Background & Objectives: Depression, anxiety and suicide are the main psychiatric comorbidities which are more prevalent among persons with epilepsy (PWE). This study aims to determine the prevalence of depression, anxiety and suicidal ideation/behaviour in PWE and to correlate their clinical profile with psychiatric comorbidities in a population in North India. Methods: This study was conducted at Pt. BD Sharma PGIMS, Rohtak Haryana among PWE attending outpatient clinic at the Department of Neurology. A total of 100 eligible PWE were included in this study. The demographic and clinical history was documented. All patients filled up the Hospital anxiety and depression scale (HADS) and Columbia-suicide severity rating scale (C-SSRS) questionnaire. Results: The prevalence of depression and anxiety among PWE was found to be 60% and 70% respectively and the prevalence of suicidal ideation and suicidal behaviour was 42% and 3% respectively among PWE. Female gender, longer duration of epilepsy, higher seizure frequency, temporal lobe epilepsy, polytherapy, uncontrolled epilepsy and drug resistant epilepsy were found to be positively correlated with these psychiatric comorbidities. Conclusion: This study shows that the prevalence of depression, anxiety and suicidal ideation/ behaviour is high among PWE in Haryana, North India. PWE should be screened for these psychiatric comorbidities to improve their quality of life

This study was carried out to analyse retrospectively the data of 1,349 patients receiving antiepileptic drugs (AEDs) distributed drug wise into subtherapeutic, therapeutic, toxic and not detectable ranges. Patients were divided into three groups based on the monotherapy they received. In Phenytoin group (n=1255), 26.4% were found to be in therapeutic range, 51.6% in the subtherapeutic range and 20.6% in the toxic range. For Carbamazepine (n=63), 52.4% were in the therapeutic range, 14.3% were in subtherapeutic range, 31.7% in the toxic range and 1.6% were undetectable. Phenobarbitone levels (n=31) were found to be 64.5% in therapeutic range, 22.6% in subtherapeutic range, 9.7% in toxic range and 3.2% in the undetectable range. In 100 patients of phenytoin analyses which were under good seizure control and free of adverse effects, 46% were found to be in therapeutic range, 31% were in subtherapeutic range and 23% were found to be in toxic range. On the basis of this data, it is recommended that therapeutic drug monitoring should be carried out in all patients receiving AEDs for better overall management and long term clinical outcome.

Background & Objective:Epilepsy may have an impact on bone health of the patients even before drug therapy is initiated, particularly in the developing countries. This is in view of long delay in diagnosis and lifestyle changes. Therefore, in this study, bone health markers like bone mineral density (BMD) and urinary hydroxyproline were assessed in newly diagnosed epilepsy patients. Methods: The BMD was assessed by DEXA scan, and 24 hour urine hydroxyproline was estimated colorimetrically in 25 newly diagnosed epilepsy patients. Other bone markers like calcium, phosphorus, vitamin D and alkaline phosphatase were also estimated. Results were compared with 25 age and sex matched healthy controls, and were analyzed statistically. Results: The BMD and vitamin D were found to be significantly decreased (p<0.05) while serum alkaline phosphatase and urine calcium and phosphorus were observed to be significantly increased p<0.05) in epilepsy patients as compared to healthy controls. The difference in urinary hydroxyproline and serum calcium/ phosphorus in the two groups was not found to be statistically significant (p>0.05). Conclusions: Bone health is found to be already compromised in epilepsy patients in this study from North India. BMD and urinary hydroxyproline may act as simple, non-invasive, convenient and inexpensive markers to assess bone health in these patients
Bone Density ; Epilepsy

CDRI compound no. 99/411 is a potent 1,2,4-trioxane antimalarial candidate drug under development at our Institute. An HPLC method for determination of CDRI 99/411 with its starting material and intermediates has been developed and validated for in process quality control and stability studies. The analytical performance parameters such as linearity, precision, accuracy, specificity, limit of detection (LOD) and lower limit of quantification (LLOQ) were determined according to International Conference on Harmonization ICH Q2(R1) guidelines. HPLC separation was achieved on a RP-select B Lichrospheres column (250 mm ? 4 mm, 5μm, Merck) using water containing 0.1%glacial acetic acid and acetonitrile as the mobile phase in a gradient elution. The eluents were monitored by a photo diode array detector at 245 and 275 nm. Based on signal to noise ratio of 3 and 10 the LOD of CDRI 99/411 was 0.55 mg/mL, while the LLOQ was 1.05 mg/mL. The calibration curves were linear in the range of 1.05-68 mg/mL. Precision of the method was determined by inter- and intra-assay variations within the acceptable range.

PURPOSE: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). METHODS: Singleton term newborns with BA and < or =72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. RESULTS: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. CONCLUSION: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.
Alanine Transaminase ; Apgar Score ; Aspartate Aminotransferases ; Asphyxia Neonatorum ; Asphyxia* ; Hepatitis ; Humans ; Hypoxia, Brain ; Hypoxia-Ischemia, Brain ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Ischemia ; Jaundice ; L-Lactate Dehydrogenase ; Liver* ; Parturition* ; Prospective Studies ; Transaminases

We conducted a retrospective study and reviewed the temporomandibular joint (TMJ)-related papers published in a leading international journal, Journal of Oral and Maxillofacial Surgery, between January 2014 and December 2015. The study was conducted to ascertain and compare the trends of articles being published in the years 2014 and 2015. A total of 28 articles were reviewed, of which most of the full-length articles were on clinical management and outcomes and the role of radiology. The bulk of the studies were prospective, and less interest was shown in experimental research. A thorough review and analysis thus gives the impression that there is a great need for well-designed clinical studies on TMJ.
Ankylosis ; Prospective Studies ; Retrospective Studies ; Surgery, Oral ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSETo evaluate the functional and radiological outcome of comminuted radial head fractures, which were not amenable for classical open reduction with internal fixation, treated by on-table reconstruction and fixation using low profile plates.

METHODSWe reviewed 6 patients of Mason type III radial head fractures treated by on-table reconstruction technique between 2011 and 2013. There were 5 men and 1 woman with a mean age of 35 years (range 25-46 years). All surgeries were carried out at our tertiary care level 1 trauma centre within a mean of 3 days (range 1-8 days) from date of injury using on-table reconstruction technique. The functional outcome was measured using elbow functional rating index described by Broberg and Morrey and the patient-based Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure.

RESULTSThe mean follow-up period was 25 months. The average elbow flexion was 135°(range 125°-140°) and theaverage flexion contracture was 5°(range 0-10°). The average supination and pronation was 75°(range 70°-80°) and 70°(range 65°-82°) respectively. According to Broberg and Morrey scoring system, the average score was 90 points (range 75-100). The mean DASH score was 2.49 points.

CONCLUSIONOn-table reconstruction and fixation of comminuted radial head fractures using low profile plates is a reasonable option. The reconstructed radial head acts as spacer and provides reasonably good results and no surgical intervention is required for asymptomatic nonunion of these fractures regardless of the radiological findings.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Reconstructive Surgical Procedures ; methods

Objectives: The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. Methods: This community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. Results: A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. Conclusions This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage.Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.

Selected isolates of Pseudomonas fluorescens (Pf4-92 and PfRsC5) and P. aeruginosa (PaRsG18 and PaRsG27) were examined for growth promotion and induced systemic resistance against Fusarium wilt of chickpea. Significant increase in plant height was observed in Pseudomonas treated plants. However, plant growth was inhibited when isolates of Pseudomonas were used in combination with Fusarium oxysporum f. sp. ciceri (FocRs1). It was also observed that the Pseudomonas spp. was colonized in root of chickpea and significantly suppressed the disease in greenhouse condition. Rock wool bioassay technique was used to study the effect of iron availability on the induction of systemic resistance to Fusarium wilt of chickpea mediated by the Pseudomonas spp. All the isolates of Pseudomonas spp. showed greater disease control in the induced systemic resistance (ISR) bioassay when iron availability in the nutrient solution was low. High performance liquid chromatography (HPLC) analysis indicated that all the bacterial isolates produced more salicylic acid (SA) at low iron (10microM EDDHA) than high iron availability (10microFe3+ EDDHA). Except PaRsG27, all the three isolates produced more pseudobactin at low iron than high iron availability.
Biological Assay ; Chromatography, Liquid ; Cicer* ; Colon ; Fusarium* ; Iron* ; Plants ; Pseudomonas fluorescens ; Pseudomonas* ; Salicylic Acid ; Wool

Objectives: The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. Methods: This community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. Results: A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. Conclusions This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage.Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.