A Simple Method of Preventing Needle Stick Type Injury to the Operator’s Finger While Performing Intermaxillary Fixation

Erich arch bars and other wiring techniques were commonly used for closed reduction of many maxillofacial fractures. These wires can cause inadvertent finger puncture of the operator’s finger and can increase the risk of spread of blood borne diseases like HIV and Hepatitis. To avoid this complication we recommended the use of dynaplast adhesive tape (Johnson and Johnson Ltd., Mumbai, India) over all the finger tips, before wearing the gloves, while performing IMF.     

Advances in adjuvant systemic therapy for non-small-cell lung cancer

Non-small-cell lung cancer remains a leading cause of death around the world. For most cases, the only chance of cure comes from resection for localised disease, however relapse rates remain high following surgery. Data has emerged over recent years regarding the utility of adjuvant chemotherapy for improving disease-free and overall survival of patients following curative resection. This paper reviews the clinical trials that have been conducted in this area along with the studies integrating radiation therapy in the adjuvant setting. The role of prognostic gene signatures are reviewed as well as ongoing clinical trials including those incorporating biological or targeted therapies.     

Social media and cadaveric dissection: A survey study

The use of social media opens content to the general public and, as a result, places images of cadaveric dissection in an open forum. This raises the question: should the general public have access to such material? A survey was conducted examining whether the general public should have access to gross cadaveric dissection images and videos for educational purposes via social media. Both medical and laypersons were queried. Questions included in the survey considered whether images were too graphic, whether online cadaveric content should be age‐restricted, and whether consent by the deceased was necessary. A link to the survey was accessible to 63,562 followers through the Seattle Science Foundation's Facebookpage for 3 weeks. Among 300 responders, 89% (267/300) agreed that portrayals of cadaveric specimens/dissection on social media should be accessible by the general public for anatomical education, and 84.67% (254/300) stated that cadaveric dissection is not too graphic for untrained eyes. There was agreement by 60.33% (181/300) that an age restriction should be in place for the viewing of cadaveric dissection on social media, and 39.33% (253/300) of responders suggested restriction to 18 years and older. No statistically significant association was noted between a prior or current history of anatomy education and the frequency of positive responses to the survey questions. Social media is an innovative tool for dispensing anatomical education. The use of cadaveric images and videos provides accessibility to the general public who wish to learn more about human anatomy and their own body. Clin. Anat. 32:1033–1041, 2019. © 2019 Wiley Periodicals, Inc.     

Comparative analysis of different methods used for molecular characterization of Burkholderia cepacia complex isolated from noncystic fibrosis conditions

PurposeBurkholderia is a Gram-negative opportunistic bacterium capable of causing severe nosocomial infections. The aim of this study was to characterize Burkholderia cepacia complex and to compare different molecular methods used in its characterization.MethodsIn this study, 45 isolates of Burkholderia cepacia complex (Bcc) isolated from clinical cases were subjected to RAPD (Random amplified polymorphic DNA), recA-RFLP (Restriction fragment length polymorphism), 16SrDNA-RFLP, whole-cell protein analysis, recA DNA sequencing and biofilm assay.ResultsOf the 45 isolates tested, 97.7% were sensitive to ceftazidime, 82.2% were sensitive to Cotrimoxazole, 73.3% were sensitive to meropenem, 55.5% were sensitive to minocycline and 42.2% were sensitive to levofloxacin. Majority of the isolates harbored all the tested virulence genes except bpeA and cblA. The RAPD generated 11 groups (R1-R11), recA-RFLP 10 groups (A1-A10), 16SrRNA-RFLP 5 groups (S1–S5) and SDS-PAGE (Sodium Dodecyl Sulphate-Polyacrylamide gel electrophoresis) whole cell protein analysis revealed 12 groups (C1–C12). recA sequencing revealed that most of the isolates belonging to the genomovar III Burkholderia cenocepacia. Though all the methods are found to be efficient in differentiating Burkholderia spp., recA-RFLP was highly discriminatory at 96% similarity value. The study also identified a new strain Burkholderia pseudomultivorans for the first time in the country. Further, recA sequencing could identify the strains to species level. Majority of the multidrug-resistant strains also showed moderate to strong biofilm-forming ability, which further contributes to the virulence characteristics of the pathogens.ConclusionsThe study highlights the importance of combination of molecular methods to characterize Burkholderia cepacia complex. Molecular typing of these human pathogens yields important information for the clinicians in order to initiate the most appropriate therapy in the case of severe infections and to implement preventive measures for the effective control of transmission of Burkholderia spp.     

Thrombocytopenia in children with malaria–A study from coastal Karnataka,India

ObjectiveTo study the occurrence and severity of thrombocytopenia in children with malaria.MethodsIt was a retrospective study, done at Fr Muller Medical College Hospital Mangalore, in Karnataka, India. Data regarding all positive cases of malaria < 15 years admitted in the hospital between January 2010 to June 2011 were obtained. Patients were further assessed for thrombocytopenia and its severity. Data were analysed by Chi square test using SPSS version 13.0.ResultsA total of 159 cases were included in the study with a mean age of presentation of 9 years. Plasmodium vivax was identified in 106 (66%) patients while Plasmodium falciparum in 26 (16%) and mixed infection in 27 (18%) patients. Thrombocytopenia was observed in 113 (71%) cases, of which 35 (31%) cases had mild, 49 (43%) cases moderate and 29 (26%) cases had severe thrombocytopenia. Thrombocytopenia was equally found in vivax and falciparum infection with no significant difference in severity between vivax and falciparum species.ConclusionsThrombocytopenia is frequently seen in malaria and it is not dependent on type of malaria. In any acute febrile illness, thrombocytopenia should alert one to the possibility of malaria.     

Experience with direct acting anti-viral agents for treating hepatitis C virus infection in renal transplant recipients

In recent past, direct-acting anti-viral drugs (DAAs) have become the standard of care for the treatment of hepatitis C virus (HCV) infection. However, the experience with the use of these drugs in Indian renal transplant recipients is limited. We retrospectively reviewed our experience with DAA-based treatment for HCV infection in such patients. Between April 2015 and December 2016, six adults (median age 41 [range 34–52] years, male 5; GT1 2, GT3 3, and GT4 1; including three with prior failed interferon-based treatment) had received genotype-guided, DAA-based anti-HCV treatment 1 to 158 (median 15) months after renal transplantation. Of them, four completed the planned 24-week treatment without any significant adverse event. One of them had increase in serum creatinine after 16 weeks of treatment with sofosbuvir and daclatasvir, with acute interstitial nephritis on kidney biopsy; his renal function improved on stopping the drugs. The other patient had preexisting mild renal dysfunction, which worsened after 8 weeks of sofosbuvir-ledipasvir treatment; this did not reverse on stopping treatment. All the six patients achieved undetectable HCV RNA after 4 weeks of treatment and also achieved sustained virologic response, i.e. lack of detectable HCV RNA in serum 12 weeks after stopping treatment. Overall, DAA-based treatment was effective in treating HCV infection in our renal transplant recipients; however, caution and monitoring of renal function during such treatment is advisable in patients who have additional factors that predispose to renal injury.