Quality of life in children with cerebral palsy

Background: Cerebral palsy (CP) is the most common motor disability in childhood. Quality of life (QOL) has emerged as an important concept in childhood, especially for children with disabilities. CP has an impact on a child’s capacity to do activities of daily living thus affecting QOL of patients and their families. Aims and Objectives: The objective of present study was to assess the QOL in children with CP. Materials and Methods: In this study, 29 children with CP in the age group of 4–12 years were evaluated for QOL was assessed using CPQOL-Child Primary Caregiver Questionnaire (4–12 years). The questionnaire was completed by one of the parents or their caregiver. Scores for each domain of QOL were converted to a scale ranging from 0 to 100 and analyzed. Results: The scores as reported by the parents were low for each of the domains with maximum effect seen in functioning domain and least in pain domain. Girls had better QOL than boys. The QOL scores were negatively related to the severity of CP which was assessed by gross motor function classification system suggesting that severity of disability had negative impact on QOL. Conclusion: QOL of children with CP was found to be poor and was influenced by age, sex and motor functioning

Are Parents Willing to Vaccinate Their 6- To 11-Year-Old Children Against COVID-19? A Community Based Study in Murshidabad, India

Context/Background: The future of Corona virus disease is still uncertain due to viral mutations. Immuniza-tion against COVID-19 has not yet been introduced for children aged 6-11 years. Parents are instrumental for the success of any immunization programme, being the chief decision makers for their wards. The study aims to assess the perceptions of parents regarding COVID 19 vaccination among children aged 6-11 years in an urban slum of Murshidabad and identify the factors influencing such perceptions among them. Methodology: A cross sectional study was conducted among 106 parents in a slum area of Murshidabad, West Bengal. Participants were interviewed using a validated WHO Vaccine Hesitancy Scale (VHS). Bivariate and multivariable analysis were done using Chi square test and binary logistic regression respectively. Results: Majority of the study subjects instead of parents were unlikely to vaccinate their children against COVID-19. The major concern centered around the safety (73.5%) of the vaccine. Higher level of education (p=0.003), previous history of COVID-19 infection in the family (p=0.004) and having a children aged between 6-8 years (p=0.006), influenced such perceptions, with the latter being the single most important predictor (AOR 4.126, P=0.007). Conclusions: The likelihood of parents to vaccinate their child was found to be low. This underscores the im-portance of an effective communication strategy when such programme will be rolled out.

A Systematic review of factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India.

Background: Iron-folic acid deficiency is the most common complication during pregnancy. Iron deficiency is responsible for various health complications among pregnant women. Compliance with IFA supplementation is variable across India several factors are associated with compliance with IFA supplementation. Objective: The objective of this systematic review is to assess the factors affecting compliance toward oral iron-folic acid supplementation among pregnant women in India. Methods: The primary search was carried out using PubMed, Google scholar, the WHO website, and Research Gate which provide access to full?text research articles from January 2012 to 25th January 2022 published data were searched. Result: A total of 74 studies were identified, and 20 were included in this review. Out of the 20 studies, sixteen were cross-sectional, two mixed methods, and two randomized control trials. knowledge of IFA, education, socioeconomic status, the timing of registration and number of antenatal visits, type of family, and age of the pregnant women were the factors that affect the compliance of IFA supplementation. Conclusion: Knowledge of iron-folic acid supplementation, Timing of registration and number of Antenatal Care visits, educational level of the pregnant women, and age of the pregnant women were factors associated with the compliance of IFA supplementation among pregnant women in India.

Evaluation of COVID-19 appropriate behavior among fully vaccinated students in a medical college of north-east India

Background: The current COVID-19 pandemic is one of the greatest public health challenges. The spread of COVID-19 infection continues unabated despite vaccination. Adherence to COVID-19 appropriate behavior is critical to prevent COVID-19 infection. Aim and Objectives: To find out the pattern of COVID-19 appropriate behavior among vaccinated medical students and to estimate the incidence of COVID-19 infection after vaccination. Materials and Methods: A cross-sectional observational study using a questionnaire was carried out for a period of 3 months. The questionnaire was prepared based on the guidelines of Ministry of Health and Family Welfare, Government of India. The data were collected using a pretested Google Form (online digital questionnaire) by means of a web-based survey. Results: About 96.5% of the participants wear face cover or mask while meeting someone or during visit to public places and 91.6% maintain respiratory hygiene, whereas 11.6% spit in the open, 16.1% travel unnecessarily, and 36.8% do not discourage crowd. There is significant (P < 0.05) increase in COVID-19 infection after vaccination. Conclusion: This study suggests that more emphasis should be given on sensitizing the medical students about the standard COVID appropriate behaviors because strict adherence to COVID-19 appropriate behavior is the key to the long-term management of this pandemic.

Burden of bacterial contamination: A cross-sectional study to estimate the bacterial isolates from the surfaces of a bacteriology laboratory

Background: Contamination in a bacteriology laboratory setup may result in erroneous interpretation. Aim and Objective: To estimate the bacterial isolates from different surfaces of the bacteriology laboratory of a tertiary care hospital. Materials and Methods: A total number of 165 samples were taken from different surfaces of the laboratory including tabletops, floor, walls, and workbench tops at the beginning of morning session for consecutive thirty working days (June 2019). Surface swab technique was followed using pre-incubated Nutrient agar (Basal plate), Mac-conkey’s agar (Selective and differential media), and Blood agar plates (enriched media). Aerobic incubation was done overnight at 37°C. Discrete colonies were studied by Gram, Ziehl-Neelsen, and Albert staining followed by the tests for motility and a series of biochemical reactions. Results: Out of 165 collected swabs, growth was observed in 23 (13.93%). Out of these 23 isolates, none was from the workbench top. Majority (47.82% i.e., 11/23) was from the floor. Amongst 23 isolates, 14 (60.86%) were Gram-positive in nature and 7 (30.43%) found to be motile. Isolated bacteria comprised Micrococcus spp. (34.78% i.e., 8/23), Pseudomonas spp. (17.39%,4/23), Coagulase-negative Staphylococcus spp. (13.04% i.e., 3/23), Bacillus spp. (13.04%, i.e., 3/23) and Acinetobacter spp. (21.73% i.e., 5/23). From floor, majority of the isolates were Micrococcus spp. (45.45%, i.e., 5/11) whereas in wall, mostly Bacillus spp. (33.33%, i.e., 3/9) and tabletop, all of the isolates were Coagulase-negative Staphylococcus spp. Conclusion: Vigilant disinfection and maintenance of personal hygiene of laboratory workers are essential to eliminate contamination.

Development And Evaluation Of Novel Estimation Techniques For In Vitro Dissolution Study And Validation Protocol For Escitalopram As Antidepressant Drug And Their Formulation

Objective: To develop and validate the RP-HPLC method and in vitro dissolution study for escitalopram as antidepressant drug and their formulation. Methods: The chromatographic separation was done by using a C-18, 150 mm column and a mobile phase consisting of phosphate buffer (40%) and acetonitrile HPLC grade (60%). Detection was carried out at 211 nm with a flow rate of 1 ml/min with an injection of 20 μl. The method was validated with different parameters such as linearity, precision, accuracy, robustness, and limit of detection (LOD), the limit of quantification (LOQ) according to ICH guidelines. Results: The linear calibration curve was obtained in the concentration range of 0-50 μg/ml and gave an average correlation factor 0.992. The retention time was observed at 2.96 min. The Minimum concentration level at which the analyte can be reliably detected (LOD) and quantified (LOQ) were found to be 0.03 and 0.09 µg/ml, respectively. The relative standard deviation of intra and the inter-day assay was found to be less than 2. The dissolution studies show moderate dissolution (23.4%) after 45 min, but it reaches a plateau after approximately 25 min. Conclusion: This method was found to be simple, rapid and economic with less run time. The validated parameters manifest the method is reliable, linear, accurate and precise as well as robust with minor variations in chromatographic parameters. Therefore, the developed method can be applied for both routine analysis and quality control assay and it could be a very powerful tool to investigate the stability of escitalopram.

Patho-morphological Study of Gigantocotyle spp. Infection in Water Buffaloes (Bubalus bubalis)

A total of 12 adult buffaloes were presented for the necropsy over the period of 6 months at the Department of Veterinary Pathology, CGKV, Anjora, Durg, Chhattisgarh. Prevalence of Gigantocotyle spp. parasite infection was found to be 16.67% (2/12). Significant number of parasites was found in the bile duct and ductules of the infected liver along with the necrotic debris caused by parasite. Other gross lesions observed were included hepatitis, haemorrhages and fibrosis of the liver. Black color hard nodules at the site of mucosal attachment of parasites were noticed. Microscopic changes observed were included bile duct hyperplasia, haemorrhages, moderate fibrosis and granulomatous nodule characterized by infiltration of inflammatory cells

Focal nodular hyperplasia of the liver in children: A report of 2 cases

Focal nodular hyperplasia (FNH) is a benign non-neoplastic lesion of the liver usually found in adults. It is uncommon in children, comprising 2-10% of all pediatric liver tumours. In children, it can occur at all ages, with increased frequency between 6-10 years. We present two cases of FNH in childhood- the first being that of a 5-month-old infant, and the second in a 6-year-old boy. The possibility of congenital FNH had been excluded in the first case. The second case posed diagnostic difficulty initially and was wrongly treated for hepatoblastoma by neoadjuvant chemotherapy, but later correctly diagnosed to be FNH. Both the children are doing well on follow-up. Paediatric FNH though rare, should be kept in mind while dealing with a hepatic mass. Radiological features can be variable and needle sampling may not be sufficient to reach to a diagnosis. Histological examination with glutamine synthetase immunostaining should be performed in doubtful cases to differentiate FNH from other paediatric liver masses, as management differs.

Assessment of microbiological status after successful completion of intermittent revised national tuberculosis control programme directly observed treatment, short course regimen for microbiologically confirmed pulmonary tuberculosis cases: While new daily regimen going to be implemented in India

Purpose: The Revised National Tuberculosis Control Programme (RNTCP) is now introducing daily fixed-dose regimen instead of Directly Observed Treatment, Short Course (DOTS) regimen for treatment of drug-sensitive tuberculosis (TB) in India. It would be beneficial to understand the drawbacks, barriers and advantages of the existing system for better implementation of new policy. Our study was aimed to evaluate the current microbiological status of new microbiologically confirmed pulmonary TB patients who have successfully completed intermittent DOTS regimen within last 2 years and also to find the economic barriers faced by beneficiaries to avail DOTS treatment. Materials and Methods: We included patients who had completed CAT 1 DOTS regimen within the last 2 years. The patients were interviewed. Sputum sample was collected for microscopy and cartridge-based nucleic acid amplification test. Results: All patients were adhered to intermittent DOTS therapy, and sputum conversion rate was 83%. Minor gastrointestinal side effects were experienced by 60% of cases and 87% consumed drugs under supervision. On microbiological examination, 10% of the study population was found to be positive for TB and they all were rifampicin sensitive. Those who had completed treatment within 1 year with no clinical symptoms re-appeared after treatment. Conclusion: Till date, RNTCP does not follow up the patients for any period of time after successful completion of treatment. Through the present study, we could find relapse cases in 10% of the previously treated non-symptomatic patients. These unnoticed relapse cases have potential to spread TB and increase disease burden of country. Thus, we can conclude that RNTCP has to follow up the patients after successful treatment to determine whether they relapse. It is needed for the success of programme and control of the disease in the country.

Detection of anti-hepatitis C virus and hepatitis C virus RNA in dried blood spot specimens using Whatman No. 1 filter paper

Purpose: Dried blood spot (DBS) specimen simplifies blood collection, processing, storage and shipment and may reduce the cost of testing for hepatitis C virus (HCV) infection. We wanted to see if DBS using a cheap filter paper is reliable alternative to serum for detection of anti-HCV and HCV RNA. Materials and Methods: At a tertiary care hospital in Northeast India, we collected 91 paired DBS and serum specimens from patients at risk of HCV infection from July 2014 to June 2015. DBS was collected on Whatman No. 1 filter paper. After processing, the specimens were subjected to anti-HCV detection by a third-generation Enzyme-Linked Immunosorbent Assay (ELISA). The reactive DBS and serum specimens were further subjected to HCV RNA detection by polymerase chain reaction. The results were analysed in paired screen-positive study design. Results: Anti-HCV was detected in 9 (9.9%) DBS specimens and 10 (10.9%) serum specimens. There was statistically significant (P < 0.0001) correlation between the optical density values of DBS and serum specimens (Pearson r = 0.9181, 95% confidence interval: 0.8781–0.9453). HCV RNA was detected in 5/9 (55.6%) reactive DBS and 9/10 (90.0%) reactive serum specimens. There was no correlation between HCV RNA levels in the DBS and the serum specimens. The relative sensitivity rate and the relative false-positive rate of DBS anti-HCV ELISA were 0.89 and 1.00, respectively. Conclusions: DBS using Whatman No. 1 filter paper is quite reliable as serum for detection of anti-HCV. It can be useful in effective surveillance. However, it is not suitable for confirmation of chronic HCV infection.

Profile of Disease in Leprosy Patients Diagnosed in a Tertiary Care Centre in Kolkata during 2014-2017

Study of profile of leprosy in a Tertiary care Centre in an Urban Metropolitan settings has important epidemiologically relevant messages. This study has been carried out to find out the profile of leprosy patients attending a Tertiary Care Centre at Kolkata and to interpret data in respect to different epidemiological variables. The cases attending R.G. Kar Medical College for the year 2014-2017 and who were referred to Microbiology Department for slit skin smear examination were studied. Their profile analyzed according to age, sex, type of disease, past treatment, presentation of disease, deformity status, presence of reactions, bacteriological status of the patients and treatment history. Diagnosis was based on the clinical assessment and slit skin smear for Bacteriological Index (BI) as well as Morphological index (MI). Among 2380 cases 720 (30.25%) were females and 1660 (69.75%) were males. Maximum patients (74%) belong to upper lower (Class IV) socio-economic class. 20-40 years age group was reported as peak age of onset with average onset of age as 35 years, 7.56% were children below 15 years of age. Maximum patients (63.87%) were in reproductive age group. Multibacillary (BL/LL) cases are more prevalent (71.47%). 21% of cases were bacteriologically positive with 10.9% having >3+ BI. MI upto 25% was observed in 92% of 360 smears examined for this purpose. Proportion of type 1 reaction was more than type 2 in both males and females. 440 (18.5%) had reactions, 12.6% had type 1 and 5.9% type 2 reactions. Reactions in females were more associated with pregnancy/ lactation. 24% of cases had grade I disability whereas grade II disability was present in 14% of cases which indicates delayed diagnosis and inadequate management or both. Both grade 1 and grade 2 were more in males. Leprosy was found to be more prevalent in males, more prevalent in upper lower (Class IV) socioeconomic class and more commonly of borderline type. Strategy need to be fine tuned to improve early detection, more focus on females during the reproductive years and appropriate intervention to reduce overall morbidity and deformity/disability

Effect of lambda cyhalothrin on rats: An acute toxicity study.

The objective of the study was to evaluate the acute toxicity of lambda cyhalothrin in rat. Male albino rats were exposed to 80 mg/kg body weight of lambda cyhalothrin by means of gavage. The toxicological manifestations include myocardial hyalinisation, lysis of reticular framework in spleen, and spermatogonial cell degeneration in testes.

Chronic low dose exposure to hydrogen peroxide changes sensitivity of V79 cells to different damaging agents.

Chinese hamster V79 cells were repeatedly exposed to a low dose of hydrogen peroxide (H2O2) over several weeks and then exposed to H2O2, cisplatin or ultraviolet (UV) light. Cell killing was examined by colony formation, following these treatments. It was seen that cells conditioned by multiple low doses of H2O2 showed resistance to killing in case of H2O2 and cisplatin but the sensitivity to UV light was same as the control cells. Apoptosis was also determined in these cells after the same treatments. UV light failed to induce apoptosis in both conditioned and in control cells, but in case of cells treated with H2O2 and with cisplatin, there was less apoptosis in the conditioned cells compared to the control cells. From our observation we can say that the enhanced survival of cells after treatment with H2O2 or cisplatin could be due to inhibition of apoptosis.

Experimental amebiasis: molecular weight analysis of Entamoeba histolytica antigens recognized by IgG antibodies.

The reactivity of sera from experimentally infected animal was studied from 5-60 days postinoculation to determine which of the E. histolytica antigens are recognized frequently to infection. Crude extract of E. histolytica trophozoites was used and sera were examined by immunoelectrotransference assay. It was observed that sera recognized polypeptide with 70 kDa molecular mass after 15 days postinoculation onward and later 14 to 24 polypeptide with molecular weight of 110-22 kDa were recognized. All the amebic antigens (polypeptides) could be recognized by sera till 60 days postinoculated animals. Significance of expression of different amebic polypeptides in terms of pathogenesis needs further investigations.

Optimisation of different physical parameters for bioleaching of phosphate by Aspergillus niger from Indian rock phosphate.

A mutant strain of Aspergillus niger AB100 was incubated with samples of rock phosphate. Mutation resulted in a greater amount of solubilisation (30 to 35%) as against the parent strain (10 to 15%). The influence of leaching parameters such as ore concentration (pulp density), particle size, initial pH of the medium, temperature, volume of the medium in 250 ml flasks, inoculum concentration and age of inoculum was studied. When low quantity of rock phosphate is applied (0.1%) the solubilisation of phosphorus was optimal (40.5%). Optimum particle size was--200 to 240 mesh, initial pH of the medium 4.0, optimum volume of the fermentation medium 160 ml, time period of incubation was 8 days, inoculum volume was 7.5 ml, and age of inoculum 7 days. The maximum leaching of phosphorus by using these optimum physical parameters is 45 to 50%.

Molecular analysis of the cholera toxin gene & antibiotic sensitivity profile of Vibrio cholerae O1 & O139 associated with mixed infection.

In the context of the reemergence of V. cholerae O1 in India and the recent evidence that O139 strains could have evolved from O1 E1 Tor strains, restriction fragment length polymorphism (RFLP) of the rRNA and the ctx genes and the antibiotic sensitivity profile of the two strains of V. cholerae, one an O1 and the other an O139, associated with mixed infection, were examined to determine their relatedness. Our results demonstrate that although the strains belonged to different clones of V. cholerae, they showed similar antibiotic sensitivity, profile indicating some exchange of genetic elements.