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CORRESPONDENCE
WhatsApp: A new tool for recruitment and retention of voluntary blood donors
Umakanth Siromani, Thankamony Thasian, Rita Isaac, Kurusilappattu Gurupachai Selvaraj, Dolly Daniel, Joy John Mammen, Sukesh Chandra Nair
January-June 2015, 2(1):72-72
DOI:10.4103/2349-4220.159176  
  11,687 216 1
DISPATCHES
Typhoid fever with acute abdominal pain masquerading as surgical emergency!
Sumit Mehndiratta
January-June 2016, 3(1):31-33
DOI:10.4103/2350-0298.184673  
Typhoid fever is a common childhood infectious illness in resource-poor countries. Gastrointestinal manifestations are common presentation in this illness. We report a series of 3 cases with acute abdominal pain as presenting feature which were initially presumed to have a surgical emergency but were later on diagnosed to have typhoid fever. Confounding presentations and unusual features can sometimes pose a diagnostic dilemma even in a common illness.
  9,752 201 -
REVIEW ARTICLE
Esophageal cancer in India: Current status and future perspectives
Inian Samarasam
January-June 2017, 4(1):5-10
DOI:10.4103/IJAMR.IJAMR_19_17  
Esophageal cancer is the fourth common cause of cancer-related deaths in India. It is prevalent among both men and women. Squamous cell carcinoma (SCC) accounts for up to 80% of these cancers, although adenocarcinoma is on the increase due to changing lifestyles. The etiological factors for SCCs show a regional variation in different parts of India, but tobacco consumption in various forms, alcohol, hot beverages, and poor nutrition remain the predominant predisposing factors. Generally, these cancers present late and therefore have a poor prognosis. The current status of esophageal cancer in India in relation to the demographics, diagnosis, staging, multimodality treatment, surgical therapy, and the future perspectives are discussed in this review article.
  8,967 776 1
The scope of mobile devices in health care and medical education
Devi Prasad Mohapatra, Madhusmita M Mohapatra, Ravi Kumar Chittoria, Meethale Thiruvoth Friji, Shivakumar Dinesh Kumar
January-June 2015, 2(1):3-8
DOI:10.4103/2349-4220.159113  
The use of mobile Internet devices (MIDs), smartphones, and proprietary software applications (also known as "apps" in short) can improve communication among medical caregivers. The utilization of these mobile technologies has further transformed health care, communications, commerce, education, and entertainment, among other fields. Newer technologies have the potential to be adapted for improvement in health care and medical education in general. Mobile technology is one of the latest strings of technological innovations that can be integrated into medical education. M-learning (the use of mobile technologies in teaching/training) has been used as a complimentary resource for interaction between students and instructors for motivation and learning. The main uses described for mobile devices in medical education can be divided into (a) information management (IM), (b) communication, and (c) time management. The field of mobile technology in health-care services and medical education is quite new and throws open ample opportunities for researchers to conduct further studies. Educators in medicine, dermatology, and public health as well as practicing physicians and surgeons need to embrace this new technology, study its further adoption, and assist in the responsible integration of these devices into the art and practice of medicine.
  7,937 826 3
ORIGINAL ARTICLES
Knowledge and perceptions of sexually transmitted diseases, HIV/AIDS, and reproductive health among female students in Dhaka, Bangladesh
Sabrina Zaman Mou, Faiz Ahmed Bhuiya, Sheikh Mohammed Shariful Islam
January-June 2015, 2(1):9-15
DOI:10.4103/2349-4220.159118  
Background: Young people are most vulnerable to sexually transmitted diseases (STDs) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in Bangladesh. Lack of knowledge about reproductive health issues is also common in this group. Aims: This study aimed to assess the knowledge and perceptions of STDs, HIV/AIDS, and reproductive health of young female university students (19-27 years) in Dhaka, Bangladesh. Methods: A cross-sectional study was carried out among 402 female students from seven universities in Dhaka, Bangladesh. Data were collected through face-to-face interviews using a structured questionnaire on sociodemographic information, knowledge, and perceptions of STDs, HIV/AIDS, and reproductive health. Descriptive analysis was used, and data were presented as frequencies and percentages. Results: The majority of the participants were young, unmarried, undergraduate students. Most of the participants reported that they knew about STDs (79%) and HIV/AIDS (66%). However, knowledge about the modes of transmission and prevention of the diseases was poor. HIV/AIDS was considered by 90% participants as a public health threat to Bangladesh, mostly due to illiteracy (76%), increased mortality (20%), existence of risky sexual behavior (18%), and aggression of Western culture (31%). About 65% of the participants mentioned that AIDS can be prevented by safe sexual practice, 55% mentioned prevention through upholding religious values and moral education, and 59% mentioned that education about AIDS would help prevent transmission. Conclusions: Although a majority of young Bangladeshi female students reported knowing about HIV/AIDS, their knowledge regarding transmission and prevention of the diseases was poor. Strategies for creating reproductive health education targeted at young female students are essential for the prevention of STDs and HIV/AIDS.
  7,032 637 -
Prevalence of cataract among adults above 50 years in a rural community of Villupuram, Tamil Nadu
R Aarthi, Gautam Roy, Sitanshu Sekhar Kar, Renuka Srinivasan
January-June 2015, 2(1):50-54
DOI:10.4103/2349-4220.159170  
Background: In India, overall prevalence of blindness is 1.1%, the principal cause being cataract (62.6%) affecting over 9 million people. Aim: The present study was carried out to find the prevalence, barriers and facilitating factors related to cataract health services in a rural community of Tamil Nadu. Methods: The study was carried out in four villages in sub-center Kondur, under Primary Health Centre (PHC) Kondur, Villupuram district, Tamil Nadu, during November-December 2010. All adults of more than 50 years (n = 331) residing in the sub-center Kondur, were examined for lenticular opacity and visual acuity. A structured proforma was used to assess the awareness, barriers and facilitating factors related to available cataract health services. Results: The prevalence of cataract among the population studied was 62.8% (95% confidence interval [CI]: 57.5-67.9%). There was a significant increase in cataract with increase in age (P < 0.001). Only 13% (95% CI: 9.6-16.3%) of the persons with cataract were operated at the time of interview. The major barriers were no one to accompany (25.5%) and absence of felt need (22.6%). Less than one-fifth (17.8%) reported the awareness of cataract as a condition affecting eye. The facilitating factors were free surgery in camps (83.7%), self-decision due to defective vision (69.7%) and quality of service provided (65.1%). More than one-half (56.7%) of subjects diagnosed for cataract during the survey were willing to be operated. Conclusion: Prevalence of cataract was high in Kondur PHC area. It is vital to increase the level of awareness regarding the need and availability of cataract health services.
  5,573 447 1
EDITORIAL
Benign hematological disorders in India: The status
Tarun Kumar Dutta
July-December 2014, 1(2):35-36
DOI:10.4103/2349-4220.147996  
  2,219 3,018 -
REVIEW ARTICLES
Non-cirrhotic portal fibrosis
Venkatesan Mukta, Kalaimani Sivamani, Lakshmi C Panicker
July-December 2014, 1(2):45-51
DOI:10.4103/2349-4220.147999  
Portal hypertension occurs commonly in patients with cirrhosis and rarely in those without cirrhosis of liver. The two most important causes of non-cirrhotic portal hypertension are non-cirrhotic portal fibrosis (NCPF) and extrahepatic portal venous obstruction (EHPVO). Unlike EHPVO, there is no thrombosis of the extrahepatic portal vein in NCPF. In NCPF, there occurs sclerosis of medium and small branches of the portal vein. The hepatic venous pressure gradient (HVPG) is normal in NCPF, when compared with cirrhosis where it is elevated. NCPF is also known as non-cirrhotic intrahepatic portal hypertension (NCIPH), idiopathic portal hypertension, hepatoportal sclerosis, and benign intrahepatic portal hypertension. It is a disease of obscure etiology, predominantly affecting the middle-aged males and females who present with hematemesis and massive splenomegaly.
  4,622 452 1
EDITORIAL
Gentle handling of fragile preterm for better outcome
Adhisivam Bethou, Ballambattu Vishnu Bhat
July-December 2015, 2(2):77-79
DOI:10.4103/2349-4220.172879  
  1,566 3,270 -
ORIGINAL ARTICLES
Prevalence of undernutrition among tribal preschool children in Wayanad district of Kerala
Rekha Rachel Philip, Krishnapillai Vijayakumar, Pillaveetil Sathyadas Indu, Basavegowdanadoddi Marinaik Shrinivasa, Thekkumkara Prabhakaran Sreelal, Jayapaul Balaji
January-June 2015, 2(1):33-38
DOI:10.4103/2349-4220.159135  
Background: Nutritional status especially that of preschool children is a sensitive indicator of health and nutritional status of a community. Aim: To estimate the prevalence of undernutrition among tribal preschool children and to assess the factors associated with variation in nutritional status. Methods: A cross-sectional survey was conducted among 438 tribal preschool children in 10 clusters of Wayanad district of Kerala. Height, weight, mid-arm circumference and hemoglobin level were measured. Children more than two standard deviations (SDs) below the standard median of World Health Organization Multi Centric Growth Reference Study were considered underweight (weight-for-age), stunted (height-for-age) and wasted (weight-for-height) respectively. Qualitative variables such as prevalence of underweight, stunting and wasting were summarized using percentages. Mean (SD) was used, to summarize, quantitative variables such as height and weight. Generalized estimating equation models were constructed to assess associations. Adjusted models included social factors and child morbidities. Results: More than half of the children say 58.7% (257/438) had deficits in at least one of the three anthropometric indicators. The prevalence of underweight, stunting and wasting was 39% (171/438), 38% (167/438) and 20.5% (90/438) respectively. The prevalence of anemia was 95.7% (419/438). Bivariate analysis showed significant associations between undernutrition and educational status of parents, tribe to which the child belonged, diarrheal episode and low birth weight. In adjusted analysis, lower educational status of mother (adjusted odds ratio 1.9, 95% confidence intervals 1.2-3) and an episode of diarrhea (1.8, 1.03-3.2) independently predicted undernutrition in a tribal preschool child. Conclusion: Undernutrition in the form of stunting, wasting and underweight is very high among the tribal preschool children. There is an urgent need to improve health care services to the tribal population and tribal children.
  4,212 457 2
Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India
R Nithya, Gowri Dorairajan, Palanivel Chinnakali
January-June 2017, 4(1):11-17
DOI:10.4103/IJAMR.IJAMR_68_16  
Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic random sampling of every 10th woman exiting the antenatal clinic was done. Results: We studied 382 pregnant women. Of them, 188 (49.2% [95% confidence interval (CI): 44%–54%]), 104 (27.2% [95% CI: 23%–32%]), and 81 (21.2% [95% CI: 17%–26%]) women had sufficient knowledge about danger signs during pregnancy, labor, and childbirth, respectively. On multivariable analysis, lack of exposure to formal awareness raising health counseling classes was the only factor found to be significantly associated with a lack of knowledge about danger signs of pregnancy (adjusted prevalence ratio, 95% CI: 1.8 [1.2–2.7]) and after childbirth (1.4 [1.1–1.7]). Lower education level was significantly associated with a lack of knowledge about danger signs of labor (1.2 [1.1–1.4]). Conclusion: We found that lack of exposure to formal awareness raising health counseling classes is a modifiable risk factor to improve knowledge about danger signs. We recommend structured mandatory health awareness sessions addressing the danger signs of pregnancy and child health to all pregnant women.
  4,144 353 2
Under graduate nursing students' knowledge and attitude toward people living with human immunodeficiency virus/acquired immunodeficiency syndrome
Mythili Dharmalingam, Vijayalakshmi Poreddi, Sailaxmi Gandhi, Rama Chandra
January-June 2015, 2(1):22-27
DOI:10.4103/2349-4220.159124  
Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become one of the significant public health problems in the world. Research regarding HIV/AIDS among nursing professionals is limited from India. Aim: The aim was to assess nursing student's knowledge and attitude toward people living with HIV/AIDS. Methods: A descriptive cross-sectional design was adopted among conveniently selected under graduate nursing students (n = 172) using self-reported questionnaires. Results: The overall mean knowledge (38.05 ± 4.91) and attitude score (51.26 ± 6.2) indicate that majority of the students have good knowledge (77.6%) and moderately favorable attitudes (67.4%) toward HIV/AIDS patients. However, statistically significant differences were observed between age (P < 0.001, P < 0.019) education (P < 0.34, P < 0.01) and experience in taking care of HIV/AIDS patients (P < 0.01, P< 0.01) with knowledge and attitude. Conclusion: Though, a majority of nursing students had adequate knowledge, few students hold discriminatory attitudes toward people with HIV/AIDS. These findings indicate that there is an urgent need to improve the level of knowledge and attitudes among nursing students toward HIV/AIDS as they have a key role in prevention, care and treatment in their future career as nurses.
  3,995 494 1
Perception of electronic medical records (EMRs) by nursing staff in a teaching hospital in India
Naveen Kumar Pera, Amrit Kaur, Raveendra Rao
July-December 2014, 1(2):75-80
DOI:10.4103/2349-4220.148008  
Background: Currently, in India, many healthcare organizations and their managements appreciate the advantages of electronic medical records, but they often use them. The current push for universal health coverage in India with National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) helping toward healthcare reforms highlights the importance of implementing information technology as a means of cutting costs and improving efficiency in healthcare field. The quality of documentation of patient care rendered at healthcare destinations is very important to showcase the growing stature of healthcare in India. Aims: As maintaining the medical records is very important, storage and retrieval of the information is also important for future patient care. In this regard, implementation of electronic medical records in hospitals is essential. Through this study, we wanted to highlight the perceptions of healthcare personnel, who are in the core team of delivering healthcare, toward implementation of electronic medical records. Methods: A cross-sectional study was carried out among doctors (post-graduates) and staff nurses. The sample size for post-graduate students and nurses was 164 and 296, respectively, in this study. The study was carried out during the period from January to June 2013, and a survey was conducted with the help of a validated, pre-tested questionnaire in a tertiary care medical college hospital in India. Results: The results showed that 75% of the study population are comfortable working with electronic medical records. They mentioned that display of diagnosis, medications, and allergies of patients on the records was most important. Their perception was that electronic medical records improve timely decision-making and patient care due to immediate access to the patient's disease history. Conclusion: The major problems faced by nurses, as per our study, are delay in services due to dispersion of records, multiplicity of form types consuming major time, and inability to understand doctors' notes.
  4,045 434 2
STUDENTíS RESEARCH
Understanding data for medical statistics
Sonali Sarkar
January-June 2014, 1(1):30-33
DOI:10.4103/2349-4220.134449  
  4,121 350 -
EDITORIALS
Bidding adieu to International Journal of Advanced Medical and Health Research
Devinder Mohan Thappa
Jul-Dec 2016, 3(2):53-54
DOI:10.4103/2349-4220.195949  
  1,847 2,586 -
REVIEW ARTICLES
Rabies: An overview
Tarun Kumar Dutta
July-December 2014, 1(2):39-44
DOI:10.4103/2349-4220.147998  
Rabies is a fatal disease caused by rabies virus, a neurotropic virus and a prototype of Lyssavirus of Rhabdoviridae family. It is transmitted to human beings through infected saliva of dogs and cats during bite. Dog is the cause of more than 90% of human rabies in India. The incubation period is 4-8 weeks (but it may vary from 5 days to 7 years). There are two clinical types of rabies - encephalitic (furious) and paralytic (dumb) types. In the encephalitic (furious) form, the principal malfunction is in the brain stem and limbic system. Patient has hydrophobia in the full-blown form, but the mind remains clear till the end. Death occurs within a week after the onset of symptoms. Paralytic rabies resembles Guillain-Barre syndrome. Diagnosis is mostly clinical. However, direct fluorescent antibody test is used to identify the antigen in skin biopsy from the nape of neck. In the postmortem specimen, demonstration of Negri bodies in the brain confirms the diagnosis. Anti-rabies vaccine is used for pre- and post-exposure prophylaxis. The commonly used intramuscular (IM) regimen is being superseded by intradermal (ID) vaccine because it makes the treatment economical. Whereas touching of animal or lick on intact skin does not require vaccination, any transdermal bite with bleeding requires immediate administration of rabies immunoglobulin (RIG) and simultaneous vaccination with a tissue culture vaccine (TCV). Minor abrasion without bleeding may require only vaccination and no RIG. Rabies human monoclonal antibody (RMAb) is the newest entry in the prophylaxis of rabies which may ultimately replace RIG. Prognosis is grave since there are just six reports of survivors. Treatment is mainly palliative with heavy sedation and/or therapeutic coma (Milwaukee protocol).
  3,775 463 2
ORIGINAL ARTICLES
Determinants of the unmet need for family planning among women of Jaipur, Rajasthan
Rajaat Vohra, Anusha Vohra, Suchi Sharma, Madan Singh Rathore, Bhoopendra Nath Sharma, Mahesh Prasad Sharma
January-June 2014, 1(1):20-25
DOI:10.4103/2349-4220.134446  
Background: More than 100 million women in less developed countries or about 17% of all married women would prefer to avoid pregnancy, but are not using any form of family planning. Despite the government's many efforts, the unmet need for family planning in India is still 12.8%. The present study is aimed to assess prevalence of the unmet need for family planning, its determinants, and the reasons for the unmet need for family planning. Materials and Methods: A sample size of 500 was divided equally among the rural and urban areas. A simple random technique was used to select the first household for the survey. A predesigned and pretested questionnaire was used to record the information. Data was entered on Microsoft Access and analyzed using the statistical software SPSS version 11.5 for Windows Vista. The chi square test was used for finding the association and trends. Results: In the present study, 35% of the population had an unmet need, of which 58.28% belonged to rural area, while 41.71% belonged to the urban area. The significant determinants associated with the unmet need for family planning were religion, type of family, husband's education and occupation, socioeconomic class, women's age, women's education and occupation, exposure to mass media, and healthcare facility where services were provided. Overall, lack of motivation and obstacles were the major reasons for the unmet need. Conclusion: Improved access to family planning services, better education, improved standard of living, and higher exposure to mass media can significantly decrease the unmet need of family planning.
  3,779 348 -
Enhancing trunk stability in acute poststroke subjects using physioball exercise and proprioceptive neuromuscular facilitation technique: A pilot randomized controlled trial
Ravichandran Hariharasudhan, Janakiraman Balamurugan
January-June 2016, 3(1):5-10
DOI:10.4103/2350-0298.184681  
Background: Stroke is one of the leading causes of death and disability worldwide. Poststroke, most survivors experience trunk control impairment and instability. Previous works on exercise on an unstable surface to improve trunk stability in nonstroke population had proven effective. Thus, physioball exercises (PBEs) in poststroke subjects may be useful in the recovery of trunk stability and thereby reduce disability. We hypothesize that PBE is feasible and effective in enhancing trunk stability. Aims: To test the feasibility and successful implementation of conducting a randomized controlled study to assess the clinical effectiveness of PBE and proprioceptive neuromuscular facilitation (PNF) technique to enhance trunk control in poststroke subjects. Methods: This study was conducted in a stroke unit of Global Hospitals and Health City, Chennai, India. Thirty patients with the first onset of stroke within 40 days of stroke duration, lesion to one side, and ability to sit independently with or without arm support for 15 days were recruited. All thirty poststroke subjects were randomized either into PBE group or PNF group, and outcome assessors involved in the trail were blinded to allocation. PBE group performed task-oriented activities on an unstable surface and PNF group were treated with PNF-specific trunk stability exercise program for 4 weeks (30 min/day, 5 times/week). Trunk impairment scale (TIS) was used as a main outcome measure. Results: Data were analyzed using Wilcoxon signed rank sum test and Mann–Whitney U-test for intra- and inter-group comparison. The baseline characteristics between both groups were statistically nonsignificant. Within groups, there were significant improvements between baseline and at 4 weeks in the measure of TIS. In addition, PBE group showed a significant increase in trunk control (mean 2.33, 95% confidence interval 1.14-3.52, P = 0.002) than the PNF subject. Conclusion: This pilot randomized controlled trial (RCT) showed the potential efficacy of PBE in developing more trunk stability than PNF in poststroke subjects. The current study had proved the feasibility of undertaking a large-scale RCT. Since this is a pilot study to establish any sort of conclusive evidence on the efficacy of PBEs in the poststroke population, a larger sample-sized trial is needed.
  3,465 453 -
Pregnancy outcome in cases of oligohydramnios after 28 weeks of gestation
Sita Ghimire, Ashima Ghimire, Saugat Chapagain, Sumitra Paudel
Jul-Dec 2016, 3(2):68-72
DOI:10.4103/2349-4220.195939  
Background: Amniotic fluid volume may reflect a problem with fluid production or circulation due to fetal, placental, and maternal pathology. Some authors have shown that amniotic fluid index (AFI) is a poor predictor of adverse pregnancy outcome, but others have not confirmed the association of adverse perinatal outcome with oligohydramnios. Objectives: To compare the mode of delivery and neonatal outcome in patients with oligohydramnios (AFI <5 cm) with no-oligohydramnios group (AFI 5–25 cm). Methods: A prospective hospital-based observational study was carried out in the Department of Gynecology and Obstetrics, Nobel Medical College, Biratnagar; a referral center in eastern Nepal. In 1 year duration, 100 patients who completed 28 weeks of gestation with AFI <5 cm were included in the oligohydramnios group and 100 patients having AFI 5–25 cm were enrolled to the no-oligohydramnios group. Results: A total of 8096 women were admitted during the study from March 1, 2015 to February 28, 2016. Among them, 100 patients meeting the inclusion criteria were taken into oligohydramnios group. AFI <5 cm was more in primipara 58 (58%) and 43 (43%) were postdated pregnancy. Increased operative delivery [85 (85%)] was found in oligohydramnios group, whereas it was 30 (30%) in the no-oligohydramnios group. The neonatal outcome which was assessed by Apgar score (P < 0.003) and Neonatal Intensive Care Unit admission (P < 0.026) were significantly different between the two groups. Conclusion: Isolated oligohydramnios in the absence of any other maternal or fetal complicating factor is associated with need for operative intervention and adversely affects the fetal outcome, when compared to no-oligohydramnios group with normal AFI.
  3,529 303 -
DISPATCH
Hemifacial spasm due to non-ketotic hyperglycemia
Subrata Chakrabarti
July-December 2014, 1(2):90-92
DOI:10.4103/2349-4220.148016  
Different movement disorders including chorea and hemichorea-hemiballismus are known to be some interesting presentations of uncontrolled hyperglycemic states (both in type 1 and 2 diabetes mellitus). Hemifacial spasm is rarely reported as a manifestation of hyperglycemic state. Here, the author reports an extremely rare case of hemifacial spasm which developed as the presenting manifestation of non-ketotic hyperglycemia in type 1 diabetes mellitus.
  3,627 160 1
DISPATCHES
Synergistic effect of nifedipine and magnesium sulfate causing symptomatic hypocalcemia in a preeclamptic patient
P Veena, S Soundara Raghavan
Jul-Dec 2016, 3(2):105-106
DOI:10.4103/2349-4220.195942  
Magnesium sulfate has an established role as an anticonvulsant. Hypocalcemia with magnesium sulfate therapy is a well-known complication but rarely encountered in clinical practice. Concurrent use of nifedipine may unmask hypocalcemia in these patients. The resulting hypocalcemia can lead to acute cardiac events endangering patient's life.
  3,456 139 -
REVIEW ARTICLE
Sepsis genomics: Stepping forward toward sepsis prevention?
Benet Bosco Dhas, Hiasindh Ashmi, Ballambattu Vishnu Bhat
January-June 2014, 1(1):8-15
DOI:10.4103/2349-4220.134444  
The era of personalized medicine has already begun and now it is time to initiate personalized prevention strategies against diseases. Infectious diseases have a higher mortality than any other illness, especially in developing countries. Among newborns and young children the situation is even worse. The microorganisms are becoming resistant to almost all known antibiotics. Hence, it is imperative to improve the preventive strategies against infections. 'Pathogens are everywhere, but not every individual is getting diseased,' - this basic logical thinking needs to look into the genetic predisposition/host susceptibility to sepsis. Interestingly, genetic studies have shown that the type of infecting organism, outcome of infections, and mortality can be predetermined by analyzing an individual's genome. Exploration of inter-individual genetic variations and their association with sepsis will help in the development of new prognostic markers to provide novel personalized therapeutics and predict the outcome. In this review article, we discuss the genetic variations and their association with sepsis, studied by various researchers in different regions.
  3,183 359 -
ORIGINAL ARTICLES
Mupirocin resistance in clinical isolates of methicillin-resistant Staphylococcus aureus from a tertiary care rural hospital
Charan Kaur Dardi
July-December 2014, 1(2):52-56
DOI:10.4103/2349-4220.148000  
Background and Aims: Mupirocin is a topical antibiotic that has been used extensively for treating methicillin-resistant Staphylococcus aureus (MRSA) associated infections. However, the prevalence of mupirocin-resistant MRSA has increased with the extensive and widespread use of this agent. The aim was to determine the rates of high-level and low-level mupirocin resistance in MRSA to study the antimicrobial resistance pattern and clindamycin resistance in mupirocin-resistant MRSA. Methods: A total of 267 non-duplicate clinical isolates of MRSA from various clinical specimens were tested for mupirocin resistance by the disk diffusion method using 5 and 200 μg mupirocin disks. MRSA isolates were tested for antibiotics by Kirby-Bauer disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Erythromycin-resistant isolates of MRSA were further studied for inducible clindamycin resistance by "D test" as per CLSI guidelines. Results: Of 267 MRSA isolates, high-level mupirocin resistance was observed in 5.99% and low-level resistance in 15.35%. Mupirocin-resistant MRSA isolates showed higher antibiotic resistance to fusidic acid (14.03% vs 7.14%), rifampicin (5.26% vs 2.38%), erythromycin (68.42% vs 58.57%), and clindamycin (52.63% vs 45.71%). No MRSA strains were found to be resistant to vancomycin and linezolid. Mupirocin-resistant MRSA isolates showed higher constitutive macrolide-lincosamide-streptogamin B (cMLS B ; 51.28% vs 42.98%) and inducible macrolide-lincosamide-streptogamin B (iMLS B ; 17.94% vs 13.15%) resistance, as compared to mupirocin-sensitive MRSA isolates. Conclusion: The emergence of mupirocin resistance could be limited by regular surveillance and effective infection control initiatives so to inform health care facilities to guide therapeutic and prophylactic use of mupirocin.
  3,002 338 2
PERSPECTIVE
Safety and health concerns of school going children in India
Adhisivam Bethou, Chandrasekaran Venkatesh
January-June 2014, 1(1):6-7
DOI:10.4103/2349-4220.134443  
  3,078 246 -
DISPATCHES
Essential palatal myoclonus: A rare cause of objective tinnitus
Thuruthiath Nisha, Arayamparambil Rajagopalan Vinayakumar
Jul-Dec 2016, 3(2):91-93
DOI:10.4103/2349-4220.195936  
Palatal myoclonus is one of the rare causes of tinnitus characterized by rhythmic involuntary contraction of muscles of soft palate as well as pharynx. Among the two types, the essential palatal myoclonus, which is idiopathic as no cause can be identified in children, is rarely reported in literature. In this case report, we present a 12-year-old girl who complained of hearing abnormal sound in her ears, which could be perceived by the examiner also. She had myoclonus of soft palate and uvula for which no obvious cause could be identified. Hence, it was diagnosed as essential palatal myoclonus and was successfully treated with clonazepam.
  3,145 117 1