This study analyzed 99 suspected diphtheria cases admitted to a hospital in Assam, India over 3 years. Throat swabs were collected and tested. Corynebacterium diphtheriae was isolated in 26 cases (26.26%). The highest culture positivity was in patients aged 5-9 years (53.84%) and 10-14 years (30.76%). Culture positivity was highest in non-immunized patients (62.5%) and surprisingly high in fully immunized patients too (31.58%). The study findings suggest a re-emergence of diphtheria in Assam, calling for intensive monitoring and review of immunization programs and vaccine quality/handling in the state
A Study to Assess the Effectiveness of Planned Teaching Program on the Knowle...ijtsrd
Malnutrition and Tuberculosis chronic infectious disease are both problems of considerable magnitude in the most underdeveloped regions of the world. Malnutrition can leads to secondary immunodeficiency that increase the host susceptibility to infection. The aim of the study was to assess the effectiveness of planned teaching program on the knowledge and practice regarding dietary pattern among mothers of children with tuberculosis admitted in pediatric ward. Quasi experimental with two groups pre test post test design was used for 60 mothers at IPD and OPD of pediatric department and purposive sampling technique was used. Self structured questionnaire was used to assess knowledge and checklist for practice. In post test experimental group mothers have 63.3 average knowledge, 26.6 poor knowledge and 10 good knowledge while in the control group, 53.3 poor knowledge, 46.6 average knowledge and non hove good knowledge. In experimental group mean score was 17.9 1.96 while in control group mean score was 11.8 2.99. At the “p” value 0.05, the calculated t value 3.21 was compared with the tabulated value 2.01 . In post test experimental group, mothers have 53.3 good practice, 46.6 average practice and none have poor practice while in the control group, 63.33 average practice, 23.3 poor practice and 13.3 good practice. In experimental group mean score was 19.13 1.99 while in the control group, mean score was 14.06 2.85.At the “p” value 0.05, the calculated t value 3.28 was compared with the tabulated value 2.01 . These finding reveals that the planned teaching program on dietary pattern was effective. Mrs. Anchal Tiwari | Mrs. Anugrah Charan | Dr. Sarika Gupta "A Study to Assess the Effectiveness of Planned Teaching Program on the Knowledge and Practice Regarding Dietary Pattern among Mothers of Children with Tuberculosis Admitted in Pediatric Ward at KGMU Hospital, Lucknowv" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38591.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/38591/a-study-to-assess-the-effectiveness-of-planned-teaching-program-on-the-knowledge-and-practice-regarding-dietary-pattern-among-mothers-of-children-with-tuberculosis-admitted-in-pediatric-ward-at-kgmu-hospital-lucknowv/mrs-anchal-tiwari
Clinic Epidemiological Characteristics of Chronic Hepatitis C on the Backgrou...ijtsrd
Since the problem of the incidence of hepatitis C and tuberculosis in the population is still a very important and urgent problem not only in Uzbekistan and the whole world, we decided to study how these diseases flow against the background of each other. During our study, we observed 80 patients at the regional tuberculosis dispensary and at the regional infectious diseases hospital in Samarkand, which were divided into 2 clinical groups. Mukhammedova Fariza Farkhodovna "Clinic - Epidemiological Characteristics of Chronic Hepatitis C on the Background of Tuberculosis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45174.pdf Paper URL: https://www.ijtsrd.com/economics/other/45174/clinic--epidemiological-characteristics-of-chronic-hepatitis-c-on-the-background-of-tuberculosis/mukhammedova-fariza-farkhodovna
A Serological Survey of Human Parainfluenza Viruses (HPIVs) among Children in...iosrjce
This study was done to carry out a survey of Human Parainfluenza Virus in children aged 1-12years
in Kaduna Metropolis, Nigeria using the Enzyme Linked Immunosorbent Assay Diagnostic kits. Of the 376
samples tested for IgG antibody of HPIV 1, 2 and 3, 288 were seropositive (76.6%). Risk and demographic
factors such as age of the children parental occupation, parental educational status, vitamin A deficiency,
frequency of eating, household size, duration of breastfeeding, environmental smoke, respiratory symptoms,
fever, sickle cell and underlying diseases were analysed. Age (χ2=17.408, p=0.001), parental occupation
(χ2=10.116, p=0.039), duration of breastfeeding (χ2=8.439, p=0.015), presence of respiratory symptoms
(χ2=5.116, p=0.024) were significantly associated with the infection. Observation from the study showed the
importance of Human Parainfluenza Virus as an agent of respiratory tract infection in children. As antiviral
drugs are not readily available, preventive measures should be adhered to in the control of the infection.
Patients Knowledge and Attitude towards Tuberculosis in a Rural Setting in Al...inventionjournals
Introduction: Tuberculosis is a major cause of illness worldwide. The burden is rising globally due to poverty, increasing population and HIV/AIDS. In developing countries, poor knowledge and perception of tuberculosis is prevalent, which causes delay in diagnosis and treatment of tuberculosis..India has the highest number of TB cases in the world. Material and Methods: The present study was conducted in Rural Health Training Centre, Jawan, of Jawahar Lal Nehru Medical College,AMU, Aligarh .A semi structured questionnaire was used to collect data from January- March,2015. A total of 80 subjects ,more than 15 years age group,residents of Jawan,were selected who either had completed tuberculosis treatment or are still on treatment.An informed consent was taken,before starting the questionnaire. Results: shows that out of 80 subjects under study,50% were in age –group 35 to 55 years and 75 % were males. Radio/T.V. was the maximum source of information on tuberculosis (60%), followed by health workers or community workers(50%) .Few subjects got information about T.B. from family members and friends/neighbours. 87.5% of the subjects were aware of the evening rise of temperature inT.B., followed by blood in sputum(80%) and cough more than 3 weeks(42.5%).Regarding causes of T.B.,76.25% of the subjects said that T.B. was due to smoking, followed by alcohol consumption(42.5%). 85% of the subjects knew that T.B. was a communicable disease.70% of the subjects knew that the mode of transmission of T.B. was during coughing.50% of the subjects believed that tuberculosis could be transmitted by sharing of common materials with T.B. patients.70% of the subjects reported that BCG immunization prevented tuberculosis. More than half(55%) of the participants reported that the transmission of T.B. could be prevented by avoiding personal contact with the T.B. patient. Conclusion: The study showed that the knowledge of people relating to T.B. is insufficient in most of the aspects.TB awareness programs should focus on reduction of TB associated stigmas.We need to train our health workers and also educate our masses especially those living in rural areas
A Study to Assess the Effectiveness of Planned Teaching Program on the Knowle...ijtsrd
Malnutrition and Tuberculosis chronic infectious disease are both problems of considerable magnitude in the most underdeveloped regions of the world. Malnutrition can leads to secondary immunodeficiency that increase the host susceptibility to infection. The aim of the study was to assess the effectiveness of planned teaching program on the knowledge and practice regarding dietary pattern among mothers of children with tuberculosis admitted in pediatric ward. Quasi experimental with two groups pre test post test design was used for 60 mothers at IPD and OPD of pediatric department and purposive sampling technique was used. Self structured questionnaire was used to assess knowledge and checklist for practice. In post test experimental group mothers have 63.3 average knowledge, 26.6 poor knowledge and 10 good knowledge while in the control group, 53.3 poor knowledge, 46.6 average knowledge and non hove good knowledge. In experimental group mean score was 17.9 1.96 while in control group mean score was 11.8 2.99. At the “p” value 0.05, the calculated t value 3.21 was compared with the tabulated value 2.01 . In post test experimental group, mothers have 53.3 good practice, 46.6 average practice and none have poor practice while in the control group, 63.33 average practice, 23.3 poor practice and 13.3 good practice. In experimental group mean score was 19.13 1.99 while in the control group, mean score was 14.06 2.85.At the “p” value 0.05, the calculated t value 3.28 was compared with the tabulated value 2.01 . These finding reveals that the planned teaching program on dietary pattern was effective. Mrs. Anchal Tiwari | Mrs. Anugrah Charan | Dr. Sarika Gupta "A Study to Assess the Effectiveness of Planned Teaching Program on the Knowledge and Practice Regarding Dietary Pattern among Mothers of Children with Tuberculosis Admitted in Pediatric Ward at KGMU Hospital, Lucknowv" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38591.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/38591/a-study-to-assess-the-effectiveness-of-planned-teaching-program-on-the-knowledge-and-practice-regarding-dietary-pattern-among-mothers-of-children-with-tuberculosis-admitted-in-pediatric-ward-at-kgmu-hospital-lucknowv/mrs-anchal-tiwari
Clinic Epidemiological Characteristics of Chronic Hepatitis C on the Backgrou...ijtsrd
Since the problem of the incidence of hepatitis C and tuberculosis in the population is still a very important and urgent problem not only in Uzbekistan and the whole world, we decided to study how these diseases flow against the background of each other. During our study, we observed 80 patients at the regional tuberculosis dispensary and at the regional infectious diseases hospital in Samarkand, which were divided into 2 clinical groups. Mukhammedova Fariza Farkhodovna "Clinic - Epidemiological Characteristics of Chronic Hepatitis C on the Background of Tuberculosis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45174.pdf Paper URL: https://www.ijtsrd.com/economics/other/45174/clinic--epidemiological-characteristics-of-chronic-hepatitis-c-on-the-background-of-tuberculosis/mukhammedova-fariza-farkhodovna
A Serological Survey of Human Parainfluenza Viruses (HPIVs) among Children in...iosrjce
This study was done to carry out a survey of Human Parainfluenza Virus in children aged 1-12years
in Kaduna Metropolis, Nigeria using the Enzyme Linked Immunosorbent Assay Diagnostic kits. Of the 376
samples tested for IgG antibody of HPIV 1, 2 and 3, 288 were seropositive (76.6%). Risk and demographic
factors such as age of the children parental occupation, parental educational status, vitamin A deficiency,
frequency of eating, household size, duration of breastfeeding, environmental smoke, respiratory symptoms,
fever, sickle cell and underlying diseases were analysed. Age (χ2=17.408, p=0.001), parental occupation
(χ2=10.116, p=0.039), duration of breastfeeding (χ2=8.439, p=0.015), presence of respiratory symptoms
(χ2=5.116, p=0.024) were significantly associated with the infection. Observation from the study showed the
importance of Human Parainfluenza Virus as an agent of respiratory tract infection in children. As antiviral
drugs are not readily available, preventive measures should be adhered to in the control of the infection.
Patients Knowledge and Attitude towards Tuberculosis in a Rural Setting in Al...inventionjournals
Introduction: Tuberculosis is a major cause of illness worldwide. The burden is rising globally due to poverty, increasing population and HIV/AIDS. In developing countries, poor knowledge and perception of tuberculosis is prevalent, which causes delay in diagnosis and treatment of tuberculosis..India has the highest number of TB cases in the world. Material and Methods: The present study was conducted in Rural Health Training Centre, Jawan, of Jawahar Lal Nehru Medical College,AMU, Aligarh .A semi structured questionnaire was used to collect data from January- March,2015. A total of 80 subjects ,more than 15 years age group,residents of Jawan,were selected who either had completed tuberculosis treatment or are still on treatment.An informed consent was taken,before starting the questionnaire. Results: shows that out of 80 subjects under study,50% were in age –group 35 to 55 years and 75 % were males. Radio/T.V. was the maximum source of information on tuberculosis (60%), followed by health workers or community workers(50%) .Few subjects got information about T.B. from family members and friends/neighbours. 87.5% of the subjects were aware of the evening rise of temperature inT.B., followed by blood in sputum(80%) and cough more than 3 weeks(42.5%).Regarding causes of T.B.,76.25% of the subjects said that T.B. was due to smoking, followed by alcohol consumption(42.5%). 85% of the subjects knew that T.B. was a communicable disease.70% of the subjects knew that the mode of transmission of T.B. was during coughing.50% of the subjects believed that tuberculosis could be transmitted by sharing of common materials with T.B. patients.70% of the subjects reported that BCG immunization prevented tuberculosis. More than half(55%) of the participants reported that the transmission of T.B. could be prevented by avoiding personal contact with the T.B. patient. Conclusion: The study showed that the knowledge of people relating to T.B. is insufficient in most of the aspects.TB awareness programs should focus on reduction of TB associated stigmas.We need to train our health workers and also educate our masses especially those living in rural areas
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
PREVAILENCE OF MIGRIANE IN A LOW INCOME COMMUNITY OF KARACHIJing Zang
Migraine is the most common problem affecting large population, with prevalence frequency 10-12 %. This study was conducted to evaluate the prevalence of migraine in a low income community in Karachi from June-Oct, 2013. Three hundred and seven participants were involved in this study. For this purpose cross-sectional community based questionnaire was designed in accordance with the diagnostic criteria given by International Headache Society. Data collection was carried out by personal visit to patients and through clinics. It was observed that females (65.5%) are more affected from migraine then male. 32.9% housewives reported that they are suffering from migraine. This medical problem is common among youngsters (38.1%) than old citizens. Employees working in different organizations (39.7%), were found to be mostly affected from migraine then self employed persons. Majority of the migraine patients (41%) reported that they are suffering from common symptoms including: photophobia, phonophobia, nausea, vomiting etc. Dietary habits of individuals were found to be closely associated with migraine such as use of caffeine, chocolate are prominent; and their use is common among 75% patients cumulatively. It was evaluated that certain disease conditions i.e. stress (33.6%), depression (22.1%) and anxiety (18.9%) are more common among sufferers of migraine.
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alri...CrimsonpublishersCJMI
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alribat University hospital, Khartoum State, Sudan, 2017 by Mohammed HMN in Cohesive Journal of Microbiology & Infectious Disease
Post Endodontic Restoration: Are You Serious?IOSR Journals
After root canal obturation of sound posterior teeth, dentists are always in hurry of giving full
crown. They are not serious in giving proper post endodontic restoration which results in fracture of tooth or
restoration, if patient delays the full crown treatment. The inherent causes of failures are rarely evaluated.
Thus, it was the purpose of this study to analyze the opinion of practicing dentist and after 24 months of clinical
observation to present a logical approach to this subject as the final success of endodontic treatment is depend
on the proper and timely coronal restoration.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...Dr.Samsuddin Khan
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
Profile of Sexually transmitted infections (STIs) among students of tertiary ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Abstract—The aim of the study was to observe the prevalence of various microorganisms from throat swab specimens in patients attending a tertiary care hospital at Chinakakani, Guntur. Throat swab specimens were collected aseptically from 100 patients and cultured on appropriate bacteriological media. Isolates were identified by biochemical tests & antimicrobial susceptibility performed by standard methods. Out of 100 Samples, culture was positive in 25 samples. So Bacterial infection was found in 25% of Pharyngitis. Streptococcus pyogenes was the commonest isolate, followed by Staphylococcus aureus and Candida albicans. Majority of bacteria were Streptococcus pyogenes, Staphylococcus aureus and Candida albicans. In 60% it was mixed infection. The susceptibility patterns varied depending on the drugs, but most of the organisms were susceptible to penicillin, erythromycin and vancomycin. Improved personal hygiene and health education of the masses on how to care for ear, nose and throat will greatly reduce these microbial infections. This study will be useful for control strategies and for predicting pathogen prevalence in throat swabs.
Knowledge and Practice of Immunization amongst the care-givers of 12-23 month...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
PREVAILENCE OF MIGRIANE IN A LOW INCOME COMMUNITY OF KARACHIJing Zang
Migraine is the most common problem affecting large population, with prevalence frequency 10-12 %. This study was conducted to evaluate the prevalence of migraine in a low income community in Karachi from June-Oct, 2013. Three hundred and seven participants were involved in this study. For this purpose cross-sectional community based questionnaire was designed in accordance with the diagnostic criteria given by International Headache Society. Data collection was carried out by personal visit to patients and through clinics. It was observed that females (65.5%) are more affected from migraine then male. 32.9% housewives reported that they are suffering from migraine. This medical problem is common among youngsters (38.1%) than old citizens. Employees working in different organizations (39.7%), were found to be mostly affected from migraine then self employed persons. Majority of the migraine patients (41%) reported that they are suffering from common symptoms including: photophobia, phonophobia, nausea, vomiting etc. Dietary habits of individuals were found to be closely associated with migraine such as use of caffeine, chocolate are prominent; and their use is common among 75% patients cumulatively. It was evaluated that certain disease conditions i.e. stress (33.6%), depression (22.1%) and anxiety (18.9%) are more common among sufferers of migraine.
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alri...CrimsonpublishersCJMI
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alribat University hospital, Khartoum State, Sudan, 2017 by Mohammed HMN in Cohesive Journal of Microbiology & Infectious Disease
Post Endodontic Restoration: Are You Serious?IOSR Journals
After root canal obturation of sound posterior teeth, dentists are always in hurry of giving full
crown. They are not serious in giving proper post endodontic restoration which results in fracture of tooth or
restoration, if patient delays the full crown treatment. The inherent causes of failures are rarely evaluated.
Thus, it was the purpose of this study to analyze the opinion of practicing dentist and after 24 months of clinical
observation to present a logical approach to this subject as the final success of endodontic treatment is depend
on the proper and timely coronal restoration.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Adverse Events among HIV/MDR-TB Co-Infected Patients Receiving Antiretroviral...Dr.Samsuddin Khan
Abstract
Background
Significant adverse events (AE) have been reported in patients receiving medications for multidrug- and extensively-drug-resistant tuberculosis (MDR-TB & XDR-TB). However, there is little prospective data on AE in MDR- or XDR-TB/HIV co-infected patients on antituberculosis and antiretroviral therapy (ART) in programmatic settings.
Methods
Médecins Sans Frontières (MSF) is supporting a community-based treatment program for drug-resistant tuberculosis in HIV-infected patients in a slum setting in Mumbai, India since 2007. Patients are being treated for both diseases and the management of AE is done on an outpatient basis whenever possible. Prospective data were analysed to determine the occurrence and nature of AE.
Results
Between May 2007 and September 2011, 67 HIV/MDR-TB co-infected patients were being treated with anti-TB treatment and ART; 43.3% were female, median age was 35.5 years (Interquartile Range: 30.5–42) and the median duration of anti-TB treatment was 10 months (range 0.5–30). Overall, AE were common in this cohort: 71%, 63% and 40% of patients experienced one or more mild, moderate or severe AE, respectively. However, they were rarely life-threatening or debilitating. AE occurring most frequently included gastrointestinal symptoms (45% of patients), peripheral neuropathy (38%), hypothyroidism (32%), psychiatric symptoms (29%) and hypokalaemia (23%). Eleven patients were hospitalized for AE and one or more suspect drugs had to be permanently discontinued in 27 (40%). No AE led to indefinite suspension of an entire MDR-TB or ART regimen.
Conclusions
AE occurred frequently in this Mumbai HIV/MDR-TB cohort but not more frequently than in non-HIV patients on similar anti-TB treatment. Most AE can be successfully managed on an outpatient basis through a community-based treatment program, even in a resource-limited setting. Concerns about severe AE in the management of co-infected patients are justified, however, they should not cause delays in the urgently needed rapid scale-up of antiretroviral therapy and second-line anti-TB treatment
Profile of Sexually transmitted infections (STIs) among students of tertiary ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Abstract—The aim of the study was to observe the prevalence of various microorganisms from throat swab specimens in patients attending a tertiary care hospital at Chinakakani, Guntur. Throat swab specimens were collected aseptically from 100 patients and cultured on appropriate bacteriological media. Isolates were identified by biochemical tests & antimicrobial susceptibility performed by standard methods. Out of 100 Samples, culture was positive in 25 samples. So Bacterial infection was found in 25% of Pharyngitis. Streptococcus pyogenes was the commonest isolate, followed by Staphylococcus aureus and Candida albicans. Majority of bacteria were Streptococcus pyogenes, Staphylococcus aureus and Candida albicans. In 60% it was mixed infection. The susceptibility patterns varied depending on the drugs, but most of the organisms were susceptible to penicillin, erythromycin and vancomycin. Improved personal hygiene and health education of the masses on how to care for ear, nose and throat will greatly reduce these microbial infections. This study will be useful for control strategies and for predicting pathogen prevalence in throat swabs.
Knowledge and Practice of Immunization amongst the care-givers of 12-23 month...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Comparative Study of the Efficacy of 5 Days and 14 Days Ceftriaxone Therapy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTIONAnil Haripriya
Fournier’s gangrene which is a rapidly progressive, fulminant polymicrobial synergistic infection of the perineum and genitals is now changing its pattern. Both genders can be affected and the mortality is still high (around10%). The clinical presentation in many patients in early stage may not be prominent. Thus rapid and accurate diagnosis is must for prompt treatment. Extensive surgical debridement and broad spectrum intravenous antibiotic remains the mainstay of treatment in order to reduce the morbidity and mortality.
Involvement of Helicobacter Pylori in the Genesis of Precancerous Stomach Les...semualkaira
Helicobacter Pylori is a bacterium involved in the genesis of precancerous lesions of the stomach. This infection is universally
prevalent but is higher in developing countries. A retrospective
study spread over 3 years (2018-2019-2020) was conducted at the
pathological anatomy laboratory of the Chadli Bendjedid Hospital
in El Tarf, northeast Algeria. All patients were submitted to a fiberscope, and the diagnosis was established by histological examination. The results show that of the 134 patients examined, 100%
were diagnosed with chronic gastritis. The prevalence of H. pylori
infection was 61.94%; 63.86% of women were affected, and the
most susceptible age group was 50-59 years; 36.14% of men were
affected, mainly in the age group 30-39 years. Locally, the fundic antrum area appeared to be the most affected (81.93%) with
moderate chronic atrophic gastritis (78.57%) and silent activity
(94.28%), which favors the development of cancer cells.
Involvement of Helicobacter Pylori in the Genesis of Precancerous Stomach Les...semualkaira
Helicobacter Pylori is a bacterium involved in the genesis of precancerous lesions of the stomach. This infection is universally
prevalent but is higher in developing countries. A retrospective
study spread over 3 years (2018-2019-2020) was conducted at the
pathological anatomy laboratory of the Chadli Bendjedid Hospital
in El Tarf, northeast Algeria. All patients were submitted to a fiberscope, and the diagnosis was established by histological examination. The results show that of the 134 patients examined, 100%
were diagnosed with chronic gastritis. The prevalence of H. pylori
infection was 61.94%; 63.86% of women were affected, and the
most susceptible age group was 50-59 years; 36.14% of men were
affected, mainly in the age group 30-39 years. Locally, the fundic antrum area appeared to be the most affected (81.93%) with
moderate chronic atrophic gastritis (78.57%) and silent activity
(94.28%), which favors the development of cancer cells.
Involvement of Helicobacter Pylori in the Genesis of Precancerous Stomach Les...semualkaira
Helicobacter Pylori is a bacterium involved in the genesis of precancerous lesions of the stomach. This infection is universally
prevalent but is higher in developing countries. A retrospective
study spread over 3 years (2018-2019-2020) was conducted at the
pathological anatomy laboratory of the Chadli Bendjedid Hospital
in El Tarf, northeast Algeria. All patients were submitted to a fiberscope, and the diagnosis was established by histological examination. The results show that of the 134 patients examined, 100%
were diagnosed with chronic gastritis. The prevalence of H. pylori
infection was 61.94%; 63.86% of women were affected, and the
most susceptible age group was 50-59 years; 36.14% of men were
affected, mainly in the age group 30-39 years. Locally, the fundic antrum area appeared to be the most affected (81.93%) with
moderate chronic atrophic gastritis (78.57%) and silent activity
(94.28%), which favors the development of cancer cells.
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Rega...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
—Fungal organisms are ubiquitous. A common location for these organisms to enter the human body is through the external acoustic canal, oral cavity, and pharynx and sino-nasal cavity. A study was conducted with clinical and mycological analysis of various fungal infections in ENT. Patients suspected for having fungal infections attending at Department of ENT were interrogated and analysed. Swabs collected from these cases were sent for direct microscopy by KOH mounts for fungal examination and fungal culture. Microbiological confirmed 100 cases were finally included in the study Histopathological examination of nasal mass and polyposis was also done. It was observed in this present study otomycosis was most common and accounted for 84% of the total cases followed by candidiasis in oral cavity and pharynx in 9%, allergic fungal rhinosinusitis in 4% and rhinosporidiosis in 3%. Aspergillus niger was that most common fungus isolated in 61% cases, followed by Candida albicans in 24% cases, Aspergillus flavus in 9% cases, Aspergillus fumigatus and Rhinosporodium seeberi in 3% cases each. All the cases of fungal infection of oral cavity and oropharynx were due to Candida albicans.
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Maternal Immunization with Tdap Vaccine Dr. Sharda Jain Lifecare Centre
Maternal
Immunization
with Tdap Vaccine
Agenda
Pertussis:Key facts & Epidemiology
Who is at risk?
Source of Pertussis infection
What is Tdap vaccine?
Recommendations for Maternal Immunization with Tdap vaccine
Safety data on Maternal Immunisation with Tdap vaccine
Summary
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Clinical Safety and Side Effects of Intra Dermal regimen of Tissue culture Anti-rabies Vaccine-Rabies is 100% fatal but preventable disease. WHO recommends Tissue culture Anti-rabies Vaccines for post exposure treatment but this prophylaxis becomes expensive. So for reducing the 1/6th cost of this prophylaxis intradermal ARV regime was also recommended. But again there is a question mark for balance between cost effectiveness and safty so this cross sectional study was carried out in year 2013 on 654 recipients of Purified Chick Embriyo Cell Vaccine (PCECV) anti-rabis vaccine (ARV) at Anti Rabies Clinic (ARC) of a tertiary-care teaching hospital (SMS) at Jaipur, Rajasthan. Side effects were observed during the follow up visits on days 3, 7 and 28. Though all the recipients complained of local side effects at site of inoculation but these symptoms were relieved by simple administration of paracetamol and ceterizine orally. The side effects (local symptoms) noted on First dose were local itch (4%), local pain (3.8%), low grade fever (2.1%) and the local signs noted are local induration (22.3%), local erythema (1.2%). Same pattern of sign and symptoms were observed in D3 and D7 dose of injection but in decreased frequency. None of the cases had anaphylaxis or regional lymphadenopathy. Thus, this cost effective way of treating the animal bite cases using PCECV in Intra Dermal Rabies Vaccination (IDRV) is recommended to deal with the burden of animal bite cases for the prevention of Rabies in India.
EVALUATION OF SERUM LEVELS OF FASTING LIPID PROFILE IN PRE-ECLAMPTIC WOMEN
Wuraola Serah Nnaemeka, Olisekodiaka, MJ, Onuegbu, AJ, Ezeugwunne, IP, Maduka, IG, Suru, SM , Johnkennedy Nnodim
IRO INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES 2018, 1(1):20-23.
SOCIAL AND ECONOMIC BURDEN OF CANCER ON 2020- REVIEW Tamizhazhagan, Pugazh...Earthjournal Publisher
SOCIAL AND ECONOMIC BURDEN OF CANCER ON 2020- REVIEW
Tamizhazhagan, Pugazhendy, Sakthidasan, Jayanthi, Ki-Hyun Kim
IRO INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES 2018, 1(1):24-30.
DEVELOPMENT AND VALIDATION OF STABILITY INDICATING RP-HPLC METHOD FOR ESTIMAT...Earthjournal Publisher
DEVELOPMENT AND VALIDATION OF STABILITY INDICATING RP-HPLC METHOD FOR ESTIMATION OF TERCONAZOLE
Gandhi Santosh V , Phalke Truprti R, Chaudhari Atul P
IRO INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES 2018, 1(1):14-19.
PDF
Call for case report,review and research article for journals
1.International journal of medical and applied sciences.
Volume 6 issue2,2018
2.IRO International journal of medical and applied sciences.
Print journal
Volume 1 issue2, 2018
email: earthjournals@gmail.com
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. Recent Advances in Mucoadhesive Buccal Drug Delivery Systems and Its Marketed Scope and
Opportunities
K.P.Sampath Kumar ,DebjitBhowmik .AmitsankarDutta, Shravan Paswan, Lokesh Deb
Critical Review in Pharmaceutical Sciences 2012, 1(1):83-98.
NEUROLOGICAL MANIFESTATIONS OF HIV/AIDS: A CLINICAL PROSPECTIVE STUDYEarthjournal Publisher
&Objectives: To study the clinical profile of neurological manifestations of Human immunodeficiency
virus(HIV)/Acquired immunodeficiency syndrome(AIDS) and to correlate with the CD4+T lymphocyte
count.Material & Methods : 50 patients who were in the age goup18-55 years, had HIV infection and history
suggestive of Nervous system manifestations were included. The HIV patients with past/present history of
other immunocompromised conditions ( cytotoxic drugs for malignancies, Post organ transplant patients,
Patients using steroids for long term), previous history of epilepsy, focal neurological deficit and head injury
were excluded from the study. All the patients were examined in detail by history and clinical neurological
examination. For all the patients have done routine investigations, and specific investigations like CT/MRI
Brain, Nerve Conduction Studies, CSF Analysis,EEG and Specific antibodies for organisms or parasite done
only wherever it is required. All the patients were correlated with the CD4 T cell count.Results:: Among 50
patients, Commonest age group affected was 26-35 yrs with male predominance(62%). Most common symptom
was non specific headache(38%).Most common opportunistic infetction was Tuberculous meningitis(34%).
Toxoplasmsa encephalitis was the most common space occupying lesion(20%).More number of patients were
seen in the CD4 range in between 51-200 cells/mic.L(72%) with all the diseases had correlation with CD4 T cell
activityCONCLUSION: In the present study, Opportunistic infections were the leading cause in patients
infected with HIV having Neurological manifestastions, usually occurs when the patients had severe
immunosuppresion (CD4 count< 200 cells/μL).
Key words: HIV Positive patients, CD4 T cell count, Neurological manifestation
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. www.earthjournals.in
IRO INTER. J. MED. APPLIED SCI./ Vol.1 /Issue 1/2018 Page 2
MATERIALS AND METHOD
The study was conducted over a period of three years from January, 2013 to December, 2015,
in the Department of Microbiology, Gauhati Medical College & Hospital (GMCH), Guwahati, Assam.
Institutional Ethical Committee clearance was duly obtained. The WHO case definition for surveillance
of diphtheria was followed for ascertaining the probable and confirmatory diagnosis of patients.
The subjects of the study included a total of 99 patients with clinical diagnosis of diphtheria,
coming from the lower Assam districts, and admitted in GMCH, during the study period. The inclusion
criteria of the study cases were, - an illness of the upper respiratory tract characterized by laryngitis or
pharyngitis and an adherent membrane of tonsils, pharynx and/or nose.
Sample Collection and Processing: Two samples of throat swabs were collected from each case, one for
direct microscopy and another for culture, after informed consents. For direct microscopy, smears were
prepared and stained with Gram stain and Albert stain to look for Gram positive bacilli and Kleb-
Loeffler’s bacilli (KLB). The other throat swab was immediately inoculated on Blood agar, Loeffler’s
serum slope and Tellurite Blood agar media, and incubated at 370
C for 24 to 48 hours. Typical colonies
grown on the media were picked up and stained with Gram stain and Albert stain and examined under
microscope to look for Gram positive bacilli and typical diphtheria bacilli.
RESULTS AND OBSERVATION
Out of the total of 99 cases, 40 in 2013, 28 in 2014 and 21 in 2015, the highest number of 35 cases were
in the age group 5-9 years, followed by 25 in age group 15-45 years, 20 in 10-14 years, 16 in 0-4 years,
and the lowest number of 3 in patients aged >45 years.(Table-1). Gender wise, there were more male
cases (56) than females (43).(Table-2).
Twenty-six (26.26%) cases of the study were positive for diphtheria both by direct smear
microscopy and by culture. Four (4.04%) cases were positive by direct smear microscopy but were
negative in culture.(Table-3).
Culture positivity rates among cases admitted in 2013, 2014 and 2015 were 15%, 57.14% and 12.9%,
respectively (not shown in table). In patients agewise, C. diphtheriae was isolated in 14(40%) out of 35
cases in the age group 5-9 years, 8(40%) out of 20 in age group 10-14 years, 3(12%) out of 25 cases in
age group 15-45 years, 1(6.25%) out of 16 in age group 0-4 years. None of the 3 cases aged >45 years
yielded C. diphtheriae. Overall, out of the total of 26 culture positive cases, the highest culture
positivity rate of 53.84% was in cases aged 5-9 years, followed by 30.76% in cases aged 10-14 years,
11.53% in cases aged 15-45 years, and 3.84% in 0-4 years age group.(Table-3).
Gender wise, C. diphtheriae was isolated in 17 (30.35%) of 56 male cases and 9 (20.93%) of
43 female cases. And out of the total 26 culture positive cases, more males (65.38%) than females
(34.62%) yielded C. diphtheriae in culture.(Table-4).
As per the history of immunization obtained, out of 99 study patients, 19 were fully
immunized, 13 were partially or incompletely immunized, 8 patients were not immunized at all. The
status of immunization of the rest 59 patients was not available due to ignorance and illiteracy of those
patients and/or their attendants. Culture positivity was the highest in non-immunized patients (62.5%),
and surprisingly, culture positivity was observed in 31.58% of the fully immunized patients. Among the
patients with unknown status of immunization, 23.72% were culture positive, and in partially or
incompletely immunized patients, culture positivity was observed in 7.69%..(Table-5).
Clinically, all of the 99 cases of the study had mild to moderate fever and sore throat.
Pseudomembrane formation in throat was seen in 26 cases who had very mild dyspnoea also. None of
the cases had symptoms and signs of myocarditis, polyneuritis, cranial nerve palsies, and secondary
pneumonia. The twenty six cases presenting with pseudomembrane formation with mild dyspnoea were
found to be positive for diphtheria bacilli both in direct smear microscopy and in culture. Regarding
clinical features and immunization status, it was observed that all categories of cases – fully immunized,
partially immunized and non immunized, clinical features were the same viz., fever, sore throat, mild
dyspnoea and pseudomembrane formation.(notshown in separatetableorchart).
3. www.earthjournals.in
IRO INTER. J. MED. APPLIED SCI./ Vol.1 /Issue 1/2018 Page 3
Table-1. Diphtheria Study Cases : Age wise
Table-2. Diphtheria Study Cases : Gender wise
Table-3. Diphtheria Study Cases : Age and Culture Positivity
Table-4. Diphtheria Study Cases : Gender and Culture positivity
Table-5. Diphtheria Study Cases : Immunization Status and Culture positivity
Year Total
Cases
FI*
Cases
Culture
+ve
PI*
Case
Culture
+ve
NI*
Cases
Culture
+ve
UI*
Cases
Culture
+ve
2013 40 17 4 12 0 5 2 6 0
2014 28 2 2 1 1 3 3 22 10
2015 31 - - - - - - 31 4
Total 99 19 6
(31.58%)
13 1
(7.69%)
8 5
(62.5%)
59 14
(23.72%)
*FI=Fullyimmunized; PI= Partially immunized; NI= Non-immunized; UI= Unknown Immunizationstatus
Year
Age Group in years TOTAL
0 - 4 5 - 9 10 - 14 15 - 45 >45
2013 11 13 3 10 3 40
2014 1 12 11 4 0 28
2015 3 10 6 11 0 31
Total 16
(16.16%)
35
(35.35%)
20
(20.20%)
25
(25.25%)
3
(3.03%)
99
(100%)
Year Male Female Total
2013 22 18 40
2014 13 15 28
2015 21 10 31
Total 56
(56.56%)
43
43.43%)
99
(100%)
Age Group
In yrs
Total
Cases
Smear+ve
Culture +ve
Smear+ve
Culture-ve
0 - 4 16 1(6.25%)
(3.84%)
5 - 9 35 14(40%)
(53.84%)
10 - 14 20 8(40%)
(30.76%)
15 - 45 25 3(12%)
(11.53%)
>45 3 0
Total 99 26(26.26%)
(100%)
4(4.04%)
Gender Total
Cases
Smear+ve
Culture +ve
Smear+ve
Culture-ve
Male 56 17 (30.35%)
(65.38%)
Female 43 9 (20.93%)
(34.62%)
TOTAL 99 26(26.26%) 4(4.04%)
4. www.earthjournals.in
IRO INTER. J. MED. APPLIED SCI./ Vol.1 /Issue 1/2018 Page 4
DISCUSSION
Diphtheria, if not diagnosed and treated promptly, can lead to significant mortality and morbidity
because of its severe critical complications such as obstructive airway disease, myocarditis,
polyneuritis, cranial nerve palsies, and secondary pneumonia. In the present study, all the culture
positive cases presented with mild to moderate fever, sore throat, and formation of a pseudomembrane
on examination. The overall culture positivity for Corynebacterium diphtheriae was 26.26% in the
present study for the period of three years from 2013 to 2015. In a similar study carried out from 2012
to 2014, S. Bhagat et al from Delhi also reported persistence of Corynebacterium diphtheriae in Delhi
and the National Capital Region (NCR), in about 23% of cases.8
Diphtheria mainly affects children aged 1 year to 5 years. However, for the better vaccine
coverage worldwide, a shift in the age wise incidence of the disease from pre-school to school age (5 to
15 years) has been observed with more cases now reported among adults.6
In our study also,
C.diphtheriae positive cases were more among the patients aged 5 years and above, – 53.84% and
30.76%, respectively, in age groups 5-9 years and 10-14 years, which is similar to the study of Nandi R.
et al 7
from Assam, who reported it as 59%. A shift in age of diphtheria cases was also reported by
Saikia L.et al. 9
In their study of an outbreak in Dibrugarh district of Assam, they reported 100% cases
to be aged >5 years. In contrast, S. Bhagat et al8
reported most of their cases in 1-5 years of age.
Serological studies in many countries revealed that due to lack of adult vaccination as well as natural
immunity, a high proportion of adults become susceptible to diphtheria.10
The potential for outbreaks of
diphtheria in a community may be enhanced when there are susceptible adults and unimmunized
children in the same community.3
Culture positivity for C. diphtheriae in the present study was found to be more in males
(65.38%) than in female patients (34.62%). Meera M. et al 11
from Andhra Pradesh reported that 60% of
females in their study were culture positive for C. diphtheriae. The higher culture positivity in our study
may have been due to the fact that male children in our communities are more active than females and
their contact is closer with their friends and others some of whom may be already infected or may be
carriers.
The present study revealed that 62.5% of non-immunized patients were culture positive for C.
diphtheriae. Surprisingly, 31.58% of the fully immunized patients were also culture positive. Similar to
our findings, Meera M. et al 11
also reported culture positivity among fully immunized patients (5%) in
Andhra Pradesh and high culture positivity among non-immunized patients (94%).
Mild to moderate fever and sore throat were common clinical features of all of the total 99
study cases while pseudomembrane formation with mild dyspnoea were present in the 26 cases showing
positive smear microscopy and culture for diphtheria. Moreover, no specific immunization status of the
confirmed diphtheria cases was observed as diphtheria was confirmed in all categories of patients,–
fully immunized, partially immunized and non-immunized.
CONCLUSION
The study signifies re-emergence of diphtheria in the Northeast Indian state of Assam,
which calls for intensive monitoring and review of UIP implementation in the state including vaccine
quality, vaccine storage and transport conditions. Enhancing effective awareness campaigns on the
importance of immunization and its various benefits, both among the care providers and the
communities,12
would also contribute towards an improved state.
Limitation of the study : Incomplete history of immunization of many of the study cases, which was
due mainly to illiteracy and ignorance of the patients and/or their attendants; and toxigenicity tests of
the C. diphtheriae isolates, which could not be performed due to some inconveniences.
5. www.earthjournals.in
IRO INTER. J. MED. APPLIED SCI./ Vol.1 /Issue 1/2018 Page 5
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