Use of information technology to improve patient compliance: A pilot study

Background: Compliance with treatment is the key link between treatment and outcome in medical care, non-compliance leads to failure of treatment. Noncompliance with antimicrobial agents (AMAs) is the important reason for Resistance to antimicrobials. Forgetting to take medicine is one of the important causes of non-compliance. Aim and Objectives: Hence, the present study was planned to evaluate the compliance for antimicrobial treatment in patients receiving a short course of antimicrobials, with or without reminding them to take medicine using a smartphone app. Materials and Methods: Prospective interventional study was planned in a tertiary care hospital after permission from the ethics committee. The present pilot work of the study was carried out on 30 patients receiving AMAs. Patients receiving a short course of chemotherapy were enrolled and stratified based on the frequency of administration of antimicrobials. They were then allocated alternately in control (15) and study (15) groups. After explaining the prescription to all, “Pill Reminder” app was downloaded on smartphones of participants in the study group. All were contacted to enquire about compliance at the end of the treatment period. Results: Baseline characteristics of participants in both groups were comparable. URTI, UTI Tinea cruris, Tinea capitis were the disorders for which they received AMAs. The frequency of administration was once/twice/thrice a day. Duration was 3–14 days in both groups. At the end of the study, 53.3% of patients in control group and 100% of patients in intervention group were compliant to the treatment. Conclusion: The use of the reminder app significantly improved patient’s compliance with medications. Further studies are required to validate these results.

Management of corneal perforations: An update

Corneal perforation is a potentially devastating complication that can result from numerous conditions that precipitate corneal melting. It is associated with significant morbidity and prompt intervention is necessary to prevent further complications. Causes include microbial keratitis, ocular surface disease, and autoimmune disorders and trauma. Various management options have been described in the literature to facilitate visual rehabilitation. This rview discusses the treatment options that range from temporising measures such as corneal gluing through to corneal transplantation, with decision making guided by the location, size, and underlying aetiology of the perforation.

A rare masquerade of chalazion: Adenoid cystic carcinoma

Adenoid cystic carcinoma (ACC) is a rarely seen malignant epithelial tumor of the eyelids. We present a rare case of primary ACC arising from the tarsal plate of the lower lid that clinically resembled a chalazion. A 66-year-old female presented with a recurring nodule in her left lower lid. She gave history of surgery for chalazion removal from the same site twice earlier. An initial diagnosis of a recurrent chalazion was made, and incision and curettage was done. Light microscopy showed a solid tumor composed predominantly of sheet-like and nested pattern of basaloid to low-columnar cells with intervening fibrovascular septa and lacking an obvious cribriform or tubular architecture. The tumor cells were positive for pan-cytokeratin and CD117 and negative for adipophilin, HMB45, and BerEP4. A diagnosis of solid variant of ACC of the eyelid was made. Wide excision was performed and eyelid defect was reconstructed.

Current concepts in crosslinking thin corneas

Corneal cross-linking (CXL), introduced by Wollensak et al. in 2003, is a minimally invasive procedure to halt the progression of keratoconus. Conventional CXL is recommended in eyes with corneal thickness of at least 400 microns after de-epithelialization to prevent endothelial toxicity. However, most of the keratoconic corneas requiring CXL may not fulfill this preoperative inclusion criterion. Moderate-to-advanced cases are often found to have a pachymetry less than this threshold. There are various modifications to the conventional method to circumvent this issue of CXL thin corneas while avoiding the possible complications. This review is an update on the modifications of conventional CXL for thin corneas.

A preliminary study of recombinant human interferon-α-2a activity against rabies virus in murine model.

Rabies remains an important public health problem in the world due to uncontrolled enzootic rabies. Although rabies associated fatalities may be prevented with timely immunoprophylaxis, but till date a therapeutic molecule has remained elusive. We investigated the role of rhuIFN α-2a in murine model challenged with rabies virus. Titre of 104.25 LD50/0.03 ml of 10% w/v RV CVS stock suspension were obtained. Based on 1LD50 titre, challenge dose of 50 LD50 was administered along with rhuIFN α-2a with pre-exposure (primed) and post-exposure with the rabies virus. Both showed increased survival time as compared with the virus controls. These fi ndings suggest that the rhuIFN α-2a might have some anti-viral activity, which can be used for the treatment of rabies infection. Further research on the effi cacy of interferon along with anti-viral drugs for the treatment will be helpful in designing combination therapy against the disease.

Prevalence of leptospirosis among dogs and rodents and their possible role in human leptospirosis from Mumbai, India.

A total of 100 blood and 18 urine samples of rodents and suspected dogs were collected from Mumbai, India during 2006-2008. In order to determine the role of animals in transmission of the disease to humans, all the samples were screened retrospectively by real-time polymerase chain reaction for leptospiral DNA and antibodies were detected using microscopic agglutination test. Leptopsiral DNA was detected from two blood and fi ve urine samples from rodents. Of a total of 71 rodent and dog samples investigated for anti-Leptospira antibodies, 14 (19.7%) were positive. Pyrogenes was the predominant serovar found in 100.0% (7/7) and 85.7% (6/7) from suspected canine cases and rodents, respectively; followed by Icterohemorrhagiae, which was found in one rodent sample 14.28% (1/7). The study proves that there is high prevalence of leptospirosis in rodents and dogs in this region, which proves possible role of these animals in transmission of leptospires to humans. Hence it is imperative to necessary control measures to prevent human leptospirosis.

Prevalence of influenza virus among the paediatric population in Mumbai during 2007-2009.

Purpose: Influenza has a major impact on public heath, annually affecting 15-20% of the global population. Information on the activity of influenza virus in Mumbai is limited. The present study was carried out to determine the prevalence of influenza viruses causing acute respiratory infections in children by molecular methods. Objective: To study the prevalence of influenza viruses among the paediatric population in Mumbai by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR). Materials and Methods: From July 2007 to July 2009, 100 respiratory samples (nasal and throat swabs) were collected from paediatric patients with acute respiratory symptoms. attending out patients department, and admitted to the paediatric wards of B. J. Wadia Hospital for Children, Mumbai. The samples were collected and processed as per World Health Organization (WHO) guidelines. Viral RNA was extracted and one-step rRT-PCR was performed to detect influenza type A (H1 and H3) and influenza type B virus. Results: Out of 100 samples processed by rRT-PCR, a total of 11 samples (11%) were positive for influenza virus. The typing for influenza A subtypes showed 1% (1) positivity for H1 and 5% (5) positivity for H3 subtypes and 5% (5) samples tested positive for influenza type B virus. Conclusion: It was observed that both influenza type A and B viruses were prevalent in Mumbai during the study period. Such surveillance data are important in the early detection of any antigenic variants that may be helpful in global influenza vaccine preparation and for any pandemic preparedness activity.

Molecular diversity in rice genotypes differing in physiological mechanisms of salt tolerance through SSR and ISSR markers.

Two different DNA-based techniques viz, simple sequence repeat (SSR) and inter simple sequence repeat (ISSR) markers were used to estimate genetic diversity among 20 rice genotypes possessing different physiological mechanisms contributing to salt tolerance. A total of 11 clear and repeatable bands were amplified from ten selected SSR primers pairs and 43 fragments were detected from nine ISSR primers. The level of polymorphism was 1.1% with SSR compared to 90.7% with ISSRs. Mean genetic similarity of 0.88 based on SSRs and 0.85 using ISSRs was observed. A total of 43 (39 polymorphic) and 11 bands were detected using 9 ISSR primers and 10 well distributed mapped SSR markers, respectively. Estimates of genetic similarity of ISSRs based on the 39 polymorphic markers between 20 rice cultivars ranged from 0.55 for PR108/CSR19 to 0.94 for Pokkali/CSR20 with an average of 0.81. The estimates revealed by the 11 polymorphic SSR bands showed the average value (0.94) and also the range of genetic similarity (from 0.86 to 1.00 for CSR22/CSR18 and CSR24/CSR20, respectively) reflecting their hyper variability and their high resolution power. The findings are likely to expedite breeding new salt tolerant cultivars by involving parents from diverse molecular clusters.

Anti-malarial activity of Eclipta alba against Plasmodium berghei infection in mice.

The anti-malarial activity of Eclipta alba leaves extract was evaluated against Plasmodium'berghei ANKA strain in mice. A standard inoculum of 1 x 10(6) infected erythrocytes was used. The methanolic leaf extract (250-750 mg/kg) produced a dose-dependant chemosupression or schizontocidal effect during early and established infection and high mean survival time (m.s.t.) values particularly in the group administered 750 mg/kg/day of extract. The plant extract also exhibited repository activity. The results of the preliminary studies carried out with E. alba are encouraging, which can be exploited in malaria therapy.

Sinus histiocytosis of the thyroid with massive lymphadenopathy (Rosai-Dorfman disease).

A 63-year-old woman presented with a midline neck swelling which clinically appeared as goitre with bilateral cervical lymphadenopathy. Pre-operative investigations were suggestive of malignancy with lymph node metastasis for which a subtotal thyroidectomy with lymph node excision was done. But the histopathological examination of the operative specimen was reported as sinus histiocytosis of the thyroid and the cervical lymph nodes.

Profile and characteristics of animals bites in India.

Animal bites and so also the incidence of rabies in India are on rise. There are regional differences in the animal responsible for the bite. Different practices including use of traditional remedies are prevalent for wound treatment. In India this report analyses the profile and characteristics of animal bites in 869 patients from various regions. Apart from dog and cat, other animals such as cow, monkey, horse, pigs, camel were responsible for bite and could be possible vectors in transmission of rabies. Traditional remedies such as application of chilly paste is still practiced in state of Rajasthan.