STATISTICAL ANALYSIS OF THE ANTIMICROBIAL ACTIVITY OF WRIGHTIA TINCTORIA LEAF AND BARK EXTRACTS

Objective: Wrightia tinctoria has been extensively used in Folk medicine. It has been reported to have good analgesic, anti-inflammatory, anthelmintic, antiulcer, antidysentric, antidiabetic, anticancer, antipyretic activities and also effective in the treatment of psoriasis. The present investigation was undertaken to statistically evaluate the antimicrobial activity of the leaf and bark extracts of Wrightia tinctoria. Methods: The antibacterial and antifungal activities of leaf coconut oil extracts (1, 4, 7 and 15 days exposure to sunlight), bark and leaf methanol, ethyl acetate, chloroform and petroleum ether extracts of Wrightia tinctoria (Apocynaceae) against nine pathogenic bacteria such as Bacillus cereus, Enterobacter faecalis, Salmonella paratyphi, Staphylococcus aureus, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae, Pseudomonas aeruginosa and Serratia marcescens and two fungi viz. Aspergillus niger and Penicillium chrysogenum were statistically analyzed so as to evaluate the medicinal potential of these plant extracts. Results: Wrightia tinctoria leaf and bark methanol extracts were found to be potent extracts and their activity is quite comparable with the standard antibiotics such as tobramycin and gentamycin sulphate screened under similar conditions. Conclusion: Methanol extracts of the leaves and bark of Wrightia tinctoria can be used as a potential external antiseptic and can be incorporated into drug formulations

Occurrence of Blast Disease in Hybrid Napier

Hybrid napier, a cross between pearl millet (Pennisetum glaucum) and napier grass (Pennisetum purpuriam) is a popular cultivated fodder grass in India. It is popular due to high yield, palatability and adaptability to varying soil and climatic conditions. It is relatively free from most of the pests and diseases and the question of plant protection normally does not arise. However, sporadic incidence of blast like symptoms has been observed in hybrid napier maintained in the college farm and the disease has been confirmed as blast caused by Pyricularia grisea Sacc. The disease causes severe leaf blight in some cultivars leading to leaf senescence. Leaf blast reduced photosynthetic rate of the remaining green parts of infected leaves (Bastiaans, 1991). Bastiaans and Kropff (1993) reported reduction in canopy photosynthesis because of the effect of blast lesions and shading by dead leaf area. Severe leaf blight caused by the pathogen induces production of phytotoxins and disruption of normal biochemical and physiological balance (Young-Ki et al., 2010)

Endometrial pathology in abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a common presenting symptom in gynecological outpatient department. Endometrial sampling could be used as the first diagnostic step in AUB. Aim of our study was to evaluate the endometrial causes of AUB and to observe the incidence of various pathology in different age groups.Methods: A study was conducted on 167 patients who presented with AUB, during the period from July 2015- January 2017.All endometrial curettage and hysterectomy specimens received in the Department of Pathology, Kannur Medical College during  this  period  were included.Results: Maximum numbers of patients were in the perimenopausal age group and normal cycling endometrium was the commonest pattern observed (41.3%).Abnormal patterns noted were hyperplasia without atypia (20.9%), disordered proliferative pattern (16.1%) and endometrial carcinoma (1.7%).Conclusion: Histopathological examination of endometrium showed wide spectrum of lesions from normal endometrium to malignancy. Accurate analysis of endometrial sampling is important in the management of AUB

Gender differences in perceived health related quality of life among persons living with HIV

In the era of HlV/AlDS and in the context of the developing world HIV/AIDS has led to a pandemic. HIV antiretroviral drugs are inaccessible and unaffordable and the only choice that health care providers have is to work towards improving the quality of life of individuals as long as they live with this dreaded disease. This study on 203 seropositive individuals, 102 women and 101 men, was undertaken to find out the differences in the quality of life perceived by women and men living with HIV/AIDS. The WHOQOL-BREF scale was used to assess the quality of life. The findings from this study reveal that men report a poor quality of life in the psychological domain (p<0.01) while women in the sociological domain (p=0.03). The stage of illness does not seem to influence quality of life among women and men. The findings emphasize the need for health providers to assess the QOL among people living with HIV/AIDS. This information would be helpful in planning effective intervention strategies for men and women living with HlV/AlDS in order to be ensured of a quality of life

Is awareness of HIV enough to alter high-risk behaviour? What do HIV positive individuals have to say? A study from south India

This study was done to find out the awareness of HIV among HIV positive individuals before being diagnosed HIV positive. The study also provides information on whether their knowledge influenced their risk behavior if any. This is a descriptive study and data has been collected from 108 HIV positive individuals from Chennai, South India. Awareness of HIV and its mode of transmission were as high as 85%. Gender and literacy has not been a barrier to awareness. In spite of awareness of HIV/AIDS and its spread, 73% of the respondents continued risk behaviour. The respondents included men and women and their reasons for risk behavior and their manifold misconceptions have been reported. The findings call for the need to address these issues in preventive programmes aimed at HIV control

Feasibility of community DOT providers for tuberculosis treatment in HIV infected individuals - A pilot study

Background: This paper summarises our experiences about the role of community DOT providers in management of TB treatment in HIV infected persons in a mainly rural population of Tamilnadu. Objectives: To evaluate the feasibility of employing Community DOT providers for the treatment of tuberculosis in HIV infected persons, to study patients’ acceptance of Community DOT providers in the closely-knit village communities and to find out the attitude and awareness of DOT Providers on TB and DOT. Method: A total of 62 tuberculosis patients (58 males and 4 females) with HIV infection attending the Government Hospital for Thoracic Medicine, Tambaram and Chennai between July 1999 and July 2002 were selected for this study. Patients were given all the doses under supervision (clinic-based DOT) during the initial intensive phase and through Community DOT providers in the continuation phase. Data was collected both from the patients and their DOT providers about their views on DOT, advantages of DOTS, drug intake, treatment adherence, problems faced by the patients and their DOT Providers in addition to the level of awareness of Community DOT Providers on tuberculosis and DOTS. Results: Regarding treatment adherence, 95% of 62 patients had taken >75% of drugs and 39% had taken 100% drugs. DOT was appreciated both by the patients and their DOTS Providers since it is cost-effective and patient-friendly. Conclusions: Community contribution to TB care even among HIV infected population is feasible, affordable and costeffective. There is a need for greater health education and training on tuberculosis and DOTS for community DOT Providers

Pulmonary tuberculosis in HIV individuals: Preliminary report on clinical features and response to treatment

Objectives: To study the clinical, radiological and immunological profile of pulmonary tuberculosis in HIV infected patients and assess the response to short-course chemotherapy regimens. Methods: Seventy eight patients (68 males and 10 females) with HIV infection and having symptoms suggestive of tuberculosis attending the Government Hospital for Thoracic Medicine, Tambaram or the Tuberculosis Research Centre, Chennai were studied. The diagnosis of tuberculosis was based on clinical evaluation, bacteriological examination including sputum smear and culture and chest skiagram. HIV diagnosis was based on two tests (rapid/ELISA), detecting different antigens. CD4+ T cell counts were done on all patients initially and at the end of treatment. Blood tests and skiagrams were repeated at 2 months and at the end of treatment. All the patients were treated with standard (RNTCP) short course regimens. Patients were given all the doses under supervision during the initial intensive phase and through community DOTS providers in the continuation phase. Results: Sixty five patients had culture confirmed pulmonary tuberculosis, of whom 54 had smear positive disease, initially. The radiological manifestations were varied, with 11 subjects having miliary tuberculosis, 54 with non-homogeneous opacities and 10 with cavitation. The mean CD4 cell count at intake was 192 ± 172 cells/cumm. Patients showed good initial response to treatment with significant weight gain. At the end of 2 months of treatment, 91% of patients had sputum cultures negative for Mycobacterium tuberculosis. However, the CD4 % fell significantly by the sixth month. The study is being continued to assess the long-term response to SCC of patients with HIV and tuberculosis. Conclusions: Tuberculosis has a varied clinical presentation in patients with HIV infection. The spectrum of radiographic features ranges from normal to a miliary pattern. Inspite of clinical and bacteriological improvement during treatment, immunologic deterioration may continue

Feasibility of Provider-Initiated HIV Testing and Counselling of Tuberculosis Patients Under the TB Control Programme in Two Districts of South India

BACKGROUND:Provider-initiated HIV testing and counselling (PITC) is internationally recommended for tuberculosis (TB) patients, but the feasibility, effectiveness, and impact of this policy on the TB programme in India are unknown. We evaluated PITC of TB patients across two districts in India considered to have generalized HIV epidemics, Tiruchirappalli (population 2.5 million) and Mysore (population 2.8 million). METHODOLOGY/PRINCIPAL FINDINGS:Starting June 2007, healthcare providers in both districts were instructed to ascertain HIV status for all TB patients, and refer those with unknown HIV status to the nearest Integrated Counselling and Testing Centre (ICTC)--often in the same facility--for counselling and voluntary HIV testing. All TB patients registered from June 2007 to March 2008 were followed prospectively. Field investigators assessed PITC practices and abstracted data from routine TB programme records and HIV counselling registers to determine the proportion of TB patients appropriately evaluated for HIV infection. Patient records were traced to determine the efficiency of referral links to HIV care and antiretroviral treatment (ART). Between July 2007 and March 2008, 5299 TB patients were registered in both study districts. Of the 4701 with unknown HIV status at the time of TB treatment initiation, 3368 (72%) were referred to an ICTC, and 3111 (66%) were newly tested for HIV. PITC implementation resulted in the ascertainment of HIV status for 3709/5299 (70%) of TB patients, and detected 200 cases with previously undiagnosed HIV infection. Overall, 468 (8.8%) of all registered TB patients were HIV-infected; 177 (37%) were documented to have also received any ART. CONCLUSIONS:With implementation of PITC in India, HIV status was successfully ascertained for 70% of TB patients. Previously undiagnosed HIV-infection was detected in 6.4% of those TB patients newly tested, enabling referral for life-saving anti-retroviral treatment. ART uptake, however, was poor, suggesting that PITC implementation should include measures to strengthen and support ART referral, evaluation, and initiation

Perceptions of gender and tuberculosis in a south Indian urban community

Background: The Revised National Tuberculosis Control Programme (RNTCP) in India advocating Directly Observed Treatment-Short course (DOTS) detects nearly three times more male than female TB patients. The reasons for this difference are unclear. An understanding of the community’s health beliefs, perceptions on the disease and behaviour towards TB patients may throw some light on this issue. Material and Methods: A qualitative study using focus group discussions was conducted among men and women of younger and older age groups from lower income neighbourhoods. The information obtained was grouped into themes which included, understanding of TB, vulnerability, access to health care and social responses. Gender differences in community perceptions on TB seem to be critical in issues related to marriage. Results: The stigma of TB is more visible in women than men when it comes to marriage. Men and children were perceived to get preferential attention by their families during illness. While the younger age group, irrespective of gender, accessed care from private providers, the older group preferred a government facility. Awareness of TB was acceptable but it seemed more associated as a respiratory disease and the common symptom associated with TB was cough. Conclusion: This study highlights the need for gender specific intervention strategies to enhance better access of TB services