Azithromycin resistance and its molecular characteristics in Neisseria gonorrhoeae isolates from a tertiary care centre in North India

Treatment guidelines for management of uncomplicated gonorrhoeae have been recently modified owing to alarming upsurge in azithromycin resistance. This study investigated the prevalence and genetic determinants of gonococcal azithromycin resistance in India. Four (5.7%) of 70 gonococcal isolates were resistant to azithromycin. Of 16 isolates investigated for molecular mechanisms of resistance, 13 (81.3%) and 6 (37.5%) isolates exhibited mutations in coding and promoter regions of mtrR gene, respectively. However, ermA, ermB and ermC genes or mutations in rrl gene were absent in all isolates. Azithromycin resistance is low in India posing no immediate threat to use of dual-therapy for syndromic management.     

Respiratory support in children

Respiratory failure is defined by the inability of the respiratory system to adequately deliver oxygen or remove carbon dioxide from the pulmonary circulation resulting in hypoxemia, hypercapnia or both. A wide variety of disease processes can lead to respiratory failure in children. Multiple interventions can support the paediatric patient with respiratory failure, from simple oxygen delivery devices to high frequency oscillatory ventilation and extracorporeal membrane oxygenation. This article will review available devices to improve oxygenation and ventilation, their advantages and disadvantages, and help guide physicians in the management of children with respiratory failure.     

Assessment of knowledge and attitudes in human nutrition among nurses of Delhi.

The present study revealed that the majority of nurses had adequate knowledge about dietary practices during the antenatal and post-natal period. However, their knowledge about nutritive value of foods and nutrition advice during disease conditions was inadequate. It is recommended that to make the training more meaningful, the identification of the incorrect dietary beliefs of trainees should be done at the beginning of the training course. Each incorrect belief should be explained in detail for better comprehension of the correct knowledge in nutrition.     

Antihepatotoxic Effects of chlorogenic acid from Anthocephalus cadamba

In the present study, chlorogenic acid (CGA) isolated from Anthocephalus cadamba was screened for hepatoprotective activity by in vitro and in vivo assay methods using carbon tetrachloride (CCl₄) as a model of liver injury. Intraperitoneal administration of CGA to mice at a dose of 100 mg/kg body weight for 8 days caused significant reversal in lipid peroxidation, enzymatic leakage, cytochrome P450 (Cyt P450) inactivation and produced enhancement of cellular antioxidant defence in CCl₄-intoxicated mice, revealing that the antioxidative action of CGA is responsible for its liver protective activity. CGA exhibited a better therapeutic protective action than silymarin (SM), in CCl₄-administered mice.     

International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study.

Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals.     

Perception towards breast feeding amongst working women teachers of a public school in Delhi.

A declining trend of breast feeding (BF) was noticed in the early 1970s, but a decade of intensive campaigning by national and international agencies for BF has reversed this. The objective of the present study was to assess the knowledge and attitude amongst teachers before launching an orientation course in maternal and child health care for them. A structured questionnaire was administered to 62 married women teachers of middle socioeconomic background and education. 98% of mothers knew that breast milk was the nutrition of choice up to 4-5 months of age, and 94% mentioned that BF should be started immediately after birth. 94% of subjects knew that colostrum should be given, 95% were aware that protective substances were present in breast milk. 61% were cognizant of the need to continue BF as long as possible. 92% of the subject knew about improved mother-infant bonding owing to BF. Only 60% knew that lactation provided complete protection against pregnancy during the first 4 months. 615 of the mothers deemed BF in public embarrassing. All subjects were aware that unhygienic bottle feeding caused diarrhea, whereas BF offered protection. Many of them felt that BF should be stopped when the mother had tuberculosis (16%), malaria (55%), and diarrhea (60%). 65% of mothers had misconceptions that diluted top milk should be given even after 4 months of age, while 35% were mistaken that commercial preparations of milk were more nutritious than breast milk. 76% had the erroneous knowledge that high consumption of almonds, cashew nuts and other dried fruits increased the volume of breast milk. 94% of the teachers knew that the child should get colostrum, and almost 37% felt that bottle feeding should be entirely avoided. These results point to the urgent need of starting nutrition education programs for working mothers.