iosr-JDMS   Volume-13 ~ Issue-11 ~ November-2014

Abstract: With the ever changing health care scenario demanding highest of quality care coupled with high expectations of patients to have their needs well satisfied when they visit a health care provider, there is an imminent need for every hospital to be aware of the demand and make all out efforts, to meet them, in order to remain as an active player in the field. Patients expect to be satisfied not only by the quality of health care they receive, but also fulfillment of their needs at all service areas of a health care institution where ever they require to interact. Keeping with the vision of the institution, to provide always the best of patient care to its clientele, a patient satisfaction survey in inpatients of a tertiary care teaching hospital has been carried out. Methodology adopted was to capture responses of a sample of patients, on a structured questionnaire, covering various dimensions of patient satisfaction. Patients' ratings and suggestions showed that while the quality of medical and nursing care has adequately satisfied them, the ancillary services of the hospital, such as the environment, meal service, billing and pharmacy, seemed to be wanting in meeting the desired satisfaction levels and thus rendering them the focus areas for improvement. Patient satisfaction survey is a valuable tool to measure the outcomes of quality care rendered by a health care institution. Meeting the patient needs and expectations at every service transaction, not only indicates the quality of care delivered but also is vital to the institution's reputation and its sustenance through competitive environment.

Keywords: Patient satisfaction, Patient Centered Care, Quality

[1] Morris, B. J., Jahangir, A. A., & Sethi, M. K. (2013). Patient satisfaction: an emerging health policy issue. American Academy of Orthopedic Surgeons Now, 7(6).
[2] Korda, H. Patient Satisfaction: The new rules of engagement. The Health Care Blog. http://thehealthcareblog.com/blog/2012/10/26/patient-satisfaction-the-new-rules-of-engagement/ (last access June 30, 2014).
[3] Al-Doghaither, Abdullah H., et al. "Patients' Satisfaction with primary health care centers services in Kuwait city, Kuwait." Journal of family & community medicine 8.3 (2001): 59.
[4] Arshad, Andrabi Syed, et al. "Measuring patient satisfaction: A cross sectional study to improve quality of care at a tertiary care hospital." Healthline, Journal of Indian Association of Preventive and Social Medicine 3.1 (2012): 59-62.
[5] Doyle, Cathal, Laura Lennox, and Derek Bell. "A systematic review of evidence on the links between patient experience and clinical safety and effectiveness." BMJ open 3.1 (2013).

Abstract: Genetic polymorphisms in interleukin-1 (IL-1A and IL-1B) isoforms have been associated with Chronic Periodontitis (CP) in Caucasians, Asians and Arabs but little is known about their role in Africans. Therefore, this study was to resolve the association between genetic polymorphisms in IL-1A and IL-1B isoforms and chronic periodontitis in a Kenyan community.
Methods: This was a case-control study. After informed consent, a clinical examination was conducted. Buccal swab samples were then obtained. Deoxyribonucleic acid was isolated from the swabs using QIAamp DNA purification protocol followed by polymerase chain reaction amplification using specific primers to IL-1A (loci -889 & +4845) and IL-1B (loci -511 & +3954). The amplicons were digested using Nco1, Fnu4H1, Ava1 and Taq1 respectively. Restriction fragment length polymorphisms (RFLP) were recorded. Association analyses of the RFLP and clinical data were carried out. Results: After screening 523 Swahili participants from old town Mombasa, 100 cases and 100 controls were included in the study.

Keywords: Chronic Periodontitis, IL-1 polymorphisms, Kenya, plaque, Swahili.

[1] Michalowicz B S, Diehl S R, Gunsolley J C, Sparks B S, Brooks C N, Koertge T E, Califano J V, Burmeister J A and Schenkein H A 2000 Evidence of a substantial genetic basis for risk of adult periodontitis Journal of periodontology 71 1699-707
[2] Michalowicz B S 1994 Genetic and heritable risk factors in periodontal disease Journal of periodontology 65 479-88
[3] Michalowicz B S, Aeppli D, Virag J G, Klump D G, Hinrichs J E, Segal N L, Bouchard T J, Jr. and Pihlstrom B L 1991 Periodontal findings in adult twins Journal of periodontology 62 293-9
[4] Nikolopoulos G K, Dimou N L, Hamodrakas S J and Bagos P G 2008 Cytokine gene polymorphisms in periodontal disease: a meta-analysis of 53 studies including 4178 cases and 4590 controls Journal of clinical periodontology 35 754-67
[5] Armitage G C, Wu Y, Wang H Y, Sorrell J, di Giovine F S and Duff G W 2000 Low prevalence of a periodontitis-associated interleukin-1 composite genotype in individuals of Chinese heritage Journal of periodontology 71 164-71

Abstract: Children undergoing cardiopulmonary bypass (CBP) for repair of congenital heart defects are at substantial risk for excessive bleeding due to hemodilution, hypothermia, systemic inflammatory response causing platelet dysfunction and increased fibrinolysis, contributing greatly to morbidity and mortality. The antiplasmin and antikallikrein action of aprotinin provides a significant anti-fibrinolytic and anti-inflammatory effect. Hence, it was used to decrease bleeding and the need for transfusion. Methods: Forty patients of either sex scheduled for surgical closure of either Ventricular Septal Defects (VSD) or Atrial Septal Defects (ASD) were randomly allocated into two groups. Group (A) patients received 20000 KIU/kg (Kallikrien Inhibitor Units) of aprotinin bolus after induction, 20000 KIU/kg in prime and maintenance infusion dose of 10000 KIU/kg/min till skin closure. Group (P) patients received equal volume of Ringer Lactate solution. The time interval from protamine administration to skin closure, the volume of blood loss in chest drain for initial 24 hours and the volume of blood transfused postoperatively were studied. Conclusion: For the parameters studied, reduction in the frequency and amount of blood transfusion, and reduced operative closure times remains as important benefits of aprotinin.

Key words: Aprotinin, antifibrinolytics, blood conservation

[1]. Barrons R.W., Jahr J.S. A review of post-cardiopulmonary bypass bleeding, aminocaproic acid, tranexamic acid, and Aprotinin. Am J Ther 1996;3:821-828.
[2]. Tempe DK, Virmani S: Coagulation abnormalities in patients with cyanotic heart disease. J Cardiothorac Vasc Anesth 16:752; 2002.
[3]. Charles R. Bridges Valid Comparisons of Antifibrinolytic Agents Used in Cardiac Surgery. Circulation. 2007;115:2790-2792
[4]. Brown JR, Birkmeyer NJO, O'Connor GT. Meta-analysis comparing the effectiveness and adverse outcomes of antifibrinolytic agents in cardiac surgery. Circulation. 2007;115:2801–2813.
[5]. Chauhan S, Kumar BA, Rao BH, et al: Efficacy of Aprotinin, epsilon- aminocaproic acid, or combination in cyanotic heart disease. Ann Thorac Surg 70:1308;2000.

Abstract: Fractures of limb especially the lower limb bring tough time not only for the patient but for the entire family owing to prolong immobilization and disability. Early restoration of joints motion with a stable fixation of fracture, return to normal physiological function and minimal morbidity is now regarded as ideal fracture treatment Peritrochanteric/intertrochanteric fractures are of intense interest globally. Peritrochanteric area includes part of femur from extracpasular part of neck to a point 5cm. distal to lesser trochanter. It can be divided in to Intertrochanteric Area between greater and lesser trochanter of femur and subtrochanteric area 5 cm. below lesser trochanter. Being a transition zone between neck and shaft of femur and cancellous bone, this area has different fracture characteristic. Weight bearing is also unequally distributed throughout this area. Medial comminution influence influences the fracture stability and treatment outcome. Peritrochanteric fracture can be stable or unstable depending on integrity of posteromedial cortex and pattern of fracture. Evans in 1949 described about stability of Peritrochanteric fracture, according to him in stable fracture posteromedial cortex remains intact or has minimal comminution. Unstable fracture on other hand has greater comminution of posteromedial cortex. Although they are inherently unstable these fracture can be converted in to a stable reduction if medial cortex apposition is obtained. Reverse oblique pattern of fracture is also unstable type of fracture.

[1]. Evans E. The treatment of intertrochanteric fractures of the femur. . J Bone Joint Surg Br 1949; 31:190-203.
[2]. Gulberg B, Jhonell O, Kanis J. Worldwide projection for hip fractures. Osteoporos Int 1997: 7:407-413.
[3]. Melton Lj 3rd , Kearns AE ,Atkinson EJ et al. Secular trends in hip fracture incidence and recurrence . Osteoporos Int. 2009; 20(5): 687-694.
[4]. Hagino H, Furukawa K, Fujiwara S, et al. Recent trends in incidence and lifetime risk of hip fracture in Tottori, Japan Osteoporos Int. 2009; 20(4):543-548 .
[5]. Gallgher JC, Melton LJ, Riggs BL, Bergath E. Epidemiology of the fractures of the proximal femur in Rochester, Minnesota. Clin orthop 1980; 150:163-171.

Abstract: For thousands of years, pain relief could be secured only at the expense of central nervous system depression as with the use of mandragora, wine and opium in ancient china, mandragora and poppy in ancient Egypt, Rome and Greece ,and atropine, opium, cocaine and hallucinogens by the Incas and ancient Peruvians. Subarachnoid block is defined as the temporary interruption of transmission of nerve impulses produced by the injection of local anaesthetic agents in to subarachnoid space subarachnoid block is one of oldest forms of regional block and is still a very commonly used one in our country. When given to properly selected patients subarachnoid block gives a clear advantage which is difficult to duplicate with general anaesthesia for surgical procedures below the level of the umbilicus. Advantages- Easy, Cheap, Highly reliable, Rapidity of onset, Safe

[1]. Axelsson KH, Edström HH, WidmanGB:Spinalanaesthesia with glucose-free 0.5% bupivacaine: effects of different volumes.Br J Anaesth 1984 Mar;56(3):271-8
[2]. Alexandre Faust, Roxane Fournier, Elisabeth Van Gessel, Pierre Hoffmeyer, and ZdravkoGamulin: Isobaric vs Hypobaric Spinal Bupivacaine for total hip arthroplasty in the lateral position.AnesthAnalg 2003;97:589 –94
[3]. C. O.Ogun, E. N. Kirgiz, A. Duman,S.Okesli and C. Akyurek: Comparison of intrathecal isobaric bupivacaine±morphine and ropivacaine±morphine for Caesarean delivery. British Journal of Anaesthesia2003; 90 (5): 659-64
[4]. Sergio D.Belzarena,MD: Clinical effects of intrathecally administered fentanyl in patients undergoing caeserean section. Anesthesia Analgesia 1993;74:653-7
[5]. H.Singh, J Cue, G.Gaines, A.H.Geisecke: Effect of intrathecal fentanyl on onset and duration of hyperbaric subarachnoid block. Anesthesia Analgesia 1994:78;400

Abstract: Ischemic monogenic neuropathy (IMN) reported mostly in diabetics with peripheral neuropathy or peripheral vascular disease is a rare condition .Usually seen after AV fistula for haemodialysis, it is a preventable entity. We describe a rare case of ischemic monomelic neuropathy (IMN) in a young girl with involvement of all three nerves developing after preventive tourniquet application in a presumed snake bite.

Key words: Ischemic, neuropathy, snake bite, tourniquet

[1]. Wilbourn AJ, Furlan AJ,Hulley W,Ruschhaupt W. Ischemic monomelic neuropathy. Neurology1983;33:447-451.

[2]. Natasha M. Rogers and Paul D. Lawton.Ischaemic monomelic neuropathy in a non-diabetic patient following creation of an upper limb arteriovenous fistula. Nephrol Dial Transplant.2006; 22: 933–935

[3]. Muhammad Awais, Johann Nicholas, Abdul Al-Saleh and Jules Dyer Ischaemic monomelic neuropathy (IMN) following vascular access surgery for haemodialysis: an under-recognized complication in non-diabetics .Clin Kidney J .2012; 5: 140–142

[4]. Andary, M. T. (2013, Aug 14). Ischemic Monomelic Neuropathy. Retrieved June 14, 2014,Medscape: http://emedicine.medscape.com/article/315915-overview

[5]. Payman Zamani, James Kaufman, Scott Kinlay.Ischemic steal syndrome following arm arteriovenous fistula for hemodialysis. Vascular Medicine 2009; 14: 371–376

Abstract: The objective of this study was to evaluate the Role of MRU as a single imaging modality in evaluation of Pelvi-ureteric junction obstruction. 40 patients of hydronephrosis suspected to have PUJ obstruction were enrolled for the study from May 2010 to Nov. 2012. All patients under went USG, intravenous Urography (IVU), Glomerular filtration rate (GFR) Calculation by Cockcroft-Gault formula and renal DTPA Scan for determining split renal function and GFR calculation of each kidney. MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento; Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with USG, IVU, manual GFR and Renal DTPA scan. The anatomical findings were compared with operative findings.Stastical analysis was performed and data expressed as mean ±SD. MRU GFR, DTPA GFR and manual GFR were compared by Wilcoxson Method. MRU showed morphology in 39 out of 40 patients (97.5%) and a close correlation was observed between DTPA-GFR, and MRU-GFR (P<0.0001). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace multiple investigations.

Keywords: Pelvi-ureteric junction obstruction (PUJO) MRU (Magnetic Resonance Imaging) IVU (Intravenous Urography)

[1]. SauloKlahr. Geriatric nephrology and urology 1999; 9: 101-107.
[2]. Gulmi F A, Felson D, Vaughan ED. The pathophysiology of urinary tract diseases. Campbells Urology 7th ed. 1998:342-385).
[3]. Cendron et al. 1996
[4]. Murnaghan GF. The dynamics of the renal pelvis and ureter with reference to congenital hydronephrosis. Br J Urol 1958; 30:321-24.
[5]. Hanna JK. Antenatal hydronephrosis and ureteropelvic junction obstruction: the case for early intervention. Urol 2000; 55:612-15.
[6]. Michael Grasso, III, MD, Robert P Caruso, MD, and Courtney K Phillips, MD UPJ Obstruction in the Adult Population: Are Crossing Vessels Significant? Rev Urol. 2001 Winter; 3(1): 42–51.

Abstract: Purpose: To assess whether the awareness regarding Oral Cancer, in a high risk, semi-urban, blue collared personnel, is impacted by its proximity of work with a highly educated student population. Materials and methods: A questionnaire-based survey was carried out over a period of five days in three locations across the township of Manipal, India. 578 members of the University ancillary personnel answered this survey. Result: Even though 77.9 % of the targeted group had heard about Oral Cancer before, over 90% had never been screened for it, despite working in a prominent Health Sciences University. 42.2% believed that smokeless tobacco (a habit prevalent in India) was safer than smoked tobacco and a similar percentage was unsure of alcohol's role in Oral Cancer. Most participants were not aware of how to recognize and treat the disease. Discussion: While general knowledge of the existence of Oral Cancer and its causes was common, the lack of understanding towards its risk factors, clinical features and prevention factors, is grossly worrying. Employed in a Health Science University, one would assume that such workers would undergo timely screenings. However, the survey reveals it isn't so. Conclusion: Lack of facilities and monetary support in India, has created difficulties in reaching out to different sub-groups and create awareness. However, blue collared workers that are employed in and nearby Health Care Universities are accessible for educational campaigns and free screenings by students and faculty. It is hence, suggested that such Universities take initiative in educating fellow workers.

Key words: Oral Cancer; Screening; Knowledge; Awareness; Risk factors.

[1]. Seiwert T, Jagadeeswaran R, Faoro L, Janamanchi V, Nallasura V, El Dinali M. The MET receptor tyrosine kinase is a potential novel therapeutic target for head and neck squamous cell carcinoma. Cancer research. 2009; 69(7), 3021-3031.

[2]. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral oncology. 2009; 45(4), 309-316.

[3]. Bhalwar R. 209 General Principles & Practice of Healthy Lifestyle.

[4]. Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme. Community Dentistry and oral epidemiology. 2003; 31(s1), 3-24.
[5]. Agarwal M, Pandas S, Jain S, Maitin S. Oral Cancer Awareness of the General Public in Gorakhpur City, India. Asia Pacific J Cancer Prev. 2012; 13(10), 5195-5199.

Abstract: Acquired Immune Deficiency Syndrome (AIDS) remains a public health problem of major significance in most parts of the world. The first HIV infection was detected in 1988 in Nepal. Since then HIV and AIDS epidemic has evolved from low to concentrated among "High risk groups" i.e. Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men having Sex with Men (MSM) and Seasonal labor Migrants. The objective of this study was to find out knowledge, attitude on HIV-AIDS among the respondents and assess the types of behavior that places them at risk of contracting HIV_AIDS in Jhapa district of Nepal. This was the cross sectional descriptive study carried out among High risk behavior group (FSWs, and Clients of FSWs) who come for treatment at VCT centre of Jhapa district. Multi stage purposive and random sampling was adopted and data were collected using a pre-tested interview schedule. Maximum no. of respondents (98.9 %) had heard about HIV and (100.0 %) had heard about AIDS, (100.0 %) using condom, among which (82.2%) used consistently. About half of the respondents (50.1%) had thought that they have chances of contracting HIV/AIDS. Sex at an early age was the prevalent practice among the study population as (46.6%) of them reported to have initiated before the age of 15 years. As the age at first sex increases RTI problems decreases (p=0.018) and vice versa. Less than half of the respondents (71.2%) had used alcohol during sexual activity, among which, (59.6%) had neglected to use condom. Knowledge about HIV-AIDS and condom was high. More than half of the respondent perceived their high risk to HIV/AIDS infection, judging from their present sexual behavior. The frequency of condom use was unsatisfactory (82.2%). Alcohol use and negligence to use condom during sexual activity was high.

Key words: knowledge, attitude and practice

[1]. Alene G.D. (2002). Knowledge and practice of condom in preventing HIV/AIDS infection among commercial sex workers in three small towns of northwestern Ethiopia. Ethiopia Journal of Health Development.16 (3):pp.277-286
[2]. Barrientos J. E., Bozon M., Ortiz E. and Arredondo A. (2007). HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile. Cad. Saúde Pública, Rio de Janeiro, 23(8):1777-1784.
[3]. Begum S., Mallick P.S., and Kelly R.J. (2004). Reducing the HIV vulnerability of Female Sex Workers (FSWs) in Bangladesh: Reality or Rhetoric. FHI (Family Health International), Dhaka, Bangladesh.
[4]. Bhatta D.N. (2014). HIV-related sexual risk behaviors among male-to-female transgender people in Nepal. International Journal of Infectious Diseases, Volume.22, pp. 11-15.
[5]. Bhatta P, Thapa S, Neupane S, Baker J, and Friedman M. (1994). Commercial Sex Workers in Kathmandu Valley: Profile and Prevalence of Sexually Transmitted Diseases. JNMA (Journal of Nepal Medical Association); 32:192-203

Abstract: Oral cancers are one of the leading cancers in the world.However ,in India,it is one of the most common cancer and a major public health problem.The purpose of this study was to evaluate retrospectively the demographics,histopathological and clinical profile of patients with oral cancer reported at a tertiary level referral hospital in Central India.A total of 908 biopsy proven OSCC cases were retrospectively analyzed and data was collected for a period of 7 years from January 2007 to December 2013 with reference to age,sex,site involved,habits,TNM staging and final diagnosis based on histopathological findings and the results were formulated to chart the trends in central India population.Male to female ratio was 2.54 : 1. Most of the patients of OSCC were in the age group of 51-60 years ( 28.52%) .The most common site of presentation of primary tumor was mandibular alveolus region.Tobacco chewing along with smoking was the major cause for the development of OSCC(25.66%).Majority of the patients were presented in Stage IV (45.94%) and histopathologically well differentiated squamous cell carcinoma(54.95%) was the most common presentation.This study showed that OSCC is wide spread in the patients of this region and most of the cases report at advanced stages of the disease due to lack of awareness among the common masses.To decrease the morbidity and mortality associated with OSCC ,early detection of localized lesions combined with appropriate treatment is required.
Keywords: Biopsy,Mandibular Alveolus, Oral Cancer ,Squamous cell Carcinoma,Tobacco,.

[1] Mehrotra R, Pandya S, Chaudhari A,et al,Prevalence of oral premalignant and malignant lesions at a tertiary level hospital in
Allahbad , India. Asian Pacific J Cancer Prev 2008;9:263-266.
[2] Bagan JV, Scully C. Recent advances in Oral Oncology 2007: Epidemiology, aetiopathogenesis, diagnosis and prognostication.
Oral Oncol 2008;44:103-8
[3] Muir C, Weiland L. Upper aerodigestive tract cancers. Cancer 1995;75:147-53.
[4] Warnakulasuriya S. Causes of oral cancer-an appraisal of controversies. Br Dent J 2009;207:471-5.
[5] Morelatto RA, Herrera MC, Fernández EN, Corball AG, López de Blanc SA. Diagnostic delay of oral squamous cell carcinoma in
two diagnosis centers in Córdoba Argentina. J Oral Pathol Med 2007;36:405-8.

Abstract: The study determined the availability of visual inspection with acetic-acid requirements for cervical cancer screening in secondary health care institutions of Kaduna state. A cross-sectional descriptive survey was used for the study. The study population comprises all nurses, midwives, and nurse-midwives working in all the secondary healthcare institutions of the state. The sample size used for the study was 300 using the Yamane sample size selection formula. The technique involved was stratified sampling method whereby the three existing senatorial zones served as strata. Each of the stratum was clustered according to the existing local government areas. A purposive sampling was further used to select nine local governments, three from each senatorial zone that have secondary health care institutions. A proportionate sampling was used to distribute questionnaire copies to the health workers. The instrument used for data collection was a questionnaire which has been modified to four point likert scale. Three hundred (300) questionnaire copies were administered out of which (297) were retrieved. The data collected was analyzed using one way analysis of variance (ANOVA) at 0.05 level of confidence to answer the hypotheses. A post-hoc scheffe test was further used to determine were th differences are. Findings from the study shows that VIA requirements are not available in the secondary health care institutions for cervical cancer screening with an aggregate mean score of (2.1458). There is a significant difference among the secondary health care institutions in the availability of VIA requirements to screen for cervical cancer in Kaduna state where (P<0.05). It is therefore recommended that the hospital management board should make provision of VIA requirements so that they can be available in the institutions for VIA
screening services.
Key words: Availability, Visual Inspection, Acetic- acid, Requirements, Secondary healthcare institutions.

[1]. Alliance for Cervical Cancer Prevention (2004a). Planning and implementing cervical cancer prevention and control programs. A
manual for Managers settle.(2004)pp 20-23.
[2]. Dim,C.C.(2012).Improving cervical screening in Nigeria; A review of the basics of neoplasm and cytology practice. Nigerian
journal of clinical practice. Volume 15(3) pp 247-252. Available at http:// www.njcp online.com/text.asp? retrieved on 5/3/2013
[3]. Evaluation of Cervical cancer in Nigeria (2013). Oxbridge writers, brand of all answers ltd. No 4964706.VAT NO:842417633.
Available at http://www.oxbridge writers. Com/essays/health/evaluation-of-cervical-cancer-in-nigeria.php# ixZZ2QFFdY61Y
[4]. Ferlay,J., Bray, F., Pisani,P., and Parklin, D. M.(2013). Cancer incidence, mortality and prevalence worldwide. GLOBACOM,IARC
Cancer Base No.5 Version 2.0, Lyon, IARC Press
[5]. Gaffikin L., Mcgrath J., Arbyn M., and Blumenthal P.D (2007). Visual inspection with acetic acid as a cervical cancer test; accuracy
validated using latent class analysis. BMC medical research methodology (2007) (vol) 10, pp 7-36.

Abstract: Abnormal uterine bleeding is the commonest presenting symptom and major gynecological problem responsible for as many as one-third of all out patient gynecologic visit.1,2 The endometrium which lines the uterine cavity is one of the most dynamic tissues in the human body. It is characterized by cyclic processes of cell proliferation, differentiation and death in response to sex steroids elaborated in the ovary.3 Menorrhagia affects 10-30% of menstruating women at any one time, and may occur at some time during the perimenopause in upto 50% of women.4 Abnormal uterine bleeding is defined as any bleeding pattern that differs in the frequency, duration and amount from a pattern observed during a normal menstrual cycle or menopause. It is a common problem having a long list of causes in different age groups.5 The prevalence of abnormal uterine bleeding in reproductive age group ranges from 9% to 30%.6

...............................................................!

Abstract: Purpose: The purpose of the study is identify and characterizes different species of dermatophytes from 300 clinically defined cases of ring worm infections. Based upon their morphological features studied by microscopic, culture and biochemical techniques and comparison of Sabouraud dextrose agar (SDA) and Dermatophyte test medium (DTM) for the primary isolation of dermatophytes from the clinical samples. Method: About 300 samples were collected under sterile precautions and observed under microscopy for fungal elements. The culture was done in SDA and DTM and dermatophytes characterization were done by slide culture, bromocresol purple agar, urease test and hair perforation test. Results: Out of 300 samples, 129(43%) were positive for dermatophytes with majority being Trichophyton mentagrophytes(38.75%) followed by Trichophyton rubrum (27.13%). Various species were isolated from skin, hair and nail samples. There was no statistically significant difference between the SDA and DTM (p< 0.01) in primary isolation of dermatophytes. Conclusion: With the increasing incidence of severe dermatophytic fungal infections has increased significantly in immunocompetant and also in immunocompromised, there arises a need for effective and rapid diagnosis of such infections.
Keywords: Dermatophytes, SDA and DTM, BCP

[1]. Rippon JW. 3rd edn. Philadelphia: Saunders; 1988. Medical Mycology: The pathogenic Fungi and the Pathogenic Actinomycetes ; 1988; pp. 140–275.
[2]. Burzykowski, T, Molenberghs G, Abeck D, et al.High prevalence of foot diseases in Europe: results of the Achilles Project. Mycoses. 2003; 46: 496–505.
[3]. Robert R, Pihet M. Conventional Methods for the Diagnosis of Dermatophytosis Mycopathologia 2008; 166:295–306.
[4]. Singh S, Beena PM. Comparative study of different microscopic techniques and culture media for the isolation of dermatophytes. Ind J Med Microbiol. 2003; 21(1):21-24.

[5]. K. J. Kwon-Chung and J. E. Bennett Dermatophytoses. In: Kwon-Chung K J, Bennett J E, editors. Medical mycology, Philadelphia,Pa: Lea & Febiger; 1992. pp. 105-161.