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Aims: To estimate the problem of behavioural co morbidity and to determine risk factors associated with epi-lepsy in children. Methods: A prospective observational study using Hindi and Gujarati version of Strength & Difficulty ques-tionnaire (SDQ) was conducted. Children aged 6 to 17 years with epilepsy (CWE) as cases & without epilepsy as controls enrolled. Detailed demographic and clinical data were recorded. The total difficulty score and the subscale scores were compared between two groups. Comparison of the scores were done among the children with epilepsy group also. Results: 52 children in each group were included. Self-reported SDQ used in 76% and parent reported SDQ used in 27% participants. Prevalence of behaviour abnormality was 25% in CWE. (p 0.004). CWE had signifi-cantly higher mean total difficulty score (p<0.001) and mean emotional (p <0.0001) and conduct subscale score (p 0.0024). Children having uncontrolled epilepsy (OR 15, 95% CI 2.9 - 76.3, p 0.0005) and having num-ber of seizures more than 3 (OR 13.33 95% CI 3.4 - 51.04, p 0.0004) were found to be significantly associated with behavioural abnormality. Conclusion: Epileptic children are at more risk of behavioural problem than in normal children, especially emotional problem and conduct problem. Uncontrolled epilepsy and frequency of seizure were significant risk factor for occurrence of behavioural problem.
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Background: It is usually difficult to diagnose brucellosis clinically in the absence of specific clinical features. Hence serological testing forms the mainstay of diagnosing the disease. Seroepidemiological determinants of brucellosis in rural western Maharashtra have not been closely investigated. Aim: The present study was therefore conducted to determine the incidence and to analyze seroepidemiological determinants of Brucellosis in cases of pyrexia of unknown origin (POU) in rural western Maharashtra. Material and methods: The present hospital based cross sectional survey was carried out in Rural Medical College, Loni on 500 cases of PUO. SPSS version 20.0 was used for analysis. The serum samples were subjected to serological tests like Rose Bengal Plate Test (RBPT) and Standard Tube Agglutination Test (STAT). The inoculated agar plates were watched daily for the presence of growth Brucella on culture. Results: Males (51.6%) outnumbered females (48.4%) in the study sample. Out of 500 cases 10 samples showed the presence of Brucella agglutinins. The male female ratio in the seropositive cases was 2.33:1. Headache and joint pain was observed in 5 and 3 cases respectively. 50% samples yielded the growth of Brucella on culture. All the culture positive samples had titer of 640 IU or more. Conclusion: Agglutination test if properly performed can be used as a very dependable laboratory procedure for rapid diagnosis of Brucellosis.
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Background: Understanding current perceptions and opinions of medical students regarding learning pharmacology may prove useful in improving the teaching of this discipline. Students’ feedback would probably reveal whether the so-called reforms are acceptable to them and their opinion for the betterment of teaching/learning Pharmacology subject. Aim: The study aimed to determine the opinion of students regarding the teaching of pharmacology, the best way of knowing and retaining the subject and application of the subject in future practice. Methods: The present cross sectional study was carried out by the Department of Pharmacology in collaboration with Medical Education Unit, MSDS Medical College, Fatehgarh among the undergraduate students currently studying the Pharmacology and who were due for appearing in final examination. A 30 item self administered questionnaire was administered to the students in the classrooms just after completion of classes. Time allocated for the completion of the questionnaire was 30 minutes. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Data of 77 study subjects was analyzed. 77% students were in favour of inclusion of real life case studies and their treatment whereas 73% of the students showed interest in Problem Based Learning. Only one student wanted to include more number of seminars. 45% agreed that pharmacology education had given them capacity for self-directed learning whereas 25% of the students reported oppositely. 58% students were in the view of inclusion of recent advances in Pharmacology curriculum. Conclusion: In general students’ perceptions regarding learning pharmacology was observed to be positive. Its need of an hour to address students point of view to make learning the subject from a futuristic practical therapeutic point of view and simultaneously mitigating the general stigma that the study of this essential medical subject is boring.
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Background: A medication error is an episode associated with use of medication that should be preventable through effective control system. Investigating the incidence, type, and nature of medication errors are very crucial to prevent them. Aim: The study aimed to analyze and ascertain profile and pattern of medication errors among admitted patients in a tertiary care teaching hospital. Material and methods: The present prospective study was carried out by the Department of Pharmacology in collaboration with the Department of Internal Medicine and Office of Medical Superintendent, MSDS Medical College, Fatehgarh, among the patients admitted to the General medicine ward during October 2013-February 2014. Hospital/medical records, Case sheet of the study subjects, a 46 item self administered questionnaire and Medication error reporting and documentation form served as study tools. Results: Overall incidence of medication errors was found to be 28.3%. 31.4% were ‘Errors in medication ordering and transcription’, 24.4% were ‘Errors in medication dispensing’, whereas 44.2% were observed as ‘Nursing errors in medication administration’. Most frequent nursing errors in medication administration was found to be ‘Medication not given’ i.e. Omission error. 67.4% were due to nurses, 22.1% were due to pharmacists and remaining 10.5% were due to physicians. Most of the nurses attributed cause of this error to ‘Repeated distraction’ and ‘High activity duty hours’ 41.4% and 39.6% respectively. Conclusion: A robust surveillance system to detect such medication errors is need of an hour. Competencies of pharmacology department hibernating in a tertiary care teaching institution could be utilized in the early detection and prevention of medication errors and thus can improve the delivery of care quality to the patients.
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Background: Acne vulgaris is one of the most common skin disorders in puberty. The widespread and indiscriminate use of antibiotics in the treatment of acne has resulted in the spread of resistant bacterial strains and treatment failure. Aim: The study aimed to analyze the microbiological spectrum in acne vulgaris and to evaluate its susceptibility to the antibiotics widely used for acne. Material and methods: The present cross sectional study was carried out by the Department of Microbiology and Dermatology, MSDS Medical College, Fatehgarh among the patients seeking care for acne vulgaris with pustular and nodulocystic skin lesions in the Dermatology OPD of a rural medical school from western Uttar Pradesh. Patients with pregnancy or endocrinal problems like hirsutism, menstrual dysfunction or adrenal dysfunction and those taking drugs or contraceptives were excluded. The samples were cultured individually on blood agar and Muller-Hinton media. The cultures were then incubated under both aerobic and anaerobic conditions for 2-7 days . Bacteria were identified and their resistance to common antibiotics was evaluated according to the standard procedures. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Aerobically, Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acne and Micrococcus spp were detected in 44%, 47%, 1% and 46% of samples respectively whereas anaerobically these were 39%, 21%, 34% and 1% respectively. Propionibacterium acne Staphylococcus epidermidis and Staphylococcus aureus were more sensitive to rifampin (almost 90%) compared to other drugs. Neomycin was found to be least sensitive. Conclusion: The study highlighted the need to discourage antibiotics' abuse. Rifampin is a suitable antibiotic for acne patients, but to achieve a better result, combination of rifampin with other antibiotics should be tried. It is also suggested that studies with bigger sample size on evaluation acne vulgaris treated by rifampin should be undertaken.
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Background: It is well-appreciated that many communities in developing countries face severe public-health problems relating to drinking-water. The supply of safe water is important to protect the health of the community people. Aim: The study aimed to evaluate the bacteriological quality of drinking water from various active sources of water utilized in the catchment area of a tertiary care teaching hospital. Material and methods: The present cross sectional study was carried out by the Department of Microbiology and Community Medicine, MSDS Medical College, Fatehgarh during 2013-14. Randomly selected 100 active water sources which were being used for drinking purpose and a fairly good number of people using that water source for drinking purpose were included in the study. National Environmental Engineering Research Institute (NEERI) guidelines for drinking water quality assessment were adopted. Culture and bacteriological tests of drinking water were performed as per standard protocols. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Out of one hundred water samples collected, fifty one, twenty seven and twenty two samples of water were collected from municipal tap water, government hand pump and water cooler respectively. Almost half of the samples were found to be unsatisfactory. E. coli was found to be responsible for 26% of samples whereas Pseudomonas in 20% of collected samples. E. coli and Klebsiella tested positive with Methyl Red whereas Pseudomonas sp. and Klebsiella tested positive with Citrate test reagent. E. coli showed positive result with Indole reagent whereas Klebsiella tested positive with Urease. Regarding mix population organisms, Escherichia coli, Klebsiella Sp. and Pseudomonas Sp. were found to be positive in 3 samples whereas Klebsiella Sp. and Pseudomonas Sp. were found to be positive only in 1 sample Conclusion: The study highlighted unsafe nature of current active sources in the study area with regard to drinking water purpose which are not fit for consumption of water. Surveillance of water sources and regular bacteriological assessment of all water sources for drinking is recommended on regular basis.
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Background: Despite having a well documented relationship of cleft palate with middle ear effusion, little data exists regarding otopathology in Indian children with cleft palate. Objectives: Therefore, the present study was planned with an objective to determine the various otological manifestations that occur in patients with cleft palates seeking care at a tertiary care teaching hospital. Material and methods: The present study was carried out in the Department of Otorhinolaryngology of a tertiary care teaching hospital of northern India during June 2012 to May 2014 among 30 cases of cleft palate. On the first visit, history and thorough clinical examination are undertaken. Next, common and special investigations are undertaken to evaluate and assess the status of disease. X-ray mastoids, Pure tone audiometry and Tympanometry were also carried out. Results: The ears are found affected in 86.7%, 60.1% ears had an intact but dull tympanic membrane whereas 16.7% ears had CSOM with a central perforation. On pure tone audiogram (n=18) 33.33% had a hearing loss in one ear and 44.44% had a hearing loss in both ears in the form of a mild or moderate degree of conductive deafness. On tympanogram, 23.3% had an ‘A’ type of tympanogram whereas 44 ears had a `B’ type of tympanogram indicative of recurrent effusions in the middle ear. Majority from this sub-group >80% had associated conductive hearing loss-mild to moderate degrees. Conclusion: Cleft palate individuals should always be evaluated for possible otological manifestations.
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Background: Sinusitis causes inflammation of the middle ear mucosa with increased and persistent mucoid/ mucopurulent discharge and remains as a active mucosal disease. Without correcting the sinusitis the management of ear including surgery has frequently led to failures and poor prognosis Objectives: To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal disease. An additional objective was to accentuate the need of proper diagnostic endoscopic evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery. Material and methods: A total of 50 patients aged 18-49 years with Chronic otitis media active mucosal disease (Tubotympanic type of C.S.O.M.) patients with persistent ear discharge even following culture directed topical and systemic antibiotics with 3 months and more of ear discharge seeking care at Otorhinolaryngology outpatient department were included in this study. Results: Mean age of patients was 42.5 ± 10.6 years. 76% subjects were found having septal deviation/ turbinoseptal deformity which was the most common anatomical variant, 34% had enlarged middle turbinate, 32% had medialised uncinate, 30% had enlarged bulla, 22% had enlarged bulla with prominent agger and 18% had paradoxical middle turbinate. Of these 22 patients had the accessory ostium in the posterior fontanel and 10 patients had accessory ostium in the anterior fontanel. Majority (26, 52%) of subjects had Grade I disease i.e. minimal disease limited to Osteo Meatal Complex followed by Grade II 24% i.e. moderate incomplete opacification of one or more sinuses. On otoendoscopy, 36 patients (72%) had a large central perforation, while 14 patients (28%) had a subtotal central perforation Conclusion: A thorough diagnostic nasal evaluation of all Chronic Otitis Media active mucosal type of patients is essential in comprehensive management of the disease. Deviated nasal septum, enlarged middle turbinate, medialised uncinate predispose to sinusitis.