Primary oral myiasis : a case report

Myiasis is the infestation of live human and vertebrate animal with dipterous larvae which feed on the host?s dead or living tissue. A case of oral myiasis in the maxillary anterior region in a 42-year-old female with neurologic deficit caused by the larvae (maggots) of Musca Nebulo (Family Diptera) is reported. The treatment consisted of manual removal of the larvae by topical application of turpentine oil, oral therapy with ivermectin and surgical debridement of the oral wound

Knowledge, Attitude, and Practice of Health Care Workers in Management of Bio-Medical Waste – A Cross-Sectional Study

Background: Management of Bio-Medical Waste involves a great concern. Therefore, awareness of Health-Care Workers (HCWs) becomes very important as improper management leads to injuries and the spread of infection to the staff, patients, and environment. The objective is to assess the Knowledge, Attitude, and Practice (KAP) among Health Care Professionals regarding Bio-Medical Waste Management (BMWM). Method: This cross-sectional survey was conducted among HCWs at GMC Jammu, India. Study participants were divided into III groups (Group I- 32 Doctors, group II- 48 Paramedical staff including nurses & laboratory technicians, and group III- 20 sanitary workers). Data was collected using a pre-designed questionnaire regarding BMWM and scored as good, average, and poor. Results: In our study, knowledge regarding symbols of BMWM and awareness regarding categories and segregation of BMW was good in I and II groups but averaged in group III. None in group III has attended CME regarding BMWM in the past. In contrast, this percentage was 61% in group II and 31% in group I. Regarding the capping and destroying of needles, 88% of Paramedics were doing it correctly. None of the class IV employees received the booster dose of HBV vaccination. Conclusion: Knowledge regarding BMWM was average in Group I and Group II, whereas Group III had the slightest knowledge. Attitude regarding the BMW was good in the case of groups I and II, Whereas Group III scored average. Practices were scored average in Group I, good in Group II, and poor in group III

Reflections on Sustaining Morale and Combat Motivation in Soldiers

Military morale and motivation formulate the signature strength of a fighting force. However, sustenance of these faculties is a bigger challenge than generating them. The exponential development in the neo-cortex and emerging social structure has made human beings hardcore individualistic. The sense of ‘self’ has become much stronger than the sense of the whole. This results in the recurrent violation of collective identity, as evidenced by the rise in numbers of misconduct behaviors, mutinies, estranged leader-led relations, desertion, fragging, and suicides. Utilizing the lessons from various ecological systems and derived scientific principles, the present paper takes note of significant researches in the area to arrive at a reflective model of Morale and Combat Motivation in soldiers. Firstly, it attempts to understand ‘why and why not the soldiers shall fight’ and subsequently give suggestive guidelines to ‘how they will continue to fight’ with particular reference to the Indian military setup. The model can be utilised by military leaders and policymakers alike who are entrusted with the herculean task of upkeeping battle-mind state of soldiers in military organisations

Otorhinolaryngological myiasis: the problem and its presentations in the weak and forgotten

Introduction: Myiasis is common in tropical regions, but now increasing incidence is seen in the west due to international travel. Otorhinolaryngological myiasis is uncommon and is seen in diabetics, alcoholics or patients unable in self-care.Objectives: To study presentations of otorhinolaryngological myiasis, identify associated risk factors and species of flies causing myiasis.Methods: Clinical findings and co-morbidities of 67 myiasis cases were noted. Maggots were identified, manually removed, and patients were managed with topical treatment, systemic ivermectin and antibiotics.Findings: Thirty-three nasal myiasis, 13 aural myiasis and 5 patients with oral myiasis were noted. Seven patients with head neck wounds myiasis and nine patients of tracheostome myiasis were recorded.Discussion: Warm humid climate of tropical regions is a major concern along with co-existing conditions like poor sanitation, alcoholism, psychiatric diseases and neuropathies. Hesitancy is seen in attendants and health care professionals to deal with myiasis.Conclusion: Awareness about risk factors is important in avoiding myiasis along with prompt treatment which reduces morbidity. Tracheostome myiasis is an under-documented entity rather than a rare presentation.Keywords: Myiasis, Ivermectin, screwworm, Chrysomya bezziana, Musca domestica, Lucilia sericata.Funding: Non

EVALUATION OF EFFECT OF SHAKTIVARDHAK YOG IN UPPER RESPIRATORY TRACT (URT) INFECTIONS

Upper respiratory tract (URT) infection is one of the common causes of physicians visit for children and associated with significant morbidity. Children with recurrent respiratory tract infections represent a great challenge for the paediatrician, from both therapeutic and preventive standpoints. Still in the modern and Ayurvedic world of treatment there is no permanent cure for common cold exist, but the symptom can be treated accordingly. Thus proposed study aims to study effect of immune booster Shaktivardhak yog to reduce frequency of occurrence of URT infections in order to improve general health condition. Present study includes 30 clinically diagnosed children of URT infection of both the gender having age group 3-5 years. Children were selected randomly and treated with immune booster. Shaktivardhak yog as immune booster yog was given for 12 weeks and follow up taken monthly. It is observed that number of incidences of occurring URT infections decreases significantly as p<0.0001 in comparison with the frequency of occurring URT infections on admission with the help of paired t test analyzed by statistical software prism 444. Finding of study shows that Shaktivardhak yog reduces frequency of incidence of URT infections in significant manner

Predictive significance of C reactive protein in spontaneous preterm delivery: a prospective cohort study

Background: To evaluate the predictive significance of C- reactive protein in spontaneous preterm delivery.Methods: A group of 280 pregnant women between 12-22 weeks of gestational age attending antenatal clinic were included in a prospective cohort and followed through the pregnancy, delivery and early puerperium till discharge. Finally details of 250 women were available for analysis. CRP estimation in early pregnancy is done. Patients followed up to delivery. Gestational age determined by LMP or ultrasound estimation. Status of the newborn at birth, and at discharge, and its gestational age is noted. Data were analyzed by descriptive statistics like chi-square test, p-value and odds ratio. Main outcome measures gestational age at delivery and neonatal condition at discharge.Results: Out of 250 patients, 78 (31.2%) were CRP positive and 172 (68.8%) were CRP negative. CRP positivity showed positive association with preterm labour with odds ratio 2.384 (95% CI: 1.153-4.928 & p value 0.01). Neonatal morbidity & mortality was also higher in newborns of CRP positive mothers.Conclusions: CRP positivity in early pregnancy is associated with nearly a two fold increased risk of preterm delivery. Neonatal complications like preterm, low birth weight, septicaemia, birth asphyxia and others are more common in CRP positive mothers

Clinical study of chemotherapy induced febrile neutropenia: talcott’s versus multinational association for supportive care in cancer risk assessment scoring systems

Background: Cancer is a leading cause of death worldwide, accounting for 8.2 million deaths in 2012. Febrile neutropenia (FN) is fever associated with abnormally low neutrophil count signifying an immunocompromised state secondary to malignancy or its treatment. The aim of this study was to evaluate clinical outcome of chemotherapy induced febrile neutropenia.Methods: This was a hospital based prospective, descriptive observational study. Patients of either sex, age (18-90 years), with cancer on chemotherapy, single oral temperature ≥101°Fahrenheit (38.3°C) or a temperature ≥100.4° Fahrenheit (38.0° C) for ≥ one hour with absolute neutrophil counts <500 cells/mm3 or <1000 cells/mm3 with a predicted decrease to less than 500 cells/mm3 in the next 24 hours, only with first febrile episode occurring during study period and prior or concurrent radiation therapy were included in this study.Results: Among 87 patients, 70 (80.5%) were less than 60 years and 17 (19.5%) were ≥60 years. The mean age of study patients was 44.46±15 years, (range 18 to 77 years), 31(35.6%) were male and 56 (64.4%) were female. Talcott’s and MASCC risk predicting tool versus outcome, p values for Talcott’s and MASCC were significant (<0.05).Conclusions: Neutropenic fever is a potentially life-threatening complication of cancer chemotherapy. MASCC and Talcott’s model can be used to identify low and high risk patients. MASCC risk index may have a better performance than the Talcott’s model in risk classification

Abnormal semen parameters among males in infertile couples: a cross sectional study from a tertiary care centre

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality

A Cross-Sectional Study on Empathy and its Association With Stress in Medical Students

Introduction: Empathy is the cornerstone of the doctor-patient relationship and a crucial quality associated with better patient compliance and clinical outcomes. This study aims to assess the level of empathy and its association with the level of stress in 3rd and 4th year medical students Methods: This cross-sectional study was conducted in Kathmandu Medical College after taking ethical approval from the Institutional Review Committee and informed written consent from all the participants. The respondents completed a structured questionnaire including demographic profile, Jefferson Scale of Empathy-Student Version, and Perceived Stress Scale. Data were entered and analyzed in Statistical Package for the Social Sciences version 20. Results: A total of 255 questionnaires were obtained with a response rate of 85.2%. The mean empathy score was 101.79 (SD  =  11.26) and the mean perceived stress score was 18.55(SD = 5.56). There was a statistically significant negative correlation between empathy and stress (p-value &lt;0.01) and similar negative correlations were seen in sub-group analysis. Female students had higher empathy scores compared to their male counterparts (p-value &lt;0.01). Fourth-year students reported lower empathy scores than third-year students (p-value &lt;0.05).  Conclusion: Stress was found to be a significant determinant of empathy among medical students. Medical educators must be aware of this and should try to incorporate means to alleviate stress in medical education. Furthermore, effective stress management techniques to preserve empathy in medical students with a view to improve clinical competency and achieve optimum patient care needs to be studied

Evaluation of retinal nerve fibre layer, optic nerve head, and macular ganglion cell analysis measurements for early glaucoma detection using spectral domain optical coherence tomography

Background: Glaucoma is the leading cause of irreversible blindness worldwide. It is very important to diagnose glaucoma in early stages so that timely management can be done. Spectral domain optical coherence tomography (SD-OCT), is a newer device which helps to diagnose glaucoma early. The aim of our study was to evaluate the RNFL, ONH, and mGCA (GCL+IPL) measurements for early glaucoma detection using spectral domain optical coherence tomography (SD-OCT).Methods: Total 30, POAG (primary open angle glaucoma) suspects were compared with 30 normal controls. The Cirrus HD-OCT optic disc cube 200 × 200 protocol was used to measure ONH, RNFL and macular parameters.Results: The average cpRNFL thickness of all quadrants was significantly lower in POAG suspects, (84.13±7.42 μm versus 103.85±8.95 μm, p<0.001). The superior GCL+IPL thickness of POAG suspects and controls was 75.75±2.60 μm and 80.05±1.74 μm, respectively, (p<0.001). The inferior GCL+IPL thickness of POAG suspects and controls was 75.98±2.59 μm and 80.00±1.79 μm, respectively, (p<0.001).Conclusions: The SD-OCT is an important device to diagnose POAG suspects, early. The GCA measurements and average RNFL (especially superior and inferior) measurements, both are equally good to discriminate between glaucoma suspects and normal controls