Perfusion index is a non-invasive method to assess the peripheral perfusion at a specific monitoring site measured by masimo pulse oximeter using signal extraction technology. Perfusion Index is an important measure to diagnose peripheral perfusion noninvasively. Present study is planned to find out the cut-off value of perfusion index for preterm neonates. 633 preterm neonates of 28-36 wks were followed simultaneously for perfusion index and capillary refill time. Capillary refill time more than 3 is a sign of poor peripheral circulation. Using the statistics of diagnostic tests, the perfusion index cut-off for sick preterm is 1.3sec by plotting in receiver operator characteristics curve. Capillary refill time more than 3 is taken as gold standard. The sensitivity of perfusion index is 88%. Perfusion index is a very important non-invasive measure to diagnose sick preterm.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetes mellitus. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. Retina nerve fiber layer thickness was negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma and diabetes mellitus. Such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of type 2 diabetes mellitus, and patients of primary angle glaucoma suffering from type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of type 2 diabetes mellitus and patients of primary open angle glaucoma suffering from type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. The presence of type 2 diabetes mellitus in patients of primary open angle glaucoma significantly affected the thickness of retinal nerve fiber layer specially in superonasal and inferotemporal quadrants as compared to patients of primary open angle glaucoma or diabetes mellitus individually. RNFLT is negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma having diabetes mellitus, and such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Retinal nerve fiber layer thickness is affected in several ocular and systemic conditions, most commonly glaucoma and diabetic retinopathy. The present cross sectional study was conducted to compare the retinal nerve fiber layer thickness in patients of primary open angle glaucoma and patients of primary angle glaucoma suffering from type 2 diabetes mellitus. A total of 120 consecutive eyes of 60 patients were assigned to 2 groups of 30 patients each of primary open angle glaucoma and patients of primary open angle glaucoma having type 2 diabetes mellitus. Retinal nerve fiber layer thickness was measured with spectral-domain optical coherence tomography. Readings from all the areas of retina (superior nasal, inferior nasal, inferior temporal, superior temporal, nasal upper, nasal lower, temporal lower, temporal upper) were measured in both eyes. The presence of type 2 diabetes mellitus in patients of primary open angle glaucoma significantly affected the thickness of retinal nerve fiber layer specially in superonasal and inferotemporal quadrants as compared to patients of primary open angle glaucoma. Retinal nerve fiber layer thickness is negatively correlated with the duration of glaucoma, duration of diabetes and HBA1c levels. Hence, care should be taken in interpreting optical coherence tomography readings in patients of primary open angle glaucoma having diabetes mellitus, and such patients should not be over treated. The changes in retinal nerve fiber layer thickness can be used to monitor the progression or regression of diseases affecting nerve fiber layer and efficacy of treatment modalities in individual cases.

Background: Good communication between the clinics and the laboratories and among the health professionals enhances diagnostic capability, efficiency and better management of the patient and is necessary for accurate and precise results. The study was carried out to audit and assess communication flow between the clinic and laboratory at the Haematology Department of the University of Nigeria Teaching Hospital - Enugu. Method: A total of 1000 laboratory request forms were collated in the study and each of these forms was monitored from time of inception till dispatch. Information in the laboratory request forms were grouped into four categories; patient’s biodata, clinical information, laboratory parameters and administrative parameters and analyzed statistically. Results: In patients biodata; age, sex and ethnic group fell short by 74.7%, 13.3% and 35.7% respectively. In clinical information category; clinical detail, provisional diagnosis, previous haematological requests and nature of specimen were insufficiently completed in 68.0%, 14.0%, 84.4% and 7.4% of the forms respectively. Ward, referring doctor and hospital reference number, were deficient by 1.2%, 2.4% and 65.0% respectively. Date, time of collection and date of arrival in the laboratory were lacking in all the forms. Out of the 1000 samples that arrived to the laboratory, 2% were inadequately collected or clotted and hence rejected. The information about these specimens was not communicated to the clinic/ward either through telephone or immediate dispatch for necessary repeat collection. Conclusion: We observed poor information communication between the clinicians and the laboratory and this may affect the accuracy of results. The inclusion of formal training in investigations, collection and handling of pathological samples in medical curriculum and training of practicing doctors through continuing education is recommended. Advances in technology or change in procedure should be adequately communicated to all concerned in the utility of laboratory results. Pathologists should play the critical roles of not only interpreting the results of the tests but also the continuing education of young doctors.

Objective: To study the clinic bacteriological profile and outcome of Empyema Thoracis in children between 1 month to 12 years of age admitted at Calcutta National Medical College and Hospital (CNMCH), Kolkata. Methods: Study subjects were enrolled from children admitted at Paediatrics Department of CNMCH, Kolkata with fever, cough, respiratory distress and diagnosed as Empyema Thoracis by basic investigations like Chest X Ray (CXR), Pleural fluid analysis,Ultrasonography of Chest (USG chest), blood culture and sensitivity. Result: Rapid diagnosis by basic investigations and early initiation of IV antibiotics with intercostal chest tube drainage was an effective method of therapy. The common organisms isolated were Staphylococcus aureus and Streptococcus pneumoniae. Only 4% cases of the sample size required surgical intervention. Malnutrition was an important co morbid condition. Conclusion: IV antibiotics and intercostal chest tube drainage is an effective means of therapy of Empyema Thoracis in children at resource poor settings.

This research work was carried out in 360 eyes of 180 patients
 to study the white without pressure (WWOP) lesions regarding its incidence, morphology, distribution, associated retinal and vitreous changes and its predisposition to retinal detachment in 60 patients each of emmetropes, myopes and hypermetropes. The patients were examined by indirect ophthalmoscopy and Goldman-three mirror lens. The maximum numbers of patients were in the second to fifth decade of life. Maximum number of eyes had 0-2 diopters of refractive error. The WWOP lesions were detected in 3.61% eyes. The WWOP lesions were found to be more common in the third decade of life. There was no predilection for sex in patients of WWOP. The lesions were found more frequently in myopic eyes compared to other groups. These lesions were observed between the ora serrata and equator. Isolated lesions were more common than the confluent lesions. The superotemporal quadrant of the retina was the most frequently involved. The peripheral retinal lesions capable of causing retinal detachment were seen more frequently in myopic eyes with WWOP. The vitreous changes were observed in all the eyes with WWOP irrespective of the type of refractive error. The WWOP lesion as such may not be having any potential
for causing retinal detachment, but because of the more frequent association to the predisposing peripheral retinal degenerations and retinal breaks, it has been suggested that these eyes should be examined more exhaustively and followed up more frequently to prevent the development of retinal detachment.

Chalcones comprise of a three carbon enone system. These are the products of condensation between aromatic aldehydes and acetophenones in the presence of a strong base. They represent a main skeletal in the plenty of organically dynamic molecules including synthesized and natural products. Synthesized chalcones or their disengagement from normal sources are being explored worldwide for the improvement of progressively powerful and proficient medications for the treatment of a few loathsome sicknesses, for example, malignant growth, diabetes, HIV, tuberculosis and so on. In this review, we will be focusing on the synthetic methods including gree methods for synthesis of chalcones and an overview of anticancer and anti-HIV activities of chalcones.

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a major public health concern in sub-Saharan Africa. Opportunistic diseases cause substantial morbidity and mortality to human immunodeficiency virus (HIV)-infected patients. HIV-HBV co-infection is common we report the case of an association of cerebral toxoplasmosis with mediastinal lymph node tuberculosis in a patient with HIV-HBV co-infection. The diagnosis of this extra-pulmonary tuberculosis and cerebral toxoplasmosis was presumptive and was made probable by the test therapies that were effective. Concomitant treatment of these two opportunistic infections with antiretroviral therapy resulted in severe drug hepatitis that was probably favored by hepatitis B that HIV infection would have worsened. The choice of effective and less toxic antiretroviral triple therapy was difficult in the absence of recommendations for such combinations.

We report the case of an infective Candida albicans fungal endocarditis occurring in a 68-year-old male patient operated on for valvulopathy and with a pacemaker, with a delay of 06 years between his cardiovascular surgery and the onset of endocarditis. The diagnosis was confirmed by blood culture and echocardiography showing the presence of vegetations, the patient was then put under fluconazole with clinical and transient biological improvement before the worsening of the clinical picture and control echocardiography increase the size of his abscess of the mitral ring, which motivated the decision of a surgical treatment.

Although remarkable advances have been made in the detection and management of mood disorders over the last few decades, the increasing worldwide prevalence of depression continues to challenge researchers and clinicians alike. In spite of the availability of antidepressant drugs depression continue to be a major medical problem. Although there are many effective antidepressants available today, the current therapy is often inadequate with unsatisfactory results in about one third of all subjects treated. Various plants are being used in complementary and alternative medicines for management of mood disorders. The methanol stem-bark extract of Ficus vallis was investigated for antidepressant activity using the Forced Swim Test and Tail Suspension Test models. The locomotor activity was also evaluated using the Open Field Test so as to rule out possible psyco-stimulant activity. It was observed from our study that Ficus vallis methanol extract showed significant (p < 0.05) reduction in immobility at 200 and 400 mg/kg doses in the Tail Suspension Test. While in the Forced Swim Test there was a significant (p < 0.02) with the 400 mg/kg dose when compared with normal saline. The methanol stem-bark extract of Ficus vallis possesses antidepressant properties in mice with significant decrease in duration of immobility.

Background: Lack of medication adherence to anti-diabetic therapy causes suboptimal glycemic control and leads to treatment failure and increased mortality from diabetes complications. The study aimed to assess medication adherence among type 2 diabetes mellitus patients at outpatient setting and its correlation with glycemic control. Methods: A cross-sectional observational study was conducted between January 2019 and March 2019 at several outpatient clinics in Ibb city, Yemen. A total of 370 patients of type 2 diabetes mellitus who use oral hypoglycemic drug therapy for at least 3 months were enrolled in the study. Fasting and postprandial blood glucose as well as glycosylated hemoglobin were measured and details of drug therapy were noted. Morisky Medication Adherence Scale was used to assess medication adherence. Results: Only 1.1% of type 2 diabetes mellitus patients had high medication adherence to oral hypoglycemic drugs, while 61.9% had moderate and 37% had low medication adherence. Most common medication adherence issues identified in type 2 diabetes mellitus patients were forgetting to take their medication when traveling, stopping of medication once feeling better, and difficulty to adhere to medication plan. Only 12.1% were having optimally controlled glycemic levels, whereas 87.8% were having uncontrolled glycemic levels. Conclusions: Despite having a good overall medication adherence among type 2 diabetes mellitus patients, the glycemic control still low in most patients. The study shows urgent need for reviewing anti-diabetic pharmacotherapy, counseling, and health education of patients.

Occipital Aneurysmal bone cyst is a rare benign tumor-like mass of the children and young adults. It is more frequent to the long bones and to the spine, but its location to the cranium is unusual. It is a lytic lesion, causing bone augmentation with a heterogeneous bloody content. Since its first description in 1942, only few cases have then been published in the literature and all have been listed in the text. We discuss through a successfully managed case of a 2 years old child the pathogenicity, the morphologic and radiologic criteria suggestive of this unusual pseudo-tumor and also discuss treatment options.

Background: To become a successful practitioner, dental professionals need to understand the theory and practice of marketing strategies. Social media has a lot of potential for marketing dental services in a cost-effective manner to influence the modern dental practice. The purpose of this paper is to study the influence of dental service marketing and the use of social media marketing within the field of dentistry. Materials and method: A probability sampling was done to select three different dental clinics among five major cities across the India where one clinic promoted digital marketing and other two had conventional marketing policy. After selecting the dental clinics a cross sectional study was conducted to assess the relationship between patients outcome in digital and non-digital marketing based clinic. Clinics were then evaluated and compared on the basis of outcome of the patients for six months. One way anova is done to compaire patients inflow of three clinics with post hok Turkish test to evaluate the result. Result: One way anova showed highest patient frequency of patients with the clinic having digital marketing. Clinically significant value came for clinic 1 proving that digital marketing does affect the outcome of the patient in clinics. It was concluded that digital marketing has shown to be of great importance in the dental services market in comparison with conventional advertisement strategies.

Benign anal or perianal conditions including haemorrhoids, anal fissures, perianal abscesses, and fistulae are commonly observed in general practice. This study carried out to evaluate the most common perianal conditions in adult patients of varying age treated surgically in a periphery general hospital, examining complications, recurrence and mortality rates. A prospective cross sectional study was conducted, at Almikhwah General Hospital, with a minimum follow-up of 6 months. A total of 75 patients subjected to surgical treatments for bengin perianal disease were eligible. Their mean age was 35.8 years, and male to female ratio was 1.8:1. The mean duration of symptoms was 35.6 days. The most common conditions were abscess and haemorrhoids that’s seen in 44% and 29% respectively, whereas, fistula in ano was the least (6.7%). The mean hospital stay was 2.1. Complication was encountered in 1.3%. The mean duration of analgesic use was 2.07. One year follow up revealed no recurrence or mortality. In conclusion, most patients presenting with anorectal symptoms will have benign anorectal pathology and can be successfully treated in the periphery hospital setting.