Objectives: To compare the vitamin D levels between genders, age groups and geographical locations in a tertiary care hospital of Dakshina Kannada. Materials and Methods: A total of 208 (n=208) reports containing vitamin D levels were collected from Central laboratory, which were reported between January 2015 to December 2015. The values are tabulated in Microsoft excel sheet. Student‘t’ test was applied to compare the vitamin D levels between males and females. Whereas, ANOVA was applied for comparing vitamin D levels between different age groups and geographical locations. Results: Out of 208 vitamin D reports, 86 (41.3%) reports were from male and 122 (58.7%) from females. The mean values of vitamin D in males and females were 32.9±14.7 and 31.1±21.4 respectively. Even though females have low levels of vitamin D when compared to males but statistically it was not significant (p=0.512). The mean value of vitamin D from different geographical locations ranged from 20.9 ng/ml (from Ankola) to 78.6 ng/ml (from Dharwad) and 27.3±11.1 being noted from Dakshina Kannada. The intergroup comparison of vitamin D levels of individuals from different locations didn’t show any statistical significance (f =1.33 & p= 0.191).Similarly, there is no statistical significant difference in the vitamin D levels of different age groups. Conclusion: The present study concludes that there is no statistical significant difference in the vitamin D levels of males with females and also no significant difference was found in the vitamin D levels of different age groups and different geographical locations.

The purpose of this paper is to show how our lives are shaped by our thoughts. It might seem like an easy task because we all have different thoughts and we all think that we know how to handle them but I believe the reality is a little bit different. Indeed, we have the ability to think for ourselves, to distinguish between what we feel like is wrong or right but at the same time we often end up in a situation where we are faced with other thoughts. And we do not always know how to cope with them. Also, sometimes we might have deeper thoughts opposite thoughts about a specific subject, a feeling or a person and we feel like we are overwhelmed. It is not something strange. I believe it is part of what makes us human beings. In order to perceive our lives we need to be able to understand how we think so we can shape our existence how we like it not how someone else tells us to do.

Background: The aim of induction of labor is to initiate labor when maternal and fetal conditions necessitate delivery before the onset of spontaneous contractions. The success of this obstetric practice is highly dependent upon the condition of the cervix. Cervical ripening is a complex process that results in physical softening and distensibility of the cervix, ultimately leading to partial cervical effacement and dilatation. Objective: The purpose of the current study was to compare the effectiveness and safety of the pessary to intravaginal dinoprostone gel for induction of labor. Results: A total of 200 women were included in the study, of whom100 received dinoprostone pessary and 100 dinoprostone intravaginal gel. Tachysystole was diagnosed by the research team in 33 women, (4.5%) of those received the pessary and (2.4%) of those received gel (Table 4). In Caesarean section for suspected fetal compromise associated with uterine Tachysystole was performed in seven women in the pessary group and one in the gel group. There was no correlation between the initial Bishop score and the occurrence of uterine Tachysystole. (4.1%) women in the pessary group had a postpartum haemorrhage with estimated volume of ≥ 1000 mL compared to (2.2%) women in the gel group (P = 0.08). Conclusion: In this retrospective study, use of dinoprostone vaginal pessaries for induction of labour resulted in no advantage compared with dinoprostone intravaginal gel and clinically significant tachysystole appeared more common.

The challenges of unmonitored or partial usage of solar power for cooperate firms that generate this power has motivated the need for this research to develop a smart system to monitor and control the varying parameters of PV systems. Voltage, current and temperature sensors were used to monitor the energy generated, consumed, stored and losses that are connected to the system. This system was able to monitor radiations from the sun and temperatures of the PV modules. Also, with the aid of programmable microcontrollers, ECUs and routers, gathered information was transmitted real-time for a specified period. Results were displayed in digital values using graphs and. transmitted to the internet with aid of dedicated servers. This system senses slightest variations on variables, captures any anomaly and transmits prompt results via text message / internet. It is recommended that microchips’ Internet of Things (IOT) board should be utilized in future monitoring due to its shorter deployment time and encrypted transmission of data. Moreso, cooperate bodies and individuals investing on PV systems in terms of security should be supported fully most especially by the government and renewable energy policies as practiced in developed nations should be emulated by developing and underdeveloped nations.

Adolescents in peri-urban settings are at increased risk of sexual and reproductive health challenges. Most peri-urban settings in developing countries are characterised by violence, illicit sex and drugs, abortions, limited access to quality health information and services among other challenges. Adolescent’s friendly centres are believed to be one of the innovative strategies and approaches for delivering age and culturally appropriate sexual and reproductive health information and services for at risk and sexually active adolescents in peri-urban settings. Health based project organizations in peri-urban environments are routinely delivering health information and services for at-risk adolescents through ‘adolescent’s friendly centres’. However, few studies have assessed the relationship between adolescent friendly service provision approach and delivery of sexual and reproductive health information and services for sexually active peri-urban adolescents. The objective of this study was to assess the influence of adolescent friendly service provision approach on delivery of sexual and reproductive health information and services for sexually active peri-urban adolescents enrolled in reproductive health projects in peri-urban settings within Kisumu City. A cross sectional study design was used. The target population was 1299 adolescents, project managers and ASRH service providers. A sample size of 297 was computed using the Krecjie and Morgan sample estimation. A self-administered questionnaire was used. Descriptive and inferential data were analysed using SPSS. The descriptive statistics included frequencies, percentages, means and standard deviations. Inferential statistics included Pearson’s correlation(r), co-efficient of determination (R2), Anova Test (p value) and Beta coefficients (β). There was statistically significant positive association between adolescent friendly centre approach and delivery of ASRHS (r=304 p<0.01). It is recommended that project based reproductive health organizations specializing in adolescent sexual and reproductive health projects should strengthen adolescent friendly centres to ensure sustained uptake of age and culturally appropriate sexual and reproductive health information and services for sexually active adolescents in peri-urban settings.

Currently, one of the most efficient and cleanest forms of renewable energy source for effective power generation is Photovoltaic (PV) source. It is because of its cheapness, almost free maintenance cost, friendliness to the environment etc. However tracking the sun energy with the solar panels for effective utilization of its energy still pose a major challenge to researchers. Hence tracking these energy is very important. The paper is on simulation of MPPT using P&O and INC methods. Mathematical model of 100KW PV system was developed using Matlab M-file. Both models were designed and simulated using MATLAB/SIMULINK. It is shown that PV system output power increases with rise in solar irradiation and in lower cell temperature. Therefore, solar cell performs better in warm environment than cold environment. The P&O gives the best duty cycle as compared to constant time interval control in getting the PV system’s highest power and the INC method extract a high maximum power than P&O. Both popular MPPT methods were used in the simulation which was controlled by the signal builder and the results displayed. It was observed that INC MPPT has better performance than P&O algorithm. The voltage obtained from the panel system is increased by the DC-DC boost circuit with a load resistance connected to it. It is recommended that the MPPT The system should consist of fractional, three-point, temperature-based MPPT for more effective and improved comparison. Moreso the perturb and observed method should be improved on by varying of the irradiance to maintain an increase constant voltage.

Introduction: Sickle cell disease (SCD) results from the substitution of a valine residue for glutamic acid at position 6 in the beta-subunit of hemoglobin. It is characterized by chronic hemolytic anemia, vaso-occlusive process and multiple organ infarction resulting from wide spread vascular occlusion. Sickle cell disease is the most common inherited disorder worldwide. Pregnancy in sickle cell disease is at very high risk. Many reports have documented a considerable maternal risk of morbidity and mortality and high peri-natal adverse outcomes. Case report: 26 year old G3P1D1A1 presented with 39 weeks 4 days gestation with gestational hypertension with mild tricuspid regurgitation with pulmonary hypertension. She was diagnosed with sickle cell disease. Results: Patient is taken for emergency LSCS and transfused with 1 pint packed cells along with Thrombo prophylaxis. Both mother and baby are doing well till date. Conclusion: This case report highlights the fact that anemia in pregnancy should be evaluated systematically and early diagnosis and effective multidisciplinary approach will yield a better maternal and neonatal outcome.

Vaginal melanoma is a rare malignant tumor that is aggressive, with a bad prognosis, affecting women in their 6th and 7th decade of life. The factors contributing to its development are not well known. Vaginal melanomas constitute 0.3% of all malignant melanomas and less than 3% of all vaginal carcinomas. To date, there is no clear consensus concerning treatment. A precise and early diagnosis and rapid investigations are essential to arrive to appropriate therapeutic decisions. We described inthis article acase of 31 years old women with primary vaginal melanoma. Our purpose is to focus specealy on management particularitis of this rare gynecological malignant tumor.

The street play based learning is becoming more popular to support learning process of students in professional colleges by asking students to understand the basis of clinics and also the attitude and behavioural learning using a street play which the students will display to other students. Bed side clinics are the gold standard but as the number of colleges is increasing the number of patients is slowly decreasing. It is practically impossible to show all the cases to the learning students. But there is a way and it is in this way that the professional actors or the doctors themselves who has knowledge of the disease can enact and thus teach the students. This study puts in a sincere effort to find the answer of which method is better.

Introduction: Hypothyroidism is receiving greater attention as an important cause of disturbance in mineral metabolism by its direct action on bone turnover, and also as one of the causes for secondary osteoporosis. Calcium (Ca2+), phosphorus (PO4 2−), and magnesium (Mg2+) are necessary for metalloenzymes and various crucial metabolic pathways directly or indirectly regulated by thyroid hormones. Methodology: Patients attending the General Medicine department who were diagnosed clinically as hypothyroid for the first time (n=120) and referred to the central laboratory for thyroid function tests were enrolled for the study. 60 normal healthy individuals were chosen as controls. Results: In hypothyroid patients, the mean values of calcium and magnesium were found to be higher compared to that of the controls’. Whereas mean value of phosphorous was found to be lower compared to that of the controls’. Conclusion: Serum calcium, magnesium & phosphorous levels are widely altered in patients having hypothyroidism. So we suggest that constant monitoring of these minerals in hypothyroid patients will be of great benefit in improving clinical manifestation. Complications can be avoided by planning holistic disease management strategies for these patients.

Respiratory infections are quiet common in today’s world. Endemics ad Pandemics like SARS and Corona Virus infections has made headlines already. Especially in the urban or semi developed areas the people more prone to such conditions. This study puts in an effort to find pathological complications of Upper respiratory tract.

Papanicolaou (PAP) smear is a cyto-diagnostic technique, which is a simple, safe, non- invasive and effective method for detection of pre-cancerous and non- cancerous changes in cervix as well as vagina. Clinical follow up of reported abnormal cases was done by revisiting the records or by following it up with histopathological specimens of the same patient received in our department and cytology-histopathological correlation was done. A total of 2624 PAP smears were analysed during the study period. 51 smears had abnormal PAP findings, out of which 44 cases had histopathology correlation. The present study encountered that cervical cytology is more sensitive in diagnosing glandular malignancy than squamous cell abnormalities.

Tuberculosis is one of the dreaded infections which are commonly found in our country. In fact there is a saying that if none of the medicines wok and the patients is still ill then there is a high chance of the patient suffering from tuberculosis in India. Vitamin D has been observed to be low and has been always understood to have an influence in the patient’s outcome also. There is no base line study done to understand the involvement of the Vit D in the patients. So this study is one such novel effort to understand the same.

Background: Diagnostic challenges are associated with skin adnexal tumors because of a broad spectrum of tumor and tumor-like lesions along with their histological variants, the degree of differentiation, the rare incidence of few of these tumors, and the complex nomenclature. The aim of this study is to study the spectrum and microscopic features of Skin adnexal tumors. Methods: A prospective study was conducted over a period of 2 years from August 2017 to July 2019 in the Department of Pathology, Narayana Medical College and Hospital, Nellore. Formalin fixed, paraffin embedded tissue sections were stained with Hematoxylin and Eosin. Result: Out of the total 30 cases diagnosed as Skin adnexal tumors, 15 (50%) tumors were showing Eccrine differentiation followed by tumors with Pilar differentiation, 8 (26.67%), Apocrine differentiation, 5 (16.67%) and Sebaceous differentiation, 2 (6.66%). The age ranged from 13 to 73 years and male to female ratio was 1.14:1. Most of the tumors were benign, 29 cases (96.67%) while only 1 case (3.33%) was malignant. Clear Cell Hidradenoma was the most common tumor. Conclusion: Morphological features and identifying the path of differentiation are of great importance in diagnosing Skin adnexal tumors.

Gall bladder disease is rather encountered on a daily basis in the OPD’s now a day[1]. Many of these get admitted. Most of the cases admitted in the hospitals require radiological intervention. Routine examination of the gall bladder using USG is difficult and challenging. After cholecystectomy has been done it shows different histopathological changes ranging from inflammation to premalignant and carcinoma. This study puts in an effort to find the answer for the same.