Knowledge and awareness regarding eye donation among medical and para medical students in a tertiary care hospital in Odisha: a comparative study

Background: India needs around 2,77,000 donations annually to perform 1,00,000 corneal transplants. To enhance the procurement of corneal donations further, raising the level of public education on eye donation was the most important first step. The Govt. of India under the 11th 5-year plan envisages eliminating avoidable blindness completely by 2020. The aim and objective of the study was to compare the awareness of eye donation and willingness to donate eyes among medical and paramedical students.Methods: A cross sectional study was carried out among 400 final year MBBS students and interns and also among the final year B.Sc. nursing students and at Hi-Tech Medical College and Hospital, Bhubaneswar from August 2018 to September 2018.Results: The study participants were in the age group of 18-25 years. While 100% medical students had heard about organ donation, 85.5% of paramedical students heard about organ donation. Positive opinion regarding donation of eye post death was got from all the medical students as against 85% of paramedical students. More than 1/3rd of the study participants in both the groups were willing to donate eyes and know more regarding the same and also had a fair idea regarding shortage of donors in India.Conclusions: Awareness of eye donation is better in medical students compared to paramedical students, preferably due to the exposure and study curriculum. Most of the students in both groups were inclined to pledge for eye donation. Awareness regarding eye donation will form the prime base for the elimination of avoidable blindness in India.

Awareness of patients towards eye diseases in middle aged population in rural Odisha

Background: One of the most important public health issue for developing nations in the world with special reference to India is preventive blindness. In the world, 36 million people are blind and 217 million people are with moderate or severe distance vision impairment. The aim and objectives of the study were a qualitative survey to get an initial picture of rural residents knowledge of the prevalent eye disease; serve as an initial assessment of patient’s baseline knowledge of eye conditions and possible treatment methods to aid in the future development of educational outreach initiatives and studies.Methods: A cross sectional study was carried out in the rural areas of Jajpur, Nayagarh, Puri and Cuttack district of Odisha during preventive eye screening camps. The study was carried over 6 months from Jan to July 2018. The sample size was calculated to be 914 and the study subjects were all aged 40 years and above comprising of 64.7% male and 35.3% female.Results: In this study we found out that 60.18% reported previous eye doctor visits, 24.08% reported using eye drops prescribed by a non-doctor, while 60.18% of the non-doctor visitors reported not knowing that a doctor should prescribe eye drops. While 76.69% had little or no awareness regarding glaucoma, 51.87% had a fair idea regarding cataract surgery.Conclusions: The increase in patient awareness of prevalent eye diseases and treatments could lead to an increase in patient acceptance regarding the importance of routine eye examinations for proper identification and treatment of various eye conditions.

Extracellular phospholipase production of oral Candida albicans isolates from smokers, diabetics, asthmatics, denture wearers and healthy individuals following brief exposure to polyene, echinocandin and azole antimycotics

Abstract Objective Candida albicans is the primary causative agent of oral candidosis, and one of its key virulent attributes is considered to be its ability to produce extracellular phospholipases that facilitate cellular invasion. Oral candidosis can be treated with polyenes, and azoles, and the more recently introduced echinocandins. However, once administered, the intraoral concentration of these drugs tend to be sub-therapeutic and rather transient due to factors such as the diluent effect of saliva and cleansing effect of the oral musculature. Hence, intra-orally, the pathogenic yeasts may undergo a brief exposure to antifungal drugs. We, therefore, evaluated the phospholipase production of oral C. albicans isolates following brief exposure to sub-therapeutic concentrations of the foregoing antifungals. Materials and methods Fifty C. albicans oral isolates obtained from smokers, diabetics, asthmatics using steroid inhalers, partial denture wearers and healthy individuals were exposed to sub-therapeutic concentrations of nystatin, amphotericin B, caspofungin, ketoconazole and fluconazole for one hour. Thereafter the drugs were removed and the phospholipase production was determined by a plate assay using an egg yolk-agar medium. Results The phospholipase production of these isolates was significantly suppressed with a percentage reduction of 10.65, 12.14, 11.45 and 6.40% following exposure to nystatin, amphotericin B, caspofungin and ketoconazole, respectively. This suppression was not significant following exposure to fluconazole. Conclusions Despite the sub-therapeutic, intra oral, bioavailability of polyenes, echinocandins and ketoconazole, they are likely to produce a persistent antifungal effect by suppressing phospholipase production, which is a key virulent attribute of this common pathogenic yeast.

Sunflower seed husk agar: a new medium for the differentiation of Candida dubliniensis from Candida albicans.

A sunflower (Helianthus annuus) seed husk agar medium has been developed and evaluated for differentiation of Candida dubliniensis from Candida albicans on the basis of colony morphology and chlamydospore production. All C. dubliniensis isolates (n=40) produced rough colonies with hyphal fringes and abundant chlamydospores whereas 101 of 105 (96.2%) C. albicans isolates produced smooth colonies with no evidence of chlamydospore production. Since this medium is free from oil droplets, chlamydospores can be examined with greater clarity by Dalmau plate technique. This medium provides a simple and cost-effective tool for the presumptive differentiation of C. dubliniensis from C. albicans and is particularly suited for clinical microbiology laboratories where biochemical or molecular methods for the differentiation of these two species are not available.

Trichosporon asahii as an emerging etiologic agent of disseminated trichosporonosis: A case report and an update.

PURPOSE: To report a fatal case of disseminated trichosporonosis caused by Trichosporon asahii in a patient with acute myeloblastic leukemia (AML) and to present an update on systemic trichosporonosis with special reference to India. METHODS: The diagnosis was based on repeated demonstration of budding yeast cells and arthroconidia by direct microscopic examination of sputum and by isolation of T. asahii in culture of sputum and blood. The update is largely based upon literature search in Medline and Review of Medical and Veterinary Mycology. RESULTS: A 41-year-old male presented with acute myeloblastic leukemia, cough and fever. He had received cytotoxic drug therapy, broad spectrum antibiotics and was neutropenic. Trichosporon asahii was repeatedly demonstrated in his sputum by direct microscopy and culture, and also isolated from blood. It was identified by appropriate morphological and physiological characteristics viz., arthroconidium formation, diazonium blue B reaction, urease activity and assimilation of carbon and nitrogen compounds. The identification was confirmed by PCR amplification and direct DNA sequencing of internally transcribed spacer (ITS) 1 and ITS2 of rDNA. CONCLUSION: With greater awareness of etiologic significance of T.asahii, trichosporonosis is likely to be recognised more frequently than apparent from the available published reports.

Sporotrichosis in India: First case in a Delhi resident and an update.

PURPOSE: To report the first case of sporotrichosis in a Delhi resident without history of travel to any known endemic area, and to present an update of the disease with special reference to India. METHODS: OThe case was tentatively diagnosed by clinical features, and confirmed by culture and histopathologic examination of a biopsy specimen. The update on the disease is based upon literature review (1932-2001). RESULTS: A 40-year-old female hospital employee developed lymphocutaneous lesions, involving her right middle finger, wrist and forearm following accidental pricking with a hypodermic syringe needle. A definitive diagnosis of sporotrichosis was established by culture of S. schenckii, verification of its dimorphic character, morphology in histopathologic sections and a positive pathogenicity test (intratesticular inoculation) in male white mice. The patient was successfully treated with saturated solution of potassium iodide. Of 205 cases compiled from literature, 91 (44%) came from West Bengal, 56 (28%) from Himachal Pradesh and 45 from Assam whereas the remaining 13 (6.3%) occurred sporadically in other states, including Bihar, Punjab and Karnataka. CONCLUSIONS: The available literature does not provide a true index of regional distribution of sporotrichosis in India. More correctly, it seems to reflect the distribution of groups of investigators with a special interest or expertise in sporotrichosis and S. schenckii. Further studies are likely to reveal new endemic areas for sporotrichosis.

Invasive fungal infections in Kuwait: A retrospective study.

A retrospective review of a five year period (1994-1998) revealed that opportunistic mycoses caused by ubiquitous fungal pathogens are a serious problem in the immunocompromised patient population of Kuwait. Patients with renal transplantation and diabetes mellitus were most susceptible to aspergillosis, cryptococcosis, and zygomycosis, whereas patients with candidemia/hematogenous candidiasis had multiple risk factors. Basidiobolomycosis of the rectum in a Bangladeshi male, cryptococcosis due to Cryptococcus neoformans var. gatti in an AIDS patient,fungal peritonitis due to Absidia corymbifera in a patient on peritoneal dialysis, and endocarditis due to Aspergillus terreus detected by direct microscopic examination and culture of the blood clot are some of the notable cases diagnosed during the period under review. The predominance of Candida species other than C. albicans as bloodstream pathogens is another noteworthy observation. Although outbreaks of C. parapsilosis candidemia in neonatal intensive care units contributed significantly to this shift in favour of non-albicans Candida species, a surveillance strategy comprising of molecular, epidemiologic and antifungal susceptibility studies is warranted. With the proposed expansion of organ and bone marrow transplantation facilities in Kuwait, the incidence of opportunistic fungal infections is likely to increase.

Farmer's lung disease in north-western India--a preliminary report.

A study of farmer's lung (FL) disease was carried out in 197 subjects engaged in farming and having respiratory complaints of varying duration. It revealed that 13.2% of the subjects had precipitating antibodies against thermophilic actinomycetes, with Faenia rectivirgula (Micropolyspora faeni) alone accounting for 85% of the positive reactions. Precipitating antibodies against Thermoactinomyces vulgaris and T. thalpophilus were observed only in 1.5% and 0.5% of the subjects, respectively. Two subjects concomitantly demonstrated F. rectivirgula and T. vulgaris-specific serum precipitins. Sixty (30%) of the subjects related their respiratory symptoms to exposure to wheat straw/thresher's dust or other vegetable substrata in the working environment. Based upon a suggestive clinical history, roentgenography, pulmonary function studies and demonstration of serum precipitins against F. rectivirgula, FL was diagnosed in 4 subjects whose salient features are presented and discussed. To the best of our knowledge, this is the first authentic report on FL from India. A comprehensive epidemiological survey is indicated to determine the prevalence of FL in different geo-climatic regions of the country.