King Vision Videolaryngoscopy Versus Direct Laryngoscopy in Patients Requiring Endotracheal Intubation for General Anaesthesia: A Comparative Study

With new advances in technology, intubation using video laryngoscopy has been gaining popularity, particularlyin patients with difficult airways or as rescue devices in failed intubation attempts. This study was done tocompare the effectiveness of King Vision video laryngoscope (KVL) and Macintosh laryngoscope whenperforming tracheal intubation under general anesthesia Eighty patients requiring endotracheal intubationduring general anaesthesia were randomly assigned into two groups to undergo tracheal intubation usingeither a King Vision video laryngoscope (n=40) or Macintosh laryngoscope (n=40). The primary outcomeswere the time of intubation and Cormack-Lehane grading and secondary outcomes were number of attemptsand optimisation manoeuvres required and complications related to laryngoscopy and intubation. King Visionvideo laryngoscope was found to be significantly better than the Macintosh laryngoscope in terms of Cormackand Lehane grading, requirement of optimisation manoeuvres and need of second attempt for intubationexcept time of intubation which was comparable between the two groups.

Actinomycotic lacrimal canaliculitis: a rare case report

Actinomyces israelii is a gram-positive anaerobic organism commonly associated with canaliculitis in adults. Actinomyces are normal commensal bacteria in humans and primarily cause opportunistic infections during immunosuppressive state or when loss of continuity of epithelial lining in mucosa occurs. Lacrimal canaliculitis is a relatively rare condition and is undiagnosed for long periods of time. Being a relatively rare condition, it is commonly overlooked and undiagnosed for long periods of time. Primary chronic canaliculitis is an uncommon problem and Actinomycosis may form in up to 2% of all lacrimal disease. Here present study reports a case of lacrimal canaliculitis caused by Actinomyces israelii.

A study on needle stick injuries among health care workers in a tertiary care hospital in India

Background: Needle stick injury among health workers is regarded as an occupational hazard. Health care workers are at risk of having blood-borne diseases in case they are exposed to blood and other biological samples of the patients. Moreover, staff including doctors working in tertiary care hospitals has high work load which results in increased chances of getting these injuries. The aim and objectives of this study were to find out the prevalence of needle stick injury among different categories of health care workers. Authors also aimed to assess the knowledge, attitude and practices associated with it.Methods: A hospital based cross sectional study design to know the prevalence of needle stick injury among various health care workers of Karpagam Faculty of Medical Sciences and Research, a tertiary level care hospital in Coimbatore, Tamilnadu, India. A total of 250 health care workers were selected for the study purpose. A self-designed, semi-structured, pre-tested questionnaire was used to assess the prevalence of needle stick injuries and the factors associated with it.Results: A majority of health care workers (94%) knew about needle stick injury and 92% were aware that HIV can be transmitted through needle stick injury, 78.4% and 69.65% were aware of Hepatitis-B and Hepatitis-C transmission respectively. About 28.4% of subjects had encountered needle stick injury in their past. Furthermore, it was found that type of exposure and place of exposure was significantly associated with different categories of health care workers (p <0.001).Conclusions: Prevention of health workers against needle stick injury is the best possible way to prevent several bloods borne diseases. There should be a prevention programme which special focus on training of health care workers. Further strategies aiming at preventive measures and reporting of the Needle stick injuries accidents should be made compulsory among health care workers.

Prevalence and Risk Factors for Vancomycin Resistant Enterococci Isolated from Clinical Samples in Kashmir, North India: A Hospital Based Study.

Aims: To find out the prevalence and risk factors for vancomycin resistant Enterococci in a leading tertiary care center of north India. Design: Cross sectional study. Place and Duration of Study: Sher-I-Kashmir Institute of Medical Sciences, Srinagar. Kashmir. One year study. Methodology: A total of 400 isolates of Enterococci from patients admitted to our hospital were recovered using standard microbiological procedures, during a period of one year. Antimicrobial susceptibility of these isolates to various antibiotics was performed according to Clinical Laboratory Standard Institute (CLSI) guidelines. Minimum inhibitory concentration (MIC) of isolates found to be resistant to vancomycin on disc diffusion was done by microbroth dilution method. Various risk factors like placement of IV line catheter, urinary catheter, hospital stay and prior use of antimicrobial agents was noted for all the patients. Results: A total of 25 (6.3%) isolates of Enterococci were found to be vancomycin resistant, most of them recovered from the blood samples. E. faecium 16 (64%) was the predominant VRE isolated followed by E. faecalis 9 (36%). Factors like stay in an ICU, prior use of antimicrobials, placement of IV line and urinary catheter were associated with vancomycin resistant Enterococci (VRE) acquisition. Conclusion: VRE were recovered from our hospital and strict adherence to infection control guidelines needs to be followed to control their dissemination.

Lower Respiratory Tract Infections in Intensive Care Units. A Four Year Study from North India.

Title: Lower respiratory tract infections in intensive care units. A four year study from North India. Study Design: Prospective study Place and Duration of Study: Sher-i-Kashmir Institute of Medical Sciences, Srinagar Kashmir. Four years (July 2010 and June 2014). Methodology: A prospective analysis of respiratory specimens from various intensive care units (ICUs) was done over a period of four years. Antimicrobial susceptibility of culture positive isolates to various antibiotics was performed as per Clinical Laboratory Standards Institute (CLSI) guidelines. Gram-negative bacteria (GNB) were screened for extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) production; whereas methicillin and vancomycin resistance was searched in staphylococci and enterococci isolates respectively. Results: The frequencies of Gram-positive and Gram-negative bacteria were 26% and 68% respectively with yeast recovered in 8% of the specimens. K. pneumoniae and Acinetobacter spp were the most common Gram-negative bacteria and S. aureus the most common Gram-positive one. High level resistance to all the antimicrobials was seen; with K. pneumoniae being the most multidrug resistant GNB isolated in the ICU setting. ESBL production was also highest in K. pneumoniae isolates (67.1%). Also 59.6% of Acinetobacter isolates were found to be MBL producers. Methicillin resistance was seen in 48% of S. aureus and 85.5% of coagulase negative staphylococci (CoNS) isolates with vancomycin resistance seen in 6.7% of enterococcal isolates. Conclusion: An increasing trend over the years in the antibiotic resistance of respiratory pathogens in ICUs of this north Indian state was seen that calls for urgent measures to limit their continued rise.

An epidemiological study on quality of life among rural elderly population of nothern India.

Background: Population ageing is a recognized international reality, both in developed and developing countries. The number of elderly in the developing world is increasing due to demographic transition, whereas their condition is deteriorating as a result of fast eroding traditional family system coupled with rapid modernization and urbanization. Current statistics for the elderly gives a prelude to a new set of medical, social and economic problems that could arise if a timely initiative in this direction is not taken. Aims & Objective: To determine the pattern of physical morbidity in rural elderly population and to study health related quality of life and utilization of health services among them. Material and Methods: A community based cross-sectional design was adopted for studying the health problems of elderly and their health related quality of life, using WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire. Simple random sampling technique was used for sample collection. A total of 660 individual ≥ 60 years of age were taken up for the study purpose. Results: An overwhelming majority (68.2%) of elderly enjoyed a good quality of life, while those having a fair/poor quality of life were ≤ 15%. Quality of life was better in males in physical, psychological, social and environmental domains. It was more in subjects who had graduated and currently married, belonged to non-scheduled cast and living in extended families (p<0.001). Majority of the subjects were anaemic (64.5%), suffering from dental problems (62.2%) and joint pains (51.4%). Maximum numbers of subjects (92.7%) were utilizing non-government health care facility due to long distance from their houses (33.3%). Conclusion: There is a need to highlight the medical and psychosocial problems that are being faced by the elderly people in India and strategies for bringing about an improvement in their quality of life.

Heat shock and the heat shock proteins: An overview.

Organisms are exposed to a variety of stressful condition that damage important cellular structures and interfere with essential functions. In response to heat and other insults, cells activate an ancient signalling pathway leading to the transient expression of heat shock or heat stress proteins (HSPs). HSPs exhibit sophisticated protection mechanisms that protect the damaged cells. HSPs assist in protein folding, translocation and assembly of newly synthesized polypeptides. They also stabilize proteins during heat shock and other stresses, thus contributing to cell survival after injury. The elevated expression of stress proteins is considered to be a universal response to adverse conditions. In this Review we summarize the concepts of the HSPs protective mechanism.

Prevalence and pattern of substance abuse among school childern in nothern India: A rapid assesment study.

Background: Substance abuse among children has become an issue of concern throughout the world. Increasing substance abuse and its impact on physical and psychosocial health is a worldwide public health concern affecting the early youth and subsequently the whole life of the individuals. Particularly disturbing fact is that the age of initiation of abuse is progressively falling. To plan effective interventions, it is essential to have information on the extent and type of substance abuse among school children and their attitude towards its control. Aims & Objective: To find out the prevalence and pattern of substance abuse among school children and the associated risk factors. Material and Methods: A descriptive cross-sectional survey was conducted among students (13-19 years) studying in classes 7th-12th in rural and urban areas of district Ambala, using the Self-Administered WHO Model Core Questionnaire. Stratified random sampling technique was used to select the respondents. A total of 1500 students studying in various government and private schools were taken for the study purpose. Results: Overall prevalence of substance abuse was 60.0% for ever users and 34.93% for regular users. Substance abuse was more among male urban students belonging to nuclear families (p<0.001). Among ever users, alcohol (44.49%) was the most common substance abused while tobacco (14.42%) was mostly consumed by regular users. Substance abuse was more in age group of 17-19 years. Overall 42% were using more than one drug combination. Conclusion: Prevalence of substance use among school children in Northern India is high and causes significant physical and psychosocial problems in this population. A large proportion of those using drugs reported serious adverse effects, raising the necessity of targeted interventions to reduce the risk of subsequent substance dependence and other deleterious consequences.