Clinico-epidemiological Profile of Erythema Nodosum Leprosum Cases in Western Odisha

This study was carried out in a hospital setting in Odisha to find out the epidemiological profile and clinical spectrum of ENL and their association with bacillary load, clinical types of leprosy and comorbid conditions of leprosy patients. Out of 1352 cases of leprosy, 97 were diagnosed with rd th ENL. Male patients outnumbered the females (4.3:1), and leprosy patients in their 3 and 4 decade were more commonly found to be having ENL. Majority of the patients belonged to the lepromatous leprosy (LL) spectrum (74.22%). A positive family history of Leprosy was obtained in 7.21% of cases. Diabetes mellitus followed by hypertension was the most common comorbid condition. Whether these conditions have any direct link with ENL needs to be investigated by proper prospective studies. 79.38% of cases had arthritis whereas glomerulonephritis and peripheral edema were observed in 29.89% of cases each. Observations of this study will be useful for planning field based studies in population from Odisha.

Clinico-epidemiological Profile of Pure Neuritic Hansen's Disease in Western Odisha: a Hospital Based Retrospective Cross Sectional Study

There is a complete lack of data on clinico epidemiological profile of pure neurotic leprosy from Western Odisha region, despite the area still being endemic for leprosy. This study has been carried out to address this issue to identify the profile of pure neuritic leprosy reporting to a Tertiary Care Centre in Western Odisha. Patient's case records with clinical diagnosis of PNL who reported to this centre between October 2012 to October 2014 were studied. Demographic details, educational qualification, clinical presentation, pattern of peripheral nerve involvement, type of disabilities and complications occurring if any, were noted from the patient records and analyzed. Data collected and analysed shows that out of total 1460 of these leprosy patients 145 (9.93%) patients had been diagnosed with pure neuritic form of the disease. The mean age of PNL patients was 34.43 + 1.09 years. The various clinical presentations, that were observed and recorded, included sensory loss, tingling, pain, hypoesthesia, trophic ulcer and various grades of motor nerve disabilities. Neuropathic pain was complained by 28.3% patients. Mononeuritic presentation was observed in 79/145 (54.5%) patients with ulnar nerve being the most commonest nerve involved. Grade 2 disabilities were present in a large proportion of these PNL cases. Disabilities were more common in polyneuritic type of cases compared with mononeuritic cases. Such high disability rates in these PNL cases at our Tertiary Care Centre might be due to late self reporting of cases for treatment or diagnosis being delayed. These figures may not reflect the proportion/percentages at population level which should be verified by actual surveys after proper training of staff. As PNL demands early diagnosis to prevent progression of nerve damage and multiple nerve involvement, all patients having the above clinical presentations should be suspected of PNL in leprosy endemic areas

A Rare case of Subcutaneous Mycosis due to Rhizoctonia solani.

Rhizoctonia solani is a very common soil borne pathogen with a great diversity of host plants. A 52 year old lady presented with sole manifestation of subcutaneous swelling over the left leg for 3 months Pus was collected by aspiration revealed septatate fungal hyphae. After culture on SDA at 25 C showed white cottony growth initially, progressed to buff colored to black colonies on further incubation. On LPCB mount we found septate hyphae with acute and right angled branching with out any conidia and hyphal anastomosis which resembled features of Rhizoctonia solani. Patient was put on Fluconazole and responded well to the treatment.

A Rare case of Subcutaneous Mycosis due to Rhizoctonia solani.

Rhizoctonia solani is a very common soil borne pathogen with a great diversity of host plants. A 52 year old lady presented with sole manifestation of subcutaneous swelling over the left leg for 3 months Pus was collected by aspiration revealed septatate fungal hyphae. After culture on SDA at 25 C showed white cottony growth initially, progressed to buff colored to black colonies on further incubation. On LPCB mount we found septate hyphae with acute and right angled branching with out any conidia and hyphal anastomosis which resembled features of Rhizoctonia solani. Patient was put on Fluconazole and responded well to the treatment.

Utilization of the prevention of parent-to-child transmission of HIV (PPTCT) services in a tertiary care hospital, Odisha, India.

Aims: To assess seroprevalence of HIV among antenatal women and the extent of utilization of interventions to minimize the risk of mother-to-child transmission. Study Design: Descriptive cross-sectional study was carried out among antenatal women who attended integrated counseling and testing center (ICTC) of HIV. Sample sizes were determined from the number of pregnant women that attended ICTC. Place and Duration of Study: Data and samples were collected from a tertiary care hospital, Odisha, India during January 2009 to December 2012. Methodology: All pregnant women were counseled and tested for HIV by rapid test. All HIV-seropositive antenatal women (ANW) were linked to services and followedup for institutional delivery, single-dose nevirapine (sdNVP) prophylaxis, infant feeding options and testing of children at 18 months. Results: Out of 11,508 ANW registered and pretest counseled, 11,390 (98.97%) accepted HIV testing. Sixty women were found to be seropositive, thus showed seroprevalence rate of 0.53% (60/11,390). CD4 testing was carried out in all ANW and five (8.33%) were eligible for antiretroviral therapy (ART). Seven (11.67%) had opted for medical termination of pregnancy (MTP). All 48 ANW delivered institutionally, only 7 (14.58%) received cesarean delivery. Out of 46 live births, 5 (10.87%) ANW were on ART, 35/41 (85.37%) received sdNVP mother baby-pair prophylaxis and only 8/46 (17.39%) mother opted for replacement feeding. Twenty one children have reached 18 months till date and among them three (14.29%) were HIV-seropositive. All three were delivered vaginally, received sdNVP prophylaxis and were exclusively breast fed for 6 months. Conclusion: The HIV-seroprevalence rate among antenatal women was 0.53% and mother-to-child transmission (MTCT) rate was 14.29%. Reduction in MTCT rate needs pre or early antenatal HIV testing, prenatal antiretroviral medication, preference for cesarean delivery, 100% antiretroviral prophylaxis coverage and education on avoidance of breast feeding.

Dipylidium caninum infection in a child: A rare case report.

Dipylidiasis is a zoonotic parasitic infestation caused by the dog tapeworm Dipylidium caninum. Human dipylidiasis has been rarely reported in English literature. Young children are mostly at risk of acquiring the infection due to their close association with dogs and cats. We report a rare case of Dipylidium caninum infection in a 4 year old male child. The diagnosis was based on microscopic examination of stool. Confirmation of the proglottid segments was done by histopathological examination. To the best of our knowledge this is the first human case of Dipylidium caninum reported from this part of the country.

Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training.

The present study aimed at assessing the effects of a set of yoga practices on normal adults (n = 37), children (n = 86), and patients with rheumatoid arthritis (n = 20). An equal number of normal adults, children, and patients with rheumatoid arthritis who did not practice yoga were studied under each category, forming respective control groups. Yoga and control group subjects were assessed at baseline and after varying intervals, as follows, adults after 30 days, children after 10 days and patients after 15 days, based on the duration of the yoga program, which they attended, which was already fixed. Hand grip strength of both hands, measured with a grip dynamometer, increased in normal adults and children, and in rheumatoid arthritis patients, following yoga, but not in the corresponding control groups, showing no re-test effect. Adult female volunteers and patients showed a greater percentage improvement than corresponding adult males. This gender-based difference was not observed in children. Hence yoga practice improves hand grip strength in normal persons and in patients with rheumatoid arthritis, though the magnitude of improvement varies with factors such as gender and age.

Yoga training and motor speed based on a finger tapping task.

A finger tapping task was used to assess motor speed (MS) of both hands in 53 adults and 152 children before and after yoga training and in 38 adults of a non-yoga (control) group. All subjects were right hand dominant. The 30-second tapping speed (TS) test was considered as three time intervals, i.e. 0-10 second (TS1), 10-20 seconds (TS2) and 20-30 seconds (TS3). There was a significant (Student's t-test) increase in all three TS values following 10 days of yoga in children and 30 days of yoga in adults. However for both groups at baseline and final assessments, TS2 and TS3 were significantly lower than TS1. Hence the TS was increased after yoga training during the first 10-seconds of the test but not during the next 20 seconds. These results suggest an increase in motor speed for repetitive finger movements following yoga training, but not in strength or endurance, as the increase was not sustained over 30 sec.