April 2021

Aim: To investigate the microbiological effectiveness of intravenous immunoglobulins in the complex treatment of "ventilator-associated" pneumonia (VAP) in premature newborns. Material and methods: We conducted a microbiological study of tracheo-bronchial aspirates (TBA) in 98 premature newborns with respiratory distress syndrome complicated by the development of "ventilator-associated" pneumonia (VAP). The 16 infants received intravenous immunoglobulins (IVIG) from the second day of life. The 47 infants received IVIG in the acute period of VAP from 5 to 8 days from the onset of the disease. The comparison group consisted of 35 infants with VAP who were not given IVIG. Infants from all groups received antibacterial therapy. Results: The content of microorganisms in TBA in the amount of lg3 colony-forming units in 1 ml or more is an unfavorable sign for the development of VAP in premature newborns. The use of IVIG in infants with VAP is characterized by high microbiological efficiency, which occurs in most patients within a day from the start of treatment. The greatest inhibition of growth is observed against bacteria, Mycoplasma pneumonia, Mycoplasma hominis, Ureaplasma urealyticum and Chlamidia trachomatis. The effect was weaker against Candida spp. The best effect was with the early administration of IVIG: the respiratory tract was sanitized faster and secondary infection developed less frequently.

Background: Cortisol quantification is important in clinical practice to measure periods of stress. The cortisol test is used to diagnose adrenal gland disorders. These include Cushing's syndrome, which causes the body to make too much cortisol, and Addison's disease, which causes the body to not make enough cortisol. Objective: In this work was to develop a validated UV/Vis spectrophotometric method to quantify cortisol in saliva samples from subjects whose ages ranged from 18 to 24 (25 women and 10 men) and ranged from 45 to 55 years old (8 women and 7 men). Methods: For the experimental study, a saliva sample was taken in the first hours of the morning (1.5 mL). The sample was homogenized and read at an absorbance of 280 nm using diluted saliva as a control and carrying out an extraction with ethanol and trichloroacetic acid to identify cortisol. Results: This method was linear (r = 0.9999) for an interval of 2.5 to 25 µg/mL, accurate, precise (variation coefficients of repeatability and reproducibility were less than 1.5%, andless than 2%, respectively). it is specific and with limits of detection and quantification of 0.019 µg/mL and 0.16 µg/mL. The concentration in young people was 52.58  8.59 g/dL (women) and 49.75  7.65 g/dL (men); in older adults 38.83  2.82 g/dL (women) and using this method 25.76 g/dL (men). Conclusion: This method shows to be specific and sensitive with limits of detection and quantification of 0.019 µg/mL and 0.16 µg/mL, respectively. Cortisol average concentration found using this method was higher in young people (women= 52.58  8.59 g/dL and men= 49.75  7.65 g/dL) than in older adults (women= 38.83  2.82 and men= 25.76 g/dL).

An assessment of the seasonal variations of the river water quality of GangaRiver at Ghazipur. ranges of the estimated physico-chemical parameters are mentioned as temperature (20.40C -31.90C), pH(7.3-8.86), TDS( 313mg/L -387mg/L), EC(297µmhos/cm -367µmhos/cm), Alkalinity( 175mg/L -327mg/L), TH (127mg/L -200mg/L), sulphate(16.2mg/L -37.2 mg/L), phosphate(0.41mg/L -0.96mg/L), nitrate(0.41mg/L -0.96mg/L), chloride (20.5mg/L -31.3mg/L), DO (5mg/L -6.5mg/L),BOD (5.3mg/L -15.2mg/L) and COD(11.2mg/L -30.1mg/L). EC, BOD and COD were above the USPHS and BIS standards at all the sites of Ghazipur. Correlation coefficient revealed varied positive and negative correlations in the physicochemical parameters of the river water.

De plus en plus, ces dernières années dans les zones forestières ivoiriennes, l’intérêt prononcé pour l’extraction industrielle et artisanale de l’or porte sur les impacts positifs comme le développement de l’entreprenariat rural et l’augmentation des revenus ruraux au niveau des individus comme des collectivités locales. Cependant, attendue comme opportunité de développement et d’emplois, l’exploitation artisanale de l’or,dans les villages de Bobo-Niessoko et Gamina de la sous-préfecture de Zaïbo, a entrainé des effetsnéfastes. En effet, le développement de cet orpaillage a induit de nombreuses transformations sociales, économiques et environnementales dans lesdits villages aurifères. Cet article analyse les effets néfastes induits (directs et indirects) de l’orpaillage artisanal sur le cadre de vie des communautés villageoises et sur l’environnement des populations locales de Zaïbo. Cette analyse des mutations dues au développement de l’orpaillage artisanal s’appuie sur une démarche d’enquête de terrain combinant, dans la collecte de données, l’enquête quantitative, l’enquête qualitative et l’observation directe. Les résultats obtenus indiquent que l’activité d’orpaillage artisanal,bien que génératrice de revenus, affecte négativement la santé des populations, l’économie et l’environnement dans la sous-préfecture de Zaïbo. En définitive,la dynamique de l’orpaillage a donné lieu au développement et à l’aggravation des problèmes sur le plan social, économique, environnemental.

Esthetic treatment of severely decayed primary teeth is one of the greatest challenges for pediatric dentist. There are different types of restorations for complete crown coverage. These restoration technique includes stainless steel crowns, polycarboate crown, acid etch crown etc. Each of these techniques presents technical, functional or esthetic compromises that complicate their efficient and effective usage. Due to a increasing in esthetic and concerns about toxic and allergic reactions to certain alloys, zirconia was proposed as a new ceramic material in the later part of 20th century. It has become a popular alternative to alumina as biomaterial and is being used in dental applications. This article presents a brief history, properties, dental applications and tooth preparation of zirconia crown. Subject Area: dentistry Keywords: stainless steel crown, zirconia, dental caries, primary molars

In this study we had subjected Winkin Cow (Vanillicious) thick shake, Winkin Cow (Chocolicious) thick shake, Hershley’s Milkshake (Chocolate Flavour), Dreamery Milkshake (Chocolate Flavour). These four milkshakes are available in tetrapack. We had studied physico-chemical parameters like Salinity, TDS, Conductance, pH, DO and biologically significant ions like sodium, potassium, calcium and nitrate. Generally milk product beverages are less acidic and have high TDS, salinity and conductance values1. All these milkshakes are rich source of sodium, potassium and calcium ions.

The study was conducted to review the important role of antioxidants in human health and disease. Early research on the role of antioxidants in biology focused on their use in preventing the oxidation of unsaturated fats, which is the cause of rancidity. An antioxidant can be defined as: “any substance that when present in low concentrations compared to that of an oxidisable substrate, significantly delays or inhibits the oxidation of that substrate”. Oxidative damage in DNA can cause cancer. Several antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase etc. protect DNA from oxidative stress. It has been proposed that polymorphisms in these enzymes are associated with DNA damage and subsequently the individual's risk of cancer susceptibility

Introduction: December 2019, in the city of Wuhan, an outbreak of Severe Acute Respiratory Syndrome began. Although the respiratory system is the most affected, experimental studies show involvement of the nervous system. In view of the similarity in the SARS-CoV-2 genome with SARS-CoV and MERS-CoV, and the presence of reports of neuropathies in patients infected with these, the aim of this article is to describe the main evidence regarding the causal relation between COVID -19 and peripheral neuropathies, in addition to possible mechanisms involved in this process. Methodology: This is an integrative literature review, made through articles that discuss the relation between COVID-19 infection and the manifestation of neuropathies. The databases used were: PubMed, LILACS, BIREME, being considered important scientific bases of international scope. Searches were limited to articles from the year 2020, in English and Portuguese. Discussion: It is known that the involvement generated by the coronavirus is diffuse, even acting on the central and peripheral nervous systems. Although there are studies that propose a possible causal relation between the new human coronavirus and the manifestation of Guillain-Barré Syndrome, Miller-Fisher Syndrome, and cranial polyneuropathy, there is no evidence to prove this. Conclusion: The manifestation of neuropathies by patients with COVID-19 has been demonstrated in different studies. Even so, the mechanism responsible for the appearance of these clinical conditions must be better elucidated. Therefore, it is not yet possible to determine whether the relation between COVID-19 infection and presentation of neuropathies is causal or coincidental.

Background: Chronic suppurative otitis media (CSOM) is a common infection having a high prevalence rate of 7.8-16% in India and is one of the leading causes of conductive deafness particularly in the adolescent age group. CSOM is frequently associated with multidrug-resistant organisms with the ability to form biofilm, which is an important virulence factor and results in treatment failure. Aim: The main objectives of the study are to identify the spectrum of bacteria associated with CSOM, their antibiotic sensitivity pattern, and to detect the biofilm formation. Methods: This was a prospective cross-sectional study at a tertiary care hospital conducted from 2016-2019. Patients up to the age of 80, having otorrhea for more than 6-12 weeks and attending the ENT outpatient department were included. Samples of pus were collected from the deeper aspect of external auditory meatus and processed using standard techniques for culture and sensitivity. Biofilm detection was done. Results were compiled and statistically analysed. Results: 120 samples were processed and 86 yielded positive cultures. Staphylococcus aureus was the predominant organism, followed by Pseudomonas aeruginosa. Biofilm formation was seen in 38 (44.18 per cent) of the organisms. Biofilms were formed predominantly by Staphylococcus aureus (47.36 per cent). Conclusion: Multidrug resistance has become increasingly common amongst the causative organisms of CSOM, this trend being particularly evident among biofilm producers. Therefore, screening for biofilm formation, along with the usual antibiogram, needs to be performed as a routine procedure in CSOM to effectively manage the situation by choosing an appropriate modality of treatment.

Tooth fragment reattachment restores morphological, functional and esthetic aspects of the dentition, while maintaining the shape, contour, texture, colour and alignment of the natural teeth. Furthermore, fragment reattachment can be considered a fast and low cost treatment solution, creating a positive emotional and psychological response in the patient. Different preparation techniques as well as adhesive materials have been described throughout the literature, designed to increase the chemical and mechanical retention of fragments. This case report describes reattachment of fragment in a pulpally involved tooth where biologic width was not compromised. If the fractured fragment is available and is in a good condition reattachment is the better treatment option. When compared to more aggressive prosthetic techniques like crowns and veneers, the reattachment technique is both conservative and aesthetic.

In Indian English Literature, much attention has not been paid to the tribal life and culture by the writers. The present paper aims to study and explore the life, loss of culture and exploitation, as it has emerged in the post independence novel Paraja. Gopinath Mohanty’s novel Paraja (1945) documents the cultural history and heritage of ethnicity, myths, legends and socio-cultural representation of the Paraja tribe of the Koraput region in Odisha, simultaneously signifying their poverty and struggle and their exploitation by the non- tribes. The novel is unique in ways because it offers a study of tribal life and culture from anthropological, sociological and ecological perspectives.

Objective: To explore the corelation between asymmetry rate of the cerebral peduncle (ARCP) and the recovery of poststroke aphasia (PSA). Methods: Thirty-three recurrent stroke participants with PSA completed the retrospective study. They were divided into two groups according to the sides of recurrent stroke, ipsilateral group (dominant side) and contra lateral group. The aphasia quotient (AQ) of post-first time stroke (AQpostFS), pre-recurrent stroke (AQpreRS), and post-recurrent stroke (AQpostRS) were collected, which were based on the Chinese version western aphasia battery. The ARCP was calculated based on the latest magnetic resonance imaging (MRI). Changing of AQ (∆AQ, ∆AQ1= AQpreRS-AQpostFS; ∆AQ2= AQpreRS-AQpostRS), and the correlation between ∆AQ and ARCP of the two groups were analyzed. Results: The AQpostRS of the contralateral group is significantly lower than that of the ipsilateral group (32.42 [18.73] vs. 44.97 [11.65], p=0.029).∆AQ2 in CG was higher than that in IG (38.54 [17.89] vs. 27.03 [10.76], p=0.034).∆AQ1 (r = 0.792, p<0.0001) and ∆AQ2 (r = 0.940, p<0.0001) showed a significant correlation with ARCP. Subjects with an ARCP of more than 1.5 presented a higher ∆AQ2 than patients with ARCP less than 1.5 In CG (56.77 [2.98] vs. 25.77 [11.11], p<0.0001), a contrary consequence was observed in IG (19.08 [11.44] vs. 30.64 [8.68], p=0.042). Conclusion: Patients with higher ARCP showed a worse prognosis of PSA followed recurrent stroke of the non-dominant hemisphere, The synergistic effect between the two hemispheres is the key mechanism of PSA recovery.

Oral soft tissue thickening or grafting procedures are often necessary to cover tooth recession, re-establish an adequate width of keratinized tissue, correct mucogingival deformities improvingesthetics, prepare a site for an implant or prosthetics, for ridge preservation procedures, and soft tissue contouring around dental implants. Gingival recession and root or implant exposure are commonly associated and have led to mucogingival deficiencies that have traditionally been treated with free gingival grafts and autogenous soft tissue grafts. Pouch roll implant soft tissue augmentation provides an easy and less traumatic correction of a mild or moderate buccal ridge deficiency by thickening the soft tissue around the dental implant. This review presents modified tissue augmentation techniques which are proposed to enhance aesthetics in mild or moderate horizontal defects ; however, the choice of therapy depends on the dimensions and position of the defect.

Prematurity has become a global health problem, Newborn deaths account for 40 percent of all deaths among children under five years of age. Prematurity is the leading cause of newborn deaths especially in the first 4 weeks of life and it is the second leading cause of death after pneumonia in children under the age of five years. The major causes of newborn deaths in India are pre-maturity/preterm (43.7 percent); neonatal infections (20.8 percent); intrapartum-related complications/ birth asphyxia (19.2 percent); and congenital malformations (8.1per cent) and others 8.2%. 15 million premature babies are born annually all over the world and it accounts for more than 1 in 10 babies born preterm. In India, out of 27 million babies born every year (2010 data), 3.5 million babies born are premature. More than 80% of birth occurs at 32-37 weeks of gestation and die needlessly for lack of simple, essential care such as warmth and feeding support. Many survivors face a lifetime of disability, including cerebral palsy, neurodevelopmental delay, learning disabilities, visual and hearing problems. A premature baby requires sophisticate medical and nursing services to reduce neonatal mortality and morbidity. This review highlights the medical and nursing care of premature neonates and strategies to improve the neonatal care.

Pesquisas nos últimos 10 anos vêm localizando sítios arqueológicos de distintos períodos e origens na Ilha de São Luís, estado do Maranhão. Em resumo, as pesquisas estão concluindo que toda a região insular foi ocupada por grupos humanos sem indícios de abandon da região, por pelo menos 7 mil anos. Trata-se, portanto, de um local atrativo para os grupos humanos, sendo considerada um lugar persistente, ou seja, uma região onde as características naturais e culturais tornam-na propícia à ocupação e reocupação humana ao longo dos milênios, que podem ser marcadas por ciclos de abandonos e reocupações. Este artigo apresenta uma proposta metodológica que vem sendo aplicada pelo projeto de pesquisa Inventário de conhecimento dos sítios arqueológicos dos municípios da Ilha de São Luís, Maranhão: gestão territorial e zoneamento.

The Sustainable Environmental and Economic Development (SEED) project was developed in Kuwait to undertake remediation and rehabilitation of abandoned upstream production areas within the Oil Fields of Kuwait. The aim of the rehabilitation component of the project was to leave previously contaminated areas of the oil fields, such as effluent pits, sludge pits and gatch pits, in a relative natural state in order that once remediated, they would not require ongoing management and would not pose a significant risk to sensitive environmental receptors. To this end, the rehabilitation component of the project included a native plant restoration and monitoring program with the purpose to evaluate the effectiveness of restoration methods, namely the use of irrigation and soil amendment, in facilitating the establishment of a native plant community. In addition, the remediated soil was returned to the various pits and if native plants could be established, that would provide an indication of the success of the soil remediation process. This study focuses on the remediation and rehabilitation undertaken in three pits (one sludge pit and two effluent pits). The contaminated soil was subjected to either bioremediation or thermal treatment, then reapplied to the pits. A reference area was planted in a location that represented a relatively undisturbed site in the oil field to establish an experimental control. If plant establishment was similar or better in rehabilitated features to the undisturbed reference areas, then rehabilitation could be considered on a similar trajectory as a natural ecosystem. Components of the rehabilitation program included eight native plant species, high-level and low-level irrigation and soil amendment (biogenic fertilizer). Plants were installed in the features using a block design whereby equal numbers of plants received the irrigation and soil amendment treatments, as applicable. The planting blocks were subdivided with half established with amended soil and half in unamended soil, these were then further divided into areas of high and low irrigation. In the reference area blocks, half of all plants received high-level irrigation and the other half received low-level irrigation. Plant survival and growth were measured over the monitoring period. Results of the monitoring showed that several factors can play a role in affecting establishment of native plant species. Overall, plant survival varied quite markedly depending on the site. It was hypothesized that plant survival would be best in the reference areas where soil disturbance was minimal. This hypothesis is consistent with the findings of this study. It was also hypothesized that high-level irrigation may result in better plant survival and growth by providing more available water at the root zones of plants. However, results showed that although irrigation events generally improved soil moisture levels, the difference in soil moisture between high and low irrigation rates was overall, not significant. This indicates that plants receiving high-level irrigation had similar moisture near their roots as plants receiving low-level irrigation. This could be the reason why in general, high irrigation resulted in only small improvements to plant survival and plant growth in some pits. In the sludge and effluent pits, the addition of an amendment to remediated soil was tested because of the potential to provide useful nutrients to plants and to improve soil texture and water holding capacity, thereby potentially improving plant survival and growth. There were significant differences in plant survival among the features; however, the addition of the soil amendment did not provide a clear or consistent improvement in plant survival, nor did it result in much greater plant growth (small improvements were realized). Rather, plant survival appeared to be more influenced by the size of plants at the time of installation. Because established criteria for planting the rehabilitated features was used, there was some control over certain variables that could affect plant establishment, such as species selection, site preparation, spacing of plants, and frequency and amount of irrigation. However, other variables not controlled could have also affected plant establishment and played a role in the results of this research. Differences in site conditions (i.e. location, aspect, wind, natural rainfall), soil texture and micronutrients, and the propagation and handling of plant material (in the plant nursery and during planting) could be confounding factors, together with irrigation rate and soil amendments. Several lessons learned were identified from this study and may be worth consideration in future restoration and rehabilitation of decommissioned facilities and/or disturbed landscapes across Kuwait oil fields. Adaptive management (i.e. the ability to direct change based on feedback from monitoring as one gains experience with local conditions) is very important, and it allows for the effective incorporation of lessons learned into the decision making process as the project evolves, and to positively affect the delivery of new projects as they are developed. The findings of this study lead to amendments to statutory remediation standard for future remediation projects within the oil fields of Kuwait.

India as an agrarian economy employs large section of the society in primary economic activity. India being endowed by diverse physical features host numerous tactics of farming’s carried out by both gender, None can ignore the participation of each gender, the necessity of gender roles in agricultural activities within the country become an interesting research gap, thus, research has been conducted to find out gender dimensions, by assessing female work participation in Mizoram and examining the contribution of female workforce on agriculture in Mizoram. To ensure wide and explicit coverage of the study literature review has been done specifically for this paper, reports published by govt and reliable organizations have been splendidly covered to draw the finest output.

Objectives: In this study, our objectives were to facilitate early diagnosis and reduce subsequent complications of neonatal jaundice by appropriate treatment. Methods: The study was done as Random Sampling of neonates noticed to have deep yellow discolouration of whole body that were born in Rockland Hospital, Delhi, during the period 01.01.2012 till 07.08.2014. Results: In our cross-sectional study of 661 neonates, the results showed that the prevalence of physiologic jaundice in neonates was 86.99% and the prevalence of pathologic indirect hyperbilirubinemia in neonates was 13.01%. Physiological jaundice in newborns was transient and dissipated without medical intervention. Sunbathing was advised in all cases of physiologic jaundice. Bilirubin count is also lowered through excretion — bowel movements and urination —so frequent and effective feedings were vital measures to decrease jaundice in infants. In pathologic jaundice cases when serum bilirubin levels were greater than 12 mg/dL, infant was treated with single surface or double surface phototherapy, depending on the infant's age and prematurity status. All the neonates with TSB more than 18mg/dL were also associated with early onset neonatal sepsis, so they were given antibiotics, phototherapy and other supportive treatment. No neonate with jaundice required exchange transfusion or liver transplantation. Conclusions: No neonate discharged from hospital was reported to have hydrops foetalis, kernicterus or cerebral palsy during admission or on follow up. Besides, the Neonatal Mortality Rate was zero, in our study. Thus, it is evident in our study that the morbidity and mortality are completely preventable in neonates by appropriate management of neonatal jaundice and associated risk factors.

Since its independence, Madagascar has not been able to easily improve its economic situation. This situation is also reflected in the educational system. The economic incapacity justifies the long-term financial dependence of the Malagasy education system on international organizations. Despite this, the success rates in public schools are very low compared to those in private schools. The analysis of the results of a survey of a sample of 80 private school managers in the Antananarivo renivohitra Cisco, allowed us to detect the reasons for the success of the educational system of these schools. The pedagogical strategies and the management system that they have adopted play a major role in their performance. Discipline, culture, academic achievement, and the quality of educational services offered are the hallmarks of an effective private educational institution. At the same time, the experience of private schools in resource management, their organizational cultures and the satisfaction of their teachers, justify their performance.

Education systems local and international took a heavy beating from the COVID-19 pandemic. Teachers all around the world are faced with different challenges.From the changes in curriculum, the administrator’s demand, relationship with their colleague, to keeping up with the needs of the students and parents. Not only that, teacher’s needs to prepare lesson plans, conduct classes, hand-out modules while making sure that the quality of learning still remains even with the absence of face to face interactions. Each are taking up a toll on the Teacher’s physical, mental, and emotional health. The shift in curriculum, teacher’s development, performance review and the whole apparatus around lesson observation seems to place a strong emphasis on the challenges that the teachers are facing in securing the learning of all the students in a class. It can be extremely difficult even for an experienced teacher to nail every student’s learning and this needs to be recognised. Management processes needs to be geared towards supporting teachers to tackle the real challenges they encounter in this New Normal Education. And the deciding factor that determines whether the teachers in any given school will lean toward positive and productive or desperate and crushed is the Administrator. Administrators work in schools, but not as teachers. They are responsible for overseeing the administrative duties at schools from preschool through post-graduate levels. Administrators ensure teachers have the equipment and resources necessary to deliver educationally effective curriculum. In this Research Article, we will be talking about the probable ways on how the administrator can provide solution and direction to teacher’s problem to achieve a smooth running curriculum.

Objectives: The aim of the present study was to assess the technical feasibility and oncologicalsafety of laparoscopic gastrectomy with D2 dissection. Material and Methods: This prospective observational study was conducted at Govt. Medical College Srinagar since June 2013 to June 2019. The Kashmiri population comprises of endemic zone for gastric cancers due to their cultural and environmental influences. The study sample of patients were explained the various available modalities of treatment with their potential benefits and risks and also about the possibility of conversion to open surgery in case of any technical difficulties. This study was approved by the ethical committee of our medical college. Allthe patients included in the study were pathologically proven adenocarcinoma of the stomach. Results: Most of our patients were in the age range of 50 to 70 years and 34 (72.34%) patients were Males. In most of these patients the site of tumor was distal third 30 (63.82%), followed by diffuse involvement 06 (12.76%), and upper third 07 (14.89%) and middle third 04 (8.51%). The diagnostic laparoscopy was done in all patients. Laparoscopic partial gastrectomy with Gastrojujunostomy with D2 lymphadenectomy was performed in 26 (55.31%). Laparoscopic total Gastrectomy with Esophago-jejunostomy with D2 lymphadenectomy in 17 (36.17%), Laparoscopic gastrojejunostomy in 3(6.38%) and Laparoscopic feeding jujunostomy in 1 (2.01%) were performed.The median operative time was 150 min (range 130-180) in Partial Gastrectomy and 210 min (range 200–250) in total Gastrectomy, the median estimated blood loss was 110 ml (range 90-130) in partial Gastrectomy and 150 ml (range 100–200) in total Gastrectomy. There were no major intra operative and post operative complications. Wound infection developed in 3 (6.38 %) patients, one (2.12 %) patient developed duodenal stump leak and one (2.12%) patient was convertedinto open and 2 (4.2%) patients developed intra abdominal sepsis. The median number of lymph nodes retrieved was 20 (10-32). A positive proximal margin was detected in 2 patients (4.65%) The median time to start oral fluid was 4 days (3-7) days in partial Gastrectomy and 7 days (5-9) in total Gastrectomy. The median hospital stay was 5 days (4-7 days) in partial Gastrectomy and 7 days (range 5–10 days) in total Gastrectomy.There was no motality in our study sample. Conclusion: Laparoscopic gastrectomy is safe and feasible, and it can be performed by experienced surgeons to achieveoptimal oncological short-term outcomes.

AIM: To assess the antitumor activity and safety profile of topotecan plus cyclophosphamide regimen in patients with relapsed/refractory paediatric type tumors and to analyze the progression free survival (PFS) and overall survival (OS) of these patients. MATERIALS AND METHODS: The details of patients of recurrent paediatric type tumors, treated over a period of consecutive five years from 2014 to 2018, with topotecan and cyclophosphamide regimen, were analyzed retrospectively. The patients should have had already received at least a previous chemotherapy regimen and had either a disease progression or relapse before being considered for the TC regimen. RESULTS: A total of 51 patients (median age 12yrs with 39 males and 12 females) received the TC regimen. The median number of cycles was 3 (range, 2–8). The response rate was: CR 0%, PR 35.3%, and disease stabilization (SD) 21.6 %. The median duration of PR in the patients was 7m (range4m -34m) and the median duration of disease stabilization was 6m (range 4m -16m). The median PFS and OS were 4m and 8m respectively. CONCLUSION: Topotecan plus cyclophosphamide is a well tolerated regimen for recurrent/ refractory paediatric type tumors, both in paediatric and adult populations, showing a good response rate. But, the duration of response (PFS) and OS is dismal.

Background: Menopause symptoms, in spite of being a normal physiological process can sometimes cause symptoms which can be severe and can affect everyday life. It is a cause for concern that many women are unaware of certain menopausal symptoms. Objectives: The objective of the present study is to assess the menopausal symptoms using modified Menopause Rating Scale (MRS) in perimenopausal women. Methods: It is a cross-sectional study where menopausal rating scale(MRS) questionnaire was used to assess the menopausal symptoms. Results: In the present study 52% of the patients experienced hot flushes out of which 53.8% had mild symptoms, 34.6% had moderate and 7.6% had severe and only 3.8% had very severe symptoms. 18 % experienced chest discomfort 65 % of the patients experienced sleep problems 29 % of the patients experienced depressive mood. 50 % of the patients experienced irritability out of which 24 % had mild symptoms, 56 % had moderate and 8 % had severe and only 12 % had very severe symptoms.72 % of the patients experienced physical and mental exhaustion, 26 % of the patients experienced sexual problems, 19 % of the patients bladder problems, 50 % of the patients experienced vaginal dryness, 88 % of the patients experienced irritability. Conclusion: In the present study the most common symptom reported was joint and muscular discomfort followed by depressive mood heart discomfort and physical and mental exhaustion and hot flushes. The urogenital symptoms were comparatively less. The women in perimenopausal age group make large part of the population, although there is lot of emphasis that is given for improvement of health of the women in reproductive age group, the women in perimenopausal age group need the same amount of care.

Soft tissue sarcoma (STS)–Leimyosarcoma of the chest wall is a rare entity with dismal survival. Surveillance, Epidemiology and End Result a 5 year survival rate of STS was 81%, 56%, 15% for localised, regional and distant metastasis respectively. Here we present a 31 year man with chest wall leimyosarcoma who is treated with primary surgery and multiple metastasectomy along with six lines of chemotherapy. The outcome of these efforts has resulted in prolong survival with good performance status worth reporting.

Introduction: Electronic health record (EHR) is an indispensable tool for medical and health professionals. They are the product of decades’ worth of innovation and constant improvement. EHRs are implemented around the world a while ago.Though India has progressed well in the adoption of IT in other sectors, such as banking, railway reservation, etc, it has not yet utilized the potential of IT in the healthcare sector. The Union Health Ministry has notified the National eHealth Authority (NeHA) which plays a role for setting directions for public and private eHealth initiatives, including electronic health records storage and health information exchange capabilities and other related health information technology efforts & regulation of the same. Objectives: The study aims at strategic planning for implementation of Electronic Health Record in the government Hospitals in India. Methods: A descriptive analytical study for implementation of electronic health records using SWOT (Strength, Weakness, Opportunities, and Threats) and PESTLE (Political, Economical, Social, Technological, Legal and Ethical) analysis. Results: A broad range of administrative, technical, financial and organizational factors should be considered when adopting an EHR system. Communication between different healthcare providers canenable hospitals to properly plan, select, implement and integrate different health IT projects. The hospitals should collaborate with each other to bridge the gap between internal capacity and external resources. Conclusion: Timely & quick access to information is the important strength. Lack of hardware and infrastructures are the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics is the significant opportunity of EHR. The most substantial threats are the physicians' and other clinical staff's resistance in the use of electronic health records. The successful implementation of EHR requires a coordinated effort the Central Government, State Governments, healthcare providers, medical associations, IT industry.

Hospital being the first point of contact for the MLC cases, proper documentation of the cases is vital for the hospital to fulfill the legal responsibilities. Keeping clear, accurate and contemporaneous patient records is a prime responsibility of all medical practitioners. A good medical record should be comprehensive and accessible, legible and pinned to a particular date in a legal context, good patient records are always more valuable than memory. Aim: The aim of the study is to assess the completeness of the documentation of medico-legal cases in a MLC register in a tertiary care hospital. Objectives: To study the pattern of distribution of different mlc cases To study the age and gender distribution of mlc cases To study the area wise distribution of cases- urban vs rural Methodology: A total of 1530 cases were registered as medicolegal during the year 2020. Sample Size is 312 obtained from Raosoft Inc. (sample size calculator). These cases were studied by stratified random sampling (26 cases from each month) • The relevant details in the hospital mlc form were analyzed, grouped, tabulated and assessed for completeness by taking various parameters like Name, Age, Address, Brought By, Identificaton marks, Type of Injury, Diagnosis, Details of the Doctors, Overwriting, Striking Results: Out of 312, A total of only 74 mlc records were having all the parameters completely filled. 232 were males, 72 were females, 160 were from urban area and 146 were from rural area. Only 138 records had name and signature of the doctor and 174 records had only the signature of the doctor. Most common manner of injury was the RTA (172 cases out of 312). Conclusion: Vigilance and proper documentation while attending to MLC is instrumental in preventing grave consequences to the patient, the doctor or even the health institution in the court of law. Good notes corroborate evidence given in court and will enhance your credibility. Reorientation courses and Continuing Medical Education programs of medical practitioners are recommended for getting acquainted with the management of medicolegal cases

Hereditary spherocytosis (HS) is a familial haemolyticdisorder characterizedby formation of abnormal red blood cells with fragile cell walls causing anaemia, jaundice, splenomegaly and gallstone formation. Most children have a mild disease and hencedo not require splenectomy, mainly reserved for a severe disease or in patients with symptomatic gall stone disease. The anaesthetic management of hereditary spherocytosis mainly depends upon the degree of haemolysis and severity of anaemia.We reportanaesthetic management in a case of HS with splenomegaly for elective laparoscopic SOS open splenectomy.

‘Nirgudi’plant Vitex negundo Linn. from family Verbenaceae is important medicinal plant in Indian Pharmacopoeia with variety of bioactive phytochemicals having importance in pharmacology and tribal medicines. It was found to contain many polyphenolic compounds, terpenoids, steroids, glycosides and alkaloids. Bioactivity guided preliminary phytochemical analysisof various extracts of leaves of V. negundo resulted in the qualitative analysis of ten metabolites.All the crude extracts from various solvents were evaluated for their antibacterial properties. They were found to have significant antibiotic activity against Staphylococcus aureus, Klebsiella pneumoniae, Escherischia coli, Pseudomonas aeruginosa, Salmonella typhi and Bacillus subtilis. The significance of antibacterial activity was compared with standard antibiotic tetracycline.

Birch leaves were used as a substitute for birch bark, buds, and Chaga of birch. In traditional medicine, birch leaves are considered to have less toxic. Numerous researches conducted in Russia, Bulgaria, Japan, and China on Betula pubescens Ehrh., Betula pendula Roth., Betula rezniczenkoana (Litv.) Schischk., Betula humilis Schrank., Betula mandshurica (Regel) Nakai found that birch barks and leaves contain antioxidants, and they have anti-cancer, anti-yeast, antibacterial and anti-inflammatory properties, protect the liver and promote bile secretion. The studies showed that the medicinal plants had anti-inflammatory on stomach inflammation during extreme stress and promoted bile secretion. The birch leaf Phyto preparations used in experimental animals reduced insulin resistance of peripheral tissues and lowered blood glucose. It was noted in Traditional Mongolian Medicine that the birch bark was used to treat inflammation for acute diseases. The aim of this study was to determine the effect of two species of birch leaves on blood glucose and antioxidant activities in diabetic rats. The study was conducted at the Drug Research Institute of the Monos Group. 40 WISTAR non-linear white rats weighing 150-204 g, dry extract of birch leaves of the two species (Alloxan monohydrate Tokyo Chemical Industry LTD), IGM-100 3A blood glucose meter (Blood glucose test meter, Infopia LTD, Brussels Belgium), glucose test (Blood glucose test strip only), antioxidant activity kit (Rat Malondialchehyche Elisa KIT, cat. № EKRAT- 0266, Jilin province, China). The blood glucose level of the pathological control group rats reduced from 31.5 mmol/l to 17.1 mmol/l in 14 days. The blood glucose levels of Betula platyphylla group lowered to 6.3 mmol/l; Betula hippolytii group’s lowered to 6.9 mmol /l. The results showed that the maximum MDA level was determined from the control group, Betula hippolytii and Betula platyphilla groups. The maximum MDA rate was reduced by 33.9% and 53.5%, respectively for Betula hippolytii and Betula platyphilla groups. Betula hippolytii birch leaves and Betula platyphilla birch leaves have been shown to lower blood glucose levels and have antioxidant activity for diabetic animals.

This situation had risen in the context of the outbreak and is considered to be unique as there is no evidence of the similar situation in a couple of decades. ‘Janata Curfew’ followed by ‘lockdown’ is painstaking decision laid on Indian citizens to fight against the global epidemic war. Due to the decision imposed on the people, all the sectors of various departments functioning have come to a halt. Among the all the sectors, education sector is one entity which is shut in all the parts of the nation. To bridge the gap in an optimistic approach, creativeness in learning and teaching has come forward for adoption by various universities and schools. Hence, using technology, teaching, students’ assessments are in action online.