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Background: Dengue is one of the most rapidly spreading mosquito-borne viral diseases in the world. Aedes aegypti mosquito is the main vector of dengue and Chikungunya. Entomological surveillance on Aedes mosquito has been standardized on different indices like House index, Container index, Breteau index. Larval indices are important predictors of outbreaks and are valuable in taking preventive measures. The objectives of the present study was to study the trend of larval indices over four months in selected wards of Kaiparambu Panchayat, Thrissur, Kerala, India and to identify the major breeding sources.Methods: A series of surveys were conducted from May to August of 2017 in Kaiparambu Panchayat under the field practice area of Amala Institute of Medical Sciences Thrissur. Houses were selected serially from 4, 5 and 6 wards with roughly 120 houses being covered each month.Results: A total of 489 houses were surveyed over 4 months. Overall, positive containers (with larvae) were present in 375 of 4055 potential containers showing a calculated House index (HI) is 44.4%, Container index (CI) is 11.5% and the Breteau Index is 76.7%. All three indices increased from May to June, peaked in July and dropped by August. Plastic containers were the most common source of breeding.Conclusions: The indices indicate risk even in the pre-monsoon season and there is a marked rise during monsoon. Hence, control measures need to be adopted during the pre-monsoon season so as to reduce the impact of the impending outbreak.
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Background: Cardiac toxicity after self-poisoning from ingestion of yellow oleander seeds is a common toxicological emergencyin South India.Objectives: The objectives of this study were to identify the various cardiac arrhythmias and electrolyte abnormalities in yellowoleander poisoning. This study was also designed to identify the clinical and biochemical parameters at presentation whichcan predict serious arrhythmias.Materials and Methods: This was a observational study among 111 patients who attended our emergency department afterconsuming yellow oleander seeds. Clinical, biochemical, electrocardiographic, and treatment details were collected from thepatients and recorded. Patients were monitored with serial electrocardiograms (ECGs).Results: Oleander seed poison was most prevalent in the 20–40 years of age. Incidence was more among the young females.ECG abnormalities were found in majority of the individuals. More the crushed seeds consumed and delay to admission to thehospital, poorer was the outcome. All symptomatic patients had conduction defects affecting the sinus node, atrioventricularnode, or both. Patients showing cardiac arrhythmias that required specific management had significantly higher serumpotassium concentrations. At presentation, 21 patients had serious arrhythmias, and on follow-up, 4 developed new-onsetserious arrhythmia. Sinus bradycardia (41.8%) was the most common arrhythmia followed by segment-wave changes (33%).Mortality rate was 1.9%.Conclusions: The arrhythmias produced by this poisoning might range from sinus bradycardia to complete heart block andventricular tachycardia. Although serum potassium correlated significantly with serious dysrhythmias, it did not predict thedevelopment of new-onset serious arrhythmia. On the whole, serious dysrhythmias were significantly associated with ingestionof crushed seeds, delay in admission, hyperkalemia.
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Background: Left ventricular diastolic dysfunction (LVD) is very common in chronic obstructive pulmonary disease (COPD) patients. The aim of the present study was to LVD function in COPD patients using echocardiogram and to detect the presence of LVD dysfunction in all stages of COPD.Methods: This was an observational study done at Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, during the period from March 2015 to August 2015. The study included 100 patients with COPD. All patients were subjected to chest X-ray, electrocardiogram, pulmonary function test (PFT) and echocardiogram.Results: The results showed the prevalence rate of LVD dysfunction in 80% patients with COPD. There was a good significant correlation between age (p<0.001), status of smoking (p<0.05), chest X-ray findings (p<0.001) and stages of COPD (p<0.001) with incidence of LVD in study population.Conclusions: High prevalence of LVD dysfunction was noticed in patients with COPD. Hence patients with COPD should undergo routine examinations timely to prevent the incidence of associated cardiovascular complications.
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background: Highly active antiretroviral therapy and adequate chemoprophylaxis for opportunistic infections for humanimmunodeficiency virus (HIV) infected patients have led to increasing survival in people living with HIV/AIDS. The nervous systemis among the most frequent and serious targets of HIV infection. 40–70% of all persons infected with HIV develop symptomaticneurological disorders. This study was undertaken to study the diverse clinical presentations of neurologic abnormalities in HIVpatients admitted in a tertiary care center in South Tamil Nadu.Materials and Methods: A prospective study was conducted for 2 years in HIV-infected patients who were admitted at a tertiarycare hospital were subjected to thorough neurological evaluation and those with symptoms referring to neurological illnesswere enrolled, and clinical signs and symptoms were noted. CD4 counts of all the cases were performed by FACS counter,and neuroimaging study was performed on necessary cases.Results: A total of 71 cases with 74.6% males and 25.4% females were enrolled. Mean age for males 34.6 years; for females31.1 years. Headache was the most common symptom (67.3%) followed by altered sensorium (40.8%). Central nervous system(CNS) tuberculosis (TB) is the most common disease in patients presenting with neurological abnormalities (42.25%). Thereis a significant correlation between the levels of CD4 counts and the type of neurological manifestations.Conclusions: Incidence of neurological illness in HIV infection was 41.7%. Opportunistic infections are the leading cause ofneurological disorders in our population. Meningitis was the most common neurological presentation (57.7%). TB is the singlemost common organism affecting CNS (42.2%).