Proposed drug interventions for SARS CoV 2 infection

As the pandemic has already taken lots of lives across the globe, there’s an urgent need for finding treatment options that might help in protection of infected people by either slowing or preventing the progression of the disease. It’s important to understand the structure of virus, the mechanism by which it enters the host cell, replicates and infects other cells causing progression of the disease. This article focuses on use of already available and approved drugs for treatment of corona virus based on their mechanism of action and the structure and the life cycle of the virus.

Factors Associated with the Occurrence of Canine Parvoviral Enteritis in Dogs

A prospective study was conducted to identify the risk factors associated with the incidence of Canine Parvoviral Enteritis (CPE) in dogs. Total of 120 animals screened using PCR assay, 72.50 percentage of animal were found positive for Canine Parvo Virus (CPV). Incidence in history of unvaccinated and vaccinated dogs was 79.69 and 64.29 per cent respectively. Age-wise predisposition of CPE indicated that the highest incidence was observed in both less than 3 months (78.08 %) and 3 to 6 months of age group (77.42 %) followed by 6 to 12 months of age group (34.50 %). Incidence of CPE in scheduled and unscheduled vaccination was 30.00 and 83.33 per cent respectively. In this study, unvaccinated status, unscheduled vaccination and young age groups are found to be significant risk factors associated with the occurrence of CPE

Vascular malformations – Treatment modalities

Background: Vascular malformation is a general term that includes congenital vascular anomalies of veins, lymph vessels, both veins and lymph vessels, or both arteries and veins vascular malformation, is a blood vessel abnormality. These are all present at birth and become apparent at different ages. Most are known to occur during development of the arteries, veins, and/or lymph vessels, but without specific cause. Most are congenital and few appear late in life. Aim: It was using different treatment modalities to reform, reshape, and reorganize to obtain near normal appearance and function. Materials and methods: An observational study done in VIMS - Visakha Institute of Medical Sciences, a superspeciality hospital, 20 cases of vascular malformations are taken from period January 2017 –August 2019. Consent was taken from all the patients, and counseling was done regarding the procedures we do, about surgical/ non-surgical methods, stages required and follow up. Results: Statistical analysis was done, results were tabulated and displayed in pie diagrams. Satisfaction scale was shown by VAS (visual analogue scale). Conclusion: Vascular malformations are mesenchymal lesions may be congenital/ acquired and may present late in life. Sometimes few congenital hemangiomas spontaneously resolve by growth of child, some if large may require steroids for suppression and to prevent recurrences. They are known for recurrences or residual lesions and surgery may be done in stages to obtain optimal results. Nonsurgical methods are done by intralesional sclerosants.

Assessing the nicotine content of smoked and smokeless forms of Tobacco Available in Bhopal

Abuse of tobacco, such as drug and alcohol abuse, is a worldwide public health problem. Once a person is addicted to nicotine, quitting smoking is difficult. A measure of the addictive potential of tobacco products is the amount of nicotine available from them. The present study is an attempt to assess the nicotine content of tobacco products available in Bhopal. Aims: This study aims to assess the nicotine content of some popular brands of smoked (cigarettes and bidis) and chewed forms (pan masalas containing tobacco) of tobacco available in Bhopal. Settings and Design: This was an in vitro cross-sectional study. Subjects and Methods: Six brands of cigarettes (filtered), six brands of bidis, and six brands of chewed tobacco (pan masalas) were used for the study. The methodology published by Association of Official Analytical Chemists was followed, and reagents conforming to American Chemical Society specifications were used. Statistical Analysis Used: One-way ANOVA, Bonferroni post hoc test. Results: The mean nicotine levels for cigarettes, bidis, and chewed tobacco were 7.84 ± 5.10, 16.86 ± 5.66, and 16.30 ± 3.33, respectively. The differences in the mean scores were compared using one-way ANOVA and were found to be statistically significant with F = 6.636 and P = 0.009. Bonferroni post hoc test assessed the difference in mean nicotine content among the groups indicating that the difference between cigarettes versus bidis and cigarette versus chewed tobacco was significant with P = 0.016 and 0.024, respectively. Conclusions: Bidis had the highest content of nicotine, followed by chewed tobacco (pan masalas) and cigarettes.

Hematological parameters in cardiovascular diseases

Background: Cardiovascular diseases are one of the leading causes for morbidity and mortality worldwide. They are mainly caused by atherosclerosis and its complications. Limited literature is available on the role of various haematological parameters.Our objective was to study various haematological parameters like RBC count, Haemoglobin, Haematocrit, Mean Corpuscular Volume [MCV], Mean Corpuscular Haemoglobin [MCH], RedCell Distribution Width [RDW] in patients with Coronary Artery Disease [CAD]

Methods: This was a descriptive study carried out on patients with CAD admitted to Sri Jayadeva Institute of Cardiovascular Sciences and Research, KRHospital Campus, Mysore, India in the age range of 30-60 years. Patients with impaired renal or hepatic function, known congenital heart disease/valvular heart diseases, known case of anaemia or being treated for anaemia, prolonged drug intake, thyroid disorders were excluded from the study. Blood samples were collected in an EDTA vaccutainers and analysed in automated cell analysers

Results: About 26.7% of the patients were <40 years age, 31.7% between 41-50 years and 41.7% were in 51-60 year group; 28.3% were known patients of hypertension, while 43.3% had diabetes mellitus. Haemoglobin in 48.3% of the study population was within normal range, while 16.7% of them had low levels and 35% had higher levels. Eighty percent of them had normal RBC count, 15% had increased count and 5% had decreased count. Fifty percent subjects had normal PCV while 20% had increased and 30% had decreased values. There was increased RDW-SD and RDW-CV in 66.7% and 50% of the study population respectively

Conclusion: There is role of various parameters like haemoglobin, MCV, RDW in pathogenesis of CAD. Alterations in various haematological parameters over a long run may be one of the various other reasons for the development of CAD. Regular health check-ups with precautionary measures taken in advance may reduce the prevalence of the disease

Seropositivity of Widal Test in Febrile Illness Cases–A Study at a Tertiary Care Hospital in Rural Area.

Background: Typhoid fever, caused by the bacterium Salmonella typhi, remains an important health problem in developing countries including India. Human beings are the only reservoir and host for typhoid fever, which is transmitted by faeco-oral route. The Widal agglutination test is the diagnostic test, commonly used to diagnose typhoid fever. The interpretation of the Widal test depends upon the baseline titre of that area. Aims and objectives: 1.T o know the positivity rate of widal test, 2. To know the titres for both ‘O’ & ‘H’ antibodies in typhoid fever. Methods: Widal test was done for 1525 serum samples for detection of antibodies of S. typhi. A titre of more than 1 in 80 for ‘O’ antibody and 1 in 160 for ‘H’ antibody was taken as positive in the diagnosis of typhoid fever. Results: 44.78% of samples (683/1525) were from 11-30 years age group. The rate of positivity was increased as the age increases except in the age group of 21- 30 yrs. Widal test was positive in 43.01% of samples. Positivity rate was high among females (50.73%) when compared to males (32.34%). Conclusion: 1. The percentage of positivity was 43.01% .2. The rate of positivity was increased as the age increases except in the age group of 21- 30 yrs. 3. Positivity rate was high among females (50.73%) when compared to males (32.34%). 4. Highest positivity rate was seen in males in the age group of 51- 60 yrs (80.39%) and in females in the age group of above 60 yrs (72.85%).

Proptosis Secondary to Extracranial Ethmoidal Meningioma: A Case Report.

Meningiomas of sinonasal tract are rare entities. A case of primary extracranial meningioma of the right ethmoid sinus is reported. A 55-year-old female patient presented to the Department of ENT with symptoms of visual disturbance and swelling of right eye since 6 months, progressive nasal obstruction on the right side since 3 months with few episodes of epistaxis. Clinical examination showed a solid mass occupying right nasal cavity. Imaging studies showed a well-defined mass lesion with central cystic and sclerotic margins, in the region of right ethmoid sinus, causing mass effect on surrounding structures and displacing the medial rectus muscle with alteration of course of the optic nerve. Transnasal endoscopic removal of the mass was done in-toto, and histopathological studies including immunohistochemistry proved it to be a psammomatous meningioma.

Pattern of lymphadenopathy in fine needle aspiration cytology: a retrospective study.

Background: Lymphadenopathy is of great clinical significance as underlying disease may range from treatable infectious etiology to malignant neoplasm. In fact it is also essential to establish that swelling in question is lymph node. Incidence of lymphadenopathy appears to be increasing especially among young adults all over the world. Inflammatory and immune reaction are most frequent cause of lymph node enlargement and are self limiting in majority of cases. Lymphnode are also affected as a result of primary neoplasm or from metastasis of malignant neoplasm from regional and distant organ. Aims: Study different cytomorphological patterns associated with various lymphadenopathy and spectrum of lesion with respect to age and sex. Methods: A total of 1774 cases came for FNAC of lymphnode in the Department of Pathology, MMC & RI, MYSORE from NOV 2011 to OCT 2014 were retrieved and studied retrospectively. Results: Out of total cases, 908 were males and 865 females with age range from 3mth to 90 years with maximum number of cases diagnosed with reactive lymphadenopathy (26.2%) followed by metastatic lymphadenopathy (21.2%), Non specific lymphadenitis (18.5%), granulomatous lymphadenitis (14.65%), tuberculous lymphadenitis (14.65%), suppurative lymphadenitis (3.94%) and lymphoma(0.73%). Conclusion: FNAC recognized as a diagnostic technique because of simplicity, cost effectiveness, easily availability of results, accuracy and minimal invasion. With the advent of FNAC most of inflammatory, reactive and neoplastic condition can be diagnosed without biopsy.

Syringocystadenoma papilliferum of eyelid- A deviant case report.

Syringocystadenoma papilliferum, a distinct dermatologic entity, is an exceedingly rare benign skin neoplasm and seems to have arisen from apocrine or eccrine adnexal structures. The diagnosis is clinically suspected and histologically confirmed due to its non distinct clinical findings and varried presentations. Since it usually appears at birth or during puberty and adolescence, it is called as Childhood tumor. Complete surgical excision is the treatment of choice followed by detailed histologic examination, to avoid the risk of maligrant degeneration. Herein, We have reported a rare case of Syringocystadenoma papilliferum of eyelid in an adolescent female.

A rare case report of Ectopic Cervical Thymoma.

The thymus, a lymphoepithelial organ, during the early fetal life originates from the superior neck and descends to the mediastinum. Embryological maldescent may lead to ectopic rests of thymic tissue along the pathway of its descent, neck being the most common site of ectopic thymic rests. Ectopic cervical thymoma is an extremely rare entity, showing a striking female preponderance whereas a mediastinal thymoma has a slight female preponderance. We characterized a case of ectopic cervical thymoma using convential light microscopy and immunohistochemistry in a 40 years old male patient who presented with a neck swelling simulating a thyroid neoplasm clinically.

Studies on genetic diversity for grain yield and physiological parameters in maize (Zea mays L.).

The D2 statistics is useful tool to assess genetic diversity among genotypes. It also provides qualitative measures of association between geographical and genetic diversity based on generalized distances. In the present study data on forty nine genotypes were subjected to D2 analysis, which revealed the presence of substantial amount of genetic variability among them. The pattern of distribution of genotypes into various clusters was random, suggesting that geographical and genetic diversity were not related. The experimental material was partitioned into eight clusters. Flag leaf area per plant contributed maximum towards genetic diversity followed by days to 50 per cent tasseling.

Oral health status of 12-year-old children with disabilities and controls in Southern India.

Background: This study explores the association of disabilities and oral health. The aim of the study was to compare and assess oral health status of 12-year-old children with disabilities with healthy controls in Karnataka, Southern India. Methods: A total of 191 schoolchildren with disabilities were examined from 12-year age group. For comparison, 203 healthy children were randomly selected from other government schools. Clinical data were collected on periodontal status, dental caries, treatment needs and dental malocclusion using WHO criteria. A chi-squared test was used to compare between categorical variables. Linear and logistic regression analysis was performed to determine the importance of the factors associated with caries status. Results: Significant differences were noted in the frequency of sugar consumption between subjects with disabilities and their healthy controls. Subjects with disabilities had significantly higher CPI (community periodontal index) scores than their healthy counterparts (p<0.001). Dental caries was present in 89.8% children from special schools as compared with 58.6% from the control group. Mean DMFT (decayed, missing, filled teeth) values for special school children and healthy controls were 2.52 ± 2.61 and 0.61 ± 1.12, respectively. Higher prevalence of malocclusion was seen in subjects with special healthcare needs, with 66.4% having definite malocclusion and 17.4% of controls having malocclusion (p<0.001). The mean values for treatment needs were higher in subjects with disabilities. Regression analysis showed that, type of school, male gender, low frequency of brushing, increased frequency of sugar consumption between meals and dental malocclusion were significantly related to dental caries. Conclusion: Poor oral health of children with disabilities as compared with their healthy controls in terms of periodontal status, dentition status, treatment needs, and dentofacial anomalies was found in our study, which confirms a need for preventive treatment for these children.

The Effect of Chemical (Glutraldehyde ) And Microwave Sterilization on Flexural Strength Autopolymerizing (PMMA ) Resings.

This Study evaluated the effect of disinfection methods on the Flexural Properties of Auto Polymerizing Resin. (Tooth Colored and Repair Resin). Specimens were exposed to microwaves for 15 min and 2 % Glutaraldehyde for 10 hours. Specimens stored in Water for 12 hours were used as control. For each procedure 10 specimens were used. The result indicated that changes in Flexural Strength observed were of no significance for both Tooth Colored and Repair Resin. The Microwave method is useful alternative to immersion disinfection having advantage of less time consumption.

Etiology and epidemiological analysis of glaucoma-filtering bleb infections in a tertiary eye care hospital in south India.

Purpose: To evaluate the microbial etiology and associated risk factors among patients with blebitis following trabeculectomy. Materials and Methods: A retrospective analysis of all culture-proven blebitis was performed in patients who underwent trabeculectomy between January 2004 and December 2008. A standardized form was filled out for each patient, documenting sociodemographic features and information pertaining to risk factors. Swabbing of the infected bleb surface was performed for all suspected cases and further subjected to microbiological analysis. Results: A total of 23 patients with culture-proven blebitis were treated during the study period, with a mean age of 59.2 years (59.2 ± SD: 12.8; range, 30-81 years). Duration of onset was early (≤36 months) in six (26%) cases and late (> 36 months) in 17 (74%) cases with a range between 15 and 144 months (mean, 82.91 months; SD: 41.89). All 23 blebs were located superiorly and of which, 21 (91%) were microcystic avascular, 1 (4%) diffuse avascular, and 1 (4%) vascular flattened. The predominant risk factor identified was bleb leak (35%; 8 of 23) followed by thin bleb (22%; 5 of 23) and blepharitis (17%; 4 of 23). Bleb leaks (100%) were recorded only in patients with late onset (≥ 9 years) of infection (P< 0.001), while the incidence of ocular surface disease (100%) occurred early (≤3 years) (P< 0.001). Use of topical steroids was associated frequently with cases of thin blebs (80%; 4 of 5) (P< 0.001), while topical antibiotics showed bleb leaks (88%; 7 of 8) (P< 0.001). Coagulase-positive staphylococci were frequently recovered from blebitis with thin blebs (71%; 5 of 7) (P = 0.001), Coagulase-negative staphylococci (CoNS) with bleb leak (100%; 8 of 8) (P< 0.001), Corynebacterium with blepharitis (100%; 3 of 3) (P = 0.001), and Streptococci with releasable sutures (75%; 3 of 4) (P = 0.001). Conclusion Bleb leak is the principal risk factor responsible for late-onset blebitis, while early-onset blebitis could be ascribed to ocular surface diseases. Streptococci were mainly responsible for early onset of infection, while the late onset was due to CoNS.

The Effect of Chemical (Glutaraldehyde ) And Microwave Sterilization On Impact Strength of Autopolymerizing ( PMMA ) Resins.

This study evaluated the effect of sterilization methods on the Impact strength of a self cured resins. A 10 hours immersion in 2 % alkaline glutaraldehyde, 15 minute exposure to microwaves energy was employed as a sterilization procedure. Storage in water for 10 hours was used as control. For each procedure 10 specimens were used. Results indicated that impact strength of the two groups did not change significantly as compared to control. Microwave sterilization can be opted as effective method and time saving procedure than immersion in chemical solution.

Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India.

Aims: To identify the etiology, incidence and prevalence of ocular bacterial infections, and to assess the in vitro susceptibility of these ocular bacterial isolates to commonly used antibiotics. Materials and Methods: Retrospective analysis of consecutive samples submitted for microbiological evaluation from patients who were clinically diagnosed with ocular infections and were treated at a tertiary eye care referral center in South India between January 2002 and December 2007. Results: A total of 4417 ocular samples was submitted for microbiological evaluation, of which 2599 (58.8%) had bacterial growth, 456 (10.3%) had fungal growth, 15 (0.34%) had acanthamoebic growth, 14 (0.32%) had mixed microbial growth and the remaining 1333 (30.2%) had negative growth. The rate of culture-positivity was found to be 88% (P < 0.001) in eyelids’ infection, 70% in conjunctival, 69% in lacrimal apparatus, 67.4% in corneal, 51.6% in intraocular tissues, 42.9% in orbital and 39.2% in scleral infections. The most common bacterial species isolated were Staphylococcus aureus (26.69%) followed by Streptococcus pneumoniae (22.14%). Sta. aureus was more prevalent more in eyelid infections (51.22%; P = 0.001) coagulase-negative staphylococci in endophthalmitis (53.1%; P = 0.001), Str. pneumoniae in lacrimal apparatus and corneal infections (64.19%; P = 0.001), Corynebacterium species in blepharitis and conjunctivitis (71%; P = 0.001), Pseudomonas aeruginosa in keratitis and dacryocystitis (66.5%; P = 0.001), Haemophilus species in dacryocystitis and conjunctivitis (66.7%; P = 0.001), Moraxella lacunata in blepharitis (54.17%; P = 0.001) and Moraxella catarrhalis in dacryocystitis (63.83%; P = 0.001). The largest number of gram-positive isolates was susceptible to moxifloxacin (98.7%) and vancomycin (97.9%), and gram-negative isolates to amikacin (93.5%) and gatifloxacin (92.7%). Conclusions: Gram-positive cocci were the most frequent bacteria isolated from ocular infections and were sensitive to moxifloxacin and vancomycin, while gram-negative isolates were more sensitive to amikacin and gatifloxacin.

Visual prognosis, intraocular pressure control and complications in phacomorphic glaucoma following manual small incision cataract surgery.

Aims: To evaluate intraocular pressure (IOP) control, visual prognosis and complications following manual small incision cataract surgery among eyes with phacomorphic glaucoma. Materials and Methods: This prospective, non-randomized interventional consecutive case series included all patients with phacomorphic glaucoma who presented to a tertiary eye care referral center in South India between March 2006 and April 2007. All patients underwent slit-lamp bio-microscopy, applanation tonometry and gonioscopy of the other eye to rule out angle closure. Small incision cataract surgery with intraocular lens implantation was performed in all affected eyes. Complete ophthalmic examination was done at each follow-up visit. Results: A total of 74 eyes with phacomorphic glaucoma were included in this study. The preoperative mean IOP was 38.4±14.3 mmHg and mean IOP at last follow-up was 12.7±2.4 mmHg. There was a statistically significant difference between IOP at presentation and IOP at last follow-up (P< 0.001). None of the eyes required long-term antiglaucoma medication. No significant intraoperative complications were noted. The final postoperative best corrected visual acuity was 20/40 or better in 51 patients. Eighteen eyes had corneal edema and 36 eyes had anterior chamber inflammation. Both conditions resolved with standard medical therapy. Conclusion: Manual small incision cataract surgery is safe and effective in controlling IOP and achieving good functional visual acuity with minimal complications in the management of phacomorphic glaucoma in developing countries.

Prevalence of bacterial pathogens causing ocular infections in South India.

Background / Aims: The eye may be infected from external sources or through intra-ocular invasion of micro-organisms carried by the blood stream. This study was undertaken to isolate and identify the specific bacterial pathogens causing ocular infections and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents. Materials and Methods: A retrospective analysis of all patients with clinically diagnosed bacterial ocular infections such as blepharitis, conjunctivitis, internal and external hordeolum, suppurative scleritis, canaliculitis, keratitis, dacryocystitis, preseptal cellulitis, endophthalmitis and panophthalmitis presenting between January 2005 and December 2005 was performed. Extra-ocular and intra-ocular specimens were collected and were subjected to direct microscopy and culture. Results: A total of 756 patients with bacterial ocular infections were analyzed, of which 462(61%) eyes had adnexal bacterial infection, 217(28.7%) had corneal infection, 6 (0.8%) had scleral involvement and the remaining 71(9.39%) eyes had infection of the intra-ocular tissues. The predominant bacterial species isolated was S. aureus (195 of 776; 25%) followed by S. pneumoniae (169 of 776; 21.78%) and coagulase negative staphylococci (142 of 776; 18.3%). The largest number of gram-positive isolates were susceptible to cefazolin (545 of 624; 87.34%), chloramphenicol (522 of 624; 83.65%) and gatifloxacin (511 of 624; 81.89%) and gram-negative isolates were to amikacin (127 of 136; 93.38%), gatifloxacin (125 of 136; 91.91%) and ofloxacin (119 of 136; 87.5%), while aerobic actinomycetes were to amikacin (100%), gatifloxacin (14 of 16; 87.5%), chloramphenicol (14 of 16; 87.5%) and ofloxacin (13 of 16; 81.25%). Conclusions: S. aureus frequently causes infections of eyelids and conjunctiva, S. pneumoniae of lacrimal apparatus and cornea and coagulase negative staphylococci causes intra-ocular infections. Of all routinely used antibacterials tested, flouroquinolones, especially gatifloxacin and ofloxacin represented a good choice for treating bacterial ocular infections.

Comparative in-vitro efficacy of fluoroquinolones against Streptococcus pneumoniae recovered from bacterial keratitis as determined by E-test.

Background and Objectives: The advent of new fluoroquinolones has drawn the attention for reliable methods on the in-vitro susceptibility testing of Streptococccus pneumoniae. This study attempts to determine the minimum inhibitory concentration (MIC) of second-generation (ciprofloxacin and ofloxacin), third-generation (levofloxacin) and the fourth-generation (moxifloxacin and gatifloxacin) fluoroquinolones against S. pneumoniae recovered from bacterial keratitis. Materials and Methods: In retrospect, the MICs of 50 strains of S. pneumoniae isolated from the corneal scrapes of patients with bacterial keratitis were determined against ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS) susceptibility patterns and the potencies of the MICs were statistically compared. Results: The median MIC of ciprofloxacin (0.25μg/ml) was found to be lower than the median MICs of ofloxacin (0.5μg/ml) (P<0.449) and levofloxacin (1.0μg/ml) (P<0.001). The median MICs of gatifloxacin (0.1μg/ml) was lower than the median MICs of ciprofloxacin (0.25μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and levofloxacin (1.0μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had showed lower median MICs than gatifloxacin (0.1μg/ml) (P<0.001) levofloxacin (1.0μg/ml) (P<0.001), ofloxacin (0.5μg/ml) (P<0.001) and ciprofloxacin (0.25μg/ml) (P<0.001). Moxifloxacin (0.06μg/ml) had a lower MIC50 (μg/ml) than gatifloxacin (0.1μg/ml), levofloxacin (1.0μg/ml), ciprofloxacin (0.25μg/ml) and ofloxacin (0.5μg/ml). MIC90 (μg/ml) of moxifloxacin (0.06μg/ml) was found to be lower than the MIC90 (μg/ml) of gatifloxacin (0.5μg/ml), levofloxacin (1.0μg/ml), ofloxacin (0.5μg/ml) and ciprofloxacin (0.5μg/ml). Conclusion: Based on in-vitro testing, the five portrayed fluoroquinolones 100% sensitivity to S. pneumoniae. However, the fourth-generation fluoroquinolone, moxifloxacin appeared to be more effective against S. pneumoniae than gatifloxacin, levofloxacin, ofloxacin and ciprofloxacin.