Allied Sciences Research Articles

From research desk to policy makers and community: MUHAS research symposia and policy briefs targeting the stakeholders

All too frequent, valuable research output and scholarly materials from expensively conducted research work in different parts of the world end up in research desks, academic libraries, and scientific journals. Muhimbili University of Health and Allied Science (MUHAS) through the Directorate of Research and Publications initiated a series of symposia that aim to disseminate the evidence generated by the researchers to the policy makers and the community. In two of the six conducted University-wide symposia in the last one year, MUHAS produced two important policy briefs summarizing the impact of MUHAS research in two important—though distinct areas of local and global health impact—Elimination of Mother to Child Transmission (EMTCT) of HIV, and Diarrhea diseases.

Editorial – News About the Journal of the History of Medicine and Allied Sciences

Oxford University Press (OUP), the publisher of the Journal of the History of Medicine and Allied Sciences, has informed us that the recent Covid-19 crisis has hastened a plan they have been discussing for some time: to transition the journal to an online-only format. The plan had been to make this change during 2021, but the pandemic moved the timeline up such that the last print issue was the last one published (April 2020). This decision was made primarily to reflect the reality of how readers are using journal content in the days of internet access. The vast majority of users are accessing individual articles online through subscriptions (either individual or institutional). It does not appear that a transition to an online-only version of the journal will change the way that most people read it. The online-only presence of the journal will not change our rigorous peer-review process, nor the value of the journal to the history of medicine community.

Family Disruption as a New Prospect to Consider in Traumatic Brain Injury

Background: Different types of behavioral changes are seen in head injury patients, and these changes are directly or indirectly related to the daily activities of both patient and the family members. The impact of head injury has affected the relationships in the family and friendship status too. Even it has brought about divorce and other family disruption in the present modern world. This study was designed with the aim of evaluating family disruption in different grades of head injury.
 Materials and methods: This is a prospective analytical study that included 76 patients with non-probability consecutive sampling conducted at the National Institute of Neurological and Allied Sciences, Bansbari, Nepal over 6 months duration. All head-injured patients above the age of 16 years were included and patients with Extended Glasgow Outcome Scale of less than 3 at 6 months follow up were excluded. Their age, gender, mode of injury, GCS at presentation were collected. Extended Glasgow Outcome Scale and their family adjustment were evaluated at 6 months. The family adjustment was seen and analyzed from the GOS-E interview questionnaire. Data analysis was done using SPSS v.20.
 Results: The total number of patients was 76 among which 71% were below 40 years of age and the majority (87%) were males. The commonest mode of injury was a road traffic accident (35, 46%) followed by injury due to fall and physical assault. Of all, 76% (58/76) were mild head injured followed by 15% (11/76) severe head-injured patients. At 6 months, the Extended Glasgow Outcome Scale (EGOS) of 7 and 8 were obtained in 37% and 43% of the patients respectively. All the family who had severe head-injured patients and about 85% of the family with moderate head-injured patients had a significant degree of family disruption. Also, 8% of families with Mild head-injured patients had some degree of family disruption. Family disruption and its extent of severity were significantly related to the severity of the head injury.
 Conclusion: Family disruption and extent of disruption/ strain are also strongly associated with the severity of the head injury.

Occupational Exposure to Blood and Body Fluids among Medical Laboratory Science Students of the University of Health and Allied Sciences during Vocational Internship in the Volta Region of Ghana.

Medical laboratory science students (MLSS), likewise health care workers (HCW), invariably get exposed to blood and body fluids (BBF) of patients. The degree of exposure of these students is even worsened due to their inexperience, which is usually revealed during their vocational training programme. This study therefore determined the prevalence of exposure to BBF and its risk factors among MLSS at the University of Health and Allied Sciences (UHAS). A cross-sectional survey was employed using simple random sampling to enrol 178 students into the study. The study was conducted from February 1 to March 31, 2018, after the annual vocational training programme completed in August 2017. Self-administered questionnaires based on the objectives of the study were given out to participants to complete after their consent was sought. Descriptive data were reported as absolute number with percentages, whereas bivariate and multiple logistic regressions were done to describe relationship between risk factors and exposure to BBF. The study findings revealed that, out of 178 MLSS that participated, 90 (50.6%) experienced at least one exposure to BBF. Also, work experience before university education increased the chances of exposure to BBF (AOR = 7.37, 95% CI = 1.22–44.43, pvalue = 0.029) compared with those with no experience. In contrast, adequate personal protective equipment (PPE) reduced the tendencies of exposure to BBF (AOR = 0.41, 95% CI = 0.20–0.88, p value = 0.023) compared with students who had insufficient PPE. The study showed high, 50.6% (95% CI: 43.0%–58.1%), exposure to BBF. Work history and sufficient PPE were the most significantly associated risk factors. In view of this, there is the need to promote training and education on exposure to BBF particularly among experienced students and also encourage health facilities to continue providing enough PPE for students during their annual obligatory vocational internship programmes.

Epidemiology and Pattern of Traumatic Brain Injuries at Annapurna Neurological Institute & Allied Sciences, Kathmandu, Nepal

Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem worldwide. It represents the greatest contribution to death and disability among all trauma-related injuries globally. TBIs are a leading cause of death and disability in Nepal, despite improvements in safety regulations and implementation of strict drunk driving laws. We describe the epidemiology of patients with TBI following admission to our hospital. We discuss the implementation of specific strategies to reduce its incidence. We conducted a retrospective cross-sectional study of patients presenting to Annapurna Neurological Institute & Allied Sciences (ANIAS), Kathmandu, with a TBI between September 2018 to September2019. One-hundred and sixty-seven patients presented with a TBI. The most common age groups were younger than 15 years old and 15-25 years old, and the majority were male (73%). The commonest cause of TBI was road traffic accidents (RTA) (59%). Drivers riding motorcycles were the predominant mechanism of RTA (38%). Helmet use was seen in 57% of patients riding 2-wheelers. Alcohol consumption was reported in 22% of all patients. Skull fractures were the most common diagnosis. Most patients were managed conservatively (84%). TBI should be recognized as an important public health problem in Nepal. TBI is responsible for a considerable number of neurosurgical admissions to ANIAS. Our study showed patients most vulnerable to TBI are males younger than 25 years old. The implementation of stricter traffic rules and regulations, helmet law enforcement, and public education programs may be helpful in decreasing the number of TBI.

Prevalence and Correlates of Depression among Bugando Medical Centre and Catholic University of Health and Allied Sciences staff – Mwanza Tanzania, A Cross Sectional Study

Prevalence and Correlates of Depression among Bugando Medical Centre and Catholic University of Health and Allied Sciences staff – Mwanza Tanzania, A Cross Sectional Study

A Study on the Literature about Learning Method of Biological Health and Allied Sciences Student’s Subjects

A Study on the Literature about Learning Method of Biological Health and Allied Sciences Student’s Subjects

Maternal Pesticides Exposure and Child Development Among Smallholder Tomato Farmers in Southern Corridor of Tanzania

Background: Exposure to pesticides with its associated effects prenatally and at early childhood has not received much attention. There is little scientific data on this aspect in Tanzania therefore this study was meant to contribute to the deficit in the subject. Objective: The objective of this cross-sectional study was to assess maternal pesticides exposure and child developmental effects among smallholder tomato farmers in southern agricultural corridor in Tanzania. Method: A sample of 286 of mother to child pair participants were enrolled whereby 172 and 144 were exposed and non-exposed respectively, mothers who had been working in the tomato sprayed farms were exposed and mothers who had not been working in the tomato sprayed fields were un-exposed, child aged 0-6 was chosen from each mother sampled. Malawi child development Tool (M-DAT) was employed to assess child level of development, and height and weight of the children were collected and analyzed by WHO anthropometric calculator. Checklist and questionnaire were used to observe and assess maternal exposure. Bivariate and Multivariate analysis were conducted to assess the relation within various factors of exposure. Results: Overall 15% of the children examined were not well developed and the most used pesticides were those posing develipong effect. On bivariate analysis model, mother who worked more than a year were more likely of having a child with development effect [OR 4.3 (1.5-11.5)] and those living in Ludewa cluster were more likely to have child with developmental effect [ OR=11.9 (2.7-52.07) ] . Mothers who worked while pregnant were more likely to have child with developmental effect OR=5.8(1.29-26.3) on bivariate analysis. On multivariate analyses adjusted for age mother factors remain in the model were say distance from home [AOR=9.4(4.2-20.5)], and working while pregnancy [AOR=5.8(1.29-26.3)] other were removed due to collinearity effect. Conclusions: The findings from this study have indicated that maternal pesticides exposure among farm worker resident in the SAGCOT area has a potential association with child developmental effect. Funding Statement: This study was funded by the principal investigator himself. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: Ethical clearance was obtained from the Senate of Research Publication Committee of Muhimbili University of Health and Allied Sciences. A permission to collect information from the district selected was requested from the Regional Administrative Secretary office who will write a letter to the respective district where permission to take survey in district was granted through the District extension officer but the information and the permission letter was sent to the SAGCOT respective cluster so as to easily reach the farmers. Study participants was informed the aim of the study and its importance and informed consent was provided to the participants before recruit them in the study which was a formal written consent and confidentiality. The information from this study was used for academic purpose only, thus each participant was treated anonymously. And all children identified with development effect was listed and recognized by the administration responsible for further support.

Exploration of Associations Between Deliberate Self-Poisoning and Psychiatric Disorders in Rural Sri Lanka: A Case Control Study

Background: Psychiatric disorders are important predictors of self-harm behaviour. The present study was carried out to determine associations between DSM-IV TR Axis- I & II disorders and deliberate self poisoning (DSP) in a Sri Lankan rural agricultural district. Methods: Patients who had attempted DSP, who resided within the district were selected randomly for the study. Both the cases and age, sex and residential area matched controls were assessed for DSM-IV TR Axis- I & II disorders based on the Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders (SCID I & II) conducted by a specialist psychiatrist. Findings: Cases consisted of 207 (47.3%) males and 231 (52.7%) females. TR axis-I and/or TR axis-II psychiatric diagnoses was found in 89 (25.6%) of cases and 14 (3.2%) controls. Cases with a TR axis-I diagnosis were older (32 and 19 years), p =30 years and having an alcohol use disorder carried a 21 time excess risk for DSP. A fivefold excess risk for DSP was found among 10-19 years old females with borderline personality traits. Interpretations: Depressive disorder and alcohol related disorders were significantly associated with older participants who had attempted DSP. The prevalence of psychiatric disorders among DSP in rural Sri Lanka is significantly lower than reported rates in western countries. Health and research priorities to reduce self-harm in Sri Lanka will also need to address non-psychiatric issues. Trial Registration: (Sri Lanka Clinical Trial Registry No. SLCTR/2010/008). Funding Statement: The study was supported by two Australian National Health and Medical Research Council grants: NHMRC 630650 and NHMRC Fellowship 1059542 (https://www.nhmrc.gov.au/). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Ethics approval for “A clustered RCT of educational interventions on treatment of patients with acute poisoning in rural Asian hospitals” was obtained from Ethical Review Committee of the Faculty of Medicine, University of Peradeniya. Ethical approval for the sub study was obtained from the human ethics review committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka.

The relationship between the exposure to healthcare settings and colonization with methicillin-resistant Staphylococcus aureus among medical students.

Medical students who engage in clinical learning in healthcare settings can be potential methicillin-resistant Staphylococcus aureus (MRSA) carriers. This is a descriptive cross-sectional study having a follow-up approach. Three batches of medical students who were studying at the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka (1st, 3rd and 5th study years of MBBS course) were screened for nasal and axillary MRSA colonization. The first-year students were screened before and 6 months after clinical learning. The knowledge of the students about infection control was scored (percentage) using a questionnaire in the one week before and later one year after the hospital exposure. Data was compared using two-sample t test. The percentage of MRSA colonization was 6.36% (7/110) and 49.57% (59/119) before clinical exposure and after 2.5 years of exposure, respectively (p<0.012). The percentage of correct responses obtained by the students for the questionnaire about infection control was 28% and 66.9% one week before the exposure to the hospitals and one year after the exposure to the hospitals, consecutively. MRSA carriage was significantly associated with the time duration of the clinical training of the medical students. The knowledge of students about infection control was significantly inadequate one week before the hospital exposure and they have gained the knowledge only after being exposed to the hospitals.

Outcome of transforaminal epidural steroid injection for lumbar radiculopathy: initial three-year experience at Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Nepal

BackgroundThe prevalence of low back pain with radiculopathy in general population varies from 9.9% to 25%, which can be due to bony narrowing of the lateral recess or due to prolapsed intervertebral disc. Transforaminal epidural injection of a mixture of long-acting anaesthetic (bupivacaine) and particulate steroids (depomedrol) has been a treatment modality in patients not responding to initial physiotherapy and neuropathic pain medications.MethodsTo analyze the effectiveness of transforaminal epidural steroid injection (TFESI) in the treatment of low back pain with radiculopathy, a retrospective case series evaluating the records of patients that received TFESI (1 mL 0.5% bupivacaine +1 ml/40 mg depomedrol) under C-arm guidance from January 2015 to December 2018 (3 years) at Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences (UDM-NINAS), their lumbo-sacral MRI and the pre-procedure, 1-week and 3-month numeric pain rating scale, were analyzed. Successful treatment (reduction of pain scale by more than 50% of baseline at 3 months) in the patients with bony recess stenosis and those with prolapsed intervertebral disc was compared.ResultsOut of 67 patients that received TFESI, 35 (52.23%) could be followed up. The mean age was 55.8 ± 14.39 years and 51.3% were females. 68.57% had L5 and 20% had S1 radiculopathy. Bony recess stenosis was seen in the aged 40% and PIVD was the cause of radiculopathy in 60%. The median duration of radicular pain prior to intervention was 3 months. TFESI was effective as the mean numeric pain scale before injection was 8.97 ± 1.32 which reduced to 3.91 ± 3.23 (paired t test p value < 0.001) at 1 week post injection and 3.23 ± 3.34 (paired t test p value < 0.001) at 3 months post injection. Twenty-six of the 35 patients (75.29%) had more than 50% pain relief compared to baseline at 3 months and were satisfied. Nine patients continued to have pain; however, only one required a surgical intervention. The effectiveness of TFESI was not significantly different in different ages (Fisher’s exact test p value 0.182) and in different anatomic levels (Fisher’s exact test p value 0.241). Six out of eight patients with bony recess stenosis benefited as compared to 14 out of 19 patients with PIVD, though it was not statistically significant (Fischer’s exact test p value 0.688). There were no adverse events recorded.ConclusionTFESI is a safe and efficacious treatment modality in patients with radicular low back pain especially in aged patients in whom surgery under general anaesthesia is not free from risk.

Outcome of Endoscopic third Ventriculostomy for Obstructive Hydrocephalus due to Posterior Fossa Lesions

Background and purpose: Obstructive hydrocephalus can be treated with External ventricular Drainage (ETV), Ventriculo peritoneal shunt insertion, upfront tumor removal without cerebrospinal fluid diversion procedures or more recently ETV. Aim of our study was to study the outcome of ETV in treating such patients.&#x0D; Material and method: Descriptive observational study conducted at Upendra Devkota Memorial Institute Of Neurological and Allied Sciences from Sep 2015 to may 2017.&#x0D; Result: Twenty-three patients met the inclusion criteria. Among which, 14 (39%) patients were male with male to female ratio of 1.55. We included wide age range from 3 years to 68 years. Seven patients (30.4%) were less than 10 years while 6 patients (23%) were above 60 years old. Patients with Posterior fossa presented with varied symptoms. Ten patients (43.4%) presented with decreased level of consciousness, 14 (60.8%) presented with visual symptoms, 17 (73.9%) presented with vomiting and 23 (100%) presented with headache (Figure. 3). Visual acuity was normal among 3 (13%), decreased among 11 (48%) and with no perception of light among 3 (13%). However, acuity was not assessed among 6 (26%) patients (Figure 4).Funduscopic evaluation revealed papilledema among 20 (87%) patients while secondary optic atrophy among 3 (13%) patients. Patients were evaluated in follow up for symptomatic improvement. Consciousness were improved among 8 (80%) patients, visual symptoms improved among 10 (71.4%) patients, vomiting subsided among 15 (88.2%) patients while headache improved among 100%. Following ETV, 5 (21.7%) patients developed complications, 3 (13%) patients had intraventricular bleeding while 2 (8.6%) patients had CSF leakage from the wound.&#x0D; Conclusion: Endoscopic third ventriculostomy is a relatively safe and valid option for treatment obstructive hydrocephalus due to posterior fossa lesions.

Congenital Hypothyroidism among Newborns and its Association with Maternal Biosocial Factors in Rajshahi Medical College Hospital

Congenital hypothyroidism is the commonest preventable cause of mental retardation. It is more prevalent in endemic goiter regions like Bangladesh. This study was done to assess the congenital hypothyroidism in neonates (age 4 to 28 days) admitted in Rajshahi Medical College Hospital. It was a cross sectional descriptive study conducted at pediatric department of Rajshahi Medical College Hospital from July 2016 to June 2018. After taking written consent from each mother/guardian, 3 ml venous blood was collected and sent to the laboratory of Institute of Nuclear Medicine and Allied Sciences, Rajshahi to estimate serum TSH/ serum TSH and T4 level. Total 500 samples were collected in two years of study period. All information was put in the data collection sheet and was analyzed through standard statistical method by using SPSS version 16.0. Serum level of TSH ≥ 20 μIU/ml was considered as congenital hypothyroidism. Serum level increased but bellow 20μIU/ml were recalled to repeat serum TSH level within 2 to 6 weeks of age. Among 500,321(64.2%) male and 179 (35.8%) female, Among 500 study population, 199 and 135 came from Rajshahi and Chapai Nawabganj district respectively. Total 7 mothers were hypothyroid and on thyroid replacement therapy. TSH level above 20 μIU/ml was found in 5 neonates, 11 to 20 μIU/ml in 7 neonates. After repeat TSH testing one infant had serum TSH level above 20 μIU/ml. Finally total 6 infants were diagnosed as having congenital hypothyroidism. Thus frequency of congenital hypothyroidism was 1.2%. Congenital hypothyroidism in Rajshahi region is very high in relation to global incidence. Although this is not the actual picture of our country but this figure is alarming. Therefore neonatal screening program should be started as soon as possible to reduce the number of mentally retarded child. Maternal obesity and thyroidal status have significant association with neonatal TSH level.&#x0D; TAJ 2019; 32(2): 36-42

Assessment of Quality of &amp;lt;i&amp;gt;Artemisia afra&amp;lt;/i&amp;gt; Powder Used as Antimalarial in Tanzania

The quality of herbal medicine can be affected by environmental conditions where by the medicinal plants are grown or collected, the area where they are dried and processed, storage conditions, transport conditions and manufacturing processes at the point of production. The study aimed to determine the quality of heavy metals, aflatoxins and microbial contaminants of Artemisia afra leaves powder used as herbal medicine processed at the Institute of Traditional Medicine of the Muhimbili University of Health and Allied Sciences (MUHAS). Artemisia afra leaves powder was obtained from The Institute of Traditional Medicine (ITM) in Tanzania where it is processed and packed as Fivisia. Microbial contaminants were analyzed by using plate count method for moulds and Shigella spp. while Most Probable Number (MPN) method used for determination of E. coli; Heavy metals were analyzed using; Inductively Couple Plasma – Mass Spectrometry (ICP-MS) and aflatoxin analysis was done using High Performance Liquid Chromatography-Mass Spectrometry (HPLC-MS). The data were tabulated, expressed in mean±S. D and presented in graphs and compared to WHO guidelines. The quantity of molds was between 1.1× 103 – 1.2× 103 CFU/g which is below the legal limit according to WHO of maximum of 105 CFU/g, none of the samples were contaminated with E. coli or Shigellas sp. Levels of heavy metals were within the permissible limit for consumed herbal product according to WHO standard guidelines; Chromium 1.69 ± 0.08 ppm, Lead 0.22 ± 0.01, Cadmium 0.08 ± 0.01, Mercury 0.15± 0.08 and Arsenic 0.04 ± 0.02. All samples were found below the detection limit for aflatoxin B1, B2, G1 and G2. The Artemisia afra leaves powder processed and packed as Fivisia at the Institute of Traditional Medicine; Muhimbili University of Health and Allied Sciences (MUHAS) is safe for human consumption based on the quality parameters that have been studied.

Effect of integrated nutrient management practices on growth attributes of transplanted rice

An experiment was conducted at experimental research farm, Rampur, Doon PG college of Agriculture and Allied Sciences, Rampur, Selaqui, Dehradun “Effect of Integrated Nutrient Management Practices on Yield Attributes of Transplanted Rice (Oryza Sativa L.)” during kharif season of 2016.Twelve treatments viz., Control (T0), FYM @ 12.5 t ha-1 + 100% RDF, FYM @ 12.5 t ha-1 + 75% RDF, GM @ 6.25 t ha-1 + 100% RDF, GM @ 6.25 t ha-1 + 75% RDF, FYM @ 12.5 t ha-1 + Biofertilizer + 100% RDF, FYM + @ 12.5 t ha-1 + Biofertilizer + 75% RDF, FYM @ 12.5 t ha-1 + Biofertilizer, GM @ 6.25 t ha-1 + Biofertilizer + 100% RDF, GM @ 6.25 t ha-1 + Biofertilizer + 75% RDF, GM @ 6.25 t ha-1 + Biofertilizer, FYM @ 12.5 t ha-1 + GM @ 6.25 t ha-1 conducted in a randomized block design (RBD) with three replications. Rice variety “PS-5” was used as test crop. The soil of experimental plot was silt clay loam in texture, medium organic carbon and available nitrogen, high in available Phosphorus and rich in Potassium status. The results of the experiment indicated that maximum value of growth attributes viz., plant height, no of tillers and dry matter accumulation were conspicuously increased with the application of GM @ 6.25 t ha-1 + Biofertilizer + 100% RDF (T8) and was superior over rest of the treatments but at par with GM @ 6.25 t ha-1 + Biofertilizer + 75% RDF (T9) and FYM @ 12.5 t ha-1 + Biofertilizer + 100% RDF (T5). However the lowest growth attributes were recorded with the treatments Control (T0), FYM @ 12.5 t ha1 (T11).Based on the results, it can be concluded that higher grain yields and net profit from Transplanted Rice crop can be obtained with the application of GM @ 6.25 t ha-1 + Biofertilizer + 100% RDF (T8).

Out of the closet

An editorial on lesbian, gay, bisexual, and transgender (LGBT) community and the initiatives of an activist for the community with those of the Society for Mental Health in LAMIC (SoMHiL) as well as the Open Journal of Psychiatry & Allied Sciences (OJPAS®).

Severity of violence and quality of life of women with psychiatric disorders as compared to normal controls.

Background:Despite the fact that violence against women is a significant public health problem, there is a paucity of research into this area, and little is known about the extent to which women with psychiatric disorders are affected.Aim:The aim of the study was to assess and compare the severity of violence and quality of life of women with psychiatric disorders and normal controls.Materials and Methods:Based on purposive sampling technique, a sample consisting of 120 participants was selected from in-patient (female section) and outpatient services of the Ranchi Institute of Neuro-Psychiatry and Allied Sciences and Kanke Area. Both groups were matched on sociodemographic details. Normal controls were screened using General Health Questionnaire-12. The severity of violence against women scale and the revised Conflict Tactics Scale were used to assess the severity of violence, and World Health Organization Quality of Life (WHOQOL)-BREF scale was used for the assessment of the quality of life. Scales were scored as per their test manuals. Results were tabulated and compared using appropriate statistical tests.Results:Women with psychiatric illness as well as normal controls faced various forms of symbolic violence equally. Women with psychiatric disorders faced significantly higher severity of physical assault, sexual coercion, and injury as compared to normal controls. Women with psychiatric disorders had significantly lower scores on WHOQOL BREF compared to normal participants.Conclusion:Women with psychiatric disorders suffered significantly higher severity of both physical and sexual violence and had significantly worse quality of life compared to normal controls.

Clinical, Pathological, Treatment Pattern and Post-management Follow-up Features of Differentiated Thyroid Carcinoma (DTC) in a Tertiary Level Health Care Center of Bangladesh

Introduction: This study evaluates clinical, pathological, treatment pattern and post-management follow-up features of differentiated thyroid carcinoma affected patients who had attended Rajshahi Medical College Hospital as well as private clinics and then Institute of Nuclear Medicine &amp; Allied Sciences, Rajshahi for primary surgical management and post-operative radioiodine ablation therapy respectively.&#x0D; Materials and Methods: It is a retrospective study. Clinico-pathological, treatment and post-management follow-up features of 254 patients of histologically proved differentiated thyroid carcinoma (DTC) were recorded from their ultrasonography report, pre-operative cytology, operation note, post-operative histopathology and radioiodine ablation therapy related follow-up book between 2011 and 2015 and analyzed using statistical software IBM SPSS v. 16.&#x0D; Results: Among the sample (n=254), 211 (83 %) were female and 43 (17 %) were male. Mean age group was 30-39 years. In relation to FNAC findings of thyroid nodules among this study sample (n=254), 223 (88%) had malignant cytology, 16 (6%) had borderline cytology and 15 (6%) had benign cytology. Regarding the histopathological findings of thyroid nodules, 241 (95 %) had papillary carcinoma and 13 (5 %) had follicular carcinoma. Regarding radioiodine ablation dose, 198 (78%) had been given 138 millicurie (5.1 gigabecquerel) and 56 (22%) had been given 178 millicurie (6.6 gigabecquerel).&#x0D; Conclusion: Early and successful management of differentiated thyroid carcinoma is required to practice widely and equitably in order to significantly reduce mortality and morbidity related to such conditions.&#x0D; Medicine Today 2020 Vol.32(1): 25-28

Experiences of First Insulin-Treated Patients (1922-1923).

Historical description of first insulin trials just after its discovery. The review includes first initiatives of insulin treatment. The probability of other trials, not reported to the Insulin Committee of the University of Toronto and conducted in the years 1922 and 1923, is quite low. (1) Archival Collections, University of Toronto: Insulin Discovery and Early Developments of Insulin (University of Toronto Libraries digital special collection, with a particular section entitled "From a Patient's Point of View" containing letters, patient charts, newspaper clippings, and photographs). (2) Thomas Fisher Rare Book Library: Academy of Medicine Collection, F. G. Banting Papers, C. H. Best Papers, J. B.Collip Papers, W. R. Feasby Papers, E. Hugues Papers, J. J. R. Macleod Papers. (3) National Library of Medicine: PubMed search for the topic of history of insulin, History of Medicine-on syllabus archive. (4) Selected Journals for History of Medicine: Bulletin of the History of Medicine, Journal of the History of Medicine and Allied Sciences, Medical History. (5) Selected books: The Discovery of Insulin (M. Bliss); Diabetes, Its Medical and Cultural History (D. von Engelhardt); H. C. Hagedorn and Danish Insulin (T.Deckert), Continuing Quest (W. A. Tomkins). This historical review shows the quick progress from impure pancreatic extract to the selective isoelectric precipitation of the hormone, which made possible the introduction of insulin in the clinic. The coordination between the Departments of Physiology (Connaught Laboratories) and Medicine (Toronto General Hospital) was essential for the discovery and implementation of insulin therapy. The Insulin Committee was decisive for the negotiation with the pharmaceutical industry, the purification, grand-scale production, patents' achievement, and provision of licenses to expert clinicians and prestigious health centers. At the end of the year 1923, insulin treatment was already extended to Europe (mainly Scandinavia, Great Britain, and Spain). Insulin discovery and treatment changed the clinical spectrum of diabetes.

Entrepreneurial intentions of agriculture &amp; allied sciences students of Gujarat

India is experiencing a youth bulge and expected to be home to a skilled workforce of 500 million by 2022. Yet, the ‘Make in India ’campaign and the ‘Start-up India ’campaign recently launched by the Hon'ble Prime Minister Shri Narendra Modi cannot be successfully implemented until the youth brigade abandons the mentality of ‘Job Seeker ’and intend to be a ‘Job Giver ’. India, gradually heading towards becoming the country with the highest population, need to inculcate entrepreneurial zeal among the students at the higher education forum. This is particularly true for the students of Agriculture and Allied Sciences as there are ample opportunities for becoming the ‘Agriprenuers (Agri Entrepreneurs)'; provided these students inculcate such positive mentality. As we are aware that entrepreneurship is a process of organizational emergence. Entrepreneurial intentions are crucial to this process, forming the first in a series of actions to organizational founding. In this regard, the present Empirical Paper, utilizing the published theoretical literature and Communication Approach of the Descriptive Cross-sectional research design, is focused on assessing the entrepreneurship intentions among the students, the entrepreneurial self confidence of the students and the perception/opinions on entrepreneurial intention of the Post Graduate (PG) students of various disciplines related to Agriculture and Allied Disciplines studying in a State Agricultural University located in the coastal region of Gujarat State in India. Data collected from 100 respondents suggests that personal attitude of the student, perceived behavioral control and perceived structural support have significant impact on entrepreneurial intention. The outcome of this hitherto research study will help the institutions and higher-ups of the university to come up with action plan to guide, encourage and motivate the students and facilitate their entrepreneurial journey.