Knowledge and Awareness about the Mode of Transmission of Vector Borne Diseases among General Public

Vector borne diseases account for more than 17% of other contagious diseases and can be caused either by parasites, bacteria or viruses. Malaria is a parasitic infection caused by female Anopheles mosquitoes. It causes millions of cases globally and most deaths occur in children. Dengue is another vector disease caused by Aedes mosquito and also affects millions of people, also causing more deaths. Other vector diseases may include yellow fever, zika fever, west nile fever, chikungunya, elephantiasis etc.  The aim of the study was to assess the knowledge and awareness about the mode of transmission of vector borne disease among the general public and also to analyse the correlation between gender and the level of awareness about vector borne disease among them. A cross sectional questionnaire survey was conducted among people in the region of Chennai. A set of 15 questions including questions on knowledge and awareness on the mode of transmission of vector borne diseases among the general population. It included questions like examples of vector borne diseases, mode of transmission of disease, preventive measures etc. The people of age group between 25-45 years were involved in the survey. There were 100 responses to the survey. The duration of the study was about 7 days. It is clear that the population was aware about the vector borne diseases but not very clear about the preventive measures to be taken to prevent the spread of vector borne diseases.

Knowledge and Awareness about Antibiotic Usage and Emerging Drug Resistance Bacteria among Dental Students

Antibiotics are commonly used in dental practice. It has been estimated that 10% of all antibiotic prescriptions are related with dental infection. Antibiotic treatment is a feature of pharmacotherapy with the particularity of providing both prophylactic and curative action. It was introduced in the mid twentieth century in the form of sulfa drug (1935), penicillin (1941), tetracycline (1948) and erythromycin (1952). Since then, antibiotics have focused much clinical and pharmacological research, in response antibiotics, the consolidation of new disease, and novel clinical situations.to “Penicilin antibiotics are commonly use in dental practice. Amoxicillin, metronidozole and clavulanate are frequently prescribed drugs by dentists.” The aim of this study is to create knowledge and awareness about antibiotic usage and emerging drug resistance bacteria among dental students. The Questionnaires had been prepared and distributed to 100 participants of dental students. The resulting data have been analyzed using SPSS statistical software. Descriptive statistical analysis was carried out and chi square test was used and p value was calculated. Most of the participants in the survey were aware about antibiotic use and emerging drug resistance bacteria. From this present study, it can be concluded that the participants are aware about antibiotic usage and drug resistance bacteria

Isolation, Detection and Molecular Characterization of Staphylococcus aureus from Postoperative Infections

Post operative infections that occur after surgical procedures can cause a lot of complications like sepsis, organ failure or even death. These are the third most commonly reported healthcare associated infection. The most common cause of wound infection regardless of procedure performed remains gram-positive cocci which comprise more than 50% of all infections. Specifically, Staphylococcus aureus and coagulase-negative staphylococci are the most frequent organisms isolated from a wound infection. There has been an increasing incidence of MRSA strains reported in hospitals across the globe. The main aim of our study is isolation, detection and molecular characterization of Staphylococcus aureus from postoperative infections. Samples were collected from post operative patients with infected wounds. The area around the wound was cleaned. Exudates were collected from the wound with a sterile swab stick. The samples were inoculated on different solid culture mediums and the plates were incubated in the presence of oxygen at 37°C overnight. There were many standard procedures done in which tube coagulase was taken as the main criteria. Antibiotic susceptibility testing was done by Kirby Bauer method following Clinical and Laboratory Standards Institute (CLSI) guidelines using commercially available cefoxitin (30 μg) disc (HiMedia) and the results were compared with Staphylococcus aureus ATCC 25923 and MRSA ATCC 43300 control strains. The MRSA strains were identified and detection of Mec A gene that codes for methicillin resistance is done using PCR technique.

US Doppler Indices in Umbilical and Fetal MCA in Diagnosis of IUGR Fetuses

Background: Intrauterine growth restriction remains a leading contributor to perinatal mortality and morbidity. There is no cure, management is reliant on a structured antenatal surveillance program with timely intervention. Recent advances in ultrasound and Doppler have elucidated several mechanisms of evolution of disease and prediction of threat of intrauterine hypoxia and acidaemia well in advance of other surveillance tests. Materials and methods: This prospective study was conducted in 110 high risk pregnant women attending OPD, admitted in antenatal wards and labor room at Government General Hospital, Siddipet, over a period of 2 years from October-2016 to September 2018; Ultrasound examination was done for interval growth, AFI, placental pathology. Fetal well-being was assessed with Doppler studies of UA and MCA, daily fetal movement count, NST, BPP. Results: In the present study, PIH was found to be the commonest (50.9%) cause of IUGR. Abnormal Doppler Indices in Umbilical and MCA correlated statistically with lower birth weight, higher rates of caesarean delivery, oligohydramnios, lower Apgar scores, perinatal death, and higher admissions to NICU. AEDF/REDF was associated with highest perinatal loss, poor perinatal outcome. Cerebroplacental ratio < 1 (C/U<1) had 100% specificity and 100% PPV. Conclusion: Doppler technology enables a better understanding of the hemodynamic changes in the fetus. It can help in identifying the changes in the fetal circulation well in advance of other surveillance tests, thus identify the truly hypoxic fetus. Interval changes in Doppler indices are useful in determining monitoring frequencies and optional time for delivery.

Intraperitoneal nebulization of ropivacaine 075% vs intraperitoneal nebulization of bupivacaine 05% for post-operative analgesia in laparoscopic surgeries: Prospective double blinded randomised controlled trial

Background: Laparoscopic surgeries being minimally invasive surgeries are associated with a relatively minor surgical trauma. Excessive pain, nausea and vomiting and fatigue will delay the discharge. Bupivacaine and Ropivacaine, the long acting Local Anaesthetics when given intraperitoneally provide effective pain relief when the pain peaks within 4-6 hours of surgery. Aim: To compare the efficacy of intraperitoneally nebulised Ropivacaine 0.75% and Bupivacaine 0.5% for postoperative analgesia in Laparoscopic surgeries. Materials and methods: This study was a double blinded randomised controlled trial in ASA grade I and II patients” was conducted in 60 patients of both sexes, of age group 20-45 years. They were randomly divided into two groups of 30 patients each: Group R (Ropivacaine) – received intraperitoneal nebulization of Ropivacaine 0.75% 4 ml (30 mg) after the placement of umbilical port and Sreedevi Porika, T. Venkata Naga Lakshmi. Intraperitoneal nebulization of ropivacaine 0.75% vs intraperitoneal nebulization of bupivacaine 0.5% for post-operative analgesia in laparoscopic surgeries: Prospective double blinded randomised controlled trial. IAIM, 2018; 5(9): 105-117. Page 106 Group B (Bupivacaine) – received intra peritoneal nebulization of Bupivacaine 0.5% 4 ml (20 mg) after the placement of umbilical port. Results: There was no significant difference in age and weight between the two groups. Intraoperatively statistically significant differences were observed SBP - At 15 and 30 min post nebulization and at extubation. No significant differences were observed with respect to DBP and HR. Postoperatively DBP and HR differences were found to be statistically significant at 4th post-operative hour. There were no statistically significant differences in SBP and MAP between both the groups. Dynamic VAS scores were statistically significant at extubation and in first 6 hours and not significant at 24 hours between both the groups. Static VAS scores were not statistically significant at all times compared between both the groups. Mean Time for first rescue analgesic requirement was 8.23+0.511 hours in group R vs.7.59+0.52 in group B and was statistically significant (p=0.0001). Mean total rescue analgesic required was 95+33.3 mg Diclofenac in group R vs. 112.6+38.4 in group B with 26% of group R requiring 2 nd dose of rescue analgesic and 50% of patients in group B required 2 nd dose and was not statistically significant. Mean time for unassisted ambulation was 12.8+0.61 hours in group R vs.13.16+0.6 hours in group B which was not statistically significant (p=0.52). Conclusion: From the present study, it is concluded that both Bupivacaine and Ropivacaine are safe and similarly efficacious in reducing postoperative pain following intra-peritoneal nebulization in laparoscopic surgeries.

Association between bacterial vaginosis and preterm labor and high risk cases for preterm labor

Background: Preterm delivery is a major contributor to neonatal morbidity and mortality and its prevention assumed special importance in the practice of obstetrics It is well known that the risk of neonatal death increases exponentially with decreasing gestational age and weight Aim of present study was to study the incidence of bacterial Vaginosis in established preterm labor and also in Pregnant Women with previous History of Preterm Labor in our Population as several recent studies have documented association between bacterial vaginosis and Preterm labor Materials and methods: The present study was undertaken for a period of two years from 2015- 2017 at Government Hospital, Siddipet 50 Cases with high risk for preterm labor were included in the study and 50 cases with term labor in control group Results: Majority of the women in both groups were between 20-24 years Majority of the cases had no previous abortion in both the groups Mean gestational age who has gone into preterm labor was 31-33 weeks The incidence of BV was higher among the study group (36%) compared to control group and was statistically significant (p<005) BV has significantly associated with 345 fold risk for preterm labor (odd’s ratio – 345) CI 128-98 statistically significant when compared to controls Conclusion: In this study, a significant difference in the presence of BV in patients of preterm labor and term labor was found (P<005) This observation could indicate a definite association of BV with preterm labor The relative risk of the presence of the BV in preterm labor was found to be 345 (95% CI -128 -918) Also BV was associated with 25 fold increased risk for preterm labor at earlier gestational age

Morphological variations of soft palate and influence of age on it: A digital cephalometric study

Background: Digital Lateral Cephalograms are the most commonly used radiographs for evaluating morphological variations of soft palate. It is a relatively inexpensive method and provides a good assessment of the soft-tissue elements that define the soft palate and its surrounding structures. The present study was conducted to investigate the morphological variations of the soft palate and influence of age on it. Materials and methods: The present study consisted of 150 digital cephalograms of subjects aged between 20 to 60 years taken from the department of oral medicine and radiology, Sri Sai College of Dental Surgery, Vikarabad. The subjects were categorized into five groups, group A: 20- 30 years, group B: 31- 40 years, group C: 41- 50 years, group D: 51- 60 years and group E: 61- 70 years. Digital lateral cephalograms were obtained and analyzed to categorize the soft palate into six morphological types, based on the classification by You, et al. Results: Type 1: leaf shaped soft palate was the most common type, type 4 and 6 varieties were the least common among all age groups. Type 5: S-shaped soft palate was found in considerable proportions among all the age groups (6.7% - 25.8%). There was no significant correlation found between the different age groups and the type of soft palate. Conclusion: Radiographic analysis of morphological variations of soft palate can help us better understand the velar morphology and may assist in success of surgical procedures aimed for correcting deformities of soft palate.

Study of upper gastrointestinal tract involvement in pemphigus by esophago-gastro-duodenoscopy.

INTRODUCTION: Involvement of upper gastrointestinal tract in pemphigus vulgaris is not uncommon. AIM: To study the involvement of upper gastrointestinal tract (UGIT) with the help of esophago-gastro-duodenoscopy (EGD) in patients of vesiculobullous dermatoses with emphasis on pemphigus vulgaris. METHODS: Forty-two patients (M-22, F-20) with vesiculobullous dermatoses, diagnosed on the basis of clinical features and skin histopathology as pemphigus vulgaris (PV)-40 patients and pemphigus foliaceus (PF)-2 patients were included in the study. The EGD was performed and mucosa of the esophagus, stomach and first part of the duodenum were examined. Mucosal biopsies were taken from the lower esophagus in 26 patients of PV and studied after H and E staining. RESULTS: On EGD, esophageal involvement was seen in 67% patients of PV (27/40). Of these, Grade I esophagitis was observed in seven, Grade II in 11, Grade III in four and Grade IV involvement was seen in five patients of PV. Three PV patients had associated esophageal candidiasis. Involvement of esophageal mucosa was also observed in one out of two patients of PF. Gastric mucosa was involved in 52% and duodenal mucosa in 20% of PV patients. Acantholysis was observed in seven out of 26 (27%) esophageal biopsies of PV patients. Two patients of PV vomited a tube-like structure, indicative of 'esophagitis dissecans superficialis'. The involvement of the gastric mucosa in patients with history of oral corticosteroid intake (60%) was compared to the group without history of oral corticosteroids (30%). CONCLUSION: Among PV patients under study, significant involvement of oral (87%), esophageal (67%), gastric (52%) and duodenal mucosa (20%) was observed.

Comparison of two systems of classification of leprosy based on number of skin lesions and number of body areas involved--a clinicopathological concordance study.

BACKGROUND AND AIMS: WHO guidelines classify leprosy patients for therapeutic purposes into paucibacillary (PB) and multibacillary (MB) leprosy based on the number of skin lesions. An alternative system of classification has been in practice in Nepal from 1985 onwards, based on the number of body areas involved in patients of leprosy. We attempted a clinicopathological approach for comparison of these two systems of classification in leprosy patients for their ability to demarcate patients into groups of PB and MB leprosy. MATERIALS AND METHODS: The study included 108 leprosy patients (80 males and 28 females). Complete clinical examination and body charting was carried out in each patient noting the count of skin lesions and the number of body areas involved. Slit skin smears and skin biopsies were taken from an active skin lesion in all patients. RESULTS: On analysis, it was observed that there was good clinicopathological correlation between patients with 5 or < 5 skin lesions and 2 or < 2 body areas involved. (Clinical 95% and histological 96%) A similar correlation was also observed in the other group of patients with > 5 skin lesions and > 2 body areas involved, (Clinical 94% and histological 96%). There were almost identical numbers of patients represented in these two groups of classification. CONCLUSIONS: Our findings suggest that patients with involvement of 2 or less body areas can be classified as PB leprosy and those with more than 2 body areas involved can be classified as MB leprosy for the purposes of therapy. The study of areas of involvement in leprosy patients not only provides additional patient information but also adds another parameter as a basis for the study of leprosy patients.

Pulse therapy and its modifications in pemphigus: a six year study.

BACKGROUND: Dexamethasone-cyclophosphamide pulse (DCP) therapy for the pemphigus group of disorders is being widely used in India after its introduction in 1986. However, there are certain limitations to its application due to the serious side effects of cyclophosphamide. METHODS: Between 1995 and 2001, we treated 41 patients of pemphigus with modified pulse therapy. These modifications included certain changes in the DCP therapy protocol and substitution of cyclophosphamide with either azathioprine or methotrexate in a few patients. RESULTS: We observed a good response to pulse therapy in all 34 patients who took treatment regularly. CONCLUSIONS: We found the modifications to the original DCP therapy protocol to be very effective and useful.

Multicentric reticulohistiocytosis.

A 41 -year-old man presented with multiple, painful and tender nodules on the palms, soles, scalp; and on the limbs predominantly around the joints with associated arthropathies. Smaller nodules were seen on the ear helices. There was no other clinically evident or investigative abnormality. Histopathological study confirmed a diagnosis of multicentric reticulo histiocytosis.

Multi focal tuberculosis.

A 19-year-old salesman presented with multiple fusiform, fluctuant, non-tender swellings involving dorsum of the left hand, left index finger and little finger. He also had multiple sinuses with puckered scars on the right thumb, left little finger and right elbow. He was provisionally diagnosed as tuberculous gumma. X-ray chest showed apical cavity and infiltration suggestive of tuberculosis X-ray both hands showed osteolytic lesions with pathological fracture. AFB was cultured on Lowenstein Jensen medium and the patient was given antituberculosis treatment with clinical improvement.

Disseminated superficial porokeratosis.

A 65-year-old male diabetic presented with erythematous and hyperpigmented plaques with scaling and crusting involving the trunk and extensor surfaces of extremities of 10 years duration associated with mild itching. Cutaneous examination revealed large hyperpigmented and erythematous plaques with raised borders over the trunk and extremities. A small plaque on the (L) forearm showed a raised thread like margin with a furrow. A provisional diagnosis of disseminated superficial porokeratosis was made. Skin biopsy confirmed the diagnosis of disseminated superficial porokeratosis.

Multifocal tuberculosis.

A 19 -year-old salesman presented with multiple fusiform, fluctuant, nontender swellings involving dorsum of left hand, left index finger and little finger. He also had multiple sinuses with puckered scars on right thumb, left little finger, and right elbow. He was provisionally diagnosed as tuberculous gumma and was investigated further. X-ray chest showed apical cavity and infiltration suggestive of tuberculosis. X-ray both hands showed osteolytic lesion with pathological fracture. AFB was cultured on Lowenstien Jensen s medium and the patient was put on ATT with clinical improvement.

Primary pachydermoperiostosis associated with Menetrier's disease.

Primary pachydermoperiostosis and Menetrier's disease are both hypertrophic conditions of skin and mucous membrane respectively. Here we report a case of association of these two conditions in a 30 -year-old man.