Study of Correlation of High-Resolution Ultrasonography and Ultrasonography Guided Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy in a Tertiary Care Hospital

This study assesses the features of high-resolution ultrasonographic and ultrasound-guided FNAC of peripheral nerves and correlates the findings in clinically suspected cases of pure neuritic leprosy (PNL). As per the study protocol, clinically screened pure neuritic leprosy cases from January 2017 to June 2018 were subjected to high resonance ultrasonography and ultrasonography-guided FNAC. The aspirated material was stained with modified ZN stain for AFB. Nerves showed hypoechogenicity, loss or distorted echogenic rim, and fibrillary echotextures in ultrasonography. Epithelioid cells, epithelioid cell granuloma was found in the histopathology sections of FNAC specimens with the presence of AFB in some cases. From these findings it may be concluded that HRUS and ultrasound-guided FNAC could be incorporated as rapid and reliable diagnostic tools for PNL. It may enlighten the future path as an early indicator of neural damage and be critical and useful to prevent the disabilities.

Development of perceived prenatal maternal stress scale

Background: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. Objectives: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. Methods: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. Results: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). Conclusions: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.

Rare cause of floaters: A motile live worm in vitreous cavity

Ocular filariasis commonly presents as subconjunctival or eyelid nodules. We report a rare case of a live, motile worm causing floaters. The worm was isolated from the vitreous cavity and revealed to be Dirofilaria repens. Correct recognition of the worm is necessary as human dirofilariasis does not present as microfilaremia and does not require systemic therapy; in contrast to other causes of ocular filariasis, which require systemic therapy. As ophthalmologist may be the first physician to encounter such patients, a high index of suspicion is required for timely and adequate management.

Bilateral Tinea Nigra of palm: A rare case report from Eastern India.

A 14 year old girl from a coastal district of Odisha presented with a six month history of asymptomatic brownish patches on the palm of the both hands. Epidermal scrape from these patches showed brown septate hyphae with occasional yeast like cells. Hortaea wernekii was isolated from the fungal culture. A diagnosis of Tinea nigra was made. The patches resolved completely after treatment with topical 1% clotrimazole cream.

Endophytic fungal communities associated with two ethno-medicinal plants of Similipal Biosphere Reserve, India and their antimicrobial prospective.

To study endophytic fungi associated with two plant species used as ethno-medicines by aboriginal tribes of Similipal Biosphere Reserve and evaluation for their antimicrobial potentials against some clinically significant human pathogens. A total of 458 endophytic isolates were obtained from leaf, stem and fruit tissues of Solanum rubrum and Morinda pubescence. The dominant endophytic fungi belong to genera Aspergillus, Colletotrichum, Curvularia and Mycelia sterilia. Maximum endophytic isolates were obtained from leaves segments followed by stem and fruit tissues. In both the plants class hypomycetes were dominant over other fungal classes. Shannon- Weiner and Simpson indexes showed rich diversity of endophytic fungi suggesting even and uniform occurrence of various species. The endophytic isolates showed varying degree of antimicrobial activity against 9 human pathogens. In S. rubrum 20% and 10% of the isolates inhibited all the Gram-positive and Gram-negative bacteria and 35% of the isolates displayed antifungal activity against all the test fungal pathogens. One of the isolate showed considerable antimicrobial activity against all the test pathogens. Endophytic isolates of M. pubescence showed 24% antibacterial activity against Gram-positive bacteria and 28% antifungal activity against all the test fungal pathogens. The study revealed that medicinal plants associated endophytes could be a rich source of antimicrobial agents.

Clinicoepidemiological profile of 590 cases of beetle dermatitis in western Orissa.

BACKGROUND: Beetle dermatitis is a very common condition in western Orissa. It is often misdiagnosed and causes significant morbidity among the rural population. AIM: This study was conducted to determine the epidemiological and clinical profile of beetle dermatitis in western Orissa. METHODS: All clinically diagnosed cases of beetle dermatitis were included in the study. Detailed history was taken and thorough clinical examination was conducted in all the cases. One urban and three rural localities were visited regularly to detect the epidemiological trends of the disorder. RESULTS: A total of 590 cases were studied: 486 males and 104 females. The age of the patients ranged from 2 to 65 years. Forty-four percent of the patients belonged to the pediatric age group. Majority of the cases (85%) presented during the months of March to July, indicating a distinct seasonal trend. The disorder was prevalent in the localities nearer to paddy and sugarcane fields and grasslands with stagnant water. The clinical lesions included papules, erosions, crusted lesions, urticarial plaques and vesiculobullous lesions. Distribution was mainly linear, but kissing lesions were also observed. Head, neck and upper extremities were the most commonly involved sites. Lymphadenopathy and systemic features such as fever and malaise were observed in 24% and 15% of the cases, respectively. CONCLUSION: Beetle dermatitis should be included in the differential diagnosis of the acute onset of vesiculobullous lesions in the endemic areas.

Fnac study of histoid nodule: an early tool for diagnosis.

Histoid lesion, a variety of lepromatous leprosy, is due to alteration in the growth pattern of Mycobacterium leprae, possibly due to loss of immunity in localized areas. The distinction is based on cellular morphology by demonstrating pallisading arrangement of multi-layered spindle-shaped histocytes. Cytodiagnosis by fine needle aspiration cytology is therefore an early tool to recognize the histoid variety, differentiating it from a conventional LL module, as it is a simple and less traumatic procedure.

Prevalence of leprosy among household contacts of leprosy cases in western Orissa.

The prevalence rate of leprosy among household contacts is an important epidemiological indicator in the character and trend of the disease. During the period January 2001 to December 2002, families of 400 primary cases were studied to detect contact (secondary) cases. Seventy-two cases were detected from 54 families; of these 72 cases, 45 (62.5%) were in the paediatric age-group (0-14 years) and of these 45.8% belonged to 6-14 years group. Out of the 72 cases, there were more (58) of paucibacillary (PNL+I+TT+BT) cases. Secondary cases were significantly high when there was lepromatous type of leprosy in the family. The attack rate among those exposed to paucibacillary type (TT, BT) of leprosy, though much less, was still observed. The influence of duration of contact revealed that a maximum number of cases (N=43, 59.7%) acquired the disease during 0-6 years of contact. A majority of the patients belonged to low-income groups, were illiterate and lived in extended families. The father was the source case for most of the secondary cases (N=41, 57%). Conjugal leprosy was very rare. The results of the study points to the fact that PB leprosy is still a potential source of infection and cannot be ignored. It is important to evolve a hospital-based surveillance programme for contacts of leprosy patients since early detection and treatment of contacts are important measures for reducing the reservoir of infection in the community.

Lupus vulgaris on keloid.

A 28-year-old man presented with multicentric lupus vulgaris on keloids over chest, axilla, neck and back for last 6 months. He had pulmonary tuberculosis. All the laboratory investigations were in favour of clinical diagnosis. The patient responded to antituberculosis therapy.

Silent neuropathy in leprosy.

Twelve patients of silent neuropathy attending the OPD of Skin and VD, VSS Medical College Hospital during 1996-1998 were taken for study. On clinical analysis 5 cases were present as silent neuropathy, 4 cases during MDT and 3 cases after completion of MDT Seventy percent of cases showed good response to systemic steroid.

Effect of vitamin A excess on germ cell development in prepubertal rat testis.

Vitamin A in graded doses of 125, 250 and 375 U.S.P./kg body wt, po, for 10 days (d 21-30) drastically reduced the testicular weight by 25 to 62% and seminiferous tubular diameter by 14 to 35% in prepubertal rats in lowest and highest doses of the treatment. The treatment induced disproportionate enlargement of nuclei and cytoplasm of the germ cells; predominantly the preleptotene and pachytene spermatocytes. These abnormal germ cells, often with 2 or 3 nuclei displayed vacuolated cytoplasm surrounding pyknotic or granulated or dispersed chromatin granules within the nuclei in a dose proportionate manner. The round spermatids were the most sensitive cell types which completely disappeared in two higher doses of treatment. Vacuolation of Sertoli cell cytoplasm in about 25% of the tubules with associated increase in intertubular space was also observed in rats treated with the highest dose of the vitamin. Circulatory levels of FSH, LH and testosterone remained unaltered following the vitamin excess treatment. Therefore, it is suggested that excess vitamin A even for shorter duration like the present one is detrimental to developing cell types and prevents the progress of the spermatogenic process beyond the round spermatid stage.