Study of correlation between age of menarche and body mass index in adolescent

Background: Younger age at menarche is associated with higher body mass index (BMI) for adolescents. Obesity has a strong association with infertility and menstrual irregularities. Higher BMI at menarche is associated with an earlier occurrence of menarche.  The timing of menarche was associated with the BMI, waist circumference, thickness of skin fold, but more strongly so with the BMI.Methods: This cross-sectional study was conducted at Durgapur (West Bengal), where total 600 adolescent girls aged 12-17 years from DAV Model School, Durgapur and GMPS High School, Durgapur were selected.Results: In studied girls, maximum girls 267 (44.5%) attained menarche at age of 13 years. 129 girls (21.5%) had menarche at age of 12 years. 87 girls (14.5%) had menarche at age of 11 years. 77 girls (12.8%) had menarche at age of 14 years. 39 girls (6.5%) had menarche at age of 15 years. Only 1 girl (0.2%) had menarche at age of 10 years. 119 girls with BMI of 25 kg/m2 had mean age of menarche 12.60±1.07 years.Conclusions: Mean age of menarche in adolescent girls was 12.75±1.06 year. Mean BMI was found 21.6±3.64 kg/m2. High BMI girls had earlier menarche, comparatively to normal BMI girls and underweight girls

The Extent of Mitigation of Risks through Regulation of Over-the-Counter (OTC) Derivative Markets in Different Jurisdictions

Over the last decade dealing with derivative financial instruments (basically forwards, futures, options and combinations of these), particularly in the Over-The- Counter derivatives market has become a central activity for major wholesale banks and financial institutions. Major new regulatory initiatives are under consideration in various jurisdictions and also adopted in some, as a means for increasing transparency and reducing the various types of risks involved in OTC derivative trading. This paper tries to understand the concept of derivatives as a whole. The main aim of the paper will be to analyze the different types of risks that are involved in OTC derivative trading. It will put forward these risks in a manner so as to enable the reader to get an in depth study of the risks in OTC derivative market through qualitative and quantitative research. As mentioned above, this paper will then focus on the regulatory regimes of three major jurisdictions i.e. India, United States and Europe and will conclude that these regulations are sufficiently able to mitigate these risks in their respective jurisdictions. Lastly, certain measures are recommended for different jurisdictions so as to further increase the ambit of sufficiency in mitigating the risks involved

A Brodie's abscess of femoral neck mimicking Osteoid osteoma: Diagnostic approach and management strategy

BACKGROUND: Brodie's abscess usually presents as a diagnostic dilemma resulting in a diagnostic delay. It mimics various benign and malignant conditions both clinically and radiologically.CASE DETAILS: This report describes a case of a 14 year old boy who presented with a clinical and  radiological picture of osteoid osteoma of proximal femur but found to have a brodie's abscess on histology and culture.CONCLUSION: It describes the clinical spectrum of subacute osteomyelitis, its unusual MRI features and the importance of obtaining a histological diagnosis before definitive treatment.KEYWORDS: Brodie's abscess; osteoid osteoma; bone tumour mimicker

C-reactive protein and Apo B as better predictor of STEMI than lipid profile

Background: Total cholesterol, triglycerides, high density lipoprotein and low density lipoproteins are the recommended lipid variables for diagnosis and treatment of coronary artery disease. However, recent information shows the importance of apolipoprotein B and CRP as risk predictors of suspected CAD. Inflammation plays a major role in atherothrombosis and measurement of inflammatory markers such as CRP may provide a promising novel biochemical indicator for detecting individuals at high risk of plaque rupture.Methods: A total number of 43 cases of acute myocardial infarction with ST elevation myocardial infarction were included in this study. In this study CRP was elevated in more patients than LDL/HDL ratio (60.5% vs 20.9% respectively). Similarly, Apo B was elevated in more number of patients than LDL (72.1% vs 39.5% respectively). Also, Apo B/Apo A1 ratio was elevated in more number of patients than LDL/HDL ratio (51.2% vs 20.9% respectively).Results: In our study maximum incidence of ST elevation MI was present in age group 56-65 years with youngest of age 28 years and oldest of age 75 years. Out of 43 patients who suffered from STEMI 72.1% were males and only 27.9% were females. Out of 43 cases, 46.5% of cases had anterior wall MI, and 46.3% of the cases had inferior wall MI and only 9.3% of the cases developed anteroseptal wall MI. In our study death was encountered in only 9.3% (N – 4) of the cases.Conclusions: The results of the current study support the concept that the levels of apolipoprotein B, Apo B/Apo A1 ratio and CRP are strongly related to Coronary artery disease in addition to the conventional lipid profile

Study of menstrual disorders and its correlation with BMI in adolescents

Background: Due to change in lifestyle, habits, diet, the prevalence of obesity has increased. Excess weight and obesity are associated with irregular menstrual cycles, which reduce fertility and increase hormone-sensitive cancers. Obesity is considered to cause abnormality of sex steroid hormone balance. Irregular menstruation is more frequently observed in women who became obese during puberty than in those who were obese during infancy. Obesity has a strong association with infertility and menstrual irregularities. Methods: This cross-sectional study was conducted at Durgapur (West Bengal), where total 600 adolescent girls aged 12-17 years from DAV Model School, Durgapur and GMPS High School, Durgapur were selected. Results: Out of total 600 girls, 119 girls (19.8%) had BMI<18.5 kg/m2, 357 girls (59.5%) had BMI between 18.5-24.99 kg/m2 and 124 girls (20.7%) had BMI>25 kg/m2. Only 68 girls (57.1%) with less BMI, 205 girls (57.4%) with normal BMI and 62 girls (50%) with BMI>25 kg/m2 had dysmenorrhoea. Only 19 girls (16%) with less BMI, 46 girls (12.9%) with normal BMI and only 15 girls (12.1%) with higher BMI had menorrhagia. Only 4 girls (3.4%) with less BMI, 14 girls (3.9%) with normal BMI and 12 girls (9.7%) with high BMI had hypomenorrhoea. Only 10 girls (8.4%) with less BMI, 37 girls (10.4%) with normal BMI and only 28 girls (22.5%) with high BMI had irregular cycles. Only 5 girls (4.2%) with less BMI, 12 girls (3.4%) with normal BMI and only 11 girls (8.9%) with high BMI had oligomenorrhoea. Only 2 girls (1.7%) with less BMI, 3 girls (0.8%) with normal BMI and only 4 girls (3.2%) with higher BMI had polymenorrhoea. Only 43 underweight girls (36.1%), 166 girls (46.5%) with normal BMI and 68 girls (54.8%) with higher BMI had premenstrual symptoms. Conclusions: Mean BMI was found 21.6±3.64 kg/m2. High BMI girls had more oligomenorrhoea, hypomenorrhoea, irregular menstrual cycles, polymenorrhoea, premenstrual symptoms and less dysmenorrhea and menorrhagia comparatively to normal BMI girls and underweight girls.

The role of forceps in current obstetrics: a retrospective study

Background: Forceps has been an integral part of the obstetrician’s armamentarium. Obstetric forceps was designed to assist extraction of the fetal head and thereby accomplish the delivery of the fetus. In this present day when there is universal concern regarding the alarming rise of cesarean section rates, a better understanding of this instrument will help the patient as well as the obstetrician. Methods: This was a retrospective observational study done over a two-year period. Cases were enrolled in the study after satisfying the inclusion and exclusion criteria. All data compared in terms of age, parity, gestational age, indications, maternal and neonatal outcome. Results: A total of 1150 antenatal cases were delivered out of which 42 cases were delivered by outlet forceps. Incidence of outlet forceps was 3.75%. Mean baby birth weight was 3.07 kg. No maternal mortality and morbidity recorded. Conclusions: Obstetric forceps have a significant place in modern obstetrics as it is a lifesaving procedure for mother and fetus in many situations

Efficacy of Intense Pulse Light with Triple Combination Cream Versus Triple Combination Cream alone in the Treatment of Melasma

Introduction: Various studies explored the use of intense pulse light (IPL) therapy in treating melasma, but only a few randomized clinical trials have evaluated the combination of triple combination cream (TCC) with IPL so far. Objective: This study compared the efficacy and safety of the combination of IPL and triple combination cream with triple combination cream alone in treating melasma. Material and Methods: Sixty patients with melasma were enrolled in this assessor-blinded, parallel-group randomized controlled study. Thirty patients were treated with IPL (15J/cm2, two sessions at 2-week intervals) and TCC (Hydroquinone 2%, tretinoin 0.025%, fluocinolone acetonide 0.01%) at night and broad-spectrum sunscreen during day time whereas other groups received only TCC and broad-spectrum sunscreen. The median percentage reduction in melasma area and severity index (MASI) and physician’s global assessment scale was assessed at 12-week to determine the efficacy of the treatment. The incidence of adverse effects at each follow-up and relapse at 16-week were also noted during the study period as the secondary outcome measure. Results: The median reduction in MASI achieved at 12 weeks was 48% in the IPL+TCC group and 13.1% in the TCC group from the baseline.  The incidence of relapse was seen in 7.14% and 13.04% patients in the IPL+TCC group and TCC alone group respectively at 16 weeks however, this difference was not statistically significant (p<0.05). Conclusion: Our study supports that IPL and TCC are more effective than TCC therapy alone in treating melasma

Methodology for designing alternative ecosystem for restoring indigenous knowledge of smallholder communities in India

The Green Revolution led to the introduction of the modern high yielding varieties (HYVs) of seeds during the period 1960s-1970s. It also systematically replaced the approach of farmers collectively sharing and preserving indigenous best practices with transfer of knowledge regarding industrialised farming and increased productivity being routed through agricultural extension service agents. This “expert-driven” approach systemically created a dynamic that has led to the breakdown of social networks and community safety net structures that were earlier accessible to smallholders. This ongoing research study presents a methodology for designing an alternative ecosystem for restoring indigenous knowledge of smallholders in India, through a bottom-up model of community- based solutions that will provide them with more equitable as well as sustainable agricultural outcomes (Titzer, 2017). To demonstrate the merit of transitioning to such an alternative agricultural ecosystem for restoring indigenous knowledge we performed a multiple case study analysis on existing IEK systems. Systems thinking helped us gain a holistic understanding of the agricultural ecosystem in its current state, pinpoint the root causes of its dynamic behaviour and identify leveraging points in the system to make it more equitable for smallholders through the restoration of IEK