Medical Sciences

After beginning his historical work in Switzerland in the 1950s and then continuing it in the United States at the Menninger Foundation, Henri Ellenberger (1905–1993) became the leading historian of " dynamic psychiatry ". This expression commonly denotes mental medicine that draws from psychotherapeutic practices and psychological theories to improve our understanding of mental diseases and to cure them. Although still used today, usually in juxtaposition to 19th century alienism or to biological psychiatry, the origin and meaning of this expression are unclear. An unpublished lecture (1956) by Ellenberger on this subject, accompanied by an explanatory introduction, is reproduced here to shed light on Ellenberger's interpretation of that term. This article additionally aims to draw certain parallels and distinctions between Ellenberger, Michel Foucault and George Devereux's teaching in the 1950s. Considering that the history of psychiatry is now a well-established speciality in the academic world, Ellenberger's lecture is also an original document which enables us to trace the professionalization of psychiatric historiography as an academic discipline back to its beginnings after World War II.

This article explores a new open-source method for developing and manufacturing high-quality scientific equipment suitable for use in virtually any laboratory. A syringe pump was designed using freely available open-source computer aided design (CAD) software and manufactured using an open-source RepRap 3-D printer and readily available parts. The design, bill of materials and assembly instructions are globally available to anyone wishing to use them. Details are provided covering the use of the CAD software and the RepRap 3-D printer. The use of an open-source Rasberry Pi computer as a wireless control device is also illustrated. Performance of the syringe pump was assessed and the methods used for assessment are detailed. The cost of the entire system, including the controller and web-based control interface, is on the order of 5% or less than one would expect to pay for a commercial syringe pump having similar performance. The design should suit the needs of a given research activity requiring a syringe pump including carefully controlled dosing of reagents, pharmaceuticals, and delivery of viscous 3-D printer media among other applications.

El análisis de los síntomas y signos del estado patológico constituye el punto de partida del médico
para establecer el diagnóstico de una enfermedad y, posteriormente, proponer o realizar el
tratamiento oportuno.
Al ingresar el alumno al Hospital o Consultorio, después de haber cursado sus asignaturas
básicas, debe enfrentar por primera vez al enfermo, quien acaparará, desde entonces, su atención a
lo largo de su vida como médico.
Para esta nueva fase de su actividad, el estudiante de Medicina debe contar con nuevos medios
y conocimientos que le permitan cumplir con las tareas de la atención de los pacientes a su cargo.
Debe ser capaz de acercarse al paciente con respeto por su condición de hombre que sufre, y con
sabiduría para poder ayudarlo a salir de su estado.
Afortunadamente, el estudiante se encuentra en esta etapa inicial especialmente dispuesto para
incorporar estos nuevos conocimientos y técnicas que le permitirán cumplir con lo que considera
más propio de su actividad médica, que había debido postergar hasta entonces para completar su
formación básica.
El conocimiento de los síntomas y signos de la enfermedad, la nueva nomenclatura que debe
usar, la habilidad para obtener la información necesaria mediante el diálogo con el enfermo, la
pericia para la búsqueda de elementos útiles para formular el diagnóstico en el examen físico
cuidadoso, se alcanzan mediante el, esfuerzo ordenado y sistemático y de la experiencia vivida con
docentes experimentados.
Los conocimientos elementales de Semiología y los hábitos adquiridos en esta etapa tienen la
mayor importancia en el ejercicio futuro de la Medicina. Esta importancia es mayor aún en nuestro
país por las limitaciones en medios auxiliares de laboratorio que obligan a.1 médico a alcanzar el
diagnóstico y vigilar la eficacia de su tratamiento con los medios más sencillos que pone a su
alcance la enseñanza de la Semiología.
Conscientes de su importancia, el profesor Soto y sus colaboradores han elaborado este
Manual de Semiología para facilitar y ordenar el proceso de adquisición de estas herramientas
básicas del médico.
En esta segunda edición que se pone al servicio de alumnos y docentes, se ha incluido un
nuevo capítulo que se refiere al examen neurológico y se han
revisado y corregido el examen cardiológico y algunos aspectos de la anamnesis Sin duda, estas
mejoras contribuirán a superar los fines de servicio que el Dr. Soto y demás autores se han
propuesto al escribir este Manual de Semiología que ahora aparece en su segunda edición.

People abused by angry discipline as children, may tend to abuse or overly punish other people or themselves for perceived wrongs in their adult life. In some individuals, aggressive personality traits may be genetically inherited. The aggressive personality may feel weakened by having guidelines or boundaries for anger. Anger is a normal human emotion, and these guidelines can help express anger in a healthy way.

Background: Acrylamide, a potential toxicant and carcinogen, maybe formed in carbohydrate-rich food cooked at very high temperature. Its effect on gastric mucosa defense is not fully elucidated. Hence, the effect of acrylamide ingestion on gastric mucosal integrity was investigated. Methods: Fifty-four (54) Wistar rats (150-200g) were randomly divided into 3 groups; Group I (control) received 0.2mL distilled H20, Groups II and III received 7.5mg/kg body weight and 15mg/kg body weight acrylamide respectively. Both acrylamide and distilled water were administered orally for 28days. Thereafter, gastric secretion was obtained and analysed for gastric acidity. Gastric antioxidants status (superoxide dismutase (SOD), reduced glutathione, catalase), lipid peroxidation, mucus content, nitric oxide, bicarbonate, prostaglandins-E and gastric mucus content were determined. Blood samples were also collected and evaluated for haematological indices. Histological changes, parietal and mucus cell counts were evaluated on gastric tissues. Results: Gastric secretion and acidity increased (P < 0.05) in the 15mg/kg acrylamide treated group. Glutathione, SOD, catalase, mucus content, bicarbonate, prostaglandins-E2, mucous cell count were reduced (P < 0.05) while parietal cell count, lipid peroxidation and nitric oxide increased (P < 0.05) in both acrylamide treated groups compared to control. White blood cell count in group II was increased compared to control (P < 0.05). Acrylamide treated groups displayed gastric epithelial cells with poor architecture, lamina propria, submucosa inflammatory cell infiltration and vascular congestion. Conclusion: Acrylamide exposure degenerates gastric mucosal integrity in a dosedependent manner via reductions in gastric protective factors, which thus predisposes the gastric mucosa to erosions and lesions.

Introduction: Cytological examination of pleural fluid is considered
less invasive than biopsy, more simple, inexpensive,
allows faster diagnosis and it facilitates in cancer screening
in some cases. Cytological examination of pleural fluid is of
great diagnostic value in both non neoplastic and neoplastic
effusions. Aim of the study was to retrospectively analyse,
all the pleural effusions, to get prevalence of benign and malignant
pleural effusions and to evaluate the cytological value
of pleural fluid in the diagnosis of benign and malignant
lesions.
Materials and Methods: Total 240 cases collected from all
the patients who underwent thoracocentasis. Data were collected
and analysed. From the received fresh sample, 10ml
fluid was taken and fluid was centrifuged at 2500 rpm for 15
minutes and smears were prepared from the sediment and
stained with MGG stain and H and E.
Results: In the study of 240 cases of pleural effusion the age
of patient ranged between 17-87 years. The male to female
sex ratio was 1:1.1.The maximum numbers of cases were in
the age group of 41-50 years, constituting 54 cases (22.4%)
of the total cases (Table 1). Most of the pleural effusion were
associated with benign conditions (84.6%). The rest (15.4%)
of the effusions showed malignant aetiology. Amongst the malignant
effusions adenocarcinoma was the most common type
of secondary (70.3%, 26 cases out of 37).
Conclusion: Cytological examination of pleural fluids is the
most effective procedure to differentiate between benign and
malignant effusion and also to know primary site of lesion in
many cases.

Chronic neutrophilic leukaemia is a rare myeloproliferative neoplasm. It requires exhaustive workup and puts a diagnostic challenge to the clinician as well as pathologist. It should be differentiated from chronic myelogenous leukemia and reactive neutrophilia. Prognosis of the disease is poor. Here we report a case presented to us with 4 months of fatigue and fever. Investigation shows leucocytosis with predominant neutrophilia, evaluated and diagnosed as Chronic Neutrophilic Leukaemia (CNL) according to revised WHO criteria.

Based on several reports including genome-wide association studies, genetic variability has been linked with higher (nearly half) susceptibility toward coronary artery disease (CAD). We aimed to evaluate the association of chromosome 9p21 single nucleotide polymorphisms (SNPs): rs2383207, rs10757278, and rs10757274 with the risk and severity of CAD among Arab population. A prospective observational case-control study was conducted between 2011 and 2012, in which 236 patients with CAD were recruited from the Heart Hospital in Qatar. Patients were categorized according to their coronary angiographic findings. Also, 152 healthy volunteers were studied to determine if SNPs are associated with risk of CAD. All subjects were genotyped for SNPs (rs2383207, rs2383206, rs10757274 and rs10757278) using allele-specific real-time polymerase chain reaction. Patients with CAD had a mean age of 57 ± 10; of them 77% were males, 54% diabetics, and 25% had family history of CAD. All SNPs were in Hard...

For more than 25 years, we have been looking for biomathematical laws controlling and structuring DNA, genes, proteins, chromosomes and genomes [1,2]. In 1997 we discovered a simple numerical law based solely on atomic masses, unifying the 3 languages of biology: DNA, RNA, and amino acids. This law, “The Master Code Of Biology” is published in 2009 in the book codex biogenesis [3] and then in 2015 in a reference article peer review [4]. In 2017 we publish different applications: HIV, SNPs, brain genetics [5-8]. On the other hand, at the beginning of the 2000s we studied the integrity of the Prions proteins (CJD, Creutzfeldt-Jakob disease), showing a common invariant bi-attractors in “W”, while the amyloid was characterized by a pattern in “V” shape. Since that time, biologists such as Claudio Soto have visually demonstrated in 3D the same biological form in horseshoe for the amyloid protein [9-13].

Rhabdomyosarcoma (RMS) is a rare but aggressive malignancy of infants and children. Alveolar, embryonal, pleomorphic, and spindle/sclerosing rhabdomyosarcoma are the common types. Multimodality treatment 5 is almost always required. It Includes surgery, radiation therapy and chemotherapy. RMS were initially described by Weber in 1854. 6

Background: Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. In 2016, 39% of adults aged 18 years and over (39% of men and 40% of women) were overweight. Overall, about 13% of world adult populations [11% of men and 15% of women] were obese in 2016. Objectives: To assess the effectiveness of Information, Education and Communication on prevention of obesity among young adult and adolescent among nursing students before and after structured teaching programme and to find out the relationship between the level of knowledge regarding prevention of obesity in pretest and posttest. Methodology: A Quasi Experimental Design was carried out in the study the sample comprised of 50 students who were selected by purposive sampling technique. The tool comprises of demographic profile and 30 multiple choice questionnaire. Reliability of the tool was checked by using multiple choice questionnaire. The data were analyzed by using structured questionnaire. The data was analyzed by using descriptive and inferential statistics. Results: There is significant association between the knowledge and the selected demographic variables. Conclusion: Obesity in adolescents and children has raised to significant levels globally with serious public health consequences. The findings of the study concluded that IEC was very effective in improving the knowledge of the students on prevention of obesity.

Between April and May 2005, some selected computer keyboards in Bayero University, Kano, Nigeria were bacteriologically examined to evaluate the load and types of bacterial organisms associated with them. Eighty (80) computer keyboards were randomly sampled and analysed using surface carpeting method. Aerobic mesophilic bacterial count ranged between the highest of 2.37 x 10 2 cfu/m 2 and the lowest of 1.09 x 10 2 cfu/m 2. Characterization of the bacterial isolates using cultural, morphological and biochemical methods revealed the presence of seven bacterial genera namely: Corynebacterium, Klebsiella, Listeria, Pseudomonas, Shigella, Staphlococcus and Streptococcus. Generally, Staphylococcus aureus was the most isolated {43(58.1%)} while Corynebacterium species and K. pneumoniae were the least, each with 1(1.4%) occurrence rate. Statistically, there was a significant difference between sites (P<0.05) as it relates to the recovery of the bacteria. The implications of the results have been discussed in relation to human health and productivity. Suggestions have been made on how to improve the situation.

Anterior sacral meningocele is characterized by the herniation of the thecal sac into the retroperitoneal space. A 33-year-old man was referred to our hospital with the complaints of a longlasting constipation and nonspecific lower abdominal pain. At ultrasound, a cystic mass was detected at the presacral space. Computed Tomography revealed a defect at the anterior aspect of the sacrum, together with a presacral cystic mass which showed a connection with the dural sac. At Magnetic Resonance Imaging, it was demonstrated that the cystic mass made an impression on the rectum, and did not possess any solid components. An anteroposterior pelvis radiogram demonstrated a sacral deformity and the scimitar sign. Upon these imaging findings, the patient got the diagnosis of an anterior sacral meningocele. The possibility of an anterior sacral meningocele must always be kept in mind in the differential diagnosis of a pelvic cystic mass.

The COVID-19 pandemic has caused a surge of demand for medical supplies and spare parts, which has put pressure on the manufacturing sector. As a result, 3D printing communities and companies are currently operating to ease the breakdown in the medical supply chain. If no parts are available, 3D printing can potentially be used to produce time-critical parts on demand such as nasal swabs, face shields, respirators, and spares for ventilators. A structured search using online sources and feedback from key experts in the 3D printing area was applied to highlight critical issues and to suggest potential solutions. The prescribed outcomes were estimated in terms of cost and productivity at a small and large scale. This study analyzes the number and costs of parts that can be manufactured with a single machine within 24 h. It extrapolates this potential with the number of identical 3D printers in the world to estimate the global potential that can help practitioners, frontline workers, a...

Background: Most of the emergency abdominal surgeries are either contaminated or dirty, they carry a higher rate of complications, aided by lack of optimization of the patient before surgery as opposed to elective surgeries. Complications related to surgical site encompasses a majority and may be aggravated by pre-existing co-morbid conditions. Seroma, hematoma, wound dehiscence, surgical site infection (SSI) are some of the major complications of surgical wounds. A prospective study was carried out in Department of General Surgery, Assam Medical College and Hospital (AMCH), Dibrugarh, Assam to find out the incidence of surgical site infection (SSI), clinical presentations and causative organisms including their antibiogram.Methods: Total 280 patients undergoing emergency abdominal surgeries in Department of General Surgery, AMCH from June 2017 to May 2018 were included in the study. Preoperative, intraoperative and post-operative details were collected, recorded and analysed. In ca...

Pulmonary alveolar proteinosis, (PAP) is a rare disease of unknown etiology, characterized by accumulation of intraalveolar proteinaceous material which is rich in lipid and positive on periodic acid-Schiff stain. Two clinically different pediatric types have been defined as congenital PAP which is fulminant and fatal, and a late-onset PAP which is similar to the adult form and less severe. Eight children with late-onset PAP were hospitalized from 1998 to 2005 in Mofid Children Hospital. Characteristics of these patients and the methods of diagnosis and treatment are presented in this case series.

Background: India is a developing country and is on the road of rapid progress, in every aspect. So, to further boost the development process, India joined many other developing countries and showed an intent to promote a cashless economy. However, this penetration is not much in the rural areas which constitute the building blocks of the country. Awareness regarding digital transaction schemes of government of India is imperative to success of such schemes. Hence, the current study for assessing the awareness of the digital transaction schemes and finding out the sources in their implementation will help cater these issues.Methods: A  descriptive cross sectional study was conducted among 60 respondents belonging to different age groups, socio economic strata and with different education status, to explore the awareness and acceptance percentage of respondents in rural block Paragraph  in relation to digital transaction schemes and methods and the their sources of information. Study...

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by increase in destruction of circulatory platelets and is the most common cause of acquired thrombocytopenia in childhood. ITP can be classified based on duration of thrombocytopenia as acute and chronic form. Recurrent ITP is defined as recurrence of symptoms, after at least three months of remission sustained without any treatment. It is a rare entity and seen in just 5% of all ITP cases. Further, its treatment is often cumbersome and warrants use of non-conventional drugs and splenectomy. Reported here is a case of ITP in a 10-year-old girl, who presented with three recurrences and all episodes were successfully treated with either oral Prednisolone or resolved spontaneously.

Background: Relaparotomy after cesarean section is associated with significant maternal morbidity and mortality which can be prevented with proper precaution during the primary surgery. The objective of the study was to determine factors associated with relaparotomy after cesarean section.  Methods: A hospital based descriptive cross sectional study conducted by analyzing the records of 3 years from 1st July 2017 to 30th June 2020, among the women who underwent relaparotomy after cesarean section at Paropakar Maternity and Women’s Hospital, Kathmandu. Results: There were 21,270 cesarean sections among 64,475 deliveries with the mean incidence of 32.6%. A total of 22 patients underwent relaparotomy out of  which 18 had their primary surgery performed at our hospital i.e. 0.08% of the total caesarean section, and 4 cases were referred from peripheries. 60% of primary surgery were done by residents and the commonest indications of primary surgery were previous CS (36.3%) and obstructed...

Background: Cross sectional observational comparative study in a tertiary care hospital on Prevalence of Hypertension among tribals of Jharkhand with Chest discomfort.Methods: 102 subjects (53 male and 49 female) were selected for the study, who had presented with chest discomfort and history of Hypertension.Results: In the current study total 102 subjects were taken, 53 were males. Among tribal males prevalence rate of hypertension, using (J.N.C.-7) criteria majority of them (41subjects 77.35%) were Prehypertensive. 8 subjects (15.09%) had normal blood pressure, 3 subjects (5.66%) had stage -I hypertension and only 1 subject (1.88%) had stage-2 hypertension. In females out of 49 subjects 28 subjects (57.14%) were pre hypertensive, 17 subjects (34.69%) were Normotensive and only 2 subjects (4.08 %) had stage -1 hypertension, as well as 2 subjects (4.08 %) had stage-2 hypertension.Conclusions: The prevalence of Hypertension among tribal patients of chest discomfort was found to be pr...

Background: Uterine rupture has continued to be an obstetric catastrophe with tragic maternal and foetal outcomes particularly in Nigeria.Methods: an institutional, cross sectional retrospective study was carried out at Jos University Teaching Hospital, North-Central Nigeria. Case files of mothers with uterine rupture managed at the hospital from 1 January 2011 to 31 December 2019 were retrieved and included in the study. Data extracted from case files included maternal age, parity, gestational age, booking status, presence of uterine scar, obstetric interventions prior to rupture, site of rupture, type of surgery, units of blood transfused, intensive care unit admission and duration of hospital stay and maternal or foetal death.Results: the incidence of uterine rupture was 1 in 497 deliveries (0.2%). The mean age of the patients was 30.1±5.1years. About 75% of the patients were para 1-4. Seventeen (70.8%) patients were unbooked while fourteen (58.3%) had unscarred uterine rupture. ...

Background: Cardio respiratory fitness in childhood is an important predictor of morbidity and mortality in adulthood. Overweight and Obesity are the major health concerns that the adolescents are facing globally. Obesity is the root cause for various cardiovascular, metabolic and musculoskeletal disorders that are life threatening ailments. There are no studies that have documented the cardio respiratory fitness in adolescent girls of Hyderabad. The objective of this study is to know the Cardio respiratory endurance (VO2max) among normal, overweight and obese adolescent girls of Hyderabad. To find the changes in VO2max with increase in body fat mass. Materials & Methodology: This is a cross sectional study involving 60 girls with an age group of 14-16 years and were categorized into 3 groups (n=20) based on their BMI and WHR. All three groups were assessed for Cardio respiratory fitness using 20m shuttle run test. Results: The data was analyzed using ANOVA and (P< 0.05) in all the 3 groups. This suggests the significant difference of VO2max in all the 3 groups. Conclusion: VO2 max was higher in normal group which suggests a good cardio vascular profile. VO2 max in overweight was better than obese group and less than in control group. VO2 max was poor in obese group indicating that increase in fat mass has a negative relationship with cardio respiratory fitness and the low VO2max is associated with many cardiovascular risk factors in later life.

Liver fibrosis is the excessive accumulation of extracellular matrix proteins, including collagen, that occurs in most types of chronic liver diseases. Advanced liver fibrosis results in cirrhosis, liver failure, and portal hypertension and often requires liver transplantation. Knowledge of the cellular and molecular events associated with the formation of liver fibrosis has greatly advanced. Activated hepatic stellate cells, portal fibroblasts, and myofibroblasts of bone marrow origin have been identified as major collagen-producing cells in the injured liver. These cells are activated by fibrogenic cytokines such as TGF-ᵝ1, angiotensin II, and leptin. Reversibility of advanced liver fibrosis in patients has been recently documented, which has encougaged researchers to continue their research for potent and safer antifibrotic drugs. Emerging antifibrotic therapies are aimed at inhibiting the accumulation of fibrogenic cells and/or preventing the deposition of extracellular matrix proteins. Although many therapeutic interventions are effective in experimental models of liver fibrosis, their efficacy and safety in humans are largely unknown.

Fahr's syndrome is a rare, genetically dominant, inherited, neurological disorder characterised by abnormal deposits of calcium in areas of the brain that control movement, including the basal ganglia and the cerebral cortex. Symptoms of the disorder may include deterioration of motor functions, dementia, seizures, headache, blurring of vision, spasticity (stiffness of limbs) and athetosis (involuntary, writhing movements). The most common site of calcification is the globus pallidus. However additional areas of calcification are putamen, caudate nucleus, internal capsule, dentate nucleus, thalamus, cerebellum and cerebral white matter. We are presenting a case of a 30 year old male, who complained of stiffening of upper limbs and blurring of vision followed by giddiness which was associated with slowness of movements. His CT scan revealed a symmetrical large area of calcification over the basal ganglia. Secondary causes of this disease were ruled out to make the clinical diagnosis of Bilateral Striopallidodentate Calcinosis, [BSPDC] which is otherwise called as the Fahr's syndrome.

I find it amazing that my Hematologists and other Hematologists I have been in touch, abstain from answering the following 3 questions, vital to my at critical crossroads health
They do not know the answers ?
If Liver Fe keeps going down with Exjade will Ferritin follow suit or the Exjade limitations appearing in the recent paper of  Fenaux, Platzbecker, Raza, Santini ea will prevail ?
Can Hematologists account for the combination of my Exjade driven Liver Fe and Ferritin pictures ?

Skin diseases are among the most common health problems worldwide. In this article we proposed a method that uses computer vision based techniques to detect various kinds of dermatological skin diseases. We have used different types of image processing algorithms for feature extraction and feed forward artificial neural network for training and testing purpose. The system works on two phases- first pre-process the colour skin images to extract significant features and later identifies the diseases. The system successfully detects 9 different types of dermatological skin diseases with an accuracy rate of 90%.

Background: Freshly registered nurses’ experience of conversion from student to skilled professionals calls for making significant adjustments to shifting personal and professional roles at the beginning of their career as a nurse. Nursing education is aimed to help students to become beginning practitioners in the field of nursing. This study was taken up to explore the perception of the outgoing nursing students about their readiness to work in the clinical settings after graduation. On completion of graduation, these budding practitioners are anticipated to adjust in the clinical settings rapidly and be proficient of providing innocuous care for patients with multifaceted care needs. It is expected from graduate nurses to be well equipped for clinical practice, but reality may be different and there could be numerous barriers associated with it.Methods: It was a descriptive cross-sectional survey. A total of 176 outgoing graduate nursing students were selected using total enumera...

Granulosa cell tumour (GST) belongs to the sex-cord/stromal tumours of the gonads. We received slides and blocks for review of a 27 years female whounderwent Right oopherectomy. On microscopic examination, architectural pattern was suggestive of either yolk sac tumor andgranulosa cell tumor. Cellular features were suggestive of Granulosa cell tumor because of presence of nuclear grooves. So we decided to go ahead with immunohistochemistry. We used following IHC markers: Inhibin, Calretinin, EMA (Epithelial Membrane antigen), Glypican and PLAP (Placental alkaline phosphatase). Tumor cells were positive for Inhibin, Calretinin and negative for EMA, Glypican and PLAP. We gave a final diagnosis of adult granulosa cell tumor considering morphological and immunohistochemical findings.

Primary choriocarcinoma of the uterine cervix is an extremely rare disease. The clinical diagnosis of cervical choriocarcinoma is difficult, because of its rarity and being non-specific abnormal vaginal bleeding the most common symptom. In the present report, the authors present a case of cervical choriocarcinoma, which was initially misdiagnosed as a cesarean section scar ectopic pregnancy. Remission of cervical choriocarcinoma was accomplished with the combination of hysterectomy and chemotherapy.

Background: Granulomatous dermatosis shares the histological finding of granuloma formation; it is usually formed because of the persistence of a non-degradable product of active hypersensitivity. The identical histological picture may be produced by several causes, which pose a diagnostic challenge to dermatopathologist, Present study aims at classifying cutaneous granulomatous dermatosis based on the morphology and aetiology of granulomas, and to highlight its significance for specific clinical diagnosis.Methods: A retrospective analysis of skin biopsy was done and cases of cutaneous granulomatous lesions diagnosed on histopathological examination were retrieved for a period of 8 years. Clinical data and diagnosis were retrieved from hospital records. Hematoxylin and eosin stained paraffin sections were reviewed. The morphological pattern of granuloma was classified into sarcoidal, necrotizing, necrobiotic and suppurative granulomas and further aetiological evaluation for the gran...

Introduction: Diabetes mellitus is recognized as one of the leading cause of death and disability worldwide. Information and education gives improvement in the knowledge, attitudes and skills which leads to better control of the disease and is widely accepted to be an integral part of the comprehensive diabetes care. More emphasis should be given to the standardization and improvement of techniques, the people to become more aware of their responsibility and make fewer mistakes during insulin administration, since the treatment of diabetes continues for lifetime, there is a need to monitor the knowledge, understanding and practice of clients in relation to their disease process and its management. Purpose: to assess the knowledge and practice of self-administration of insulin in a view to develop self-instructional module among the patients with diabetes mellitus in selected hospitals of Pune city Objectives: To assess the knowledge regarding self-administration of insulin among patients with Diabetes Mellitus, to assess the practice regarding self-administration of insulin among patients with Diabetes Mellitus, to associate findings with selected demographic variables. Methods: This was a Non experimental descriptive research design and quantitative research approach. 60 diabetic patients were selected from selected hospitals by non-probability purposive sampling technique. Self-structured questionnaire was used to assess knowledge with the observational check list for assessing practice of self-administration of insulin. Results: Mean score of knowledge regarding self-administration of insulin in patients with diabetes mellitus was 19.81with 3.25 standard deviation that shows good knowledge, Mean score of practice regarding self-administration of insulin in patients with diabetes mellitus was 7.85 with 1.81 standard deviation that shows Average practice, and the 'p' value was more than level of significance 0.05 so no any association found between all demographic variables with knowledge and practice Conclusion: knowledge regarding self-administration of insulin was good and practice was average.

Introduction: The spread of multidrug resistant bacteria has added a new angel to the problem of wound infections which are a major cause of morbidity. To avoid difficulty in treatment of such infections it is mandatory for every pus sample to undergo Culture and sensitivity.
Aim: To isolate and study the antibiogram of the aerobic bacteria from pus samples.
Materials and Methods: A total of 426 pus samples received from various wards in the Microbiology department. Andhra Medical College, Visakhapatnam were processed as per standard guidelines in the laboratory. All the aerobic bacterial isolates obtained were kept for antibiogram by Kirby Bauer’s disc diffusion method as per CLSI Guidelines.
Results: Out of 426 samples 394 (92.4%) were culture positive. Among culture positive samples 90.6% were pure cultures and 9.4% were mixed isolates. Gram negative bacilli were 72.8% of the total isolates and 27.2% were Gram positive cocci. Escherichia coli and Klebsiella pneumonia were the predominant isolates (30.3% and 28.9%) followed by Pseudomonas aeruginosa (24%), Proteus species (9.7%) and Acinetobacter species (6.9%). Among Gram positive cocci Staphylococcus aureus (62.6%), Enterococci (20.5%) and Coagulase Negative Staphylococcus (11.2%) and Streptococci (3.7%). GNB were more sensitive to Colistin (92%), Amikacin (86%), Imipenem and Meropenem (86% and 84.4%), Piperacillin Tazobactam (84%), Gentamycin (78%), Cefaperazone Sulbactam (76.2%) and Ciprofloxacin (56%). Gram positive cocci were sensitive to Linezolid and Teicoplanin (98% each), Vancomycin (96.2%), Clindamycin (84%), Gentamycin (79%), Azithromycin (76.4%), Ciprofloxacin (66%) and Amoxiclav (54%) out of 62.6% Staphylococcus aureus isolates 31.4% were MRSA and out of 72.8% of Gram negative bacilli 38.2% were ESBLS.
Conclusion: As multidrug resistant bacterial strains are emerging in various infectious and pyogenic wound infection is most important cause of morbidity, it is important for a clinician to send all pus samples for microbiological analysis and their antibiogram before putting cases on antibiotics.

Background: Cataract is a major cause of blindness worldwide with a greater prevalence in developing countries like India. Presenile cataract refers to an onset of this disease below 50 years of age. Objectives: To study the factors associated with development of presenile cataract among the total cataract patients who attended outpatient clinic of Ophthalmology department from Data was retrospectively entered and analysed. Results: There were 100 (49 males and 51 females) patients between the age 30 and 50 years. Around 70 study participants had co-morbidities. The average axial length was 22.5532mm, the average haemoglobin content was 13.01 g/dL, average total count was 8590.85, average BL urea was 22.755 mg/dL, average serum creatinine concentration was 0.9611 mg/dL and average GRBS concentration was 131.43 mg/dL. Drug history of 69 patients was observed in the current study. Conclusion: The most common type of cataract seen was posterior subcapsular cataract followed by mature cataract. Diabetes mellitus was the predominant risk factor in posterior subcapsular cataract.

Chronic Kidney disease is becoming a global public health problem throughout the world. The aim of the study was to assess management status of the hemodialysis unit in a specialized hospital. It was a hospital based descriptive cross sectional study. A total of 17 participants were selected by purposive sampling method on the basis of defined selection criteria from January 2015 to December 2016. The place of study was National Institute of Kidney Diseases and Urology (NIKDU) hospital, Dhaka. The research instruments were a semi structured questionnaire and a checklist. The socio-demographic status of the respondents showed that 11.8 %(n=02) were doctor, 58.8 %(n=10) nurses and 29.4 %(n=05) were technician. Mean age of care providers was 38.82±8.79 years. Majority of respondents, were satisfied regarding the unit including physical facilities 76.5% (n=13) cleanliness of the unit 58.8% (n=10) and medical record facility 52.9% (n=9). Need to strengthen infection control measure and BCC activities among the service providers to improve the management status of the hemodialysis unit of NIKDU hospital.

Background: Lumbar spondylosis is a leading cause of low back pain worldwide and is also considered as a socioeconomic burden to the society. A wide range of treatment options are present for the management of this degenerative joint disease.
Aim: To study and find out the effect of activity specific spinal stabilization exercises on pain and spinal mobility in lumbar spondylosis.
Methods: The study was an experimental study conducted at Krishna hospital, Physiotherapy OPD, Karad after being approved by the institutional ethical committee. The study included 64 subjects who were randomly divided into two groups with 32 individuals in each group. Group A received conventional physiotherapy and activity specific spinal stabilization exercises and Group B received conventional physiotherapy alone (Hot moist pack, TENS, static back exercises) for a period of 3 weeks.
Results: Statistical analysis was done by using paired t test and unpaired t test. Post intervention analysis of inter group for pain done by Visual analogue scale (VAS) showed very significant difference with p value= 0.001, for ROM flexion showed very significant difference with p value =0.004 as well as extension also showed significant difference with p value= 0.024 also right and left lateral flexion showed significant difference with p values 0.031 for lateral flexion towards right side and p value= 0.016 towards left side respectively. Oswestry low back pain disability index also showed significant difference between the group with p value= 0.026.
Conclusion: The present study concludes that activity specific spinal stabilization exercises have significant effect on pain and spinal mobility in lumbar spondylosis.