BACTERIOTHERAPY: A NOVEL THERAPEUTIC APPROACH

The alteration in the homeostasis of gut microbiota and harmful bacteria is associated with various kinds of diseases. Many gastrointestinal disorders such as inflammatory bowel diseases, irritable bowel syndrome, colorectal cancer and systemic diseases such as diabetes, obesity and atherosclerosis are due to dysbiosis in human gut. Many recent clinical studies revealed that probiotic is effective in treatment of various ailments by defending against colonization by opportunistic pathogens, production of antimicrobial substances and immunomodulation. Studies have shown that prebiotics and probiotics or the combinations of two i.e. synbiotics can restore the aberrant gut and can improve the health of gut. There is rapid growth and demand of dairy-based probiotics food in the market due to its awareness among the consumers. Bacteriotherapy has good hold future as novel therapy as consumers are looking for safe, cost effective and no adverse side effects therapeutic approach

PREVALENCE OF VARIOUS BETA LACTAMASES AMONG GRAM NEGATIVE BACILLI IN URINARY ISOLATES FROM PATIENTS IN A TERTIARY CARE HOSPITAL OF NORTHERN INDIA

Objective: Urinary tract infections are considered among the most common infections, occurring either in the community or health-care setting. We are left with very few options for the treatment due to rapid development of antibiotic resistance among the organisms. To find out the prevalence of various types of β-lactamases among urinary isolates.Methods: Seven antibiotic discs (HiMedia) were placed in combinations and approximation in a particular sequence on a 90 mm diameter MuellerHintonagar plate.Results: Out of a total 165 urinary isolates, 66 (40%) isolates were positive for extended spectrum β-lactamase (ESBL) production, AmpC β-lactamases(AmpC) activity was present in 31 (18.78%) isolates, co-production of both ESBL and AmpC was seen in 16 (9.69%) isolates, 3 (1.81%) isolatesproduced metallo β-lactamase (MBL), 2 (1.21%) isolates produced both MBL, and ESBL and 1 (0.60%) isolates were positive for inducible third generation cephalosporin resistance.Conclusion: With the presence of such high prevalence of various β-lactamases in clinical isolates of gram-negative bacilli and also other types ofantibiotic resistance, antibiotic policy should be made, and strict adherence should be followed.Keywords: Extended spectrum β-lactamase, AmpC β-lactamase, Metallo β-lactamase

A STUDY ON PATTERN OF ALCOHOL USE USING AUDIT AMONG THE COLLEGE STUDENTS IN A MEDICAL COLLEGE OF NORTH INDIA

ABSTRACT Background: Alcohol and other substance use by medical students poses risks to them and can also have serious consequences on their effectiveness and fitness to practise as tomorrow's doctors. The aim of the study was to find out the prevalence of alcohol use among the undergraduates of Rohilkhand Medical College, Bareilly and the factors affecting its use

SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion

Abstract: The B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in the state of Maharashtra in late 2020 and spread throughout India, outcompeting pre-existing lineages including B.1.617.1 (Kappa) and B.1.1.7 (Alpha)1. In vitro, B.1.617.2 is sixfold less sensitive to serum neutralizing antibodies from recovered individuals, and eightfold less sensitive to vaccine-elicited antibodies, compared with wild-type Wuhan-1 bearing D614G. Serum neutralizing titres against B.1.617.2 were lower in ChAdOx1 vaccinees than in BNT162b2 vaccinees. B.1.617.2 spike pseudotyped viruses exhibited compromised sensitivity to monoclonal antibodies to the receptor-binding domain and the amino-terminal domain. B.1.617.2 demonstrated higher replication efficiency than B.1.1.7 in both airway organoid and human airway epithelial systems, associated with B.1.617.2 spike being in a predominantly cleaved state compared with B.1.1.7 spike. The B.1.617.2 spike protein was able to mediate highly efficient syncytium formation that was less sensitive to inhibition by neutralizing antibody, compared with that of wild-type spike. We also observed that B.1.617.2 had higher replication and spike-mediated entry than B.1.617.1, potentially explaining the B.1.617.2 dominance. In an analysis of more than 130 SARS-CoV-2-infected health care workers across three centres in India during a period of mixed lineage circulation, we observed reduced ChAdOx1 vaccine effectiveness against B.1.617.2 relative to non-B.1.617.2, with the caveat of possible residual confounding. Compromised vaccine efficacy against the highly fit and immune-evasive B.1.617.2 Delta variant warrants continued infection control measures in the post-vaccination era

Prevalence of anaemia and its socio demographic determinants among pregnant women in Bareilly district, Uttar Pradesh

Background: About one-third of the global population is anaemic. WHO has estimated that prevalence of anaemia in pregnant women is 18% in developed countries and relatively high 56% in developing countries. Prevalence of anaemia in South East Asian countries is highest in the world. WHO estimates that even among the South East Asian countries, India has the highest prevalence of anaemia. Aims & Objectives: To determine the prevalence of anaemia among pregnant women and to determine association of anaemia with its socio-demographic factors. Material & Methods: A descriptive cross sectional study was conducted among pregnant women 2nd trimester onwards who came to ante natal clinic of obstetrics and gynaecology department during January-March 2014 by using pre-designed, pretested schedule. A total of 300 pregnant women were clinically examined. Written consent was taken. Haemoglobin estimation was done by Cyanmethaemoglobin method and anaemia was graded according to WHO criteria. Statistical analysis was done using Microsoft Excel 2007 and SPSS Version 17. Results: Overall prevalence of anaemia among the pregnant women was found to be 58.3%. It was seen that 31% of women were illiterate and 38.7% of them belong to upper middle class. Factors such as level of education of women, occupation and consumption of Iron Folic Acid were found to be significantly associated with prevalence of anaemia in pregnancy. Conclusion: A very high prevalence of anaemia in pregnancy needs awareness about late marriage, birth spacing, one or two child norm, antenatal care, green leafy vegetable in diet, mandatory regular supply of IFA tablets to adolescent and pregnant women along with correction of other nutritional deficiencies

Solitary Langerhans cell histiocytosis of the hard palate: a diagnostic pitfall

Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease characterized by an abnormal proliferation of immature dendritic cells. It is predominantly seen in children with adults showing less than ten times the incidence compared to childhood. The clinical presentation and organ involvement is highly variable. Oral manifestations generally consist of mucosal ulceration associated with lesions of the underlying bone. Lesions limited to the oral mucosa are rare. We present a case of a 45-year-old male who presented with an ulcer on the hard palate showing histopathologic features of LCH. The present case is a reminder of the possibility of occurrence of this unusual entity in the oral cavity. Appropriate use of immunohistochemistry is advocated to avoid diagnostic pitfalls

Role of magnetic resonance imaging in the diagnosis of cervical lymph node metastasis with unknown primary

Visual inspection and bimanual palpation are the cornerstones of diagnosis of diseases of the oral cavity. Clinical examination, however, could underestimate the deep spread of tumors and thereby the submucosal extent and limiting accurate pretreatment staging of disease. Imaging provides additional staging information such as precise location and local extent of the tumor which help in the selection of most effective treatment option and extent of surgical excision. Magnetic resonance imaging (MRI) offers an excellent aid for the evaluation of tumors of the oral cavity due to direct visualization of soft tissue in multiple planes. An interesting case of a 35-year-old male patient with extensive lymph nodal mass involving left side of the neck with limited mouth opening is reported. MRI was very helpful in locating the site of primary neoplastic mass along with providing the exact extent of the tumor and its effect on adjacent vital structures

Monitoring of Intracranial Pressure During Intracranial Endoscopy

Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001). Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000): 240-245

Economic evaluation of health technology in the Indian context - A scoping review protocol

Recent scientific advancements have led to the use of many technologies to improve health and well-being[1]. “Technology” may be defined as the “dynamic clustering of techniques, methods, skills and processes used in the production of goods or services or in the achievement of outcomes that deliver desired benefits for consumers”[2]. The World Health Organization defines Health Technology (HT) as the “application of organized knowledge and skills in the form of devices, drugs, vaccines, procedures and systems developed to solve a health problem and improve quality of life”[3]. It comprises a vast array of health services spanning from simple charting to advanced decision support and integration with medical technology. These mainly intend to provide numerous opportunities for transforming healthcare by reducing human error, improving clinical outcomes, facilitating care coordination, improving practice efficiencies, and tracking data over time. This has contributed to better health indicators for numerous countries across the globe [4]. Technologies can often lead to increase in healthcare costs with 50-70% increase attributed to newer technologies in health care. In countries like India where the government spending on health is only ~1.15% GDP[5], people pay out-of-pocket for their healthcare utilization.. This could lead to technologies that are not affordable to potential patient groups. Rising health expenditures lead to the question of value for the money spent. Economic evaluations (EE) provide a framework to calibrate the potential benefits in health outcomes (value) with associated costs.[6] In developed countries, economic evaluations that compare health technologies in terms of their costs and its impact on quality of life aid in decision making on investments in these technology However, this area is emergent in India, somewhat complex, fragmented, and challenging,[7] and will benefit from a systematic study of current practice of economic evaluations of health technologies in Indian context. Therefore, we propose to conduct a scoping review of economic evaluations conducted in India to describe their application and utility. Towards this goal, our review will aim to (1) identify the existing studies in terms of target populations, technologies, and outcomes; (2) describe the type of analyses; and (3) describe the variety of cost and outcome metrics used to generate evidence. This will help in understanding the existing evidence base, broader disease or application areas in which this approach is used, technologies evaluated, and allow to highlight any major challenges/limitations reported for studies in India. More specifically, we will map areas in which economic evaluations was used, and understand the type of information, criteria, methods, and evidence that feature in them