Comprehensive Survey to Study Awareness,Knowledge and Attitude Towards HIV/AIDS and Hepatitis B Amongst Dental Professionals Working in Rural India

Introduction

Thirty years into the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic, social and behavioral research on HIV/AIDS remains limited. Data on sexual behavior and AIDS-related knowledge and attitudes are sparse and difficult to compare. The present survey aims primarily towards acquiring unique source of information from health professionals in rural population in order to document AIDS and hepatitis B awareness. The Surveys is an attempt to contain a wealth of data on HIV/AIDS and hepatitis B which until now was not disseminated to rural audience.

Materials and Methods

Pre-formed questionnaire of 45 questions will be given to all dental professionals, practicing in rural sector, willing to participate in study. Instructions will be given regarding filling the questionnaire. All participants requested to complete the questionair with best of their knowledge and without any assistance. Questionnair were completed in front of author and collected back personally.

Conclusions

The outcomes of the present study, it is clear that our efforts in the last two decades in spreading the knowledge about the disease have met with some limited success. The fact that increasing number of cases of HIV/AIDS are being reported from rural parts, there is certainly a need to reorient the ongoing training programmes towards rural population.     

Changing trend in the morphology of cataracts at a tertiary eye care centre in South India due to COVID-19-pandemic related national lockdown

Purpose:To study the changing trends in the morphology of cataracts at a tertiary eye care center in South India due to COVID-19 pandemic-related national lockdown.Methods:A retrospective study conducted at a tertiary eye care center in Andhra Pradesh state of South India, which included 1724 patients (1753 eyes) who underwent cataract surgery at our center during April 2019–July 2019 (1298 eyes of 1271 patients) and April 2020–July 2020 (455 eyes of 453 patients). Factors studied included preoperative lens status, associated phacodonesis or subluxation, pupil size, other eye lens status, associated retinal problems, glaucoma, and complications during surgery. Postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal clarity, intraocular pressure (IOP), and disc status at postoperative day 1, 1 week, and 1-month visits were compared.Results:A significantly lower proportion of nuclear sclerosis (decreased from 83.2% in last year before lockdown to 55.2% during lockdown) and significantly higher proportions of mature, brown, or black cataract and phacomorphic, phacolytic, or Morgagnian cataract (increased from 15.5% in last year before lockdown to 43.8% during lockdown) were observed. The proportion of small-incision cataract surgery decreased significantly (from 63.2% to 57.4%), whereas the proportion of phacoemulsification increased significantly (from 35.9% to 41.5%) during lockdown as compared to last year. A significantly higher proportion of eyes with small pupils and association with retinal pathology were also observed during the lockdown.Conclusion:During the national lockdown, there was a shift from nuclear sclerosis grade toward mature, brown, black grade of cataracts. In addition, the proportion of small-incision cataract surgery decreased significantly whereas the proportion of phacoemulsification increased significantly during the lockdown. More number of cataracts with small pupils and associated retinal pathology were observed during the lockdown.     

Outcome of Hemorrhagic Stroke: Host Immune Response can Be a Prediction Tool!

How to cite this article: Nasa P. Outcome of Hemorrhagic Stroke: Host Immune Response can Be a Prediction Tool! Indian J Crit Care Med 2022;26(1):2–4.     

Clinico-Epidemiological Profile of Breakthrough COVID-19 Infection among Vaccinated Beneficiaries from a COVID-19 Vaccination Centre in Bihar,India

BackgroundWhen the whole world is fighting in an unprecedented pace against COVID-19 pandemic, the breakthrough COVID infections poise to dampen the rapid control of the same. We carried out this project with two objectives; first, to estimate the proportion of breakthrough COVID-19 infection among completely vaccinated individuals and second, to study the clinico-epidemiological profile of breakthrough COVID-19 infections among them.MethodsThis cross-sectional analytical study was conducted among 2703 fully vaccinated individuals from AIIMS, Patna COVID Vaccination Centre (CVC), Bihar, India. The participants were selected randomly using a systematic sampling technique from the list of beneficiaries maintained at the CVC. Telephonic interviews were made to collect the information by trained data collectors.ResultsA total of 274 fully vaccinated beneficiaries [10.1% (95% CI: 9.1%, 11.4%)] were diagnosed with breakthrough COVID-19 infection. The infections were more among males (10.4%) and the individuals aged ≤29 years (12.5%). The beneficiary categories, the healthcare-worker and the frontline-worker, were identified as predictors of the breakthrough COVID infections. Only one in three participants had adopted adequate COVID appropriate behaviour following the full vaccination. The majority of the breakthrough infections occurred during the second wave of COVID-19. The majority of the individuals with breakthrough infections were asymptomatic and no death was reported among them.ConclusionOne in every ten fully vaccinated individuals can get the breakthrough COVID infections. The healthcare-worker and the frontline-worker had independent risk of getting the breakthrough infections. Very few with breakthrough infections were serious and no death was reported among them.     

Over expression of brain and acute leukemia,cytoplasmic and ETS-related gene is associated with poor outcome in acute myeloid leukemia

The high expression of brain and acute leukemia, cytoplasmic (BAALC) and ETS-related gene (ERG) has been reported to influence the outcome in acute myeloid leukemia (AML), but due to limited prospective studies, their role as prognostic factors is unclear. At diagnosis, the prognostic value of BAALC and ERG expression with respect to other cytogenetic and molecular markers was analyzed in 149 AML patients. Patients were divided into quartiles which resulted in the formation of four groups (G1–G4) based on expression values of BAALC and ERG and clinical response defined across groups. Groups with similar survival probabilities were merged together and categorized subsequently as high versus low expressers. Patients with high BAALC and ERG expression had significantly lower overall survival (OS; BAALC: p = 0.001 at 5 years 29.4% vs. 69.8%; ERG: p < 0.0001 at 5 years 4% vs. 50.4%) and disease-free survival (BAALC: p = 0.001 at 5 years 19.5% vs. 69.8%; ERG: p < 0.0001 at 5 years 4.2% vs. 47%). Patients were further stratified combining BAALC and ERG expression in an integrative prognostic risk score (IPRS). After a median follow-up of 54 months (95% CI 45–63 months) among survivors, IPRS for high versus low expressers was a significant predictor for OS (BAALC + ERG: 4% vs. 71.6%, p < 0.0001) and DFS (BAALC + ERG: 4.5% vs. 74.1%, p < 0.0001). In a multivariate model, IPRS of BAALC + ERG expression retained prognostic significance for OS (hazard ratio [HR] 2.96, 95%CI 1.91–4.59, p < 0.001) and DFS (HR 3.61, 95%CI 2.26–5.76, p < 0.001).     

Overuse of organ biopsies in immunoglobulin light chain amyloidosis (AL): the consequence of failure of early recognition

Introduction: The diagnosis of amyloidosis requires histological confirmation of Congo-red (CR) deposits. The tissue source is preferably fat aspiration and/or bone marrow (BM) biopsy, but at times organ biopsy is required.

Methods: We studied 612 patients with systemic immunoglobulin light chain amyloidosis to characterise the tissues used to establish the diagnosis.

Results: The median number of tissue samples was 3. About 95% of BM biopsies were stained for CR, while 79% of patients had fat aspiration CR-stained. CR stain sensitivity was 69% in BM, 75% in fat aspiration and 89% for both sources combined. In comparison, CR sensitivity was 97–100% for heart, renal and liver biopsies. About 42% of patients with renal involvement, 21% of patients with liver involvement and 13% of patients with heart involvement underwent organ biopsy, when a less invasive biopsy would have established the diagnosis. Predictors for the requirement for organ biopsy were male sex, limited organ involvement and lack of fat aspiration.

Discussion: Fat aspiration is underutilised for histologic confirmation of amyloidosis. A high rate of organ biopsies represents a failure to recognise the disease. Early awareness of amyloidosis in patients with organ dysfunction may lead to more judicious use of organ biopsies in this disease.

• Key messages

• Fat pad aspiration is underutilised to establish the diagnosis of amyloidosis.

• Bone marrow and fat pad aspiration obviates the need for invasive biopsies.

• The excessive use of organ biopsy in AL amyloidosis reflects failure to recognise the disease early in its course.

     

Role of bronchoscopy in early diagnosis of lung cancer

Lung cancer is a leading cause of cancer deaths and the incidence is rising. Most patients with lung cancer present to the clinician in a fairly advanced stage and at best only 25-30% of patients can be offered curative resection. Screening tests using sputum cytology and chest radiograph have been used with limited success. Value of low dose spiral CT scan as screening tool for lung cancer is being evaluated and its limitations include high costs, need for repeated scanning and necessity to obtain histological confirmation with additional procedures. There have been significant advances in the early diagnosis of lung cancer in high risk patient groups using bronchoscopic methods such as white light bronchoscopy, autofluorescence bronchoscopy, high magnification bronchoscopy, narrow band imaging and endobronchial ultrasound. These techniques appear to be promising tools as they might allow to visualise changes of early lung cancer and also permit sampling for histological confirmation.