Age Wise Distribution Research Articles

Age and gender wise distribution of cases presenting with cervical lymphadenopathy: A retrospective study

Introduction: Cervical lymphadenopathy is a common clinical presentation of various diseases its FNAC serves as an excellent clue to the underlying disease. The presentation of cervical lymphadenopathy varies in different age groups and in both the both the gender as well. Objective: To analyze the spectrum of lesions causing cervical lymphadenopathy as well as to see the age and gender wise distribution of cases of tubercular lymphadenitis. Materials and Methods: It is a retrospective study and included three years data. A total of 222 cases that underwent FNA for cervical lymphadenopathy were recorded with their clinical history. For all cases, MGG, Pap and AFB slides were re evaluated and results were recorded. Epidemiological variables were analyzed by cross tabulation to assess their relationship. Result: Out of 222 cases 117 cases were of Tubercular lymphadenitis followed by 81 cases of reactive lymphadenitis, 10 cases presented as metastatic deposit of squamous cell carcinoma, 9 with Lymphoma (NHL) followed by 5 cases of adenocarcinoma deposits. Females to males ratio in Tuberculosis lesions was 1.3:1. Conclusion: In both pediatric and adult population Tuberculosis was an important cause of cervical lymphadenopathy while in children less than two years reactive lymphadenitis was more common. Tuberculosis was more common in females as compared to males and here FNAC is an inexpensive and valuable fist line tool in assessing cervical lymphadenopathies. Keywords: Cervical lymphadenopathy, Tuberculosis, FNAC, Age and gender.

Incidence of lung malignancy in a tertiary care centre – A one year study

Background: Lung cancer is the most common type of cancer in males and the leading cause of death in both sexes. It accounts for 11.3% of all new cancers in India and also associated with a mortality rate of 13.7%. This desolate mortality necessitates for the early diagnosis of lung cancer. The study was conducted to evaluate incidence, gender and age wise distribution of lung cancer and its association with smoking. Methodology: This study was done in the department of pulmonary medicine in Guntur Medical College from September 2016 to august 2017. The study includes 52 patients having clinical and radiological suspicion of lung cancer. All the cases were subjected to USG guided transthoracic needle aspiration was sent for cytology. Inconclusive and malignant cases were further subjected to histopathological examination for confirmation. Results: Out of the 52 patients suspicious of malignancy, 32 patients were finally diagnosed as malignant, 5 patients had benign/inflammatory lesions, 6 cases had no evidence of malignancy/non-specific inflammation, 8 had no opinion possible. Most common type is adenocarcinoma followed by squamous cell carcinoma with an incidence rate of 71.8% & 15.7% respectively. The highest incidence of lung malignancies is seen in 5th decade in both sexes. Conclusions: There is increase in the incidence of lung malignancies in females, throwing light on the causes other than smoking like bio-mass fuel exposure and second-hand smoking. Adenocarcinoma is the most common type. Further, USG guided transthoracic needle aspiration has a good sensitivity in detecting lung malignancies. Keywords: Adenocarcinoma; Transthoracic fine needle aspiration; Lung malignancy.

A study of prevalence and pattern of congenital heart disease at Sopore, Kashmir, North India

Background: Early detection of congenital heart disease is of paramount importance to improve the quality of life of children and prevent morbidity and mortality. Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Present aim was to study the prevalence, age and sex wise distribution, and clinical spectrum of congenital heart disease (CHD) at Sopore, Kashmir, North India.Methods: Around 39829 children in the age group 0 months to 18 years were screened for Defects at birth, Diseases in children, Deficiency conditions and Developmental Delays including Disabilities over the period of 18 months under RBSK. Clinical examination, echocardiography and color Doppler were used as diagnostic tools.Results: A prevalence of 5.3 per 1000 population was observed. VSD (ventricular septal defect) was the commonest lesion (30.1%), followed by PDA (patent ductus arteriosus) in 21.6 % and ASD (atrial septal defect) in 20.2%. Tetralogy of Fallot was the commonest cyanotic heart disease (8.0%). Maximum numbers of children with heart disease were diagnosed in the age group 6 weeks to 6 years.Conclusions: For better estimation of prevalence of congenital heart diseases, more elaborate community-based studies are needed. Such community based studies can be easily done by collecting and analyzing data collected from screening programs like RBSK. Such community based screening programs helps in detecting silent cardiac ailments, their prevalence and pattern, and early therapeutic intervention. A few prevalence studies have been carried out piecemeal in different locations of India; and more such studies can be easily done by collecting and analyzing data collected under RBSK screening program.

Study of leukocyte profile in patients of fever with splenomegaly

Background: There are many different possible etiologies of fever with splenomegaly; few patients with prolonged fever will remain undiagnosed despite an intensive diagnostic work-up. The presence of splenomegaly in patients with fever narrows down the differential diagnosis. Objectives: The objectives of this study were as follows: (I) To evaluate the causes of fever with splenomegaly and (II) to study the leukocyte profile which includes pattern of total leukocyte count and differential leukocyte count (DLC) in various diseases presenting as fever with splenomegaly. Materials and Methods: A total of 100 patients with fever and splenomegaly were included in the study. Complete hematological study such as complete blood count provided with main focus on total leukocyte count and DLC including neutrophil, basophil, eosinophil, lymphocyte, and monocyte and peripheral blood smear to especially note the morphology of white blood cells (WBCs) and to determine their relative percentage in blood. Results: A total of 100 patients of fever with splenomegaly with male and female ratio of 1.7:1 were included in the study. While considering age-wise distribution, the highest percentage of cases was fell in the age group of 21–30 years. Infectious causes constituted 55% of cases, followed by hematological malignancies constituting 33% of cases. Other causes included 12% of cases. Kala-azar was the most common cause of fever with splenomegaly in our study followed by malaria and acute myeloid leukemia. Pancytopenia was found in 29% of cases and followed by 38% of bicytopenia cases in our study. About 32% of cases presented with normal total leukocyte count, 39% of cases showed leukopenia, and 29% of cases showed leukocytosis. Leukopenia was commonly found in kala-azar followed by hypersplenism. Neutropenia was most commonly present in kala-azar. Conclusion: This study helps in understanding the distribution of leukocyte count and DLC pattern in various diseases presented as fever with splenomegaly and also the variable presenting signs and symptoms of these diseases so that the patients of fever with splenomegaly investigated and treated in a proper manner.

Histopathological Spectrum of Testicular Tumors in a Tertiary Care Centre

Background Testicular tumors are rare type of tumors affecting adolescents and young adults. However, in many western countries, its incidence has been increasing. These tumors contribute for 1–2% of all malignant tumors and most malignancy in men in the age-group of 15–25 years. This study was undertaken to analyse the histopathological pattern of testicular tumors at the tertiary level hospital in Assam Medical College, Dibrugarh highlighting pathological findings, diagnostic evaluation and laterality. Objective The purpose of the study was to analyse the histopathological pattern, age-wise distribution and laterality of testicular tumors. Materials and Method This one year study was performed in the Department of Pathology, Assam Medical College, Dibrugarh, India from January 2018 to December 2018. For the study, the orchidectomy specimens received in Pathology department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumor typing and subtyping were done according to WHO classification (2004). Results A total of 12 cases of testicular tumors were included in the present study. Out of these 12 cases, right testis was affected in 58.4% of cases whereas left testis was affected in 41.6% cases. Germ cell tumor was the most common type accounting for 91.5% of tumors followed by Sex cord stromal tumor (8.5%). Most tumors were seen between the age-group of 21–30 years. Conclusion Testicular tumors are uncommon in our population. Study of testicular tumor is important for pathologist because grossly identifiable benign pathology may harbour focus of malignancy. At the end, we conclude that despite new technique in imaging and tumour marker assay, the diagnosis of testicular tumor is dependent on HPE only.

Prevalence of Alcohol Consumption in an Urban Population of Dehradun

A descriptive, randomized and observational study was conducted to assess the prevalence of alcohol consumption in an urban population of Patelnagar, Dehradun, Uttarakhand. A total of 1214 subjects were randomly selected and initially screened as alcohol consumer. Out of 1214 subjects, 544 subjects were alcohol consumers showing prevalence rate of 44.81%. Basic socio-demographic data of 544 alcohol consumers were collected by using self-modified structured questionnaire. Prevalence of alcohol consumption was more among males (40.36%) as compared to that in females (4.45%). Gender wise distribution of alcohol consumers showed that there were more males (90.07%) as compared to female (9.93%) and age wise distribution showed that majority of alcohol consumers belongs to the age group of 26–35 years (35.29%). Illiterate consume alcohol at a higher rate (47.05%) than other educated groups. Majority of alcohol consumers belongs to medium level of living standard (46.69%) and consumption of alcohol was found higher in those who are occupationally skilled and professional (64.7%) as compared to unskilled and semi-skilled (35.29%). So, educational interventions among those who are at a higher risk and management of alcohol dependent subjects may help in reducing the burden of alcohol use in them.

Percentiles of Pregnancy Outcomes with Maternal Age

Background: Maternal age is one of the prime factors in healthy pregnancy outcomes. Extremes of maternal age will lead to adverse effects on the growth trajectory of fetus and placenta. Hence, current study assessed the impact of maternal age with the percentiles of birth weight and placental morphometry. Materials and Method: Study was conducted on 391 subjects in a teaching hospital of North Karnataka, India for a period of 6 months. Ethical clearance was obtained. Data was collected by using standard pretested proforma. Percentiles of the birth weight and placental morphometry in different maternal age has been expressed in table, and Box plots have been plotted. Result: Age-wise distribution of 391 mothers reveals that 7.2 percents were less than 20 years of age and 7.6 percent more than 30 years and above, with mean 23.6 and SD 3.7 years. Percentiles of the birth weight and placental morphometry did not show any consistent relationship with increasing groups of age. Conclusion: The study conveys that in different groups of maternal age percentiles of birth weight exhibited consistent increasing trends only in higher percentiles (75th to 95th) whereas, percentiles of placental morphometry did not exhibit consistent relationship with mother’s age.

Application of D-Dimer in Prognosis of Pulmonary Embolism

Abstract Introduction Pulmonary embolism (PE) is a relatively common cardiovascular emergency. It can lead to a variety of outcomes, from potentially reversible right ventricular failure (by occluding the pulmonary arterial bed) to eventual death. The diagnosis of PE is often missed due to its nonspecific clinical presentation. Materials and Methods This is a descriptive cross-sectional study conducted at tertiary care center in India from October 1, 2016 to September 30, 2018, which includes 36 cases of PE. Institutional ethics committee clearance was obtained before start of the study. Written and informed consent was obtained from all patients. Patients were informed regarding purpose, procedures, risks, and benefits of the study in their own vernacular language. Results The age-wise distribution of patients in this study showed that most patients were up to 40 years amounting to 58.4% of cases. Sex-wise distribution also showed that most patients were male (66.7%). Fifty percent of the patients had no thrombosis on Color Doppler findings of the involved limb, and 31.25% had superficial venous thrombosis. Blood investigation revealed that 94.4% patients had troponin negative and 94.4% had D-dimer positive. This study also attempted to correlate the D-dimer findings and Well's score. It can be seen that as per Well's score, 13 patients were with high probability, 18 with moderate probability, and 5 with low probability. Conclusion This study states that D-dimer assays are highly sensitive and have a low rate of false-negative results. The assays have been found safe and effective when the clinical probability of PE is low. When the D-dimer result is negative in patients with low clinical probability of having PE, the presence of acute PE can be safely ruled out without diagnostic imaging.

LAPAROSCOPIC CHOLECYSTECTOMY

Introduction: Laparoscopic cholecystectomy is the treatment of choice forsymptomatic cholelithiasis. Intraperitoneal instillation of bupivacaine is one of the methods usedto improve pain relief after laparoscopic cholecystectomy. Objective: To compare the mean painscore after intraperitoneal instillation of bupivacaine with placebo during laparoscopiccholecystectomy. Study Design: Randomized Control trial. Setting: This study was carried out asurgical unit PGMI Lady Reading Hospital and Hayatabad Medical Complex, Peshawar.Duration: The duration of study was 6 months from 15th May to 15th December, 2013. Subjectsand Methods: 92 patients in each group were included in study to compare the mean pain scoreof intraperitoneal instillation of bupivacaine (Group A; study group) with 0.9% normal salinesolution (Group B; placebo group) using visual analogue scale after laparoscopiccholecystectomy at 12th hour after surgery. Data was entered in software SPSS version 16.0. Ttest was used to compare the mean pain scores. Results: The mean age of patients in Group Aand B was 41.82 ± 7.34 and 40.95 ± 9.24 respectively (p=0.483). Group A has low mean painscore (3.619 ± 0.676) according to Visual Analogue Scale then Group B (3.837 ± 0.667) with astatistically significant p value (p=0.036). A t test failed to reveal a statistically reliable differencebetween gender (p=0.513) and age (p=0.767) wise distribution of mean pain between group Aand B. Conclusions: Mean pain score of intraperitoneal instillation of bupivacaine is significantlyless than 0.9% normal saline solution at 12th hour after laparoscopic cholecystectomy.

Isolation and Identification of Salmonella paratyphi from Enteric Fever Patients at Different Hospitals of Quetta City.

Salmonella paratyphi cause enteric fever which is an important public health problem worldwide. In Pakistan incidence is increasing and affect all age groups. Therefore, the present research was designed to study the different microbiological aspects of Salmonella paratyphi. The study was conducted to identify the Salmonella paratyphi from blood samples in Quetta. Total 480 blood samples were collected from different hospital of Quetta. Specific colony characters, microscopic examination, biochemical tests and PCR were used for identification of Salmonella paratyphi. Total 55% samples were positive and 45% were negative for Salmonella paratyphi. Results showed that males (34%) were more affected with Salmonella paratyphi as compare to female (20%). Age wise distribution revealed that Salmonella paratyphi was high in 20-30 years (38%) followed by 10-20 years (9.16%) and 1-10 years (7.5%) age group patients. Paratyphoid fever cases were significantly high (25.41%) in Pashtoon population as compare to other population of Balochistan. The 40% paratyphoid fever was observed in the patients with low socioeconomic status, 9.16% in middle socioeconomic status and 5.83% in the patients belonged to high socioeconomic status. The Salmonella paratyphi were sensitive to Chloramphenicol (23 mm), Amikacin (24 mm), Gentamicin (12 mm), Quinolones (23) and Polypeptide (13 mm) classes. The PCR based identification of Salmonella paratyphi showed clear bands of 329 bp of flic-a gene. To control paratyphoid fever strong initiatives must be taken to improve water sanitation, hygiene level, supply of save drinking water and vaccination is recommended in order to eradicate the disease.

Comparative Study of Oral Hygiene Among Urban and Urban Slum Dwellers of Ahmedabad

Aims and Objectives: To compare the oral hygiene practices and study the proportion of dental problems among urban and urban slum areas.
 Methodology: An observational, cross sectional study was carried out in 150 people in urban and urban slum areas. The study duration was four months (June 2015 to September 2015). The data was collected in a pre-designed proforma. The knowledge of the community was considered with regards to oral hygiene and harmful effects of bad food habits and tobacco consumption. The oral problems and hygiene was assessed by using mouth mirror and probe. The data was analyzed using SPSS version 24.0 Software.
 Results: Out of the total data collected, 75 of the data entries were obtained from urban area and urban slum area each. The age wise distribution was done as well in both the areas. Among them, most common age group was 20-45 years (50.7% in urban while 48.0% in urban slum) followed by 10-19 years, 46-60 years, 1-9 years and 60and above age group. The common symptoms observed like broken teeth (28%), gingivitis (13.30%), caries (21.10%) etc. were more in urban as compared to urban slum areas. Most common brushing practice was using paste (90%) followed by powder (10%) and salt (1%). More number of people in urban area (28%) consumes carbonated drinks as compared to urban slum (6.7%) (P value = 0.001). The proportion of sensitive teeth was more in urban (36%) as compared to urban slum (26.7%) (P value = 0.126). Most of the people in urban as well as urban slum area (97.3%) change their brush within 15 days-3 months.
 Conclusion: The proportion of gingivitis, dental illness, grinding teeth, sensitive teeth are more commonly seen in urban areas as compared to that of the urban slums. However, the proportion of bleeding gums, awareness regarding dental problems, frequency of brushing teeth and pattern of brushing were almost similar in both of the areas.

Risk Factors and Microbiological Studies on Streptococcus pneumoniae Isolated from Pneumonia Patients of Quetta Balochistan.

Pneumococcal diseases remain a major cause of morbidity and mortality worldwide. Streptococcus Pneumoniae causing pneumonia in India, Pakistan, Bangladesh and Afghanistan in children under 5 years of age and older adults. Therefore; the present research was design to study the different microbiological aspects of Streptococcus pneumoniae. A total of 480 sputum samples were collected from pneumonia patient at different government hospitals of Quetta. The detail of patient's gender, age, economical status and educational status were taken on performa. Sputum samples were inoculated into selective strep agar Streptococcus pneumonia colonies were observed on plates and confirmed through different biochemical tests and PCR. Total 480 samples were collected in which 36.6% were Streptococcus pneumoniae positive and 63.3% were negative. The sex wise ratio showed that female (24.10%) were more affected with pneumoniae as compare to male (12.50%). The pneumonia infection age wise distribution was 9% in 1-10 years old patients, 16% in 10-20 years old patients and 11% in 20-30 years old patients. The status wise distribution of pneumonia infection showed that lower class (16%) was more affected as compare to middle class and higher class of Quetta. The percentage of pneumonia infection in hazara race was 14%, in Pathan 8.30%, in Punjabi 7.60% and in Baloch 6.60%. It was seen that illiterate patients were more affected with pneumonia infection (28.3%) than literate (8.3%). The Streptococcus pneumoniae was confirmed through gram staining, different biochemical tests, different sugar fermentation tests and PCR. Whereas confirmed by PCR showed clear band of 329 kb of ply gene. It was concluded that the rate of pneumonia infection was high in female and lower class was more affected with pneumonia.

Epizootiological observations on canine microfilaremia in Gujarat state, India.

Aim:The present investigation was conducted to study the prevalence of microfilaremia in dogs in Gujarat.Materials and Methods:A total of 418 adult dogs aged between 2 and 14 years with signs of weakness and non-specified complaints, presented at TVCC, Deesa (North Gujarat), Nandini Veterinary Hospital, Surat (South Gujarat), and Private Clinics, Ahmedabad (Central Gujarat), were included in the present investigation for studying the prevalence of microfilaremia from July 2016 to May 2017.Results:A total of 418 dogs were screened, of which 33 were found positive for circulating microfilariae with the prevalence rate of 7.89% in the population. Among microfilaremic dogs, the finding of microfilariae of Dipetalonema (Acanthocheilonema) reconditum was more common (23 cases; 69.69%) than Dirofilaria immitis (10 cases; 30.30%) making their prevalence in the population of 418 dogs as 5.50% and 2.39%, respectively. Breed-wise distribution of microfilaremic dogs revealed that 12 (36.36%), 8 (24.24%), 5 (15.15%), 4 (12.12%), 2 (6.06%), 1 (3.03%), and 1 (3.03%) cases were observed in Pomeranian, non-descript, German Shepherd, Labrador, Great Dane, Lhasa Apso, and Pug dogs, respectively. Of 10 cases of D. immitis, 5, 2, 2, and 1 were observed in Pomeranian, Labrador, non-descript, and Great Dane dogs, respectively. Cases of Dipetalonema reconditum were highest in Pomeranian (7), followed by non-descript (6), German Shepherd (5), Labrador (2), Great Dane (1), Lhasa Apso (1), and Pug (1). Age-wise distribution recorded significantly (p≤0.01) higher number of cases in adult dogs (4-14 years) for D. immitis (30.30%) and D. reconditum (39.39%). Sex-wise distribution of microfilaremic dogs showed that male (22/33, 66.66%) was more predisposed to microfilaremia rather than females (11/33, 33.34%). It is apparent from the study that the number of dogs with microfilaremia due to D. reconditum was significantly (p≤0.01) higher than that of D. immitis.Conclusion:The present study revealed that microfilaremia due to D. immitis and D. reconditum is prevalent in the state of Gujarat. The infection with D. immitis was associated with severe lung and cardiac pathological manifestations.

SEX & AGE-WISE DISTRIBUTION AND CAUSES OF DYSPHONIA IN CHILDREN

Background: Dysphonia is common in children due to which they suffer adversely both at home and at school. The objectives of this study were to determine the sex & age-wise distribution and causes of dysphonia in children. Materials & Methods: This descriptive cross-sectional study was conducted at the Department of ENT and Head & Neck surgery, Hayatabad Medical Complex, Peshawar, Pakistan from January 1, 2017 to December 31, 2018. Sample size consisted of 72 patients presenting with chronic dysphonia, selected using the non-probability consecutive sampling technique Inclusion criteria were children presenting with dysphonia for more than 4 weeks. Exclusion criteria were children with stammering, puberphonia, acute respiratory distress, deaf mutism, speech articulation and increased or decreased nasal twang in voice. The demographic variables were sex and age groups and research variables were causes of dysphonia. All variables except age being categorical were analyzed by frequency and percentages carried out using SPSS 16.0 for windows. Results: Mean age of the sample of patients was 8.78+3.6 with range of 12 years (3-15). Out of 72 patients, 44(61.11%) were boys and 28(38.89%) girls with boy to girl ratio of 1.57:1. Chronic nonspecific laryngitis was the commonest etiology followed by reflux laryngitis. Functional dysphonia was noted only in girls and vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were noted only in boys. Conclusion: Chronic nonspecific laryngitis and reflux laryngitis were the commonest causes especially in males less than 9 years of age. Vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were found only in boys and functional dysphonia was noted only in adolescent girls.

In-Vitro Biofilm Detection among Uropathogens and their Antibiogram Profile

Objectives: The study was carried out in Kathmandu Model Hospital, Kathmandu with the aim of in- vitro biofilm detection among uropathogens and its correlation with antibiotic resistance.
 Methods: Uropathogens (n=234) were isolated, and identified with standard microbiological techniques and further subjected to Modified Congo Red Agar Method for the biofilm detection in-vitro; antimicrobial susceptibility testing (10 antibiotics) was performed by Modified Kirby Bauer disc diffusion method. The MIC and MBEC values of Levofloxacin were determined by agar dilution for planktonic forms and by microdilution method for biofilm phase respectively.
 Results: Among 234 urine isolates, 134(57%) were positive for in-vitro biofilm production and 88(37.6%) were multidrug resistant (MDR). E. coli was the predominant biofilm forming uropathogens. The incidence of biofilm producers was found to be independent of age-wise, gender wise and indoor-outdoor distribution of patients. The association between biofilm production and multidrug resistance among uropathogens was found statistically non-significant (p-value>0.05). The MBEC values of biofilm phase of growth were found to be greater than the MIC values for their planktonic counterparts. The MBEC values ranged from 4 to more than1024 μg/ml whereas the MIC values ranged from 0.003-16 μg/ml.
 Conclusion: The results of the present study suggest that biofilm detection is a critical step to fight against biofilm-involved infections. However, further studies are needed for the development of effective preventive and treatment strategies of biofilm associated UTIs to avoid recurrence and persistence.

Isolation, identification and antibiogram profiles of enterovirulent Escherichia coli from diarrhoeic goat in some selected areas of Rangpur district of Bangladesh

Enterovirulent Escherichia coli remain as an important etiological agent of goat diarrhoea in Bangladesh. The present study was designed with a view to isolate and identifies E. coli from field cases. For this purpose, a total of 135 faecal samples (85 from diarrhoeic and 50 from apparently healthy goat) were collected during the period from January 2012 to July 2012 from different areas in Rangpur District. It was found that the prevalence of E. coli was higher (18.82 %) in diarrhoeic goats while it was lower (14.00 %) in non diarrhoeic goats. Age wise distribution of E. coli isolates were 26.42% in day old to 1 year, 10.53% in 1-2 years and 11.36% in above 2 years age of goat respectively. All the isolates of E. coli revealed greenish black colony with metallic sheen in Eosine methylene blue agar, bright pink color smooth transparent colony in MacConkey agar and slight pinkish smooth colony in Salmonella-Shigella agar. Gram stain and hanging drop techniques were performed with the cultured bacteria. Biochemical properties of the isolates were studied, and antibiotic sensitivity test was done by agar disk diffusion method. In Gram stain, the organisms revealed Gram negative, small rod shaped, occurs singly or paired. Biochemically, all of the isolates showed fermentation of dextrose, sucrose and maltose with the production of acid and gas, negative result to Voges-Proskauer test, positive result to Methylred test and differential result to Indol test. All the isolates of E. coli were highly sensitive to ciprofloxacin and gentamicin while moderately sensitive to colistin, livofloxacin and azithromycin and less sensitive to ceftraexon and tetracyclin and resistant to amoxycillin, ampicillin, erythromycin, and neomycin. Therefore, ciprofloxacin and gentamicin may be the antibiotics of first choice, and colistin, livofloxacin and azithromycin may be the second choice among the test antibiotics for the treatment of illness caused by these bacteria.Asian J. Med. Biol. Res. March 2018, 4(1): 36-43

Demographic and Disease Patterns at a Primary Healthcare Setting

The assessment of disease pattern and burden in a defined population based on the symptomatology as well as the organic presentation is quite fruitful.Objectives: This study was designed to determine demographic characteristics and disease patterns related to different organ systems presenting at first tier of primary healthcare system. Methods: A cross-sectional study was conducted using Basic Health Unit’s (BHU) Outdoor Patient Department (OPD) database retrospectively in order to determine the age, gender and organ system wise distribution of various diseases. Secondary data was collected from standard OPD register in which all patients that presented in the outpatient department of the facility during a period of 6 months from 1st January, 2017 to 30th June, 2017 were included and no patient was excluded. Results: Out of total 2357 patients, 1024 (43.4%) were males and 1333 (56.6%) were females. Most of the patients 1057 (44.8%) belonged to the age group of 15-49 years whereas only 96 (4.1%) were less than one year old. About 2204 patients (93.5%) presented for the first time to the BHU and 153 patients (6.5%) were follow-up patients. Majority of patients 735 (31.2%) presented with symptoms of respiratory system. Certainsystems were more involved in females than males like musculoskeletal system (257 v/s 113), respiratory system (377 v/s 358) and especially the genitourinary system (50 v/s 5). Conclusions: Addressing and treating the diseases presenting at this basic level (BHU) can prove to be very useful in reducing patient load at the level of tertiary care and teaching hospitals.

Monitoring of adverse drug reactions in medicine, paediatric and surgical departments of a tertiary care hospital: a prospective observational study

Background: the aim of the study was to monitor all adverse drug reactions in the departments of Medicine, Paediatrics and Surgery in a Tertiary Care Hospital.Methods: It was a prospective study undertaken in a 300 bedded tertiary care hospital. Patients presenting with adverse drug reactions in Medicine, Paediatrics and Surgery Departments were studied. Causality and severity of the adverse drug reactions were analysed Other parameters such as age wise and gender wise distribution of the ADRs, types of ADRs and drugs causing ADRs were studied.Results: There were 33 cases of ADRs were enrolled for the study in the duration of Sept. 2016 to Aug. 2017. Female preponderance was seen. The largest number of ADRs were seen in the age group of 21-30 years (30.3%). The most common ADR was skin rash (30.3%) followed by periorbital edema (12%). There were two SAEs namely Anaphylaxis and Steven Johnson syndrome. The most offending class of drug was antibiotics (30.3%) followed by intravenous fluids (12.1%).Conclusions: The maximum number of cases were reported from the Medicine Department which was 11 (33.33%). The highest number of ADRs fell in the probable category (63.6%). The number of cases of mild and moderate severity were equal (42.4%). The knowledge of these adverse drug reactions is necessary while prescribing drugs to patients as patient safety is absolutely essential. Also the healthcare provided by the institution will improve. This data has been collected with a view to establish an ADR monitoring centre at our hospital.

Prevalence and age-wise distribution of Human Papillomavirus type 16/18 infections among hospital screened women of a peri-urban area in West Bengal: Impact of socio-demographic factors

BackgroundWe undertook the current study on cervical Human Papillomavirus (HPV) prevalence along with cytology in women visiting the Gynecology Out-patient Department of a hospital for common gynecological ailments, subsequent to our earlier population-based study on HPV prevalence from India. MethodsWe analyzed data on cervical-cytology (Pap smears) and PCR-based molecular detection of HPV infection along with socio-demographic variables (N = 696). ResultsWe identified 36.84% HPV-positive women amongst whom, HPV16 and 18 together predominated (79.37%) over other HPV types (20.63%). Contrarily, only 6.4% women revealed abnormal cytological lesions, of which, 46.51% were HPV-positive and 95% of such women harbored HPV16/18, while 5% harbored other HPV types. Individuals with normal cytology portrayed 36.09% HPV infections, of which, 77.97% were HPV16/18-positive and 22.03% harbored other HPV types. Overall HPV prevalence decreased significantly (ptrend = 0.047) with increase in age, but HPV16/18 infections were significantly over-represented compared to the other HPV types across all age-groups. Specifically, HPV16 prevalence increased (p trend < 0.01) with increase in severity of cervical lesions. HPV16 prevalence did not differ between the Hindus and Muslims but HPV18 was significantly higher among the cytologically normal Muslim women (24.14%, p = 0.02), compared to the Hindus (11.91%), specifically among those ≥ 30 years of age. There was a significant (p < 0.05) overrepresentation of HPV16 prevalence among women who were users of oral contraceptive-pills, irrespective of cytology. ConclusionsOur study highlights the need for HPV16/18-based screening of cervical cancers in India considering the immense socio-cultural and genetic diversity at the population level.

Swallowing difficulties among healthy elderly: prevalence and aetiology

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Dysphagia is a common problem among elderly individuals. Very few studies have been done to know the prevalence of dysphagia among healthy elderly individuals. So a study was done to assess the prevalence of swallowing difficulties among healthy elderly individuals and to find out the various causes for it in them. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;259 elderly individuals were screened using the swallowing disturbance questionnaire to assess the prevalence of swallowing disorders. Those individuals with swallowing disorders were further subjected to modified Barium swallow to know the aetiology. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Of the 259 elderly individuals screened, 85 were females and 174 were males. The mean age and standard deviation was 66.16±6.233. The prevalence of swallowing difficulties was 20.1%, with no significant difference in the gender wise distribution or age wise distribution. Among the various aetiologies diagnosed, idiopathic cause is the commonest, followed by oesophageal neoplasm (21.1%), and then the achalasia cardia (9.6%). Among oesophageal neoplasm, mid-thoracic esophageal neoplasm (9.6%) is the commonest. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Considering the time and cost involved, it is not feasible to subject all elderly for instrumental swallowing evaluation like videofluoroscopy. Hence it would be beneficial to screen the elderly individuals for dysphagia and educate them regarding its importance, as dysphagia can also be associated with serious underlying pathology and complications such as aspiration.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;