Histoid Leprosy: Are We Still Harbouring Potential Community Menace? A Case Series from North-East India

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Histoid leprosy is considered an uncommon multibacillary form of leprosy characterized by presence of histoid lepromas which present as erythematous round or oval shaped glistening nodules. Most commonly this form of leprosy is seen in patients on irregular therapy with MDT. In this series we report a total of three cases with their clinical, histopathological and dermoscopic findings.

Progressive Trends of Childhood Immunization in Rajasthan: A study based on the NFHS database

Any public health program's efficacy may be evaluated solely based on the available statistics. A program's ability to be tracked relies heavily on data. There are several systems in place in India for gathering data on the health of individual states and the country as a whole. The National Family Health Survey (NFHS) is one of these mechanisms. Children's vaccination status is one of the many data points collected by the National Health Interview Study (NFIS), a representative sample survey. NFHS is commonly used to evaluate and monitor the progress of any health program in the country, therefore, to sum it up: According to Rajasthan's NFHS-4 and NFHS-5 reports, there has been a significant increase in the state's coverage status. Despite the difficulties and the closure of the corona, this research will investigate the data that has demonstrated extraordinary rises and the causes that have made it possible or the huge efforts by the state government.

Analgesic Activity Of Bark And Leaves Of Ficus Religiosa L. From Nepal

Objective: Because of adverse side effects, caused by NSAIDs, tolerance, and dependence induced by opiates, the use of these analgesic agents has not been successful in all cases. Therefore, alternative analgesic drugs from plant sources are the new target now days. The objective of this study was to evaluate the analgesic activity of ethanolic extracts of stem barks and leaves of Ficus religiosa. Methods: The analgesic activity of ethanolic extract of stem barks and leaves was evaluated in the Swiss albino mice model using acetic acid-induced writing response and Eddy’s hot plate method. Analgesic activity was demonstrated with the percentage inhibition of acetic acid induced writings and the percentage increased in latency time of paw licking. The potency of test extracts was compared with standard drug, Diclofenac. Results: Ethanolic extract of leaves and bark of F. religiosa showed potential analgesic activity from both methods. From Eddy’s hot plate model, it was observed that the percentage of increased latency time at 90 min by ethanolic extract of leaves and stem bark was found to be 70.81 % (8.54 min) and 70.78 % (8.53 min) respectively at a dose of 400 mg/kg. Both of these results are statistically significant (p<0.05) as compared to the test group. Furthermore, both of these extracts showed the dose-dependent and time-dependent increased in latency time and these results are compared to that of standard drug Diclofenac. Similarly, ethanolic extract of leaves and stem at 400 mg/kg significantly inhibited the number of writhings induced by acetic acid. The percentage inhibition of writhings by ethanolic extract of leaves at a dose of 400 mg/kg was 68.47 % which was similar to that of standard drug Diclofenac (68.47 %). However, ethanolic extract of bark showed relatively lower percentage inhibition (60.79 %) as compared to leaf extract and standard, but the result was significant as compared to that of the test group (p<0.05). Conclusion: Ethanolic extracts of F. religiosa stem bark and leaf possess both central and peripheral analgesic properties and these effects may be beneficial for the management of pain.

Characterization of cultural beneficial bacterial diversity for plant growth promoting attributes associated with rice rhizosphere

Aim: The study was undertaken to isolate, characterize and molecularly identify plant growth promoting rhizobacteria (PGPR) associated with rice rhizosphere occurring in Gangetic plains of the country. Methodology: One hundred forty three plant growth promoting rhizobacteria were isolated on various culture media and characterized culturally and morphologically through Scanning Electron Microscope. These rhizobacterial isolates were further screened for plant growth promoting activities like HCN production, siderophore production and phosphate solubilisation. The 16S rDNA sequencing was done to decipher phylogenetic relationship among 19 selected PGPRs. Besides, these were also tested for anti-oxidative enzyme production to mitigate deleterious effects of various stresses on plant growth and metabolism. Results: Nineteen potential plant growth promoting rhizobacteria were characterized for plant growth promoting attributes and were indentified at molecular level. Rice is well colonized by bacteria mainly Bacillus spp., Pseudomonas spp., Burkholderia sp., and Acinetobactor spp., Rice seeds treated with microbial consortium of MAU 143 + MRT 84 recorded in increased antioxidant production–SOD activity (0.02 U mg−1 f.w.t.), POX activity (0.16 U mg−1 f.w.t.), POP activity (0.06 U mg−1 f.w.t.) and TPC assay (1.17 µg gallic acid mg-1 extract) which might have stimulated the growth of radical (2.2 cm) and plumule (1.6 cm) over control. These three PGPRs viz., MAU 143, MRT 84 and MRT 92 strain showed great potential to improve antioxidant and total polyphenol production and seed vigour of rice seedlings. The identified rhizobacterial strains may be used for plant growth promotion and improvement in nutrients mobilization and oxidative stresses in rice production. Interpretation: The study suggested that plant growth promoting rhizobacteria isolated from rice rhizosphere have greater potential to improve soil nutrients status while provide resistance against infection of pathogenic microbes due to production of anti-oxidative enzymes and phenolic compounds in rice seedlings.

Pattern of Leukaemias in a Tertiary Care Hospital - A 5 Years Retrospective Study of 103 Cases.

Objective: To study the distribution of various types of leukaemia in the RIMS Hospital in terms of types, age, sex and among various ethnic groups. Material and Method: It’s a retrospective study carried out in the department of Pathology, Regional Institute of Medical Sciences (RIMS) Hospital over a five years period between November 2006 and October 2011. Diagnosis was based on peripheral blood count, peripheral blood smear and bone marrow examination for morphology along with cytochemistry study whenever required. FAB classification is followed in the study. SPSS software package, version 16, was used for statistical analysis. Result: Out of total 103 cases, 49cases (47.6%) were children and adolescents and 54 cases (52.4%) were adults. Age range was 9 months to 79 years with a mean age of 31.2 years. Among the children and adolescents, 30 cases were males and 18 cases were females (M: F ratio 1.7:1). In the adults 34 cases were males and 21 cases were females with M: F ratio 1.6:1. Overall male female ratios was 1.6:1. Out of 103 cases, 85.4% were of of acute leukaemia and rest were chronic leukaemia (14.6%). Acute leukaemia was the most common leukaemia in all age groups. Of all leukaemia cases reported, maximum cases were of acute myeloid leukaemia (AML). Acute lymphoblastic leukaemia (ALL) is the most common type of leukaemia in the children (60.7%) and adolescents (52.3%). AML (66.7%) is the most common acute leukaemia in adults. Among ALL, L2 is the most common variant (82.3%) and in AML, M3 is the most common (38.8%). Chronic leukaemia was more common in adult (80%) than children and adolescents. Out of total 12 cases of the chronic leukaemia reported in adults, 10 were of chronic myeloid leukaemia (CML), 2 were chronic lymphocytic leukaemia (CLL). The maximum cases of leukaemia were among Meitei community (64%) followed by tribal community (28%) and minimum in Muslims (8%). Conclusion: In this study, acute leukaemia was the most common leukaemia in all age groups. Of all leukaemia cases reported, maximum cases were of AML and minimum cases were of CLL. Chronic leukaemia was more common in adult. In children, majority of cases were ALL and chronic leukaemia was rare. Leukaemias were more common in males. Meitei community was affected the most.

Assessment of hand pump waters in three tribal dominated districts of southern Rajasthan, India.

Udaipur, Banswara and Dungarpur districts of southern Rajasthan (India) have dominance of tribal population. In these districts besides other water resources, hand pumps are catering the need for drinking water. The present study was undertaken to assess the level of chemical and bacteriological status for comparing the water quality with the prevailing standards. 18 hand pumps were studied for selected water quality parameters such as, pH, hardness, chloride, fluoride, NO3 -N, EC, orthophosphate, TDS, TSS, BOD, total coliforms and faecal coliforms, following the standard methods. The data on chemical parameters revealed that in all 18 hand pumps the water quality was within the permissible level of WHO. However, in eight hand pumps the faecal coliforms were higher (2-6 MPN/100 mL) than the permissible limit which confirm organic contamination in these drinking water resources. On the basis of this study, suitable remedial measures for protection of water quality have been suggested.

Cytodiagnosis of papillary thyroid carcinoma--a study of 37 cases at RIMS Hospital, Imphal.

Papillary carcinoma is the most common malignant tumour of thyroid gland which can occur in any age group with most tumours diagnosed in the third and fifth decades predominantly in the females. FNAC is emerging as the first line of investigation for any thyroid enlargement including tumours as a safe, rapid and cost -effective procedure. Many studies have reported diagnostic accuracy of FNAC in detecting neoplasms. The present study aims to evaluate the diagnostic accuracy of FNAC in the cytodiagnosis of papillary carcinoma and to highlight the clinco-pathologic correlation. A total of 37 cases were diagnose cytologically as papillary carcinoma, out ofwhich 28 cases were histologically proved. The remaining 9 cases were not available for biopsy. It was observed that careful cytomorphologic assessment with particular attention to cellular arrangement and nuclear characteristics aided in the correct diagnosis.

Simultaneous continuous ambulatory peritoneal dialysis catheter implantation and inguinal hernia repair.

Continuous ambulatory peritoneal dialysis is a new modality of treatment for end stage renal disease. Although this procedure is largely underutilised in India, in Manipur this procedure is routinely offered to patients of end stage renal disease. Continuous ambulatory peritoneal dialysis catheter implantation was started in Manipur in May, 2001. Till now continuous ambulatory peritoneal dialysis catheter has been implanted in 116 cases. Out of this 3 patients had associated inguinal hernia. Inguinal hernia is a relative contra-indication for continuous ambulatory peritoneal dialysis. Still the inguinal hernia was repaired in the same sitting with the catheter implantation. The procedure is described along with the outcome.

A comparative study of PUVASOL therapy in lichen planus.

BACKGROUND: PUVA therapy is reported to be effective in lichen planus. However, PUVASOL therapy is more easily available in India. AIM: To carry out a three way open comparison of oral PUVASOL therapy with oral metronidazole and with the conventional oral antihistamine plus topical steroid therapy. MATERIAL AND METHODS: Seventy-five cases of lichen planus were studied for 12 weeks with three different modalities: 1. Oral metronidazole and topical emollient cream, 2. Oral PUVASOL and topical emollient cream, and 3. Oral cetirizine and topical betamethasone dipropionate cream. Lesions were assessed before starting the treatment and after every 4 weeks. RESULTS: Seventy patients completed the trial. Statistical analysis showed that therapy 1 was less effective than 2 and 3, which were found to be equally effective. CONCLUSION: It is concluded that PUVASOL therapy is a useful alternative to conventional therapy in lichen planus in our country where sunlight is available in plenty.

Mesenchymal hamartoma of the liver--a case report.

Mesenchymal hamartoma of the liver is a rare benign tumor of infancy and childhood. A case of mesenchymal hamartoma of liver seen in a 37 day old child is reported and the available literature on the subject is briefly reviewed.

Diagnostic clinical features of atopic dermatitis.

Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy-three patients of atopic dermatitis and 71 age matched controls were studied. All the subjects were examined using a set of 34 potentially useful clinical features selected from different studies, including features for evaluation of photosensitivity. Multiple regression technique was used for analysing the data. It was found that 6 clinical features were diagnostic, 1. presence of itch, 2. history of flexural involvement, 3. history of dry skin, 4. family history of atopy, 5. personal history of diagnosed asthma and 6, visible flexural dermatitis. Photosensitivity was not a significant feature.

Segmental renal dysplasia--a case report.

A case of segmental renal dysplasia presenting with loin pain, a renal mass and hypertension in a young girl of 16 years is being reported. Clinical and histological features of this rare renal anomaly are discussed.

Peritonitis in India--a decade's experience.

Generalised peritonitis is a common and dreaded surgical emergency. Its tropical spectrum continues to be different from its western counterpart. The study represents a retrospective analysis of 250 cases of peritonitis managed surgically over a decade at a large referral surgical unit at New Delhi. Perforations of the upper gastrointestinal tract viz: duodenal ulcer, enteric perforations etc. constitute the majority unlike western series where lower gastrointestinal tract perforations predominate. Despite significant delays in presentation, the overall prognosis remains comparable to the western figures. A comparatively younger age group involved may be responsible for better outcome.

Primary hyperparathyroidism--an Indian study.

Twenty eight patients of sporadic primary hyperparathyroidism seen over a period of 10 years were studied. There were 18 females and 10 males with a mean age of 35.9 years. Bone involvement was the commonest clinical presentation (90%) followed by renal involvement (65%) and more than half the patients (54%) had involvement of both the skeletal and renal systems. The tumor was clinically palapable in six patients. Thalliumtechnetium subtraction scan had a sensitivity of 87% followed by computerised tomography (70%), and ultrasound (65%) in diagnosing parathyroid pathology. All the patients underwent surgical excision of the abnormal gland (S). Adenomas constituted the single largest group (90%). Histologically, only 32% of the patients had chief cell morphology. Clear cell (32%) mixed cell, and oxyphil cell (7.2%) types accounted for the remaining adenomas. Majority of the patients (82%) had symptomatic postoperative hypocalcemia requiring intravenous calcium with or without vitamin D supplementation. In contrast to western reports most of our patients were young, presented late with florid bone and renal disease and had large palpable tumors.

Falciparum malaria complicating cholestatic jaundice and acute renal failure.

Nine patients of acute falciparum malaria with severe hyperbilirubinemia developed acute renal failure (ARF). All of them had evidence of intrahepatic cholestasis and needed hemodialysis for several weeks; 7 survived and 2 died, one due to cerebral malaria, the other multiple organ failure. Interestingly, referal diagnosis did not include malaria as a cause of ARF in 8 out of 9 patients.

Immunotoxic responses of cypermethrin, a synthetic pyrethroid insecticide in rats.

The study was undertaken to evaluate immunotoxic effects of cypermethrin administered orally (in ground nut oil) to male albino rats at dose levels (mg/kg) of 0 (control), 5, 10, 20 and 40 once daily for 90 days. Cypermethrin administration produced a significant leucopenia at 40 mg/kg on day 90. A dose dependent decrease (P greater than 0.05) in delayed type hypersensitivity reaction was noticed on day 61 post treatment. Humoral response as evidenced by serum haemagglutinin and haemolysin titres did not show any definite pattern on day 90. However, a significant decrease in spleen weights and significant increase in adrenal weights was recorded in rats receiving the highest test level. Total body weights and liver weights did not show any significant change with any of the dose level studied. Results of the study reveal that low doses (5 and 10 mg/kg) did not have any adverse effect on the immuno-competence of rats.

Clinical utility of ketoconazole in cases of adrenocortical carcinoma.

Ketoconazole, an imidazole derivative is known to decrease adrenal steroid biosynthesis by inhibiting cytochrome P450 dependent adrenal enzymes. Three patients of adrenal carcinoma treated with ketoconazole, 600-1200 mg daily showed significant fall in plasma and urinary cortisol levels, but no reduction in tumor size, one patient developed liver dysfunction which reverted back to normal on discontinuing the drug.