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Background: The re-emerging Monkeypox disease is spreading worldwide, thus if prevention measures are not followed or awareness is not raised, chaos could result. Aims and Objectives: The present study aimed to assess the awareness and preventive measures of Monkeypox among medical students in a tertiary care hospital of Kolkata. Materials and Methods: A hospital-based, descriptive, observational, and cross-sectional study was conducted over 6 weeks, among final year MBBS students of Medical College Kolkata. Convenience sampling was done. Minimum sample size calculated was 110. A pre-designed, pre-tested, semi-structured, and self-administered questionnaire which was face and content validated by experts used as the study tool in this study. Questionnaire was answered while keeping their identities confidential. Data were collected and entered in a coded manner in MS Excel. Using SPSS version 25, tabulation, the necessary tables, and diagrams were created. The Institutional Ethics Committee of the Medical College in Kolkata was consulted for ethical approval. Results: The students lacked sufficient information. Majority of them responded well when asked about the disease’s cause, incubation period, natural host signs and symptoms, mode of transmission, preventive measures, and treatment, but it was clear that they were unsure about identification of a suspected, probable, or confirmed case and definitive diagnosis. Conclusion: The present study reported that the students had limited knowledge about Monkeypox disease.
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Background: Hemoglobinopathies are the major cause of anemia throughout the world complicating pregnancy outcome. Hence, detection of hemoglobinopathies in antenatal period is of critical importance as it not only predict the possibility of birth of a child with thalassemia but also reduces the complications associated with anemia in pregnancy. Hence, identification of a reliable cost-effective screening method for detection of hemoglobinopathies is of utmost importance. Aims and Objectives: The present study was conducted to evaluate the role of red blood cell (RBC) parameters including hemoglobin (Hb%), RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in detection of thalassemia carriers among healthy antenatal mothers in a tertiary care hospital of Eastern India. Materials and Methods: Venous blood samples were collected from total 1458 antenatal mothers aged 18 years or above with <17 weeks of gestation and were analyzed for complete blood count, serum ferritin level, and high-performance liquid chromatography for identification of abnormal Hb. Patients with iron deficiency anemia as diagnosed by serum ferritin <15 ng/ml were excluded from this study. Results: The prevalence of hemoglobinopathy was found to be 12.55% with ß-thalassemia trait (BTT) being the most common type (7.9%). All the RBC parameters were significantly lower among the BTT group compared to individuals with normal or other hemoglobinopathies (P < 0.05). Conclusion: RBC parameters such as Hb, RBC, MCV, and MCH can be used as cost-effective yet very effective screening method to identify different hemoglobinopathies among antenatal mothers.
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1 Background: Geriatrics refers to people aged 60 years and above. In India, the absolute number of elderly people increased from 76 million in 2001 to 100 million in 2011(8.6% of total population) and 138 million in 2021 (10.1% of total population). Common morbid conditions in older age include hypertension, diabetes, hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, dementia, and complex health states commonly called the “Geriatric Syndromes.” Aims and Objectives: The present study described the morbidity pattern, quality of life and their relationship among geriatric patients attending Medical College and Hospital, Kolkata. Materials and Methods: An observational, descriptive, cross-sectional study was conducted with a semi-structured data collection form having “OPQOL-Brief questionnaire” among 110 older subjects in a systematic manner who have attended the Geriatric Medicine OPD of Medical College, Kolkata, during the months of March–April, 2021. The data were entered into Microsoft Excel spreadsheet (version 10) and analyzed with the help of SPSS (version 25). Results: About 59.1% of study subjects were male. The most common morbidity was hypertension (47.27%), followed by diabetes mellitus (39.1%), bronchial asthma (27.3%), and heart diseases (19.1%). About 50.9% of the patients (49.23% of male and 53.33% of female) had a good quality of life. Conclusion: This study showed that these patients’ quality of life had significant relationship with their socioeconomic status and number of comorbidities present. It was advisable to adopt policies for affordable solutions for diagnosis and management of geriatric comorbidities overall.
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Certain anticonvulsants, cyclosporine, and calcium channel blockers like amlodipine have been shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients in response to local factors. These drugs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. Therefore, it is tempting to speculate that these agents may act similarly on gingival connective tissue and cause a hyperplastic response. This tissue reaction may involve a disturbance of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bacterial inflammation may exist. The management involves Phase I therapy followed by surgical intervention. The purpose of these case reports is to highlight certain modifications in existing surgical techniques like gingivectomy, to have better aesthetic and functional outcome.
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Background: COVID-19 pandemic quickly became significantly major cause of worldwide morbidity and mortality over the next years till date in an unforeseen manner. Aims and Objectives: Our study aims at unfolding the sociodemographic, epidemiological, and clinical characteristics of this disease, based on a metropolitan dedicated tertiary care hospital of India. Materials and Methods: Along with patient particulars, we recorded sociodemographic data, presenting symptoms, vital parameters, and blood parameters based on a pre-designed questionnaire, followed by complication analysis for 101 patients. Written consent was taken from each of the respondent before the interview and ethical approval was taken from Institution Ethics Committee (IEC) of Medical College and Hospital. [(Ref No. MC/KOL/IEC/Non-Spon/842/11/2020), Date- 5/11/2020]. Results: This study justified the trend of already available data such as median age of presentation (40–69 years), higher urban population (85.1%), higher rate of infection in health-care professionals (12.9%), and in patients with poor socioeconomic status. It revealed increased community transmission (74.3% with no definitive exposure), higher number of symptomatic cases admission (89.1%) with most common symptoms being fever (46%), shortness of breath (45%), sore throat (32%), and cough (26%). Hypertension (48%) and diabetes (34%) were major comorbidities in patients who were also proportionally more symptomatic and experienced more adverse effects compared to non-comorbid patients. A major chunk of the patients (46.53%) required some form of oxygen support for their treatment. Most common adverse effect was disseminated intravascular coagulation (23.76%) among which 67.74% had one or more comorbidities. We also reported slightly higher number of deaths (6.9%) compared to what other similar studies found. Conclusion: History of probable exposure was not a sole risk factor of acquiring infection, that is, community transmission was evident. Healthcare professionals were at high risk of getting infected, persons with comorbidity are at the highest risk of developing symptoms as well as complications.
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Background: A balanced sex ratio is needed to stabilize India, a patriarchal subcontinent. Aim and Objective: The study aims to find out whether there is any association between the socio-demographic characters and perceived gender preference among the study subjects. Materials and Methods: The study is an observational, descriptive study with cross-sectional study design. An exit interview of 80 pregnant mothers, both primi and multigravida, selected by systematic random sampling attending antenatal clinic of Medical College, Kolkata for 1st time was conducted for 1 month, using a pre-designed pre-tested semi-structured data collection form after ethics committee approval. Statistical analyses were done using Chi-square tests, at P ? 0.05 level of significance in Statistical Package for Social Sciences. Results: Mean age of study participants was 24.15 ± 4.38 years. The majority (77.5%) of them belonged to age group 20–29 years. 58.8% mothers were nulliparous, 53.8% from rural areas, 63.7% followed Islam, 52.5% from joint family, 31.3% belonged to middle class. 95% of the mothers had no history of abortion. Regarding education, the majority (32.5%) of the study participants were educated till secondary level. Among their husbands, 28.7% were educated till middle level. 40% study participants had no any gender preference, 40% had male preference and 20% had female preference. Main reason behind male preference was an earlier female child. Some preferred daughters due to their earlier male child. Nulliparous mothers had no gender preference while lesser-educated mothers had gender preference. Conclusion: The majority of the study participants had gender preference. Male preference was more than female preference.
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Background: Dyslipidemia is one of the common conditions associated with poor glycemic control in Type 2 diabetes mellitus (T2DM) patients. It is associated with an increased risk of cardiovascular disease which is the leading cause of death in these patients. Glycated Hemoglobin (HbA1c) is the gold standard test for monitoring glycemic control. Thus, the level of HbA1c could potentially be utilized as a possible biomarker for predicting the risk of dyslipidemia. However, there is a discrepancy in the data available till now regarding the relationship between HbA1c and the lipid profile. Hence, it requires further studies. Aim and Objectives: The present study was conducted to assess the role of glycemic control (as indicated by HbA1c level in blood) on lipid profile of patients with T2DM. Materials and Methods: This was an analytical cross-sectional study done over a period of 5 months. Total 165 participants were randomly selected from out patient department OPD of which 138 were diagnosed cases of T2DM and 27 were age and sex-matched non-diabetic healthy individuals. Patients of T2DM were sub grouped based on American Diabetic Association Criteria (2013) as having either controlled diabetes with HbA1c ?7% or uncontrolled diabetes with HbA1c >7%. Blood samples collected from all the participants were analyzed for HbA1c and lipid profile using standard methods. The collected data were analyzed with Statistical Package for the Social Sciences software using appropriate statistical method. Results: In the present study, we found a significant positive correlation between HbA1c and total cholesterol, Triglyceride, Low-density lipoproteins, and very low-density lipoproteins (P < 0.01) though high-density lipoprotein was not significantly correlated with HbA1c level. Conclusion: We concluded that apart from a reliable index of glycemic control, HbA1c can also be used as a predictor of dyslipidemia in T2DM patients, and thus regular monitoring of it can help us to reduce the mortality of these patients.
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Background: Overweight among adolescents has high prevalence on the eastern part of India, especially West Bengal. Objectives: The current study was conducted to estimate and compare the effects of different dietary habits and habits related to physical activity in the development of overweight and obesity among rural schoolgoing adolescents. Methods: A prospective repeated measures study was conducted on 645 schoolgoing adolescents from selected rural government-aided schools from June 2017 to December 2017. Dietary habits of the students and physical activity-related factors were the major predictors. Adjusting for the age and sex of the participants, effect of these factors on the development of overweight and obesity was analyzed by generalized estimating equations for 2 repeated measures, taken 6 months apart. Results: Most of the respondents were aged ?16 years (56.90%), female (52.87%), Hindu (76.74%), from a nuclear family (76.74%), and studying in the secondary level (57.68%). There was a stark rise in proportion of overweight from 0.93% to 7.44%. The prevalence of unhealthy dietary habits was 68.99% at the baseline, and 66.82% on follow-up. The overall prevalence of inadequate physical activity increased to 48.68% from 47.91%. Female gender and older age group were at higher risk of being overweight or obesity. Overall fast food showed highest risk (3.04, 95% confidence interval [CI]: 1.86–4.95), while among the boys, it was with less vegetable consumption (4.64, 95% CI: 1.84–11.69). Conclusions: Strong evidence was generated of dietary practices being more rigidly related to overweight among the adolescents. Healthy dietary practices coupled with physical activity should be promoted to mitigate the risk of obesity.
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The mismatch amplification assay is a modified version of polymerase chain reaction (PCR) that permits specific amplification of gene sequences with single base pair change. The basis of the technique relies on primer designing. The single nucleotide mismatch at the 3' proximity of the reverse oligonucleotide primer makes Taq DNA polymerase unable to carry out extension process. Thus, the primers produce a PCR fragment in the wild type, whereas it is not possible to yield a product with a mutation at the site covered by the mismatch positions on the mismatch amplification mutation assay (MAMA) primer from any gene. The technique offers several advantages over other molecular methods, such as PCR-restriction fragment length polymorphism (RFLP) and oligonucleotide hybridization, which is routinely used in the detection of known point mutations. Since multiple point mutations in the quinolone resistance determining region play a major role in high-level fluoroquinolone resistance in Gram-negative bacteria, the MAMA-PCR technique is preferred for detecting these mutations over PCR-RFLP and sequencing technology.
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To understand antimicrobial resistance (AMR) patterns and mechanisms of horizontal gene transfer in human-associated environments is essential to AMR surveillance. Gram-negative bacteria (1122 isolates) from food-animal environments were characterized for antimicrobial susceptibility and AMR genes. Seventy five per cent of the isolates (837 of 1122) were resistant to at least one of the antibiotics tested. Resistance to more than three groups of antimicrobials (multidrug resistance) was observed in 43 isolates with most often encountered (12 of 43) resistance to ?-lactams, tetracycline, quinolones and nitrofurantoin. The profile of frequently reported plasmid-mediated resistance gene in these isolates was determined. The mobility of these elements as plasmids or phages was examined. The blaCTX-M gene was present in the plasmid of 61 per cent and packed in induced phage fractions in 72 per cent of the isolates and blaTEMin 69 per cent phage fractions compared to 15 per cent presence in the plasmid.
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Background & objectives: The resistance to antibiotics in pathogenic bacteria has increased at an alarming rate in recent years due to the indiscriminate use of antibiotics in healthcare, livestock and aquaculture. In this context, it is necessary to monitor the antibiotic resistance patterns of bacteria isolated from the environmental samples. This study was conducted to determine the phenotypic and genotypic profile of antimicrobial resistance in Gram-negative bacteria isolated from environmental samples. Methods: Two hundred and fifty samples were collected from different sources, viz. fish and fishery products (99), livestock wastes (81) and aquaculture systems (70), in and around Mangaluru, India. Isolation, identification and antimicrobial profiling were carried out as per standard protocols. The isolates were screened for the presence of resistance genes using PCR. Results: A total of 519 Gram-negative bacteria comprising Escherichia coli (116), Salmonella spp. (14), Vibrio spp. (258), Pseudomonas spp. (56), Citrobacter spp. (26) and Proteus spp. (49) were isolated and characterized from 250 samples obtained from different sources. A total of 12 antibiotics were checked for their effectiveness against the isolates. While 31.6 per cent of the isolates were sensitive to all the antibiotics used, 68.4 per cent of the isolates showed resistance to at least one of the antibiotics used. One-third of the isolates showed multidrug resistance. Maximum resistance was observed for ampicillin (43.4%), followed by nitrofurantoin (20.8%). Least resistance was seen for carbapenems and chloramphenicol. PCR profiling of the resistant isolates confirmed the presence of resistance genes corresponding to their antibiotic profile. Interpretation & conclusions: This study results showed high rate of occurrence of antimicrobial resistance and their determinants in Gram-negative bacteria isolated from different environmental sources.
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Background & objectives: Infection from fluoroquinolone-resistant extra-intestinal Escherichia coli is a global concern. In this study, isolation and characterization of fluoroquinolone-resistant extra-intestinal E. coli isolates obtained from hospital samples were undertaken to detect plasmid-mediated quinolone resistance (PMQR) genes. Methods: Forty three isolates of E. coli obtained from patients with extra-intestinal infections were subjected to antibiogram to detect fluoroquinolone resistance. The mechanism of fluoroquinolone resistance was determined by the detection of PMQR genes and mutations in quinolone resistance determining region (QRDR). Results: Of the 43 isolates, 36 were resistant to nalidixic acid (83.72%) and 28 to ciprofloxacin (65.11%). Eight E. coli isolates showed total resistance to both the antimicrobials without any minimum inhibitory concentration. The detection of PMQR genes with qnr primers showed the presence of qnrA in two, qnrB in six and qnrS in 21 isolates. The gene coding for quinolone efflux pump (qepA) was not detected in any of the isolates tested. The presence of some unexpressed PMQR genes in fluoroquinolone sensitive isolates was also observed. Interpretation & conclusions: The detection of silent PMQR genes as observed in the present study presents a risk of the transfer of the silent resistance genes to other microorganisms if present in conjugative plasmids, thus posing a therapeutic challenge to the physicians. Hence, frequent monitoring is to be done for all resistance determinants.
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Background: Unintentional injuries have become a major noncommunicable disease burden, especially among the adolescents. Objective: The current study was conducted to estimate the effect of different aspects of daily activities of adolescence for sustaining serious unintentional injuries in the past 1 year. Methods: A cross-sectional survey with multistage sampling with validated pretested questionnaire was done among the school-going adolescent boys in Kolkata. Poisson regression was used to model the counts of serious injuries. To account for the excess of zero in the outcome, zero-inflated Poisson regression was performed. Results: Among the participants, 73.5% did not report any serious unintentional injury sustained in the past 1 year, 11.9% reported to have sustained serious unintentional injury once in the past 1 year, and rest had more than one count. Statistically significant higher chance of sustaining an episode of injury was found among frequent users of motorbike (incidence rate ratio [IRR]: 1.183), frequently walking on roads (IRR: 1.910), and frequently crossing major roads on bicycle (IRR: 2.181) were observed. A statistically significant protective rate ratio was also obtained for those frequently obeying traffic signals while crossing roads (IRR: 0.493) and frequent users of bicycles (IRR: 0.384). Significantly lower rate ratio for sustaining a serious injury was observed with frequently getting into fight at home (IRR: 0.343) and getting beaten up at school (IRR: 0.595). Conclusions: The study revealed traveling in a car and obeying traffic rules were protective from sustaining serious injury. However, walking and participation in sports appeared to be risky, especially for sustaining another episode of serious injury.
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Trace Elemental concentration of the Ayurvedic medicinal plant, Karunthakali (Solanum rubrum Mill), is investigated for the first time in detail, using EDXRF technique. Ca, K, S, Si, Cl, and Fe are the elements found more in leaf while K, Si, AL, Fe, Ca, S, and Mg are more in the root, and which are available in mg/g level. V, Cr, Cu, Rb, As, Co, Se, Br, and Pd are available in µg/g level. The lowest concentration of heavy minerals and a higher concentration of essential minerals placed it in the traditional medicine of Ayurveda system. Presence of Rb in leaf and root (1:2) 70 µg/g plays a crucial role in the central nervous system of human body. This paper explores the maximum possible utility of it in the pharmaceutical industry in accordance with its content of the elemental composition. This may be classified as poisonous plant due to its higher content of the aluminium.
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Hypoplastic right ventricular is a rare congenital heart disease. A few cases have been reported. We presented a case with hypoplastic right ventricular and multiple associated anomaly (Ventricular septal defect, atrial septal defect and pulmonary stenosis) in whom the main concern was whether biventricular repair or Fontan type surgery would be the optimal management in this patient. Biventricular repair was done successfully using the multimodality cardiac imaging with intraoperative transesophageal echocardiography.
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Acardiac twinning is a rare congenital anomaly of monozygotic twin pregnancy which often results from abnormal placental vascular anastomosis. It leads to twin reversal arterial perfusion with complex pathophysiology. Current information on early recognition and treatment for salvation of the normal twin is based on individual case reports in the literature. Mortality of Acardiac twin is 100%. Pump twin though structurally normal suffers due to heart failure and prematurity and has high morbidity and mortality all due to pumping blood to the acardiac twin. The acardiac twin receives all its blood supply from the pump twin through anastomotic channels, the term reversed perfusion is used to describe this condition because blood enters the acephalic twin through umbilical artery and exit through umbilical vein which is opposite to the normal blood supply. The acardiac twin loses direct vascular connection with the placental villi and receives its entire blood supply from the pump twin. Here, we have presented a primigravida of 24-26 weeks of gestation with twin gestation of monochorionic diamniotic type in preterm labor. One of the twin was acardiac acephalous and another a pump twin with hydrops.
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A case of Peters anomaly with bilateral post axial polydactyly, convex soles, ocular hypertelorism, a low nasal bridge, retrognathia, undescended testis, microphthalmia and club foot was examined in a neonatal Indian baby girl who had been delivered in the hospital and admitted to the newborn unit. She died aged five days. There were no cases of Peters anomaly recorded in India according to a literature search. In addition, available data point to the majority of the principal associations in Peters anomaly to be genitourinary anomalies, making this case a rare one in its isolated collection of musculoskeletal associations. A Indian baby girl of who was born through a Cesarean section presented in the new born unit of our hospital with bilateral corneal opacities, bilateral polydactyly, camptodactyly and club foot. This is a rare case of Peters anomaly and its association with Patau syndrome makes it special
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We studied the morbidity pattern of inpatient adolescents over a period of 17 months. Of 32115 admissions in this period, 2742 were adolescents (39.7% females). 93.9% were partially immunized, 37.3% were malnourished, 2.8% were overweight and 56% were anemic. Dengue and dengue-like illness (528) were the most common illness.
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Of the 102 samples collected from mammals and birds, both domestic and captive wild, 48 were found to be positive for Clostridium perfringens. Most of the mammal isolates (84.38%) appeared to have been collected from clinically affected animals, while 33.33% of the bird samples were from clinically affected and 21.43% from apparently healthy birds infected with C. perfringens. Isolates revealed high sensitivity to ciprofloxacin, enrofloxacin and norfloxacin. Among the isolated C. perfringens, 30 (62.50%) showed DNase production. Hemolytic activity was recorded in 14 (24.16%) of the isolates and 28 (58.33%) showed phospholipase C production. All the phospholipase C positive isolates revealed the presence of cpa gene encoding alpha (α) toxin. Of the 102 samples collected from mammals and birds, both domestic and captive wild, 48 were found to be positive for Clostridium perfringens. Most of the mammal isolates (84.38%) appeared to have been collected from clinically affected animals, while 33.33% of the bird samples were from clinically affected and 21.43% from apparently healthy birds infected with C. perfringens. Isolates revealed high sensitivity to ciprofloxacin, enrofloxacin and norfloxacin. Among the isolated C. perfringens, 30 (62.50%) showed DNase production. Hemolytic activity was recorded in 14 (24.16%) of the isolates and 28 (58.33%) showed phospholipase C production. All the phospholipase C positive isolates revealed the presence of cpa gene encoding α toxin.(AU)
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Animais , Toxinas Biológicas , Infecções por Clostridium/veterinária , Clostridium perfringens/isolamento & purificação , Clostridium perfringens/patogenicidade , Aves , Reação em Cadeia da Polimerase/métodos , Índia , Animais Domésticos , MamíferosRESUMO
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.