COVID-19: Knowledge, attitude, and practice of health-care workers in tertiary care hospitals of Odisha – A cross-sectional survey

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a contagious viral pathogen, creating a public health emergency, and affecting lives and livelihood of millions of populations globally. Good knowledge, attitude, and practice are essential to prevent and stop the widespread transmission. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practices regarding COVID-19 among health-care workers (HCWs) in tertiary care hospitals of Odisha. Materials and Methods: The present study is an observational, cross-sectional, and question-based online research. Questions were created on Google forms. Link was generated and given through social media apps. The questionnaire consists of four sections. First section comprised demographic characteristics. Second, third, and fourth sections contain questions on knowledge, attitude, and practice related to COVID-19, respectively. Descriptive and inferential statistical procedures were done through IBM SPSS statistics version 24.0. The research was granted approval by Institute Ethics Committee of IMS and SUM Hospital. Results: Data were analyzed in 430 subjects, 205 females and 225 males. The majority of HCWs have good knowledge score 86.5%, attitude score 80.9%, and practice score 91.2%. The mean knowledge score was 6.6 ± 0.84 and mean attitude score was 28.5 ± 1.89. Knowledge and attitude score was found to be significantly different among age groups and gender, p<0.001. Mean attitude score had a significant difference with working status, P = 0.025. Mean knowledge and attitude score was significantly higher across professions and work experience, P < 0.001. Good practice score varies significantly across professions, P < 0.001. Conclusions: The most of HCWs had good knowledge, positive attitude, and adopted appropriate practices regarding COVID-19. Periodic educational interventions are strongly recommended for HCWs to upgrade their knowledge, attitude, and practices regarding coronavirus diseases.

Attitude and practice of self-medication among 2nd-year dental students in a tertiary care teaching hospital: A questionnaire-based cross-sectional study

Background: It is a common believe that self medication prevails more in medical students. Dental students do believe in self medication. With this background, current study aimed to determine the attitude and practice of self medication among dental students. Aim and Objective: To know prevalence, attitude and practice of self medication among dental students in a dental college. Materials and Methods: A descriptive cross-sectional study was conducted among 2nd year dental students in a tertiary care teaching hospital to assess attitude and practice regarding self-medication. Data were collected from 90 students using a semi-structured self-administered questionnaire. Results: The study finding revealed that overall prevalence of self medication is 86.67% among the participants. There is an increase in prevalence of self medication from 58.97 to 86.67% after joining to professional course. Most common source of self medication is senior抯 advice (92.30%) followed by book reference (83.33%). Most common disease for which self medication is used are fever, headache/body ache, cold/flu (100%) followed by acid peptic disease (92.30%). The use of self medication is more in communicable/infectious disease (91.02%) than noncommunicable disease (62.82%). Most commonly used drug for self medication are analgesics, antiallergics and antipyretics (100%) followed by antacid/PPI (84.61%). The prevalence of use of antibiotics among the participants are 73.07%. 26.29% participants use herbal medication as self medication. Most of the participants use self medication as and when basis (52.57%). Only 25.64% participant took full course of the medication and 21.79% participants use self medication for long term. Most of the participants strongly agree or agree for self medication in community and among dental students. About 54% disagree saying medicine should be prescribed by licensed medical practitioner. Conclusion: Attitude and practice of the students towards self-medication was positive and reason being dental students and influence of seniors. Since they are in the initial year of course with inadequate knowledge, awareness must be created about appropriate use and adverse drug reaction arising from self-medication.

Exploring spinal muscular atrophy and its impact on functional status: Indian scenario

The present study aimed to find out the effect of disease-related impairments on functional status in individuals with spinal muscular atrophy and identify perceived barriers to undergo physiotherapy. The cross-sectional observational study was conducted on 90 participants from January to March 2018 using validated patient-reported questionnaire via electronic mail, along with Fatigue Severity Scale and ACTIVLIM. Results revealed that difficulty in sitting was due to scoliosis (36%) and muscle weakness (23%), the latter also contributing toward difficulty in standing and walking (59%). Inverse relationship exists between ACTIVLIM measures and fatigue severity scores (r = ?0.338, P < 0.05), body mass index (r = ?0.225, P < 0.05), age (r = ?0.258, P < 0.05), and duration of illness (r = ?0.257, P < 0.05). Economic constraints (27%), difficulty in traveling (17%), and lack of family support and mobility (14%) are perceived barriers to undergo physiotherapy. Functional impairments and identified barriers must be addressed as part of rehabilitation.

Enteric fever in an HIV/AIDS patient: atypical manifestations

Bloodstream infections with Salmonella typhi, is uncommon in human immunodeficiency virus [HIV]-infected persons. The symptoms in such patients are often non-specific and have a rather insidious onset and progression. We report a patient with sepsis and lower limb gangrene due to Salmonella typhi infection in an HIV-infected patient.

Drug resistance profile of human Mycobacterium avium complex strains from India.

PURPOSE: To determine minimum inhibitory concentration (MIC) of various anti-tuberculosis drugs for Mycobacterium avium complex (MAC) strains isolated from clinical samples. METHODS: Forty-nine human isolates of MAC were tested for susceptibility to nine chemotherapeutic agents. All isolates were from Indian patients suffering from chronic pulmonary mycobacteriosis. Drug susceptibility was performed both by agar dilution and MIC method. MIC values were analysed, both visually and by enzyme-linked immunosorbent assay reader. RESULTS: More than 40% of the MAC isolates were sensitive to ciprofloxacine (48.98%), amikacin (46.94%) and roxithromycin (42.86%) by the MIC method. In contrast, the isolates showed high degree of resistance to the first line antituberculosis drugs: only 28.6% were sensitive to rifampicine, 22.85% to isoniazid and ethambutol each and 36.7% were sensitive to streptomycin. In addition, 22.85% of the strains were sensitive to clofazimine and 34.7% to kanamycin. CONCLUSIONS: Results of the study confirm the suitability of the rapid broth micro dilution (MIC) method as a simple yet reliable method to assay for the drug susceptibility of nontuberculosis mycobacterium.

Role of cytokines in immune response to pulmonary tuberculosis.

Immunopathogenesis of tuberculosis needs to be explored in search of a proper vaccine as well as for adjunctive immunotherapy particularly in patients with drug resistant tuberculosis. In tuberculosis, IFN-gamma, a product of T lymphocytes, contributes to protective immunity against M. tuberculosis by activating macrophages to a more effective elimination of these organisms. Interleukin-12 and interleukin-18 are macrophage products that favor the development of Th1 type of protective immune response. Production of these cytokines may not only facilitate granuloma formation and bacillary elimination but may also cause local tissue necrosis and systemic effects such as fever and wasting, due to the release of TNF-alpha into the circulation. The production of anti-inflammatory cytokines such as IL-10, TGF-beta and IL-4 in response to M. tuberculosis may down regulate the immune response and limit tissue injury by inhibiting excessive inflammatory response. These cytokines, if produced in excess, may result in failure to control infection resulting in widely disseminated tuberculosis. It is the balance between the inflammatory and protective immune response that determines the outcome of tuberculosis infection. In that context, increased IFN-y as against reduced TNF-alpha probably suggests a better outcome. Similarly, an effective vaccine has to stimulate a precise combination of T cells and cytokines needed for the many aspects of immune response and a potent immunotherapeutic agent may require to encompass the multiple parameters to be of therapeutic relevance.

Histobiochemical changes in lung of protein deficient rats following repeated exposures of MIC vapour.

Adult male albino rats, maintained on normal or protein deficient diets from weanling, were exposed to repeated doses of MIC vapour (0.32 mg/L for 8 min for 5 consecutive days) under static conditions. Histopathology and the activities of alkaline and acid phosphatases and GSH content of lung were studied upto day 14 after exposure. Mild but repeated exposures of MIC vapour caused severe pulmonary lesions like denudation of bronchiolar epithelial lining tissue, cellular infiltration, edema, emphysema followed by hyperplasia, hypertrophy, fibrosis and intraluminal fibroplasia. The activities of alkaline and acid phosphatases were increased at earlier intervals while GSH content decreased significantly and remained low throughout the experimental duration. Protein deficiency was found to aggravate the toxic potentials of MIC in present condition.

Inhalation toxicity of methylisocyanate: assessment of germ cell mutagenicity and reproductive effects in rats.

Adult male Wistar rats were exposed to methylisocyanate (MIC, 3.2 mg/l, single inhalation exposure for 8 min under static condition) or ethyl methanesulphonate (EMS, 150 mg/kg, single ip dose) for the assessment of germ cell mutagenicity and reproductive effects. Sequential matings of treated males with normal females on days 1-7, 8-14 and 15-21 post-exposure did not indicate any induction of dominant lethal mutation (increased frequency of preimplantation losses and early fetal deaths) by MIC but it was significantly induced by EMS as compared to respective controls. Males, necropsied after 21 days of exposure, showed no effect of MIC on epididymal sperm density and morphology. EMS also had no effect on sperm density but it significantly induced morphological abnormalities in sperm as compared to untreated controls. There was an acute and transitional reduction in reproductive performance (10-21%) of MIC-exposed males during days 1-14 post-exposure followed by recovery to the normal level during days 15-21 post-exposure. The progeny of MIC-exposed males was also normal in terms of litter size, litter weight, neonatal survival and body weight gain in litters up to 10 days post-partem. It is concluded with the evidence at hand that the observed failure of MIC to cause germ cell mutagenicity is related to its poor biodistribution to the target site(s) and a transient reduction in the reproductive performance of MIC-exposed males is a result of general stress and disconsolate copulation.