Extended-spectrum – beta lactamases (ESBLs) are increasingly detected globally among Escherichia coli (E.Coli) and Klebsiella pneumoniae (K.pneumoniae). This study was designed to determine the prevalence and antibiogram of ESBLs produced by E.coli and K.pneumoniae clinical isolates obtained from various clinical specimens through different hospitals in Khartoum state -Sudan. An analytical comparative cross-sectional study was conducted. Identification of the isolates was done by using conventional biochemical methods ESBL screening, confirmatory according to CLSI guidelines. Statistical analysis was performed using the Statistical Package of Social Sciences (SPSS). Total of 368 isolates of Escherichia coli(n=216) and Klebsiella pneumonia (n=152) isolates were processed , Overall ESBL phenotype prevalence was 36.7 %, 40.1% and 34.2% of K. Pneumoniae and E. coli isolates respectively were confirmed to be ESBL phenotype. In this study, meropenem and imipenem were the most active antimicrobial agents against them. This study was indicated high prevalence of ESBL phenotype in Khartoum-state, with multidrug resistant trend, there is a need for longitudinal and nationwide surveillance as this help in tracking antibiotic resistant and regulating antibiotic policy.

Low accessibility to credit facilities has been devastating the small scale farming business in Nigeria. Therefore, the small scale farmers in Nigeria are encountering difficulties as these farmers cannot directly access credit facilities to boom and develop their farm business activities, and this has led to agricultural business setback in the country. This paper investigated how micro-insurance policy has influenced peace of mind among the small scale farmers in Nigeria. The study used survey research methodology, with the south-western part of Nigeria as the scope of the study. The data for this study was extracted from primary source through well structure designed questionnaires, using correlation and linear regression analysis to analyze the extracted data. And to determine the present and future relationship between examine the present and future relationship between the independent variable (micro-insurance (MI) and the set of dependent variables (health risk (HR); financial protection (FP); vulnerability risk (VR); and Poverty alleviation (PA)). The findings revealed that using micro insurance as an health risks management tool among the small scale farmers in rural areas, and the less privileges will be an efficient platform to alleviate their proneness to the risks of sickness, because it will assist this them to overcome the anxiety of hospital bills payments, and other medical expenses. The study conclude that Micro-insurance can mitigate vulnerability among the small scale farmers in the country by providing low income households, business and farmers with access to post eventuality compensation, thus compensates them for injury, damage and providing coverage for their ill-health, which invariably leads to development among the small scale farmers.

Postoperative pain in patient undergoing open prostectomy is quite uncomfortable for the patient. All the techniques for multimodal analgesia has some or the other side effects. Transversus abdominis plane (TAP) block is newer, effective and comparatively simpler to perform and provides better and denser pain relief than pharmacological agents. This randomized control study was conducted on 60 male patients of ASA grade 1 and 2 undergoing open prostectomy after taking ethics committee approval. In group R (n = 30), 0.25% Ropivacaine hydrochloride (20ml) and in group S (n=30), 20 ml of normal saline was given through TAP block after completion of surgery. Time of first rescue analgesia and total dose of analgesic consumption for 24 hour postoperatively along with pain visual analogue scale (VAS) were measured and compared along with other vitals like heart rate, SBP, DBP and MAP. Postoperative TAP block using ropivacaine just after completion of surgery results in better analgesia in post-operative period in patients undergoing open prostectomy. Time of rescue analgesia in group R was 158.5±42.08 and in group S was 68.6±98.8. Also total analgesic consumption and VAS score in postoperative period was significantly low in ropivacaine group when compared with the saline or control group (p<0.05). TAP block using roipvacaine 0.25% in open prostectomy patients provide better analgesia in postoperative period and reduces amount of total analgesic consumption and thus the side effects associated with the later.

Cavernous hemangioma is a benign vascular tumor related to single or multiple hemangiomas, probably developing from embryonic remnants of angioblastic cells. This entity is very rare and constitutes barely 0.6% of bladder tumors. However its diagnosis can be easily established by cystoscopy and confirmed by pathological examination. Hematuria is the most common mode of manifestation. Bladder hemangioma is most often sporadic, but it can be associated with a KlippelTrenaunay syndrom, in this case they are multiple. Treatment consists of tumor resection. Selective arterial embolisation is rarely used. Endoscopic treatment by photocoagulation Neodymium laser seems a satisfactory therapeutic option.

Patients undergoing surgery are most feared of postoperative pain. All the techniques for multimodal analgesia has some or the other side effects. Transversus abdominis plane (TAP) block is newer, effective and comparatively simpler to perform and provides better and denser pain relief than pharmacological agents. It could be used in abdominal and inguinal surgeries. This randomized control study was conducted on 60 male patients of ASA grade 1 and 2 undergoing open prostectomy after taking ethics committee approval. In group L (n = 30), 0.25% Levobupivacaine hydrochloride (20ml) and in group S (n=30), 20 ml of normal saline was given through TAP block after completion of surgery. Time of first rescue analgesia and total dose of analgesic consumption for 24 hour postoperatively along with pain visual analogue scale (VAS) were measured and compared along with other vitals like heart rate, SBP, DBP and MAP. Postoperatively, TAP block using levobupivacaine just after completion of surgery results in better analgesia in post-operative period in patients undergoing open prostectomy. Time of rescue analgesia in group L was 209.3±27.25min and in group S was 70.6±9.8 min. Also total analgesic dose consumption and VAS score in postoperative period was significantly low in levobupivacaine group when compared with the saline or control group (p<0.05). TAP block using levobupivacaine 0.25% in open prostectomy patients provide better analgesia in postoperative period and reduces amount of total analgesic consumption and thus the side effects associated with the later.

The study was conducted to assess the extent of seropositivity of Hepatitis C among HIV positive patients at tertiary care hospital in Rajkot from June 2016 to May 2017 and evaluate the need of routine screening for this infection among such patients. The samples were tested for HIV as per Strategy III of National AIDS control organization by using different system of testing to establish diagnosis of HIV. A total of 300 confirmed HIV-positive samples were tested for anti-HCV antibodies by using one step immunochromatographic assay based on the principle of the double antigen-sandwich technique. Out of total 300 HIV positive patients, 69.67% were male and 30.00% were female. Only one was transgender. Out of 300 samples tested, 5(1.67%) were positive for HCV with 2(0.96%) of male and 3(3.33%) of female patients. Highest prevalence was observed among age group 21–30yrs i.e 2(3.77%), while not a single anti-HCV positive case were recorded in age group ≤20 and ≥51 which implies that HIV and HCV infection is more common in younger generation. We believe our data could help health professionals to deal better with HIV infected patients. We also believe our data reinforces the need of prevention programs on HIV transmission, which also lead to reduction in prevalence of Hepatitis C.

(3H)‒quinazolin‒4‒ones were reported for enhanced antibacterial, antiviral, antifungal and antimalarial activities with aryl and styryl substituents at position two and three respectively. In the present work, synthesis of some newly substituted (3H)‒quinazolin‒4‒ones starting from 2‒aminobenzoic acid and acetic anhydride producing 2‒methyl‒benzoxazin‒4‒one (Step‒I) has been undertaken. Replacement of ring oxygen from benzoxazin‒4‒one (step‒II) with nitrogen atom of 4‒chloro aniline produced first series of title compounds (QIa-QIk). In addition, 2-methyl group of benzoxazin‒4‒one was extended further as ethenyl (‒CH=CH‒) linkage joining to various substituted aldehydes (Step‒III). It has produced sufficient quantity of 2‒styryl‒3‒aryl‒(3H)‒quinazolin‒4‒ones (QIa‒QIk, Scheme I). In obtaining second series compounds (QIl‒QIt), identical approach was followed with replacement of benzoxazin-4-one ring oxygen with nitrogen atom of various substituted amines (Step‒II).There is extension of methyl group of benzoxazin‒4‒one as ethenyl group (‒CH=CH‒) joining 2‒chloro benzaldehyde. It has produced sufficient quantity of 2-[2-(2-Chloro-phenyl)-vinyl]-3-aryl‒(3H)‒quinazolin‒4‒one (QIl‒QIt, Scheme II). Structures of synthesized compounds were established by elemental analysis (C, H, N, O and X=halogen), FT‒IR, 1H NMR, 13C NMR and HR‒MS. In-vitro disk diffusion assay was performed using Gram‒positive bacteria Bacillus subtilis (NCIM2711), Staphylococcus aureus (NCIM2079), Gram‒negative bacteria Kleibsella pneumonia (ATCC 4352), Pseudomonas aeruginosa (ATCC27853) and fungi Candida albicans, Aspergillus niger. Ciprofloxacin and Griseofulvin were the positive control standards for bacteria and fungi respectively. Excellent antimicrobial activity (MIC=9.07‒10.54 µM x 10-3) was exhibited by compounds as (QId), (QIf), (QIg), (QIi), (QIj), (QIk), (QIl), (QIm), (QIn), (QIq), (QIr) and (QIs). Present study of (3H)‒quinazoline‒4‒ones will serve as an important path in the development and discovery of newer antimicrobial agents.

Chikungunya Fever is one of the most important arboviral infections of medical significance. It is characterized by an abrupt onset of fever with severe arthralgia followed by constitutional symptoms and rash lasting for 1-7 days. The disease is almost self-limiting and rarely fatal. Chikungunya virus (CHIKV) is a RNA virus belonging to the family Togaviridae, Genus Alpha virus. Aim of the study is to know the seroprevalence of Chikungunya infection in a Tertiary Care Hospital in Jamnagar, Gujarat, India. A retrospective study was conducted at a Microbiology Department, Shree M.P. Shah Govt. Medical College, Jamnagar, Gujarat. Serum samples were collected from 382 suspected cases of Chikungunya fever and tested for Chikungunya IgM antibodies by ELISA over a 1 year period from July 2017 to June 2018. Of the 382 serum samples tested, 67 (17.54%) were positive for Chikungunya IgM antibodies. Out of these 67 positive samples, males were 30 (44.78%) and females were 37 (55.22%). The most affected age group was 31 to 45 years 22 (32.84%), followed by 16 to 30 years 17 (25.36%). From the present study it can be concluded that the Chikungunya cases are on rise. Hence, Chikungunya has become a major public health problem in India. Favorable mosquitogenic condition during monsoon period is primarily responsible for the rapid spread of Chikungunya. This requires continuous monitoring of the viral circulation in both endemic and nonendemic areas and rapid implementation of Chikungunya control programme. For these infections early detection and access to proper medical care will cause lower fatality rate.

To evaluate the serum lactic dehydrogenase (LDH) level as a marker of severity of preeclampsia. Antenatal mothers without complications were taken as controls and women with preeclampsia taken as cases. They were evaluated for serum LDH levels. All enrolled women were followed till delivery and their course of pregnancy and fetal outcome were noted. Mean value of LDH in the control group was 395.16+ 92.54IU/L. The LDH level in non severe type of preeclampsia was 566+ 219IU/L and in severe type of preeclampsia was >600 IU/L where it was highly significant (p<0.001). Antenatal complications and neonatal complications were 25% more in severe preeclampsia where serum LDH levels were >800IU/L. The severity of maternal and fetal complications was correlated well with increased LDH levels in preeclampsia.

Temporomandibular ankylosis is defined as a permanent constriction of the temporomandibular joint. It can be an articular or juxta-articular origin, and includes various pathologies. We report here an unusual cause of temporo mandibular ankylosis which is an osteochondroma diagnosed by an anatomopathological study of the bone block. A 16-year-old patient who consults for a difficulty in opening the mouth. The clinical examination was without particularities. The cranian scan revealed the presence of a bony block at the right temporo mandibular joint with almost complete disappearance of the joint space.It was the histological examination of the osseous block that led to the diagnosis of osteochondroma.

Cutaneous larva migrans (CLM) is a tropical and subtropical parasitic infection caused by hookworm infection which inhabit in domestic pets such as cats and dogs. Larva found in infected soil, accidently penetrates the intact skin and causes lesions which are an erythematous, serpiginous, and extremely itchy. The reported case was clinically diagnosed as CLM had multiple lesions without complications and successfully treated with albendazole.

Acquired Immune Deficiency Syndrome (AIDS) is caused by lymphotropic retrovirus which was first recognised in 1981 and subsequently HIV was discovered in 1983. HIV infection causes derangement in hematopoietic system which directly results in lymphopenia with the progression of disease and leads to decrease in CD4 lymphocytes, which is directly related to prognosis of disease. It is said that other blood cells may also be deranged due to HIV infection leading to anemia, neutropenia or thrombocytopenia. The purpose of this study was to assess various haematological various haematological changes in HIV patients and to correlate the finding with CD4 counts. A total of 50 seropositive patients were studied over a period of 1 year. All patients diagnosed as HIV 1 and 2 were included in the study. Patients with no haematological study or CD4 count were excluded from the study. The hematological parameters included under this study were – Hemoglobin, Total Leucocyte count, Absolute Lymphocyte count, Platelet count, Mean Corpuscular Volume (MCV) and CD4 count. In this study 26 (52%) were male and 24 (48%) were females. Majority of cases (50%) were between the age of 30 – 44 years. Decrease in CD4 count correlated with lymphopenia with CD4 count less than 500/µl in majority (88%). Anemia was the commonest abnormality (62%), predominantly normocytic normochromic type. Thrombocytopenia was the least noted (14%). This study reiterated that absolute lymphocyte count is the best correlated parameter with CD4 count in seropositive patients.

Our aim was to formulation development and evaluation of herbal face pack without adding any preservatives. Face pack was formulated with different natural ingredients (sandal wood powder, multani mitti, china rose flower powder, turmeric, rose water) which are rich sources of vitamins and minerals that are essential for the health and glow of the skin. Evaluation methods were organoleptic, physico-chemical, rheological parameters and stability along with irritancy test. All prepared formulations were standardized by different parameters. Organoleptic parameters showed that the pack was smooth and rheological findings proved the flow properties of the pack as it was found to be free flowing and non-sticky in nature. The results showed that the formulation was stable on all aspects. Stability tests performed revealed the inert nature of the pack. Irritancy test was showed that no irritancy after use. Face packs are generally used to increase the fairness, glow and smoothness of the skin. They are non-toxic, non-allergic and having lesser side effects. Thus in the present work, it was a very good attempt to formulate and evaluate the herbal face pack containing natural herbal ingredients.

Macrocytosis in adults is defined as a red blood cell (RBC) mean corpuscular volume (MCV) >100 FL. Macrocytic anemia is generally classified into megaloblastic and non-megaloblastic anemia. The objective of this study was to assess haematological findings in patients of macrocytic anemia based on complete blood count and peripheral blood smear and to classify them based on clinical, serum vitamin B 12 and folic acid levels .The study was carried out over a period of one year at a tertiary care teaching hospital. 100 patients were selected on simple random sampling with MCV>99 FL and peripheral blood smear showing features of macrocytosis. Out of the 100 patients studied of macrocytic anemia, 55 percent had megaloblastic anemia and remaining 45 percent had non-megaloblastic anemia due to various causes. In our study, megaloblastic anemia was the most common cause of macrocytic anemia and among non- megaloblastic causes liver disorders like hepatitis was the most important cause.

Lead is a well known environmental and reproductive toxicant. This study was designed to evaluate the blood lead levels in pregnant women in Nnewi, Anambra State, South Eastern Nigeria. A total of 100 apparently healthy subjects comprising of 75 pregnant women and 25 non-pregnant women (control) aged between 18 and 45 years were recruited for the study. Thereafter, 2mls of blood sample was collected into EDTA container for the estimation of lead concentration using atomic absorption spectrophotometric method. A structured questionnaire was used in obtaining relevant data for age, dietary and lifestyle patterns of subjects. The result showed a significantly higher lead level in pregnant women compared with control group (p=0.000). Also, the mean blood lead level differed significantly between the first and second trimester as well as between first and third trimesters of pregnancy (p<0.05), but values obtained were similar between second and third trimesters of gestation (p>0.05) respectively. This study further revealed significantly higher blood levels in pregnant women that consume caffeine, animals killed by ammunition, and food items as well as in pregnant women that smokes (p<0.05). Also, blood lead level was significantly elevated in pregnant women that used well and piped water respectively (p<0.05). Therefore, there is need to avoid avenues of lead exposures in pregnancy in order to sustain the low blood level recorded in this study and hence, limit the potential adverse implications of lead exposures.