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Background:Incidence and prevalence of dermatophytosis have increased recently. The clinico-mycological characteristics of dermatophytosis in the past and present were compared to determine the difference, if any, that canexplain the present scenario.Material and Methods:Hospital-based cross-sectional study design with retrospective data comparison was done. The clinico-mycological data of 425 patients in 2019 was compared to 124 patients in 2011 with a Chi-square statistic. Result:Significant differences were observed in the following socio-demographic and disease characteristics in the present compared to the past: female gender (57.9% vs.33.9%, P-0.000002), chronicity (29.4% vs. 16.1%, P-0.003), sharing of clothes (35.3% vs. 20.5%, P-0.0014), co-morbidity of atopy (22.6% vs. 6.5%, P-0.00005), prior use of topical antifungals (64.5% vs. 30.7%, P <0.0001), prior use of systemic antifungals (43.1% vs. 13.7%, P <0.0001), prior use of topical steroids (24.7% vs. 12.1%, P-0.0028), and infection in multiple sites (25.2% vs. 11.3%, P-0.001). T.mentagrophyteswas the most common isolate in the present compared to the past (73.6% vs. 32.8%, P-0.0035). Other isolates were T.rubrum(13.2%) and M.gypseum(13.2%) in 2019 and T.rubrum(53.1%), M. gypseum(9.4%),T. schoenleinii(1.6%) and E. floccosum(3.1%) in 2011.Conclusion:T. mentagrophyteshas emerged as thedominant species. Irrational use of topical and systemic antifungals and steroids has increased considerably.Frequent training of general practitionersregarding appropriate management andeducating patients about avoidance of tight-fitting clothing, personal hygiene, and avoidance of over the counter medications, and adherence to treatment schedule can decrease the disease burden to some extent.
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Background@#Right ventricular pacing (RVP) increases heart failure, AF, and death rates in pacemaker patients and ventricular arrhythmias (VAs) in defibrillator patients. However, the impact of RVP on VAs burden and its clinical significance in pacemaker patients with normal range LVEF of > 50–55% remains unknown. We sought to evaluate the relationship of RVP and VAs and its clinical impact in a pacemaker patient population. @*Methods@#Records of 105 patients who underwent de novo dual-chamber pacemaker implant or a generator change (Medtronic™ or Boston Scientific™) for AV block and sinus node disease at a tertiary care center between September 1, 2015, and September 1, 2016, were retrospectively reviewed. @*Results@#Data from 105 patients (51% females, mean age 76 ± 1 years, mean LVEF 61 ± 0.7%) without history of VAs (98.2%) were reviewed over 1044 ± 23 days. Dependent patients (100% RVP) exhibited the lowest VAs burden when compared to 1/h of PVC runs and increasing PVC runs/h were significantly associated with hospitalization (p = 0.04) and all-cause mortality (p = 0.03), respectively. @*Conclusions@#In pacemaker patients with normal range LVEF (> 50–55%), 100% RVP is associated with the lowest burden of NSVT. Furthermore, patients with < 1% RVP also exhibit low VA burden; however, intermittent RVP seems to significantly correlate with non-sustained VAs.
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@#In many lower- and middle-income countries, the public health system is made more accessible in rural areas through training lay people to become community health workers (CHWs) within their communities. This mixed-methods study aims to evaluate such a CHW program in rural Uttarkashi, India, which is being run by a non-government organization (NGO). In the CHW program to be evaluated, the CHWs give monthly health awareness classes during women’s self-help group (SHG) meetings. By involving women’s SHGs, community participation is supposed to be fostered and health knowledge spread. Therefore, it was hypothesized that communities with an active CHW should achieve a higher number of correct answers on a health knowledge test than communities without an active CHW. Moreover, using qualitative methods, we explored the SHG members’ and CHWs’ viewpoints on the impact of the awareness classes held during SHG meetings. Five focus group discussions were conducted with members of SHGs, as well as with NGO-trained CHWs and government-employed CHWs. Results confirmed that the respondents from a community with an NGO-trained CHW performed significantly better on the health knowledge test, although not uniformly across all sampling areas. The qualitative data revealed a substantial impact of the health awareness classes on behavior changes among SHG members and their families. Further, the NGO-trained CHWs collaborated well with other government-employed CHWs. In conclusion, the authors feel that is would be worthwhile to employ more NGO-run CHW programs throughout India, to supplement the government-run programs, especially in remote and underserviced areas.
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Patients having restricted mouth opening and limited movement of tempro-mandibular joint present as difficult airway scenario. Fibre-optic assistance is a gold standard technique for anticipated difficult intubation, but it’s availability and expertise still is a challenge at most of places worldwide especially in developing countries.The retrograde intubation technique can be an alternative and less invasive than other emergency surgical airway options for such cases. We present a case of difficult intubation, successfully managed with the help of retrograde intubation.
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A total of 12 adult buffaloes were presented for the necropsy over the period of 6 months at the Department of Veterinary Pathology, CGKV, Anjora, Durg, Chhattisgarh. Prevalence of Gigantocotyle spp. parasite infection was found to be 16.67% (2/12). Significant number of parasites was found in the bile duct and ductules of the infected liver along with the necrotic debris caused by parasite. Other gross lesions observed were included hepatitis, haemorrhages and fibrosis of the liver. Black color hard nodules at the site of mucosal attachment of parasites were noticed. Microscopic changes observed were included bile duct hyperplasia, haemorrhages, moderate fibrosis and granulomatous nodule characterized by infiltration of inflammatory cells
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We report a case of two months old infant diagnosed with acute myocarditis, with a ventricular septal defect (VSD) of 0.9 mm size, admitted to our hospital with gangrene of left foot. A below knee amputation was planned under general anaesthesia with caudal block. Digoxin and diuretics were continued. Induction was done with fentanyl and sevoflurane and supraglottic device was used to secure the airway. Caudal block with bupivacaine was administered.The recovery was satisfactory and postoperative stay was uneventful.
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OBJECTIVE: Hepatitis A vaccine has been recommended for patients with chronic liver disease since they have high mortality following acute hepatitis. This study was done to assess the prevalence of antibodies to hepatitis A virus in Indian patients with liver cirrhosis to determine the relevance of this recommendation in India. METHODS: Consecutive patients with cirrhosis of liver seen at two referral hospitals in southern India were tested for antibodies to hepatitis A virus using EIA. Age-matched non-cirrhotic adults attending the OPD served as controls. RESULTS: Of the 52 patients (mean [SD] age 57.1 [11.0] years; 33 men) and 50 control subjects (52.0 [14.8] 5 years; 39 men), 51 patients and all the controls tested positive (p=ns). CONCLUSION: Most patients with liver cirrhosis have antibodies against hepatitis A virus and thus immunization against this infection without screening appears unnecessary in them.