Clinical and aetiological profile of Pneumonia in age group between 1 month to 1 year: a hospital based prospective study

Background: Pneumonia is one of the leading causes of morbidity and mortality in children under five years of age across the world. The present study was designed to clinically evaluate the children of age 1 month to 1 year with pneumonia, correlate it with bacteriological, radiological findings and to study the risk factors.Methods: Clinical, bacteriological, radiological features and risk factors of community acquired pneumonia in children of age group 1 month to 1 year were noted and analysed.Results: As per WHO ARI control programme, 72% had pneumonia, 25.3 % had severe pneumonia and 2.6% had very severe pneumonia. Bacterial pneumonia was detected radiologically in 4.6% and viral pneumonia in 88.6% of cases. Chest X-ray was normal in 6.6% of cases. Tachypnoea, chest retractions, crepitations alone and crepitations with rhonchi correlated well with positive radiological findings. Inappropriate immunization for age, lack of breast feeding, preterm birth, smoking in family were significant risk factors for severe Pneumonia. 39.3% had leucocytosis and 24% had positive CRP. Culture was positive in 23 cases (15.3% culture positivity).Conclusions: Radiologically confirmed Pneumonia should be treated with antibiotics because, in clinical practice, it is virtually impossible to distinguish exclusively between viral pneumonia and bacterial pneumonia. As the viruses are most common causative agents of Pneumonia in 1 month to 1 year, PCR kits should be used to identify viral etiological agents. Early and exclusive breast feeding should be promoted to decrease the risk of pneumonia.

Incidence of Hookworm Infection Related Anemia in Children in a Teaching Hospital in Telangana.

Background: Ancylostoma duodenale and Necator americanus are the blood sucking nematodes commonly called hookworms. They cause mild to severe anemia in patients especially children. The most common cause for hookworm infection is unhygienic conditions of the surroundings. Methods: 780 stool samples were collected from the children in wards, ICUs and schools. All the stool samples were subjected to wet mount by iodine and saline. They were also subjected to concentration technique by formalin ethyl acetate solution. Complete Blood Picture, estimation of Hemoglobin was done for all children for anemia and eosinophil testing. Results: 10.1% of the stool samples were positive for hookworms with 43 boys and 36 girls. 79.1% of the males and 88.3% of females were anemic with overall percentage being. Most of the children were from poor background with unhygienic conditions. Conclusion: Since most children belonged to poor background with unhygienic conditions, health education, improvement in sanitation, and mass treatment in affected areas can be tried.

Role of Induced Sputum, Bronchial Aspirate and Post Bronchoscopic Sputum in the Diagnosis of Sputum Smear Negative Pulmonary Tuberculosis.

Background: The diagnosis of Pulmonary Tuberculosis is largely dependent of the positive result of the sputum smear by ZN staining. But in many cases, although active tuberculosis is present, due to many reasons, sputum smear may yield a negative result. With a late culture result, no reliable serological test available to enable an early diagnosis, role of induced sputum and bronchoscopy has been tried with excellent results. Methods: 50 fresh smear negative cases between the ages of 16-65 years, clinically and radiologically suspected of Pulmonary Tuberculosis were subjected to induced sputum and bronchoscopy after detailed history and thorough clinical examination as done. Clinical symptoms were noted, 2 sputum smears (spot and early morning) and chest x-rays were taken for all patients. Results: Males between 24 – 44 years were seen to be predominant patients. The most common symptom appeared to be cough in 80% followed by fever in 60% of the cases. 76% of patients had unilateral lesions and 24% with bilateral lesions. 84% of the sputum negative patents were identified as active tuberculosis cases. Conclusion: Induced sputum and fiber optic bronchoscopy with bronchial aspirate and post bronchoscopic sputum can provide excellent material for diagnosis of suspected cases of Pulmonary Tuberculosis in whom smears of expectorated sputum do not reveal mycobacteria. There is minimum patient discomfort, reduced complications and relatively good yield which makes these procedures justifiable in the diagnosis of fresh smear negative pulmonary tuberculosis.

A Study of Lipid Profile Changes in Diabetes Mellitus.

Background: In the recent years, increase in the incidence of Diabetes Mellitus in developing countries has been associated with complications resulting in mortality and morbidity. This research determined the Lipid profile abnormalities in diabetes mellitus which is one of the leading cause of complications of diabetes mellitus. The incidence of type 2 diabetes mellitus (Type 2 DM) with altered lipid profile in one of the main causes of cardiovascular disease. Methods: 100 diabetic and 100 non diabetic patients enrolled in our hospital were included in the study. Biochemical tests for blood sugar levels, glycated hemoglobin, Total cholesterol, triglycerides, LDL, VLDL and HDL were performed. Results: The high levels of Total cholesterol, TGL and LDL were seen more among females than in males. Elevated levels of lipids were seen more among the diabetics than normal controls. Conclusion: Since high lipids with diabetes is a very dangerous combination, people should be educated properly towards the risk of this so that proper action can be taken maintain normal lipid levels.

Amyloid ß lowering and cognition enhancing effects of ghrelin receptor analog [D-Lys (3)] GHRP-6 in rat model of obesity.

Obesity arising due to the dietary and life style changes is fast reaching epidemic proportions all over the world. There is increasing evidence that the incidence of Alzheimer disease (AD) is significantly influenced by a cluster of metabolic diseases, including diabetes and obesity. This study was aimed to test the suitability of experimentally-induced obesity in rats as an experimental animal model of AD. We used the procedure of neonatal administration of rats with monosodium L-glutamate (MSG), which generates adult obese animals as our study design and assessed the AD-like changes by measuring amyloid ß (1-42) and acetylcholinesterase (AChE) levels in the hippocampal extracts and cognitive impairments by Barnes maze task. Further, we investigated the influence of anti-obesity substance [D-Lys (3)] GHRP-6 on blood glucose, hippocampal Aß, AChE levels and restoration of cognitive deficits. Results revealed that administration of MSG to neonatal rats exhibited increased body mass index and serum glucose levels over the controls. Measurement of markers for AD-like molecular changes i.e. amyloid ß (Aß) and AChE levels showed marked elevation in these two parameters in the hippocampus of MSG-treated rats. Assessment of cognitive abilities by Barnes maze revealed spatial disorientation characteristic of AD. Administration of ghrelin receptor analog [D-Lys (3)] GHRP-6 to obese rats resulted in significant restoration of serum cholesterol, glucose, leptin and ghrelin levels to that of control with concomitant reduction in hippocampal Aß and AChE levels. In addition, the treated animals exhibited marked improvement in Barne’s maze task. These findings suggest that MSG-induced obese rats may serve as non-transgenic animal model for AD research. Further, the results indicate the potential of [D-Lys (3)] GHRP-6 as a promising anti-Alzheimer candidate.

In vitro antimicrobial activity of cefsulodin and kanamycin in combinations.

Background: Infectious diseases are the greatest challenge of the world. The main failure in the treatment of infectious diseases is development of antibiotic resistance by the infective agents. Combination drug therapy is proposed to be more successful to contain diseases. But before the selection of combination of antibiotics, it is important to determine interaction of such antibiotics. Two antibiotics may have either synergistic or antagonistic action. In this study it was designed to find out the Minimum Inhibitory Concentration (MIC), and Minimum Bactericidal Concentration (MBC), which is usually used for the quantitative assessment of bacterial sensitivity to antibiotics. Methods: Checkerboard titration in microtitre trays used for this assay, and Fractional Inhibitory Concentration (FIC) and Fractional Bactericidal Concentration (FBC) measured to identify the type of interaction between the two antibiotics. Cefsulodin (Cef) and Kanamycin (Kan) were used against Escherechia coli (Esch. coli) and Staphylococcus aureus (Staph. aureus) to determine the efficacy of these antibiotics in combination. Results: MIC of cefsulodin and kanamycin against Staph. aureus was 3.125 and 3.125 respectively. MIC of Cef for Esch. coli was 6.25 and for Kan 50. FIC for Staph. aureus was 1. FIC for Esch. coli was different in different antibiotic concentrations and the least value was 0.37. There was no bactericidal effect of these antibiotics in combination against these organisms. Conclusion: Combination of two drugs cefsulodin and kanamycin showed synergistic action against Esch. coli and additive against Staph. aureus. So combined drug therapy can be used for better treatment with low toxicity, broad spectrum activity, and prevent emergence of drug resistance organism.

Olfactory tract transection in neonatal rats: Evidence for Mitral cell regeneration and restoration of functional connectivity with its targets.

Central Nervous System (CNS) regeneration and repair mechanism are two important aspects of functional recovery in the adult central nervous system following brain and spinal cord injury. Following olfactory tract transection in neonatal rats, functional connectivity between the olfactory bulb and the piriform cortex gets re-established by 120 days. The recovery of the dendritic morphology was associated with the synchronized oscillatory activity between olfactory bulb and piriform cortex. Mitral cells which were regenerated after the transection showed profuse branching, indicative of their undifferentiated state. However, normal dendritic morphology could be seen by 120 days after olfactory tract transection. These results thus provide a supportive evidence for the restoration of the functional connections between the olfactory bulb and the piriform cortex at 120 days.

Completeness of low anterior resection pathology report: A hospital-based audit with recommendations on improving reporting.

Aims: To audit the information content of the pathology report on Low Anterior Resection (LAR) specimens and to provide recommendations in order to improve the existing standard of reporting. Materials and Methods : All the reports of LAR specimens during 2004 - 2005 were collected from the Hospital Information System (HIS). Individual items of information were compared with the minimum data sets provided by the Royal College of Pathologists (RCP). Results : Fifty-nine reports were audited. Nineteen percent of the reports were classified as satisfactory. Although many items were well reported, only 30.5% (18/59) of the reports contained a statement on the completeness of excision at the circumferential resected margin and only 25.4% of all reports mentioned the relation of tumors to the peritoneal reflection. Conclusion : The information content of the reports on colorectal cancer resection specimens is inadequate. The use of the standard proforma (template) for reporting rectal cancer is therefore recommended, along with improved education, review of laboratory practices in the light of current knowledge, and further motivation of pathologists through their involvement in multidisciplinary cancer management.

Elderly and depression.

It is believed that it is 'normal' for the elderly per sons to become depressed and many cases aren't recognized and thus lead to untold misery for the sufferers and their families. We have found that majority of the clients under study were females belonging to low socio economic status, uneducated and unemployed. Majority of the clients had moderate depression (58%), And about 19% of them had severe depression. The problems related to subjective depressive feelings were investigated through a structured questionnaire surveyed among 100 elderly clients in Udhyava Village of Udupi district. We conclude that there is a significant relationship between family--friend relationships and depressive feelings of aged people.

Conversion efficiency and nutrient digestibility of certain seaweed diets by laboratory reared Labeo rohita (Hamilton).

Impact of three different types of seaweed diets on growth, feed utilization and nutrient digestibility of L. rohita was studied for 120 days. The seaweed diet fed fishes, especially Ulva based diet showed comparatively higher growth and weight increment. Good food conversion ratio, food assimilation efficiency, protein efficiency ratio and better nutrient digestibility were recorded for seaweed diet fed fishes. The results suggests the suitability of utilizing seaweeds, Ulva fasciata, Spyridia insignis and Sargassum wightii as partial substitute for fishmeal in formulated diets of L. rohita.