Assessment of knowledge, attitude and practice about dengue in factory workers of Jammu region, India

Background: Dengue, a mosquito borne, arboviral disease has become a major cause of health concern in the recent times throughout the world. In India, we have been witnessing annual outbreaks for the past few years and lack of knowledge about prevention and treatment of dengue among majority of the population leads to increased mortality. In spite of this fact, very few studies have been done to know about the knowledge of people regarding dengue fever and whether proper preventive measures are being practiced by the community to limit its spread. The objective of the study is to assess the knowledge, attitude and practices (KAP) regarding dengue in factory workers in Jammu.Methods: An observational study was conducted in a factory of Jammu to assess knowledge, attitude and practices of factory workers about dengue.Results: Majority of workers had knowledge about dengue (92.56%), source (81.81%), nature of disease, symptoms, but complications were not known. Majority of the workers had no idea that laboratory test for dengue is not available in every laboratory.63.63% of the workers knew that papaya is useful in dengue. 74.38% of the workers knew that low platelet count is found in dengue. There were 82.64% of the workers told that they think dengue is curable and preventable. There were 54.54% of the workers told that dengue can be prevented by avoiding stagnation of water. 57.85% of the workers told that they are aware about the sprays used by govt. to kill mosquito.Conclusions: There is a need to bring awareness about dengue, prevention and treatment as it is a prevalent disease now.

Concurrent dengue and typhoid infection: study from a tertiary care centre in Muzaffarnagar, India

Background: Acute febrile illness is a common presenting complaint during the rainy season. Rains predispose to both water and vector borne diseases. Co-infection of dengue with malaria, leptospirosis, typhoid, scrub typhus and other arboviral diseases can occur in endemic areas. Such dual infections are difficult to diagnose and create a diagnostic dilemma for the treating physician. Here in this study authors attempt to find out rates of concurrent dengue and typhoid infection.Methods: This retrospective study was done between August to November 2017. 403 patients presenting with acute febrile illness were studied. Diagnosis of dengue was done by rapid card test detecting NS1 antigen, IgM and IgG antibodies. Serodiagnosis of Salmonella infection was done by tube Widal test.Results: : Out of 403 febrile sera samples tested 154 (38.2%) were positive for dengue (either NS1 antigen or IgM antibodies or both), 71(17.6%) were positive for Widal test O and H titres ≥1:160) and 28 (6.9%) were positive for both dengue as well as Salmonella (Widal test).Conclusions: Acute febrile illnesses with diagnostic dilemma may be seen in cases of co-infection. Only better clinical judgement and right choice of laboratory tests can diagnose these diseases timely and prevent fatal outcomes.

A Comparative Study Between Laparoscopic Appendectomy and Conventional Open Appendectomy

Objective: A comparative study between laparoscopic appendectomy and conventional open appendectomy (OA). Materials and Methods: Our study was carried out on 88 patients admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with S. S. Medical College Rewa, Madhya Pradesh. Patients of acute and/or recurrent appendicitis, or cases who came for interval appendectomy, admitted through casualty or transferred from other department or reported in OPD during the period of study were included in the study. Detailed history and clinical examination, baseline blood investigations, and radiological investigations were done. Initial conservative management, including IV fluid resuscitation with Ringer’s lactate solution/Foley’s catheterization/nasogastric intubation, was done as per need. Operative procedure (laparoscopic appendectomy or OA) was planned and performed as per the patient choice and patient’s consent of that particular operation and patient’s pre-operative condition. Both procedures were compared in relation to duration of operation, post-operative pain, postoperative hospital stay, complications, conversion rate, time taken for return to normal activity, diagnosis of additional pathologies, relief of symptoms, and cosmesis. Result: Laparoscopic appendectomy is better as compare to OA in relation to post-operative pain, post-operative hospital stay, early return to normal activity, diagnosis of additional pathologies (especially in female patients and patients with diagnostic uncertainty), and subjective cosmesis. Disadvantage of laparoscopic appendectomy is longer mean operating time and conversion into OA. Overall complication rate and relief of symptoms are similar in laparoscopic and OA group. Conclusion: Laparoscopic appendectomy is thus a safe, simple, and efficient technique for treatment of appendicitis in experienced hands. Cases with unsure anatomy due to adhesions were the most difficult to complete lap

Comparative study of the smear microscopy, with conventional culture in clinically suspected cases of pulmonary and extra pulmonary tuberculosis.

Background: Tuberculosis is a significant cause of morbidity and mortality in the Indian subcontinent. A major challenge to clinical microbiology is the detection of Mycobacterium tuberculosis as accurately as possible. Objective: Tthe most important tool in the diagnosis of tuberculosis is direct microscopic examination of appropriately stained specimens for acid- fast bacilli and the gold standard for diagnosing tuberculosis is MTB convention culture on L-J media So, the present study was undertaken to compare smear microscopy by Z – N staining with conventional culture on L-J media, in cases of clinically suspected Pulmonary Tuberculosis and Extra Pulmonary Tuberculosis. Methods: 279 samples were processed within 24 hours of receipt. Samples from non-sterile sites were subjected to decontamination by the modified Petroff’s method. Sterile samples were directly processed as per conventional methods. Smear microscopy was done by Z- N staining and culture was done on L- J media. A control organism in the form of M. tuberculosis H37Rv was also tested with each batch of clinical isolates. Result: Results of smear microscopy and conventional culture of pulmonary and extra pulmonary specimens were compared. 22 and 14 more cases were detected by culture as compared to smear in case of pulmonary and extra pulmonary specimens respectively. Conclusion: From this study we can state that direct microscopic examination of appropriately stained Pulmonary and Extra Pulmonary specimens for acid fast Bacilli is an important tool in the diagnosis of tuberculosis. The Technique is simple, inexpensive and fast .However many Paucibacillary cases may be missed on smear microscopy. Thus specimens from all suspected cases of Pulmonary and Extrapulmonary Tuberculosis should be subjected to conventional culture on LJ media. This is the Gold Standard for Diagnosing Tuberculosis.

Effect of stress on academic performance in medical students – a cross sectional study.

Introduction- Stress, a universal phenomenon, affects an individual’s productivity either by increasing it (‘eustress’) or decreasing it (‘distress’). It is widely acknowledged that the medical fraternity is predisposed to enormous stress. The same may be true for the budding medicos- the undergraduate medical students. In our study we attempted to identify situations that predisposed the medical students to stress and their effects on academic performance and to suggest certain coping mechanisms. Objectives- firstly to explore common sources of stress in medical students, secondly to establish correlation of stress, gender, attendance, and academic performance if any. Method- 114 medical undergraduates were assessed for the common sources of stress and the level of stress using semi structured Performa and stress scale. The results were compared and correlated with various variables like attendance, demographic factors, average marks etc. Pearson correlation coefficient was used for statistical correlation amongst different variables. Results & Conclusions- Stress shows beneficial effects in females when compared to males. High attendance and better day to day performance in female medical students was associated with more amount of stress when compared to male students. Thus, stress among medical students should be acknowledged and attempts should be made to alleviate it.

Immediate changes in muscle strength and motor speed following yoga breathing.

The present study was conducted to assess the immediate effect of high-frequency yoga breathing on muscle strength and motor speed. Bilateral handgrip strength, leg and back strength, finger tapping and arm tapping speed were assessed in fifty male participants (group mean age±SD, 26.9±6.2 years) before and after (a) high frequency yoga breathing for 15 minutes and (b) breath awareness for the same duration. Sessions (a) and (b) were on two different days but at the same time of the day. The schedule was alternated for different participants. There was a significant increase (P<0.05) in right hand grip strength after high frequency yoga breathing. Both finger and arm tapping improved after both practices. The results suggest a role for high frequency yoga breathing in improving the hand grip strength as an immediate effect.

Hazardous, harmful and dependent alcohol users according to audit in an urban slum, Meerut.

Background: Alcohol consumption is the world’s third largest risk factor for disease and disability; in middle-income countries, it is the greatest risk. Approximately 4.5% of the global burden of disease and injury is attributable to alcohol. Alcohol is a causal factor in 60 types of diseases and injuries and a component cause in 200 others. Alcohol is attributed to nearly 3.2% of all deaths and results in a loss of 4% of total DALYs (58 million). Aims & Objective: To assess the pattern of alcohol use among the males aged >15 years in the urban slum, Multan Nagar in Meerut. Material and Methods: A cross-sectional study was conducted in the catchment area of UHTC (Urban Health and training Centre) among 324 males aged > 15 years. Data was collected by home visit using WHO questionnaire (AUDIT: Alcohol use disorder identification test) along with other questions related to the type, initiation and reason behind alcohol use. Chi square test followed by logistic regression was applied to know the association of alcohol use with the socio-demographic determinants. Results: According to the AUDIT score, Hazardous, Dependent and harmful drinkers were 7.7%, 9.2% and 2.4% respectively. Most common age of onset was 20-30 years (46.9%) among the drinkers with most common reason being peer pressure (13.6%). Logistic regression was applied and marital status, family history of alcohol use and caste retained their statistical significance (p-value< 0.05, 95% confidence interval). Conclusion: It can be concluded that early age of onset and peer pressure are the alarming challenges for the eradication of this social evil.

Working Memory Deficits In Obsessive Compulsive Disorder.

Background: Cognitive deficits could be functioning as an intermediate variable between neurological abnormalities and OCD symptoms. There is lack of such data in our country. Aim : To assess the cognitive functioning of a group of patients with OCD and a group of matched normal controls using Spatial Working Memory Test (SWMT). Method : Patients of OCD were screened for selection criteria. Diagnosis of OCD was made on the basis of DSM IV TR. They were assessed using SWMT for neuro-cognitive impairments and compared the same with matched controls. Conclusions : On SWMT, OCD patients showed significant impairment.

Neuropsychological Correlates for Obsessive Slowness.

Aim : To assess the cognitive functioning of a group of patients with OCD and a group of matched normal controls. Method : Patients of OCD were screened for selection criteria. They were assessed on Wisconson Card Sorting Test (WCST) and Continuous Performance Test (CPT) for neuro-cognitive impairments and compared the same with matched controls. Conclusions : On WCST, clinical group performed poorly, which is statistically significant. On CPT, the patient groups made significantly more wrong responses, more missed responses and took more time to respond, which is statistically significant.

Cognitive functions in stable schizophrenia & euthymic state of bipolar disorder.

BACKGROUND & OBJECTIVE: Some cognitive deficits in schizophrenia and bipolar disorders persist after the subsidence of active symptoms. We carried out this study to assess and compare the cognitive functioning of patients with stable schizophrenia and bipolar disorder. METHODS: Fifteen each of stable maintained schizophrenic patients and euthymic bipolar-I patients attending outpatient clinic in a tertiary care psychiatric hospital in north India were included in the study as also equal number of age and education matched control subjects. Cognitive assessments were done using Wisconsin's Card Sorting Test (WCST), Spatial Working Memory Test (SWMT) and Continuous Performance Test (CPT). RESULTS: Stable schizophrenia patients performed poorly on all the neurocognitive parameters as compared to both controls and bipolar euthymic patients. Euthymic bipolar patients showed significant difference on executive functions with normal controls. Patterns of cognitive disturbances in tasks of executive function are similar in both groups but are quantitatively more marked in schizophrenia. INTERPRETATION & CONCLUSION: Our results showed that stable schizophrenia patients performed significantly worse on cognitive measures than patients of euthymic bipolar disorder which was consistent with their poorer functional outcome. The results further indicated that stable schizophrenia and euthymic bipolar disorders may be distinguished qualitatively in neuropsychological terms with different profiles of cognitive impairment.

Drug susceptibility of Mycobacterium tuberculosis to primary antitubercular drugs by nitrate reductase assay.

BACKGROUND & OBJECTIVES: Rapid susceptibility testing of Mycobacterium tuberculosis strains is imperative for therapy selection but traditional drug susceptibility tests take weeks or are expensive. In this study we evaluated nitrate reductase assay which utilizes the detection of nitrate reduction as an indication of growth and therefore results can be obtained faster than by visual detection of colonies. METHODS: One hundred clinical isolates of M. tuberculosis were tested for four first line antitubercular drugs by nitrate reductase assay (NRA) and were compared with standard proportion method. The bacteria were inoculated on Lowenstein-Jensen (LJ) medium with primary antitubercular drugs and potassium nitrate was incorporated. After incubation for 7- 14 days, nitrate reduction indicating growth could be detected by colour change when reagents were added. RESULTS: Resistance of isolates as determined by both methods for isoniazid, rifampicin, streptomycin and ethambutol was 32, 35, 62 and 15 per cent respectively. Agreement between NRA and proportion method was 99 per cent for isoniazid and ethambutol. Complete agreement (100%) was found for rifampicin and streptomycin. Results were available in 7-14 days by NRA as compared to proportion method which takes 4-6 wk. INTERPRETATION & CONCLUSION: Nitrate reductase assay is a rapid and inexpensive method for susceptibility testing of M. tuberculosis for primary antitubercular drugs and could be an appropriate alternative to existing methods, particularly in resource-poor settings.

Depression in general clinical practice.

Worldwide currently about 340 million people suffer from depression. If not treated, it leads to increased morbidity and mortality. Risk factors include female sex, young age, lower socio-economic study, separated or divorced, positive family history, stressful life events, certain medical illness and so on. Aetiology lies on genetic factors, biochemical abnormality and personality and environmental factors. Clinical features lie on cardinal and other common symptoms. Depression usually starts before 40 years of age, average duration of one episode being 3-9 months. Treatment consists of a variety of psychotherapeutic approaches, pharmacotherapy and electroconvulsive therapy. A clinician may start therapy with low dose SSRIs which is considered as 1st line drugs. To educate patients about anti-depressants is very important.