Introduction: Leptospirosis is zoonotic disease worldwide caused by genus Leptospira. It is characterized by non-specific clinical presentation with broad spectrum manifestations. Due to unreliable, unsophisticated diagnostic techniques, misdiagnosis is not uncommon & leads to endemic. Aims and objective: Evaluate hepatic dysfunction & correlation between CPK and other liver enzymes in Icteric & Anicteric group. Material and Methods: Total 170 subjects were examined by clinician & grouped in Icteric, Anicteric and healthy controls. Blood samples of all subjects were analyzed for Liver profile & IgM antibodies. The clinical finding includes myalgia, bilateral congectival suffusion, jaundice, abdominal cramps, albuminuria, hematuria & rashes on body were reported. Results: Male patients are more prone to Leptospira infection due to various occupational exposures. Serological tests comes positive until the second week, by that time organism implicate Liver and Renal function. Measurement of elevated CPK level and increased Faine’s score will predict early diagnosis of disease. Morbidity & mortality can be minimized at an early stage of disease. Conclusion: Outcomes of this study will help clinicians to diagnose Leptospirosis at an early phase of disease and morbidity, mortality can be minimized.

Background: Rheumatic heart disease is an inflammatory disease which predominantly affects the valvular endocardium culminating in crippling valve deformities. Inorder to find out the role of complement proteins in inducing the pathogenesis, serum analysis of complement proteins C3a, C4a, C5a, C3c and C3d and acute phase protein MBL in patients with Rheumatic heart disease were performed. Methods and Results: Blood samples were collected from twenty eight subjects who were diagnosed with Rheumatic heart disease (RHD). Same number of samples was also collected from healthy volunteers as control. The levels of the anaphylatoxins namely C3a, C4a and C5a and the acute phase protein MBL (Mannose Binding Lectin) were assessed quantitatively in the samples using Sandwich ELISA. The breakdown products of the complement protein C3b namely C3c and C3d were assessed qualitatively using western blot assay. Among the three anaphylatoxins, the C5a level and the MBL level were significantly higher in RHD subjects than the control samples. The breakdown products of C3b namely C3c and C3d were observed only in RHD patients and not in control samples. Conclusions: Significant levels of C5a and MBL noticed in blood samples of RHD subjects when compared to the healthy controls indicate that these two proteins might corroborate the chronic inflammatory activity present in these individuals and contribute to valve injury through complement activation. Along with these results, the presence of C3c and C3d only in the RHD samples and not in the controls indicates that these products of C3 complement protein may also contribute for the inflammatory pathogenesis of the disease.

The aims of this study were to measure grip force (flexion and extension force) in patients with Rheumatoid Arthritis (RA) and compare them with healthy subjects. We also wanted to explore the possible causes of impaired finger extension force with the help of ultrasound muscle analyses. The study group comprised of 20 patients with RA and 20 healthy age-matched controls. The grip force was measured and the extensor digitorum communis muscle was examined with ultrasound. The results showed significant differences in force capacity as well as differences in structural parameters and the intra muscle movements were more pronounced in the healthy subjects than in RA patients. The results show differences in structural parameters as well as functional tests, i.e. contraction time and extension muscle force capacity, between normal and RA muscles. Ultrasound and grip force measurements are useful tools for evaluation of muscle architectures and grip force after rehabilitation.

Introduction: Premenstrual syndrome is a psychoneuroendocrine disorder of unknown etiology. Even after > 80 years of its 1st description, its definition, presenting patterns , diagnostic plan and treatment modalities are surrounded by many questions and controversies. This results in a large number of studies with different criteria’s and methodologies so that their results are not comparable. Objective : To descries variability in opinions about PMS and highlight problems encountered in designing and conduct of clinical trials of various drugs in premenstrual syndrome. Method : The literature available in journals since inception of the term Premenstrual syndrome was reviewed. Variability in opinions of different workers regarding definition of PMS, days of premenstruum, diagnostic parameters was recorded and analysed. The methodological constraints in clinical trials of PMS due to lack of consensus among workers are mentioned and some corrective measures are suggested. Results : There is no consensus among workers regarding different aspects of premenstrual syndrome resulting in difficulties in designing and conduct of clinical trials in PMS. Conclusion : The authorities and organizations involved in research on PMS must frame standard guidelines for acceptable criteria and trial designs. So that comparative study of different trials becomes possible. Large multicentric trials in identical groups of population at same period of time by uniformly trained investigators are another alternative. Further research to elucidate exact etiopathogenesis and treatment guidelines is essential.

Regulation has been considered as a tool of performance improvement and an instrument of social justice. Iranian criminal legislator didn’t specify criminal policy for a clear regulatory model in Iranian medical law. Lack of clarity and stability of medical regulation in Iranian medical institutes paves the way for some institutes to commit crimes against patients' rights and make their situation even worse. As such, this is going to increase the dark number of crimes committed and to simultaneously create a safe heaven for offenders to continue committing their crimes. To make the matters worse, most of Iranian medical institutes are reluctant to abide by criminal provisions. The authors try to discuss different criminal policies for medical regulation in Iranian statutes. After introducing Iranian health system with its main three sections, the authors explain the necessity of a clear regulatory model then discuss regulating managers and personnel, clinical governance, internal and external regulatory models with legislative approaches. The authors also conclude that crimes against patients’ rights sometimes increase due to diversified regulatory models and new measures including severe criminal sanctions should be considered in Iranian Acts. Finally, the hybrid regulatory model is suggested to use as an appropriate regulatory model with the most benefits and the least disadvantages.

Use of diagnostic and therapeutic laparoscopy in infertility has been a focus of attention in recent years and demonstrated to be very effective method in evaluating these cases.. In our study, we were able to carry out therapeutic intervention in 22 cases (61.1%). It is observed that diagnostic laparoscopy is indicated in all cases of bilateral tubal anomalies and has identified important pelvic pathology in significant number of selected infertile patients even after normal findings. It is concluded that laparoscopy is useful in diagnosing cases with endometriosis and tubal factor infertility and exclusion of bilateral anatomical tubal pathology by diagnostic laparoscopy could avoid IVF treatment in these cases. The importance & scope of newer procedure like fertiloscopy along with laparoscopic evaluation is also discussed.

Use of unclaimed or donated bodies for education & research in anatomical sciences have been recognized as valuable means of cadaver by the Anatomical professionals but adequate and continuous availability of cadaver has been one of the major concerns of the stakeholders of health science institutions and biomedical research organisations in order to fulfil objectives of anatomy curriculum of the graduate, postgraduate and specialist training & research programmes in medical sciences. Deficiency of cadaver for dissection and research in medical institutions has been further deteriorated in present scenario attributed to steep increase in number of medical, dental and other health science institutions during last decade. The present paper analysed the existing sources of cadavers associated with challenges in process of procurement by the medical colleges and other health science institutions to identify the issues needs to be addressed immediately in order to ensure sustained solutions of these challenges and augment adequate cadavers supply to meet rapid rate of advancement in surgical techniques, altered pattern of structural shape, size and histology. An attempt has also been made to suggest possible sustainable solution for promoting voluntary whole body donation as well as corrective measures for optimum utilisation of unclaimed body in acceptable form from government sources for learning & research in anatomical sciences.

Purpose: Low-dose aspirin (acetylsalicylic acid; ASA) is in routine use today in preventing myocardial infarction and cardiovascular events. Fasprin® (ASA, 81 mg) is a new orally disintegrating tablet formulation of low-dose ASA (ODA) that was designed as a fast-acting, quick-dissolving solid dosage form. The purpose of this work was to (1) evaluate, comparatively, the in vitro dissolution, and (2) evaluate the absorption kinetics of ASA in healthy adults following oral administration of the ODA product. Methods: USP type II dissolution apparatus was implemented in the dissolution studies. For the pharmacokinetic studies, a single ODA dose was administered and blood samples were collected and analyzed for ASA content using a validated HPLC method. Absorption-related pharmacokinetic parameters were estimated using WinNonlin®. Results: Dissolution rate and extent of ASA from the ODA formulation were either higher than or similar to those from leading aspirin-containing products. Noncompartmental pharmacokinetic analysis of ASA plasma profiles from the ODA product revealed a lag-time of at least three minutes. The maximum concentration (Cmax) of ASA was 0.61 µg/mL and the time of Cmax (tmax) ranged from 15 - 75 minutes. The elimination rate constant of ASA was 0.0245 min-1, corresponding to a terminal t½ of 28.3 minutes. Conclusion: The ODA product demonstrated favorable dissolution compared to some leading ASA-containing products. It also provided systemic concentration of ASA at a relatively early time. While the overall absorption kinetics of the ODA product was generally comparable to those from other low-dose ASA-containing products, a direct product comparison is warranted.

The benefits of partogram and its individual components have been a debatable issue amongst the obstetricians of developed countries. There are numbers of reports conflicting WHO recommendations in the recent years. The authors of the present paper assessed the efficacy of partogram in patients of having previous caesarean birth. The present study was carried out screening of 77 patients for giving trial of labor using WHO recommended partograms to evaluate the effectivity of partogram in patients in labor with a previous LSCS and the predictability of the progress and outcome of labor. It was observed that incidence of cesarean section were reduced in 88%, demonstrating the higher efficacy of partogram.

The purpose of this study was to evaluate the regulatory role of L-alanine supplementation at high level on hepatic gluconeogenesis in rats fed on either ketogenic diet and/or biotin deficient diet. Seven groups each of eight adult male Albino rats (Sprague-Dawely) strain, mean weight varied between 105.2. to 112.7 g were fed on basal control diet (CD), biotin deficient diet (BDD), ketogenic diet (KD), and ketogenic-biotin deficient diet (KBDD). L-alanine (L-Ala) was supplemented to biotin deficient and/or ketogenic diets at a level dose 10% throughout the experimental period (35 days). Plasma and liver were analyzed for biochemical parameters. The results showed that the plasma levels of glucose, insulin, free fatty acids (FFA), total proteins and liver glycogen were decreased significantly (p<0.01) in rats fed on biotin deficient (BDD) and ketogenic diets (KD and KBDD). Plasma β-hydroxybutyrate, acetoacetate, lactate, pyruvate, total cholesterol and triacylglycerol levels were significantly increased. Supplementation of L-alanine significantly restored these values near to normal value after 35 days of the experiment. Deficiency of biotin and feeding ketogenic diets reduced the activities of glucose-6-phosphatase (Glu-6-Pase), pyruvate carboxylase (PC), and phosphoenolpyruvate carboxykinase (PEP-CK) when compared to control. Addition of L-alanine increased the activity of Glu-6-Pase when compared to BDD and KD groups. The activities of PEP-CK and PC tended to be decreased in all tested rats when compared to control. The present study concluded that, supplementation of biotin-free diet and ketogenic diet with L-alanine stimulates glucose production and regulates hepatic gluconeogenesis.

We present a clinical case report regarding the atypical resolution of a chronic conjunctivitis in young patient with recurrent pharyngitis, asymptomatic chronic prostatitis and infertility of couple, solved after treatment with local, oral and intraprostatic infiltration of massive specific antibiotic therapies. Although several infectious agents are reported causing chronic conjunctivitis, seldom this ocular disease is investigated for Chlamydia trachomatis by molecular PCR approach, in all its whole issue. The chronic conjunctivitis in a young patient represents one of the most common clinical evidences which must be investigated for infectious chlamydial pathology by PCR Chlamydia trachomatis-DNA research together at the other biological sources from different ecosystem sites of the body, but this rarely happens. Further, the couple infertility of the patient was also solved after the massive oral and intraprostatic antibiotic therapies causing a clean-up from several and large intraprostatic parenchymal fibro-calcific areas, condition due to an asymptomatic prostatitis by chronic chlamydial infection. Lastly, the patient developed a precocious reactive arthritis, being a HLA-B27 positive subject.

Selenium is a trace element that plays role in antioxidant defense mechanism via selenium dependent glutathione peroxidases (GSH-PX) and selenoproteins. When selenium is lacking, the intima of the arteries is prone to get oxidative damage and involve in development of atherosclerosis. It has been observed in clinical studies that the serum selenium levels in patients with myocardial infarction and with angina pectoris have been significantly lower than that in healthy people. In the present study we found significantly low concentration of serum selenium in acute myocardial infarction (AMI) compared with the age and sex matched healthy controls with p value less than 0.001.