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   2013| September-October  | Volume 6 | Issue 5  
    Online since June 3, 2014

 
 
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ORIGINAL ARTICLES
Prevalence of acute respiratory infections (ari) and their determinants in under five children in urban and rural areas of Kancheepuram district, South India
Dhananjaya Sharma, Kumaresan Kuppusamy, Ashok Bhoorasamy
September-October 2013, 6(5):513-518
DOI:10.4103/1755-6783.133700  
Background: Acute respiratory infection (ARI) is a major public health problem worldwide. It is a significant cause of morbidity and mortality and main reason for utilization of health services among children. Identification and intervention of major risk factors can reduce the burden of ARI among children. Objective: To determine the prevalence of ARI and its risk factors among under five children in urban and rural areas of Kancheepuram district, South India. Materials and Methods: A community-based, cross-sectional study was done in urban and rural field practice areas of Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research (MAPIMS), Melmaruvathur, Kancheepuram (District) Tamil Nadu, south India, during the period of October 2009-February 2010, covering a study population of 500 under five children. Descriptive statistics was done and chi-square was used as test of significance. Results : Overall, prevalence of ARI was found to be 27%. ARI was noticed more among low social class (79.3%), illiterate mothers (37.8%), those living in kutcha houses (52.6%), overcrowded houses (63.7%), use of smoky fuel for cooking (67.4%), inadequate cross ventilation (70.4%), history of parental smoking (55.6%), low birth weight children (54.8%), and malnourished children (57.8%). Rural children (62.2%) were more affected than urban children. Conclusion: The present study had identified low socioeconomic status, poor housing conditions, cooking fuel used, birth weight, and nutritional status as important determinants for ARI. Interventions to improve these modifiable risk factors can significantly reduce the ARI burden among children.
  14,861 38 -
REVIEW ARTICLE
A review of the national tuberculosis and leprosy control programme (ntblcp) of Nigeria: Challenges and prospects
Akaninyene A Otu
September-October 2013, 6(5):491-500
DOI:10.4103/1755-6783.133685  
This review evaluates the National Tuberculosis and Leprosy Control Programme (NTBLCP) of Nigeria to identify challenges and prospects for reducing the burden of tuberculosis (TB) in Nigeria. TB remains the leading cause of death due to an infectious agent globally. Nigeria has the tenth largest burden of TB cases in the world. Rates of TB morbidity and mortality in Nigeria are spiralling despite expressions of political will to control TB and a clearly articulated NTBLCP policy. This is in contradistinction to the global decline in incidence and mortality from TB recorded from 2004. Information for this review was gotten from NTBLCP annual reports and peer reviewed articles. Literature search was conducted using various databases. Through review and analysis, NTBLCP of Nigeria was found to have sub-optimal Directly Observed Treatment Short course (DOTS) population coverage with shortage of skilled TB health workers at Primary Health Care (PHC) level. There were shortfalls in TB laboratories and quality assurance services with weak integration of TB and Human Immunodeficiency Virus (HIV) services. Multidrug-resistant (MDR) TB care services were fledgling and funding for TB control was inadequate. Also identified were weak Advocacy, Communication and Social Mobilization (ACSM) and Public-Private-Mix (PPM). There was poor implementation of TB infection control strategies in health facilities. Prospects for TB control in Nigeria included the existence of a 20 year old TB control programme. Others were the presence of political commitment by the Nigerian government and willingness of development partners to assist. Some effective TB control strategies were also examined.
  14,234 38 -
CASE REPORTS
Priapism: A chronic myeloid leukemia harbinger in exigency
Kalachand Jana, Ramesh Aggarwal, Atul Gawande, Moti Lal
September-October 2013, 6(5):583-585
DOI:10.4103/1755-6783.133752  
Chronic myeloid leukemia may commonly present with atypical manifestations such as hearing loss or chloromas where the underlying diagnosis is revealed only on subsequent blood investigations. This case presented in the medicine emergency with one of the unusual complications of CML and so the diagnosis of CML was not suspected on the first instance. Prompt and comprehensive management of the patient not only saved him but also reiterated the fact that a rare presentation like priapism can sometimes forewarn of a more critical clinical condition.
  5,766 19 -
ORIGINAL ARTICLES
Pediatrician wearing a white coat: A survey of preferences among children and their care givers
Herbert A. Obu, Josephat M. Chinawa, Pius C. Manyike, Ikechukwu Obi, Bismarck C. Eke, Uchenna Ekwochi, S Agwu
September-October 2013, 6(5):508-512
DOI:10.4103/1755-6783.133699  
Background: The practice of wearing white coats, also called laboratory (lab.) coats, by doctors is very common throughout the western world and is also found in the rest of the world. The exact origin of this practice is unclear and its relevance, especially in pediatric practice, is being questioned of late. Objectives: To find out whether the mode of dressing of a pediatrician, especially wearing of white coats, has an influence on the perception of the doctor by parents and/or children in a pediatric ward. Materials and Methods: A structured self-administered questionnaire was used to collect information from the caregivers of children, (and older children) who were admitted in the hospitals during the study period. Three photographs of a doctor dressed differently (formal dressing with shirt and tie and a white coat, formal dressing with shirt and tie but no white coat and casual dressing with T-shirt upon jeans trousers) were shown to the children and their parents/caregivers and were asked to indicate which of the pictures they would prefer as their child's doctor. Results: A total of 227 child/caregiver pairs were interviewed. Ninety-four of the children [41.4%] were females whereas133 [58.6%] were males. The preference of the caregivers on the appropriate dress style for doctors was mostly the corporate attire alone was 74 [32.6%]; and with a white coat was 126 [55.5%]. The preference of the children for the corporate look was also 67 [29.4%] and the corporate look with white coat was 88 [38.7%] as the preferred attire for their attending doctor. Conclusions: Our findings suggest a preference for the wearing of white coats by pediatricians, especially among caregivers and older children.
  5,383 24 -
Risks and indications for cesarean sections in primiparous women: A case-control study
Salah Roshdy Ahmed, Muneera A. Alsheeha, Mohamed Alkhatim Alsammani
September-October 2013, 6(5):541-544
DOI:10.4103/1755-6783.133711  
Objective: The objective of the following study is to determine the indications and risks for cesarean section (CS) among primiparous women. Materials and Methods: This register-based study was conducted from January to December 2011, at the Maternity and Children's Hospital, Buraidah, Saudi Arabia. The total number of primiparous women who delivered during the study period was 1146. Of the 367 who delivered by CS, 13 multiple pregnancies were excluded from the study. The remaining 354 women that comprised the study group were compared with 354 primiparous women who had delivered vaginally during the same period (control group). Logistic regression analysis was used to compare selected variables for the risk of CS. Results: Of the total 1146 primiparous women who had delivered during the study period, 32% (n = 367) underwent CS, with most (71.7%, n = 263) undergoing an emergency CS. Common indications for CS were fetal distress (30%, n = 110), breech presentation (19.3%, n = 71), failure of labor progression (18.8%, n = 69), and failure to induce labor (11.7%, n = 43). Logistic regression analysis showed that the rate of CS increased significantly in association with lower maternal age (odds ratio [OR] = 1.868, 95% confidence interval [CI] = 1383-2.523, P < 0.0001) and a fetal weight of ≥4 kg (OR = 3.491, 95% CI = 2.082-5.854, P < 0.0001). No fetal or maternal mortality was reported. Conclusion: This study shows that the cesarean section rate (CSR) is increasing. Common indications for CS were fetal distress, breech presentation in labor, failed induction of labor, and failure to progress. This increase in the CSR was significantly associated with younger maternal age (≤22 years) and a fetal birth weight ≥4 kg.
  5,390 17 -
CASE REPORTS
Fatal complications of Plasmodium vivax malaria: A series of three case reports
Deepak Sundriyal, Naveen Kumar, Arun Chandrasekharan, Brijesh Sharma, Itish Patnaik, Ulka Kamble
September-October 2013, 6(5):578-580
DOI:10.4103/1755-6783.133748  
Plasmodium vivax malaria once thought to be benign, is now being seen increasingly as complicated disease in various manifestations. These complications include cerebral malaria, acute respiratory distress syndrome, acute pancreatitis, hepatic dysfunction, coagulopathy-associated hemorrhages, and others. Even if at the onset, disease appears benign, clinicians should be careful to watch for the complications and timely management.
  5,350 19 -
ORIGINAL ARTICLES
Fasting in pregnancy: A survey of beliefs and manners of Muslim women about Ramadan fasting
Mozhgan Firouzbakht, Azadeh Kiapour, Bita Jamali, Fatemeh Kazeminavaei, Fatemeh Taghlilin, Ali Morad Heidari Gorji
September-October 2013, 6(5):536-540
DOI:10.4103/1755-6783.133710  
Background: Fasting during Ramadan is compulsory in the Muslim faith. Although pregnant women may be exempted, many still choose to fast because of a confluence of social, religious and cultural factors. Objective: Little is known about the physiological effects of fasting during Ramadan on the mother or unborn baby, and thus nurses and other health-care providers are faced with the difficult task of providing appropriate medical advice to Muslim women regarding the safety and impact of their fasting. In this study, we examined the practice of fasting among pregnant Muslim women in Amol/Iran, and examined their beliefs on fasting during the holy month of Ramadan 2011. Materials and Methods: This is a retrospective study of all Muslim women in Amol who were pregnant and received antenatal care in healthcare center during the month of Ramadan. Exclusion criteria were all women with any problem in pregnancy. A questionnaire was tool of study. Data were analyzed with Statistical Package for the Social Sciences software (SPSS) (P < 0.05). Results: From 250 questionnaires, 215 were responded and collected. 31.8% pregnant women fasted during Ramadan. The average time of fasting was 9.88 days. There was a significant relationship between parity (0.035) and gestational age (0.049) and fasting. 85% of women believed that fasting during pregnancy is a ritual. 71.7% women did not change their prenatal care. 73.5% of pregnant women consulted the obstetrician about fasting. The most common complication in mother was fatigue and weakness. The average size of the head circumference and length of newborn was normal. Conclusion: Midwifes and other health workers need to learn as much as possible about the multicultural best practices and research-driven information about fasting in order to help Muslim women make informed decision.
  4,490 25 1
Obstetrics fistula repairs in Kano, Northern Nigeria: The journey so far
Zainab Datti Ahmed, Hauwa Musa Abdullahi, Amiru Imam Yola, Ibrahim Adamu Yakasai
September-October 2013, 6(5):545-548
DOI:10.4103/1755-6783.133712  
Background: Obstetric fistulae are still very common in developing countries with many patients living with this agony due to the huge backlog of untreated cases. This study aim to look at the large number of cases repaired and the good outcome they had, from a single center in Northern Nigeria, over a 12 months period, at Murtala Muhammed Specialist Hospital, Kano. Materials and Methods: We review case files of 288 patients that had fistula repair between October 2011 and September 2012. The result was analyzed using statistical Package for the Social Sciences version 18 and presented in tabular forms. Results: A total of 343 patients were seen at the center with vesicovaginal fistula, rectovaginal fistula or both. 288 (83.97%) had the repair and all were successfully closed with only 11.1% of those repaired having stress incontinence. All cases were done through the vaginal route using spinal anesthesia and had no significant surgical or anesthesia-related complications. Conclusions: We believe with good commitment and training of more fistula surgeons the reservoir of untreated patients in developing countries will reduce. Effective health education, provision of skilled birth attendant at delivery and presence of adequate obstetric emergency facilities is corners stone in obstetric fistulae prevention.
  4,332 18 -
CASE REPORTS
Acute glomerulonephritis in dengue hemorrhagic fever: A rare case report
KR Meena, Pradeep Kumar, Anita , Premila Paul
September-October 2013, 6(5):581-582
DOI:10.4103/1755-6783.133749  
An 11-year-old male child presented with fever, bodyache, swelling over the whole body, and oliguria. He had hypertension. Urine microscopy showed hematuria and glomerular casts. Renal functions were deranged and had low complement C3 level. Chest X-ray showed plural effusion and ultrasonography abdomen showed mild ascitis. The immunoglobulin (Ig)M and IgG enzyme-linked immunosorbent essay for dengue virus were positive. Diagnosis of dengue hemorrhagic fever with acute glomerulonephritis was made. He was managed with maintenance fluid, antihypertensive medicine and supportive care. He recovered gradually and was discharged 12 days after admission.
  3,828 21 -
Egg and larvae of filarial worm in fine-needle aspiration smears of lymph node
Jitendra Singh Nigam, Dinesh Kumar, Vatsala Misra, Kachnar Varma
September-October 2013, 6(5):569-570
DOI:10.4103/1755-6783.133745  
Filariasis is a major health problem in tropical countries like India. Detection of egg with or without larva in fine-needle aspiration cytology (FNAC) is very unusual despite the high incidence of this parasite in endemic zone. Early diagnosis and treatment prevent the more severe manifestations of disease. A 6-year-old male from eastern Uttar Pradesh presented with the complaints of axillary swelling, fever and loss of appetite. On examination, swelling was 3 cm × 2 cm in size, freely mobile, firm and non-tender. FNA was performed and air-dried smears were stained with Giemsa stain. Smears showed many short and blunt larvae without any distinct sheath and nuclei. Numerous round to oval eggs with short coiled larvae inside them were also seen. A diagnosis of filarial lymphadenopathy was made. The case was considered worth documentation to highlight the finding of filarial eggs in FNA of lymph node, which can be missed or misdiagnosed by an unexperienced pathologist leading to delayed or wrong treatment of a curable disease.
  3,605 21 -
An interesting case of fever, pancytopenia and hyperpigmentation
Swayamsidha Mangaraj, Ganeswar Sethy, Samira Ku. Behera, Nirmala Ch. Sahu
September-October 2013, 6(5):586-588
DOI:10.4103/1755-6783.133754  
Vitamin B 12 deficiency is a rare cause of fever of unknown origin. We describe here a case report of a 24-year-old pure vegetarian male who presented to us as pyrexia of unknown origin (PUO). After meticulous evaluation and exclusion of infective, inflammatory and endocrine causes, the cause of illness was attributed to Vitamin B 12 deficiency. There was swift and dramatic recovery with parenteral Vitamin B 12 supplementation. Vitamin B 12 deficiency should be borne in mind, whereas evaluating a febrile patient particularly with pancytopenia and hyper pigmentation as it is one of the rarer, but easily correctable and reversible causes of PUO.
  3,437 20 -
ORIGINAL ARTICLES
Prevalence and etiology of sexually transmitted infections in a gynecologic unit of a developing country
Fusi-Ngwa Catherine Kesah, Vincent Khan Payne, Augustine Asakizi
September-October 2013, 6(5):526-531
DOI:10.4103/1755-6783.133708  
Background: Despite enormous sensitization and management options available for sexually transmitted infections (STIs) in the last 2 decades, these infections remain highly endemic in certain parts of Cameroon. This is a descriptive study of genital hygiene and predisposition to STIs in some women in Dschang, West Region, Cameroon. Materials and Methods: A total of 2172 consenting women seeking gynecological care at the Dschang District Hospital from 2009 to 2010 were interviewed, examined, cervical/blood specimens collected, and analyzed. Results: Inadequate healthcare systems; lack of reproductive health knowledge; vaginal washing with contaminated water or chemicals; contaminated sanitary towels or gynecologic equipment; unsterile sharps; dirty and damp lavatories; synthetic and tight underwear; multiple or concurrent sex partners; primitive traditions; myths; polygamous and inherited marriages; asymptomatic carriage of pathogens; self-medication; antibiotic abuse; traditional therapy; reinfections; poverty; poor sanitation; and illiteracy were related to genital conditions identified in 1466 (67%) study subjects, excluding 41 (2%) cases with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) only. In total, 1353 (62%) patients were infectious cases, 113 (5%) had noninfectious vaginitis, 171 (8%) were positive for HIV/AIDS serology, with 6% having concurrent genital infections. Of the 1507 patients diagnosed with STIs, 62% were symptomatic and 7% asymptomatic comprising 5% convalescent and 2% healthy carriers. Bacterial vaginosis 24%, vaginal candidiasis 18%, chlamydia 15%, and active syphilis 11% predominated over trichomonas, gonorrhea, hepatitis B, herpes, and warts with rates ≤1%. Conclusion: In mitigation, hand washing, clean toilets, sexual behaviors that contribute to STIs, delay sexual debut, condom usage, rational employment of examination methods, improved medical diagnostics testing both men and women, attitude change and prevention education were emphasized on.
  3,263 25 -
The epidemiology of HIV seropositive malaria infected pregnant women in Akure Metropolis, Southwestern Nigeria
Ajibade Kwashie Ako-Nai, Blessing I. Ebhodaghe, Patrick O. Osho, Ebun A. Adejuyigbe, Folasade M. Adeyemi, Adeniran A. Ikuomola, Olakunle O. Kassim
September-October 2013, 6(5):519-525
DOI:10.4103/1755-6783.133703  
Background: HIV increases the risks of malaria in pregnant women, while maternal human immunodeficiency virus (HIV) viral load also facilitates perinatal transmission to neonates. Malaria and HIV coinfection has been shown to exacerbate adverse pregnancy complications. Our study was designed to determine the HIV prevalence of pregnant women at an antenatal clinic in Akure in southwestern Nigeria, investigate the relationship between dual HIV and malaria infection and HIV viral load and CD4+ T cell counts. The study also estimated the risks of adverse pregnancy outcomes in a selected cohort of 74 pregnant women. Materials and Methods: We evaluated the HIV serostatus of 3,225 pregnant women, who attended the antenatal clinic between August 2012 and April 2013. A cohort of 74 pregnant women was selected for the investigation of the relationship between coinfection of HIV and malaria and HIV viral load and CD4+ cell counts. Their HIV status was determined during three trimesters of pregnancy by both HIV-1/2 strips and confirmatory enzyme-linked immunosorbent assay (ELISA) method. Malaria parasitemia was determined by Giemsa-stained thin and thick blood smears. CD4 cell count was by flow cytometry using the CyFlow Counter (Partec, Germany). Viral load estimated by Amplicor HIV-I monitor assay. Results: We found 3.53% prevalence of HIV serostatus among the 3,225 pregnant women who were screened. Forty-four of the 74 subjects were HIV positive and 30 were HIV negative controls. The results show HIV infection among the pregnant women reduced the CD4 cells from a mean of 750 cells/ml for HIV negative women to a mean of 363 cells/ml for HIV seropositive women. Additionally the presence of malaria more than doubled the HIV viral load from a mean of 7,270 ribonucleic acid (RNA) copies/ml for HIV positive women without malaria to 15,148 RNA copies/ml for HIV positive women with malaria. Conclusion: In this study, HIV infection significantly increased risk of acquiring malaria in pregnant women (odds ratio (OR) = 2.27). Dual HIV/malaria infections exacerbated adverse pregnancy outcomes
  3,113 29 -
Prevalence and risk factors of Clostridium difficile - associated diarrhea in Iranian hospitalized patients
Shohreh Farshad, Mehdi Azami, Gholamreza Pouladfar, Mazyar Ziyaeyan, Maneli Aminshahidi, Abdolvahab Alborzi
September-October 2013, 6(5):554-558
DOI:10.4103/1755-6783.133715  
Context: Clostridium difficile is a frequently identified cause of nosocomial gastrointestinal disease. It has been proved to be a causative agent in antibiotic-associated diarrhea. Aims: This study was aimed to determine the prevalence and risk factors of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients with nosocomial diarrhea in Shiraz, Iran. Materials and Methods: In this study from June to December 2012, a total of 122 stool samples of patients with nosocomial antibiotic associated diarrhea that were admitted in to the intensive care units (ICUs) (41), surgery (16) and organ transplantation wards (65) in Namazi hospital, Shiraz, Iran were collected. All stool samples were cultured on a selective Cycloserine Cefoxitin Fructose Agar and grew isolates were analyzed by cytotoxicity assay and enzyme immune assay for detection and conformation of toxins. Results: The mean ± standard deviation of age was 49.4 ± 13.8 and 75 (61.5%) of patients were male. Nine (7.4%) cases of nosocomial diarrhea were diagnosed as CDAD that all isolates were toxigenic. Five of 65 organs receive transplant patients and 4/41 hospitalized patients in ICUs ward were developed CDAD. None of samples that obtained from surgery ward infected with C. difficile. Ceftazidime and Ampicilline-Sulbactam were the most common antimicrobial drugs used. Multivariate analysis showed that use of diapers, antibiotic and immunosuppressive therapies were significantly associated with CDAD (P < 0.05). Conclusions: Hospital transmission of C. difficile commonly occurred, supporting infection-appropriate measures directed toward the reduction of CDAD.
  2,919 19 -
Perception and practices of Lagos state residents on the prevention and control of malaria in Lagos, Nigeria
Kikelomo O. Wright, Fola Tayo, Olumuyiwa O. Odusanya, Yetunde A. Kuyinu, Babatunde Odugbemi, Tolu Arowolo, Omowunmi Bakare
September-October 2013, 6(5):503-507
DOI:10.4103/1755-6783.133698  
Background: Malaria remains one of the major public health problems worldwide. It is an important cause of death and illness in children and adults in sub-Saharan Africa accounting for over a million deaths per year. The purpose of this study was to determine the perception and practices of the Lagos state residents on malaria. Materials and Methods: A descriptive cross-sectional study was conducted in five of the 20 local government areas (LGAs) in Lagos Nigeria. Using a multistaged sampling method, 5 LGAs and 12, 500 study participants were selected. The survey instrument was a structured, pretested, interviewer-administered questionnaire which sought for information on knowledge, attitude, and practices of the respondents on malaria. Data analysis was done using Epi-info V6.04d software. Results: The mean age was 35.5 ± 10.5 years. There were 8697 females (69.7%) and 3786 (30.3%) males. About 84% of the respondents correctly knew that malaria is transmitted by mosquitoes. Headache was the most recognized symptom (56.6%), while vomiting was the least (17.9%). About half of the participants recognized cleaning the environment as a primary preventive measure and the same number claimed to do so. Approximately, half of respondents claimed usage of insecticide-treated bed nets. Sulphadoxime-pyrimethamine (Fansidar) was the most frequently used (32.7%) antimalarial agent and the use of artemisinin combination therapy was low. Conclusion: Knowledge of malaria symptoms was average and the use of preventive measures was suboptimal. Increasing awareness of all stakeholders on traditional and contemporary preventive measures may enhance the control of this health condition.
  2,834 32 -
CASE REPORTS
Adenoid cystic carcinoma of buccal mucosa with extensive hyalinization: A unique case report
Kumaraswamy LR Naik, Pushparaja Shetty, Padmaraj Hegde
September-October 2013, 6(5):571-574
DOI:10.4103/1755-6783.133746  
Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary glands, 50% of which affect the minor salivary glands. ACC is known for its prolonged clinical course, multiple recurrence rates, and delayed onset of distant metastasis. The tumor usually shows one of the three histopathological variants which are cribriform, tubular, or solid pattern. Here we present a case of ACC affecting rightbuccal mucosa which histopathologically showed cribriform pattern with abundant hyalinization. Surgical excision was the only treatment done without any additional modalities and patient is free of disease since 10 years.
  2,741 19 -
ORIGINAL ARTICLES
Vaccination sessions; challenges and opportunities for improvement: Experiences from Karnataka
Narayana Holla, Sagar Borker, Shruthi Bhat
September-October 2013, 6(5):559-564
DOI:10.4103/1755-6783.133716  
Background: It is estimated that immunization averts between 2 and 3 million deaths every year. India has declared 2012-2013 as a year of intensification of routine immunization. Because the doctors train the health workers and paramedics in proper implementation of vaccine delivery, their knowledge should be perfect and no error or ambiguity of any sort is pardonable. Research Question: What is the operational knowledge about immunization among doctors? What is the effect of training in routine immunization among doctors? What is the effect of supportive supervision on field staff? Setting: Directorate of Health Services, Bangalore on 06/03/2007, East Godavari on 11/03/2007, Bangalore Mahanagar Pallike on 5-7/10/2007 and Mandya on 8-10/03/11. Supervision sessions were conducted at 33 sites of the Dakshina Kannada district. Study Design: This study is cross-sectional. Participants: Participants include RCH officers, medical officers, and immunization field staff. Materials and Methods: The questionnaire and interview method was followed. The pretest questionnaire was administered to RCH officers and MOs. The training program in two of these four areas was held immediately and the impact of training through the posttest was studied in one area. Supportive supervision sessions were then conducted in purposively selected immunization sites. Results: The overall knowledge among doctors improved after the training session. The mean score improved significantly in all the variables included in the study. Supportive supervision was also found useful in improving the routine immunization sessions at the field level.
  2,530 27 -
Brucella infections in high-risk population and in patients hospitalized for fever: A serological study at Kolar, Karnataka
Dhanalaxmi Aniyappanavar, Subba Rama Prasad, Khaji Mohammed Tanveer, Srinivasa Rao
September-October 2013, 6(5):549-553
DOI:10.4103/1755-6783.133714  
Background: Brucellosis, one of the world's major zoonoses, is endemic in many parts of India. It is an occupational hazard for veterinary employees, butchers, dairy personnel, and laboratory workers. There is no information available on human brucellosis from Kolar region of southern India. Methods and Materials: Serum samples from 154 adults, at high risk for brucellosis and residing in and around Kolar, Karnataka, India, were screened for antibodies to brucella by the Rose Bengal plate agglutination test and immunoglobulin (Ig)G Enzyme-linked immunosorbent assay (ELISA). Sera detected to be positive by these screening tests were further tested by standard tube agglutination test (SAT), SAT with 2 Mercaptoethanol, and IgM ELISA. In addition, serum samples from 100 hospitalized patients with prolonged fever were also subjected to the above tests to detect acute brucella infections among patients. Results: Among the 154 individuals at high-risk screened, brucella antibodies were detected in 15 (9.74%) of the subjects. The seropositivity rate was 30.76% among veterinarians, 14.28 among cattle businessmen, 9.67% among butchers, and 3.79% among animal owners. Seropositivity was associated with drawing blood and exposure to animals during parturition. Symptoms such as myalgia, low back ache, and joint pains were significantly more among seropositives. When the results of all the tests were taken together, 33.3% seropositives could be classified as past brucella infections and 66.6% as possible chronic brucella infections. Among the 100 hospitalized patients with prolonged fever acute brucellosis was diagnosed in one patient. Conclusion: Brucellosis is an important zoonosis in Kolar region. Among individuals at high risk many have serological profile of possible chronic brucellosis; such individuals may need treatment and follow-up.
  2,389 22 -
CASE REPORTS
Local invasive Actinomyces infection mimicking liver tumor
Mustafa Kerem, Ali Celik, Ozlem Erdem, Irfan Tastepe
September-October 2013, 6(5):567-568
DOI:10.4103/1755-6783.133720  
Actinomycosis is a chronic, suppurative disease characterized with granulomatosis and fibrosis. Although it causes oral and cervicofacial infections generally, in 20% of cases it is abdomino-pelvic located. A 24-year-old male patient was examined with the diagnosis of diaphragm, adrenale and chest wall-invasive mass in liver vault. Exploration and mass excision were made with pre-diagnosis of liver tumor and the pathologic result of the patient was reported to be Actinomyces infection. Having no problem in the post-operative period, patient was discharged following the arrangement of antibiotic treatment.
  2,028 15 -
Isolation and identification of Mycobacterium tuberculosis from pediatric patient having Pott's disease: Case report of two cases
Dnyaneshwari P. Ghadage, Archana Bhimrao Wankhade, Rupali J. Mali, Arvind V. Bhore
September-October 2013, 6(5):575-577
DOI:10.4103/1755-6783.133747  
A 4-year-old young male child was investigated for spinal tuberculosis (TB) and Mycobacterium tuberculosis was isolated from the sample. In another case, a 2-year-old male patient with Potts spine, M. tuberculosis was isolated from the pus sample. In both cases, Bacillus Calmette-Guιrin (BCG) scar was absent. BCG vaccination may prevent bone TB.
  1,998 16 -
LETTERS TO THE EDITOR
"Revised National Tuberculosis Control Programme" in India, a strong need to revise
Samir Anil Singru, Anagha Samir Singru
September-October 2013, 6(5):596-598
DOI:10.4103/1755-6783.133776  
  1,745 25 -
COMMENTARY
The performance of a tuberculosis control program in a high burden country: The Nigeria situation
Kingsley N. Ukwaja, Cajetan C. Onyedum
September-October 2013, 6(5):500-502
  1,609 34 -
ORIGINAL ARTICLES
Left behind radiographs in an emergency setting of a tertiary care centre in India: Time to rethink
Mukesh K. Yadav, Anmol Bhatia, Akshay K. Saxena, Niranjan Khandelwal
September-October 2013, 6(5):532-535
DOI:10.4103/1755-6783.133709  
Context: The problem of left behind radiological investigations is encountered round the world, which adds to the wastage of resources. Aims: This article attempts to highlights the problem of left behind conventional radiographs in an emergency setting in a tertiary care center of northern India. Settings and Design: Tertiary care center, retrospective study. Materials and Methods: The number of radiographs left behind in the emergency over a period of 14 months was retrospectively assessed. The radiographs were classified as normal, abnormal and technically poor. The technically poor radiographs included the ones with poor centering, inadequate inspiration and improper exposure factors limiting the interpretation. Statistical Analysis Used: Discrete categorical data is presented as n (%). Results: A total of 2783 radiographs were left behind. The total cost of these left out radiographs worked out to 139,150 Indian rupees. Of the 2783 radiographs, 1108 had positive findings (39.8%) and 1399 were normal (50.2%). The technically poor radiographs were 276 (10%) and no definite conclusion could be given as no clinical history was provided in the majority of these cases. Conclusions: A joint cost-effective strategy should be formulated by hospital administration, radiology and allied departments to overcome the problem of ever increasing bundles of left out radiography, especially in the developing countries having resource-poor settings.
  1,546 18 -
COMMENTARY
Role of physician's knowledge in routine immunization coverage
Tanmay Mahapatra
September-October 2013, 6(5):564-566
  1,177 22 -
LETTERS TO THE EDITOR
Unusual presentation of a common disease: Labial cysticercosis with florid granulomatous reaction; diagnosis by fine-needle aspiration cytology
Prem Singh, Monika Garg, Nanak Chand Mahajan
September-October 2013, 6(5):594-595
DOI:10.4103/1755-6783.133774  
  1,169 19 -
Deep cerebral vein thrombosis in a case of breast carcinoma
Trilochan Srivastava, Kadam Nagpal
September-October 2013, 6(5):593-594
DOI:10.4103/1755-6783.133772  
  1,129 26 -
Assessment of risk from oral intake of arsenic contaminated rice: A necessary action
Viroj Wiwanitkit
September-October 2013, 6(5):592-593
DOI:10.4103/1755-6783.133769  
  1,107 15 1
Acute primary Epstein-Barr virus infection in a well-to-do man: Existence in the area with high rate of seropositivity
Kamon Chaiyasit, Viroj Wiwanitkit
September-October 2013, 6(5):590-591
DOI:10.4103/1755-6783.133758  
  986 16 -
Effective health care system
Shunhai Qu, Viroj Wiwanitkit
September-October 2013, 6(5):591-592
DOI:10.4103/1755-6783.133763  
  960 18 -
Acute hepatitis A infection in a postoperative patient: A tropical nosocomial infection to be mentioned
Somsri Wiwanitkit, Viroj Wiwanitkit
September-October 2013, 6(5):589-589
DOI:10.4103/1755-6783.133755  
  934 15 -
T cells epitopes within hemagglutinin of H7N9: A clue for vaccine development
Viroj Wiwanitkit
September-October 2013, 6(5):589-590
DOI:10.4103/1755-6783.133756  
  821 12 -
Business and pandemic preparedness: From infection control to occupational medicine
Beuy Joob, Viroj Wiwanitkit
September-October 2013, 6(5):591-591
DOI:10.4103/1755-6783.133761  
  760 18 -
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