An Empirical Study of the Nutritional Status of Severe Acute Malnourished (SAM) Children between Pre and Post Admission in Nutrition Rehabilitation Center (NRC)

The aim and objective of this research study was to compare the nutritional status of Severe Acute Malnourished (SAM) Children between Pre and Post admission in Nutrition Rehabilitation Center (NRC). The exploratory as well as descriptive research design was used. The nutritional status was checked by four test variables as Weight-kg, Height-cm, MUAC (Mid-Upper Arm Circumference). The sample size of this study was 211. The normality test was performed using One-Sample Kolmogorov-Smirnov Test. Since the data of four test variable was not normal, hence non-parametric test (Wilcoxon Signed Ranks Test) was used for the comparative study between pre and post condition. The findings concluded that there was a difference of the weight, height, MUAC, of the children in pre and post medical treatment in the NRC for the SAM children.

Levofloxacin in enteric fever--a study.

Typhoid fever is an important cause of morbidity and mortality in patients especially in developing country. Therapy with conventional drugs is associated with increasing resistance, non-compliance to therapy and toxicity. Oral fluoroquinolones have been shown to be effective compared to parenteral broad-spectrum cephalosporins in the treatment of uncomplicated typhoid. However, there is no data available regarding the use of levofloxacin in the treatment of typhoid fever in spite of the susceptibility of Salmonella species to levofloxacin. The present study was undertaken to evaluate the efficacy, safety and tolerability of oral levofloxacin 750 mg once daily in the treatment of typhoid fever. Results indicated that levofloxacin 750 mg administered orally once daily was an effective, safe, well-tolerated and cost-effective option in the treatment of typhoid fever in adult Indian males and non-pregnant females.

Screening and in vitro production of diplodiatoxin from the isolates of Stenocarpella maydis and its toxigenic effect on bacterial strains.

Stenocarpella maydis from different maize growing regions in South Africa were collected and screened for the presence of diplodiatoxin. The presence of diplodiatoxin in these isolates was detected by thin layer chromatography and further confirmed by atomic pressure chemical ionization mass spectrometry. Samples containing diplodiatoxin showed a strong positive ion at m/z=307. MC34, MC35, MC43 and MC50 isolates of Potchefstroom region produced high amount of diplodiatoxin, whereas some of the isolates from Potchefstroom (D72, D74, D78, D79 and D80) and Cedara (CH3 and U3H) regions did not contain diplodiatoxin. Experiments were conducted to optimize in vitro production of diplodiatoxin using the isolate MC 43. A varied range of pH (3.0 to 5.0) and various culture media viz., PDB, CME, CLM and MSM were tested. Growth of mycelium and production of diplodiatoxin was maximum in PDB media at pH 4.5 and it was observed that diplodiatoxin was produced in detectable quantity in the cultures older than 6 weeks in this media. Further, diplodiatoxin was isolated and purified from 8-weeks-old cultures of MC43 isolate and confirmed by nuclear mass resolution. The standard and the compound purified showed similar NMR spectrum. Sixty-gram (fresh weight) mycelium yielded 19.52 mg of diplodiatoxin. Effect of diplodiatoxin on the growth of various bacterial strains in agar-gelled LB media was studied. They showed different range of tolerance to diplodiatoxin. The increasing order of tolerance to diplodiatoxin was Stenocarpella maydis < B. cereus < B. subtulus < P. fluorescense < E. coli. Further, the effect of different concentrations (4.88-49.70 microg/mL) of diplodiatoxin on the growth of S. aureus in LB liquid media was studied. Presence of diplodiatoxin in the media reduced cell growth as compared to the control thus, confirming anti-bacterial activity of diplodiatoxin.

Observations on the breeding habitat of Aedes species in the steel township, Rourkela.

Prompted by report of large number of dengue fever cases in township of Rourkela steel plant, entomological surveys were carried out to know the distribution and extent of Aedes breeding in and around the dengue fever affected areas. Out of 2062 water containers searched, 819 were positive for Aedes larvae. The house index (HI), container index (CI) and Breteau index (BI) were 53.4, 39.7 and 118.5 respectively. 27.9% of the houses had single breeding habitats. The breateau index of single storeyed houses and double storeyed buildings was 149.8 and 54.6 respectively, showing that the single storeyed houses have more potential for Aedes breeding. The breeding preference ratio (BPR) was highest for plastic containers. Three species of Aedes were found breeding in different habitats and Aedes aegypti was found breeding in coolers, cement tanks, tyres and miscellaneous containers with a prevalence rate of 13.2%. The role of entomological surveillance and health education has been highlighted for the control of disease through community participation.

Nocardia Asteroides keratitis: report of seven patients and literature review.

PURPOSE: To describe clinical features and treatment outcomes in patients with advanced Nocardia asteroides keratitis. METHODS: Retrospective review of case records of 7 patients with culture-proven Nocardia keratitis. RESULTS: Corneal infection occurred after corneal trauma in two patients, cataract surgery in three patients, penetrating keratoplasty in one patient and was associated with a silicone buckle element infection in one patient. Mean duration of infection at presentation was 33.4 days (7-75 days), and five patients had received prior treatment with corticosteroids. Six of seven patients had deep corneal suppuration at the time of presentation, clinically suggestive of mycotic keratitis. In two patients who had received prolonged corticosteroid therapy (> or = 45 days), the eyes could not be salvaged. Complete resolution of infection was achieved in all 4 eyes treated with topical fortified cefazolin eye drops (50 mg/ml).

Partial flap during laser in-situ keratomileusis: pathogenesis and timing of retreatment.

PURPOSE: To report the timing of retreatment and clinical outcomes in patients with a partial corneal flap during laser in-situ keratomileusis (LASIK), and to describe the causes of this complication. METHODS: Retrospective review of case records of four patients (4 eyes) who had a partial corneal flap during LASIK. RESULTS: The mean age of the four patients was 23 +/- 4.7 years, and mean preoperative spherical equivalent (SE) refraction was -9.1 +/- 3.1 D (range, -5.5 to -13 D). A 160 microns corneal flap was attempted during the initial treatment. Retreatment with a 180 microns corneal flap was performed at a mean of 5.1 +/- 1.6 weeks (range, 4 to 7.5 weeks) after the initial procedure. There were no intraoperative complications during retreatment. Post-LASIK mean SE refraction was -1.0 +/- 1.1 D (range, +0.38 to -2.0 D), after a mean follow up of 19 +/- 15.7 weeks (range, 7 to 42 weeks). Best spectacle-corrected visual acuity decreased in one eye from 6/5 to 6/6 and was maintained in the others. CONCLUSION: LASIK retreatment can be performed as early as one month after a partial flap, if the refraction is stable and a thicker corneal flap is created.

Fellow eye treatment in excimer photo refractive keratectomy.

PURPOSE: To describe symmetry of response in fellow eyes of patients undergoing photorefractive keratectomy (PRK) for myopia, analyse the risk factors leading to asymmetry in response and to determine if delayed treatment of the second eye increases safety and predictability of PRK. METHODS: Retrospective review of case records of 133 patients who underwent bilateral myopic PRK and had a minimum follow up of 6 months in both eyes. RESULTS: Postoperative uncorrected visual acuity, spherical equivalent (SE) refraction within +/- 1 D of emmetropia, best-corrected visual acuity (BCVA) and corneal haze were not significantly different in fellow eyes of patients undergoing PRK for myopia. Of 87 eyes in group 1 (myopia < 6 D), 96.6% had uncorrected visual acuity > or = 6/12, 89.7% were within +/- 1 D of emmetropia, none lost > or = 1 line BCVA, and none had haze > or = grade 3. Similar results for 98 eyes in group II (myopia 6 to 9.9 D) were 75.6%, 55.1%, 2.0% and 2.0% respectively. For 81 eyes in group III (myopia > or = 10 D) the results were 42.7%, 33.3%, 8.6%, and 4.9% respectively. Among 84 patients with similar preoperative myopia in both eyes, 54 (64.3%) patients had a postoperative SE difference < or = 1 D in fellow eyes. Risk factors for asymmetric response among fellow eyes included increasing preoperative myopia (p < 0.001) and dissimilar treatment technique in the two eyes (p = 0.03). Corneal haze did not increase significantly after the third postoperative month. CONCLUSION: This study demonstrates that considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK. Early PRK in the fellow eye of patients with < 6 D myopia is safe and allows quick visual rehabilitation of the patient. In patients with myopia > or = 6 D, a 3-month interval before treating the second eye may improve the safety of the procedure.

Herpes simplex virus DNA in the lens one year after an episode of retinitis.

The present report describes a case where HSV was detected by polymerase chain reaction (PCR) in the lens cortical material removed during cataract surgery one year after resolution of retinal inflammation in a patient with ARN.

Inferior limbal-conjunctival autograft transplantation for recurrent pterygium.

PURPOSE: To study the safety and efficacy of inferior limbal-conjunctival autograft (LCAT) transplantation in the surgical management of recurrent pterygium. METHODS: Prospective non-comparative case series. Inferior limbal-conjunctival autografting was performed on 11 patients (11 eyes) with recurrent pterygium. Pterygium recurrence was considered a surgical failure. RESULTS: Recurrence of pterygium was noted in two (18.2%) eyes, after a mean follow up of 16.2 +/- 0.9 months (range: 10-19 months). Neither recurrence required further surgical treatment. Nonprogressive pseudopterygium formation was noted at the donor site in five (45.5%) eyes. CONCLUSION: Inferior LCAT appears to be a safe and effective option in the management of recurrent pterygium. In patients with suspected or proven glaucoma, this may be the procedure of choice, if mitomycin C is contraindicated.

Excimer laser phototherapeutic keratectomy: indications, results and its role in the Indian scenario.

PURPOSE: To report indications, technique, and results of excimer phototherapeutic keratectomy (PTK), and describe possible reasons for the small numbers of such procedures performed in a referral institute in India. METHODS: Retrospective review of case records of 10 patients (11 eyes) who underwent excimer PTK at our institute between February 1994 and September 1997. RESULTS: Corneal scars were the most common indication for treatment. Best-corrected visual acuity (BCVA) improved in 6 eyes (mean: 2 lines of Snellen acuity). All eyes had BCVA > or = 6/12 after treatment. None of the patients experienced loss of BCVA after treatment. Unaided visual acuity improved in 3 eyes and decreased in 2 eyes. Change in spherical equivalent refraction > or = 1 diopter occurred in 77.8% of eyes after treatment. Treating central corneal scars resulted in a significant hyperopic shift in refraction. CONCLUSIONS: Excimer PTK is a safe and effective procedure for the treatment of superficial corneal opacities. Post-treatment ametropia may require further correction with optical aids. Inappropriate referrals, deep corneal scars, and cost of the procedure could have contributed to the small numbers of PTK performed at our institute. Improved understanding of procedural strengths and limitations could lead to increased use of this procedure, with satisfying results in selected patients.

Conjunctival-limbal autografts for primary and recurrent pterygia: technique and results.

Our technique of pterygium excision with conjunctival-limbal autografting is described and the safety and efficacy of the procedure in India is analysed. Case records of 51 consecutive patients (53 eyes) who underwent surgery at our institute between November 1992 and September 1994 were retrospectively analysed. Recurrence was defined as fibrovascular tissue crossing the corneoscleral limbus onto clear cornea in the area of previous pterygium excision. 2 (3.8%) of the 53 pterygia (primary 36; recurrent 17) recurred, after a mean follow up of 18.9 +/- 12.1 months (range: 1.5-43 months). Both recurrences occurred within a year of follow up, in patients who were < or = 40 years of age. No major operative or postoperative complications were encountered. The inclusion of limbal tissue in conjunctival autografts following pterygium excision appears to be essential to ensure low recurrence rates. The technique is safe, simple and inexpensive and is recommended for the management of both primary and recurrent pterygia in Indian eyes.

Underutilization of the available services by the needy disabled leprosy patients in Government Leprosy Control Unit Puttoor, Chittoor district, Andhra Pradesh, South India.

This study was undertaken to find out the deformity profile, utilization of disability care services, factors associated with underutilization and the impact of educating leprosy patients with visible disabilities in self-care practices in the area covered by the LCU Chittoor. The disability prevalence rate in the area was 15 per 10,000 population. Training of the staff and teaching leprosy patients in self-care practices has shown a remarkable improvement in skin texture and ulcer situation of disabled leprosy patients.

Evaluation of laboratory tests for diagnosis of chlamydial infections in conjunctival specimens.

We evaluated the chlamydial direct diagnostic tests and McCoy cell culture methods for detection of Chlamydia trachomatis in 234 conjunctival scrapings from 127 patients. Direct (rapid) diagnostic methods of Giemsa stain cytology, fluorescent antibody test (FAT) and immunoperoxidase (IPO) stain and McCoy cell culture isolation method using IPO staining and FAT for detection of C. trachomatis antigen were carried out. McCoy cell culture isolation using FAT antigen detection method was considered as the gold standard. The specificity of all the direct diagnostic tests were above 90 per cent but sensitivity of Giemsa cytology, FAT and IPO stain were 36, 54 and 53 per cent respectively showing that as direct diagnostic tests Giemsa stain cytology was inefficient and FAT and IPO were useful. Specificity and sensitivity of McCoy cell culture using IPO stain for detection C. trachomatis antigen were above 90 per cent and it is suggested that this test can be used as a routine diagnostic method.