041951   IHSAN T, EDWIN T, AZWIR Y, DEROSYA V (Environmental Engineering Dep, Andalas Univ, West Sumatra, Indonesia, Email: taufiqihsan@eng.unand.ac.id) : Fatigue analysis to evaluate workloads in production area at crumb rubber factories of Padang city, West Sumatra Indonesia. Indian J Occup Environ Med 2020, 24(3), 148-52.

Work fatigue had the potential to cause work accidents that had an impact on losses to the company. This study aimed to analyze the level of subjective‑work fatigue and evaluated the effect of workload on fatigue in the production area at The Crumb Rubber Factories of Padang City, West Sumatra, Indonesia. The research respondents were all workers in the production area in the three largest crumb rubber factories in Padang, totaling 348 workers. The respondents consisted of 135 workers in the wet division and 213 workers in the dry division. Subjective fatigue analysis uses the Industrial Fatigue Research Committee (IFRC) questionnaire method. Measures workload based on Indonesian Standards No. 7269 of 2009 concerning Workload Assessment based on Calorie Level according to Energy Expenditures. The percentage of work fatigue in the production area was 26.32 % light level, 72.63 % medium level, and 1.05 % heavy level. The workload had a significant effect on work fatigue, with a P value of 0.003. On the basis of the results of multiple regression analysis of all the variable characteristics of the respondents and work area, the most influential factor affecting the occurrence of fatigue in a crumb rubber factory was the workload. All crumb rubber factories in Padang should make improvements related to workload in controlling work fatigue.

3 illus, 4 tables, 20 ref

046748   HAMADA T A, ABDULKREEM R S, YOUNUS H M (Tikrit Univ, Tikrit, Iraq) : Efficiency of Aspergillus species to produce the lipase enzyme from various types of oil seeds. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194425.

Filamentous fungi can easily degrade agroindustrial wastes in solid- state fermentation processes synthesizing many important commercial biocompounds such as lipolytic enzymes. Lipases have various applications in industry so the aim of this study to evaluate the effect of the composition of the solid culture medium on the production of lipolytic enzymes by various species of Aspergillus, so in this study we use different types of of oil seeds to isolate different species of Aspergillus and study their effect on production of lipase enzyme by using of this different seeds as a substrate for culturing of this fungi and in this study Aspergillus niger that are isolated from pistacia vera seeds is more efficient for production of the lipase enzyme.

1 illus, 1 table, 14 ref

045474   VIJAYANATH V, ANITHA M R (Forensic Medicine Dep, ESIC Medical Coll & PGIMSR, Bengaluru, Karnataka, Email: dranithamr167@gmail.com) : Psychosis in alcohol addicts. J Indian Acad Forensic Med 2020, 42(2), 133-6.

Psychosis is the commonly reported psychiatric condition in the psychiatry department. With the social and some traditional ways of treating this psychosis is by consuming alcohol. But many of them are not aware that alcohol itself can take them into psychotic conditions. To make the differentiation between the real psychosis patient and those who are victim of psychosis by consuming alcohol in heavy quantity. The study is to know the possibility of alcohol induced psychosis reporting without really knowing the fact that alcohol can also induce psychosis. This was a clinic-based cross-sectional descriptive study. The study consisted of 1000 alcoholdependent patients. The main aim of the study was to find out the prevalence of alcohol-induced psychosis in society among the alcohol users. The mean age of the sample was 30.74 years and the majority of the patients were below 40 years. The majority of the patients were males (92 %), married (88 %), Hindus (92 %). The majority were from below class II socioeconomic class as per the classification by Prasad. About 68 % of patients initiated the consumption of alcohol between the age group of 30-40 years. About 52 % were consuming alcohol for a period between 10-20 years. Female alcoholics had later age initiation of alcohol consumption, long duration of alcohol consumption and longer years consumption prior to becoming alcohol dependent. Alcohol-induced psychosis was present in 37 % of patients. The age at initiation of alcohol consumption, the duration of consumption, and the duration of consumption prior to becoming dependent did not have any bearing on the onset of alcohol-induced psychosis.

4 tables, 12 ref

046747   JASSIM S D, WITWIT L J, ABOOD F M (Periodontology Dep, Babylon Univ, Babylon, Iraq, Email: suradak85@yahoo.com) : High levels of tumor necrosis factor-alpha and interferon gamma in patients with gingival recession. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194424.

Gingival recession considers as a common condition that associated with transposition of the margin of the gingiva in to the position apical to the cemento-enamel junction which consequently result in an exposure of the root . Inflammatory biomarker including interferon-gamma and tumor necrosis factoralpha associated with a significant role in periodontal tissue destruction . The main goals of current study were to compare the levels of interferon-gamma and tumor necrosis factor-alpha in patients with different degree of gingival recession and control participants. Blood samples taken from twenty four male participants and they grouped in to three groups as: group 1 (8 control subjects) , group 2 (8 patients with class 1 and 2 gingival recession ) and group 3 (8 patients with class 3 and 4 gingival recession). Enzyme-linked Immunosorbent Assay was utilized to evaluate tumor necrosis factor-alpha and interferon-gamma levels. The levels of both biomarkers were greater in group 3 than group 1 and group 2 as well as group 2 had higher levels of these biomarkers than group 1. : Interferon-gamma and tumor necrosis factor-alpha could reflect periodontal destruction in patients with gingival recession.

2 illus, 1 table, 46 ref

046746   KADHEM Q I, AL-HUMAIRI A K, HUSSAIN A M (Family and Community Dep, Babylon Univ, Babylon, Iraq) : Comparative assessment of patients’ satisfaction in secondary and tertiary outpatients of Marjan Medical City in Babil across sectional study. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194423.

Patient satisfaction is a basic measure by it the value of health care facilities is assessed. It a personal assessment of the service received and the person’s prospects. This study would have significant input in assessing the level of patients’satisfaction in secondary and tertiary outpatient health care services. A cross-sectional study of 300 patients random sample visit outpatients of Marjan medical city the interview was conducted at general and specialist outpatient only. The specialist outpatients include cardiac, gastrology, nephrology and diabetology outpatient. 150 patients from secondary outpatient &150patients from tertiary outpatient. The purpose of study was to assessing the level of patients’satisfaction in secondary and tertiary outpatient health care services. Majority of patients visit general and specialist outpatients with age 31-50 (45.5 %,46 %), female (57.3 %, 62.75), low income patients 5 km (77 %,79 %), the majority of patients were not satisfied with health services produced to them (53 %, 63 %). Showed no. of patients not satisfied health services more than patients satisfied, majority of patients with low income and just primary level of education, the majority of patients came to outpatients from rural area these data for both secondary and tertiary outpatient. Patients with bad satisfaction are18-50 years, self-referral to tertiary outpatient, not satisfaction also in urban patients.

2 tables, 22 ref

045473   KUMARI S, RATHORE S, SINGH M , RUPANI R , VERMA A , RANJAN R, SINGH R , SINGH R (Forensic Medicine and Toxicology Dep, KGMU, Lucknow, Uttar Pradesh, Email: rajarupani68@gmail.com) : The pattern of unnatural female deaths in Lucknow district – A post mortem study. J Indian Acad Forensic Med 2020, 42(2), 130-2.

Uttar Pradesh has topped the list with 56,011 cases of crime against a woman in 2017, this includes murder, rape, dowry death, suicide, abatement etc. A steady increase in the number of road traffic accidents, accidental burns, poisoning, drowning, electrocution, as well as increase in crime &domestic violence against females or dowry deaths has also been observed in last few decades. So the aim of our study was to study and compare the pattern of unnatural deaths in female autopsy cases brought in the mortuary of KGMU, Lucknow from year November 2017 to October 2018 and November 2018 to October 2019. A total 2,437 female autopsy cases with 1239 cases in Year 1 and 1198 cases in Year 2, was brought. Parameters such as age, religion, region (rural or urban), seasonal variation and cause of death were analyzed. The results in our study showed that out of total 10,458 cases, 2,437 (23.30 %) were female deaths. Majority of females deaths were from rural areas. The most common age group affected in both years was 21-30 years with 422 (34.06 %) cases in Year 1 & 425 (35.48 %) cases in Year 2. There was no specific seasonal variation. The deceased females were mostly Hindus followed by Muslims. Most common unnatural causes of death was seen to be due be blunt trauma, followed by burn, and asphyxial deaths, and the most common age group involved was 21-30 years, which suggest that drastic measures and strengthening of on-going means, like road safety measures, safe cooking, awareness and education of female child about sex and sex related offences are still needed at large.

6 tables, 6 ref

041947   MOHAMMADY M J, SEDIGHI A, KHALEGHDOOST T, NEJAD E K, JAVADI-PASHAKI N (Guilan Univ of Medical Sciences (GUMS), Rasht, Iran, Email: n.javadip@gmail.com) : Impacts of occupational cognitive failure and subjective workload on patient safety incidents among intensive care units nurses. Indian J Occup Environ Med 2020, 24(2), 96-101.

Life-saving treatments and high-quality care techniques increase the opportunity for patient safety incidents in Intensive care unit. This descriptive correlation study aimed to determine the impacts of occupational cognitive failure and subjective workload on patient safety incidents among intensive care units nurses. One hundred seventy-six nurses working in intensive care units were included using census sampling. The data collection tools consisted of demographic and occupational data, standard questionnaires of subjective workload (NASA-TLX) and occupational cognitive failure (OCFQ), and a question about frequency of patient safety incidents. Data analysis was performed using Mann–Whitney and Kruskal–Wallis, Spearman rank correlation coefficient, and logistic regression tests. Occupational cognitive failure (OR = 1.043), subjective workload in dimension of “performance” (OR = 0.982), age (OR = 0.947), and gender (OR = 3.726) were important predictive variables of patient safety incidents. Nursing mangers and policymakers can consider the factors identified for staffing nurses and development of patient safety programs.

4 tables, 29 ref

046745   ASSI M A (Community Health Dep, Al-Furat Al-Awsat Technical Univ, Najaf- 54003, Iraq, Email: razaq_assi@yahoo.com ) : Estimation of Serum Cystatin-C as early marker of kidney dysfunction in correlation with Serum Ferritin among β-Thalassemia major patients. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194422.

The Cystatin C is early predictor for evaluation the kidney functions. The Serum Cystatin C is a cysteine proteinase inhibitor, that the nucleated cells produce it at stable rate. It is filtered through the glomerular filtration membranes of kidneys, and the filtration rate will be unaffected by external factors. A group of recessively inherited hemoglobin disorders called Major Beta-thalassemia and considered the most common genetic disorder all over the world, which could be noticed by the reduction in of β-globin chain synthesis. To study Serum Cystatin-C estimation as early marker of renal function in relation with other parameters in beta thalassemia patients. A case-control study was executed on thalassemia patients between February and April 2019 at Al-Zahra’a Teaching Hospital in Najaf/Iraq. The results in this study showed there are significant differences (p< 0.05) between major beta thalassemia patients and control group in regarding to hematological parameters. The result of biochemical parameters showed there are variations between patients and control where there were significant statistical increases in our thalassemic patients comparing to the control about Cystatin-C (1.27 ± 0.33and 0.7 ± 0.24 ng\ ml respectively). The cystatin –C is useful marker at major beta thalassemia patients that suffering from renal dysfunction.

3 illus, 2 tables, 20 ref

045472   MADDILETI B, YAMINI K, INFANT RAJ A , KUMAR V, RAJENDRA KUMAR R (Forensic Medicine Dep, Trichy SRM Medical Coll Hospital and Research Centre, Irungalur, Trichy, Email: drbala44@gmail.com) : Medico legal study of female burn victims: A circumstantial context. J Indian Acad Forensic Med 2020, 42(2), 127-9.

Female burns are the burning problem of Indian society. Accidental, suicidal and homicidal burns have been reported in the women. A circumstantial approach is required to analyse the circumstances of female burns. A retrospective study of medicolegal autopsies was carried out for autopsies conducted between January 2016 and December, 2018 in the mortuary of the Government Medical College, Anantapuramu. The majority of incidents happened in the kitchen; frequently in the evening hours. Most of the homicidal and accidental burns were first noticed by their husbands or in-laws. The majority of them rescued either by in-laws, husbands or neighbors. In large number of cases police was intimated by the medical officer as a part of their duty.

5 tables, 16 ref

041945   CHANDA S, RANDHAWA S, BAMBRAH H S, FERNANDES T, DOGRA V, HEGDE S (Piramal Swasthya Management and Research Institute, Guwahati - 781021, Assam, Email: drsub05@yahoo.co.in) : Bridging the gaps in health service delivery for truck drivers of India through mobile medical units. Indian J Occup Environ Med 2020, 24(2), 84-90.

Truck drivers in India suffer from many lifestyle‑related health problems. Providing primary health care services to truck drivers is essential to improve their overall health and well‑being. This paper reports the findings of a community‑based mobile medical unit program providing nonemergency and basic primary care services to truck drivers along the major highways of India. Piramal Swasthya Management and Research Institute launched this community-based mobile medical unit program, in partnership with Shriram Transport Finance Corporation Limited (STFCL). The paper describes the program model, its coverage, the sociodemographic profile, and common health morbidities of the truck drivers availing the program services. 2-year routine program data (April 2017 to March 2019) were accessed and analyzed. A total of 1,167,210 number of unique truck drivers availed the program services during the reference period, of which 61,331 had complete data. The majority of truck drivers were male (99.1 %) and just a few women (0.88 %) and transgender (0.003 %). The mean age was 45.5 years ± 10.91 and nearly half (49 %) were in the productive age group (31–45 years). Noncommunicable and other chronic diseases (34.74 %), musculoskeletal problems (24.17 %), communicable diseases (14.52 %), oral cavity-related problems (1.23 %), and other minor ailments (17.77 %) were the major consultation categories. Truck drivers in India have significant health morbidities. Providing primary health care services to truck drivers through mobile medical units is a step toward achieving universal health coverage.

4 illus, 4 tables, 24 ref

046745   SULEIMAN J M, SAED O-A S, AL-KUBAISI S, HASAN M S, OWAIN M S, HUSSEIN M A, JARAD A S (Internal and Preventive Medicine Dep, Tikrit Univ, Tikrit, Iraq) : Molecular characterization of Eae and Stxs genes for E. coli O157:H7 isolates from calves. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194421.

This study aimed to detect eae and Stx genes of thirty two E. coli O157:H7 isolates recovered from calves. These isolates were isolated and identify by traditional methods of culturing and latex agglutination test from fecal swabs of four diarrheic calves and twenty eight apparently healthy calves. The eae and Stx genes were detected by a realtime PCR applied on the extracted bacterial DNA. The results showed that 19 isolates had stx1 gene, 10 isolates had stx2 gene and 17 isolates had eae gene. It is concluded that molecular characterization by using real time PCR is a good test for confirming infection with E. coli O157:H7 and detection of their eae and Stx genes .

1 illus, 21 ref

041943   GHASEMI S-R, KHEZELI M, RAJABI-GILAN N, KOULANI M, MOLOUDI-SAFA N, HEMATI A, AFKARI M, ZOLFAGHARI F (Kermanshah Univ of Medical Sciences, Kermanshah, Iran, Email: rajabi_nader@yahoo.com) : Sleep quality and health-related quality of life in workers of Kermanshah industrial town: A correlation study. Indian J Occup Environ Med 2020, 24(2), 72-7.

Sleep Quality (SQ) is one of the most important predictors of quality of life in individuals. This study was conducted to evaluate the quality of life and SQ of industrial male workers in Kermanshah. In this cross-sectional study, 404 male workers selected by stratified sampling in the Kermanshah Industrial Town participated. The research questionnaires included demographic information checklist, the 36-Item Short-Form Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by SPSS18 software, using descriptive statistics, Pearson’s correlation, and partial correlation tests. The mean age of respondents was 35.33 ± 7.31; ranged from 20 to 62 years old. The mean score of mental health and physical health were 55.01 ± 21.62 and 54.96 ± 21.93, respectively. Out of all participants, 58.6% of participants had a score of 50 or less in terms of health-related quality of life (HRQL). Two dimensions of subjective SQ (1.48 ± 0.97) and sleep duration (1.48 ± 0.97) had the worst mean score, and sleep efficiency (0.05 ± 0.3) had the most favorable mean score. The results of the Pearson’s correlation test showed that the total score of SQ had a negative and significant correlation with the main dimensions of quality of life (P < 0.001). The highest correlation was found between physical pain (r = 0.350) and mental health (r = 0.332) with SQ. This study showed that more than half of the workers reported poor HRQL. Besides, a considerable number of workers had some degree of sleep disorders. The results of the study showed that there is a moderate correlation between SQ and HRQL.

4 tables, 42 ref

041942   PANHALE V P, WALANKAR P P, SRIDHAR A (Musculoskeletal Sciences Dep, MGM Coll of Physiotherapy, Navi Mumbai, Maharashtra - 410 209, Email: prachita30@gmail.com) : Analysis of postural risk and pain assessment in bharatanatyam dancers. Indian J Occup Environ Med 2020, 24(2), 66-71.

Bharatanatyam dance form is an amalgamation of emotion, rhythm, expression, and sculpturesque poses that demand high levels of physical and psychological power during a performance. To explore musculoskeletal pain and analyze risk factors in Bharatanatyam dancers. The level of injury risk for the “Natyarambham” posture adopted by dancers was also assessed. A cross-sectional study was conducted in forty female Bharatanatyam dancers who received a minimum of 5 consecutive years of formal dance training from a recognized dance institute. Aself‑designed questionnaire comprising of demographic profile, dancing characteristics, presence of musculoskeletal pain, and specific area of pain according to the body region was administered. The injury risk of the “Natyarambham” posture was evaluated using a rapid entire body assessment tool (REBA). Among 40 female dancers, 75 % dancers (n = 30/40, 75 % [95 % CI 0.61, 0.89] reported pain. The most common site of pain was the low back (n = 22/40, 55 % [95 % CI 0.39, 0.71]). Using Bonferroni correction for multiple independent comparisons, a significant difference was identified between dancers with and without pain for average performances per year (P = 0.028). As per REBA risk level scoring for Natyarambham posture, 62.5 % (n = 25/40, 62.5 % [95 % CI 0.22, 0.53]) dancers were in the category of high-risk level. The findings of this study indicated that the point prevalence of pain in Bharatanatyam dancers is high. Natyarambham posture is considered high risk based on postural assessment.

5 tables, 22 ref

041940   KITULWATTE I D G, EDIRISINGHE P A S (Forensic Medicine Dep, Kelaniya Univ, Ragama, Sri Lanka, Email: indiradgk@yahoo.com) : An analysis of medicolegal reporting in workman injuries referred for medicolegal examination in a tertiary care hospital of Sri Lanka. Indian J Occup Environ Med 2020, 24(2), 55-9.

A reasonable number of workman injuries are reported for medicolegal examination every year. In addition to report on the degree of severity and consistency of the injuries with the historical evidence, the medical officers are expected to opine on degree of disability as well. However, routine Medicolegal Examination Form or Report used in Sri Lanka to report these cases does not carry a section for disability or impairment. To gain an insight into the pathology of workplace injuries and to evaluate the role of medicolegal examination and reporting among the victims presented with injuries at work. A retrospective descriptive study was carried out on workmen who were referred for medicolegal examination during a period of 5 years in a Tertiary Care Hospital in the Western Province of Sri Lanka. Out of 172 subjects who got injured at work, none had claimed for a report of compensation. 47 % (81) of the injured workers were in the age group of 19–30 years. 81 % (139) were males. Factory workers were the most vulnerable workers (34 %) followed by drivers (15 %). A majority 39 % (67) of injuries were located on upper limbs. 52 % (90) of the victims had grievous injuries. However, a majority 61 % (105) had no permanent disability. Disability is not a direct reflection of the category of hurt. Therefore, testifying on routine medicolegal reports on cases of workman compensation will not serve justice to the patient.

5 tables, 23 ref

045472   DUTTA S, MEENA R K, SIMATWAL N K (Forensic Medicine Dep, SMS Medical Coll & Attached Hospital, Jaipur, Email: naveen.simatwal@gmail.com) : Patterns of suicides in Jaipur: An autopsy based study. J Indian Acad Forensic Med 2020, 42(2), 123-6.

Suicide is an important cause of abrupt and preventable death. It is the consequence of mental, social, and psychological factors interplaying. Globally, suicide is one of the commonest causes of death especially in the most economically productive young age category. The forensic pathologist plays a crucial role in the determination of the manner of death as homicide, suicide, accident, or natural. Limited literature is available regarding the factors surrounding suicides and the rate of committing them in general population. This descriptive observational hospital-based study was undertaken to investigate suicide trends in the Jaipur region. In the present study, a total of 101 cases were studied, with male predominance, mostly belonged to 31-40-year age group, and rural population. Poisoning was observed as the most common method of suicide. The present research was conducted to know the magnitude and the socio-cultural factors of the problem of suicides so that a sound prevention program could be suggested, planned, and implemented for reducing the incidence of suicides.

26 ref

045471   RUPANI R, RATHORE S, SINGH M, KUMARI S, SINGH R, VERMA A K, RANJAN R, SHARMA V (Forensic Medicine and Toxicology Dep, KGMU, Lucknow, Uttar Pradesh, Email: dr.sangeeta.sahni@gmail.com) : Demographic profile and outcome of near hanging cases presenting in tertiary care hospital in Northern part of India: An observational study. J Indian Acad Forensic Med 2020, 42(2), 120-2.

Suicide a serious public health issue every society is facing today and is highly preventable with timely and strategic intervention. Attempted suicide is often underreported in India. The present study aims to provide a complete demographic profile of near hanging cases which often go underreported from the medico-legal point of view. The present study is an observational study of patients presenting with near hanging and referred to the department of Forensic Medicine and Toxicology, for medico-legal opinion from Medicine Department of King George's Medical University, Lucknow. All the cases presenting with near hanging from November 2018 to November 2019 were studied. A total of 140 cases of near hanging were reported, out of 140 cases, 73 (52.14 %) were male, and 67 (47.86 %) were female. The most common age group involved was 21-30 years with male (62.96 %), majority of the cases (57.14 %) were married, and the common materials used for hanging were dupatta (39.29 %). In the majority of cases, reason for hanging was a family dispute (40 %) followed by marital disputes (21.43 %). Majority of the patient (93.57 %) had attempted hanging for the first time.84.29 % of the patients got discharged, and in only 10 % of cases, mortality was reported. Early hospitalization and rigorous medical intervention showed favorable outcome.

4 tables, 8 ref

045470   KUMAR A , TANDON S , SHARMA G S K, YADAV A (Forensic Medicine Dep, AIIMS, New Delhi, Email: drayad_in@yahoo.com) : Study of facial injuries sustained in cases of fatal accidents and intentional violence. J Indian Acad Forensic Med 2020, 42(2), 114-9.

Injuries or mutilation on the face can have disastrous effect on individuals. Unnoticed cranio-facial injuries especially those with fractures can lead to blindness, deafness, facial paralysis with many other medical problems and disabilities. Substantial progress has been made in treating craniofacial trauma with several specialties like maxillofacial, plastic, ENT and neurosurgery being involved. This study aimed to analyze the epidemiological data, injury pattern, role of patient and prevalence of cases in facial injuries. The study was a cross-sectional observational study conducted during the period of 18 months, on the cases of deaths associated with facial injuries, brought for medico legal autopsy to the mortuary of the Department of Forensic Medicine, V.M.M.C. &Safdarjung hospital, New Delhi. The study included 257 cases that were reported to the Mortuary with facial injuries. The peak incidence was, however, observed in the age group of 15 - 24 years with a male: female ratio of 2.43:1. Road Traffic Accident (RTA) that resulted in 55.64 % of total followed by burns 30 % and Assault 09.33 cases. Two-wheeler (motorcycle/ scooter) occupants dominated the list with 43.35 % cases and Pedestrians seconded the list with 20.27 % cases. Alcohol association was observed with the etiology of facial injuries. Most common type of injury was found to be soft tissue injuries (93.33 %) cases. The authors gave recommendation to reduce the incidents/accidents leading to Facial injuries.

5 illus, 5 tables, 28 ref

046744   AL-KUBAISI S M A , SAED O-A S, SULEIMAN J M, HASAN M S, OWAIN M S, JARAD A S (Internal and Preventive Medicine Dep, Fallujah Univ, Fallujah, Iraq) : Isolation and identification of facultative anaerobic bacteria from feces of pet dogs. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194420.

A fifty fecal swabs (25 from Anbar province and 25 from Salahuddin province) were collected from both sexes dogs with different global breeds, different ages. These swabs were cultured onto blood , nutrient and MacConkey agars, then the colonies were purified on nutrient and MacConkey agars. A gram stain and biochemical tests were done including catalase, oxidase and TSI. The results of isolation and identification showed that Salmonella spp. were isolated from 5 out of 14 puppies (35.7 %), while E. coli from 9 (64.3 %) and Serratia spp. from 1(7.1 %), whereas, from adults , salmonella spp. isolated from 9 (25 %) dogs and E. coli from 24 (66.7 %) out of 36 adult dogs. It is concluded that Salmonella spp. and E. coli are the most prevalent in asymptomatic dogs and puppies in Anbar province and Salahuddin which means that the dogs are a reservoir for these bacteria and it is considered as a bad indication for transmission of this pathogen to human being and other animals.

1 illus, 1 table, 28 ref

045469   KUCHEWAR S V, BHOSLE S H, PADOLE T O (Forensic Medicine Dep, Shri V. N. Govt. Medical Coll, Yavatmal- 445 001, Maharashtra, Email: santoshbhosle09@gmail.com) : Correlation of diagonal ear-lobe crease with coronary artery disease among indians: An autopsy study. J Indian Acad Forensic Med 2020, 42(2), 109-13.

Atherosclerotic coronary artery disease (CAD) incidence, prevalence, morbidity and mortality are rapidly increasing across the world and particularly in India. Diagonal ear lobe crease (DELC) or Frank's sign had been known as a cutaneous marker of atherosclerotic coronary artery disease since many decades. However, only few Indian clinicians are aware of the relevance. The aim of the present study was to correlate diagonal earlobe crease with presence and extent of atherosclerotic coronary artery disease among Indian population. This was a prospective observational study for duration of 19 months, carried out in the Department of Forensic Medicine and Toxicology, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra state (India). The association between DELC and the extent of coronary artery atherosclerosis was analyzed on autopsied subjects. Amongst 767 cases, 79.1 % were male, 93 with DELC and 674 without DELC. The prevalence of DELC was 83.3 % in those with CAD and 4.1 % without CAD. The numbers of coronary artery involved were more with DELC (2.10 ± 0.68) than without DELC (1.32 ± 0.55). Considering DELC as one of the diagnostic markers for CAD, validity of this diagnostic marker i.e. sensitivity and specificity were 0.83 & 0.96 respectively. Positive predictive value and negative predictive value for DELC was 0.70 & 0.98 respectively. From the above study we conclude that the diagonal ear lobe creases is a specific and sensitive marker for atherosclerotic coronary artery disease.

1 illus, 3 tables, 28 ref

045468   NAGENDRA KUMAR A , KAMALAKANNAN G (Forensic Medicine Dep, Government Tiruvannamalai Medical Coll, Tiruvannamalai, Tamil Nadu, Email: drkamalkannan28@gmail.com) : Histopathological study of changes in temporal bone in cases of drowning. J Indian Acad Forensic Med 2020, 42(2), 103-8.

Drowning is a global health problem which contributes to about 360000 deaths per annum worldwide viz., about 9% of global burden of deaths, according to WHO census of 2015. Establishment of drowning as a cause of death is a real challenge for the medical examiners on autopsy. Even though, there are so many corroborative evidences to establish the diagnosis of drowning in fresh dead bodies, it is still very difficult to establish the same in decomposed ones. In this study, various pathological changes in the temporal bones of about 11 cases of drowning were discussed. These changes can be very much helpful in clinching the postmortem diagnosis of “Death due to drowning”. It has been established that, a spectrum of findings can occur ranging from mere oedema of soft tissues of mastoid air cells and middle ear, frank haemorrhage of mastoid air cells alone, with or without middle ear haemorrhage and inner ear oedema and haemorrhage in extreme cases as the pressure differential across the tympanic membrane increases. These findings were recorded by both gross and histopathological evidences. We also observed that, depending upon the degree of struggle (violent inhalation and exhalation of water) and the magnitude of pressure differential across the tympanic membrane, the degree of temporal bone pathology varies from mere oedema to frank haemorrhage within the ear cavities. However, alcoholism and incapacitation prior to get into the water, found to play a major role in presence or absence of such temporal bones changes in drowning.

6 illus, 18 ref

046743   AL-ANI W A T, AL-DELAIMY A K (Family & Community Medicine Dep, Al-Mustansiriyah Medical Coll, Baghdad, Iraq) : Assessment of the understanding of medical ethics subject among Anbar medical group students. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194419.

Future doctors and medical students are expected to learn about the important moral ethical communication with their patients and health care personnel. The study aimed to have opinion of medical students on medical ethics education. Cross sectional study carried out in both medicine and pharmacy colleges of at Anbar University for a period extended from 4th of November 2018 till the 28th of May 2019. The study was conducted on total sample size of 211 both males and females in medical and pharmacist students at Anbar University who age group ranging from 20-24 years old. About 86.3 % of students under study believe that medical ethics subject is important in the curriculum of medical group colleges so as to learn basic knowledge of attitude (47.8 %), and about 48 % have the opinion of taking such subject in the first/second year of college. At the same time, 45.6 % of students believe that the subject is boring and patient communication lecture was the highest percentage (47.9 %) chosen by students as the most important item among the medical ethics subject. : Low perception and knowledge about the importance of medical ethics subject among medical group students in their near future career.

6 tables, 20 ref

045467   TRANGADIA M M , GUPTA B D (Forensic Medicine Dep, P. D. U. Government Medical Coll, Rajkot, Gujarat, Email: dr.maheshtrangadia@yahoo.com) : Sex determination based on morphological and morpho-metric study of clavicular rhomboid fossa in Saurashtra region, Gujarat. J Indian Acad Forensic Med 2020, 42(2), 93-8.

The correct determination of the sex of a person are critical requirement in physical anthropology and one of the essential steps in personal identification of an individual from the skeletal remains. The present study was conducted prospectively on 200 pairs of the clavicles which were obtained from the dead bodies brought for post mortem examination during the period of January 2014 to December 2014 in Forensic Medicine department, M. P. Shah Govt. Medical College, Jamnagar, Gujarat. The results indicate that Incidence of rhomboid fossa on right side of clavicle in males and females was statistically not significant (p>0.05). While the greater difference in fossa expression was noticed between male and female clavicles of left side, which had statistical significance (p<0.01). Elevated rhomboid fossa is more frequent in both the sexes, followed by flat nature and then depressed nature. The mean length of rhomboid fossa of right side clavicle was 20.56mm±5.99 in male and 15.28mm±4.89 in female, while on left side, the length was 19.24mm±5.57 and 15.97mm±5.88 respectively for males and females. The mean breadth of rhomboid fossa of right side clavicle was 10.71mm±3.51 in male and 8.35mm±2.73 in female, while on left side breadth was 9.58mm±2.83 and 8.13mm±2.89 respectively for male and female. It has been concluded that the length and breadth of rhomboid fossa of clavicle as a single parameter can't establish the sex of each clavicle in study population.

3 illus, 4 tables, 9 ref

046742   HADI A M, ABBASS Y I, YADGAR M A (Surgery Dep, Tikrit Medical Coll, Tikrit, Iraq, Email: azzawy.Mostafa@tu.edi.iq , ) : The impact of L-carnitine supplement on semen variables and the levels of sexual hormones (Serum LH, FSH, Testosterone, and Inhibin) in males with infertility. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194418.

It had been estimated that tenth of partners had infertility, and in approximately half of these cases, the imperfection can be ascribed to male related causes. Fecundity in men necessitate regular functioning hypothalamus, pituitary gland, and testes axis. aberrant spermatogenesis is habitually incorporated to permuted serum gonadotropins and testosterone. L-carnitine is an supreme antioxidant existing in a lofty concentration in epididymal excretions. It affords liveliness for sperms to earn their dynamism in the epididymis. The study proposed to explore the effect of L-carnitine supplement on semen parameters, and sex hormones milieu in patients with primary or secondary infertility. A clinical trial conducted on a 58 patients(mean age± SD: 30.6 ± 6.07) treated with 2 gm of L carnitine, which prescribed orally at a daily dose of 2 gm a day in divided doses for 3 months. Before, and after the end of the L-carnitine treatment, semen analysis and serum levels of LH, FSH, Testosterone, and inhibin were performed. The mean values of sperm count, total motility and normal morphology of and oligo-asthenoteratospermic were found notably changed (p<0.05) with 3 months carnitine supplement. The outcome of this trial exhibited that L-carnitine supplement can improve sperm concentration, and count, as well active motility. Additionally it has been noticed that the serum gonadotropin (FSH and LH) levels were noteworthy declined, while serum testosterone and inhibin levels were upraised in infertile males when compared with the levels before, the 3 months course of L-carnitine treatment. 

2 tables, 29 ref

045466   NIMMA V, CONTRACTOR I, JAKHETE A, RAMASWAMI E, KADAM S (Oral Medicine and Radiology Dep, Government Dental Coll and Hospital, Mumbai, Email: drvijayaomr@gmail.com) : Estimation of stature in children and young adults using odontometric approach. J Indian Acad Forensic Med 2020, 42(2), 88-92.

There has been a marked increase in the number of crimes against children and young adults in the last decade, hence calling for an increase in the methods of identification of remains using forensic odontology. Dental morphometrics is a subject of great significance in forensic odontology in the identification of an individual. The use of teeth to represent a physical profile is valuable for the identification of and individual. The aim of the study was to check the reliability and accuracy of Carrea's index in deciduous and permanent dentition. The study was conducted on 51 participants in the age group 2-6 years and 51 participants in the age group of 12-20. The arch and chord values were measured intraorally using digital vernier calipers and the stature was measured using a standardized measuring tape. All this data was used to validate Carrea's formula and the results were analyzed statistically. We observed a positive correlation between measured stature and calculated stature using Carrea's index in young permanent dentition group and it was found to be statistically significant. (p-value 0.042). In females, it was more accurate as compared to males. Our results also showed that stature estimated using measurements from the dentition of the left side was more accurate as compared to the right side.

1 illus, 6 tables, 18 ref

041939   KHERUKA S C, KUMARI S, ORA M, TANDON P, GAMBHIR S (Nuclear Medicine Dep, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, Email: gaambhir@yahoo.com) : Assessment of radiation exposure and radioactivity from the liquid discharge in a nuclear medicine facility. Indian J Nucl Med 2020, 35(4), 321-5.

Radionuclide imaging and therapies produce radioactive liquid waste that may lead to significant radiation exposure to the general public. The study aims to assess the radiation exposure rate to public sewerage from a modified delay tank facility. We shall also evaluate the exposure rates and overall radioactivity at several points. After having appropriate permission from the AERB, we measured the radiation exposure from the radionuclide therapy ward. Ward has three isolation beds and a single delay and decay tank of a capacity of 7500 liters. Effluents from the delay tank are processed at the filtration plant of the institute and subsequently released in the public sewerage. We obtained samples from several sites to determine discharged radioactivity. A total of 38 patients received 129.4 ± 42 mCi (Range 40- 200) radioiodine therapy during the study. Discharge of the tanks was done two times during the study. The radioactivity discharges into aeration plant were 89.2 and 71.2 mCi that correspond to 440.05 and 351 MBq/ m3, respectively. This was diluted by the aeration tank (6 million liters). Finally, at the discharge time, the radioactivity in the discharge was 1.6 and 1.5 MBq/m3, respectively. The highest exposure rates were 14 μSv/h near the delay tank, which rapidly decreased on moving to the surrounding. Our study indicates that the addition of the dilution method and close monitoring may significantly reduce the radiation exposure and overall radioactivity release from the facility. Old facilities that do not have space to add up the tank capacity may get a benefit from it. A small change in the practice, such as admitting patients alternate months or providing extra decay time for radioactive waste, may lead to a cost-effective alternative.

5 illus, 12 ref

045465   MISHRA K D, KOKATANUR C M (Forensic Medicine and Toxicology Dep, Krishna Institute of Medical Sciences, Karad, Maharastra, Email: chanduk2005@yahoo.com) : Estimation of stature from Bi-mastoid breadth. J Indian Acad Forensic Med 2020, 42(2), 84-7.

Stature is defined as “natural height of a person in standing position”. Bi-mastoid breadth is referred as distance between outermost prominent point on lateral surfaces of two mastoid process of temporal bone. The present study was conducted to estimate stature from bi-mastoid breadth. The cross sectional study was conducted involving 200 medical undergraduate students who are born and bought up in different parts of India and were the age group of 18 to 24years for a period of 2 months from April 2018 to May 2018. The height of an individual was measured using stadiometer and bi-mastoid breadth by spreading caliper. The present study showed moderate significant positive correlation between stature and bi-mastoid breadth for males with correlation coefficient (r) 0.528 and low significant positive correlation for females with correlation coefficient (r) 0.269 which are statistically significant at 0.01 levels. It is concluded that forensic expert can estimate stature from bi-mastoid breadth in males in situation where only skull/ head is available.

2 illus, 3 tables, 16 ref

041938   KHALILI H, RAKHSHA A, GHAEDIAN T, NIAKAN A, MASOUDI N (Neurosurgery Dep, Shiraz Univ of Medical Sciences, Shiraz, Iran, Email: abbasrakhsha4@gmail.com) : Application of brain perfusion spect in the evaluation of response to zolpidem therapy in consciousness disorder due to traumatic brain injury. Indian J Nucl Med 2020, 35(4), 315-20.

Traumatic brain injury (TBI) is a critical health problem with various comorbidities and socioeconomic consequences. Tending to increase in recent decades, TBI results in more cases of consciousness disorders including vegetative state (VS)/minimally conscious state (MCS). However, no definite or effective treatment still exists for these conditions. The aim of this article is to study the effects of zolpidem in patients with VS caused by TBI by using brain perfusion single‑photon emission computed tomography (SPECT). This was a prospective clinical trial on a cohort of patients with VS. We evaluated the TBI database to find VS/MCS patients, between the ages of 20 and 65 years. We received written consent from their family members prior to enrollment and compared their clinical status and brain perfusion SPECT prior and after 2 weeks of zolpidem therapy. Among the 12 patients included in this study, six patients changed to MCS after 2 weeks. Comparison of their motor score, revealed a statistically significant difference (2.08 vs. 3.75, P = 0.007, respectively). None of the quantitative or qualitative brain perfusion parameters showed any differences after zolpidem therapy. However, the perfusion pattern, with focal or multifocal cortical defects, was significantly more prevalent in the responder group (five patients vs. one patient, P = 0.015). Zolpidem therapy may improve consciousness levels and motor function in a considerable portion of VS patients with TBI. This study showed that the presence of focal brain perfusion defect can predict response to zolpidem.

2 illus, 3 tables, 16 ref

046741   ATHBI H A, ABED-ALI H N (Adult Nursing Dep, Kerbala Univ, Karbala, Iraq) : Risk factors of acute otitis media among infants children in Kerbala pediatric teaching hospital: A case-control study. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194417.

To explore the most prevalent risk factors those are associated with AOM among infant children. A case-control study design was carried out in the outpatient clinic at Kerbala pediatric teaching hospital, from the period from January 2017 to February 2019. A purposive sampling method of 100 infants was included in this study, 50 of them were infected with AOM and the others are not. A data were collected directly from infant’s parent by the researchers through the interviewing technique, then the collected data were analyzed by using the program of IBM Statistical Package of Social Sciences (SPSS) Version 24. The results of this study revealed that about 40 %, 64 % and 40 % of infected infants were 7-9 months of age, females and urban residency respectively. The study showed a significant association between AOM and nasal obstruction at p-value 0.02, child’s position during feeding at p-value 0.00, mother’s position in case of bottle feeding at p-value 0.00, and using bottle feeding at night (for breast feeding infants) at p-value 0.002. Infants exposed to cigarette smoking, and that’s were using pacifiers when sleeping also identified a significant risk factors for AOM at p-value 0.00, and 0.00 respectively.

2 illus, 2 tables, 18 ref

041937   KHERUKA S C, ORA M, CHAUDHARY S, GAMBHIR S (Nuclear Medicine Dep, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, Email: gaambhir@yahoo.com) : Assessment of radiation dose delivered and volume measurement by low- and high-dose diagnostic computed tomography: Anthropomorphic liver phantom study. Indian J Nucl Med 2020, 35(4), 310-4.

Liver volume measurement is a mandatory test before measure liver surgeries and transplantation. We aimed a study on the difference in volume measurement and radiation dose to an anthropomorphic liver phantom using high‑dose and low‑dose diagnostic computed tomography (CT). Several measurements of the manual total volume measurement done on an anthropomorphic liver phantom mounted with thermoluminescent dosimeter. We exposed the phantom with diagnostic CT, low‑dose CT, and a low‑dose CT with copper filter. Phantom underwent ten scanning for each exposure. There was no significant difference in the total volume measurement in comparison to the phantom volume. The volume of phantom measured by low‑dose CT, low‑dose CT with copper phantom, and high‑dose CT were 1869 ± 18 cm³, 1852 ± 24 cm³, and 1908 ± 12 cm³, (P = 0.3), respectively. However, the radiation dose delivered was significantly different (1.54 mGy, 0.77 mGy, and 5.84 mGy [P = 0.001], respectively). Total liver volume measurement provides essential clinical information in several clinical conditions. We recommended that the volume measured by a low‑dose CT has an excellent correlation with the diagnostic quality CT and should be a routine in the routine clinical practice. CT volumetry achieves the same result while using very less radiation exposure. It may also be used with functional imaging to give complete information.

3 illus, 1 table, 26 ref

045464   VENKATESH J , CHAUDHARI V A , SUKUMAR S , SENTHIL KUMARAN M (Forensic Medicine and Toxicology Dep, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry ? 605 006, Email: drvinodchaudhari@gmail.com) : Estimation of stature from various sternal lengths: An autopsy based study in South Indian population. J Indian Acad Forensic Med 2020, 42(2), 80-3.

The stature of deceased along with various sternal measurements was taken to obtain a linear regression equation to estimate the height of an individual in Southern Indian population. The cross-sectional study was conducted on 210 sternums obtained from medico-legal autopsies conducted at JIPMER, Pondicherry, India. A significant and positive correlation was observed between the stature of deceased (STAD) and all measurements of sternal lengths (P<0.05 for LM, LB, LMB) for both sexes. The stature with LMB showed highest correlation (R=0.490) for males and LB showed the highest correlation (R=0.472) in females. This study will be of more helpful to forensic experts and anthropologists when only the trunk of the body was recovered with no available long bones.

1 illus, 5 tables, 18 ref

041936   ETTIAPPAN S, PONNUSAMY M (Nuclear Medicine Dep, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry - 605 006, Email: freethinker_13@yahoo.co.in) : Cardiovascular risk scores in women undergoing stress myocardial perfusion scan and comparison with scan-predicted risk. Indian J Nucl Med 2020, 35(4), 305-9.

Death due to cardiovascular disease is a major concern in the field of noncommunicable disease. Assessment of cardiovascular risk score using Framingham score and WHO/ISH score is a noninvasive, easier method of predicting the adverse cardiovascular event in the general population. The aim of the study was to assess the cardiovascular risk using Framingham score and WHO/ISH in women undergoing stress myocardial perfusion imaging (MPI) and comparison with scan‑predicted risk. Adult females with suspected coronary artery disease referred to the department of nuclear medicine for 2 months were included in the study. Data pertaining to the risk score assessment were collected, and the risk scores were calculated. Subsequently, the patients underwent scheduled Tc‑99m methoxy‑isobutyl‑isonitrile myocardial stress imaging, and scan‑predicted risks were calculated. Then, the risk score of Framingham and WHO/ ISH methods were compared with stress myocardial perfusion score using Cohen’s kappa statistic. The mean age of the sample was 52 years (standard deviation: 11). Framingham and WHO/ ISH risk scores predicted low, intermediate, and high risk in 62.2 %, 28.9 %, and 8.9 % and 68.9 %, 22.1 %, and 8.89 % of the population. The two scoring methods showed moderate agreement (κ =0.59). However, the scores showed only slight and fair agreement, respectively, with risk predicted by stress MPI. Although the risk scores have been shown to benefit in screening general population, they may not perform well in symptomatic patients with suspected angina. Out of the two methods, WHO/ISH fares better than Framingham score in this population.

3 tables, 14 ref

046740   AL-SAADI E A K, HASSAN D M, AL-SABBAGH W R (Pathology Dep, Karbala Univ, Karbala, Iraq, Email: doc.eadff@ gmail.com) : Patterns of haemoglobinopathies diagnosed by high performance liquid chromatography in Karbala population and correlations between different hematological parameters. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194416.

To know the patterns of hemoglobinopathies and their prevalence in Kerbala society by using high performance liquid chromatography and to conclude if there is any correlations between different hematological parameters in Hemoglobinopathic patients. A total of 70 cases studied from 16th of February 2018 to 20th of June 2018 for hemoglobin variant analysis at the teaching labrotarioes of Al- Hussseini Teaching hospital which were studied for patterns of hemoglobinopathies. When the samples were received, Complete Blood Counts including: Hemoglobin concentration, Total White blood cells count (WBC), Mean Cell Volume (MCV), Mean Cell Haemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), Serum ferritin, Total Iron Binding Capacity ( TIBC), Hemoglobin H (HbH) preparation were done. Out of total 70 patients screened for patterns of hemoglobinopathies the result of the study revealed that 48 Patients which represent (68.57 %) of total patients had B-thalassemia trait which form the predominant percentage of patients with haemoglobinopathy, 11.85 % of patients had sickle cell trait, 5.71 % of them had B-Thalassemia Major, 4.29 % had Hb S/B+Thalassemia Trait, 2.86 % had HbS/Alpha thalassemia trait, 1.43 % of them had Hb S homozygosity, 1.43 % Alpha thalassemia trait, 1.43 % had D-Los Anglos, 1.43 % had HbS/B+ Thalassemia trait and 1.43 % had HbC/B-Thalassemia trait.

4 tables, 18 ref

041935   SATAPATHY S, MITTAL B R, SOOD A, DAS C K, SINGH S K, MAVUDURU R S, BORA G S (Nuclear Medicine Dep, Post Graduate Institute of Medical Education and Research, Chandigarh ? 160 012, Email: sood99@yahoo.com) : Health-related quality-of-life outcomes with actinium 225 prostate specific membrane antigen 617 therapy in patients with heavily pretreated metastatic castration-resistant prostate cancer. Indian J Nucl Med 2020, 35(4), 299-304.

Actinium‑225 (²²⁵Ac) labeled prostate‑specific membrane antigen (PSMA)‑617 is a novel treatment modality in the management of metastatic castration‑resistant prostate cancer (mCRPC). The present study was conducted to assess the impact of ²²⁵Ac‑PSMA‑617 therapy on the quality‑of‑life of patients with heavily pretreated mCRPC using the National Comprehensive Cancer Network‑Functional Assessment of Cancer Therapy‑Prostate Symptom Index‑17 (NCCN‑FACT‑FPSI‑17) questionnaire. This was a retrospective single‑center study where data of consecutive heavily pretreated mCRPC patients treated with ²²⁵Ac‑PSMA‑617 from January 2019 to February 2020, was collected and analyzed for the biochemical response, quality‑of‑life outcomes and treatment‑related toxicity. Eleven heavily pretreated mCRPC patients received a median cumulative dose of 8.3 MBq (interquartile range [IQR] 5.6–20.4 MBq) ²²⁵Ac‑PSMA‑617 over 1–4 cycles. 5/11 patients (46 %) showed a ≥50 % decline in Prostate Specific Antigen (PSA), while stable values and PSA progression were observed in 3/11 (27 %) patients each. Pre‑ and post‑therapy NCCN‑FACT‑FPSI‑17 questionnaires revealed statistically significant improvement in the total FPSI score (P = 0.003) as well as the disease‑related symptoms‑physical (P = 0.004) and disease‑related symptoms‑emotional (P = 0.046) subscores. Among the physical symptoms, significant improvement was noted with respect to pain, difficulty in urination, bone pain, fatigue, and restriction in physical activity. No significant change was noted in the treatment side‑effects subscore. Of the treatment‑related adverse effects, Grade 3 dryness of the mouth, anemia, and nephrotoxicity was observed in 1/11 patients (9 %) each and Grade 3 thrombocytopenia in 2/11 patients (18 %). Health‑related quality‑of‑life of the mCRPC patients improved significantly with²²⁵Ac‑PSMA‑617 despite extensive pretreatment and advanced nature of the disease.

2 illus, 4 tables, 21 ref

046739   ALZEYADI S, MOHAMMED S H (Psychiatric and Mental Health Nursing Dep, Kerbala Univ, Kerbala, Iraq) : Measures self-esteem among undergraduate nursing students. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194415.

A large body of research has highlighted self-esteem and self-concept for their importance and relatedness to various aspects of students’ academic and personal life. Self-esteem is significantly associated with the positive psychological outcomes of both individual and society, including, but not limited to psychological adjustment, positive emotion, and academic performance. A descriptive-correlational study was done through the period of November 10th, 2017 to February, 11th, 2019. The study also aims to assessing levels of self-esteem in the study sample, and to determine the relationship between self-esteem and the following variables: age, gender, academic year, residency place, father job, mother job, family’s monthly income, and interest of attending the nursing college. A non-probability, convenience, sampling of (600) undergraduate nursing students were selected from four nursing colleges located in Middle Ephorates region. A two parts questionnaire was used to fulfil the study objectives. The first part includes student’s sociodemographic information. The second part is the Rosenberg self-esteem scale to measure levels of self-esteem. The finding indicates that in majority of nursing students had a self-esteem levels range between average (52.2 %) to high level (44.8 %).

1 illus, 3 tables, 21 ref

041934   SAMMARTANO A, MIGLIARI S, SCARLATTEI M, BALDARI G, RUFFINI L (Nuclear Medicine and Molecular Imaging Dep, Hospital of Parma Univ, Parma, Italy, Email: ansammartano@ao.pr.it) : Validation of quality control parameters of cassette-based gallium-68-DOTA-Tyr3-octreotate synthesis. Indian J Nucl Med 2020, 35(4), 291-8.

Gallium (Ga)‑68‑DOTA peptides targeting somatostatin receptors have been assessed as a valuable tool in neuroendocrine tumor imaging using positron emission tomography. However, at the moment, a specific monograph in the European Pharmacopoeia (Ph. Eur.) does exist only for Ga‑68‑edotreotide (DOTATOC) injection. Here, we report on the validation process of Ga‑68‑DOTA‑Tyr3‑octreotate (DOTATATE) cassette‑based production and quality control (QC). Preparation of Ga‑68‑DOTATATE was performed according to the current European Union‑good manufacturing practices, the current good radiopharmacy practice, the Ph. Eur., and the guidelines on validation of analytical methods for radiopharmaceuticals. Process was validated via three consecutive production runs to ensure that the methods are reproducible and reliable in routine use. The QC tests for Ga‑68‑DOTATATE were radiochemical purity (RCP – high‑pressure liquid chromatography [HPLC]), radiochemical impurities ⁶⁸Ga³⁺ (HPLC and instant thin layer chromatography [ITLC]), chemical purity (HPLC and gas chromatography [GC]), pH (pH‑strips), radionuclidic purity (principal γ‑photon), germanium‑breakthrough (⁶⁸Ge‑content), Ga‑68 half‑life (γ‑ray spectrometry), and sterility/endotoxin assay. Radiolabeling procedure of Ga‑68‑DOTATATE fits all the applicable Ph. Eur. specifications. RCP measured via ITLC was >99 % in the three validation batches. HPLC‐measured RCP resulted 99.45 %, 99.78 %, and 99.75 %. Germanium‑breakthrough was far below the recommended level established in the Ph. Eur. Ga‑68‑DOTATOC injection (#2482). Residual ethanol tested with GC was less than 10 %. All the batches were tested for endotoxin content, which always resulted lower than 17.5 EU/ml. All preparations passed the sterility tests. pH of the final product was 7 in all samples. Ga‑68‑DOTATATE fulfilled all the pre‑set QCs and release criteria in the batches considered for this validation study. The results demonstrated a batch‑to‑batch reproducibility, ensuring that synthesis process leads to the expected final product in terms of yield, quality, reliability, safety, and efficacy.

5 illus, 1 table, 36 ref

046738   OBAID K B (Baghdad Univ, Baghdad, Iraq, Email: address:bkhamees@yahoo.com) : Impact of caring child with Diabetes Mellitus Type1 upon mothers at specialized center for endocrinology and diabetes in Baghdad City. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194414.

The purposes of the study to assess the impact of caring children with Diabetes Mellitus Type 1 upon mothers. A descriptive study was conducted at Specialized Center for Endocrinology and Diabetes in Baghdad City. To achieve the objectives of the study, a (Convenience) samples of (50) mothers who have children with Diabetes Mellitus Type 1. Data were collected by an application of direct interview as a means of data collection. The results indicated that mothers of diabetic children are experiencing a moderate level of burden regarding care of their children (86.5 %), in which they are experiencing a moderate psychological and social burden (61.5 % and 51.9 %), while they show moderate to high financial burden of care for their children (40 %). The study concluded that child with Diabetes Mellitus Type I are experiencing a moderate impact on their mothers .

5 tables, 17 ref

041933   CHANDRA P, RAJAIAN S, KRISHNAMURTHY K, MURUGASEN L, CHANDRAN G, KUMAR J S, NATH S (Nuclear Medicine Dep, MIOT International Hospital, Chennai - 600 056, Tamil Nadu, Email: drpiyushchandrak@gmail.com) : Diagnostic accuracy of prebiopsy Ga-68 PSMA PET/CT in detecting primary prostate carcinomas with prostate specific antigen. Indian J Nucl Med 2020, 35(4), 283-90.

Serum prostate‑specific‑antigen (PSA) guided systematic transrectal ultrasound (TRUS)‑guided biopsies are known to have a low predictive value in detection of primary prostate carcinomas (PCa). Our aim was to evaluate the accuracy of gallium‑68 (Ga‑68) prostate‑specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for the detection of PCa with serum PSA <50 ng/ml. We retrospective analyzed prebiopsy Ga‑68 PSMA PET/CT’s of all patients with suspected PCa from October 2019 to March 2020. Several quantitative clinical and PET/CT variables were compared in benign and malignant groups and assessed for significance using an independent t‑test. Diagnostic performance of PSMA PET/CT for detection of cancer was evaluated and compared with the diagnostic performance of cancer risk predicting calculator (European Randomized Study for Screening of Prostate Cancer [ERSPC3]). The standard of reference was 12‑core TRUS‑guided biopsies. Sixty‑four patients were included with mean age 70 years (range 48–94 years); mean PSA 15.67 ng/ml (range 1.74–44), mean PSA density 0.32 ng/ml2 (range 0.01–0.99) and mean prostate volume 54.55 cc (range 16.5–182). 64 % (n = 41/64) patients had benign histology and 36 % (n = 23/64) had carcinoma. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PSMA PET/CT for detecting PCa reported using the prostate cancer molecular imaging standardized evaluation (PROMISE) was 74 %, 92 %, 85 %, 86 %, and 86 %, respectively. Mean prostate maximum standardized uptake value (SUVmax) was significantly higher in PCa versus Benign lesions (19.56 ± 18.11 vs. 4.21 ± 1.5, P = 0.00001), in patients with PSA >20 ng/ml versus PSA 7 versus GS ≤7 (28.1 ± 20.3 vs. 10.2 ± 8.9, P‑0.010). SUVmax cutoff value of 5.6 on PSMA PET/CT showed a sensitivity of 95 % and specificity of 90.9 % (area under the curve 0.990, P < 0.0001). Ga‑68 PSMA PET/CT can differentiate benign and malignant lesions of the prostate with very high accuracy and when used alongside with ERSPC3 calculator and magnetic resonance imaging, could potentially reduce painful and often unnecessary prostate biopsies.

6 illus, 7 tables, 31 ref

046737   ALI E H A, RAHEEM S M A (Al-Mustansiriyah Univ, Baghdad, Iraq) : Gingival and salivary changes in correlation with multiple sclerosis. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194413.

Multiple sclerosis: chronic degenerative autoimmune disease of the central nervous system marked by patchy destruction of the myelin sheath that surrounds the nerve fibers. The gingival or oral changes that associated with multiple sclerosis might be related to disease itself or as sequel of medications that used for treatment. Aims;-to determine the gingival index and assess the SIgA, SFR and PH in MS patients in compare to control group as well as analyses theses parameters according to age group, gender and type of MS. 36 patients with proven diagnosis of MS were selected randomly between 1st Nov.2016-1st nov.2017 from MS center. Medical city .Baghdad. Iraq. Oral examination was done to measure the gingival index as well as saliva was taken to assess the salivary IgA level, salivary flow rate and PH of saliva, in addition 20 subjects who are free of MS or any others autoimmune disease were selected as control group. The GI of patients group was significantly higher than control group(3.4 ,1.4) respectively while the SIgA ,SFR and PH of saliva was significantly lower with patients group in compare to control group510,0.56,6.6 for patients group) 941.8,1.7,7.1 for control group

6 tables, 21 ref

041932   BANIHASHEM S, ARABZADEH M, BAHRI R S J, QUTBI M (Nuclear Medicine Dep, Shahid Beheshti Univ of Medical Sciences, Tehran 1985711151, Iran, Email: mohsen.qutbi@gmail.com) : Psychological status and quality of life associated with radioactive iodine treatment of patients with differentiated thyroid cancer: Results of hospital anxiety and depression scale and short-form (36) health survey. Indian J Nucl Med 2020, 35(3), 216-21.

The objective is to investigate psychological status and quality of life (QoL) using Hospital Anxiety and Depression Scale (HADS) and Short-Form (36) Health Survey (SF-36) questionnaires in patients with proven differentiated thyroid cancer (DTC) who are referred for radioactive iodine (RAI) ablation before, during, and after treatment. Of patients who underwent total thyroidectomy with a pathologically proven DTC (papillary and follicular types) referred for RAI treatment to our department in 2018, 150, in whom the diagnosis was newly established, were referred for the first course of RAI treatment and were consecutively enrolled in the study. The patients received an oral dose of radioiodine (3700 or 5550 MBq). For evaluation of anxiety, depression, and QoL, all patients are given two standard questionnaires, HADS, and SF-36 and are requested to answer them at four time points. First one was at 1 month before RAI, second was at the time of RAI treatment. Third and fourth ones were 1 week and 6 months later, respectively. The mean age of patients was 39.17 (±12.95) years and 121 (80.7 %) were female and 29 (19.3 %) were male. Values of HADS and SF-36 scores at corresponding time points were significantly correlated using Pearson correlation (HADS and SF‑36 scores at 1 month before RAI: r = −0.56, P < 0.001; at time of RAI: r = −0.71, P < 0.001; 6 months after RAI: r = 0.19, P = 0.021). Using paired-sample t-test, for HADS, except for difference between time points of 1 month before RAI and time of RAI, pairwise difference between scores of other time points was statistically significant after Bonferroni correction. For SF‑36, pairwise difference between scores of all three time points was statistically significant. Interaction of age, gender, RAI dose, and thyroid‑stimulating hormone level at the time of RAI on HADS and SF‑36 scores did not show statistical significance. Trend in scores over several-months’ time discloses gradual improvement of QoL and merits close observation but limited psychiatric intervention.

3 illus, 3 tables, 17 ref

046736   SHLASH A M J, KADHIM N K, RADHI M M, ALSHEMARI B A A, ALBAGHDADI D S A A, ALMOHAMADAWI H H Z, MOHAMMED H S M (Warith Univ, Kerbala Province, Iraq, Email: ahmedmoh1994.ar@gmail.com) : Infection control measures for nurses staff concerning with hepatitis B and C at hemodialysis unit in Hilla hospitals. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194412.

Hepatitis an infection in the liver is very contagious and is caused by the hepatitis virus. The study aims to evaluate nurses performance concerning infection control practices, and to determine the relationship between nurses performance and their demographic characteristics. As well as, to determine the relationship between nurses performance and patients clinical data. A quantitative descriptive design was conducted in Hilla City Hospital for the period of from September 2018 to March 2019. A checklist was used as a means of data collection from those who works at Hemodialysis unit. Non probability sampling (purposive) has been performed on (30) nurses and (30) patients in dialysis unit. direct observation as mean of data collection. Nurses were observed three times while they are working in the dialysis unit. The data were analyzed through the application of descriptive and inferential data analysis. The study results reveals that (80%) sometime applied hand washing, (76.7 %) were sometime apply uniform, and (66.7 %) were always apply gloves, (53.3 %) never wearing gown, and (86.7 %) never wearing mask. A majority of (63.3 %) of nurses were partially performed infection control measures. There is insignificant association with nurses demographic characteristics at p-value >0.05.

4 tables, 17 ref

041930   ORA M, NAZAR A H, PRADHAN P K, MISHRA P, BARAI S, ARYA A, DIXIT M, PARASHAR A, GAMBHIR S (Nuclear Medicine Dep, SGPGIMS, Lucknow - 226 014, Uttar Pradesh, Email: gaambhir@yahoo.com) : The utility of ¹⁸f-fluorodeoxyglucose positron emission tomography/ computed tomography in differentiated thyroid cancer patients with biochemical recurrence and negative whole-body radioiodine scintigraphy and evaluation of the possible role of a limited regional scan. Indian J Nucl Med 2020, 35(3), 203-9.

¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) is used in the management of recurrent differentiated thyroid cancer (DTC) patients presented with rising thyroglobulin (Tg) or anti-Tg antibody (Atg) levels and negative whole-body I-131 scan (WBS). We aimed to evaluate the utility of regional or limited PET/CT in a large population preset with variable Tg/(ATg) levels. In a retrospective study, we analyzed 137 PET/CT done on DTC patients presented with raised Tg/Atg and negative WBS. Retrospective evaluation of other available clinical information was done. One hundred and thirty-seven patients aged 8–72 years (41 ± 17.7 years) were included in the study. Eighty-nine (64.9 %) patients had positive findings on ¹⁸F-FDG PET-CT. It included thyroid bed recurrence, cervical, mediastinal lymphadenopathy, lung, and bone lesions. In addition, 36 patients had metabolically inactive lung nodules detected on CT. Serum Tg and female sex were the only predictors for a positive PET scan. In most (97.1 %) of the patients, the disease was limited to the neck and thoracic region. PET/CT is an excellent imaging modality for evaluating DTC patients presented with biochemical recurrence. It not only finds the disease in more than 80 % of the patients but also detects distant metastatic disease, which precludes regional therapies. Lesions were noted mostly in the neck and thoracic region with very few distant skeletal metastases (4/137 patients). In most of the patients, routine vertex to mid-thigh imaging could be avoided.

4 tables, 35 ref

045463   MEWARI N S, CHAUHAN R S (Veterinary Pathology Dep, G B Pant Univ of Agriculture and Technology, Pantnagar, Uttarakhand, Email: profchauhan58@gmail.com) : Immunopathology of abortions—An overview. J Immunol Immunopathol 2020, 22(1), 92-127.

Expulsion of a dead foetus prior to the normal full gestation period is called abortion. Many fertilised ova, embryos or early feotuses may be aborted without being seen. This is especially true in beef cattle, sheep and other animals not closely observed. In the cow, abortions occurring before the fifth month of gestation are seldom followed by retention of the placenta, but those occurring after four months of gestation are frequently characterised by retention. Abortion is mostly due to infection of the foetus, placenta or the uterus as these conditions cause the death of the foetus. The nature of the causative agent of the abortion may determine the degree of damage to the foetal membranes and endometrium and the frequency of retained afterbirths and sterility that follows the abortion. The main diseases/causal agents associated with abortions in animals are brucellosis, vibriosis, trichomoniasis, listeriosis, epizootic bovine abortion, leptospirosis, abortion in mares by Salmonella abortus equi and equine herpes virus, equine viral abortion, equine Rhinopneumonitis virus (equine influenza), equine viral arteritis, bovine herpes virus-1 in cattle, Chlamydia psittaci, Mycobacterium tuberculosis, Toxoplasma gondii, Mycoplasma mycoides, abortion caused by the virus of Infectious Bovine Rhinotracheitis, mycotic abortion in cattle and sheep caused by Aspergillus sp., Coccidioides sp. and Absidia sp. and some toxins/poisons are also known to cause abortions. Immunopathology includes the disorders of the immune system characterised by increased response or hypersensitivity, response to self-antigens (autoimmunity) and decreased responses (immunodeficiency). Control of diseases requires a host inflammatory response, which is likely to contribute to pathology and abortion. Mouse models have been widely used to provide insight into the role of specific immune cells in controlling infection and disease. In this article, we will review current knowledge of the innate and adaptive immune responses required for resistance to various diseases associated with abortions and the events that lead to the development of immunopathology and the natural regulatory mechanisms that limit excessive inflammation during the infection.

207 ref

046733   DIBBY H J, SHLASH R F (Physiology Dep, Al-Qadisiyah Univ, Al-Diwaniyah province- 58001, Iraq, Email: huda.budairy@qu.edu.iq) : The predictive value of Red Cell Distribution (RDW) in patients with Type 1 and Type 2 Diabetes Mellitus. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194409.

Epidemiologically speaking the diabetes mellitus is one of the common leading causes of mortality and morbidity worldwide. Prognosis of the disease is variable and depends on the development of macrovascular and microvascular complications. Researchers are nowadays spending plenty of time trying to identify prognostic factors in order to make treatment approach be tailored according to the predictive value of such prognostic factors. One of these newly introduced factors is red cell distribution width (RDW). The current study was aiming at shedding light of the possible prognostic role of RDW in patients with type 1 and 2 diabetes mellitus. The present case control study was carried out at diabetes center in Al-Diwaniayh Teaching Hospital, Al-Diwaniyah Province, Iraq. The study started on January 2019 and ended on August 2019. The study included 30 patients with established diagnosis of type 2 diabetes mellitus, 30 patients with type 1 diabetes mellitus and 30 apparently healthy control subjects. Diabetic patients were selected randomly from the pool of patients already registered in that center. We grouped diabetic patients into two groups according to HbA1c level, ≤7 % and > 7 % and contrasted hematological levels between those new groups. The results showed no significant difference in mean hematological values between the two groups in diabetic type 1 and type 2 patients (P > 0.05). There was no significant role for RDW in predicting poor glycemic control of patients with type 1 or type 2 diabetes mellitus.

3 tables, 21 ref

041929   EDUPUGANTI H S, KRISHNAMURTHY V (Pathology Dep, JSS Medical Coll, Mysuru - 570 022, Karnataka, Email: vanidrsri@gmail.com) : Prevalence of constitutional macrothrombocytopenia in the immigrants of Northern and Eastern states of India. Indian J Pathol Microbiol 2020, 63(4), 593-6.

Thrombocytopenia is generally alarming to both clinicians and patients as the consequence can be disastrous. However, some of the conditions associated with thrombocytopenia can be innocuous. Unless this is recognized, detection of thrombocytopenia results in series of further investigations and management plan by clinicians. Hematological investigation in an apparently healthy/asymptomatic individual can throw up many surprises. One of them is thrombocytopenia and giant platelets on peripheral smear examination. Asymptomatic constitutional macrothrombocytopenia (also called as Harris platelet syndrome) is increasingly recognized in north and eastern parts of India. However, this condition is nearly unknown in southern part of our country. With Increased immigrants to south India from northern and eastern states, it becomes imperative for both clinicians and lab physicians to be aware of the magnitude of the condition and interpret appropriately. This can avoid unnecessary anxiety and investigations. Blood samples from 300 north and northeastern immigrants (Cases) and equal number of healthy subjects from south India (Controls) were examined for hematological parameters. Peripheral smears were examined for the presence of giant platelets. Constitutional macrothrombocytopenia was seen in 4.3 % of the cases and in 0.66 % of the controls. The difference was statistically significant with a Fischer exact P value of 0.0067. The prevalence of macrothrombocytopenia on subjective assessment of peripheral smear was 6.7 % in the cases and 1 % in the control group. The prevalence of Harris platelet syndrome was found to be 4.3 % in the immigrants from north and northeastern states.

1 illus, 4 tables, 15 ref

041928   GUPTA K L, BAGAI S, RAMACHANDRAN R, KUMAR V, RATHI M, KOHLI H S, SHARMA A, CHAKRABARTI A (Nephrology Dep, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, Email: klgupta@hotmail.com) : Fungal infection in post-renal transplant patient: Single-center experience. Indian J Pathol Microbiol 2020, 63(3), 587-92.

Fungi are ubiquitous organisms and significantly alter the post-transplant course. They are a major cause of morbidity and mortality and more so in developing countries. To study the clinical profile, etiology, risk factors, treatment, and outcome of fungal infections in post-renal transplant recipients. This was a cross-sectional observational retrospective study from January 2014 to June 2017 wherein renal transplant recipients with invasive fungal infection were included and were followed. Amongst 550 renal transplant recipients, 56 (10.2 %) patients developed invasive fungal infection. Mean age of patients was 40.61 ± 10.06 (13-66) years and mean duration of acquiring infection posttransplant was 25.33 ± 23.65 (1-96) months. Male to female ratio was 3:1. Fever was the commonest presentation observed in 89.3 % patients. Cough (76.8 %), breathlessness (64.3 %), sputum (55.3 %), hypoxia (50 %), and hemoptysis (10.7 %) were other common clinical symptoms at presentation. Mean serum creatinine at presentation was 1.70 mg/dl. Most common invasive fungal infection isolated was Mucormycosis 15 (26.7 %), foolwed by Aspergillosis 13 (23.2 %), Pneumocystis jiroveci 12 (21.4 %), Cryptococcus 6 (10.7 %), Candida 4 (7.1 %), Histoplasmosis 3 (5.3 %), Phaeohypomycosis 2 (3.5 %), and 5 (8.9 %) patients had undetermined fungal etiology. Twenty (35.7 %) patients had evidence of dual infection. Use of antithymocyte globulin 27 (48.2 %), post-transplant diabetes mellitus 18 (32.1 %), Cytomegalovirus (CMV) infection 16 (28.5 %), anti-rejection therapy 9 (16 %), and Hepatitis C infection 7 (12.5 %) were some identified risk factors. Ten (17.8 %) patients had graft loss and 12 (21.4 %) patients died in the study period. Invasive fungal infection is a serious threat to renal transplant recipients. Patient and graft survival is significantly affected by fungal infection in developing world.

2 illus, 4 tables, 25 ref

041927   CHEN Y-A, LAI Y-C, LIN S-J, YANG C-S (Pathology and Laboratory Medicine Dep, aichung Veterans General Hospital, Taichung ? 40705, Taiwan, Email: ycshuenn@gmail.com) : Utility of cell block as an adjunct to liquid‑based cytology for diagnosing papillary thyroid carcinoma. Indian J Pathol Microbiol 2020, 63(4), 581-6.

Although liquid‑based cytology (LBC) has gained popularity among clinical laboratories, it is unclear whether it is equivalent to conventional smears for making a definite diagnosis of papillary thyroid carcinoma (PTC). The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) suggests a definite diagnosis of PTC is preferred when there are at least one of three features (papillary architecture, psammomatous calcifications, and frequent pseudonuclear inclusions) plus other typical cytomorphological findings. This study evaluated whether an additional cell block (CB), prepared from the residual LBC material, could help improve the diagnosis of PTC. A total of 62 cases with both ThinPrep LBC and CB preparations and histopathological follow-up of PTC were retrieved between November 2016 and March 2019. The ThinPrep LBC and CB slides were reviewed separately to identify any papillary architecture, psammomatous calcifications, or pseudonuclear inclusions for diagnosing PTC. Among the 51 cases with cytological diagnosis of PTC in the LBC+CB slides, the CB provided additional diagnostic information in 15 cases, which were initially diagnosed as suspicious for PTC based on the LBC slides alone. This information included papillary architecture (n=11), psammomatous calcification (n=1) and pseudonuclear inclusions (n=5). The number of specimens in the 51 cases containing at least one of the three features increased from 42 (LBC) to 51 (LBC+CB). The accuracy for diagnosing PTC increased from 58.1 % for LBC alone to 82.3 % for the LBC+CB examination. An adjunctive CB preparation may improve the LBC technique for diagnosing PTC.

4 illus, 4 tables, 30 ref

041926   TANG Q, LI Z, HAN W, CHENG S, WANG Y (Urology Dep, South China Univ, Hunan, 421001 China, Email: 594031927@qq.com) : High expression of lncRNA SNHG1 in prostate cancer patients and inhibition of SNHG1 suppresses cell proliferation and promotes apoptosis. Indian J Pathol Microbiol 2020, 63(4), 575-80.

This study aimed to investigate the expression of long non‑coding RNA (lncRNA) small nucleolar RNA host gene 1 (SNHG1) in prostate cancer (PCa) patients and to assess the effects of SNHG1 on PCa cell proliferation and apoptosis. A total of 134 PCa patients were randomly included from patients who underwent surgical resection at our hospital from October 2015 to December 2016. The SNHG1 expression levels in PCa tissues and paired adjacent non‑cancerous tissues were detected by quantitative reverse transcription polymerase chain reaction (qRT‑PCR). The association of the SNHG1 expression with clinical‑pathological features of PCa patients was summarized and evaluated. A short interfering (si) RNA targeting SNHG1 and pcDNA3.1‑SNHG1 were transfected into PC3 and DU145 PCa cell lines, and transfection efficiency was verified by qRT‑PCR. Cell proliferation and apoptosis were assessed by methylthiazolyldiphenyl‑tetrazolium bromide (MTT) and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays, respectively. The SNHG1 expression was significantly upregulated in PCa tumor tissues compared with paired adjacent non‑cancerous tissues. The SNHG1 expression was obviously associated with the TNM stage, Gleason Score, lymph node invasion, and long‑term metastasis mortality rate. Silencing of SNHG1 inhibited cell proliferation and promoted apoptosis in PC3 and DU145 PCa cell lines in vitro, while overexpression of SNHG1 led to opposite results. LncRNA SNHG1 was upregulated and associated with aggressive malignant behavior in PCa progression. SNHG1 might serve as a potential prognostic biomarker and potential therapeutic target for PCa.

4 illus, 1 tables, 20 ref

046732   BDEWI S Y, KAREEM M H, SHWAISH M M, HASAN M S (Fallujah Univ, Fallujah, Iraq, Email: drmustafasalah7@gmail.com) : Isolation of MRSA from drinking water supplies in Al-Anbar Province, Iraq. Med Legal Update 2020, 20(1), 10.37506/v20/i1/2020/mlu/194408.

This study was aimed to isolate MRSA from water supplies from different places in alanbar province, fifty water samples were cultured on nutrient, macConkey and blood agars then subcultured on MSA and Staph 110, then gram stain and biochemical test done to confirm this bacteria. Then antibiotic susceptibility test were done on S. aureus by using different antibiotics including Methicillin, erythromycin, Doxycycline, Sulfa-trimethoprim, penicillin, chloramphenicol, ciprofloxacin. The results showed that 12 (24 %) samples were diagnose as S. aureus, these were showed complete resistance to methicillin, erythromycin, Doxycycline and showed different percent for resistance to other antimicrobials that used. In conclusion, the MRSA were isolated from drinking water in significant percentage and this strain of bacteria were showed higher resistance to antibiotics. 

3 illus, 2 tables, 23 ref

045460   DEEKSHA, CHAUHAN R S (Veterinary Pathology Dep, GB Pant Univ of Agriculture and Technology, Pantnagar, Uttarakhand, Email: profchauhan58@gmail.com) : Type IV hypersensitivity reaction and its associated disorders in animals. J Immunol Immunopathol 2020, 22(1), 56-65.

The major defence mechanism against intracellular pathogens like Mycobacterium, Brucella, fungi and certain parasites is delayed type of hypersensitivity. Delayed hypersensitive reaction is induced by cytokines, secreted by subpopulation of activated T cells during encountering with certain type of antigens. Delayed type hypersensitivity reaction is slower in onset and develops within 72 h and the response is prolonged. Sensitisation of the CD4+ cells of Th1 type occurs during its first exposure to an antigen. These sensitised Th1 cells remain in the circulation for a very long time. On subsequent exposure to the same antigen, sensitised Th1 cell release chemotactic factor for macrophages which leads to recruitment of macrophages at the site of infection. Various cytokines are also releases that lead to the tissue injury. Tissue damage is also mediated by CD8+ cells through direct toxicity. Delayed type hypersensitivity reaction also helps in the diagnosis and eradication programme of diseases caused by intracellular pathogen where cellular immunity plays an important role. Tuberculin reaction is one such example of the delayed type of hypersensitivity reaction. Allergic contact dermatitis is skin’s delayed-type hypersensitivity caused by the non-irritating agents like paint, cosmetics, collars, etc. these allergens are identified by the patch testing. Allograft rejection is also a T-cell-mediated response that makes organ transplantation unsuccessful.

1 illus, 53 ref

041925   ABDULLAH B H, JASSAM S A, HADI W A, HAMEED B (Clinical Laboratory Sciences Dep, Mustansiriyah Univ, Baghdad, Iraq, Email: baydaah.abdullah@uomustansiriyah.edu.iq) : Gallbladder stone formation in Iraqi patients is associated with bacterial infection and HLA class II‑DRB1 antigens. Indian J Pathol Microbiol 2020, 63(4), 570-4.

Gallbladder stone is recently increased among the Iraqi society due to many risk factors such as bacterial infection and some HLA class II antigens. This study investigates the types of bacterial infection and HLA‑DRB1 antigens’ ratio that may be correlated with gallbladder stone formation. The study included 45 patients and the same number of healthy individuals as a control group. Patients were with multiple gallstones. Gallstone bacterial culture was demonstrated to diagnose viable bacteria. HLA‑DRB1 alleles’ frequency was investigated using sequence‑specific oligonucleotide probes (PCR‑SSOP). Irrespective of gallstone type and size, different types of living viable bacteria were isolated from the cores of the studied gallstones in 80 % of the studied cases versus 20 % of sterile gallstones. Gram‑negative bacteria cultures were the dominant(89.3 %), including Escherichia coli, Klebsiella spp., Proteus spp., Acinetobacter spp., and Enterobacter spp. Mixed infection of Gram‑positive and negative bacteria was noted: Escherichia coli and Enterococus spp. and the others of Escherichia coli and Acitobacter spp., and Klebsiella spp. and Pseudomonas spp. Gram‑positive bacteria cultures were also detected at lower rate (10.7 %) including Staphylococci spp. The frequency of HLA‑DRB1*03:01, HLA‑DRB1*4:03, HLA‑DRB1*13:22, and HLA‑DRB1*15:10 alleles was significantly elevated in patients compared to the healthy control group. Results ensured the viability of the bacteria isolated from the core of gallstones and showed positive correlation between gallbladder stone and different bacterial infection. In addition, HLA‑DRB1 alleles were significantly high in patients compared to healthy control group suggesting them as risk factors (P < 0.05).

2 illus, 4 tables, 26 ref