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Liquid biomedical waste management: An emerging concern for physicians
Sasmita Biswal
July-December 2013, 4(2):99-106
The safe and effective management of health care biomedical waste has received much attention for improper and inadequate management is associated with an increase in the incidence of health risks to the healthcare workers, the patients, and their environment and to the community at large. Hence the development of safe and effective management of biomedical waste along with handling protocols, institutional plans and policies, appropriate training and feedback programs on proper waste management and handling for all the healthcare workers are highly recommended. In India, with the implementation of Biomedical Wastes (Management & Handling) Rules 1998, emphasis is being placed mainly on the proper handling, segregation and disposal of the healthcare waste by which the risks and hazards to an individual and to the community can be considerably reduced. Though a technology and treatment protocol already exists, liquid biomedical waste management still remains a major problem for all healthcare facilities. So proper training in handling of waste will enable the healthcare facility to diffuse this critical problem safely and cost effectively while managing their liquid biomedical waste. So a literature search using the terms liquid biomedical waste was done and this review describes the problems associated with its management.
  25,879 1,717 1
Costophrenic angle blunting: Always abnormal?
Venkatraman Indiran
January-June 2018, 9(1):39-40
  24,724 222 -
Steroid pulse therapies in dermatology
Gaurang Gupta, Ambuj Jain, Naveen Kikkeri Narayanasetty
July-December 2014, 5(2):155-158
Steroids pulse therapies are used in inflammatory and autoimmune conditions as they are cumulatively less toxic. Pulse therapy is the administration of supra therapeutic administration of steroids in intermittent manner. This form of therapy has given excellent treatment response with very few side-effects. Various modifications of steroid pulse therapies have been tried in pemphigus, alopecia, vitiligo etc., successfully.
  20,871 1,656 -
Decision and non-decision making among blood donors and non-blood donors towards voluntary blood donation
Umakanth Siromani, Thankamony Thasian, Rita Isaac, Kurusilappattu Gurupachai Selvaraj, Dolly Daniel, Joy John Mammen, Sukesh Chandra Nair
July-December 2015, 6(2):182-183
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Awareness of physiotherapy among the Anganwadi workers in Dakshina Kannada: A survey
Tania Johnsey, Narasimman Swaminathan, Sydney Rebello, Kavitha Vishal
July-December 2013, 4(2):57-63
Purpose: The physiotherapist facilitates optimum functional independence, health and well being of the community. An idea of the range of conditions that a physiotherapist can treat will help the community to benefit from their skill. Anganwadi workers (AWW) play a key role in health education and care at the primary care settings especially in rural India. Objectives: The objective of this study was to assess the awareness of physiotherapy among AWW in Dakshina Kannada. Materials and Methods: A cross-sectional survey using a validated questionnaire was conducted among 112 AWW. The data obtained were analyzed and described. Results: Fifty percent of the 112 respondents were not aware of the role of physiotherapy in many of the impairments and only 3% of the AWW were informed during their training period regarding physiotherapy. Conclusion and Implications: Awareness about physiotherapy among the AWWs who participated in the study was poor. Adequate awareness programs among the AWW with regard to physiotherapy, through the various means of information transfer, can be beneficial in helping them to direct the people who are in need of such services.
  7,104 622 -
A study to assess the awareness regarding occupational health hazards among the employees in the laundry department of a selected hospital
Merlin Manuel, Lourdes Daphnie, Sweta D'cunha, Sucharitha Suresh
January-June 2015, 6(1):40-44
Background: The importance of a clean environment and linen for optimal patient care has been stressed upon since the very inception of hospitals. Individuals who work in a laundry are required to be adequately informed about the physical and health hazards present in the laundry, the known risks, and what to do if an accident occurs. Every laundry worker must be trained to know the location and proper use of the available personal protective clothing and equipment. Therefore, safe environment in the laundry is essential to maintain their health, and awareness programs should be conducted. Objective of the Study: To assess the awareness regarding occupational health hazards among the employees in the Laundry Department. Materials and Methods: The research method adopted in this study is of a descriptive type. The study was conducted in the Laundry Department of the selected hospital. The sample consisted of 15 respondents. All the employees in the department were included. The tools used to collect the data were an informal interview and the check-list and observation methods. The collected data was analyzed by percentage. Result: The study reveals that a majority of the respondents were knowledgeable about the occupational health hazards and safety measures. However, very few of them were aware of the types of occupational hazards. Conclusion: Awareness of occupational health and safety among the employees is important in the laundry area; therefore, planned orientation, training programs, and proper guidance to the employees will help reduce any kind of danger involved in the job and adoption of the necessary safety measures.
  6,808 581 1
Perampanel: New drug for treatment of refractory partial onset seizures
Santosh Kumar Singh, Dick B. S. Brashier
July-December 2014, 5(2):195-199
Perampanel (2-[2-oxo-1-phenyl-5-pyridin-2-yl-1,2-dihydropyridin-3-yl] benzonitrile hydrate) is the latest antiepileptic drugs for treatment of refractory partial onset seizures. Perampanel inhibits α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)-induced increase in intracellular Ca 2+ and selectively blocks AMPA receptor-mediated synaptic trans­mission, thus reducing neuronal excitation. Three Phase III multicenter, randomized, double-blind, placebo-controlled trials demonstrated the efficacy and good tolerability of perampanel as adjunctive treatment in patients with refractory partial-onset seizures. The drug is approved for use in the European Union and United States. The pharmacology of perampanel offers potential as more than just another new antiepileptic drug. This first-in-class drug will provide another option for practitioners of rational polytherapy.
  6,192 648 -
A hospital-based study of anti-TPO titer in patients with thyroid disease
E Jacob Jeena, M Malathi, K Sudeep
July-December 2013, 4(2):74-77
Context: Autoimmunity against the thyroid gland is one of the most important causes for thyroid dysfunction. Anti-thyroid antibody test is an important tool in the evaluation of autoimmune thyroid disorders. Aims: To study the prevalence of thyroid hormone dysfunction and positive anti-TPO antibody titers in patients being evaluated for thyroid-related disorders. Settings and Design:This retrospective cross-sectional study was done in Father Muller Medical College. Materials and Methods: The TSH (Thyroid stimulating hormone), FT 4 (Free thyroxine), and anti-TPO titer reports of 74 subjects undergoing evaluation for thyroid-related disorders were analyzed. Statistical Analysis Used: Statistical significance was estimated by P value. Results: About two-third (60%) of hypothyroid patients showed raised TPO antibody titer. The titer was significantly higher in hypothyroid subjects when compared to the euthyroid subjects, and a majority of the hypothyroid subjects had a titer at least twice the upper limit of normal. Two of the three subjects with hyperthyroidism also had elevated anti-TPO titers. Conclusions: The commonest cause of hypothyroidism in our study subjects was autoimmune-related thyroid disease. Anti-TPO antibody estimation is a very useful test for establishing the etiological diagnosis of autoimmune thyroid diseases in our population. In situations where there is a diffuse non-progressive goiter, anti-TPO antibody estimation can substitute for an invasive FNAC.
  6,425 393 2
Histopathological profile of ovarian tumours: A twelve year institutional experience
Deepti Vijay Mankar, Gaurav K Jain
July-December 2015, 6(2):107-111
Context: Ovarian tumours represent about 30% of all cancers of the female genital system. They manifest in a wide spectrum of clinical, morphological and histological features. Aim: To study the frequency of incidence of different histopathological types of ovarian tumours in our institute. Materials and Methods: This retrospective study included 257 cases of histopathologically proven ovarian tumours, reported in the Department of Pathology of a rural tertiary care referral hospital, over a 12 year period (January 2000 to December 2011). These were classified according to the WHO classification of ovarian tumours (2003). Clinical presentation of the patients was analysed from archived case records. Results: Of the 257 tumours studied, 162 (63.04%) were benign, 15 (5.84%) were borderline and 80 (31.12%) were malignant. Surface epithelial tumours were the most common (68.48%) followed by germ cell tumours (15.95%). Mucinous cystadenomas (32.69%) were the most common benign tumours, while serous cystadenocarcinomas (31.13%) were the most common malignant tumours. Most ovarian neoplasms (43.19%) occurred in the 21-40 years age-group. Dull abdominal pain was the most common clinical presentation. Conclusions: Benign ovarian tumours were more common than malignant ones across all age groups. Surface epithelial tumours were the most common histopathological type of ovarian tumour. Due to vague symptoms, patients present late. Development of methods for early diagnosis of ovarian neoplasia is therefore, a pressing need today. The relative frequency of incidence of different ovarian tumours shows regional variations, highlighting the need to identify region-specific risk factors.
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Yo-yo reflux in partial duplication of ureter: A diagnosis on the color and pulse Doppler study
Kamini Gupta, Ritu Galhotra, Kavita Saggar
July-December 2013, 4(2):116-118
The diagnosis of yo-yo reflux in patients with partial collecting system duplications is difficult. We report a case of recurrent urinary tract infections due to partial duplication of the collecting system in which yo-yo reflux is demonstrated with color and pulse wave Doppler. Our aim is to highlight the fact that radiologists and clinicians should be aware of this noninvasive, inexpensive, and easily accessible modality so as to diagnose this phenomenon more frequently in future.
  6,092 289 1
Prevalence of Anemia among rural population living in and around of rural health and training center, Ratua Village of Madhya Pradesh
Sanjay Kumar Gupta, Sanjay S Agarwal, Rituja Kaushal, Ambuj Jain, Vineet Kumar Gupta, Neeraj Khare
January-June 2014, 5(1):15-18
Introduction: Nutritional anaemia is a worldwide problem with the highest prevalence in developing countries. It is found especially among women of child-bearing age, young children and during pregnancy and lactation. It is estimated to affect nearly two-thirds of pregnant and one-half of non pregnant women in developing countries. Objectives: To study the trend and severity of anaemia among people attending at Ratua RHTC and various socio demographic factors for the same. Materials and Methods: Hospital based cross sectional study. Observation: The trend of anaemia from 2008 to 2011 was in increasing trend, 9%, 15%, 22%, and 27% respectively and in 2012 constant around 26%. Anaemia was more common in females than males, 18% males and 82% females were reported anaemia of various degrees in the study period. Anaemia was highest among 11-25 years of age 42% followed by 26-40 years 23% and lowest among 0-10 years of age 8.69%. Anaemia among elderly was quite higher 15.5%. Most of the males had mild anaemia 16% followed by moderate 6.61% and severe 0.77% in contrast most of the females had moderate anaemia 42% followed by mild 31.35% and severe 3%. Trend of anaemia in female patients were in increasing trend from 2008-2009, than little decreases in 2010 and further decreases in 2011 after that again increases in 2012. Conclusion: Anaemia was significantly higher in females in comparison to males in moderate and severe category. Anaemia was highest among 11-25 years of age group.
  5,416 630 1
Perceived behavior and practices of adolescents on sexual and reproductive health and associated factors in Kathmandu, Nepal
Dillee Prasad Paudel, Laxmi Paudel
July-December 2014, 5(2):106-112
Background: Adolescence is a period of both opportunities and threats. It is an episode of exploring new options and ideas as opportunity. It is also a phase in life marked by vulnerability to risky sexual behavior and underprivileged reproductive health outcomes. Due to the deficiency of courtesy and proper guidance, millions of adolescents are facing the problems of teenage pregnancy, unsafe-abortion, psycho-social abomination, sexually transmitted diseases (STDs) and HIV/AIDS. The aim of the study was to explore the sexual and reproductive health (SRH) practices, perceived behavior, and associated factors among the adolescents. Materials and Methods: An institutional based cross-sectional study was conducted from January to May 2007 in different educational institutions of Kathmandu. Information was collected from 417 adolescents using pretested and self-administered questionnaire with their informed consent. Analysis was done using computer database SPSS-12.5 version applying appropriate statistical rules. Results were presented in tabular, graphical, and narrative forms. Results: The mean age of respondents was 17.7 ΁ 0.86 years and 57.9% of them were in grade XII. About 70.9% had good practice on Sexual and reproductive health (SRH). Most of them (83.9%) were informed on SRH via radio, TV or the internet (98.63%) and through books and newspapers (94.52%). About (22.9%) were involved in premarital sex in which 75.0% of them used condom. About 44.2% discussed on the SRH issues with family members. Gender, family income, family types, and knowledge of SRH were found significant (P < 0.05) factors affecting SRH practice. Conclusion: Nearly one quarter of the adolescents under the study had been involved in premarital sexual contact. Half of them were found to discuss on SRH with their family members. Awareness and curriculum based teaching-learning activities will support to reduce the consequences of premarital sexual contact and teenage pregnancy.
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Knowledge, attitude, and practice of mothers of under-five children regarding diarrheal illness: A study from coastal Karnataka
Laxmipati Hanumantagouda Gollar, K Shreedhara Avabratha
July-December 2018, 9(2):66-70
Background: Diarrhea is the second most common cause of morbidity and mortality among children under 5 years old worldwide. Most of the mortalities and morbidities due to diarrhea can be prevented. Accurate knowledge regarding signs and symptoms, timely and appropriate management at household, and in health services remains an important intervention for reducing mortality and morbidity. The present study was conducted with an objective to determine the knowledge, attitude, and practice of mothers of under-five children regarding the diarrheal illness. Methods: A cross-sectional study was conducted in a Medical College Hospital, Mangaluru. A pretested questionnaire was given to mothers of under-five children when they attended hospital for treatment of their children either as outpatient or inpatient. Results were tabulated and analyzed statistically using frequency, percentage, and Chi-square test. Results: A total of 100 mothers were selected randomly. Majority (40%) of them were in the age group of 21–25 years. All of them were literate with 47% mothers completed high-school education. Majority (40%) of mothers belonged to Class III socioeconomic status. Most of the mothers (84%) had good knowledge regarding signs and symptoms, spread, and prevention. Majority of mothers (77%) had serious attitude toward diarrheal illness. Most of the mothers (76%) practiced good dietary and preventive measures during diarrheal episodes. Rotavirus vaccine was given by 35% mothers to their kids. A strong association is found between age group, educational status, and socioeconomic status and knowledge, attitude, and practices regarding diarrheal illness (P ≤ 0.0001). Conclusion: Maternal education in particular health education should be used as an effective tool to promote knowledge and good practice regarding diarrheal illness in children under 5 years of age. Inclusion of rotavirus vaccine in national immunization schedule will help in improving its coverage.
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Onychomycosis: Insights in disease development
P Chaitra, Nanda Kishore Bala
July-December 2014, 5(2):101-105
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Yellapragada Subba Row: The Unsung Hero
Priyanka Kamath, K Ashok Shenoy
July-December 2013, 4(2):130-132
A genius in more than one basic field, with many important discoveries/inventions such as folate, methotrexate, aureomycin, and diethylcarbamazine etc., The wonder drugs he created helped conquer many diseases considered incurable till then, and even today, these drugs continue to be used routinely. Also, his discoveries led to better understanding of various basic physiological processes in man. Though he received all the support for his research on foreign soil, it is said he always remained an Indian at heart. The accolades he received for his work were few, and moreover, delayed. This article briefly describes the journey of this great man, his discoveries and achievements, which even today remain largely unknown.
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Couvade syndrome among 1 st time expectant fathers
Thilagavathy Ganapathy
January-June 2014, 5(1):43-47
Background: Couvade syndrome reflects physiological changes in men in preparation for fatherhood. Objective: The objective of this study is to analyze the frequency of Couvade symptoms among1st time expectant fathers and their associations with socio-demographic factors. Materials and Methods: An exploratory study was conducted in three Private Maternity Hospitals, Bangalore. A total of 123 low risk 1 st time expectant fathers attending the antenatal clinic along with their low risk term primigravidae at 36-40 weeks of gestation were selected by purposive sampling. Each one of the 1 st time expectant fathers were interviewed on a four points ordinal scale for measurement of Couvade syndrome which included 29 symptoms. Results: The results revealed that 1 st time expectant fathers experienced Couvade syndrome related to physical symptoms - (changes in appetite, flatulence, constipation, indigestion, fatigue, nausea, vomiting, food cravings, diarrhea, abdominal pain, headache, fainting, tooth ache, weight loss, weight gain, back pain, leg cramps, skin problems) and psychological symptoms (insomnia, mood swings, irritability, feeling close to tears, night mares, feeling lonely, helpless, guilty, fear of being alone, resentful and not interested in usual activities). Socio-demographic characteristics were not associated with Couvade syndrome. Conclusions: Health-care providers should anticipate needs and problems of expectant fathers and assist them in working through the challenging aspects of fatherhood.
  4,866 374 -
Photodynamic therapy: Truly a marriage between a drug and a light
Harveen Singh, Heena Khurana, Harshneet Singh, Manmohit Singh
January-June 2014, 5(1):48-55
Microbial biofilms in the oral cavity are involved in the etiology of various oral conditions, including caries, periodontal and endodontic diseases, oral malodor, denture stomatitis, candidiasis and dental implant failures. It is generally recognized that the growth of bacteria in biofilms imparts a substantial decrease in susceptibility to antimicrobial agents compared with cultures grown in suspension. It is therefore not surprising that bacteria growing in dental plaque, a naturally occurring biofilm, show increased resistance to antimicrobial agents. As result there is pronounced interest and keenness in the development of alternate antimicrobial concepts. Therefore, the application of alternative method to eradicate bacteria from periodontal pockets is desirable. One such approach is photodynamic therapy (PDT). The purpose of this review was to evaluate the effectiveness of PDT for periodontitis as an adjunct to non-surgical treatment of scaling and root planning. This review provides an overview of PDT with emphasis on its current status as an antimicrobial therapy to control oral bacteria. Finally, new frontiers of antimicrobial PDT research will be introduced, including targeting strategies that may open new opportunities for the maintenance of bacterial homeostasis in dental plaque, thereby providing the opportunity for more effective disease prevention and control. Thus, the available knowledge of PDT should encourage a more clinically oriented application of this technique.
  4,496 471 3
Clinical, immunophenotype and cytogenetic profile of acute lymphoblastic leukemia in children at tertiary health care centre in India
Sirisha Rani Siddaiahgari, MA Awaghad, MS Latha
July-December 2015, 6(2):112-118
Objective: Data on acute lymphoblastic leukemia (ALL) in Indian children being limited, we analyzed the clinical, immunophenotype and cytogenetic profile of ALL in our pediatric patients. Materials and Methods: This was a prospective and retrospective observational study in which data of 103 children with ALL, aged three months to 18 years were analyzed. Results: Definite male preponderance (70.87%) was observed, 58.25% patients were aged between two to five years. Common clinical features included fever (92.33%), pallor (87.38%), hepatomegaly (85.44%) and splenomegaly (83.50). central nervous system involvement was seen in 6.80% and tumor lysis syndrome in 32.04% patients. Hemoglobin was <5 gm/dl in 43.69%, between 5-10 gm/dl in 45.63% patients; white blood cell count between 5,000-50,000/hpf seen in 69.90%, >50,000 in 20.39% patients. Platelet count was <50,000 cells/hpf in 48.54%. Blast cells in peripheral smear present in 67.96% patients of 97 in whom immunophenotyping was done, 82.44% were Pre B cell ALL. Pre T and T cell ALL was seen in 15/97 (15.46%) patients. Karyotyping revealed hyperdiploidy in 9/89, hypodiploidy in 2/89, miscellaneous changes in 35 patients. FISH analysis in 63 patients revealed Philadelphia chromosome positivity in seven (11.11%). MLL gene was positive in 12.70%. TELAML was positive in 13.64% (3/22) patients. 97.06% patients went in to remission post induction. Conclusion: Most of our patients come under standard risk by their age, WBC count, immunophenotyping and cytogentic analysis. We suggest larger multi-centric studies even in developing countries to understand the clinical profile and RT-PCR technique in cytogenic analysis for better risk stratification to help in risk adopted therapy.
  3,371 1,582 4
A comparative assessment of nutritional and health status between tribal and nontribal under five children of Mysore, India
Sarjapura V Divakar, Pishey Ashwathnarayan Balaji, Siddaraju Poornima, Smitha R Varne, Syed Sadat Ali, M Puttaswamy
July-December 2013, 4(2):82-85
Context and Aim: The tribal populations are recognized as socially and economically vulnerable; thereby patterns and trends in tribal areas are required to monitor local epidemics and to assess the effectiveness of public health programs in prevention and control of diseases. This prompted us to assess the health status and morbidity pattern among the tribal and non-tribal population of Mysore. Settings and Design: A cross sectional study was carried in the forest areas of Mysore in the 33 tribal hamlets present. Materials and Methods:Among 33 tribal hamlets, a random selection of 18 hamlets was performed by lottery method. A pre-tested structured interview was used for data collection through house to house visits by individual and family scheduling. Data were statistically analyzed using measures of central tendency, standard normal test (Z), and Chi-square test (χ2 ). P-value of <0.05 was considered statistically significant. All the tests were performed using Smith's Statistical Software version 2.80. Results: The study revealed more of tribal (45.03%) children compared to non-tribal (22.47%) were suffering from protein energy malnutrition with P < 0.001 and 7.35% of tribal children were severely malnourished. Among tribal under five children, morbidity pattern observed was more with skin infections (31.33%), followed by (21.20%) dental caries; (19.20%) intestinal infections; (21.85%) while in non-tribal counterparts, skin infections were (12.98%), (7.78%) dental caries; (17.98%) intestinal infections; (25.84%) respiratory infections; and (20.22%) vitamin deficiencies. Conclusion: Tribals have low socio-economic status, poor nutritional status, increased prevalence of morbid conditions compared to non-tribal population. Further detailed research surveys among tribal population would be invaluable.
  4,375 536 -
Significance and prospective of "Consumer Protection Act" deliberations for the dentist
Puneet Kumar, Prince Kumar, Roshni Dupare, Vineet Gupta, Ashish Khattar
January-June 2013, 4(1):18-22
Practicing medicine in India has revolutionized during the last five decades affecting the health-care delivery in both positive and negative directions. This actually let the establishment of norm that would legally govern the medical treatment and make it answerable everyway; therefore, doctors were covered by various laws. Moreover, the doctor-patient relationship has undergone a transition throughout the ages. This liaison was primarily between a patient in quest of help and a doctor whose decisions were silently compiled with by the patient. Medical negligence arises from an act or omission by a medical/dental practitioner, which no reasonably-competent and careful practitioner would have committed. Here, authors have sought the Consumer Protection Act and related legal-issues that may assist dental professionals to be on a legally safer side.
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Immunobullous disorders: Clinical histopathological and immunofluorescence study of thirty-six cases
Srinath M Kambil, P Madavamurthy
July-December 2014, 5(2):134-138
Background: Immunobullous disorders are characterized by antibody-mediated bullous lesions affecting the skin and mucosa. Accurate diagnosis of these disorders requires clinicopathological correlation along with immunofluorescence study. Aims and Objectives: To study the clinical, histopathological, and immunopathological features of immunobullous disorders and to analyse the utility of immunofluorescence in the diagnosis of these disorders. Materials and Methods: A total of 36 cases of immunobullous disorders observed over a span of 2 years in our institution were studied. Detailed clinical examination, histopathological examination and immunofluorescence study were done in all cases. Results: Out of 36 cases studied, 18 cases (50%) belonged to pemphigus group, 10 cases (27.78%) were bullous pemphigoid (BP), 5 cases (13.89%) were linear IgA disease (LAD), 2 cases (5.56%) were cicatricial pemphigoid (CP) and 1 case (2.77%) was lichen planus pemphigoides (LPP). Twenty-one patients (58.33%) were in the age group of 21-60 years, 9 patients (25%) were above 60 years and 6 patients (16.67%) were below 20 years. Histopathology of all cases of pemphigus vulgaris (PV) showed suprabasal bulla with acantholytic cells. Pemphigus foliaceus (PF) showed subcorneal bulla in all three cases. Immunofluorescence in all 15 cases of PV showed IgG deposition in intercellular substance (ICS) and C3 deposition in ICS in six cases. PF showed IgG deposition in ICS in all three cases. BP and CP showed deposition of IgG and C3 in a linear band at basement membrane zone (BMZ) in all cases. All cases of LAD showed linear IgA band at BMZ. Conclusion: In three cases (two cases of BP and 1 LAD), immunofluorescence was absolutely essential to come to a final diagnosis, while in two cases of CP immunofluorescence helped in confirming the clinical diagnosis as histopathological finding was nonspecific. In the remaining cases it helped in confirming the diagnosis suggested by clinical examination and light microscopy.
  4,387 360 1
Publishing in an indexed journal
Narasimman Swaminathan
July-December 2013, 4(2):51-52
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Clinical and radiological findings in psoriatic arthritis: A hospital-based cross-sectional study
Neetha Vijayakumaran, Neelakandhan Asokan, Jijith Krishnan, Beena Narayanan
July-December 2016, 7(2):91-95
Context: There is limited published data on psoriatic arthritis (PsA) from India. Aims: To analyze the clinical and radiological findings of patients with PsA attending a tertiary care teaching hospital. Settings and Design: Cross-sectional descriptive study in a dermatology department of a tertiary care teaching hospital over a 1- year period. Materials and Methods: Demographic profile, clinical profile, and radiological changes of patients with PsA were studied. Statistical Analysis Used: Qualitative data were analyzed using means, percentages, and chi-square test and quantitative data were analyzed using Spearman's rank correlation and Z-test. Results: There were 53 patients (35 males). The most common age group was 40-59 years. The age of onset was earlier among females. The most common type of PsA was asymmetric oligoarthritis (35/53; 66%). Overlapping types were seen in 19 (35.8%) patients. The knee was the most common joint involved (21/53; 39.6%) followed by the distal interphalangeal (DIP) joint and shoulder joint (18/53 each; 34%). Enthesitis and dactylitis were present in 3 (6%) and 7 (13.2%) patients, respectively. Nails were affected in 47 (88.7%) patients; the most common finding was pitting of the nail plates. There was no correlation between clinical type of PsA and the severity of disease as assessed by Psoriasis Area and Severity Index (PASI) and body surface area of involvement (BSA). Twenty-five (47.2%) patients were either overweight or obese. A majority of the patients (41/53), particularly females (17/18), had central obesity. 34% of the patients had systemic hypertension (HT), diabetes mellitus, or both. The most common (24.5%) radiological change was marginal erosion of the phalanges. Conclusions: Asymmetric oligoarthritis was the most common clinical type of PsA. The knees, shoulders, and DIP joints were the more commonly affected joints. Severity of psoriasis was not associated with any particular type of PsA. A majority of patients, particularly females, had central obesity. The most common radiological finding was marginal erosion.
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Expanded newborn screening: Guiding principles, concerns and relevance
Seema Pavaman Sindgikar, Rathika Damodar Shenoy
January-June 2014, 5(1):59-63
Since its introduction in 1960s, universal newborn screening (NBS) using the heel-prick dried blood spot samples has become an integral part of public health system in developed countries expanded to pre-symptomatic detection of specific inherited metabolic, endocrine and hematologic disorders. In our country, NBS may become relevant with epidemiological shift and increasing access to technology. Current recommendations include a phased introduction of screening for congenital hypothyroidism, congenital adrenal hyperplasia and glucose 6-phosphate dehydrogenase deficiency. In this review, the guiding principles of NBS, some of the individual disorders, the concerns and relevance to our country are discussed. Establishing a pre- and post-screening care and education are of utmost priority before NBS is adapted into health care system.
  3,929 482 -
Detection of Rotavirus and Adenovirus diarrhea in children below five years, in Dakshina Kannada District, a coastal region of Karnataka State, India
Anup Kumar Shetty, Faizan Mohammad Kalekhan, Sibin Jose Muthiravalapil, Rekha Boloor, Beena Antony
July-December 2014, 5(2):143-148
Context: Diarrheal disease is the second largest cause of death of children under 5 years. Viral diarrhea is most common which is usually caused by Rotavirus followed by enteric Adenovirus. Rotaviruses are responsible for approximately 527,000 deaths mainly in low-income countries of Africa and Asia. There is limited number of studies done on viral diarrhea in this coastal belt. Aim: To determine the prevalence of Rotavirus and Adenovirus diarrhea among children below 5 years of age and its epidemiological importance in this coastal region of Karnataka State, India. The impact of factors like socio-economic status, drinking water, and Rotavirus immunization status that can contribute to the disease were also evaluated and recommendations are formulated for disease prevention. Materials and Methods: Children below 5 years of age with history of diarrhea, vomiting and fever of less than 3 days were included in this study. The sample size was 35. General physical examination, clinical findings and other details like socio-economic status, personal hygiene, growth milestones and family income were also recorded. A commercial Rotavirus and Adenovirus antigen detection kit was used to detect the presence of Rotavirus and Adenovirus antigen from the stool sample. Results: Out of 35 patients screened, 25 (71.43%) patients were negative for both Adenovirus and Rotavirus, 10 children (28.57%) were positive for Rotavirus and no patients were positive for Adenovirus. Severe dehydration, fever, loose stools and vomiting were the commonest symptoms seen in Rotavirus positive children. The highest incidence of infection with Rotavirus was seen among 7-12 months age group. Children whose stool was positive for Rotavirus used public water supply. Conclusions: Rotavirus is an important cause of diarrhea in children below 5 years in this coastal region. A simple, rapid immunochromatography test is useful and economical tool to simultaneously detect and screen Adenovirus and Rotavirus. Low socioeconomic state and unsafe water supply contributes to diarrheal disease.
  3,907 417 1