Bacteremia due to Rhodococcus equi--a case report

Rhodococcus equi (R. equi) primarily causes zoonotic infections affecting grazing animals and is an unusual cause of infection in immunocompetent human beings. We report a case of bacteremia due to R. equi a rare isolate in a child suffering from protein energy malnutrition     

Seroprevalence of anti HCV antibody in and around Cuttack, Orissa

One hundred ninety (190) serum samples and 52 control samples consisting of high risk individuals were screened for anti HCV antibody by 3rd generation ELISA test. The prevalence rate was found to be 1.57% in total but it was 2.12% in healthy voluntary blood donors. All were males between the age group of 21 to 40 years. All the control samples were found to be seronegative for anti HCV ab.     

General practitioner registrars'' views about a career in general practice.

BACKGROUND. Current low morale in general practice and the fall in the number of general practitioner registrars (trainees) has led to concern about the decline in popularity of general practice as a career. AIM. A study was performed to evaluate the career intentions of general practitioner registrars and the factors underlying their decisions. METHOD. An anonymous postal questionnaire seeking both quantitative and qualitative data was sent to 138 registrars during June 1993. All were registrars at practices in the south west region of England. Outcome measures used were the popularity of different types of general practice work and identification of variables and emergent themes considered important in career choice. RESULTS. A total of 101 registrars returned questionnaires (73%). Of the respondents, 96% expressed an interest in general practice as a career. However, registrars expressed considerable uncertainty about the future of general practice and therefore their career. Continuity of care and a holistic approach were considered valued aspects of work in general practice. Increased workload, increased out-of-hours work and erosion of professional autonomy emerged as negative aspects of a career in general practice. Of the respondents, 91% considered time for leisure activities an important factor when considering future career, 72% would have been glad to do away with 24-hour cover and 99% agreed that general practitioners increasingly fear litigation. CONCLUSION. Although registrars were interested in general practice as a career they had many concerns and expressed uncertainties. The future popularity of general practice is likely to depend on addressing these concerns and on the clarification of the future direction of the profession.     

Responsibilities and resources of on-call public health doctors

We investigated the resource available for public health doctors to carry out statutory responsibilities out-of-hours by a postal questionnaire survey of consultants in communicable disease control (CsCDC) in England and Wales. The questionnaire requested details of local District Health Authority (DHA) population profile, major incident and outbreak policies, the background of the CCDC, out-of-hours communication, access and resources, reference materials and medical equipment carried by the public health doctor on duty. The CsCDC from 96% (121/126) DHAs in England and Wales responded. Whilst 85% (101/119) of public health doctors carried policies on infectious disease when on duty, only 28% (32/116) carried policies on dealing with chemical incidents and 25% (28/111) carried the District policy to deal with radiation hazards. Twenty-six per cent (32/121) of public health physicians had no access to their District headquarters. There is a wide variation in the standard of resources available to on-call public health doctors in England and Wales; following Department of Health and Department of the Environment guidance, Health Authorities need to ensure that they have adequate arrangements in the event of any major incident or outbreak.     

Viscoless Manual Small Incision Cataract Surgery with Trabeculectomy

Purpose: To compare the efficacy of combined manual small incision cataract and glaucoma surgery with anterior chamber maintainer (ACM) alone versus that with intraoperative viscoelastics. Methods: Hospital electronic medical records of patients who underwent small incision cataract and trabeculectomy and intraocular lens implantation without Mitomycin-C from 2014 to 2016 were identified from the hospital operation theater database for this retrospective, hospital-based comparative study. All MSICS surgeries were performed by a single surgeon under peribulbar block. Data retrieved from all patients undergoing surgery with viscoelastic (group 2) or under AC maintainer without viscoelastic (group 1) included preoperative visual acuity, preoperative treated intraocular pressure, number of anti-glaucoma medications before surgery, total surgical time, intraoperative complications, postoperative best-corrected visual acuity and IOP at one week and one month, need for additional procedures, and corneal clarity. Differences in surgical time and postoperative course in both groups were compared. Results: Of 268 manual combined cataract and glaucoma surgeries done from 2014–2016, we identified 147 eyes of 130 age-matched patients, which included 51 PACG, 50 POAG, 12 NTG, and 24 PXG eyes with a mean age of 66 ±11.2 years and 64± 10.8 years in group 2 (n=74) and group 1 (n=73), respectively; p=0.9. The surgical time was significantly lower in group 1 (16±4.8 minutes compared to 44±14.6 minutes for group 2; p<0.001) with transient edema seen <1 week after surgery in 24 eyes of group 2 and seven eyes of group 1; p=0.02. The postoperative IOP at all postoperative visits dropped to >50% in both groups with 11 eyes (PXG n=6, PACG n=5) requiring medications for rise in intraocular pressure at a median time of 1.2 months (r=0.2–3 months). The final visual acuity improved >4 snellen lines in all cases with two patients with advanced damage having 1 line improvement in Snellen acuity at final follow-up. Conclusion: The ACM can help completely avoid the use of viscoelastic during surgery, which can be an effective technique for MSICS with trabeculectomy in low resource stings. Training for such procedures should be incorporated into residency training programs.     

Medicinal chemistry of oxazines as promising agents in drug discovery

Oxazines have brought much synthetic interest due to their extensive biological activities. These are the important category of heterocycles, which may be formally derived from benzene and its reduction products by convenient substitution of carbon (and hydrogen) atoms by nitrogen and oxygen. In the last few decades, oxazine derivatives have documented as worthy synthetic intermediates and also blessed with notable sedative, analgesic, anticonvulsant, antipyretic, antimicrobial, antitubercular, antimalarial, antioxidant, and anticancer activities. Nowadays, it is important to develop new classes of compounds with more effective mechanisms due to drug resistance activity in which the ability of drug to effectively treat disease can be reduced. The aim of the article is to collect and make a more generalized review on the synthesis of oxazine derivatives and their pharmaceutical and biological activities. We hope this review will provide ample references for the researchers concerned with azines in generally and oxazines in particular.     

Correlation between peripheral arterial disease and coronary artery disease using ankle brachial index-a study in Indian population

ObjectiveTo study the prevalence of peripheral arterial disease (PAD) of the lower limbs in a high-risk population and its correlation with coronary artery disease (CAD), using the ankle brachial index (ABI).MethodsThe present study was conducted in randomly selected indoor patients >45 years of age with one or more risk factors for PAD admitted in the cardiology and medicine wards in a tertiary care institute.ResultsBased on ABI <0.9, PAD was diagnosed in 32 of the 182 (18%) patients. Coronary artery disease was present in 15 cases of PAD which was statistically significant.ConclusionThere is a definite and strong correlation between PAD and CAD. Correct diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.