الملخص
Aeromonas, a common bacterial resident of freshwater is known to cause gastrointestinal illness in humans. Contaminated water and aquatic foods are the usual sources. Gastrointestinal disease is usually mild in normal individuals and responds to common antibiotics. However, extra-intestinal infections by Aeromonas species have been increasingly reported. Severe skin and soft tissue infection followed by septic shock may be seen in immunocompromised individuals. Bacteremia can also occur secondary to invasive gastroenteritis in persons with impaired immunity. Patients with decompensated chronic liver disease have been noted to be at especially high risk for fatal infection due to this pathogen. It can cause early bacteremia and rapid death without surgical debridement. We report a case of fatal Aeromonas cellulitis with septic shock in a patient with known advanced alcoholic liver disease. It started following minor skin injury and subsequent exposure to pond water. The patient presented late with septic shock and succumbed to his illness.
الملخص
Technology socialization process has operationally been defined as the interactive summation of all possible responses to a technology application process in terms of adoption, rejection, discontinuance and reinvention. Here, this interactive summation is measured against a set of standard practices applied in pulse enterprises and the level of socialization as measured against a “recommended technology”. The following specific objectives are set to intervene the present study. Those are, to generate basic information on socialization of pulse crop in the study area to identify and standardize the variables, dependent and independent, impacting on both socialization of pulse crop in the study area, to elucidate inter and intra level interaction between dependent variables i.e. Socialization with those of selected socio economic and ecological variables, to delineate the micro level policy based on the empirical result on effective socialization process. The study has been carried out in two developed block namely Chakdah and Haringhata of Nadia District in West Bengal. The multistage purposive and random sample techniques were the key to contrast sampling design in the present study. The following variables, gross return, area under pulse cultivation, training received, yield, farmer’s attitude towards pulse cultivation have been found generating significant functional impacts on the predicted character, technology Socialization. The statistical tools like mean, standard deviation and coefficient of variation, coefficient of variation, coefficient of correlation, multiple regression, step down multiple regression and path analysis. The study also responded to the inquiry as to where and how the classical crop production process can be replaced with pulse crop and whereas this replacement will be much rewarding and beneficiary to the common farmer. The determinants like gross return, area under pulse crop, training received, productivity of pulse crop and farmer’s attitude are decisively characterizing the socialization process of pulse crop.
الملخص
Waste is a ceaselessly developing issue at worldwide and territorial just as at neighborhood levels. Due to vigorous globalization and product proliferation in recent years, more waste has been produced by the soaring manufacturing activities. The social ecology of waste recycling implies the structural, functional and managerial intervention of waste generation process. The specific objective of the research was to isolate and identify the system variables characterizing and the management of waste recycling process and to estimate intra and inter level of interaction amongst and between the variables for respective, inductive and interactive contribution. The present study takes a look into the approach, process and impact of ongoing waste management process, followed by the both kalyani and jalpaiguri municipalities. A set of agro-ecological, socio-economic and techno managerial factors have been developed by selecting two sets of operating variables: Independent Variables: Age(x1), Education(x2), Family member(x3), Total cost of energy(x4), Household land(x5), Income(x6), Expenditure of family(x7), Volume of waste generation per household(x8), Water consumption per day(x9), Total bio diversity(x10), Impact of waste management on health(x11), Impact of waste management on agriculture(x12), Impact of waste management on livestock(x13), Impact of waste management on water(x14), Impact of waste management on soil(x15), Impact of waste management on micro flora and fauna(x16), Exposure to media(x17),Training received(x18), Participation on waste recycling programmer (x19), Perception on environmental impact of waste management(x20), Waste management at household level with value addition by percentage (x21a), Waste management at household level with value addition by percentage (x21b). Dependent variables: Volume of waste used for different purposes (y1). The following independent variables have come out with stark contribution on this consequent variable. Result suggested that in terms of variable, behavior and responses there have been stark differences between jalapaiguri and kalyani municipal areas. In kalyani, some few variables like perception of environmental impact on waste management, waste management at household level with value addition by percentage, impact of waste management on agriculture have recorded the distinct contribution on volume of waste used for different purposes and in jalpaiguri total household land, volume of waste generation from household, water consumption per day have gone in the determinant way. So, in kalyani and jalpaiguri municipal areas these variables have maximum influence on the dependent variable. Household wastes mostly are bio degradable in nature. It can be converted to organic manure which has a great nutritional value for plants and if these bio wastes can be converted into organic manure then amount of waste will be reduced. Not only bio waste but we can use non bio degradable wastes for energy production also.
الملخص
Aim: Digital rectal examination (DRE) grading and the grade of prostatomegaly on cystoscopy are routinely used in clinical practice, but its correlation to prostate volume is understudied. This study was done to assess the correlation of DRE and endoscopic grading with the prostate volume on trans-rectal ultrasound (TRUS). Materials and Methods: This study was carried out in 101 eligible patients with prostatomegaly. Each patient was evaluated for three parameters, prostate volume by TRUS examination, DRE and endoscopic grading on cystoscopy. Pearson correlation coefficient was calculated to find the correlation between variables, p<0.05 was taken to be statistically significant. Data were analyzed using the Epi Info (TM) 7.2.2.2. Results: Significant positive correlation (p<0.001) was found between TRUS Volume and DRE grading (Pearson Correlation=0.945) and TRUS volume and Endoscopic grading (Pearson Correlation=0.949). Both the grading were also significantly positively correlated (Pearson Correlation=0.989, p<0.001). Conclusion: Our attempt for correlating the digital rectal grading and endoscopic grading with prostate volume is satisfactorily validated in the clinical setting. These grades are sufficient to provide a rough estimation of the prostate volume and to classify patients with prostatomegaly.
الملخص
Background: Objective was to study the prevalence of asthenopic symptoms among computer operators in central India and assess the change in their practices related to factors affecting asthenopia symptoms and relief measures.. Methods: Longitudinal Educational Interventional Study, done on 150 employees of computer based company offices of Bhopal city in duration of 3 months from August 2018 to October 2018 after obtaining Ethical clearance from the institutional ethics committee and they were asked to fill a pre-tested questionnaire, after obtaining their verbal consent. Other relevant information was obtained by personal interview and inspection of their working area. The data was entered in MS excel and analysis was done using Epi-info 7 software. Results: Among the 150 participants studied, the overall prevalence of asthenopia (at least 1 symptom present) is 87.3%. The prevalence of various asthenopic symptoms varied from 85.3% (eye fatigue) to 18.7% (blurring of vision). With educational intervention, significant change was observed in symptoms and relief measures. Conclusions: Prevalence of asthenopia was found to be quite high in computer operators, especially in those who started its use at an early age. Individual as well as work-related factors were found to be associated with asthenopia.
الملخص
Introduction:Urolithiasis is one of the most common clinical conditions in the history of medicine. Treatment methods include conservative, surgical treatment and extracorporeal shock wave lithotripsy (ESWL). Several stone characteristics are known to affect outcome of ESWL such as fragility, Hounsfield unit, size, site, composition etc. No study has been done till now regarding the efficacy and safety of ESWL in eastern Indian patients. Objectives: To assess the efficacy and safety of ESWL in the management of patients with renal and ureteral stones. Methods: 112 outpatients were treated with ESWL. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. Result & Conclusion: The authors found significant association between the size and number of stones with fragmentation status. The authors found that stones of more than 11mm size are more resistant to ESWL. Authors found statistically significant association between the number of ESWL sessions with fragmentation status. However, more than 3 sessions also did not help much. It was also found that complications were more in partially fragmented group and more adjunctive procedures were required in partially fragmented group. The authors also noticed that the stented or non stented status and total number of shocks were not significantly associated with the fragmentation status of stones.
الملخص
INTRODUCTION:Because patients covered by medical insurance are being denied legitimate claims, doctors are working shoulder to shoulder with them and have garnered significant experience in this matter. We, therefore, decided to a systematic survey under the Medic LAWgic banner and presented the data.METHODS:A short, 8-question multiple-choice survey was conducted online among doctor clinicians. Duplicate replies were removed. The remaining replies were evaluated, interpreted, and the data are being presented here.RESULTS:A total of 377 doctors responded. The majority (208, 55%) had faced problems with medical insurance claims in more than 10% of their patients. Almost half of them (48%) had outright rejection of the claims in more than 10% of their patients. Reduction in claim amounts was faced in more than 10% instances by 262 (70%). The five most common causes for refusal or rejection of claims included failure of patient to disclose pre-existing illness (234, 62%), other insurance policy terms related issues (157, 42%), oral medication (199, 53%), treatment without admission (155, 41%), and treatment with new modes of therapy (152, 40%). As many as 301/377 (80%) doctors had written letters to the insurance companies for supporting their patients’ claim. Such supporting letters from the treating doctors resulted in the claim being accepted or approved in 216 instances (57%).DISCUSSION:Mediclaim denial is a major and growing problem. People who need financial assistance the most are also the most vulnerable to denial. In the USA, such denial rates ranged from 1% to 45% of in-network claims in the year 2017. Unfortunately, <0.5% of patients appealed such claim denial. The insurance regulatory and development authority of India (IRDA) have issued guidelines that all claims need to be settled within 30 days and that insurance companies must fulfill their contractual commitment for genuine claims, even if timely intimation was not possible. Insurance companies are running a business for profit. Hence, even the most expensive plans will have a list of exclusions, in the fine print. Indian patients need to be proactive in following up when claims are rejected or reduced. Doctors are their pillar of support, whose advantage needs to be taken by them. IRDA and consumer courts are also looking after patients’ rights in this matter.CONCLUSION:Patients are increasingly facing challenge of medical insurance companies denying legitimate claims. Doctors help by writing to the insurance companies supporting their patients claim and such letters help in the majority of instances. Patients and their families need to follow up aggressively when their claims are not approved, rejected or reduced. They should also request the help of their doctors when facing such challenges.
الملخص
Within the wide range of nitrogen-containing heterocyclic compounds, the derivatives of 1,8-naphthyridine (NPTR) have gained a rising interest due to their reported versatile biological activities. The derivatives of NPTR scaffold are found to invite special interest from researchers nowadays on the significance of their manifestations of multiple attractive pharmacological activities which establish them as an effective and versatile tool in pharmaceutical chemistry and drug discovery. The diverse biological activities mainly include anti-inflammatory, antimicrobial, antiviral, anticancer, antihypertensive and analgesic activities. Novel NPTR scaffold has emerged its potency to treat neurological diseases like depression and Alzheimer's disease. Further these agents possess different inhibitory activities, such as anti-HIV, anti-osteoporotic, αvβ3 antagonism, antimalarial, platelet aggregation, anti-oxidant, anti-allergic, gastric antisecretory, anticonvulsant, epidermal growth factor receptor (EGFR) inhibition, protein kinase inhibition, ionotropic properties, β3 antagonism, phosphodiesterase 4 (PDE 4) inhibitions, adenosine receptor agonistic activity, adrenoceptors antagonism and DNA stabilizing activity, etc. In this review, we highlight the updates of different 1,8-naphthyridine derivatives and explain the key data available in the context of various biological activities of NPTR derivatives available from the literature. This may direct opportunity in researches in the synthesis of novel medicinal agents and the development of new heterocycles for modification of existing biological actions as well as evaluation of other possible pharmacological activities.
الملخص
Noncommunicable diseases (NCDs) have become a major public health problem in India accounting for 62% of the total burden of foregone DALYs and 53% of total deaths. Out-of-pocket expenditure associated with the acute and long-term effects of NCDs is high resulting in catastrophic health expenditure for the households. A large national survey in India found that spending on NCDs accounted for 5.17% of household expenditure. According to a macroeconomic analysis, it is estimated that each 10% increase in NCDs is associated with a 0.5% lower rate of annual economic growth. The income loss due to hypertension is the highest, followed by diabetes and cardiovascular diseases. The macroeconomic impact of NCDs is profound as they cause loss of productivity and decrease in gross domestic product. Since the health sector alone cannot deal with the “chronic emergency” of NCDs, a multisectoral action addressing the social determinants and strengthening of health systems for universal coverage to population and individual services is required.
الملخص
@#The object of this study was to identify patients with diagnosed dengue infection, who were positive for both dengue-specific NS1 antigen and IgM antibody.
الملخص
BACKGROUND: Renal cell carcinoma (RCC) is the one of the dreadful urological carcinoma. In comparison to the West, it is very rarely seen in Asia as well in India. Very small number of studies is available in this geographical area. AIMS: We studied the demographic pattern, presentation, risk factors and survival of RCC in an Eastern Indian institution. We characterized and compared these data with available literature SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 81 patients of RCC from January 2008 to December 2012 were enrolled. Their pre‑operative data were reviewed. They were followed as per institutional follow‑up protocol. STATISTICAL ANALYSIS USED: Kaplan‑Meier plot was constructed for survival analysis. Comparison of survival curves was performed by Logrank test. P < 0.05 was considered to be significant. RESULTS: A total of 75 patients were analyzed with a mean follow‑up of 26.3 ± 17.7 months. The mean age of presentation in our study was 52.79 years with a peak at 5th decade. Nearly 73.33% patients having one or more risk factors. 9 out of 10 had presented with some symptoms. The survival for localized RCC was 100% and significantly greater than advanced RCC ( P < 0.0001). Similarly in the stage III, significant greater survival ( P < 0.0001) was noted compare to stage IV. CONCLUSIONS: The age of presentation of RCC in India has been found in 5th decade, which is a decade earlier than the western countries. Symptomatic RCC is still majority in India. Organ confined tumors have good prognosis. When it metastasizes to lymph node or distant organ, the outcome is poor. Our results may form the basis for further studies and it may be used as future reference.
الملخص
Rabies is 100% fatal zoonotic disease which can be prevented by appropriate anti rabies post exposure prophylaxis. The incidence of animal bite is managed poorly due to ignorance and rampant myths & misconceptions. It is discovered that a vital time period is lost in taking medical aid as people due to ignorance opt for traditional medications the authenticity of which is not completely established. Aims & objectives: 1) To study the social, demographic characteristics of victims of animal bites. 2) To study the treatment seeking behavior of persons and to find their correlations. Methods: An observational cross-sectional study. The respondents were selected amongst new cases of animal bites attending Anti Rabies clinic of Gandhi medical college Bhopal M.P. India for 3 months using pretested questionnaire. Data was analyzed & interpreted using percentages and tests of significance using Epi info 7. Results: Out of total 315 cases of animal bite nearly 38.75% were below 15 years of age. In total, 82.5% cases were bitten by dogs. The majority of cases (73%) had a category III bite, only 45% consulted within 24 hours of the bite. Nearly 9% did not wash the wound with soap & water instead applied home remedies or opted for traditional or non-allopathic treatment. A statistically significant (P <0.0001) association was found between educational status & knowledge of fatality due to rabies. Conclusions: Rising level of literacy enhances knowledge about the fatality of rabies.
الملخص
Background: Tuberculosis had been declared by the World Health Organization (WHO) as ‘public health emergency’ in 1993. Extra pulmonary tuberculosis (E.P.T.B.) comprises 20-25% total burden of the disease in which genitourinary tuberculosis (G.U.T.B.) is 4%. Timely diagnosis and treatment will prevent the sequelae of this disease. Aims: To know the varied clinical presentations, diagnostic modalities and management of G.U.T.B. Methods: During a 13-year-period, 117 retrospective cases of GUTB were admitted in the tertiary care centre. They were analyzed for clinical presentation, diagnostic modalities and management. Results: Young patients mainly in third decade of life were commonly affected with higher incidence in females. In our study, the most common presentation was irritative voiding symptoms (66.47%) followed by haematuria (47.60%). Although it can affect the entire organ in genito-urinary system but, in the present study, kidney was the most affected organ (64.9%) following ureter (27.35%), urinary bladder (17.09%), prostate (3.4%) and epididymis (5.19%). In this study, we had not encountered any case of testicular and penile tuberculosis. Among the different diagnostic modalities in this study, the diagnostic positivity rate was 41.6% for the urine AFB test, 55.4% for the urine M. tuberculosis culture test and 67.7% for PCR. Chest x-ray was positive in 25.6% (30). ESR was raised in 62.5% and Mantoux test was positive in 61.2% patients. Conclusion: A high index of suspicion and a wide range of investigations may be required to achieve a complete diagnosis of genitourinary tuberculosis. Though short course chemotherapy with four-drug-regimen for sixmonth- duration is the mainstay of treatment, surgical interventions were required in 60% of cases of this study.
الموضوعات
Antitubercular Agents/therapeutic use , Diagnostic Imaging/methods , Diagnostic Techniques, Urological , Female , Forecasting , Humans , Incidence , India/epidemiology , Male , Reproducibility of Results , Retrospective Studies , Sex Distribution , Sex Factors , Survival Rate/trends , Tuberculin Test , Tuberculosis, Urogenital/diagnosis , Tuberculosis, Urogenital/drug therapy , Tuberculosis, Urogenital/epidemiologyالموضوعات
Aged , Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy , Digestive System Surgical Procedures , Esophageal Neoplasms/pathology , Esophageal Neoplasms/therapy , Eye Neoplasms/secondary , Eye Neoplasms/therapy , Humans , Male , Neoplasm Staging , Positron-Emission Tomography , Radiotherapy , Tomography, X-Ray Computedالملخص
Aims: Inverted papilloma (IP) is an uncommon benign neoplasm of the urinary tract. Its multiplicity, recurrence, and association with transitional cell carcinoma (TCC) leads to conflicting clinical conclusions regarding its biological behavior, and hence, the need for rigorous follow-up protocols. In this study, we review all cases of urinary bladder IP in our institution and determine the need for strict follow-up. Materials and Methods :0 We included consecutive patients from August 2004 to August 2008 with IP of the urinary bladder in this study who did not have prior or concurrent urothelial carcinoma. A single pathologist performed the histologic review. The patients had undergone strict a follow-up schedule every 6 months. Results: In our study of the 24 patients, the mean age at presentation was 53.5 (range 22-81) years. The mean follow-up period was 25.8 months (range 6-58 months). Of the 24 patients, 21 were men and 3 were women. No patient had a synchronous or previous bladder tumor. The most common presenting symptoms were macroscopic hematuria and dysuria. All were solitary tumors except one, most commonly found at the bladder neck and trigone. The average follow-up period was 2.5 years without any evidence of recurrence. Conclusions: We conclude that when diagnosed by strictly defined criteria, IP as benign urothelial neoplasm was with extremely low incidence of recurrence and good prognosis. It does not seem to be a risk factor for TCC, especially if located in the bladder. Therefore, a good transurethral resection is adequate therapy and follow-up protocol as rigorous as those for TCC may not be necessary.
الموضوعات
Adult , Age of Onset , Aged , Aged, 80 and over , Female , Humans , India , Male , Middle Aged , Papilloma, Inverted/pathology , Retrospective Studies , Urinary Bladder Neoplasms/pathology , Young Adultالملخص
Stool samples collected from the districts of Darjeeling, Jalpaiguri, Hooghly and Calcutta in West Bengal were examined for hookworm and associated parasites. It was found that maximum prevalence of hookworm was in Hooghly district (24.8%). N. americanus appeared to be more prevalent species in all the districts studied. The load ofhookworm infection appeared to be mostly in the mild range. Ascaris lumbricoides appeared to the most common accompanying infection. In the affected population, the degree of anaemia was mostly mild.
الموضوعات
Adolescent , Adult , Aged , Anemia/etiology , Animals , Child , Child, Preschool , Female , Hookworm Infections/complications , Humans , India/epidemiology , Infant , Male , Middle Aged , Necator americanus , Necatoriasis/complicationsالموضوعات
Adolescent , Adult , Child , Child, Preschool , Disease Outbreaks , Female , Humans , India/epidemiology , Infant , Infant, Newborn , Jaundice/epidemiology , Male , Middle Aged , Water Supplyالملخص
Out of 867 sex workers examined during 1998-2000 from the five important red light areas of Kolkata, 26.18%(227) were suffering from active syphilitic infection having positive VDRL test with titre 1/8 and above. Vaginal smear for gram staining was collected from all sex workers, and found positive for active gonorrhoeal infection in 41.8% (362). Culture positivity for gonorrheal infection was 34.14% (296). Sex workers were also having other STD infection, 23.64% (205) Trichomonas infection, 13.26% (115) Candidiasis, 8.77% (76), Gardenella and 3.0% (26) Chanchroid for which vaginal samples were found positive. HIV sero-positivity was found to be 13.2% (115) out of 867 blood samples examined from all sex workers under study. There were 0.34% (3) sex workers who were also positive for HIV II infection along with HIV-I infection. A case of HIV II alone was not detected in any of the sex workers. Around 49.6% (430) knew that STD/HIV can be prevented by use of condom. However, condom was used by only 6.57% (57) sex workers.
الموضوعات
Chancroid/epidemiology , Female , Gonorrhea/epidemiology , HIV Infections/epidemiology , Humans , India/epidemiology , Prevalence , Sex Work , Sexually Transmitted Diseases/epidemiology , Syphilis/epidemiologyالملخص
The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively.