Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

Perceptions And Attitude Towards The Use Of Generic Drugs By Oncologists From Emerging Markets: A Multinational Cross Sectional Survey

Introduction Generic drugs provide same therapeutic effect as an originator, at more affordable price. Still, they are not best adopted. We conducted a survey to understand oncologist’s perceptions and attitudes towards generic drugs and understand factors that influence their prescribing behavior. Methods Oncologists from 15 countries were invited for this cross-sectional survey. Assessment was completed using a series of structured, closed qualitative questions to which participants could select from predefined answers. Results Fifty three oncologists participated in the. About 70% oncologists acknowledged high-cost of originator drugs often limits providing guidelines based therapy to patients. Most of the participants (86%) opined that quality of generic drugs depends on the manufacturing company. More than 90% respondents agreed that good generic companies often match the quality of originator drugs. Amajority (67.5%) of the oncologists believed that side effects caused by generics were similar to those caused by originator drugs. Conclusions Our finding suggest that educational programs highlighting the benefits of generic drugs should be imparted to the key stakeholder including patients.

Evaluation of the Efficacy and Tolerability of Oral Ciprofloxacin used in the Comprehensive Treatment of External Bacterial Otitis: An Observational Prospective Study

Abstract Introduction Otitis Externa is common ear infection with a prevalence of 1%. Objective The objective of this study is to evaluate the clinical and microbiological efficacy and safety profile with oral ciprofloxacin in the external bacterial otitis (EBO) management. Methods This is a prospective observational study conducted with EBO outpatients referred to the otorhinolaryngology center in Moscow betweenMarch and August 2013. Our study included patients from two cohorts, acute external bacterial otitis (AEBO) - Group 1 - and exacerbation of chronic otitis externa (CEBO) - Group 2. We administered Ciprofloxacin 500 mg twice daily with standard topical EBO treatment for up to 10 days. Patients underwent evaluation on study visit days 1, 3, 5, and 10 for the severity. Bacteriological examination of ear canal cultures took place on Day 1 and Day 10. Results We collected data from 60 EBO outpatients (AEBO: N = 30 and CEBO: N = 30). Swimming was the major risk factor associated with the disease in addition to the most common pathogenic organisms - Staphylococcus aureus and Pseudomonas aeruginosa. was We attained complete resolution of the inflammatory process in 28 (93%) and 27 (90%) patients in the AEBO and CEBO group, respectively. We confirmed this by microbiological test with almost complete eradication of the causative organisms. Overall, we observed good positive dynamics of ear canal with no major side effects. Conclusion We found that Ciprofloxacin 500 mg, when administered orally twice daily for 7 to 10 days in otitis externa patients is clinically and microbiologically effective and comparatively safer than other antimicrobials.

Rotavirus Diarrhea in Children Presenting to an Urban Hospital in Western Uttar Pradesh, India.

Objective: To determine the proportion and clinical profile of rotavirus-associated diarrhea in children aged 6 months to 5 years. Methods: Clinical details and stool samples were collected from 254 children aged between 6 months to 5 years presenting with acute diarrhea, irrespective of hydration status, to the outpatient department or emergency room of a hospital in Meerut, Uttar Pradesh, India. Results: Rotavirus accounted for 26.3% (51 of 194) of diarrhea cases overall, and 41.2% (14 of 34) in hospitalized children. Rotavirus infection was associated with significantly longer duration [3.3 (1.4) d vs. 2.5 (1.1) d; P=0.004) of diarrhea, and more chances of dehydration (OR 1.85; 95% CI 1.19, 3.57) as compared to non-rotavirus diarrhea. Conclusion: Rotavirus is a common cause of acute diarrhea in under-five children, and is associated with a longer duration and more chances of dehydration than non-rotavirus diarrhea.

Squamous cell carcinoma of tympanomastoid region – A rare and often misdiagnosed entity.

Squamous cell carcinoma of the temporal bone and external auditory canal is a rare entity. We present a case of 62 year old male, with stage IV squamous cell carcinoma of tympanomastoid region. As the tumour was deemed unresectable, mass debulking was done and patient was given post-operative radiotherapy. The objective to report this case was to emphasise the importance of early diagnosis and prompt treatment for a better survival. A high index of suspicion is necessary as the initial presentation may mimic more common otologic conditions

Newborn Screening for G6PD Deficiency: A 2-year Data from North India.

Glucose-6-phosphate dehydrogenase (G6PD) defi ciency is the most common erythrocyte enzymopathy, being present in more than 400 million people worldwide that may lead to neonatal jaundice or hemolytic crisis due to drugs or infections. In our study, we aimed to study the frequency of G6PD defi ciency in neonates and the proportion of defi cient neonates, who developed neonatal hyperbilirubinemia in the study population. The study was an observational one, conducted at the Division of Genetics of Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, over a 2-year period from January 2011 to December 2012. A total of 6,000 newborns delivered during that period underwent newborn screening on 24-72 h of birth. Neonatal hyperbilirubinemia was presented in 13.3% of the study population. Of female neonates, 16% demonstrated G6PD defi ciency. This is worth noting for an X-linked recessive trait. Thus, in view of a high gene frequency for a disorder that is manageable with just elimination of few drugs and foodstuff, we stress the need for a newborn screening program for G6PD deficiency.

A Fatal Outbreak of Trichosporon asahii Sepsis in a Neonatal Intensive Care Unit.

We describe an outbreak of Trichosporon asahii in 8 newborn infants with sepsis. Six out of these 8 infants died. The organism was identified on specific culture and morphologic characteristics. The organism was sensitive to amphotericin-B but resistant to fluconazole. Laminar flow unit was suspected to be the source of the outbreak.

Etiology of Acute Bacterial Meningitis in Hospitalized Children in Western Uttar Pradesh.

We retrospectively studied clinical and etiological profile of acute bacterial meningitis in hospitalized children for two consecutive years at a pediatric hospital in western Uttar Pradesh. Etiological diagnosis could be made in 30 (44.8%) out of 67 cases with either culture or latex agglutination test. Pneumococcus was the commonest pathogen found in 17 (25. 4%) cases. The overall mortality was 10. 5%.

Gender Differences in Phenomenology of Patients with Obsessive Compulsive Disorder.

Previous studies have shown differences in clinical features of obsessive-compulsive disorder (OCD) between men and women, including mean age at onset of obsessive-compulsive symptoms (OCS), types of OCS, comorbid disorders, course, and prognosis. The aim of this study was to compare male and female patients with OCD on several demographic and clinical characteristics. All new patients with OCD (ICD 10, criteria) who sought treatment at the OCD clinic were evaluated. The assessment instruments used were the semi structured pro forma especially designed for the study, Yale-Brown Obsessive-Compulsive Scale and check list to evaluate OCD severity and symptoms, and a semi structured interview along with standard mental-state examination. Forty seven percent of the patients (n = 31) were males. They had significantly earlier age at onset of OCD and were less likely to be married. They presented significantly more sexual obsessions and females with significantly more contamination obsessions and cleaning and checking compulsions. With regards to comorbidity, we did not find any differences in the frequency of co morbid psychiatric disorders between male and female patients with OCD. No significant differences were observed between sexes concerning family history of OCS or OCD, and global symptoms severity, either in obsession or compulsive subscale or insight point. The present study confirms the presence of sex-related differences described in other countries and cultures. The fact that the OCS starts earlier and probably have a worse impact in men can eventually lead to more specific and efficacious treatment approaches for these patients.

Emerging vancomycin resistance in enterococci in India.

Infection caused by vancomycin resistant enterococci (VRE) leads to adverse outcome and is a real challenge. Despite increasing reports of VRE in different countries, there is scanty data on this issue from India. A total of 685 enterococci were isolated from various clinical samples from January to December 2004. Antimicrobial susceptibility was performed as prescribed by National Committee for Clinical Laboratory Standards (NCCLS). Vancomycin resistance was confirmed by minimum inhibitory concentration (MIC). Resistant phenotype was determined by Polymerase chain reaction (PCR). Of 685, 456 (67%) were E. faecalis and 229 (33%) were E. faecium. Resistance to various antibiotics in E. faecalis and E. faecium was as follows: ampicillin 33% and 54%, erythromycin 91% and 86%, ciprofloxacin 69% and 81%, tetracycline 50% and 54% and high level gentamicin resistance in 62% and 77% respectively. Vancomycin resistance was confirmed in 10 (1.4%) cases by MIC and all had Van A phenotype by PCR. Emergence of vancomycin resistant enterococci is of great concern because of its epidemic potential and scanty therapeutic options. Prompt diagnosis and efficient infection control measures can restrict its spread.