The automated hematology analyzer providing CBC has become the keystone of modern hematology laboratories and has replaced the traditional manual methods. Morphological typing of anemia is routinely done based on RBC indices like MCV, MCH, MCHC and RDW and also by peripheral smear examination. In this study morphological typing of different types of anemia were done by indices obtained from automated analyzer and by peripheral smear and were compared.400 cases of anemia were analyzed by sysmex XT 1800i analyzer and results compared and correlated. Out of 400 cases 351 cases showed a concordant typing and 49 cases showed a non-concordant typing and 12.25% of cases required a peripheral smear review for the correct typing of anemia. The sensitivity and specificity of the sysmex XT 1800i analyzer were calculated as 97% and 91% respectively for the detection of microcytes, 96.5% and 97.5% respectively for the detection of macrocytes and 91% and 90.5% respectively for the detection of normocytes. Most of the non-concordant cases belonged to the category of normocytic normochromic anemia with raised RDW. Morphological typing of anemia from the RBC indices and RDW showed a high sensitivity and specificity, except for some cases with a raised RDW which required an additional peripheral smear examination for the correct typing. So manual peripheral smear examination still holds important role in the modern laboratory practice as it provides us with many information for the proper diagnosis and management.

It has been reported that there are effects of deep breathing and breath holding on the cardiovascular and blood pressure parameters. It is generally seen that BP tends to decrease during inhalation and increase during exhalation these changes may alter blood pressure measurements resulting in measured blood pressures being different. This study aims to find the effects of slow deep breathing practice on the blood pressure and Heart rate of young healthy adult male and female medical students. Methods: This study was conducted in the Department of Physiology, RVM Institute of Medical Sciences, Laxmakapally, Telangana. A total of n=50 subjects were selected randomly; the subjects were the medical students of RVM institute. Out of which (n=25) Group (M) males and (n=25) Group (F) were females. The baseline parameters of the subjects were recorded at the beginning of the study and the subjects were then trained for slow deep breathing @ 6 breaths per minute for a period of 3 months under the supervision of the investigator. Subjects are asked to take slow and maximal inspiration lasting for five seconds, followed by maximal expiration which also lasts for five seconds at a rate of 6 breaths per minute during each practice. A standard BP measurement was performed using a pneumatic cuff while listening to "Korotkoff sounds". All cardiovascular functional parameters were recorded before the trial, during breath-holding, and during recovery. Results: The values of SBP parameters in Group (M) Male before and after training were found to be significant. The DBP change in initial and final values in this group was not significant. The respiratory rates changes were also found to be significant in the Group (M). In the Group (F) no parameter was found to be changed significantly between the initial and final readings. The intergroup comparison of the parameters in the final readings shows a significant change in both SBP and DBP. Conclusion: it can be concluded that slow deep breathing for a period of 3 months decreases the blood pressure and heart rates and improves the autonomic functions. The effects are more marked in the male participants as compared to females of the same age group. The effect of slow deep breathing for long durations tends to improve the parasympathetic tone

Aim: The aim of the present study was to perform clinico-histopathological correlation of skin lesions in all patients with a clinical suspicion of Hansen’s disease. Materials and Methods: A 3 year retrospective study from 2016-2018 was carried out with all the clinically suspected cases of Hansen’s disease along with histopathological examination of skin biopsies. Results: Out of the 60 cases diagnosed as Hansen’s disease, majority belonged to age goup 31-40 years with a male preponderance. Most number of cases diagnosed were of Borderline tuberculoid type (24/60). Overall clinicohistopathological correlation was 58.3%. Maximum correlation was evident at the polar ends of the spectrum with a slightly better correlation for lepromatous leprosy (75%). Conclusion: Correlation between clinical and histopathological features is required for accurate classification of Hansen’s disease. Clinical detection and histopathological diagnosis of borderline lesions remains challenging and hence the need for interpretation along with the clinical findings.

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production [1]. Aims and Objective: To evaluate the performance of Enzymatic and HPLC assay systems for determination of HbA1c. Material and Methods: This study was conducted from November, 2016 to December, 2017. The subjects under the study were enrolled from outpatient department of Medicine after obtaining written informed consent in bilingual languages from all the 100 subjects after describing all pros and cons. Fasting Plasma glucose and HbA1c were estimated in Department of Biochemistry, SRMS IMS. Result and Discussion: Maximum percentages of patients were in age 51 to 60 years (32%) while the least percentage of patients was from the age group 21 to 30 years (2%). Present study comprising 38% females and 62% males. HbA1c distribution in subjects by Enzymatic method in Mean ± SD (8.598 ± 2.29) with minimum of 6.2% and maximum 20.4%. The FPG distribution in Subjects 154.37 ± 40.13 (Mean ± SD) with minimum FPG of 96 mg/dl and maximum 289 mg/dl. Conclusion: HbA1c has come to play an integral role in the management of diabetes, one of the world’s most prevalent non-communicable diseases. HbA1c defines an end point as the fuel of diabetic therapy and provides a powerful stimulus to the patients to improve their compliance. HbA1c remains the gold standard in the assessment of glycemic control with availability of standardize methods.

Introduction – With the coming of adjuvant hormonal therapy, evaluation of hormone receptors now plays a pivotal role in the therapeutic management in breast carcinoma. HER2/neu positive tumors are resistant to tamoxifen based therapies. With the advent of Trastuzumab, the prognosis of this subset of tumors has improved. In this bewildering array of prognostic factors, the conventional prognostic histological features seem to have lost their importance. Material and methods- Fifty cases of mastectomy performed for breast carcinoma were taken in the study. Immunohistochemistry was performed for ER, PR and HER2/neu. Correlation between them and the conventional histological prognostic features was studied. Chi square test was used for statistical analysis. Results- ER, PR showed a statistically significant positive correlation with each other. PR & HER2/neu showed no correlation with tumor size whereas ER showed a statistically negative correlation with size of the tumor. An inverse correlation was seen between tumor grades, mitotic count and ER, PR. HER2/neu showed no correlation with either grade or mitotic count though a significant positive correlation was seen with nuclear pleomorphism. Neither the hormone receptors not HER2/neu showed any correlation with lymph node status. Conclusion- Histological features are still valuable in judging the prognosis of breast carcinoma. Triple negative and ER+PR- tumors are unresponsive to systemic adjuvant hormone therapy. In addition cost and availability can be limiting factors in applicability of these tests especially in low socioeconomic conditions and resource limited centers.

Worldwide, retention of skilled employees has been of serious concern to managers in the face of ever increasing high rate of employee turnover. Excessively high and low turnover rates, both have a negative consequence on the success and productivity of the sector. The focus of the study is to investigate the influence of non-monetary factors on employee’s satisfaction and retention in Nigeria organizations. A survey of 60 full- time employees selected through stratified sampling techniques in Edo and Taraba state reveals that age of the firm, autonomy in work place; training, internal career opportunity, reward and recognition have positive significant relationship with employee’s retention. However, the study recommends that organizations should emphasize on the extrinsic factors like attractive salary package and also should give additional benefit for the good performances of the employees. Finally, organizations should adopt adequate and competitive monetary policy strategies that will discourage employee turnover. Keywords: Employees Satisfaction, Employees Retention, Non-Monetary

Although there are several reports on the prevalence of HBsAg in Nigeria, there is paucity of data on the prevalence of HBsAg and HBAb among motor park workers in the country. Objective: This study aimed to determine the seroprevalence and risk factors among commercial Motor park workers in Jos, Nigeria. Methods: One hundred and thirty one (131) commercially motor park Workers who consented to take part in this study were recruited. Aseptically, 5ml of venous blood was collected from each participant and screened for HBsAg and HBAbs markers using one step, rapid chromatographic immunoassay and associated risk factors using structured questionnaire which was voluntarily completed by the participants and the data were thereafter analysed. Results: Of the 131 participants, 105 were males and 26 females with age range between 16-75 years. An overall HBsAg seropositivity of 16.8% and HBAbs positivity of 74.8% were observed. On multivariate analysis, factors such as multiple sexual partners: HBsAg (35.0%), anti-HBs (10.0%), anti-HBe (20.0%) and anti-HBc (35.0%); history of surgery: HBsAg (64.3%), anti-HBs (21.4%), anti-HBe (7.1%) and anti-HBc (7.1); lack of condom usage: HBsAg (15.7%) anti-HBs (28.7%), anti-HBe (18.3%) and anti-HBc (27.8%) were among some determinants of HBV infection in this study. Conclusion: The data results suggest high prevalence of HBV among this mobile group of people;, and with the increasing number of individuals and corporate bodies engaged in one or more activities at motor parks, there is the need for deliberate efforts for preventive measures.

Objective: This retrograde study was designed to compare between POCT glucometer and Laboratory reference method for glucose measurement in neonates especially in Neonatal Jaundice. The main objective of the study was to find the acceptability of POCT Glucometer against laboratory reference method. Material and Methods: 200 samples data were collected from the laboratory of neonatal jaundice. The samples neonatal jaundice with total Bilirubin >2mg/dL was considered for analysis., Glucose dehydrogenase method(Glucometer) and GOD-POD method (Reference Laboratory method) was used to measure glucose measurement in samples that were obtained. Results: Glucometer accuracy was evaluated using linear regression, Passing-Bablock regression, Bland-Altman analysis. There was no significant difference. Clarke Error Grid analysis, >98% results were in zone A. The Mean bias of Glucometer was 1.9%; with P <0.05. Conclusion: POCT Glucometer (Glucose dehydrogenase method) measurement performance was acceptable in hypoglycemic range especially in Neonatal Jaundice.

Higher morbidity and mortality is seen with bacteraemia caused by Biliary tract infection. Due to the presence of biliary sphincter, bile remains sterile despite presence of high concentration of bacteria in duodenum. Increased ductal pressure due to obstruction in biliary tree, can result in biliary stasis and bacterial multiplication resulting in cholangitis. 16% to 85% of bacteriobilia have been reported in various studies worldwide in patients of biliary tract infection. Govind Ballabh Pant institute of Postgraduate Medical Education & Research (GIPMER) is a super speciality hospital providing care to patients from all over India. This study was performed to identify the bacteria causing Biliary tract infection and study their resistant pattern. A total of 229 intraoperative bile aspirates from gastrointestinal surgery department were received in microbiology department of GIPMER and analysed. Identification and antimicrobial susceptibility testing was performed as per standard techniques. Bacterial growth was seen in 166(72.48%) out of 229 patients. Polymicrobial cultures 27(16.27%) were less frequent in comparison with Monomicrobial growth 139(83.73%). Commonest isolate was Escherichia coli (47.94%) followed by Klebsiella pneumonia (17.53%), Pseudomonas aeruginosa (16.49%), and Enterococcus spp. (11.34%). High resistance was observed against routinely used antibiotics by Gram negative bacteria, such as ciprofloxacin, ceftriaxone, piperacillin/tazobactam, and low resistance was observed against carbapenems and colistin. The study shows that analysis of bile can be valuable in preparing a better treatment strategy in biliary tract infection. Rapid development of multidrug resistance in gram-negative bacteria causing biliary tract infections remains the cause of concern.

Acute appendicitis is one of the most common surgical emergencies. It involves 10 to 20% patients in causality. The aim of the study is to predict the credibility of clinical, radiological and laboratory findings in acute appendicitis with normal leukocyte counts. Material & Methods: This study was carried in our tertiary care hospital over a period of one year by retrieving the data from hospital records to access the diagnostic factors in acute appendicitis with normal leukocyte counts. Results: The median age was 16 years. 228 were males and 149 females. Alvarado scores ranged from 5 to 10, with a median score of 8. Temperature at time of presentation ranged from 36.8°C to 38.33 °C. The duration of symptoms was less than 24 hours in 134 patients and more than 24 hours in 243 patients. Total WBC count was found to be normal in 55 patients (14.58%) as compared to elevated total WBC counts found in 322 patients (85.41%). Polymorph nuclear leucocytes were more than 75% in 52 of the Group B patients (94.54 %). The same was found in 306 (95.03 %) patients of Group A

Introduction: Biofilm are surface associated bacterial communities surrounded by a matrix of exo-polymers and are responsible for development of clinical infections.Urinary tract infections are considered to be one of the most common bacterial infections.Uropathogenic strains of Escherichia coli account for 70-95% of the UTIs. The bacteria enclosed within the biofilm are extremely resistant to treatment. Objective: To study Biofilm formation of Uropathogenic Escherichia coli by Tube method and Tissue Culture Plate method. Material and Methods: The study was carried out at Department of Microbiology, MGM Medical College, Kamothe, Navi Mumbai from October 2015 – September 2016. Total 200 urine samples were processed. Out of 200 samples, 100 isolates of Uropathogenic Escherichia coli were included in this study. They were identified by standard microbiological procedures. These isolates were subjected to biofilm production by Tube method and Tissue culture plate method. Results: Out of 102 Uropathogenic Escherichia coli isolates 40.19% were biofilm producers by Tube Method and 47.05% by Tissue culture Plate Method. Conclusion: Tube Method correlated well with Tissue Culture Plate method for strong biofilm detection in Uropathogenic Escherichia coli.

Background: Midline line incisions are known for its versality of rapid and wide access to the peritoneal cavity with least damage to abdominal wall musculature, vessels and nerves. The closure technique varies from operating surgeon to institutions. The aim of this study was to see the postoperative results in reference to small tissue bites in the closure of abdominal wall. Materials and methods: The study was conducted in the department of general Surgery SKIMS, MCH Bemina Srinagar. A total of 50 cases were managed with small bites technique that underwent midline laparotomy in both elective and emergencies from 2016 to 2018. Patients were operated with small tissue bite sutures placed 5 - 7 mm from the wound edge and 5 - 7 mm apart and included only the aponeurosis in the stitches without peritoneum. Results: Maximum number of patients were males, maximum number of patients were in age group of 20-30 years (56%), serum albumin was ≥3 in36 (72%) of patients. Surgical site infection was seen in 12 (24%) of patients. Conclusion: Our study showed that small stitch length between 5 to 7 mm with SL: WL ratio: greater than or equivalent to 6:1 to achieve safe closure of midline laparotomy incision

Introduction: ‘Viral Hepatitis’ denotes a primary infection of liver by heterogeneous group of Hepatitis virus. They are clinically indistinguishable, leading to morbidity and mortality. Mainly diagnosed by serological and molecular markers. Hepatitis A and Hepatitis E viruses are transmitted by faeco-oral route and cause sporadic as well as outbreaks of acute viral hepatitis. Objectives: Prevalence of HAV and HEV in patients of acute viral hepatitis along with their co-existence and correlate it with seasonal trend. Materials & Methods: Study was conducted in our institute from January to December, 2018. 275 samples were tested for HAV and HEV infection of clinically suspected cases. Samples were analyzed for anti HEV IgM and anti HAV IgM antibody by ELISA method. Results: Out of 275 samples, 66 were positive for anti HAV IgM indicating prevalence rate of 24%, majority patients were in pediatric age group of 0-14 yrs. In case of HEV, 71 samples were positive with prevalence rate of 25.8%, majority patients were in age group 15-45 yrs. Infection rate was higher in males. Co infection rate was 1.09%. Seasonal trend shows maximum positive cases in summer and monsoon. Conclusion: HAV and HEV infection should be considered as an etiology of acute infectious viral hepatitis. It is suggested that health care facilities should make an effort to increase the awareness among general public for personal hygiene and cleanliness, thus reduce morbidity, mortality and economic burden.

Job satisfaction is among the most expansively explored subjects in the organizational behavior and human resource management domains. Hence, in healthcare context, satisfied doctors are likely to demonstrate greater productivity and commitment towards their job. Similarly, committed doctors denotes low turnover. However, globalization of health sector has motivated many doctors to migrate for better opportunities, better career growth and greater job satisfaction. The recent years have seen the rapid growth of this people-centric health care sector. For the achievement of effective delivery of health services and doctor retention, job satisfaction among hospital doctors needs to be assured. Therefore, this paper attempts to ascertain the gaps and search the diverse factors impacting job satisfaction. Hence, the previous studies concerning job satisfaction among hospital doctors are reviewed. From the past works, positively correlation was found between monetary benefits, work conditions, recognition, autonomy, achievement, and growth and development opportunities, and job satisfaction

Dengue fever is the most common Arboviral disease in India. Dengue is endemic in almost all states and leading cause of hospitalization in India. An overview on Dengue burden, prevalence, Geographical distribution and seasonal trends at a particular area is necessary for administration of appropriate preventive and control measures. The present study was aimed to assess the prevalence of dengue infection among the patients suffering from acute febrile illness at GGH Mahabubnagar. A total number of 3076 clinically suspected cases of dengue were included in the study. Serum samples from these patients were collected and were subjected either dengue IgM or NS1 ELISA based on the duration of fever. Out of 3076 cases 206 were positive for dengue serology, out of them 112 were positive by NS1 ELISA and 94 were positive by IgM ELISA. In the present study commonly effected age group is 0-20yrs and showing male preponderance. Dengue infection is common in post monsoon season from September to November months. These epidemiological details in the particular region will help in proper planning of resources in disease prevention and control.