Middle Ear Carcinoid Tumour a Diagnostic Dilemma.

Carcinoid tumours are neuroendocrine tumours associated with gastrointestinal tract, lungs and rarely seen in middle ear. A 29 year old male presented with nonspecific symptoms of blocking sensation, reduced hearing and tinnitus in the right ear. Otoscopy showed congestion of right tympanic membrane with bulge in anterior quadrant with no blanching on siegalization. Audiometry showing conductive hearing loss. CT scan showing mildly enhancing mass in the right middle ear cavity. Complete excision was done and Histopathological studied showed features favouring adenoma and immunohistochemistry showed positive staining of Pan Cytokeratin, Synaptophysis and Chromogranin A, with Ki-67 01% suggestive of carcinoid tumour. Patient underwent PET Scaning post operatively to rule out carcinoid tumour elsewhere in the body. Patient is on follow-up every month to look for any recurrence.

Mental Health Among Bus Drivers and Conductors: A Cross-Sectional Study From Karaikal, South India.

Background Health hazards faced by bus drivers and conductors due to their stressful working conditions can vary greatly depending on the country and specific circumstances. In some regions, stringent regulations mitigate the risks, while in others, lack of enforcement exacerbates the situation. The common mental health issues faced by bus drivers and conductors are anxiety and depression. Therefore, this study was planned to determine the prevalence of anxiety and depression among bus drivers and conductors and identify the risk factors associated with depression and anxiety. Methodology A cross-sectional study was conducted among the bus drivers and conductors working in government and private transport in Karaikal, Puducherry, South India. After institutional ethics committee clearance, 450 male transport workers with a mean age of 42.6 ± 8.56 (SD) years were interviewed to assess their mental status according to the Hospital Anxiety and Depression Scale. Bivariate and multivariate analyses were employed using SPSS software version 20 (IBM Corp., Armonk, NY, USA) to ascertain the association between dependent (anxiety/depression) and independent variables. Results About 16% and 13% of bus drivers and conductors were suffering from anxiety and depression, respectively. Age, education, marital status, bus route type, years of experience, and depression were significantly associated with anxiety. Whereas type of employment, years of experience, and anxiety were significantly associated with depression (p < 0.05). Conclusions Anxiety and depression in drivers and conductors constitute a major public health problem. Proper job rotation, enabling good ergonomics, and social support are some recommendations to promote mental health among transport workers.

COVID-19 Vaccine Hesitancy Among Pregnant and Lactating Mothers Attending Government Health Care Centers in Karaikal, South India.

INTRODUCTION AND AIM: The Government of India has endorsed COVID-19 vaccination for pregnant and lactating mothers. However, the vaccine acceptance rate among this target group is not satisfactory. The study aimed to assess the awareness level, acceptance rate, and hesitancy for COVID-19 vaccination among pregnant and lactating mothers attending government health care centers and to identify the psycho-social factors associated with vaccine hesitancy. MATERIALS AND METHODS: A government facility-based cross-sectional study was conducted in various government primary and secondary health care centers in Karaikal for a period of six months. After Institutional Ethics Committee (IEC) clearance, a semi-structured questionnaire was used to collect the data from 904 pregnant and lactating mothers. Bivariate and multivariate logistic regression were employed. RESULTS: Despite a high awareness level (87%), vaccine hesitancy was high (55%) among the study participants. In multivariate analysis, age > 30 years, primi mothers, lactating mothers with < 6 months old children, unawareness, and recent COVID-19 infection were significantly associated with vaccine hesitancy. Fear of side effects for baby and mother following vaccination and family pressure were the prime reasons for vaccine hesitancy. CONCLUSION: Despite sufficient awareness about the eligibility for COVID-19 vaccination, the acceptance rate was low. There is a dire need to motivate the higher age group, primigravidas, and lactating mothers at the community level to get rid of their fear factors related to vaccination.

Isolated Laryngeal Tuberculosis: a Diagnostic Dilemma.

Laryngeal tuberculosis is a rare condition, isolated laryngeal tuberculosis without pulmonary manifestations is even more rare. Patients usually presents with voice change, difficulty in swallowing and other constitutional symptoms. The symptoms and findings can look like malignancy in most of the cases. Here, we present a case of primary laryngeal tuberculosis without pulmonary tuberculosis. A 24 year old man who presented to us with hoarseness of voice with 1 year duration. Laryngoscopic study showed a proliferative growth in the epiglottis, aryepiglottic folds and vocal cords and was diagnosed to have laryngeal tuberculosis on histopathology by the typical appearance of granuloma and caseous necrosis. The patient was started on standard antitubercular therapy and he had an excellent response to the same within 6 months. Isolated laryngeal tuberculosis should be suspected in patients with laryngeal complaints with no pulmonary symptoms, especially in a developing country like India where pulmonary tuberculosis is prevalent. Even though isolated laryngeal tuberculosis cases are rare, we should keep in mind the possibility of tuberculosis in the differential diagnosis of laryngeal tumors, as the incidence of tuberculosis is steadily increasing.

Views on virtual education during the COVID-19 pandemic among medical and paramedical students in India.

The COVID-19 pandemic has made the educational institutions to implement the mandatory virtual learning in medical education. It is undeniable that electronic gadget aided learning have a significant role to play during a pandemic. Both faculty and students are getting accustomed to this 'New Normalcy'. Therefore, it is of interest to determine the effectiveness and perception of virtual teaching and learning during the COVID 19 pandemic. A cross-sectional study was conducted in which 336 medical and 336 paramedical students of both the genders with age group of 17 - 21 years participated. The data obtained were analyzed using the SPSS software. The shift from class room teaching to virtual learning has led to many health issues among students such as eye strain, anxiety, depression, musculoskeletal problems and obesity. The students also had inadequate time to interact with faculties. Data shows that virtual learning an alternative mode to traditional method during a pandemic.

Formation and weathering assessment of oil-suspended sediment aggregates through a laboratory investigation.

Formation of oil-suspended sediment aggregates (OSAs) is believed to be one of the natural cleaning processes in the marine environment. In this study, we have investigated the formation processes of OSAs under different mixing periods (continuous mixing and with the addition of sediments in between), oil-sediment ratios (1:1, 1:2 and 2:1) and crude oils (Arabian Light (AL), Kuwait (KW) and Murban (MB)). The results revealed that size of OSAs significantly increased (up to ≈ 1.41 mm) with the addition of sediments. Aggregates (total 36) were extracted for n-alkanes and polycyclic aromatic hydrocarbons to quantify and assess their weathering and toxic levels. The maximum n-alkane depletion was 84% (111-02), 94% (212-02) and 84% (321-02) and PAH depletion was ≈ 72% (111-02), 79% (212-02) and 81% (311-03) for the OSAs of AL, KW and MB crude oils, respectively, for the different samples considered, indicating that n-alkanes were depleted relatively higher than the PAHs. The highest depletion of both n-alkane and PAHs has occurred in OSAs of 10-h continuous mixing. The depletion of both n-alkane and PAHs reduced after the addition of sediments, however, escalated the growth of OSAs, resulting in bigger size OSAs. The concentration of PAHs of all 36 OSAs is greater than 5000 ng/g, indicating very high PAH pollution. Though the formation of OSAs helps in cleaning the spill sites, the carcinogenic threat to the marine ecosystem caused by these OSAs cannot be ignored.

Sertraline induced mandibular dystonia and bruxism.

Specific serotonin reuptake inhibitors have been associated with the occurrence of drug-induced parkinsonism, dystonia, dyskinesia, and akathisia. Here, we describe a young female patient with a diagnosis of the moderate depressive episode who developed mandibular dystonia and bruxism with sertraline in the absence of concurrent prescription of medications, which have potential action on the dopaminergic system.

Comparative study of sexual dysfunction and serum prolactin level associated with olanzapine, risperidone, and clozapine in patients with remitted schizophrenia.

BACKGROUND: Sexual dysfunctions have been a major side effect of the second generation anti-psychotic drugs which often affects treatment compliance in patients with schizophrenia. There is no/few systematic review or research addressing sexual dysfunction and their effect on serum prolactin level among different atypical antipsychotics in India. AIMS: To determine and compare the frequency of sexual dysfunction associated with olanzapine, risperidone, and clozapine and their effect on serum prolactin level in remitted patients with schizophrenia. SETTINGS AND DESIGN: Cross-sectional hospital-based study. Recruitment by purposive sampling. Estimation of serum prolactin was done using enzyme-linked immunosorbent assay technique. MATERIALS AND METHODS: The total sample size was 103, consisting of 31, 23, and 19 patients in olanzapine, risperidone, and clozapine groups, respectively and 30 controls. A Brief Psychiatric Rating Scale, Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and Sexual Functioning Questionnaire were administered. Analysis of variance was used to compare clinical variables. Chi-square test was used to identify the frequency of sexual dysfunction. Kruskal-Wallis test was used to compare UKU side effect, sexual dysfunction, and blood parameters across the study groups. RESULTS AND CONCLUSION: Eighty-six percentage reported sexual dysfunction in one or more domains of sexual functioning in risperidone group as compared to 48.3% in olanzapine and 31% in clozapine groups, respectively. Prolactin level elevation was statistically significant in risperidone group followed by clozapine and olanzapine groups, respectively.

In-vitro antimicrobial activity of marine actinobacteria against multidrug resistance Staphylococcus aureus.

OBJECTIVE: To investigate the antibacterial activity of marine actinobacteria against multidrug resistance Staphylococcus aureus (MDRSA). METHODS: Fifty one actinobacterial strains were isolated from salt pans soil, costal area in Kothapattanam, Ongole, Andhra Pradesh. Primary screening was done using cross-streak method against MDRSA. The bioactive compounds are extracted from efficient actinobacteria using solvent extraction. The antimicrobial activity of crude and solvent extracts was performed using Kirby-Bauer method. MIC for ethyl acetate extract was determined by modified agar well diffusion method. The potent actinobacteria are identified using Nonomura key, Shirling and Gottlieb 1966 with Bergey's manual of determinative bacteriology. RESULTS: Among the fifty one isolates screened for antibacterial activity, SRB25 were found efficient against MDRSA. The ethyl acetate extracts showed high inhibition against test organism. MIC test was performed with the ethyl acetate extract against MDRSA and found to be 1 000 µg/mL. The isolated actinobacteria are identified as Streptomyces sp with the help of Nonomura key. CONCLUSIONS: The current investigation reveals that the marine actinobacteria from salt pan environment can be able to produce new drug molecules against drug resistant microorganisms.

Neck mestastasis from unknown origin-results of planned primary surgery and post-operative radiation therapy.

Ninety-two patients with metastasis of unknown origin were studied between 1986 and 1997 at Kidwai Memorial Institute of Oncology, India. Treatment included planned primary radical neck dissection followed by radiotherapy. Sixty-seven patients completed our multimodal therapy. Thirty-eight of these patients had a median follow-up pf 35.7 months. Nine patients had a median follow-up of 8.3 months. Twenty patients were lost in follow-up after completing the above protocol. Twenty-five patients did not comply with prescribed therapy. Of the followed up patients 78.9% were disease free. The failure rate was 21%, which comprised of regional failure in 16% and liver metastasis in 5%. Primary manifested at base of tongue in 2 patients. In a third world cancer center like ours, advanced neck disease and unreliable follow-up mandate multimodal therapy to be instituted at the first instance. Manifest primaries should be treated on individual basis.