Background: Oxidative stress and inflammation leads to, generation and overproduction of the reactive oxygen species and reactive nitrogen species and hence are responsible for many diseases such as Alzheimer's disease, Parkinson's disease, diabetes mellitus, rheumatoid arthritis, and neurodegenerative motor neuron diseases. Antioxidants are found in varying amounts in vegetables, fruits, grain cereals, eggs, meat, legumes and nuts. However, there is always a search for antioxidants that can quench and breakup the chain of generation of free-radicals. Aims: Astaxanthin, a ketocarotenoid, has exceptional antioxidant activity and hence can be used for prevention of cardiovascular diseases, inflammatory and neurodegenerative diseases, boosting of the immune system, anti-Helicobacter pylori activity, and cataract prevention. Hence, an attempt has performed in this review to compile data on astaxanthin and its several diverse applications over the last decade with an aim to escalate the intense interest in undertaking new research on this natural fascinating molecule. Materials and Methods: A literature search using astaxanthin and antioxidants as keywords using Google as the search engine was done and the data obtained were compiled and presented. Results and Conclusions: Astaxanthin can be a great supplement for everyone in enhancing immunity, preventing a myriad of diseases in our hectic lifestyle by providing more energy, reducing oxidative damage, producing clarity of vision as well as protection from the harmful ultraviolet rays of the sun! Further the immunomodulatory, antioxidative, and antiinflammatory activity of astaxanthin a bioactive natural supernutrient carotenoid may be very important to human health in treating many such untreatable diseases.

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Background: Functional status can be conceptualized as an individual's ability to manage activities related to personal self-care and self-maintenance. Functional status assessment is fundamental aspect of geriatric examination. This assessment helps clinicians and policymakers to design and implement interventions that help elderly to live safely and independently. Aims and Objectives: The primary aim was to assess the prevalence of limitation in activities of daily living (ADL) and instrumental ADL (IADL) among elderly population. The secondary aim was to identify the factors that predict IADL limitation among them. Materials and Methods: A total of 400 community dwelling elderly persons residing in Shimla hills of North India were interviewed using valid and reliable functional assessment scales namely Katz ADL and Lawton and Brody IADL. Statistical procedures for the analyses included descriptive statistics and logistic regression. Results: The prevalence of ADL and IADL activity limitation was 5.5% (22/400) and 21.8% (87/400), respectively. The results of logistic regression analysis revealed that advancing age (70 years and above), poor self-rated health and ailments namely musculoskeletal problems and cataract significantly predict functional limitation. Conclusions and Recommendation: Elderly having musculoskeletal problems should be provided with rehabilitative support in the community settings. Cataract surgeries patients should be identified and operated upon so as to improve visual functioning and thus their functional ability. Further, cities, towns, and rural areas should be made age-friendly.

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Background: School health has been acknowledged as important since the beginning of 20 ^th century. Nutritional status is a major component of school health services. This study was undertaken to assess the nutritional status of government and private primary school children of Mysore city. Materials and Methods: Cross-sectional study design was adopted. One private and one government school were selected using multistage stratified random sampling method. A total of 1566 school children aged 6-12 years were measured for height and weight. Data on demographic details, dietary habits, and physical activity of child and education status, occupation, monthly income of their parents were collected. Results: Of 1566 children, 385 (24.5%) were underweight, 132 (8.4%) were overweight, and 65 (4.1%) were obese. Majority of underweight children 226 (32.5%) were found in government school. Except for two overweight children in government school, all overweight and obese children were found in private schools. Socioeconomic status, dietary habits, and physical activity of the child were found to be the determinants of their nutritional status. Conclusion: This study attempt to highlight the dual nutritional problem, under-nutrition among the lower socioeconomic class on one hand and growing epidemic of obesity among the affluent on the other.

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Xanthogranulomatous inflammation is an uncommon form of chronic inflammation in which the affected organ is destroyed and is replaced by large number of lipid - containing macrophages with an admixture of lymphocytes, plasma cells and multinucleated giant cells. The most commonly affected organs are the kidney and gall bladder, followed by anorectal area, bone, stomach, and testis. The inflammation most often affects the endometrium in the female genital tract, but involvement of the vagina, cervix, fallopian tube, and ovary may also occur. Only a few cases involving the ovary have been reported. We report a case of xanthogranulomatous infection of ovary in a 40-year-old female who presented with abdominal pain and bleeding per vaginum. Her clinical examination, radiological evaluation, surgical findings and gross features were likely to be mistaken for malignancy if xanthogranulomatous inflammation was missed as a differential diagnosis.

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Tuberculosis (TB) is known to involve any part of the body. Intestinal TB accounts for the majority of extrapulmonary TB, ileocecal region is the most common site with involvement of the sigmoid colon a rare occurrence. TB has been known to be associated with various types of malignancy. The most common association is malignancy and pulmonary TB. However, association of extra pulmonary TB and malignancy at the same site is relatively uncommon and cases of colonic TB associated with mucinous adenocarcinoma are extremely rare. Involvement of sigmoid colon is even rarer and to the best our knowledge, the present case is the first reported case from India of coexistent adenocarcinoma and TB in the sigmoid colon. We report here an interesting case of coexistent colonic TB and malignancy in a 23-year-old female presenting to the emergency room with features of intestinal obstruction.

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Context: Musculoskeletal disorders (MSDs) are a significant concern for health care professionals due to the nature of work that exposes them to injuries. Aims: The aim was to assess the prevalence of MSDs among doctors. Settings and Design: Cross-sectional survey among doctors working in Mangalore. Materials and Methods: Self-administered questionnaires distributed among medical specialties professionals of two major hospitals (Government Wenlock Hospital and Kasturba Medical College Hospital) of Mangalore. Statistical Analysis Used: Descriptive analysis and Chi-square test (P < 0.05 with 95% confidence interval). Results: Lower back (25%), neck (20.21%), and knees (14.36%) were the common MSDs among doctors in different specialties. MSDs association with respect to age, gender, and work experiences were nonsignificant, except physical activity (P = 0.042). Conclusions: About 58.5% doctors reported MSDs and lower back disorders were most common.

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Listeriosis is a zoonotic infection seen normally in herd animals. Humans can be infected by consumption of raw meat, fish, milk, vegetables or canned refrigerated foods. There are many reports of listeriosis in pregnant females, neonates and immune-compromised individuals. However, due to limited clinical suspicion in India, only a few cases has been reported, most of them in neonates. We report here a case of Listeria meningitis in an elderly alcoholic male who was treated successfully with ampicillin and vancomycin.

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Facial mucormycosis is a known complication in patients with immunological or metabolic compromise. Mainstay of treatment includes reversal of the compromised state, systemic antifungals and repeated radical debridements. The resultant deformity following debridement causes gross morbidity and psycho-social embarrassment. Surgical reconstruction is difficult on account of co-morbid diseases. Nonsurgical prosthetic rehabilitation gives fairly accurate correction in these patients. We report a case of a 62-year-old male diabetic with facial mucormycosis where debridement resulted in a gross morbid defect. However, effective rehabilitation was achieved using extraoral prosthesis.

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Background: Chronic diseases are becoming major health problems in India including the rural population. Non Communicable Diseases (NCDs) are increasingly becoming a disease of poor and younger segments of the population. Methods: A cross sectional study was carried out among 2112 participants through our fixed mobile clinic among 30 villages to assess the risk factors for lifestyle diseases in a rural block in Tamil Nadu. Results: The proportion of study population smoking and being alcoholic was 5.7% each. More men (15.2%) smoked as compared to women (0.9%). More than half of the study population was overweight. About 19.3% had a systolic blood pressure of more than 140 mm hg and 14.8% had diastolic blood pressure of more than 90 mm hg. On an average, fruits were consumed on 2.92 days/week. Conclusion: Sound community based comprehensive behavioral and life style intervention approach should be established to reduce the modifiable risk factors of CVD.

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A 27-year-old female with 6 months amenorrhea and pregnancy induced hypertension was referred from Obstetrics Department for routine fundus examination. Vision and anterior segment were normal. Fundus examination showed media clear and disc normal. Vessels showed yellowish orange in color, becoming more paler toward periphery and no distinction between arteries and veins. On suspecting lipemia retinalis, we advised lipid profile, which showed very high triglyceride levels. The patient was referred to endocrinologist for opinion. Even if it is asymptomatic condition, it should not be ignored and we should advise immediate treatment to prevent cardiovascular complications and fetal anomalies.

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Background and Objectives: The menstrual cycle is much more than a cycle of periods. Gonadal hormones influence the cardiovascular system both directly and indirectly. Ventricular arrhythmias are more common in women and seem to exhibit variation in accordance with the menstrual cycle. There are contradictory hypotheses regarding the influence of the menstrual cycle on the QT and QT _c intervals of electrocardiogram (ECG). This study is an attempt to evaluate the effect of different phases of the menstrual cycle on the QT and QT _c intervals of ECG. Materials and Methods: A total of 30 healthy female students, who were aged 18-22 years and had regular menstrual cycles over past 6 months, were included in the study. All the subjects were monitored on three separate occasions during two consecutive menstrual cycles. ECG was recorded for 5 min in Lead-II using ADInstruments PowerLab, once during every phase. The computerized recordings of heart rate (HR), QT and QT _c intervals thus obtained were analyzed statistically using repeated measures ANOVA, at P < 0.05 to assess if any significant difference existed in these parameters during the different phases of the menstrual cycle. Results: This study showed the HR was highest in the luteal phase when compared with the follicular and menstrual phases, while the QT and QT _c intervals were prolonged in the follicular phase of the cycle in comparison to the other two phases. The differences in both QT and QT _c intervals between the phases were statistically significant. Conclusion: This study showed prolonged QT and QT _c intervals during the follicular phase, which maybe aggravated in individuals on concurrent treatment with drugs that may further increase the QT _c interval. This would increase the predisposition of developing potentially fatal arrhythmia in such women. Hence, such drugs must be prescribed with caution.

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Background: Memory impairment is the major adverse effects associated with antiepileptic drug therapy. This study was designed to assess the memory impairment activity of zonisamide (ZNS), an antiepileptic drug, in mice. Memory deficit potential of ZNS was compared with phenytoin (PHT), a standard antiepileptic known for its memory impairment activity. The protective effect of Ocimum sanctum extract (OS) and piracetam (PIR) on memory impairment induced by ZNS was also assessed. Materials and Methods: ZNS was administered orally for 29 days and the extent of memory deficit was evaluated by Morris water maze (MWM) test on maximal electro shock-induced epileptic mice. The animals were observed for escape latency time (ELT) and time spent in target quadrant (TSTQ) on MWM test. The brain acetylcholinesterase level was estimated to determine the brain acetylcholine concentration. Result: Chronic administration of ZNS has shown memory deficit in mice and this was significantly restored by co-administration of OS extract and PIR. PIR showed best nootropic activity, whereas OS showed good nootropic as well as synergistic anti-convulsant activity. Conclusion: This study reveals that chronic administration of ZNS produces memory impairment in mice, which can be significantly minimized by co-administration of OS extract and PIR without compromising on ZNS antiepileptic potency. These results provide evidence for potential corrective effect of nootropics in cognitive deficit associated with ZNS.

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Introduction: The study is a clinical trial done on patients with inguinal hernia, who were treated by open preperitoneal sutureless mesh repair, using inferior epigastric vessel complex as landmark. Aim: To study the postoperative complications and recurrence rates associated with the open preperitoneal sutureless mesh repair. Materials and Methods: Total 100 patients of inguinal hernia were recruited in this clinical trial from January 2009 to December 2012. Those with bilateral inguinal hernia or recurrent hernias were excluded from the study. Results: The average time taken to complete the surgery was 42.2 minutes and the average hospital stay was 2.5 days. Post-surgery, at a median follow-up period of 2 years, only 2 patients had seroma formation. Visual analog scale pain scores of 4 and 6 were seen in 60% and 40% cases, respectively. No recurrences were encountered post-surgery in any of the case till the last follow-up. Conclusion: This procedure was found to have fewer complications and was less time-consuming as compared to the other conventional open hernia repairs.

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Background: Thyroid abscess is a rare clinical entity and infrequently encountered. We hereby present a review of 11 adult age group patients who presented to our hospital, which is a tertiary care referral center with thyroid abscess and the management being incision and drainage of abscess. Aims and Objective: In this paper, we have studied the association of acute suppurative thyroiditis (AST) with diabetes mellitus (DM), its early diagnosis and management. Materials and Methods: All the suspected AST cases were admitted to endocrine surgical unit of S.C.B Medical College and Hospital, Cuttack, India and studied prospectively. Thorough history taking and physical examination were done. All blood counts, serology and thyroid function were done. Plain radiograph, ultrasonography, computed tomography scan, magnetic resonance imaging of the neck were done as per the requirement. Indirect laryngoscopy was done as a routine procedure. Diagnostic aspiration was done in every case followed by incision and drainage. Results: We report our observations from the 11 cases of AST being managed in endocrine surgical unit. All the patients were of female sex and their age ranging from 27 to 65 years. Each of them had a pre-existing goiter of duration from 1 to 7 years. Staphylococcus aureus (nine cases) was the most common pathogen followed by Escherichia coli (two cases). Proper antibiotics as per culture sensitivity (cefuroxime, amikacin), control of diabetes with insulin, daily copious irrigation of the wound with normal saline healed all these abscesses. They were discharged from the hospital after full resolution of the infection and underwent thyroidectomy at a later date. Conclusion: Type-2 DM is rapidly emerging as a public health problem in South East Asia particularly in India leading to a wide variety of infectious complications in different anatomic locations. It is the single most important cause of AST in our population. Early recognition and prompt institution of surgical and endocrinological management by a multidisciplinary team is required and hence diabetic patients with pre-existing goiter should be recommended for planned thyroidectomy at an early date to reduce its complication. S. aureus is the most common pathogen followed by E. coli in our study group.

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