In the recent years, many modern technologies have been established in the pharmaceutical research and development area. The field of nanotechnology has been revolutionary as substantial and technical, and scientific growth, in basic sciences plus manipulation by physical or chemical process of individual atoms and molecules have widened its horizon. Polymeric nanoparticles with a size in the nanometer range protect drugs against in vitro and in vivo degradation; it releases the drug in a controlled manner and also offers the possibility of drug targeting. The use of polymeric drug nanoparticles is a universal approach to increase the therapeutic performance of poorly soluble drugs in any route of administration. The present review discusses the physico-chemical properties of polymeric nanoparticles, production methods, routes of administration and potential therapeutic applications.

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Background: Poor infant feeding practices and their consequences are one of the world's major problems and a serious obstacle to social and economic development. Various studies have shown that infant feeding could be influenced by socioeconomic status, maternal education, place of living and many other factors. Hence a prevalence study on exclusive breastfeeding was conducted in rural Tamil Nadu. Aim and Objective: To assess the prevalence of exclusive breastfeeding practices and the factors influencing them among women in a rural area in Tamil Nadu. Materials and Methods: It is a cross-sectional study conducted in Attyampatti Panchyat Union, Salem district, Tamil Nadu, from March 2011-June 2011. All the 291 children in the age group of six months to two years in Attyampatti Panchayat Union were included in the study, irrespective of any sample. The data was analyzed using SPSS package. Results: Among the study population 52.6% were male children and 47.4% were females. Only 99 (34%) children were exclusively breastfed for six months. The majority of women (60.5%) initiated breastfeeding within half an hour after delivery. Various demographic factors like the education of the mother, type of delivery, type of family, occupation, number of children, monthly income, family size, age at marriage and religion had a direct influence on exclusive breastfeeding, which in turn influenced the weight of the baby and immune status of the child. Most of the mothers (44.7%) inferred that the main reason for giving bottle feed is because of inadequate breast milk secretion. Conclusion: The prevalence of exclusive breastfeeding is low in this particular area. Hence promotion of exclusive breastfeeding and focus on the factors affecting them is highly warranted in this area.

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Drug delivery to eye has become a demanding task because of various constraints of eye i.e., physiological and anatomical, which results in improper therapeutic concentration at the site of action. Due to this problem, frequent dosing was recommended causing patient incompliance and adding to the cost of therapy. To overcome these barriers, researchers have discovered novel ocular delivery systems like hydrogels, ocuserts, colloidal carriers, etc. However, every delivery system has its own advantages and disadvantages. Hydrogels are presently utilized as delivery system for actives because of their comparable physical properties to that of living tissue. A plethora of biodegradable polymers are used for hydrogel formulations like polyanhydrides, poly (orthoesters), polyesters and poly (2-hydroxyethyl methacrylate) (pHEMA), chitosan and sodium alginate out of which pHEMA hydrogels are becoming popular from a therapeutic point of view for the ocular drug delivery. The present paper broadly describes the recent advances on drug delivery using pHEMA hydrogels with exhaustive details of researches explored till date.

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Background: Mitochondrial damage and oxidative stress plays important role in Parkinson's disease (PD). Mitochondria are very crucial part in the cell and have many cellular functions including the generation of ATP and intracellular calcium (Ca ²⁺ ) homeostasis. Mitochondria also contribute in the formation of reactive oxygen species (ROS) and activating the programmed cell death response, apoptosis. Usually ROS is eliminated by antioxidants present in body, but in case of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induction all the antioxidants become ineffective. Aim: The present study investigated the effects of the non selective cyclooxygenase (COX) inhibitor aspirin and L-type calcium channel inhibitor nimodipine in the prevention of motor impairments and observed anti-oxidant effects in rats after induction of early phase of Parkinson's disease by using neurotoxin MPTP. Materials and Methods: The PD was induced in animals by single injection of MPTP. After 48 hrs of induction animals were treated with aspirin and nimodipine for 60 days, then behavioral, biochemical and antioxidant parameters were evaluated to examine the effectiveness of treatment. Statistical analysis was carried out by using one-way ANOVA followed by Bonferroni multiple comparisons test. Results: The treatment with combination (Aspirin 50mg/kg, Nimodipine 30mg/kg) showed significant (P < 0.001) increase in brain dopamine level, improves the complex I activity and also ameliorate the amount of antioxidant enzymes like superoxide dismutase (SOD), glutathione reductase (GSH), catalase (CAT) and decrease in lipid peroxidation. Conclusions : These results strongly suggest that combination shows a good neuroprotective effect compared to single treatment on motor, biochemical and antioxidant parameters in early phase of Parkinson's disease.

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Background: Myofascial trigger point (MTrP) is a hyperirritable point or spot, usually within a taut band of skeletal muscle or in the muscle fascia which is painful on compression and can give rise to characteristic-referred pain and motor dysfunction. Studies suggest that various types of massage forms are available for treating MTrPs. Aims: To find the difference in effect of two forms of massage techniques: Ischemic compression and muscle energy technique (MET) on upper trepezius MTrPs. Settings and Design: Quasi experimental design was conducted with convenient sampling method. Materials and Methods: Patients ( n = 30) who fulfil the screening criteria were randomly assigned to Group A ( n = 15) treated with ischemic compression and ultrasound and Group B ( n = 15) treated with MET and ultrasound for 4 weeks and they were assessed at baseline and after 4 weeks. Outcome measures included pain intensity by visual analog scale (VAS) and range of motion by universal goniometer. Statistical Analysis Used: Intergroup analysis was done with Mann-Whitney test and intragroup analysis was done with Wilcoxon signed-rank test. Results: Statistically, no significant ( P > 0.05) changes in the scores were found in the Groups A and B for VAS, and statistically significant ( P < 0.05) changes in the scores were found in the Groups A and B for Range of Motion (ROM) with greater change scores in the Group B compared with Group A. Conclusion: Treatment program consisting of MET with ultrasound may be more effective in reducing pain and improve ROM in patients in upper trepezius MTrPs.

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Background/Objectives: Ice application is one of the treatment procedures used in hydrotherapy. Though its various physiological/therapeutic effects were reported, ice bag application (IBA) to head and spine on cardiovascular changes were not reported. Hence, this study aims at evaluating the immediate effect of IBA to head and spine on cardiovascular changes in healthy volunteers. Materials and Methods: Twenty-eight subjects were randomized into three sessions ([i] IBA [ii] tap water bag application [TWBA] and [iii] control) and intervention was given in one of the 3-different orders. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) was assessed before and after 20-min of each intervention. Pulse pressure, mean pressure (MP), rate pressure product (RPP), and double product (Do-P) were derived by standard formula. Statistical analysis was performed by repeated measures of analysis of variance and post-hoc analysis with Bonferroni adjustment for multiple comparisons with the use of Statistical Package for Social Sciences version-16. Results: The results showed no significant difference between sessions in all variables. Within-group analysis showed significant reductions in SBP, PR, RPP, Do-P in IBA and TWBA sessions; Significant reduction in DBP, MP in IBA unlike TWBA; and no significant changes in all the variables of control session. Conclusions: Result of our study suggest that though both IBA and TWBA to head and spine might be considered as having effect on improving cardiovascular function in healthy volunteers, IBA to head and spine could be considered as a better choice than TWBA.

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Background: The Indian elderly population is currently the second largest in the world. Mental disorders have got high prevalence and low priority among elderly in most of the countries around the world, of which depression being the most common treatable condition. In India, there is scarcity of research on prevalence and factors influencing depression among elderly from urban poor locality by adopting a geriatric depression scale-15 (GDS-15) scale. Objectives: (1) To find out the prevalence of geriatric depression, (2) to find out the factors associated with depression. Methodology: A cross-sectional study was conducted at urban poor locality of Bengaluru on 100 elderly people by applying GDS-15 Kannada version to assess the prevalence of depression and information regarding the sociodemographic characteristics, financial status, and comorbid conditions were collected. Results: The prevalence of depression assessed by using GDS-15 Kannada version was found to be 36%. Depression was more among 12 (70.6%) from medium standard of living index (SLI) group compared to 24 (28.9%) from high SLI group, which was shown to be statistically significant. Among the elderly with depression, 31 (86.1%) had some medical comorbidities when compared with 33 (51.6%) elderly without depression, which was found to be statistically significant. Conclusions: The current research has shown prevalence of depression according to GDS-15 (Kannada version) as 36% and influenced by SLI, hold on assets, insomnia and comorbidities, which needs to be confirmed by undertaking further studies.

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Context: Computers have become an epitome of modern life, being used in every aspect of life. This has also ushered in a new genre of occupation-related health problem. Aims: To estimate prevalence of health problems among software professionals. Settings and Design: Cross-sectional descriptive study of 4 months duration from January 2011 to April 2011 was conducted among software professionals working with a private firm. Materials and Methods: List of software professionals working with the firm was obtained and then all professionals satisfying the inclusion criteria were included as study subjects. Inclusion Criteria: working in current job since past 6 months and on computer for at least 4 h/day. The selected study participants were then interviewed face to face using a pre-tested semi-structured questionnaire after taking their informed consent. Statistical Analysis Used: SPSS version 17 using the chi-square test. Results: The prevalence of any type of computer-related morbidity in software professionals was 178 (89%). The proportion of visual, musculoskeletal, and stress was found to be 67%, 63%, and 44%, respectively. A statistically significant association was found between subjects with visual and musculoskeletal complaints using antiglare screen and soft keypads and those not using them respectively. Conclusions: Ocular discomfort, musculo-skeletal disorders and psycho-social problems form key category of health problems found among constant computer users. This study has also brought into focus factors contributing to the occurrence of these problems. Thus, the problem requires a multidisciplinary action and hence there is an immediate need for the concerned authorities to collaborate and enforce suitable preventive measures.

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Introduction: Healthcare workers must know the various measures for their own protection. They should improve organization of work, implement standard precautions and dispose biomedical waste properly to prevent occupational exposure. This study aimed at assessing the perception and practice of infection control measures amongst the healthcare workers in Mangalore. Materials and Methods: This cross-sectional study was conducted by using a pretested semi-structured proforma, by interview cum observational technique. One hundred and twenty healthcare workers (70 hospital staff including nurses and technicians at the two Government District Hospitals and 50 final-year MBBS students) were selected using convenient sampling and their perception and practice regarding infection control measures were studied. Results: Of the 120 participants, the majority (85.8%) was aware of disposing used needles and syringes in puncture-resistant containers but only 55.7% were actually practicing it. Three-fourths (75.8%) of the participants were aware about not recapping the needles after use but on observation, only 35.4% were practicing this. All healthcare workers were aware about the indication for using masks and gloves while handling patients, while only 77.1% were using them. We also found that only 61.8% washed their hands after attending every patient, 94.3% cleaned the area with a sterile swab before giving injections and only 35.7% of the labs/ wards/ operation theatres had three colored bags. Few (11.7%) of the workers have already been exposed to infectious blood samples and some (19.2%) are still not immunized against Hepatitis B. Conclusion: There is a need for improvement in the perception and practice of infection control measures among healthcare workers for both self and patient's protection. They should also get themselves immunized against Hepatitis B and report accidental exposure to infectious samples to the infection control committee.

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

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Background and Aim: Oral submucous fibrosis (OSMF) is a high-risk premalignant condition largely seen in the Indian subcontinent. A number of studies have proven the use of antioxidants in the management of OSMF. Therefore, the aim of the present study was to compare the efficacy of two antioxidants, lycopene and aloe vera in the management of OSMF. Material and Methods: One hundred and twenty clinicopathologically diagnosed OSMF patients, were included in the study. They were divided equally into, Group A (lycopene group) and Group B (aloe vera group). Group A was administered 8mg lycopene in two divided doses of 4mg daily and Group B was given5mg aloe vera gel to be applied topically thrice daily for 3 months. Different clinical parameters were evaluated at regular intervals and data was analyzed using the Student's paired t-test and Chi-square test. P < 0.001 was considered to be statistically significant. Results: Clinical improvements in mouth opening and tongue protrusion were significant in Group A (P < 0.001). Subjective symptoms of burning sensation (P = 0.007), pain associated with the lesion (P = 0.005), and difficulty in swallowing and speech (P = 0.003) improved in both the groups, but were insignificant. There was a mild to moderate decrease in the size of the lesion. Conclusion: The present study concludes that though, there is no definitive treatment for the condition; however, lycopene can bring about significant clinical improvements in the symptoms like mouth opening and tongue protrusion when compared to aloe vera. Both the drugs appear to be promising in the treatment of OSMF.

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Introduction: Facebook was founded in 2004 and is one of the most popular social networking sites. Although Facebook is used to connect and stay in touch with friends and also to maintain relationships, there may be situations where an individual uses the site way too much. Relatively little research has been carried out to explain effects of usage to Facebook in terms of addiction in India. Objectives: The aim was to find out the burden of Facebook addiction among college students of health university. Subjects and Methods: This exploratory qualitative study was conducted in Bengaluru City covering six colleges attached to a health university using convenient sampling from May 2013 to July 2013. About 400 students had enrolled for the study. Results : It was observed that the burden of addiction was 7.25% and high risk was 24.75% in the study subjects. 61 (31.12%) males and 38 (18.62%) females were categorized as high-risk behavior subjects. 12 (6.12%) males and 17 (8.33%) females were categorized as having Facebook addiction. 64% of study subjects used Facebook daily. 32% of the subjects felt strain in the eye, 11% watering of the eye, 20% felt frustrated and 17% were anxious when they did not have access to Facebook. Conclusion: The burden of Facebook addiction and high-risk behavior was observed in one-third of the subjects.

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Introduction: Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome in the upper extremity leading to the functional disability. The consequence of the entrapment is the poor health of the nerve (conduction, mobility, and blood flow). Purpose of the Study: The aim of the study is to evaluate the effect of neural mobilization on the motor nerve conduction velocity and function in the CTS patients. Methods: Thirty CTS patients (only females) were scrutinized on the basis of the inclusion and exclusion criteria. They were randomized into two groups A (n = 15) and B (n = 15) using simple random sampling. Group A patients were treated with the conventional physiotherapy regimen and Group B were provided neural mobilization. Results: The data analysis was done using SPSS version 22. The t-test reveals that there was statistically significant improvement in posttreatment values of Group B for numeric pain rating scale, symptom severity scale, function status scale, motor nerve conduction latency, and velocity at P≤ 0.05. Conclusions: Neural mobilization in the CTS patients improves the motor nerve conduction and functional status. It may be incorporated in the physiotherapy treatment protocol of CTS patients.

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Background: Protein carbonyl (P) is oxidatively-modified protein with diagnostic potential for acute myocardial infarction. However, many findings indicated the elevation of serum PC content level related to exercise, which could cause false positive results and limiting the specificity for acute coronary syndrome diagnosis. This study aims to evaluate the level of serum protein carbonyl content in healthy volunteers subjected to exercise stress test (EST). Materials and Methods: Serum from healthy volunteers was collected 5-10 min before performing EST and 1 hour after the EST was achieved. The serum was collected, and the serum PC content level was determined by spectrophotometric DNPH assay. Results: The serum PC content level after exercise stress test was significantly higher than that of before performing EST (0.373 ± 0.05 nM/mg vs. 0.275 ± 0.02 nM/mg, P < 0.0001). The results demonstrated that in both male and female, serum PC content level after EST was significantly higher than that of before performing EST (0.29 ± 0.03 nM/mg vs. 0.36 ± 0.05 nM/mg P < 0.0001 in male, 0.27 ± 0.02 nM/mg vs. 0.38 ± 0.06 nM/mg P < 0.0001 in female, respectively). Conclusions: This study demonstrated that exercise stress test could result in non-specificity and false positive increasing in serum PC content level in healthy subjects, which may cause misinterpretation when using PC as cardiac marker, especially in patients, who underwent exercise stress test or patients who performing heavy physical activities.

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This article reports clinical and epidemiological profiles of a case of concurrent malaria and dengue infection. The literature on the subject is briefly reviewed to high-light the significance of the concurrent infection to the clinicians practicing in geographical areas endemic to both infections.

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Bacterial mastitis is the most common variety of mastitis and is often caused by Staphylococcus aureus. Chronic mastitis is usually caused by tuberculosis, syphilis and Mondor's disease. A 33-year-old female presented with lump in the right breast for the past two years with pain for the past 15 days and discharge for the past two to three days. There was no history of diabetes mellitus, hypertension, bronchial asthma and tuberculosis. On examination, the lump measured approximately 9×5 cm in size with a discharging sinus just lateral to the areola. No regional lymphadenopathy was noticed. A clinical diagnosis of "Lump in the right breast with sinus probably due to tuberculosis was made. The lump was excised and per-operative sample grew Salmonella paratyphi A in culture. She responded to Ceftriaxone and unnecessary use of anti-tubercular drugs could be avoided. In chronic mastitis and breast abscess Salmonella species should be considered as one of the etiological agents.

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Background: Assessment and management of abnormal lumbar spine mobility are essential in the clinical setting. There are limited studies carried out to obtain lumbar range of motion values in children of the Indian population and to explore the anthropometric measurements on it. Purpose: The purpose was to find any association of anthropometric measurements, hamstring muscle length with lumbar range of motion in school age children from South India. Methodology: Active flexion, extension, and right- and left-side bending, and rotation of the lumbar spine were measured using modified Schober's test for 294 normally developing school going children 6-12 years (147 girls, 147 boys) from Mangalore, Karnataka, India. Means were determined for each motion by age and sex. Further, the correlation between spinal mobility and individual factors such as body mass index and hamstring flexibility was explored. Results: Females were identified as have a significantly higher forward flexion, lateral flexion, and rotation range of motion than males. Age, anthropometric parameters, and hamstring length were significant correlates of lumbar spinal mobility. Conclusion: This study provides the reference values for lumbar spinal flexibility in healthful school going children (6-12 years) from India. Females were found to have a considerably higher forward flexion, lateral flexion, and rotation range of motion than males. Age, anthropometric parameters, and hamstring length were significant correlates of lumbar spinal flexibility.

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Context: Majority of falls are multifactorial and results from a complex interplay of predisposing and precipitating factors. Falls and their sequelae are potentially preventable. Aims: To determine the risk factors for falls among the elderly. Settings and Design: A community-based cross-sectional study in urban part of Bengaluru. Subjects and Methods: Study conducted for a period of 1-year, among elderly population 60 years and above, were residents since 1-year. Complete enumeration by census methodology applied. A pretested semi-structured questionnaire was administered to collect information about falls. Statistical Analysis Used: Univariate and multivariate logistic regression employed using SPSS version 18. Results: Of the 416 elderly persons studied, prevalence of falls rate 29.8%. The rate of fall for medical factors varied 33.3% diabetes mellitus to 71.4% foot problems. Among the people with behavioral factors, higher fall rate seen among those who were underweight 77.7%, abnormal finding in balance test 59.5%, abnormal gait 51.4%, low Mini Mental State Examination score 50%, Obese 50%, those who had difficulty with steps/stairs 45.3%, habit of smoking 45.1%, low activities of daily living score 45.4%, persons with abnormal get up and go test 43.8% and those who were on alcohol 43.1%. Logistic regression analysis revealed elderly with backache, nonsteroidal anti-inflammatory drugs, visual problem, difficulty in getting on/off toilet, smoking, cataract, TCA's loose slipper outside home were at higher risk of fall, was found to be statistically significant. Conclusions: Majority of the falls in the elderly are due to medical, behavioral factors which are predictable and preventable.

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Background: Severe acute malnutrition (SAM) continues to be the reason for increasing hospitalization and also a major killer disease. Objectives: Identify socio-epidemiological determinants among both groups of SAM and evaluate impact of nutritional rehabilitation center (NRC) in its management. Methodology: A prospective observational study was conducted in a medical college on SAM children aged 6 months to 5 years over 1 year. Socio-epidemiological risk factors were compared in both groups. Therapeutic nutrition was provided as per World Health Organization guidelines. Serial weight monitoring and response criteria were analyzed at the time of discharge. Cases were followed up serially at 1, 2, 3, and 6 months for weight monitoring to assess long-term impact of NRC. Results: A total of 91 cases were enrolled; (Group 1: Group 2: 43: 48). Assessment of risk factors in SAM groups revealed a significant association between late initiation and lack of exclusive breastfeeding with group 1 SAM. Significant referrals (P : 0.001) from anganwadi centers included group 1 SAM. Majority responded to NRC management. Statistically significant weight gain noted at each follow-up in both types of SAM. At the end of 6 months, the recovery rate of group 1 SAM was statistically significant (P : 0.023), total defaulter rate was high (29.6%) and none had relapsed. Conclusion: Though NRC was effective in improving nutrition in SAM, results were not sustained in view of high defaulter rates at follow-ups. There is a need to improvise health education to caregivers, link NRC centers with community health centers for better follow-up and address modifiable socioepidemiological risk factors.

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Objective: The paper focuses on the microwave synthesis of a new series of 9-anilinoacridine derivatives 4a-g, 5a-g, and 6a-g. Materials and methods: The compounds were confirmed by physical and analytical data. The synthesized compounds when screened for in vitro anti-microbial activity showed promising activity for many compounds. The in vitro anti-microbial activities of the synthesized compounds were evaluated against some bacteria and fungi strains. Results and Discussions: The results suggested that, the products 4a-g, 5a-g, and 6a-g exhibited good inhibitory effect against most of the tested organisms. Especially, 4b, 5a, 5d, 6b, and 6e were shown to be most effective against Bacillus subtilis, Escherichia coli at the concentration of 25 μg/ml and Candida albicans at the concentration of 50 μg/ml.

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Introduction: Cardiovascular diseases are leading cause of morbidity and mortality. Such phenomenon is not only seen in urban and rural population, but is also evident among the tribal population. There is a need to understand the burden of hypertension among people residing in Jenu Kuruba Tribe of Karnataka. Objectives: (i) To estimate the prevalence of hypertension in the Jenu Kuruba tribal population and (ii) To describe the age- and sex-wise pattern of blood pressure (BP). Materials and Methods: A population-based cross-sectional study was carried among 1,290 individuals aged between 20 and 60 years. Information about their sociodemographic characteristics, risk factor profile was collected in a pretested proforma by interview technique. Measurements of BP were performed as per standard procedures. Results: Mean systolic and diastolic BP (SBP and DBP) among the study subjects was 123.07 ± 14.09 and 77.43 ± 10.33 mmHg, respectively. Mean SBP and DBP were significantly higher with increase in age and were also significantly different for men and women. Overall prevalence of hypertension was 21.7% (95% confidence interval (CI) =19.45-23.95%). Prevalence of hypertension among men was 28.2% and among women was 16.5%. Conclusions: Hypertension is emerging as a significant public health problem even among Jenu Kuruba tribal population.

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Background: Advance in mechanization and acceleration of travel has been accompanied by an increase in number and severity of fractures and those of the tibial plateau are not an exception. As it is one of the major weight bearing joints of the body, fractures around it will be of at most importance. Aims: (1) To restore articular congruity and limb alignment by open reduction and rigid internal fixation. (2) To enable early knee motion and improve quadriceps and hamstring power. (3) To study the role of surgical treatment and functional outcome in tibial plateau fractures and its complications. Settings and Design: A prospective study was carried out, 32 cases of the tibial plateau fractures, which were admitted from August 2010 to April 2012 at Department of Orthopedics of our Hospital. Materials and Methods: 32 patients underwent surgical treatment for tibial plateau fractures. Fractures were classified according to the Schatzker's system. The indications for surgery were defined as the presence of displacement, depression and instability being more than 4 mm, 10 mm and 10 degrees. The mean follow-up was 12 months. The selected patients were evaluated and were taken up for surgery. The indicated fractures were treated with closed reduction and internal fixation with percutaneous cannulated cancellous screws, external fixator, open reduction and internal fixation with buttress plate with or without bone grafting. The range of motion was started soon after surgery. The patients were advised nonweight bearing up to 6-8 weeks. Total weight bearing deferred until 12 weeks or complete union of fracture. Statistical Analysis: All parameters before and after the treatment were expressed in mean ± standard deviation and analyzed by the Student's t-test using SPSS version 16. Results: The knee range of motion was excellent to very good and weight bearing after complete union was satisfactory. Malunion in two cases, knee stiffness in three, redepression in one case, wound dehiscence in two cases and no cases of nonunion were recorded.

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Background: Socio-economic status (SES), human immunodeficiency virus (HIV) knowledge and self-efficacy influence risky behaviors and female sex workers (FSWs) are not exception. Aims: This study was aimed to investigate if SES, HIV knowledge and self-efficacy predict frequency of unprotected sex with injecting drug users (IDUs) among a sample of FSWs in Iran. Setting and Design: Universal Network for Health Information Dissemination and Exchange HIV Risk Study was a survey of IDUs and FSWs, conducted in eight different provinces of Iran, 2009. Materials and Methods: A total of 55 FSWs were entered in this study. Frequency of unprotected sex with IDUs during the past 6 months was the dependent variable. Number of sexual partners during the past 6 month, SES, HIV Knowledge, self-efficacy, perceived HIV risk and intention for change were predictors. Statistical Analysis: We used hierarchical regression for data analysis. In each step, a block of predictors were added to the model. SES block composed of education level, owning a house and living alone. Results: In the absence of SES in the model, HIV knowledge and self-efficacy were not significantly associated with the frequency of unprotected sex with IDUs during the past 6 months, However, with adding SES block to the model, HIV knowledge became significant predictor of the outcome. Thus, among our sample of Iranian FSWs, SES has a suppressor effect for the effect of HIV knowledge on frequency of unprotected sex with IDUs during the past 6 months. Conclusion: Studies which wish to understand the role of theory-based psychological constructs such as HIV knowledge on high risk behaviors need to include SES an essential contextual factor. This finding may also explain why literature is mixed on the effect of HIV knowledge on HIV risk behaviors.

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Background: Early mobilization is an important component of physiotherapy used to prevent and decrease pulmonary and immobilization complications, which are the major goals of physiotherapy in the intensive care unit (ICU). Prolonged bed rest and hospitalization leads to deconditioning and weakness which can further increase the length of the ICU stay. This study was conducted to find an answer to whether early mobilization is as effective as or better than routine physiotherapy in reducing the length of ICU stay in mechanically ventilated patients. Study Design: Randomized controlled study. Study Setting: Medical ICU, Father Muller Medical College Hospital. Mangalore, Karnataka, India. Aim: To detect the effectiveness of graded early mobilization and routine physiotherapy and to compare these techniques with respect to the length of ICU stay in mechanically ventilated patients. Materials and Methods: Fifteen subjects of both gender who were on mechanical ventilators fulfilling the inclusion criteria were randomly assigned to two groups, group 1 (graded early mobilization, n = 8) and Group 2 (routine physiotherapy, n = 7) by using the randomization plan from the website www.randomization.com. All the vitals of the subjects were noted as they were made to perform particular maneuvers depending on the group they belonged to. Participants recruited into the early mobilization group were mobilized as soon as their vitals were stable and were able to participate in the therapy. The patients who underwent routine physiotherapy were mobilized once they were extubated. At the time of discharge from the ICU, days of weaning, days first out of bed, and length of ICU stay were noted. Results: A significant difference was observed between early mobilization and routine physiotherapy groups with respect to the length of ICU stay. Conclusion: Early mobilization showed better outcome compared to routine physiotherapy in reducing the length of ICU stay in mechanically ventilated patients. The results of this study cannot be generalized due to the small number of subjects.

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