ISOLATION AND CHARACTERIZATION OF LACTOSE AND NON- LACTOSE FERMENTING BACTERIA FROM TERTIARY CARE HOSPITAL AND THEIR ANTIMICROBIAL SUSCEPTIBILITY TESTâ€

Objective: The purpose of the present study was to identify the fermenting and non-fermenting gram negative bacteria from the tertiary care hospital.Methods: The conventional method of identification by biochemical analysis and antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method. Furthermore, analysis of microbes was done by Vitek-2.Results: 424strains of lactose fermenting and non-lactose fermenting gram negative bacilli were isolated from 3097 clinical samples. From the total lactose fermenting bacteria Escherichia coli was the predominant isolate accounting for 50.94% specimens, followed by Klebsiella pneumonia 27.59% and Enterobacter 0.47%. From the total non-lactose fermenting gram negative bacilli Acinetobacter baumannii was the predominant isolate accounting for 12.73% specimens followed by Pseudomonas aeroginosa 6.13%, other isolates were Stenotrophomonas maltophilia 1.17% , Burkholderia cepacia 0.94%. In the present study male were more infected than female. The study also showed that lactose fermenting bacteria were more infectious than non lactose-fermenting bacteria and isolates were from urine samples.Conclusion: Both Non-Lactose Fermenting Gram Negative Bacilli and Lactose Fermenting Gram Negative Bacilli were found to be major contaminants, and are important pathogenic bacteria causing wide range of infections in the tertiary care hospital.Keywords: Lactose fermenting gram negative bacteria, Vitek-2, Tertiary Care Hospital, Kirby-Bauer Disc Diffusion, Lactose non-fermenting gram negative bacteria Â

PREVALENCE OF VITAMIN D/B12 DEFICIENCY AMONG URBAN POPULATIONS COMPLAINING PAIN OF LOWER LIMB AND GENERALIZE WEAKNESS

Objective: The current study was carried out to assess the prevalence of vitamin D/B12 deficiency among urban populations complaining pain oflower limb and generalize weakness.Methods: A cross-sectional study was conducted in a sample of 188 men and women of different age who attended private tertiary care hospital forthe complaint of pain in lower limb and have generalize weakness. A brief questionnaire was designed to obtain the information such as age, type ofdiet, outdoor physical exercise and intake of alcohol or smoke. Blood samples were collected for vitamin D and B12 analysis.Results: The majority (57.4%) of the participants had vitamin D deficiency or insufficiency (< 20 ng/ml) and 48.4 % of subjects had vitamin B12deficiency (< 198 pg/ml). In our results the prevalence of both vitamin D/B12 deficiencies appears to increase with the age. Risk factors such as age,diet and smoke (cigarette consumption) were significantly associated with vitamin D/B12 deficiency (p=0.001). Unlike vitamin B12, outdoor physicalexercise was significantly associated with vitamin D status (p=0.001). Conclusion: The findings of this study report high prevalence of vitamin D/B12 deficiencies among urban populations complaining pain of lower limband have generalize weakness. A vegetarian diet, cigarette smoking seems a strong risk factor for vitamin D/B12 deficiencies. Our study emphasizesthe need of regular monitoring of these two micronutrient status so that appropriate intervention programs can be implemented to address thisproblemKeywords: Vitamin D, Vitamin B12, India

ADVERSE EFFECT OF COMBINED ORAL CONTRACEPTIVE PILLS

Oral contraceptive (OC) pills contain estrogen and progestin that are synthetic analogs of natural hormones. These synthetic hormones affect the hypothalamus-pituitary-gonadal axis of the female reproductive system. There are many types of contraceptives; most of the OC pills prevent pregnancy by inhibiting ovulation. Estrogen and progestin are two female reproductive hormones that are critical. Typically, estradiol is produced by growing follicle (ovaries) which stimulates the hypothalamus to produce the gonadotropin-releasing hormone, which further stimulates the anterior pituitary to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH production triggers the ovulation. Similarly, the progesterone is produced by corpus luteum (ovaries), which triggers the production of FSH and LH. There are many types of progesterone available. Long-term usage of synthetic estrogen and progesterone can disturb the balance between the level of these hormones in the body. This imbalance may lead to severe side effects such as breast cancer, cervical cancer, thrombosis, direct impact on the brain, and infertility.Keywords: Estrogen, Progesterone, Contraceptives, Herbal contraceptives.Â

Prospective study to evaluate management of ectopic pregnancy in a tertiary care centre

Background: To study the pattern of management of ectopic pregnancy in a referral Centre in North India.Methods: This prospective study was conducted over a period of one year in the department of obstetrics and gynecology, in a tertiary care Centre in North India. Total number of cases who reported to hospital with ectopic pregnancy during the study period were 110. All the cases were analyzed and managed either with conservative, medical or surgical treatment depending on the condition of cases at the time of presentation to the hospital. Frequencies of different variables were compared by chi square test using Graphpad Prism 9, p value less than 0.05 was considered statistically significant.Results: The incidence of ectopic pregnancies reported in present study was 18.62 per 1,000 deliveries. Total of 110 cases with ectopic pregnancy reported to hospital during the study period. Mean age of the cases was 28.72 years. Out of 110 cases, laparotomy was performed in 100 cases and medical management in 10 cases. Medical management failed in one case and necessitated surgery in that case. There was no maternal mortality during the study period.Conclusion: Most of the cases presented late to the hospital due to lack of awareness, topographically tough terrain in Himachal with limited transport facilities which delayed management of ectopic pregnancy and precludes conservative management either in the form of medical management or conservative surgery. Screening of high-risk cases, early diagnosis, early referral and early intervention reduces the maternal mortality and morbidity. So awareness at the primary health care level is the necessity of the hour

Comparison of low dose Dhaka regimen of magnesium sulphate with standard pritchard regimen in eclampsia

Background: The purpose of this study was to determine the effects of altitude on severe preeclampsia and eclampsia and subsequent perinatal outcome.Methods: This prospective study was carried out during 1st March 2011 to 29th February 2012 in Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla situated at a height of 2200m from sea level. All the subjects with severe preeclampsia or eclampsia were included in the study and their perinatal outcome was noted.Results: There were a total of 5897 deliveries. There were 423 cases of PIH making an incidence of severe preeclampsia and eclampsia 15.4% and 7.3% among PIH, respectively. Majority of cases (60.4%) belonged to age group 18-25 year with mean systolic blood pressure in eclampsia was 184.3±18.6 mm of Hg and in severe preeclampsia was 171.5±13.9 mm of Hg. Mean diastolic blood pressure was 125.8±12.6 mm of Hg in eclampsia and 118.6±4.3 mm of Hg in severe preeclampsia. Various other complications in eclampsia and severe preeclampsia cases included IUGR (35.1%) cases, abruptio placentae (15.9%), HELLP syndrome (9.6%) cases, spontaneous preterm labour (21.3%) and intrauterine death (6.4%). Live births were 85.1%; fresh still births were 8.5%. Mean birth weight was 2192.5±572grams. Respiratory distress syndrome was seen in 21.3% neonates, Hyperbilirubinemia was seen in 26.2% neonates intracranial bleeding was seen in 7.5% neonates. Perinatal mortality was 27.7% which constitute14.9% still birth neonatal deaths.Conclusions: Efficacy of MgSO4 in prevention and treatment of eclamptic convulsions is time tested and supported with a variety of studies. Since its narrow therapeutic and toxicity is major concern, the use of low dose MgSO4 protocols is a viable alternative to standard dose therapy. However, because of small study design further studies on the larger scale are required to support routine clinical use of low dose protocols

NOSOCOMIAL INFECTION BY NON-FERMENTING GRAM NEGATIVE BACILLI IN TERTIARY CARE HOSPITAL: SCREENING AND CURE

Objective: The purpose of the present study was to identify the Non-Fermenting Gram Negative Bacteria from the tertiary care hospital.Methods: The conventional method was used i.e. Antibiotic susceptibility test which was performed by Kirby–Bauer disc diffusion method and analysis of microbes was done by Vitek-2.Results: 172 samples were identified as Non-Fermenting Gram-Negative Bacilli from 1526 respiratory samples. Acinetobacter baumanii was the predominant isolate accounting 103 (59.88%) specimens followed by Pseudomonas aeruginosa 33.13%. Other isolates were Stenotrophomonas maltophilia 5.23% and Burkholderi acepacia1.74%. From the 172 samples, Endotracheal Aspirate was found to be the most infected amongst all the other samples. Acinetobacter baumanii and Pseudomonas aeruginosa were the most common NFGNB isolated in our study from patients of Respiratory Tract Infections.Conclusion: Both Acinetobacter baumanii and Pseudomonas aeruginosa showed good sensitivity to colistin, amikacin, cefoperazone while in most cases carbapenam is found to be highly resistant. Colistin along with amikacin and cefoperazone should be used against this pathogen for treatment.Keywords: Nosocomial infection, Gram negative bacilli, Tertiary care hospital, Lower respiratory tract infection, Non-fermenting bacill

What is better: cryocautery or electrocautery for cervical erosion?

Background: Present study was conducted with a background in mind to compare the efficacy of electrocautery and cryocautery for the management of cervical erosion. Aim of this study was to compare the efficacy of electrocautery and cryocautery for the treatment of cervical erosion and to check cost effectiveness.Methods: A comparative study was conducted at Maharishi Markandeshwar medical college and hospital, Kumarhatti (Solan) between July’13 to June’14 among 100 patients of reproductive age group with cervical erosion. They were grouped into 2 groups A (Electrocautery) & B (Cryocautery) and data obtained was analysed by paired t-test.Results: Though in short- term follow-up at 4-6 weeks after cautery, apparently electrocautery was superior to cryocautery in terms of erosion healing rate 92% vs. 76% as P value (0.4557) is not statistically significant, but in long-term follow-up at 12-14 weeks there was no significant difference in erosion healing but electrocautery was cost effective.Conclusions: Both types of cautery were equally good for treatment of cervical erosion in long-term follow-up. But electrocautery occupies less space and there is no chance of gas leakage in electrocautery, so electrocautery is more cost effective.

ASSESSMENT OF DENTAL FLUOROSIS IN CHILDREN OF JAIPUR DISTRICT, RAJASTHAN, INDIA

Objective: The objective of the present study was carried out to explore the potential association between fluoride concentration in drinking water and severity of dental fluorosis (DF) in the children.Methods: The study of dental fluorosis (DF) in the children (6-14 years old) was conducted in the two blocks (a) Jamwaramgarh block ;Heerawala, Palera ,Nayabas, Saipur and Birasana, (b) Amber block; Jugalpura, Chitanukalan, Sunder ka bas, Peelwa and Sirsali of Jaipur district, Rajasthan, India of the study villages. Total 150, children were surveyed. The role of fluoride (F) levels in drinking water in the etiology of dental fluorosis (DF) and the cases of dental fluorosis (DF) in both dentitions and teeth were also assessed using DEAN'S classification. The fluoride (F) concentration in source of drinking water was estimated by fluoride (F) ion specific electrode (Thermo Scientific Orion Star A329, USA).Results: The F concentration in (Tube well and Hand pump) water ranges from 0.7 to 15.0 parts per million (ppm) in Jamwaramgarh block and 1.40 to 5. 10 parts per million (ppm) in Amber block. Prevalence of dental fluorosis (DF) 27 (36%) in Jamwaramgar block and 26 (34.66%) in Amber block out of 75 children were examined in each block. Significantly increase in levels of F in drinking water is positively correlated with dental fluorosis.Conclusion: This study finding has shown the relation of dental fluorosis (DF) to high fluoride (F) levels in drinking water sources. A higher fluoride (F) levels in source of drinking water is a major risk factor for dental fluorosis. In view of the severity of the problem the intake of calcium rich foods and defluoridation techniques may help reducing risk of dental fluorosis (DF) in the children.Â

Role of Toll like receptor in progression and suppression of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is one of the most common type of head and neck squamous cell carcinoma and one of the multifactorial process that consists of most contributing factors such as tobacco smoking, chewing and alcohol consumption that altered the intracellular environment. Recent studies have shown relevance of Toll like receptor (TLR) associated with carcinogenesis. This review aim’s to explore that how TLR associates with progression and suppression of OSCC. This review is a classical review that has confined to articles published in the past 19 years (i.e. 2000-2019) and has summarized the perspective of the authors. 62 articles were reviewed and it was found that progression and suppression of OSCC is associated with different TLRs promoting tumor development and also inhibiting the progression of oral neoplasm. It was found that TLR2, TLR3, TLR4, TLR5, TLR7 and TLR9 are associated with tumor development i.e. in progression of OSCC, where as suppression of OSCC through TLR3 and TLR7. We authors would like to conclude that literature survey has indicated effective TLR’s against OSCC development and can be explored to investigate other TLRs that can be used for therapeutic purposes in near future

Association of COL1A2 gene polymorphism with dental fluorosis in children of Jaipur district of Rajasthan, India

In India major districts are affected through dental fluorosis. In the Rajasthan, almost all the districts are affected from the fluorosis due to excess ingestion of fluoride through drinking water. Fluoride content calculated in the drinking water and blood through fluoride ion specific electrode method. A case-control study was conducted in two blocks (Jamwaramgarh, Amber) of Jaipur district of Rajasthan, India to investigate the COL1A2 gene polymorphisms with relation to dental fluorosis in Indian children (6-14 years). COL1A2 gene polymorphisms were genotyped using polymerase chain reaction-restriction fragment length polymorphism analysis. Two sites (rs2621208, rs414408) were analyzed for the polymorphism. PCR performed for respective amplicon size for RsaI (865bp) and PvuII (401bp). For the rs414408, PCR product (401bp) was digested with Pvu II enzyme and band pattern was C/C for 240 and 161 bp band, A/C/T for 401,240 and 161 bp band, A/A, T/T 401 bp band. In the control sample pattern type is A/C/T. In the fluorosis affected patients sample band pattern is C/C, A/C/T and C/C. For the rs2621208 site, PCR product (865 bp) was digested with Rsa-I enzyme and expected band pattern was C/C for 412,301,128 and 24 bp band, G/C for 412, 301,152, 128 and 24 bp band, G/G 412, 301 and 152 bp band. In the control sample pattern type is A/C/T. In the fluorosis affected patients sample band pattern is C/C, G/C and G/G. An association between dental fluorosis and the COL1A2 gene polymorphism was observed in fluoride-exposed populations of Jaipur district of Rajasthan, India