Abstract: Normal pregnancy is associated with significant hyperlipidemia. Hyperlipidemias are well known as a modifiable risk factor for ischemic heart disease, which is one of the leading causes of morbidity and mortality worldwide. Traditionally LDL is referred to as 'Bad Cholesterol'. It is now established that more than LDL as a whole, it is the small dense subtype of LDL in particular which is responsible for the atherogenicity of LDL. In this study we aimed to determine whether normal pregnancy is associated with a shift in distribution of LDL subtypes, and whether a shift to a more atherogenic lipid profile is an inevitable consequence of normal pregnancy. 100 women with normal, uncomplicated pregnancy were enrolled in the study. Blood samples were collected in the middle of each trimester and 3-4 months post partum, and LDL and small dense LDL levels were estimated. Repeated Measures Anova with post hoc correction was used to compare the mean values of LDL and sdLDL among the different trimesters. P value < 0.05 was considered statistically significant. Normal pregnancy was associated with a progressive and significant rise in both LDL and sdLDL levels, peak values being attained in the third trimester. Post partum, LDL levels returned to the base line, whereas the sdLDL levels still remained significantly higher than the baseline. Normal pregnancy is associated with an increase in the levels of small dense sub fractions of LDL, which is not fully reversed by 3-4 months postpartum.

Staphylococcus aureus is one of the most common causes of Blood Stream infections (BSI), skin and wound infections, osteomyelitis, endocarditis, and nosocomial infections, especially pneumonia, surgical site infections (SSI), and continue to be a major cause of community-acquired infections. Methicillin Resistant Staphylococcus aureus (MRSA) is an important cause of community and hospital acquired infections. MRSA are mainly nosocomial and are increasingly reported from many countries worldwide. The purpose of present study was to determine the sensitivity of S. aureus isolated from infected patients to methicillin and to evaluate the possible presence of VRSA in our tertiary care hospital. Staphylococci were isolated and identified by standard microbiological procedures. Methicillin resistance was detected by using cefoxitin (30 µgm) by disc diffusion method. MRSA strains detected were then subjected to vancomycin agar screen test and E test to detect vancomycin resistance. Out of the total 500 S.aureus isolates, methicillin resistance was observed in 47.4% of isolates. . By E-test, 24.1 % MRSA isolates had Vancomycin MIC value of 0.75 and 21.9% of MRSA had Vancomycin MIC value of 0.5. Only one isolate had MIC value of 2.

Abstract: Ciliated epithelial cells are fairly common in gynecologic lesions; however malignant growth showing these elements and occurring in the ovary are very rare. In the case under discussion, the ovarian tumour coexisted with an endocervical growth with different morphology. 90% of ovarian endometroid tumour showed ciliary processes in our patient and these findings are discussed with a comparison to the available literature on this subject.

Thyroid cancer is the most prevalent type of malignancy. The present study was conducted to assess clinical and pathological features of papillary thyroid carcinomas. The present study was conducted on 520 specimens submitted to the department. All slides were reviewed and given the WHO classification of thyroid tumors, each case was reassigned accordingly. Clinical features were also recorded. Males were 280 and females were 240. The difference was non- significant (P> 0.05). <20 years had 90 cases, 20-40 years had 190 cases, 4060 years had 160 cases and >60 years had 80 cases. Common clinical findings in patients were neck mass (90%), dysphagia (42%), dysphonia (25%), weight loss (18%), lymphadenopathy (12%) and hyperthyroidism (7%). Metastatic type of PTC was seen in 220 cases and nonmetastatic type in 300 cases. Maximum cases were seen in age group 20-40 years. Males showed higher prevalence than females.

Abstract: Despite achievements in antenatal health care, the incidence of maternal mortality and morbidity remains high in India. Lack of efficient obstetric services at primary level lead to more referrals. This study addresses scenario of obstetric care in women referred to a Rural Medical College Hospital located in Central India. This was a prospective observational study conducted in a tertiary care Institute in Ujjain, Madhya Pradesh over a period of 1 year from July 2016 to June 2017. Various parameters studied include distance of referral center, time from referral decision to hospital admission, causes for referral, mode of delivery; and maternal and perinatal outcome. Total number of referred cases in study period was 100 which were 6.68% of total deliveries in the hospital. Fifty percent cases were referred from the city District hospital and travelled less than 10 kilometers reaching within 6 hours of referral. Most common cause of referral was preeclampsia (16%) followed by previous cesarean delivery and fetal distress (13%). Fifty two underwent emergency cesarean delivery, 43 had a vaginal delivery and 4 cases were managed conservatively. Perinatal mortality was 13 and 24 required NICU admission. Inspite of financial aids provided by Government of India majority of referrals were from city District hospital indicating lack of efficient operative facilities and emergency obstetric care. Strengthening of infrastructure, qualified medical and paramedical staff of Civil Hospital may help in improving maternal care. Triage at primary centers might help in lessening burden on tertiary centers and also facilitate specific referral.

Prevalence of air borne Nosocomial infection is a major attribute to morbidity and mortality in immunocompromised patients. Two methods are commonly used for measurement of bacterial density in hospital environment particularly Operation theater. Air samples from conventionally ventilated operating rooms and intensive care units were taken simultaneously by the sedimentation method (settle plate) and with the HiAir petri air sampler. Bacterial density was calculated in form of colony forming unit (cfu). The isolated bacteria were identified by conventional methods. The investigations showed that the number of colony forming units per cubic metre obtained with the sedimentation method was, on an average, higher than those found with the HiAir petri air sampler from the same area. The most common isolate from settle plate method was Bacillus subtilis (54.91%) followed by Pseudomonas aeruginosa (38.09 %), Co-agulase negative staphylococcus (30.12%), Klebsiella pneumoniae (25.85%), Acinetobacter baumanii (23.12 %), Escherichia coli (10.22 %), Staphylococcus aureus (8.32%) and Proteus mirabilis (2.72%). Settle plate method was found to be more informative than the air sampling system for bacteriological analysis of air in present study.

Abstract: Adenoid cystic carcinoma (ACC) of the breast is a rare neoplasm. We report a case of 45yeras old female patient who consulted for a mastalgia. Clinical examination showed limited painful breast nodules. On ultrasound and mammography it was a well-limited mass without malignant signs. Core needle biopsy of the breast was done. Diagnosis was based on histopathological exam completed by immune-histochemistry. It’s a triple negative phenotype. The patient was treated by mastectomy plus radiotherapy and remains alive in remission.

The development of bacterial resistance to the available antibiotics and increasing popularity of traditional medicine has led researchers to investigate the antibacterial compounds in plants. One traditional medicine in that category is turmeric (Curcuma longa) which belongs to the ginger (Zingiberaceae) family. Its major constituents are fat soluble, polyphenolic pigments known as curcuminoids which give turmeric its unique aroma, flavour and medicinal properties. In this study, the in-vitro antimicrobial activity of the aqueous extract of Curcuma longa rhizome was investigated against standard strains of Staphylococcus aureus (ATCC 6571), Escherichia coli (ATCC 25922), Salmonella typhi (ATCC 6539), Pseudomonas aeruginosa (ATCC 27853) and Bacillus subtilis (6633) using the agar well diffusion method. Different concentrations of the extract were prepared ranging from 12.5 mg/ml to 400 mg/ml. Staphylococcus aureus was more sensitive to the extract with zones of inhibition ranging from 13 mm to 27 mm. Escherichia coli was the least sensitive with zones of inhibition ranging from 7 mm to 22 mm. Mean Minimum Inhibitory Concentration (MIC) values were as follows: S. aureus (12.5 mg/ml), E. coli (25 mg/ml), S. typhi (50 mg/ml), P. aeruginosa (50 mg/ml) and B. subtilis (12.5 mg/ml). Qualitative phytochemical screening revealed the presence of alkaloids, flavonoids, saponins, glycosides and tannins.

Persistent Genital Arousal Disorder (PAGD) is an uncommon female sexual dysfunction that was first described in 2001. It is a condition that has been under-researched and not fully understood for so many years. Its prevalence is estimated to be between .5% to 6.7%, but it is believed to be under-reported because of the stigmatization of the disorder, as it is characterized by prolonged periods of persistent subjective feelings of genital arousal that are recurrent, intrusive and distressing, which usually subside by masturbation resulting in orgasm. These symptoms are not associated with sexual thoughts or urges, which prompted sex therapists and researchers to change its name from persistent sexual arousal disorder to PGAD. Now that we have a better understanding of its risk factors and pathophysiology, this review article will guide gynecologists, general practitioners and pelvic floor physiotherapists to diagnose, investigate the cause and treat patients with PGAD.

Isolation of microorganisms is very important for accurate treatment and is one of the important concerns for clinical microbiologists. The accuracy and rapidity of treatment are critical for successful treatment. The present study was undertaken to find the time duration for detection of various microorganisms with BACTEC 9050 system. Methods: The present study was done on inpatients the Thumbay New Life Hospital, Chaderghat road, Hyderabad from the period of June 2016 to June 2017. Samples are drawn from the patient and injected directly into BACTEC 9050 culture vials. Positive cultures are immediately flagged by an indicator light on the front of the instrument and displayed on the monitor. When positive vials are identified, it is removed and isolated for identification of organisms. Results: Out of total 475 samples collected during this duration 315 samples were from male patients and 160 from female patients. Out of 315 male samples, 69 were found to have a positive culture in 69 (21.9%) samples. Similarly out of 160 samples from females 41(25.62%) were found to have a positive culture. The most common organism detected by BACTEC in positive cultures Enterobacteriaceae in 39 (35.45%) out of 110 samples Staphylococcus aureus in 21 (19.09%), Streptococcus spp in 15 (13.63%), CoagulaseNegative staphylococci in 13 (11.81%). The conventional method showed the growth only in 77 (16.21%) of the total 475 samples during the study period however the same samples in BACTEC showed 110 (23.15%) growth Average time to detection was highest in Cryptococcus spp in 78.9 hours, Corynebacterium spp 72.1 hours, Candida spp 65.5 hours. Least time to detection Enterobacteriaceae was 14.9 hours. Conclusion: it can be concluded that the BACTEC culture method is superior to the conventional method as it detects the presence of bacteria faster and it is not affected by patient's use of antibiotics and it is also economical. Hence BACTEC culture methods must be used whenever it is feasible.

The study was undertaken to find out the effects of chronic consumption of oxidized palm oil on renal handling of Na+, K+, Cl-, HCO3- in Wistar rats. Twenty four male wistar rats weighing 140-160 grams at the begining of the experiment were randomly divided into four groups namely: control, fresh palm oil diet fed (fed 15% w/w fresh palm oil), photoxidized palm oil diet fed (fed 15%w/w photoxidized palm oil), thermoxidized palm oil diet fed ( fed 15% w/w thermoxized palm oil) groups. All four groups received water at libitum. At the end of twelve weeks, urine and blood samples were collected for the analyses of the concentration of Na+, K+, Cl-, HCO3-. Results showed that Plasma Na+ and Cl- concentrations in the TPO and PPO groups were significantly lower than the control (P<0.001) groups and FPO (P< 0.001 and 0.01 respectively)groups. Their (TPO and PPO) Na+ urine concentrations were however significantly (P<0.001) higher than the control and FPO. K+ plasma levels on the other hand, were significantly higher in the TPO (P<0.001) and PPO (P<0.05 and P< 0.01respectively) groups when compared with the control and FPO; but significantly (P<0.001 and P<0.01)lower in the urine. Plasma HCO3- concentration in the TPO group was significantly (P<0.01) lower than the control, FPO and PPO groups while that of PPO was significantly (P<0.05) lower than FPO. Urine K+ concentration of TPO was significantly(P<0.001) lower that the control and FPO while PPO levels were significantly (P<0.05) lower than the FPO only. In conclusion, chronic consumption of oxidized palm oil causes hyperkalemia, hyponatremia and hypobicarbonatemia.

There is the need to move away from chemical growth promoters to natural products in the poultry industry, as these have negative effects especially with regard to fat accumulation. In this regard, Moringa oleifera is known to have a number of beneficial effects on hematology and serum chemistry of humans. This study was therefore conducted to investigate the effects of M. oleifera leaves on lipid profile and some serum enzymes in Nigerian local Chickens. Thirty adult Chickens were used for the study. The birds were randomly assigned to three groups(n=10).One group served as control while two treatments received a daily oral dose of 12.5mg and 25mg Moringa leaf solution respectively. The experiment lasted for 28 days. Data obtained were subjected to analysis of variance. Results indicate that the mean values of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, Triglycerides were statistically similar for all groups. Furthermore, mean values for serum levels of aspertate aminotransferase, alanins aminotranferae and alkaline phosphatase were statistically similar for all treatment groups. It is concluded that the administration of M. oleifera leaves at the dose used in this study has no significant effects on lipid profile and the serum enzymes evaluated. It is recommended M. oleifera leaf meal can be used to supplement expensive protein sources in chicken diets.

Pakistan stands among the top five highest tuberculosis burden countries. Emergence of multi drug resistant Mycobacterium tuberculosis limited the spectrum of drugs of choice to treat tuberculosis. Among several, the activation of efflux pumps is one of mechanisms that mediate drug resistance in M. tuberculosis. Here, we tested efflux pump inhibitor verapamil and third line tuberculosis drug linezolid for antimicrobial activity against locally isolated multi drug resistant M. tuberculosis isolates using MGIT 960. M. tuberculosis isolates were collected from two tertiary care hospitals based in Lahore. Out of 100 isolates, 56 % (n=56) were found to be multi drug resistant (MDR). Out of MDR-TB, 5.36% (n=3) were additionally resistant to linezolid and 41.07% (n=17) were resistant to amikacin. One moxifloxacin resistant isolate was identified. In linezolid resistant strains, rplC gene was sequenced where rplC T640C mutation was identified in two of three linezolid resistant strains. The minimum inhibitory concentration of verapamil in 84.5% isolates was 256 μg/ml and the growth of remaining 16.5% isolates was inhibited by verapamil at the concentration of 512 μg/ml. Assessment of synergism between verapamil and other drugs including rifampicin, isoniazid, linezolid, amikacin and moxifloxacin revealed that verapamil at the concentration of 256 μg/ml inhibited the growth of MDR-TB isolates in presence of respective drugs. Our findings suggest that linezolid resistance have started emerging in local isolates. Further studies are required at higher level to identify the exact mechanism.

Agarwood oil is a highly priced type of oil due to its unique aroma. Agarwood oil is widely used in perfume, medicine and cosmetic industries due to its unique properties and high medicinal value. The oil is generally extracted from the fragrant resins that form in the heartwood of agarwood tree. These unique properties of agar oils are contributed by the presence of certain chemical compounds. The market demand for agarwood oil is very high. Agarwood oil is traded based on grade, corresponding to expensive and cheap price. Currently, the grading of agar oil depends on its physical appearance such as color, odor and essential oil components, like present of sesquiterpenes. The present research analyzed essential oils from Aquilaria malaccensis obtained from Moulvibazar, Bangladesh based on GC-MS data and antimicrobial properties. GC-MS analysis found Sesquiterpenes, alcoholics, fatty acids and other chemical groups in the exportable agar oils. Farm-1 contained 94.95%, Fram-2 contained 95.37% and Farm-3 contained 93.90% sesquiterpenes which is the most important properties for stronger odors and high quality. All the agar oils contained about 75% 5-Azulenemethanol-1,2,3,4,5,6,7,8-octahydryo.alpha.alpha.3.8- tetramethyl-3,7-Cyclodecad iene-1- ethanol.alpha.alpha.4,8–tetramethyl-[s-(Z,Z)]. They also contained other sesquiterpenes like Ledene oxide- II; Aromandendrene; Bicyclo[4.4.0]dec-5-ene,1,5-dimethyl-3-hydroxy-8-(1-methylene-2-hydroxyethyl-1)- 1H-3 a,7-methanolazulene, deca hydro-1,4,9,9-tetramethyl-Diethyl Phthalate; Isoaromadendrene epoxide. Other groups like alkane ~2%, alcoholics ~1% and fatty acid were found above 2%. The essential oils from all the farms except farm-2 have shown non-significant sensibility in antimicrobial test against E. coli, S. aureus, Salmonella,Vibrio.

In an attempt our study was to assess health-related quality of life, anxiety & depression among patients with Rheumatoid arthritis. In this study demonstrates that the Rheumatoid arthritis patients evaluated were more likely to have lower Quality of Life, and high prevalence rates of depression and anxiety, the factors leading to an increased risk of depression among Rheumatoid arthritis patients included being female and older. As depression is the one of the major factor for medication non adherence ,So it could be better if Rheumatoid arthritis patients should be regularly assessed and should be monitored for accompanying anxiety and depression during follow-up, to achieve better therapeutic outcome, and to improve patient Quality of Life. We are taking Out of 50 patients, both men and women. It is a six months observational prospective cohort study conducted at King George Hospital, we have to assess the health-related quality of life in patients with RA along with Anxiety and depression in these who are patients suffering with Rheumatoid arthritis. In the data was collected from the direct patient-reported survey, and we are analysed the data by using the Microsoft excel spread sheet along with, Hamilton Rating Scale for Depression HAM-D, Hamilton Anxiety Rating Scale (HAM-A) and we are taken informed consent forms and with proper compliance and age greater than 18 years those who are positively diagnosed with rheumatoid arthritis.