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Good quality health, nutrition and demographic survey data are vital for evidence-based decision-making. Existing literature indicates system specific, data collection and reporting gaps that affect quality of health, nutrition and demographic survey data, thereby affecting its usability and relevance. To mitigate these, the National Data Quality Forum (NDQF), under the Indian Council of Medical Research (ICMR) - National Institute of Medical Statistics (NIMS) developed the National Guidelines for Data Quality in Surveys delineating assurance mechanisms to generate standard quality data in surveys. The present article highlights the principles from the guidelines for informing survey researchers/organizations in generating good quality survey data. It describes the process of development of the national guidelines, principles for each of the survey phases listed in the document and applicability of them to data user for ensuring data quality. The guidelines may be useful to a broad-spectrum of audience such as data producers from government and non-government organizations, policy makers, research institutions, as well as individual researchers, thereby playing a vital role in improving quality of health, nutrition and demographic data ecosystem.
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Background: Background: Staphylococcus aureus is a gram-negative bacterium that can build strong biofilms on biotic and abiotic surfaces, quickly acquire drug resistance mechanisms, and cause major issues with the treatment of hospital infections. The creation of new therapeutic options has become important due to the limited supply of new antibacterial medications. One of the main sources of bioactive molecules is medicinal plants, and monolaurin is a naturally occurring substance with a variety of biological functions. In light of this, the goal of this study was to assess monolaurin's antibiofilm activity against S. aureus. Methods: Using the AutoDock programme, a docking study of monolaurin against Clf A (clumping factor A) was carried out, and Pymol software was used to evaluate the generated hydrogen bonds in the docked complex. This study demonstrates the positive potential of monolaurin as an antibacterial product and lends support to upcoming pharmacological research on this molecule with an eye toward its therapeutic use. Results: Research was done to support the theoretical absorption of monolaurin in this work and in silico. It was feasible to forecast if the monolaurin molecule may be produced as a medication based on the values of the physical-chemical parameters evaluated using the online tool Swiss ADME. Conclusion: The compound monolaurin demonstrated good receptor ClfA binding affinity with an estimated binding energy of kcal/mol. Natural anti-staphylococcal chemical monolaurin was used as a possible medicine for treating staphylococcal infections in humans by carrying out drug design studies for S. aureus.
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Background & objectives: Contrary to overall declining trend in smokeless tobacco (SLT) use in India, an increase is observed in north-east (NE) India. This study examined the predictors of daily SLT use by gender and assessed the demographic and socio-economic characteristics that contribute to gender differences in SLT use in NE India. Methods: Data collected from 15,259 and 13,574 adults in the two rounds of Global Tobacco Adult Survey 1 and 2 for NE India during 2009-2010 and 2016-2017 were analyzed. Relative change, multivariable binary logistic regression and Blinder-Oaxaca decomposition analysis were used for analysis. Results: The findings suggest that among women in NE India, the daily SLT use significantly increased by 58 per cent between 2009-2010 to 2016-2017. Women residing in Nagaland, Manipur, Mizoram and Tripura were 3.5 and 2.5 times, respectively more likely to be daily SLT users compared to those in Assam. While age, education and wealth were the significant predictors of SLT use in both women and men, increased odds of SLT use were observed with women’s type of occupation and the State of residence. The majority of the gender differences in daily SLT use was explained by differences in work status (44%), age (26%), education (14%) and wealth status (9%) between men and women. Interpretation & conclusions: Increasing prevalence of SLT use amongst women in the NE States necessitates integration of gender-specific messages on harmful effects of SLT in the ongoing tobacco control programmes and development of culturally appropriate community-based interventions for cessation of SLT use.
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Omicron is currently shaking the world to its core. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol) that infected people exhale as they breathe, talk, cough, sneeze, or sing. “UK becomes first country in Europe to pass 1,50,000 COVID deaths Omicron clouds forecasts for Covid end game.Omicron is a variant of nSARS-CoV-2 that has been identified initially in COVID19 patients in Botswana and South Africa. The chief of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, has said that the combination of Delta and Omicron variants of coronavirus is driving a tsunami of COVID-19 cases. The statement came as record new cases were reported from the United States and countries across Europe. France recorded the highest ever daily numbers in Europe for the second consecutive day, at 208,000 new cases.Vaccines offer strong protection from serious illness.
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Background & objectives: COVID-19 pandemic has triggered social stigma towards individuals affected and their families. This study describes the process undertaken for the development and validation of scales to assess stigmatizing attitudes and experiences among COVID-19 and non-COVID-19 participants from the community. Methods: COVID-19 Stigma Scale and Community COVID-19 Stigma Scale constituting 13 and six items, respectively, were developed based on review of literature and news reports, expert committee evaluation and participants’ interviews through telephone for a multicentric study in India. For content validity, 61 (30 COVID-19-recovered and 31 non-COVID-19 participants from the community) were recruited. Test–retest reliability of the scales was assessed among 99 participants (41 COVID-19 recovered and 58 non-COVID-19). Participants were administered the scale at two-time points after a gap of 7-12 days. Cronbach’s alpha, overall percentage agreement and kappa statistics were used to assess internal consistency and test–retest reliability. Results: Items in the scales were relevant and comprehensible. Both the scales had Cronbach’s ? above 0.6 indicating moderate-to-good internal consistency. Test–retest reliability assessed using kappa statistics indicated that for the COVID-19 Stigma Scale, seven items had a moderate agreement (0.4-0.6). For the Community COVID-19 Stigma Scale, four items had a moderate agreement. Interpretation & conclusions: Validity and reliability of the two stigma scales indicated that the scales were comprehensible and had moderate internal consistency. These scales could be used to assess COVID-19 stigma and help in the development of appropriate stigma reduction interventions for COVID-19 infected, and mitigation of stigmatizing attitudes in the community.
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@#Despite clinical suspicion of an infection, brain abscess samples are often culture-negative in routine microbiological testing. Direct PCR of such samples enables the identification of microbes that may be fastidious, non-viable, or unculturable. Brain abscess samples (n = 217) from neurosurgical patients were subjected to broad range 16S rRNA gene PCR and sequencing for bacteria. All these samples and seven formalin-fixed paraffin-embedded tissue (FFPE) samples were subjected to species-specific 18S rRNA PCR for neurotropic free-living amoeba that harbour pathogenic bacteria. The concordance between smear and/or culture and PCR was 69%. One-third of the samples were smear- and culture-negative for bacterial agents. However, 88% of these culture-negative samples showed the presence of bacterial 16S rRNA by PCR. Sanger sequencing of 27 selected samples showed anaerobic/fastidious gram negative bacteria (GNB, 38%), facultative Streptococci (35%), and aerobic GNB (27%). Targeted metagenomics sequencing of three samples showed multiple bacterial species, including anaerobic and non-culturable bacteria. One FFPE tissue revealed the presence of Acanthamoeba 18S rRNA. None of the frozen brain abscess samples tested was positive for 18S rRNA of Acanthamoeba or Balamuthia mandrillaris. The microbial 16/18S rRNA PCR and sequencing outperformed culture in detecting anaerobes, facultative Streptococci and FLA in brain abscess samples. Genetic analyses of 16S/18S sequences, either through Sanger or metagenomic sequencing, will be an essential diagnostic technology to be included for diagnosing culture-negative brain abscess samples. Characterizing the microbiome of culture-negative brain abscess samples by molecular methods could enable detection and/or treatment of the source of infection.
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Data on the clinicopathological features of acute promyelocytic leukemia (APL) patients from India is limited. Present study was a cross sectional study which included 18 patients of APL. Medical records of these 18 patients were reviewed to collect their clinical details and laboratory results. High risk patients (total leucocyte count >10,000/cmm) were treated with modified APML 4 protocol.Low risk patients (total leucocyte count <10,000/cmm) were treated with protocol APL- 0406-Intergroup Study AL WP GIMEMA-DSIL protocol. Outcomes in terms of complete remission were assessed in both these groups. Mean haemoglobin levels was 7.03gm%, mean total leucocyte count was 30,462per cmm, mean platelet count was 27,222/cmm. Bone marrow was reported as suggestive of APL in 17 cases while in 1 case, BM aspirate was inadequate. Average percentage of abnormal promyelocytes in bone marrow was 84.25%. PT was prolonged in 15 cases, while APTT was prolonged in 3 cases. Flow cytometry analysis was done in 12 patients. All patients were CD45, MPO, CD13, CD33 and CD64 positive. Chromosomal analysis was possible in 11 cases. t(15;17)(q22;21) was identified in 6 cases (54.62%). 3 cases (27.27%) showed normal karyotype. 2 (18.18%) cases had additional cytogenetic abnormalities. All patients under high risk category attained CR. 1 patient under low risk category with additional cytogenetic abnormality died 6 days after induction therapy was started. 10 (55.55%) patients developed complications such as neutropenic sepsis, intracranial hemorrhage, differentiation syndrome, cerebral venous sinus thrombosis, pseudotumorcerebri, QTc interval prolongation, and pneumonia.
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Background: Post-hernioplasty chronic groin pain is one of the most important complications encountered after inguinal hernia repair. Routine ilioinguinal nerve excision has been proposed to avoid chronic post-hernioplasty neuralgia. The study aimed to evaluate the effect of routine ilioinguinal nerve excision compared to nerve preservation on chronic groin pain and other sensory symptoms in lichtenstein inguinal hernia repair.Methods: The study was conducted in the department of general surgery, at S.P. Medical College and PBM Hospital, Bikaner for duration of 15 months from august 2018 to November 2019. A total of 60 patients of uncomplicated inguinal hernia, who met the inclusion criteria, planned for lichtenstein hernioplasty were randomly divided into 2 groups with 30 cases with ilioinguinal nerve preservation (group A) and 30 cases with elective division of the nerve (group B). Follow up was done upto1 year and patients were inquired regarding pain, hypoesthesia and numbness and data was compared and analysed.Results: The incidence of post-operative neuralgia was 23.33% vs 6.67% (p=0.05) at 1 year in group A and group B respectively. The difference in pain was significant in both groups. The incidence of post-operative hypoesthesia was 10% vs 16.67% (p>0.05) at 1 year follow up in group A and group B respectively. The incidence of numbness was 11.11% vs 16.67% (p>0.05) at 1 year in group A and group B respectively. No statistically significant difference was found in both groups.Conclusions: The prophylactic exicision of ilioinguinal nerve during lichtenstein mesh repair decreases the incidence of chronic groin pain after surgery.
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Idiopathic Granulomatous Mastitis (IGM) is described as an uncommon, benign inflammatory breast disease of unknown etiology. Although its exact prevalence is unknown, IGM is considered to be very rare. Here, we report the case of a 36-year-old female who came to our hospital with complaints of pain and lump in the right breast since 2 months. We diagnosed the case as Sthana Vidradhi and vathakaphasamana chikithsa was administered. The wound was managed with vranaropakalepa and kashaya. After treatment, the wound was healed. Pain and tenderness were reduced and the lump was disappeared after two months of medication. The medication continued and complete recovery was noted after 6 months of treatment. The patient was monitored for six months after the complete cure.
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Efavirenz, a non-nucleotide reverse transcriptase inhibitor is an important drug for treating patients with Human Immunodeficiency Virus infections. It belongs to BCS class II have low solubility and poor intrinsic dissolution rate. It is highly basic (pKa 10.2) which makes it suitable candidate for floating dosage form for continuous delivery in stomach.The study was aimed to improve the solubility by solid dispersion technique.Saturation solubility study and drug content were evaluated for solid dispersion preparation. Saturation solubility shows 8 fold increases in 0.1 N HCL compared to plain drug and drug content was found to be between 95%-102%. Further effervescent floating gastroretentive drug delivery system was prepared by 32 full factorial design with independent variables i.e., concentration of HPMC K100 as matrix forming agent and citric acid as gas generating agent. Lag time, floating time, percent drug release were studied as responses. The optimized batch exhibited floating lag time of 40 sec and the in vitro release studies showed 89.5% drug release in 9 h and tablet remained floating for greater than 8 h. The study thus demonstrated that solubility is increased by solid dispersion technique and floating delivery systems may increase solubility and bioavailability of Efavirenz.
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Drug solubility poses numerous challenges in design of formulations for drugs with poor aqueous solubility. Ethionamide is an antitubercular drug belonging to biopharmaceutical classification system class II drug having less aqueous solubility. Nanosuspensions were prepared by using various solvents such as methanol, ethanol, acetone and chloroform and it was prepared using anti-solvent precipitation technique by using probe sonication. Various stabilizers such as tocopherolpolythytlene glycol succinate, polyvinylpyrrolidone and tween 80 singly or in combination were studied. A 32 factorial design was employed to study the effect of independent variables, concentration of stabilizers and stirring speed on particle size and cumulative percent drug release. The particle size of the optimized batch was 97.54 ± 8.47 nm with polydispersity index of 0.36 and zeta potential -10.1 ± 2.3 mV. The cumulative percent drug release of optimized batch was found to be 95.01 ± 1.16% in 60 min. Optimized batch was ultracentrifuged and evaluated for saturation solubility studies, stability and powder X-ray Diffraction studies. Optimized nanosuspension was loaded on Espheres by spraying in a coating pan and then coating of Eudragit controlled release polymers. The coated Espheres were evaluated for drug content, friability, scanning electron microscopy, ex-vivo permeation studies and drug release kinetics studies. The friability value for primary coated sphere was found to be 0.8 ± 0.12% and for secondary was 1% and the best fit model was found to be Korsmeyer-Peppas model which is indicative of diffusion controlled release. Ex vivo diffusion studies revealed a moderate increase in permeability.
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Shoulder arthroscopic surgeries can produce intense postoperative pain. Interscalene block provides good analgesia after shoulder surgery, but concerns over its associated risks have prompted the search for alternatives. Suprascapular block along with axillary nerve block was recently proposed as an alternative to interscalene block, but evidence of its comparative efficacy is conflicting. The aim of our study was to compare suprascapular and axillary nerve blocks with interscalene block in shoulder surgery for postoperative analgesia. Methods: A total of 76 patients scheduled for shoulder arthroscopic surgery were equally divided into two groups of 38patients each: Interscalene (ISB) group and suprascapular with axillary nerve (SHB) group. Both the nerve block was achieved by both ultrasound and nerve stimulator guidance. Visual analogue scale score was evaluated at 1, 4, 6, 12, and 24 h postoperatively. The time to first analgesia request, total analgesic requirement for 24 hr postoperatively, patient satisfaction, and any complications were recorded. Results: SHB provided equivalent analgesia to ISB in terms of post operative VAS scores.Time to 1st analgesia request was 7.2±1.3 hr in ISB group and 5.9±1.2 hr in SHB group which was not statistically significant.Patient satisfaction scores were significantly higher in SHB group compared to ISB group. Complication like subjective dyspnea and weakness of arm was significantly higher in ISB group compared to SHB group. Conclusions: SHB was as effective as ISB for postoperative pain relief but with fewer complications due to selective blockade of suprascapular and axillary nerve.
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Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus block prolongs motor and sensory blockade. However, the effect of dexamethasone when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in supraclavicular brachial plexus block. Methods: Ultrasound guided SCBP block was given to sixty patients, randomly assigned into two groups. Group S (thirty patients) received 2 mL normal saline with 25 mL levobupivacaine (0.5%) and Group D (thirty patients) received 2 mL of dexamethasone (8 mg) with 25 mL of levobupivacaine (0.5%), respectively. Time for the first rescue analgesia, number of rescue analgesics required in 24 h and different block characteristics was assessed. Chi square test and Student’s t test were used for statistical analysis. Results: Time for request of the first rescue analgesia was 396.13 ± 109.42 min in Group S and 705.80 ± 121.46 min in Group D (P < 0.001). The requirement for rescue analgesics was more in Group S when compared to Group D. The onset of sensory and motor block was faster in Group D when compared to Group S. The mean duration of sensory and motor block was significantly longer in Group D than Group S. Conclusions: The addition of dexamethasone to levobupivacaine in SCBP blockade prolonged time for first rescue analgesia and reduced the requirement of rescue analgesics with faster onset and prolonged duration of sensory and motor block.
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Carpal tunnel syndrome (CTS) is a common peripheral entrapment neuropathy in patients with hypothyroid. The diagnosis of CTS is usually clinical and confirmed by electrodiagnostic procedures. This study aimed to describe the diagnostic accuracy of high-resolution ultrasonography (US) as an alternative method to nerve conduction study for the diagnosis of subclinical CTS in patients with hypothyroidism before and after hormone replacement therapy. Methods: Sixty patients diagnosed with hypothyroidism were included in this study. Electrodiagnostic workup and ultrasonographic assessment of both right and left median nerves were done at the initial time of diagnosis and 3 months of euthyroid state after hormone replacement. Results: The comparison between right and left median nerves motor and sensory functions before and after treatment showed a significant change (P < 0.001). Right median nerve distal and proximal CSA were 13.5±1.4 mm2 and 10.6±1.5 mm2 respectively. On the left side CSA values were 13.1±2.1 mm2 and 9.9±0.5 mm2 respectively. After hormone replacement, values changed to 11.0±1.4 mm2 (distal) and 0.086±.003 mm2 (proximal) on the right side and 11.0±1.6 mm2 (distal) and 8.2±.0.4 mm2 (proximal) on the left side. 40 patients showed significant electrophysiological and radiological improvement with hormonal control. Conclusions: The US for median nerve cross sectional area can be used as a noninvasive diagnostic method which may be used for prognostication of CTS.
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To determine the etiology of headache in patients undergoing computed tomography (CT) scan of brain both with or without neurologic abnormality in South Odisha. Methods: A prospective study of six months duration was carried out at the M. K. C. G Medical College & hospital. It included 200 patients who underwent a brain CT for headache. CT findings of patients were analyzed. Results: The total number of our patients was 200. These etiologies were stroke (15%), followed by tumor(11%),sinusitis(7.5%),trauma (7.5%), abscesses(5%) and encephalitis (4%). Conclusions: CT of brain has revealed in 62.5% of cases as normal and detected the various causes in rest of cases.
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Background: Otosclerosis is not an uncommon condition in Telangana. Various methods such as perforator and laser are usedin performing stapedotomy during its surgical management. Stapedotomy performed with slow-speed microdrill technique forotosclerosis, and difficulties encountered during surgery, complications, and auditory gain in the post-operative period wereanalyzed in this study.Aim of the Study: The aim of this study was to use low-speed microdrill technique in stapedotomy and to analyze the difficulties,complications, and audiological evaluation in the post-operative period of 18 months.Materials and Methods: A prospective study of 62 patients undergoing stapedotomy for otosclerosis over a period of 2 yearswas reviewed. Stapedotomy with skeeter microdrill was evaluated using audiometric results (air conduction thresholds, boneconduction thresholds, air-bone gap closure, and pure tone average) and the incidence of complications during post-operativeperiod. Teflon prosthesis was used in all the patients.Observations and Results: Among the 62 patients, there were 37 females (59.67%) and 25 males (40.32%) with a male-tofemale ratio of 1:1.48. The patients belonged to the age group of 25–55 years with a mean age of 32.65 ± 4.15 years.Conclusions: Stapedotomy performed with microdrill technique for otosclerosis was a safe surgical technique to perforate thestapes footplate. The microdrill (skeeter) has low noise intensity and low torque. For duration of a few seconds, it seems to bea safe tool in creating a perforation in the footplate of the stapes, without causing acoustic trauma.
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Introduction: Mental foramen is defined as the funnel-like opening in the lateral surface of the mandible at theterminus of the mental canal. The mental foramen is the termination of the mandibular canal in the mandible,transmits the inferior alveolar nerve and vessels. Accurate position of the mental foramen would help surgeonsin achieving successful anaesthesia to the terminal branches of the inferior alveolar nerve. The aim of the studywas to evaluate the most common radiographic position of mental foramen in costal population of AndhraPradesh.Materials and methods: A total of 250digital panoramic radiographs were collected between age of 16 and60yrs, which fulfil the inclusion criteria.Results: We observed that, in 40.4% of individuals mental foramen was in line with second premolar (position 4)followed by 27.8% between the first and second premolars (position 3), least common is position 1 in 4% of thepopulation. We also observed the mental foramen position to vary with gender and on right and left sides.Conclusion: The most common position of mental foramen is position 4. Gender and right and left side variationswere also observed in our study. surgeons should carefully identity mental foramen position in achievingsuccessful anaesthesia to the terminal branches of the inferior alveolar nervebefore going for the surgery of thelower jaw and floor of the mouth
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The mortality rate from cardiovascular disease (CVD) in India is higher than the global figures (272 per 100,000 persons vs. 235 per 100,000 persons, respectively). Smoking, obesity, hypertension, diabetes and dyslipidemia are the known risk factors for atherosclerotic cardiovascular disease (ASCVD). The treatment of either condition aims to reduce the risk of ASCVD. This goal is achievable only when a holistic, simultaneous treatment is initiated and is monitored to reduce the blood glucose, blood cholesterol, and BP. India heralds a huge population of nearly 73 million people with diabetes. Diabetes is one of the major contributors of ASCVD, dyslipidemia and hypertension often coexist with diabetes. Patients diagnosed with either condition need risk stratification, followed by defining the treatment target for each risk category and developing appropriate treatment strategies based on the risk category. Unfortunately, there is no clear guideline that defines the treatment targets and subsequent management. This statement has been created based on the vast experience and an extensive literature review conducted by experts from multidisciplinary teams to address several treatment dilemmas that are routinely faced by clinicians when treating their patients with diabetes. An attempt is made to provide well-defined answers to these quandaries. This statement discusses screening, diagnosis, risk stratification, treatment targets, and management of dyslipidemia and/or hypertension in patients with diabetes and provides a roadmap for the treatment of Indian patients to curtail the risk of ASCVD.