Prevalence Of Allergic Rhinitis and Its Perceived Effect on Academic Activity Among College Students � A Cross-Sectional Study

Background: Allergic rhinitis (AR) is a widespread and under diagnosed upper airway disease. It has significant social and economic burden. Symptoms may cause fatigue, mood changes and difficult sleep that may have deleterious effect on student抯 academic activity. Methods: This was an observational cross-sectional study among 1337 college students in Vadodara city of Gujarat, selected by cluster sampling method. Response was recorded using SFAR (Score for allergic rhinitis) scale and a semi structured questionnaire. Results: Prevalence of AR using SFAR was 19.22% among college students, out of them 65.4% were girls and 34.6% boys. The prevalence of two major variant of AR, perennial and seasonal was 38.91% and 51.75% respectively. 81.32% were aware about their allergy, 20.23% had gone for allergy test and 73.08% among them resulted positive. 82.49% students had perceived that AR is affecting their academic activity among SFAR?7 group. Conclusion: The results of this survey showed elevated prevalence of AR among college students in Vadodara city; however, allergy tests and physician visits for AR conditions were less. Major proportion that had self-reported AR has shown associated comorbidity. Students with AR, perceive a negative effect on their academic activity that equally affects girls and boys.

Organ Weights and Intestinal Morphology of Broiler Chickens Fed Diets Containing Different Supplements

The present study was evaluated the effect of dietary inclusion of various feed supplements and their combination on the performance index, glucose and serum cholesterol for 6 weeks. Day-old broiler chicks (n=252) were randomly assigned to seven treatment groups, each with 3 replicates. The first treatment was designated as control (T0) in which no supplement was added to the feed, while in treatments T1; organic mineral mixture (Organomin forte), T2; organic mineral mixture (Vannamin), T3; probiotics (Microguard), T4; enzyme (Brozyme -XPR) and probiotics, T5; emulsifier (Lipigon) were provided through feed. In the T6 group, 3 percent less energy was given through feed. The weight of vital organs viz. heart, liver, gizzard, and spleen were significantly (P<0.05) increased by the feed supplements of which were in the normal range. The gut morphology was also favorably altered due to feed supplementations. This indicates that the organic mineral mixtures, probiotics, enzymes and emulsifiers, and their combinations can be used as a growth promoter in broiler diets and can improve gut health. These products show promising effects as alternatives for antibiotics as pressure to eliminate growth-promoting antibiotic use increases

Clinical and Radiological Study of Serum Fluoride in Relation to Knee Osteoarthritis

@#Introduction: Fluorosis has been associated with an increased risk of degenerative changes in the knee. Multiple studies have found an association between arthritis and elevated fluoride levels. We aim to delineate if elevated fluoride level has any direct correlation with the degree of radiological grading and clinical symptoms in knee arthritis. Materials and Methods: A cross-sectional study of 80 knee arthritis patients was conducted from February 2017 to April 2018. Serum fluoride levels were measured and patient’s pain scores, WOMAC scores and radiological grading were correlated with the elevated fluoride levels. Results: In our study, 30 out of 80 patients had increased serum fluoride level. Statistically significant differences were noted in VAS score, WOMAC score and Kellgren and Lawrence radiological grades between patients with normal serum fluoride level and those with elevated fluoride level. Conclusion: There is an increased risk of knee arthritis in patients with elevated blood fluoride levels and patients with increased fluoride levels are associated with more severe symptoms and radiographic disease.

Status of adult immunity to hepatitis A virus in healthcare workers from a tertiary care hospital in north India

Background & objectives: Humans are considered to be the principal host for hepatitis A virus (HAV) infection. In India, heterogeneous groups of susceptible individuals coexist in different regions. There has been a decline in antibody titres to HAV among young adults which may pose a major public health problem. The objective of this study was to assess the IgG anti-HAV level among healthcare workers (HCWs) in the age group of 20-60 yr and its association with the socio-demographic variables. Methods: Blood sample (2 ml) was collected under aseptic conditions from each participant followed by the preparation of serum and storing at ?20癈. ELISA-based kits were used for the determination of IgG antibodies to HAV in the human serum samples. Results: Two hundred and fifty four HCWs were enrolled. IgG anti-HAV antibodies were detected in 97.2 per cent of the samples analyzed. No differences were observed in the levels of IgG anti-HAV antibody and education, income, occupation and socio-economic classes of the HCWs. A seropositivity rate of over 90 per cent was seen amongst all the socio-economic classes. Interpretation & conclusions: High levels of IgG protective antibodies were seen among the studied HCWs, hence HAV vaccination may not be required. It will be advisable to do a cost-benefit analysis of vaccination for HAV.

Basilar imagination : a rare cause of "top of basilar artery" syndrome.

"Top of Basilar Artery" Syndrome as the presentation of CVJ anomalies is extremely rare. The association between skeletal CVJ anomalies and vertebro-basilar insufficiency (VBI) is recognised and angiographic abnormalities of the vertebro-basilar arteries and their branches have been reported. Atlanto-axial dislocation (AAD) is the commonest skeletal cranio-vertebral junction (CVJ) anomaly in India, followed by occipitalisation of atlas and basilar invagination. They usually present with a progressive neurological deficit (70 - 94% cases) implicating the high cervical cord, lower brainstem, and cranial nerves. We report one such case with the even more rare presentation of "Top of Basilar Artery" Syndrome as the initial presentation of basilar invagination.

Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: A rare case report.

Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6‑year‑old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a “kuhl” (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non‑nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the “kuhl” from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

An Interesting Case of Meckel-Gruber Syndrome.

Meckel-Gruber syndrome, also known as ‘Dysencephalia splanchnocystica’, is a rare lethal autosomal recessive disorder consisting of central nervous system malformation- mainly posterior encephalocele (80%), multicystic kidneys (95%) and polydactyly (75%). Besides the classic triad of neural tube defects, polydactyly and cystic dysplasia of the kidneys, other abnormalities can occur in association with the syndrome, which may be detected sonographically include micrognathia, cardiac abnormalities, syndactyly, clinodactyly and clubbed foot. We report a case of a 26-year-old woman with previous LSCS referred from a private practitioner with abnormal ultrasonographic findings. She was diagnosed to have Meckel-Gruber syndrome. Woman and her husband were counseled regarding this lethal condition incompatible with life and after proper consent and information, pregnancy was terminated.

Anti-tuberculosis activity of selected medicinal plants against multi-drug resistant Mycobacterium tuberculosis isolates.

Background & objectives: Emergence of multi-drug resistant (MDR) and extensively-drug resistant (XDR) strains of Mycobacterium tuberculosis has further complicated the problem of tuberculosis (TB) control. Medicinal plants offer a hope for developing alternate medicines for the treatment of TB. The present study was done to evaluate in vitro anti-tubercular activity of five medicinal plants viz., Acalypha indica, Adhatoda vasica, Allium cepa, Allium sativum and Aloe vera. Methods: Aqueous extracts of leaves of A. indica, A. vasica, bulbs of A. cepa, cloves of A. sativum and pure gel of A. vera leaves, were tested in vitro for their activity against two MDR isolates (DKU-156 and JAL-1236), reference susceptible strain M. tuberculosis H37Rv as well as rapid grower mycobacterial pathogen M. fortuitum (TMC-1529) using Lowenstein Jensen (L-J) medium and colorimetric BacT/ALERT 3D system. Activity in L-J medium was evaluated by percentage inhibition which was calculated by mean reduction in number of colonies on extract containing as compared to extract free controls. Results: Extracts of all the five plants A. indica, A. vasica, A. cepa, A. sativum and A. vera exhibited anti-tuberculosis activity in L-J medium, the proportion of inhibition of these plants extract in respect mentioned above is 95, 32, 37, 72, 32 per cent, respectively for MDR isolate DKU-156 and 68, 86, 79, 72, 85 per cent, respectively for another MDR isolate JAL-1236, while for sensitive M. tuberculosis H37Rv, inhibition was found to be 68, 70, 35, 63 and 41 per cent, at 4 per cent v/v concentration in L-J medium. There was no inhibition against rapid grower M. fortuitum (TMC-1529). In BacT/ALERT also, extracts of these plants showed significant inhibition against M. tuberculosis. Interpretation & conclusions: Our findings showed that all these plants exhibited activity against MDR isolates of M. tuberculosis. While the anti-TB activity of A. vera, A. vasica and A. sativum against MDR isolates confirm earlier results, activity of the extracts of A. indica and A. cepa is reported for the first time. Further studies aimed at isolation and identification of active substances from the extracts which exhibited promising activities, need to be carried out.

Identification of environmental mycobacteria isolated from Agra, north India by conventional & molecular approaches.

Background & objectives: Several environmental mycobacteria have been shown to be important human pathogens linked to immunomodulation especially in relation to effect on vaccination. Hence identification of mycobacteria to the species level is not only relevant to patient management but also to understand epidemiology of mycobacterial diseases and effect on vaccination. We undertook this study to assess the usefulness of various conventional and molecular methods in identification of environmental mycobacterial species from Agra, north India. Methods: One hundred nineteen isolates of environmental mycobacteria were grown from 291 (116 soil and 175 water) samples. These isolates were identified by standard biochemical tests, and a simple, rapid and cost-effective in-house developed gene amplification restriction analysis targeting 16S-23S rRNA spacer and flanking region and 16S rRNA sequencing. Results: Biochemical tests could clearly identify only 68.1 per cent (81/119) of isolates to species level. An in-house developed gene amplification - restriction analysis method could confirm the identity of 102 of 119 (85.7%) isolates and the remaining 17 isolates (14.3%) were confirmed by 16S rRNA sequencing also. These 119 environmental mycobacterial isolates, included several potentially pathogenic species such as M. fortuitum, M. chelonae, M. avium, M. marinum, M. manitobense, M. kansasii and others belonged to nonpathogenic species, M. terrae, M. smegmatis and M. flavescens. M. chelonae was isolated from water samples only whereas M. fortuitum was isolated from both water as well as soil samples. Interpretation & conclusion: The in-house developed gene amplification restriction analysis method though failed to accurately identify 14.3 per cent of isolates, facilitated rapid differentiation of most of environmental mycobacteria including potential pathogens from this area and thus would have diagnostic potential in cases with NTM infections. This combination strategy using PCR-RFLP and 16S rRNA sequencing may be useful for characterization of mycobacteria from similar environmental settings from other parts of world.

Impact of environmental changes on the reproductive biology in Pyrostegia venusta Presl.

Local environment (temperature and relative humidity) affects reproductive biology in Pyrostegia venusta (Bignoniaceae) growing at Agra and Mysore. At Agra, the species flowers profusely during December to March, but fails to bear fruits. At Mysore, on the other hand it flowers during November to February and produces well developed fruits with winged seeds. This species, growing at two places, exhibited differences in their pollen fertility and in vivo pollen germination. Pollen fertility at Agra and Mysore was 27.55 and 80-90%, respectively. The in vivo pollen germination on stigmatic surface was only 3-4% at Agra, but 85-95% at Mysore. The flowers at Agra also exhibited heterostyly and increased number of stamens and stigmatic lobes. The significantly low and wide ranged temperature (4.5-33.8oC) and between 23-98% RH during the flowering period at Agra could be the cause for reduced in pollen fertility, floral polymorphism and inhibition of pollen germination on the stigmatic surface and fruitlessness. At Mysore, where temperature ranges between 20.2-33.5oC and RH varies from 33-75% profuse fruiting takes place. The study shows a direct control of environment over the process of reproduction.

Growth and periodicity of cyanobacterial bloom in a polluted pond of Agra city.

Periodical changes in physico-chemical properties and cyanophycean bloom in a pond ofAgra city during the year 2005 and 2006 were studied. It was recorded that the pond water was polluted throughout the study period and this was closely associated with Cyanobacterial bloom. During summer (March to June), the pond water was highly polluted, as it was rich in various nutrients and phosphates in particular. The pH of pond water was high with low DO and this was associated with the highest peak of water bloom. On the other hand, during winter (November to January), the bloom was at its lowest. The quantity of various nutrients in the pond water was low and the pH was also low but DO was high. Bloom consisted of eighteen members of Cyanophyceae of which Oscillatoria limosa, O. formosa, O. splendida, Anabeana iyengarii, Microcystis arruginosa and Nostoc muscorum were observed throughout the year. On the other hand, Oscillatoria agardhi, and O. tenuis were found only in winters, while O. annae in rainy season only. Similarly, Oscillatoria brevis, Anabaena flosaquae, Aphanizomenon sp. and Lyngybea birgei were found in abundance in summer.

Assessment of bio-medical waste management in three apex government hospitals of Agra.

Waste management practices in three apex government hospitals of Agra viz., Sarojini Naidu Medical College, Lady Lyall Maternity Hospital and District Hospital were studied during January 2004-January 2005. Data were collected with the help of (i) personal observations of the waste treatment and disposal practices and (ii) assessment of knowledge, attitude and practices of working personnel with the help of questionnaires. The results obtained indicated lack of knowledge and awareness regarding legislations on bio-medical waste management even among qualified hospital personnel. None of these hospitals were equipped with higher technological options e.g. incinerator autoclave, microwave and had no facilities to treat the liquid waste generated inside the hospital. It is concluded that generation and implementation of a waste management policy institutiona/organizational set up, training and motivation must be given paramount importance to meet the current needs and standards of bio-medical waste management in these hospitals.

Reproductive health problems and help seeking behavior among adolescents in urban India.

OBJECTIVE: To assess their reproductive health problems and help seeking behaviour among urban school going adolescents. METHOD: A sample of 300 urban school going adolescents between 11-14 years were chosen at random and assessed using four tools namely, self administered questionnaire : provision of adolescent friendly services; medical screening and focus group discussions. RESULTS: Seventy two percent girls and 56% boys reported health problems during survey with an average of 1.93 complaints per girl and 0.5 complaints per boy. However, only 43% girls and 35% boys reported to the clinic voluntarily to seek help and only one fifth the amount of problems were reported at the clinic in comparison to the quantum of problems reported in survey, which probably reflects a poor health seeking behaviour. A medical checkup with emphasis on assessment of reproductive health and nutritional status helped in detecting almost the same number of reproductive health problems as reported by them in survey. This intervention helped to increase the client attendance in subsequent period of next one year from 43% to 60% among girls and from 35% to 42% among boys. CONCLUSION: Our study shows that to increase help seeking behaviour of adolescents, apart from health and life skill education, their medical screening with a focus on reproductive health by trained physicians, parental involvement, supported by adolescent friendly centers (AFC) for counseling, referral and follow up are essential.

Seasonal phytoplanktonic diversity of Kitham lake, Agra.

Two years (Jan. 2000 - Dec. 2001) data on the seasonal studies of phytoplanktonic diversity of Kitham lake (Sur Sarovar) Agra revealed the presence of 73 algal species. A limited number of these were recorded throughout the year, while others were distributed in different seasons mainly in winter and summer seasons. During winters, Chlorophyceae was the most dominant group followed by Bacillariophyceae. On the other hand, Cyanophyceae and Euglenophyceae were the most dominant during summers. Certain species e.g. Pandorina morum, Pediastrum tetras, Gonium sp., Chlorella vulgaris, Scendesmus quadricauda, Oedogonium cardiocum, Synedra ulna, Oscillatoria agardhii and Euglena gracillis were recorded throughout the year. Chlorella, Stigeoclonium, Pandorina, Micratinium, Oscillatoria, Anacystis, Nitzschia and Cymbella were found to be good indicators of water pollution.

Pre-hospital treatment of snake envenomation in patients presented AT a tertiary care hospital in Northwestern India

Snakebite is an important medical emergency. Anti-snake venom along with supportive care is the only specific treatment. However, many people put their faith in non-registered medical practitioners. Where medical aid is available, lack of trained health personnel jeopardizes the situation. This retrospective study, the first of its kind, was aimed at studying the pre-hospital treatment as well as the behavior of patients bitten by snakes and referred to the Postgraduate Institute of Medical Education and Research, Chandigarh, India. A total of 88 cases that occurred between January 1997 and December 2001 were studied. Seventy patients received treatment prior to admission (the majority was treated by non-registered medical practitioners, registered medical practitioners, and MBBS doctors). The various treatment modalities used were: anti-snake venom (ASV), tourniquet, incision and drainage (I&D), tetanus toxoid, injections, and tablets. Non-registered medical practitioners still preferred tourniquet and I&D. The patients who were referred within 24 hours stayed less time in the hospital and spent less money on the treatment compared to those who were referred after 24 hours. Non-registered medical practitioners and inadequately trained health staff are often the first contact of snakebite victims. Their traditional and unscientific methods of treatment lead to unnecessary morbidity and increased treatment cost. It is therefore necessary to train these people adequately so that proper treatment can be instituted at the earliest.

Cryptococcal meningitis in acute lymphoblastic leukemia.

The occurrence of cryptococcal meningitis in acute lymphoblastic leukemia (ALL), despite being immunosuppresed state is uncommon. We report a 28-year gentleman in the maintenance treatment phase of ALL developing cryptococcal meningitis. The diagnosis was made by positive India ink staining and detection of cryptola antigen by latex agglutination. The patient was successfully treated with amphotericin B. The rarity of this condition in ALL is briefly discussed.

Impact of air pollution on floral morphology of Cassia siamea Lamk.

Cassia siamea plants growing at two different sites (polluted and non-polluted) on two important roads of Agra city exhibited significant differences in their flowering phenology and floral morphology. The flowering in plants growing at polluted site is delayed and there was a marked reduction in flowering density, flowering period, size of floral parts, pollen fertility, fruit and seed-set. SEM observations revealed the presence of well developed glandular structures and reduction in the number and size of large stomata on the anther surface at polluted site. These changes were found to be closely associated with the extent of air pollution caused mainly by significant in the number of automobiles.

Role of phenolics and boron in reproductive success in seasonally transient sterile Tecoma stans L.

Quantitative and qualitative analysis of phenolics and boron in stigma of transient sterile Tecoma stans L. during seedless (May-July), partially seedbearing (August-November, April) and seedbearing periods (December-March) was made. UV absorption profile of stigmatic exudates indicated the presence of simple phenolics. Total phenolics were higher in stigma during seedless period. Thin layer chromatographic analysis of stigmatic extracts exhibited only three principal spots. Mass spectrophotometry showed the presence of derivatives of cinnamic acid, namely, caffeic acid in these spots. Quantity of boron in stigma during seedless period was lowest but the difference with other periods was not significant. It was suggested that the accumulation of higher quantity of caffeic acid in the stigma during seedless period due to high temperature (40 degrees-45 degrees C) could lead to inhibition of pollen germination in vivo, thereby rendering the plants seedless. This was confirmed by inhibition of in vitro pollen germination in the basal medium containing higher quantity of caffeic acid.