The incidence of inguinal hernia is very common especially in older individuals. Often patients are unaware of the presence due to absence of any symptoms unless detected accidentally or detected in those causing presence of pain or other symptoms. The anterior open inguinal hernia repair with mesh was described by Lichtenstein in 1989. This tension free operation has become popular. We in the present study operated on the patients with uncomplicated unilateral inguinal hernia with Lichtenstein tension free technique under Local Anesthesia and Spinal Anesthesia to evaluate their outcomes. Methods: This prospective study was conducted in the Department of General Surgery, Prathima Institute of Medical Sciences, Naganoor, Karimnagar. A total of 74 patients admitted to the hospital with the diagnosis of uncomplicated inguinal hernia were included in the study. They were divided into two groups Group I (LA) included 36 patients and group II [GA] 38 patients. The investigations required as routine for diagnosis and to test the sensitivity to the local anesthetic night before surgery. Lichtenstein tension free hernioplasty is performed irrespective of type of anesthesia. The postoperative pain was measured with the Visual analogue scale (VAS) at 4h, 8h, 12h & 24h. Results: Mean time taken for duration of surgery in LA group is 58.8 + 6.02 minutes & in SA group is 56.6 + 6.74 minutes. P = 0.246 not significant. Mean time spent in operating room in LA group is 68.1 + 6.35 minutes & in SA group is 76.4+6.52 minutes with a significant P value of <0.01. The mean VAS score at 4h, 8h, 12 h, & 24h for LA group was low when compared to the SA group. The maximum VAS score was observed at 8h in both the groups and less in LA group at 3.13 ± 1.26 as compared to SA group 4.31 ± 1.66 at 12 hours also VAS was less in LA at 1.97 ± 1.02 as compared to SA 3.15 ± 1.88. Conclusion: From our study it is observed that Lichtenstein tension free hernioplasty done under local anesthesia offers following several advantages over spinal anesthesia and it is Safer even in the patients with medical comorbidities and on antiplatelet therapy. Therefore local anesthesia may be considered as the anesthesia of choice for Lichtenstein tension free hernioplasty for an uncomplicated, primary, inguinal hernia

Neonatal thrombocytopenia is one of the most common hematological problems encountered in the NICU. We designed a study to determine the frequency, etiological profile, predisposing factors of thrombocytopenia in our NICU. The clinical impact of thrombocytopenia and its influence on the neonate's outcome were also studied. Methods: 179 consecutive NICU admissions in a 6 month period were included in our study. The subjects were grouped into 3 cohorts based on their platelet counts and their association with various variables was studied. The efficacy of the treatment protocol practiced for thrombocytopenia was evaluated. The neonates were followed up over a period of 6 months. To assess the prognostic value of severe thrombocytopenia; 12 variables that were significantly associated with poor outcome in the univariate analysis including low platelet count, along with other variables that are known to be associated with a poor outcome in NICU graduates, were subjected to multiple logistic regression using SPSS 13.0. Results: The prevalence of thrombocytopenia in our NICU was 39%. Septicemia was the common etiology. Maternal PIH, age at presentation, NEC, DIC, candiduria and assisted ventilation were identified as the predisposing factors. Severe thrombocytopenia was independently associated with a poor outcome based on multiple logistic regressions. Conclusion: Neonatal thrombocytopenia is far more common in our NICU as compared to that of the western studies. Septicemia is the most common cause. There are various predisposing factors for neonatal thrombocytopenia. Severe thrombocytopenic neonates are more likely to bleed and have a prolonged clinical course. Severe thrombocytopenia can be used as a prognostic indicator in sick NICU graduates. Fresh whole blood transfusion is a good alternative to platelet concentrates in the treatment of severe thrombocytopenia

Bad obstetric history(BOH) is specific to women specially during childbearing age, causes by TORCH group (Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV), Herpes simplex virus) and others agents like Chlamydia trachomatis, Treponema pallidum, Neisseria gonorrhoeae, HIV,etc The objective of the study is to evaluate the incidence of TORCH infections in pregnancy wastage in women with bad obstetric history (BOH).The study included 200 women aging from 15 to over than 46years with bad obstetric history and 75 clinically normal women with previous normal full term deliveries. Serological evaluation for TORCH infections was carried out by IgM ELISA method. Seropositivity for toxoplasma was 27.33%, rubella 21.66%, cytomegalovirus 34.33% and herpes simplex virus 17.66 with high frequency of stillbirths 94.11 %, Maximum number of cases of abortion (27.27%), intrauterine growth retardation (9.37%), intrauterine death (17.64%) and preterm labor (18.18%) was associated with toxoplasma infection. Seropositivity in women with BOH is demonstrates a strong association between the infectious agents (Toxoplasma, Rubella and CMV)) A previous history of pregnancy wastage and the serological reaction for TORCH infections during current pregnancy must be considered while managing BOH cases so as to reduce the adverse fetal outcome.

Ridge density means the number of ridges present in a specified area of a fingerprint and several researches have been carried out on this aspect of fingerprints. This study was conducted with an aim to establish a relationship between sex and fingerprint ridge density. The fingerprints were taken from 100 subjects (50 males and 50 females) in the age group of 18-25 years. After taking fingerprints, the ridges were counted in the upper portion of the radial border of each print for all ten fingers and mean value was calculated. The results have shown that a the ridge density ranges from 7-16 ridges/25mm2 in male and 11-17 ridges/25mm2 in females. It has been successful to support the hypothesis that women tend to have a statistically significant greater ridge density than men

There have been conflicting reports by researchers on the effect of aqueous leaf extract of Ocimum gratissimum (OG) on haematological parameters This study was carried out to evaluate the dose-dependent effect of OG leaf extract on some haematological parameters in wistar rats. Twenty-four male rats were randomly assigned into four groups of six rats each. Group 1 was a control while groups 2, 3 and 4 were test groups (T1 – T3) and were given 450mg/kg, 800mg/kg and 1800mg/kg respectively of OG leaf extract daily for 30 days. All rats had free access to water and rat chow. Results showed a significantly decreased RBC count in T2 (p<0.05) and T3 (p<0.01) compared with control. Platelet count and PCV were significantly decreased in T3 (p<0.05) compared with control. A significant increase in total WBC count was observed in T1 (p<0.05) and T2 (p<0.01) when compared with control. A significant reduction in neutrophil count in T1 (p<0.05), T2 (p< 0.05) and T3 (p<0.01) compared with control was observed. Lymphocyte count was significantly increased in T1 (p<0.05), T2 (p<0.01) and T3 (p<0.01) compared with control. There was no significant difference in MCV, MCH and MCHC in the different groups. In conclusion, aqueous leaf extract of Ocimum gratissimum caused reduction in RBC count, PCV, platelet count and neutrophil count but caused increases in total WBC count and lymphocyte count

This is a preliminary descriptive study of college students’ attitude toward natural health remedies where the researcher uses captive audience survey to collect data from undergraduate and graduate students attending private and public colleges and universities in the United States. Five factors are especially important in describing college students’ attitude toward natural health remedies: Economics (costs of healthcare), Knowledge (familiarity and understanding of health and healthcare), Relational or Relationship (influence of family, friends or significant others on healthcare choices), Beliefs (perceptions regarding health and healthcare), and Security (concerns about safety regarding healthcare practices and methods) - “EKRBS”. Quality and Satisfaction (Q-S) were also found to be important factors when it comes to attitude toward healthcare and natural health remedies. Overall, Knowledge (familiarity and understanding of health and healthcare) is the most important factor affecting college students’ attitude toward natural health remedies, followed by Economics (costs of healthcare). All these factors are revealed to have varying impact on students’ attitude toward natural health remedies

Paederus dermatitis is a type of irritant contact dermatitis caused by beetles of the Paederus species. The objectives of this study were to know the incidence, clinical varieties, histopathological changes, and microbiological findings. Methods: 100 patients of Paederus dermatitis were considered, a detailed history was taken and a general examination was done. Skin biopsy and skin swabs were taken from all the patients and findings were noted. Follow-up was done to know the prognosis of the patients. Results: The study showed that males were more frequently affected than females with a ratio of 3:2, most prevalent in the months of March and September. Itching and burning were common symptoms with the majority of the lesions appearing on uncovered areas of the body. The most common lesions seen were erythema, vesicles, and erosions. Different stages of the lesions showed different histopathological changes with epidermal necrosis, dermal edema, and lymphocytic infiltrate being most common. Hyperpigmentation was a common complication which could be avoided if treatment is taken in the early stages. Conclusion: Pruritus was the predominant complaint in the patients with burning sensation being present in almost equal numbers. Hyperpigmentation was the main complication which was long-standing if the patients did not initiate treatment in the early stages of the disease. Use of preventive measures against the beetles along with prompt treatment reduces the complications and improves the quality of life for the patient.

Adverse Drug Reactions (ADRs) are scantly reported with poor contribution by healthcare professionals worldwide and in particular in developing countries. The aim of this study was to assess the knowledge and awareness of ADRs reporting and pharmacovigilance system among doctors and nurses in KLEs Tertiary care hospital Belagavi. A questionnaire was designed addressing; awareness of ADRs, knowledge of pharmacovigilance system, availability of ADRs reporting system. The questionnaire was distribute to doctors (n=160) and nurses (n=140) working in hospital. Completed questionnaires were collected, data were analyzed and data were expressed in number as well as percentage. Of the 300 questionnaires circulated, a total of 107 doctors and 107 nurses responded. The percent of the respondents who accepted to enroll in the study was 66.8% of doctors and 76.4% of nurses. Most of the respondents were unable to correctly define the pharmacovigilance term, but they were aware of ADRs. The awareness of the national pharmacovigilance system among doctors was 32.5% and nurses were 37.9%. (42.5%) doctors and (54.3%) nurses follow the reporting system to pharmagovigilance center. Our study has demonstrated a lack of knowledge and awareness of pharmacovigilance and ADRs reporting among healthcare professionals in hospitals. The poor knowledge of ADRs reporting emphasized the urgent need to implement the appropriate strategies to improve the awareness ofpharmacovigilance practices and ADRs reporting in our hospitals

Lassa fever is a disease of public health importance with high mortality and morbidity especially among rural dwellers.This study was done to determine the knowledge of transmission, risk factors, prevention, symptoms and the preventive practices against Lassa fever among adults in Ukpom, a rural community in Akwa Ibom State, Nigeria. A community based descriptive cross-sectional study was done among 228 adults selected by multi-stage sampling in 2016 using a pre-tested interviewer-administered questionnaire and analysed with SPSS.Ninety point eight percent (90.8%) claimed to have heard of Lassa fever mainly through radio and TV (64.9%). The majority knew that consuming food contaminated with rat feces and urine (88.6%) including eating poorly cooked rats (82.5%) transmits Lassa fever. Most knew that a clean environment (95.2%), proper covering of food (93.4%), no holes in homes (93.4%) and not eating rats (89.5%) prevents Lassa fever .The top 2 risk factors for Lassa fever known were non- covering of food (91.7%) and poor refuse disposal (89.9%). Common symptoms known were headache (69.3%), fever unresponsive to antibiotics (68.4%) and vomiting (66.2%). Major practices to prevent it were covering of food (98.2%), not eating rats (97.4%) and keeping a clean environment (95.6%). Only 15.8% stopped burning bushes, 32.9% stopped drinking garri and 17.5% fumigated their houses as practices to prevent Lassa fever. Age was significantly associated with level of knowledge. (p=0.000). Good level of knowledge of Lassa fever was found among community members though some misconceptions still existed. Intensified health education is recommended.

The aim of the present study was to compare the efficacy of oral versus vaginal misoprostol in the induction of labor after 34 weeks of gestation to 40 weeks gestation and to find out any variation in the maternal and fetal outcome. Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Prathima Institute of Medical Sciences, Karimnagar, and Telangana state for the period of one year. In the present study 100, antenatal women who are more than 34 weeks of gestation and who need induction of labor were selected for the study. To calculate the EDD, calculated using Naegele’s Formula. Women divided into Group A – 50 pregnant women, aged 18-32 years; with oral administration of 25 mcg Misoprost every 4th hourly, maximum of 6 doses (150mcg). Group B - 50 pregnant women, aged 18-32 years, with vaginal administration of 25mcg Misoprost every 4th hourly, maximum of doses of 6 doses(150mcg). In all the patients, the cervical status was assessed by using Bishop's score prior to induction. Repeat bishop's score was assessed at 4th hour and then before every repeat dose. Results: Parity a total of 57 women was primigravida while 43 were multigravida. For oral group 29 cases (58%) were primigravida, 21 cases (42%) were multigravida for the vaginal group, 28 cases (56%) were primigravida, 22 cases (44%) were multigravida. Augmentation with Oxytocin Of the total, 45% of the cases were on Oxytocin while remaining was not. For Oral Group 27 cases (54%) required augmentation with Oxytocin. Failed Induction In the study group, nearly 3% of the cases failed induction. In Oral group Failed induction incidence was in 3 cases (6%). In the Vaginal group, there was no failure of induction. 75% of the cases had a normal delivery, 12% showed vacuum delivery followed by C section (10%) and 3% cases had the forceps delivery.

Contact dermatitis is an inflammatory response of the skin as a result of exposure to an exogenous agent. It is divided into two main types: 1. Contact Irritant Dermatitis (CID) 2. Contact Allergic Dermatitis (CAD). The prevalence of CAD in the general population has been reported to vary from 1.5-5.4%. The aim of the present study was to evaluate the precipitating and aggravating factors in CAD and study to evaluate the results of the patch test in patients having allergic contact dermatitis. Methods: A total of 50 patients of either sex with clinically suspected contact dermatitis who attended the Out Patient Clinic of Dermatology Department of Prathima Medical College, Nagnoor, Karimnagar. These patients were later subjected to a patch test after taking informed consent. The test units were thus prepared were stuck on the upper back of the patient in the vertical role in paravertebral position. Gentian violet was used for writing the numbers an occlusion of 48 hours was kept and the chambers were removed after the patient rendered to the clinic after 2 days. Results: The morphological pattern of lesions observed in Contact Dermatitis cases were Lichenification in male 40%, 18% was dry scaling 16% cases had erythema, cracking and fissuring. In female 32% had Lichenification and 22% had cracking and fissuring, dry scaling 24%, 16% each had erythema, papulovesicular and hyperpigmentation. Distribution of single and multiple antigens was studied in the patients. 76.92 % of the male had single antigen and 62.5% of the female was detected with a single antigen. Two antigens were found in 12.5% male and 4.16% female. Conclusion: Within the limitations of the present study it is concluded that contact dermatitis is very common in patients reporting to dermatology OPD. The most commonly affected were female house workers. Lichenification was the commonest morphological pattern followed by dry scaling, erythema, papulovesiculation, oozing, and depigmentation. Patch test was able to reveal the etiology in 70% of the patients. Potassium dichromate is the common sensitizer followed by Parthenium in this group of the population.

The client M.H was 23 years old male, referred by his psychologist for the management of his addiction that he sniff and injects heroin, aggressive behavior, restless and body pain. An assessment was done through Clinical interview, Behavioral observation, Subjective ratings, Anger scale and Mental Status Examination which results shows the client was orientated to person, place and time. Other subjective ratings like aggressive behavior of client which he rate on 10 scale and insight about addiction on 5. The client was diagnosed with “other (or Unknown) Substance Withdrawal”. Different management techniques were used like, Distraction techniques, Psychoeducation and Disease concept were given to the client. The overall response toward therapeutic intervention was productive. Total number of 10 sessions was done with the client

Acne is a common problem that can also leave behind permanent scarring leading to low self-esteem. Various treatment modalities can help dealing with these acne scars. The aim of this study is to compare efficacy of PRP with dermaroller against with PPP with dermaroller. A prospective study of 31 patients was done. After microneedling, PRP and PPP was applied on each side of face. The procedure was repeated every four weeks and scars were evaluated by Goodman and Barron grading system. Significant improvements were found on both sides of face and no substantial difference was observed on either of the treated sides. Also dermaroller therapy showed improvement in rolling type and boxcar types of acne scars only. Dermaroller is a safe and affordable device used with or without PRP and PPP for treatment of post acne scars