Pattern and associated socio demographic factors of tobacco use among health care staff in a tertiary care setting at Faridabad

Background: This study aimed at assessing prevailing pattern and risk factors of tobacco consumption among health care workers of tertiary care centre, in Faridabad.Methods: A cross-sectional approach was used. A sample of 306 participants included housekeeping and nursing orderly. Participants were interviewed during their lunch time. Semi structured questionnaire was used for data collection.Results: The overall prevalence of tobacco use was found to be 42.8% (n=306), of which (30.7%) prevalence among housekeeping’s compared to nursing orderlies (12.7%). The consumption of smokeless tobacco was higher among housekeeping staff. Khaini (45%) was the main consumption type, followed by hookah (21%) and cigarettes (19.5%) among the current tobacco user (n=133). The consumption of tobacco was found to be associated with gender (male), education, and nature of job (designation) at the hospital setting.Conclusions: Tobacco use is very common in hospital staff in Faridabad as reflected by results of our study. We should build on success encountered in banning smoking in educational institutions and healthcare facilities. This is important for their health and also overall health of patients also as they can influence the behaviour of people that surrounds them.

Profile Of Medico-Legal Deaths Due To Drowning - A Retrospective Study

Death due to drowning is almost frequent in India, so it is but natural that, medico-legal expertise is called upon for investigations. Determining the cause of death in bodies found in water is quite challenging, which can be done by thorough investigation and complete autopsy by forensic pathologist. The present study was a retrospective, which was conducted for one year during June 2016 to May 2017 considering upon history and postmortem finding of the deceased. The maximum drowning cases were of male sex (74.73%), with commonest affected age group being 21-30 years (30.64%). Most of the drowning cases were accidental (55.91%) in nature and occurred commonly in water canal (55.37%), and rivers (25.26%). The most significant findings noted on autopsy were decomposition and animal bites (gnawing effects) (54.83%) and presence of heavy, voluminous, edematous and congested lungs with c/s showing copious frothy fluid (52.15%)

Cost–benefit analysis of controlling rabies: prioritizing areas in rural setting of Maner: a cross sectional study

Background: Rabies being a preventable disease with no treatment available once onset starts but can be easily prevented by post-exposure among all animal bite victims. So it is essential to take the full course of vaccination for complete protection.Methods: The present study was a hospital based cross sectional study and was carried out in rural health training centre in Maner, Patna.Results: Our study included 340 patients who attended anti rabies clinic for post exposure prophylaxis. Among them 65% were children (<15 years) comprising mostly males (69%) and mostly of category III exposure. Direct cost of post exposure vaccination when compared with the cost of pre exposure prophylaxis is one-third (approx).Conclusions: Compliance to anti-rabies vaccination for post-exposure prophylaxis is still low and they are still at risk of developing rabies. Reasons being irregular supply of vaccine and immunoglobulin in government hospitals, loss of wages, forgotten dates, cost incurred to buy from outside and distance from the hospital if referred to other centre. Seeing the current scenario, planning and prioritizing areas to achieve our goal and lessen economic burden is need of the hour. We infer that pre exposure prophylaxis may be a cost effective strategy which can aid in the control and elimination of rabies in endemic settings.

Angiomatous-Angiectatic Nasal Polyps: A Varied Clinical, Radiological and Histomorphological Spectrum

Background: Angiomatous nasal polyp (ANP) is a rare interesting clinical entity cause diagnostic dilemma by presenting either gradually progressive or sometimes in acute fashion with sign and symptoms suggestive of malignancy. Objective: To study the varied clinical symptoms, growth pattern and spectrum of radiological, histomorphological features. Methods: Here we studied 10 cases diagnosed with this entity and characterized the histomorhological features. We have also discussed clinical presentations and radiological features of this disease as described in the literature. Results: ANP have a prominent component of dilated capillary-type blood vessels with intraluminal thrombosis- infarction with compromise of their blood supply and extensive accumulation of extravascular stromal, perivascular pools of eosinophilic, congo red -negative pseudoamyloid- like material. Conclusion: Angiomatous nasal polyp is although benign does at times mimics malignancy causing radiologically evident surrounding bone erosion / destruction. Preoperative radiological diagnosis helpful in avoiding extensive surgery but final diagnosis is usually made by histopathological examination.

Cytokeratin Positive Cystic Epithelioid Gastrointestinal Stromal Tumor Mimicking Gastric Carcinoma- Immunohistochemical Analysis and Review of Literatures.

Gastrointestinal stromal tumor is biologically heterogeneous in both morphological appearance and clinical behavior. Immunohistochemical analysis and literature review was done to explore the necessity of mutation study. We present a case study of a 40 year old male presented with upper abdominal lump, exploratory laprotomy done and a large cystic mass involving transverse colon, omentum, stomach along with gross hemoperitoneum was found. Ruptured large cystic tumor mass measuring 19X16 cms was received for histopathological examination. Grossely the cystic mass show variegated outer nodular surface with attached piece of stomach and a segment of colon. Bright field microscopy show striking perivascular arrangement of tumor cells and geographical necrosis and the report signed out as undifferentiated carcinoma stomach. Battery of immunohistochemical markers was done. Tumor cells displayed diffuse positivity for CD117, DOG1, and pan-CK along with more than focal positivity for CD34 and negative for SMA, desmin, S-100, synaptophysin, chromogranin, Bcl-2, Ki- 67. Tumor turned out to be Cytokeratin positive epithelioid gastric GIST. Cytokeratins may be expressed in high grade GISTs rarely and CK positive GISTs must be differentiated from carcinomas, melanomas and a range of CK- positive sarcomas. A panel of immunohistochemistry markers is required for diagnosis and prognostication of the tumor.

Significance of history taking before autopsy: A case study.

Many cases are being reported before the Forensic Experts, in which it becomes difficult to find out the precise cause of death. A 73 year male was brought for autopsy examination at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand with suspicion of death due to brain tumor. The findings of autopsy examination was edema of brain matters and depressed area in right frontal lobe of brain with several stitches marks on right side of head. Detailed history from all the concerned persons were taken which reveals previously person was operated by neurosurgeon for space occupying lesion in cranial cavity. Histo-pathology examination of mass showed Koch’s lesion as tuberculoma en plaque a very rare presentation of tuberculosis which is very common in our country even in the era of 21st century. Case is being presented with brief discussion showing the need of early and prompt history taking including hospital records details before an autopsy examination. It may reveal important facts as well as helps the Forensic Experts to take the consideration of therapeutic artefacts during autopsy to find the exact cause of death.

Determination of time elapsed since death from the status of transparency of cornea in Ranchi in different weathers.

Determination of ‘time elapsed since death’ (TSD) is one of the important content of the post-mortem report. Although the status of transparency of cornea is variable, depending on different factors like other parameters used for the purpose of determination of time since death but it is less variable as compared to others. The study sample comprised of 238 medico-legal autopsies conducted in the department of Forensic Medicine & Toxicology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand during June 2006 to September 2007. In majority of cases cornea remains transparent & moist in 0—06 Hrs and becomes transparent & dry in 06—12 Hrs, transparent to hazy in 12—24 Hrs, hazy to opaque in 24—36 hrs and opaque in >36 Hrs. In sequence, changes occurs more in warm & moist weather then in warm & dry weather and cold & moist weather respectively and least in cold and dry weather.

Presence of Hb S in Uttaranchal.

Haemoglobin-S has been reported in several studies on remote populations from various parts of India eg Maharashtra, Madhya Pradesh, Andhra Pradesh, Orissa, West Bengal, Rajasthan and Malaysian Indians. Uttaranchal also has got scattered areas with people living in remote-pockets due to its geophysical nature. There has been no previous report from this state about prevalence of Hb-S. In the present study on 38 individual eight were found to have Hb-S positivity by sickling test. In one of these electrophoretic confirmation was positive with demonstration of associated Beta thalassaemia. The group was a family of muslims in village Baghori near Haldwani. Due to technical, geographical and social restrictions further study could not be done. However, this study does establish the presence of Hb-S-Beta thalassaemia in Uttaranchal State for the first time. Follow up study in the affected area and elsewhere in the state might discover more of Hb-S positivity, other haemoglobinopathies and thalassaemias.

TORCH infection in women with bad obstetric history--a pilot study in Kumaon region.

TORCH infections in the mother are transmissible to fetus in the womb or during the birth process and cause a cluster of symptomatic birth defects. In mother they are inapparent or asymptomatic and hence difficult to diagnose clinically. Over a nine months period 20 pregnant women with bad obstetric history were-studied. Seropositivity of Toxoplasma, rubella, CMV, and HSV infections (TORCH) were demonstrated by the presence of IgM and IgG antibodies by ELISA method. It was found that, IgM antibodies were positive in 4 cases (20%) for Toxoplasma, 4 cases (28.6%) for rubella and 4 cases (26.7%) for CMV and HSV each. IgG antibodies were positive in 11cases (55%) for Toxoplasma, 10 cases (66.6%) for rubella, 14 cases (93%) for CMV and 11 (73%) for HSV. Therefore all antenatal cases with BOH should be routinely screened for TORCH as early diagnosis and appropriate intervention will help in proper management and fetal outcome.

Isolated necrotizing vasculitis of gallbladder: a report of two cases and review of literature.

We report two cases of isolated necrotizing vasculitis of gallbladder without evidence of systemic involvement which was histologically indistinguishable from classic polyarteritis nodosa (PAN), displaying vascular lesions in different stages of progression like those of PAN. The literature has been reviewed in order to evaluate the significance and possible aetio-pathogenesis of gallbladder (GB) vasculitis. Localized PAN of gallbladder is a rare incidental postoperative finding, the serological work-up for autoantibodies may be negative and the disease is likely to remain self-limited.