Effect of concomitant HIV infection on adverse drug reactions by first line antitubercular drugs - a case series analysis

The pattern and severity of adverse drug reactions (ADRs) due to first-line anti-tubercular drugs in solely tubercular and TB-HIV co-infected patients could be different due to drug-disease and drug-drug interactions in TB-HIV co-infected patients. Nevertheless, the studies regarding this aspect are very meager. Hence a retrospective appraisal of individual case safety reports (ICSR) due to first-line antitubercular drugs spontaneously submitted to the ADR monitoring center was done for solely tubercular and TB-HIV coinfected patients. Out of eight ICSRs, four had concomitant HIV infection, and two of them were on antiretroviral (ARV) drugs. Co-infected patients showed rare and severe ADRs like optic neuritis, acute renal failure, and drug-induced liver injury (DILI). In contrast, four non-HIV co-infected tubercular patients suffered from comparatively less severe cutaneous reactions and vertigo. A high negative (-0.774) correlation coefficient between HIV co-infection and recovery status found that HIV co-infected patients had low chances of fully recovering. In conclusion, HIV co-infection and ARV drugs can affect the pattern, severity, and recovery status of adverse drug reactions due to first-line antitubercular drugs

Tetraquark Masses by using extension of Gursey-Radicati Mass Formula

Tetraquark states are classified using the $SU(6)_{sf}$ spin-flavor symmetry and Young tableau technique. Further, by using the extension of Gursey-Radicati mass formula, masses of tetraquark states are predicted upto good level of accuracy. Also, Decay channels and decay widths of tetraquark states are calculated and found to be in good agreement with the experimental and available theoretical data.Comment: 12 pages , 4 figure

Spectroscopic Analysis of Hidden-Charm Pentaquarks

In this work, the multiquark approach is used to analyze the spectroscopy of hidden-charm pentaquark states, motivated by recent discoveries at the LHCb collaboration. Using the SU(3) flavor representation, pentaquarks having $J^P = 5/2^-$ are arranged into 10 (decuplet) of the SU(3) flavor multiplets. The masses of these pentaquarks are calculated by using the extension of the Gursey-Radicati mass formula. Further, we suggested the possible production modes for $J^P = 5/2^-$ pentaquarks from bottom baryon decays. Finally, by adopting an effective Lagrangian approach for $J^P = 5/2^-$, we calculated the partial decay widths in terms of the coupling $g_1^2$. This coupling is then adjudged from the literature to get the final partial widths of predicted states. Our results may provide crucial information for future experimental studies of hidden-charm pentaquark states with the help of suggested strong decay channels and partial widths

Early onset osteoarthritis knee in premature menopausal women

Background: Women with early menopause medical (disease) or surgical (hysterectomy) are having postmenopausal symptoms after a variable period. Osteoarthritis (OA) strikes women more often than men and it increases in prevalence, incidence and severity after menopause. The present study was done to evaluate early onset osteoarthritis knee in premature (early) menopausal women.Methods: We have studied 160 women with early menopause (before 40 yrs of age) developing symptoms and well established osteo arthritic knees. We have studied various factors with early menopause. The data was analysed using SPSS software version 22.Results: In our study 138 cases (86.25%) were surgical menopause (hysterectomy) and 22 cases (13.75%) were medical menopause where definite cause was not obvious. An early onset knee pain was noted in 1 to 2 years. But late OA was noted after 6 to 7 years of menopause. Effective treatment was wanted by majority of the patient from the point of view of post-menopausal osteosaropaenia and physiotherophy. Even in urban population erratic treatment was maximum (75%). Dysfunctional uterine bleeding, fibroid or severe intractable infection appeared be the most common indication for hysterectomy.Conclusions: We concluded that with better awareness of menopause, effective regular treatment and physiotherapy can herald the process of osteoarthritis. The difficulties were mainly developed early because of lack of awareness, no effective regular treatment and physiotherapy. Pain is the starting feature which may continue to severe disability later on

Prevalence of hepatitis B in pregnant women and management of babies born to Hepatitis B positive mother: A criterion based clinical audit

Introductions: This study aims at identifying the prevalence of Hepatitis B virus infection in pregnant women and adherence to the management of the newborns of these women as per the international guidelines. Methods: This is a cross sectional study conducted at Patan Hospital from January 1, 2008 to December 30, 2014. Prevalence of HBsAg in pregnant women and management of babies born to these women, immunization status, breast feeding status and follow up advise for the babies were studied.  These data were analyzed to see whether we were following international guidelines for preventing mother to child transmission of hepatitis B infection. Results: There were total of 58,917 deliveries and 59,438 births during the seven year study period. Total 148 cases of pregnant ladies with HBsAg positive status were recorded. Prevalence of HBsAg positive case was 1 in every 398 (0.25%) deliveries. Fifty four babies (87%) received hepatitis B vaccine (HBV) and hepatitis B immunoglobulin (HBIG) within 12 hours of birth. Eight babies (22%) failed to receive HBV and HBIG within 12hours of birth. Mother’s HBsAg positive status was not the reason for formula feeding in any of the babies. Follow up HBsAg status was not advised in any of the babies. Conclusions: At Patan hospital, we seem to be following most of the guidelines in the management of HBV infection, except for checking the HBsAg status of the babies at 9-18 months of age.Keywords: chronic liver disease, HBsAg positive, hepatitis B vaccine, Hepatitis B immunoglobulin, mother to child transferÂ

Study of clinical profile of patients of bipolar mood disorder with and without substance abuse and clinical course variables in the substance abusing bipolar group in one of the tertiary care centre of North India

Background: Bipolar disorder is the sixth leading cause of disability worldwide and has a lifetime prevalence of about 3% in general population. In patients with bipolar disorder there was 58 % lifetime prevalence of co-occurring alcohol abuse and a 38 % lifetime prevalence of co-occurring other substance abuse. Substance abuse interferes with treatment and management approaches of the bipolar disorder.Methods: A cross sectional observational study of 120 male patients divided in substance abusing (60) and non-substance abusing groups (60) with bipolar disorder according to DSM-V, who met the Inclusion criteria . A written informed consent was obtained from the patients and/ or their family members. Patient’s information was recorded on the socio-demographic and clinical profile sheet .Thereafter, YMRS or HAM-D scales were applied as per the phase of the illness.Results: Most of the patients were between 15-25 years in SAB group and 35-50 years in NSAB group, educated, semiskilled and married. Tobacco abuse was the commonest followed by cannabis and alcohol abuse. The mean duration of hospital stay in SAB group was 41.40 days and in NSAB group was 43.20 days. Dysphoric mania, aggressive behavior and suicidal attempts were more in SAB group. Mean total YMRS score of SAB group was greater than NSAB group.Conclusions: Maximum patients had onset of substance abuse before the onset of affective symptoms. Manic symptomatology was more severe in substance abusing group

Clinical profile of patients with post-caesarean wound infection: experience of Patan Hospital, Nepal

Introduction: Would infection following caesarean delivery adds physical, psychological, and health burden to individual and health care system. This hospital based study aim to determine the rate of infection, the risk factors, pathogens and antibiotic sensitivity. Method: A prospective study was carried out to analyze the wound infection in women following caesarean delivery in the Department of Obstetrics and Gynecology, Patan Hospital, Nepal, between January 2018 to December 2018. The study was approved from the institutional review committee. Clinicodemographic data during perinatal period of caesarean delivery were descriptive analyzed in relation to wound infection. Result: Wound infection occurred in 102 (3.1%)of 3285 caesarean section (of total 7131 deliveries during the study period. The caesarean SSI rate was 3.1%, all were incisional SSI (84 superficial and 18 deep) and there were no organ-space SSI. Majority (81.3%) SSI cases were detected in emergency LSCS. Coagulase Negative Staphylococci was the most common organism isolated from wound swab. Routine postoperative antibiotics did not have a major impact in reducing wound infection rate. Multiple per vaginal examinations, prolonged rupture of membrane and staples for skin closure were more commonly associated with SSI. Conclusion: Reduction in caesarean rate is the major key factor for decreasing the post caesarean wound infection. Protocol should be developed and strictly implemented by all the health care professionals in order to minimize and prevent the infection rate after caesarean section. Keyword: Caesarean section, surgical site infection (SSI), wound infectio