Knowledge and Training of Primary School Teachers in First Aid - A Questionnaire Based Study.

BACKGROUND: Students at schools may need first aid due to illness or accident. Therefore, teachers at school should know first aid measures and be able to put them into practice. The aim of this study is to assess awareness regarding first aid training among primary school teachers. METHODS: Subjects were 150 primary school teachers from nine schools in the Udupi district of Karnataka. They were assessed by predesigned questionnaire proforma, after which each teacher was interviewed and responses were discussed separately in smaller groups. RESULTS: Of the subjects, 11.3% felt that first aid is important and 87.7% said that it is very important and wanted to learn first aid. About a third (30.2%) of the teachers knew some basic treatments for minor emergencies but they didn't recognize such treatments were called first aid. Most of the subjects (69.8%) were unfamiliar with the expression "first aid". CONCLUSION: First aid training should be included in the teacher training curriculum, and such training should be updated regularly.

An Unusual Presentation of Scrub Typhus.

Presentation of scrub typhus associated with brachial neuritis is extremely rare with only a few cases reported so far. Here, we report a case of a 45-year-old female who presented with fever and right shoulder pain. Laboratory parameters showed leucocytosis with ELISA and PCR for scrub typhus positive. Electromyography (EMG) and Nerve Conduction Velocity (NCV) study was suggestive of brachial neuritis. She was given doxycycline therapy for 10 days following which her shoulder pain resolved.

Hypokalaemic Periodic Paralysis- A Prospective Study of the Underlying Etiologies.

BACKGROUND: Hypokalaemic periodic paralysis (HPP) is a rare muscular disorder characterised by episodic weakness associated with hypokalaemia. The disease can either be inherited or acquired and misdiagnosis of the disease is quite common. Most of the data available on the disease is from the western world. Studies reporting aetiological, clinical and metabolic profiles of Indian population are sparse. Hence we tried to provide insights of the disease among the Indian population. AIM: To study the aetiological, clinical and metabolic profile of patients diagnosed with Hypokalaemic Periodic Paralysis (HPP). MATERIALS AND METHODS: This is an observational and analytical study on HPP diagnosed patients, during September 2011 to September 2014 in Kasturba Hospital, Manipal. A total of 23 patients were studied. Detailed history, clinical evaluation and metabolic workup for secondary causes of HPP were analysed. RESULTS: Of the 23 patients, 57% had primary HPP while 43% had secondary HPP. The group of patients with primary HPP comprised of 92% males and 8% females with mean age of 28 years and the mean duration of symptoms of 18 hours. The group with secondary HPP comprised of 70% males and 30% females with mean age of 38.7 years and the mean duration of symptoms of 60 hours. The secondary causes of HPP were thyrotoxicosis (50%), infective diarrhea (20%), Crohn's disease (10%), renal tubular acidosis (RTA) Type I (10%) and Conn's syndrome (10%). CONCLUSION: In our study primary HPP was found to be more common than secondary HPP. Males were predominantly affected in both groups. HPP should be ruled out before starting therapy for Guillain-Barré Syndrome (GBS).

Therapeutic assessment of chloroquine-primaquine combined regimen in adult cohort of Plasmodium vivax malaria from a tertiary care hospital in southwestern India.

BACKGROUND: Of late there have been accounts of therapeutic failure and chloroquine resistance in Plasmodium vivax malaria especially from Southeast Asian regions. The present study was conducted to assess the therapeutic efficacy of chloroquine-primaquine (CQ-PQ) combined regimen in a cohort of uncomplicated P. vivax mono-infection. METHODS: A tertiary care hospital-based prospective study was conducted among adult cohort with mono-infection P. vivax malaria as per the World Health Organization's protocol of in vivo assessment of anti-malarial therapeutic efficacy. Participants were treated with CQ 25 mg/kg body weight divided over 3 days and PQ 0.25 mg/kg body weight daily for 2 weeks. RESULTS: Of a total of 125 participants recruited, 122 (97.6%) completed day 28 follow up, three (2.4%) participants were lost to follow-up. Eight patients (6.4%) were ascertained to have mixed P. vivax and Plasmodium falciparum infection by nested polymerase chain reaction test. The majority of subjects (56.8%, 71/125) became aparasitaemic on day 2 followed by 35.2% (44/125) on day 3, and 8% (10/125) on day 7, and remained so thereafter. Overall only one therapeutic failure (0.8%, 1/125) occurred on day 3 due to persistence of fever and parasitaemia. CONCLUSIONS: CQ-PQ combined regimen remains outstandingly effective for uncomplicated P. vivax malaria and should be retained as treatment of choice in the study region. One case of treatment failure indicates possible resistance which warrants constant vigilance and periodic surveillance.

Pulmonary nocardiosis due to Nocardia otitidiscaviarum in an immunocompetent host- a rare case report.

Nocardiosis is a localized or disseminated infection caused by soil-borne aerobic actinomycetes. Pulmonary nocardiosis is a rare infection mostly occurring in immunocompromised patients. We reported a case of 36 year old immunocompetent non-smoker female patient with no premorbid illness who presented with fever, cough with scanty sputum, hemoptysis, left sided chest pain and exertional dyspnea for two weeks. There was no past history of tuberculosis, diabetes mellitus or steroid therapy. Chest X-ray showed homogenous peripherally based opacity in the left upper zone. Bronchoscopy was done and brushing sent for culture, which showed colonies with features of Nocardia species after 48 hours. Further phenotypic characterization revealed it to be Nocardia otitidiscaviarum. Patient was treated with cotrimaxazole for six months after which complete recovery was evidenced symptomatically and radiologically. We report this case to emphasize the fact that among the Nocardia species, Nocardia otitidiscaviarum as causative agent of pulmonary disease is rarely reported even in immunocompromised individuals.