Pattern of tuberculosis among tribal population of Central India with special reference to cartridge based nucleic acid amplification test as diagnostic tool: a descriptive study at tertiary care hospital

Background: Tuberculosis (TB) kills close to half a million Indians every year. Lack of reliable rapid diagnostic techniques for TB hampers timely diagnosis and leads to continued disease transmission, causing significant morbidity and mortality. The potential of newly recommended CBNAAT in TB and MDR-TB detection has been underutilized in our area due to lack of awareness regarding the same. Hence we utilized this rapid, logistically simplified test to study the pattern of tuberculosis among tribal population of Central India.Methods: Descriptive study of suspected TB patients in tertiary care centre from March 2016 to March 2019. Appropriate specimens from suspected TB patients were collected and subjected to CBNAAT and AFB smear to study the pattern of TB and Rifampicin- Resistant(RR) TB  in our area.Results: CBNAAT detected overall 27% MTB cases; 27.72 % Pulmonary-TB cases as against smear positivity rate of 20.73% whereas 12.74% Extra-pulmonary-TB (EPTB) cases as against smear positivity rate of 1.59%.Overall 94.91% were RiF Sensitive( RS-TB) and 4.58% were RR-TB. Of the 57 (4.16%) HIV-TB coinfected cases; 96.49% were RS-TB and 5.26% were RR-TB. Co-infected patients have high incidence of EPTB(21.05%) involvement  with RR-TB 3.50%. Among EPTB cases; lymph node aspirate and pus provided highest CBNAAT positive cases and almost 90.62% EPTB specimens were RS-TB .Conclusions: Availability of new diagnostic services has increased early identification of TB and RR-TB. Awareness among physicians regarding diagnostic utility of CBNAAT should be further increased as early identification of possible MDR cases is key to reducing community transmission and treatment initiation, particularly in high-burden, resource-limited settings.

Evaluation of dermatoglyphic patterns using digital scanner technique in skeletal malocclusion: A descriptive study

Skin is the largest human organ, which performs a dynamic role in life. The ectodermal layers of the skin found on the palm with intricate lines are stable throughout life and have grabbed scientific attention. Any disturbances during their formation might possibly have the likelihood of a person developing malocclusion. Aims and Objectives: The aims of this study were to evaluate and compare the dermatoglyphic pattern with various skeletal malocclusions. Materials and Methods: The study was carried out on 40 outpatients reported with an age group of 18–20 years divided into four groups as follows: Group: I – 10 (Class I occlusion), Group: II – 10 (skeletal Class I malocclusion), Group: III – 10 (skeletal Class II malocclusion), and Group: IV – 10 (skeletal Class III malocclusion). The fingerprints were recorded using scanner exclusively designed for diagnostic purpose of the study. The collected data were analyzed using SPSS statistics software Version 23.0 to find which groups had significant differences. Results and Conclusion: Increased frequency of arch pattern was present in participants with Class I malocclusion, and loop patterns were observed in those with Class I occlusion and Class III malocclusion and whorl patterns in Class II malocclusion with P < 0.05. Dermatoglyphic pattern remains constant throughout life and it can be used as a noninvasive aid in determining the development of malocclusion at a very early age.

Prevalence Of Hepatitis B And HIV And Their Co-infection In Female Sex Workers In Nagpur Region.

Background and Aim: The Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV), have common modes of transmission. Globally, sexually transmitted infection (STI) rates are the highest among population subgroups such as sex workers. Objective is to - (i) Study of Hepatitis B infections and HIV infection in female sex workers (ii) Co-infection rate of HBV and HIV among this population (iii) Simultaneous comparision of infection HBV and HIV infection in healthy female population(blood donar). Methodology: This study was conducted in the department of microbiology IGGMC Nagpur from October 2014 to August 2015. Their sera were tested for the HBsAg and HIV antibodies. Results: A total 400 samples were tested (200 samples of female sex workers and 200 samples of healthy female blood donors. The seropositivity of HBV in FSWs is 1.5% and of HIV is 2%, none of FSWs were coinfected with both the infections. That of healthy female donors HBV prevalence is 0.5% and HIV is also 0.5% similarly none were coinfected with both the infections. Conclusion: The prevalence of Hepatitis-B virus infection and HIV infection is low among the female sex workers in Nagpur region. Similarly prevalence in healthy female population is also low. Targeted intervention among the risk group is effective measure in decreasing the hepatitis B infection rate.

Intracardiac tumor causing left-ventricular outflow-tract obstruction in a newborn

The following report describes the case of newborn girl with an asymptomatic systolic murmur, which on imaging revealed a nearly obstructive mass in the left-ventricular outflow tract. The mass was resected and found to be consistent with a rhabdomyoma. Here, we describe the pathologic and clinical characteristics of this tumor

Outcomes of recurrent laryngeal nerve injury following congenital heart surgery:a contemporary experience

Objective: Injury to the recurrent laryngeal nerve can lead to significant morbidity during congenital cardiac surgery. The objective is to expand on the limited understanding of the severity and recovery of this iatrogenic condition

Design: A six-year retrospective review of all congenital heart operations at a single institution from January 1, 2008 to December 31, 2013 was performed. All patients with documented vocal cord paralysis on laryngoscopic examination comprised the study cohort. Evaluation of time to vocal cord recovery and need for further surgical intervention was the primary focus

Results: The incidence of post-operative vocal cord paralysis was 1.1% [32 out of 3036 patients; 95% confidence interval: 0.7-1.5%]. The majority were left-sided injuries [71%]. Overall rate of recovery was 61% with a median time of 10 months in those who recovered, and a total follow up of 46 months. Due to feeding complications, 45% of patients required gastrostomy tube after the injury, and these patients were found to have longer duration of post-operative days of intubation [median 10 vs. 5 days, p = 0.03], ICU length of stay [50 vs. 8 days, p = 0.002], and hospital length of stay [92 vs. 41 days, p = 0.01]. No pre-operative variables were identified as predictive of recovery or need for gastrostomy placement

Conclusion: Recurrent laryngeal nerve injury is a serious complication of congenital heart surgery that impacts post-operative morbidity, in some cases leading to a need for further intervention, in particular, gastrostomy tube placement. A prospective, multi-center study is needed to fully evaluate factors that influence severity and time to recovery

Seroprevalence of HIV-2 in and around Nagpur.

Abstracts: Backround: Human immunodeficiency virus type 2 (HIV- 2) belongs to the family Retroviridae and is morphologically similar to HIV-1. Reliable and up-to- date information on the HIV-2 epidemic in India is still lacking. Methodology: We conducted this study to know the seroprevalence of HIV-2 in our region. Results: A total 15046 samples were screened at ICTC that includes 6343 from ANC mothers and 8703 samples from direct walk-in clients and referred patients.for HIV-2 antibodies. Also, we found 9 (0.10%) samples positive for HIV-2. One patient was coinfected with HIV-1 and HIV-2. There were no HIV-2 positive cases in ANC and paediatric age group. Conclusion: As HIV-2 is being reported from various parts of the country and its treatment modalities differ from HIV-1 hence screening for HIV-2 should be carried out routinely.

Single center experience on dosing and adverse events of recombinant factor seven use for bleeding after congenital heart surgery

There are limited data on the relationship between the administered dose of recombinant factor seven [rFVIIa] and the development of adverse clinical outcomes after congenital heart surgery. This single institution case series reports on dosing, adverse events, and blood product usage after the administration of rFVIIa in the congenital heart surgery patient population. A retrospective review identified 16 consecutive pediatric patients at an academic, free-standing, children's hospital who received rFVIIa to curtail bleeding following congenital heart surgery between April 2004 and June 2012. Patients were assessed for survival to hospital discharge versus in-hospital mortality and the presence or absence of a major neurological event during inpatient hospitalization. The median age at surgery was 6.8 months [range: 3 days-42 years]. Seven patients [44%] survived to hospital discharge and nine patients [56%] died. The cause of mortality included major neurological events [44%], uncontrolled bleeding [33%], and sepsis [23%]. Eight patients [50%] required extracorporeal membrane oxygenation support following congenital heart surgery. The median cumulative rFVIIa dose administered was 97 mcg/kg, and the median cumulative amount of blood products administered was 452 ml/kg. In conclusion, this case series underscores the need to prospectively evaluate the effect that rFVIIa has on patient survival and the incidence of adverse events, including thrombotic and major neurological events, in congenital heart surgery patients. Ideally, a randomized, multicenter study would provide the sufficient numbers of patients and events to test these relationships

Quantification of transition metals in biological samples and its possible impact on ferro-alloy workers.

Increased risk of ill-health and diseases has been associated with employment in the ferro-alloy factory. Since measurement of transition metals in human blood and hair along with respective exposure rates, provides a means of assessing individual risk, it has been the most important part of the study. In the study majority of the elements in the transition series, such as, vanadium (V), chromium (Cr), iron (Fe), manganese (Mn), cobalt, (Co) nickel (Ni), copper (Cu), zinc (Zn), molybdenum (Mo) and cadmium (Cd) were considered which are randomly emitted from the source, that is, manganese ore (used during ferro-alloy manufacturing process). The commonly available transition, metals, observed in biological samples of ferro-alloy workers, were found to be Fe, Zn, Co, Ni, Cu, Cr, Cd, V Mn and Mo in blood, while in hair, Mn, Fe, Zn, Co, Ni, Cu, Cr, Cd, V and Mo were present in decreasing order Surveillance of bio-concentration of these metals in workers, exposed to close proximity of the coke-ovens and smelting furnaces, revealed that the workers were prone to several physical disorders.