Super refractory seizures with autoimmune encephalitis and ventilator associated pneumonia: a case report

Autoimmune encephalitis is an immune-mediated syndrome with sub-acute to chronic presentations, such as memory impairment, altered sensorium, behavioral abnormality, psychosis, and seizures. Treatment as such must not be procrastinated due to pending laboratory workup, as early recognition and initiation of therapy prevents long term neurological sequelae. This is a case report of an 11-year-old male who presented with neuropsychiatric symptoms, altered sensorium and high-grade fever which evolved into refractory status epilepticus and autonomic dysfunction. While his MRI had positive findings of encephalitis, he tested negative for infectious diseases and antibody panels.

Clinical management and outcome of extreme preterm infant with respiratory distress syndrome, early onset sepsis and necrotizing enterocolitis stage 1: a case report

Respiratory distress syndrome, although it is common in extreme preterm infants, early and effective management will aid in better outcome. Preterm also comes with multiple co- morbidities which has to be considered and stepwise treatment is utmost important in tackling them. Here, we report a case of an extreme preterm baby who experienced respiratory distress syndrome with early onset sepsis along with necrotizing enterocolitis. Early diagnosis and management helped in the discharge of the infant in stable condition

An approach of clinical pharmacist pertaining to solve drug related problems in pediatric patients

Background: The objectives of the study were to assess the outcomes of clinical pharmacist intervention in solving drug related problems in pediatric patients and to identify the drug related problems in accordance with the causes observed.Methods: It was a prospective observational study done over a period of six months (October 2019 to March 2020) at Apollo children’s hospital in Chennai.Results: Total of 480 subjects were enrolled into the study, out of which 248 were male children and 232 were female children. The patients were divided into 4 age groups. In this study 60.41% pediatric patients were prescribed with less than 5 drugs 290 (60.41%). Drug related problems which were identified during the study was classified according to Pharmaceutical Care Network Europe (PCNE) and drug-related problem (DRP) classification (v9.00). The most frequent DRP was drug choice problem 37 (33.33%). The total number of caused drug related problems was 73 and same number of interventions was given by clinical pharmacist. The most frequent cause of drug related problems was identified as dose selection 31 (42.46%). Outcomes of interventions revealed that 70 (95.89%) problems were solved overall.Conclusions: In this study, clinical pharmacist’s level of involvement has shown interesting results. Moreover, they play an essential role in improving patient safety and outcome, reducing cost and providing quality of care for ill patients

A characteristic study of humic acids isolated from Arctic fjord sediments

Humic substances are ubiquitous natural materials found in sediments as a product of biochemical transformation reactions representing a significant proportion of organic carbon cycle on earth. This study involves the analysis of humic substances with special emphasis on humic acids (HAs) in sediments collected from the Kongsfjorden System of Arctic region in June, 2017. The characterization of the isolated HAs were done using various spectroscopic techniques viz. UV-visible, Fluorescence, FTIR and NMR. Isolated HAs were also undergone for elemental analysis along with other characterization. The UV spectral analysis results with a lower E4/E6 ratio suggesting the presence of HAs with high degree of aromaticity and condensation. Indications for the presence of hydroxyl, methyl, methylene, carbonyl, carboxyl, phenol, alcohol and amide groups were obtained from the FTIR spectrums of HAs. NMR spectral characteristics also confirm the presence of OH group as well as the presence of CH protons adjacent to C=X, were X can be any electronegative element. This also confirms the presence of carbonyl group which is also evident in the FTIR spectral studies. Presence of aliphatic regions slightly more dominated with long chain and/or alicyclic moieties rather than methyl groups was also inferred from the results of NMR

IJCM_168A: Cardiovascular disorder risk among the police personnel in Ernakulam District, Kerala, India

Background: Appropriate assessment and management of cardiovascular risk is vital in reducing the occurrence of fatal and non fatal cardiovascular events like stroke or myocardial infarction in high risk occupational group such as Police personnel. Several studies have reported high prevalence of risk factors of cardiovascular diseases (CVD) such as hypertension, high blood lipids, physical inactivity, obesity, positive family history etc among police personnel Objective: To estimate the 10-year risk of cardiovascular events (fatal or non-fatal) among police personnel in Ernakulam City, Kerala, India Methodology: A cross sectional study was carried out among police personnel in various police stations of the district. All the police stations in the district were listed and selected randomly using the MS Excel random number generator. After getting prior permission from the concerned authorities in the Police department, Police personnel above the age of 40 years in Ernakulam city were screened for CVD risk using the WHO – non-laboratory-based CVD risk chart. Data was entered into Microsoft Office Excel and analysed using Jamovi version 2.3.28 Results: Out of 246 participants studied, the mean age was 48.4 + 3.97. Less than half of the participants (44.3%) were Civil Police Officers (CPO) or Senior Civil Police Officer (SCPO). About a third of the participants (32.1%) were having CVD risk in yellow category (5-50 years (OR – 3.36[1.73,6.5]) and duration of service>20 years (OR – 4.9[2.35,10.23] were the independent determinants of higher CVD risk (yellow and orange category) Conclusion: About 35% of the participants belonged to higher risk category (yellow and orange) and duration of service>20 years, age>50 years were the independent determinant

A Case Report on Congenital Adrenal Hyperplasia, Varicella Zoster Infection, Varicella Encephalopathy & Cerebellitis

Congenital adrenal hyperplasia (CAH) comprises a family of autosomal recessive disorder and it will disrupt adrenal steroidogenesis. The most common form of CAH is due to 21-hydroxylase deficiency associated with mutations in the cyp21a2 gene which is located at chromosome 6p21. The clinical features associated with this adrenal steroidogenesis represent a clinical spectrum reflecting to the consequences of the specific mutations. Treatment goals include normal linear growth velocity and “on-time” puberty in affected children. [1] Infection with Varicella zoster virus (vzv) causes chickenpox means Varicella that can be severe in immunocompromised individuals, infants and adults. The primary infection is followed by latency in ganglionic neurons. During this time, no virus particles will produce and no obvious neuronal damage occurs. Reactivation of virus leads to virus replication, which will causes zoster (shingles) in tissues innervated by the involved neurons, inflammation and cell death [2]. Potential complications of this infection are involved in the central nervous system causing encephalitis. An increased risk of this complication is associated with the immunocompromised patient. [3] Keywords: congenital adrenal hyperplasia, varicella zoster infection, varicella encephalopathy, cerebellitis.</jats:p

Humic acids from an Arctic fjord, Krossfjorden, Spitsbergen

Humic substances are ubiquitous materials found in terrestrial and aquatic ecosystems. Humic acids, a diagenetic product can interact with various components present in aquatic sediments. The present research is on the evaluation of sedimentary humic acids from the Krossfjorden glacial fjord situated within the Svalbard archipelago. The results of this study are needed to understand the structural characteristics of humic acids isolated from the fjord. Surface sediment samples were collected from four stations throughout the fjord during a summer period in 2018. Various spectroscopic techniques such as UV-visible, Fourier-transform infrared spectroscopy (FTIR), and Nuclear magnetic resonance spectroscopy (NMR) were applied for studying the humic acids. The elemental composition as well as the presence of tannin and lignin were also analyzed. The results of this study revealed the variation in the structure of humic acids from aliphatic to aromatic from the outer to the inner region of the fjord. This change in humic acids was well supported by the FTIR and NMR results with differences in the spectrums

IJCM_263A: Vaccine Hesitancy in Tribal Communities: A Study on Parents of children under 5 years of age

Background: People who delay or refuse vaccines for themselves or their children are presenting a growing challenge for countries seeking to close the immunization gap. Objective: To determine the proportion of vaccine hesitancy and associated factors among informants of children under five years of age (U-5) within tribal communities in Wayanad. Methodology: A cross sectional study was carried out in tribal colonies of Kalpetta taluk of Wayanad District. Sample size was calculated to 168 based on a study on vaccine hesitancy conducted among tribals at Murshidabad where the prevalence of vaccine hesitancy was 36.9% with an absolute error (d) = 7%. Out of the 175 colonies in the taluk of Kalpetta, 11 colonies were randomly selected. Informants of children ages < 5 years Vaccine hesitancy among parents and guardians was assessed individually for each child in the household. If the informants were hesitant to give any vaccine included in the national immunization schedule they were listed as vaccine hesitant. A total of 208 U-5 children informants were interviewed. Vaccine hesitancy was assessed by adopted SAGE questionnaire. Results: Mean age of the informants was 30.3 + 7.90 and of U-5 children were 2.87 years + 1.45. Majority of the informants were mothers of U-5 children (88.5%), more than 3/4th of the informants belonged to Paniya tribe, most of the participants were unemployed (64.9%). Vaccine hesitancy to any of the vaccine in the immunization schedule was found among 23 participants (11%), majority were hesitant to take Pentavalent vaccine 12(5.76%). Fear of needles, too many vaccinations at 1 sitting and adverse effects following vaccinations were common reasons for being hesitant. Conclusion: The vaccination program is driven by health workers reducing vaccine hesitancy, however with greater motivation and awareness among the community vaccine hesitancy can be further reduced