Implementation of RNTCP in a private Medical College: Five years' experience.

Background: Revised National Tuberculosis Control Programme (RNTCP) recognizes the need for involvement of all sectors, public and private, to create an epidemiological impact on Tuberculosis control .The private health sector in the country is an important source of care, even with the availability of public health services and Directly Observed Treatment Strategy (DOTS).The data regarding Private-Private mix in our country is lacking. Aim: To evaluate the contribution of {private health sector (Private Medical Colleges and Private practioners (PP)} in TB case-detection, diagnosis and treatment outcomes in Delhi NCR , Ghaziabad, India. Methodology: We analyzed the TB registers from May 2006-Dec 2010 from our institution and recruited the patients in our study, irrespective of the source. We strengthened the referral by promoting educational intra and inter departmental activities and awareness programme with more stress on retrieval action by contact tracing and counselling. We made a list of PP in our drainage area and regularly met them and tried to understand the barriers in referring cases to DOTS centre. During the study, we tried to maintain the flow of information working as a single window information system. We regularly passed on the information of follow up of patients to private practioners referred to us by them to generate confidence in them. During the study, no incentive was offered to any patient. Various indicators and data were collected annually and analyzed statistically. Statistics: Retrospective, Descriptive Analysis Results: There was a substantial increase of 116.3% in the total patients referred from all sources to Santosh Hospital. The proportion of extra-pulmonary cases was 29.1% to 34.4% of all total cases from the year 2006 to 2010. During subsequent years, we found a significant increase in referral from Private Practioners that was the result of our activities performed in private set up. It was 12.5%, 21.2%, 30.8%, 27.3%, and 29% during 2006, 2007, 2008, 2009 and 2010 respectively. The outcome in our study was in accordance with the outcome at national level under RNTCP. Conclusion: Because of extensive educational activities, single window information system and referring the patients back to private sector after completion of treatment increased the confidence amongst the private physicians. These results strengthen the Private - Private Collaboration and show that a stronger link can be developed between medical college and private setup, leading to implementation of successful Private-Private Strategy.

Inflammatory variant of a well-differentiated retroperitoneal liposarcoma: case report of a rare giant variety.

Inflammatory liposarcoma is a rare variant of a well-differentiated liposarcoma (WDLPS). We present a case of a 37 years old male who had a giant variety of this inflammatory WDLPS. CT scan revealed a large abdomino-pelvic mass abutting the left kidney and pushing the IVC, Aorta and the left ureter across the midline. CT guided FNAC did not reveal any malignant cells. A large 9-kg fibro-fatty mass, which appeared irregular, congested and bosillated was excised. Microscopic picture revealed foci of fibrosis with mature adipose tissue. Lymphocyte and plasma cell infiltrate was abundant along with multi-nucleate giant cells and few lipoblasts. There are no case reports of a giant inflammatory variant of WD-LPS in world literature and this is the first of its kind from the Indian sub-continent. We present a case report of this rare giant variant of inflammatory WDLPS and discuss the review of literature.

In vitro activity of ceftriaxone plus tazobactam against members of Enterobacteriaceae.

AIMS: To study the in vitro activity of ceftriaxone alone and in combination with the beta-lactamase inhibitor tazobactam against bacterial isolates belonging to the Family Enterobacteriaceae. METHODS: One hundred and five consecutive isolates of Escherichia coli and Klebsiella spp. that had been recovered from various high-risk areas of the hospital were included in the study. MIC estimation to ceftriaxone and a combination of ceftriaxone and tazobactam was performed by the agar dilution method. RESULTS: By the MIC studies, 88.6% of the strains appeared to be resistant to ceftriaxone with the MIC90 value being > 256 microg/ml. When the MIC were done to ceftriaxone in combination with tazobactam, the resistance rate dropped to 4.8% with the MIC90 value being 4.0 microg/ml. CONCLUSION: The combination of ceftriaxone and tazobactam appears to be an excellent therapeutic alternative with 94.6% of ceftriaxone resistant strains being susceptible in vitro to this combination.