ABSTRACT
This study aims at reporting the indigenous knowledge of the medicinal flora from the inhabitants of surroundings of the World's largest artificial planted forest "Changa Manga", Pakistan. Data were collected by direct interviews and group meetings from 81 inhabitants including 32 local healers having information regarding the use of indigenous medicinal plants over a period of one year. Different statistical tools were applied to analyze the data including Frequency citation (FC), Relative frequency citation (RFC), Use Value, Factor of informants consensus and fidelity level. This study reported 73 plant species belonging to 37 plant families and 46 genera. The majority of plant species belong to compositae family. The most commonly used medicinal plants were P. hysterophorus L., P. dactylifera L., S. indicum L, P. harmala L., P. emblica L., and A. indica A.Juss. The greatest number of species was used to cure gastrointestinal disorders. The highest fidelity level (68.18%) was of E. helioscopia to cure gastrointestinal disorders. Maximum fresh uses (17) were reported by C. dactylon (L.) Pars. While the highest number of species reporting fresh uses in similar number was 13. In this study, five novel plants are being reported for the first time in Pakistan for their ethnomedicinal worth. Our data reflect unique usage of the medicinal plants in the study area. The statistical tools used in the study proved useful in pointing the most important and disease category specific plants. High use value plant and the new reported medicinal plants might prove an important source of the isolation of pharmacologically active compounds.
Este estudo tem como objetivo relatar o conhecimento indígena sobre a flora medicinal dos habitantes do entorno da maior floresta artificial plantada do mundo, a Changa Manga, no Paquistão. Os dados foram coletados por meio de entrevistas diretas e reuniões em grupo de 81 habitantes, incluindo 32 curandeiros locais, com informações sobre o uso de plantas medicinais indígenas durante o período de um ano. Diferentes ferramentas estatísticas foram aplicadas para analisar os dados, incluindo citação de frequência (FC), citação de frequência relativa (RFC), valor de uso, fator de consenso dos informantes e nível de fidelidade. Este estudo relatou 73 espécies de plantas pertencentes a 37 famílias de plantas e 46 gêneros. A maioria das espécies de plantas pertence à família Compositae. As plantas medicinais mais utilizadas foram P. hysterophorus L., P. dactylifera L., S. indicum L., P. harmala L., P. emblica L. e A. indica A. Juss. O maior número de espécies foi usado para curar distúrbios gastrointestinais. O maior nível de fidelidade (68,18%) foi de E. helioscopia para cura de distúrbios gastrointestinais. Os usos máximos em fresco (17) foram relatados por C. dactylon (L.) Pars. enquanto o maior número de espécies relatando usos frescos em número semelhante foi de 13. Neste estudo, cinco novas plantas estão sendo relatadas pela primeira vez no Paquistão por seu valor etnomedicinal. Nossos dados refletem o uso exclusivo das plantas medicinais na área de estudo. As ferramentas estatísticas utilizadas no estudo mostraram-se úteis para apontar as plantas mais importantes e específicas da categoria de doença. Plantas de alto valor de uso e as novas plantas medicinais relatadas podem ser uma importante fonte de isolamento de compostos farmacologicamente ativos.
Subject(s)
Humans , Plants, Medicinal , Forests , Gastrointestinal Diseases , Indigenous Peoples , Medicine, Traditional , PakistanABSTRACT
Allergic fungal rhinosinusitis (AFRS) forms a significant group of patients presenting with the commonest health problem encountered in rhinology. Patients commonly present with typical symptoms of sinusitis, and the diagnosis is often made after imaging and/or intraoperatively. Infections caused by Chrysosporium species are very rare and are very rarely been reported to cause sinusitis in humans. Usually, human chrysosporial infections are mild and unmarked by symptoms. We report a rare case of allergic fungal sinusitis (AFS) caused by Chrysosporium species in a 41-year-old male with the history of diabetes mellitus.
ABSTRACT
Background: A large surge of intensive care unit (ICU) admissions leading to mortal outcome was observed in wave-2 of coronavirus disease 2019 (COVID-19) due to the higher virulence of the Delta variant of the COVID-19 virus, which led to the scarcity of resources in hospitals. This study was done to observe the clinical characteristics of COVID-19 patients with fatal outcome. Materials and methods: We conducted a retrospective cross-sectional study in adults with COVID-19 pneumonia having fatal outcome during wave-2 of COVID-19, and their clinical characteristics were studied. Results: Out of 136 patients included in the study, the most common risk factors leading to adverse outcome were in the male gender, age (middle and elderly), with hypertension and diabetes mellitus (DM) as predominant comorbidities, early onset dyspnea, high C-reactive protein (CRP), high neutrophil to lymphocyte ratio (NLR), high D-dimer, bilateral lower zone involvement of lungs in chest X-ray (CXR), and development of acute kidney injury (AKI). Conclusion: The characteristics of the severely ill COVID-19 patients highlighted in the study could help clinicians in the early identification and management of high-risk patients. This study would help with resource planning and preparation for further COVID-19 waves and future pandemics.
ABSTRACT
Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.
Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.
Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Young Adult , Plants, Medicinal , Pakistan , Surveys and Questionnaires , Plant Leaves , Ethnobotany , Phytotherapy , Medicine, TraditionalABSTRACT
Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitants age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.
Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.
ABSTRACT
Background: Diarrhea can cause significant deaths and morbidity in children whose age is below 5 years in developing countries. In children under five, it is the third cause of mortality. Aims and Objectives: The main aim of this study was to examine recent trends in the management of acute diarrhea in children below 5 years of age and to identify the pattern of pharmacotherapy for acute diarrhea in children the specific age group of <5 years of age. Materials and Methods: A non-interventional study that was prospective and observational in nature was conducted in 50 patients that were admitted in the pediatric wards at a teaching hospital that was tertiary care. Only those participants whose parents/guardian gave written informed consent were included in the study. Results: Of enrolled 50 patients, 30 (60%) were male patients and 20 (40%) were female patients. Most patients (42%) were between the ages of 6 months–1 year. All the 50 participants were prescribed WHO-ORS and Zinc. About 60% of children were administered the antibiotics with intravenous fluids. Antipyretics were administered to 90% children, antispasmodic and antisecretory agents to 40%, and probiotics to 92% children. The commonly used antibiotics were ceftriaxone, cefpodoxime, metronidazole, ofloxacin, and ornidazole. Conclusion: There was strict adherence to guidelines for treating the children who suffered with acute diarrhea. However, there was poor awareness among the parents regarding the compliance to the treatment, hygienic practices, and its consequences.
ABSTRACT
Background: The E-Learning has significant impact in developing medical education and accepted by medical students. It can be used either as sole platform for teaching or can be integrated with traditional teaching. However, during the time of COVID-19 outbreak, online learning was ahead and continued to provide education in the pandemic phase. Aims and Objectives: The study was aimed to assess medical students’ perception toward usefulness and challenges of online learning and to compare the students’ perception toward online learning and traditional learning. Materials and Methods: This survey based educational study was carried out among total no of 501 undergraduate medical students of our institution. A pre-validated structured feedback questionnaire was sent to the participants and the response was collected. Results: Out of 501 students, a total number of 201 (40.11%) students experienced that the online learning is not comfortable as well as it is exhausting in comparison of face to face learning. About 255 (50.8%) students thought that online learning does not motivate students for interactive learning. It was found that 52% students preferred traditional with online learning, 41.51% students liked face to face learning while only 6.38% students have chosen only online learning. Conclusion: The online learning has its own advantages but, classroom-based learning is still most preferred by students for effective learning in terms of motivation and interaction. However, it can be incorporated in traditional learning for better teaching learning experience.
ABSTRACT
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor occurring in the stomach with characteristic morphological features. Approximately 7–8% of all neuroendocrine tumors (NETs) are gastric NETs. However, simultaneous occurrence of both of them in stomach is a rare event. Here we present a rare case of synchronous GIST and NET in stomach of a 73 years old female patient. In our case, GIST showed Low risk category morphology as well as characteristic CD117 positivity proven by Immunohistochemistry. NET, our case, was well differentiated Grade I type showing positivity for synaptophysin and chromogranin A. Reporting of such rare cases is important for surgeons as well as pathologists to provide better patient management.
ABSTRACT
A 10-year-old girl presented to us with inferonasally displaced, non-axial proptosis of oculus dexter (OD), with ipsilateral, painless massive cervical lymphadenopathy of ten weeks duration. After a detailed hematological work-up and imaging, the histological evidence obtained on cervical lymph node biopsy established the diagnosis of Rosai-Dorfman disease. Although, Rosai-Dorfman disease of unilateral lacrimal gland is extremely infrequent, a high degree of suspicion is warranted in a case of young patient presenting with unilateral isolated lacrimal gland swelling and associated lymphadenopathy, wherein no other cause is found. Treatment protocol should be individualized as per the extent of systemic involvement and functional disability.
ABSTRACT
Hygrophila salicifolia is an erect herb (family: Acanthaceae). It has many medicinal uses like diuretic and anti inflammatory in traditional systems of medicine. Till date no data available for its standardisation therefore isolation of phytoconstituent was done from methanolic extract of Hygrophila salicifolia. Besides a known flavonoid, Isoquercitrin was isolated for the first time from a Hygrophila species, namely Hygrophila salicifolia (Acanthaceae). Its structure was established on the basis of its spectroscopic data.
ABSTRACT
Background: Meckel’s diverticulum (MD), a congenital anomaly of the gastrointestinal tract due to failed vitelline duct obliteration, affects 2% of population. It is a true diverticulum located along the antimesenteric border of distal ileum within 100 cm of the ileocecal valve. It contains heterotropic mucosa, 60% of which is gastric mucosa followed by pancreatic acini, colonic mucosa, etc. The key surgical principle is to completely remove symptomatic ectopic tissue. Objectives: The objectives of the study were to investigate clinical features and common complications of MD in different ages and genders that serve as a reminder to clinicians evaluating potential cases and help them giving proper management. Materials and Methods: A combined prospective and retrospective study of 30 patients operated for MD found incidentally on operative table or planned electively was done. Results: In our study, there was a clear male predominance with 21 cases (70%). It was more common in young and middle age (11–40 years) with 26 cases (86%). Common symptomatic presentations were obstruction (30%), perforation (13%), and diverticulitis (10%). The cases were surgically managed according to the size of base and length of the diverticulum. Post-operative complications were commonly seen in older age and symptomatic patients. Conclusion: MD is having low incidence, overlapping signs and symptoms of other conditions and higher post-operative complications. Hence, it is quite important to include it in differential diagnosis, diagnose it early and apply prompt surgical management.
ABSTRACT
Introduction -It is observed that our young generation is increasingly being exposed to noisy environment, as they remain engage in such recreational activities like listening music on mobile phones, personal music players or through laptops,ipads,ipods. They are also attending discotheques, rock concerts andvideogames for recreation.Unfortunately not much attention is being given to effect of the increasing trend of prolonged exposure to noisy recreational environmentin the younger generation of Indians.
ABSTRACT
Objective Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons.In this study,we proposed the concept of C-NTS,a scoring criterion for NTS based on real scenarios (for example,history taking) and video recording,and verified its practical application effects.Methods Study objects were divided into the tutor group and the student group.The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree).The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females).Before and after the training,the tutor rated the same anonymous video by C-NTS.One-factor analysis of variance was used to compare the differences between and within the groups,and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.Results After the tutor receiving training,Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017),which confirmed the effectiveness of the training.Conclusion C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment.Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.
ABSTRACT
@#Diarrhoea is a leading killer of children, accounting for 9% of all deaths among children under age 5 worldwide and 3% in Malaysia in 2015. A large proportion of diarrhoea illnesses among children in developing countries are ascribed to an unknown etiology because microscopic examination was the only available technique which has low detection limits. The proposed study aimed to evaluate a new quadriplex PCR assay to detect parasitic pathogens namely E. histolytica, G. lamblia and C. parvum which considered responsible for the majority of human infections. Three set of specific primer pairs were designed for detection of parasitic pathogens. Quadriplex PCR assay was optimized and an internal amplification control was incorporated to check for PCR inhibitors in samples. The PCR assay was evaluated using spiked stool samples. Specific primer pairs were successfully designed and simultaneously amplified the targeted genes. The analytical sensitivity of the quadriplex PCR at the DNA level was found to be 50 ng DNA. The analytical specificity was evaluated with 11 reference protozoal and bacterial strains and was found to be 100%. We concluded that the developed quadriplex PCR assay was rapid and gave results within 5 hours which is essential for the identification of parasitic pathogen and might be useful as an additional diagnostic tool whenever time is important in the diagnosis of parasite that cause diarrhoea.
ABSTRACT
CONTEXT: To identify prognostic factors in carcinoma penis with its impact on survival. AIMS: To find out the relation of various prognostic factors of carcinoma penis with the various outcomes. SETTINGS AND DESIGN: Retrospective cohort study. SUBJECTS AND METHODS: Each patient diagnosed as having carcinoma of penis by incision biopsy and operated from January 2004 to May 2009 at the institute was included in the study (n = 117). Data were collected and analyzed. STATISTICAL ANALYSIS USED: The Chi‑square (χ2) test was used to test for the significance of association between the independent (predictor) and dependent (outcome) variables. Multivariate logistic regression analysis was used to determine predictor variables that predicted the outcome. Five year disease‑free survival (DFS) and overall survival (OS) were calculated using the Kaplan–Meier method. RESULTS: Of the total 117 patients studied, 30 patients died within 5 years (median = 25 months). Recurrences (local or systemic) were seen in 23 patients (median = 14 months). Five‑year DFS was 80.34% and OS was 72.22%. Kaplan–Meier analysis showed that well to moderately differentiated grade, lymph node negative disease and low stage have higher survivals than poorly differentiated grade, lymph node positive disease and higher stage, respectively. Multiple logistic regression analysis revealed that inguinal lymph node positivity and grade were significantly associated with local or systemic recurrence. CONCLUSIONS: Penile cancer patients with advanced disease had poor survival. Tumor grade and inguinal lymph node metastasis are factors affecting DFS. Lymphadenectomy remains an integral part of the management of patients with penile cancer.
ABSTRACT
Background: Suicide is a global health problem and the second leading cause of death in 15-29 years of age. There were reports of nursing students committing suicide in Gujarat. As nursing teachers are the important gatekeepers, it was essential to study their attitude towards suicide prevention. Methodology: A questionaire containing 20 statements, derived from the Attitude towards suicide prevention scale and from the Suicide opinion questionnaire, to be marked as ‘agree’, ‘disagree’ or ‘uncertain’ was administered to 80 nursing teachers from Gujarat. This was followed by an interactive session on suicide prevention. Results: Most of the nursing teachers felt that suicide prevention was their responsibility, that a large proportion of suicides was preventable, most suicides were impulsive and that suicide in the young was particularly puzzling. However, nearly 80 % felt that those who are serious about committing suicide usually don’t tell anyone. Around one-fifth felt there was no way of knowing who was going to commit suicide and they were not comfortable in assessing suicide risk. Conclusion: The overall attitude of the nursing teachers towards suicide prevention was positive. However more educational and skill-based training programmes are required to better equip the nursing teachers for suicide prevention.
ABSTRACT
Background & Objective: Mental health needs of a society are ideally met by integration in primary care. Under the District Mental Health programme, Surat is the nodal centre for Dang, a tribal region. In order to make medical care available to the patients in need, it was vital to train the peripheral health workers of the region. The aim was to provide mental health education to the peripheral health workers of Dang and assess its impact on their knowledge and attitude regarding mental health issues. Methodology: 150 peripheral health workers were posted in the Department of Psychiatry in batches of 20-30 each for a 7-day, extensive, in-house training. The improvement in knowledge and attitude was assessed by a pre-post semi-structured questionnaire and structured feedback. Results: The training resulted in a significant improvement in scores related to clarification of myths. The knowledge and attitude related to mental health issues improved significantly and the participants reported that they were sensitized by the training and would identify and refer patients to the visiting psychiatrist. Conclusion: The training in mental health could bring about improvement in the knowledge and attitude of the peripheral health workers. However, to what extent does this change reflect in actual practice, needs to be ascertained.
ABSTRACT
Background: MDR-TB is defined as resistance to isoniazid and rifampicin with or without resistance to other drugs. India is one of the countries with largest burden of MDR TB in the world. Second line Anti-tuberculous therapy is now available for patients with MDR-TB under the RNTCP Category IV. but there are many challenges for MDR-TB control in india. This study was done to analyses the RNTCP data for MDR-TB maintained at a TU, in the city of Ahmedabad, Gujarat, and to compare it with the data available in literature. This study also aimed to identify challenges faced while treating MDR-TB and to address the same. Material and methods: We had restropectively analyzed 353 patients referred to the TU from the respective Direct Microscopy Center (DMC) with suspicion of MDR-TB during a period of January 2014 to December 2014. Results: Of the 353 suspected MDR_TB patients referred to the TU, 48 patients (13.597%) were diagnosed to have MDR-TB. Of these 48 patients, 46 patients had pulmonary TB (95.833%) and 2 patients had extra-pulmonary MDR-TB (4.166%). Of the 48 patients, 08 (16.67%) patients were transferred to their respective TU and 40 patients (83.33%) were enrolled for Cat IV from our TU. Of the 40 patients enrolled at our TU, 30 patients (75%) were continuing Category IV at the end of 2014 (25 were on intensive phase and 05 were on continuation phase), 03 patients (7.5%) died during treatment, 01 patient (2.5%) defaulted treatment, 05 patients (12.5%) refused treatment and 01 patient had XDR-TB (2.5%). Of the 40 patients, 05 patients (12.5%) had ofloxacin resistance. NO patient had intolerance to any oral or injectable ATT. None of the diagnosed MDR-TB patients had HIV co-infection Conclusion: Drug resistance in tuberculosis is a “man-made problem”. Anti-TB chemotherapy must be given optimally by (i) ensuring adequate absorption of drugs, (ii) timely diagnosis and management of drug toxicities and (iii) treatment adherence. To ensure that all patients get adequate treatment and to have a close follow-up of defaulters and patients who refuse treatment; we need to strengthen our existing management information system and also incorporate private sectors into our system.
ABSTRACT
Most of the tumors that form in the trachea and bronchi in adults are malignant but a few are benign. Common benign tumors of the trachea are squamous cell papilloma, fibroma, hemangioma and leiomyoma. Leiomyoma of trachea constitute only 1% of the common benign tumors of the trachea and hence few cases are reported in the literature. Meningiomas are a diverse set of tumors arising from the meninges, majority of these tumors are usually benign and only 8% are either atypical or malignant, which could recur after treatment or removal. Presence of both this uncommon tumors in a single patient is quite rare. We present a case of a woman with both the tumors.
ABSTRACT
Objectives: To study and establish clinical and haematological correlation in cases of dengue viral infection. Methodology: A total 169 serum samples were received from L.G. Hospital for the detection of Dengue IgM during the period of October 2013 to January 2014. They were tested for the same with ELISA method. The clinical -haematological case study was done and the data was analyzed retrospectively. Results: Total 169 serum samples were tested, out of which 44(26.03%) were positive for Dengue IgM antibodies. Out of the total serum samples, Male: Female ratio and Urban: Rural ratio was 1.6:1 and 2.8:1 respectively. Peak incidence of the disease is seen in October. Clinically fever was the commonest presentation in 39(88.6%) patients followed by headache and muscle pain i.e., 33(75%) and 16(36.3%) respectively; the least common was epistaxis in 4 (9.04%) patients. Retrobulbar pain was in 3(6.8%) rash was in 6 (13.6%) and hemorrhagic manifestations in 12 (27.2%) patients. Amongst total WBC count, the proportion of Lymphocyte was above 70% in 3(6.8%) cases, between 50-70% in 17(38.6%) cases, and between 35-49% in 16(36.3%) cases and below 35% was in 8(18.18%) cases. The platelet count less than 50,000 was observed in16(36.3%) cases, 50,000 to 1, 00000 in 15(34.09%) cases and greater than 1,00,000 was in 13(29.5%) cases.19(43.1%) patients had erythrocyte sedimentation rate less than 7mm/hr, While 15(34.09%) patients had8- 20mm/hrand 10(22.7%) had more than 20 mm/hr.