were 7.4 ± 1.5 g/dL and 6.5 ± 1.3 g/dL, respectively, while in mutant and nonmutant cases of c.2044T>C polymorphisms, mean hemoglobin values were 8.2 ± 1.7 g/dL and 7.2 ± 1.2 g/ dL, respectively (p = 0.0042 and 0.0002). In mutant and nonmutant cases of IVS4+44C>A polymorphisms, serum ferritin levels were 11.7 ± 2.5 µg/L and 10.8 ± 1.3 µg/L, respectively, while 12.4 ± 3.1 µg/L and 11.6 ± 1.5 µg/L in c.2044T>C polymorphisms, respectively (p = 0.0132, 0.0220). We reported significant elevation of ferritin and hemoglobin in IVS4 + 44C>A and c.2044T>C mutations, while decreasing level of ESR and CRP. Clinical frequency of iron-deficiency anemia is less severe in IVS4+44C>A and c.2044T>C mutations. We concluded that IVS4+44C>A and c.2044T>C mutations may be predictor of IDA; these DMT1 variant genotypes need to be diagnosed.

In Mobile Ad hoc Network (MANET) all the nodes are mobile in nature having limited battery capacity that is called energy. Due to the dynamic behavior of network link are not maintained for long time. All nodes in network are energy dependent and efficient energy utilization is one of the important issue in MANET. The location based DREAM (Distance routing Effect Algorithm for Mobility) protocol are maintained the location of each node on the basis of respective sender and receiver. This paper proposed a new location based energy efficient scheme with AODV (DREAM-EAODV) protocol. In this scheme energy dependent nodes are do routing with AODV protocol on the basis of location based protocol DREAM. Nodes in network are not intimated about their energy status, for that remove the suddenly link breakage. If the nodes in network are know about the energy status and also about the status of location of receiver that reduces the energy consumption. If the node ia apart of communication then in that case no link is break but if not then break. The main aim of proposed scheme is to enhance the energy utilization in network. Simulation has done by using ns-2 simulator and reduces energy consumption. The performance is measure on the basis of performance parameter like Normal Routing Load, Packet Delivery Ratio.

Background: There is requirement of specialized female surgical clinics nowadays, which should be addressed routinely in the surgical department. For management of surgical problems in female patients, multidisciplinary approach mainly general surgery, obstetrics and gynaecology, general medicine, paediatrics, dermatology and psychiatry is required. The main aim and objective of this study is to assess the effectiveness of training and orientation of interns by introduction of specialized female surgical clinic. Methods: Prospective educational interventional study was conducted. 60 sensitized interns were introduced and oriented in the specialized female surgical clinic. A total of 952 patients visiting the clinic were studied. Statistical analysis was done. Results: Feedback of interns with respect to female patients were taken and recorded. There was a significant improvement in the knowledge and skill of the participating interns. Most of the interns were willing to continue their duties to such a specialized clinic in future. Conclusions: It can be concluded that the interns sensitized and exposed to this innovative method of training have shown a positive approach to this new method of learning. Such fully functional specialized female surgical clinic is required in hospital, in which participation of interns is useful.

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Background- This study aims to observe prole of TB in PLHIV patients and their correlation with CD4 counts. Methods- This is a crosssectional observation study done from January 2021 to June 2022 in department of respiratory medicine GMC Bhopal. PLHIV patients between 12-60 years of age with clinico-radiological and microbiological evidence of TB were included. Patients with history of TB treatment with currently no evidence of active TB and with any chronic ailments were excluded to avoid bias. Results- Out of 100 patients, 53 patients had only pulmonary TB, 18 patients had only EPTB and 29 patients had disseminated TB. Pleural effusion was the most common EPTB (31.9%). In this study HIV-TB coinfection is more prevalent in male (70%) with maximum 40 cases in 30-40 year age group. According to CD4 counts 68 patients were in CD4 counts <200 cells/mm3. Most common clinical feature was cough (89%) followed by decrease appetite (88%), fever (85%), loss of weight (85%), expectoration (73%), dyspnea (46%) and night sweats (31%). Out of 100 cases, 31 cases detected by CBNAAT among which 16 cases also had positive sputum microscopy. Chest x-ray among 100 patients showed inltrates in 82 cases with maximum (70.7%) in CD4 counts<200 cells/mm3.Also chest x-ray showed inltrates with cavity in 14 patients with maximum (71.4%) in CD4 counts >500 cells/mm3. Conclusion- In this study, severity of clinical feature, radiological ndings, EPTB & disseminated TB cases increase as CD4 counts decrease. Overall pulmonary TB is still more common presentation. Also microbiological diagnosis is poor in lower CD4 counts due to paucibacillary disease. Presentation of TB become more atypical as CD4 counts decreases. .We recommend that special attention has to be given to all patients with low CD4 counts as they are more prone to atypical features, EPTB & disseminated TB.