Knowledge of hand cleanliness among medical students and nurses at tertiary healthcare centre: a cross-sectional study

Background: Hand hygiene is documented as one of the foremost techniques to prevent cross-transmission of germs. Objectives: This paper aims to assess the knowledge of hand cleanliness among medical students and working nurses. Methods: It was a cross-sectional descriptive study, carried over a sample selected by non-probability convenient sampling technique. The questionnaire used here to assess the knowledge and practice on hand hygiene was adapted from the World Health Organization (WHO) Guidelines on Hand Hygiene in Health Care. The data thus collected were presented in terms of counts and percentages. Chi-square test was used to test the significance of the differences, and a p-value of less than 0.05 was considered as statistically significant. Results: Overall, 92.08% of participants have received training in handwashing. Twenty-five (41.60%) medical students believed that the microbes already present with the patient were responsible for hospital-acquired infection (HAI). Medical students had significantly higher knowledge than working nurses regarding dryness of skin due to hand rubbing over handwashing (p<0.05). Medical students also had substantially higher awareness about the performance of handwashing and hand rubbing in sequence (p<0.05), which they think was not right. Knowledge on the colonisation of hands with harmful microbes was more with the nurses. Conclusion: There is a need to increase awareness among medical students and nurses regarding procedural hand hygiene methods to prevent HAI. The current findings can be a basis for conducting a training programme on hand hygiene practices for the medical students, including paramedical staff members.

Rhinoscleroma Revisited

ABSTRACT Rhinoscleroma (more appropriately 'scleroma') is a chronic, disfiguring inflammatory lesion that is rarely encountered in the present-day otolaryngology practice. The diagnosis often becomes difficult especially when it recurs and presents late with complications. This report illustrates the clinical and histologic features of rhinoscleroma in a defaulter patient who represents advanced-stage disease with orbital and intracranial extensions. Special emphasis has been provided on the computed tomography impressions such that the evolution of scleroma with time can be studied.

Diversity and management of plant species in an Eri silkworm agroforestry system by Mishing tribe of Assam, India

Aim: The present study was conducted to investigate the status and diversity of plant species used for rearing of Eri silkworm and their traditional management in the homegardens of Mishing tribe.Methodology: A total of 45 homegardens from three villages were surveyed randomly which were primarily associated with rearing of Eri silkworm. Vegetation was studied using quadrat method. The data on traditional knowledge associated with the management of plants species for rearing of Eri silkworm were collected using semi structured questionnaires. Results: The average size of studied homegardens was 0.35 ha. A total of 243 plant species were recorded from the studied homegardens of which six species were used as food plants for rearing of Eri silkworm and 10 species were used in construction of mountage. Trees related to Eri culture contributed to 37.47% of the total importance value index (IVI) in the studied homegardens. Heteropanax fragrans (Roxb.) Seem and Ricinus communis L. were the primary food plants of Eri silkworm and were found to be dominant in the homegardens. Activities such as land preparation, sowing, pruning, weeding and watering are carried out for the management of Eri silkworm food plant species and were found to vary for different species. Interpretation: There is an urgent need to document the indigenous knowledge and traditional practices associated with the management of host and food plants used in the rearing of Eri silkworm in the present day context as it is a part of their cultural heritage and should be reoriented through integration of modern farming technique.

Genetic characterisation of influenza A(H1N1)pdm09 viruses circulating in Assam, Northeast India during 2009�15

Introduction: Influenza A(H1N1)pdm09 virus, since its identification in April 2009, has continued to cause significant outbreaks of respiratory tract infections including pandemics in humans. In the course of its evolution, the virus has acquired many mutations with an ability to cause increased disease severity. A regular molecular surveillance of the virus is essential to mark the evolutionary changes that may cause a shift to the viral behavior. Materials and Methods: Samples of Throat/Nasal swabs were collected from a total of 3715 influenza-like illness cases and screened by Real-time Reverse Transcription-Polymerase Chain Reaction for influenza viruses. Nucleotide sequence analysis was done to identify changes in antigenicity of the virus strains. Results: The present study describes the molecular characteristics of influenza A(H1N1)pdm09 viruses detected in Assam of Northeast India during 2009�15. Influenza A viruses were detected in 11.4% (425/3715), of which influenza A(H1N1)pdm09 viruses were detected in 41.4% (176/425). The nucleotide sequencing of influenza A(H1N1)pdm09 viruses revealed a total of 17 and 22 amino acid substitutions in haemagglutinin (HA) and neuraminidase (NA) genes of the virus, respectively, compared to contemporary vaccine strain A/California/07/2009. The important mutations detected in HA genes of A/Assam(H1N1)pdm09 strains included E391K, K180Q and S202T. Mutation 'N248D' which has an ability to develop oseltamivir resistance was also detected in NA gene of A/Assam(H1N1)pdm09 strains. Conclusions: Regular molecular surveillance of influenza A(H1N1)pdm09 is important to monitor the viral behavior in terms of increase virulence, drug resistance pattern and emergence of novel strains.

Response to growth hormone therapy in indian patients.

Objective. To analyse response to growth hormone therapy on Indian patients with short stature. Methods. Data were collected on 71 patients of short stature on GHT. All patients underwent clinical and hormonal evaluation. GHD was diagnosed in the presence of short stature (height SDS < 2) and peak GH levels < 10 ng/ml. Bone age was estimated using Tanner Whitehouse 3 method (TW3). Results. Primary GHD (73%) was the commonest diagnosis among patients on GHT, followed by organic GHD (12.6%), genetic syndromes (8.4%) and systemic diseases (5.4%). Mean chronological age at presentation was 10.07±3.26 years (median-11 years, range 3-15 years), mean height age was 6.98±2.82 years (median 7.5 years, range 1-13 years) and mean bone age (available for 55 patients) was 7.19±3.1 years (median 8.2 years, range 1.3 - 13 years). Patients with systemic diseases (6.75±3.5 years) presented earlier, compared to patients with GHD (10.27±3.16 years) and genetic syndromes (10.18±3.20 years) (p=0.349). Most of the patients on GHT were in the age group 9-15 years (60.6%). Mean height gain with GHT was 8.7±2.7 cm (median 8.3 cm, range 3.0-13cm) during 1st year then decreased to 6.9±2.4 cm (median 7.0 cm, range 3.0-12.5 cm) in the second year, and was maintained through the third year (mean 7.1±3.0 cm, median 7.0, range 3.0-13 cm). Among patients with GHD, those with primary deficiency had significantly better response to GHT in 1st year than secondary deficiency (9.0±2.65 vs 6.8±3.03 cm, p = 0.026). Response to GHT was negatively correlated with CA (r-0.27, p = 0.05), HA (r-0.47, p = 0.027) and BA (r-0.31, p=0.022) at presentation. Four patients (5.6%) developed hypothyroidism and one patient each developed disseminated tuberculosis and rickets. One patient of Turner's syndrome died of adrenal carcinoma. Short follow up and absence of measurement of IGF-1 and IGFBP3 were major limitations of this study. Conclusions. Response to GHT in Indian patients is comparable to western counterparts. Maximum height gain on GHT is during the first year than decreases in second year, but is maintained through third year. Patients with primary GHD had better response than secondary GHD. Response to GHT is negatively correlated with chronological, height and bone age at presentation.

Poly (DL-lactide-co-glycolide) based delivery systems for vaccines and drugs.

Current vaccination and drug delivery strategies emphasize on the development of controlled release techniques for persistent and sustained effects. In the recent years, polymer based systems for the delivery of bioactive agents have gained considerable attention due to their marked adjuvanticity, established biodegradability and biocompatibility, excellent mechanical strength and controlled release profiles. This review deals with the potential applications of synthetic polymers mainly PLG polymers in delivery of vaccines and drugs.

Detection of rabies virus in different tissues of experimentally infected mice at preclinical and postclinical stages of the disease.

Rabies fixed virus (CVS) was passaged 10 times in mice by intramuscular (im) route followed by experimental inoculation of the titrated virus in 4 groups of mice with the dose of 0.1 ml of 1000 mouse (LD50 0.03 ml) using intracerebral (ic), intravenous (iv), intramuscular (im), intraocular (io), and intranasal (in) routes respectively. No marked variation in clinical signs due to variation of routes could be detected. Involvement of brain with io route could be detected even in preclinical stage. Although the virus could be detected in the postclinical stage in all the tissues under study (brain, skin, salivary gland and corneal impression), with io and ic routes spread of the virus was observed in comparatively higher concentrations.

Genetic investigations among the Ahom of Assam.

The Ahom has been investigated for the distribution of ABO blood groups, phenylthiocarbamide taste sensitivity, earlobe attachment and age at menarche. The present sample of Ahom displays a good amount of homogeneity with most of the neighbouring mongoloid population. Only biological features that set apart Ahom from other mongoloid populations is earlobe attachment types. It is quite possible that the higher frequency of phenotype B among the Ahom may be due to the gene flow from the surrounding caste (Indid) populations as a result of admixture.

A case control study of cancer cervix patients attending Command Hospital, Pune.

A case control study was undertaken with the objective to determine the association of certain host factors like marital status, age at first marriage, duration of married life, parity, literary status and genital hygiene, in the subsequent development of cancer cervix. A total number of ninety-two cases and an equal number of control subjects, under matched case control design, were studied at Command Hospital, Pune over a period of nine months. Salient findings of this epidemiological study have been highlighted in this communication. Few of the risk factors viz early age at first marriage, longer duration of married life, increased and early parity, low educational status and poor genital hygiene were found to have played significant role in the subsequent development of carcinoma cervix.