Evaluation of COVID-19 appropriate behavior among fully vaccinated students in a medical college of north-east India

Background: The current COVID-19 pandemic is one of the greatest public health challenges. The spread of COVID-19 infection continues unabated despite vaccination. Adherence to COVID-19 appropriate behavior is critical to prevent COVID-19 infection. Aim and Objectives: To find out the pattern of COVID-19 appropriate behavior among vaccinated medical students and to estimate the incidence of COVID-19 infection after vaccination. Materials and Methods: A cross-sectional observational study using a questionnaire was carried out for a period of 3 months. The questionnaire was prepared based on the guidelines of Ministry of Health and Family Welfare, Government of India. The data were collected using a pretested Google Form (online digital questionnaire) by means of a web-based survey. Results: About 96.5% of the participants wear face cover or mask while meeting someone or during visit to public places and 91.6% maintain respiratory hygiene, whereas 11.6% spit in the open, 16.1% travel unnecessarily, and 36.8% do not discourage crowd. There is significant (P < 0.05) increase in COVID-19 infection after vaccination. Conclusion: This study suggests that more emphasis should be given on sensitizing the medical students about the standard COVID appropriate behaviors because strict adherence to COVID-19 appropriate behavior is the key to the long-term management of this pandemic.

Structural evaluation of perimetrically normal and affected hemifields in open angle glaucoma

Purpose: To study macular ganglion cell layer--inner plexiform layer complex (GCL + IPL) in relation to peripapillary retinal nerve fiber layer (RNFL) in glaucomatous eyes with superior or inferior hemifield defects (HD) and to study structural configuration in normal hemifield. Methods: This was an observational cross-sectional study. Data from consecutive 45 superior HD (SHD) and 50 inferior HD (IHD) eyes were analyzed. Each patient underwent detailed ocular examination, standard automated perimetry, and spectral domain optical coherence tomography (SD-OCT). After adjusting for age, gender, and signal strength, area under receiver operating characteristic curve (AUC) was calculated to determine diagnostic ability of GCL + IPL and peripapillary RNFL. Apparently normal hemifield was compared with true normal hemifield. Data were analyzed with SPSS, analysis of variance, t-test, Chi-square test, and receiver operating curve. Results: In the SHD glaucoma group, best parameters for discriminating normal eyes from glaucomatous eyes were inferotemporal GCL + IPL thickness (0.935) and inferior quadrant RNFL thickness (0.971). For IHD glaucoma, average GCL + IPL thickness (0.877) and average RNFL thickness (0.950) had best AUC values. When evaluating apparently normal hemifield in both groups, statistically significant difference was found in inferior GCL + IPL sector (0.865) and inferior quadrant RNFL (0.883) in IHD and superonasal GCL + IPL (0.725) and superior quadrant RNFL (0.842) in SHD groups. Conclusion: SD-OCT may be a useful ancillary diagnostic tool for evaluation of early macular and circumpapillary structural changes in glaucomatous eyes with localized visual field defects. Apparently normal hemifields show structural damage and should be considered in management of glaucoma.

Internal limiting membrane peel: Does it change the success rate of primary vitrectomy without belt buckle in rhegmatogenous retinal detachments?

Purpose: To compare the anatomic success of pars plana vitrectomy (PPV) after internal limiting membrane (ILM) peeling at macular area and macular plus peripapillary area versus no peeling in rhegmatogenous retinal detachments (RRD). Methods: A prospective observational study between July 2014 and March 2017 conducted on 289 eyes of 287 patients with RRD were randomly assigned to three treatment procedures, viz., PPV with no ILM peeling, PPV with macular peeling, and PPV with macular plus peripapillary peeling. Recurrent RD (ReRD) was treated as an event and accordingly the overall primary (PS) and final success (FS) rates were obtained. The risk of ReRD associated with peeling procedures after adjusting for risk factors were obtained using Cox-proportional hazard analysis. Results: The PS percentage for no peel, macular, and macular plus peripapillary procedures were 77.78% (70/90), 82.18% (83/101), and 94.89% (93/98; maximum), respectively, which was statistically significant with a P value of 0.003. The FS percentage for no peel, macular, and macular plus peripapillary were 93.33%, 95.04%, and 100%, respectively, which was significantly different with a P value of 0.048. With reference to no peeling, the adjusted hazard ratio for macular peeling was 0.841 [95% CI: 0.44–1.60] while 0.235 [95% CI: 0.088–0.626] for macular plus peripapillary peeling. Conclusion: The anatomic success rate of PPV with macular plus peripapillary ILM peeling was significantly higher as compared to no peel category. The hazard of ReRD in patients undergoing macular plus peripapillary peel was significantly reduced as compared to no peel procedure.

Linear discriminant score for differentiating early primary open angle glaucoma from glaucoma suspects

Purpose: To determine the diagnostic accuracy of a linear discriminant function (LDF) based on macular ganglion cell complex (GCC), optic nerve head (ONH) and retinal nerve fibre layer (RNFL) for differentiating early primary open-angle glaucoma (POAG) from glaucoma suspects. Methods: In this cross-sectional study, data from consecutive 127 glaucoma suspects and 74 early POAG eyes were analysed. Each patient underwent detailed ocular examination, standard automated perimetry, GCC and ONH and RNFL analysis. After adjusting for age, gender and signal strength using the analysis of covariance; Benjamin–Hochberg multiple testing correction was performed to detect truly significant parameters to calculate the LDF. Subsequently, diagnostic accuracy of GCC and ONH and RNFL were determined. The obtained LDF score was evaluated for diagnostic accuracy in another test set of 32 suspect and 19 glaucomatous eyes. Data were analysed with the R-3.2.1 (R Core Team 2015), analysis of variance, t-test, Chi-square test and receiver operating curve. Results: Among all GCC parameters, infero temporal had the best discriminating power and average RNFL thickness and vertical CDR among ONH and RNFL parameters. LDF scores for GCC had AUROC of 0.809 for a cut-off value 0.07, while scores for ONH and RNFL had AUROC of 0.903 for a cut-off value ? 0.24. Analysis on combined parametric space resulted in avg RNFL thickness, vertical CDR, min GCC + IPL and superior GCC + IPL as key parameters. LDF scores obtained had AUROC of 0.924 for a cut-off value 0.1. The LDF was applied to a test set with an accuracy of 84.31%. Conclusion: The LDF had a better accuracy than individual GCC and ONH and RNFL parameters and can be used for diagnosis of glaucoma.

Needle sticks injury among nurses involved in patient care: a study in two medical college hospitals of West Bengal.

A hospital-based retrospective study on a sample of 228 nurses involved in patient care, in two medical college hospitals of West Bengal, showed that 61.4% of them sustained at least one Needle Stick Injury (NSI) in last 12 months. The risk of such injuries per 1000 nurses per year was found to be 3,280. Out of the most recent injuries among 140 nurses, 92.9% remained unreported to appropriate authorities; in 52.9% events hand gloves were worn by the nurses; only 5% of those nurses received hepatitis B vaccine, 2.1% hepatitis B immunoglobulin and none of them received post exposure prophylaxis for HIV.

Septic abortions: a descriptive study in a teaching hospital at North Bengal, Darjeeling.

A hospital based cross sectional study for one year done among 57 diagnosed and admitted septic abortion cases, revealed that 71.9% septic abortions were performed by untrained persons, 63.2% mothers were illiterate, 22.8% mothers were in adolescent age group. Exploratory Laparotomy was needed in 46.3% cases and important complications for referring were severe anaemia and septic shock.

Noise level in different places of Dhaka Metropolitan City (DMC) and noise-induced hearing loss (NIHL) in Dhaka City dwellers.

A cross sectional, exploratory study was designed at "National Center for Hearing and Speech for Children" (NCHSC), Dhaka, Bangladesh, from May 2001 to June 2002, with a view to determine the average noise level in different places of Dhaka Metropolitan City (DMC), and also aiming at evaluating the extent of Noise-induced Hearing Loss (NIHL) in different groups of city dwellers and finally a base line information. A total of 32 places in DMC were selected randomly. The highest noise level recorded 104 dB at Sayedabad bus terminal and the lowest 68 dB in Banani and Baridhara residential area. In silent zone of DMC, average noise level was 79 dB, in residential zone 72 dB, in commercial zone 90 dB, and in mixed zone average noise level was recorded at 91 dB. Measured noise levels were more than acceptable and permissible levels in all places of DMC. A total of 312 persons aged between 15-45 years (mean age- 24.64 years) were enrolled for the study as per inclusion criteria. Gender-wise male were 211(67.62%) and female were 101(32.57%). Profession-wise Automobile drivers were 57(18.26 %), Garment workers 58(18.55 %), City dwellers 72(23.07%), Students 72(23.07%), Traffic polices 12(3.85%), Hawkers and Road side shopkeepers were 41(13.1%). Definite noise notch (>25dB) at 4KHz observed in 33(10.58%) audiogram of persons under study. Automobile drivers, Traffic polices, Road side hawkers and Shop keepers, Garment workers are mostly affected were 17.54%, 16.4%, 12.09% and 12.06% respectively. A total of 201 persons (64.42%) were not aware of their hearing impairment, 244(78%) of the person had poor level of knowledge regarding bad effects of noise on health and about protective means available. Amongst persons (33) found to have NIHL did not use any protective device.

Hepatitis B virus genotype D infection among antenatal patients attending a maternity hospital in Calcutta, India: assessment of infectivity status.

A seroepidemiological study was conducted to determine the hepatitis B virus carrier rate and infectivity status among antenatal patients in Calcutta. Fifteen of 400 antenatal mothers (3.74%) were carriers of HBV genotype D. Four (1.0%) of them were positive for HBeAg with a high risk of transmitting infection to their babies. The presence of precore mutant HBV, which has been associated with transmission events from HBeAg mothers to their babies, was not detected in any of the HBeAg negative mothers.

In vivo enhancement of nucleopolyhedrovirus of oriental Armyworm, Mythimna separata using spindles from Helicoverpa armigera entomopoxvirus.

When the third instar larvae of M. separata were exposed to eight varying concentrations of polyhedral occlusion bodies (POB's) of nucleopolyhedrovirus of M. separata (MsNPV) ranging from 2.6 x 10(-1) to 2.6 x 10(8) POB's/ml, the percent mortality and incubation period ranged from 16-100% and 14 to 9 days respectively. On the other hand when the same third instar larvae of M. separata were exposed to only five varying concentration of POB's of MsNPV ranging from 2.6 x 10(2) to 2.6 x 10(6), POB's/ml along with a constant dose of entomopox viral spindles from Helicoverpa armigera, the per cent mortality ranged from 63 to 100% with reduction in incubation period from 7 to 4 days respectively. The enhancement index (log10) of the virus was 2.76 or reduction of more than 500 times in LC50. The ability and the mechanism of the spindles from H. armigera entomopoxvirus to enhance the infectivity of MsNPV has been discussed.

Profile of hepatitis B e antigen-negative chronic hepatitis B.

BACKGROUND: Although chronic hepatitis B occurs in hepatitis B e antigen (HBeAg)-negative patients, its prevalence and clinical significance are not known. AIM: To determine the prevalence and profile of HBeAg-negative chronic hepatitis B virus (HBV) infection. METHODS: A retrospective analysis of 363 consecutive patients (mean age 36 y; 288 men) with chronic HBV infection was performed. All patients were HBsAg-positive. Tests for liver profile, HBeAg and anti-HBe antibody were performed in all patients. Serum HBV DNA was tested using branched DNA assay in 245 patients. The patients were classified into three groups: no cirrhosis with normal ALT levels, no cirrhosis with elevated ALT levels, and clinical or histological evidence of cirrhosis. RESULTS: Of 363 patients, 141 (39%) were HBeAg-positive and 222 (61%) HBeAg-negative. Of HBeAg-negative patients, 120 (54%) had normal ALT, 45 (20%) had elevated ALT and 57 (26%) had evidence of cirrhosis; corresponding figures in the HBeAg-positive patients were 40 (28%), 66 (47%) and 35 (25%). HBV DNA was positive in 53 of 131 (40%) HBeAg-negative patients tested; of these 53 patients, 9 (17%) had normal ALT, 20 (38%) had elevated ALT and 24 (45%) had cirrhosis. Thus, 72% of HBeAg-positive and 46% of HBeAg-negative patients had elevated ALT and/or cirrhosis. Among the latter group, 83% of HBV DNA-positive patients had elevated ALT and/or cirrhosis. Overall, 18% of HBsAg-positive patients had HBeAg-negative, HBV DNA-positive liver disease. CONCLUSION: HBeAg-negative chronic hepatitis B is not an uncommon and benign entity and chronic liver disease develops in a significant proportion of such patients.

Age related seroprevalence of antibodies to varicella in India.

OBJECTIVE: To determine the age related prevalence of Varicella Zoster Virus (VZV) antibodies in India. SETTING: This was a cross sectional multicentric study performed in 4 major cities of India: Calcutta (outpatients), Mumbai (outpatients), Lucknow (walk-in patients to a diagnostic laboratory, orphanage and factory workers) and Bangalore (outpatients and walk-in patients to a diagnostic laboratory). METHODS: A total of 1609 volunteers from birth to 40 years of age were included into the study. IgG antibodies against VZV were determined using commercial kits (ELISA-Enzygnost). RESULTS: Overall seroprevalence of anti VZV antibodies was 68. 22percnt. The age related seroprevalence rate of anti VZV antibodies was 29percnt in the age group of 1-5 years, 51.1percnt in 5-10 years, 71.7percnt in 11-15 years, 79.8percnt in 16-20 years, 88.1percnt in 21-30 years and 91.1percnt in 31-40 years. CONCLUSION: A significant proportion of adolescents and adults are susceptible to varicella in India, as in other tropical countries

Tuberculosis and HIV illness.

The HIV infection leading to AIDS is considered to be one of the greatest biomedical challenges in the present century. Like all other communicable diseases AIDS is gradually penetrating the underprivileged sections of society in all countries. Nearly 5 million people in India are living with AIDS at present that makes India a single country with highest number of HIV infected people in the world. The hallmark of HIV disease is the reduction of CD4+ T-lymphocytes, the key cells of immunity. The initial phase of the disease may be termed as HIV seroconversion illness. The next phase is termed asymptomatic HIV infection. When the CD4 count falls below 400/microliter, the patient develops early opportunistic infections which may be termed as early symptomatic HIV infection or AIDS related complex (ARC). Mycobacterial infections are also common in these patients and have led to an alarming resurgence of tuberculosis (TB) in many countries. The available information suggests that TB may be the commonest HIV related disease in the world. The clinical presentation of TB in HIV infected individual is influenced by the degree of HIV related immunosuppression. The atypical features like extrapulmonary TB and absence of positive Mantoux test are generally noticed at a fairly advanced stage. The x-ray chest is also an important adjunct to diagnosis of TB in HIV infected individual. The studies on TB and AIDS in the early part of HIV epidemic in developed countries suggest that extrapulmonary TB is more common in co-infected people but when TB infection is considered in all HIV infected persons, extrapulmonary TB is less common than pulmonary TB. The result of treatment in co-infected pulmonary TB cases is almost similar with the cases suffering from TB alone. Treatment failure, however, has been noticed rarely at extrapulmonary sites.

Projection of HIV infection in Calcutta.

Starting with the base year of 1991, the HIV infection projection for 1992-99 for the total, as well as various high-risk sub-populations of Calcutta, the first of its kind is provided. These projections are based on statistical methodology developed in this paper. Our methodology for spread of HIV infection takes into account various social interactions and practices and also uses available data. Rates of these interactions and practices and estimates of demographic parameters used in making projections were obtained primarily from surveys and census data. Since one of these estimated rates, that of HIV transmission rate through heterosexual encounters between an infected and an uninfected had a large range, we have provided two sets of projections based on the largest of these rates (worst-case scenario) and another that is consistent with the available data. The total projection of the number of HIV infected cases in Calcutta for 1999 is between 49,000 and 1,26,000. Separate projections are also provided for high-risk sub-groups. Among these, the sex workers expectedly will continue to manifest the highest numbers of newly infected cases. The temporal rate of increase in prevalence is projected to be alarmingly higher in the general population than even among sex workers, although the actual prevalence will continue to be the lowest in the general population compared to all other sub-groups of the population.

Diagnosis of pulmonary tuberculosis by polymerase chain reaction for MPB64 gene: an evaluation in a blind study.

Polymerase chain reaction (PCR) has been found to be a sensitive and rapid method to confirm a clinical diagnosis of tuberculosis. We evaluated PCR for M. tuberculosis complex specific MPB64 gene for the diagnosis of pulmonary tuberculosis, in a double blind study. One hundred and eighty-two clinical samples (sputum, bronchioalveolar lavage and pleural fluid) from patients with a clinical diagnosis of pulmonary tuberculosis and 72 samples from patients with non-tubercular pulmonary lesions and normal healthy individuals were included. The samples were coded and clinical details were concealed from the laboratory, where conventional diagnostic methods and PCR were carried out independent of each other. On decoding and analysing the data, PCR was positive in 59% of single sputum samples from clinically diagnosed pulmonary tuberculosis, while M. tuberculosis could be grown in 18% of the samples. PCR could identify M. tuberculosis in 81.8% of the culture positive sputum samples. PCR was also positive in 71.4% of bronchioalveolar lavage (BAL) fluid and 60.7% pleural fluid samples from clinically suspected cases, which were mostly culture negative. On comparison with response to treatment, PCR was positive in 79.5% of patients who improved on anti-tuberculosis treatment, with a positive predictive value of 92%. PCR for MPB64 gene provides a useful alternative for the diagnosis of pulmonary tuberculosis from sputum and paucibacillary samples like BAL and pleural fluid in which conventional methods show low sensitivity, especially in areas from which strains show a low copy number of other PCR targets like the IS 6110 insertion sequence.

Serodiagnosis and immune profile in rheumatoid arthritis.

One hundred and seventy-five cases of clinically diagnosed rheumatoid arthritis, 82 non-rheumatoid cases suffering from various other diseases and 40 healthy normal controls were investigated for detection of rheumatoid factor, quantitation of serum immunoglobulin, demonstration of antinuclear antibody (ANA) and LE cell phenomenon. Microlatex agglutination test of serum for rheumatoid factor (RF) showed 64% positivity in rheumatoid group and 1.2% positivity in non-rheumatoid group. All three immunoglobulins (IgG, IgM, IgA) were found to be raised in serum of patients with rheumatoid arthritis, whereas only IgA level was elevated in serum of patients with non-rheumatoid diseases. ANA and LE cell phenomenon were observed in 3.4% and 2.8% cases respectively in cases of clinically diagnosed rheumatoid arthritis who had been suffering from severe active rheumatoid arthritis. In non-rheumatoid group RF was positive in significant titre in only one case of leprosy. Synovial fluid and synovium were found to be heavily infiltrated by plasma cells and lymphocytes. RF appears first in synovial fluid and then in serum. Hence RF titre in blood may not attain significant level for the first several months.

Epidemiological correlates of dental caries in an urban slum of West Bengal.

The overall prevalence of dental caries was found to be 57.47 percent in an urban slum irrespective of sex, with a maximum of 75.88 percent in the age group of 5-9 years. Habit of taking hard and sticky food, bad oral hygiene were some of the important epidemiological correlates. Fluoride content of drinking water did not show any significant role.

An in vitro qualitative assay for the detection of antibodies to HIV type 1/2 contained in human saliva.

There is ample evidence that saliva contains secretory antibody against most infections. Therefore, saliva has been recommended as a non invasive, safe and effective alternative to serum, for HIV antibody testing. The present study attempted comparative evaluation of antibody detection by serum and saliva specimens in laboratory by ELISA and Western Blot for diagnosis of HIV infection in the Indian situation. From a study of 42 test sera it is concluded that test apart from its simplicity and reproducibility, is almost free from any false positive and false negative reactions.