic ovarian syndrome is a multisystem endocrinopathy with ovarian expression of metabolic disturbances and a wide spectrum of clinical features. It is a multi-factorial and polygenic condition. The prevalence of PCOS in the age group of 15-25 years is 20-30%. The diagnosis of PCOS in adolescent girls is difficult, mainly due to similarities in the irregular bleeding patterns among adolescent girls with PCOS and normal postmenarchal girls. But an early detection helps in preventing long term complications and management can be, by lifestyle modifications (diet, exercise and stress management). With the early onset of menarche and increasing incidences of PCOS among urban adolescent girls, the need to imply methods of prevention and awareness at school level arises. This research addresses the issue and brings forward the need to adopt means of early, better and efficient management of PCOS.

 Pilonidal sinus is a common chronic disease of the sacrococcygeal region. The treatment varies according to the clinical presentation of the disease. Although many surgical methods have been suggested, an ideal method is still lacking because of high recurrence rates. The aim of this work is to assess the rhomboid flap’s role in promoting primary healing in recurrent pilonidal disease and to evaluate the morbidity and recurrence. Patients and methods: This prospective study included 30 patients (25 males and 5 females) who were treated with the use of a rhomboid flap closure for recurrent sacrococcygeal pilonidal sinus. The follow up period ranged from 1-3 months.

 Disaster management is also known as emergency management is dealing with disasters in an organised way . In most disasters the loss during the actual event may not be as significant , but losses due to inability to manage the situation in a timely manner are very high. Also our country is predisposed to many disasters like floods, epidemics, storms, earthquakes, tsunamis etc.Hence there is a serious need to promote awareness among the population especially medical students.

To describe a new technique for fistula-in-ano surgery aimed at total sphincter preservation, and evaluate the preliminary results concerning non-healing and intact anal function. A prospective observational study in Twenty fistulain-ano patients treated by ligation of intersphinctericfistula tract (LIFT) technique, from September 2011to April 2012. Fistula-in-ano in eighteen patients healed primarily (90%). There was one non-healing case (5%). The mean healing time was four weeks. None had disturbances in clinical anal continence. The early outcome of the LIFT technique is quite impressive. Results warrant a larger study with longterm evaluation. This technique has the potential to become a viable option for fistula-in-ano surgery

 Leptospirosis is essentially an animal infection by several serotypes of Leptospira and transmitted to man under certain environmental conditions and is fairly widespread throughout India. The most frequent hosts are rodents, especially the common rat (Rattus norvegicus). Most outbreaks of leptospirosis have been reported in coastal regions: Gujarat, Mumbai, Kerala, and the Andaman Islands. A retrospective cross-sectional study was undertaken to find the proportion of leptospirosis from the fever cases in the last 5 years in Coastal Karnataka and to determine the risk factors of leptospirosis. All the Leptospirosis case records from the district office of IMA of the past five years (2007-2011) were collected. Proportion was calculated from the total number of fever cases admitted to the hospital during this period. Case-fatality rate was 12 deaths per 100 hospital admissions. Males are more prone to infection (73.63%). All age groups are affected however maximum case-fatality was seen in the age-groups of 30-39 years (14%) as well as greater than 60 years (13%). Maximum numbers of cases were reported from Mangalore (40.65%). This report highlights the demographic risk factors and the high prevalence of the disease in Coastal Karnataka. Administration and policy making have been found wanting in the area and the incidence can be reduced by increased health education, community participation and better policy development

 In India the DS births occur with a frequency of 1 in 800. Because of medical advances and improvements in overall medical care; the median survival of individuals with DS has increased considerably. This longer life expectancy requires giving the necessary care to the individual with DS over their total longer lifespan and determining factors that aim at better quality of life both for the children and for their parents. As concerns about mortality diminish, causes and consequences of morbidity for these children gain importance ( Horwitz et al 2000). This study was tailored to look at the reasons for hospitalization and mortality which may contribute to increased costs and loss of daily wages to their parents and have significant impact on the quality of life of the care givers.

 Health seeking behaviour in terms of illness; behaviour refers to those activities undertaken by individuals in response to symptom experience. Health seeking behaviour is influenced by a large number of factors apart from knowledge and awareness. This behaviour among different populations, particularly in rural communities, is a complex outcome of many factors operating at individual, family and community level including their bio-social profile, their past experience with the health services, influences at the community level, availability of alternative health care providers including indigenous practitioners and last but not the least the perception regarding efficiency and quality of services. Belief systems prevalent in the communities i.e. how people conceptualise the aetiology of health problem and how symptoms are perceived is an important factor in deciding the first step of treatment seeking. With this perspective, present study was undertaken with an objective to find the factors associated with the health seeking behaviour of community members (above 60 years)and also to know the difference between rural and urban health seeking behaviour. 

 According to the International Telecommunication Union there were an estimated 5.3 billion subscriptions globally by 2010. As they have now become an essential part of business, commerce and society it has become extremely important for us to know the health hazards caused by them.Most phones emit radio signals at Specific Absorption Rate levels of between 0.5-1W/kg. SAR is a measure of rate of radio energy absorption in body tissue. The SAR limit recommended by International Commission of Non Ionizing Radiation Protection is 2 W/kg2. There is a consistency seen between the RF radiations and the health problems like dizziness, fatigue, headache, sleep disturbances, impairment of short term memory, an increase in frequency of seizures in epileptic children, brain tumors and hypertension. Many studies have been done in other countries regarding the health hazards due to cell phones but data from our country is lacking. This cross sectional study was conducted in Maulana Azad Medical College and the associated Lok Nayak Hospital. Patients coming to OPD and their attendants were interviewed. Students and hospital staff were also undertaken in the study.A total of 50 mobile phone users and 50 non mobile phone users were undertaken in the study. Extensive mobile users: defined as those using mobile phones for more than 4 years and at least one hour a day.

 Fluoroquinolones are widely used antimicrobial agents for the treatment of various infections. These agents produce clinically significant excitatory side effects on central nervous system. and are attributed to the inhibition of g-aminobutyricacid (GABA) binding to the GABA- A receptor. GABA is involved in the regulation of dopaminergic neuronal activity within the forebrain and nigro straiatal system. Evidence indicate that the GABA-mimetic drugs potentiate neuroleptic-induced catalepsy. In this context as there are no evidence about the effects of fluroquinolones on haloperidol induced catalepsy, the present study was undertaken to evaluate the effects of ciprofloxacin, a fluroquinolone on haloperidol induced catalepsy in mice.

 Healthcare, in India, is provided as a three tier system asPrimary, Secondary and Tertiary levels.Complexities of infectious diseases, increasing population, and difficult to maintain resources appears to have adversely impacted health care sector thereby compromising the health of our vast manpower, at least qualitatively.To generate newer ideas for providing better healthcare by modifying the existing strategies or introducing newer concepts appears to be the need of the hour. In current scenario, introduction of Telemedicine as an addition to our multipronged health strategies provides an excellent option. By improving the health of our vast manpower, India will not only sustain but, also, further, improve the economic growth and development.To accomplish the same, generating awareness among health care workers and policy makers about introduction of Telemedicine as an additional prong is very much essential. Therefore, the present study is undertaken with the aims and objectives as.

 Non-compliance with oral hypoglycemic agents (OHA) is a central issue in patients of type II DM, as it decreases the efficacy of treatment and leads to development of long-term complications.The prescribed drugs are usually to be taken 20-30 minutes prior to a meal, which is ordinarily missed by patients resulting in the declining health of diabetic patients due to development of complications.As such, little data is available on compliance specifically to OHA in type II DM, but previous studies have reported it to be poor to satisfactory.

 Immunisation remains one of the most important public health interventions and a cost effective strategy to reduce both the morbidity and mortality associated with infectious diseases. Over two million deaths are delayed through Immunisation each year worldwide. Despite this, Vaccine preventable diseases remain the most common cause of childhood mortality with an estimated three million deaths each year. Uptake of vaccination services is dependent not only provision of these services but also on other factors including knowledge and attitude of mothers, density of health workers, accessibility to vaccine clinics and availability of safe needles and syringes. Assessing Immunisation coverage helps to evaluate progress in achieving programme objectives and in improving service delivery. With this perspective the above survey was conducted for assessing vaccination coverage for childhood vaccines and maternal factors impacting coverage in a Rural and urban communities of Bellary, Karnataka.

 Spiritual health is defined as a state of being where an individual is able to deal with day-to-day life in a manner which leads to the realization of one’s full potential; meaning and purpose of life; and happiness from within. It has been found that spiritual practices have a positive correlation with survival, low blood pressure, less remission time from depression, less number of cigarettes smoked per day per week, less severe medical illness, better quality of life, cooperativeness, etc. In last two decades, there has been scientific search for the relationship of the spirituality with intelligence, with emotions and also well-being. Measurement instruments have been developed to measure spiritual intelligence, which is a spiritual correlate to intelligence quotient and emotional quotient. Like emotional quotient, spiritual quotient is assuming importance in scientific research and philosophical/psychological debates. In this direction, National Institute of Health and Family Welfare, New Delhi has developed a statistically reliable and valid spiritual health scale.***Objective: To assess the spiritual health status of medical students using the spiritual health scale developed by NIHFW, New Delhi.

 In India, Proteinuria is quite common, occurring in upto 50% of patients, resulting in decreased patient survival and increased prevalence of cardiovascular disease. ACE inhibitors (ACEI) & Angiotensin receptor blockers (ARB) have been the mainstay of therapy in native kidney proteinuria, though may not succeed in all patients because of side effects. Pentoxyfylline has been advocated as an anti-inflammatory measure, probably contributing to amelioration of proteinuria. Decreasing proteinuria is the mainstay of therapy in order to delay the progression of CKD. Burden of disease Diabetic nephropathy (DN) is the main cause of endstage renal disease (ESRD). Diabetic Nephropathy is the leading cause of DM-related morbidity and mortality. Both microalbuminuria and macroalbuminuria in individuals with DM are associated with increased risk of cardiovascular disease.Prevalence of diabetic nephropathy in INDIA- 30.3%.

 Fibroadenoma is the most common benign tumor of the female breast with the highest incidence before age 30. Fibroadenoma may be associated with fibrocystic changes, proliferative epithelial changes, and extremely rarely, with non-invasive and invasive cancer. Malignant transformation of a fibroadenoma is rare with only about 100 cases reported in the world literature. A 38 year old Indian lady operated previously for fibroadenoma of the right breast presented with a recurrent lump at the same site. She had a strong family history of breast carcinoma. Mammography and trucut biopsy was suggestive of infiltrating duct carcinoma. She was managed by modified radical mastectomy with a satisfactory outcome. There was no evidence of BRCA- 1, BRCA-2 mutation on immunohistochemistry. Fibroadenoma occurring in middle aged woman with a strong family history of breast or ovarian cancer should be investigated with a high suspicion for malignancy.

 With the highest adolescent population in India, the real challenge for the nation is to provide nutrition, health and education in this segment, especially for girls, according to UNICEF report. The Integrated Child Development Services (ICDS), a countrywide programme of the Government of India, offers a fundamental intervention for addressing the nutrition and health problems and promoting early childhood education among the disadvantaged population of the country. The ICDS programme successfully works through a network of over 946,000 village level anganwadi center (AWCs) setup at the community level across 5,959 development blocks and urban slums. Based on the consistent reports from recent journals and articles related to ICDS services and their functioning throughout the country, it has come to light the fact that 81.4% adolescent girls are unaware of the ICDS programme in the country. Among the remaining 18.6% adolescent girls, the services provided to them were inconsistent and incomplete as they were also unaware of the various services.Keeping this in mind the following project is based on the services being provided by the individual anganwadi services concerning to mainly the girls of adolescent age group (10yrs-19yrs).So we have undertaken this project to highlight the service utilization by adolescent girls at anganwadi centres of urban slums of Bellary city and also the factors influencing the service utilization by adolescent girls.

 Systemic lupus erythematosus (SLE) is a systemic autoimmune connective tissue disease more precisely a type III hypersensitivity reaction that can affect any part of the body. SLE is a disease of remissions and flares; a clinical activity index would enable standardisation of definition of flare and measurement of reduction in disease activity in response to treatment. Such scales could then be used to dictate the need for or response to treatment in clinical trials or to monitor the course of disease in longitudinal studies of outcome.

 The popularity of portable listening devices (PLDs) including iPods has increased dramatically over the past decade. PLDs allow users to listen to music uninterrupted for prolonged periods and at levels that may pose a risk for hearing loss in some listeners, particularly those using earphones. Many of them use earphones while driving and walking on the streets thus posing the risk of accidents. This fact and the very limited studies in this field aroused our interest to pursue this topic.

 According to UNAIDS it is estimated that 38% of adults living with HIV/AIDS are women. The increasing prevalence of HIV among women can consequently be seen in the form of increased mother to child transmission of HIV and nearly five percent of infections are attributed to it. Preventing unintended pregnancy among HIV-positive women constitutes a critical and cost-effective approach to primary prevention of mother-to-child transmission of HIV and is a global public health priority for addressing the desperate state of maternal and child health in HIV hyper-endemic settings. However, very little is known about the knowledge, attitude and practices about contraceptive usage in HIV couples. There is also a need to know about the factors influencing the choice of contraceptive measures and the level of awareness of mother to child transmission of HIV and its prevention which explains the rationale behind the work.

 Acute Rheumatic Fever (ARF) is a common disease in India. It inevitably damages the heart resulting in Rheumatic Heart Disease (RHD), thereby crippling the patient for life. Fortunately it is a preventable health problem. This study was done to find out clinical profile, risk factors, compliance with treatment and outcome of RF/RHD cases so as to help medical practitioners in better case management and for suggesting preventive remedies.

 Breast cancer is the most prevalent malignancy amongst women in India. Due to theincreasing use of multimodallity approach, there is an increase in the number of long term breast cancersurvivors. To determine the long term effects of breast cancer and to evaluate the complete outcome ofcancer treatment, it is essential to assess the quality of life (QOL) in breast cancer survivors.

 The aim was to evaluate and correlate anxiety and depression levels with response to neoadjuvant chemotherapy in patients with breast cancer. The study also assessed the effects of family support on distress levels.

 Recognizing the prevalence of sickle cell anemia in Yavatmal district, the study was carried out to find out distribution of the disorder in Yavatmal and to study the extent of various manifestations in homozygous sickle cell cases & correlate them with fetal hemoglobin levels using HPLC.

 Cervical cancer has become the most common cancer in women claiming about 72825 lives per year, in India. The initial changes that may occur in some cervical cells are not cancerous. However, these precancerous cells form a lesion called dysplasia or cervical intraepithelial neoplasia. Dysplasia is a common condition and the abnormal cells often disappear without treatment. However the precancerous cell may become cancerous.This can happen in less than a year. Moderate to severe dysplasia may be called carcinoma in-situ. Eventually, the abnormal cells grow uncontrollably into the deeper layers of the cervix, becoming an invasive cervical cancer. The screening for cervical cancer is done through Papanicolaou test which has 72% sensitivity & 94%specificity  Though the incidence of cancer cervix have reduced in the urban population but its rate is still alarmingly high in the rural sector. Through the analysis of the results obtained from the study, we wish to reduce the incidences of cervical cancer by educating the rural women about the risk factors and the importance of pap smear screening.

 To report the outcomes of antiretroviral therapy (ART) in treatment-naïve acquired immunodeficiency syndrome (AIDS) patients, treated under programmatic conditions in a resource-constrained setting and the occurrence of TB and other opportunistic infections.

 Among younger generation the problem of substance has increased by alarming rate in India. Leading causes for this increase has been changing cultural values increasing economic stress and dwindling supporting bonds. To study the perceptions concerning substance abuse among college going students, to assess the attitude and practices related to substance abuse among the subjects and study the socio-demographic factors influencing substance abuse.

 Diffusion MRI is an essential and very useful tool for stroke patients. While it takes hours to reach a diagnosis of ischemic stroke with conventional MRI, CT. Diffusion waited MRI allows detection of disease within minutes. But this technique is not available yet in many hospitals in India, so increasing the mortality rate. It is essential for accurate and early diagnosis of ischemic stroke in ensuring patients receive prompt treatment which improves there chance of survival and increase their likelihood of recovery

 Hyperthyroidism is associated with decreased libido, impotence and gynaecomastia due to raised levels of oestradiol suggesting a hyperestrogenemic environment. In adult rodents sexual dimorphism of hypothalamo-pituitary axis is complete and cannot be influenced by any epigenetic influence. Therefore, under no environmental and epigenetic influence can the sexual dimorphism of the pituitary gland be abolished in these animals. To find out whether such sexual dimorphism of hypothalamo-pituitary axis exists in humans too, we studied the relationship of the peripheral gonadal steroid with the circulating gonadotropins, markers of hypothalamo-pituitary axis function in hyperestrogenic, hyperthyroid males. We chose a disease model, as experimental hyperestrogenism cannot otherwise be induced in healthy human male subjects

 Reaction Time is a reliable indicator of processing of sensory stimulus by central nervous system and its execution in the form of motor response. Our study aimed to evaluate the effect of hyperglycemia and other complications of Diabetes Mellitus on the central processing of signals and on peripheral nerves. 

 Mismanagement of hospital waste has the potential to cause healthcare facility associated infections, and can often be traced to inadequate training and awareness among healthcare workers (HCWs)

 Telepathy has remained a subject of interest and exploration immemorial. Emotional quotient (EQ) has also emerged as a topic of interest among scientists and sociologists worldwide. This small study was undertaken to explore any existent or potential link between telepathic potential (power) and EQ. The participants were subjected to tests for EQ score and telepathic potential as available on worldwide websites. Every subject got a chance to act as transmitter and receiver. The average telepathic potential of each subject was calculated as the mean of the average values of transmitting and receptive powers. The results reveal an apparently existing link between telepathic potential and higher EQ scores. Based on the results and keeping in view the fact that EQ can be improved raises an interesting possibility of enhancing telepathic potential in humans, thus providing a potentially novel form of communication. This telepathic potential has also been proved in various other forms of life including plant kingdom. Thus this interesting finding can also be applied in these living systems in their various accessible functioning and exploration associated with them like reviewing their memory of the past times to formulate them in to motion pictures and also in the defense system to prevent cross-border terrorism.

 In elderly persons,etiology of anemia differs sufficiently from the etiology in younger adults to warrant considering anemia in elderly as a distint entity.The clinical element in treating anemia is to identify reversible etiologies for the anemia.

 Outpatient care is any health care service provided to a patient who is not admitted to a health facility, which is often supplemented by medications administered at home. pediatric patients are exposed to up to 3 times the rate of potentially dangerous medication errors compared to their adult counterparts. The reasons for poor compliance are mainly discontinuation of treatment, say, when the patient felt better or when the immediate expected results of therapy did not appear. either of the reasons is based on deliberate action,misinterpretation or inadequate information. We conducted this study to assess the level of understanding of the prescriptions among the attendants’ of the pediatric patients at the outpatient department of Government Wenlock Hospital and also identify reasons for misunderstanding,as understanding the prescription completely is of prime importance for therapeutic response.This would help in suggesting remedial measures to improve the understanding of the prescriptions and the patient compliance.

 A strong blood donor program is the life force of any transfusion service and the goal of every blood donation system is to have a stable, safe and adequate blood supply. Continual monitoring of the demographics of the blood donor population of any community is required to identify the problems in and direct efforts towards reaching this goal.Our Aim was to study the socio- demographic profile of blood donors and analyze the reasons for deferral.

 Post caesarean wound infection is a leading cause of morbidity and prolonged hospital stay. In order to prevent it, it is important to understand its etiology and risk factors.Patients and method: Women with post caesarean wound dehiscence were critically analyzed as regards the incidence,demographic profile and risk factors in the antepartum, intrapartum and postpartum period.

 Suicide is the most common cause of death amongst medical students. The recent incidence of suicide by a medical student at one of the Nation’s leading medical college prompted a search for similar incidents of suicide in India from January 2010 onward. In this study, we tried to study the suicide among medical students in India over a period of two years.

 Introduction:Iron deficiency anaemia (IDA) is most prevalent among Indian women in reproductive age from lower socio economic strata (95% of women with anaemia suffer from IDA). This study was done with the intention of finding efficient substitutes in the form of non haem iron of vegetable origin i.e. moringa oleifera leaves(drumstick) and jaggery to treat anaemia.

 Though declared eliminated by WHO, leprosy still remains a commonly diagnosed problem in developing countries. Hence it is essential for clinicians to correctly label, report and treat every case of leprosy

 India is one of the largest and most populated countries in the world, with over 1 billion inhabitants, of whom 2.5 million are living with HIV. This crisis deepens as it becomes clearer that the epidemic is affecting all sectors of Indian society and not just the high risk groups. The Aim of our study is to evaluate the socio-demographic profile of attendees at the VCTC/ICTC at KMC Hospital Mangalore and assess the presence of high risk behavior pattern among them.

 Globally, breast cancer is the most common neoplasm in women. Late presentation contributes to poor outcome and high fatality rate. Most successful approach to decrease mortality due to breast cancer is the application of secondary prevention which includes Breast Self-Examination (BSE), Clinical Breast Examination (CBE) and Mammography. Mammography is expensive and technology driven. BSE is easy, cheap and self monitored. Therefore, it is important to empower women on the BSE as a primary tool for screening especially among the high risk group in developing countries. Despite the effectiveness of BSE in reducing mortality, research findings indicate the screening rates remain low. The foremost barriers being forgetfulness, lack of time, ignorance, fear and anxiety and low level of education. The health care workers play an important role in communicating health behaviours to the public hence it is important to assess the level of knowledge regarding the BSE as well as their attitude and practice towards it.*Methodology A sample size of 200 randomly selected female health care workers (HCW) (107 doctors & 93 nurses) was taken. A selfadministered, pre-tested, structured, close ended questionnaire was used to assess the knowledge of breast cancer, breast self-examination and responses to the practice of breast self examination by the study subjects.

 Gastric cancer remains one of the most common cancers in Asia. Gastric carcinoma is the third most common cancer in India and the second leading site of cancer occurrence worldwide. According to the data provided by the Department of Pathology, Kasturba Medical College, Mangalore and literature, incidence of gastric carcinoma is increasing. This study was done to find out the proportion of gastric cancer& the associated factors.

 Dermatological manifestations are seen at every stage of HIV/AIDS, and are often the presenting features. These manifestations not only act as markers but also reflect the underlying immune status. .This study is an attempt to observe the various mucocutaneous manifestations and the corresponding CD4 counts. This study also included the comparison of mucocutaneous manifestations between patients on antiretroviral therapy (ART) and those who are not on ART (treatment naive cases).

 The problem of negative appendectomy has long been recognized. This issue has been studied in west and recommendations are made to decrease it, however such studies from developing nations are scarce.Aim: To identify the rate of negative appendectomy at our Institute and compare the results with the world statistics with emphasis to undertake measures for decreasing its incidence.

 Human immunodeficiency virus(HIV) and the acquired immunodeficiency syndrome (AIDS) has a profound effect on practice of medicine in 20 years since its discovery. Initially a disease of homosexuals and haemopheliacs,now it affects individuals of every age, sex and socioeconomic group, becoming a worldwide epidemic and spreading into regions of globes such as SE asia.In 2008, there were about 4.7million [3.8million- 5.5million] Asians living with HIV/AIDS including 3,50,000 [2,60,000-4,00,000] who became newly infected in 2007, also about 21,000 children were newly infected with HIV. Head and neck manifestations of disease are prevalent, and upto 100% of HIV patients will have some head and neck presentation of the disease during the course of their illness.Often an Otolaryngologist is the primary physician to diagnose HIV infection. They represent a diverse spectrum of diseases ranging from common complaints treated as sinusitis and otitis media to unique presentations.

 Impact of HIV on Specific Biological Parameters.Ramesh K, Gangadhara Goud T, Sangeetha Gandhi,Vishwas RaoBackground: AIDS is a pandemic now. It has multiple risk factors and of all the risk factors, sexual behavior acts as a double edged sword. On one hand, the risk of HIV acquisition is known to be closely associated with unprotected sexual intercourse and on the other, diagnosis of AIDS is shown to have a paramount importance on the sexual behavior of the person. Research shows that there are HIV infected people who do engage in unprotected sex, just as there are HIV negative people or people with unknown sero status who do so. Sex is an integral part of one’s living. As we extend our vision to the effects of sexual behavior following diagnosis of AIDS from conventional view of sexual behavior as a risk factor, other curious questions take wings. How exactly does diagnosis of AIDS have its influence on sexual behavior of the diseased? Does the diagnosis of HIV positive help in reducing the risky sexual behavior or do people still opt to continue the same way? In this study we have tried to discover answers to some of these questions. Methodology Study Area: ART Centre,Vijayanagara Institute of Medical Sciences Bellary, KarnatakaStudy design: Case - series study.Study period: March 2010 to September 2010. Study Population: HIV positive patients coming to the ART centre for seeking treatment.Sample Size & Sampling technique: Totally 100 patients included for the study based on consecutive sampling technique.

 Medically inappropriate, ineffective and noneconomical use of pharmaceutical products is commonly observed in the health care system throughout the world and especially so in developing counties. Inappropriate prescription increases the cost of medical treatment and increases morbidity and mortality. The rational use of drugs requires the patients to receive medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time and at the lowest cost. Rational prescribing forms the corner stone of successful implementation of the rational use of drugs. There is an urgent need to ensure that patients are always given evidence-based, cost-effective and rational treatments. Children constitute about 40% of the Indian populations . One significant study has shown that potentially harmful medication error can be three times more common in paediatric population than in adults. Therefore the present study was planned to understand the prescription pattern of paediatric patients in the Yavatmal District, India.

 Chronic myeloid leukaemia (CML) is characterized by the increased and unregulated growth of myeloid cells in the bone marrow and the accumulation of these cells in the blood. In 95% of cases it is caused by the product of the BCR-ABL oncogene, located on the Philadelphia (Ph) chromosome, which is generated as a result of a reciprocal t(9;22) chromosomal translocation. P53 is a tumor suppressor gene involved in DNA repair, induction of growth arrest and apoptosis. The p53 gene is the most commonly mutated tumor suppressor gene in human cancers. In addition to the loss of tumor suppression activity, gain of function mutations in p53 can promote tumorigenesis and drug resistance in various types of human cancers. A common p53 polymorphism occurs at codon 72 of exon 4, with two alleles encoding either arginine(CGC) or proline(CCC). This polymorphism is associated with leukemia susceptibility

 With increasing incidence of non-communicable diseases in the society, we decided to study the frequency of diabetes mellitus, hyperthyroidism, cardiac disease, kidney and liver disease, lipid abnormality, prostate/ cervical cancer in subjects coming for routine health check up by use of multiphasic screening on age criteria . Method: Brief detail of participant’s family and personal history was taken followed by complete physical examination and battery of test was conducted. Frequency of disorders was calculated and statically analyzed. Result: Out of150 asymptomatic subjects, 104 were male and 46 female. The prevalence of non communicable disorders is highest among middle age group. Diabetes mellitus was the most common non communicable disorder found in the earlier asymptomatic participants (20%) with highest number of cases in middle age group. Hypothyroidism was next common disorder amongst the 8 non communicable diseases taken. We found out that high level of SGOT, SGPT and Alkaline Phosphatase which are the main criteria for detecting the liver abnormality was on an average higher in the middle age group. The level of LDL and cholesterol was higher in male as compared to female and in middle age group as compared to other age group. The prevalence rate of disease was common in males than in females. The results were in accordance with the study done by Collen, Rubin and Davis in 1964 who reported the advantages of automation and computer analysis in screening with economy heading the list. With sedentary lifestyle and poor diet habits, there is a transition from death due to communicable disease to death from non communicable diseases in our country. The increasing stress and the workload contribute to the increasing number of cardiac disorders in the population. Our study concludes the benefit of multiphasic screening program in asymptomatic persons coming to hospital for routine health check up. Taking in the consideration, the parameters studied in the study, it would be of interest to further investigate the screening program of non communicable diseases to modify the natural course of disease and hence reduce the cost factor associated with treatment at later stage.

 Iron deficiency anaemia is one of the most commonly encountered problem in clinical practice. It is associated with poor concentration span,poor quality of life and low energy levels. Treatment options include blood transfusion,oral iron, intravenous iron replacement with iron sucrose. Among them intravenous therapy with iron sucrose has been shown to improve anaemia quickly and effectively

 Iron deficiency anaemia (IDA) affects nearly two thirds of the pregnant women in developing countries. It is associated with 20 percent of all maternal deaths and nine times higher risk of perinatal mortality. In India, the National Nutritional Anaemia Control Programme (NNACP) was initiated in 1970 to provide free iron-folic acid supplementation to all pregnant women. But NFHS-III, 2005-06 has reported a rise in prevalence of IDA. Our study compares the efficacy of oral Iron Folate with jaggery, with Oral iron Folate alone and IV iron sucrose complex (ISC) for treatment of IDA of pregnancy to find the most suitable therapy which can provide maximum benefit to the patient in minimum cost and with minimum side effects.

 Presence of angiotensin converting enzyme (ACE) in aqueous humor and other ocular tissues has been earlier demonstrated. ACE inhibitors used topically may lower the IOP by increasing the uveoscleral outflow and may also have a neuroprotective effect without the systemic side-effects. The present study evaluated the oculohypotensive effect of enalaprilat in comparison to timolol using an IOP recovery model. 

 Emergency surgery is defined as non elective surgery performed with the aim to prevent morbid or fatal health consequences of a surgically treatable disease. It is one such situation where surgeon is faced with therapeutic dilemma.

 Diaphragmatic injuries have always posed diagnostic and therapeutic challenges to trauma care physicians. The presentations vary from gross hemodynamic instability and cardiac arrest to GIT obstruction and respiratory insufficiency from weeks to years later. Patients were found to be asymptomatic in upto 53% of the hernias resulting from blunt trauma to 44% from penetrating trauma .Lack of a single reliable radiological diagnostic modality and concomitant multisystem injuries often complicate diagnosis by shifting attention away from the diaphragmMotor vehicle accidents cause blunt diaphragmatic injury with penetrating injuries resulting from gunshot or stab wounds. Traumatic rupture of the diaphragm together with concomitant abdominal injuries dictates the need for emergency surgical intervention after initial resuscitation. Patients who present late require surgical repair as gut viability may be compromised.Chest radiology, CT Scan, Focused Assessment by Sonography in Trauma (FAST) and MRI scan are the main diagnostic pillars.Initial management is as per ATLS protocols. This is followed by an emergency thoracotomy with one lung ventilation (OLV) as part of the anaesthetic technique. Invasive hemodynamic monitoring along with monitoring of respiratory parameters in the peri-operative period is the dictum. Post-operative management in an Intensive Care Unit with haemodynamic, biochemical, haematological, neurological and ventilatory management are an integral part of treatment. Thereafter, rehabilitation of polytrauma victims by chest physiotherapy and other modalities needs to be carried out for optimal patient outcome.The surgical approaches could be either diagnostic or therapeutic, open or minimally invasive, by a thoracotomy or laparotomy, as per protocols being followed by individual trauma units and surgeon preferences. Post-operatively such cases frequently require ICU care with/without ventilatory support and/or hemodynamic interventions, maintaining scrupulous asepsis, good nursing care, adequate sedation, appropriate resuscitative measures, etc. such measures auger well for patient recovery. Ventilator associated pneumoniae (VAP), sepsis and DIC, especially in cases of polytrauma, are causes of great concern. A few cases are being presented to illustrate the various management strategies involved. Case 1: A 39 year old male presented with blunt chest trauma with multiple rib fractures and acute onset respiratory distress. Patient was resuscitated, found to have left sided traumatic rupture of diaphragm with herniation of viscera into the thoracic cavity. Patient underwent emergency thoracotomy with repair of diaphragmatic tear, reposition of herniated viscera and ICD insertion followed by ventilatory support in the ICU.Case 2: A 22 year old male presented with history of stab injury to left upper abdomen and breathlessness and features suggestive of hemorrhagic shock. Patient underwent emergency laparotomy with splenectomy and repair of stomach tear, suturing of diaphragmatic rent and ICD insertion. He was shifted to the ICU for observation and further management. Case 3: A 30 year old female presented with history of road traffic accident, sudden onset breathlessness, bilateral chest trauma with features of hemorrhagic shock. Patient was trapped in an automobile and extricated from the mangled wreck. Patient was resuscitated, underwent thoracotomy with repair of diaphragmatic tears, splenectomy and bilateral ICD insertion followed by ventilatory support in the ICU.Case 4: A 60 year old male with a gunshot injury to the abdomen was brought to the emergency, being referred from a private hospital. Patient was disoriented at the time of presentation. After appropriate resuscitation patient underwent exploratory laparotomy with splenectomy and repair of a transverse colon perforation(splenic flexure). A small diaphragmatic rent found on exploration was also repaired.Case 5: A 48 year old mason working at a construction project had fallen from a height of about 20 feet onto iron rods resulting in penetrating trauma to the chest and abdomen. Patient underwent exploratory laparotomy with splenectomy, partial gastrectomy with repair of multiple diaphragmatic perforations with bilateral ICD insertion.Patient was transferred to ICU for elective ventilator support.

 Cervical cancer, one of the few highly preventable cancers through successful screening, is the most common cause of death from cancer in women in the developing world. Successfulness of any screening program depends on the screening modality being used. The present screening modalities used in the screening for cervical cancer such as, cytology; VIA; HPV DNA screening and optical spectrometry, failed in decreasing the toll of disease in developing world owing to lack of their adequate sensitivity, specificity, reproducibility, affordability, complicated, and the most important is non-real time to ensure wide coverage through screen and treat and curtail loss to follow up. This brief hypothesis postulates a screening tool aimed to have a real time screening of cervical cancer using LIBS modality. Laser Induced Breakdown Spectroscopy (LIBS) is a spectrochemical method for determining the elemental composition of various samples present in any phase, by simultaneously vaporizing and exciting the sample and thus it improves the spectrochemical techniques by eliminating the requirement of sample pre-treatment. LIBS system focuses a high peak power laser pulse onto a targeted material to produce a laser spark or microplasma. Elemental line spectra is created, collected and analyzed by a fiber spectrophotometer since nano- to micro-grams of material are ablated in femto- to nano-seconds (depending on the laser pulse duration), the whole process can be considered as minimally destructive and real time.The postulated hypothesis is aimed to use laser induced breakdown spectroscopy (LIBS) in the screening of cervical cancer as trace mineral elements acts as biological signature in tissues like bones, teeth, hair, blood, etc., from the living phase and store information regarding habitat, nutrition, and other environmental conditions. Previous researches have shown significant differences in concentrations of trace elements between normal and cancerous tissue cells, so modulation of trace elements level in both benign and malignant tissues may be of potential to be used as diagnostic marker of the disease process and its possible relationship etiologically. This will be achieved by focusing a high peak power laser pulse onto the cervical transformation zone under full visualization, as it is the location where cervical dysplasia most often occurs and used for cervical cytology scrapings and VIA and recording and analyzing the emission wavelength. The technique is exemplified by suggested use of LIBS in studying biological samples such as tissues, gall stones, biological aerosols and in vivo cancer detection. Finally, the hypothesized concept can also be used in other fields like forensic medicine in determining the time of death of an individual by assessing the change in the trace element concentration in different body parts with time and in suspected snake bite cases, to whom we just keep under observation, by determining the change in serum carbon and nitrogen which is the main component of snake venoms as like any other protein to just rule out envenomation in real time.

 College is the best time of life for almost all young adults. However, in the face of cut throat competition, academic demands and family expectations these years maybe undermined by anxiety, depression, substance abuse and sleep disordersAccording to the Centre of Disease Control and Prevention, 7.8% of men and 12.3% of women in the age group of 18-24 years reported frequent mental distressQuality of life is a multidimensional concept defined by WHO as “an individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’’It is a broad ranging and holistic concept incorporating in a complex way the persons’ physical health, psychological state, level of independence, social relationships, personal beliefs and their relationships to salient features of the environment With this study, we endeavoured to compare the quality of life and prevalence of mood disorders, predominantly Stress, Anxiety and Depression, in a cross section of students from various fields so as to assess the overall well being.

 Interpleural and paravertebral blocks are indicated for providing intra operative and post operative analgesia in unilateral surgeries of the chest and abdomen including breast surgery. The aim of this prospective randomized study was to evaluate the intra operative analgesic requirement, haemodynamic parameters, efficacy and duration of postoperative analgesia and the possibility of home readiness of patients receiving paravertebral block or interpleural block as an adjuvant to general anaesthesia.

 There is a high burden of anemia in India. IMNCI advocated identification of anemia by observing palmar pallor. Hence this study is taken up to compare IMNCI tool- palmar pallor and SAHLI‘S method in detecting anemia among under five children.

 An Ostomy is a surgically created opening to discharge waste from the digestive or urinary tract. A stoma is the actual end of the small or large bowel or ureter that can be seen protruding through the abdominal wall. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel and the colon. The most common intestinal stomas are the ileostomies (end and loop) and the colostomies (end and loop). Although great advances have been made with regard to stoma formation and management, both early and late complications are common. Various Indications for which intestinal stomas are formed: Ulcerative Colitis, Bowel obstruction, Cancer of colon & rectum,Crohn’s disease, Congenital Bowel defects, Uncontrolled bleeding from large intestine, Injury to the intestinal tract, IBD, Ischemic Bowel disease, Carcinoma Urinary Bladder and Spinal cord injury. Typhoid and tuberculosis being the frequent causes of acute enteric perforations, remains a public health problem in our part of world.Despite Extensive Surgical expertise, complications after stoma creation still occur and often cause social isolation and a significant reduction in the quality of life. Though the formation of a stoma is one of the easiest procedures for a practicing surgeon, complications such as leakage, prolapse, parastomal hernia, retraction and stenosis still occur frequently.Aims and Objectives: To identify common indications and complications associated with intestinal stoma in a tertiary care set-up

 Elderly person experience a complex array of physical, psychological and social changes while they struggle to adjust with the aging process .Depression which contributes a major health related issues and despite high prevalence it still remains under diagnosed. Salutogenesis or genesis of health as opposed to pathogenesis is a concept establishing the sense of coherence or integrity of an individual as one of the key factors in genesis and maintenance of health.

 Irrational use of medicines is a major problem worldwide. It is a major cause for increased healthcare costs due to loss of intended therapeutic benefit, development of drug resistance and adverse drug reactions. Previously, many drug utilization studies carried out in various medical centers in India have highlighted the practice of irrational use of medicine. In general, lack of awareness, time, and incentives in conjunction with unavailability of standard treatment guidelines, and lack of access to essential medicines and low level of information about medicines within the institutional set-up have been implicated for irrational prescribing behaviour. However, the relevance of these factors in promoting irrational use of medicines has not been systematically explored in India. Our study was undertaken to survey the physicians’ knowledge, attitude, and perceptions towards rational prescribing and use of essential medicines in the departments of Medicine, Pediatrics and Surgery. A composite, prevalidated questionnaire, based on survey instrument of Theodorou et al (2009) and WHO drug use indicators was used for data collection. Respondents’ from the three departments included physicians with varying designations (Non-PG junior residents, PG-junior residents, senior residents and faculty members) qualifications, and experience and there was considerable variation in the responses obtained in the survey. Specific educational and administrative measures would be useful in promoting rational use of medicines amongst physicians in the tertiary set-up. Submitted by Sumit kumar Ridhima kaul Guided by Dr. C D Tripathi Dr. Biswa Mohan.

 Fibroadenoma of breast is a common cause of a benign breast lump in premenopausal women. as progress a solitary lump should always be differentiated from carcinoma.

 Practices and beliefs about the care of newborn infants have evolved over generations. Often the intent is healthy, but the consequences may be unbeneficial, inconsequential, or even harmful. Infant rearing practices are varied and are determined by the educational status, social and economic factors, cultural and religious beliefs of the mother, which reflect on the society as a whole.The objective of our study was to understand the knowledge of the rearing practices among mothers attending government health services in Mangalore.

 The advent of Corticosteroids has revolutionized the treatment of various inflammatory and auto immune disorders. They provide the answer to everything ranging from a cosmetically disfiguring skin condition to a life threatening anaphylactic shock. But the flip side to the coin is the wide spectrum of horrifying side effects that accompany the chronic use of these drugs . Side effects range from trivial irritants such as oral ulceration to grossly debilitating conditions like osteoporosis. Needless to say, the most commonly seen side effects like moon face, weight gain and buffalo hump which adversely the alter physical appearance are highly unacceptable to most patients, especially women, directly affecting patient compliance.It is unfortunate that in this day and age the medical fraternity has turned a blind eye to the physical and mental agony faced by the patients on a chronic regimen of corticosteroids. Most physicians do not give adequate pre medication counseling nor do they prescribe any preventive measures to minimize this misery. We must keep in the mind that these patients are already suffering from a chronic and often serious disorder. The aim of medical science is to ameliorate this suffering, not add to it. No doubt some degree of adverse effects are unavoidable, but we can optimize the situation and prevent most major issues by suggesting certain simple precautions.This study has been undertaken to analyze what are the commonly encountered side effects and how they can be tackled and reduced to a bare minimum by following simple and effective techniques. These methods can be employed directly by patients or can be used by health educators as part of a pre treatment counseling programme. The first part of the study deals with side effects. A large cohort of patients taking corticosteroids on a long term basis were analyzed. Some of the pertinent questions addressed the following issues :- what percentage of patients were given pre treatment counseling, whether it was adequate or not, what were the points covered and whether or not compliance was effected. The results of the study have been evaluated and summarized.The next part of this study deals with solutions. I have attempted to integrate the wisdom of senior physicians, patients’ personal experiences with the drug, and even indigenous system of medicines found in Ayurveda to provide sustainable and do-able solutions.

 Project Village-Reach aims at developing a publicprivate partnership to deliver comprehensive healthcare in rural communities. This will be achieved by strengthening the ASHA worker, ( provided by the government under the NRHM), improving her outreach, and ensuring accessibility of health services by training CHWs (community health workers) to work under her. CHWs will be chosen from the villages , to provide education, information about public infrastructure, and to form the vital link between the community and the ASHA worker, and thus further to the public facilities. •Personnel Required -One ASHA worker, 5 CHWs and One sanitary supervisor. •Equipment- 6 moblie phones, One motor cycle, training and educational material. •There will be 5 Community Health Workers under one ASHA worker. CHWs will be equipped with zerotext educational material and a mobile phone,. They will go door to door to provide education. about hygiene, sanitation , health care, family planning, potable water, etc . They will distribute ORS, chlorine tablets, Over the counter drugs, contraceptives,pain killers,mosquito nets to the needy, and iron , calcium ,vitamins, protein supplements for children and expectant mothers.They will be responsible for providing life saving measures in emergencies and organising ambulance facilities. One CHW will be “ on call” around the clock to attend to emergencies. They will be given cash incentives for emergency care, immunization of children and expectant mothers, successful completion of dots therapy etc. For training purposes we will collaborate with non profit organizations. The sanitary officer will provide a link with the municipal corporation and organize maintenance activities like drainage of stagnant water pools, spraying of mosquito repellent,clearing of garbage etc. They will also teach proper hand washing techniques and distribute soaps.

 Blood is a vital healthcare resource used in a broad range of hospital procedures. It is also a potential vehicle for harmful, and sometimes fatal, infectious diseases, such as HIV, hepatitis B and C. Every year, millions of people are exposed to life-threatening risks through the transfusion of unsafe blood which is completely avoidable. Optimizing blood collection and processing would reduce the rate of discard of blood and improve the efficiency of blood transfusion services and make available safe blood for the needy, also preventing potentially deadly iatrogenic infections.

 To know effect of regular counselling will on the incidence of exclusive breast feeding in the interventional group.2. To measure the impact of programme on weight of the infant at 6 months.

 Should routine contrast study be a norm before stoma reversal? A retrospective study of patients with temporary ileostomy after emergency laparotomy.***IntroductionA large number of patients with acute abdomen undergo emergency laparotomy. Many of these patients are found to have pathologies of small bowel where a primary repair is not suitable. A temporary ileostomy in such cases may not only be life saving but also a better option [1, 2]. In developed countries most temporary ileostomies are made to protect a distal anastomosis and it may be prudent to do a contrast study before stoma reversal to check for anastomotic leak or stricture [3]. This may not be true for all our patients where stoma is made for a different indication. At some institutes a routine contrast study is not done at all before reversal of ileostomy [4], although it is a routine practice at our institute. It burdens the hospital resources [4], exposes patients to radiation and increases the cost to patient. The waiting period for a contrast study adds considerably to the overall waiting time. Delay in stoma reversal is associated with increased morbidity [5] and affects quality of life [4]. Early closure is associated with less stoma related complications [6].This study tries to examine the reports of contrast study of ileostomy patients who underwent stoma reversal subsequently. The surgical records of these patients at time of the index operation will also be scrutinized especially for surgeon-documented intra operative findings. A statistically significant correlation between the two findings will be sought. If the findings correlate then it may be reasonable to reverse stomas without routine contrast study in selected patients where the surgeon has clearly documented a normal distal bowel. The study will also look at other parameters that have a bearing on patient care and the institution. Studies addressing similar issues in such patients with temporary ileostomy could not be found on literature search.

 Adolescents and young adults (15-24 yrs) are at greater risk of acquiring Sexually transmitted diseases. Lack of knowledge and information can lead to lack of health. Aim of the study was to assess the level of knowledge about sex related issues in youth and their willingness to discuss about the same.A cross sectional survey using a self administered questionnaire was conducted among 150 students (59 medical and 91 non medical) of two college of Delhi.The questionnaire contained questions regarding knowledge, attitude, practices of sex and suggestions about sex education and related issues. Personal details were optional. The study was promoted and sponsored by STS program of ICMR.There were 120 girls and 30 boys who participated in the survey. 38.67% (58/150) have never received any form of sex education.90 % (135/150) never approached anybody for sex education. 75% (112/150) never discussed sex related issues with their parents. 26% (39/150) still had queries regarding sexual issues. Minimum age for onset of sexual activity is 20 yrs. 45% (41/91) of the non medical college students do not have any idea about contraception. Only 13.2% (12/91) of the non medical students knew the name of another STD other than AIDS. But, overall 84.67% (127/150) knew that condoms provide protection against STD’s and 44% (66/150) are willing to use condom as contraceptive. 62.7% (94/150) felt that a lecture on sex education should be included in the curriculum.The results infer that there is hesitancy among youth to approach about sex related issues. There is communication gap between the parents and the children regarding sexual issues. Knowledge regarding STD’s and contraception is poor among non medical students. It is promising that the knowledge and attitude towards condom use is good among the youth and they are receptive towards sex education.

 Breast Cancer is the leading cause of mortality and morbidity in women world-wide. The present study attempts to highlight some of the clinico-pathological features of breast cancer patients seen at a tertiary cancer care center. The parameters studied included age, menopausal status, morphological patterns of tumor, histological grade and stage at presentation. Various predictive imminohistochemical markers like Estrogen (ER), progesterone (PR), human epidermal growth factor receptors (HER2), BRCA I and II were also evaluated. Patients and method: All patients registering for breast cancer treatment from 2003 to 2011 will be evaluated using a specified proforma. Mean and standard deviation and Odds ratios along with 95% confidence intervals were estimated. The statistical analysis was done using Chi2/Fisher’s exact test for proportions.

 Problem statement: Prevention and cure are the basis for public health. When disease has started, curing it efficiently and effectively decreases the mortality and morbidity to a large extent. Apart from the disease cause, appropriate and timely intervention has a huge impact on the outcome. This present study is focused on the various factors affecting this appropriate timely intervention at the level of parents, basic health care system and transport to the tertiary care. It is intended to study some non-pathological factors (missing links) like lack of awareness regarding new borne care and identifying danger signals and factors leading to the delay in bringing the child to proper health care facility. Infant mortality is high(44/1000) in India. A major fraction (two thirds) is constituted by the young infants (up to 2 months). In this study we have taken young infants as subjects.Methods: This is a tertiary care hospital based cross-sectional study of young infants, conducted at Institute of Child health, Niloufer Hospital. The study period is 60 days we have included 400 young infants from those admitted in NICU and wards excluding the ones admitted directly from our labour room/OT or directly from that of another hospital. The infant’s guardian is investigated with a detailed questionnaire. The data obtained is analyzed to study the factors delaying the timely arrival of the sick young infant to a local hospital/ Tertiary care centre; study the level of awareness of household members regarding identification of sick young infant at home; study whether mothers/ decision makers were imparted knowledge regarding newborn care and danger signs at the time of delivery and later.Results: final results will be presented as the study is completed. At three fourth the way in the study some facts found include; none of the parents were counseled anything about child care at any health institution but the daayi’s gave the counseling in instances when they did the delivery; illiterates and highly educated people scored less delay compared to the less educated; people giving home remedy is very less than expected ;the anganwadi system has a significant coverage of population which could be exploited more;…Conclusions: will be made when study is completed.

 To find out the level of awareness & attitude towards pharmacovigilance and extent of ADR reporting in healthcare professionals & medical students.

 The drug resistance in nosocomial S.aureus is very common. The primary objective was to study the drug resistance in nosocomial S. aureus with special reference to methicillin resistance and inducible clindamycin resistance and to study the types of infections caused by methicillin resistant S. aureus (MRSA) and methicillin sensitive S. aureus (MSSA).

 The incidence of concomitant common bile duct stones varies between 8% to 20%. Common bile duct management has been a challenge to the surgeons since time immemorial, with gaining expertise in procedure like ERCP which is considered as the first and promising approach to this problem. The CBD stones are managed either by ERCP or surgery. Our study is an effort to categorize patients with CBD stones to be intervened either by ERCP or surgical procedures with an objective to study the efficacy of endoscopic and surgical management of CBD stones in terms of outcomes, morbidity and mortality.

 Patients admitted for breast cancer surgery were studied. Patients received Tab. Etoricoxib 90mg per orally 1hr prior to surgery. General anesthesia was induced using Propofol and Fentanyl. Subjects were randomized to receive, in a double blind manner, either by Inj. Dexamethasone 16mg (Group D) or a placebo (saline-Group P). Both study groups were administered 20-30 ml Bupivacaine 0.25% as incisional wound infiltration at the end of surgery. Post operative pain, nausea and vomiting were evaluated in all subjects using a questionnaire in the immediate post operative period, 24 and 72 hrs post surgery

The aim of this study was to identify the risk factors for development of sepsis & to evaluate clinical impact of severe sepsis on out come in patients with gram negative bacteremia.

 To know the patterns of junk food consumption among adolescent students. To study the sociodemographic factors influencing the junk food consumption.

 Background and Objective Malaria is a life-threatening disease which is caused by malaria parasite. It is a major public health problem in India. The purpose of this study was to examine the possible changes in the serum electrolytes (Na+ and K+) in 915 cases of malaria, on the basis of their severity as compared to 199 volunteer control subjects.

 Purpose Statistics is the cornerstone of any study but we are least comfortable with this. My aim is to outline basic points so that clinical studies become easier in future. Methods Sample size is calculated based on study population which in turn represents target population. Nature of any study will depend on this. Data collection and statistical analysis will establish hypothesis. Comparing is done by chi-square for proportions, t-test for mean and Mann-Whitney U test for mode.

 The research which i have conducted is regarding the assessment of both the qualitative and quantitative knowledge both doctors and the common man possess regarding the first aid management of snake enevenomationthe reason that motivated me to perform this particular research is that i am a person belonging to Andhra Pradesh, brought up in Rajasthan and underwent ug education at Kerala. These three states are just some of the most snale infested states. On my experience i found that the knowledge possessed by the people regarding the management of snake bite poisoning is very limited.The times of India article dated dec 6, 2011 states that nearly 46,000 people die due to snake envenomation. But majority of the Indians don’t know about this fact.To gather information regarding this research, I assessed nearly 100 doctors randomly selected over various specialities. I also assessed nearly 300 common people. The assessment was based on a questionnaire answering process which was given to them on paper and which in turn were submitted in written.At the end over the research I discovered that approximately 60% of doctors and approximately 85% of common people did not know the basic first aid management of snake envenomation poisoning.The implication of my research is to not only to assess the knowledge of first aid management regarding management of snake poisoning but also to provide with the correct management protocols. This is because more than half of people bitten by snakes can be saved from death if proper first aid management techniques applied.

 Despite advances in treatment primary pulmonary hypertension continues to carry considerable maternal morbidity and mortality. We report a patient who was diagnosed with severe pulmonary hypertension of unknown cause in the 32nd week of gestation. The patient had an emergency cesarean section due to fetal growth restriction with absent diastolic flow in umbilical artery. The postoperative period was uneventful and she was discharged on day 14 due to NICU stay of baby. This report adds to the amount of evidence that pregnancy in a patient with Idiopathic pulmonary hypertension may have a better outcome in hands of a multidisciplinary team.

 HIV continues to spread rapidly,it is the 4th biggest killer in the world(after heart disease, stroke and respiratory diseases).Across the world, in many early cases male homosexuals and i.v. drug abusers were concentrated but as the epidemic has spread there has been progressive shift towards heterosexual transmission and increasing HIV infection rates and deaths in females. The age patterns of infection are significantly different for the two sexes. Beyond the statistics of sex based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV/AIDS infections in male and female reflecting differences in biology, sexual behaviour, social attitudes and pressures, economic power and vulnerability. It is for these reasons that HIV/AIDS is inherently a gender based issue and should be addressed effectively.HIV/AIDS will only be conquered when the effort to achieve gender equality is successful.

 Due to its unique geo-climatic conditions, India has always been susceptible to natural disasters. Boloor is a semi-urban area located about 5kms away from Mangalore prone to flooding. Concerted action must be taken to reduce the loss of life, damage to property, economic and social disruptions in the event of a disaster.The purpose of the study is to ascertain the attitudes and practices towards disaster preparedness among the inhabitants of Boloor, Mangalore. The study is to assess the current status of awareness of management regarding disaster preparedness, to determine attitudes towards disaster management plans and drills and to determine current practices employed by them to safeguard against such disasters.

 Staphylococcus aureus is one of the most common causes of nosocomial or community-based infections that were resistant to â-lactam antibiotics due to production of ß-lactamase and presence of mecA gene. Most laboratories use disk diffusion method and MIC for detection of methicillin resistance in S. aureus. The latex agglutination test is an alternative to PCR for rapid detection of mecA gene. The aim of the study is to detect and differentiate BORSA (Borderline Oxacillin Resistant Staphylococcus aureus) from MRSA (Methicillin Resistant Staphylococcus aureus) and to compare MRSA latex agglutination test with standard susceptibility testing methods viz., oxacillin agar screen, Cefoxitin disc diffusion test and MIC.

 Background of the Study: Despite sufficient funding by the Government of India, tuberculosis (TB) still remains one of the most efficient and relentless killers of Indian society. This can be attributed to lack of attention to the role of social determinants of TB, which are usually overshadowed by focusing more on diagnostic and treatment aspects. Thus it is required not only to invest in strengthening diagnostic and treatment aspects of tuberculosis control programs, but also to act on its social determinants. Paradoxically qualitative analysis of this issue has not been systemically reviewed to bring out deep-rooted connections TB and social determinants of health.Objectives: To explore the perspective of TB patients and their family members on tuberculosis and its related social determinants together with patient experiences, meanings, behaviour and impact.

 Inadequate physical activity is the primary cause for chronic non-communicable diseases. To plan interventions it is necessary to assess physical activity patterns effectively. There are no other published reports exploring the perceptions & physical activity patterns among undergraduate medical students in our country, so this study was conducted.

 Many factors directly or indirectly impair placental development and therefore fetal growth. If factors affecting placental growth can be known then fetal growth can be indirectly assessed through placental growth.Materials: placentas, scissors, weighing machine.

 Mortality after admission is an important indicator of hospital performance and forms a part of several sets of quality indicator.Methods: A retrospective descriptive study were the information about dead cases obtained from medical records which are available at Department of Statistics Planning and Medical Registration in Ibn Sina Teaching Central hospital during the period from 1st January to 31th December 2008, Hadhramout Governorate, Republic of Yemen. ****Results: The overall mortality rate among all cases admitted in Ibn Sina Teaching Central hospital during 2008 was (4.22%). The results of studied files, 344 were males (59.1%) and 238 were females (40.9%). The most age group died among all children dead cases was < 30 days (32.7%) and in adults dead cases was (60 years – 70 years) with percentage about (38.1%). The frequencies of leading causes of death among adults were Cerebrovascular diseases followed by Diseases of the Heart, Renal Failure, Infectious Diseases and Malignant Neoplasm. While the frequency of leading causes of death among children were Congenital Anomalies followed by Head Injury, Infections and Renal Failure. Conclusion Cerebrovascular diseases ranked the first leading cause of deaths among adults and Congenital Anomalies were the first leading cause of deaths among children. There are a lot of work should be done in order to improve the situation and at the end to decrease this figure.

 Background and Objectives Eosinophilic Esophagitis is a disorder whose incidence has been reported to be on the rise in the west. There is an overlap between symptoms of GERD and EE but the treatments for these differ markedly. Morover, EE is associated with atopy. So this study was designed to estimate its prevalence in a selected group of patients who presented with the symptoms consistent with EE. These symptoms were evaluated with the following objectives:· To assess if EE could be responsible for some of the cases of chronic cough of unexplained etiology.·To assess what proportion of GERD patients has evidence of underlying EE.

 To assess the implementation of an acute pain service in Safdarjung Hospital by means of an initial audit of 200 epidurals in the perioperative period.

 Iron deficiency anemia is one of the serious public health problem in India especially in the younger children.Iron deficiency anemia (IDA) is the most common malnutritional deficiency. Worldwide affecting approximately a quarter of the global population and particularly widespread in developing countries. The prevelance of IDA in children ranges about 35%-45%. Iron deficiency anemia affects all the system in the body including growth and cognitive functions. Hence supplementation should be given at right age to reverse the changes.

 Poor infant feeding practices are to a great extent man made problem which directly or indirectly, contribute to infectious illnesses, malnutrition and mortality in infants.

 Pneumonia is a major cause of morbidity and mortality worldwide, particularly among children in developing countries, where half of the pneumonia related deaths occur less than one year of age. Use of the World Health Organization guidelines is associated with a sensitivity of about 70% to 74% and a specificity of 40% to 70% in correctly identifying pneumonia confirmed on the chest x-ray. Thus to improve sensitivity and specificity, other diagnostic tests (chest Xray,laboratory test) have been employed with variable rates of accuracy. The ideal surrogate marker for pneumonia should be accurate, minimally invasive, and readily available.

 Stent thrombosis (ST) is an uncommon but serious complication that almost always presents as death or a large non-fatal MI following drug eluting stent (DES) implantation.

 Intro Cervical cancer is the third largest cause of the cancer deaths in India. It has an incidence of 30.7 per 100,000 women (highest relative to that of all other types of cancer). The prevalence and burden of cervical cancer is much higher among rural women mainly due to the lack of access to screening and health services, and lack of awareness of the risk factors of cervical cancer. HPV infection and precancerous lesions go unnoticed and develop into full blown cancer before women realise they need to go for medical help.

 Migraine is a recurrent primary headache disorder characterised by different clinical presentations. The identification of triggers throws a new light into the pathogenesis of migraine.

 Normally the axes of the two eyes remain parallel to each other in all directions of gaze. Disturbances of this parallelism may occur, resulting in squints. Manifest squints are termed heterotropias. Heterophorias are mal-alignments of the visual axes which are kept latent by fusion mechanisms. The effort to maintain the paralellism in the presence of latent squints causes a strain on the extraocular muscles leading to aesthenopic symptoms such as heaviness of eyes, frontal or occipital headaches, diplopia, and, pain in and around eyes. Visual problems occur during the critical period of visual development. Heterophorias can have long term effects on visual acuity, scholastic performance and quality of life of the child. Various studies have reported a prevalence of heterophorias in children to be between 2.8% to 14.6%. Of these children, the incidence of poor scholastic performance has been reported to be approximately. Timely detection and treatment of heterophorias and associated refractive errors has been shown to ameliorate symptoms of aesthenopia.

 Achieving proper anesthesia is imperative to performing most dental procedures. The most commonly used nerve block in mandibular dental procedures: The Inferior alveolar nerve block sometimes fail even when performed by the most experienced clinician.

 A Study Of Wearing Apparels For Retrospective Reconstruction Of Crime Scene In HomicideField of Research – Forensic Medicine and Forensic scienceAuthors – 1.Janmenjoy Mondal – 2nd Proff MBBS Student, Bankura Sammilani Medical College, Bankura 2. Dr.Suparna Datta – Associate Professor and Head, Deptt of FSM, Bankura Sammilani Medical College, Bankura.

 The culture based techniques in isolation of Vibrio cholera have disadvantage like requirement of upto 72hrs for completion ,failure to detect viable but nonculturable (VNBC) cells and some difficulties arising where Vibrio cholerae are outcompeted by other bacteria during enrichment and subculturing steps. Thus trials for detection of ctxb gene using molecular technique like Polymerase Chain Reaction (PCR) were done by us which was rapid, sensitive, highly selective and did not require extensive hands on time. As a preliminary step, we wanted to check wether clinical isolates produced from culture of stool amplified the toxin gene in PCR. We also studied the antibiotic susceptibility patterns of the isolates to check for the emergence of any resistant strain.

 Rheumatoid Arthritis(RA) a chronic disease with articular and extra-articular involvement has a multifactorial etiology. Adenosine Deaminase (ADA) is an enzyme involved in the metabolism of Purine bases. Methotrexate being successfully used as a DMARD acts through purine metabolism. It seemed justified to estimate ADA, a biomarker as a diagnostic, therapeutic and prognostic tool in RA.

 In the complex setting of a medical school it becomes essential to utilize an approach to teaching and learning that is best suited to the needs of the students. Hence, we conducted a survey to study the perceptions and preferences of medical students regarding teaching methods in a medical college which also identified the barriers in learning as perceived by the students.

 Curcumin is a natural yellow-pigmented polyphenol component of the spice turmeric, which is derived from the roots of the plant Curcuma longa plant, indigenous to Southeast Asia. The coloring & flavoring properties of Curcumin (difeuloy l methane) have led to its wide use as a dietary additive in a variety of foods. Extracts containing Curcumin have also been used in traditional Indian medicines for generations & have been useful in treatment of inflammation, skin wounds, cough, coryza & certain tumors. Curcuminoids inhibit the generation & propagation of free radicals and act as an antioxidant, inhibiting lipid peroxidation and oxidative DNA damage . The anti-inflammatory property of Curcuminoids have been attributed to the inhibition of lipo-oxygenase and cyclooxygenase resulting in decreased arachidonic acid release and metabolism, along with the property to inhibit activation of NF-B. The role of Curcumin has been studied extensively in breast cancer lines, where it has been able to induce cell cycle arrest & apoptosis by inhibiting cyclin-dependent kinase (cdk) activity, suppressing cyclin D1 and cyclin E expression, increasing levels of cdk inhibitors p21 and p27, and inducing p53 transcriptional activity. Majority of Curcumin’s effects have been attributed to its ability to inhibit transcriptional activity of nuclear factor kappa B (NF-kB), leading to reduced expression of antiapoptotic, proliferative, pro-angiogenic, and metastatic target genes of NF-kB, with subsequent inhibition of mammary tumorigenesis and metastasis in vivo. Importantly, apoptosis in response to Curcumin appears to be far more pronounced in cancer cell lines versus non-tumorigenic breast epithelial cells.With this background a prospective randomized control trial is being contemplated to assess the role of Curcumin in altering the response to NACT in patients with locally advanced breast carcinoma. Materials & Methods A prospective randomized control trial is being contemplated at the Department of Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, to assess the role of Curcumin in altering the response to anthracycline based neo-adjuvant chemotherapy (NACT) in patients of locally advanced breast carcinoma (LABC). 100 histo-pathologically proven LABC patients would be included in the study after informed consent & would be randomized into two groups based on random numbers. The study group would receive oral supplementation of Curcumin along with NACT (CAF regime), whereas the control group would receive a placebo along with the NACT regime. The response to NACT would be evaluated by RECIST (Response Evaluation Criteria in Solid Tumors) criteria, after three cycles of NACT using an MRI. Statistical analysis would be carried out using the SPSS software.

 A neonate who has greater than the average chance of morbidity and mortality within the first 28 days of life, irrespective of birth weight, size or gestational age is considered a high risk infant. The risk factors may be preconceptual, pre-natal or post-natal that interfere with the normal birth process leading to various complications and congenital anomalies among the neonates.

 Nosocomial infections develop in hospitals leading to significant morbidity and mortality. The ultrasonogram is the most commonly used imaging modality in tertiary care hospitals. Ultrasound equipment comes into direct contact with patients and practitioners during scanning procedures, enabling it to be a potential vehicle for the spread of nosocomial infections. The prevention of disease transmission between patients is of primary importance in sonography department. The aim of the present study is to assess the microbiological contamination of the ultrasound probes and to formulate effective decontamination guidelines for the ultrasound probes.

Keywords: Nosocomial infections, Ultrasound Probes, Ultrasound Coupling Gel, Decontamination.

 Even with all available techniques, ACS still carries high mortality and treatment strategies are evolving. So, we require additional parameters than established markers to stratify the risk in ACS like RDW which has been shown to be independently associated with an increased risk of major cardiovascular events. 

 The association ofcoronary artery disease (CAD) and chronic kidney disease (CKD) is well established.There is paucity of information relating CKD in acute coronary syndromes (ACS).Low GFR detection at one point testing may be due to CKD or acute renal insultwhich may be reversible.

 The incidence of deep fungal infections in patients with malignancies has increased dramatically over the past decades. Majority of these infections occur in patients with hematologic malignancies due to a multitude of predisposing risk factors. However over the years due to antifungal prophylactic therapies in these patients there is an increase in anti-fungal resistance in various fungi like Candida spp. and Aspergillus spp. which is a matter of concern and needs to be dealt with. The present study was undertaken to determine the prevalence of fungemia, various risk factors predisposing to it and antifungal susceptibility of fungal isolates.

 Biomedical waste is the waste generated in the diagnosis, treatment, immunization of human being or animals, in research or in the production of biological products including all categories of infected and toxic waste that is a potential threat to human beings and the environment. It must be properly managed to protect the general public, specifically healthcare and sanitation workers who are regularly exposed to biomedical waste as an occupational hazard.

 Urinary Tract Infections (UTIs) are among the most common bacterial infections in clinical practice both in community and hospital settings. The diagnostic methods of UTI have changed little in the past few decades. Culture remains the gold standard for the diagnosis of UTI. However, it takes 24-48 hours to complete. Rapid screening methods like wet mount examination, Gram’s stain, urine dipstick (leukocyte esterase or nitrite), catalase test are used with varying success. Different laboratories use varying procedures for screening and rapid diagnosis of UTI.

 Tuberculous pleural effusion is one of the most common forms of extra pulmonary tuberculosis. For its definitive diagnosis, getting pleural fluid as smear positive followed by culture positive for Mycobacterium tuberculosis is traditionally considered the gold standard. However the utility of these conventional tests is tedious and has a low sensitivity in pleural fluid samples including the delay in obtaining the results. As reported by various studies, the sensitivity (31.3–81%) and specificity (96.6–100%) of PCR are variable. This study was undertaken to evaluate the utility of a molecular tool in the reconfirming a clinical diagnosis of pleural tuberculosis.

 To know the scenario of Knowledge Attitude and Practice regarding HUMAN PAPILLOMAVIRUS Vaccine usage among doctors of VMMC and Safdarjung Hospital, New Delhi and To derive relevant associations.

 Breast cancer is the second leading cause of cancer deaths in women worldwide. Although chemotherapy is effective, resistance to drugs develops over time and can account for treatment failure in over 90% of metastatic breast cancer patients. HOX genes are homeobox-containing transcription factors well-known for their role in morphogenesis. However, accumulating evidence has emphasized their importance during carcinogenesis and metastasis. HOXC10, a protein in this family, was found to be overexpressed in a large subset of primary and metastatic breast cancer. The goal of this study is to understand the role of HOXC10 upregulation in the response to chemotherapy. Cell survival assays after different chemotherapy drug treatment showed that overexpression of the exogenous HOXC10 in MCF10A cell lines reduced their susceptibility to most drugs, and vice versa, its knockdown in SUM159 cells increased their vulnerability to drug treatment. Further, HOXC10 expression increased upon DNA damage in vitro at the RNA and protein levels, and this upregulation was concentration and time dependent. Supporting the results, SUM159 and MDAMD231 xenografts that were treated with doxorubicin, etoposide, paclitaxel or carboplatin over weeks and that showed partial to no response tended to have a higher expression of HOXC10. Finally, HOXC10 was found to be significantly overexpressed in MCF7 isogenic cell lines gradually selected to be resistant to some chemotherapeutic drugs.We show for the first time that HOXC10, previously known to be involved in development, is upregulated upon DNA damage in breast cancer cell lines, and that this upregulation modulates the response of the cells to chemotherapy treatment. Further work should be done to investigate the mechanism of HOXC10 in DNA damage repair and survival pathways, and eventually the clinical and prognostic implication of its overexpression in breast cancer patients.

 Dieting is emerging as the preferred mode for weight loss among adolescent females. Despitebeing medical students, the adverse effects of improper dieting may be ignored by many. Healthydiet restriction and restriction of majority of food components for weight loss is perceived assimilar.Thus, often in the process of unguided dieting, intake of even those nutrients which are essentialfor health is neglected. This may lead to various deficiencies and disorders, e.g. deficiencies offat soluble vitamins (A,D,E,K), osteoporosis, menstrual abnormalities, etc.This research is an effort to study the prevalence of dieting among female medical collegestudents and the physica

 Last decade has seen a tremendous surge of dengue fever in India, with published literature on neurological manifestations. Some workers feel that neurological involvement in dengue is increasing and suggest that the virus is turning neurotropic.

 Congenital posterolateral diaphagmatic hernia, where abdominal contents herniate through the poserolateral segments of diaphragm. Most of CDH present with life threatening cardio-respiratory distress in neonatal period . Rarely the hernia remain silent untill late childhood and presented as intestinal obstruction. Here our case presented at age of 12yrs with symptoms of intestinal ostruction and surgically contents were reduced and defect closed primarily.Regardless of technique use to repair the diaphragmatic defect , recurrence rate ranges from3-22%. And very few studies regarding the recurrence and no reports regarding the late recurrence almost 10year after primary repair

 Breast cancer is one of most common malignant tumors with the highest incidence and the second highest mortality among all malignant tumors in females. Activation of EGF receptor and HER2 is an important factor for initiation and progression of malignancies, including breast cancer where the status of HER2 is an essential step in the diagnostic workup; EGFR overexpression has been associated to the so-called basallike breast carcinomas, which opens a new avenue for diagnosis and therapeutic approach in these tumors. In this study HER1 codon 497 and HER2 codon 655 polymorphisms in breast cancer patients of 19 malignant and 43 controls were genotyped by PCR-restriction fragment-length polymorphism-based assay and the association of the polymorphic alleles with breast cancer evaluated. It is found that there is high risk for breast cancer in HER1 R 497K mutation OR=2.5 and for HER2 Ile655Val mutation OR=2.2 but combined HER1 Lys and HER2 Val mutation showed lower risk OR=1.2.

 Carcinoid syndrome poses many challenges intraoperatively, including hypertension, hypotension and bronchospasm. These complicatons decrease in magnitude with the routine use of Octreotide. We report the perioperative use of Octreotide in a 37 yr old man, with carcinoid tumor in terminal ileum, who underwent undergoing emergency laparotomy for subacute intestinal obstruction

 A 25-year-old woman, gravida 1 para 1, presented in active labor at 39 weeks gestation. She was diagnosed with pre-eclampsia.The anaesthetic plan of performing the procedure under epidural anaesthesia was made. Patient complained of tingling sensation on left cheek which gradually increased to numbness and miosis and ptosis on the left side.

 A 45 year old male patient, ASA physical status I, pre - operatively administered inj. Metoclopramide 10 mg I.V. developed restlessness, agitation and exhibited movements of the arms and legs (crossing and uncrossing of the legs).Symptoms subsided after administration of inj. Midazolam 1.5 mg I.V.We believe that drugs commonly administered in the peri - operative period have the potential of inducing akathisia. We should keep a high index of suspicion of akathisia with use of Metclopramide.

 CKD is emerging as a major public health problem in recent years.Studies conducted worldwide concluded that the number of patients with earlier stages of CKD ( stage 1 – 4 ) are likely to exceed by as much as 50 fold that of those reaching End stage Renal Disease. Early detection of CKD and interventions aimed at preventing progression into advanced stages are likely to be the key factors in alleviating the future burden of ESRD

 Unfortunately in India most of the tobacco cessation centers are concentrating only on urban population whereas literature reveals that it is rural population which shows high frequency of consumption of tobacco.

 A pilot study to find out occurrence of ocular defects among siblings of children with ocular defects by giving a sibling motivational card (SMC). Materials and methods: At an Ophthalmic tertiary care set up of South India, over a period of 5 months, patients of pediatric age group with ocular defects like refractive error, amblyopia, squint and cataract, who had siblings, the parents were given a SMC to evaluate their other children who were not having any apparent complaints.Results: Out of 177 SMC given, 69 siblings (39%) turned up for evaluation and of which 37 (46.4%) had ocular defects. Conclusion: Giving SMC is a newer innovation to persuade the parents to evaluate their other children with no apparent complaints to find out the ocular morbidity at the earliest and to treat them accordingly to prevent future complications.

 A 28 years old young man, presented with history of febrile episode of three days duration, with no co-morbid condition on initial assessment. Fever was high grade associated with chills and rigor. He denied any history of stay in heavily malarial infested area. Evaluation confirmed him to have evidence of sepsis in the form of leucocytosis (TLC 18,000) with predominant polymorphocytosis (polymorphs=92% on DLC) with toxic granules. Ultrasonography of the abdomen revealed hepatosplenomegaly. Accordingly management comprised broad spectrum antibiotics and empirically parenteral antimalarial along with general supportive measures in the form of antipyretics. Contrary to patient’s expected improvement, he started developing features of organ dysfunction, hypoperfusion, hypotension, developed lactic acidosis, oligouria and deteriorating mental function. As hypoxia was progressively worsening, he was managed with intubation and ventilatory support in the ICU. Further radiological imaging using CT scan confirmed him to have developed splenic infarct and frank ARDS. Accordingly antibiotics were upgraded and antifungals were added to the treatment. Patient recovered after a week of intensive care and was weaned off ventilator support. However patient continued to have persistent pain in the region left upper quadrant of the abdomen. Repeat USG abdomen revealed splenic abscess with subcapsular collection. The splenic abcess rupture was confirmed with CT scan abdomen. Patient was prepared for splenectomy after pneumococcal vaccination. Patient had an uneventful post-operative phase and walked out after 45 days of hospitalisation.

 Apache II is a successful scoring system assessing severity of illness and prognosis of ICU patients. The objective of this study was to assess the accuracy of the Apache method for predicting hospital mortality and morbidity among critically ill cases of acute abdomen and to evaluate differences in the accuracy of Apache II and Apache IV models.

 Primary To compare effect of 30ml/kg and 10ml/kg crystalloid infusion on postoperative nausea and vomiting after diagnostic gynaecological laparoscopy. Secondary To correlate incidence of postoperative nausea and vomiting associated with different phases of menustral cycle.

 Appendicitis is one of the commonest causes of pain abdomen in all age groups. This study was conducted from January 2011 to 2012, for a period of 12months in J.S.S Medical college and Hospital, Mysore. The aim of the study is to compare open and laproscopic appendicectomy with respect yto postoperative hospital stay , pain , recover, complications and cost. Methods For this study 100 patients (59 males and 41 females) with a diagnosis of suspected appendicitis between January 2011 to 2012 were randomly assigned either to OA (n=50) or LA(n=50).All 100 cases satisfied the inclusion and exclusion criteria. Results Wound infection was significant higher in the open group (10%) than in the laparoscopic group(0%;p<0.000). There were no intraabdominal infections in both groups. Hospital stay was significantly shorter in the laparoscopic group(p<0.000), but operative time was a little longer than in the open group(p<0.000). There was no conversion to open surgery. Laparoscopic group was associated with less pain (p<0.001) as compare to open group. Return to normal activity was earlier in laparoscopic group(p<0.000) than in the open group at the cost of hospital expenses(p<0.000). Conclusion Laparoscopic appendicectomy offers significant improvement in postoperative outcomes at the cost of a longer operation and hospital expenses.

Keywords: Open appendicectomy, Laparoscopic appendicectomy

 The prevalence of common obesity has become an issue of major public health concern across the globe. Studies conducted world wide have shown an association between common obesity and vitamin D deficiency. Vitamin D deficiency can account for the secular trends in the prevalence of obesity and for individual differences in its onset and severity. Thus it may be possible to reverse the increasing prevalence of obesity by improving the vitamin D status.

 Preterm birth is an important cause of neonatal morbidity and mortality. The incidence of pre-term birth in India is estimated to be 11-14% in 2004.In Safdarjung Hospital, 17.01% of all births were pre-term in the year 2009. However, only about 10-50% of women who present with signs and symptoms of pre-term labour actually deliver prematurely. It is important to identify which of these women are likely to deliver pre-term, so that appropriate management strategies can be directed towards that particular group. Therefore, there is an urgent need of developing markers to predict the likelihood of pre-term birth in women who present with threatened preterm labor. Cervical length and cervicovaginal âhCG have been evaluated alone, and together, to predict preterm delivery by very few studies in symptomatic women. The current study has been undertaken to evaluate whether a these factors alone, or in combination,will improve the predictability of preterm labour and hence decrease the unnecessary intervention.

We report a case of 65-year-old man undergoing an elective face lift operation. He was taking Tamsulosin 0.8 mg OD and Dutasteride 0.5 mg OD since last 2 years for benign prostatic hypertrophy (BPH). Tamsulosin, a á-1 selective adrenergic receptor (á-1-AR) antagonist, is used as first-line drug for BPH. He developed persistent hypotension during the maintenance phase of anaesthesia while receiving O2/N2O and 1% Isoflurane. High index of vigilance for unexpected hypotension is important in patients, who are treated with selective á- 1-AR blockers, undergoing surgery. If hypotension occurs, vasopressors that act directly on á-1-AR could be more effective.

 Breast cancer is the commonest cancer in urban Indian women. Screening helps in early detection & improves the survival of affected patients. Female doctors see more women than surgeons and can have a major impact in early detection of breast cancer

 Primary To compare insertion characteristics of two different supraglottic devices (I-gel and PLMA). Secondary To observe any associated complications. Study Design: This prospective, randomized study was conducted in 80 patients [Group I - I-gel insertion (n = 40) and Group P - LMA Proseal insertion (n =40)] of ASA grades I/ II, of either sex in the age group 18-65 years. Both groups were compared with respect to ease of insertion, insertion attempts, fiberoptic assessment, airway sealing pressure, ease of gastric tube placement other complications.

 Heavy Metal Contamination of River Ganges: Detection of Ten Heavy Metals by Inductively Coupled Plasma Atomic Emission Spectroscopy.

 Six cases of amniotic band syndrome/limb body wall complex were studied in respect to clinicopathologic characteristics. The diagnosis was based on two out of three of the following manifestations: cranio facial clefts; limb body wall defects and amniotic band attachment. Four cases were stillborn and associated with internal defects, including central nervous system. Two cases had facial and limb defects and were live born (3–5 years old at examination). Phenotypic features of the stillborn cases were craniofacial clefting, thoracoabdominoschisis, amputation,ring constriction, amniotic band adhesion, placental adhesions, and internal malformations.Histology of bands revealed fibroconnective tissue as well as flattened epithelial cells together with neuroectodermal elements. Umbilical cord section revealed an abnormal number of vessels.When analyzing the observed data in relation to their etiology, it was found that amniotic disruption, vascular disruption or genetic disruption could explain the amniotic band syndrome/limb body wall complexes, alone or in combinations.The research was conducted at the Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of MedicalSciences (SGPGIMS), Lucknow.

 GERD is the most common gastrointestinal disorders encountered in clinical practice. It is more than Heartburn, which is one of the several complaints. Patients can also suffer from regurgitation, nausea, cough , sore throat, hiccups, chest pain, sleep disturbances etc... which not only significantly impair the quality of life but also pose diagnostic challenges resulting in poor management. The detailed characterization of the various symptoms and their link with clinical and epidemiological profile (Age, Body mass index, lifestyle etc.) would help physicians to better individualized and adaptive management options enabling good therapeutic response.

 Despite counselling of the postnatal women admitted to our wards about the effectiveness, safety & benefits of postpartum IUCD insertion the lack of enthusiasm of patients towards IUCD insertion led us to explore the reasons behind the reluctance of patients to accept PPIUCD .Study design-Prospective longitudinal cohort study. 

 Postpartum period provides a golden opportunity for contraceptive usage . The excellent clinical performance of intrauterine device inserted in immediate postpartum period has prompted its widespread use. The overall acceptance of PPIUCD in very low on all morning rounds. Subsequent counselling,scientific information,accessability and the promise of follow up does not really improve the acceptance.

 Tuberculosis (TB) is endemic in India, and diagnosis is frequently delayed. Unsuspected TB cases contribute to TB transmission because they are not being treated and may go unsuspected for days or weeks, and may visit multiple health-care facilities. Unless TB is considered, available diagnostic tests may not be used, proper treatment might not be initiated and proper TB infection control measures might not be in place. Therefore, TB Infection Control (TB-IC) measures should be implemented effectively to reduce transmission.

 Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in low-resource countries. Lack of knowledge and awareness regarding Cervical cancer awareness leads to delay in its detection and hence contribution to considerable mortality. Therefore, the present study was undertaken with the objective to assess knowledge and awareness of cervical cancer prevention among the women attending a gynaecological clinic in west Delhi.

 A comparative study to isolate organisms from reusable plastic cover from hospital wards and household kitchens and there role in spread of infections and also the methods to prevent the same.

 The stigma and discrimination associated with HIV positive individuals remain unchanged in the minds of people in spite of significant and effective measures taken for their eradication. The effective counselling and access to quality treatment on a regular basis provided by ARTC can prove to improve the quality of life of patients’ detected HIV positive. To easily access the treatment personal profile is must; for effective prevention and control of infection, the percentile contribution by various modes of transmission should be analysed. So, it is quite evident that the findings of our study help in improvising the awareness level and to reduce the population at risk.

 Drugs resistance in tuberculosis comprisesa. Multi drug resistance tuberculosisWHO defines MDR-TB as the strain which is at least resistant to isoniazid and rifampicin with or without resistant to other anti tubercular drugs.b. Extensively Drugs resistance TB: - Cases of TB that are resistant to almost all second line dragger termed extensively drugs resistantThus a person infected with MDR-TB & XDR-TB will unable to be cured by short course chemo therapy which relies chiefly on these two drug. Primary drug resistance occurs mainly to a single drug and combination of drug lessen the chances of drug resistance. In all countries and specially those where the number of case of TB is rising rapidly because of the association with HIV the development of resistant strain, the development of resistance strain of TB is serious concern. In 2008 about 0.5 million people worldwide are estimated to be infected with strain of drug resistant TB.An accurate picture of drug resistance is not available because few countries not having are available drug resistance surveillance system. It is estimated that primary MDR-TB in India is around 3% .The drug resistance retreatment cases is 12-17%. Although the level of MDR-TB in the country is low in relation to percentage and proportion, it translates in to a large absolute number. The most serious danger MDRTB is that, it is much more difficult to treat even where second line drug are available ,treatment of MDR, TB can take at least two year and the result are poor. The magnitude of the crisis remains to be determined with the dip in the laboratory capabilities for conducting quality assured susceptibility test especially for second line drug

 Many risk factors for CVD including obesity and diabetes are substantially influenced by dietary factors, and since they are modifiable through dietary means; intake of fruit and vegetables is such an important preventive measure by which the risk of CVD can be reduced. In support of the role of thrombolytic drugs in reducing the incidence of death from thrombotic disorders; Flavonoids that are widely distributed in fruits and vegetables, have anti-oxidant and anti-thrombotic properties. Palm date fruit was selected to test its thrombolytic effect. Aim: To investigate the Thrombolytic Activity of Palm date extracts by using an in-vitro “Clot Lysis” procedure. ***Methods: The study included 5, 7 and 9 dates flesh extracts and 18 blood samples. The date flesh extract was prepared. 5ml of venous blood had been collected from healthy volunteers, incubated for 45 minutes at 37 degree and supernatant had been aspirated. The clots were weighed. Then the extracts, positive control “Tissue Plasminogen Activator” and water as negative control had been applied on blood samples that followed with second incubation for 90 minutes, aspiration of supernatant and weighing the samples again in order to detect clot lysis as a percentage of weight reduction. Results There was clot lysis in all samples compared to the negative control. 5 dates extract dissolved 11% of clot weight, while 7 and 9 date extract dissolved 9 and 7 % respectively compared to positive control that dissolved 8 %. Conclusion Flesh extract of 5, 7 & 9 dates has proved to have a clot lysis effect compared to tissue plasminogen activator (positive control) & distilled water (negative control).

 It is mandatory for TB patients to take Anti TB drugs in correct and complete form. Many a time long duration of treatment leads to non-adherence to treatment. Poor adherence to treatment leads to emergence of multidrug-resistant bacilli, so ensuring compliance is of utmost importance to control TB and halt the MDR TB epidemic at its beginning. The focus must remain on dealing with important reasons of default and timely retrievals of patients who interrupt treatment.

Despite the enormous role of LBW in neonatal mortality and morbidity as well as adolescent and adult morbidity, no clinical attempt is made to predict the possibility of a LBW neonate. A study conducted in Cleveland, Ohio, U.S.A proposed a Four factor scale (low family functioning, stressful events, Quetelet’s Index, and cigarette smoking) which predicted the low birthweight with 65% sensitivity, 84% specificity and 42% positive predictive value. The need for such a scale in the Indian context was strongly felt and the present study undertaken with the objective of coming up with a scale to predict LBW in the Indian scenario.

 Maternal nutrition plays a deciding role in the progression of pregnancy and the health of the newborn. If the mother’s intake is not sufficient it will limit the supply of nutrients to the foetus and may lead to foetal malnutrition. Fe deficiency will lead to decreased level of Hb and hence oxygen delivery to the foetus. Deficiency of folate is known to lead to neural tube defects.Hence nutrition requires special attention during pregnancy, particularly during the second and third trimesters. Unlike heredity or pre-existing conditions, diet is a modifiable factor and so determination of its knowledge and practices along with the factors affecting these is essential to figure out the lacunae and in finding solutions to them. This study was conducted to assess the knowledge and practices of diet during pregnancy among Indian women coming for regular ante-natal check-ups to the Obstetric OPD of Safdarjung Hospital, New Delhi, India

 Leprosy is a disease, which still strikes fear in the societies as a mutilating, disfiguring, contagious and incurable disease. It is estimated that between 11 and 12 million people living in the world today have suffered from leprosy. Although most of that number will not now have active disease, for many the stigma of leprosy is still real and needs to be addressed. It is simply not enough for the medical profession and society to treat the disease and ignore the patient as a whole person. Many, despite their leprosy being dealt with, are still living a sub existence, mere shadows of their former selves and their true potentials. Leprosy mainly affects the skin and nerves; if untreated, there can be progressive and permanent damage to the skin, nerves, limbs and eyes. Humiliation and fear can prevent diagnosis and treatment, leading to more severe manifestations of the disease and causing deformities. Where social stigma persists, patients are compelled to hide their condition and avoid diagnosis, allowing a completely curable disease to worsen to the point of disfigurement. The AIIMS are to assess the sociodemographic factors and treatment seeking behaviour of leprosy patients attending out-patient, Department of Dermatology, K.G.H. in terms of age, sex, occupation, and place of seeking treatment, marital status and place of living. Study site is out-patient, Department of Dermatology, K.G.H, Study Period is 01-05-2011 to 31- 05-2011, Tools are Pre-tested questionnaire, Variables are Diagnosis of Leprosy, treatment seeking behaviour, follow up and Analysis will be done using percentages and no tests of significance are applied.

 Breast cancer is the most common cancer among Indian women. Approximately 6% to 7% of women diagnosed with breast cancer are younger than 40 years at the time of their diagnosis. For many young women with early breast cancer, fertility is a priority. Increasing survival rates in patients affected by oncological disease and advances in reproductive medicine have led to the development and increasing use of various fertility preservation techniques.

 Introduction To find out factors that are responsible for the patient or provider delays in the diagnosis of breast cancer in India. Design This prospective study was designed to be conducted over a period of two years including a cohort of 100 patients with locally advanced breast cancer. The delays were assessed using questionnaires prepared according to the Indian scenario. Setting A prospective study in an Indian setting. Participants One hundred patients with locally advanced breast cancer receiving neoadjuvant chemotherapy were included after providing informed consent and receiving ethical committee clearance. Main outcome measures The most common factor responsible for delays in diagnosis was observed to be the health providers, although illiteracy and lack of adequate healthcare services also contributed significantly. Unregistered medical practitioners or quacks contributed significantly to the delays in reporting and diagnosis of the disease. Results One hundred patients of locally advanced breast cancer were evaluated using standardized questionnaires to assess the delays in diagnosis. Provider delays were found to be significant (the unregistered doctors or quacks being a significant cause of delays).The average time lapse before diagnosis for rural patients was higher (67.5 days) compared to urban patients (53.7 days). The literacy levels of the patients also had a significant impact on the delays at diagnosis. The delay in illiterates was 60.6 days compared to 49.5 days for literates. Conclusion The most common factor responsible for delays in reporting and diagnosis was observed to be at the end of the health providers, although illiteracy and lack of adequate healthcare services also contributed significantly. Unregistered medical practitioners or quacks contributed significantly to the delays in reporting and diagnosis of the disease.

 Breast cancer is one of the most extensively studied cancers and its genetic basis is well established. Dermatoglyphic traits are formed under genetic control early in development but may be affected by environmental factors during first trimester of pregnancy. They however do not change significantly thereafter, thus maintaining stability not greatly affected by age. These patterns may represent the genetic make up of an individual and therefore his/her predisposition to certain diseases. Patterns of dermatoglyphics have been studied in various congenital disorders like Down’s syndrome and Kleinfelter syndrome. The prints can thus represent a non-invasive anatomical marker of breast cancer risk and thus facilitate early detection and treatment.

 The tribal population groups form about 635 biological isolates (tribes and sub tribes) whichconstitutes 8.08% (about 84.3 million) of the total population of India. These are known to bevulnerable to a majority of heritable disorders like thalassemia. Haemoglobin consists of haem and globin chains. The electrophoresis of normal adult haemoglobinreveals HbA which has molecular structure (á2â2) and the minor components HbF (á2ã2) and HbA2(á2ä2). In Individuals with two â thalassemia alleles (â0/â0 or â0/ â+ or â+/ â+) is referred to have âthalassemia major. Heterozygote carrying one normal gene and one â thalassemia gene (â0/â or â/â+) is referred to have â thalassemia trait. We have hypothesize that in tribals there is closeassociation with beta thalassemia trait. Method Eighty samples were taken from ante- natal tribal women attending antenatal clinic and hospital basedcross sectional study was done. About 2-3 ml blood was collected after obtaing Inform Consent.Haematological Indices were measured using Sysmax cell counter. Background information of eachindividual like age, caste, consaguity etc were also recorded. Haemoglobin Electrophoresis wascarried out using BIORAD HPLC. The value of HbA2 more than 3.5% was taken as cut off point forbeta thalassemia. The data was then analysed and mean, median & prevalence was calculated. Results Median age was 19 and 48.75% of the tribals were illiterate. The mode is the 3rd trimester in whichwomen was screened. 32.5% of women were found anaemic and 76.25% had low MCV values.11.25% of the tribals were having Beta thalassemia trait, but the trait was more prevalent towards thetwo such tribes Murmu’s and Soren’s, rather than involving the whole population. Conclusion The prevalence of Beta thalassemia among tribals was found to be 11.25%. The risk to particulargroup is far more than the whole tribal population.

Keywords: Beta thalassemia; Tribal.

 In out patient clinic an attendant of a patient, on being told that for patient operation is absolutely required and will only cure the fracture showed his own (attendant’s) knee – showing that he was walking normally and was able to do every thing . He (attendant) gave his own history - telling that he had broken his knee cap about 10 years back and was told same thing about operation, he underwent operation but operation failed leading to recurrence of the problem within 3 to 4 weeks. On being told for reoperation he refused and ultimately he has cured his knee by doing exercise (but no reoperation) and now he is alright for so many years. On clinical examination he was felt to have fracture patella with two fragments felt separately. He did have an extensor lag of about 5-7 degrees but he said that this did not bother him as he is able to do all activities. On radiological examination he was found to have grossly displaced fracture patella with implant failure in the form of broken stainless steel wire. The clinical pictures (a video - if arrangements are possible – showing range of movement) and X rays will be shown. The purpose of presentation is to show the importance of body’s reserve and a good result in spite no reoperation, for failed surgery – which should be kept in mind every time, whenever we tell patient that only surgery will cure the disease.

 Diabetes mellitus is a growing cause of morbidity and mortality in India and worldwide. It can be attributed as one of the cause as well as consequence of sarcopenia.There is paucity of data on sarcopenia and its correlation with metabolic control in diabetic patients. Therefore this study was undertaken to measure the Hand Grip Strength (HGS) in type 2 diabetic patients as a measure of sarcopenia and compare with age-sex matched non-diabetic subjects and to study its correlation with the glycaemic control (HbA1c level).

 HIV infection is a global pandemic & has grown into a public health problem of unprecedented magnitude. Integrated Counselling and Testing Centres (ICTCs), previously known as Voluntary Counselling & Testing Centres (VCTCs) provide key entry points for the continuum of care in HIV/AIDS for all segments of the population.I carried out a retrospective study of 524 clients who tested positive for HIV & were registered at ICTC of teaching hospitals of Kasturba Medical College i.e. KMC, Attavar (170 clients) & Government Wenlock Hospital (354 clients).As per the study carried out, it was found that there has been a declining trend of HIV positive cases in the past 10 years, with a little rise in 2006. The majority belonged to the reproductive agegroup, i.e. 25-40 years, which is also the most economically productive group. Amongst those who tested positive, majority were males(63%), belonged to married category (67%). The HIV Status of spouse was unknown in majority of cases (66%) & amongst those it was known, most of them tested positive (81%) for HIV.As per the analysis, majority of the crowd were literate(86%) i.e. they received primary education & were daily wage workers( 62%). There were also 21 cases (4%) of clients less than 10 years of age.Heterosexual mode of transmission was found to be the most common mode route, being responsible for 91% of the HIV positive clients, followed by 19 cases (3.6%) of parent to child transmission. There were also 2 cases of MSM in our study. Majority of the clients who tested positive for HIV at ICTCs were referred to ART Centres accounting for 85% cases, some cases were also referred to DOTS Centres.Such a study will help us in evaluating the performance of ICTC & designing the information,education and communication to increase the client uptake in terms of quality and quantity.

Keywords: ICTC; HIV positivity.

 There is no single previous study of renal stone in the Saurashtra region had been done, in spite of claims that a “stone belt” exists in this region. Due to lack of epidemiological data a startling gap remains between the services offered and the benefits incurred. Considering that this problem which ails most parts of the Saurashtra region is both correctable and preventable and has a high social impact due to its recurrent nature, an investigative study in this matter will do much to sort it out. This report is the first description of the epidemiology of renal stones in a Saurashtra region.

 Introduction: m-TOR (mammalian target of Rapamycin; a kinase enzyme) inhibitors (For example Rapamycin(R), Everolimus(E), Temsirolimus(T) which were used in this study) act by inhibiting the various growth and survival signals mediated via this kinase enzyme. In this in-vitro study, their role as chemotherapeutic agents for prostate cancer is being studied.Methodology: Using LNCAP M. Luc (Prostate cancer) cell line, time and dose dependent effect of mTOR inhibitors on cell viability was seen. The cell line was repeatedly subcultured in T150 cell culture flasks for 2 weeks before. Cells were grown in RPMI1640 media and appropriate Antibiotics (Ciprofloxacin and Gentamycin) were used to prevent contamination. Different concentrations of m-TOR inhibitors (R – 6.25µM (max conc.) and obtained 5, 2-fold dilutions and same for ‘E’ and ‘T’; E - 125µM (max conc.); T – 12.5µM (max conc.) 5E4 cells (2mL volume media) were counted and plated in 6 well plates along with appropriate control. Additional 2mL of drugs (of different concentration) plus media were added. A chemiluminiscence assay was performed using Luciferin as substrate. Metridia Luciferase, a bioluminescent reporter gene has been used to measure real time viability of mammalian cells. Luminescence was measure using Chemi-luminescence enzyme assay with for Metridia Luciferase enzyme (incorporated in genetic code of LNCAP cells). Cell viability was measured at 37 and 61hr. Data was collected in RLU (Relative Light Unit).Results: 6.25µM of Rapamycin killed 44.7% cells in 37 hrs which increased to 58.8% in 61hrs. The least concentration of Rapamycin used, i.e. 0.390625µM also managed to kill 29.5% in 37 hrs and 50.8% in 61hrs. Similar results were obtained for Everolimus (125µM(max conc.) – 47.7% in 37hr and 53.1% in 61hr; 7.8125µM(min. conc) – 52.6% in 37hr and 58% in 61hr) and Temsirolimus (12.5µM (max. conc.) – 41.7% in 37hr and 50.2% in 61hr; 0.78125µM (min. conc.) – 6.7% in 37 hr and 23.4% in 61hr). IC 50 of Rapamycin was calculated to be 1.5625 µM; Everolimus had IC 50 83µM and that of Temsirolimus is 12.5µM.Conclusion: Plotting of RLU (Relative Light Unit) versus concentration of m-TOR inhibitor used showed an inverse relationship which proves that there is dose dependent action of drug on LNCAP cells. Also, variation in percentage cell death was observed for the two time pints (37hr and 61hr) . These preliminary results prove the sensitivity of LNCAP M. Luc prostate cancer cell line to m-TOR inhibitors.

 The increasing burden of Non Communicable Diseases (NCD), particularly in developing countries including India, threatens to overwhelm already stretched health services. Because of developmental transition and changing pattern of life style, the risk factors of NCD are on rise. This study is carried out based on the felt need to quantify the risk factors in our area.Objectives: To carry out risk assessment for noncommunicable diseases among health care employees in VIMS, Bellary.Materials and methods: A crosssectional study was carried out on 200 health care employees of VIMS Bellary. A pretested predesigned proforma for NCD risk assessment developed by ICMR was administered on individuals aged above 20 years. Data analysis was analyzed using SPSS 17. Results: The study population comprised of 132 males and 68 females. About 45% of the subjects were in the age group of 31-49 years. Majority of the study subjects were graduates (69%) and married (75.5%). Nearly 17% of the respondents had high NCD risk score. High NCD risk score was noticed in males (65.7%) and individuals aged above 50 years (40%) which was statistically significant (P value >0.00). about 60 % of married persons (p value >0.05) and 65% of the graduates had high risk score. Conclusion Substantially high NCD risk score suggests an urgent need for life style modification. The increased risk observed among the younger generation calls for urgent corrective steps and measures for long-term monitoring of all major risk factors.

 Introduction little efforts have been done to know if the strategies for prevention of parent to child transmission of HIV are giving results in India. So this study was undertaken. Material & methods This is a retrospective record based study of HIV positive women who delivered between years 2003 to 2009 in Mangalore district of Karnataka. Chi-square for linear trend was calculated to assess significance of the changes with time. Results The number of new antenatal cases (ANCs) receiving pre-test counselling showed an upward trend from 2003 to 2009 (3364 – 5254) & HIV positive ANCs showed a downward trend (42 – 14) over the years. The other trends are as follows (%): spouses of HIV positive women receiving counselling and consenting for HIV test has been decreasing (62 to 36), Babies receiving Nevirapine prophylaxis has increased (97 to 100), HIV+ babies at the end of 12 & 18 months were very less indicating the effectiveness of NVP, Women opting to breast feed ( 0 to 0.03). Conclusions Though the magnitude of mother to child transmission of HIV has been decreasing. Breast feeding after delivery, consent of spouses for undergoing testing remain the areas of concern.

 Meconium Aspiration Syndrome (MAS) continues to be threat to many newborns throughout world with a case fatality rate of 5%(as much as 40%), in addition to short and long term pulmonary and neurodevelopmental sequale. India has the unfortunate distinction of claiming more than a quarter of the total newborn deaths in the world. In resource poor countries where modern electronic gadgets for fetal monitoring are not available, it is difficult to predict the fetal outcome. Therefore, this study is planned to highlight the antenatal, intranatal factors responsible for MSL and markers for early fetal mortality and morbidity. With this knowledge, we provide approach to enhance health outcomes among neonates by early enactment.

 Epidemiological data about elderly population is still scarce in developing countries. With a rapidly increasing population of the elderly, data regarding the prevalence of illnesses would aid in better health planning. This study is done to find the frequency and pattern of morbidity among the elderly population in an old age home.

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 Dhat syndrome is a cultural bound syndrome; patient mis-percept seminal discharges either in urine or stool, attributing to nightfall, masturbation and overindulgence in sex. Explore factors associated with it, reprehensibility of alternative and complementary medicine practitioners, as they may not always give correct advice to such a patient. 110 individuals participated in this Ethnographic-Qualitative study. We used a semi-structured questionnaire based on ICD-10 guidelines. 38 participants turned out with Dhat syndrome. Invariably, complained of undue concern regarding debilitating effects of seminal discharge. This syndrome accounts to psycho-engineered sexual myths and aggravated by spurious propaganda cultivated by quacks and faith healers.

Keywords: Dhat syndrome; Cultural bound syndrome; Practitioner of alternative and complementary medicine

 Liver abscess continues to remain a surgical problem with considerable morbidity. Over the years minimally invasive techniques like percutaneous needle aspiration and catheter drainage have gained usage in combination with intravenous antibiotics. Most of the liver abscesses in India are amoebic in etiology. Amoebic liver abscesses generally do not require drainage, amoebicidal agents being effective alone. Hence, these must be distinguished from pyogenic liver abscesses which are not uncommon. Many clinical and laboratory parameters can aid in this differentiation. The aim of this study is to compare the clinical, radiological and biochemical profile of these patients with their bacteriological, parasitological and serological findings to identify new trends in etiology of liver abscesses and determine the differentiating parameters that can aid in management of these patients.

 Introduction Neonatal mortality rate is regarded as one of the indicators for measuring the health status of a nation. Septicaemia continues to be a major cause of neonatal mortality and morbidity worldwide. At present, in the developing countries, gram negative bacilli remain the major cause of neonatal septicaemia. These organisms have developed multi-drug resistance over the last two decades. The knowledge about these factors is limited, hence the current study was done to study these pathogens and antibiotic resistance pattern in them. Materials and methods A retrospective study of 210 neonates(less than 30 days of age and with septecaemia), using microbiology culture report of neonatal septicaemia cases from 2008 to August 2011,was undertaken in Department of Microbiology, Kasturba Medical College, Mangalore. It was a proforma based study. Microbiological details with regards to blood culture reports and antibiotic susceptibility profile were obtained from the laboratory records. Results In the present study, out of 210 bacterial isolates, majority of the isolates causing neonatal septicaemia are Staphylococcus aureus followedby Acitenobacter spp, Klebsiella pneumonia, Pseudomonas aeruginosa, Escherichia coli, Enterobacterspp., Streptococcus viridians group, Staphylococcus epidermidis, Citrobacter spp., Enterococcus spp, Proteus spp and Klebsiellaoxytoca. Maximum resistance among the isolated organisms was seen against amoxycillin/ ampicillin. The resistance level to third-generation cephalosporins—cefotaxime, ceftriaxone and ceftazidime was also high, indicating that the use of these drugs alone may be ineffective. About 5.7% strains were Methicillin Resistant S.aureus(MRSA). . The high level of resistance could be due to extended spectrum â lactamases expression in bacteria. Resistance levels were higher in acitenobacter spp. and K.pneumoniae. Conclusion The bacteriological profile of neonatal septicaemia is constantly under change with advances in early diagnosis and treatment. Therefore, continued surveillance for various pathogens and their susceptibility profile should be done to effectively and timely treat the patients of neonatal septicaemia.

Keywords: Bacteriological profile; Neonatal septicaemia; Drug resistance; Extended spectrum â lactamase.

 Skin and soft tissue infections constitute a high in our health system with significant morbidity and motality.The factors affecting outcome have not been thoroughly studied prospectively, especially from our country. Tropical pyomyositis constitutes a higher proportion of SSTIs in our setting than described in literature.Study aimed to study the etiology and outcome of SSTIs, to establish the proportion of cases of SSTIs affected by tropical pyomyositis, and to evaluate factors associated with poor outcome in cases of SSTIs.This is a prospective observational, analytical study in a tertiary care hospital.Sixty-four(64) inpatients (moderate-to-severe SSTIs) were recruited, using defined clinical criteria for four subtypes: cellulitis, abscess, pyomyositis, and, necrotizing soft tissue infections.Clinical records were collected and maintained.With the main outcome as mortality, factors affecting the outcome were statistically analyzed using chi-square and Fischer’s Exact tests (p<0.05).Out of the 64 patients admitted there were 48 males and 16 females with mean age of 41.73. There were 39 patients of necrotizing soft tissue infections, 11 patients each of tropical myositis and abscess, and, 3 patients of cellulitis.Mortality was observed in 12 patients (18.75%). Mortality in the four groups was 9/39 (23%) in necrotizing soft tissue infections, 3/11 (27.3%) in tropical myositis. There was no mortality observed in patients with abscess and cellulitis. The body parts involved were lower limb in 37 (58%) patients, perineum in 11 (17%) patients, upper limb in 9 (14%) patients, trunk in 7 (11%) patients.The proportion of tropical myositis admitted with us (15-20%) is higher than previously reported, especially in the summer and monsoon seasons.Most patients of SSTIs have no obvious etiological factor at admission.The significant factors associated with mortality in our patients are: history of trauma, pulse rate>100bpm, systolic blood pressure<100 mm Hg, respiratory rate > 20/min, raised body temperature, presence of bullae, body surface area >10%, presence of gangrene, skin discoloration, muscle necrosis, compartment syndrome, Hb<=8 g/dL, blood urea>50 mg/dL, serum creatinine >1.2 mg/dL, serum bilirubin >2.5 mg/dL, and, requirement of inotropes, dialysis, and blood products. All clinicians must keep possibility of tropical myositis in mind as this has to be treated more aggressively.

 Introduction India is the highest tuberculosis (TB) burden country in the world and accounts for nearly one fifth of the global burden of tuberculosis, two-third of the cases in South East Asian Region. Every year approximately 1.8 million person develop tuberculosis of which about 0.8 million are new smear positive highly infectious cases. TB kills about 0.32 million people every year. Annual risk of becoming infected with TB is 1.5% and once infected there is 10% life-time risk of developing TB disease. 2 out of every 5 Indians are infected with TB bacilli. The case detection of new smear-positive cases in Revised National Tuberculosis Control Program (RNTCP) reported a minor improvement between 2007 and 2008 in India. Despite this, it has been reported that an estimated 19% of the new smear-positive cases in India remained undetected by the DOTS Program in 2007, the highest globally. An important cause of these missed cases in India is because many patients with the symptoms of TB did not seek formal care for treatment of tuberculosis. Inadequate knowledge about the disease or its presenting symptoms and availability of TB treatment free of cost at Public health institutions, overreliance on informal health care providers and lack of accessibility to treatment are the reasons behind. However there are some guidelines which aim to reduce the gaps in providing care, to increase coverage and to ensure quality of care which in turn increases the satisfaction of both patients and service providers. This also helps in improving compliance of the patients and enhances the chances of a favourable outcome. Against this background, the present study has been planned to ascertain these gaps in care-seeking behaviour of the tuberculosis patients who are undergoing treatment under RNTCP in Bankura Municipal area as well as to identify clinic-social profile and perception about disease and treatment which might have some bearings on care-seeking behaviour, in order to identify strategies for effective tuberculosis control. Methods After obtaining informed consent, the participants will be interviewed to collect their clinic-social profile, perception about the disease and treatment as well as care-seeking behaviour at the DOTS centres using the predesigned, pilot-tested, semi-structured proforma. Tuberculosis treatment card, sputum form will be reviewed to collect relevant information. Mean, proportion and standard deviation will be calculated as appropriate. Bivariate tests of significance will be used to examine relation of clinic-social profile and perception of patients with careseeking behaviour. Results The project is under process and has not been completed soon. Conclusions The project is under process and has not been completed soon.

Keywords: Tuberculosis; RNTCP

 The study of lipid profile requires the fasting subjects to voluntarily give blood, requiring a higher level of motivation. If, simpler tests or anthropometric indices could predict dyslipidemias or future risk of cardiovascular events, these tests can be applied easily to larger sections of the society. Specific objective To study the lipid profile pattern in adult healthy population of urban Mysore district along with anthropometric indices and lifestyle history to assess the risk of future cardiovascular disease.

 Comparative study of use of social networking sites by medical students & resident doctors and its correlation with perceived social support, social integration and stress management.

 Introduction Poor nutritional status of tribal children observed in different studies across the country calls for a need to introspect for various factors affecting it to seek remedial measures. Objectives: Study the nutritional status of preschool children and know the prevalence of malnutrition and associated socio-demographic factors. Methods Community based study was done in Jenukuruba tribes of Mysore district in the month of July-August 2011 among 220 children aged 1-5years. Sociodemographic information and anthropometric measurements were obtained by using standard techniques. Height and weight of each child was compared with WHO child growth standards-2006 reference data for that particular age and sex to get W/ A, H/A and W/H Indices and below 2SD of the reference median on any of these indices were considered as underweight, stunted and wasted respectively. Results Prevalence of underweight, stunting and wasting was 38.6%, 36.8% and 18.6% respectively which was statistically significant with respect to age and not significant with respect to sex, literacy status of mother, family type, SLI and Immunization status. Conclusion Poor nutritional status in this children calls for government and NGOs to take immediate steps in uplifting the socioeconomic standard of the tribal community.

Keywords: Jenukuruba; Underweight; Preschool children.

 Corneal infection or Keratitis is a leading cause of ocular morbidity andblindness worldwide. Keratitis is a suppurative, ulcerative, and sight threatening infection of the cornea that leads to loss of the eye if mistreated or left untreated which is a common scenario in developing countries including India. The National Programme for Control of Blindness stresses on early diagnosis & management of causes of blindness like corneal ulcer (requiring transplant of donated eyes), Cataract, Glaucoma and Refractive errors. National Programme for Control of Blindness–India, in a report ranks trachoma and other corneal scarring at 3rd position and Glaucoma at 5th position both being practically inevitable complications of keratitis at advanced stages.Corneal infection thus can be considered to be the root to almost half of theprevalent causes of blindness in India. Emerging antibiotic resistance makes it important for us to know the present and emerging pathological trends treatment of which requires formulation of an uncompromising protocol such as the antibiogram prepared in the study. The dissemination of the results of this study will help reduce global burden of blindness as a whole.

 Bacteremia caused by Staphylococcus aureus continues to be a common problem worldwide. Antimicrobial drug resistance in S.aureus arose early after the development of antimicrobial agents and continues to evolve. This resistance limits the potentially efficacious agents and results in frequent use of glycopeptides, such as vancomycin. The reliance on vancomycin causes difficulties because vancomycin has been shown to be less effective than isoxazolyl penicillins (e.g.,flucloxacillin) in treating severe infections caused by S.aureus. This may be one explanation for the higher death rate associated with bacteremia caused by MRSA, compared with that caused by MSSA. S. aureus remains a common cause of bloodstream infections of community onset; increasing numbers of these being caused by MRSA. Some of these infections are caused by hospital strains carried into the community by patients or healthcare workers, while others are caused by true community strains in patients who have had no recent healthcare contact. Certain population of patients have a significantly greater risk of invasive staphylococci infection than normal population; represented by those receiving hemodialysis, peritoneal dialysis, IV drug abusers, patients suffering from Diabetes Mellitus and alcohol abusers. S.aureus have developed resistance to virtually all antibiotic classes which include Aminoglycosides, Tetracyclines, Cotrimaxazole, Quinolones, and new Oxazolidinones. Methods for susceptible testing of MRSA include disk diffusion method, Broth dilution method, agar screen methods. This study helps us to have a clear knowledge about the risk factors associated with MRSA and the antibiotic sensitivity pattern of the organism which guides to formulate an empirical therapy for the patients with staphylococcal infections.

 Breastfeeding is best feeding for infants till six months of age. WHO has advocated exclusive breastfeeding (EBF) till 6 months and complementary feeding till 2 years of age. EBF supports normal growth and development of the baby, lessens the number of infections and reduces cost of living for the family. Antenatal counselling on breastfeeding and lactation improves rates of exclusive breastfeeding . This study was undertaken to assess whether antenatal visits were utilized for promotion of exclusive breastfeeding . Aim of the study is to assess the adequacy of antenatal education on breastfeeding knowledge in primigravida mothers. Main objective is to identify potential gaps in communication about breastfeeding practices.

 India with a 1.21 billion population ranks second in the world. Limited resources, lack of political bill and rampant illiteracy are some of the reasons behind population explosion. Quinacrine Sterilisation (QS) – a transcervical method was thought to be a simple and cost effective alternative to surgical sterilisation. Material and MethodsReviewed the published research articles on QS and related subjects and reports of the Indian National Health surveys.

 Study of the Association of Genetic Polymorphisms in Biotransformation Genes (CYP1A1, GST, EPHX1) and Tumor-Suppressor Gene (p53 codon72) with the Susceptibility to Adult Acute Myeloid Leukemia

Keywords: Polymorphism; Acute Myeloid Leukemia.

 Comparative evaluation of a multiple- antigen (GlcB, HspX, MPT51,Ag 85B and PstS1) based diagnostic protocol versus Polymerase Chain Reaction assays (qRTPCR and gel-based duplex PCR) for Rapid and Efficient diagnosis of childhood tuberculous meningitis.

Keywords: Tuberculous Meningitis; PCR; ELISA.

 Study of factors responsible for crisis of Sickle Cell Anemia and Its medical management at Dr.P.D.M.Medical College,Amravati.Introduction –1. In the world’s population 5% population carries genes responsible forHemoglobinopathies.2. Sickle cell anemia is a group of heredieatary disease characterized bytransformation of red cell into sickle shape on deoxygenating. It’s commonin people whose ancestors come from Sub Saharan Africa, India, countries.Cyprus is a country where Sickle Cell Anemia was very common butbecause of counseling its prevalence has been reduced almost to zero.3. Poor prenatal diagnostic facilities are available to detect Sickle CellAnemia and no marriage Counseling facilities are available in India.4. Sickle Cell Anemia is more prevalent in Vidarbha region of Maharashtra,it’s more prevalentin backward communities particularly in schedule caste,schedule tribes and other backwardcommunities. In eastern part of Vidarbha region i.e. Chandrapur,Ghadchiroli, Wardha,Nagpur and Amravati are the districts where more no.of cases are found.5. Chronic Anemia(Hb level around or <8gm/dl),painful crisis due tovasoocclusion and Acute Chest Syndrome are the common symptoms maylead to organ damage, susceptibility to infection, growth failure,etc.Manifestation of Sickle Cell Anemia are unpredictable and variabletherefore there are no fix guidelines and specific drugs are available formanagement and treatment of crisis.6. Though the disease is very common it is neglected and comparativelyless medical literature is available. There is no National Policy in availablein India for treatment and prevention of disease.7. Use of Hydroxyurea which has shown good result in crisis is less usedotherwise crisis is treated symptomatically.8. There are many factors which precipitate the crisis in Sickle Cell Anemiaso to study these factors is the main aim of this study and to educatecounsel and prevention is also a part of this study

 Oral cancer continues to burden the clinical and economic dimensions of health care around the world. InIndia, oral cancers constitute 40% of all cancers and rank as the most common cancer in men and third mostcommon cancer in women. Recently, a trend has been observed towards increasing incidence of oral canceramong young adults. In this study we assessedKnowledge, attitude and practices regarding oral cancer among first year medical collegestudents in Delhi, India.In addition, the relationship between socioeconomic-demographics and oral hygiene wasexamined.Materials and methodsThis was a crosssectional study among 200 First year medical college students in Delhi. Students were givena selfadministered questionnaire, which was pre-tested, after getting a written informed consent. Data wereentered in SPSS-17 version. ‘p’ value < 0.05 was considered statistically significant.ResultsTwo hundred students, 117 males (58.5%) and 83 females (41.5%) participated. The mean age was 19.5±0.05SD years (Range: 17-22 years). Majority (75%) knew oral cancer to be the commonest in India, followed by lungcancer (13.5%). 95% students responded that they knew about the risk factors for oral cancer, viz. smoking(89%), tobacco chewing (99%), alcohol intake (43%), poor oral hygiene(56%), family history (53%), recurrentoral ulcers (60%). The pre-malignant lesions were known to 23% students. Awareness about symptoms of oralcancer was: bleeding/recurrent oral ulcer (85%), painful lesions in mouth (26%), loose teeth (4%), difficulty inmouth opening (4%), dysphagia (9%) and weight loss (2%). 82% respondents visited a dentist (55% for regularcheck-up and 45% for other dental problems). Relatives of 6 study subjects (3%) suffered from oral cancer inthe past for which all of them underwent treatment. Only 55% respondents perceived their oral hygiene to begood/ excellent and 64% were doing self oral examination. Around 92.5% subjects strongly disagreed to thestatement “White patch in the mouth should be ignored”. 22% of the respondents consumed tobacco in someform (65.1% consumed in the form of hookah, followed by cigarette 28%). 17.5% study subjects reported tohave ever consumed alcohol. Tobacco consumption was higher among males, i.e. 34/117 (29%) as comparedto females, i.e. 9/83 (10.8%) (‘p’ = 0.002), and 27/117 (23%) males as compared to 8/83 (9.6%) femalesconsumed alcohol (‘p’ = 0.03). Families with less than 5 members brushed more than once a day (52.8%) ascompared to families with 5 or more members (45.5%) (‘p’ = 0.021). Families with per capita income morethan Rs. 30,001 brushed more than once a day (75.7%) as compared to the families with per capita income lessthan Rs. 30,000 (45.3%) (‘p’= 0.029). Awareness about risk factors for oral cancer was higher among Females(33.7%), as compared to Males (15.4%) (‘p’=0.02), and 100% Females as compared to Males (94%) were awareabout pre-cancerous lesions of oral cavity (‘p’=0.02).ConclusionMajority of the medical students were aware about oral cancer (75%), signs and symptoms (49%), risk factor(95%), pre-malignant lesions (23%). Of the respondents, 22% have ever smoked, 17.5% have ever consumedalcohol and 63.5% were doing oral self examination. Families with a higher income pay more attention to oralhygiene. The study suggests the need for focussing on reduction of tobacco and alcohol consumption, andencourage oral self examination among study subjects. It will be important to achieve this in this study groupwho will be later involved in health care and education of oral cancer in the general population.

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 Metastatic lesions to the oral cavity from distant tumours are uncommon, accounting for only 1% of all oral cavity malignancies. They mainly involve the bony structures (particularly the mandible), whereas primary metastases to soft tissues is extremely rare (only 0.1% of oral malignancies) [1]. The most common sites of metastasis are the tongue and gingiva followed by the lips, with occasional case reports of metastasis to the palatal or buccal mucosa [2]. We describe a case report of a patient of breast cancer with metastasis to the buccal mucosa.