Comparison of Multisystem Inflammatory Syndrome (MIS-C) and Dengue in Hospitalized Children

Objective Multisystem infammatory syndrome (MIS-C) in children is a febrile illness that has overlapping presentation with other locally prevalent illnesses. Clinicolaboratory profle of children admitted with MIS-C and dengue were compared to understand their presentation at the outset. Methods This was a retrospective study of children?12 y admitted with MIS-C (WHO defnition) or laboratory-confrmed dengue between August 2020 and January 2021 at a tertiary center in North India. Results A total of 84 children (MIS-C - 40; dengue - 44) were included. The mean (SD) age [83.5 (39) vs. 91.6 (35) mo] was comparable. Rash (72.5% vs. 22.7%), conjunctival injection (60% vs. 2.3%), oral mucocutaneous changes (27.5% vs. 0) and gallop rhythm (15% vs. 0) were seen more frequently with MIS-C, while petechiae [29.5% vs. 7.5%], myalgia (38.6% vs. 10%), headache (22.7% vs. 2.5%), and hepatomegaly (68.2% vs. 27.5%) were more common with dengue. Children with MIS-C had signifcantly higher C-reactive protein (124 vs. 3.2 mg/L) and interleukin 6 (95.3 vs. 20.7 ng/mL), while those with dengue had higher hemoglobin (12 vs. 10.2 g/dL) lower mean platelet count (26 vs. 140× 109 /L), and greater elevation in aspartate (607 vs. 44 IU/L) and alanine (235.5 vs. 56 IU/L) aminotransferases. The hospital stay was longer with MIS-C; however, PICU stay and mortality were comparable. Conclusion In hospitalized children with acute febrile illness, the presence of mucocutaneous features and highly elevated CRP could distinguish MIS-C from dengue. The presence of petechiae, hepatomegaly, and hemoconcentration may favor a diagnosis of dengue.

Prevalence And Determinants of Anemia Among Adolescents in Coimbatore District, Tamil Nadu – A School Based Analytical Cross-Sectional Study

Context: The objective of the study was to estimate the prevalence of anemia among adolescents 10 to 19 years of age disaggregated by age group and gender. We also assessed the determinants of anemia among ad-olescents. Methods: An analytical cross-sectional study was carried out between July and November 2019 in a senior secondary public school, located in Coimbatore district, Tamil Nadu, India using a predesigned, semi-structured, pretested proforma that included haemoglobin estimation using oxyhemoglobin method. Results: The overall prevalence of anemia was 88.6% (95% CI 87.2 to 89.8); it was ten percent points higher in females (93.8%, 95% CI 92.1 to 95.1) compared to males (83.9%, 95% CI 81.7 to 85.8). Multivariate regres-sion analysis showed that early adolescents (AOR 3.05, 95% CI 2.19 to 4.24), females (AOR 6.94, 95% CI 4.90 to 9.83), those with A or B or AB blood groups (AOR 2.58, 95% CI 1.92 to 3.49), physical inactivity (AOR 2.18, 95% CI 1.43 to 3.33) and attainment of menarche (AOR 2.69, 95% CI 1.73 to 4.21) were independent predic-tors of anemia in adolescents. Conclusion: It is the need of the hour to identify vulnerable groups; factors that predict occurrence, prioritize them to design and implement an effective public health action. Also, the effectiveness of existing strategies in the form of periodic deworming, Iron and Folic acid tablets (IFA) should be reassessed.

Simulation-based training in ear, nose and throat skills and emergencies

Abstract Objectives: The aim of the study was to compare lecture-based teaching and simulation-based hybrid training for ENT induction and objectively assess the performance of trainees in a simulated environment. Methods: This is a prospective interventional study that included 60 interns in their rotatory internship with no prior exposure to ENT emergencies. The interns came in batches of 5-6 for their 15-days ENT postings. On the first day, a pre-test questionnaire, lecture-based teaching on three scenarios and then allocation into one of the three simulation groups- Group A (Tracheostomy group), Group B (Nasogastric tube group), and Group C (Epistaxis group) was done. Hands-on simulation training was given only to the assigned group. At the end of 15-days, post-test questionnaire and an objective assessment of the three scenarios in a simulated environment was conducted. The same training was repeated for each batch of participants who attended the posting. Results: The participants had significant improvement in the post-test scores in all three scenarios (p < 0.05), and these improvements were marked in those who had received simulated training. On comparing simulation scores, the participants who received hands-on training on a particular scenario outperformed other (p < 0.05). Conclusion: Simulation-based training improves cognition and overall confidence in managing ENT skills and emergencies. In simulation training, objective and standardized assessment is the key to achieve specific learning objectives to improve the psychomotor and cognitive skill. Level of evidence: II.

Endovascular management of bilateral renal angiomyolipoma in a perimenopausal woman / Manejo endovascular de angiomiolipoma renal bilateral em uma mulher na perimenopausa

Abstract Renal angiomyolipoma is a benign and progressive tumor consisting of smooth muscle, fat, and vascular elements and is commonly associated with the tuberous sclerosis complex. Bilateral occurrence is rare and recent evidence suggest strong tumor positivity to female hormones with enlargement during pregnancy and oral contraceptive therapy. Treatment varies from a minimally invasive approach with selective embolization of the renal artery to partial nephrectomy or sometimes even radical nephrectomy. Presented here is a case of bilateral renal angiomyolipoma in 50-year-old lady who was successfully treated with super-selective embolization.

Resumo O angiomiolipoma renal é um tumor benigno e progressivo composto por músculo liso, gordura e elementos vasculares, comumente associado ao complexo da esclerose tuberosa. Sua ocorrência bilateral é rara, e evidências recentes sugerem forte positividade do tumor para hormônios femininos, com aumento do tamanho durante a gravidez e uso de contraceptivos orais. O tratamento varia desde uma abordagem minimamente invasiva de embolização seletiva da artéria renal até nefrectomia parcial ou, às vezes, nefrectomia radical. Apresentamos um caso de angiomiolipoma renal bilateral em uma mulher de 50 anos que passou por tratamento bem-sucedido com embolização superseletiva.

Comparison conventional endoscopic myringoplasty with fibrin glue supplemented endoscopic myringoplasty

Introduction: The fibrin tissue glues have been used in many surgeries to reinforce surgical sutures and tissue adhesion. Myringoplasty is the commonly done ear surgery for the perforations of the tympanic membrane, where no suturing is done between remnant membrane and graft. Aim: The aim of the study is to compare the results and effectiveness of this biological fibrin tissue glue in myringoplasty surgeries as a supplementary procedure to conventional endoscopic myringoplasty (CEM) surgeries. Materials and Methods: Seventy patients with chronic suppurative otitis media with tympanic membrane perforation without ossicular and mastoid involvement have been chosen. One group of 35 patients underwent CEM surgeries. In another group of 35 patients, biological fibrin tissue glue, TISSEEL, has been used as supplementary to the CEM surgeries, and the graft uptake rate and hearing improvement were evaluated and compared postoperatively. Results: The graft success rate at 3 months postoperatively was 91.42% in both the groups, that is, 32/35, and these values were not statistically significantly different (P = 1.00). There was a highly statistically significant hearing outcome before and after the surgery in both the CEM and the fibrin tissue glue supplemented endoscopic myringoplasty groups. However, there was no statistically significant change in hearing outcomes between the two groups. Conclusion: In our study, we have got more or less similar results compared with the results of the studies on routine CEM cases. But the high-cost nature of the commercially available fibrin tissue glue makes it difficult to recommend for use in all routine endoscopy myringoplasty cases

Prevention and amelioration of erythrocyte instability observed under deficiency of vitamin B12 alone or combined with micronutrient limitation through dietary supplementation with Chlorella and Spirulina

Micronutrient rich microalgae, Chlorella and Spirulina, could be natural food supplements to overcome the micronutrient deficiency, increasingly recognised as a global health issue. In two independent experiments, the Spirulina and Chlorella were evaluated as prophylactic and ameliorative dietary supplements of vitamin B12. Erythrocyte stability (relative osmotic fragility and haemolysis percentage), haematological parameters, micronutrient deficiency (serum levels of iron, zinc), plasma vitamin B12 and vitamin B12 biomarker (methylmalonic acid) were analysed. The deficient groups receiving Spirulina and Chlorella as prophylactic dietary supplements showed a 1.34 to 1.41 folds increase in serum iron and a 2.13 to 2.19 folds increase in plasma vitamin B12, compared to B12 deficient group. Supplementation of Spirulina to ameliorate vitamin B12 deficiency combined with micronutrient limitation showed an increase of 1.14 folds and 1.2 folds in serum iron and zinc respectively and 1.51 folds in plasma vitamin B12 compared to the deficient group. The relative osmotic fragility of erythrocytes in deficient experimental animals was 17 to 45% higher compared to the control. The osmotic fragility and deformation in the morphology of erythrocytes observed under vitamin B12 deficiency, alone or in combination with micronutrient limitation, were prevented and ameliorated on dietary supplementation with the microalgal biomass.

Delayed presentation of enterocutaneous fistula after tubal ligation: a case report

A 50-year-old woman with a history of tubal ligation nine years earlier, presented with a complaint of discharge from the scar site. She was found to have an enterocutaneous fistula. The patient underwent an exploratory laparoscopy. The tract excised and primary repair of bowel done. A unique feature of the case is the formation of an enterocutaneous fistula after an extremely long latency due to gauze threads, which has not been previously reported in the literature.

Hairy Tongue - A Series of 4 Cases

The term black hairy tongue was first coined by Amatus Lusitanus in the year 1557.1 It is a reactive hypertrophy and defective desquamation of filiform papilla causing hair-like projections usually affecting the dorsum of the tongue. Hairy tongue is known by other names such as lingua villa nigrosa. Patients with Hairy tongue is usually asymptomatic but occasionally complaints of dysgeusia, Glossopyrosis, or Halitosis. The Glossopyrosis in Hairy tongue was probably due to the growth of candidal colonies, which causes burning sensation on the affected dorsum of the tongue.Hairy tongue is a benign condition characterised by hypertrophy of Filiform Papilla on the dorsum of the tongue. Hairy tongue is prevalent among 0.4 % among south Asian Population. Hairy tongue clinically appears as elongated hair like projections on the dorsum of the tongue which gets stained blackish brown due to the presence of carbon in the tobacco smoke.CONCLUSIONSHairy tongue is usually asymptomatic. Some cases were associated with halitosis, glossopyrosis and dysgeusia (altered taste sensation), and metallic taste. A thorough detailed history is always necessary for establishing the diagnosis and treatment of hairy tongue.

Dosimetric evaluation of 6 MV and 18 MV intensity-modulated radiotherapy plans for treatment of carcinoma of the cervix

Introduction: Cervical cancer (Ca Cx) is the fourth most frequent cancer in women with an estimated 57000 new cases in 2018 representing 6.6% of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries. Material and Methods: A retrospective radiotherapy treatment planning comparative study conducted at the Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore during June 2018- March 2019. Result: All the plans were normalized to 100 % at Target mean to achieve a similar target dose for quantitative comparison of DVHs. The results for target coverage, OAR sparing, integral dose, and monitoring units. Conclusions: The tradeoff of using 6 MV and 18 MV for cervix patients depends on many parameters. Since the same PTV coverage was forced for both energies by having the same optimization constraints, there was little difference in target coverage and conformity index for both energies.

Cadmium (Cd) and Chlorpyrifos (CPF) Induced Pulmonary Toxicity in Wistar Rats

The present study was aimed to know the pulmonary toxicity by individual toxicities of cadmium, chlorpyrifos and their combination in albino wistar rats. The experiment was carried out for 28 days. Group 1 - Control. Group 2 - Cadmium chloride (Cd) @ 22.5 mg/ kg b.wt /per oral / day. Group 3 - Chlorpyrifos (CPF) @ 25 mg/ kg b.wt /per oral / day. Group 4 - Cadmium chloride (Cd) @22.5 mg + Chlorpyrifos (CPF) @ 25 mg/ kg b.wt /per oral / day. Lungs showed mild to moderate congestion in groups 2 and 3 and moderate to severe in group 4 on 15th and 29th day of the experiment. Lung sections of control rats showed normal architecture. Lung sections of group 2 rats on 15th day showed hemorrhages in the interstitium spaces with infiltration of lymphocytes, On 29th day, mild hyperplasia and desquamated bronchial epithelial cells, peri bronchial and peri vascular lymphoid aggregates were noticed. The sections of lung on 15th day of group 3 rats showed exudate and desquamated epithelial cells in the lumen of secondary bronchiole , on 29th day, emphysematous alveoli with loss of architecture of alveolar epithelium, interstitial edema with infiltration of lymphocytes, mild hyperplasia of bronchial epithelial cells were also noticed. In group 4 rats, similar lesions as described in groups 2 and 3 were observed with severe intensity on 15th and on 29th day of the experiment. In combined toxicity group, the severity of lesions were more thus suggesting synergistic effects of these components.

Knowledge, attitude and practice of mothers and prospective mothers in neonatal care and utilization of perinatal care services

Background: The present study was done with the aim to study existing knowledge, attitude and practice (KAP) about neonatal care, perinatal care and its services, among mothers (pregnant and lactating mothers).Methods: This cross-sectional study was done among 624 pregnant women and in mothers of newborn in both rural and urban areas around Vijayawada during the period from October 2015 to November 2017. A structured questionnaire reflecting KAP about neonatal care and perinatal care services was used in the study. The collected data was placed in a proforma and analysed.Results: Rural (53.8%) and urban (46.2%) mothers are equally represented in the present study. There is a slight preponderance of lactating mothers (52.2%). Most of the mothers are homemakers (82.1%) and belong to nuclear families (90.1%). There is a considerable deficiency in the knowledge nearly 45% ad practices nearly 40%, related to the number of ANC's. The proportion of mothers receiving baby's immunization advice from obstetrician is 18.5% and from paediatrician is 26.4%. Neonatal infection prevention was not advised in 71.3% of mothers and 23.5% mothers receive advice from obstetrician and 19.1% from paediatrician. The practice of staring first breast feed within one hour is not implemented about 88% of mothers. Nearly 30% of the mothers are not keeping the baby warm and nearly 90% of the mothers are not aware of KMC.Conclusions: The findings of the study conclude that there is a need for systematic and planned health education by the paediatrician and obstetrician to increase the KAP among mothers about neonatal health care.

Clinical epidemiology of paediatric febrile and afebrile in-patients and their association with thrombocytopenia

Background: Fever is one of the commonest and thrombocytopenia is one of the common clinical problems in children. The current study was done with the aim to identify the frequency and the etiology of thrombocytopenia in febrile children. This study was planned to identify epidemiological observations associated with pediatric fever and with febrile thrombocytopenia children, in this area among hospitalized children.Methods: A sample of 530 children of age 6 months to 18 years were studied. Febrile children were taken as cases (n=268) and afebrile children as controls (n=262). Demographic, clinical and laboratory characteristics were measured and compared between the cases and controls.Results: Significant proportion of 1-3 years age group of children belong to febrile group compared to afebrile group. There is no significant difference in the gender, region, WFH or BMI, WFA, HFA between febrile and afebrile children. No significant difference in pulse rate, respiratory rate; TLC, ALC, ANC, Hb; Widal test or CRP was noted between pyrexial and apyrexial children. The median platelet count, in the pyrexial group is significantly lower than that of apyrexial group. Prevalence of thrombocytopenia in pyrexial group is significantly more than that observed in apyrexial group. The commonest illness in pyrexial group is non-bacterial-probable viral illness (59.7%). In the apyrexial group the common diseases are neurological (36.6%) disorders.Conclusions: Prevalence of thrombocytopenia is 11.45% in febrile children and in afebrile children it is 2.38%. In this study, viral infections and neurological disorders are the commonest etiology in febrile group and afebrile children respectively.

Immunomodulatory effect of Quercetin on dysregulated Th1/Th2 cytokine balance in mice with both type 1 diabetes and allergic asthma

T-helper subtype imbalance is intricate in type 1 diabetes (T1D) and asthma initiation. The role of quercetin in immunedysregulation in comorbid conditions of T1D and asthma is not available. In this study, it was thought worthy toevaluate the role of quercetin on modulating Th1/Th2 cytokine dysregulation in comorbid diabetic asthma. Male Balb/cmice were injected intravenously with alloxan (80 mg/kg) to persuade T1D. Succeeding diabetes introduction, twointraperitoneal sensitizing doses of ovalbumin emulsion (50 µg ovalbumin blended with 2.5 mg alum/sensitization) weregiven on days 3 and 8. Mice were given intranasal challenges of ovalbumin (100 µg ovalbumin/25 µl of sterile saline) ondays 13–15. Oral quercetin treatment (10–30 mg/kg) was given daily on days 3–15. Nasal hyperresponsiveness (NHR)was recorded immediately after Ova challenge on day 16. Bronchoalveolar lavage fluid (BALF), blood, and lungs werecollected 1-hour post NHR for further analysis. Quercetin treatment significantly decreased eosinophils, interleukin-4while increasing interferon-gamma in blood, and BALF and reduced the allergic airway inflammation by inhibitinginflammatory cell infiltration and mucous cell metaplasia. Furthermore, quercetin with a dose of 30 mg/kg demonstrateda significant glucose reduction. Thus, quercetin exerted dose-dependent anti-asthma activity by modulating Th1/Th2balance with glucose-lowering potential in comorbid mice.

Paclitaxel and spirulina co-loaded polymeric nanoparticles: in-vitro and in-vivo anticancer study

Paclitaxel spirulina nanoparticles were said to have promising anticancer activity against gastric cancer. Nanoparticles of paclitaxel-spirulina were prepared for treating gastric cancer using precipitation technique. The synergistic anticancer efficiency againstMKN45 cells retains when the paclitaxel and spirulina were encapsulated into nanoparticles. To increase the site specific delivery, intra-tumoral administration was carried in the in vivo evaluation. There was an increase in overall survival in an MKN45-transplanted mice model and notable improvement in anti-tumour efficacy when paclitaxel-spirulina nanoparticles were delivered through intra-tumoral administration. The further investigation of overall anticancer mechanism of these nanoparticles is made as a major part in this research. Hence, the conjecture of this research is that, the paclitaxel-spirulina encapsulated nanoparticles could be an effective chemotherapeutic formulation for gastric cancer.

Rapid deployment of an emergency department-intensive care unit for the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic mandated rapid, flexible solutions to meet the anticipated surge in both patient acuity and volume. This paper describes one institution’s emergency department (ED) innovation at the center of the COVID-19 crisis, including the creation of a temporary ED–intensive care unit (ICU) and development of interdisciplinary COVID-19–specific care delivery models to care for critically ill patients. Mount Sinai Hospital, an urban quaternary academic medical center, had an existing five-bed resuscitation area insufficiently rescue due to its size and lack of negative pressure rooms. Within 1 week, the ED-based observation unit, which has four negative pressure rooms, was quickly converted into a COVID-19–specific unit, split between a 14-bed stepdown unit and a 13-bed ED-ICU unit. An increase in staffing for physicians, physician assistants, nurses, respiratory therapists, and medical technicians, as well as training in critical care protocols and procedures, was needed to ensure appropriate patient care. The transition of the ED to a COVID-19–specific unit with the inclusion of a temporary expanded ED-ICU at the beginning of the COVID-19 pandemic was a proactive solution to the growing challenges of surging patients, complexity, and extended boarding of critically ill patients in the ED. This pandemic underscores the importance of ED design innovation with flexible spacing, interdisciplinary collaborations on structure and services, and NP ventilation systems which will remain important moving forward.

Correlation Between Length of Work and Work Posture With Low Back Pain Complaint among Back Office Employees at X Hospital Serpong District, South Tangerang, Indonesia

@#Introduction: Low Back Pain (LBP) is an occupational disease that is often the main cause of disability, thus affecting the work and general welfare of LBP sufferers. The objective of the present study is to determine the correlation between length of work and work posture with complaints of LBP among back-office employees at X Hospital. Method: The design of this study was a descriptive analysis, with cross-sectional study design, by total sampling technique for 44 back-office employees. Work posture risk assessment uses the Ovako Working posture Assessment System (OWAS) method and LBP complaints are measured using the Modified Oswestry Low Back Pain Disability Questionnaire. Results: Most respondents experienced LBP complaints in the moderate disability category, and 40 people (90,9%) needed to improve their work posture. Spearman correlation statistical test results showed there was a relationship between age (p-value =0,000), the length of work (p-value = 0,000), work posture (p-value = 0,009) with LBP complaints on back-office employees. Conclusion: Providing work facilities with ergonomic chairs and tables position and doing stretching in between work hours can reduce LBP complaints.

Rapid deployment of an emergency department-intensive care unit for the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic mandated rapid, flexible solutions to meet the anticipated surge in both patient acuity and volume. This paper describes one institution’s emergency department (ED) innovation at the center of the COVID-19 crisis, including the creation of a temporary ED–intensive care unit (ICU) and development of interdisciplinary COVID-19–specific care delivery models to care for critically ill patients. Mount Sinai Hospital, an urban quaternary academic medical center, had an existing five-bed resuscitation area insufficiently rescue due to its size and lack of negative pressure rooms. Within 1 week, the ED-based observation unit, which has four negative pressure rooms, was quickly converted into a COVID-19–specific unit, split between a 14-bed stepdown unit and a 13-bed ED-ICU unit. An increase in staffing for physicians, physician assistants, nurses, respiratory therapists, and medical technicians, as well as training in critical care protocols and procedures, was needed to ensure appropriate patient care. The transition of the ED to a COVID-19–specific unit with the inclusion of a temporary expanded ED-ICU at the beginning of the COVID-19 pandemic was a proactive solution to the growing challenges of surging patients, complexity, and extended boarding of critically ill patients in the ED. This pandemic underscores the importance of ED design innovation with flexible spacing, interdisciplinary collaborations on structure and services, and NP ventilation systems which will remain important moving forward.

Development of a microarray-based method for simultaneous detection and serotyping of Streptococcus pneumoniae from culture negative serum samples

Streptococcus pneumoniae identification and serotyping are vital for disease management, surveillance, vaccinedevelopment, and to monitor the emerging serovars. Despite the potential benefits of conventional typing methodbased on culture isolate, it lacks the ability to type directly from the clinical samples. To address the challenge,a novel microarray method was developed to identify and serotype S. pneumoniae in culture positive andculture negative serum specimens. The custom pneumococcal microarray chip was designed using sure designsoftware and evaluated with 90 reference strains, culture positive quantitative real time multiplex polymerasechain reaction (qmPCR) positive (n = 8) and culture negative qmPCR positive (n = 96) serum samples. Toselectively amplify S. pneumoniae DNA from serum, three different methods: (a) Capsular polysaccharidePCR, (b) Whole genome amplification, and (c) Microbial DNA enrichment were assessed. An in-housedeveloped excel-based software was used to quantify the signals from each serotype. With a combination ofMicrobial DNA enrichment, the custom pneumococcal microarray chip identified all the reference strains andserum samples serogroup/type information accurately. Of the 104 serum samples, 65 were uniquely identifiedand 39 were assigned with a combination of their homologous types. A 100% concordance was observed withthe results of qmPCR and PCRSeqTyping methods with an additional advantage of multiple serotype detection.Our results signify the ability of the microarray technology to identify and detect S. pneumoniae serogroup/typefrom culture-negative serum specimens. The test is of use even in patients with prior antibiotic treatment andcan be used in surveillance and vaccine impact studies.

Cytological intracellular glycogen evaluation using PAS and PAS-D stains to correlate plasma glucose in diabetics

Background: Oral cytology studies have claimed that cytoplasmic Periodic Acid Schiff (PAS) positivity in type-2 diabetics is due to glycogen content. But, it can also be due to mucin and glycoconjugates. Aim: 1. To confirm that cytoplasmic PAS positivity in type-2 diabetics is due to glycogen using diastase. 2. To know the effect of diabetes by determining the number of glycogen-containing cells in the smear. 3. To assess the impact of duration of diabetes based on PAS staining of cells. 4. To correlate between random blood glucose level and the number of PAS-positive cells. Materials and Methods: Study population comprised 45 individuals with 30 type-2 diabetics as case group (Group I < 5 years duration; Group II > 5 years duration) and 15 healthy volunteers (age and gender-matched) as control. For all subjects, random blood glucose was estimated and two cytosmears were obtained. The smears were stained with PAS and PAS-diastase stains (PAS-D). Staining intensity was documented as score 1 (mild-to-moderate) and score 2 (moderate-to-intense) and data obtained were statistically analyzed in SPSS version 16.0. Results: Mann-Whitney U test revealed that in diabetics cytoplasmic PAS positivity is because of glycogen (P < 0.05). There is an increase in the number of glycogen-containing cells (P < 0.05) in diabetics. The duration of diabetes had less impact on intracellular glycogen accumulation (P > 0.05). Spearman's correlation test revealed no significant correlation (P > 0.05) between random blood glucose and a number of PAS-positive cells. Conclusion: PAS positivity is because of intracellular glycogen accumulation in type-2 diabetics. It can convey the glycaemic status of an individual in the recent past, thus a beneficial role in screening and therapeutic monitoring.

Evaluation of coverage and compliance to mass drug administration for lymphatic filariasis elimination in two endemic districts of Karnataka

Background: Lymphatic filariasis is a debilitating and disfiguring disease causing significant socioeconomic burden. India is endemic for filariasis which includes Kalaburagi and Yadgir districts in Karnataka. India has the target for filariasis elimination by 2020 and mass drug administration [MDA] is a strategy for elimination. The objective of the study was to evaluate the coverage and compliance of mass drug administration against lymphatic filariasis. Methods: The study was a cross sectional study conducted during the month of October 2018 in Kalaburagi and Yadgir districts. The study subjects included all the residents of cluster except subjects aged below 2 years and pregnant women. Multi stage sampling was used and three clusters from rural area and one cluster from urban area from each district. Data collection was done by household survey after informed consent using a standard questionnaire. Results: A total population of 1,963 subjects residing in 399 houses of two districts was included. Majority of the study subjects 1517 (77.27%) were in the age group of more than 15 years with predominantly males 984(50.12%). The coverage rate and compliance rate of MDA was 83.17% and 92.46% in Kalaburagi district and 86.71% and 86.98% in Yadgir district respectively. The effective coverage rate and coverage compliance gap was 76.89% and 7.53% in Kalaburagi district, 75.42% and 13.01% in Yadgir district. Incomplete dose of MDA was consumed by 17 subjects in Kalaburagi district and 21 subjects in Yadgir district. Conclusions: The effective MDA coverage in both the study districts is below 85% which is not satisfactory.