Knowledge attitude and practice on prevention of hepatitis B infection among medical students of a tertiary care centre in Tamil Nadu, India

Background: Hepatitis B infection is a serious global public health problem. About two billion people are infected with hepatitis B Virus (HBV) all over the world. The prevalence of HBV infection in India is 4%(2%-8%) with more prevalence among health care workers. Medical students represent a group that is at high-risk for acquiring and spreading hepatitis B infection. Despite increasing prevalence of HBV infection, there is paucity of knowledge, attitude and practice on HBV among medical students. Objective of the study was to assess the knowledge, attitude and practices on prevention of hepatitis B infection among medical students of Sree Mookambika Institute of Medical Sciences, Kulasekharam.Methods: A cross sectional study was conducted among 205 MBBS students using a pretested self-administered questionnaire for assessing the knowledge, attitude, and practice on prevention of HBV infection after obtaining informed consent from the participants.Results: Among 205 MBBS students, correct response towards Knowledge, Attitude, and Practices were given by 77.07%, 77.56%, and 76.59% respectively, 79.5% of the students were fully vaccinated; 20.5% were partially vaccinated against Hepatitis B Virus infection.Conclusions: The medical students are at a very high risk of contracting HBV infection during their training period in view of low HBV vaccine uptake rate and high chance of accidental exposure to blood infected with HBV. Creating awareness among medical students on various aspects of Hepatitis B infection through health education programs before their exposure in medical colleges and subjecting them to active immunization against HBV are mandatory to control the spread of Hepatitis B viral infection.

Prevalence of complications of diabetes among patients with diabetes mellitus attending a tertiary care centre in Tamil Nadu

Background: Diabetes will be the 7th leading cause of death by the year 2030 as per the World Health Organization. In adults the prevalence of diabetes globally has risen from 4.7% in 1980 to 8.5% in 2014. Level of awareness depends on socioeconomic class, literacy of the patients, training received by them, source of information on diabetes. Knowledge, attitude, and practices about diabetes mellitus and its complications are important to reduce the prevalence and morbidity associated with diabetes mellitus and its complications.Methods: The cross sectional study was conducted among 201 patients with diabetes visiting. Outpatient department of Sree Mookambika Institute of Medical Sciences, Kulasekharam, Tamil Nadu during a period from January 2017 to June 2018 using a pre-tested, semi structured questionnaire.Results: Among 201 patients with diabetes included in the study, 69.0% had one or more of the complications of diabetes. Factors significantly associated with high rate of complications were the female gender (p<0.001), obesity, rural residential area, high blood pressure (p<0.001), familial history of diabetes (p<0.001), duration of the disease above 5 years (p< 0.001) and high HbA1c level (p<0.001).Conclusions: This study revealed that type 2 diabetic patients followed up in the OPD of SMIMS showed a high rate of chronic complications which often occurred in age more than 50 years. Socio-demographic and biological factors were significantly associated with the high rate of complications of diabetes.

Assessing response of perimenopausal abnormal uterine bleeding after treatment.

Background: Abnormal Uterine Bleeding (AUB) is caused by either Organic lesions such as genital tract infections, tumors, adenomyosis, pregnancy and its complications, systemic disorders or Dysfunctional Uterine Bleeding (DUB). In women ≥ 40 years, and certainly in menopausal patients, it mandates evaluation to confirm benign nature of the problem, by ruling out endometrial carcinoma, so that medical treatment or conservative surgery can be offered and unnecessary radical surgery can be avoided. Objectives: Categorizing of Perimenopausal women with AUB for further management according to histo-pathological report and to study the efficacy of medical management (Mainly Progestins). Material and Methods: A total of 60 patients were selected who presented with symptoms of abnormal uterine bleeding at perimenopausal age group (40-54 years). Histopathological results were evaluated after obtaining endometrial tissue and patients are treated accordingly. Treatment response was assessed and tabulated. Statistical Analysis has done by danielsoper.com using chi-square test. Results: Abnormal uterine bleeding was mostly seen in multiparous women with parity >2 about 63.3%. Among menstural irregularities, 45% of cases presented with menorrhagia. Most of the patients were diagnosed as Anovulatory DUB about 60%. Out of 11 hyperplasia patients, 2 (18.1%) patients diagnosed as complex hyperplasia without atypia. No progression of AUB has seen after MPA treatment among all patients with endometrial hyperplasia. Conclusion: Cyclical oral progestogens are effective in regulating and reducing irregular bleeding due to Oligo/Anovulation. Majority of the cases of endometrial hyperplasia without atypia can be successfully treated with progestogen therapy.

Multiple discharging sinuses: an unusual presentation caused by Absidia corymbifera.

A case of zygomycosis presenting with non-healing multiple discharging sinuses in a diabetic patient is reported here. The debrided tissue on histopathological examination revealed dense infiltration with aseptate fungal hyphae. Potassium hydroxide mount showed hyaline aseptate hyphae suggestive of zygomycosis. On culture, Absidia corymbifera was isolated. The patient responded to surgical debridement and therapy with amphotericin B followed by itraconazole.

Isolation, distribution and prevalence of various species of enterococci isolated from clinical specimens in a tertiary care hospital.

Various clinical specimens were processed to find the prevalence rate of enterococci and to identify the species of clinical isolates of enterococci. Screening of various clinical specimens revealed that enterococci were prevalent in 2% of the total specimens, with urine and wound to be the major site of isolation. Conventional test scheme proposed by Facklam and Collins and commercially available systems Rapid ID 32 Strep (biomereiux) were successfully used to speciate enterococcal strains. Five species of enterococci were identified in the study from a set of 396 cultures, with E. faecalis (79.79%), and E. faecium (11.11%) predominating. E. hirae (3.03%), E. gallinarum (3.03%), and E. casseliflavus (3.03%), were the other members of Enterococcus species identified.

Superantigens - Concepts, clinical disease and therapy.

The term superantigen was introduced in microbiology and immunology only a decade ago. The unique feature of superantigen is that it bypasses the antigen processing mechanism and specifically binds to TCR v segment and forms a trimolecular complex along with major histocompatibility complex class II. Since its discovery, several studies have been carried out to unravel the properties of superantigens. They are implicated in the pathogenesis of diseases of bacterial, viral and fungal origin. They are also known to play a role in autoimmune diseases. Therapy for these superantigens is being worked upon. Studies have shown that intravenous gamma globulin containing specific antibodies to these superantigens inhibits the activation of T-Cells and also the cytokine production by them resulting in dramatic recovery from superantigen mediated diseases. The use of superantigen in the therapy of cancer is being explored.

Prevalence of bacterial vaginosis in antenatal women.

Bacterial vaginosis is an established risk factor in pregnant women for premature rupture of membranes and preterm delivery. This study was carried out to find out the prevalence of Bacterial Vaginosis (BV) in antenatal women with vaginal discharge and the effect of treatment with Metronidazole gel on pregnancy outcome. One hundred and fifty symptomatic and fifty asymptomatic women in second trimester of pregnancy in the age group of 20-30 years were included in the study. Gram stained smears of vaginal discharge were examined for evidence of BV with a scoring system by Nugent et al and was found to be positive in 38.5% in symptomatic antenatal women. Intravaginal metronidazole gel application was found to be an effective therapeutic option. Incidence of preterm labour was more in untreated cases.

Studies on the incidence of leptospirosis and possible transmission of Leptospira during leptospiraemia.

During the year 1991 and in the first half year of 1992 a total of 179 cases and 288 cases respectively were tested for the presence of Leptospira by dark ground microscopy and 86 cases (48%) and 157 cases (54.5%) were found to be positive for Leptospira in their blood samples only. The disease was endemic and more prevalent in the age group of 5 to 14 years and 15 to 54 years and affected both sexes. Clinical categorisation of 169 cases in 1991 and 266 cases in the first half of the year 1992 along with the dark ground microscopy results showed that there was no strict correlation between the concentration of Leptospira in the blood and the severity of infection. Epidemiological data regarding the occupation and the contacts indicated that students and medical staff accounted for more than fifty percent of leptospiral infection and there was the possibility of transmission of Leptospira during leptospiraemia. Dark ground microscopy studies on blood samples from 20 cases who came for repeat testing showed the presence of Leptospira in blood up to 43 days and suggested that the convalescent carrier may have a role in the transmission of Leptospira during Leptospiraemia.

MHA-Tp testing on HIV positive and negative women in vigilance home at Madurai.

In the study group of 94 cases of female prostitutes and their children 55 cases showed positive for HIV infection by ELISA and Western Blot tests. They showed positive also for syphilis in 37 cases by VDRL and in 43 cases by MHA-Tp tests among HIV positive and negative women. The association of HIV infection and syphilis was observed in this study due to sexual transmission of these infections. But congenital spread from infected mother to their children was not observed in this study since both mothers and their children were negative for these infections. MHA-Tp testing confirmed VDRL test results in 27 cases and also increased specificity of MHA-Tp test result over VDRL result in 16 cases and exclusion of biological false positive by VDRL in 10 cases were noticed in this study.

Studies on the oxidation of tannins by Aspergillus flavus.

A method for the estimation of tannin in presence of catechin, pyrogallol, protocatechuic acid and gallic acid using polyamide column chromatography was developed. Tannin added to the growing culture of Aspergillus flavus was oxidised to different extents depending on the duration of incubation. The oxidised compound was identified in the culture filtrate as a polymerised product of tannin.