Assessment of Knowledge and Practices on Rabies among Veterinary Staff in Cuttack City, Odisha

Background: Veterinarians and their staff are placed in the high-risk group of acquiring rabies due to the frequent exposure to rabid animals, experiences as a part of their routine job schedule. Research focusing on rabies control among veterinarians is very limited. This study attempts to assess the knowledge andpractices regarding rabies prevention and control among veterinary staff of Cuttack city.Objectives1. To assess the knowledge on rabies among veterinary staff2. To know the extent of pre- and post-exposure vaccination coverage against rabies among veterinary staff.Methodology: A cross-sectional survey was done among the government veterinary staff in Cuttack city from February to April, 2016. A pretested and predesigned questionnaire was used to collect the data by interviewing method.Results: Most of the surveyed veterinary individuals were aware of the disease rabies. Bite and saliva contact of rabid animals with open wound was known as mode of rabies transmission to 82.5% of the respondents. 42.5% of the study subjects used three or more personal protective measures while handling the animals. Of total 40 respondents, only 22.5% had taken full pre-exposure vaccination against rabies.Conclusion: Despite being a risk group of acquiring rabies because of their job, the total veterinary staff currently vaccinated fully either by pre or post-exposure with anti-rabies vaccine is very low. Proper education and awareness need to be provided to all the veterinary staff regarding seeking dog bite management and the need to take pre-exposure vaccine

Serum Sickness in Patients Receiving Equine Rabies Immunoglobulin

Background: Equine Rabies Immunoglobulin (ERIG) is being used for treatment of category-III animal bite cases. ERIG is economical as compared to Human Rabies Immunoglobulin (HRIG) and hence more affordable to patients in developing countries, like India. Despite high degree of purification, there are reported cases of serum sickness like reactions, anaphylaxis, and other allergic reactions following ERIG administration. Serum sickness is a type III or immune-complex-mediated hypersensitivity reaction that results from the injection of heterologous or foreign protein or serum. Because of fear of side effects (including serumsickness- like reaction) following ERIG, the use of ERIG is minimal among doctors.Objective: (1) To assess the incidence of serum sickness following the administration of ERIG. (2) To see the clinical features of serum sickness.Methods: This is a hospital-based cross-sectional study carried out in the ARV OPD of SCB Medical College, Cuttack, Odisha, India. All patients who received ERIG between September 2016 and December 2016 were included in the study. Side effects were monitored during the subsequent follow-up visits.Results: Out of 1548 category-III animal bite cases who received ERIG, 3.1% developed serum-sickness-like reactions, which manifested as rashes in 97.82%. Most of them had symptoms after seventh day following ERIG administration. Symptomatic relief with oral antihistamines like Cetirizine, Levocetirizine in 60% of cases and Inj. Avil (chlorpheniramine maleate) in 17% was achieved, and only one case required shortcourse corticosteroids.Conclusion: Despite 3.1% of serum sickness cases reported in our present study, the safety of ERIG has been proved and serum sickness can be managed with oral analgesics and antihistamines. Hence ERIG should be encouraged among doctors for use in category-III animal bite patients to prevent rabies

Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia

CLINICO-PATHOLOGICAL CHARACTERISTICS OF LUPUS NEPHRITIS IN EASTERN ZONE OF INDIA: A SINGLE TERTIARY CENTER EXPERIENCE

Objective: Lupus nephritis (LN) is the most common and serious manifestation of systemic lupus erythematosus (SLE) and an important cause of morbidity and mortality. Although diagnosis of LN is straight forward in a patient with SLE and proteinuria, and active urine sediment and perhapsrenal insufficiency, still renal biopsies are required at diagnosis to enable classification of nephritis severity, to provide prognostic information, and toguide treatment. Hence, the objective of this study is to determine the frequency of distribution of different classes of LN based on renal biopsy reports and to correlate it with various laboratory findings.Methods: Retrospective study was done in all patients with LN who had at least one representative renal biopsy and evaluated in NephrologyDepartment of SCB Medical College, Cuttack, in 6-month duration. Various laboratory values were recorded and correlated with histopathologicallupus classifications.Results: Out of 35 patients enrolled, 33 (94.28%) were females and 2 (5.71%) were males. Mean age was 27.53±12.26 years. Majority of cases belong to Class IV followed by Class V. Patients of Class IV LN have a significantly low hemoglobin level. Similarly, serum urea and creatinine are higher in Group IV than other groups, and serum creatinine was found to be significant. 24 hrs urinary protein excretion has a significant correlation with the classes of LN.Conclusion: This study suggests some meaningful correlation between laboratory findings and histopathological lupus classification. This study alsosuggests that renal biopsies are still beneficial for better evaluation of renal status and determination of LN classes.Keywords: Clinico-pathological correlation, Lupus nephritis, Biopsy

The saving-investment relationship revisited: new evidence from regime-switching cointegration approach

This paper exploits the regime-switching threshold cointegration approach to elicit the dynamics in the saving-investment relationship and capital mobility in India. Empirical results offer key insights into the threshold cointegration between the saving and investment rates. We find that the adjustment in investment rate in the upper regime is faster than in the lower regime, indicating the higher mobility of capital in the upper regime. Further, results reveal the absence of firm evidence of long-run vs. short-run asymmetries between saving and investment rates. However, results suggest that cumulative positive and negative sums of saving rates affect investment rates. We have made adjustments to cyclical and trend patterns in our data using Hamilton's (2018) filter and have produced robust results with regard to asymmetric cointegration. The posterior estimation results suggest that a downward trend in the saving rates substantially impacts the investment rates, and widening the gap between saving and investment rates facilitates huge mobility of international capital in the long run

Failure of Antibody Production to Intra-Dermal Rabies Vaccination in Management of Category III Animal Bite: A Case Report

Rabies is a 100% fatal and 100% preventable disease. Intra-dermal rabies vaccination (IDRV) is a World Health Organization (WHO) approved cost-effective method of treatment for animal bite cases, and the Updated Thai Red Cross (TRC) regimen of IDRV method is being widely used in the world for treating category II and III animal bite cases. The VNA titer response ideally should be determined 2–4 weeks (WHO) or 1–2 weeks (ACIP) after the last dose of vaccine to assess whether an additional dose is needed. The acceptable WHO cut-off level, indicating an adequate adaptive immune response, is 0.5 IU/mL; the ACIP cut-off level is 0.1 IU/mL (complete virus neutralization at serum dilution of 1:5).A 3-year-old boy, who had a category III dog bite over his left palm, was treated only with purified verocell rabies vaccine (PVRV) according to updated Thai Red Cross regimen at Jagatsinghpur District Head quarter Hospital, Odisha. Even after taking four doses of PVRV vaccine through intra dermal route, the desired protective antibody titer (>0.5 IU/mL) could not be attained after even one month of completion of treatment.The patient then was further re-treated with purified chick embryo cell culture vaccine (PCEC) Inj. Rabipur through Essen Regimen as intra-muscular (IM) route and along with human rabies immunoglobulin (HRIG) Inj. Berirab P administered locally at the site of bite as per body weight. The patient is protected against rabies using Essen regimen of PCEC and HRIG.Non-responders to IDRV need to be addressed and use of reconstituted volume of IDRV should be given in right route with maintenance of idle cold chain (+2 to +8°C)

Do religious freedom vis-a-vis trade openness affect economic growth?: a cross-country empirical investigation

Does religious freedom steer economic growth impact of trade-openness? This paper employs the method of moments-quantile regression to panel data of 117 developed and developing countries to show that countries that accommodate greater liberal religious beliefs enjoy, on average, higher growth in per capita income via deeper trade openness. Empirical results reveal that the dynamic nexus between trade and economic growth across developing countries is subject to the institutional environment. Therefore, results indicate that trade openness favours economic growth when institutional quality improves

Evaluation of Mass Drug Administration Programme in Gajapati District, Odisha

Background: India contributes to 40% of the total global burden of filariasis. Odisha is one of the endemic states in India. Mass drug administration (MDA) of single dose of antifilarial drugs (DEC & Albendazole) for 5 years or more to the eligible is required to interrupt transmission of the disease. The objective was to estimate the coverage of MDA in the households of Gajapati district and to assess the proportion of population who had consumed the drugs.Methods: Multi stage sampling method was adopted for post MDA assessment in the district. Total of 476 household in 16 villages of four blocks taken out of seven irrespective of rural or urban status. Gajapati were surveyed.Results: Total 476 households were surveyed. The household wise MDA distribution coverage in the district was found to be 87.78% with 1096 (88.15%) of males and 1003 (87.41%) of females have taken the drugs. About 62.93% study population were aware that MDA campaign is done to prevent filaria and 76.47% knew that two types of drug distributed under MDA campaign. The major source of drugs distribution in the district are Angan Wadi Worker (69.76%) and ASHA (27.82%).Conclusion: The necessity for high distribution coverage, high consumption rate and high compliance for the MDA, which is essential for lymphatic filariasis elimination, should be well understood by grass root level workers and the members of the community. Parents need to be motivated to ensure consumption of the antifilarial drugs by their children. Involving school teachers can also improve the consumption among young children

What drives energy consumption in BRICS countries? Evidence from ARDL bounds testing approach

Rapid urbanization, openness and growth in human development index are some of the leading determinants of energy consumption in developing countries, particularly in BRICS economies (Brazil, Russia, India, China and South Africa). Thanks to their innate tendency to converge to the growth path of developed nations, BRICS countries are under increasing pressure to limit high energy consumption-triggered by outsourcing from developed nations. This paper attempts to weigh the relative importance of various determinants of energy consumption in BRICS countries between 1980 and 2016, studying in-depth the long-run co-movement pattern of energy consumption with demographic characteristics (depicting demand pressure) and macroeconomic aggregates (depicting cheap production cost). By leveraging on the trade-off between domestic and foreign demand and by employing the autoregressive distributed lag bounds testing approach, we establish differential effects of various predictors: Whilst an increase in population growth rate, gross domestic product and capital account openness exert a positive and significant impact on energy consumption in Brazil, China and South Africa, foreign direct investment (FDI) and human development appear to enhance energy consumption in India, China and South Africa. The growth in external demand and the FDI inflows appear to have pushed urbanization, leading to greater energy consumption during the study period. Keeping in mind the sustainability goal, stronger green energy practices and sustainable urbanization patterns are needed to curb excessive energy sources.</p