SARS-CoV-2 antigen detection in deceased bodies: implications for infection prevention

Background & objectives: High transmissibility of the SARS-CoV-2 has significant implications on healthcare workers’ safety, preservation, handling, transportation and disposal of the deceased bodies. The objective of this study was to detect SARS-CoV-2 antigen in nasopharyngeal samples and its implications in handling and care of COVID-19 deceased bodies. Methods: A study was conducted at a dedicated COVID-19 centre on deceased individuals from April to December 2020. Rapid antigen test (RAT) and reverse transcription (RT)-PCR was compared on all the SARS-CoV-2 positive cadavers recruited in the study. Results: A total of 115 deceased individuals were included in the study. Of these, 79 (68.7%) were male and 36 (31.3%) were female and majority were in the age group of 51-60 yr [31 (27%)]. SARS-CoV-2 antigen test was positive in 32 (27.8%) and negative in 83 (72.1%) individuals. The mean time interval between deaths to the sample collection was 13.2 h with interquartile range of eight to 20 h. Reverse transcription (RT)-PCR was used as the reference test and 24 (20.9%) cases were true positive; 93.6 per cent [95% confidence interval (CI) 88.8-98.4%] sensitivity, 45.2 per cent (95% CI 35.5-55%) specificity, 60.2 per cent (95% CI 50.6-69.8%) positive predictive value and 88.8 per cent (95% CI 82.7-95%) negative predictive value of antigen test was computed. Interpretation & conclusions: SARS-CoV-2 antigen test was positive beyond 19 h in COVID-19 deceased individuals. Antigen test was found to be highly sensitive in the deceased. Patients, suspected of having died due to COVID-19, can be screened by this method. As infectiousness of the virus in the deceased bodies cannot be directly concluded from either the antigen or RT-PCR test, yet possible transmission cannot be completely ruled out. Strict infection control measures need to be followed during the handling and clearance of COVID-19 cadavers.

Retrospective Study of Varicose Vein and its Management in IGIMS, Patna

Introduction: The management of varicose veins haschanged rapidly in recent years. Conservative therapy istypically the first-line treatment for many patients withsymptomatic varicose veins. The present study was conductedfor retrospectively analyzing the profile of varicose vein andits management.Material and methods: A total of 100 patients within the agegroup of 15 to 65 years with varicose vein complications wereincluded. Complete demographic details of all the patientswere obtained from the data record files. Clinical details werealso obtained. A Performa was made and results of routineinvestigations were recorded. Details regarding the treatmentprotocol used (conservative, sclerotherapy, surgical) andfollow-up data was also recorded separately. Patients were notwilling and unfit for surgery and patients with complicationsaccording to data record files, were treated by conservativemanagement.Results: Dilated veins only were found to be present in 18percent of the patients while dilated veins with pain waspresent in 64 percent of the patients. Dilated veins withulcerations and dilated veins with bleeding were present in40 percent and 8 percent of the patients respectively. In 33patients undergoing Sclerotherapy, complete response wasseen in 17 patients, recurrence was seen in 6 patients whilethe remaining 10 patients did not come back on follow-up. In31 patients undergoing surgical therapy, complete resolutionat time of discharge was seen in 28 patients while residualvaricosities were seen in 3 patients.Conclusion: Varicose veins are a frequently encounteredpathology affecting the middle aged group with commonestpresentation being unilateral limb involvement. Hence agood clinical assessment with investigations is necessary forreducing the morbidity associated with it.

unusual case of neonatal stridor

A 25-day baby neonate presented with fever and stridor. He had severe respiratory distress at admission. The systemic examination was unremarkable. The roentgenogram of soft tissues of neck revealed widening of superior mediastinum. Computed tomography of neck and upper chest revealed multiple abscesses in the retropharyngeal space, parapharyngeal space, and superior mediastinum. The child improved on aggressive antibiotic treatment protocol. It raises awareness among paediatricians to consider this diagnosis when confronting neonate with fever and stridor. An early diagnosis and aggressive appropriate management will reduce mortality and morbidity associated with this life-threatening condition. A thorough search for a primary source of infection should be done. Neonate should be screened for primary and secondary immunodeficiency disorders before discharge

Ventricular Tachycardia due to Perinatal Asphyxia.

Background: Perinatal asphyxia is known to precipitate myocardial dysfunction, rhythm abnormalities and congestive cardiac failure. Case characteristics: A 2-day old neonate with perinatal asphyxia. Observation: He developed shock secondary to ventricular tachycardia, and required synchronized cardioversion for reversion of abnormal rhythm. Outcome: Reversal of arrhythmia leading to recovery. Message: Early identification and management of ventricular tachycardia in neonate with perinatal asphyxia can be lifesaving.

Emblica officinalis improves glycemic status and oxidative stress in STZ induced type 2 diabetic model rats

OBJECTIVE@#To evaluate the antidiabetic and antioxidant potential of Emblica officinalis (E. officinalis) fruit on normal and type 2 diabetic rats.@*METHODS@#Type 2 diabetes was induced into the male Long-Evans rats. The rats were divided into nine groups including control groups receiving water, type 2 diabetic controls, type 2 diabetic rats treated with glibenclamide (T2GT) and type 2 diabetic rats treated with aqueous extract of fruit pulp of E. officinalis. They were fed orally for 8 weeks with a single feeding. Blood was collected by cutting the tail tip on 0 and 28 days and by decapitation on 56 day. Packed red blood cells and serum were used for evaluating different biochemical parameters.@*RESULTS@#Four weeks administration of aqueous extract of E. officinalis improved oral glucose tolerance in type 2 rats and after 8 weeks it caused significant (P<0.007) reduction in fasting serum glucose level compared to 0 day. Triglycerides decreased by 14% but there was no significant change in serum ALT, creatinine, cholesterol and insulin level in any group. Furthermore, reduced erythrocyte malondialdehyde level showed no significant change (P<0.07) but reduced glutathione content was found to be increased significantly (P<0.05).@*CONCLUSIONS@#The aqueous extract of E. officinalis has a promising antidiabetic and antioxidant properties and may be considered for further clinical studies in drug development.

Sirenomelia: A Rare Entity

Sirenomelia also called as Mermaid Syndrome, is a rare congenital malformation of uncertain aetiology. It is characterised by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformation. It should be suspected in antenatal period in cases presenting with severe oligohydramnios and intra-uterine growth retardation. Here, we report a case of sirenomelia in a 26th weeks foetus.

Sirenomelia: A Rare Entity.

Sirenomelia also called as Mermaid Syndrome, is a rare congenital malformation of uncertain aetiology. It is characterised by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformation. It should be suspected in antenatal period in cases presenting with severe oligohydramnios and intra-uterine growth retardation. Here, we report a case of sirenomelia in a 26th weeks foetus.

Attitudes and Perceptions of Medical Doctors Towards Their Jobs in the State of J and K, India

Background: Management gurus have long since established a relationship between the attitudes held by an organization's work force and its job satisfaction. The foundations of individual behavior lie in individual attitudes, and employee attitudes, if understood properly, can be modified by operant conditioning

Methodology: The following study was undertaken in different but comparable study populations of doctors in Medical Education and Health selected through stratified random sampling to understand their attitudes towards and satisfaction from their work, through a cross sectional study design with the help of an anonymous questionnaire

Results: Doctors in both Health and Medical Education have comparable levels of job satisfaction i.e. 67% for Health and 69% for Medical Education. Both study populations strive for professional excellence, but self-actualization is a potent motivator for doctors in Medical Education while financial and social security are exceedingly important for doctors in the Health sector. Satisfaction falls among doctors by the second decade of service to rise again gradually

Discussion: Job satisfaction among doctors is at the lowest during the most productive years of their lives, when knowledge is tempered with experience and age is still on their side. It is important to recognize the motivations of doctors and provide them with opportunities and resources for professional excellence, self-actualization and growth

Conclusions: Both study populations were found to have a high level of job satisfaction. They also rated professional excellence on a high scale as a job motivator, but did not think that their organization considered it important

Attitudes and perceptions of medical doctors towards their jobs in the state of J and K, India

Management gurus have long since established a relationship between the attitudes held by an organization's work force and its job satisfaction. The foundations of individual behavior lie in individual attitudes, and employee attitudes, if understood properly, can be modified by operant conditioning. The following study was undertaken in different but comparable study populations of doctors in Medical Education and Health selected through stratified random sampling to understand their attitudes towards and satisfaction from their work, through a cross sectional study design with the help of an anonymous questionnaire. Doctors in both Health and Medical Education have comparable levels of job satisfaction i.e. 67% for Health and 69% for Medical Education. Both study populations strive for professional excellence, but self-actualization is a potent motivator for doctors in Medical Education while financial and social security are exceedingly important for doctors in the Health sector. Satisfaction falls among doctors by the second decade of service to rise again gradually. Job satisfaction among doctors is at the lowest during the most productive years of their lives, when knowledge is tempered with experience and age is still on their side. It is important to recognize the motivations of doctors and provide them with opportunities and resources for professional excellence, self-actualization and growth. Both study populations were found to have a high level of job satisfaction. They also rated professional excellence on a high scale as a job motivator, but did not think that their organization considered it important

Impact assessment of mass measles vaccination.

OBJECTIVE: The mass measles vaccination campaign was conducted in the slums of Surat City, in Gujarat State, as a part of urban measles control initiative in India. One dose each of the vaccine was administered to children in the age range of 9-59 months residing in these slums, regardless of their previous vaccination status. METHODS: One year later, (October 2000), the present study was carried out in order to assess the impact of the mass vaccination campaign on the vaccination coverage and on the incidence of measles by comparing the findings with those of the baseline survey carried out in May 98. This was a retrospective study with a recall period of the preceding year. 3,147 children under five were studied in thirty slum clusters selected by the cluster sampling method. The parents/caretakers of these children were interviewed for information on any episode of fever with rash conforming to the case definition. RESULT: The incidence rate for measles declined from 7.7 percent reported in the baseline (May 1998) to 3.5 percent in the impact assessment study. The incidence was 8 times higher in unvaccinated children. The mean and median age at contracting the illness increased from 26 +/- 14.2 months and 26 months in the baseline to 30.9 +/- 14.7 months and 30 months respectively in the impact assessment. The vaccination coverage had improved from 48.3 percent to 73.7 percent following the campaign. CONCLUSION: The compaign increased vaccination coverage decreased disease incidence and caused a shift towards higher age-groups in vaccinated children.

A survey of missed opportunity for immunization in Lucknow.

An exit interview of the women accompanying the children of 0-2 years visiting the three large urban hospitals and three randomly selected rural primary health centres of Lucknow district was undertaken to assess the magnitude of problem of missed opportunity for immunization at health facilities. The WHO suggested protocol for the study was followed. Observations reveal that in 59.1% children, the opportunity to vaccinate was missed. Only 3% children had a true contraindication for vaccination. Also 44.6% of women accompanying the children and in the reproductive age group could have been immunized against tetanus. A high level of acceptability of immunization in those with missed opportunity was noted.

Sex bias in immunization coverage in an urban area of U.P.

Two hundred and ten female and two hundred and ten male children aged 1-2 years were identified using 30 cluster random sampling technique in the Nagar Palika of Sitapur. The immunization status was determined to assess differences, if any, in the coverage in accordance with the sex of the child. Except for measles, a significantly higher vaccination coverage was observed for male children as compared to females for every vaccine, this being 65.2 and 60.9%, respectively for DPT III and OPV III for males as compared to 51.9 and 49.5%, respectively for girls. The drop out rates for DPT and OPV were also found to be higher (p greater than 0.05) in female children. However, no difference was observed in the reasons for non-immunization between the female and male children.