Food hygiene practice among mothers and its association with occurrence of diarrhea in under-five children in selected rural community area

Background: Diarrhea is the condition of having at least three loose or liquid bowel movements each day. Diarrhea is the main cause of death among under-five children in India. It often lasts for a few days and can result in dehydration due to fluid loss. Mother’s basic knowledge of diarrhea depends on various factors such as educational status, prior experience of managing the disease, and food hygiene. Diarrheal diseases remain an important cause of mortality and morbidity among children, particularly in low- and middle-income countries. Objective: The main aim is to measure the food hygiene practice among mothers and occurrence of diarrhea in under-five children. Materials and Methods: A non-experimental descriptive research design was conducted among 186 under-five children, mothers were selected using convenient sampling technique who fulfill inclusion criteria from the rural area of Doiwala block. Information was collected with the help of structure questionnaire on child feeding hygiene practice and practice checklist on food hygiene. Ethical permission and written consent were taken from the ethical committee of university and participants. Results: The research finding highlights that less than half of mothers (44.6%) use bowel spoon for feeding to their child. Majority of mothers (84.9%) wash his child hand with soap. Most of the mothers (74.2%) were not wash vegetables after cutting. Only 63% had check expiry of the food material before giving it to the child. Most of mothers (97.3%) wash hand of child before eating food. Nearby 38.2% of children had diarrhea in the past 6 months due to the unhygienic food practice. Conclusion: The investigator observed that there is a need to improved food hygiene practice among under 5-year children mothers because diarrhea is directly related to unhygienic food condition. The under-five children are totally depend on the mothers. If mothers will not improve food hygiene practice, then children will suffer from the diarrhea disease again and again.

Novel technique for traumatic cyclodialysis repair with phacoemulsification and Cionni's ring implantation

A 17-years-old boy presented with cataract, 360° choroidal effusion and disc oedema secondary to chronic hypotony. Gonioscopy and AS-OCT revealed 2 clock hours of cyclodialysis in the superonasal quadrant. The case was successively managed with phacoemulsification with foldable IOL in the bag and Cionni's ring sutured in the superonasal quadrant. Post surgery, the BCVA improved from counting finger 1 meter to 20/40. IOP returned to normal and there was resolution of choroidal effusion and fundus signs. The case highlights the use of Cionni's ring in management of small cyclodialysis cleft by providing internal compression.

Evaluation of used eye drop containers for microbial contamination in outpatient department of tertiary care teaching hospital

Background: Contaminated eyedrops are considered as serious risk factor for many iatrogenic ocular infections. Apart from the risk of infection, microbial contamination may alter the pH of the solution thereby reducing the efficacy of drugs. Presently many preservatives are added to these eye drops preparations to extend the duration of use. Hence authors aimed this study to find the contamination rates in such eye drop preparations.Methods: This was a prospective observational research conducted at Ophthalmology OPD, of tertiary care teaching hospital for the period of 2 months. Total fifty five used eyedrops were collected.Results: Authors found that 25.45% of the collected eye drops were contaminated with various organisms, viz. E. coli (10.90%), Staphylococcus aureus (9.09%), Pseudomonas aerugenosa (1.81%), Bacillus subtilis (1.81%) and Candida albicans (1.81%). Among various eyedrops, mydriatic (60%) eyedrops had the highest rate of contamination. We also found that, different preservatives in the eye drops were presents with different level of microbial contamination.Conclusions: The present study showed that there is a definite co-occurrence between eyedrop contamination and ocular infections irrespective of preservatives. This research raises a concern about questionable efficacy of preservatives.

A Rare Case Report of Total Aplasia of Paranasal Air Sinuses with Posterior Fossa Malformation (Dandy Walker)

Background: Total aplasia of paranasal air sinuses is a very rare condition. Dandy Walker malformation is the most common posterior fossa malformation involving cerebellum and IV ventricle. We present herewith a rare case of aplasia of paranasal sinuses with Dandy Walker malformation. There is no parallel case reports of these combined anomalies found in one patient available to our knowledge. Case report: A mentally retarded 7 years old male child was referred for CT scan study of P.N.S. and Brain. The C.T. findings of P.N.S. and Brain showed aplasia of all paranasal air sinuses and characteristic of Dandy Walker malformation such as Hypoplasia of cerebellar vermis, Dilated IV ventricle, Mega cistern magna etc. Conclusions: Total aplasia of paranasal sinuses is a very rare condition. Computed Tomography (CT) scan remains the gold standard in revealing anatomic details of paranasal sinuses. Dandy-Walker malformation is a rare congenital anomaly of posterior fossa involving cerebellum and IVth ventricle. Treatment depends upon the severity of abnormality and status of patient at the time of its detection.

Panchagavya Ghrita, an Ayurvedic formulation attenuates seizures, cognitive impairment and oxidative stress in pentylenetetrazole induced seizures in rats.

Panchagavya Ghrita (PG), according to Ayurvedic formulary of India (AFI), is used to treat epilepsy (apasmara), fever (jvara), mania (unmade) and jaundice (kamala). In the present study, we examined its effect on convulsions, oxidative stress and cognitive impairment in pentylenetetrazole (PTZ) induced seizures in rats. PG @ 250, 500, 1000, 2000 and 4000 mg/kg was administered orally for 7 days to male Wistar rats. On day 7, PTZ (60 mg/kg) was injected intraperitoneally 2 h after the last dose of PG. Sodium valproate (300 mg/kg) was used as positive control. Latency to myoclonic jerks, clonus and generalized tonic clonic seizures (GTCS) were recorded for seizure severity. Cognitive impairment was assessed using elevated plus maze and passive avoidance tests. Malondialdehyde and reduced glutathione levels were measured in rat brain. The results have shown that pretreatment with PG @ 500, 1000, 2000 and 4000 mg/kg exhibited 16.6, 33.3, 50 and 100% protection against occurrence of GTCS. The pretreatment with PG has significantly improved cognitive functions and the oxidative stress induced by seizures demonstrating its protective effect against PTZ induced seizures, and further, use of PG as an anticonvulsant in Ayurvedic system of medicine.

Tonsilla Lymphangioma.

Lymphagiomas are uncommon benign tumours of tonsils. Lymphangiomas are benign lymphatic tumours typically composed of dialated lymphatic channels which often occur subcutaneously in the head and neck region. Tonsillar lymphangiomas have been reported rarely in the literature which presents as a mass lesion. Histological confirmation is necessary for diagnosis. We report a case of lymphangioma of the tonsil in an otherwise well 17 year old female patient and review the clinical and histological features of this tumour. These lesions are usually cured by simple surgical excision.

Assessment of autonomic functions in hypothyroidism.

Disturbances in autonomic functions have been observed in many diseases including hormonal disorder (Banisters 1983). Present study was undertaken to study the autonomic functions in thyroid hormones on in 60 untreated hypothyroid patients, using Valsalva and deep breath test, cold pressor test, hand grip test and orthostatic test to assess the sympathetic and parasympathetic reflexes. The results obtained in this study were compared with the age sex matched controls. It is concluded that the sympathetic response is not altered in the hypothyroid cases while reflex vagal activity is significantly reduced.

Granular parakeratosis presenting with facial keratotic papules.

A 27-year-old female presented with pruritic keratotic papules over the left side of the face since one month. The lesions developed a few days after working in a hot humid environment and were preceded by severe uncontrollable pruritus for which she had repeatedly wiped the area with handkerchiefs and towels. A biopsy from one of the keratotic papules revealed granular parakeratosis with a markedly thick stratum corneum that had parakeratosis and also housed keratohyaline granules. Similar changes were seen in keratotic plugs of dilated follicular infundibula.

Comparison of computed tomography and magnetic resonance based target volume in brain tumors.

PURPOSE: This study was mainly framed to study the difference in tumor volumes as seen on computed tomography (CT) and magnetic resonance (MR) and their significance in planning. MATERIALS AND METHODS: Twenty-five patients with brain tumor of different diagnoses who underwent stereotactic radiotherapy were included in this study. CT and MR imaging was done for all the patients with 2.5 mm slice thickness. The CT tumor volume and MR tumor volume were measured and compared with each other. The center of mass (CM) of the tumor volume delineated on CT and MR were computed and the shift between the two CMs was determined. RESULTS: The mean and median volume of the tumor as measured from MR scans was 19.67 cc +/- 13.73 and 16.13 cc (range: 3.25 cc-50.37 cc). Similarly, the mean and median volume of the tumor as measured from CT scans was 15.05 cc +/- 10.13 and 11.63 cc (range: 3.0 cc-36.25 cc) respectively. The mean and median CM shift between CT and MR was 5.47 mm and 5.21 mm respectively. CONCLUSION: The study demonstrates that MR is an indispensable imaging modality in radiotherapy for planning brain tumors.

Fungal maxillary sinusitis: a prospective study in a tertiary care hospital of eastern Nepal.

INTRODUCTION: The incidence of mycotic infections and the diversity of pathogenic fungi have increased dramatically in recent years. Fungal sinusitis should be considered in all the patients with chronic maxillary sinusitis (CMS), especially in association with certain clinical features that serve as clue to the diagnosis. Aspergillus is the most common fungal pathogen in maxillary sinus. METHODOLOGY: A total of 100 patients those who fulfilled the diagnostic criteria (Lanza and Kennedy, 1992) for chronic rhinosinusitis were eligible for this open level and randomized prospective study. Only those above 14 years of age were included. RESULTS: Fungal maxillary sinusitis was seen in 14% of all cases of chronic maxillary sinusitis in eastern part of Nepal. We identified Acremonium and Candida species as commonest fungi involved in fungal maxillary sinusitis (FMS). To the best of our knowledge this is the first such study conducted in eastern Nepal.

Stromal luteoma: report of a rare case.

Steroid cell tumours (SCTs) account for less than 0.1% of all ovarian tumours. Three major categories ofSCTs include (1) stromal luteoma, (2) steroid cell tumour not otherwise specified and (3) Leydig cell tumours that do not have another component. Stromal luteomas constitute 20% of SCTs. They usually occur in postmenopausal women and about 60% present with estrogenic manifestations. We report a case of stromal luteoma in an elderly lady who presented with postmenopausal bleeding secondary to endometrial hyperplasia. An interesting finding in our case was the presence of many eosinophilic hyaline globules scattered throughout the tumour, the significance of which remains to be determined.

Portal hypertension associated with sickle cell disease.

We report a 12-year-old girl with sickle cell disease who presented with pain in abdomen, fever, joint pain and hematemesis. On examination she had mild jaundice and splenomegaly. Upper GI endoscopy showed esophageal varices. She was treated with variceal band ligation and is well on folic acid supplements and propranolol.

Can hematological parameters discriminate malaria from nonmalarious acute febrile illness in the tropics?

BACKGROUND: Malaria is considered as the main differential diagnosis of acute febrile illness in the tropics, and alteration of various hematological parameters has been observed in patients with malaria. AIM: To ascertain if certain hematological parameters increase the probability of malaria in patients with acute febrile illnesses. SETTINGS AND DESIGN: Hospital based, prospective cohort study. METHODS AND MATERIAL: All consecutive in patients with fever of less than seven days in duration were included in the study. Patients where localizing cause for fever could be determined were excluded. Hematological parameters (Hemoglobin, Red cell distribution width (RDW), Leukocyte count, and platelet counts) were determined by using automated counter, and peripheral smear examination for malarial parasite was taken as gold standard for the diagnosis of malaria. STATISTICAL ANALYSIS USED: Diagnostic accuracy was measured by computing sensitivity, specificity, predictive values and likelihood ratios. The precision of these estimates was evaluated using 95% confidence intervals. RESULTS AND CONCLUSIONS: A total of 184 patients were included in the study and 70 (38%) had a positive peripheral smear for malarial parasite. Thrombocytopenia alone (platelet countless than 150,000/mm3) was a predictor for malaria (Sn 60%, Sp 88%, LR+ 5.04) and in combination with anemia (Hb < 10 g/dl) it was next best parameter (Sn 69%, Sp 74%, LR+ 2.77). RDW and leukocyte count were not predictive. The conclusion of this study is that the presence of thrombocytopenia in a patient with acute febrile illness increases the probability of malarial infection.

Accuracy of physical examination in the diagnosis of hypothyroidism: a cross-sectional, double-blind study.

BACKGROUND: Hypothyroidism is a common, potentially treatable endocrine disorder. Since hypothyroidism is not always associated with the signs and symptoms typically attributed to it, the diagnosis is often missed. Conversely, patients with typical signs and symptoms may not have the disease when laboratory tests are performed. AIMS: We aimed to determine the accuracy of physical examination in the diagnosis of hypothyroidism. SETTING AND DESIGN: Prospective, hospital-based, cross-sectional diagnostic study. MATERIAL AND METHODS: Consecutive outpatients from the medicine department were screened and an independent comparison of physical signs (coarse skin, puffy face, slow movements, bradycardia, pretibial oedema and ankle reflex) against thyroid hormone assay (TSH and FT4) was performed. STATISTICAL ANALYSIS: Diagnostic accuracy was measured as sensitivity, specificity, positive likelihood ratios, negative likelihood ratios and positive and negative predictive values. RESULTS: Of the 1450 patients screened, 130 patients (102 women and 28 men) underwent both clinical examination and thyroid function tests. Twenty-three patients (18%) were diagnosed to have hypothyroidism by thyroid hormone assays. No single sign could easily discriminate a euthyroid from a hypothyroid patient (range of positive likelihood ratio (LR+) 1.0 to 3.88; range of negative likelihood ratio (LR-): 0.42 to 1.0). No physical sign generated a likelihood ratio large enough to increase the post-test probability significantly. The combination of signs that had the highest likelihood ratios (coarse skin, bradycardia and delayed ankle reflex) was associated with modest accuracy (LR+ 3.75; LR- 0.48). CONCLUSION: Clinicians cannot rely exclusively on physical examination to confirm or rule out hypothyroidism. Patients with suspected hypothyroidism require a diagnostic workup that includes thyroid hormone assays.