Risk Factors for Erythema Nodosum Leprosum: A Case Control Study in a Tertiary Hospital of Western Odisha, India

Erythema nodosum leprosum (ENL) is a serious, often recurring and disabling, immunologically mediated reaction occurring in leprosy which often requires hospitalization. There are published several studies of ENL, but systematic studies regarding the risk factors associated with ENL in the post elimination era are few. The aim of the study was to determine the risk factors associated with ENL in a tertiary care centre in Western Odisha. This is a case control study involving 292 patients of leprosy who attended the Dermatology OPD of this tertiary care centre. These constituted 97 patients with ENL and 195 patients without ENL who attended the OPD during this period. Detailed history, clinical examination, slit skin smears were done. These included gender details, age, area of residence (rural/urban), education and socioeconomic status. The most common subtype of leprosy observed in ENL was lepromatous leprosy followed by borderline lepromatous type. Patients diagnosed with initial high BI and lepromatous leprosy were found to be significant risk factors for development of ENL. Skin diseases, Anaemia and Diabetes Mellitus were found to be more prevalent in ENL patients

Trends in Selected Birth Defects Among Parents from Below Poverty Line Population in Karnataka During 2010–2020

The aim of the study is to reveal the common birth defects among parents of newborns belonging to the below poverty line (BPL) category in Karnataka state (South India) by analyzing Suvarna Arogya Suraksha Trust data. In the last 10 years, 3672 kids in BPL families have been born with various birth abnormalities. It is found that 50.3% of newborns have anorectal malformations, 33.1% have hypospadias, 6.0% have diaphragmatic hernia, 5.1% have esophageal atresia, and 2.8% have intestinal atresia and obstruct. As a parent’s age rises, the likelihood of having a child with birth abnormalities raise as well, particularly anorectal malformations than diaphragmatic hernia. Male newborns have a higher risk of birth defects. We hypothesized that poverty, material deprivation, and low socioeconomic profile throughout the life course among the BPL community could be some of the key reasons for poor maternal health care and related neonatal outcomes.

Influenza A in Southern states of India from 2010 to 2018: A trend analysis

Background: In the past 100 years, many influenza pandemics were reported including the Spanish flu in 1919–1920 with 40–50 million deaths worldwide. After the pandemics, the strain of influenza virus continues to circulate as seasonal flu. Every year 650,000 people die of respiratory diseases linked to seasonal flu. The Government of India has done many interventions in the past few years to reduce the burden in the country. Objective: The objective of this study was to assess the burden and trend of morbidity and mortality due to influenza A H1N1 infection in the Southern states of India from 2010 to 2018. Materials and Methods: A secondary data analysis of available data (2010–2018) from reliable sources was conducted to assess the burden and trend of morbidity and mortality due to influenza A H1N1 infection in the Southern states of India from 2010 to 2018. The data were compiled, tabulated, and plotted in graphs for both morbidity and mortality. Results: As per the data, in 2018, the Southern states contribute 47.7% of morbidity and 20.2% of mortality of India due to influenza A H1N1. The contribution toward morbidity by Southern states was lowest 2013 and gradually increasing after 2015. The contribution toward mortality by Southern states is also similar to morbidity trend. Conclusion: The trend analysis showed that the burden, i.e., morbidity and mortality of influenza increases every alternate years in Southern states. The contribution toward morbidity and mortality of influenza by Southern states is gradually increasing after 2015. Detailed trend analysis for a long time period of morbidity and mortality taking the environmental changes into account, forecasting of the burden could help the concerned authority to plan the intervention effectively.

Varietal variation in physiological and biochemical attributes of sugarcane varieties under different soil moisture regimes

Physiological and biochemical changes in response to deficit irrigation (drought stress) were studied at three moisture regimes based on available soil moisture (ASM) and four commercial sugarcane varieties differing in their maturity i.e. CoS 767 (Mid late), CoH128 (Mid late), CoJ 64 (Early) and Co 0238 (Early) Plant water status was affected significantly with duration and severity of stress with maximum reduction at 30% ASM level at 90 DAP. The water potential (from -0.62 to -1.16 MPa), osmotic potential (from -0.88 to -1.77 MPa) and relative water content (from 87.59 to 65.51%) decreased significantly at 30% ASM level than at 50% ASM in all the varieties. After stress revival, a remarkable recovery was recorded in all the varieties at all the ASM levels with maximum recovery in varieties Co 0238 and CoS 767. Higher membrane injury was recorded in CoJ 64 followed by CoH 128, Co 0238 and CoS 767at 30% ASM at 60 and 90 DAP. Remarkable decrease were observed in gaseous exchange parameters in leaves viz. photosynthetic rate, transpiration rate and stomatal conductance at 30 and 40% ASM levels in all the varieties. Significant reduction was also recorded in chlorophyll fluorescence (Fv/Fm). Severe stress conditions of 30% ASM led to approx. two fold increase in total soluble carbohydrates, four folds in proline and two fold increase in lipid peroxidation. ASM levels of 40% and 30% also significantly reduced total chlorophyll content. From the results, it can be concluded that varieties Co 0238 and CoS 767 are relatively more tolerant at moderate stress to severe stress than CoH 128 and CoJ 64.

Clinical spectrum, susceptibility profile, treatment and outcome of culture-confirmed brucellosis from South India

Brucellosis, a common zoonosis, is under reported in India despite its endemicity and increased exposure to livestock among the population. This study was conducted to determine the clinical manifestations, antibiotic susceptibility pattern, treatment and outcome of culture confirmed brucellosis. Adult patients with culture confirmed brucellosis who presented to a large teaching hospital in South India between 2009 and 2015 were included. A diagnosis of brucellosis was confirmed on automated culture. Clinical profile, laboratory parameters, drug susceptibility, treatment and outcome were documented by reviewing the medical records. The cohort comprised of 22 patients with mean ± SD age of 42 ± 13 years. Twenty one (95.5%) was male. Thirteen (59%) patients were from rural area and risk of acquisition of brucellosis including occupational exposure or consumption of unpasteurized milk was evident in 16 (72.7%) patients. The mean duration of symptoms before presentation was 54.5 ± 52 days. The commonest clinical presentation was prolonged fever without a definite focus in 18 patients (82%), whereas 2 (9%) patients had osteoarticular involvement and one patient (4.5%) each had genital involvement and endocarditis. Eighteen patients (82%) with uncomplicated brucellosis were treated with aminoglycoside and doxycycline for 6 weeks. There was no relapse or mortality at 18 ± 9 months of follow up. Brucellosis in this cohort had acute or subacute presentation with prolonged fever and bacteremia. High index of clinical suspicion based on significant epidemiological history along with automated blood culture improves the efficiency of diagnosis. Cure with lack of relapse among these cases suggests a combination therapy with doxycycline and aminoglycoside is highly effective for the treatment.

Clinical and Etiological Profile of Patients with Atrial Fibrillation (AF): Analysis and implications

Background and Objectives: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia which may be either symptomatic or asymptomatic. So, this study was conducted to know clinical presentation and to find out possible clinical and etiological profile of patients with AF.Material and Methods: This cross sectional study was conducted at Osh Regional Integrated Clinical Hospital, Osh Territorial City Clinical Hospital, The Kyrgyz Republic in collaboration with Janaki Medical College Teaching Hospital, Janakpurdham, Nepal. Sixty consecutive patients with AF were taken. Presenting complaints, past history, personal history was recorded. A thorough clinical examination was done, electrocardiogram, chest X-Ray posterio-anterior view, echocardiogram, thyroid function test and relevant test were done and analyzed.Results: Forty percent of the patients complained palpitation. Systemic thrombo-embolism was found in 15% of the patients. Other presenting complaints were cough, chest pain, shortness of breath, dizziness, swelling of the legs, tremors. Eighteen percent of patients presented with features of congestive cardiac failure and 30% of the patients gave history of rheumatic heart disease, 16.6% and 11.6% hypertension and ischemic heart disease respectively. Etiology-wise, rheumatic heart disease was the most common (46.6%) followed by hypertension (21.6%), ischemic heart disease (11.6%), dilated cardiomyopathy (6.6%), hyperthyroidism (5%), pneumonia (5%).Conclusion: Rheumatic heart disease, especially mitral stenosis is the most common cause of AF in this study. Systemic hypertension was next common etiology of AF, followed by ischaemic heart disease, dilated cardiomyopathy, thyroid disease. Heart failure, Systemic thromboembolism, decreased exercise tolerance are a major determinants for development of significant morbidity and mortality.