Sputum positivity status for acid fast bacilli in patient attending a designated microscopy centre of a tertiary care hospital, Lucknow

Background: Tuberculosis is a contagious bacterial disease that is considered to be one of the deadliest diseases worldwide. It affects lungs and causes pulmonary TB. Today in India, every minute 3 to 4 people die of TB, more than 1000 die every day and more than 5 lakhs die every year. Demonstration of AFB in smear has a great important in control of TB, as smear positivity directly correlates with infectivity. Methods: It was a cross-sectional study. It lasted over a period of 6 months (January to June). Samples were collected from patients attending TB and Chest OPD of IIMS&R Hospital and sent for AFB examination by Ziehl-Neelsen (ZN) microscopy at microbiology lab. Patients with symptom of cough lasting for more than 2 weeks were included. Results: Out of 718 patient’s samples, 128 were smear positive by ZN staining method. Out of which 81 (63.28%) were males and 47 (36.72%) were females. According to age distribution 35 (27.35%) were <30 years of age, 68 (53.12%) were in between 30 and 60 while 25 (19.53%) were >60 years of age. 105 (82.03%) positive patients were found to be from rural area and remaining 23 (17.9%) patients belong to urban area. 29 patients were found to have a past history of TB of 1 year. Out of 128 positive patients none were smokers. 25 (19.53%) were tobacco chewers. 11 (8.56%) were contact with a case of TB. Conclusions: Demonstration of AFB in smear has a great important in control of TB, as smear positivity directly correlates with infectivity. Z-N staining method is the most commonly used worldwide.

FNAC as a diagnostic tool for Tuberculouslymphadentitis at peripheral health institutions

Background:Tuberculosis is a common and important public health problem in India. Fine Needle Aspiration Cytology (FNAC)is very easy, simple, quick,cheap and specific method for diagnosis of Tuberculous Lymphadenitis. The objective of this studywas to study the diagnostic yield of FNAC for diagnosis of Tuberculous Lymphadenitis by ZN staining and Cytopathologicalcharacteristics.Material and Methods: Present study was a retrospective study. FNAC/ aspiration was done in cases of superficiallymphnodes / abscess were analysed for diagnostic yield of Tuberculous etiology by ZN staining and cytopathologicalcharacteristics.Results: A total of 136 cases of superficial lymphadenitis presenting as solid swelling or abscess were subjected toFNAC examination. Smears were prepared from the aspirated material. Two separate slides prepared, stained with Giemsa and ZNstain. Total of 73 cases (53.67%) slides showed evidences suggestive of Tuberculous etiology out of which 33 (45.2%) were foundAFB positive on ZN stain. One AFB positive (not included as AFB positive in the analysis of results) slide was suggestive ofMycobact.leprae as confirmed by Fite stain.Conclusion: FNAC is a simple, safe, quick and cheap method to establish thediagnosis. Procedure is very safe, easy and can be performed by any doctor of PHI. Demonstration of AFB in the smear gives abacterilogically confirmed diagnosis very quickly. Cytological examination can further improve the diagnostic yield withoutbacteriological confirmation.

Antenatal and intra-natal care practices in urban slums of Lucknow City, UP.

Objectives: To study the Antenatal and Intra-Natal Care Practices in urban slums of Lucknow city, UP. Methods : A cross- sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows. Results : Study findings showed that Majority (71%) of the mothers received ANC. Out of those who received ANC, 32.5 percent of them received 2 ANC and 25.3 percent received 3 ANC. The tetanus toxoid (TT) vaccination was received by 80.4 percent mothers. Out of those who received tetanus toxoid, 67.9 percent received two doses of tetanus toxoid and 18.7 percent one dose of tetanus toxoid. The study findings shows that about half (51.7%) of the deliveries took place at home followed by govt. health facility (28.4%). Only 19.8 percent of the deliveries took place at private health facility. Majority (73.4%) of the deliveries were conducted by trained birth attendant. Only 19.6 percent and 7 percent deliveries were conducted by relatives and untrained birth attendant respectively. Conclusion: In majority of cases correct Antenatal and Intra-natal care practices were lacking among mothers and this should be promoted through improved coverage with existing health services.

A study of the pattern of head injury in District Aligarh. U.P.. India.

Trauma as a general rule carries medicolegal implication. Head injury adds complexity to the problem as it adversely affects the complete evaluation of trauma until some time has elapsed after a particular injury. The often ill-defined clinical manifestation, the impact of claim settlements, and malingering further add to the problem of fair decision.

Serodiagnosis of dengue during an outbreak at a tertiary care hospital in Delhi.

Dengue, an important human arboviral infection, is endemic in many parts of India. Outbreaks are now reported quite frequently from different parts of the country. We report here findings of serological investigation of serum samples received during a recent outbreak of dengue infection in Delhi from September to November 2003. Acute phase serum samples from suspected cases of dengue infection (including dengue fever, dengue haemorrhagic fever and dengue shock syndrome) of duration 5 days, were tested for dengue specific IgM antibodies by enzyme linked immuno sorbant assay (ELISA). Of the 874 serum samples tested, 456 (52.3% ) were positive for dengue specific IgM antibodies. The maximum number of positive cases was reported in October, peaking in second and third week. Patients in the age group of 21-30 yr accounted for 34.2 per cent of positive cases. This outbreak was less severe as compared to the previous 1996 outbreak and showed a shift towards an older age group.

Larvicidal activity of latex and stem bark of Euphorbia tirucalli plant on the mosquito Culex quinquefasciatus.

The methanolic, chloroform and ether extracts of Euphorbia tirucalli latex and stem bark were evaluated for larvicidal activity against laboratory-reared larvae of Culex quinquefasciatus (Diptera: Culicidae), vector of the brancroftian filariasis and worst urban nuisance mosquito. The latex extracts contain more potent larvicidal components (177.14 mg/L-326.37 mg/L) than the stem bark extracts (237.663 mg/L-513.39 mg/L). The order of toxicity (LC50) for the latex extracts was Methanol extract (177.14 mg/L) > Chloroform (200.76 mg/L) > Ether (326.37 mg/L) while the rank of order of toxicity (LC50) of stem bark extracts was Ether (237.66 mg/L) > Chloroform (343.515 mg/L) > Methanol (513.387 mg/L), Higher doses (LC90 24 h of mosquito larvae) of each extract did not cause any mortality among fishes after 24 h. The study gave a weight into the possibility of formulating suitable preparation from the latex and stem bark extracts of the plant for use in mosquito control programme.

Evaluation of analgesic, antipyretic and anti-inflammatory activity of spirobarbitunylphenothiazines in rodents.

Analgesic, antipyretic and anti-inflammatory activities of newly synthesized spirobarbitunylphenothiazines viz 10-[7, 11-Di(4-4' dimethoxphenyl)-3-oxo-9-methylaminoimino-2, 4-diazaspiro [5.5] undecane 1, 5 dione] acetylphenothiazine (test drug A) and 10-[7, 11-Di (N.N-dimethylaminophenyl)-3-oxo-9-methylaminoimino-2, 4-diazaspiro [5, 5] undecane-1, 5 dione] acetylphenothiazine (test drug B) have been screened in Swiss mice and Wistar rats. The peripheral analgesic activity of test drugs A and B was investigated by acetic acid induced writhing test in Swiss mice while the central analgesic action was assessed by hot-wire (tail flick test) of the analgesiometer and tail-clip test in Wistar rats. Antipyretic activity was assessed on Brewer's yeast induced pyrexic model while antiinflammatory activity was seen on carrageenan induced hind paw oedema. Analgesic activity was found to be only of peripheral type as there was reduction of 66% in writhing responses by test drugs A and B in dose of 80 mg/kg in mice. No change in the tail flick responses was observed on analgesiometer or by tail clip by both the test drugs. Reduction of 1.5 to 2.0 degrees C in rectal temperature was observed in pyretic rats by test drugs A and B in dose of 80 mg/kg. 80% reduction in paw volume was noted in 80 mg/kg dose of both the test drugs which was comparable to the anti-inflammatory activity of 300 mg/kg, p.o. of phenylbutazone.

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

Detection of mycobacterial antigen in circulating immune complexes in patients with childhood tuberculosis.

The presence of both components (antigen and antibody) in circulating immune complexes (CIC) were detected in tuberculosis in children. Fifty two patients with pulmonary and extrapulmonary tuberculosis showed the presence of either components or both. CIC--antigen was present in 92.3% (48/52) and CIC antibody in 88.96% (46,52). Out of these 52 patients, 20 were proved cases, CIC antigen (ag) and CIC--antibody (ab) were present in 100% (20/20). In the control group both CIC-ag and CIC-ab and CIC = ab can be taken as an additional marker in diagnosis of tuberculosis.

Benign osteoblastoma mimicking malignancy of the spine.

A case of osteoblastoma of the spine in a sixty year old female is presented. These lesions usually get misdiagnosed as tuberculosis or malignancy of the spine. Salient diagnostic features have been discussed.

Biting behaviour and biting rhythm of potential Japanese encephalitis vectors in Assam.

Studies on biting behaviour and biting cycles of medically important mosquitoes were carried out in Madhupur village and Tarajan tea estate of upper Assam. Collections were made off human baits outdoors and indoors and off cattle bait outdoors from August 1991 to July 1992. Human bait collections were performed using the 'stationary direct bait' technique. A total of 9,072 adult host seeking female mosquitoes representing 26 species and 5 genera were collected off baits of which 36.9% were collected off human baits and the rest from cattle. All mosquitoes were primarily zoophilic, although significant numbers were collected biting man outdoors. Biting preferences of important Japanese encephalitis (JE) vectors for man and cattle were studied using outdoor man:outdoor cattle ratio (attraction ratio = AR). Culex quinquefasciatus was attracted towards human baits the most (AR = 8.1:1), followed by Cx. bitaeniorhynchus (AR = 1.6:1) and Mansonia annulifera (AR = 1.3.1). The hourly biting activity of important JE vectors throughout the night on two bait types was also studied using three point moving averages. Hierarchical agglomerative cluster analysis was used to compare and classify mosquitoes on the basis of their similarity in biting rhythms.

Injury to anterior optic pathways.

Fourteen patients with injury to the anterior optic pathways have been presented and analysed. Their clinical profile, radiological data and problems involved therein have been discussed. Since an expectant policy has been the rule so far, an attempt has been made to define the role of surgery in such cases.

Effect of arteether alpha/beta on uncomplicated falciparum malaria cases in Upper Assam.

Thirty patients of uncomplicated Plasmodium falciparum malaria completed a clinical trial of arteether alpha/beta conducted in a malaria endemic tea garden of district Dibrugarh, Assam. Arteether was given intramuscularly in once a day dose of 150 mg for three consecutive days. The cure rate was 100 per cent with mean fever and parasite clearance time of 42.4 +/- 17.5 and 37.6 +/- 13.6 h respectively. Recrudescence/reinfection rate was 6.7 per cent. Palpable spleens of twenty out of twenty one cases on day 0 became non palpable within 28 days. Following the treatment, percentage of hemoglobin improved marginally with no remarkable change in total and differential leucocyte count. Arteether alpha/beta, besides being a potent and fast acting schizontocidal drug, also exhibited gametocytocidal action on P. falciparum.