Clinicomycological Profile and Risk Factors for Dermatophytosis at a Teaching Tertiary Care Centre in North India: A Cross-sectional Study.

BACKGROUND: Dermatophytosis has gained significant importance in recent years owing to increased incidence, more atypical lesions, changing mycological profile and growing antifungal resistance. Therefore, this study was planned to know the clinicomycological profile of dermatophytic infections in patients attending our tertiary care centre. MATERIALS AND METHODS: A total of 700 patients with superficial fungal infections belonging to all age groups and both sexes were taken up for this cross-sectional study. Sociodemographic and clinical details were noted on a prestructured proforma. Superficial lesions were clinically examined and the sample was collected by appropriate collection methods. Direct microscopy by potassium hydroxide wet mount was done to see hyphae. For culture Sabouraud's dextrose agar (SDA) with chloramphenicol and cyclohexamide was used. RESULTS: Dermatophytic infections were detected in 75.8% (531/700) patients. Young people belonging to age group of 21-30 years were commonly affected. Tinea corporis was the commonest clinical picture seen in 20% of the cases. Oral antifungals were taken by 33.1% and topical creams were used by 74.2% of the patients. Direct microscopy was positive in 91.3% and culture was positive for dermatophytes in 61% of the study subjects. T. mentagrophytes was the commonest dermatophyte isolated. CONCLUSION: Irrational use of topical steroids needs to be controlled. KOH microscopy can be useful as a point of care test for rapid screening of dermatophytic infections. Culture is necessary to differentiate various dermatophytes and to guide the antifungal treatment.

Epidemiological, clinical and mycological characteristics of pityriasis versicolor: Results of a study from a teaching hospital in rural part of Northern India.

Background and Objectives: Pityriasis versicolor is a common fungal infection of the skin which leads to the formation of scaly and discoloured small lesions on skin. The main objective of this study is to describe clinical and mycological characteristics and the predisposing factors in patients with pityriasis versicolor. Material and Methods: In this prospective, observational, hospital-based cross-sectional study, patients of all ages with clinically suspected lesions of pityriasis versicolor were included. After detailed history and thorough clinical examination, skin scrapings were examined with 10% potassium hydroxide (KOH) under light microscope. The scrapings were also subjected to culture examination. Results: A total of 113 patients [78 (69.0%) male; 35 (31%) female] were included in the study. A total of 87 (76.9%) patients were from rural area. Outdoor occupation and positive family history of pityriasis versicolor was present in 65 (57.5%) and 38 (33.6%) patients, respectively. Recurrent episodes were reported by 66 (60%) patients. Excessive sweating and oily skin were seen in 36 (31.8%) and 24 (21.1%) patients, respectively. History of occlusive clothing was present in 22 (19.4%) patients. Chest, back, and shoulders were affected in 36 (31.8%), 22 (19.4%), and 08 (07.0%) patients, respectively. Hypopigmented lesions were seen in 97 (85.8%) patients. Patches and macules were observed in 60 (53.1%) and 53 (46.9%) patients, respectively. A total of 27 (23.8%) patients reported mild prutitus. A total of 79 (69.9%) patients were KOH positive and culture negative, whereas 26 (23.0%) patients were KOH as well as culture positive. Eight (7.0%) patients were both KOH and culture negative. Conclusion: Pytiriasis versicolor is more common in young adults and males with the most common presentation of hypopigmentation lesions. In our study population, presentation with large patches was more common than macular lesions. Pruritus was more in patients with large patches than those with macules.

Prevalence pattern of MRSA from a rural medical college of North India: A cause of concern.

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) has become a global challenge. The shift of this organism form hospital settings to community setting and increasing resistance to non-ß-lactams antibiotics have further aggravated the crisis. This trend in MRSA has necessitated the knowledge and sensitization about this agent among physicians in rural and peripheral settings. MATERIAL AND METHODS: Present study was undertaken at Department of Microbiology at rural medical college of North India from January 2017 to December 2019 (3 years). All the clinical samples collected with aseptic precautions were processed as per standard protocol. All the Staphylococcus aureus isolates cultured were subjected to antimicrobial susceptibility testing as per CLSI guidelines 2019. Screening for MRSA was done by CLSI recommended methods, such as cefoxitin disc (30 µg), oxacillin disc (1 µg), and oxacillin screen agar as per CLSI recommendation. RESULTS: A steady increase in number of MRSA isolates was observed from year 2017 to 2019 with overall prevalence being 33.7%. Most MRSA isolates were obtained from pus samples. Cefoxitin disc diffusion method is a dependable detection method compared to oxacillin disc diffusion and oxacillin screen agar for identification of MRSA. CONCLUSION: The rising trend of MRSA impresses upon the acute need of stringent infection control practices namely strict compliance to hand hygiene, prevention of misuse and overuse of antibiotics and a continuous surveillance program for MRSA. Also sensitization about this agent among the primary health physician is the need of hour to implement the control measures and limit its spread in communities.

Hymenolepis diminuta infection in a young boy from rural part of Northern India.

Hymenolepis diminuta (H. diminuta) is primarily a parasite of rats and mice. Humans are infected by eating meal contaminated with these arthropods. This infection is not seen commonly in Indian population. We present here a case report of infection with H. diminuta in a young boy from a rural area of the North India.

Hearing Health Practices and Beliefs among over 20 year-olds in the Omani Population.

OBJECTIVES: The objective of this study was to investigate hearing health practices and beliefs among people over 20 years old in the Omani population. METHODS: This descriptive study was conducted in Oman during 2007-2008. Arabic speaking health staff interviewed a total of 598 selected people from urban and rural Oman and also industrial workers using a closed ended questionnaire with 15 questions. Participants' responses to the hearing practice related questions were graded into excellent (≥20 points), average (10 to 19) and poor (<10 points). The responses to the questions about hearing beliefs were grouped into excellent (≥25 points), good (5 to 24), average (-4 to 4), poor (-24 to -5) and very poor (<-25) grades. We calculated the frequencies, percentage proportions and 95% confidence intervals of the different grades of beliefs and hearing practice. The rates were also compared among different subgroups. We performed regression analysis to identify predictors of good hearing practice and scientific beliefs. RESULTS: Among the 598 participants, an 'excellent' grade of hearing practice and belief was noted in 386 (64.5% [95% CI 60.7-68.4]) and average in 205 (34.3% [95% CI 29.5 - 37.1]). Being in the 20 to 39 years age group (OR =1.67) and an urban resident (OR= 0.53) were both predictors of an excellent grade of hearing practice, while male gender (OR = 1.71) and illiteracy (OR= 1.80) were predictors of scientific beliefs. CONCLUSION: We noted high levels of good hearing practice and low levels of modern scientific beliefs among Omani participants. The Ear Health Care program of Oman should focus on improving the knowledge about healthy hearing so that attitudes and hearing practices are improved and noise-induced hearing loss can be prevented or delayed.