Study of surgical site infections and its antibiogram in a surgical ICU of a tertiary care hospital in south west Rajasthan

Background: Surgical infections can be caused through two major sources: exogenous and endogenous bacteria. Surgical site infections (SSIs) is one of the most common complications encountered in surgery. SSI places a significant burden on both the patient and health system, thus a major cause of morbidity, prolonged hospital stay and increased health costs. Objective of this study was to identify and isolate various bacteria from wound infections in a surgical intensive care unit and to study their antibiogram.Methods: Two wound swabs were collected from the wound and from a drop of aspirate, smear was made on clean glass slide and Gram staining was done for direct microscopic examination under oil immersion 100X objective to know various morphological types of bacteria and presence or absence of inflammatory cells. Second swab/drop of aspirate was used for culture by inoculating it on routine media like blood agar, nutrient agar and MacConkeys agar, incubated at 37° C for 24 hours aerobically.Results: Out of 150 pus samples, 122 (81.3%) were culture positive for bacterial growth and no growth was observed in 28 (18.7%) cases. Out of 122 bacterial culture positive cases, 120 were monobacterial and 2 were poly bacterial. Out of 122 bacterial isolates; E. coli (32/26.2%) was the commonest followed by P. aeruginosa (32/24.5%).Conclusions: The study concludes that variety of aerobic bacteria is responsible for surgical site infections with predominance of Escherichia coli followed by Pseudomonas aeruginosa.

Changing indications of prenatal diagnosis in molecular era: experience of single centre in North India

Background: About 3-5% of pregnancies are complicated by chromosomal aberrations and birth defects. In the past prenatal genetic testing is identified to be largely restricted to the detection of chromosomal abnormalities like aneuploidy. With advances in the field of medical genetics, there has been substantial rise in use of prenatal genetic testing and we wanted to find out the same in our cohort of patients.Methods: Study design was retrospective, single-center observational study. Pregnant patients who underwent invasive testing for prenatal genetic disorder at fetal medicine specialty were considered for inclusion in the study. The invasive procedures that were performed in our study were amniocentesis, chorionic villous sampling (CVS) and cordocentesis.Results: Total 515 pregnant women underwent prenatal testing. Amniocentesis was the most common procedure to be performed accounting for about 74% of total cases. In our cohort, abnormal aneuploidy screening was the most common indication for performing prenatal diagnosis (64% of cases), while 12.8 % underwent prenatal diagnosis due to abnormalities/genetic disorder in previous child. Abnormalities in antenatal ultrasonography accounted for 16% of cases. Quantitative fluorescene polymerase chain reaction, rapid aneuploidy testing (QFPCR) was performed in all the cases. Karyotype was performed in 273 cases while chromosomal microarray was performed on 92 samples. Multiplex ligation dependent probe amplification (MLPA) was done for 15 patients. Targeted mutation testing (Sanger sequencing) was done on 121 prenatal samples. Exome sequencing was performed on 14 fetuses. Out of 515 a total of 79 fetuses (15.3%) were found to have genetic disorder.  Aneuploidies were identified in 11 fetuses (2.1%), 12 fetuses (2.3%) were found to have pathogenic CNVs (Copy number variants). Single gene disorders were found in 56 fetuses (10.8%). Conclusions: We have moved very rapidly from Karyotyping to chromosomal microarray to exome sequencing. There has been rapid change in the indications for prenatal Diagnosis from yesteryears with coming of new era of genetics

A STUDY ON THE STANDARDIZATION PARAMETERS OF CASSIA ANGUSTIFOLIA

Objective: Now-a-days, the herbal medicines are much efficient for the treatment of various disorders as they have minimal side effects in comparison to the allopathic medicines. Cassia angustifolia, commonly called Senna belongs to the family Leguminosae and is a well-known laxative throughout the world. Senna is mostly found in Tirunelveli, Madurai, and Ramnathpuram districts of Tamil Nadu. Carbohydrates, tannins, alkaloids, flavonoids, and amino acid are the important chemical constituents of C. angustifolia. The objectives of the present study are to investigate various pharmacognostic, phytochemical analysis, and pharmacological properties of C. angustifolia.Methods: The powdered drug was used for estimating the loss on drying, ash values, fluorescence studies, chemical tests, and extractive values. Macroscopic and microscopic studies were also performed.Results: The transverse section (T.S). of leaf showed isobilateral structure along with paracytic stomata, nonlignified unicellular trichomes with warty walls, and fibrovascular bundle. The fluorescence characteristics of leaf powder were studied both in visible light and ultraviolet (UV) light (254 nm and 365 nm) after treatment with various reagents. Senna is composed of carbohydrates, tannins, alkaloids, flavonoids, and amino acid. It was reported that the total ash value was 11.23±0.25 w/w. The acid insoluble ash value was 1.4±0.1% w/w. Water soluble, ethanol, methanol, petroleum ether, and chloroform extractive values were 16.6±0.26% w/w, 3.7±1.75% w/w, 0.83±0.05% w/w, 1.6±0.1% w/w, and 3.2±0.25% w/w, respectively.Conclusion: The main pharmacological activities of Bauhinia variegata are anthelmintic, antiulcer, antitumor, antimicrobial, antidiabetic, anti-inflammatory, antigoitrogenic, and hepatoprotective. The present investigation provides the information on its pharmacognostic, phytochemical analysis, and pharmacological properties

ESTABLISHMENT OF A MECHANISM OF POLYHERBAL FORMULATION FOR ANTI-RHEUMATISM

Objective: A marketed product Dr. Ortho has been used by many patients and is gaining a positive feedback from the patients. A study is designed to establish its mechanism of action on various anti-rheumatic models in experimental animals. No studies have been investigated on this product for its anti-rheumatic activity.Methods: Dr. Ortho (55 mg/kg, p. o.) was administered during adjuvant-induced arthritis, phlogistic agents (Histamine, bradykinin, and serotonin) induced paw edema, Acetic acid induced writhing test in mice, and Eddy's hot plate. Histopathology (T. S. of knee joint) and various hematological parameters (WBC's, RBC's, and ESR count) were observed during the study.Results: Dr. Ortho decreases arthritis induced inflammation by antagonizing or inhibiting the inflammatory mediators, i.e., histamine, 5-hydroxy tryptamine and bradykinin. (20% (P<0.05) of carrageenan, 10.01%, (P<0.05) of histamine, 8% (P<0.05) of 5-hydroxy tryptamine induced paw volume). Dr. Ortho acts as both peripheral and central analgesic. Histopathology findings revealed that there is a reduction in the neutrophil infiltration, pannus formation, and bone. Hematological parameters show that Dr. Ortho decreases the elevated level of the WBC's count.Conclusion: The present study revealed some facts regarding the mechanism of Dr. Ortho in reducing arthritis induced inflammation. However study may be done further to illustrate its complete mechanism.Â

CONSTRUCTION OF PHYSICAL FITNESS TEST ITEMS NORMS OF TAEKWONDO PLAYER OF GURU NANAK DEV UNIVERSITY, AMRITSAR, INDIA

The purpose of this study was to construct Norms of Physical Fitness Test Items of Taekwondo Player. To obtain data, the investigators had selected Fourty (N=40), male Inter-College level Taekwondo Player of Guru Nanak Dev University, Amritsar between the age group of 18-28. The Muscular Strength was measured by Handgrip Strength Test, Muscular Power was measured by Vertical Jump Test, Muscular Endurance was measured by Pull-Up Test, Running Speed was measured by 20-Meter Dash, Running Agility was measured by Illinois Agility Test, Jumping Ability was measured by Standing Long Jump Test, Throwing Ability was measured by Overhead Medicine Ball Throw Test, Flexibility was measured by Sit and Reach Flexibility Test and Balance was measured by Stork Balance Stand Test. The data, which was collected by administering tests, was statistically treated to develop for all the test items. In order to construct the norms, Percentile Scale was used. Further, the scores were classified into five grades i.e., very good, good, average, poor and very poor.  Article visualizations

Cyclic Correlation of Diffuse Reflected Signal with Glucose Concentration and scatterer size

The utility of optical coherence tomography signal intensity for measurement of glucose concentration has been analysed in tissue phantom and blood samples from human subjects. The diffusion equation based calculations as well as in-vivo OCT signal measurements confirms the cyclic correlation of signal intensity with glucose concentration and scatterer size.Comment: Four figures, Five page

Association of serum cytokines IL-6, TNF-α, PTX-3 and progesterone modulation in cases of recurrent pregnancy loss

Background: Cytokines are major immune regulators, which play a critical role in the pathophysiology of unexplained recurrent pregnancy loss. Th1 class of cytokines has been shown to exert deleterious effects on pregnancy causing early loss.Methods: The changeover in the levels of Th1 cytokines was studied in two major groups; Gp I (N=30) comprised of RPL subjects with two or more consecutive spontaneous miscarriages history and Gp II (N=30) comprised of normal pregnancy controls .The efficacy of oral micronized progesterone was assessed in regulation of cytokine levels ,with Gp Ia (N=15) treated with 200 mg oral micronized progesterone and Gp Ib (N=15) comprised of untreated RPL subjects and its role in improving pregnancy outcome was also determined. The present study determined the levels of cytokine TNF-α, IL-6 and PTX-3 in serum samples for all the subjects at three time points at the time of enrolment, with (GpIa) or without (Gp Ib) progesterone administration at 20 weeks or abortion if earlier and at the time of delivery. Results: The results indicated that the levels of Th1 cytokines (TNF-α [37.80 versus 78.09], IL-6 [16.93 versus 81.12] and PTX-3 [17.42 versus 73.53]) was found to be reduced at every time point in the treated cases with an RPL history as compared to untreated ones. Further, the cases treated with with oral micronized progesterone were found to have better pregnancy outcomes (p<0.005 significant number of live births).Conclusions: The levels of interlukins, TNF-α, IL-6, PTX-3 in cases of RPL may not have a major contributory role in predicting outcome, however exogenous progesterone decreases the Th1 pro inflammatory response and efficiently improves the pregnancy outcomes by modulation of cytokine levels

Atypical neuroleptic malignant syndrome. “Doing more harm than gain”

Neuroleptic malignant syndrome (NMS) a rare, idiosyncratic, and potentially fatal adverse reaction can be deceptive especially when the hallmark features are lacking. Most diagnostic criteria include fever and muscle rigidity, although NMS may present without either. Delirium, agitation and catatonia can be the earliest features of NMS and in acute care settings, concomitant use of sedatives and anti-psychotics by the attending clinicians may even obscure the sentinel signs of NMS and further aggravate the underlying insult. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment and the strict adherence to the classical criteria of NMS may lead to a diagnostic delay and dire consequences for these patients and sometimes this delay can procure death