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  Citation statistics : Table of Contents
   2017| July-December  | Volume 8 | Issue 2  
    Online since July 10, 2017

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The impact of the educational intervention on knowledge, attitude, and practice of pharmacovigilance toward adverse drug reactions reporting among health-care professionals in a Tertiary Care Hospital in South India
Subramaniyan Ganesan, Selvarajan Sandhiya, Kishtapati Chenchu Reddy, Chandrasekaran Adithan
July-December 2017, 8(2):203-209
DOI:10.4103/0976-9668.210014  PMID:28781488
Background: Knowledge, attitude, practice (KAP)-based educational intervention is an important tool to reduce underreporting of adverse drug reactions (ADRs). Hence, this study aimed to assess the KAP of doctors and nurses working in medicine and allied departments of Jawaharlal Institute of Postgraduate Medical Education and Research on spontaneous reporting of ADRs, following an educational intervention. The study also compared the quantity of ADRs reported before and after 1 year of introducing the educational intervention. Methodology: The study was a cross-sectional questionnaire-based study involving doctors and nurses working in a tertiary care hospital in South India. A predesigned structured questionnaire was prepared to suit our ADR monitoring center, validated and then distributed to doctors and nurses working in medicine and allied departments of the institute. The study participants were asked to fill KAP pretest questionnaire followed by interactive educational intervention and post-test questionnaire related to KAP after 1 year. The impact of educational intervention among doctors and nurses was evaluated by their response to the post-test questionnaire and the number of ADR reported after intervention. The appropriate statistical analysis was used through Graph Pad InStat version 3.0. Results: A total of 235 health-care professionals were involved in the pre-KAP questionnaire, an educational intervention, and post-KAP questionnaire. Among them, doctors were 39%, and nurses were 61%. The overall response rate among doctors and nurses following educational intervention was statistically significant (P < 0.0001). Following the educational intervention, the quantity of ADR reported became double compared to pre-intervention. Conclusion: The KAP of health-care professionals improved following educational interventional program on pharmacovigilance. Continued educational intervention may inculcate ADR reporting culture among health-care professionals.
  6 3,084 464
A simple way for the preparation of natural antioxidant quercetin from rutin by subcritical water
Elena Vladimirovna Vetrova, Elena Vladimirovna Maksimenko, Salima Salimovna Khizrieva, Anastasia Fedorovna Bugaeva, Nikolay Ivanovitch Borisenko, Vladimir Isaakovitch Minkin
July-December 2017, 8(2):213-215
DOI:10.4103/0976-9668.210009  PMID:28781490
Context: Quercetin (QR) is a natural strong antioxidant of the plant origins. It is used for treating conditions of heart and blood vessels including “hardening of arteries” (atherosclerosis), high cholesterol, heart disease, circulation problems, preventing cancer, for treating chronic infections of the prostate, etc., Aims: The aim of this work was to development and study of an acid-free technique for the preparation of QR from rutin (RT) that requires no use of acids and toxic organic solvents. Materials and Methods: For the first time, the subcritical water that serves as a reactant and a solvent were used to obtain QR in good yields starting from RT. High-performance liquid chromatography combined with mass spectrometry was used to determine the quantitative and qualitative compositions of the obtained products. Conclusions: For the first time, a new acid-free technique was used for the synthesis of natural antioxidant QR from an RT by subcritical water. That way requires no use of acids and/or toxic organic solvents. It has been shown that variation of only one parameter of the process (temperature of subcritical water) allows alteration to the composition of the hydrolysis products. The new method developed for the production of QR in subcritical water is environmentally friendly and faster than conventional hydrolysis methods that use acidic or enzymatic hydrolysis. The proposed technique has a potential for the future development of inexpensive and environmentally friendly technologies for the production of new pharmaceutical plant-based substances.
  2 2,660 272
Common causes of eye enucleation among patients
A Farokhfar, A Ahmadzadeh-Amiri, MR Sheikhrezaee, Mohammad Ali Heidari Gorji, N Agaei
July-December 2017, 8(2):150-153
DOI:10.4103/0976-9668.210006  PMID:28781478
Background: We investigated the contributing causes and factors leading to eye enucleation procedure among the patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran. Patients and Methods: We retrospectively analyzed the clinical records of patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran, in the past 3 years. The data retrieved were analyzed. Results: A total of 313 patients underwent eye enucleation during the past 3 years. The average age of the patients was 36.7 years (range: 20–44 years). Two hundred and eight patients (66.5%) were males and 105 (33.5%) were females. One hundred and sixty-nine patients had the right eye enucleation while 144 patients had the left eye enucleation. The various procedures included enucleation (83%), evisceration (13.4%), and exantration (3.6%). The factors leading to these procedures included trauma (33.2%), phthisis bulbi (20.7%), tumors (15.7%), and infections (10.5%). Conclusion: In our study population, trauma was the main factor leading to eye enucleation. Hence, measures to increase social awareness and knowledge to reduce trauma cases are necessary as a preventive approach to reduce eye enucleation procedures. Concurrently, ophthalmologists should also pay more attention in early diagnoses and screening of eye health, especially detecting tumor cases such as retinoblastoma and postsurgical care to reduce secondary infections will be effective actions to reduce the overall rate of enucleation.
  2 2,460 262
The role of red cell distribution width as a predictor of mortality for critically ill patients in an inner-city hospital
Syed Atif Safdar, Tejas Modi, Lakshmi Durga Sriramulu, Hamid Shaaban, Raymund Sison, Varun Modi, Marc Adelman, Gunwant Guron
July-December 2017, 8(2):154-158
DOI:10.4103/0976-9668.210017  PMID:28781479
Background: Red cell distribution width (RDW) is a measure of the variation in the red blood cell volume that is usually recorded as a part of the standard complete blood cell count. Recent studies have demonstrated the prognostic value of RDW in many different clinical settings. The objective of this research study is to investigate the independent association of RDW with 30-day mortality in Intensive Care Unit (ICU) patients. Methods: One hundred and fifty-six patients admitted to the ICU of our hospital between July 2009 and June 2011 were included in our study. Out of 156 patients, 124 survived the hospital stay. The data on patient's demographics, interventions done in ICU, and their comorbidities were collected. Baseline variables and the RDW value were compared between survivors and nonsurvivors. The cutoff point for RDW used for the comparison was 15.75. Both univariable and multivariable analyses were done. P < 0.05 was considered statistically significant. Results: In the univariable analysis of the study between survivors and nonsurvivors, the median RDW was 17.20 for nonsurvivors, implying statistical significance (P = 0.007). In multivariable analysis, RDW remained significantly associated with inpatient mortality. The receiver operating characteristic is 0.656 (P = 0.007), with an optimal cutoff of 15.75 for RDW. At the cutoff of RDW, i.e., 15.75, the sensitivity and specificity for inpatient mortality was 71% and 89%, respectively. Conclusion: In critically ill ICU patients, RDW is an independent predictor of 30-day mortality. Taking into consideration the fact that RDW is routinely measured in complete blood count with no additional cost, this can serve as an “inexpensive prognostic marker” in critically ill patients.
  1 2,602 276
Structural and biophysical characterization of cajanus cajan protease inhibitor
Tooba Naz Shamsi, Romana Parveen, Shahzaib Ahamad, Sadaf Fatima
July-December 2017, 8(2):186-192
DOI:10.4103/0976-9668.210018  PMID:28781485
Context: A large number of studies have proven that Protease inhibitors (PIs), specifically serine protease inhibitors, show immense divergence in regulation of proteolysis by targeting their specific proteases and hence, they play a key role in healthcare. Objective: We aimed to access in-vitro anticancer potential of PI from Cajanus cajan (CCPI). Also, crystallization of CCPI was targetted alongwith structure determination and its structure-function relationship. Materials and Methods: CCPI was purified from Cajanus cajan seeds by chromatographic techniques. The purity and molecular mass was determined by SDS-PAGE. Anticancer potential of CCPI was determined by MTT assay in normal HEK and cancerous A549 cells. The crystallization screening of CCPI was performed by commercially available screens. CCPI sequence was subject to BLASTp with homologous PIs. Progressive multiple alignment was performed using clustalw2 and was modelled using ab initio protocol of I-TASSER. Results: The results showed ~14kDa CCPI was purified in homogeneity. Also, CCPI showed low cytotoxic effects of in HEK i.e., 27% as compared with 51% cytotoxicity in A549 cells. CCPI crystallized at 16°C using 15% PEG 6000 in 0.1M potassium phosphate buffer (pH 6.0) in 2-3weeks as rod or needles visualized as clusters under the microscope. The molecular modelling revealed that it contains 3 beta sheets, 3 beta hairpins, 2 β-bulges, 6 strands, 3 helices, 1helix-helix interaction, 41 β-turns and 27 γ-turns. Discussion and Conclusion: The results indicate that CCPI may help to treat cancer in vivo aswell. Also, this is the first report on preliminary crystallization and structural studies of CCPI.
  1 2,479 246
Distress and its effect on adherence to antidiabetic medications among Type 2 diabetes patients in coastal South India
Nithin Kumar, Bhaskaran Unnikrishnan, Rekha Thapar, Prasanna Mithra, Vaman Kulkarni, Ramesh Holla, Darshan Bhagawan, Avinash Kumar, Shodhan Aithal
July-December 2017, 8(2):216-220
DOI:10.4103/0976-9668.210008  PMID:28781491
Background: Distress can bring about an unfavorable attitude among the patients toward tackling their disease which can affect adherence to medications. The purpose of this study was to assess the effect of distress on adherence to medication among patients with diabetes. Methodology: In this cross-sectional study, 124 type 2 diabetes patients above 18 years, attending the hospitals affiliated to Kasturba Medical College, Mangalore, selected using nonprobability sampling were interviewed to assess the presence of diabetes-related distress (DRD) and their level of adherence to medications. Distress was assessed using diabetes distress scale. Morisky Adherence Questionnaire was used to assess the level of adherence. Approval was obtained from the Institutional Ethics Committee. Multivariate logistic regression was conducted to assess the influence of domains of distress on adherence to antidiabetic medication and P < 0.05 was considered statistically significant. Results: In our study, 41.9% (n = 52) of the participants had high diabetes distress. Exactly 43.5% (n = 54) of the participants had low adherence to antidiabetic medications. On univariate analysis, participants with low regimen distress, low physician distress, and low interpersonal distress were found to have good adherence to antidiabetic medication. However, on multivariate analysis, only low regimen distress was found to be significantly associated with good adherence to medication among the study participants. Conclusion: DRD is a problem in our study participants which affects the adherence to medications. Identifying distress at an early stage can help doctors formulate and implement remedial measures, thereby improving adherence to medications.
  1 2,720 271
Villous chorion: A potential source for pluripotent-like stromal cells
Jaianand Kannaiyan, Palaniyandi Muthukutty, M D. Tabish Iqbal, Balaji Paulraj
July-December 2017, 8(2):221-228
DOI:10.4103/0976-9668.210011  PMID:28781492
Context: Multipotent stromal cells are isolated from various fetal sources and studied for their phenotypic characterization and ability to differentiate into different lineages. Aims: In this study, we aimed to isolate mesenchymal stem or stromal cells (MSCs) from villous chorion, expand under clinical scale level, compared the potency with other source of fetal-derived MSCs and studied their differentiation capabilities to form all three germ layers. Subjects and Methods: Placenta obtained from C-section was used to isolate villous chorion-MSCs (VC-MSCs) were expanded up to tenth passage and their characteristics were assessed by proliferation rate and phenotypic characterization using fluorescence-activated cell sorting and also expanded MSCs were analyzed for differentiated into all three germ layers by cytochemical staining. Results: Stem cell isolated from VC yielded up to 2.16 × 109 cells at second passage and 3.06–4.23 × 104 cells/cm2 at tenth passage. The total yield of cells with all three sources analysis showed that VC has a low yield at second passage compared to amniotic membrane and Wharton's jelly, but the VC-MSCs yield significant amount in lesser days. The phenotypic characterization revealed positive for CD73, CD90, and CD105 and negative for CD79, CD34, CD45, human leukocyte antigen-DR proving their stemness even at tenth passage. They can able to differentiate into ectodermic neural cells, endodermic hepatocytes, and mesodermal differentiation of chondrocytes, adipocytes, and osteogenic cells proving their ability to differentiate into all three germ layers. Conclusions: This result suggests that the VC-MSCs are ideal source of stem cells with similar characteristics such as other adult stem cells. Thus, VC-derived MSCs can be potential clinical source in regenerative medicine.
  1 2,218 219
Influence of qualification and practice settings of dental practitioners on antimicrobial prescribing in Delhi and National Capital Region, India
Himika Wasan, Pooja Gupta, Apoorva Mathur, Ekta Mutneja, Vijay Prakash Mathur, Yogendra Kumar Gupta
July-December 2017, 8(2):229-234
DOI:10.4103/0976-9668.210015  PMID:28781493
Background and Objectives: Inappropriate antimicrobial prescribing is highly reported in dentistry. The objective of the study was to see the effect of dental qualification and practice settings on antimicrobial prescribing practices among dental practitioners in Delhi and National Capital Region (NCR) of India. Materials and Methods: A self-designed and pretested questionnaire was given to 667 dental practitioners holding degrees of graduation, postgraduation, and those pursuing postgraduation, working in academic institutions and private clinics in NCR of India. Data were analyzed using statistical software Stata version 12.0. Chi-square and logistic regression tests were used for analysis. Results: Out of total 539 responded, 66.4% of the practitioners prescribed by brand name and 27.8% by generic name. Amoxicillin * clavulanic acid (27.4%) was the first choice. Only 26% of the practitioners asked for antimicrobial susceptibility testing. Space infections (91.9%), impacted third molar extractions (89.7%), and periodontal abscess (88.1%) were the conditions where antimicrobials were most frequently prescribed. However, 60.9% and 53.3% of the practitioners also prescribed antimicrobials for acute pulpitis and dry socket, respectively. For prophylaxis in medical conditions, amoxicillin was the first choice. In case of history of allergy to penicillin, 52.3% of the practitioners prescribe erythromycin whereas 14.6% prescribe amoxicillin. The adverse drug reporting culture was negligible, and only 14.3% of the practitioners were aware of the Pharmacovigilance Program of India. Level of qualification had a significant effect on prescribing (P < 0.05). Interpretation and Conclusion: Frequent irrational prescribing of antimicrobials used in odontogenic conditions warrants an urgent and continued need for guidelines as well as educational intervention programs in dentistry. This will improve the quality of antimicrobial prescribing practices in dentistry.
  1 2,214 249
Cadaveric study of mode of termination of gonadal veins: Implications for procedures utilizing terminal ends of gonadal veins as entry portals
Rekha Lalwani, Sunita A Athavale, Ketu Chauhan, Guljari Lal Nigam, C S. Ramesh Babu, Sheetal Kotgirwar
July-December 2017, 8(2):210-212
DOI:10.4103/0976-9668.210005  PMID:28781489
Context: The terminal ends of gonadal veins act as an entry portal in gonadal embolization procedures used for treating varicocele in males and pelvic congestion disease in females. Here, we studied the modes of termination of gonadal veins in adult cadavers. Material and Methods: Thirty-five adult formalin-fixed cadavers (seventy sides) were studied over a period of 4 years. The modes of termination of gonadal veins were observed under the following study variables: (a) number, (b) locale of termination, and (c) termination angle. Results: Variations in study parameters were observed in eight sides of seven cadavers (seven unilateral and one bilateral). Double veins at termination were observed in six cadavers; anomalous termination was observed in three cadavers. Angle of termination differed from normal in 3 cadavers. In one of these cadavers, the left ovarian vein drained into the left suprarenal vein. Conclusion: Duplication of terminal ends, anomalous drainage site, and varied angles of termination call for caution to ensure the success of procedures, which use terminal ends of gonadal veins as entry portals.
  1 2,124 180
Neuroanatomical changes in brain structures related to cognition in epilepsy: An update
K Saniya, BG Patil, Madhavrao D Chavan, KG Prakash, Kumar Sai Sailesh, R Archana, Minu Johny
July-December 2017, 8(2):139-143
DOI:10.4103/0976-9668.210016  PMID:28781476
Understanding the microanatomical changes in brain structures is necessary for developing innovative therapeutic approaches to prevent/delay the cognitive impairment in epilepsy. We review here the microanatomical changes in the brain structures related to cognition in epilepsy. Here, we have presented the changes in major brain structures related to cognition, which helps the clinicians understand epilepsy more clearly and also helps researchers develop new treatment procedures.
  1 3,521 1,810
The dynamics of technology in revolutionizing education and research
Arun H. S Kumar
July-December 2017, 8(2):137-138
DOI:10.4103/jnsbm.JNSBM_129_17  PMID:28781475
  - 2,726 2,081
Association of neck circumference and obesity with blood pressure among adolescents in urban and rural population in North Tamil Nadu
Archana Rajagopalan, Nisha Balaji
July-December 2017, 8(2):144-149
DOI:10.4103/jnsbm.JNSBM_29_17  PMID:28781477
Aim: Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. Materials and Methods: This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Results: Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant (P < 0.001) significantly higher BMI (P < 0.01), SBP (P < 0.05), and NC (P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95th percentile values are significantly higher than rest in both urban and rural population. Only the 95th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Conclusion: Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.
  - 3,159 469
Frequency of Class 1 integron and genetic diversity of Acinetobacter baumannii isolated from medical centers in Kermanshah
Mahsa Eghbalimoghadam, Abbas Farahani, Farahtaj Navab Akbar, Parviz Mohajeri
July-December 2017, 8(2):193-198
DOI:10.4103/0976-9668.210007  PMID:28781486
Background and Objective: Acinetobacter baumannii has emerged as an important pathogen in hospital and environment that can acquire transport element and antibiotic-resistant genes. The aim of this study was to determine the resistances to different antibiotics, frequency of Class 1 integron in A. baumannii and then molecular typing for A. baumannii isolated from Intensive Care Unit (ICU). Materials and Methods: A total of 100 isolates of A. baumannii were collected from patients admitted to hospitals in Kermanshah from April 2014 to September 2015. The isolates were identified using biochemical test. Antimicrobial susceptibility test for 20 antibiotics was determined by Kirby–Bauer antibiotic testing (or disc diffusion). The prevalence rate of class integrons among the isolates was determined using polymerase chain reaction and finally 80 isolates of A. baumannii obtained from the Intensive Care Unit were selected for molecular typing by pulsed-field gel electrophoresis (PFGE). Results: The maximum drug resistance was observed against cefotaxime, ceftriaxone, mezlocillin, imipenem, and ceftazidime and piperacillin. Twenty-nine isolates were multidrug resistant (MDR); about 21 isolates were extensively-drug resistant and none were pandrug resistance and 42 isolates (42%) contained Class 1 integrons. The results did not show a significant correlation between the presence of Class 1 integrons and incidence of MDR A. baumannii. Five clusters were obtained by PFGE. Conclusion: This study did not show a significant correlation between the presence of Class 1 integrons and incidence of MDR A. baumannii. By PFGE analysis, the high level of similarity between some pulsotypes in A.baumannii strains showed genetic correlation between them.
  - 2,101 173
Evaluation of susceptibility of glycopeptide-resistant and glycopeptide-sensitive enterococci to commonly used biocides in a super-speciality hospital: A pilot study
Mohit Bhatia, Bibhabati Mishra, Archana Thakur, Vinita Dogra, Poonam Sood Loomba
July-December 2017, 8(2):199-202
DOI:10.4103/0976-9668.210010  PMID:28781487
Context: Although existence of a probable association between glycopeptide and biocide resistance among enterococci has often been hypothesized, all studies conducted so far on this subject have been inconclusive. Aims: The aim of this study was to explore the possibility of the existence of an association between glycopeptide resistance and reduced susceptibility to biocides among Enterococcus spp. Settings and Design: This was a pilot study conducted in a super-speciality hospital situated in New Delhi, India, between June and November, 2015. Patients and Methods: Fourteen isolates of Enterococcus spp. obtained from various clinical samples of inpatients were subjected to susceptibility testing by modified Kirby-Bauer disk diffusion method to the following antibiotics: ampicillin (30 μg), gentamicin (120 μg), linezolid (30 μg), teicoplanin (30 μg), and vancomycin (30 μg). Based on the preliminary glycopeptide susceptibility results, all the isolates were classified into glycopeptide-sensitive and glycopeptide-resistant groups, respectively. Isolates belonging to both of these groups were subjected to tube dilution method for determining minimum inhibitory concentration of three biocides, namely, sodium hypochlorite, povidone-iodine, and absolute ethanol, respectively. Minimum bactericidal concentration of these disinfectants was also determined as per standard guidelines. Statistical Analysis Used: Not applicable. Results: More number of glycopeptide-sensitive strains exhibited reduced susceptibility to sodium hypochlorite than glycopeptide-resistant strains of enterococci. However, more number of glycopeptide-resistant isolates exhibited lower susceptibility to povidone-iodine than glycopeptide-sensitive isolates of enterococci. Both glycopeptide-sensitive and glycopeptide-resistant enterococci were equally susceptible to absolute ethanol. Conclusions: It seems that biocide resistance is an important issue and may have links with antibiotic resistance. This study points towards a possible association between glycopeptide resistance and reduced susceptibility to povidone iodine among enterococci. More studies should be conducted in order to further explore this supposedly enigmatic issue.
  - 2,164 177
Electroencephalogram signal classification for automated epileptic seizure detection using genetic algorithm
B Suguna Nanthini, B Santhi
July-December 2017, 8(2):159-166
DOI:10.4103/jnsbm.JNSBM_285_16  PMID:28781480
Background: Epilepsy causes when the repeated seizure occurs in the brain. Electroencephalogram (EEG) test provides valuable information about the brain functions and can be useful to detect brain disorder, especially for epilepsy. In this study, application for an automated seizure detection model has been introduced successfully. Materials and Methods: The EEG signals are decomposed into sub-bands by discrete wavelet transform using db2 (daubechies) wavelet. The eight statistical features, the four gray level co-occurrence matrix and Renyi entropy estimation with four different degrees of order, are extracted from the raw EEG and its sub-bands. Genetic algorithm (GA) is used to select eight relevant features from the 16 dimension features. The model has been trained and tested using support vector machine (SVM) classifier successfully for EEG signals. The performance of the SVM classifier is evaluated for two different databases. Results: The study has been experimented through two different analyses and achieved satisfactory performance for automated seizure detection using relevant features as the input to the SVM classifier. Conclusion: Relevant features using GA give better accuracy performance for seizure detection.
  - 2,514 319
Polymorphism of the prolactin gene and its relationship with milk production in gir and kankrej cattle
Jainikkumar Bipinchandra Patel, Jenabhai Bhathibhai Chauhan
July-December 2017, 8(2):167-170
DOI:10.4103/jnsbm.JNSBM_303_16  PMID:28781481
Background: The aim of this study was to detect allelic and genotypic frequencies of prolactin (PRL) gene in Gir (200) and Kankrej (100) cattle and to analyze milk production traits of tested cattle on their PRL genotypes. Materials and Methods: The 156 bp fragment located in exon 3 was amplified using polymerase chain reaction-restriction fragments length polymorphism technique. Results: Allele frequencies in the studied breed were A = 0.52 and B = 0.48. Means and standard deviations for milk yield and fat content (%) were 3811.6 ± 462.1 and 3.99 ± 0.18 for the AA genotype, 3514.9 ± 450.8 and 4.16 ± 0.33 for the AB genotype, and 3388.8 ± 423.3 and 4.34 ± 0.11 for the BB genotype, respectively, in Gir cattle. Similarly, for Kankrej cattle, means and standard deviations for milk yield and fat content (%) were 2007.8 ± 246.3 and 4.05 ± 0.16 for the AA genotype, 1846.14 ± 133.4 and 4.10 ± 0.156 for the AB genotype, and 1767.7 ± 186.4 and 4.30 ± 0.178 for the BB genotype, respectively, in Kankrej cattle. Conclusion: This study showed differences in milk traits among PRL genotypes of Gir and Kankrej cattle.
  - 2,465 217
Assessment of directly observed treatment in revised national tuberculosis control programme: A study from North India
Srikanta Kanungo, Zulfia Khan, Mohammad Athar Ansari, Ali Jafar Abedi
July-December 2017, 8(2):171-175
DOI:10.4103/0976-9668.210003  PMID:28781482
Introduction: Directly observed treatment short-course (DOTS) strategy is one of the vital components of Revised National Tuberculosis Control Programme (RNTCP) came into existence in 1997. Directly observed treatment providers (DOT providers) are the grass root level link between program and clients. Aims: This study was undertaken to assess the quality of DOTS and facilities available at DOT centers and association between program input and outcome. Materials and Methods: This prospective study was carried out to evaluate RNTCP in a North Indian District. Totally, 42 DOT providers providing treatment to registered RNTCP patients in four designated microscopy centers were included in this study. Program input was assessed based on a ten-point questionnaire regarding processes and facilities followed DOT center. Treatment outcome of 302 patients receiving DOTS under these providers was also assessed. Statistical Analysis: Data were analyzed using SPSS version 20. Categorical variables such as age group, sex, religion, location, work experience of DOT providers are measured in frequency and percentage. Chi-square was used to find association between quality of DOTS and outcome of treatment. P < 0.05 was considered statistically significant. Results: The basic principle of DOTS was followed only in half (47.6%) of the DOT centers, counseling was not being done by 40.5% of the providers. Formal training of DOTS was given to two-thirds of the providers. The treatment outcome of patients was significantly associated with program input at DOT center level (Chi-square = 4.02, P < 0.05). Conclusions: There are few gaps in DOT practices such as administration of DOTS, patient counseling, and tracing of follow-up. This study also concluded that improved program input can enable to get a better outcome.
  - 2,566 263
Isolation and antibiotic susceptibility pattern of Escherichia coli from urinary tract infections in a tertiary care hospital of North Eastern Karnataka
Sudheendra Ramesh Kulkarni, Basavaraj V Peerapur, Kumar Sai Sailesh
July-December 2017, 8(2):176-180
DOI:10.4103/0976-9668.210012  PMID:28781483
Introduction: Clinical management of the urinary tract infections (UTI) is influenced by the antimicrobial vulnerability patterns. Objective: The study aimed to analyse the resistance pattern of the Escherichia coli (E. coli) causing UTI in patients over a period of 4 years from 2012 to 2015. Materials and Methods: 1000 samples from patients suspected of having urinary tract infections were collected and processed for culture and antimicrobial drug susceptibility as per the routine microbiological techniques. Results: Of the total 1000 samples, 395 cases were culture-positive for E. coli. These isolates were tested for antibiotic susceptibility by disk diffusion method. Of the total 395 E. coli isolates, 170 (43%) were multi drug resistant (MDR). The isolates showed high level of resistance to Ampicillin (82.53%), Cefuroxime (72.41%), Amoxycillin-clavulinic acid (71.90%), Ceftriaxone (66.58%), Ciprofloxacin (65.82%) and Cefepime (57.47%). The isolates were sensitive to Imipenem (96.71%), Nitrfurantion (92.41%), Amikacin (90.89%), Chloramphenicol (85.82%), Piperacillin-tazobactum (80.76%), Gentamicin (59.24%), Azetreonam (54.43%) and Norfloxacin (53.67%). Conclusion: We conclude that a significant number of the urinary tract infections in our study subjects were caused by multiple drug resistant E. coli. The sensitivity pattern showed a continued decline from 2012 to 2015, with Imipenem being currently the most effective antibiotic.
  - 3,994 499
Is there any benefit of integrating computer-assisted learning with conventional teaching format in pharmacology to demonstrate the effects of different drugs on mean arterial blood pressure in an anesthetized dog?: A comparative study
Parama Sengupta, Abhishek Sharma, Nina Das
July-December 2017, 8(2):181-185
DOI:10.4103/0976-9668.210013  PMID:28781484
Purpose: Computer-assisted learning (CAL) tools are often used in medical education as it can complement conventional teaching formats and as an alternative to animal experiments in undergraduate medical students. To identify if there is any benefit of integrating CAL tools with conventional teaching format in pharmacology for a specific topic. Materials and Method: Two groups of fourth semester students, Group I (n = 55) and Group II (n = 60), were taught a specific topic in pharmacology using only conventional teaching format (Group I), and both conventional teaching format as well as CAL format (EP Dog version 1.1.0) (Group II). The students were assessed with two different sets of multiple-choice questions, relevant to the topic taught, immediately at the end of the teaching sessions and after 30 days. Acceptability of the two teaching sessions by the students was also assessed using Likert scale. Results: There was no significant difference in the scores of the students of the two groups immediately after teaching (P = 0.1260), there is definitely better residual knowledge reflected by the significantly (P = 0.001) better test scores of the Group II students after 30 days in comparison to Group I students. However, there was no significant difference with regard to the acceptability of the CAL teaching format alone and along with the conventional teaching format between the two groups (P = 0.6033). Conclusion: Integrating CAL with conventional teaching format improves students' understanding and performance for a specific topic.
  - 2,098 187