Objective: The present study was designed to investigate the protective and potential effect of gallic acid against doxorubicin (DOX) induced cardiotoxicity. Materials and Methods: Adult Wistar albino rats of either sex weighing 150-200 g were used in this study. DOX administered intraperitoneally in six equal injections (each containing 2.5 mg/kg at 48 h intervals) to total cumulative doses of 15 mg/kg over a period of 2 weeks to induce cardiotoxicity. The estimation of cardiac and lipid biomarkers of both control and treated animals were observed. In vivo antioxidant parameters such as glutathione, superoxide dismutase, catalase, and malondialdehyde were also monitored. The remaining portion of the heart tissue used for histopathological studies. Results: The treatment with doxorubicin increased the levels (P > 0.01) of serum cardiac and lipid biomarker which were brought down by gallic acid treatment. It also exhibited electrocardiographic changes such as reduced R wave and ST segment elevation. Histopathological study revealed that gallic acid restored the myocardial cells towards normal. The restoration of the endogenous antioxidant system clearly depicts that gallic acid have produced its protective effect by scavenging the reactive oxygen species. Conclusion: The results of this study indicated that the cardioprotective effect of gallic acid might be attributed to its antioxidant property.

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Introduction: The prevalence of diabetes is increasing worldwide resulting in foot complications, which leads to poor quality of life and increased cost of living. Aim: The main aim of this study was to find out the foot complications in diabetic patients and to analyze the underlying etiology. Methodology: A retrospective study was carried out in the podiatry Department of Amrita Institute of Medical Sciences, Kerala among 277 diabetic patients with recent and recurrent foot complications. Results: Systemic hypertension (76.89%) has been found to be one of the major risk factor coexisting in the study population. 49.45% patients had preexisting peripheral neuropathy and non-healing ulcers were seen in 41.51%. Other complications include charcot arthropathy (10.46%), gangrene (9.38%), cellulitis (7.94%), fungal infections (6.89%), callus (3.61%), osteomyelitis (3.97%), and necrotizing fasciitis (2.52%). Culture report on foot ulcer patients revealed that Gram-positive Staphylococcus species (18.8%) and the Gram-negative Pseudomonas species (18.2%) were the predominant organisms. Other organisms isolated were Klebsiella species, Escherichia coli, Acenetobacter, Proteus, Enterococcus species, and streptococci. Fluoroquinolones were the most commonly prescribed antibiotics (33.5%), followed by penicillin (8.3%), clindamycin (6.1%), carbapenems (5.05%), cephalosporins (2.8%), cotrimoxazole (2.5%), and chloramphenicol (0.7%). Conclusion: The study highlights the importance of foot care, relevance of early detection of diabetes and subsequent monitoring of diabetic complications.

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Background: Proper knowledge about risk factors and prevention of congenital malformations in pregnant women can lead to primary prevention of disease. The aim of this study was to explore pregnant women's knowledge about congenital anomalies, risk factors, and prevention in relation to their sociodemographic profile. Materials and Methods: A cross-sectional study of the expecting mother's population was conducted over 3 months. Data collection was done through a questionnaire completed in face to face interviews using simple nonrandom sampling method in 150 pregnant women who visited the prenatal clinics in Rasht. The questionnaire contained 6 questions about specific knowledge and 12 questions for risk factors and prevention of congenital anomalies. Statistical analysis was performed using descriptive statistics, Pearson correlation, as well as multivariate regression analysis was performed using SPSS 21 software. Results: The overall knowledge of pregnant women about congenital anomalies showed a significant relationship with age (P = 0.001) and the level of education (P = 0.000). However, there was not a significant relationship between overall knowledge and parity (P = 0.183) and the number of antenatal visits (P = 0.097). The participant who had High School and University education had the highest score in overall knowledge about the disorder. The age group 41-50 years had the lowest overall knowledge about the disorder. Conclusions: There is a need for public programs to increase awareness about congenital anomalies in pregnant women and people. Use of genetic counseling for families at risk for congenital anomalies is proposed.

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Aim: This study was designed to evaluate the effect of β-asarone on diethylnitrosamine (DEN) induced and phenobarbital-promoted hepatocellular carcinoma in rats. Materials and Methods: The experiments were carried out with two models, i.e., tumor initiation and promotion model. The effect of β-asarone was evaluated by the estimation of food and water consumption, body and liver weights, liver function indicators such as aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total and direct bilirubin, cancer indicators such as alpha-fetoprotein, DNA, RNA, and total liver protein content, and histopathological studies. Results: The results showed that the levels of liver function indicators were brought down to near normal level by β-asarone. Similarly, cancer indicators were also brought down to near normal level by β-asarone. A comparative histopathological study of liver, treated with β-asarone exhibited normal architecture, which was found to be disrupted in DEN-treated rats. Conclusion: The results indicate that the β-asarone has significant hepatoprotective effect and may potentially possess an anticancer activity.

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Medicinal herbs/plants or the herbal drugs refer to the use of plant and plant-based products for the management of common ailments. World Health Organization has defined herbal medicines as finished labeled medicinal product that contains an active ingredient, aerial, or underground parts of the plant or other plant material or combinations. In India, more than 70% of the population uses herbal medicine for their health-related problems. Many of the institutions adopt “reverse pharmacology” approach to study the clinical efficacy of medicinal plants and their pragmatic utility in healthcare. Moreover, the herbal therapeutics constitutes a major share of all the officially recognized Indian systems of medicine such as Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH). However, there is evidence of spurious drugs, irrational use, and adverse drug reactions of herbal drugs which should certainly be monitored with governmental patronization. Furthermore to be accepted as a viable alternative to modern medicine vigorous method of scientific and clinical validation must be applied to prove the safety and effectiveness of these herbal products. However, the clinical trial of herbal drugs is difficult owing to some of the obvious reasons. Around 20,000 medicinal plants have been identified for their medicinal properties; however, only 7000–7500 medicinal plants are being used by traditional practitioners. Similarly, the export of AYUSH-related items has increased from 2011 to –2012 and 2012 to –2013 and decreased in 2013–2014; however, import has been consistently increased during these years. Given this background, a brief review was carried out to assess the medicinal herbs and their development in India primarily through 5-year plan documents of India.

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CONTEXT: Mortality due to noncommunicable diseases (NCDs) has increased worldwide and, according to the World Health Organization report in 2012, 68% of mortality was due to NCDs. In India, deaths due to NCDs in 2008 were 5.3 million. A rapid health transition is being experienced in India with a rising burden of NCDs. The first point of contact of patients with health services is primary health-care (PHC) facilities, which are the most appropriate places for patient screening and early detection. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) was launched in 2010 in India and in Belagavi district on September 29, 2015. Periodic evaluation helps to understand the problems a program is facing in managing and implementing so that appropriate modifications can be suggested. AIMS: To assess the implementation of NPCDCS at subcenters of Belagavi taluka. SETTINGS AND DESIGN: A cross-sectional study was conducted in Belagavi taluka of Belagavi district, Karnataka, from January 1, 2017, to December 31, 2017. SUBJECTS AND METHODS: The list of PHC centers and subcenters was obtained from the District Health Office, Belagavi. Simple random sampling method was used, and three subcenters from each of the 12 PHCs in Belagavi taluka were selected, accounting to 36 subcenters. Permission from the medical officer at the PHC was obtained, the concerned auxiliary nurse midwives (ANMs) of the selected subcenters in Belagavi taluka were contacted, written informed consent was obtained from all the participants, and the data were collected using a pretested, predesigned structured questionnaire based on personal interview by the investigator. STATISTICAL ANALYSIS USED: Rates, ratios, and percentages were calculated. RESULTS: The selected 36 subcenters in Belagavi taluka covered a population of 248,753, with a mean subcenter population of 6909. Nearly 63% of the subcenters were conducting the NCD camps weekly, with average number of NCD camps conducted per subcenter being 30/year, and the population screened for NCDs across all 36 subcenters was 64,096 accounting to 25.77% coverage. The prevalence of diabetes was found to be 4.87%, and the prevalence of hypertension was found to be 4.99% and, among the screened population, 69% of the ANMs had received training regarding NPCDCS and all the necessary equipment were adequate except for referral cards. CONCLUSIONS: NCD screening camps were being conducted at all subcenters and only 69% of ANMs had received training for NPCDCS and the necessary equipment and Information, Education and Communication materials were available at all selected subcenters for conduction of NCD camps.

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BACKGROUND: Diabetes is a major disease burden in India, and we are home to the second largest number of diabetes cases in the world with currently over 72 million cases of diabetes. The reported prevalence of obesity in type 2 diabetes mellitus (T2DM) was 60%–90%. Obesity and overweight pose a major risk for chronic diseases and are considered to be a strong risk factor for the development of T2DM. AIMS: The aim of the study was to determine the prevalence of obesity among T2DM patients. MATERIALS AND METHODS: This community-based cross-sectional study was conducted among T2DM patients residing in areas under Ashok Nagar and Rukmini Nagar Urban Health Centres, Belagavi. Three hundred and eighty T2DM patients were included in the study over a period of 1 year (January 1–December 31, 2017). Predesigned and pretested questionnaire was used to collect sociodemographic profile, and patient's height and weight were measured, and body mass index (BMI) was calculated and categorized based on Asian population. STATISTICAL ANALYSIS USED: Statistical analysis was done using the Chi-square test for categorical variables. P < 0.05 was considered statistically significant. RESULTS: The prevalence of generalized obesity (GO), abdominal obesity (AO), and combined obesity (CO) among T2DM patients were 58.68%, 81.84%, and 53.42%, respectively. Multiple logistic regression analysis showed that female gender and hypertension were significantly associated with GO, AO, and CO. Physical inactivity and hyperglycemic state were significantly associated with AO and CO but not with GO. The duration of T2DM was significantly associated with AO but not with GO and CO. CONCLUSIONS: Our study concluded that obesity is a highly prevalent comorbidity in diabetic patients. AO appears to be a better indicator of diabetic risk than BMI. The combination of a low-calorie diet, increased physical activity, and behavioral therapy as the first-line intervention for weight loss should be stressed for the effective management of T2DM.

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Background: Blood transfusion service is a sensitive issue as it is covered by “Drug and Cosmetics Act” and has legal implications. Strict criteria are followed while selecting a donor so that proper blood free of all pathogens is available for recipient. Aim: To study seroprevalence of transfusion-transmitted major infections (HIV, hepatitis B virus [HBV], hepatitis C virus [HCV], syphilis, and malaria) among blood donors at a Tertiary Care Government Hospital Blood Bank in North India and to compare positivity of markers of these infections in voluntary and replacement donors. Subjects and Methods: This study was conducted over a period of 5 years (July 2010–June 2015). A total number of donors screened during this period was 130,920. Samples were tested for HIV, HBV, HCV, syphilis, and malaria and retested if found positive by third generation ELISA tests (HIV, hepatitis B surface antigen [HBsAg], HCV). Comparative analysis was done using Chi-square for linear trend. Comparison between prevalence rates among voluntary and replacement donors was done using Chi-square tests using Microsoft Excel 2007 software. Results: Of total 130,920 donors, 114,214 (87%) were voluntary and 16,706 (13%) were replacement donors. Male donors predominated, 128,781 (98.37%) male and female 2139 (1.63%). Average seropositivity of HIV, HBsAg, anti-HCV, syphilis, and malaria was 0.10%, 1.60%, 0.18%, 0.89%, and 0.04% among all donors. Significant difference (P < 0.001) in the seropositivity of HIV, HBsAg, HCV, and syphilis was seen between voluntary and replacement donors. Seroprevalence of HIV, HBsAg, HCV, syphilis, and malaria was 0.08%, 1.56%, 0.13%, 0.71%, 0.03%, and 0.25%, 1.90% 0.51%, 2.12%, and 0.04% in voluntary blood donor and replacement blood donor, respectively. Conclusion: Comparing a retrospective data over a long period showed decreasing trend in seroprevalence of HIV, HBsAg, anti-HCV, syphilis, and malaria. Results of the study reflect the prevalence of these infections in the healthy population and warrant measures that should be taken to detect these infections and prevent transmission.

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Background and Objectives: The determination of sex in forensic investigation is an important and crucial step. Unidentifiable crania are very common due to warfare, mass disasters, intentional attempt to obscure facial identity in criminal attacks, or physical injury caused by weapons, explosives, or fire. In such a situation, the determination of sex becomes extremely complicated and challenging. Aim: The present study was undertaken to provide data on foramen magnum and occipital condyle (OC) for the purpose of sex determination for establishing the identity in cases of unknown fragmentary skulls. Settings and Design: Retrospective. Subjects and Methods: The study group included computed tomography scan images of 200 patients (100 males and 100 females) in the age range of 21-80 years fulfilling the inclusion and exclusion criteria. Seven variables were used to measure the dimensions of foramen magnum and OC. Statistical Analysis Used: Descriptive statistics, discriminate analysis, and unpaired t-test. Results: Significant differences were observed in all the metric variables in male and female population. The dimensions of foramen magnum and OC were significantly larger in male population. Discriminant function analysis revealed an accuracy of 94% (91% in male and 97% in female population). Conclusion: The dimensions of foramen magnum and OC can be accurately used for sex determination thus opening avenues for new research in the field of anthropology and forensic sciences.

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Uraga/Sarpa/Bhujaga grahonmada (UG) is one among the 18 types of bhootonmada. Bhootonmada denotes a category of psychiatric/neuropsychiatric conditions assumed to be caused by affliction of evil spirits (bhuta/graha). Till date, no studies have been conducted on UG and it is unexplored. The present study is focused on the better understanding of UG and its clinical applicability. UG is characterized by features of Krodhanam (aggressiveness/impulsivity), Nishwasantam (hyperventilation/anxiety/phobia), Bhramantam (agitation/restlessness/hyperactivity), Trasyantam (startle response/hyperekplexia/anxiety/phobia), Raktaaksha (red eyes/Kayser–Fleischer rings), Stabdha drishtim (prolonged staring/abnormal eye movements), Jihwa lolayantam/Srikkinyau lihaan (facial tics), Sarpavat prasarati/Adhomukha shaayinam (athetosis/chorea/motor tics/opisthotonus), Chalam/Vakra gamanam (gait abnormalities), Ksheera, ghrita, guda, and madhu priyam (craving for sweets), Snaana maalya priyam (obsessive-compulsive features), Gaatraani kampayantam (tremors/motor tics/seizures), Dantai khaadantam (self-injurious behaviors/oromandibular dystonia/bruxism), Nidraalu (hypersomnia/excessive daytime sleepiness), etc.. The clinical picture of UG shows similarity with various “extrapyramidal movement disorders” and also with “Tourette syndrome-plus.”

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Introduction: A major problem in ocular therapeutics is the attainment of optimum drug concentration at the site of action, which is compromised mainly due to precorneal loss resulting in only a small fraction of the drugs being absorbed. The effective dose administered may be altered by increasing the retention time of medication into the eye by using in situ gel forming polymeric systems. Materials and Methods: In the present investigation, an attempt has been made to design, formulate, and evaluate in situ gelling-based ophthalmic drug delivery system dorzolamide hydrochloride to enhance the precorneal retention and to improve the ocular bioavailability. In situ gel formulations are designed using carboxy methyl tamarind, a polysaccharide, was used with other natural polymers such as xanthan gum, gellan gum, and sodium alginate. The in situ gel formulations were characterized for physicochemical characters, namely physical appearance, pH measurement, gelling capacity, drug content estimation, rheological study, effect of sterilization on the viscosity, in vitro diffusion study mucoadhesive strength, sterility testing, preservative efficacy testing, isotonicity testing, and ocular irritation testing. Results and Discussion: The developed formulations exhibited sustained release of drug from formulations over a 9 h period, thus increased residence time of the drug. Effect of sterilization was studied to check the rigors of sterilization on the viscosity of the formulations. In the study, two optimized formulations were selected on the basis of ability to form good gelling with increased viscosity with a slow and prolong in vitro drug release pattern. The formulations were found to be nonirritating with no ocular damage or abnormal clinical signs observed. Conclusion: Therefore, the developed ophthalmic in situ gel by virtue of its prolonged corneal residence time and sustained drug release could be considered a viable alternative to the conventional eye drops formulation in achieving enhanced bioavailability.

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Introduction: Menstruation is a phenomenon unique to females. In India, limited access to products of sanitary hygiene and lack of safe sanitary facilities could increase the likelihood of resorting to unhygienic practices to manage menstruation. Materials and Methods: A cross-sectional study was conducted from April 2013 to April 2014 by interviewing 452 adolescent school girls using a semi-structured, pretested questionnaire. There were 6 schools and 1 PUC college in the study area. Data were analyzed using Epi Info 3.5.3. Objectives: The objectives of this study were (1) to study the knowledge and attitude toward menstruation among adolescent school girls, (2) to study the practices of menstrual hygiene among adolescent school girls, (3) to enumerate the common menstrual morbidities among girls, and (4) to elicit their health-seeking behavior regarding menstrual health. Results: The mean age and standard deviation of girls included in the study were 13.05 years and 0.09472. Only 37.39% girls knew that infection would occur if they do not clean their vagina regularly during menstruation. Only 34.1% girls had the right perception about menstruation as a normal physiological process. Majority of girls used sanitary pads during menstruation. 35.32% of girls said that they were scared when they first attained menarche. Only 11.08% girls said that they had no restrictions during menstruation. Conclusion: The school girls had less than satisfactory knowledge, but good practices regarding menstrual health among those who had attained menarche. Religion, mother's education, and socioeconomic status were factors determining knowledge, attitude, and practices of menstrual health among adolescent school girls.

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Objective: The aim of this study is to identify the risk factors associated with late preterm births (LPBs). Methodology: This case-control study was conducted in the Department of Obstetrics and Gynecology, teaching hospital attached to KLE University's Jawaharlal Nehru Medical College, Belagavi during May 2015–April 2016. A total of 918 women were enrolled into the study, 459 in each group. Women who delivered between 34 and 36 weeks 6 days were considered cases and controls were women who delivered from 37 weeks onward immediately after a case occurred. Gestational age was confirmed with ultrasonography before 20 weeks. Data were collected from the history of the patient and the medical records. Results: Incidence of LPB was found to be 8% among total births. It was found that 55.1% were spontaneous births. The most common risk factor for LPB was hypertensive disorders of pregnancy (gestational hypertension [HTN]–4.8%, chronic HTN–5%, preeclampsia–36%, eclampsia–4.8%) followed by preterm premature rupture of membranes (32.7%), history of prior preterm births (19.2%), gestational diabetes (17.9%), multifetal gestation (16.6%), placenta previa (13.5%), and abruption placenta (9.8%). On analyzing neonatal outcome, sepsis was found in 25%, hyperbilirubinemia in 21.9%, respiratory distress syndrome in 19%, transient tachypnea of newborn in 9%, and patent ductus arteriosus in 2.9% of the neonates. Conclusion: The indication for the induction or need for termination should be reevaluated in the late preterm gestation. To prevent LPB, identification of the risk factors is necessary and timing of delivery in each risk factor should be reassessed in advance before intended intervention. As LPB constitute the majority of preterm births, it is important to limit late preterm deliveries to clear maternal or fetal indication for delivery.

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Malignant melanoma is the most aggressive form of skin cancer, with a high mortality rate. The current chemotherapies have a relatively low success rate due to the development of multidrug resistance and side effects. Hence, there is need of discovering new compounds that are safe and more effective against melanoma to improve the efficiency and to lower the treatment cost for cancer care. Melanoma chemoprevention with natural herbal phytoconstituents is an emerging strategy to prevent, cure, or treat melanoma. This review summarizes the latest research in melanoma chemoprevention and treatment using the herbal phytoconstituents. Relevant mechanisms involved in the pharmacological effects of these phytochemical are discussed. Phytoconstituents that are discussed in this review are carotenoids, flavonoids, some polyphenols, piperine alkaloid, and sulforaphane having high anticancer potential mostly to be used for the treatment of melanoma.

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One of the latest threats emerged to the integrity of academic publishing is predatory journals. These journals have paved the way for low-quality articles by exploiting gold open-access publishing, threatening standards of evidence-based science. These journals lack the authentication of legitimate scholarly journals such as peer review, editing, editorial boards, editorial offices, and other editorial standards, imposing a number of new ethical issues in publishing research papers. Some of these claim to assess submissions within 72 h and digitally publish them on acceptance and receipt of the fee, showing their only motivation of procurement of evaluation and publication fees. While many of the predatory publications can be easily recognized as such by most in their respective professions, some present them as highly sophisticated and operate websites that mirror prominent mainstream journals. Even experienced professionals sometimes fail to recognize these dubious journals and join the editorial boards of these journals or submit articles, posing a big threat to publication standards and ethics. It is the utmost need of authors, i.e., scientific authors have ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics.

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The diseases of the pediatric airway is often challenging to the clinician. It needs a dedicated team of clinicians for evaluation and treatment. Obstructing lesions of the pediatric airway due to congenital or acquired causes often create fatal situations. Majority of the pediatric airway lesions are due to prolonged intubation or tracheostomy and prematurity. Management of the pediatric airway lesions often complicated with additional congenital malformations or severe comorbidities. It is often important for the pediatrician to understand the different pediatric airway lesions and its issues relevant to the airway management of the pediatric patients. This review article will give an overview of commonly encountered airway problems in children and its management.

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Fetal ascites is commonly seen with hydrops fetalis. Historically, fetal ascites has been associated with significant mortality and morbidity. Primary isolated fetal ascites occurs independently as an isolated disease due to numerous congenital abnormalities. Extensive antenatal and postnatal evaluation for the detection of the cause is done in these cases, if found and appropriately treated have shown good results. In conclusion, even a rare case of fetal ascites can be managed successfully.

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Background: In the present investigation, tamoxifen-loaded liposomes transdermal patch was formulated using eudragit-RL, hydroxypropyl methyl cellulose K-50, and ethyl cellulose. Materials and Methods: Liposomes were formulated by solvent evaporation method using poly (sebacic acid-co-ricinoleic acid) in varying ratios and evaluated for particle size, drug loading, entrapment efficiency, transmission electron microscopy, differential scanning calorimetry, and X-ray diffraction. Formulated tamoxifen-loaded liposomes were finally incorporated into transdermal patch and evaluated for thickness drug content, moisture content, moisture uptake, folding endurance, tensile strength diffusion coefficient, permeability coefficient, in vitro permeation, and skin irritation. Optimized transdermal patches were tested for its pharmacokinetic and pharmacodynamics parameters Results: Formulated transdermal patches showed improved bioavailability of tamoxifen when compared to its oral route. Conclusion: Tamoxifen-loaded liposomal transdermal patches could serve as a better alternative to existing marketed formulation in terms of bioavailability.

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Background and Purpose: Respiratory problems like RDS, pneumonia and acute respiratory failure in premature neonates are one of the leading causes of neonatal morbidity and mortality in developing countries. Decreased oxygenation and excess accumulation of secretion is common leading to increase in airway resistance, and complications like atelectasis requiring prolonged ventilatory assistance or oxygen support. Apart from convention chest physiotherapy techniques like percussion and vibration newer techniques like LST and vojta have been used to clear secretions, restore homogenous inflation of the lungs and improve oxygenation. In this study, we compared the effectiveness of CPT, LST and reflex rolling on oxygenation in preterm neonates with respiratory problems, in terms of blood gases and oxygen saturation. Materials and Methods: This ra ndomized controlled trial included 60 neonates with RDS and pneumonia with gestational age of 30 to 37 weeks under O ₂ therapy. The participants were randomly allocated into 3 groups. Group A received CPT, group B received LST with CPT and group C received Reflex rolling with CPT for 20 minutes duration per session at 0, 4 ^th and 8 ^th hour, three sessions per day, for a period of 2 weeks. Pre and post intervention values of pulse oximetry and Arterial Blood Gas was recorded to analyze oxygenation. Chest X-rays were taken on day 1 and last day. Results: The results showed within group improvements in SPO ₂ , PaO ₂ which was statistically significant (P < 0.001) on day 1, and post intervention on last day for all the groups whereas between groups comparison showed no significant difference with P value 0.480 and 0.258 respectively. Chest radiographs demonstrated re-expansion of collapsed airways. Conclusion: The present study concludes that the three treatment techniques viz. CPT, LST Technique and Reflex Rolling are safe and effective for improving Oxygenation in preterm neonates with respiratory problems and can be used in clinical settings.

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Background and Aims: Dexmedetomidine is a selective α₂ agonist used as an adjuvant to attenuate sympathetic response to laryngoscopy and tracheal intubation in general anesthesia. Recent studies have shown that dexmedetomidine decreases brain flow and cerebrospinal fluid pressure without cerebral ischemia. Hence, it is beneficial in neurosurgical procedures. This study was undertaken to analyze the efficacy of dexmedetomidine in neurosurgery for good perioperative hemodynamic stability with blunt sympathetic response to laryngoscopy and intubation. Materials and Methods: Sixty, American Society of Anesthesiologists grades II-IV patients between 18 and 50 years of age undergoing craniotomy under general anesthesia were divided randomly into two groups (thirty patients in each group). Group D: Dexmedetomidine was given as a bolus dose of 1 μg/kg diluted to a total volume of 20 ml with normal saline (0.9%) for 10 min before the induction of anesthesia. Group C: The patients received a similar volume of normal saline. Results: We observed a decrease in blood pressure and heart rate (HR) after intubation by dexmedetomidine, and they were highly significant on comparison (P < 0.0001). During intraoperative period, the patients in Group D had lower HR and blood pressure than baseline value as compared to Group C (P < 0.0001). We also observed decreased requirement of sevoflurane (33%) and fentanyl (45%) in Group D compared to Group C. Data were expressed as mean values ± standard deviation. P <0.05 was considered to be significant. Conclusion: Dexmedetomidine blunted the hemodynamic stress response due to laryngoscopy and intubation and perioperative hemodynamic stability in patients undergoing neurosurgery.

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Context: Attention deficit hyperactivity disorder (ADHD) commonly occurs in patients with bipolar affective disorder (BPAD). However, there is a paucity of data concerning the prevalence of adult ADHD in BPAD from India. Aims: Attention deficit hyperactivity disorder (ADHD) commonly occurs in patients with bipolar affective disorder (BPAD). However, there is a paucity of data concerning the prevalence of adult ADHD in BPAD from India. Hence, this study aimed to find out the prevalence of adult ADHD in bipolar disorder for better diagnosis and management and tried to find association with clinical and sociodemographic features. Settings and Design: The present 1 year cross-sectional study was conducted in the Department of Psychiatry, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 1, 2014, to December 31, 2014. Subjects and Methods: A total of 100 patients with diagnosis of BPAD were evaluated for the presence of ADHD. Statistical analysis was done using Epi Info 7 software. Statistical Analysis Used: The data obtained was coded and entered and analyzed using Epi Info 7. Results: Most of the patients were male (64%) and male:female ratio was 1.77:1. The mean age was 37.36 ± 11.02 years and most common age group was 31–40 years (38%). The place of residence was urban area in 53% of the patients, and 72% were Hindus. Education up to secondary schooling was noted in 63% of the patients, and 63% were unemployed. Forty-four percent of the patients belonged Class I socioeconomic status. History of other psychiatric comorbidities was noted in 55% patients, and most of the patients had alcohol dependence syndrome (23%). Conclusions: The frequency of ADHD in patients with BPAD was 15%. The most common clinical presentation was difficulty in memory/concentration and failure to finish the work, difficulty in organization, avoiding tasks requiring sustained mental effort, forgetfulness, and easily distracted were common signs.

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Introduction: The recent years have witnessed a substance abuse epidemic with serious health, social, economic, and political repercussions. Initially, a problem of the developed countries, but now has assumed alarming dimensions even in developing countries. India too has been caught in this vicious circle of substance abuse. Materials and Methods: Six hundred adolescents of age group between 10 and 19 years in the area of UHC Ram Nagar and Rukmini Nagar were interviewed with the help of predesigned and pretested questionnaire. Data were analyzed using SPSS version 20. Results: Out of 600 participants, 505 were males and 95 were females. The prevalence of substance use was found to be 71 (11.8%), with females having the highest prevalence (17.9%) than males (10.7%). Smokeless form of tobacco (78.87%) being the most common substance use followed by smoke form of tobacco (15.49%) and least (2.82%) with alcohol and ganja. Conclusion: Smokeless form of tobacco and smoke form being the most common form of substance abuse among adolescents in urban slum. Females had a higher prevalence of substance use than males.

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Background and Objectives: Depression is an important comorbid condition of chronic obstructive pulmonary disease (COPD). There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualized as an understandable reaction to COPD and not as signs of an independent depressive disorder. The exact prevalence of depression in COPD patients among the Indian population is unknown. Aim: This study aims to know the prevalence of depression in COPD patients attending tertiary care hospital. Materials and Methods: A total of 120 COPD patients were enrolled in the study according to Global initiative for COPD (GOLD) criteria 2015. They were screened for depression as per Beck's depression score. Results: Eighteen patients in stage 1, 66 patients in stage 2, 29 patients in stage 3, and 7 patients in stage 4 of the COPD were enrolled. The prevalence of depression in the study population was 55%. Conclusion: The prevalence of depression in COPD is very high. The factors associated with depression in COPD patients were the duration of the disease, body mass index, GOLD stage, and smoking. Duration of the disease and smoking was the most significant factors associated with depression in COPD. Patients with COPD should be screened for depression and those with higher depression score should undergo further evaluation. Further studies involving larger number of subjects from several centers are required to study the prevalence of depression in Indian patients with COPD.

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Endometrial thickness (EM) is one of the strongest predictors of implantation rate and ongoing pregnancy success rate. The endometrial growth is dependent on the uterine blood flow and angiogenesis. Recently, some reports discussed the possible beneficial effects of sildenafil citrate on EM. Sildenafil citrate leads to smooth muscle relaxation and vasodilation. Because of these biological properties, it is a potential candidate for female infertility, especially in the management of thin endometrium, which leads to low implantation and pregnancy rates. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, randomized controlled trials, and observational cohort or case-control studies for the role of sildenafil in thin endometrium. Systematic search through all the clinical studies showed favorable results. They documented the beneficial role of sildenafil citrate in the treatment of thin endometrium in failed in vitro fertilization-embryo transfer cycles, assisted intrauterine insemination cycles, or resistant endometrium, where it increased the uterine receptivity.

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Background: Ayurveda, the science of life, is the most ancient medical doctrine of human civilization. Some of the basic principles described in Ayurveda are still the same as today's medical science. Ayurveda does not have a specific text as epidemiology, but the principles described in piecemeal can be compiled, analyzed, and interpreted in the light of modern theories of epidemiology. Objective: An initial systematic literature review by the help of internet-based search engines revealed very negligible work in the field of Ayurveda and epidemiology. Hence, an attempt was made to analyze various principles of Ayurveda relevant to epidemiology and interpret their contemporary significance. Methodology: The work is mainly based on theoretical research using standard textbooks of epidemiology and classical treatises of Ayurveda. Discussion: A good number of principles are found in the classical texts of Ayurveda, which can be compared with the concepts of epidemiology. In the process of theoretical analysis, the following concepts were found relevant, such as the concept of causation of disease/Etiology of disease, causes of epidemic, classification of disease, modes of communicable disease transmission, and natural history of disease. In this study, attempt has been made to understand these concepts in the light of epidemiology with their most approximate delineation. However, being a classical medical doctrine, it has its own appeal that cannot exactly be compared with the concepts of epidemiology. Conclusion: It is interesting to note that the tenets described centuries back are very much relevant at this present era, and their importance cannot be neglected.

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