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   2015| November-December  | Volume 8 | Issue 6  
    Online since November 20, 2015

 
 
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ORIGINAL ARTICLES
Perceived family support and factors influencing medication adherence among hypertensive patients attending a Nigerian tertiary hospital
Akintunde J Olowookere, Samuel Anu Olowookere, Ademola Oluwasegun Talabi, Amarachukwu Chiduziem Etonyeaku, Oluwatoyin E Adeleke, Oluwatosin O Akinboboye
November-December 2015, 8(6):241-245
DOI:10.4103/1755-6783.162668  
Background and Aim: Drug adherence determines a patient's quality of life and delays the development of complications. The study assessed perceived family support and other factors that determine medication adherence among hypertensive patients in a tertiary hospital. Materials and Methods: Descriptive cross-sectional study. Consenting adult patients on antihypertensive attending the Medical Outpatient Clinic of Federal Medical Centre Owo, Ondo State, Nigeria. Results: Four hundred and twenty patients were studied. The mean age of the patients was 60.6 ± 11.7 years (range 21-85 years). There were 206 (49%) males and 214 (51%) females. Most respondents were Yoruba (86.2%), married (76.7%), and had primary education (27.6%). Most (61%) were adherent to antihypertensive therapy. Common reasons for poor adherence include belief of cure (43%), high cost of treatment (33%), and the experiencing of side effects (27%). Patients with good family support had better adherence compared to those with poor family support (P < 0.05). Conclusion: Poor family support and other factors were identified as causes of poor adherence among these hypertensive patients. Strategies targeting these factors will improve drug adherence, thereby preventing poor treatment outcomes among these patients.
  3,673 23 -
Acute viral encephalitis clinical features and outcome: Experience from a tertiary center of North India
Sukriti Kumar, Alok Kumar Pandey, Manish Gutch, Syed Mohd Razi, Abhinav Gupta, Nirdesh Jain, Shobhit Shakya, Keshav Kumar Gupta
November-December 2015, 8(6):262-266
DOI:10.4103/1755-6783.162640  
Background: Acute viral encephalitis (AVE) is an unconscious state that either accompanies or follows a short febrile viral illness and is characterized by a diffuse and nonspecific brain insult manifested by the combination of coma, seizures, and decerebration and frequently results in delayed neurological deficit. Aim and Objective: To evaluate the clinical features and the outcomes of patients presenting with AVE. Materials and Methods: The patients presenting with AVE with serologically confirmed viral parameters were consecutively recruited from the department of medicine/neurology from a tertiary care center of Lucknow, Uttar Pradesh, India. These patients were then subjected to detailed clinical examination, laboratory examination, and radiological assessment. The modified Rankin Scale (mRS) was calculated at the time of discharge and after 1 month of follow-up. Results: One hundred and eight patients were diagnosed with AVE over a period of 2 years. The mean age of the patients of AVE was 28.97 ± 16.7 years. The most common complaints were fever (100%), headache (94.4%), and altered mental state (92.5%). Out of the 108 patients, Japanese encephalitis (JE) was the most common etiology followed by herpes simplex virus (HSV) encephalitis. Of the total number of patients, 27 died, 9 were diagnosed with JE, 4 with hematopoietic stem cell (HSC) encephalitis, 5 with miscellaneous group, and 11 with the nonspecific group of viral encephalitis (NSAVE). The mRS at discharge was <3 in 44 patients and >3 in 35 patients with AVE. After 1 month, mRS was <3 in 57 patients and >3 in 22 patients with AVE. Conclusion: In this study, JE meningitis was the leading cause of AVE followed by NSAVE and HSV encephalitis. The outcome in cases with AVE can be fatal or more disabling than other etiologies and prompt diagnosis and supportive care remain the backbone of treatment.
  3,253 17 -
LETTERS TO THE EDITOR
Food poisoning due to cake intake: A case study
Viroj Wiwanitkit
November-December 2015, 8(6):307-307
DOI:10.4103/1755-6783.162618  
  3,195 16 -
ORIGINAL ARTICLES
Evaluation of nitrofurantoin activity against the urinary isolates in the current scenario of antimicrobial resistance
Rajkumar Manojkumar Singh, Mutum Usharani Devi, Kokindro L Singh, Huidrom Lokhendro Singh, Chitralekha Keisham, Kulabidhu H Singh
November-December 2015, 8(6):280-285
DOI:10.4103/1755-6783.162646  
Introduction: Urinary tract infections (UTIs) caused by antibiotic-resistant isolates have become a major health hazard in recent years as they are very difficult to treat, causing an increase in morbidity and mortality. Nitrofurantoin has been used successfully for decades for the prophylaxis and treatment of uncomplicated cystitis but the increased emergence of antibiotic resistance has made nitrofurantoin a suitable candidate for the treatment of UTI caused by multidrug-resistant pathogens. This study was taken up with the aim to determine the activity of nitrofurantoin against the wide range of resistant urinary gram-negative and gram-positive isolates. Materials and Methods: A total of 440 nonduplicate, gram-negative, and gram-positive uropathogens obtained between July 2013 and December 2014 from 3,780 fresh midstream urine samples were subjected to the VITEK-2 compact system for identification and antimicrobial susceptibility testing. Phenotypic methods for the detection of different beta-lactamases [extended spectrum beta-lactamases, AmpC beta-lactamases, metallo-beta-lactamases, and inhibitor-resistant beta-lactamases (IRT)] and methicillin-resistance staphylococci [methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCNS)] were employed. Results: High activity of nitrofurantoin was observed against MRCNS (96%) followed by MRSA (95%), extended spectrum beta-lactamases (ESBLs) (70%), IRT (66%), and vancomycin-resistant enterococci (VRE) (66%). However, the sensitivity rate was lowered to 38% and 32% for metallo-beta-lactamases (MBLs) and AmpC beta-lactamases, respectively. Conclusion: In view of the current incidence of antibiotic resistance among community uropathogens and based on efficacy, cost-effectiveness, and low impact on promoting resistance, nitrofurantoin should be considered as a reasonable alternative to trimethoprim-sulfamethoxazole (TMP-SMX) and fluoroquinolones for the first-line therapy of uncomplicated UTIs.
  3,157 20 -
Prevalence and risk factors for hepatitis B and C among sexually active undergraduates in southwestern Nigeria
Adebimpe Wasiu Olalekan
November-December 2015, 8(6):235-240
DOI:10.4103/1755-6783.162635  
Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are sources of mortality and morbidity, threatening global public health. Numerous social activities of youths, which are not perceived as risky, put them at risk of contracting these infections. The objective of this study was to assess the prevalence and risk factors for hepatitis B and C among sexually active female undergraduates in southwestern Nigeria. Materials and Methods: A descriptive cross-sectional study was carried out among 306 sexually active female undergraduates of a university in southwestern Nigeria who were selected using multistage sampling method. Research instruments were self-administered, semi-structured pretested questionnaires. Data were analyzed using the SPSS software. Results: The mean age of the respondents was 22.0 ± 2.7 years. Two hundred and fifty one (82.0%) respondents were aware of hepatitis, with 27.6% and 72.4% having "good" and "poor" knowledge, respectively, of the risk factors of hepatitis. Nineteen (6.2%) respondents were reactive to hepatitis B, seven (2.3%) were reactive to hepatitis C while two (1.6%) showed coinfection by both viruses. Based on the grouping of the identified risk factors to hepatitis, 190 (62.1%) had a single risk, 77 (25.2%) had double risk while 39 (12.7%) had multiple risk factors for hepatitis infections. Knowledge of risk factors does not have any statistically significant association with the occurrence of risk factors (P < 0.05). The occurrence of multiple risk factors was 7 and 11 times more likely to be a predictor of hepatitis B and C, respectively, compared to having sexual intercourse alone that is a single risk factor. Conclusion: University undergraduates are at a risk of contracting hepatitis infections. High awareness but poor knowledge of hepatitis and a significant seroprevalence rate underscores the need for awareness and more efforts on the part of university health services.
  2,664 19 -
Clinical profile and outcome of recent outbreak of influenza A H1N1 (swine flu) at a tertiary care center in Hyderabad, Telangana
Kadadanamari Subbaramareddy Amaravathi, Putrevu Sakuntala, Budithi Sudarsi, Siddula Manohar, Ramapantula Nagamani, Sunkara Rajeswar Rao
November-December 2015, 8(6):267-271
DOI:10.4103/1755-6783.162649  
Background: Swine influenza, also called swine flu, hog flu, and pig flu, is an infection caused by any one of the several types of swine influenza viruses. The World Health organization ( WHO) raised a worldwide pandemic alert for swine flu on June 11, 2009 that was a first of its kind in the past 70 years. In India, the index cases were reported from Pune, Maharashtra. We witnessed a recent outbreak in India during late 2014 and early 2015. Methodology: A retrospective study was carried out to describe the clinical profile and outcome of the confirmed cases of swine flu who were admitted at our center between December 10, 2014 and May 11, 2015. The cases were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on respiratory specimens. Results: A total of 514 patients with symptoms suggestive of swine flu were tested for hemagglutinin type 1 and neuraminidase type 1 (H1N1) out of whom 88 were positive, which accounted for 17.12% positivity. The mean age was 31.15 years with a range of 11-90 years, with equal distribution among males and females (males: 45, females: 43). The epidemic peaked in the month of January (n = 44.50%). Fever (95.45%) was the most common clinical manifestation followed by cough (85.22%), breathlessness (51.22%), and myalgia (50%). The majority were in category C (59.09%) based on the severity of the illness. All the patients were hospitalized and treated with oseltamivir. Of all the positive patients, 39 (44.31%) were advised home isolation after discharge for 5-7 days in view of the mild disease. Hypertension, diabetes, existing lung diseases, cardiovascular diseases, smoking habit, alcohol consumption, and pregnancy were found to be the major risk factors. Women in the third trimester of their pregnancy were found to be at a higher risk. Our study had an overall mortality of 14.77% (n = 13). Mortality was higher among pregnant women (n = 1/6, 16.66%) compared to nonpregnant women (n = 5/37, 13.51%). Multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were the most common causes of death. Conclusion: Swine flu activity has come down significantly, with a single case being reported in the month of April and none in May in 2015 at our center.
  2,298 20 -
LETTERS TO THE EDITOR
Missed appointment in rabies vaccination schedule: Do the medical personnel also generate the problem?
Beuy Joob, Viroj Wiwanitkit
November-December 2015, 8(6):314-314
DOI:10.4103/1755-6783.162624  
  2,124 16 -
ORIGINAL ARTICLES
Spontaneous and induced sputum values in the diagnosis of pulmonary tuberculosis among patients with suspected pulmonary tuberculosis
Katayoun Haji Bagheri, Shahla Afrasiabian, Behzad Mohsenpour, Naser Reshadmanesh
November-December 2015, 8(6):253-257
DOI:10.4103/1755-6783.162644  
Objectives: The quality of sputum samples is important for the diagnosis of pulmonary tuberculosis (TB). Unfortunately, it is not always possible to get a proper sputum sample. Now, sputum induction (SI) has been found to be useful for the diagnosis of many lung diseases. Therefore, this study compares the role of spontaneous sputum and induced sputum in the diagnosis of pulmonary TB among suspected pulmonary TB patients. Materials and Methods: A total of 27 patients admitted with suspected pulmonary TB were studied. Three spontaneous sputum samples were taken from these patients and in case of negative sputum smear microscopy, the SI procedure was used to take another sputum sample. Standard diagnosis included both positive sputum smear and clinical decisions. The sensitivity, specificity, and positive and negative predictive values of sputum smears obtained by two methods of spontaneous sputum and induced sputum were calculated and compared with the standard diagnosis. Results: The result of the induced sputum acid-fast bacillus (AFB) smear microscopy was negative in 16 (59.3%) patients and positive in 11 (40.7%) patients. Six (50%) of those who were negative in spontaneous sputum became positive after SI. The mean white blood cell (WBC) count in normal sputum and induced sputum was 3.8 (±3.4) and 8.8 (±2.9), respectively (P < 0.001). The sensitivity of sputum smear positive was calculated to be 67.7% for SI method and 29.4% for spontaneous sputum method. Conclusion: The diagnostic value of induced sputum in the diagnosis of TB is more than the spontaneous sputum method. In addition, the quality of sputum smear produced through induction is more than spontaneous sputum and it does not create any special complication.
  1,879 16 -
Clinical and bacteriological profile of UTI patients attending a North Indian tertiary care center
Saif Quaiser, Ruhi Khan, Fatima Khan, Meher Rizvi, Shahzad Faizul Haque, Anwar Salamat Khan
November-December 2015, 8(6):246-252
DOI:10.4103/1755-6783.162669  
Introduction: Urinary tract infection (UTI) is a common cause of morbidity in patients attending our hospital. Recently UTI has become more complicated and difficult to treat because of appearance of pathogens with increasing resistance to the commonly used antimicrobial agents. Objectives: The main aim of the study was to determine the bacteriological profile and antibiotic susceptibility pattern of UTI patients attending our hospital. Materials and Methods: 1843 patients complaining of fever with or without urinary symptoms attending medicine and nephrology clinics of Jawaharlal Nehru Medical College Hospital, Aligarh from June 2012 to July 2014 were analysed. Clean catch mid-stream urine specimens collected from each subject were subjected to urine culture and sensitivity tests. Patients with age 15 to 85 years were included. Results: Significant bacteriuria was detected in 33.4% patients. Diabetes, obstructive uropathy, and previous instrumentation were the major risk factors identified. The most common pathogens isolated were Escherichia coli (52.4%), Klebsiella pneumoniae (12.3%) and Citrobacter spp. (9.1%). Most susceptible antibiotic was Amikacin, Cefoperazone-sulbactum, Piperacillin-tazobactum and Nitrofurantoin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin (78.3%), Cefoperazone-sulbactum (72.8%), Piperacillin-tazobactum (70.5%), Gentamicin (69.3%), Nitrofurantoin (67.3%), Cefoperazone (64.1%) and Ceftriaxone (61.6%). Conclusion: This study highlights the common pathogens causing UTI in our area and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports. This would significantly decrease the incidence of drug resistance and be more cost effective to the patients.
  1,872 22 -
CASE REPORTS
A rare case of disseminated cysticercosis
Debananda Gonjhu, Kumkum Sarkar, Soumendra Nath Haldar, Netai Pramanik
November-December 2015, 8(6):290-292
DOI:10.4103/1755-6783.162643  
Cysticercosis is a common tropical disease and a common cause of seizures and neurological morbidity. Neurocysticercosis (NCC) is the most common manifestation of the disease involving the central nervous system (CNS). One of the uncommon manifestations of cysticercosis is its disseminated form. The most commonly affected organs are the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver, and occasionally the heart, thyroid, and pancreas but in widespread dissemination it can involve any organ in the body. We report here a case of a 35-year-old-female with disseminated cysticercosis (DCC). She attended our hospital with headache, fever, and symptoms of multiple palpable nodules. After the investigations, she was diagnosed with DCC involving the brain and subcutaneous tissues all over the body. Then she was successfully treated with albendazole and steroids.
  1,770 20 -
ORIGINAL ARTICLES
Association of TNF-α serum levels with response to antitubercular treatment in MDR tuberculosis patients
Mohammad Shameem, Nazish Fatima, Nabeela , Haris Manzoor Khan
November-December 2015, 8(6):258-261
DOI:10.4103/1755-6783.162627  
Introduction: Tuberculosis (TB) remains a significant public health problem, with an estimated one-third of the world's population being infected. Cytokines play a major role in protection against Mycobacterium tuberculosis (M. tuberculosis) infection and regulate the immune responses at a cellular level. Most studies on cytokines during TB are from "in vitro"-stimulated lymphoid cells with few reports on in vivo plasma levels. The aim of this study was to evaluate the levels of tumor necrosis factor-α (TNF-α) in new, undertreatment (UT), and multidrug-resistant (MDR) pulmonary and extrapulmonary cases. Materials and Methods: The study was conducted in the Department of Microbiology, Jawaharlal Nehru Medical College (J.N.M.C.), Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh, India. Results: The levels of TNF-α were measured in 76 serum samples from TB patients by an enzyme linked immunosorbent assay (ELISA) kit (Diaclone Sas, 1 BD, A Flemming Besancon Cedax, France), along with 10 healthy controls. Complete clinical, radiological and treatment data were collected. The TNF-α levels were elevated in new cases (P < 0.05) and MDR cases (P < 0.05) but not significantly for UT cases (P > 0.05). Conclusions: An understanding of this response may lead to an insight into the pathogenesis and novel therapies for TB.
  1,744 16 -
CASE REPORTS
Boerhaave's syndrome presented with right-sided hydropneumothorax and hoarseness of voice: A case report
Rupam Kumar Ta, Sourindra Nath Banerjee, Arnab Roy, Anand Kumar Pandey, Kaliprasanna Chatterjee, Pratik Barma
November-December 2015, 8(6):300-303
DOI:10.4103/1755-6783.162605  
Boerhaave's syndrome is a rare and sometimes life-threatening condition characterized by lower esophageal tear due to a sudden rise of intraluminal pressure, and it is usually presented with a history of forceful vomiting, abdominal or chest pain, and sometimes subcutaneous emphysema. Atypical and delayed presentation is also not uncommon. A high index of suspicion is needed for diagnosis. The diagnosis is confirmed by contrast esophagogram or contrast computed tomography (CT) of the chest. Mortality rates could be as high as nearly 20-40% even in the treated cases. In this article, we report a case of a 57-year-old male, who is a smoker as well as an alcoholic, with right-sided hydropneumothorax presenting with dyspnea, epigastric pain, hoarseness of voice, and features of shock. Boerhaave's syndrome was suspected on finding food particles in pleural fluid that contained very high salivary amylase level. The diagnosis was confirmed with a sterile methylene blue contrast study.
  1,680 25 -
ORIGINAL ARTICLES
Epidemiology of admitted cases of childhood injuries in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria
Ekwunife Okechukwu Hyginus, Ugwu Jideofor Okechukwu, I Modekwe Victor, Okoli Chinedu Christian, Ugezu Anthony
November-December 2015, 8(6):272-275
DOI:10.4103/1755-6783.162642  
Introduction: Injuries have become a leading cause of childhood death, and majority of these occur in developing countries. The range of injuries also varies among age groups, sex, populations and economies. Within the same population, injury pattern changes over time. Statistics of trauma from most developing countries are still not very many. To aid sound policies, documentation of trauma epidemiology from different cultures and geographies is still needful. Methodology: Hospital records of all children aged 18 years and below that presented between January 2007 and December 2011 were studied retrospectively. Results: A total of 217 patients were admitted, 125 (57.6%) males and 92 (42.4%) females. Multiple injuries occurred in 24 (11.1%) of children. Road crashes accounted for the greatest number of injuries; 109 cases (50.2%) followed by falls 60; (27.6%). Motor cycle related injuries accounted for 67 (61.5%) of the 109 road traffic injuries. The age group most commonly affected is 0-5 years accounting for 98 (45.2%) cases. Head injury was the commonest injury sustained 83 (33.9%). Majority of the injuries, 72 (66.1%) occurred in or near home. Injuries were more frequent during the weekdays 132 (60.8%) compared to the weekends 85 (39.2%). Long term functional or physical disability was seen in 62 (28.6%) of cases. Six children died giving a mortality rate of 2.8%. Conclusion: Childhood trauma rate is still high, with motorcycle related road traffic accidents constituting a major cause. Education and enforcement of road traffic regulations and limiting motorcycle transportation may help in reducing the trauma rate in children.
  1,519 19 -
CASE REPORTS
Spectrum of histopathological findings in patients with acute kidney injury following H1N1 influenza infection: A study of three cases
Lovelesh S.C. Nigam, Aruna V Vanikar, Rashmi Patel, Hargovind Laxmishankar Trivedi
November-December 2015, 8(6):296-299
DOI:10.4103/1755-6783.162614  
Acute kidney injury (AKI) and failure can be found in association with swine-associated influenza A (H1N1) virus contributing to increased morbidity and mortality. We present three cases of H1N1 infection with AKI, the first in the background of renal amyloidosis, the second in a kidney transplant recipient, and the third in a patient who presented with renal failure following upper respiratory tract infection. Renal biopsy in all of them revealed mesangial prominence with tubulointerstitial nephritis. All of them recovered following conservative management. H1N1 infection is known to be associated with dismal prognosis and kidney involvement is mainly in the tubulointerstitial compartment. Contrary to the reported literature mentioning poor prognosis, all three patients in our study recovered fully.
  1,459 17 -
Extensive marrow necrosis due to miliary tuberculosis: A case report
Tummidi Santosh, Manoj Kumar Patro, Atanu Kumar Bal, Anita Choudhury
November-December 2015, 8(6):293-295
DOI:10.4103/1755-6783.162657  
Bone marrow necrosis (BMN) is a rare clinicopathologic entity caused by hypoxemia after the failure of microcirculation that frequently manifests with bone pain, fever, and peripheral cytopenia. In most reported cases of BMN resulting from extrapulmonary tuberculosis (TB), the presence of marrow granulomas, pulmonary infiltrates and/or extrapulmonary involvement are common. We report a case of an extensive BMN from miliary TB whose initial presentation was only mild anemia and multiple bone lesions.
  1,425 24 -
Tuberculosis verrucosa cutis complicated with Pott's spine and a large iliopsoas abscess in a young pregnant woman: A case report and review of the literature
Ranjan Kumar Sahoo, Ajay Kumar Jena, Jitendra Narayan Senapati, Tapan Kumar Pattnaik, Debahuti Mohapatra
November-December 2015, 8(6):286-289
DOI:10.4103/1755-6783.162663  
A young female patient reported to the dermatologist with a skin lesion that was diagnosed as tuberculosis verrucosa cutis (TVC) after skin biopsy. She did not continue antitubercular drugs as she was having vomiting due to pregnancy. She reported to our hospital with swelling and pain in the abdomen with 18 weeks of pregnancy. On imaging, she was diagnosed to have large iliopsoas abscess with tubercular spondylitis. She took antitubercular drugs after surgical drainage of the iliopsoas abscess. She delivered a healthy male baby. Follow-up imaging revealed resolution of the skin lesion, iliopsoas abscess, and tubercular spondylitis.
  1,390 20 -
COMMENTARY
Public health perspectives on childhood injuries around the world: A commentary
Tanmay Mahapatra
November-December 2015, 8(6):233-234
DOI:10.4103/1755-6783.162664  
  1,299 19 -
CASE REPORTS
Familial clustering of hepatitis B infection in South India: A case report
Anand Pai, Santhi Selvi, K Muthukumaran, G Ramkumar, R Balamurali, Rajkumar T Solomon, P Ganesh
November-December 2015, 8(6):304-306
DOI:10.4103/1755-6783.162651  
Hepatitis B is a public health problem of worldwide importance. Familial clustering of HBV infection has been reported infrequently. Intrafamilial transmission of HBV plays a substantial role in maintaining the endemicity of the virus in the region. We report a family of 8 members, among which 5 members across 3 generations were HBsAg positive.
  1,282 19 -
ORIGINAL ARTICLES
An epidemiological study concerning pneumococcal LRTI in rural parts of Bengal and influence of socioenvironmental parameters on it
Yeshi Palden Dopthapa, Dibyendu Banerjee, Baishali Chakraborty, Banya Chakraborty, Indrani Ghosh, Dibakar Halder
November-December 2015, 8(6):276-279
DOI:10.4103/1755-6783.162671  
Background: Lower respiratory tract infection (LRTI) is a major public health problem. One of the major agents causing community acquired pneumonia is Streptococcus pneumoniae, or pneumococcus. This study was aimed to correlate between socio-environmental parameters and incidence of LRTI (by s0 pneumoniae ) in rural parts of West Bengal. Materials and Methods: A house to house survey was made in a rural community and sputum samples were collected from persons having features of lower respiratory tract infection. The socio-environmental background of the patients were taken in detail. The pneumococci isolated from the samples were tested for antibiotic susceptibility. Results: Out of 947 samples collected, 70 (4.77%) were positive for S pneumoniae. 15.71% were found to be resistant to penicillin. Highest incidence was found to occur in summer months, and in persons living in narrow spaces and in houses polluted with smoke. Conclusion: Although a low percentage of pneumococci were found among the community acquired pneumonia in rural parts of Bengal, many of the strains showed resistance to penicillin and erythromycin. That is a thing for concern in itself. Better living conditions regarding household with proper smoke outlet facility would have a good impact in bringing down the incidence in this area, where people are already burdened with lack of proper facilities for living.
  1,285 16 -
LETTERS TO THE EDITOR
Assessment of quality of life satisfaction among menopausal women through MEN-QOL questionnaire
Sagar Borker
November-December 2015, 8(6):307-310
DOI:10.4103/1755-6783.162655  
  1,274 19 -
Are we well-equipped to restore the mental health of the traumatized in emergencies?
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
November-December 2015, 8(6):321-323
DOI:10.4103/1755-6783.162620  
  1,093 17 -
Assisting the World Health Organization to effectively tackle the problem of childhood obesity
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
November-December 2015, 8(6):319-320
DOI:10.4103/1755-6783.162662  
  1,043 17 -
Neurological problem due to severe fever with thrombocytopenia syndrome virus infection
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2015, 8(6):310-311
DOI:10.4103/1755-6783.162659  
  948 17 -
Strategic information guidelines for HIV: Global perspective
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
November-December 2015, 8(6):318-319
DOI:10.4103/1755-6783.162658  
  914 17 -
Dengue and H1N1 infection
Beuy Joob, Viroj Wiwanitkit
November-December 2015, 8(6):316-316
DOI:10.4103/1755-6783.162631  
  898 18 -
Prediction of enzyme cleavage possibility on Ebola virus glycoprotein by PeptideCutter
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2015, 8(6):317-317
DOI:10.4103/1755-6783.162632  
  890 15 -
Accident during Thai new year festival: What can we learn?
Sora Yasri, Viroj Wiwanitkit
November-December 2015, 8(6):312-312
DOI:10.4103/1755-6783.162616  
  879 15 -
Local ethnopharmacological system of the Kayor Karen, Thailand
Amnuay Kleebai, Wasana Kaewla, Viroj Wiwanitkit
November-December 2015, 8(6):321-321
DOI:10.4103/1755-6783.162617  
  863 16 -
Asymptomatic severe fever with thrombocytopenia syndrome virus infection: Evidences
Somsri Wiwanitkit, Viroj Wiwanitkit
November-December 2015, 8(6):313-313
DOI:10.4103/1755-6783.162623  
  860 15 -
Emerging MERS: Do public health personnel know about it and prepare well to counter it?
Viroj Wiwanitkit, Wasana Kaewla
November-December 2015, 8(6):311-311
DOI:10.4103/1755-6783.162666  
  846 16 -
Severe fever with thrombocytopenia syndrome: No hemorrhagic complication despite thrombocytopenia
Beuy Joob, Viroj Wiwanitkit
November-December 2015, 8(6):314-315
DOI:10.4103/1755-6783.162625  
  845 16 -
Perception to call for dT and influenza vaccination and cost: A case scenario, Thailand
Beuy Joob, Viroj Wiwanitkit
November-December 2015, 8(6):312-313
DOI:10.4103/1755-6783.162621  
  826 16 -
Bufavirus contamination in diarrheal stool samples: Any difference due to ethnic group?
Sora Yasri, Viroj Wiwanitkit
November-December 2015, 8(6):315-316
DOI:10.4103/1755-6783.162629  
  819 15 -
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