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Formulation and design of sustained release matrix tablets of metformin hydrochloride: Influence of hypromellose and polyacrylate polymers
Harekrishna Roy, Chandan K Brahma, Sisir Nandi, Kirti R Parida
January-June 2013, 3(1):55-63
DOI:10.4103/2229-516X.112242  PMID:23776841
Aim: The current paper was an attempt to design a sustained release dosage form using various grades of hydrophilic polymers, Hypromellose (hydroxyl-propyl methylcellulose [HPMC] K15M, HPMC K100M and HPMC K200M) and Polyacrylate polymers, Eudragit RL100 and Eudragit RS100 with or without incorporating ethyl cellulose on a matrix-controlled drug delivery system of Metformin hydrochloride. Materials and Methods: Laboratory scale batches of nine tablet formulations were prepared by wet granulation technique (Low shear). Micromeritic properties of the granules were evaluated prior to compression. Tablets were characterized as crushing strength, friability, weight variation, thickness, drug content or assay and evaluated for in-vitro release pattern for 12 h using Phosphate buffer of pH 6.8 at 37 ± 0.5°C. The in-vitro release mechanism was evaluated by kinetic modeling. Results and Discussion: The results obtained revealed that HPMC K200M at a concentration of 26% in formulation (F6) was able to sustain the drug release for 12 h and followed the Higuchi pattern quasi-Fickian diffusion. With that, combined effect of HPMC K15M as an extragranular section and Eudragit RS100 displayed a significant role in drug release. Dissolution data were compared with innovator for similarity factor (f2), and exhibited an acceptable value of ≥50 Three production validation scale batches were designed based on lab scale best batch and charged for stability testing, parameters were within the limit of acceptance. There was no chemical interaction found between the drug and excipients during Fourier Transform Infrared Spectroscopy (FTIR) and Differential scanning calorimetry study. Conclusion: Hence, combinely HPMC K200M and Eudragit RS100 at a suitable concentration can effectively be used to sustain drug release.
  15,514 1,496 5
Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility
Indu Verma, Renuka Sood, Sunil Juneja, Satinder Kaur
January-June 2012, 2(1):17-19
DOI:10.4103/2229-516X.96795  PMID:23776802
Context: Prevalence of hypothyroidism is 2-4% in women in the reproductive age group. Hypothyroidism can affect fertility due to anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalance. Aims and Objectives: To study the prevalence of clinical/sub-clinical hypothyroidism in infertile women and the response of treatment for hypothyroidism on infertility. Materials and Methods: A total of 394 infertile women visiting the infertility clinic for the first time were investigated for thyroid stimulating hormone (TSH) and prolactin (PRL). Infertile women with hypothyroidism alone or with associated hyperprolactinemia were given treatment for hypothyroidism with thyroxine 25-150 μg. Results: Of 394 infertile women, 23.9% were hypothyroid (TSH > 4.2 μIU/ml). After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year. Infertile women with both hypothyroidism and hyperprolactinemia also responded to treatment and their PRL levels returned to normal. Conclusion: Measurement of TSH and PRL should be done at early stage of infertility check up rather than straight away going for more costly tests or invasive procedures. Simple, oral hypothyroidism treatment for 3 months to 1 year can be of great benefit to conceive in otherwise asymptomatic infertile women.
  11,339 1,404 15
Bioenhancers from mother nature and their applicability in modern medicine
Gurpreet Kaur Randhawa, Jagdev Singh Kullar, Rajkumar
January-June 2011, 1(1):5-10
DOI:10.4103/2229-516X.81972  PMID:23776764
Concept of bioenhancers or biopotentiators was first time reported in 1929 by Bose. A bioenhancer is an agent capable of enhancing bioavailability and efficacy of a drug with which it is co-administered, without any pharmacological activity of its own at therapeutic dose used. Development and consequent isolation of these molecules, such as piperine and quercetin, is considered as scientific breakthrough. A fixed drug combination (Risorine) of rifampicin, isoniazid, and piperine is the result of this research. It contains almost 60% less dose of rifampicin because of its increased bioavailability and it also prevents resistance. This concept is mentioned as yogvahi in ayurveda and was used to increase the effect of medicines by increasing oral bioavailability, decreasing adverse effects and to circumvent parenteral routes of drug administration. More such useful and economically viable drug combinations can be developed by integrating knowledge of time tested ayurveda with modern methods of research. This review is an account of these bioenhancers, available from the natural resources.
  11,159 1,565 23
A review of drug isomerism and its significance
Naveen Chhabra, Madan L Aseri, Deepak Padmanabhan
January-June 2013, 3(1):16-18
DOI:10.4103/2229-516X.112233  PMID:23776834
Isomerism finds its importance in the field of clinical pharmacology and pharmacotherapeutics, as isomers differ in their pharmacokinetic and pharmacodyanmic properties. Drug isomerism has opened a new era of drug development. Currently, knowledge of isomerism has helped us in introducing safer and more effective drug alternatives of the newer as well as existing drugs. Many existing drugs have gone chiral switch i.e., switching from racemic mixture to one of its isomers. Cetrizine to levocetrizine is one of such examples, where effective and safer drug has been made available. In this article, we have attempted to review the basic concepts of stereochemistry and chirality and their significance in pharmacotherapeutics. Various pharmacological aspects such as pharmacokinetic and pharmacodynamic variations resulting out of chirality has been discussed in detail in this article.
  10,770 1,327 49
Intradetrusor botulinum toxin type A in refractory overactive bladder: A potential future treatment
Rajiv Mahajan, Navyug Raj Singh
July-December 2011, 1(2):67-70
DOI:10.4103/2229-516X.91144  PMID:23776779
  2,703 9,298 -
Effect of preeclampsia on insulin sensitivity
Smita Sinha, Gobind Pratap Singh, Kapil Gupta, Satwant Kumar, Aekta Gupta
January-June 2014, 4(1):7-10
DOI:10.4103/2229-516X.125670  PMID:24600570
Objective: The objective of this study is to investigate whether preeclampsia is associated with exacerbation of insulin resistance. Materials and Methods: The study was conducted over a period of 7 months from November 2011 to May 2012, in a tertiary care hospital attached to a medical college. A total of 14 pregnant women in the third trimester with preeclampsia were recruited for this study and 14 well-matched normotensive women in the third trimester were taken as control. 15 g, 50% dextrose load was given intravenously and blood sampling was carried out for glucose and insulin levels up to 3 h afterward. Minimal model analysis of glucose and insulin levels was performed to arrive at results. Results: No significant changes in mean age, body mass index, gestation, serum lipid and progesterone, cortisol and androgen concentrations were recognized. No significant difference was found between the glucose decay curves and between the glucose clearance rate K, in the two groups (preeclamptic vs. normotensive: 2.1 ± 0.2 vs. 2.2 ± 0.3; P = 0.48). Therefore, there was a small but prolonged decrease in the insulin response of women with preeclampsia compared with women in the normotensive group. Conclusion: Preeclampsia per se is not a risk factor for development of insulin resistance.
  9,827 1,437 -
Yawning and its physiological significance
Sharat Gupta, Shallu Mittal
January-June 2013, 3(1):11-15
DOI:10.4103/2229-516X.112230  PMID:23776833
Although yawning is a commonly witnessed human behavior, yet it has not been taught in much detail in medical schools because, until the date, no particular physiological significance has been associated with it. It is characterized by opening up of mouth which is accompanied by a long inspiration, with a brief interruption of ventilation and followed by a short expiration. Since time immemorial, yawning has been associated with drowsiness and boredom. However, this age old belief is all set to change as the results of some newer studies have pointed out that yawning might be a way by which our body is trying to accomplish some more meaningful goals. In this review, we have tried to put together some of the important functions that have been proposed by a few authors, with the hope that this article will stimulate the interest of newer researchers in this hitherto unexplored f ield.
  10,130 885 5
Painful cervical lymphadenopathy: An unusual presentation of chikungunya
Mukundraj S Keny, Ian A Pereira, Sunita B deSa, Edwin J Gomes
January-June 2014, 4(1):47-49
DOI:10.4103/2229-516X.125695  PMID:24600579
Chikungunya is an arboviral disease transmitted by Aedes mosquito that represents a major public health burden worldwide including India. The disease presents as sudden onset of high-grade fever, severe arthralgias, and rash. Here, we describe a case of a patient who presented with cervical lymphadenopathy, fever, and myalgia and later was diagnosed as chikungunya. Lymphadenopathy has been described before as a less common symptom of chikungunya. But this is probably, the first case of chikungunya with cervical lymphadenopathy as a presenting feature.
  10,570 351 1
Will the epidemic of metabolic syndrome raise the prevalence of antiplatelet drug resistance?
Richard Kones, Umme Rumana
July-December 2013, 3(2):75-76
DOI:10.4103/2229-516X.117047  PMID:24083139
  1,771 8,704 -
To compare the efficacy and safety of fixed dose combination of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm
Sanjeev Kumar, Seema Rani, Ramchander Siwach, Prem Verma
July-December 2014, 4(2):101-105
DOI:10.4103/2229-516X.136789  PMID:25143885
Background: The fixed dose combinations (FDCs) of muscle relaxants, non-steroidal anti-inflammatory drugs and paracetamol are commonly prescribed in the treatment of acute lower backache. Aim: The present study was undertaken with the aim of comparing the efficacy and safety of FDCs of thiocolchicoside and aceclofenac versus chlorzoxazone, aceclofenac and paracetamol in patients with acute lower backache associated with muscle spasm. Materials and Methods: A total of 100 patients between ages range from 18 and 55 years having low back pain of ≤7 days duration were randomly divided into two groups. Group A was prescribed thiocolchicoside (4 mg) + aceclofenac (100 mg) while Group B was prescribed chlorzoxazone (500 mg) + aceclofenac (100 mg) + paracetamol (325 mg) orally twice daily for 7 days. Severity of pain at rest and on movement was recorded using visual analogue scale. Muscle spasm was evaluated by hand-to-floor distance and Lasegue's maneuver. Readings were noted on day 1 (baseline), day 3 and day 7. Results: There was statistically significant reduction in severity of pain and muscle spasm on day 3 and day 7 in both groups. There was no statistically significant difference in pain relief and muscle spasm among the treatment groups but clinically showed better improvement in the Group A. The adverse drug reactions occurring during study showed a statistically significant better safety profile in the Group A than Group B . Conclusion: These findings confirm that FDC of thiocolchicoside and aceclofenac is a preferred option for patients with lower backache pain associated with muscle spasm.
  9,416 1,033 6
Recent advances in antibacterial drugs
Jaswant Rai, Gurpreet Kaur Randhawa, Mandeep Kaur
January-June 2013, 3(1):3-10
DOI:10.4103/2229-516X.112229  PMID:23776832
The incidence of antimicrobial resistance is on continued rise with a threat to return to the "pre-antibiotic" era. This has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. Various efforts have been made to develop the newer antimicrobials with novel modes of action which can act against these multi-drug resistant strains. This review aims to focus on these newly available and investigational antibacterials approved after year 2000, their mechanism of actions/resistance, and spectrum of activity and their phases of clinical trials. Newer unexploited targets and strategies for the next generation of antimicrobial drugs for combating the drug resistance and emerging pathogens in the 21 st century have also been reviewed in the present article.
  9,183 1,233 12
Prevention and management of type 2 diabetes: Potential role of genomics
Rajiv Mahajan, Kapil Gupta
September 2014, 4(3):1-1
DOI:10.4103/2229-516X.140704  PMID:25298933
  1,561 8,773 -
Project-based faculty development: Indian perspectives
Tejinder Singh
August 2015, 5(4):1-2
DOI:10.4103/2229-516X.162249  PMID:26380199
  1,914 8,408 -
Vaptans: A new option in the management of hyponatremia
Suruchi Aditya, Aditya Rattan
July-December 2012, 2(2):77-83
DOI:10.4103/2229-516X.106347  PMID:23776817
Arginine vasopressin (AVP) plays an important role in water and sodium homeostasis. It acts via three receptor subtypes-V 1 a, V 1 b, and V 2 -distributed widely throughout the body. Vaptans are nonpeptide vasopressin receptor antagonists (VRA). By property of aquaresis, VRAs offer a novel therapy of water retention. Conivaptan is a V 1 a/V 2 nonselective VRA approved for euvolemic and hypervolemic hyponatremia. Tolvaptan is the first oral VRA. Other potential uses of this new class of drugs include congestive heart failure (CHF), cirrhosis of liver, syndrome of inappropriate secretion of antidiuretic hormone, polycystic kidney disease, and so on. These novel drugs score over diuretics as they are not associated with electrolyte abnormalities. Though much remains to be elucidated before the VRAs are applied clinically, the future holds much promise.
  8,367 1,790 15
Serum nitric oxide status in patients with type 2 diabetes mellitus in Sikkim
Amrita Ghosh, Mingma L Sherpa, Yazum Bhutia, Ranabir Pal, Sanjay Dahal
January-June 2011, 1(1):31-35
DOI:10.4103/2229-516X.81977  PMID:23776769
Background: Serum nitric oxide (NO) has emerged as a fundamental signal associated with the endothelial dysfunction in type 2 diabetes. Aims: To compare serum nitric oxide level among type 2 diabetic patients along with other biochemical parameters and to compare it with that of normal population in Sikkim. Settings and Design: This prospective study was carried out in the Biochemistry Department in a tertiary care teaching hospital in Sikkim on 50 type 2 diabetics compared to 100 non-diabetics. Materials and Methods: The un-hemolyzed blood sample was collected for estimation of biochemical parameters. Griess reaction was used for indirect assay of stable decomposition products in serum (serum nitrite and nitrate levels) as an index of NO generation. The comparison of different parameters between cases and control was done by using Student's t-test. Results: There was significant difference when age- and sex-matched cases and controls were compared in regard to waist circumference and body mass index. The values of fasting and postprandial serum glucose, and lipid profile between study group and control group differed significantly. The mean serum level of NO in the study and control group was 43.83 ± 11.3 μmoles/L and 58.85 ± 12.8 μmoles/L respectively, and this difference was statistically significant. Conclusion: To sum up, serum NO was observed significantly low in diabetic participants as compared to control, along with difference in other biochemical parameters.
  8,605 1,012 18
Rigor mortis in an unusual position: Forensic considerations
Deepak H D'Souza, S Harish, M Rajesh, J Kiran
July-December 2011, 1(2):120-122
DOI:10.4103/2229-516X.91160  PMID:23776792
We report a case in which the dead body was found with rigor mortis in an unusual position. The dead body was lying on its back with limbs raised, defying gravity. Direction of the salivary stains on the face was also defying the gravity. We opined that the scene of occurrence of crime is unlikely to be the final place where the dead body was found. The clues were revealing a homicidal offence and an attempt to destroy the evidence. The forensic use of 'rigor mortis in an unusual position' is in furthering the investigations, and the scientific confirmation of two facts - the scene of death (occurrence) is different from the scene of disposal of dead body, and time gap between the two places.
  8,811 356 -
Cracked tooth syndrome: Overview of literature
Shamimul Hasan, Kuldeep Singh, Naseer Salati
September-December 2015, 5(3):164-168
DOI:10.4103/2229-516X.165376  PMID:26539363
Pain is defined as an "unpleasant sensory and emotional feeling which is associated with actual or potential injury of tissue or expressed in terms of such injury." Tooth pain usually refers to pain around the teeth or jaws mainly as a result of a dental condition. Mostly, toothaches are caused by a carious cavity, a broken tooth, an exposed tooth root or gum disease. The toothache may sometimes be the result of radiating pain from structures in the vicinity of tooth and jaws (cardiac pain, ear, nose, throat pain, and sinusitis). Therefore, evaluation by both dentists and physicians are sometimes necessary to diagnose medical illnesses causing "toothache." Cracked tooth syndrome is a major diagnostic challenge in clinical practice. Accurate diagnosis and appropriate treatment are complicated due to lack of awareness of this condition and its bizarre clinical features. Early diagnosis has been linked with successful restorative management and good prognosis. This article provides a detailed literature on the causes, classification, signs and symptoms, diagnosis, and treatment planning of cracked tooth syndrome.
  7,437 1,281 6
Factors precipitating outbreaks of measles in district Kangra of North India: A case-control study
Surender Nikhil Gupta, Ramachandran Vidya, Naveen Gupta, Mohan D Gupte
January-June 2011, 1(1):24-30
DOI:10.4103/2229-516X.81976  PMID:23776768
Background: Globally, measles is the fifth killer disease among children under five years of age. Despite high immunization coverage in Himachal, outbreaks are occurring. Upon two outbreaks in a hilly district in North India, a case control study was conducted to identify factors contributing to outbreaks and to recommend remedial measures to prevent further outbreaks. Materials and Methods: Factors were reviewed under three heads: program related, health care providers, and beneficiaries related. Cold chain maintenance was determined and responses were compared between workers from study Shahpur and control Nagrota Bagwan blocks. All 69 mothers of age and sex matched children with measles were enrolled. A pre-designed pre-tested data collection instrument was used. For statistical analysis, the odds ratio (OR) and adjusted odds ratio with 95% confidence interval (C.I.) among women of children exposed and unexposed to selected characteristics were calculated. Results: Poor cold chain maintenance and gaps in knowledge of health workers supplemented with beneficiary-related issues precipitated outbreaks in case area. Univariate analysis yielded strong statistical significance to 17 variables. Important statistically significant variables are educational status; OR 27.63 (C.I. 9.46-85.16); occupation; OR 0.35 (C.I. 0.16-0.75); income; OR 5.49 (C.I. 2.36-13.00); mode of transport to health care facility; OR 8.74 (C.I. 2.90-28.23); spread of illness from one person to another; OR 5.60 (95% C.I. 1.40-25.97); first help for sick child OR 2.12 (C.I. 1.00-4.50), and place of visit after recovery; OR 3.92 (C.I. 1.80-8.63). Multiple logistic regression yielded significant association with educational status, drinking water sources, and time taken to reach the nearest health facility. Conclusion: Measles outbreaks were confirmed in high immunization coverage areas. We recommend 2nd dose opportunity for measles (MR) between 5 and 17 years; refresher trainings to workers; mobile access to health care facility, and Information Education Communication activities for social behavioral change in affected areas.
  7,101 1,039 12
Mental healthcare Act 2017: Need to wait and watch
Abhisek Mishra, Abhiruchi Galhotra
April-June 2018, 8(2):67-70
DOI:10.4103/ijabmr.IJABMR_328_17  PMID:29744316
Mental health is different from general health as in certain circumstances mentally ill people may not be in a position to make decisions on their own. Those who suffer rarely get access to appropriate medical treatment as their families try to hide their condition out of a sense of shame. Over 300 million people are estimated to suffer from depression, equivalent to 4.4% of the world's total population. According to a study conducted by the National Institute of Mental Health and Neurosciences, 1 in 40 and 1 in 20 people are suffering from the past and current episodes of depression in India. In spite of this big burden of mental health issues, unfortunately, it continues to be misunderstood in developing countries like India. The new Mental Healthcare Act 2017 rescinds/revoked the existing Mental Healthcare Act 1987 which had been widely criticized for not recognizing the rights of a mentally ill person.
  7,423 641 1
A comparative study of visual and auditory reaction times on the basis of gender and physical activity levels of medical first year students
Aditya Jain, Ramta Bansal, Avnish Kumar, KD Singh
May-August 2015, 5(2):124-127
DOI:10.4103/2229-516X.157168  PMID:26097821
Background: Reaction time (RT) is a measure of the response to a stimulus. RT plays a very important role in our lives as its practical implications may be of great consequences. Factors that can affect the average human RT include age, sex, left or right hand, central versus peripheral vision, practice, fatigue, fasting, breathing cycle, personality types, exercise, and intelligence of the subject. Aim: The aim was to compare visual RTs (VRTs) and auditory RTs (ARTs) on the basis of gender and physical activity levels of medical 1 st year students. Materials and Methods: The present cross-sectional study was conducted on 120 healthy medical students in age group of 18-20 years. RT for target stimulus that is, for the beep tone for measuring ART, and red circle for measuring VRT was determined using Inquisit 4.0 (Computer Software) in the laptop. The task was to press the spacebar as soon as the stimulus is presented. Five readings of each stimulus were taken, and their respective fastest RT's for each stimuli were recorded. Statistical analysis was done. Results: In both the sexes' RT to the auditory stimulus was significantly less (P < 0.001) as compared to the visual stimulus. Significant difference was found between RT of male and female medical students (P < 0.001) as well as between sedentary and regularly exercising healthy medical 1 st year students. Conclusion: The ART is faster than the VRT in medical students. Furthermore, male medical students have faster RTs as compared to female medical students for both auditory as well as visual stimuli. Regularly exercising medical students have faster RTs when compared with medical students with sedentary lifestyles.
  6,883 1,018 34
Acute pancreatitis in pregnancy: A treatment paradigm based on our hospital experience
Sunil Kumar Juneja, Shweta Gupta, Satpal Singh Virk, Pooja Tandon, Vidushi Bindal
July-December 2013, 3(2):122-125
DOI:10.4103/2229-516X.117090  PMID:24083148
Background: Acute pancreatitis (AP) is a rare event in pregnancy, occurring in approximately 3 in 10 000 pregnancies. The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts, and multiple organ dysfunction syndromes. As in any other disease associated with pregnancy, AP is associated with greater concerns as it deals with two lives rather than just one as in the nonpregnant population. AP is most often associated with gall stone disease or hypertriglyceridemia. Material and Methods: We present 2 years of experience during which we had eight patients of AP. Results: Of the eight patients, three underwent laparoscopic cholecystectomy and five were treated conservatively. One had multiple cysts in the abdomen which were drained. All the patients delivered at term. Prophylactic tocolysis was given for 48-72 h to only those patients who had laparoscopic cholecystectomy. All the patients recovered completely. There was no maternal or fetal mortality. Conclusion: When properly managed AP in pregnancy does not carry a dismal prognosis as in the past.
  6,955 752 8
Arthroscopic synovial biopsy in definitive diagnosis of joint diseases: An evaluation of efficacy and precision
Onis Singhal, Viplesh Kaur, Shivani Kalhan, Manish Kumar Singhal, Anshu Gupta, YV Machave
July-December 2012, 2(2):102-106
DOI:10.4103/2229-516X.106351  PMID:23776821
Context: Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Arthroscopic synovial aspiration and biopsy can help in arriving specific etiological diagnosis. Aim and Objectives: To evaluate the efficacy of arthroscopic synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases. Materials and Methods: Arthroscopic synovial biopsy along with synovial fluid analysis was studied in 30 of the 50 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis. Results: Both rheumatoid ( n = 14, 28%) and tubercular ( n = 13, 26%) arthritis were found to be more common compared to other etiologies. Next common etiology observed was chronic nonspecific synovitis ( n = 10, 20%). Clinicopathological correlation was seen in 34 out of 50 cases. As a diagnostic tool, synovial biopsy had a sensitivity of 85%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 62%. Conclusion : Arthroscopic synovial biopsy is a simple and easy to perform technique and is an important useful investigative adjunct that may give conclusive diagnosis where clinical diagnosis is equivocal.
  7,023 602 1
Evaluation of phenotypic with genotypic methods for species identification and detection of methicillin resistant in Staphylococcus aureus
Kunsang O Bhutia, T Shantikumar Singh, Shilpie Biswas, Luna Adhikari
July-December 2012, 2(2):84-91
DOI:10.4103/2229-516X.106348  PMID:23776818
Background : Phenotypic methods for the detection of methicillin resistance are inadequate, due to presence of hetero-resistant population and dependence of environmental factors that may affect the phenotypic expression of resistance. Aims: Present study was conducted, to evaluate the efficacy of phenotypic methods for the identification of species and mec-A mediated resistance in S. aureus with polymerase chain reaction (PCR), and to assess the prevalence of the Panton-Valentine leukocidin (pvl) toxin in methicillin resistant S. aureus (MRSA) and overall S.aureus population. Materials and Methods: A total of 200 clinical isolates of Staphylococci were subjected to phenotypic and genotypic methods for the species identification and detection of MRSA. Results : The specificity and sensitivity of conventional methods in the detection of S.aureus, was found to be 100 and 97.59% respectively. However, the performance of phenotypic methods in the detection of MRSA were: Oxacillin disc diffusion (DD)-sensitivity 70.58%, specificity 75.75%; cefoxitin DD-sensitivity 86.27%, specificity 83.33%; and oxacillin agar dilution-sensitivity 92.15%, specificity 90.90%. PVL gene was detected in all mec-A positive isolates irrespective of their types. Conclusion:Phenotypic methods still preferred for the species identification, but for the reliable detection of MRSA an algorithm should include a combination of tests and apply a genotypic method for confirmation of resistance isolates showing discrepant results. Considering the high prevalence of PVL-MRSA, we recommend PCR as assay, as it has an advantage of simultaneous detection of mec-A and pvl genes by multiplex PCR.
  6,879 700 6
Status of HER-2/neu receptors and Ki-67 in breast cancer of Indian women
Rajeev Singhai, VW Patil, AV Patil
January-June 2011, 1(1):15-19
DOI:10.4103/2229-516X.81974  PMID:23776766
Background: Breast cancer is a leading cause of death in women. Receptor status is the most important prognostic and predictive marker for breast cancer. Aims: The present study was conducted with an aim to analyze breast cancer of Indian women with discordant receptor status, probably hormone dependent estrogen receptor (ER) positive, progesterone receptor (PgR) negative or ER− negative and PgR+ positive subgroup profile, infiltrating ductal breast cancer (IDC) not otherwise specified. Materials and Methods: Specimens from 100 IDC were grouped into three categories according to hormonal status (group 1: ER+ positive and PgR+ positive, group 2: ER+ positive and PgR− negative or ER− negative and PgR+ positive, group 3: ER− negative and PgR− negative) evaluated prognostic parameters. Statistical Analysis: Statistically significant difference was found between tumor receptor status distribution and menopausal status (P = 0.0235), age of patients (P < 0.001), histopathologic grade (P < 0.001), vascular invasion (P = 0.006), HER-2/neu status (P = 0.004) and Ki-67 proliferation rate (P < 0.001). Results: Group 1 tumors were found exclusively in post-menopausal patients with average age 68.9 years, most of which had intermediate grade II, without vascular invasion, with HER-2/neu status score predominantly 0 or 1+ and lower Ki-67 proliferation rate. Group 2 tumors were found predominantly in younger post-menopausal patients with average age 57.5 years, with vascular invasion found in 23% of cases. Group 3 tumors mostly had higher histopathologic grade, showed the highest percentage of the Ki-67 positive tumor cells and vascular invasion in 30% of the cases. Conclusion: It is concluded that patients with group 2 breast cancer were younger post-menopausal women, with tumors moderately differentiated, HER-2/neu score 0 or 1+ and with lower Ki-67 proliferation rate.
  6,114 690 5
Psychopathology of school going children in the age group of 10-15 years
Pir Dutt Bansal, Rajdip Barman
January-June 2011, 1(1):43-47
DOI:10.4103/2229-516X.81980  PMID:23776772
Background: Psychiatric problems in children are rising and reported cases represent only the tip of the iceberg; large number remains unreported in India. There is limited data on childhood mental disorders and mental health needs in Northern-India. Aims and Objective: The main objective of this research was to study the extent and nature of psychiatric disorders in school children in a defined geographical area and to study their psychosocial correlates. Materials and Methods: In this cross sectional study, Childhood Psychopathology Measurement Schedule (CPMS) was used to measure the magnitude of 982 students in the age group of 10-15 years from four randomly selected schools in a city of North India. Screening stage was followed by detailed evaluation stage in which children were diagnosed by ICD-10 criteria. Statistical analysis was done by percentage and Chi-square test. Results: The results showed that among 982 students, 199 (20.2%) had psychiatric morbidity. Most of them were in the age group of 13-14 yrs, from middle income group and were second in birth order. No significant sexual preference was found regarding distribution of the disorders. Specific phobia; other non organic sleep disorders like sleep talking, bruxism; tension headache found to be the most prevalent disorders followed by sleep terror, hyperkinetic disorder, pica, enuresis. Conclusion: Epidemiological studies should be started early in childhood and carried longitudinally for development of preventive, promotional and curative programme in the community.
  6,027 759 5