Comparison of dermatoglyphic patterns in oral leukoplakia and oral submucous fibrosis patients

Background: Genetics plays an important role in the detection of an Oral potentially malignant lesion. A major contributor to genetic study is Dermatoglyphics or the study of fingerprints and lines of palmer and plantar surfaces. Many researchers have used dermatoglyphics to connect genetics with oral lesions and malignancies. Thus, the current study has been conducted to find out an association between dermatoglyphic patterns and oral leukoplakia, oral submucous fibrosis and healthy subjects.Methods: The present study is conducted on subjects that have been already diagnosed with oral lesions. Fingerprint patterns (whorled, loop and arch) were evaluated by utilizing fingerprints.Results: The present study showed that the loop pattern was common in all three subjects. The frequency of whorled and arch pattern is decreased in oral leukoplakia and oral submucous fibrosis that healthy subjects. Arch pattern is comparatively decreased in subjects with oral leukoplakia than oral submucous fibrosis and there is a decrease in the frequency of whorled patterns in OSMF as compared to oral leukoplakia.Conclusions: Authors conclude that simply by observing the whorled and arch patterns in a subject, authors can hypothesize that risk of occurrence of oral leukoplakia and oral submucous Fibrosis and take preventive measures against the said lesions.

Knowledge, attitude and practices towards medical research among resident doctors at a tertiary care hospital

Background: Research is a systematic process utilizing the scientific method for generating new knowledge that can be used to solve a problem or improving the existing status of a system. Human being is living a life of ease due to research in medical field. But it is important to know that whether those who are closest to society like resident doctors are involved in research process or not. Thus, the present study is planned to assess the knowledge, attitude and practice of resident doctors in a tertiary care hospital.Methods: This was the questionnaire-based study conducted among the resident doctors. Sample size calculated was 110 by open Epi software. A self-structured questionnaire was validated and distributed. Then we collected the data which was analysed using statistical analysis with MS excel and SPSS software version 21.Results: The 62% response rate was achieved. More than 50% of the resident doctors have the knowledge of p value and protocol writing. 63% students are strongly agreed that research in medical field is important while only 19% students are strongly disagreed that research increases burden over students 17% of the students have presented research paper. More than 75% student told that there are many barriers conducting research.Conclusions: This study demonstrates that more than 50% respondents have the basic knowledge about the medical research and they have the positive attitude too. But there is lack of the practices regarding research. Thus, there should be some efforts to improve practices of medical research among resident doctors.

Prothrombotic state in HIV: A study on protein C, protein S, homocysteine and correlation with CD4 counts

Introduction: Human immunodeficiency virus (HIV) may result in variable haematological manifestations. Thrombotic events are more common among HIV-infected persons than the general population, possibly due to the increased inflammatory/hypercoagulable state and presence of concurrent comorbidities. Aims and Objectives: (1) Screen for coagulation abnormalities in HIV-infected patients. (2) Detect certain prothrombotic factors such as deficiency of protein C and protein S and elevation of homocysteine as possible precursors of coagulation defects in HIV patients. (3) Correlation of coagulation abnormalities with CD4 counts. Methods: A pilot study of 1-year duration conducted in the Department of Pathology in collaboration with ART centre, KGMU Lucknow. All diagnosed HIV-seropositive patients (n = 30) who were not taking Vitamin K, antithrombotic and antiplatelet drugs including aspirin, oral contraceptives and not having known protein C/S deficiency were included in the present study as cases. Apart from this, 30 age- and sex-matched healthy individuals were also included in the present study. Assessment of the bleeding time, prothrombin time and activated partial thromboplastin time, complete blood count was done. Protein C and S were measured by calorimetric assay. Serum homocysteine was measured by the semi-automated method. CD4 count was done by flow cytometry. Results: The findings of the present study suggest a relationship between HIV, its complications and thrombosis. The HIV-seropositive patients have reduced levels of haemoglobin, CD4 counts, platelet counts, mean platelet volume, protein C and S activity as compared to the healthy individuals. Thrombophilic abnormality in the form of hyperhomocysteinaemia is more frequent in HIV-infected patients. All these parameters have a definite correlation with CD4 count.

Levels of salivary thiocyanate and its relation with occurrence of micronuclei using exfoliative cytology in smokers and nonsmokers.

Aims: To evaluate the levels of salivary thiocyanate and its relation with the occurrence of micronuclei (MN) using exfoliative cytology in smokers and nonsmokers. Materials and Methods: One hundred and twenty patients were divided into 3 groups: nonsmoker group 1 (control), smokers group 2, and smokers group 3. Their saliva was collected and analyzed for thiocyanate levels, and exfoliative cytology was evaluated for the presence of MN. Statistical Analysis Used: Fisher’s exact test and ANOVA test were used. Results: It was seen that as the grade of smoking increased, the levels of salivary thiocyanate and occurrence of MN increased. Conclusions: Detection and quantification of “biomarkers” such as salivary thiocyanate and MN in noninvasive and painless procedures such as oral exfoliative cytology can be an upcoming research domain in the field of cancer prevention and therapeutics.

Anxiolytic effect of chronic administration of ursolic acid in rats.

Anxiety is a cardinal symptom of many psychiatric disorders and an almost inevitable component of many medical and surgical conditions. Indeed it is a universal human emotion, closely allied with appropriate fear presumably serving pyschobiologically adaptive purposes. Anxiety is a normal emotional behaviour. When it is severe and/or chronic, however, it becomes pathological and can precipitate or aggravate cardiovascular and psychiatric disorders. Although many drugs are available in allopathic medicine to treat anxiety disorders, they produce various systemic side effects. Ursolic acid has been identified as the active principle of Ocimum sanctum. From our laboratory we have established the antianxiety, anticateleptic and antidepressant activity of ethanolic extract of leaves of Ocimum sanctum. In the present study, we have attempted to evaluate the anxiolytic- activity of ursolic acid in rats by employing, elevated plus maze and bright and dark arena. The rats were divided into five groups, each group containing six animals. The effects of the test drug ursolic acid (at 0.05, 0.1 and 0.2 mg/kg doses), the standard anxiolytic, diazepam (1.0 mg/kg) and control group 14% dimethyl sulfoxide (10ml/kg) were assessed after repeated doses administration for ten days. The results suggest that, ursolic acid exhibited anxiolytic like activity comparable to diazepam.

Profile of CD4 Counts and Symptoms in HIV Positive Patients on and not on Antiretroviral Therapy.

This communication pertains to a study on analysis of the profile of CD4 counts and symptoms in HIV infected adult subjects on and not on antiretroviral therapy. Clinical symptoms in HIV infected patients attending a tertiary care hospital in north India were recorded by direct questioning. Differences in distribution of categorical variables were analyzed using chi-square test. A p-value <0.05 was considered statistically significant. 317 enrolled HIV positive patients, 271/317 (85.5%) patients were symptomatic. The common symptoms were weakness (65.6%), bodyache and joint pain (63.4%), lethargy and fatigue (62.5%), prolonged fever (53.3%), weight loss (47.6%), cough (44.5%), loss of appetite (44.2%) and chronic diarrhoea (40.1%). Most symptoms were found significantly less frequently in patients on antiretroviral therapy (ART). High CD4+ T-cell counts were negatively associated with symptoms. The overall proportion of symptomatic patients was significantly higher than the number with an etiologically documented opportunistic infections (32.5%). Pulmonary tuberculosis (30.9%) was the most frequently documented opportunistic infection. Antiretroviral therapy appears to be beneficial in reducing symptoms in HIV positive patients. Affordable high quality laboratory diagnostic facilities for the diagnosis of opportunistic infections under the public health program will help to obtain an accurate picture of the range of opportunistic infections in HIV patients in India.

Prevalence and risk factors associated with worm infestation in pre-school children (6-23 months) in selected blocks of Uttar Pradesh and Jharkhand, India.

BACKGROUND: Intestinal worm infestation is widely prevalent in developing countries and can result in impaired nutrition and development. AIMS: To estimate prevalence of and risk factors for intestinal geohelminths and other intestinal parasites in children aged 6 to 23 months. SETTINGS AND DESIGN: Cross sectional study in rural India. MATERIALS AND METHODS: Proportionate population size sampling method was used to randomly select 15 villages per block. Thereafter, house-to-house survey was done to recruit eligible children and obtain fecal sample for microbiological examination. STATISTICAL ANALYSIS: Univariate distribution of variables was assessed and comparison between categorical variables and continuous variables was done using a Chi-square test and student's t-test, respectively. Odds ratio was calculated to assess associations. RESULTS: Overall 926 children were recruited and 909 fecal samples examined. Combined prevalence of infestation with intestinal geohelminths treatable by albendazole and other intestinal parasites non-treatable by albendazole was 50.3% (457/909) and 51.6% (469/909), respectively. Exclusive use of hand pump water (OR = 1.79, CI = 1.36-2.35, P CONCLUSION: Since almost half the children are infected with intestinal geohelminths treatable by albendazole, targeted deworming of population in this age group should be considered.

Studies on leptospirosis outbreaks in Peddamandem Mandal of Chittoor district, Andhra Pradesh.

An outbreak of leptospirosis in Peddamandem Mandal, Chittoor district, Andhra Pradesh occurred during Aug to Oct 2005. Out of 86 single human sera samples of suspected cases collected during the investigation, 49 (56.97%) samples from seven villages were found positive for leptospirosis both by DGM tests and IgM antibodies. Out of total 49 positive cases 16 (47.05%) were male and 33 (69.46%) female patients. The mean age of the positive cases were 42.7 years. There was no significant differences in male and female ratio and age groups in affected population. The higher degree of seropositivity was observed in adult females as they were mainly engaged in both domestic and peridomestic works. Geographical clustering of cases was evident. All the 49 positive cases had fever (100%). Myalgia (42.9%), stiffness of calf muscles (55.1%) and headache (32.6%) were the other major clinical features observed. There was only 1 (2.04%) case with conjunctival suffusion. None of the case presented with jaundice. All the suspected cases were tested negative for malaria, typhoid and dengue fever. In Peddamandem, contaminated water stagnation due to heavy rainfall and frequent contact of barefooted villagers with the infected sources registered higher incidence of leptospirosis. Most of the cases were from the contaminated water logged areas of the affected villages. In the affected villages none of the individual occupational category showed a significant association with seropositivity. It indicated that the transmission was from the common single category source in the villages i.e. contaminated stagnant water. The villagers living with livestocks and rodents were significantly associated with seropositivity.

Overview of intestinal parasitic prevalence in rural and urban population in Lucknow, north India.

Intestinal parasitic infestations are a common finding in the developing world, however, the patterns of parasitic distribution and rates are different everywhere. Intestinal parasitic prevalece in urban and rural areas in Lucknow, Uttar Pradesh were determined in this community-based study. Multistage random sampling was adopted to collect stool samples from urban and rural population in Lucknow district. Door to door survey was done. Stool samples were processed by standard methods for parasitological examination. One thousand and seventy one stool samples were collected from urban Alambagh, (n=648) and rural Mati, (n=343) areas. Overall one hundred and twenty three (11.5%) subjects had intestinal infection. Intestinal infestation rate was 5.4% and 20.8% in the urban and rural areas respectively. Giardia lamblia (22%) was the commonest pathogenic protozoan detected. The soil transmitted helminths detected were Ascaris (11.4%) and Hookworm (2.4%). Infection had no predilection for either sex or age group in both areas. The prevalence of parasitic infection appears to be relatively low in this region, probably due to improving access to health care. However due to the sheer numbers of affected individuals involved, intestinal parasitosis remains an important public health problem.

Bacterial isolates from mechanically ventilated patients with nosocomial pneumonia within intensive care unit of a tertiary care center.

Nosocomial pneumonia is a common complication in mechanically ventilated patients. A study was carried out to determine the incidence, common bacterial etiologic agents and their antimicrobial susceptibility, and outcome of such pneumonia in an Intensive Care Unit (ICU) of a tertiary care center. In Surgical ICU (SICU) 176 patients required mechanical ventilation for more than 72 hours. A total of 39 (22.1%) of these patients developed nosocomial bacterial pneumonia as determined by microbiological assays. Endotracheal aspirate cultures detected a single bacterial isolate in 22 (56.4%) patients while two and three organisms were isolated from 10 (25.6%) and 7 (17.9%) patients respectively. Fifty three (84.1%) of a total of 63 isolates were Gram negative bacilli. The most frequently encountered pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter species among the Gram negative bacilli and Staphylococcus aureus among the Gram positives. Resistance of bacterial isolates varied from 24 to 90% against commonly used antibiotics. Amikacin had the best profile, with 14% to 55% resistance against various isolates. Twenty three (59%) of 39 patients with pneumonia expired in the ICU. P. aeruginosa (25.6%) and K. pneunmoniae (17.9%) were the predominant isolates in these patients. Nosocomial pneumonia with high mortality is a frequent occurrence in mechanically ventilated patients in our ICU setting. Gram negative organisms with high levels of antimicrobial resistance are the most common isolates. Regular surveillance and monitoring of changes in antibiotic susceptibility of bacterial pathogens and appropriate therapeutic measures are likely to reduce the mortality in these patients.

A pilot study on observations on CD4 & CD8 counts in healthy HIV seronegative individuals.

BACKGROUND & OBJECTIVES: CD4 T lymphocyte count is used to measure the progression of HIV infection and is recommended as part of the standard care of HIV infected person. Information on reference CD4 counts and CD4:CD8 ratio in healthy individuals is lacking in India. Therefore the present study was undertaken to obtain base-line data on CD4 counts and CD4:CD8 ratio of healthy population from north India and to assess the feasibility of using the values as reference in an extended larger study. METHODS: In this pilot study 84 HIV negative healthy volunteers (56 males, 28 females) in the age group of 20-59 yr and who were willing to participate in the study were enrolled after proper counseling. Blood specimens were collected from each subject and processed for anti-HIV antibodies for exclusion of HIV. CD4 and CD8 counts of the samples were performed by fluorescence activated cell sorting (FACS). RESULTS: The mean +/- SD of the absolute numbers of CD4 and CD8 lymphocytes/microliter was 763.6 +/- 226 and 547.5 +/- 190 in males and 797.9 +/- 263 and 567.7 +/- 250 in females. The range of the CD4 and CD8 counts was 365-1328 and 264-991 in males and 415-1257 and 224-1126 in females respectively. The mean +/- SD of the CD4:CD8 ratio was 1.47 +/- 0.42 in males and 1.52 +/- 0.45 in females. INTERPRETATION & CONCLUSION: The results of this study showed that there is wide variability in CD4 count in our population, as is seen in studies reported from other parts of India. A large multicentric study could define the normal range for CD4 and CD8 counts and CD4:CD8 ratio in the Indian population.

Drug resistant Haemophilus influenzae from respiratory tract infection in a tertiary care hospital in north India.

Haemophilus influenzae is an important respiratory pathogen. Emergence of resistance to various antibiotics is a major problem in patient management. A total of 90 strains of H. influenzae were characterized from specimens obtained from patients of acute respiratory tract infection; 13 (14.4%) belonged to type beta. On biotyping, 90% strains belonged to biotype II. The frequency of resistance to various antibiotics was as follows: cotrimoxazole 33.3% ampicillin 21.1%, cephalexin 7.8%, chloramphenicol 7.8%, ciprofloxacin 2.5% erythromycin and tetracycline 5% each. All the ampicillin-resistant strains produced beta-lactamase as detected by nitrocefin disc method. None of the strains exhibited resistance to cefaclor and third generation cephalosporins. The present study showed emergence of variable resistance to ampicillin, cotrimoxazole and other antibiotics. It is important for the clinical microbiology laboratory to monitor drug resistant strains for instituting appropriate antibiotic therapy of respiratory infections due to H. influenzae.