Nail Fungus: Symptoms and Treatment

Nail fungus, also medically known as onychomycosis, is a chronic fungal infection of the fingernails and/or toenails by dermatophytes, also known as ringworm, yeasts and molds, leading to gradual destruction of the nail plate. It is more likely to affect toenails, particularly the first toenail, than fingernails, according to the National Institutes of Health (NIH). 

Fungal infection of the nail is very common. About half of the population is affected with nail fungus by the time they reach 70 years of age, said Dr. Raza Aly, professor emeritus of dermatology at the University of California, San Francisco Medical Center. Fungus is responsible for 50 percent of all nail disease, according to the U.S. National Library of Medicine. 

Symptoms

An infected nail often will have unsightly white/yellow or orange/brown patches or streaks. It can also turn thicker, crumbly, ragged or dull, according to the Mayo Clinic. In some cases, the nail will emit a slightly foul odor and it may separate from the nail bed, a process known as onycholysis. 

"More commonly, people don't like the way it looks," said Dr. Bernard Cohen, a professor of pediatrics and dermatology at Johns Hopkins Children's Center in Baltimore, Maryland. "[But] the nails can become friable; they break up and fall off." An infected nail can also thicken, making it difficult to clip, and cause discomfort if it catches on clothes, for instance.

Nail fungus typically begins with a fungal infection of the skin, such as athlete's foot. Once the skin is treated, however, the nails may act as a reservoir for reinfection that can spread the fungus to other parts of the body or to other people, Cohen told Live Science.

In some cases, people may have a genetic susceptibility to nail fungus, reported a 1996 study in the Journal of the American Academy of Dermatology.

Diagnosis & tests

Although half of all nail disorders can be categorized as onychomycosis, it is not always possible to identify the disease accurately by just looking at the symptoms, according to a treatment guideline commissioned for the British Association of Dermatologists. Other conditions, such as psoriasis, can result in similar nail abnormalities as well. 

Once the above symptoms are observed, lab tests consist of microscopy to visualize fungal elements and a mycological culture to help identify the species of microbes involved will provide a more definitive diagnosis. Since onychomycosis is primarily a disease of the nail bed rather than of the nail plate, skin debris and samples taken from the spot closest to the infection is likely to yield the best results, according to the British guidelines.

Treatment & medication

Onychomycosis is not self-healing and may be a source of more widespread fungal lesions on the skin, or vice versa. Additionally, a person cannot cure an infection by covering it with nail polish or fake nails, according to the American Academy of Dermatology. Cleaning the feet every day, filing off the white areas and treating the feet with over-the-counter anti-fungal creams can help with mild infections. Using a mentholated rubbing cream, such as Vicks VapoRub, has been found to be a useful at-home treatment as well. A 2011 study published in the Journal of the American Board of Family Medicine found that 15 of the 18 participants showed improvement after using a mentholated rub on their infected toes. While this small of a study sampling is inconclusive, it maybe something to try for those with mild nail fungus. 

If the nail is deformed, discolored or thickening, it is time to visit a medical professional, according to the American Podiatric Medical Association. There are both topical and oral treatments are available to help the condition.

"Oral antifungal therapy is preferred because of its ability to penetrate the nail bed and nail plate and thus sustain effectiveness," Aly said. However, because oral medication includes side effects such as potential liver damage, doctors and patients typically prefer topical creams, even though they are typically less effective because of poor penetration into the nail, he added.

Oral antifungal medications such as terbinafine (commonly marketed under the trade name Lamisil), itraconazole (Sporanox) and fluconazole (Diflucan or Trican) encourage the growth of new, non-infected nail, while slowly cycling out the infected portion of the nail, according to the Mayo Clinic. The medication is usually taken for six to 12 weeks, but a toenail may take up to 78 weeks to grow fully, and preventative measures should be taken during that gap to avoid recurrent infection.

The U.S. Food and Drug Administration (FDA) approved two other treatments in 2014. Efinaconazole (Jublia) is a topical cream that targets mild to moderate cases of onychomycosis, Aly said. About 17 percent of people taking it daily for a year had a complete cure rate, meaning that there was no fungus left on the nail and the nail looked normal, reported a 2013 study in the Journal of Drugs in Dermatology.

The second treatment, tavaborole (Kerydin), is also a topical cream that has a similar complete cure rate after a year of use, Aly said. Both of these new topical medications are more effective than the FDA-approved nail lacquer Penlac, which has a complete cure rate of about 5 percent to 8 percent, he said.

Nail removal may be an option if the infection is severe or extremely painful. This can typically be performed in-office. The new nail may take up to a year to fully grow in, according to the Mayo Clinic. 

Another treatment option is laser and light-based therapies. The therapy may be combined with other treatments, such as carbon-dioxide laser therapy combined with antifungal nail cream. 

Successful eradication of the fungus may still leave the nail looking permanently abnormal because of trauma to the nail bed and nail plate by the disease, according to a 2007 article published in the Journal of the American Academy of Dermatology. Therefore, a cure should be based on lab tests and not on visual appearance.

Prevention

The fungi that cause onychomycosis thrive in warm, moist areas, according to the NIH.

"That stuff is everywhere," Cohen said. "It lives in your shoes, it lives in your socks, it lives in your bathroom. They're resistant to freezing and heating. Even if you can get them off your skin, they're just everywhere. The risk of re-exposure is quite high."

General hygiene practices such as keeping all nails short, dry and clean will help decrease the risk of infection. One should avoid going barefoot in public places and choose a reputable salon that properly cleans and disinfects its manicure and pedicure instruments.

Even going barefoot in a locker room or public shower can lead to contracting athlete's foot, which is easily transmitted in moist environments, said Dr. Andrew Shapiro, a podiatrist in private practice in Valley Stream, New York, and spokesman for the American Podiatric Medical Association. [Barefoot in the summer: The Pleasures and Perils of Going Shoeless]

Wearing breathable socks and shoes may also help prevent fungal infections, Cohen said.

Sometimes, patients will have onychomycosis in just one nail, often because a trauma such as dropping a book on a toe, which may make it easier for a fungal infection to take hold, Aly added. Because the fungus can spread to other nails, he encouraged people to clean their nail clippers. People who pursue treatment for their feet should also buy new socks and shoes.

"Some of those fungal spores, they remain viable for months in those shoes," Aly said.

Nucleation processes

Whether it is clouds or champagne bubbles forming, or the early onset of Alzheimer's disease or Type 2 diabetes, a common mechanism is at work: nucleation processes.

Nucleation processes are a first step in the structural rearrangement involved in the phase transition of matter: a liquid morphing into a gas, a gas becoming a liquid and so on. Clouds, boiling water, bubbles, and some disease stages are all characterized by the formation of a new thermodynamic phase which requires some of the smallest units of the new structure to form before this new phase can grow. Understanding this process is critical for preventing, halting or treating cases of nucleation processes gone wrong such as in human disease. Now, a team of researchers from University College London and the University of Cambridge in Great Britain in collaboration with Harvard University have made headway toward understanding this problem from a molecular point of view in a new study. Their finding is significant across an array of phenomena, from human disease to nanotechnology.

“Perhaps an intuitive example of nucleation would be the way in which a quiet dinner party suddenly transforms into a dancing one; such a transition usually requires several people to start dancing at once, acting as a 'nucleus' around which the dancing party assembles,” explained Anđela Šarić, lead coauthor at the University College London and the University of Cambridge. The results of this study will appear this week in The Journal of Chemical Physics, from AIP Publishing.

“As commonly observed, if this group of dancers is too small, it tends to be ignored; however, above a certain size, this dancing nucleus attracts more and more people, eventually dominating the room," adds Thomas Michaels, the other lead coauthor. This minimum number of dancing people required to transform the party is what in thermodynamic terms is commonly known as the "critical nucleus."

In their research, the team considers a particularly intriguing example of a nucleated process: the formation of protein filaments. Many filamentous structures of proteins such as actin and tubulin are key for the growth, structural formation, movement and division of cells. They are an essential characteristic of living systems. However, protein filaments can also be disease-causing: Over 50 common disorders, including Alzheimer’s disease, Parkinson’s disease, and Type 2 diabetes, are associated with the formation and deposition in the brain or other organs of protein filaments commonly known as amyloids.

Using a combination of theory and computer simulations the authors explored the nucleation of protein filaments. Their goal was to establish the fundamental physical principles behind it. Their results showed that a seemingly complicated process of fibril nucleation is actually governed by a relatively simple physical mechanism: Unorganized clusters of proteins so-called oligomers are formed initially.

These structures do not resemble protein filaments yet, but have to undergo a structural conversion before they can grow into mature filaments, Šarić explained. They found that among many different steps in fibril nucleation, the shape change inside oligomers is the rate-determining step. Therefore, conformational changes in the protein inside oligomers (leading to the formation of β-sheet configurations) are crucial to understand fibril nucleation. Previously, the size of critical nucleus was considered the rate-determining factor.

The study represents an important step forward in the mechanistic understanding of the way in which protein filaments form. Such an understanding is key for studying the early stages in the onset of diseases associated with protein aggregation, as oligomers are increasingly believed to be the prime cause for cellular toxicity.

“Understanding which microscopic-level steps are determining for the formation of protein fibrils can provide invaluable information for designing rational therapies aimed at suppressing pathogenic oligomer generation," Šarić explained

Moreover, due to their unique physicochemical properties, protein filaments are finding extensive applications in materials science as biomaterials for nanotechnology," Michaels said. "Better control of filamentous growth would benefit the production of novel functional materials that have extensive applications in materials science as biomaterials for nanotechnology."

Materials provided by American Institute of Physics(AIP).

Dengue vaccine in India

                  Sanofi awaits govt approval to launch dengue vaccine in India

After receiving authorization in 11 countries, Sanofi Pasteur is still awaiting for approval from the government to launch its dengue vaccine Dengvaxia in India.

"The need for dengue prevention in India is urgent, and the Indian population is at risk for this debilitating disease, for which there is no cure or treatment and deserves to have a choice to be protected against the disease with a well-tested vaccine proven effective against dengue," Sanofi Pasteur India Country Head Jean-Pierre Baylet told PTI here.

''As soon as the government approves the use of the Sanofi Pasteur dengue vaccine, it will take minimally 6-8 months to complete the remaining regulatory requirements and make the vaccine available to the Indian population," Baylet said.

However, in a scenario where the government asks us to conduct more clinical trials in India before granting license, the vaccine will not be available to the Indian population before 2020, he said.

On the current approval status, Baylet said that as per the minutes published on 6th October 2016, the Technical Committee of the Ministry of Health and Family Welfare has recommended that Sanofi Pasteur's dengue vaccine be approved to protect adults in the 18-45 years of age in India, on the strength of the published documentation from the clinical studies on the vaccine that included more than 40,000 participants worldwide, including India.

For the last decade, it is estimated that an average of 5.7 million cases of dengue have been occurring in India every year, with related annual costs of over USD 1 billion.

The company has submitted the vaccine regulatory file to the Indian authorities last year in October, based on its worldwide clinical programme, including India. Since the submission, the vaccine has been approved for use - in quick succession - in 11 endemic countries of which two countries, Brazil and the Philippines, have introduced the dengue vaccine in their public immunization programme.

In July 2016, based on the public clinical documentation, as well as on a set of mathematical modelled outcomes of the potential public health impact of the dengue vaccine's implementation in endemic settings, the WHO recommended the use of the vaccine in highly dengue-endemic countries.

The regulatory review process is ongoing in endemic countries. The vaccine's regulatory file has already been submitted in more than 20 countries, in Asia and Latin America, reflecting the global burden of dengue. Singapore is the 11th country to approve the vaccine and we expect more to follow, he said.

Milk Teeth

                                 Mystery Behind Losing Our Milk Teeth in Childhood

                                                                          By JULIA SAMUEL

Teeth are subject to a lot of wear and tear, so it makes sense to be able to replace them during the lifetime of the animal. Surprisingly, however, the teeth of the earliest jawed vertebrates were fixed to the jaw bones and could not be shed.

Tooth shedding eventually evolved independently on two occasions, using two quite different processes. In sharks and rays, the fibres that anchor the tooth to the skin of the jaw dissolve and the whole tooth simply falls out. 

In bony fish and land vertebrates, the developing tooth becomes attached directly to the jaw bone by a special tissue known as "bone of attachment", and when it is time for the tooth to be shed this attachment must be severed; specialized cells come in and resorb the dentine and bone of attachment until the tooth comes loose. That's why our milk teeth loose their roots before they are shed. But when did this process evolve? 

The authors of the new study decided to investigate a jaw bone of the 424 million year old fossil fish Andreolepis from Gotland in Sweden, close to the common ancestor of all living bony fish and land vertebrates. 

The jaw is a tiny thing, less than a centimetre in length, but it hides a wonderful secret: the internal microstructure of the bone is perfectly preserved and contains a record of its growth history. 

Until recently it has only been possible to see internal structures by physically cutting thin sections from the fossil and viewing them under the microscope, but this destroys the specimen and provides only a two-dimensional image that is hard to interpret. 

However, at the European Synchrotron Radiation Facility (ESRF) in Grenoble, France, it is now possible to make tomographic scans that capture the same level of microscopic detail, in three dimensions, without damaging the specimen. Donglei Chen, first author of the study, has spent several years painstakingly 'dissecting' the scan data on the computer screen, building up a three-dimensional map of the entire sequence of tooth addition and loss - the first time an early fossil dentition has been analyzed in such detail. 

"Every time a tooth was shed, the resorption process created a hollow where it had been attached. When the succeeding replacement tooth was cemented in place by bone of attachment, the old resorption surface remained as a faint buried scar within the bone tissue. I found up to four of these buried resorption surfaces under each tooth, stacked on top of each other like plates in a cupboard. This shows that the teeth were replaced again and again during the life of the fish," explains Donglei Chen. 

This is the earliest known example of tooth shedding by basal resorption, and it seems to be most similar to the process of tooth replacement seen today in primitive bony fish such as gar (Lepisosteus) and bichir (Polypterus). Like in these fish, new replacement teeth developed alongside the old ones, rather than underneath them like in us.

"The amount of biological information we get from the scans is simply astonishing. We can follow the process of growth and resorption right down to cellular level, almost like in a living animal. As we apply this technique to more early vertebrates, we will come to understand their life processes much better - and no doubt we will be in for some major surprises," says Per Ahlberg, one of the leaders of the project.

                                     Dr.Devi Shetty, Narayana Hrudayalaya
                                          (Heart Specialist) Bangalore

A chat with Dr.Devi Shetty, Narayana Hrudayalaya

The transcript of the chat is given below. Useful for everyone.


Qn: What are the thumb rules for a layman to take care of his heart?

Ans:
1. Diet - Less of carbohydrate, more of protein, less oil
2. Exercise - Half an hour's walk, at least five days a week; avoid lifts and avoid sitting for a longtime
3. Quit smoking
4. Control weight
5. Control blood pressure and sugar

Qn: Is eating non-veg food (fish) good for the heart?

Ans: No

Qn: It's still a grave shock to hear that some apparently healthy person
gets a cardiac arrest. How do we understand it in perspective?

Ans: This is called silent attack; that is why we recommend everyone past the age of 30 to undergo routine health checkups.

Qn: Are heart diseases hereditary?

Ans: Yes

Qn: What are the ways in which the heart is stressed? What practices do you suggest to de-stress?

Ans: Change your attitude towards life. Do not look for perfection in everything in life.

Qn: Is walking better than jogging or is more intensive exercise required to keep a healthy heart?

Ans: Walking is better than jogging since jogging leads to early fatigue and injury to joints

Qn: You have done so much for the poor and needy. What has inspired you to do so?

Ans: Mother Theresa , who was my patient

Qn: Can people with low blood pressure suffer heart diseases?

Ans: Extremely rare

Qn: Does cholesterol accumulates right from an early age
(I'm currently only 22) or do you have to worry about it only after you are above 30 years of age?

Ans: Cholesterol accumulates from childhood.

Qn: How do irregular eating habits affect the heart ?

Ans: You tend to eat junk food when the habits are irregular and your body's enzyme release for digestion gets confused.

Qn: How can I control cholesterol content without using medicines?

Ans: Control diet, walk and eat walnut.

Qn: Can yoga prevent heart ailments?

Ans: Yoga helps.

Qn: Which is the best and worst food for the heart?

Ans: Fruits and vegetables are the best and the worst is oil.

Qn: Which oil is better - groundnut, sunflower, olive?

Ans: All oils are bad.

Qn: What is the routine checkup one should go through? Is there any specific test?

Ans: Routine blood test to ensure sugar, cholesterol is ok. Check BP, Treadmill test after an echo.

Qn: What are the first aid steps to be taken on a heart attack?

Ans: Help the person into a sleeping position, place an aspirin tablet under the tongue with a sorbitrate tablet if available, and rush him to a coronary care unit since the maximum casualty takes place within the first hour.

Qn: How do you differentiate between pain caused by a heart attack and that caused due to gastric trouble?

Ans: Extremely difficult without ECG.

Qn: What is the main cause of a steep increase in heart problems amongst youngsters? I see people of about 30-40 yrs of age having heart attacks and serious heart problems.

Ans: Increased awareness has increased incidents. Also, s edentary lifestyles, smoking, junk food, lack of exercise in a country where people are genetically three times more vulnerable for heart attacks than Europeans and Americans.

Qn: Is it possible for a person to have BP outside the normal range of 120/80 and yet be perfectly healthy?

Ans: Yes.

Qn: Marriages within close relatives can lead to heart problems for the child. Is it true?

Ans: Yes, co-sanguinity leads to congenital abnormalities and you may not have a software engineer as a child

Qn: Many of us have an irregular daily routine and many a times we have to stay late nights in office. Does this affect our heart? What precautions would you recommend?

Ans: When you are young, nature protects you against all these irregularities. However, as you grow older, respect the biological clock.

Qn: Will taking anti-hypertensive drugs cause some other complications (short / long term)?

Ans: Yes, most drugs have some side effects. However, modern anti-hypertensive drugs are extremely safe.

Qn: Will consuming more coffee/tea lead to heart attacks?

Ans: No.

Qn: Are asthma patients more prone to heart disease?

Ans: No.

Qn: How would you define junk food?

Ans: Fried food like Kentucky, McDonalds, samosas, and even masala dosas.

Qn: You mentioned that Indians are three times more vulnerable. What is the reason for this, as Europeans and Americans also eat a lot of junk food?

Ans: Every race is vulnerable to some disease and unfortunately, Indians are vulnerable for the most expensive disease.

Qn: Does consuming bananas help reduce hypertension?

Ans: No.

Qn: Can a person help himself during a heart attack (Because we see a lot of forwarded emails on this)?

Ans: Yes. Lie down comfortably and put an aspirin tablet of any description under the tongue and ask someone to take you to the nearest coronary care unit without any delay and do not wait for the ambulance since most of the time, the ambulance does not turn up.

Qn: Do, in any way, low white blood cells and low hemoglobin count lead to heart problems?

Ans: No. But it is ideal to have normal hemoglobin level to increase your exercise capacity.

Qn: Sometimes, due to the hectic schedule we are not able to exercise. So, does walking while doing daily chores at home or climbing the stairs in the house, work as a substitute for exercise?

Ans: Certainly. Avoid sitting continuously for more than half an hour and even the act of getting out of the chair and going to another chair and sitting helps a lot.

Qn: Is there a relation between heart problems and blood sugar?

Ans: Yes. Strong relationships since diabetics are more vulnerable to heart attacks than non-diabetics.

Qn: What are the things one needs to take care of after a heart operation?

Ans: Diet, exercise, drugs on time, Control cholesterol, BP, weight.

Qn: Are people working on night shifts more vulnerable to heart disease when compared to day shift workers?

Ans: No.

Qn: What are the modern anti-hypertensive drugs?

Ans: There are hundreds of drugs and your doctor will chose the right combination for your problem, but my suggestion is to avoid the drugs and go for natural ways of controlling blood pressure by walk, diet to
reduce weight and changing attitudes towards lifestyles.

Qn: Does dispirin or similar headache pills increase the risk of heart attacks?

Ans: No.

Qn: Why is the rate of heart attacks more in men than in women?

Ans: Nature protects women till the age of 45. (Present Global census show that the Percentage of heart disease in women has increased than in men )

 Qn: How can one keep the heart in a good condition?

Ans : Eat a healthy diet, avoid junk food, exercise every day, do not smoke and, go for health checkup s if you are past the age of 30 ( once in six months recommended) ....

                                                                                               Samaresh Datta

                                                                                               Asst. Professor

                                                                                               Dept. of Pharmaceutical Chemistry 

                                                                                               A.N.D. College of Pharmacy

                                                                                               Babhnan Gonda, UP

                                                                                               (Mo.+919532552534,+919616613920)

Do You Know?

RECENT MARKETED DRUGS FOR BREAST CANCER

LAPATINIB have been recently launched by GSK PHARMA to stop the production of her2 proteins. And other drug molecule is HERCEPTIN marketed by GENENTECH PHARMA in the USA by the joint collaboration with Roche International. HERCEPTIN is first artificial antibody approved for breast cancer.

TREATMENT OF CANCER

1) RADIATION

It is a process of using UV light as an ionizing radiation to destroy the cancerous cells which infected our body parts of a particular region. The main aim of the radiation therapy is stop the mutation of genes which occur in the DNA replication   under abnormal conditions. It is given in a particular dose form recommended by oncologists. It is mainly seen in Thyroid cancer and in lung cancer.

2) CHEMOTHERAPHY

It is a process of using chemical agents to destroy the cancerous cells. It is mainly applied when the cancer fails to respond to radiation and when the cancer cannot be removed surgically, these groups of chemical agents collectively known as antineoplastic agents. ANTINEOPLASTIC AGENTS acts as an epiphany in the field of tumour chemotherapy. The various categories of drugs have been able to achieve a degree of success while diagnosis the different types of carcinomas and lymphomas. Antineoplastic agents block the biosynthesis of nucleic acids to check the cell division through direct interference with the mitotic spindles. A treatment regimen must be followed while administering these drugs. These drugs are targeting specific so it has got severe side effects which includes G.I complications and Bone marrow depression. These drugs are been discovered on empirical basis since there is qualitative and quantitative differences between human cells and cancerous cells.

MONOCLONAL ANTIBODIES

The production and use of antibodies has become a areas of interest for the research field as well as for the academic purposes for its diversified applications. antibodies are often isolated by conventional method of sacrificing animals after hyperimmunizing them with ANTIGENS. ANTIBODY preparation by this method is usually heterogeneous because the cells are kept on producing a variety of antibodies. Since these antibodies are identical molecules specific for one type of antigen are called MABs (monoclonal antibodies). MABs are now been employed in human disease that are caused by a sudden attack of immune system on the tissue of the body. The most widely used MABs are OKT-3 which has been licensed for clinical use. MABs have been design to form carriers of cytotoxic substances which are termed as immunotoxins. Using MABs it has been possible to separate and remove tumour cells from normal cells of bone marrow. In case of gastrointestinal cancer it is used alone since the antibodies have the tendency to attract the cells of immune system to act against the prevailing cancerous cells. The availability of MABs that recognize immune cell antigens has resulted in improved diagnosis of particular type of lymphomas and leukemia’s.

GENETIC ENGINEERING

It is a process by which the genetic material is manipulated to have a desired result in a predetermine way. It is also known as DNA recombinant technology. The main aim of genetic engineering is to add, remove or repair the part of the genetic material by changing the qualities of a recipient organism in a useful predictable and in a permanent means. It also involves the actual planned synthesis of total new genes designed in advance to possess exactly the right combination of desired properties.

(RECENT ADVANCED TECHNIQUES IN THE TREATMENT OF CANCER)
STEM CELL THERAPY

The stem cell therapy has played the role of epiphany in the field of oncology. With the help of stem cell therapy a hope to live further gets brighter in the case of cancer patients. Stem cell is an undifferentiated cell that is able to renew itself and produce all the specialized cells with an organ. Stem cells occur in much tissue and organ. Scientist has been able to modify the stem cell taken from a bone marrow of a patient and then by the help of genetic engineering the scientist is able to incorporate the stem cell with the drugs which release the therapeutic proteins to kill the brain tumour.

DIFFERENT TYPES OF CANCER

1)    CARCINOMAS- When malignant growth occurs in epithelial tissue covering the body organs- examples: lung cancer and stomach cancer

2)    SARCOMA- These are malignant growth developing in such tissue which are derived from mesoderm- bone cancer

3)    LEUKEMIA-It developed from abnormal proliferation of WBC present in blood and their precursor in the bone marrow. WBC count increases which suppress the production of RBC and platelets- example: Myeloblastic leukaemia.

CONCLUSION-
Human wants are countless. If one want is fulfilled then he will crave for others. IN This process he is able to perceive the bad impacts associated with this cycle, so human beings are falling as a prey to this type of reticent and lethal disease. So the time has come for all of us to wake up against the disease.

BEFORE IT BECOMES TOO LATE FOR US TO REACT, IT IS BETTER TO KILL THE BABY WHEN IT IS IN MOTHER WOMB BEFORE IT SPREAD ITS TENTACLES TO KILL US.

Collected by

Raj Kishore

Asst. Professor

A.N.D.College of Pharmacy

Babhnan, Gonda