Background: Self-medication is one of the major health concerns worldwide and World Health Organization has laid emphasis on correctly investigating and controlling it. There is much public and professional concern regarding self-medication practices, which has dramatically increased in the last few decades, especially in the developing countries. Hence, this study was designed to study the prevalence and practice of self-medication practices in an urban area of Delhi, India. Materials and Methods: A cross-sectional study was conducted in March 2013 and data were collected by personal interviews using pretested questionnaires. An urban colony in the south district of Delhi was chosen and the eldest member of the family, present at the time of the visit was interviewed. Data were collected from 236 persons and analyzed using SPSS version 21. Results: The prevalence of self-medication was 92.8% (95 confidence interval: 66.5-79.4). 74.9% preferred allopathic medicines. Self-medication was found to be practiced more among younger persons than older age group persons (P = 0.000). Graduates and postgraduates practiced self-medication more than others (P = 0.002). Common cold (61.6%) and fever (51.8%) were the most common ailments for which self-medication were practiced. Paracetamol and cough syrups were the most commonly used class of drugs. Conclusion: The prevalence of self-medication in this study was high. Drugs especially antimicrobials were not taken for the proper length of time. Awareness regarding self-medication practices to help patients decide on the appropriateness of self-medication is required.

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Background: There has been an explosive growth in the use of internet not only in India, but also worldwide in the last decade. There were about 42 million active internet users in urban India in 2008 when compared to 5 million in 2000. India now has the world's third-largest national digital population, with approximately, 120 million Internet users in 2011. Aims: The aim was to study prevalence and pattern of internet usage among medical students in Guntur. Materials and Methods: A cross-sectional study was conducted among medical students (n = 211) belonging to two medical colleges, to assess the pattern of internet usage. A semi-structured proforma along with Young's Internet Addiction scale was used. Results: Of 211 medical students, 57.2% were females and 42.8% were males. The users were divided into groups: 64.4% as average users, 11.8% as possible addicts, 0.4% as addicts, and in 23.2% of medical students internet usage was less than average user. Significant usage differences were evident based on the gender of user. Medical students used the internet mostly for social networking (59.7%), downloading media files (18.9%), online gaming (12.3%), and academic purposes (0.1%). About 63% of the medical students were using mobile phones to access the internet. Conclusion: Internet usage for the purpose of social networking (Facebook, WhatsApp, Mails etc.) was very high among the medical students. Availability of high speed internet on mobile phones may be the reason for spending more time on social network websites.

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Background: Psychiatric illnesses such as, depression, adjustment disorders, delirium, and anxiety disorders are common in dialysis patients and are likely to reduce patient's quality of life (QOL). Presence of chronic medical and psychiatric illness in patients increases burden on caregivers. Aims: The aim was to assess sociodemographic profile and to estimate the prevalence and type of psychiatric morbidity, QOL in patients undergoing hemodialysis. Furthermore, the study aimed to assess perceived burden in caregivers of these patients. Materials and Methods: This was a cross-sectional observational study conducted at hemodialysis unit of an urban tertiary care hospital. Fifty consecutive patients undergoing hemodialysis were included. Sociodemographic profile was assessed through semi-structured proforma. Psychiatric morbidity was assessed using Diagnostic and Statistical Manual IV Text Revised Criteria and World Health Organization QOL Scale-BREF scale was used to measure patient's QOL. Perceived burden in caregiver was assessed using Zarit Burden Interview. Data obtained were tabulated and analyzed using the SPSS software version 17. Results: Majority of patients was males, in middle-age group, secondary educated, unemployed and married. Psychiatric diagnosis was observed in 64% of the patients. Most common psychiatric diagnoses were major depressive disorder, adjustment disorder with depressed mood. Overall QOL score in patients was significantly low in those with psychiatric morbidity. Caregiver's burden was significantly high in those caring for patients with co-morbid psychiatric illness. Conclusions: Psychiatric morbidity in hemodialysis patients is high and impairs their QOL. Perceived burden of care in their caregivers is high in the presence of psychiatric co-morbidity.

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The substance use disorder not only impacts the patient himself/herself, but also affects family members. This is more relevant in a country like India where the familial ties are stronger with family members playing a significant role in the treatment process. This narrative review takes an overview of the inter-relationship between substance use disorder and the family. The domestic violence and adverse familial circumstances, both often arise as a consequence of substance use. Although the spouses of substance users experience greater rates of psychopathology and distress, children of patients with substance user disorders demonstrate higher levels of behavioral disturbances. Codependence often develops in the familial relationship, which perpetuates the substance use disorder. Substance use places quite a burden on the family, both psychologically as well as in terms of resources. Nonetheless, family members provide motivation, emotional support, and practical help during the treatment of substance use disorders and hence need to be engaged in the therapeutic process. Finally, the changing family structure and family dynamics in India might influence the in the future both the effect of substance use disorder on the family, and the familial resource available for treatment.

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Estrogen receptor (ER) and progesterone receptor (PR) are hormone receptors found on breast cells that pick up hormone signals resulting in cell growth. Similarly, positive human epidermal growth factor receptor-2 (HER2/neu) status of the breast carcinoma means that HER2/neu gene is making too many HER2/neu proteins, which acts as receptors on the cell surface and helps the cells to grow and divide. Hormone receptor studies such as ER, PR, and HER2/neu are routinely done in breast carcinoma. It not only helps in the prognosis of the tumor but also helps in deciding its treatment. The goal of doing this receptor status is to provide right treatment to the right patient. This hormone receptor status is graded using Allred scoring and grading system. Depending on the hormone status, breast carcinomas can be divided into a number of different categories ranging from triple positive through triple negative. Another marker of proliferation (Ki-67) is also being used which is a proliferation index marker. This scoring system has its own limitation and shortcomings, which depends on a lot of pre- and post-analytical factors. Certain new techniques such as genomic assays, PAM50, and HALO screening test are being used nowadays for breast cancer detection.

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Background: Globally, India was one among the most affected countries for cases and deaths of swine flu (influenza A H1N1) during 2009 influenza pandemic with lot of public hype and panic. Aims: This study was designed to assess the awareness, attitude, myths and practices regarding Swine flu among urban population of Belgaum district, Karnataka. Subjects and Methods: This study was conducted in an urban community of Belgaum, Karnataka during 2009. A total of 250 households were interviewed using a pretested questionnaire by systematic random sampling. One person from each household preferably head of the family was asked regarding knowledge, attitude and practice during swine flu pandemic. Results: Among the study population, 73.6% had previously heard of swine flu. More than half of the participants said mass media communication was found to be the major source of information. Around 82.6% of the participants said fever was the most common symptom and using facemask was accepted as the important mode of prevention by 81.5% participants. Only 19.0% were willing to leave their locality temporarily if any cases were seen around. Majority of the participants selected government hospital for treatment facilities if they get any symptoms of swine flu. Hand washing, as a mode of prevention was known to 92.4% of the respondents. Around 33.4% of the populations were ready to share knowledge to others if they were given health education regarding swine flu. Conclusions: Knowledge regarding swine flu pandemic was low among study participants. Most of the participants had health seeking behavior. Majority of the respondents were practicing hand washing. Strategies to create more awareness about pandemic through effective mass media are vital for containing the pandemic.

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Context: Obesity is found to be the strongest risk factor for persistent hypertension, which is an important risk factor for the coronary artery disease and stroke. Urbanization, unhealthy eating patterns and reduced physical activity are the important reasons. Prevention of obesity is always better than its treatment. Aims: The aim of this study was to determine the proportion of overweight/obesity among medical student and to identify various correlates associated with it. Settings and Design: Cross-sectional study conducted in medical students in Pune. Methods: A validated, pre-designed, and pre-tested questionnaire was used. Overweight/obesity was assessed on the basis of body mass index (BMI) for age using gender specific Centre for Disease Control (CDC) charts. Statistical Analysis: Proportions, ANOVA, and unpaired t-tests were used to find any statistical significant association of mean BMI for age with various correlates. Results: Total 159 students including 66 (41.5%) female and 93 (58.5%) male took part in the study. The proportion of overweight/obesity was 13.2% (C.I: 7.84-18.5%). Daily calorie intake, lack of daily physical activity, daily consumption of Tea/Coffee/Fruit juices, playing outdoor games, socio-economic status, and family history of obesity were found to have statistically significant association with overweight/obesity. Conclusions: The problem of obesity/overweight is on the rise.

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Fruits of Citrus genus play an important role as a dietary supplement and therapeutic assent as well since ages. The present review summarizes some such attributes of Citrus genus. Literature review was done through published works to gather information on nutritional and ethnic values, phytochemical and pharmacological properties of Citrus. Information about the plant and phytochemical constituents, pharmacological activities were collected from the published reports. The plant was found to possess significant analgesic, anti-inflammatory, antioxidant, anthelmintic, antibacterial, antifungal, and hypolipidemic properties. They are found to be significant antihyperglycemic, antidiabetic, and hypoglycemic activity. The phytoconstituents which are present in the plant are mainly coumarins and flavonoids which are responsible for the actions. The phytochemical constituents and isolated bioactive compounds of Citrus can be investigated further to develop novel herbal drugs by using reverse pharmacological approaches especially in the treatment of liver diseases, arthritis, malignancies, and other inflammatory diseases.

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Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC) is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3 ^rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women.

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The potential uses of dexmedetomidine (DEX), a highly selective α₂ - adrenoceptor agonist are very diverse. DEX appears to mimic many of the actions of mythical 'ideal' sedative/analgesic agent. Although not orally active, DEX shows good bioavailability when administered via various other routes like intranasal, buccal, IM than intra-venous. DEX has similar pharmacokinetics in all age groups. Its side effects are predictable and easily treatable, hence it has found place as a part of fast-tracking anesthesia regimens in children. DEX is the sedative of choice for peri-operative use in high risk patients, since it is cardioprotective, neuroprotective and renoprotective. Premedication with DEX obtunds the autonomic pressor responses due to laryngoscopy and endotracheal intubation when used as an adjuvant to general anesthesia. DEX in high doses offers another approach to managing morbidly obese patients and patients with a compromised airway; without causing any cardio-respiratory depression. It is near ideal hypotensive agent used for controlled hypotension. Its value as a primary sedative and analgesic is becoming more accepted and evident in critically ill patients; in adult and paediatric intensive care units. Besides use in locoregional anesthesia, it is also used as an opioid substitute, for treatment of substance withdrawal, as an anti-shivering agent, for treatment of delirium and as an end of life medication. Availability of an antidote (Atipamezole) with similar elimination half life is taking the drug into new frontiers. However, use of DEX is contraindicated in patients with hepatic failure, hypovolemic shock, advanced heart block or ventricular dysfunction.

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Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. There is evidence to suggest mothers with young infants experience depressive symptoms and 10-15% major depression. Aim: To study the incidence and factors contributing toward postpartum depression Materials and Methods: Married women 18-35 years of age attending the antenatal and postnatal out-patient clinic were studied during 2007 and January 2008. 200 women who had delivered between 1 June 2007 and 1 January 2008 were included in the postpartum phase to calculate the incidence of postpartum depression. The prospective mothers were approached in their 3 ^rd trimester of pregnancy. Critically ill, past history of depression, co morbid medical or psychiatric illnesses were excluded. The diagnosis of postpartum depression (PPD) was made as per international classification of diseases (ICD 10). They were administered the beck depression inventory (BDI), Presumptive stressful life event scale, Edinburgh Postnatal Depression Scale (EPDS) and General Health Questionnaire (GHQ-12) scale. The women were subsequently reviewed in their postpartum phase in the postnatal out-patient/child immunization clinic at 2, 4 and 6 weeks after delivery. The non-depressed mothers acted as the controls. Results: A Total of 186 women out of 200 registered for the study 40 had scores above 13 on EPDS and grouped as depressive met ICD 10 diagnostic criteria. The remaining 146 were non depressive. 14 women dropped out of the study. Incidence of PPD was 21.51%. The study found 14/27 (51.8%) of the risk factors associated with PPDs were statistically significant. Significant number of mothers had high antenatal GHQ and both antenatal and postnatal BDI scores. BDI and EPDS scores remained high during the postnatal follow-up in the depressed group, which showed the presence of PPD in mothers with young infants. Conclusions: There is a need for sensitizing primary health-care givers regarding PPD and is an important health issue that should not be ignored.

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Introduction: Acute appendicitis is the most common cause of an acute abdomen requiring surgery, the clinical presentation is typical in 50% of the cases, but the decision to explore the patient can sometimes be challenging. The diagnosis is based on history, clinical examination, and few laboratory investigations. To help the surgeon make diagnosis with certainty and reduce negative laparotomy rate, a number of clinical scoring systems are in vogue. The present study was undertaken to evaluate the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score in the diagnosis of acute appendicitis. Materials and Methods: A prospective study was undertaken among 100 cases presenting with signs and symptoms suggestive of acute appendicitis. Validity of RIPASA score as a diagnostic test for appendicitis was established by calculating its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) along with 95% confidence intervals (CIs), using intraoperative diagnosis confirmed by histopathology as gold standard. Results: RIPASA had sensitivity of 82.61% (95% CI 72.02, 89.76) and specificity of 88.89% (95% CI 67.2, 96.9). It had a PPV of 96.61% (95% CI 88.46, 99.07), NPV of 57.14% (95% CI 39.07, 73.49), and a diagnostic accuracy rate of 83.91% (95% CI 74.78, 90.17). Conclusion: The RIPASA score is a simple scoring system with a reasonable sensitivity and specificity for the diagnosis of acute appendicitis.

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Brucellosis is infection of animals caused by organisms of the genus brucella. Many animal species are affected but domestic pets are the most common source of infection to man. Human brucellosis is a zoonotic disease of worldwide distribution. It is prevalent in developing countries where humans and animals live in close proximity. Prevalence in humans is directly proportional to animal disease. Animal handlers are specifically more susceptible due to their occupation. It is associated with lot of morbidity and loss of man days. Vaccination is the most important method for prevention of animal brucellosis. Control of animal brucellosis is influenced by various factors and hence, prevalence keeps on changing. Animal brucellosis is highly prevalent in many states of India. There is no collaboration between the veterinarians and the clinicians. Lack of awareness among clinicians, low index of suspicion and sometimes non availability of diagnostic tests can lead to missed diagnosis. Brucellosis is characterized by protean clinical manifestations though it commonly presents as pyrexia of unknown origin or osteoarticular disease. Other manifestations include glomerulonephritis, pneumonitis, encephalitis and hepatitis. The diagnosis can be established by blood culture and/or serology. The disease is easily treatable and completely curable, but failure to diagnose leads to non institution of appropriate treatment. This leads to chronic morbidity adding to the patient's misery. High index of suspicion, prompt diagnosis, appropriate and adequate treatment can cure the patient, prevent chronic morbidity, and loss of many days. This review aims to review the global and Indian scenario of brucellosis and increase awareness amongst the clinicians.

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Background :0 With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lesions has been revolutionized. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis. Aim :0 The aim of this study is to examine the cytological details in aspirated smears from lumps in the breast and to evaluate the role of FNAC in improving the quality of diagnosis by comparing with histopathological features. Materials and Methods: Over a period of 2 years, 334 aspirations, including 16 bilateral were performed. Suppurative and inflammatory lesions and gynecomastia were excluded from the total aspirates. A total of 56 cases were followed-up by histopathologic examination. Results: Cytohistologic correlation was 73.68%, 42.85%, 94.44% for fibroadenoma, fibrocystic disease and duct cell carcinoma respectively. False positives were observed in proliferative lesions. No false negative cases observed. The sensitivity of the fine needle aspiration (FNA) procedure was 100%, specificity, 88.5% and the predictive value of a positive result was 84%. Conclusion: Proliferative lesions may be misinterpreted as malignancy in FNA without complete clinical and mammographic details.

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Introduction: Varicose veins cause a great deal of morbidity in our population today. They are part of the penalty we pay for the adoption of the erect posture. They affect 10–20% of population in the Western world but in India, it is 5%. Varicose veins do not threaten life and are seldom disabling, but they cause a considerable demand on medical care. They are the cause of morbidity and loss of precious work hours and a significant financial burden on the health-care system. Aims and Objective: To study the epidemiological factors with respect to age, sex, and occupation and clinical profile as per Clinical, Etiologic, Anatomical, Pathophysiological classification of varicose veins. Materials and Methods: A total of sixty cases of were examined at a teaching Medical College, Hospital and Research Centre during the period from July 2013 to September 2015. Examination of patients was carried out according to the pro forma. All patients underwent detailed clinical examination followed by color Doppler ultrasound. Results: In our study, 70% patients were males and 30% patients were females. Maximum patients were in age group of 45–54 years. Twenty were in CEAP C2, 15 cases in CEAP C3 and 15 cases in CEAP C4 and 10 cases in C5. Sixty percent patients had involvement of great saphenous vein (GSV), 17% patients had short saphenous vein (SSV) while 23% patients had involvement of both GSV and SSV. Conclusion: Not only prolonged standing but also sitting posture can cause varicose veins. Obesity and increasing age are other risk factors. Classifying the varicose veins has an impact on the course of the disease and preventing its complications. Color Doppler is superior to clinical examination in the evaluation of superficial and perforator veins incompetence.

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The delusion of pregnancy is defined as the belief of being pregnant despite factual evidence to the contrary. Even being more common in a developing country, the literature about delusion of pregnancy from India is meager. The present article reports the case of delusion of pregnancy in an unmarried female associated with subclinical hypothyroidism and prominent sibling rivalry from psychological aspect. The literature in this field has addressed for the organic and psychodynamic, psychosocial aspect of this disorder and its difference from other disorders mimicking pregnancy and its relevance to the treatment plan.

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Nosocomial infections are an important cause of morbidity and mortality. The inanimate objects like mobile phones in the immediate environment of the patients can act as a source of infection. Infectious agents from patients can be transferred on to the hands of the health care workers and in the absence of adequate hand hygiene practices can be transferred on to the mobile phones during their use and this can serve as a vehicle for the transmission of nosocomial pathogens from one patient to another. Aim: To evaluate the role of mobile phones in the transmission of pathogens by health care workers in health care centres. Materials and Methods: Mobile phones and hands were tested for micro-organisms before and after application of a disinfectant. A total of 60 mobile phones were tested for micro organisms, 30 from the health care workers (study group) and 30 from relatives of patients attending Out Patient Department (control group). Swabs taken from their hands were also cultured. Results: Hands of all the health care workers and 27 mobile phones showed microorganisms on them. Only Staphylococcus aureus was isolated. The hands and mobile phones of 11 health care workers were contaminated with Methicillin sensitive Staphylococcus aureus (MSSA). Methicillin resistant Staphylococcus aureus (MRSA) was isolated from the hands of 24 (80%) and mobile phones of 16 (53.3%) health care workers. Ethyl alcohol was found to be 100% effective in disinfecting hands and mobile phones. Conclusions: To prevent the potential spread of infections through mobile phones, strict infection control practices, hand hygiene, and routine decontamination of mobile phones with alcohol should be advocated to prevent the spread of infection in the hospital settings.

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Background: In a resource-limited and high burden disease setting, satisfied human resource is an asset in terms of high productivity, efficiency and quality care. Aim: To assess job satisfaction among permanent employees working in a government hospital. Materials and Methods: A sample of 200 staff members was interviewed using 34-item, Likert response based, modified job satisfaction scale. Key factors for job satisfaction were identified after subjecting data to principal component analysis, varimax rotation and multivariate analysis using step-wise regression procedure. Results: The mean job satisfaction index was computed to be in a similar range, but was found to be highest for nurses (0.68), followed by doctors (0.66), support staff (0.63) and technicians (0.62). Nine uncorrelated and critical factors related to job satisfaction that explained 68.09% of the variability was identified, that is, communication, pay/salary, working conditions, organization supervision system, co-workers, workload, benefits, career aspects and rewards. A positive association was reported between job satisfaction score and factor scores (units) of communication (0.133), benefits (0.110), working condition (0.027) and co-workers (0.032) and a negative relation with organizational supervision system (0.118), workload (0.093), rewards (0.035), pay/salary (0.034) and career prospects (0.017) respectively for all categories of respondents. However in case of doctors, co-workers (0.023 units) showed a negative relation. Conclusion: There is scope for interventions to enhance job satisfaction and concomitant continuous monitoring can be useful in determining various service aspects that necessitate improvement. By enhancing job satisfaction, hospital administrator can improve not only the mental, psychological and social well-being of work-force, but also the financial health of an organization.

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Background: Intellectual disability (ID) is a permanent and highly disabling condition. The birth of a disabled child induces complex feelings in mother and other family members. This study was planned to investigate phenomenology of ID and the prevalence of depression in their mothers. Objective: To find prevalence, influence of various sociodemographic variables, and its clinical correlation with depression in mothers of ID children. Study Design: A cross-sectional study. Materials and Methods: A total of 100 patients diagnosed as ID were included in the study. Objective data were collected in a special Pro forma, and mothers of these patients were evaluated with the Beck's Anxiety Inventory and Beck's Depression Inventory. Results: The mean age of patients with ID was 11.52 years, had received an average of 3.01 years of schooling, mean age at diagnosis was 6.01 years, mean intelligence quotient was 45.17, and 79% had significant comorbidities. The prevalence of depression in mothers was 79%; it was more in mothers of female ID child, ID child with significant comorbidities, severer forms of retardation, and with higher levels of anxiety in the mother. Conclusions: The prevalence of depression in mothers of ID children in the present study seems to be much greater than those reported from the previous studies. The determination of predictors of depression among mothers of ID children may help health professionals in identifying mothers at risk. Regular screening of mothers of ID children should be included in the protocol for management.

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Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To estimate the prevalence and factors affecting undernutrition among under five years children using WHO growth standards. Materials and Methods: Community-based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the under five years children (336) were enumerated by house-to-house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. The children were examined for nutritional deficiencies and other morbidities. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis. Results: Total 336 children were enumerated by house-to-house visit. Only 319 children were available during the study, out of which 208 (65.2%) were undernourished. Undernutrition was significantly (P < 0.001) higher among boys than among girls. It was maximum in 49-60 months age group. The higher the level of the mother's education, the lower was the level of child weight for age (P = 0.003). The overall prevalence of morbidities was 43.4%. Conclusion: Malnutrition continues to be a public health problem in children particularly in marginalized groups.

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Context: Dengue is the most common disease among all the arthropod-borne viral diseases. There is no specific treatment or vaccine available for dengue. The sole method of prevention and control is the knowledge attitude and practices (KAP) for the same. Although, dengue is considered an urban- and semi-urban disease, in recent years, due to water storage practices and large-scale development activities in rural areas, dengue has become endemic in rural areas of India as well. Aims: To assess the KAP regarding dengue. Settings and Design: Urban and rural field practice area of a Tertiary Care Teaching Hospital in Pune, India. Materials and Methods: A pre-tested, semi-structured questionnaire was used to study the knowledge, attitude, and practices regarding dengue. Stratified random sampling technique was used. A modified B. G. Prasad criterion was used for socio-economic classification. Statistical Analysis Used: KAP represented as proportion (%). Chi-square test was used as a test of significance. P value < 0.05 was considered as statistically significant. Results: 68.4% in urban areas and 40.4% in rural area knew that dengue is transmitted by mosquito. 62.6% in urban areas and 48% in rural areas respectively stated fever as a symptom of dengue. The use of anti-adult mosquito measures was 48.05% and 51.42% in urban and rural area respectively Conclusions: There is a definite need to increase the information education communication activities for dengue in the study area.

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Background: Cervical lymphadenopathy is a common clinical problem that confronts us in daily clinical practice. The causes vary from simple treatable infections to malignancies that require highly specialized institutional management. It therefore needs to be speedily investigated. Fine needle aspiration cytology (FNAC) is simple, quick, inexpensive and minimally invasive technique that can be used as an outpatient procedure to diagnose them. Aims and Objectives: To assess the various causes of cervical lymphadenopathy through FNAC, and to see the distribution of lesions with respect to age and gender . Material and Methods: A retrospective study was conducted over a period of 10 months in a major laboratory. The cyto-morphologic features seen in the aspirates were critically analyzed and correlated with their aetiology. Results: In this study, 214 cases of cervical lymphadenopathy were analyzed. The age of the patients ranged from 9 months to 84 years of which 59% were males and 41% were females. Maximum incidence of cervical lymphadenopathy was observed in the age group of 21 to 40 years. The maximum numbers of patients (47.67%) were diagnosed as tuberculous lymphadenitis, followed by reactive lymphadenitis (44.39%), lymphomas (4.2%) malignant metastatic deposits (2.8%), and granulomatous lymphadenitis (0.94%). Conclusion: Our study concluded that FNAC is simple, quick, minimally invasive, and inexpensive technique to diagnose cervical lymphadenopathy. It can differentiate a neoplastic from a non-neoplastic process and therefore influence patient management preventing patient from being subjected to unnecessary surgery.

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Aim : The aim of this study was to find out the prevalence of dry eye and evaluate personal and environmental risk factors attributable to dry eye in a hospital-based population. Materials and Methods : In this cross-sectional study, 1890 patients above 15 years of age were screened randomly for dry eye. McMonnies Dry Eye Questionnaire, Schirmer's test, tear film breakup time (TBUT), presence of conjunctival injection, punctate epithelial erosions (PEE), and meibomian gland dysfunction (MGD) were used to diagnose dry eye. Patient demographics including age, sex, smoking, and occupation and working environment were also recorded. Correlation of dry eye signs with symptoms and TFBUT and Schirmer's tests was also assessed. Results : The prevalence of dry eye was 10.58%. The prevalence was higher in outdoor workers (17.77%). The male: female ratio was 2.33:1. The number of males was highest in the 56-60 (13%) and 60-65 (14%) years age groups while that of females was highest in the 46-50 (16.67%) years age group. A total of 10% of the patients were smokers, while 8% were tobacco chewers. A 2.15-fold increase was found in the odds for dry eye in those exposed to excessive wind, 1.91-fold to sunlight exposure, and 2.04 for air pollution. Abnormally low TBUT and Schirmer's tests were significantly associated with dry eye signs (P=0.009 and 0.014, respectively). Conclusion : Dry eye is a leading cause of ocular discomfort in OPD patients. Excessive exposure to wind, sunlight, high temperature, and air pollution was significantly related to dry eyes. There was a significant correlation between patient's history, symptoms, dry eye signs and objective tests for tear film. The rural people and those with outdoor occupation are more exposed to extraneous influences of environmental factors in tropical climate. These factors affect the tear film and ocular surface causing the dry eye syndrome.

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Aim: To analyze the clinical and laboratory features of multiple myeloma (MM). Settings and Design: A cross-sectional study of 20 newly diagnosed patients with MM over a period of 1 year in a tertiary health-care center. Materials and Methods: Based on Salmon-Durie criteria, newly diagnosed 20 patients of MM were selected for the study. Routine hematological and biochemical investigations, bone marrow examination, serum protein electrophoresis and urine for Bence Jones protein were done. Radiological investigations conducted to look for osteolytic lesions, extramedullary involvement and other pathologies. Results: Out of total 20 patients, 10 were males and 10 were females with sixth decade as the common age group at presentation. Common clinical symptoms were bone pains, localized body swelling, fever, generalized weakness and fatigue and motor weakness of lower limbs. Clinical examination revealed pallor in 80% patients, bony tenderness in 85% patients and 55% patients presented with infections. All patients had a presence of M band on serum protein electrophoresis, whereas 30% patients had urinary Bonce Jones protein positive. Among skeletal system spine and skull were the common sites of involvement 60% and 55%, respectively. Nearly, 85% patients had osteolytic lesions. Conclusions: Among 20 patients; various clinical presentations observed were infections, renal impairment, paraplegia and extramedullary plasmacytosis in addition to anemia and bony pains.

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Background : Tuberculosis is the second leading cause of death worldwide, killing nearly two million people each year. Sputum decontamination with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) is expected to improve detection of Mycobacterium tuberculosis (M. tb) by culture better than that with modified Petroff's; which is widely used in laboratories. In this study, sputum samples collected from suspected cases of pulmonary tuberculosis (TB) were cultured directly on Lowenstein-Jensen (LJ) medium and after decontamination by both the methods and the results of smear and culture positivity were evaluated to assess whether the NALC-NaOH treatment method improves smear and culture. Materials and Methods : For each decontamination method, 30 samples were obtained from suspected cases of Pulmonary TB, from Pad. Dr. D.Y. Patil Medical College and Hospital. Two sputum samples from each patient were collected on day 1 and 2. These samples then underwent decontamination process by performing the 4% NaOH, NALC-2% NaOH treatment methods and direct inoculation. After each process a smear was made and culture was done on LJ medium. Results: The modified Petroff's and NALC-NaOH treatment methods did not significantly affect the AFB smear positivity of the sputum samples (66% and 72.3%, respectively). (However, the culture positivity for M. tb on LJ medium was significantly different by the three processes. With NALC-NaOH and modified Petroff's it was 63% and 46%, respectively, while with direct culture it was 23%. Conclusion: NALC-NaOH treatment is better than modified Petroff's treatment for the detection of M. tb by culture. However, AFB microscopy does not seem to be significantly different by either process.

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