Air pollution is one of the main environmental problems in Tehran capital of Iran. Every day, a huge volume of exotic and destroying gases and different kinds of dangerous pollutants are added to the city air by cars, heavy vehicles, motorcycles, small workshops activities and garbage burners of hospitals. A hazardous complex is made by different types of carbon and nitrogen monoxides, sulfurs and solid particles of lead create such a harmful complex which is able to expose civilian’s lungs, eyes, skin to kill poisonous compounds made by the secondary and primary reactions. In fact, there is an exceeding number of those suffering from cancer, eyes, skin and pulmonary diseases. Carbon monoxide, nitrogen and sulfur oxides, ozone, and floating solar particles were studied as a monthly average within 12 months of a five- year statistical period. For each month the amount of the correlation the coefficient the hazardous pollutions with monthly average the number of pulmonary patients in Imam Hussein Hospital located in the east of Tehran has been determined in the same five- year- statistical period. Neural network models have been applied to predict the pollutants concentration for the next months. Since the correlation coefficients were in the best conditions, regressive relationships have been applied to predict the number of patients in Tehran and estimated the rate of the environmental destructive effects.

Depression is largely experienced in our societies. It is costly and highly prevalent medical condition having a lifetime prevalence of around 16% in US adults. Around 13.5 million adults got major depressive disorder in the last year and 34 million will get it at some point. Women experience it more likely about 1.5 to 3 times greater than men. Anyone can experience it at any age but most people experiences first episode in their early thirties. This review represents different factors that are associated with depression

Transseptal access from right atrium to left atrium through the fossa ovalis using transseptal puncture and patent fossa ovalis repair are widely used cardiac techniques. These techniques require through knowledge of the cardiac anatomy especially of the fossa ovalis .Evaluation of the various morphological parameters of the fossa ovalis forms an important prerequisite before undertaking any surgical procedure in this region. This study was conducted on 60 cadaveric hearts from the department of Anatomy, Government medical college, Nagpur. The right atrium was opened and the fossa ovalis was studied for its shape, size, floor and the prominence and extent of the limbus fossa ovalis was noted. The fossa ovalis was observed for the presence of any patent foramen ovale or probe patency. In majority of the cases the shape of fossa ovalis was found to be oval 66.7% cases, the average craniocaudal diameter was found to be 15.03mm, and average anteroposterior diameter was found to be 14.44mm. Limbus fossa ovalis was found to be raised in 83.33% cases and flat in 16.66% cases. Probe patency of foramen ovale was found in 15% cases but no case of patent foramen ovale was found. The floor of fossa ovalis was found to be flat in 65% cases and aneurysmal in 35% cases. In 10% cases membranous structure with multiple fenestrations or fine strand like structures were seen attached to the lower part of fossa ovalis. The findings of the present work are of immense value to interventionists and cardiologists

Objective: The point of this examination was to assess the criticalness of the fetal kidney length (FKL) for the estimation of gestational age. Method: A cross sectional study was carried out on 399 pregnant women with singleton pregnancies having no complications at Baloch Hospital Lalian. Pregnant women with single fetuses underwent standard ultrasound fetal biometry. The fetal kidney length measurements were performed from 20th weeks to 38th weeks of gestation. These measurements were used to date the pregnencies. Results: A positive linear relationship was found between gestational age (measured by femur length) and length of left kidney. G.A in weeks (measured by femur length) = 25.430+1.912 (Left Kidney in cm) with R2=0.939 and p value=0.000<0.05. Another statistically significant positive linear relationship was found between gestational age (measured by femur length) and length of right kidney.G.A in weeks (measured by femur length) =13.496+5.727(Right Kidney in cm) with R2=0.939 and p value=0.000<0.05. Conclusion: FKL is easy to identify and measure. It is most accurate single parameter for estimating GA than other biometric indices especially in cases when the other parameters like BPD, FL, AC and HC are not reliable for assessing GA in the 2nd and 3rd trimester of pregnancy

Gall Bladder Carcinoma (GBC) is the most aggressive and most common malignancy of the biliary tract in the world. GBC is common in India and shows rising trend with 10 times more incidence in northern and north eastern region than Southern region. As most of the patients are diagnosed in the advanced stage of cancer, prognosis is dismally poor and early diagnosis is essential. We aim to study the importance of Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) in the early detection and diagnosis of gall bladder malignancy in the suspicious cases of gall bladder lesions. A prospective cytomorphologic analysis of total 580 cases of suspected gall bladder lesions was conducted in the Department of Pathology, SMS Medical College, Jaipur, Rajasthan over a period of 2 years. US guided FNAC of the suspicious lesion was done and diagnosis was made on the basis of their cytomorphological features. The mean age of presentation was 54 years with male: female ratio of 1:2. The most common site for GBC was found to be Fossa (97.4%). According to nature of the smears, 73% were malignant, 18% unsatisfactory, 7% benign and 2% were suspicious. On cytomorphological diagnosis, Adenocarcinoma was found to be the most common of all malignant neoplasm (42%), followed by cholangiocarcinoma (9%), MEN (8%), metastatic (05%), adenosquamous (3%) and squamous cell carcinoma (1.5%). We concluded that US guided FNA is safe, quick and reliable procedure for an early diagnosis and pre therapeutic workup for gall bladder lesions.

For many years medical community has attempted to standardize its approach to the assessment of patients. The vital signs are a valuable parameter with which to assess and monitor a patient's response to supportive treatment and antidote therapy. Vital signs play an important role in the practice of medical toxicology beyond evaluating and monitoring a patient's overall status as they are frequently valuable physiological clues to toxicology and disease gravity. In 1970’s two paediatric physicians Howard C Mortenson and Joseph Greensher, coined a term “Toxidromes” which is a combination word of toxic syndromes. They have quoted “Some common combination of manifestation which we have termed toxidromes can give a clue to the drug involved” in an article “The unknown Poison”. Aim: This paper aims to provide an understanding on the various vital signs and symptoms which is observed during poison treatment. Methodology: An extensive review of literature was carried out to elicit information on various vital signs and toxic syndromes. Results: The study revealed that the health care professionals on understanding various toxidromes can help them to identify the type of poison, its antidote and the can provide a better treatment. Conclusion: The healthcare professionals has to undergo training on toxidromes. Which can improve the treatment and outcome in any poisoning case

The year 2009 witnessed emergence of novel H1N1 subtype of influenza A virus. This novel strain rapidly spread across the world and caused pandemic. In 2010, WHO declared pandemic to have crossed its peak and also warned that it will continue as seasonal influenza outbreaks in winter seasons. Several aspects of the epidemiology of influenza A H1N1/2009 strain have not been accurately determined. We sought to study whether the age & gender affects susceptibility to influenza. During the study period of one month, patients categorised as category C under national influenza guidelines and admitted to isolation ward were screened for influenza. Real-time reverse transcriptase PCR (rRT-PCR) was used for detection of influenza viral RNA. For PCR setup, WHO & CDC guidelines were followed. The result given was either Influenza A/H1N1/2009pdm strain positive or negative. Out of 75 samples received in the laboratory, 32 samples were positive (positivity rate of 42.66%). Positivity rate for females (46.51%) was higher than males (37.50%). Positivity rate was maximum in 70-79 years age group (100%) followed by 30-39 years age group (46.15%) and 20-29 years age group (44.44%). None of the patient was positive in 10-19 years age group (Positivity rate of 0%). The influenza (H1N1/2009) virus is still active several years after the 2009 pandemic in the various parts of the world. The incidence of H1N1 influenza is higher in old individuals. This emphasizes importance of vaccination especially in high risk group before the start of the flu season.

Objective: To determine students perspectives about effectiveness of teaching learning strategies used by nurse educators. Study Design: A cross- sectional study. Place and Duration: Isra College of Nursing Islamabad from June 2017 to September 2018. Methodology: A Structured questionnaire, including demographic information and questions regarding use of teaching learning strategies, was used. To assess the students perspectives about the effectiveness of these strategies five-point likert scale was used which include from marking point 1 for not effective to 5 for very effective. Data was analyzed using SPSS version 22. Results: Mean age and standard deviation of the participants was 28.5 ± 4.7 years respectively. In total, 36 students participated out of which 11 (30.5%) were male, whereas 25 (69.5%) were female. The most effective teaching learning strategy student perceived was case scenario and 77.8% found it very effective followed by group teaching which was found very effective by 47.2% of students, However the least effective strategy was cooperative teaching because only 11% of the students established it as effective. Conclusion: This study concluded that student perceived case based teaching as most effective teaching learning strategy than other educational methods, however students also forechoose the use of multiple teaching learning strategies for overall group learning

Background: Dengue fever (DF) and dengue hemorrhagic fever (DHF) are important arthropod borne viral diseases. Dengue is emerging as major public health concern in India and spreading with increased morbidity. Objective: This study was carried out to determine the seroprevalence of Dengue infection among patients attending in Gandhinagar civil hospital attached with medical college during the period of January 2018 to December 2018. Methods: A total of 2545 blood samples received in the department of microbiology, were tested for the confirmation of suspected cases of dengue. Dengue NS1 antigen and Dengue IgM antibody ELISA tests was performed for the confirmation of dengue cases. We estimated the incidence by applying age, sex and season adjusted dengue positivity. Results: Out of 2545 samples tested, 639were positive for dengue infection, among the positive cases 503 were NS1 antigen ELISA positive and136 were IgM ELISA positive. Higher incidence in male patients was noted. Number of positive cases was increased in rainy season. Conclusion: Virus activity is high during monsoon and post monsoon period which coincides with increased vector breeding. This study thus emphasizes the need for continuous sero epidemiological surveillance for the timely formulation and implementation of effective dengue control programme.

Aim: The study aimed to compare the efficacy of saline infusion sonohysterography (SIS) in investigation of abnormal uterine bleeding in perimenopausal women with transvaginal sonography (TVS) and histopathological examination of hysterectomy specimen. Method: The study was carried in50 women with Abnormal uterine bleeding and were subjected to Transvaginal sonography, Saline infusion sonography and D and C for diagnosing underlying pathology of AUB. The comparative efficacy of TVS and SIS were correlated with HPE results from hysterectomy and the same identified as Gold standard. In the present study menorrhagia was the most common bleeding pattern. Results: Among 15 cases diagnosed as endometrial hyperplasia in TVS, 2 were found to have polyps using SIS.1 case of endometrial hyperplasia was found to have irregular hyperplasia using SIS, which was suggestive of malignancy. TVS diagnosed 1 case of endometrial polyp as a submucous fibroid. SIS correctly diagnosed 10 cases of hyperplasia and 1 case of irregular hyperplasia suggestive of malignancy.4 cases of polyps were diagnosed as endometrial hyperplasia in TVS and 1 case of adenocarcinoma as submucous fibroid. SIS diagnosed all polyps correctly and diagnosed 1 adenocarcinoma as irregular hyperplasia. Conclusion: The use of saline infusion sonohysterography to enhance the visualization of the endometrium increases the diagnostic accuracy of TVS to approach that of diagnostic hysteroscopy and may even replace it. It is an alternative to hysteroscopy with the additional advantage of evaluating Myometrial and adnexal pathology besides being less invasive and cost effective

Background & Objective: Hepatitis B and Hepatitis C are significant problems in the management of haemodialysis patients. We aimed to investigate the incidence and prevalence of HBV and HCV infection in the hemodialysis patients as well as risk factors for infection. Methodology: All adult patients receiving maintenance hemodialysis (n=217) in General hospital, gandhinagar were studied between September to December 2018. Testing for Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies was performed at Department of Microbiology, GMERS medical college, Gandhinagar. Results: The prevalence and incidence rates were 2.30% in HBV patients and 5.06 in HCV patients respectively. There was a significant correlation of the prevalence and seroconversion of HCV and HBV with number of blood transfusion and duration of heamodialysis. Conclusion: Patients on maintenance hemodialysis have lower incidence and prevalence of HCV infection and lower rates of HBV infection in this study.

India is estimated to have the largest numbers of stillbirths globally, and the Indian government has adopted a target of <10 stillbirths per 1,000 births by 2030 through the India Newborn Action Plan (INAP) [1]. This study was conducted to analyze the maternal and fetal etiologies of intrauterine fetal death and to suggest preventive steps. 4800 patients with 25 ante partum deaths (5.20 per 1000 births) were studied in last four years. 56% were unbooked, 80% were illiterate and 60% were from very low socio economic status.16% had pre eclamptic toxemia, 12% had abruption placente, 8% had congenital anomaly in fetus and 4% mothers had anemia. Most of the etiological factors are manageable with regular ante natal care and timely treatment at tertiary care centre

Blood transfusion is most important part of medical treatment and is also associated with risk of transfusion transmitted infections (TTIs). Hence screening of blood bags is important to ensure safe blood transfusion. The present study was done to evaluate the ability of nucleic acid testing (NAT) and to compare it with ELISA assay to detect Window period for HBV, HCV, and HIV in the donor population of the blood bank of Karwar institute of Medical sciences, Karwar, Karnataka. A total of 3183 donors were screened over 4 ½ years to assess the seroprevalence of infectious disease markers. Blood units were screened for the five commonest TTIs namely HIV I & II, HBsAg, HCV syphilis and malaria using screening test like ELISA and Rapid Kit, peripheral smear and VDRL tests. All reactive sample were retested. Seropositive blood bags were discarded. All non-reactive samples were sent for confirmation testing by NAT technique for HIV I & II, HBsAg, HCV to reduce the risk of TTIs in the recipients, thus providing an additional layer of blood safety. Out of 3183 blood donors, 17 were seropositive for the TTIs. Totally 14 units were positive for HBV infection, out of those 13 were detected HbsAg positive by ELISA and 1 seropositive donor which was not detected by the serological test was detected by the NAT. NAT implementation is likely to reduce the TTIs and its implementation will be a valuable addition to the existing safety efforts.

Two different micro-emulsions based on methyl meth acrylate / butyl acrylate copolymers have been synthesized to be used as retanning agents for chrome tanned leather. The main difference and characteristics of the two prepared copolymers were studied. The nano particle size of the two co-polymers was confirmed using transmission electron microscope (TEM). The characterization of the two prepared copolymers were investigated. The properties of the retanned leather, namely, physico-mechanical properties as water absorption, tear strength; tensile strength and elongation at break were measured. Thermal gravimetric analysis (TGA) technique was used to examine the thermal stability of the retanned leather. Texture of the grain surface and fibers were inspected using Scanning electron microscope (SEM). The retanned leather showed an improvement in its physico-mechanical properties, as well as enhancement of its thermal stability. Also, it has uniform dyestuff, softness and firmness grain. All these promising results provide evidence to the applicability of the prepared copolymer emulsions as efficient retanning agents.

This study aims to look at the rate of primary productivity utilization in Jakarta waters by fisheries activities which are divided into two main zones using the Human appropriation of net primary production approach and the primary production recquirement. The fishery zone is divided based on the type of vessel weight size, namely zone I for ships with sizes <5GT and zone II for 5-10GT vessel sizes. The method used in calculating PRRi is to use the approach of Pauly and Chirstensen (1995) while for HANPP we transform the approach of Erb et al. 2009 to the Djau 2013 approach to see the value of HANPP fisheries. From the analysis, it can be seen that the PPR value for zone I is equal to 1,63 x 108 kgC.y-1 while for zone II amounting to 1,44 x 108 kgC.y-1. For HANPP value for zona II is equal 5,12 x 1010 kj and zone I 4,04 x 1010 kj. Total value (zona I dan II) PPRo = 9,88 x1010 , PPRh = 7 x 109 kj, and HANPP total = 9,17 x 1010 kj. The conclusion from this analysis is shown that harvesting rate of primary productivity by fisheries in Jakarta waters reaches more than 95% of total energy availability it means that the fisheries activities has given considerable pressure to the waters.