Extended Spectrum Beta Lactamase producing Gram negative bacteria - An emerging menace in Neonatal Sepsis.

Introduction: Neonatal sepsis caused by extended spectrum beta lactamase (ESBL) producing Gram negative bacteria (GNB) is associated with significantly high mortality and morbidity. Clinical features and risk factors for such neonatal sepsis can help in identifying it early. Objectives: Aim of the study was to estimate the incidence, risk factors, clinical features and antibiotic sensitivity of GNB and outcomes of ESBL GNB in neonatal sepsis. Methodology: A prospective observational conducted at regional tertiary care health center. Statistical analysis was carried out with SPSS version 23.0. Results: A total of 87 cases of Gram negative neonatal sepsis were included in study. Male: female was 1.7:1. Forty nine (56.3%) isolates were ESBL positive strains. The clinical features in order of frequency were shock, lethargy, sclerema, disseminated intravascular coagulation and severe thrombocytopenia. Out born neonates (p=0.03), late onset sepsis (p=0.05) and mechanical ventilation (p=0.002) were the risk factors for ESBL GNB sepsis. Mortality associated with ESBL sepsis was 26.5%. Carbapenems and Piperacillin + Tazobactum were most sensitive antibiotics and high resistant for cephalosporins was observed. Conclusion: ESBL GNB neonatal sepsis is an emerging threat with high mortality in Neonatal Intensive care unit.

Medico Legal Awareness:Where are we? – A Survey among Health Professionals in Maharashtra and Haryana

Medicine is a noble profession but there is also growing anxiety both within the medical profession and in the community regarding increasing trends of complaints and lawsuits against doctors. Knowledge about medical ethics is as fundamental to the practice of medicine as clinical skills. To assess the knowledge of health care professionals regarding medico-legal issues. The questionnaire study consisted of questions pertaining to basic knowledge of COPRA (Consumer Protection Act 1984), informed consent and Medico-legal courses. A total of 325 health care professionals enrolled for the study. Most of the health care professionals were able to answer questions about informed consent. Almost 80% of health professionals were aware about informed consent, 41.84% of health professionals were not aware about consumer protection act 92%of health professionals don’t know about the courses regarding Medico-legal issues. The participants were knowledgeable about medical ethics and informed consent but when it came to Consumer Protection act, professional indemnity claim and medico- legal courses their information was basic, they lacked knowledge about finer details hence showed an immediate need to update the understanding of these issues to be on legally safer side.​

A new technique to determine vertical dimension of occlusion from anthropometric measurements of fingers.

Purpose: The purpose of this study was to find the correlation between vertical dimension of occlusion (VDO) and length of fingers. Materials and Methods: A cross-sectional study was conducted on 400 dentate subjects comprising of 200 males and 200 females. Anthropometric measurements of VDO, length of index finger, length of little finger, and distance from tip of thumb to tip of index finger of right hand were recorded clinically using modified digital vernier caliper. Correlation between VDO and length of fingers was studied using Spearman's coefficient. For the execution of regression command and preparation of prediction equations to estimate VDO, Statistical Package for Social Sciences Software Version 11.5 was used. Results: VDO was significantly and positively correlated with all the parameters studied. In males, correlation of VDO was strongest for length of index finger (r-0.406) whereas in females, it was strongest for length of little finger (r-0.385). VDO estimation using regression equation had a standard error of ± 3.76 in males and ± 2.86 in females for length of index finger, ±3.81 and ± 2.74 in males and females respectively for length of little finger, ±3.99 and ± 2.89 in males and females respectively for distance from tip of thumb to tip of index finger. Conclusions: Since the variations between VDO and finger lengths are within the range of 2-4 mm, VDO prediction through this method is reliable, and reproducible. Also the method is simple, economic, and non-invasive; hence, it could be recommended for everyday practice.

Efficacy of various spray disinfectants on irreversible hydrocolloid impression materials: An in vitro study.

Background: Most of the materials (casts, impressions, etc.) that are sent to the dental laboratories show the presence of numerous pathogenic microorganisms. All the spray disinfectants are not equally effective against these microorganisms. Aims and Objectives: The aim was to compare the effectiveness of different spray disinfectants on irreversible hydrocolloid impressions and to find out the most effective dilution, contact time, and effect against each microorganism studied. Materials and Methods: The effects of four spray disinfectants, 5.25% sodium hypochlorite, 0.525% sodium hypochlorite, 1:213 (1 part in 213 parts of water) povidone iodine, and 2% glutaraldehyde along with control (distilled water) on irreversible hydrocolloid impressions contaminated with Staphylococcus aureus, Bacillus subtilis and Streptococcus viridans were studied. Results: Sodium hypochlorite, 5.25%, showed 1-min exposure time which was able to effect a 4log10 reduction in bacterial counts against S. aureus and S. viridans followed by 0.525% sodium hypochlorite and 2% glutaraldehyde for 10 min. None were able to effect a 4 log10 reduction against B. subtilis. Conclusion: Sodium hypochlorite with a concentration of 5.25% was the most effective disinfectant and required the shortest contact time (1 min). Not all ADA-approved concentrations of surface disinfectants work equally well on irreversible hydrocolloid impression materials.

Characterization of leprosy based on the nasal lipid profile.

While extracting the M. leprae from the nasal flushings of leprosy patients it was found that these organisms were trapped in the waxy layer, between the aqueous and the chloroform layers. Thin layer chromotography (TLC) analysis of this layer, using chloroform-methanol-water system, revealed different spots when sprayed with acid alcohol and heated at 160 degrees C. The TLC profile of lipids of lepromatous and borderline (MB according to the WHO terminology) leprosy patients was distinctly different from that of tuberculoid leprosy patients and normal human volunteers. A simple, economical and fast procedure to characterize patients belonging to different spectra has been developed.