Hemovigilance: knowledge, attitude and practice among postgraduates and interns of a tertiary care hospital

Background: Adverse reactions due to transfusion of blood and blood products should be reported for the betterment of patients health and to minimize such effects in the future. A Program was initiated to report and reduce incidence of adverse reactions to blood products which is hemovigilance program of India. Aim was to evaluate the knowledge, attitude and practice of haemovigilance among postgraduates and interns. Methods: This was a cross-sectional questionnaire-based study conducted among 159 participants of a tertiary care hospital for a period of 1 month. Results: Results obtained were analysed using descriptive and qualitative statistics. About 83.6% of the participants were aware about the concept of Haemovigilance. Only 23 out of the 159 had reported transfusion reactions in the past but the attitude towards this concept was satisfactory. Conclusions: Overall the participants had a less satisfactory overview of this concept and hence educational interventions can aid in serving the purpose.

The Trends and Growth Analysis in the Area, Production and Productivity of Turmeric in Surguja District of Chhattisgarh, India

Turmeric is an important spice crop grown in Chhattisgarh. The present study is mainly based on time series data. The secondary data on area, production and productivity of Turmeric in Chhattisgarh, were collected for the period 2001-02 to 2020-21from various publications. To analyze the trends and growth rate in the area, production and productivity of turmeric in Surguja district of Chhattisgarh state. The performance of turmeric was examined by estimating the growth rates and instability index of area, production and productivity of turmeric. Growth analysis for area, production and productivity. Focus on the Surguja district. It was positive and non-significant in the area of compound and linear growth rate, but it was positive and significant in the case of production. In terms of productivity, both compound and linear growth rate showed negatively significance. In the case of Chhattisgarh, the linear and compound growth rates in the area and production of turmeric were observed as positive and non-significant. While the growth rate in productivity in Chhattisgarh was found negatively and significant over the period. The major of constraints faced by the selected area, unavailability of improved and high yielding varieties, package and practices and Weather fluctuation. Ensure to availability of Improved and high yielding varieties for good production, productivity and good quality and Weather based information should provide for turmeric grower region.

New cell surface bound lectins with complex carbohydrate specificity from members of green algae

Lectins, algal in particular, have immense potential for biomedical applications such as anti-HIV, antitumoral, antimicrobial, anti-inflammatory and antinociceptive activities. In this context, there is a growing interest among researchers on agglutinins from green algae. Here, we have made an attempt to catalogue lectins from various unexplored green algae species. Chlorophyceae members (Chlorella vulgaris, Chlorococcum infusiformis, Desmodesmus dimorphus, D. subspicatus and Scenedesmus quadricauda) were screened for lectin activity using human, pig, sheep, goat and rabbit erythrocytes. All of them showed surface bound lectin activity with highest agglutination titre towards human blood type B erythrocytes and rabbit erythrocytes. Neuraminidase and protease treatment to human blood type B erythrocytes considerably enhanced the agglutination titre of lectins from S. quadricauda, C. vulgaris and D. subspicatus. However, protease treatment of erythrocytes showed no effect on C. infusiformis lectin activity, and decreased the lectin activity of D. dimorphus. Lectins of members of chlorophyceae have shown unique glycoprotein binding specificities as their lectin activity was specifically inhibited by glycoproteins exhibiting complex O-glycans, such as bovine submaxillary mucin, porcine stomach mucin and fetuin. All the algal cultures expressed maximum lectin activity during stationary phase of growth except S. quadricauda which expressed maximum lectin activity during mid-log to stationary phase of cultivation. Possibly, it is a new report on cell surface bound lectins from unexplored members of chlorophyceae for lectin activity.

Lectin activity in mycelial extracts of Fusarium species

ABSTRACT Lectins are non-immunogenic carbohydrate-recognizing proteins that bind to glycoproteins, glycolipids, or polysaccharides with high affinity and exhibit remarkable ability to agglutinate erythrocytes and other cells. In the present study, ten Fusarium species previously not explored for lectins were screened for the presence of lectin activity. Mycelial extracts of F. fujikuroi, F. beomiformii, F. begoniae, F. nisikadoi, F. anthophilum, F. incarnatum, and F. tabacinum manifested agglutination of rabbit erythrocytes. Neuraminidase treatment of rabbit erythrocytes increased lectin titers of F. nisikadoi and F. tabacinum extracts, whereas the protease treatment resulted in a significant decline in agglutination by most of the lectins. Results of hapten inhibition studies demonstrated unique carbohydrate specificity of Fusarium lectins toward O-acetyl sialic acids. Activity of the majority of Fusarium lectins exhibited binding affinity to D-ribose, L-fucose, D-glucose, L-arabinose, D-mannitol, D-galactosamine hydrochloride, D-galacturonic acid, N-acetyl-d-galactosamine, N-acetyl-neuraminic acid, 2-deoxy-D-ribose, fetuin, asialofetuin, and bovine submaxillary mucin. Melibiose and N-glycolyl neuraminic acid did not inhibit the activity of any of the Fusarium lectins. Mycelial extracts of F. begoniae, F. nisikadoi, F. anthophilum, and F. incarnatum interacted with most of the carbohydrates tested. F. fujikuroi and F. anthophilum extracts displayed strong interaction with starch. The expression of lectin activity as a function of culture age was investigated. Most species displayed lectin activity on the 7th day of cultivation, and it varied with progressing of culture age.

Antioxidant activity of Wattakaka volubilis (Linn. f.) leaf extract in carbon tetrachloride induced mice.

Plants are natural source of antioxidants which ameliorate a variety of diseases. In this study, we determined the in vitro and in vivo antioxidant activity of methanolic, polyphenolic and sapogenin mixture leaf extracts of Wattakaka volubilis (Linn.f.) Stapf, an ayurvedic medicinal plant. The in vitro antioxidant activity was tested spectrophotometrically by measuring ferric reducing power, DPPH and hydroxyl radical scavenging activity. Whereas the in vivo antioxidant activity was determined by estimation of enzymes catalase, superoxide dismutase (SOD), peroxidase and lipid peroxidation. In vitro study results showed that the tested extracts were capable of reducing ferric ion and scavenging free radical as well as hydroxyl radical. Treatment of mice with single dose of CCl4 resulted in decreased level of catalase, superoxide dismutase (SOD) and peroxidase, but with 3-fold increase in lipid peroxidation. However, pretreatment of mice with methanolic and polyphenolic sample extracts caused prevention of catalase, and peroxidase when compared with control, where as lipid peroxidation was brought back to normal. NOS activity was also found significantly decreased.

Symmetric peripheral gangrene associated with H1N1 infection

More and more cases of H1N1 influenza are being detected in India and so also the variety of complications this virus can cause. Here, we report a case of symmetric peripheral gangrene following H1N1 infection

Trace elements in nungsham, the red edible algae of Manipur.

Energy Dispersive X-ray Fluorescence (EDXRF) technique was used for the determination of trace elements in wild red edible algae. The elements so far detected were discussed for their importance in the food item in addition to the monitoring the pollution levels of the fresh water where they grew as algae is one of the best bioaccumulator of heavy elements.

Wound healing activities of eugenia jambolana lam. Bark extracts in albino rats.

Wound healing is physiological process, which takes place by body's natural regenerative capacity. Due to various reasons there may be delay in healing and this prolonged healing may sometimes lead to scar formation. Currently attention has been focused on natural products to prevent infection and to promote healing. In the present study, Eugenia jambolana bark extracts was taken to investigate its wound healing property. Full thickness deep burn wound model in Albino rats, were used to study the healing efficiency. Formulations (10% ointment) of crude ethanolic extract of the Eugenia jambolana bark was applied tropically over thermal wound. It was found that ointment treated rats showed accelerated healing than the control. It was observed that 10% extract of the Eugenia jambolana bark has progressive effects on wound healing in the experimental groups. This study suggests that Eugenia jambolana bark powder could be developed as a therapeutic agent for wound healing.

Call-fleming syndrome: an extraordinary complication of tonsillectomy

A 36 years old woman underwent tonsillectomy for recurrent tonsillitis. At about one week in the postoperative period, she developed sudden onset severe [[thunderclap]], recurrent headaches and focal neurological signs including visual disturbances, ataxia and myoclonic jerks. Serial imaging with MRI, MRA and CT angiography revealed reversible white matter focal edema and segmental cerebral vasoconstriction. A diagnosis of Call-Fleming syndrome was made based on her symptoms and imaging findings, and she was started on nimodipine. She made a slow recovery but still has slight unilateral foot drop even 12 months since the initial event. This is the first case of Call-Fleming syndrome occurring following an ENT procedure

Evaluation of the efficacy, safety and tolerability of valdecoxib gel (1%) in adult patients with painful inflammatory joint disease.

Valdecoxib, a COX-2 inhibitor, has recently been introduced as a gel formulation. The present study was conducted to evaluate the efficacy, safety and tolerability of valdecoxib gel in adult patients with painful inflammatory joint conditions. The present study was a 10-day prospective, open, multicentric (6 centres) trial. Patients with clinical and radiological diagnosis of painful inflammatory joint conditions were treated with valdecoxib gel (1%). Efficacy was assessed by visual analogue scale (VAS), patient's and physician's global assessment of pain relief. Grading of associated clinical manifestations such as stiffness, swelling, tenderness and restriction of mobility was done. Tolerability and safety was assessed by physical examination, laboratory parameters and evaluation of adverse events. There was a statistically significant decrease in the mean pain visual analogue score (p<0.05). Onset of pain relief was within 15 minutes. There was a reduction of 58.8%, 57.2%, 65.4% and 60.2% in mean scores of stiffness, swelling, tenderness and mobility respectively from the baseline which was statistically significant. The laboratory values were within normal limits. The drug was well tolerated. There was no report of any hypersensitivity reaction. This study confirms that valdecoxib gel (1%) is an effective and safe option for the management of painful inflammatory joint conditions.

Efficacy and safety of the first parenteral selective COX-2 inhibitor, parecoxib sodium, in adult patients with postoperative pain.

Parecoxib, a prodrug of valdecoxib, a selective COX-2 inhibitor, has been recently introduced for the treatment of moderate to severe postoperative pain. This prospective, open, multicentric study enrolled 260 patients undergoing orthopaedic, gynaecological, dental and general surgery. Postoperatively, patients were treated with parecoxib, 40 mg IM/IV. There was a statistically significant decrease in the mean pain intensity score (p<0.05). At the end of 24 hours, 89.6% of total cases had a very good to total relief of pain. The mean duration of analgesia was 19.26 hours and mean time of onset of analgesia was 16.25 minutes ranging from 11-20 minutes. The laboratory values were within normal limits. The drug was well tolerated. There was no report of any hypersensitivity reaction. This study suggests that parecoxib, in a dose of 40 mg IM/IV, is an effective and safe option for the management of postoperative pain.

Evaluation of efficacy, safety and tolerability of valdecoxib in osteo-arthritis patients--an Indian study.

Valdecoxib, a COX-2 inhibitor, has been introduced as a new treatment for osteo-arthritis (OA). The present study was conducted to evaluate the efficacy, safety and tolerability of valdecoxib, in OA patients in an Indian setting. The present 4-week study was a prospective, non-comparative, assessor blind, single group, multicentric trial with OA patients treated with valdecoxib, 10 mg once a day. Efficacy was assessed by analysing the changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), patient's and physician's global assessment of arthritis. The incidence of adverse events was monitored throughout the study. There was a clinical and statistical significant improvement in the mean pain score, stiffness score, physical function, composite WOMAC index score and VAS (p<0.05). Patient's and physician's global evaluation of valdecoxib treatment was very good to good in 84.1% and 83.6% of cases respectively. The present study has shown that valdecoxib, in a dose of 10 mg/day given over 4 weeks, is an effective and safe treatment for the signs and symptoms of OA of hip and knee joints.

Incidence of anaerobes in throat infections and their sensitivity pattern in Ludhiana.

Of 175 throat swabs processed, anaerobes were isolated from 16 (9.14%) patients. Isolation of anaerobes from healthy controls was 2 out of 25 (8%). Peptostreptococci and Bacteroides species were the commonest isolates followed by Peptococci and Propioni-bacterium. All of these isolates were sensitive to Metronidazole. Clindamycin, Erythromycin and Tetracycline also showed good response.

Changing pattern of biotypes, phage types & drug resistance of Salmonella typhi in Ludhiana during 1980-1999.

BACKGROUND & OBJECTIVES: Ludhiana, an industrial city of Punjab, has a large floating population where typhoid has become endemic. A retrospective study was carried out over a period of 20 years (1980-1999) at Ludhiana on the biotyping, phage typing and drug resistance pattern of Salmonella typhi. METHODS: Of a total of 1697 S. typhi isolates obtained, phage typing and biotyping were done of only 1243 isolates. Antimicrobial susceptibility pattern of these isolates was also studied. RESULTS: Of the 1243 S. typhi isolates, 963 (77.5%) and 280 (22.5%) were of biotype I and biotype II respectively. Twenty four different S. typhi phage types were prevalent in Ludhiana in the past two decades. Between 1980 and 1989, more prevalent phage types were phage type A (35%), O (17.6%) and E1 (15.1%). During 1990-1999, there was a considerable increase in the incidence of phage type E1 (48.1%). The cumulative analysis of past two decades revealed that the incidence of phage type E1 (38.8%) was most predominant. In the past one decade (1990-1999), 412 S. typhi isolates of 13 different phage types exhibited multidrug resistance (MDR) pattern ACCoT (resistant to ampicillin, chloramphenicol, co-trimoxazole and tetracycline). High chloramphenicol resistance (74.7%) and MDR pattern ACCoT (68.2%) was shown by phage type E1 of S. typhi. INTERPRETATION & CONCLUSION: An association was observed between drug resistance and phage type pattern of S. typhi as 70 per cent isolates of S. typhi phage types E1 and O exhibited ACCoT multidrug resistant pattern. Reemergence of chloramphenicol susceptibility in the last decade emphasizes the need for regular antimicrobial surveillance to minimize the misuse of these drugs.

Emerging antibiotic resistance among the uropathogens.

A total of 18,876 urine samples from patients of clinically suspected UTI including asymptomatic pregnant females were analysed, during the year 1997 & 1998. Culture positivity rate was found to be 37%. The incidence of Proteus was on the rise during the year 1998 especially in hospitalized patients. The antibiotic sensitivity pattern of uropathogens was also analysed to check the emergence of drug resistance. This study has revealed that withdrawal of a particular antibiotic due to high level of resistance observed during previous years, has led to re-emergence of antibiotic sensitive mutants. Further indiscriminate use of newer antibiotics like amikacin and netilimicin is responsible for emergeny of resistant variant against these antibiotics and this lays stress upon the immediate need for national antibiotic policy.

A case of recurrent pneumonias.

A description is given of the case of a young boy who presented with repeated episodes of pneumonias since childhood. In addition, he had episodes of intermittent diarrhoeas. His investigative work-up revealed a deficiency of serum immunoglobulins, that is, hypogammaglobulinaemia. The profile was suggestive of common variable immunodeficiency. Because of the relative rarity of this disease, it is often missed leading to significant morbidity. Treatment consists of immunoglobulin replacement therapy and management of recurrent infections with appropriate drugs.

Prevalence of multidrug resistant organisms in an intensive care burn unit.

During January to December, 1998, analysis of an outbreak of infections in the burn intensive care unit (BICU) of the hospital attached to the Dayanand Medical College, Ludhiana was carried out. A total of 868 clinical samples from 290 patients with more than 40 per cent thermal injury were investigated. These samples included 322 wound swabs, 325 blood and 221 urine samples. Bacterial pathogens were isolated from 80, 62 and 48 per cent samples of pus, blood and urine respectively. Among the nine different pathogens isolated, the more common were Pseudomona aeruginosa from pus, Staphylococcus aureus from blood and Escherichia coli from urine samples. Multidrug resistance was observed among these predominant pathogens. Identical drug susceptibility pattern was depicted by large number of isolates of Ps. aeruginosa, Staph. aureus, Esch. coli and Proteus mirabilis. Similar pathogens with identical drug sensitivity pattern were isolated from environmental samples of the BICU. The ongoing outbreak of hospital acquired infection (HAI) was significantly reduced after strictly adhering to the guidelines for control of HAI.

Cysticercus immunoblot assay in patients with single, small enhancing lesions and multilesional neurocysticercosis.

A single, small (< 20 mm), ring or disc shaped contrast enhancing lesion located at the cortical-subcortical junction with minimal or no surrounding edema on computed tomography is the commonest mode of presentation of neurocysticercosis in the Indian subcontinent. Serum samples of 37 patients with these single, small enhancing lesions (SSEL's) and five patients with typical multilesional parenchymal neurocysticercosis were tested by the electro-immunoblot transfer (EITB) assay and the enzyme linked immunosorbent assay (ELISA). EITB was positive in 18 patients (48.64%) and ELISA was positive in 21 patients (56.76%) with SSEL's. On the other hand EITB was positive in all five patients (100%) and ELISA was positive in four patients (80%) with multilesional neurocysticercosis. The low sensitivity of the EITB in the SSEL's is probably linked to an insufficient immune stimulation provided by a single cysticercus cyst.

Incidence of dengue fever in relation to climatic factors in Ludhiana, Punjab.

An outbreak of dengue fever occurred in Ludhiana in 1996 and 1997. A total of 505 patients who attended the hospital attached to Dayanand Medical College, Ludhiana were clinically diagnosed to have dengue fever. Of these, 460 cases were noticed between October and December 1996 while during 1997 only 45 dengue fever cases were observed. Serological examination using dengue IgG and IgM blot was performed with single serum samples of 189 patients. Of these, 129 serum samples were detected positive for anti dengue antibodies. Twenty eight patients died in the dengue epidemic, 12 of whom suffered from dengue haemorrhagic fever (DHF) and six with dengue shock syndrome (DSS). Male patients outnumbered the female patients. Seasonal and cyclic pattern of the disease incidence was observed.

Incidence of HIV risk and prevention of infection in health care settings.

Tht HIV epidemic has created awareness about blood borne pathogens transmission in health care settings. Although, the risk of transmission of HIV and other blood borne pathogen may account for a very small proportion, yet the potential for such transmission always exists. Despite this, the use of proper and careful sterile procedures is sufficient to substantially reduce or even eliminate the risk of HIV infection.