Gender-based comparison of nutritional status in tribal and non-tribal populations: a study in the Udaipur region

Background: It is imperative to examine the nutritional quality of adult populations, both tribal and non-tribal, in the Udaipur region of Rajasthan in order to comprehend the health dynamics of these societies. Tribal communities frequently encounter particular difficulties with regard to healthcare access, socioeconomic standing, and cultural customs that may have an impact on their nutritional well-being that is distinct from that of non-tribal communities. Methods: Our study group consisted of 300 tribals and 300 non tribals. The blood was tested to determine various nutritional parameters like minerals iron, calcium, phosphorus, magnesium, and vitamins like vitamin, vitamin A, vitamin D, and vitamin B12. Results: Comparable levels of parameters like calcium, magnesium, phosphorus, vitamin A, and vitamin D3 were found in both non-tribal and tribal people, suggesting that both groups' nutritional statuses were generally similar. Non-tribal males and females exhibited significantly higher iron levels compared to their tribal counterparts. Both non-tribal males and females had considerably higher levels of vitamin C and B12 compared to tribal peers. Conclusions: The study highlights the differences in iron, vitamin C, and vitamin B12 levels that occur in the Udaipur region between non-tribal and tribal individuals.

Impact of Biotic and Abiotic Stress on Survival of Lac Insects Kerria lacca Kerr. on Pigeonpea (Cajanus cajan (L.) Millsp)

Cajanus cajan is generally grown in rainfed condition. The crop is also a good annual host plant of lac insect. C. cajan is widely reported to have biotic stress due to insect pests on it. Lac insect is phloem sap feeder and hence imparts biotic stress. The present field study was conducted to evaluate the percent survival of lac insects on C. cajan by adjusting different levels of biotic and abiotic stress on the host plant. The biotic stress due to insect pests on C. cajan was minimised with periodic spray of contact insecticides. The varying level of biotic stress i.e., No, Low, Medium, and High level was maintained on C. cajan plants with lac insects on it. The three levels of abiotic stress in this experiment were considered in terms of soil moisture stress. It was managed through irrigation per plant through drip system, it was considered that creating different levels of moisture stress in soil will impact the host plant. The abiotic stress was of three levels i.e., Low, Medium, and High. The result reveals that survival percent of Lac insect from brood lac inoculation to the harvest of lac crop was highest 37.52 percent on C. cajan with one primary branch and its secondary branches with lac insect (L1- Low biotic stress). It was 32.13 percent (W3- Low soil moisture stress). The study indicates that biotic and abiotic stress play a major role in the survival of K. lacca.

Hyperacute Liver Failure with Multi-organ Dysfunction Syndrome (MODS) by Leptospirosis: A Case Report

Introduction: Leptospirosis may have multi-organ involvement in its severe form with potentially life-threatening consequences. However, acute fulminant hepatic failure is very uncommonly reported. A case study is presented here with fulminant hepatic failure and a diagnostic dilemma for etiology. Case history: A 40-year-old man with no significant medical history presented with fever, muscle pain, weakness, and pain in the upper abdomen. On clinical work, he has developed multi-organ hepatic, respiratory, and renal failure. A timely workup was done, but due to the rapid progression of the disease, the patient succumbed to the disease in the intensive care unit by the time his report for positive leptospirosis test arrived. Conclusion: Leptospirosis must be considered as an important differential diagnosis of acute liver failure patients. An early suspicion for leptospirosis in patients with fulminant hepatic failure and multi-organ failure in India particularly in the rainy season is warranted owing to its high mortality rate.

Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis

Objective: To study the impact of aceclofenac on antihypertensive action of amlodipine and ramiprilin hypertensive patients with osteoarthritis in an open label case control prospective study. Methods: This was an open label case control prospective study. Hypertensive patients on either amlodipine or Ramipril were included in control groups. A total of 120 patients were included in the study and divided into 4 groups: Group A- Hypertensivepatients on Ramipril; Group B – Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Ramipril; Group C– Hypertensive patients on Amlodipine and Group D- Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Amlodipine. Results: At the end of the first month (phase I), the ramipril subgroup in the control group had a mean systolic blood pressure of 136.73±3.80 which was an 8.19% decrease from the baseline and it was found significant (p<0.05). The systolic blood pressure measurements at the end of the second month (phase II) in the control groups revealed further fall in mean systolic blood pressure. The cases of osteoarthritis on aceclofenacand ramiprilshowedan increase in BP. The mean Systolic BP was 159.2 ± 5.816.An increase of 9.74%from the base line and 16.09% was noted at the end of phase-I (P<0.5). Patients on aceclofenac and amlodipine in contrast showed a fall in BP from base line in phase 0 and their mean systolic blood pressure at positive in of second month of phase-II was 142.07± 2.43 about 1.88% fall baseline and 2.94% increase in BP compared to Phase-I. Almost similar observations were recorded for diastolic blood pressure. Conclusion: The interaction of NSAIDs on the antihypertensive action of the ACE inhibitors is significantly greater than their blunting action on the calcium channel blockers.

Evaluation of a commercial Dengue NS1 enzyme-linked immunosorbent assay for early diagnosis of dengue infection.

Purpose: Dengue is one of the most serious mosquito-borne viral infections affecting tropical and subtropical countries in the world. Since there is no immunoprophylactic or specific antiviral therapy available, timely and rapid diagnosis plays a vital role in patient management and implementation of control measures. This paper evaluates a commercially available NS1 antigen capture ELISA vis-a-vis SD bioline Dengue NS1 antigen test for early detection of dengue virus. Materials and Methods: To evaluate a commercial NS1 antigen detection kit vis-a-vis SD bioline Dengue NS1 antigen test, a total of 91 clinical samples were tested. Virological investigations with regard to dengue virus, viz. NS1 antigen capture ELISA (Panbio, Australia), SD bioline Dengue NS1 antigen test, RT-PCR and virus isolation were performed. Results: Out of 91 samples, 24 (26%) were positive by NS1 antigen capture ELISA, 15 (16%) by SD bioline Dengue NS1 antigen test and 11(12%) positive by RT-PCR analysis. The RT-PCR-positive samples were further subjected to virus isolation and resulted in three isolates. The results of the Panbio NS1 antigen capture ELISA, SD bioline Dengue NS1 antigen test, RT-PCR and virus isolation were correlated among themselves. Conclusions: The present study comprehensively established the utility of NS1 antigen ELISA in early diagnosis of dengue infection.

Comparison of a dipstick enzyme-linked immunosorbent assay with commercial assays for detection of Japanese encephalitis virus-specific IgM antibodies.

BACKGROUND: Japanese encephalitis (JE) is a major public health concern in Asia including India. Objectives: To evaluate an in-house developed dipstick enzyme-linked immunosorbent assay (ELISA) test vis-à-vis two commercial kits for detection of JE virus-specific IgM antibodies. SETTING AND DESIGN: Comparative study carried out in Research and Development centre. MATERIALS AND METHODS: A total of 136 specimens comprising 84 serum and 52 CSF samples were tested by in-house dipstick ELISA, Pan-Bio IgM capture ELISA (Pan-Bio, Australia) and JEV CheX IgM capture ELISA (XCyton, India). RESULTS: The overall agreement among all three tests was found to be 92% with both serum and cerebrospinal fluid (CSF) samples. The sensitivity of the dipstick ELISA was found to be 91% with serum and 89% with CSF samples respectively. The specificity of the dipstick ELISA with reference to both commercial assays was found to be 100% in serum and CSF samples in this study. CONCLUSIONS: The in-house dipstick ELISA with its comparable sensitivity and specificity can be used as a promising test in field conditions since it is simple, rapid and requires no specialized equipment.

Short-term (48 hours) versus long-term (7 days) antibiotic prophylaxis for permanent pacemaker implantation.

BACKGROUND: Infection following permanent pacemaker implantation is a dreaded complication. Antibiotic prophylaxis for 1-10 days at the time of implant has been used in the past but there is no consensus regarding its duration. We carried out a prospective, randomized study of two durations of antibiotic prophylaxis to determine which one was more effective. METHODS AND RESULTS: One hundred and seventy-eight patients undergoing permanent pacemaker implantation for the first time were randomized to receive short duration (group A, n = 8 8) or longer duration (group B, n = 90) antibiotic prophylaxis for 2 days and 7 days, respectively. Patients in both groups received cloxacillin 2 g 2 hours prior to the procedure followed by ampicillin and cloxacillin (50 mg/kg/day in 4 divided doses) and gentamicin (3 mg/kg/day in 2 divided doses) for the respective duration. Patients were followed up for 1-17.3 months (9.3 +/- 1.8 months) in group A and 1-16.5 months (8.9 +/- 2 months) in group B. One patient in group B had an infection at the pacemaker site and two patients in each group had to undergo reimplantation due to pus in the pocket. There was no significant difference in the primary end-point in both groups. CONCLUSIONS: A short course (48 hours) of antibiotic prophylaxis following permanent pacemaker implantation is as effective as a longer course (7 days).

Left ventricular pacing through coronary sinus tributaries: initial experience.

BACKGROUND: Left ventricular pacing is increasingly being used as a part of biventricular pacing in congestive heart failure but data on safety, feasibility, reliability and lead maturation are sparse. METHODS AND RESULTS: Seventeen patients (13 males and 4 females) with persistent symptomatic degenerative complete heart block underwent temporary left ventricular pacing by a left subclavian puncture through the coronary sinus to its tributaries using a unipolar permanent pacing lead connected to an external pulse generator. The left ventricular pacing was done for two weeks. Permanent right ventricular apical pacing was also done at the same time through a right cephalic vein cut-down or subclavian puncture and the pacing rate was kept below that of the initial left ventricular pacing rate. Pacing parameters of the left and right ventricles were assessed at the time of implantation and at two weeks. Out of 17 patients, left ventricular pacing was successful in 11 (67.7%) patients. The time taken for the total procedure was 56+/-18.1 min. Lead displacement was noted in one patient without loss of pacing. At the time of implant and after two weeks, left ventricular pacing threshold, impedance, R wave height and slew rate were not different as compared to right ventricular pacing. Holter recording for 24 hours revealed regular left ventricular pacing at the end of two weeks in all patients. CONCLUSIONS: The present study shows that left ventricular pacing through coronary sinus tributaries is feasible and reliable. Acute and subacute maturation of left ventricular pacing are similar to right ventricular apical pacing.

Sequential MTX-5 FU chemotherapy in pallination of advanced cancer cervix.

Twenty four patients with advanced cancer of cervix were submitted to sequential chemotherapy 5FU and MTX. The response rate was 85% in stage III and 50% in stage IV. Overall response rate was 75%. Patients who had not received radiotherapy earlier responded better than those who had received it earlier. This easy and economical modality has importance in view of late reporting and advanced stage of disease encountered in our set up.

Peri-operative oxytetracycline in prophylaxis of surgical wound infections.

Experience with peri-operative oxytetracycline coverage in prevention of wound infection following elective surgery is presented; of 150 cases included in control group 21 developed infection (14%), whereas only 4 of the study group (170 cases) had infection (2.5%). The importance of peri-operative antibiotic umbrella is emphasised and some of the shortcomings of recommended schedule is highlighted.