Innovative Journal of Medical and Health Sciences

Background: Though ill effects of maternal smoking on growing foetus and placenta is well established, passive/ second hand smoking has recently been implicated as another potential risk factor. The incidence of low birth weight, Intra-Uterine Growth Retardation (IUGR), prematurity and stillbirth has been associated with passive smoking. Our study focuses on the gross and histological changes in the full term placenta of women exposed to passive smoke from a close member of a family smoking at least 20 cigarettes/bidis per day.

Method: The present study is an endeavour to observe microscopic features (light microscope under 10X and 40X only) of placenta of pregnant women who are exposed to environmental tobacco smoke from a close member of the family and simultaneously observe changes on growing foetus during level II ultrasound at 2^nd trimester in terms of IUGR if any. This is a descriptive study with statistical analysis done using ‘Independent Sample Test’.

Results: The histopathological changes seen in the placenta of passive smokers were almost alike to active smokers showing increased syncytial knots, hyperplasia of cytotrophoblast cells and proliferation of fetal capillaries. However no significant IUGR was noticed during Level II USG of the fetuses.

Conclusion: On gross findings there was a definite co-relation with low birth weight babies born to passive smokers and a compensatory enlargement of the placenta. The microscopic changes seen in the placenta of passive smokers was a consistent finding similar to ischemic changes. No definite relationship could be established between the histological changes observed amongst passive smokers and IUGR seen in the growing foetus.

Objective-To conduct a study on anatomical variations of anterior clinoid process and incidence of carotico-clinoid foramen to provide a guide to neurosurgeons  in surgical approach to anterior part of cavernous sinus. Methods-The study was conducted on twenty five dry adult skulls of either sex available in the Department of Anatomy , School of Medical Sciences and Research, Greater Noida, NCR, India. Variations in size , direction of ACP noted. Incidence & mophology of Caroticoclinoid foramen were also studied. Results- Mean length, basal width ,thickness of ACP on right and left side were 11.1±1.49mm,9.62±2.36, 4.65±0.62mm & 11.61±2.07mm, 9.66±1.27,4.8±0.55mm respectively. The tip of ACPs were bilaterally straight, curved, irregular in 16%,28%,16% respectively. Incidence of caroticoclinoid foramen was 24%, 20% on right and left side respectively. Conclusion- Considering the immense anatomical surgical and radiological importance of morphology of anterior clinoid process and caroticoclinoid process, this study was worth conducting.

Introduction: In the life, adolescence is a period of the transition from being a dependent child to becoming an independently functioning adult. Normally adolescent period was considered as healthiest period, so it may not get enough attention. But with high prevalence of HIV/AIDS among the young people, adolescent health is gaining its importance. Due to high risk taking behavior and lack of knowledge, adolescents are more susceptible for reproductive ill health. Another reproductive health problem faced by adolescents due to unprotected sexual behaviour and lack of knowledge on contraception is ‘unwanted pregnancy’.  

Materials and methods: A cross sectional, community based, study was conducted in one of the urban slum area of South India. From each house in this area, adolescent girls (10-19) were included in the study. So total number of adolescent girls included in the study were 257.

A one to one interview was conducted, and questions on knowledge, attitude and behaviour on Reproductive Health issues were asked. The primary tool of data collection was a predesigned and pretested questionnaire.

Results: Majority of respondents (40.08%) were in the age group of 13-15   years, followed by 16-19 years (32.30%). Majority of them 40.08% belonged to Class III socioeconomic status as per B.G Prasad’s Classification. Majority 62.65% of the girls had higher secondary school education.Majority of the respondents (68.8%) had attained menarche by the age of 13 years. Only 26.46% of the girls answered correctly about the organ responsible for menstruation. Majority (82.10%) of girls had knowledge about the duration of flow and 59.92% knew about duration of cycle.

Conclusion: The inadequacy of knowledge along with misinformation about the various reproductive health issues along with unfavorable attitudes and practices are hurdles in the healthy development of these adolescent girls. Equipping them with appropriate and adequate information on the various reproductive health issues will be beneficial for the generations to come. Adolescents should be given family life education which should be comprehensive in nature.

Background   Elevated levels of C-reactive protein (CRP) and Homocysteine   are associated with increased risk for incident Coronary artery disease on the basis of observation from several prospective epidemiological studies. Method We measured CRP and Homocysteine in 100 subjects which included 50 patients with confirmed CAD and 50 healthy age   matched subjects as control. Homocysteine and CRP were associated with most traditional cardiovascular risk factors. Result  Mean value of serum homocysteine level of CAD patients is 35.24±17.804 µmol/l, which was significantly elevated [p< 0.001]than control group with mean value of 9.192± 3.0618 µmol/l and serum C-RP level was also significantly elevated [p< 0.001] in patients of CAD 3.72± 2.5856 mg/dl compare to control [0.808± 0.3746mg/dl]. Conclusion   In a large population based samples, subjects with higher CRP and Homocysteine levels had a modest increase in the prevalence of CAD.

ntroduction- Eclampsia a complication of severe preeclamsia is characterized by new onset of seizures which is not attributable to any other cause in a pregnant female whose fetus has crossed age of viability i.e. 20 wks.

Objective- To compare the effectiveness of midazolam, propofol and dexmedetomidine for the sedation of eclampsia patients admitted to our intensive care unit (ICU).

Material and Methods – A study of 60 eclamptic patients was taken up who required mechanical ventilation in ICU and were randomly divided into three groups. All patients received MgSO4 2 g/h for 24 hours. GrM group received 0.05mg/kg loading dose followed by infusion of 0.1mg/kg/hr. GrP received propofol  loading dose 1mg/kg followed by infusion of 3mg/kg/hr and GrD group received dexmedetomidine at 1mcg/kg  over 20 mins followed by infusion 0.7mcg/kg/hr. patients were maintained on Ramsay sedation score of 2-3 and their mean arterial pressure was maintained between 90-130mmhg . If it exceeded the range NTG and SNP were added. Standard criteria were followed for weaning from ventilator.

Results - Dexmedetomidine produced better hemodynamic stability in eclamptic patients. There was significant reduction in requirement of additional analgesics (p< 0.035) and antihypertensives (p<0.004). Duration of ICU stay was less in eclampsia patients (p<0.0029) who required dexmedetomedine. We believe that the better results of patient in GrD group was because of ability of dexmedetomidine to denervate sympathetic nervous system.

Background:  The proto onco gene c-kit is a tyrosine kinase receptor plays significant role in embryo and postnatal development and also found to be expressed in solid tumors and hematological malignancies. Cancer associated fibroblasts (CAFs) have been found to be involved in promoting tumor growth, invasion and metastasis. The aim of study was to establish the expression pattern of c-kit and specific markers for CAFs in gastric epithelium tissues and their correlation with clinicopathological factors to establish their possible role in prognosis of gastric cancer.

Methods: Expression of c-kit and specific markers for CAF or proteins secreted by CAF were assessed by immunohistochemical and immunofluorescence staining of paraffin–embedded tissues, and RT-PCR in 64 tumors (observed group) and 33 normal gastric samples.  The clinical pathological data was statistically analyzed by chi-square methods.

Result: The positive rate of c-kit and CAF protein expression in the observed group as 84.38% (54/64) and 96.88% (62/64) respectively. RT-PCR results also showed elevated expression of c-kit, α-SMA, Vimentin, SDF-1 in gastric cancer than that of normal gastric tissues. The expression of c-kit and α -SMA was correlated with age, & gender of patients, position, size, & depth of the tumor, lymphatic invasion and node metastasis.  c-kit and α –SMA prevalence is significantly correlated with size, & depth of the tumor, lymphatic invasion and node metastasis (p<0.05). 

Conclusion: Overall this data suggest that increased expression of c-kit and CAFs might be attributed with disease progression; malignancy transformation of gastric epithelium cells and prognosis of gastric cancer.

Background: The paper attempted to travel along the life of Kerala women picking up elements that are relevant to a health study. The indicators considered in this paper can be broadly categorized as those reflecting the nutritional status, physiological health and fitness profile of working women and house wives.

Methodology: This study involved 20 working women and 20 house wives, aged 25-55 years, residents of Thodupuzha in Kerala.  The data was collected using questionnaire; anthropometric assessment, nutritional assessment, life style pattern, physical fitness components through flexibility tests and physiological profile were also recorded.

Results : While comparing the psychological profile working women are having more stress than house wives and most of them are diabetic(20%) and hypertensive(40%).With regard to adiposity, most of the housewives were found to put on more body fat(40%) and particularly with a large waistline(40%).With respect to frequency of consumption of various foods, homemakers were found to have significantly more of sweets(p<0.05) similarly there was a significant difference (p<0.05) in the consumption of fast foods and processed foods between the two groups. Psychological profile of working women also proved that they faced more stress and of course most of them had diabetes and hypertension too. With regard to adiposity, most of the housewives tend to put on more weight and particularly they had large waistline. With respect to frequency of consumption of various foods, homemakers were found to have significantly more of sweets, fast foods and processed foods than the employed women. However, there was surprisingly no difference in their physical fitness components of flexibility between two groups.

Conclusion:  On the whole the present study suggests whether employed or homemaker did not have any difference in their physical fitness components and certainly requires an intensive insight into their physical, mental and social health.

To date, various antiviral therapy options are available in treatment of chronic hepatitis B (CHB). Choosing the right drug according to patients’ profile is utmost crucial for optimal response, recovery and prevention of drug resistance. Tenofovir (TDF) is an approved first-line drug treatment for CHB. Several studies have reported on the safety and efficaciousness of TDF in treating CHB patients and achieving improvement. This narrative review article aimed to compile study evidences that highlighted the effectiveness of TDF as antiviral therapy in CHB patients. From the analysis done, it can be summarized that patients who have been undergoing TDF monotherapy or switched to TDF after other antiviral therapy had profound HBV DNA suppression level, no resistance detected and improved health condition. Based on this, TDF is strongly recommended to be continued as first-line treatment for CHB patients.