OBSERVATIONAL STUDY ON POISON CASES IN A TERTIARY CARE HOSPITAL

Objective: To evaluate the prevalence, pattern, and cause of poisoning. To characterize the poisoning cases admitted in a tertiary care hospital; followed by the outcome and to observe the antidote given for the poison cases. Methods: This observational study was undertaken in emergency departments (EMD) and Medical Record Department (MRD). Totally 557 poison cases was recruited in this study. Grade of poison was assessed by using poison severity score. Statistical analysis was done by using Statistical Package for Social Sciences (SPSS). Results: A total of 557 poison cases were identified in 2, 39, 828 patients out of which 360(64%) were suicidal and 189(34) cases admitted were accidental. The patients who were admitted between 2-5 h after exposed to poison were found to be more followed by 0-1 hr,>1-2 h,>6-24 h,>24 h and>5-6 h. More number of cases were seen in the others (Synthetic cow dung powder and medicine) type of poison 296(53%) followed by household poisoning 93(17%), bites 86 (15%), insecticide poisoning 64(12%) and food poisoning 16(3%). Activated charcoal was the maximum used antidote. Conclusion: Through this study, it was found that suicidal poisoning was the most common type

Clinical pattern of recurrent herpes simplex keratitis

INTRODUCTION: The human herpes virus is an important source of ophthalmic morbidity worldwide. Herpes simplex virus however, continues to be an important cause of unilateral corneal blindness worldwide. It is a multifaceted disease capable of inducing the most baffling problems through both infectious and immune mechanisms. Despite considerable progress in understanding the virus at cellular and molecular levels the prospect of prevention still appears to be a long way off. AIM OF THE STUDY: The main objective of the study is To study the clinical pattern To assess the disease free intervals To assess the visual outcome Of recurrent herpes simplex keratitis in Government Rajaji Hospital – Madurai. MATERIALS AND METHODS: 46 patients were examined over a period of 1 year at the cornea services Government Rajaji Hospital – Madurai All patients with a clinically documented recurrent herpes simplex infection who were treated in our hospital were included in the study. They were analysed retrospectively using a standardized questionnaire which assessed the age, sex, clinical type of previous herpes simplex virus corneal disease, duration of disease free interval, trigger factors if any, laterality of the disease. A detailed slit lamp examination was done and the clinical type of herpes simplex keratitis was assessed. A diagnosis of epithelial keratitis was made when a branching linear dendritic ulcer or a geographic ulcer appearing as a broad area of epithelial defect with amoeboid borders was seen. Stromal keratitis was diagnosed when deeper layers of corneal stroma showed diffuse infiltration and odema of the stroma with or without necrosis, ulceration and vascularization. Necrotizing keratitis, interstitial keratitis, immune ring, limbal vasculitis, disciform keratitis are included in this. Keratouveitis was diagnosed when there was a severe corneal odema with or without vascularization and marked signs of anterior uveitis. Since it was difficult to differentiate clinically mild keratouveitis and endothelitis, both were clubbed together for the pattern of analysis of recurrences. Neurotropic ulcer was diagnosed when the patients presented with persistent epithelial defect with grey thickened elevated borders. The uniform treatment policy was adopted. Epithelial keratitis was treated with topical 3%acyclovir ointment 5 times a day for 2-3 weeks and topical ciprofloxin eye drops BD. Stromal keratitis was treated with topical prednisolone acetate in dosage according to the disease severity along with prophylactic 3% Acyclovir ointment BD and prophylactic ciprofloxin drops BD along with homatropine eye drops BD. Iridocyclitis was treated in the same way as stromal keratitis. Secondary glaucoma was treated with 0.5% timolol eye drops BD. When the patient has a combined pattern of epithelial & Stromal keratitis he was initially treated with topical 3% acyclovir ointment, homatropine eye drops BD and ciprofloxin eye drops BD until the epithelium starts healing and then was started on prenisolole acetate drops. These patients were followed up for one year using slit lamp examinations at 3 specified follow up visits during the one year and at additional times when the patient developed new ocular complaints. Of the 46 patients 12 patients lost follow up and were excluded from the study. The pattern of recurrence was studied for epithelial and stromal keratitis. The average disease free interval was calculated for epithelial and stromal keratitis taking into account only those eyes which recurred purely in the same pattern as its initial presentation. CONCLUSION: Herpes simplex eye infection is an important cause of corneal blindness. Recurrences of the disease are the major cause of ocular morbidity. It is being seen from the study that herpes simplex disease often recurs in the same clinical pattern as the first episode. It is also seen that stromal involvement though accounting for only about 30% of the initial presentation, it is the one which shows more number of recurrence at a shorter interval of time than that of epithelial involvement. Thus stromal keratitis accounts for the major cause of ocular morbidity due to herpes simplex keratitis. Hence an early recognition and prompt treatment is necessary and more light is to be shown on the ways of preventing recurrences through subsequent studies

Mental health and sleep: in COVID positive health care workers in India

Background: Starting from Wuhan as a local transmission, COVID-19 turned out to be a pandemic affecting the entire global population either as a patient or at least being exposed to the novel corona virus. The present study has been done to see how much working to treat Covid patients has put stress, anxiety, depression and sleep disturbance on health care professional after becoming covid positive themselves, essentially their own life at risk. Methods: This was a prospective observational cross-sectional study done in Sri Manakula Vinayagar Medical College and Hospital, Puducherry, with ethics approval. Sample size was 145 health care workers who had covid infection. The study comprised of questions from Dass 21 questionnaire and Likert sleep scale. Results: Mild levels of stress was seen in 16 members (11.03%), moderate stress was seen in 3 members (2.06%). The chi square value was calculated as significant p value of 0.045. Mild anxiety was seen among 13 (8.96%), moderate anxiety seen in 23 (15.86%), severe anxiety was seen in 2 (1.37%), Extremely severe anxiety was seen in 1 individual (0.68%). Mild depression was seen in 12 (8.27%), moderate depression was seen in 14 (9.65%). The quality of sleep was rated on a 10-point scale, 5.5% had reported poor sleep, 53.8% reported moderate sleep disturbance. Conclusions: This study reveals that mental health issues are possible for medical professionals too and that anxiety needs to be addressed in health professionals too. More so when isolated from their families and friends

Influence of sediment chemistry on mangrove-phosphobacterial relationship

The study reveals importance of sediment chemistry in mangrove-phosphobacterial relationship. The various physicochemical parameters of sediment, bacterial distribution, and acidic- alkaline phosphatase activity were studied in Avicennia marina mangrove sediments. The sampling sites were four mangrove forests along West India. Rhizospheric, pneumatophoric and bulk/non-rhizospheric sediment were collected. The rhizospheric sediment showed higher bacterial activity. The pH was observed low in the rhizospheric sediment and good abundance of phosphate-solubilizing bacteria (PSB). This was also supported by other physico-chemical parameters. Acid phosphatase activity was found to be higher in rhizospheric sediment indicating acid production at rhizosphere by microbial action and root exudation. It is the first study indicating that alkaline phosphatase activity was observed to be higher in pneumatophoric sediment. This coincides with higher number of phosphatase-producing bacteria (PPB) and high inorganic P in the pneumatophoric sediment, revealing that this region of A. marina harbours favourably more PPB with utilization of organic P by bacterial load and conversion to inorganic forms stressing that strong bonding exists between mangrove-sediment-phosphobacterial relationships

Wound Healing Ethnomedicinal Plants Popular among the Malayali Tribes in Vattal Hills, Dharmapuri, TN, India

Healing of chronic lower extremity wounds is a global problem, especially in developing countries where traditional medicine is often used by the people in remote places. India has a rich tradition of plant based knowledge pertinent to healthcare. A survey of ethnomedicinal plant species used by Malayali’s to heal cut/ wounds in Vattal Hills of Dharmapuri was made. A large number of plants/ extracts/ decoctions/ pastes are used by tribals to heal wounds, cuts and burns. In the present study, an attempt has been made to document ethnobotanical knowledge base and methods employed by Malayali’s for treatment of cut/ wounds. A large number of ethnomedicinal plants used by the Malayali’s have not been validated for wound healing potential. The present investigation resulted in the identification of 82 medicinal plant species distributed across 39 families that are used by Malayali’s to heal cut/ wounds. This study is an attempt to gather the information on the existing ethnobotanical knowledge base and document the traditional claims toward the development of safe of effective herbal drugs for cut/ wounds. Results of the study is organized in table form depicting the botanical name, family, vernacular name and habit with a brief note on plant parts used and method of administration

Sorption characteristics of economically viable silicate sorbents for sequestration of lead ions from aqueous solutions

The adsorption of Pb2+ from aqueous solutions by sorbents based on calcium silicates, obtained in multicomponent systems CaCl2-Na2SiO3-H2O (sorbent I) and CaSO4·2H2O-SiO2·nH2O-KOH-H2O (sorbent II), was studied. Surface area of the two sorbents was found to be 100 and 40 m2/g respectively. The sorption capacities of the adsorbent materials were found to be 3.6 l/mmol and 8.4 l/mmol respectively. Characterization of the sorbent materials was carried out. The equilibrium data was fitted in Langmuir's isotherm and the adsorption capacity of the adsorbent materials was determined. The distribution coefficients at Pb2+ ions for the sorbents were determined at different ratios of solid and liquid phases

Hematological and Inflammatory Biomarkers among Stable COPD and Acute Exacerbations of COPD Patients

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is heterogeneous in nature. Acute exacerbation of COPD (AECOPD) is diagnosed clinically which is subjective and clinical judgment may vary from clinician to clinician. Since chronic inflammation underlies the pathogenesis of COPD, markers of inflammation have generated lot of interest for their potential to be used as biomarkers of COPD. This study aimed to assess the variation in levels of neutrophil lymphocyte ratio (NLR) and platelet indices in patients with stable COPD and acute exacerbation of COPD patients and its association with GOLD stages. Methods: This prospective analytical study was carried out in our tertiary care hospital from December 2018 to July 2020. About 64 subjects (32- stable COPD, 32- AECOPD) who satisfied study criteria were included. Blood sample was taken from stable and AECOPD patients and were compared. Results: It was observed that Neutrophil Lymphocyte Ratio, Platelet Distribution Width, Erythrocyte Sedimentation Rate and C-Reactive Protein were increased in AECOPD patients when compared with stable COPD patients which was statistically significant with p value of <0.001. A positive correlation was observed between Neutrophil Lymphocyte Ratio, Platelet Distribution Width and Erythrocyte Sedimentation Rate, C-Reactive Protein which was statistically significant with p value of <0.001. Conclusion: We found that neutrophil lymphocyte ratio and platelet distribution width values increased significantly in AECOPD patients when compared to stable COPD patients. Keywords: AECOPD; COPD; Neutrophil Lymphocyte Ratio; Platelet Distribution Width

Enhancement of pigeonpea productivity through adoption of drought mitigating strategies

Pigeonpea (Cajanus cajan (L.) Millspaugh) is an important drought tolerant legume crop in Indian rainfed agriculture. Though India accounts for nearly 90% of the world’s pigeonpea acreage (3.73 million ha) and production (3.07 million t), the productivity is lower at 707 kg/ha than the world average. The Morocco India Food Legumes Initiative in collaboration with the ICRISAT is aimed at improving the livelihood of small farmers to strengthen food and nutritional security through adoption of improved technologies. This paper is focused on developing and disseminating strategies to improve pigeonpea productivity in dryland regions which are characterized by erratic rainfall, frequent and prolonged dry spells and soil nutrient depletion. During 2013-16, demonstrations were conducted in 1200 farmers’ fields in Mahabubnagar district, Telangana, India, with an objective of enhancing the productivity of pigeonpea using three drought mitigating strategies: (i) adoption of short-duration cultivar PRG 176, a high-yielding and early-maturing pedigree selection of ICPL 88034 x ICPL 88039 with a duration of 130-135 days; (ii) foliar application of soluble fertilizer to maintain vegetative growth and ultimately improve pod filling; (iii) life saving irrigation at the rate of 20 mm with water harvested from farm ponds during mid season drought and prolonged dry spells. Adoption of PRG 176 resulted in an average yield of 1400 kg/ha compared to LRG 41 (1120 kg/ha). The yield improvement of 25% can largely be attributed to the good branching habit (8- 13 primary branches) and high flower to pod conversion ratio of PRG 176 under dryland conditions. Foliar application of multi-K during flowering and pod formation stages enhanced the yield to 1360 kg/ha compared to the yield of 1100 kg/ha obtained in fields without foliar spray. Life saving irrigation in PRG 176 during mid season dry spell which persisted for 17-21 days improved the yields by 20 % compared to the yield of 1200 kg/ha obtained in rainfed crop. In conclusion, the study demonstrated that the productivity of pigeonpea in dryland regions can be enhanced to an average 1560 kg/ha through an integrated drought mitigating approach by exploiting the short-duration and high-yielding potential of PRG 176, providing life saving irrigation during critical growth stages and foliar application of nutrients at flowering and pod formation stages