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March 2010
Volume 64 | Issue 3
Page Nos. 99-148
Online since Tuesday, May 08, 2012
Accessed 4,672 times.
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ORIGINAL ARTICLES
Drug susceptibility profiles of
Mycobacterium tuberculosis
isolates at Mangalore
p. 99
Sevitha Bhat, M Radhakrishna, Mohan Kotian, Sunil Rao
DOI
:10.4103/0019-5359.95928
Background and Objectives:
Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. Its resurgence in 1990s is primarily due to co-infection with HIV and the emergence of multi-drug-resistant (MDR) strains. Our objectives in this study were demonstration and grading of acid-fast bacilli in smears from sputum specimens of clinically newly diagnosed pulmonary TB patients, isolation of the organism, speciation and drug susceptibility testing of
Mycobacterium tuberculosis
isolates to isoniazid (H), rifampicin (R), streptomycin (S), and ethambutol (E).
Materials and Methods:
Sputum specimens were collected from 150 patients. Smear examination was done after Ziehl-Neelsen staining. The specimens were cultured onto Lowenstein Jensen media after Petroff's method of concentration. The growth was identified as M. tuberculosis with standard tests. Sensitivity of 50 isolates of tubercle bacilli to anti-TB drugs H, R, S, E were determined by Resistance-Ratio method.
Results:
Out of 150 sputum specimens examined, 62(41.3%) were smear positive. Out of these 62,56 grew on culture. 50 isolates of M. tuberculosis were picked up for drug susceptibility testing. Total of 31 (62%) were resistant to S, 14(28%) to H, 9(18%) to R, 6(12%) were resistant to E and 2 strains (4%) were resistant to H and R.
Conclusion:
From the small cohort, incidence of primary MDR-TB was found to be 4% in this region, which is within the expected range.
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Human trichinosis in remotes of Uttarakhand, India
p. 104
Bhawna Sethi, KS Butola, Bharti Arora, Yogesh Kumar, Vijay Suri
DOI
:10.4103/0019-5359.95929
Trichinosis is a parasitic zoonosis caused by ingestion of infected meat containing larvae of
Trichinella
, more prevalent in developing countries. Although infection with
Trichinella
is globally distributed, it has been documented only rarely in India. The reports are available where
Trichinella
larvae were found from animals in India but, to our knowledge, only one human case has been reported from India (Punjab), so far. This is the first report of small multiple outbreaks of human trichinosis in India (2009-2011). Epidemiological, clinical, and laboratory findings of trichinosis patients belonging to remote areas of Uttarakhand were analyzed retrospectively and prospectively. Patients belonged to remote areas of Garhwal, Uttarakhand, 77.78% were male, and 22.22% were female. The age of patients ranged from 9-55 yrs. History of eating meat of wild boar was given by all (100%). The signs and symptoms of the patients varied even after intake of same diet, and included generalized weakness/malaise, myalgia, fever, gastrointestinal symptoms, facial/periorbital edema, subconjunctival hemorrhages, retinal hemorrhages, muscle atrophy, and dyspnea. Laboratory investigations revealed eosinophilia, leukocytosis, creatine phosphokinase (CPK) and serum glutamic oxaloacetic transaminase (SGOT) elevation in 100%, 88.89%, 50% and 16.67%, respectively. Muscle biopsies revealed larvae in 27.78%. One patient expired while others improved. The prevalence of trichinosis is likely to be underestimated. The aim of this study is to emphasize on the magnitude of the problem, to educate people, especially in the affected areas about this health hazard and help implementation of epidemiological studies and preventive measures.
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Manual stapedotomy still holds good in the era of laser
p. 111
Sivaraman Ganesan, S Anuprasad, Sisir Kumar Patra, Pradipta Kumar Parida, Suria Gopalakrishnan, Nishikanta Verma
DOI
:10.4103/0019-5359.95931
Context:
In the present era of stapedotomy, there is an inevitable role for laser. But the conventional technique with manual burr still has its own merits in various settings such as usage in resource poor setting in developing countries and avoidance of laser hazards. AIMS: To evaluate the audiometric outcomes after manual stapedotomy.
Settings and Design:
The present study was retrospective record-based study. Patients who have been diagnosed otosclerosis and those who were not willing for surgery with laser, but gave consent for manual stapedotomy were included for the study.
Materials and Methods:
Preoperatively, and at each subsequent post-operative follow-up visits, patients were required to undergo a pure-tone audiogram. The air-bone gaps at the end of 6 months were used for final analysis.
Statistical Analysis Used:
Data was analyzed with using Statistical Package for Social Sciences (SPSS) version 12 (Chicago, IL, USA). Descriptive frequency distributions, mean, standard deviation of audiometric data were calculated. The paired t test was done to see the improvement in the air bone gap post-operatively.
Results:
The mean age of presentation is 32.2 years. Overall, the male:female ratio was found to be 1:1.2. Post-operative air bone closure to 15 decibels was obtained in 80% of patients. There was no significant correlation between the pre-operative hearing loss and post-operative gain, age, and gender of distribution of focus.
Conclusions:
The post-operative hearing after stapedotomy has been remarkable in all the patients even with manual burr. There were no major vestibular complications in any of these patients. The study has shown that the significant post-operative hearing results can be still achieved with meticulous surgery by an experienced surgeon with manual burr in the present laser era.
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Comparative assessment of multiple choice questions versus short essay questions in pharmacology examinations
p. 118
A Momin Mujeeb, ML Pardeshi, BB Ghongane
DOI
:10.4103/0019-5359.95934
This retrospective study compared the performance of medical students in multiple choice questions (MCQs) and short essay questions (SEQs). During the 3 year analysis, 533 students had an average score of 51.34% (SD 9.9) in the SEQ and 64.71%(SD 9.9)in the MCQs. Regression analysis showed a significant correlation(
r
=0.64,
P
<0.01) between MCQs and SEQs. When student performance was grouped by final course grade, a statistically significant correlation between MCQs and SEQs scores existed only for the 405 students who received a passing grade (
r
=0.21,
P
<0.01). The MCQ and SEQ scores were not correlated for the 128 students who failed (
r
=0.11,
P
=0.08) or for 70 students who achieved distinctions (
r
=-0.27,
P
=0.13). MCQ scores were significantly higher (
P
<0.01) than SEQ for each of the groups when analyzed by the two-way ANOVA test. The result of this study suggests that for most students, the strong correlation between MCQ and SEQ indicates that student performance was independent of testing format. For students at either end of the performance spectrum, the lack of correlation suggests that the performance in one of the testing format had a strong influence on the final course grade. In addition, those students who failed the course were likely to be weak in both testing modalities, whereas students in all grade groups were more likely to perform better in the MCQs than SEQs.
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Impact of smoke-free law on tobacco consumption in Chandigarh: A community-based study
p. 125
BS Chavan, Ajeet Sidana, Tanuja Kaushal
DOI
:10.4103/0019-5359.95938
Background and Objectives:
Tobacco use is a major public health issue today and it is expected that 650 million smokers will die prematurely due to tobacco use. On 15 July 2007, Chandigarh became the first city to go smoke-free. However, there is no data on the impact of smoke-free law. The objective of the present study was therefore to study the pattern and prevalence of tobacco use and to examine the impact of smoke-free law in Chandigarh.
Materials and Methods:
Total sample comprised of 3000 subjects. Socio-demographic data sheet along with initial two questions from the General questionnaire were administered on each individual. In addition, all the tobacco users underwent administration of the Fagerstrom test for nicotine dependence or the Fagerstrom test for smokeless tobacco (smokeless tobacco users).
Results:
There were 43.9% tobacco users in the sample of 3000 subjects. Out of these tobacco users, 357 (11.9%) were pure smokers and 370 (12.3%) were using smokeless tobacco and 590 (19.6%) used both. The mean number of cigarettes/bidis smoked per day was 14 (+8.64) and the mean age of starting smoking was 19.41 (SD + 4.5 years).73.2% of population was aware about implementation of smoke-free law and all the participants (100%) reported smoking in public places. 43.4% smokers reported thoughts of quitting nicotine.
Interpretation and Conclusion:
Although the prevalence of tobacco use in Chandigarh is lower than the national average but the rates are still alarming and need attention. The findings of this study will help in designing tobacco control strategies and understanding the epidemiology of tobacco related health burden.
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Evaluation of acoustic shock induced early hearing loss with audiometer and distortion product otoacoustic emissions
p. 132
RS Vinodh, N Veeranna
DOI
:10.4103/0019-5359.95939
Background:
Acoustic shock injury has been described as a permanent injury to the auditory system either due to daily noise dose of in excess of 85 decibels or very loud impulse sound reputed to be in excess of 120 decibels and acoustic incidents. This study was performed to compare the results of audiogram and the newer diagnostic method distortion product otoacoustic emissions (DPOAEs) parameters due to acoustic shock injury in call center professionals working in a noisy environment and prone to acoustic injury.
Materials and Methods:
Hearing functions of 340 subjects were first assessed with pure tone audiometry and then DPOAEs results were compared among acoustic shock exposed subjects with normal audiogram and those with abnormal audiogram.
Results:
Out of 340 acoustic shock exposed subjects 304 were normal on audiometric testing and 34 had abnormal audiograms. Subsequently on DPOAE testing out of 304 acoustic shock exposed subjects with normal audiogram 125 failed and 181 passed.
Conclusions:
This study showed that DPOAEs are more sensitive than audiometry to detect pre-symptomatic inner ear damage. It may play a role as screening and monitoring test for acoustic shock-exposed workers.
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CASE REPORT
Case report of two sisters suffering from
Weill-Marchesani syndrome
with pulmonary stenosis
p. 140
Sanjay K Mandal, Soumya S Mondal, Siddhartha Mani, Sumanta Chatterjee, Koushik Chatterjee, Raja Bhattacharya, Apurba B Pramanik
DOI
:10.4103/0019-5359.95940
We report two sisters having a rare congenital anomaly-Weill-Marchesani syndrome having disproportionate short height, restriction of joint movements, brachydactyly, dislocation of lens, bilateral glaucomatous optic atrophy, and pulmonary stenosis.
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NEWS AND FILLER
Antibodies are challenged
p. 144
Jayeeta Banerjee
Studies on antibody were documented as early as in 1890. They are proteins found in blood or other body fluid of vertebrates, and are used by the immune system to identify and neutralize antigens (like foreign objects, pathogens like bacteria and virus etc). Antibodies are dominating the biomedical research field especially detection, imaging and inhibition of biological target molecules, and therapeutics so far. However, recently aptamer has been seen to compete with antibodies in all the above areas. Aptamers are single stranded oligonucleotides or peptides that fold into well defined three dimensional shapes, allowing them to bind their targets with high affinity and specificity. Aptamer technology is relatively new and discovered only in 1990. Because of synthetic origin and similar function as antibodies, they are often termed as chemical antibody. Within 25 years of discovery, the first generation of aptamer drug "Macugen" is already marketed and available for public use. The Global market for aptamer was $236 million in 2010 and is expected to be valued at nearly $1.8 billion by 2014, with a growing compound annual growth rate of 67.5%. Various drugs being on the pipeline for clinical trials this emerging field of medical biotechnology is raising significant interest. This article gives an overview how aptamers are similar yet distinctly different from antibodies in terms of synthesis, handling, and applicability.
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© 2004 - Indian Journal of Medical Sciences
Published by
Medknow
Online since 15
th
December '04