Effectiveness of VATP on Knowledge Regarding Good and Bad Touch among Mothers of Preschool Children attending Anganawadies

Background: Touch is a fundamental need of human life. The incidence of child sexual abuse is rising day by day. Good and bad touch is a sensitive topic and theme to reduce sexual harassment among children. So, the teaching programme is an effective way to improve knowledge of good and bad touches. Methods: 100 other preschool children are included as the sample. A convenient sampling method was used. A structured knowledge questionnaire was used to gather information. Chi-square analysis uncovered the relationship between knowledge about thyroid disorders and sociodemographic factors. Results: The post-test score (17.09�71) contributes to 56.96% of the total score, and their pre-test knowledge score (9.86�08) represents 32.8%. The efficiency of VATP on good and bad touch was 7.23, with SD�63, accounting for 24.1% of the total score. Conclusion: Finally, the study concluded that VATP was extensively helpful in civilizing the consciousness level of mothers of preschool children regarding Good and bad touches.

A prospective study on emergence of mucormycosis in recently recovered COVID-19 patients

Background: Mucormycosis is an angio-invasive fungal infection with high morbidity and mortality. This infection seems to be increasing during the second wave of COVID-19. Objectives of this study were to identify and characterise the fungal species causing post-covid-mycosis, to analyze the cases for underlying co-morbidities if any and to correlate the associated risk factors with the progression of disease. Methods: Prospective observational study which constituted conventional fungal culture of 188 tissue specimens collected from clinically suspected mucormycosis patients who had history of COVID. Results: This study noted the occurrence of disease with predominance of males (72.03%). Most common symptoms were facial/periorbital swelling, followed by facial pain and headache. Among co-morbid conditions, diabetes mellitus was the most common (71.17%). Use of steroids (65.25%), antivirals therapy (22.86%), oxygen support (11.86%) used in management of COVID patients were found to be risk factors in post-covid-mucormycosis. radiological diagnosis showed involvement of paranasal sinuses (77.11%), followed by orbit (16.94%) and brain (5.90%). Mucor spp. was isolated in 21 cases. Although commonest fungus isolated was Aspergillus, analysis of the data for last 5 years showed a significant rise of Mucormycosis cases. Mortality was seen in 17.79% cases. Conclusions: Fungal aetiology should be kept in mind in patients with above clinical presentations with history of recent COVID-19 infection especially who received steroids.

A study of outcome in COVID-19 patients receiving casirivimab-imdevimab

Objectives: In December 2019, coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, as a respiratory tract infection causing symptoms, such as fever, chills, dry cough, fatigue, and shortness of breath. Despite the low mortality rate of COVID-19, patients with comorbidities such as hypertension, cardiovascular disease, and diabetes mellitus seem to be prone to more severe symptoms and to a higher mortality rate than others. Such patients are shown to benefit from usage of monoclonal antibodies. Casirivimab-imdevimab is a cocktail made up of two non-competing, neutralizing human immunoglobulin G1 antibodies that target the receptor binding domain of the severe acute respiratory syndrome coronavirus 2 spike protein and block viral entry into human cells. We assessed the clinical profile and outcome of 42 patients who received the antibody cocktail. Materials and Methods: Casirivimab-imdevimab was administered to COVID-positive patients with mild severity. Forty-two patients who satisfied the inclusion criteria received casirivimab-imdevimab and were included in the study. Demographic and clinical data were tabulated in Microsoft Excel and statistics were run in OpenEpi software. Results: No adverse reactions were seen in any of the patients. Among the 42 patients, there were no deaths. Twentytwo (52.3%) patients improved, while 20 (47.6%) worsened after receiving the antibody cocktail. Out of 21 (50%) patients who did not have any comorbidity, 13 (30.9%) worsened after receiving the drug and 8 (19%) improved, while among those with comorbidities, 7 (16.6%) worsened and 14 (33.3%) improved (P < 0.05). Thirteen (30.9%) unvaccinated patients improved, while 14 (33.3%) worsened, whereas 6 (14.2%) fully vaccinated patients improved while only 2 (4.7%) worsened. Among the patients who were administered the cocktail within 5 days of onset of symptoms, 12 (28.5%) improved and 10 (23.8%) worsened, whereas among those who received the drug between 6 and 10 days of symptom onset, ten improved, and ten worsened. There was no statistically significant association between vaccination status and outcome, and infusion interval and outcome in these patients. Conclusion: None of the 42 patients developed any reaction to casirivimab-imdevimab. There were no deaths in the study population. About 52.3% of the patients improved and 47.6% worsened after receiving the cocktail. About 33.3% of the comorbid patients improved. There was no statistically significant association between vaccination status and outcome, and infusion interval and outcome in these patients.

Glandular Odontogenic Cyst Mimicking Dentigerous Cyst: A Rare Case Report

Background: Glandular odontogenic cyst is an uncommon developmental cyst of odontogenic origin. Till now, around 200 cases have been reported in the English literature, out of which approximately 25 of them are associated with an unerupted tooth. Herein we present a case report of a 7-year-old boy with swelling in the anterior maxillary region which was later diag- nosed as a Glandular odontogenic cyst that mimicked a Dentigerous cyst. Case presentation: A painless swelling was noted in the anterior palatal region. Orthopantamogram was advised which re- vealed a unilocular radiolucency associated with an impacted supernumerary tooth. Provisional diagnosis of Dentigerous cyst was made. The cyst was enucleated in conjunction with peripheral osteotomy. The histopathological examination revealed a cystic capsule with non-keratinized stratified squamous epithelium with 2-4 cell layer thickness, with some areas showing epithelial plaque, microcysts, hobnail cells and few clear cells. Contemplating all the histological features, final diagnosis of Glandular odontogenic cyst was given. Conclusions: The presented case emphasizes the importance of histopathological examination of the unusual and rarely ob- served Glandular odontogenic cyst which can be missed due to similarities with other entities. Recurrence rates being very high, follow up of the cases is imperative.

Awareness regarding “sexual harassment of women at workplace act” among non-teaching female staff in a tertiary care hospital

Background: A safe workplace is women’s legal right. Sexual harassment at the workplace is a violation of human rights. “Sexual harassment of women at workplace act” was passed in 2013. Objectives: The objective of the study was to assess awareness regarding “sexual harassment of women at workplace act” among non-teaching female staff in a tertiary care hospital. Materials and Methods: A descriptive cross-sectional study was conducted in tertiary care hospital. A total of 60 non-teaching staff members were included in the study. Data were collected using pre-designed questionnaire. Results: About 87% of participants were aware of year of implementation of the act and occupations protected under the act. About 73% were aware regarding objectives of the act. Half of the participants were aware of the number of employees needed to form Internal Complaint Committee. Awareness was found to be poor regarding time limit to give a complaint and to conduct inquiry. All were aware regarding existence of sexual harassment committee in the institute. Conclusion: Educational sessions should be conducted to improve awareness regarding the act.

A study on community associated Staphylococcus aureus and its susceptibility pattern to Mupirocin and Fusidic acid in primary pyoderma patients

Background: Primary pyodermas are one of the most common dermatological diseases. Staphylococcus aureus (S. aureus) is frequently isolated. It has developed resistance to many antimicrobials and Methicillin Resistant Staphylococcus aureus (MRSA) is a major problem. The precipitous usage of topical antimicrobials especially Mupirocin and Fusidic acid has increased the development of multi-resistant strains of S. aureus and in India, few studies have shown susceptibility profile to these drugs. Aim: This study aimed at the clinical and bacteriological profile in primary pyoderma patients, prevalence of MRSA and the resistance pattern of S. aureus to Mupirocin and Fusidic acid. Materials and methods: Patients with primary pyodermas from community were recruited. Gram stain and culture sensitivity was done with swabs taken from the lesions. Antibiotic susceptibility for Sethi P, Betkerur J, Sethi P, Adhlakha B, Kulkarni M, Murthy KC. A study on community associated Staphylococcus aureus and its susceptibility pattern to Mupirocin and Fusidic acid in primary pyoderma patients. IAIM, 2016; 3(11): 27-35. Page 28 S. aureus was tested using VITEK- 2. Mupirocin and Fusidic acid susceptibility was determined by Estrip method. Observations: A total of 107 patients of primary pyodermas were included. Pyoderma were common in young age group (P = 0.001). Poor hygiene was the main predisposing factor. Furunculosis (45.8%) was the most common pyoderma followed by impetigo and folliculitis (16.8% each). Culture was positive in all except 3. S. aureus was isolated in 61.7% and polymicrobial flora in 13.1%. Prevalence of MRSA was 39.5% (P= 0.066). All strains of S. aureus demonstrated 100% susceptibility to Mupirocin and Fusidic acid. Conclusions: Furunculosis still has the highest incidence in adult population with a high prevalence of MRSA (39.5%). Despite extensive usage of Mupirocin and Fusidic acid, no resistance was found in this part of India.

Evaluation of mass drug administration for elimination of lymphatic filariasis in Goa, India.

Background: The most practical and feasible method of controlling lymphatic filariasis is the rapid reduction of microfilarial load in the community by annual mass drug administration (MDA) of a single dose of diethyl Carbamazine Citrate. The objective of the study aimed at the trends in coverage and compliance of Mass Drug Administration with Diethyl Carbamazine Citrate (DEC) for elimination of lymphatic filariasis in Goa. Methods: Cross-sectional population surveys were conducted after every yearly round of MDA with DEC for the years 2006, 2007, 2008 and 2010 as part of independent assessment of MDA. Four clusters were selected from each district, each cluster having 30 households. A pretested questionnaire was used to interview the study participants and the responses were recorded in pre-designed formats. The data was analysed using SPSS package. Coverage rate, compliance rate, coverage-compliance gap and effective coverage rate were calculated. Results: The total coverage ranged from a high of 95.55% in the year 2007 and a low of 84.94% in 2006. The total compliance rate fluctuated between a low of 64.68% in 2010 and a high of 93.47% in 2006. Total coverage–compliance gap ranged from a high of 35.31% in the year 2010 and a low of 6.52%. Overall coverage and compliance rates were consistently higher in rural areas compared to urban areas for all the years under study. Conclusion: Coverage, compliance, coverage-compliance gap and effective coverage rate were found to be consistently lower in urban areas compared to rural areas. For the state to reach elimination targets, the MDA strategy implementation would require thorough review and revamping. Action on this front would ensure that gains made in filarial elimination are sustained eventually leading to elimination of lymphatic filariasis in the state of Goa.

Drug utilization review of anticancer drugs in cancer outpatient department of the Government Medical College, Aurangabad.

Background: To study drug utilization of anticancer drugs in cancer outpatient department (OPD) of Government Medical College, Aurangabad. Methods: Five hundred and twelve prescription records were screened and analyzed as per the study parameters from cancer OPD of Government Medical College and Hospital, Aurangabad. Commonly used anticancer drugs were recorded; furthermore, different types of carcinomas were noted. Results: Age group of patients was in between 30 and 70, 267 were females and 245 were male patients. The most common type of carcinoma was carcinoma of the breast (17.9%). Carboplatin was the most commonly used anticancer drug (26.56%). The average number of anticancer drugs received per patient was three. Conclusion: WHO suggested drug utilization studies are needed in every health care setting. For a developing country like India, National Drug Policy and Drugs and Therapeutic Committee are a must.

Preserved to preservative free prostaglandin analogues in primary open angle glaucoma.

Glaucoma affecting 60 million people all over the world and it will be 80 million till 2020. There are approximately 11.2 million persons aged 40 years and older with glaucoma in India. Primary open angle glaucoma (POAG) is commonest type, affecting 2/3rd of glaucoma patients. POAG is estimated to affect 6.48 million persons. The estimated number with primary angle-closure glaucoma is 2.54 million. POAG develops gradually and take long time to get detected and require long term treatment with topical prostaglandin analogues (PGF2) which is the most common as well as most widely used drugs. These PGF2 analogues need to be taken for longer time and more prone to develop adverse drug reactions. Common ADR seen with PG analogues are irritation on instillation, foreign body sensation, dryness of eyes, pain in eye, increased pigmentation of iris, increased eyelash growth, changes in periorbital sulcus and fat. Some ADRs (Adverse Drug Reaction) are explained by the inherent properties of Prostaglandins and those are not explained are because of preservative used in medication and these ADRs can be minimised by using preservative free drug like Tafluprost which are having same efficacy in decreasing IOP.

Cytological Study of Effusions.

Background: Effusion fluid analysis plays an important role in clinical medicine. Clinicians rely on the reports of effusion fluids and use them as complement to their clinical assessment for the diagnosis and management. Aim: To study the incidence of neoplastic and non neoplastic effusions. Objectives: i) To study the gross and microscopic features of effusions; ii) To study the pattern of effusions in various neoplastic and non neoplastic conditions. Material and Method: 550 specimens of pleural, peritoneal and pericardial fluid were studied. Fluid samples were centrifuged for five minutes at 2000 rpm and smears prepared from deposit were stained by Haematoxylin and Eosin (H and E), Giemsa and Papanicolaou stains (Pap). Result: Out of 550, 315 were pleural effusions, 234 peritoneal and one was pericardial. Out of total 315 cases of pleural effusions, 297 were non neoplastic and 18 were neoplastic effusion. Out of total 234 peritoneal effusions 214 were non neoplastic and 20 neoplatic. Commonest malignancy in pleural and peritoneal fluid was adenocarcinoma. Conclusion: Pleural effusion was the commonest fluid in this study. Exudates were predominant in pleural effusion and transudates were predominant in peritoneal effusion. Common causes of exudates in pleural effusion were tuberculosis (TB), pneumonia and malignancy. Common causes of transudates in peritoneal effusion were liver cirrhosis and congestive cardiac failure (CCF). Adenocarcinoma was the commonest malignancy in both pleural and peritoneal effusion (30 cases).

Drug utilization pattern in OPD of government dental college and hospital, Aurangabad.

Background: To study drug prescription pattern in dental OPD of Government Dental College and Hospital. Methods: 100 prescriptions were screened & analyzed as per the study parameters from OPD of Government Dental College & Hospital, Aurangabad. Groups of drugs commonly prescribed, like antibiotic, analgesics & others prescription were recorded. Results: Most common groups of drugs prescribed by dental surgeons were NSAIDs, antimicrobials, antiseptics and multivitamins. NSAIDs- 86%; Antimicrobials- 85%; Antiseptics- 8.6%; Multivitamins- 12.3%. The average number of drugs prescribed per patient was 3 and the average number of antimicrobial prescribed per patient was 1. Conclusions: For rational prescribing of drugs there is a need of mass-awareness amongst dental surgeons about the good prescribing by following 6 steps of WHO program on rational use of drugs.

Primary Osteosarcoma of the Breast.

Primary osteosarcoma of the breast is an extremely rare and aggressive tumor representing 12.5% of mammary sarcomas. It is associated with early recurrence and hematogenous rather than lymphatic spread, most commonly to the lungs. We report a case of 55 year old lady with gradually increasing painless lump measuring 7 × 6 cm in upper outer quadrant of left breast of 2 months duration. FNAC smears revealed pleomorphic spindle cells admixed with osteoid and chondroid material. A differential diagnosis of metaplastic carcinoma and malignant phyllodes tumor was offered. Histopathology of the modified radical mastectomy specimen showed predominantly osteosarcomatous areas. Epithelial component was not seen even after extensive sampling of the tumor. On immunohistochemistry, vimentin, S100 and CD68 were positive while AE1/AE3, CAM5.2, ER, PR, Her2-neu and desmin were negative confirming a diagnosis of osteosarcoma. Primary osteosarcoma of breast must be differentiated from metaplastic carcinoma and malignant phyllodes tumor because of different biological behaviour and treatment approach. Immunohistochemistry plays a pivotal role in the diagnosis of this tumor.

Prevalence of diabetes mellitus in a rural population of Goa, India.

Background. We aimed to estimate the prevalence of diabetes mellitus and study the associated factors in a rural population in Goa, India. Methods. A cross-sectional study was done in the rural area of Mandur, Goa. Participants >20 years of age were selected by systematic random sampling. They were interviewed with the help of a structured, pretested questionnaire. This was followed by clinical examination, anthropometry and relevant laboratory investigations. Diabetes mellitus was defined as per the American Diabetes Association (ADA) criteria. Statistical analysis was done using the SPSS software package (version 14.0). Results. The prevalence of diabetes mellitus in the study population was 10.3% (130/1266) with a prevalence of 8.4% among men and 12% among women. On bivariate analysis, the prevalence of diabetes mellitus was found to be significantly associated with age, occupation, family income, family history of diabetes, smoking, obesity, hypertension, and high serum cholesterol and triglycerides levels. Multiple logistic regression analysis identified age, family history, hypertension, smoking, total cholesterol and triglyceride as the independently associated variables for diabetes mellitus. Conclusion. Innovative community outreach programmes are required to create awareness, and for screening and treatment of diabetes mellitus to curb the growing epidemic of diabetes in the population.

'Unstained' and 'de stained' sections in the diagnosis of chromoblastomycosis: A clinico-pathological study.

Background: Diagnosis of chromoblastomycosis is frequently missed for many reasons: (1) rarity of the lesion (2) requirement of careful search for diagnostic 'sclerotic' bodies which are often sparse in clinical material such as tissue and exudates (3) often they elicit tissue reactions such as verrucous lesion and micro abscesses, misleading the diagnosis (4) lack of 'clinical suspicion'. Aims: (1) To compare the feasibility of 'unstained', 'stained' and 'de stained' sections in identification of the diagnostic ' sclerotic' bodies (2) To study histopathological features of chromoblastomycosis, and (3) To highlight the importance of clinical suspicion in the diagnosis of chromoblastomycosis. Design : This is a retrospective study conducted on six clinically unsuspected, histopathologically diagnosed cases of chromoblastomycosis. Results: Most common clinical presentation was verrucous lesion over extremities affecting adult men engaged in outdoor works. Sclerotic bodies and their characteristic features were easily identified in both 'unstained' and 'de stained' sections. Special stains such as Fontana Masson and Gomori's methenamine silver nitrate are useful for demonstrating hyphal forms in keratinized layers and for illustration purposes. Conclusion: Both 'unstained' and 'de stained' sections can be used for rapid screening of sclerotic bodies. 'De stained' sections can be used as a suitable substitute for special stains for confirmation and for retrospective review of all verrucous lesions to diagnose the missed lesion. Clinical suspicion is very important in the diagnosis of chromoblastomycosis as it helps pathologist to screen for diagnostic sclerotic bodies.

Study of needle stick injuries among health care workers at a tertiary care hospital.

A cross-sectional study was conducted among health care workers at a tertiary care hospital in Goa to study the problem of needle stick injuries. A structured questionnaire was used to interview the study participants at their work place. Participants were asked to recall needle stick injuries in the preceding 12 months. Factors such as work experience, type of procedure, action taken following injury etc were also studied. Statistical analysis was done with SPSS software. Around 34.8% (200/575) of the Health care workers had experienced a needle stick injury in the last one year. Needle stick injuries were equally distributed across different work experience periods. Hollow bore needles were responsible for 77.5% of needle stick injuries followed by suturing needles (19.2%). As far as use of personal protection was concerned only 58% of the health care workers were wearing gloves at the time of the injury. There is therefore an urgent need at the hospital level to have a uniform needle stick injuries policy covering safe work practices, safe disposal of sharps, procedures in event of needle stick injury, training including pre-employment training, monitoring and evaluation of needle stick injuries and procedures for reporting needle stick injuries.

'Thinfat' phenotype in newborns.

OBJECTIVE: The objectives of the study was to know whether the 'thinfat' phenotype exists in newborns, in Central Karnataka and to correlate various factors that contribute to this peculiar phenotype, with emphasis on genetic and maternal environmental factors. METHODS: For 1000 consecutive singleton term newborns, weight, length, head, mid arm, abdominal circumferences, biceps and subscapular skinfolds were measured at birth and compared with measurements of white Caucasian babies born in Southampton UK and Mysore babies at birth. RESULTS: The Davangere babies were significantly smaller in all measurements at birth (p < 0.001) compared to Southampton babies. The deficit varied according to the measurements; It was greatest for birth weight (-1.6 SD, CI -3.0, -0.2), mid arm circumference (-2.0 SD, CI -3.3, -0.8), head circumference (-1.8 SD, CI -3.1, -0.5) and least for length (-0.4 SD, CI -1.9, 1.1) and subscapular skin fold (-0.3 SD, CI -0.25, -0.12). Predictors of skinfold thickness were maternal body mass index (p < 0.05), maternal mid arm circumference (p < 0.001) and consanguinity (p < 0.05). CONCLUSION: Despite being small, truncal adiposity was present in Davangere neonates confirming the 'thinfat' phenotype. The role of consanguinity in other words, the role of genes, is important in determining this 'thinfat' phenotype in newborns.

MRI imaging of ulnar leprosy abscess.

Leprosy is a chronic granulomatous infection, caused by mycobacterium leprae, primarily affecting the peripheral nerve trunks and cutaneous nerves. It classically presents with neural or dermal signs and symptoms. The indolent course of leprosy may manifest as erythema nodosum (appearance of tender inflamed subcutaneous nodule) and reversal reaction (inflammation in the previous skin lesion, appearance of new skin lesions, neuritis and abscess). Ulnar nerve is most commonly involved. This report illustrates the MR imaging appearance of ulnar nerve abscess. ©

Evaluation of Diuretic Activity of Aqueous and Methanol Extracts of Lepidium sativum Garden Cress (Cruciferae) in Rats

Purpose: The present study was undertaken to investigate diuretic effect of aqueous and methanol extracts of the dried seeds of Lepidium sativum in normal rats. Method: Aqueous and methanol extracts of L. sativum seeds were administered to experimental rats orally at doses of 50 and 100 mg/kg p.o. Hydrochlorothiazide (10 mg/kg) was used as positive control in study. The diuretic effect of the extracts was evaluated by measuring urine volume; sodium and potassium content; conductivity and pH. Result: Urine volume was significantly increased by the two doses of aqueous and methanol extracts in comparison to control group. While the excretion of sodium was also increased by both extracts; potassium excretion was only increased by the aqueous extract at a dose of 100 mg/kg. There was no significant change in the conductivity and pH of urine after administration of the L. sativum extracts. The diuretic effect of the extracts was comparable to that of the reference standard (hydrochlorothiazide) and the methanol had the additional advantage of a potassium-conserving effect. Conclusion: We can conclude that aqueous and methanol extracts of L. sativum produced notable diuretic effect which appeared to be comparable to that produced by the reference diuretic HCTZ. The present study provides a quantitative basis for explaining the folkloric use of L. sativum as a diuretic agent in Moroccan population