ABSTRACT
Herpes Simplex Encephalitis is the commonest form of sporadic encephalitis. Availability of effective antiviral therapy viz Acyclovir has significantly reduced the mortality of Herpes Simplex Encephalitis. Elevated intracranial pressure resulting in herniation syndromes continues to be an important cause of mortality. Antiviral therapy and medical measures for managing raised intracranial pressure including osmotic diuretics, careful usage of steroids and controlled hyperventilation continue to be the cornerstones in management of these patients. Authors present a 38-year-old male patient with Cerebrospinal fluid Meningo-encephalitic panel positivity for herpes simplex virus 1 and bilateral temporal lobe lesions with secondary decline due to impending herniation syndrome despite osmotic diuretics and steroids with patient survival and complete recovery following decompressive hemicraniectomy.
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Listeria monocytogenes is a facultative intracellular gram-positive bacillus which usually infects immunocompromised patients, though it can infrequently infect immunocompetent individuals, neonates and pregnant women as well. Neurological manifestations include meningitis and cerebritis. Brain Abscess is an extremely rare presentation with approximately 80 reported cases. Authors report a patient with a brain abscess identified on an MRI scan with positive blood culture for Listeria monocytogenes. Patient was managed conservatively with intravenous followed by oral antibiotics with resolution of the abscess.
ABSTRACT
In a bid mitigate the spread of HIV and AIDS since it was diagnosed, several interventions ranging from palliative care, increased access to HIV treatment to manage opportunistic infections and the current drive of improving clinical outcomes through suppression of viral load are all aimed at prolonging survival of HIV and AIDS patients. The authors endeavour to corroborate the effect of viral load (VL) suppression on ART HIV patients. The authors applied a comprehensive search by merging terms for survival of HIV patients to clinical, demographic and socio-economic factors in NCBI and MEDLINE databases. About 15 articles were considered by outlining research questions, generating key words and search terminologies. Only articles published since 2013 during scale up of VL interventions were considered. It is worth noting that unsuppressed VL clinically decisively causes death in HIV/AIDS patients, propelled by a number of associated causes including opportunistic infections (OIs) Tuberculosis (TB), Non communicable diseases (NCDs), age, sex, income, geographic location among others. Whereas there is marked decline in risk of dying among HIV/AIDS patients resulting from VL suppression, other factors including; early detection and timely treatment, managing OIs, NCDs and TB treatment, tackling socio-economic barriers and multi-pronged community focused interventions like Community Client Led ART Delivery CCLAD, Community Drug Distribution Point (CDDP) interventions enhance survival of HIV/AIDS patients on lifelong ART.
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Background: India is one of the most populated and rapidly growing countries in the world and is the source of humongous amounts of waste every year, including municipal solid waste, hazardous waste, biomedical waste or e-waste. Healthcare is one of the largest sectors in India both in terms of revenue and employment. With growing healthcare, there is a requirement of management of bio-medical waste. This study is conducted to assess discernment, apropos on dispensation of hospital waste by paramedics.Methods: A cross-sectional study was conducted to assess the discernment and apropos of paramedical staff in 3 private hospitals regarding disposal of waste in Bhopal city and convenience sampling was used. A total of 204 individuals were approached for the study. The collected data analysed by using SPSS 21.0 and Descriptive analysis was done.Results: Total 204 paramedical staff participated in the study out of which 125 (61.2%) were males and 79 (38.7%) were males. It showed that there was limited level of knowledge, attitude and practices among class 3 workers i.e., attenders as compared to nurses and technicians.Conclusions: Study concluded that there is lack of knowledge about waste management which leads to improper waste disposal and pointed out that class 3 workers have less knowledge as compared to class 1 and class 2 workers. The technicians and nurses comparatively were having better knowledge and attitude, and also practiced waste management better than the attenders
ABSTRACT
Dengue is emerging as the most common monsoon related illness in India, particularly over the last few years. Objective: To study the clinical profile of confirmed dengue cases admitted at a tertiary care hospital and to identify the seasonal variation of the disease. This would help in effective control of dengue in the city. Methods: 765 patients who fulfilled World Health Organization (WHO) criteria and admitted in the medical indoor wards for dengue fever from January 2018 to December 2018 were selected for study. All data were entered in the Microsoft Excel worksheet and descriptive statistics were analyzed. Results: The maximum number of patients belonged to the age group 21-30 years (29.28%). It was found that more cases of Dengue occur in and around monsoon period with peak in October. The most common presentation apart from fever and bodyache were gastrointestinal symptoms. Total 103 (13.46%) patients had complications. Investigations revealed most of the complications occurred when platelet count went below 20,000 cells/mm 3. Conclusion: As most cases were reported during around monsoon period, continued and coordinated efforts should be made to control the transmitting vectors to prevent dengue outbreaks.
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Background: Non communicable diseases (NCDs) represent a cluster of major chronic diseases. Smoking habit, alcoholism, low quality diet intakes, physical inactivity are some of the established risk factors of the NCDs. In developing country like India the problem of lifestyle and its consequent diseases needs to be addressed vigorously by all public health care personnel. Objective of the study was to assess prevalence of modifiable risk factors using the WHO STEPS approach in urban slum.Methods: A community based cross-sectional study was carried out in the field practice area of urban health training centre of the department of community medicine of PCMS and RC, Bhopal using questionnaire.Results: Highest prevalence of modifiable risk factor was inadequate diet (85.2%), followed by smokeless tobacco consumption (59.1%) and low physical activity (46.1%). Tobacco smoking (31.9%) and alcohol (22.6%) were next, followed by high blood pressure (20.1%). Prevalence of least risk factors was overweight (13.9%).Conclusions: It can be concluded from our study that the burden of risk factors for NCDs is quite high. Its prevalence even in the younger age groups is a pointer to the fact that the burden of NCDs is going to rise in near future.
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Background: Osteoporosis is commonly associated with chronic liver disease. Pathologic fracture in osteoporotic patients affects quality of life as well as decrease life expectancy. Around 40% of patients with chronic liver disease may experience osteoporotic fracture. The present study was undertaken to observe the relation of bone mineral density (BMD) with severity of liver cirrhosis along with effects of smoking and alcohol.Methods: A total of 187 liver cirrhosis patients who were admitted in SMS Hospital were taken for study and were classified into class A, B, C as per Child Turcot Pugh’s classification, after applying inclusion and exclusion criteria. All patients underwent standard laboratory testing and bone densitometric studies of the lumbar spine using dual X-ray absorptiometry (DEXA) scan. Statistical analysis done.Results: The bone mineral density was significantly low in Class C. Class C have 41 patients of osteoporosis out of 62 whereas only 16 patients have osteoporosis in Class B and only 1 case of osteoporosis in class A. Hypocalcemia and hypophosphatemia were more in class C as in comparison to class A and B. Also, chronic smoking and alcohol intake were strongly associated with the severity of cirrhosis.Conclusions: The prevalence of osteopenia and osteoporosis is higher in cirrhotic patients and significantly increases with severity. Hypocalcemia and hypophosphatemia are also associated with the cirrhosis. Thus, patients should undergo routine bone densitometry assessment and, if necessary, to be treated for osteoporosis
ABSTRACT
Background: Injections are among the most commonly used medical procedure with an estimated 16 billion administrations each year worldwide. An overwhelming majority (90%-95%) of these injections are administered for curative purposes. Immunization accounts for around 3% of all injections. According to IPEN study, 03-06 billion injections administered annually in India. Estimates suggest that at least 50% of the world‟s injections administered each year are unsafe, particularly in developing countries. Most of the curative injections are unnecessary, ineffective or inappropriate. Purpose of current study was to assess and compare the knowledge, skill and practices at different levels of health care by health care providers regarding „Safe injection practices‟. Methods: The present study has been undertaken in the outdoor departments of government health care facilities of district Gwalior. The study was done at three places namely: Civil dispensaries, district hospital & medical college hospital - Madhav dispensary (Tertiary care hospital) from 1/7/12 - 28/2/13. Results: Only 10 (33.4%) of the providers were aware regarding blood borne injection borne by faulty injection practices, the same number knew about the reasons for wearing the gloves for both patient and personal safety. All the providers had 100% knowledge regarding safe injection practices but in practical many of the skills were lacking at all the health care facilities. Conclusion: There was a great disparity between knowledge and practice of health care provider regarding injection practices. They were quite aware about the transmission of diseases to them by the faulty injection practices but more efforts are needed to be done in this regard for the improvement for the use of safe injection practices in all the health care facilities.