Self-medication and its associated factors in Amdanga block of West Bengal

Background: The WHO defines the use of medications without prior medical consultation regarding indication, dosage and duration of treatment as self-medication. The practice is a global problem. Aims and Objectives: The study was conducted to describe the care seeking behavior of rural self-medicators living in Amdanga Block of West Bengal and to assess the belief in medicines by the self-medicators. Material & Methods: A descriptive cross-sectional study was conducted by interviewing with a pretested semi-structured questionnaire on 665 self-medicators out of 1740 adults who were interviewed in 80 villages of Amdanga Block, West Bengal. A three-stage sampling method was used to reach the study population. A three month recall on self-medication practice was considered operationalizing the “pull” and “push” factors of self-medicators using a Pshycho-social framework. The variables were Socio-demographic factors, Care Seeking Behaviors, Health System related factors, Belief in Medicines according to the framework. Results: The prevalence of self-medication was found to be 38.2%. 63% of the study subjects were female and 56.3% had a literacy status of middle school and above. 54.4% relied on their old prescription for self-medication. 68.7% had an initial choice to consult a doctor but later self-medicated of whom 53.2% changed their choice due to monetary and transport issues while 38.5% thought of self-medication considering their disease was mild in nature. Conclusion: Awareness and health education can link rural subjects with primary care facility and right decisions on care can be provided.

Recording of motor and somatosensory evoked potential in an anaesthetised Wistar rat using digital polyrite system

Objectives: The aim of this article is to explain the detailed methodology to record Motor evoked potential (MEP) and somatosensory evoked potential (SSEP) in adult albino Wistar rat, male (200–250 g) which has not been defined previously. Materials and Methods: We have standardised recording of both MEP and SSEP in these rats under anaesthesia on ADI digital polyrite system. Results: Evoked potentials have been widely studied in spinal cord injured patients to estimate the degree of injury and to establish a predictive measure of functional recovery. MEPs and SSEPs, arising from the motor cortex or peripheral nerve and generated either by direct electrical stimulation or by transcranial magnetic stimulation, have been advocated as a reliable indicator of descending and ascending pathway integrity. In the rat brain, there is a physical overlap between the motor and somatosensory cortex. Hence, our objective was to identify the exact area for stimulation in the cortex where we could record maximum response with the application of minimum electrical stimulation. Conclusion: The recording of MEP and SSEP together provides a powerful neurological technique to monitor the tracts of the spinal cord.

Histoplasmosis masquerading as tuberculosis: A report of three cases in immunocompetent children

The most common cause of granulomatous lymphadenitis in countries like ours is mycobactrium tuberculosis followed by atypical mycobacterial infection, fungal infections, parasitic infection, cat scratch disease, lymphogranuloma venereum (inguinal lymphadenopathy), and leprosy Here, we present three cases of lymphadenopathy due to histoplasmosis in immunocompetent children. Two of them presented with fever, lymphadenopathy, initially diagnosed as granulomatous lymphadenitis consistent with tuberculosis on FNAC and were put on antitubercular drugs. However, their condition gradually became worse. As the patients continued to deteriorate, subsequent lymph node biopsies were done and diagnosed as histoplasmosis. Third case presented with acute loss of vision with hepatosplenomegaly and lymphadenopathy. Initially considered as acute leukemia, but eventually established as histoplasmosis. Histoplasmosis should be considered as one of the possible causes of granulomatous lymphadenitis in children.

A study on cardiovascular parameters in athlete and non-athlete adult males

Background: An old proverb teaches us “Good things come to those who sweat.” Apart from its philosophical and metaphysical meaning, it is also true by words. Many previous studies also supported this view, but study in the rural part of Bengal in this field had hardly been undertaken before. Aim and Objectives: The objective of the study was to find any difference in cardiovascular parameters, for example, arterial blood pressure, heart rate; to compare the body mass index (BMI), skin fold thickness among athletes and non-athlete adult male volunteers; and also to identify any difference in resting electrocardiogram (ECG) patterns between those two groups. Materials and Methods: The present article is a scientific validation of this statement. In technical terms, this is an institutional ethics committee certified case-control study conducted in Burdwan and Birbhum districts of West Bengal with 75 non-athlete people and 75 athletes. Results: With the help of modern diagnostic tools and rigorous statistical methods, it was found that there are significant differences (P < 0.00001) between these two groups in terms of waist circumference, abdominal skin fold thickness, BMI, diastolic blood pressure (BP), and left ventricular hypertrophy by ECG. From existing medical knowledge-base, this finding can immediately be interpreted as having higher risk factors of coronary heart diseases for non-athlete people. Conclusion: Based on these findings, authors recommended that a sedentary lifestyle should be avoided to get rid of hypertension and obesity and stay away from fatal coronary heart diseases. Regular Physical activity and healthy diet can help us to live a long and disease-free life. This article speaks nothing new and surprising but confirms an age-old truth with modern scientific experiments, methods, and techniques which is a need of the hour.

Small Colony variants of Staphylococcus aureus isolated from a patient with infective endocarditis: a case report and review of the literature

Staphylococcus aureus produces a particular morphological variant called small colony variant [SCV] which is responsible for persistent subclinical infections in predisposed individuals and is usually resistant to aminoglycosides and cell wall active antibiotics. Infections by SCV of S. aureus are an upcoming problem due to difficulty in laboratory diagnosis and resistance to antimicrobial chemotherapy. We here report a case of infective endocarditis caused by SCV of Staphylococcus aureus in a pediatric patient.

Immunomodulatory role of arabinosylated lipoarabinomannan on Leishmania donovani infected murine macrophages.

Arabinosylated lipoarabinomannan (Ara-LAM), a surface glycolipid antigen isolated from avirulent Mycobacterium smegmatis is involved in modulation of host cell signaling. In this study, we investigated Ara-LAM-mediated modulation of impaired immune responses during visceral leishmaniasis caused by protozoan parasite Leishmania donovani. Ara-LAM treatment at dose of 3 microg/ml in L. donovani infected murine peritoneal macrophages as well as J774A.1 macrophage cell line exhibited a distinct up-regulation of pro-inflammatory cytokines like TNF-alpha and IL-12 both at the protein and transcriptional level. In addition, generation of nitric oxide and iNOS expression were also observed. The present study showed that Ara-LAM was significantly effective in elimination of L. donovani parasites from both peritoneal as well as J774A.1 macrophages. Thus, it could be utilized as an immunomodulatory agent in prevention of leishmanial pathogenesis.

A study on body mass index (BMI) and some biochemical parameters of the medicos with family history of diabetes mellitus, hypertension and coronary heart disease.

Increasing prevalence of diabetes mellitus (DM), hypertension (HT), coronary heart disease (CHD) is alarming; risk factors are fairly stable, passing fairly well from childhood to adulthood; genetic factors play a role. This is important to know the status of some biochemical parameters viz, fasting plasma glucose level, fasting serum insulin (FI), serum triglyceride (STG), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) among the medicos with family history (FH) of DM, HT or CHD and the relationship of biochemical parameters with body mass index (BMI). Mean age of the sample (n=67) was 22 years with 76.12% males and 23.88% females; 44.78%, 29.85% and 19.40% had FH of DM, HT and CHD respectively; 8.96% had the FH of three diseases. High BMI was seen in 62.69% cases; it was significantly high among those with FH of DM (p<0.05) but not significant against HT (p>0.05) or CHD (p>0.05). All had normal fasting plasma glucose level. Positive association existed (a) between BMI with FI, LDL and HDL, FI with LDL and HDL, TG with TC, TC with LDL and HDL, LDL with HDL among those with FH of DM; (b) between BMI with FI, STG and HDL, FI with LDL and HDL, TC with LDL and HDL, LDL with HDL among those with FH of HT; (c) between BMI with FI, STG and HDL, FI with TC, LDL and HDL, TC with LDL and HDL, LDL with HDL among those with FH of CHD. Multiple correlation coefficients (R) also indicated moderate association.

Primary adenocarcinoma of bladder--A case report.

A 24 years old male presented with haematuria. Ultrasonography depicted an echogenic mass on bladder wall, where prostate showed normal echo characters. Cystoscopy revealed a large papillary growth involving lateral wall, neck of the urinary bladder and prostatic urethra. Punched biopsy showed features of adenocarcinoma. Radical cystectomy was performed and it was reported as a case of primary adenocarcinoma of the urinary bladder.

Frequency-dependent prey-selection of predacious water bugs on Armigeres subalbatus immatures.

BACKGROUND & OBJECTIVES: The predatory behaviour with reference to the frequency-dependent prey-selection of the water bugs Sphaerodema annulatum Fabricius and S. rusticum Fabricius was studied in the laboratory using the IV instar larvae and pupae of Armigeres subalbatus as prey to ascertain their efficacy as predator of mosquito immatures. METHODS: Field collected adult morphs of the water bugs were allowed to predate on larvae and pupae provided in different ratios and densities as per the model of Greenwood and Elton' for a fixed time period. The data obtained on their predation rate were analysed with respect to the model parameters, lnV--the frequency independent component and b--the frequency dependent component of selection. RESULTS: It was found that the prey-selection was dependent on the relative numbers of prey available, favouring apostatic selection. The b values and lnV values for S. annulatum were 0.54 +/- 0.01 and 0.92 +/- 1.04 respectively whereas the corresponding values for S. rusticum were 0.71 +/- 0.03 and 0.17 +/- 1.57 respectively. INTERPRETATION & CONCLUSION: The selection of preys by the water bugs was dependent on the relative number of the prey forms and thus they are expected to predate on the form more abundant in a heterogeneous prey population and adversely affect the adult emergence.

Endometrioid carcinoma of uterus and ovary.

A thirty-two-year-old married woman presented with pain abdomen and polymenorrhoea. Her uterus was bulky and one of the fornices was full. USG of abdomen revealed unilateral ovarian tumour associated with a mass in the uterus. Histopathological report revealed synchronous endometrioid carcinoma of the uterus and the ovary with morphological evidences in favour of independent primary carcinomas. With these perspectives the present case is reported where endometrioid carcinomas of uterus and ovary are two separate primary tumours.

An epidemiological survey of carcinoma cervix in north Bengal zone.

Correlation between various epidemiological factors and carcinoma cervix patients in North Bengal zone has been studied for the first time. Significant correlation between elderly women (41-50 years age group), low socio-economic status (SES), first coitus before 17 years of age, low literacy rate and this illness has been established. Suggestion has been made for improvement of the picture. Oncology and radiotherapy department of North Bengal Medical College and Hospital should be utilised as the centre for National Cancer Registration Project in North Bengal zone.

Influence of fowl uropygial gland and its secretory lipid components on the growth of skin surface fungi of fowl.

Fungal species, which were shown to colonize consistently on the skin surface of the breast region of adult (1 year old) white leghorn fowl, were identified as Aspergillus sydowii, A. tamarii, A. rugulosus and Absidia corymbifera. Of these, A. sydowii and A. tamarii were the dominant forms. Two species of fungi, namely, Aspergillus niger and Scopulariopsis brevicaulis were shown to be present in the cultures of the scrubbings from breast skin surface after 60 days of captivity of the fowls. Extirpation of the uropygial gland resulted in encouragement of the in vitro population growth of all species of fungi except that of A. rugulosus. The effect was found to be very conspicuous for A. sydowii and A. tamarii, particularly after 60 days of gland removal. Addition of total lipids and the wax diester component of free-flowing uropygial secretion as 0.2% suspension in Sabouraud's agar medium of individual fungal isolates caused marked suppression of the population growth of A. sydowii, A. tamarii, Absidia corymbifera and to some extent of S. brevicaulis. Other components of secretory lipids, such as wax alcohols (2,3-alkane-diols), wax acids, triglycerides and hydrocarbons (including squalene) when supplemented separately to culture medium of individual fungi at identical concentration, were also shown to cause inhibition of the growth of most of fungal species at different degrees.

Cloning and sequencing of an apparently recombinant promoter for napin gene from Brassica campestris genomic library and its evolutionary significance.

From a genomic library of Brassica campestris (brown sarson cv. B54), we have cloned and sequenced about 2 kb of upstream regulatory region from one of the 2S albumin-coding gene family. The sequence has several seed-specific promoter motifs. A sequence alignment of the 5' flanking regions of the available Brassica 2S storage protein genes showed that our sequence is a double crossover recombinant product of the two members of the napin gene family. A possible explanation of this fact is that Brassica species evolved through gene duplication and recombination from a common ancestor with fewer number of chromosomes and genes.

Cloning of ribosomal RNA genes from an Indian isolate of Giardia lamblia and the use of intergenic nontranscribing spacer regions in the differentiation of Giardia from other enteric pathogens.

The ribosomal RNA genes from an Indian isolate of Giardia lamblia have been cloned and characterized with respect to size, composition and copy number. Southern blotting and rDNA cloning of Giardia lamblia revealed that genes coding for ribosomal RNA (rRNA) are exceptionally small and are encoded within a 5.6 kb genome fragment repeat. The rDNA repeat unit of this isolate was found to be highly G-C rich like other human isolates and the physical map showed several SmaI sites. There are 132 copies of the rDNA repeat unit per cell in a head to tail arrangement. Two fragments corresponding to intergenic (0.2 kb and 0.3 kb) region and one (0.8 kb) containing both an intergenic region and a small part of the small subunit ribosomal RNA (SS rRNA) have been identified within the rDNA. These were used in heterogeneity studies of Giardia isolated from two geographic locations as well as in the analysis of cross reactivity with other enteric organisms. In Southern blots, all the three fragments were found to be highly specific for the differential diagnosis of Giardia spp. from the other enteric pathogens. These findings should help in developing a sensitive and more specific method for the diagnosis of giardiasis over currently available techniques.

Hepatitis D infectivity profile among hepatitis B infected hospitalised patients in Calcutta.

450 hospitalised cases of hepatic and non hepatic disorders and 100 normal individuals were examined for serum Hepatitis B Surface antigen and Delta Virus antigen by ELISA to find out its association with different clinical disorders. 105 patients (23.3%) and 2 control (2%) were positive for HBsAG. 60 cases with jaundice (26%) were HBsAg positive. 65% of HBsAg positive jaundiced patients had serum bilirubin level more than 2 mg per dl with a mean SGPT level of 488 iu/L. Only two cases were positive for HDV antigen among 60 HBsAg positive jaundice patients indicating a lower rate of prevalence of infection (3.3%). 62 (59%) out of 105 HBsAg positive cases did not show any history of blood transfusion or surgical interference indicating a positive HBV transmission through needle prick during investigative procedures.

A comparative study of silver binding nucleolar organiser regions (AgNORs) of breast lesions in histological sections and fine needle aspiration smears.

The study presents a comparative profile of AgNOR dot counting in different types of breast lesions in histopathological (HP) sections and fine needle aspiration cytology (FNAC) smears. The breast lesions chosen were non-neoplastic lesion like fibroadenosis, benign neoplastic lesion like fibroadenoma and malignant neoplastic lesion like infiltrating duct carcinoma-grade 2. The AgNOR counts of non-neoplastic lesion were significantly less in number than the neoplastic lesions--both benign and malignant, in both the HP section and FNAC smear. But the counts did not show significant difference in the two neoplastic lesions eg, fibroadenoma and infiltrating duct carcinoma-grade 2, in both the HP section and FNAC smear. The appearance of the dots, as felt by the observers, were more discriminating between the three lesions, eg, uniform small compact centrally placed in fibroadenosis; mostly uniform small compact but occasional large irregular in fibroadenoma and large irregular marginally located in infiltrating duct carcinoma. Counting was easier and the appearance of the dots more easily discernible in FNAC smear than the HP section as the smear was monolayer and the malignant cells were easily detected from macrophages and stromal cells. But the tissue fluid or secretions or blood when present in the smear gave the smear a dirty background which was disturbing to the observers. Thus this AgNOR technique, when applied in HP section or FNAC smear, appears cost ineffective, lengthy and tedious procedure; did not offer absolute histochemical discriminant for malignancy from benignancy. But the shape and size distribution and appearance of the dots showing much variability in FNAC smear than the HP section, might be of some help in the diagnosis of malignancy and discriminating from benignancy.