Prevalence of Taenia solium taenaisis in Kanchipuram district of Tamil Nadu (India): A cross-sectional study

Background: Taenia solium infections in humans include the infection by the adult tapeworm, these infections are of public health concern and are among the most important afflictions of humans who live in areas of poverty in the developing world and least developed countries. T. solium, a zoonotic disease, transmitted between pigs and humans and among humans, is common in developing countries. Aims and Objectives: The aim of the study was to estimate the detection rate of T. solium taeniasis among patients and random community screening with an indication of intestinal parasitic infection by routine stool examination. Materials and Methods: Stool samples were collected from the community and patients. Those who were willing, samples were screened for the cysts/ova/egg by direct microscopic examination by saline, iodine, concentration technique, and modified acid fast staining, were performed to differentiate species of T. solium and Taenia saginata. Results: Overall samples were 2030, out of which 870 stool samples were from community field screening 585 (28.81%) were positive. 1160 from tertiary care center, 668 (32.90%) were positive gave a total prevalence of intestinal parasitic infection of 61.72%. The prevalence of T. solium taeniasis was 194 (9.55%) out of which 92 (4.53%) were from community and 102 (5.02%) were from tertiary care center. Conclusion: The high prevalence of intestinal parasitic infestation might be due to the poor sanitary, contaminated water, and lack of education that is prevalent in the studied region as in other pockets in rural India. Our study showed the usefulness of the Ziehl-Neelsen modified acid-fast stain for identification of Taenia species.

Analysis of prescription pattern of antihypertensives in various stages of chronic kidney disease

Background: Chronic kidney disease (CKD) is an emerging health problem and is one of the major causes of mortality. Hypertension is closely linked with CKD and both these conditions cause severe cardiovascular events. Hence blood pressure control is pertinent in all stages of CKD. This plays a major role in preventing its progression to end stage kidney disease and death. The objectives of the study were to analyse the class, dosing schedule of antihypertensive prescribed in Chronic Kidney Disease and the incidence of monotherapy and combination therapy.Methods: This study designed as a cross sectional study was conducted in Nephrology department of a tertiary care center and antihypertensive prescription pattern of 364 CKD patients was analyzed. Demographic details, the co-morbid factors and the details of drugs received by each patient were recorded from their outpatient/ inpatient charts. Data collected were entered in MS excel sheet and descriptive analysis done using SPSS software.Results: Calcium Channel Blocker (CCB) was the most commonly prescribed antihypertensive (70.6%) in all stages and the most common CCB was Cilnidipine (54%) with the dosing schedule of 20mg twice daily (56.4%). Incidence of combination therapy was 71.7% and CCB+AA (Alpha agonist) was the commonest combination prescribed in all stages except stage 1.Conclusions: CCBSs were widely prescribed as antihypertensive in CKD irrespective of the stages. Cilnidpine was the routinely prescribed CCB and seemed to be well tolerated by the patients. The protocol followed in this tertiary care center was in accordance with the standard guidelines by Kidney Disease Improving Global outcomes 2012.

Comparative study of the toxicity of 5-fluorouracil-adriamycin-cyclophosphamide versus adriamycin-cyclophosphamide followed by paclitaxel in carcinoma breast.

Context: When cure is possible treatment should be undertaken despite life-threatening toxicities. Fluorouracil-Adriamycin-Cyclophosphamide (FAC) and Adriamycin-Cyclophosphamide (AC-P) are two popular regimens used in the treatment of carcinoma breast and the data regarding the toxicity profile of the AC-P regimen is scarce in the South Indian population. Aims: To study the severity of different types of toxicities seen in patients on FAC and AC-P regimens, to grade the toxicity according to the World Health Organization (WHO) toxicity grading, and to compare the same. Settings and Design: A prospective observational study, with 50 patients in each regimen, was conducted in the Department of Radiotherapy between February 2007 and July 2008. Materials and Methods: The high risk patients received the AC-P regimen and the rest received the FAC regimen. The toxicities developed were graded according to the WHO guidelines. Statistical Analysis Used: The data was analyzed using the chi square test in SPSS 16. Results: Anemia, hyperpigmentation, stomatitis, and diarrhea were significantly high (P < 0.05) in patients receiving the FAC regimen, whereas, leukopenia, myalgia, arthralgia and peripheral neuropathy were significantly high (P <0.05) in patients receiving the AC-P regimen. The Karnofsky performance status was higher in patients receiving the AC-P regimen. Conclusions: Although both the regimens had different toxicity profiles the quality of life was better for patients on the AC-P regimen.

Role of intraoperative echocardiography in surgical correction of the superior sinus venosus atrial septal defect.

Superior type of sinus venosus atrial septal defect (SVASD) is invariably associated with the unroofing of right upper pulmonary vein (RUPV). Warden procedure and pericardial patch repair with rerouting of the RUPV are commonly performed operations for the superior SVASD. Both operations involve the risk of obstruction to the flow of superior vena cava or rerouted pulmonary vein in the postoperative period. The sinus venosus defects are well visualized on the transesophageal echocardiography (TEE) because of the proximity of the TEE probe to these structures. We are reporting two cases operated for the superior SVASD with unroofed RUPV, highlighting the intraoperative echocardiographic features before and after the surgery.

Usefulness of an observational database to assess antiretroviral treatment trends in India.

BACKGROUND: Human immunodeficiency virus (HIV) observational cohorts, which are established worldwide, support comparative studies across different regions. They have played an important role in developing international and country-specific HIV treatment and care guidelines. We describe the YRG CARE Chennai HIV observation database (YCHOD) and highlight its utility in monitoring trends in antiretroviral treatment use and HIV disease outcomes in India. METHODS: The baseline characteristics, time trends in antiretroviral treatment, trends in incidence of acquired immune deficiency syndrome (AIDS)-defining illness and mortality following the introduction of highly active antiretroviral therapy (HAART) in India were assessed using YCHOD. RESULTS: Till January 2005, 7647 HIV-positive patients had registered in YCHOD. A majority of the patients were men (69%) and had a mean age of 32 years. At baseline, 14% had an existing AIDS-defining illness. Among patients who required therapy by the WHO criteria, 14% initiated antiretroviral therapy (ART) in 1996 and 35% in 2000. Since the dramatic cost reduction of generic HAART in 2001, there has been an increase in the proportion of patients receiving ART to 57% in 2004. In patients who were started on HAART, the incidence of at least one AIDS-defining illness was 2% in 2001, and this decreased to 0.48% in 2004. CONCLUSION: We feel observational cohorts are useful as a surveillance tool for monitoring trends in treatment and disease progression. Standardized observational data collected systematically on HIV-infected individuals will help to assess the cost-effectiveness of ART and in planning ART strategies for India.

An atypical presentation of salmonella typhi - A case report.

Breast abscess due to Salmonella typhi is an extremely rare occurrence. A lady with a lump in the left breast was diagnosed to have a fibroadenoma and was subjected to a surgical procedure. She was found to have an abscess due to Salmonella typhi as confirmed by conventional bacteriological methods. She was treated with ciprofloxacin and responded favourably.

Histological changes in intestine in semichronic diarrhoea induced by lactose enriched diet in rats: effect of Diarex-Vet.

Efficacy of Diarex-Vet (The Himalaya Drug Company, Makali, Bangalore, India) was evaluated histologically in semichronic diarrhoea induced by lactose enriched diet in rats. The rats in different groups were given lactose enriched diet alone for 2 days before starting the treatment with Diarex-Vet at a dose of 250, 500 and 750 mg/kg body weight along with lactose enriched diet for 5 days. Animals were euthanised at the end of 5 days of treatment and histological changes were observed in the ileum, caecum and colon. Semiquantitative analysis of goblet cells in intestines showed dose dependent response among the treated groups. The morphological changes were comparable to normal in the group given 750 mg/kg body wt Diarex-Vet. The effects observed were attributed to the lactase like analogous activity of Diarex-Vet or the inhibition of the osmotic processes in the intestinal lumen thereby reducing the morphological changes in the intestines.

Delayed extradural hematoma: a case report.

Three patients of delayed extradural hematoma (EDH) were seen in the last one year among forty eight consecutively treated cases of EDH. All the three hematomas were evacuated. Awareness of this entity and a high degree of vigilance are strongly recommended to detect such cases. Repeat CT should always be done, especially after decompression by either surgical or medical means, recovery from shock or whenever there is evidence of even minimal bleeding under a skull fracture on initial CT scan.

Effect of ciprofloxacin on specific immune response in rabbits.

Ciprofloxacin (10 mg/kg body weight, iv, twice daily for 4 days) failed to alter specific antibody titres, total immunoglobulin concentration, total serum protein concentration, total leukocyte count, lymphocyte percentage, phagocytic index and skin thickness in DNCB skin sensitivity test against Brucella plain killed antigen in New Zealand White rabbits. It can be concluded that ciprofloxacin at the dose and duration employed did not adversely affect specific immune response in normal rabbits.

A case of cerebral toxoplasmosis.

A histopathologically proven case of cerebral toxoplasmosis in a young HIV positive patient has been presented. The clinical problems in management are highlighted.