Conjunctival intra-epithelial neoplasia in a young Indian male with human immunodeficiency virus (HIV) infection

Conjunctival intra-epithelial neoplasia is a disease of the elderly but recently this ocular surface tumour has been observed in younger age group specially who are serologically human immunodeficiency virus (HIV)-positive. Here a case of conjunctival intra-epithelial neoplasia of a 38-year-old male who was HIV-positive from Kolkata is reported. The patient presented with a growth at limbus in his left eye. Excision of the mass under local anaesthesia was done. Biopsy report confirmed conjunctival intra-epithelial neoplasia. The serological tests for HIV were found positive.     

Genital fistula--our experience

Genital fistulas cause immense physical and psychosocial problem in women's life. The present study was conducted to note the varieties of genital fistula as well as their causative factors and the results of the operative corrections. Altogether 42 patients with different varieties of genital fistula were enrolled in the study. The causative factors of the genital fistulas, specially, that of vesicovaginal fistulas were thoroughly enquired. After confirming the diagnosis, the operative corrections were undertaken. Among the varieties of genital fistula, 76.19% were vesicovaginal fistula, 11.90% were rectovaginal fistula and 4.76%, 4.76% and 2.38% cases of ureterovaginal, urethrovaginal and vesicocervical fistulas respectively. The primipara women were the major sufferers of genital fistulas due to obstetric grounds. Regarding aetiologies of vesicovaginal fistulas, 71.87% patients had obstetric reasons, after prolonged labour, instrumental delivery and after caesarean section due to obstructed labour. Abdominal hysterectomy (44.44%) topped the list of the gynaecological causes of vesicovaginal fistulas. The cases of ureterovaginal fistulas were after abdominal hysterectomy. One case of urethrovaginal fistula was due to some chemical application for correction of genital prolapses. The rectovaginal fistulas were mostly due to obstetric reasons. The success rate after the first attempt of repair of vesicovaginal fistula was 82.75% and overall failure was 10.34%. The other varieties of fistulas were repaired with 100% success rate. The incidence of genital fistulas can be reduced by vigilant obstetric care and meticulous surgery.     

Comparison of health effects between individuals with and without skin lesions in the population exposed to arsenic through drinking water in West Bengal, India

A study was conducted to explore the effect of arsenic causing conjunctivitis, neuropathy and respiratory illness in individuals, with or without skin lesions, as a result of exposure through drinking water, contaminated with arsenic to similar extent. Exposed study population belongs to the districts of North 24 Parganas and Nadia, West Bengal, India. A total of 725 exposed (373 with skin lesions and 352 without skin lesions) and 389 unexposed individuals were recruited as study participants. Participants were clinically examined and interviewed. Arsenic content in drinking water, urine, nail and hair was estimated. Individuals with skin lesion showed significant retention of arsenic in nail and hair and lower amount of urinary arsenic compared to the group without any skin lesion. Individuals with skin lesion also showed higher risk for conjunctivitis ((odd's ratio) OR: 7.33, 95% CI: 5.05-10.59), peripheral neuropathy (OR: 3.95, 95% CI: 2.61-5.93) and respiratory illness (OR: 4.86, 95% CI: 3.16-7.48) compared to the group without any skin lesion. The trend test for OR of the three diseases in three groups was found to be statistically significant. Again, individuals without skin lesion in the exposed group showed higher risk for conjunctivitis (OR: 4.66, 95% CI: 2.45-8.85), neuropathy (OR: 3.99, 95% CI: 1.95-8.09), and respiratory illness (OR: 3.21, 95% CI: 1.65-6.26) when compared to arsenic unexposed individuals. Although individuals with skin lesions were more susceptible to arsenic-induced toxicity, individuals without skin lesions were also subclinically affected and are also susceptible to arsenic-induced toxicity and carcinogenicity when compared to individuals not exposed to arsenic.     

New Record of <Emphasis Type="Italic">Equisetum ramosissimum</Emphasis> subsp. <Emphasis Type="Italic">debile</Emphasis> from Lower Gangetic Plain,West Bengal,India and Conservation Approach

A recent survey for pteridophytic flora in the lower Gangetic plain of West Bengal, India reports the natural occurrence of Equisetum ramosissimum Desf. subsp. debile (Roxb. Ex Vauch.) Hauke (Equisetaceae) from alluvial Gangetic zone of North 24 Parganas district (22°55′39.00″N and 88°26′14.94″E) which adds new record to the existing database of pteridophytic flora in the region. Regular observations show that the population of E. ramosissimum is sustained completely by vegetative means due to non-formation of reproductive organ i.e. strobilus in an individual plant in any season. The community analyses through standard ecological methods reveal heterogeneous phyto-assemblages in both winter and rainy seasons, however, seasonal variations are observed in species diversity and frequency. Simpson’s Index of Diversity in both plant communities suggests diverse species richness and evenness in the area. Importance Value Index depicts ecological dominance of E. ramosissimum in both seasons. The plant has significant positive correlation with angiospermic taxa, Mikania micrantha and Typha angustifolia in winter and rainy seasons, respectively but is negatively correlated with Xanthium indicum and Desmostachya bipinnata, correspondingly. These observations may be taken into consideration for in situ conservation of the species. Systematic conservation plan is suggested to protect this newly revealed taxon, E. ramosissimum subsp. debile which demands regular awareness program among local people for continued future sustainability as the area is regularly invaded by human footsteps. Finally, the present investigation may motivate the young workers for field study to explore the nature in better way.     

Study of Complete Haemogram and Iron Profile From Cord Blood of Newborn with Respect to Primigravida,Multigravida and Apgar Score

Study of different parameters of cord blood usually reflects neonatal health status. One of the widely used system for assessing neonatal health is APGAR score. It is assed at 1 and 5 min from baby’s birth. Immediate medical care may improve 5 min score of neonate who showed poor score at 1 min. The main objective of this study is to establish whether any correlation exists between complete hemogram and iron profile with APGAR score and gravid of mother. Cord blood was collected from 96 new born, delivered vaginally, mothers having no chronic medical disease. Different parameters of complete hemogram were assessed along with iron profile and statistical analysis was done by Graph pad Instat3 soft ware. Statistically significant correlation exists between APGAR score (5 min) and MCV (p = 0.005), MCHC (p = 0.016), nRBC (p = 0.002), platelet count (p = 0.001), RDW (p = 0.001). Statistically weak correlation exists between TLC (p = 0.08). Comparing complete blood count with gravid of mother by unpaired t test significant correlation was obtained for HCT (p = 0.035) and RDW (p = 0.03). Apgar score and complete hemogram from cord blood are both non-invasive procedure which help us to asses fetal wellbeing as well as requirement of immediate management. Further more studies are essential to establish the relationship.     

Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn‐over and burn‐out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre‐empt incidences of OV during ED episodes of care. A five‐stage methodological framework for scoping reviews was used to identify, summarise and synthesise OV risk factors from five key databases. A validated tool was used to appraise the quality of included studies. Independent evaluation by the reviewers was used throughout. Patient factors were extracted and described from 24 methodologically and geographically diverse papers. Methodological quality for these studies varied from moderate to high. A total of 34 OV risk factors were identified. Although there was variation in, and differences between, staff‐perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.