Measles outbreak investigation in Dwarahat block of District Almora, Uttarakhand.

Background: We report an assessment of measles outbreak during the months of February 2014 to April 2014 in Dwarahat block of district Almora and the response mounted to it. Materials and Methods: An intensive door‑to‑door search to six measles affected villages in Dwarahat block of district Almora, covering a population of 2,408 was carried out to identify the cases of measles by a rapid response team (RRT). A total of ten blood samples were randomly collected for detecting IgM antibody against measles. For all cases, information on personal details, place of residence, time of onset and status of immunization were obtained. Results: Overall attack rate (AR) was 2.8%. AR among the population of age‑group 0–16 was 7.2%. Statistically significant higher AR (16.26%) was seen for the age‑group of 0–5 years as compare to 6–10 and 11–16 years of age (AR‑8.71, relative risk‑0.53, 95% confidence interval‑0.32–0.88, P value‑0.012 and AR‑0.57%, relative risk‑0.035, 95% confidence interval‑0.00–0.14, P value‑0.000, respectively). Males were affected more often than females 35 [59.2%] vs. 24 [40.8%]. Measles‑related complications were seen in three children. No death was reported. Of the 10 samples, nine were positive for measles IgM antibodies by enzyme‑linked immunosorbent assay (ELISA). Conclusion: The recognition of early warning signals, timely investigation and application of specific control measures can contain the outbreak. The unvaccinated or partially protected human beings serve as the reservoir of measles virus. Hence, there is a need for sero surveillance for measles in Uttarakhand and one catch up measles immunisation campaign to prevent future outbreak.

Three cases of Iohexol induced seizures in paediatric patients undergoing CECT head and the role of pharmacovigilance.

In the modern era, the highly specific radiological investigation are on an increase and most of them mandates the use of contrast agents. These contrast agents are not free of adverse reactions and some of them are even potentially life threatening. Strictly implementing Knowledge, Awareness and Practice (KAP) in the institution. Contributing knowledge to the medical literature about the incidence of Iohexol induced seizure, which might be on an increase on the global level. Awareness by means of Pharmacovigilance Programme (PvP) to ensure the safety of the patient. Within the short period of three days, three cases of contrast induced seizures were reported by the Department of Paediatric and were treated accordingly. The Department of Pharmacology, expedited all the three cases to the National Co-ordinating Centre, Ghaziabad, India by entering the data into Vigiflow and also directed the chief pharmacist of the drug store to immediately stop the use of Iohexol with same batch number to prevent further risk.

Antibacterial effects of azadirachta indica leaf and bark extracts in clinical isolates of diabetic patients.

Background: Antibacterial activities of crude Azadirachta indica (neem) bark and leaf extracts were investigated in bacterial species isolated from clinical samples of diabetic individuals. Methods and Material: Nine different dilutions of methanolic bark and leaf extracts were tested for this purpose in agar well diffusion method. Results: Both the extracts were active against Gram positive as well as Gram negative strains. Zones of inhibition produced by different bacteria for different concentrations were summarized by linear regression. Highest activities were exhibited for coagulase negative Staphylococcus (CONS) by both bark and leaf extracts, Y = 16.95 + 0.19X and Y = 18.90 – 0.70X, respectively. Conclusions: Results indicate that exhaustive studies involving identification of specific compounds in neem extracts and testing their activities in diabetic samples would be worthwhile considering steep emergence of multidrug resistant species in diabetic infections and infections in general.

Candida colonization in preterm babies admitted to neonatal intensive care unit in the rural setting.

PURPOSE: Candida colonization in neonates results in significant morbidity and mortality. The purpose of this study was to determine colonization of Candida spp. in preterm babies and identify the risk factors. METHODS: Swabs from oral, rectum, groin and umblicus of 103 preterm and 100 term neonates were obtained within 24 hours of birth, day three, day five, day seven and thereafter every week till the neonate was admitted in the neonatal intensive care unit (NICU). Swabs were also collected from the mother's vagina prior to delivery. Twice every month, air of the NICU was sampled by settle plate and swabs were collected from the hands of health care workers and inanimate objects of NICU. Identification and speciation was done by standard methods. Antibiotic sensitivity was studied against amphotericin B, ketoconazole and fluconazole by disk diffusion method. RESULTS: Colonization with Candida was significantly higher in preterms. Earliest colonization was of oral mucosa and 77.1% of the preterms had colonised at various sites by the first week of life. Significant risk factors in colonized versus non-colonized preterms were male sex, longer duration of rupture of membranes (DROM), administration of steroids and antibiotics and vaginal colonization of mothers, whereas those in preterms versus terms were low birth weight and gestational age. C. albicans was the commonest species, both in the colonized preterms (45.9%) and vagina of mothers. Resistance was seen to fluconazole and ketoconazole only. No Candida spp. was isolated from health care personnel or environment. CONCLUSIONS: Colonization of preterms by Candida is a significant problem in NICU and the significant risk factors observed in colonized preterms were male sex, longer DROM, administration of steroids and antibiotics and vaginal colonization of mothers.