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  Citation statistics : Table of Contents
   2019| January-April  | Volume 6 | Issue 1  
    Online since April 30, 2019

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Analysis of drug utilization pattern of antimicrobials used as surgical prophylaxis for general surgical procedures in a Tertiary Care Hospital of North Karnataka: An observational study
Bhagyashree S Patil, Anant Mahaveer Khot, Aravind V Patil, Akram A Naikwadi
January-April 2019, 6(1):22-25
Background: Surgical site infection (SSI) is an infection presenting within 30 days after the surgical procedure if no prosthetic is placed and up to 1 year if prosthetic is implanted in the patient. Despite standard protocols for preoperative preparation and antimicrobial prophylaxis, the rate of SSI varies from 2.5% to 41.9%. Reasons could be multifactorial, but one among them is lack of adherence to any of the antibiotic policy. To review the drug utilization pattern of antimicrobials in the perioperative period and to study its impact on SSI, the above study has been carried out. Materials and Methods: A cross-sectional, observational study has been carried out in the Department of General surgery of SBM Patil Medical College Hospital. Patients of either sex who underwent surgical procedures such as appendectomy and hernioplasty have been included in the study. Data were collected using a predesigned pro forma. The study was approved by the institutional ethics committee. Results: A total of 140 patients underwent surgical procedures, of which 70 were male and 70 were female. Open appendectomy was the most common procedure performed, followed by hernioplasty in 18 patients. Ceftriaxone–sulbactam was the frequently prescribed antibiotic and six patients developed SSI. Conclusion: Despite use of antibiotics, six patients developed SSI. Hence, auditing of the antimicrobial usage as surgical prophylaxis is need of the hour. Because prescriber's worldwide running out of antibiotic options, it is mandatory for each hospital to have formulary for antibiotic use depending on the pattern of organisms isolated.
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Mixed adenoneuroendocrine carcinoma: A report of four cases from South India
Saravanakumari Vijayakumar, Sajini Elizabeth Jacob, Bhawana Ashok Badhe, Bheemanathi Hanuman Srinivas
January-April 2019, 6(1):31-35
Neuroendocrine tumors (NET) are rare. Common sites of NETs are the gastrointestinal tract and pancreas. In 2010, the World Health Organization classified NETs into mixed adenoneuroendocrine carcinoma, neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma (MANEC), tumors that have both exocrine and endocrine components of at least 30% each. Since it is relatively a new entity, only case reports and case series are available. In the past 7 years, there were only eight reports from India. We report a further four cases of this nascent disorder from a single institution, obtained retrospectively. The first includes an elderly man with upper gastrointestinal symptoms and underwent subtotal gastrectomy for antropyloric growth, which was a low-grade MANEC. The second was a female patient with chronic pancreatitis and presented with obstructive jaundice due to an ampullary growth. Whipple's specimen showed an intermediate-grade MANEC. The third case was a 40-year-old female with caecal growth and ovarian mass and was found to have a low-grade MANEC. The fourth, also in a female, was a case of abdominal wall abscess with an intraabdominal connection to the intestine and she had omental deposits and high-grade MANEC. The pathological findings are discussed and compared other reports from the country.
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Epidemiology and antibiotic sensitivity pattern of asymptomatic bacteriuria during pregnancy: A cross-sectional study
Narayana Goruntla, Sandhya Jampala, Vijayajyothi Mallela, Vishnuvandana Bandaru, Rajavardhana Thamineni, Pradeepkumar Bhupalam
January-April 2019, 6(1):5-10
Background: Asymptomatic bacteriuria (ASB) during pregnancy is associated with significant maternal and fetal complications. Continuous monitoring of antibiotic sensitivity pattern of bacterial isolates is required for appropriate management of ASB. Aims: The study aims to assess the prevalence, risk factors, and antibiotic sensitivity profile of ASB during pregnancy. Materials and Methods: A cross-sectional, hospital-based study was conducted in the pregnant women attending Obstetrics and Gynecology Department of a tertiary care hospital. A suitably designed data collection form was used to collect sociodemographic profile, obstetric history, and illnesses suffering from the participants. Urine specimens of the participants were processed for isolation and identification of bacterial species. Kirby–Bauer disc diffusion test was used to screen antibiotic sensitivity of the isolated bacteria. Statistical Analysis: Descriptive statistics were used to represent the sociodemographic data. Chi-square test was used to associate risk factors for the development of ASB during pregnancy. Results: A total of 1332 women were participated in the study. The prevalence of ASB among pregnant women was 86 (6.4%) and Escherichia coli (58; 67.4%) was the most predominant bacteria. Meropenem, cephalosporin's, and gentamycin were shown higher sensitivity in ASB. Advanced age, illiteracy, rural residency, multigravida, multiparity, history of abortion, and medical illnesses were strongly associated to develop ASB during pregnancy. Conclusion: E. coli were the most predominant isolated uropathogen in ASB. The study observed that there is a wide variation in the antibiotic sensitivity pattern of isolated organisms. Hence, there is a need of routine urine culture sensitivity screening in pregnant women for rational use of antibiotics and to reduce the antibiotic resistance.
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Beta-cell function and insulin resistance among First-Degree relatives of persons with type 2 diabetes in a Northwestern Nigerian Population
Yakubu Lawal, Fatima Bello, Felicia Ehusani Anumah, Adamu Girei Bakari
January-April 2019, 6(1):26-30
Background and Aims: Pancreatic beta-cell deficit and insulin resistance (IR) form two major factors in the etiopathogenesis of type 2 diabetes. The aim of this study is to assess beta-cell function and IR among first-degree relatives (FDRs) of persons with type 2 diabetes in a Northwestern Nigerian population. Other objectives include assessing the relationships among HOMA-%B, HOMA-IR, plasma glucose levels, and some obesity indices and to determine whether beta cell function, IR, and some obesity indices are independent determinants of glucose intolerance in the studied population. Materials and Methods: A total of 200 individuals and 200 controls were recruited through cluster sampling from their respective communities after due consent. The relevant biodata was documented and appropriate examinations including anthropometric measurements were carried out. Oral glucose tolerance test was carried out and fasting plasma insulin levels were also measured. IR and beta-cell function were calculated using homeostasis model assessment (HOMA) method. Results: Mean HOMA-IR was higher while HOMA-% B lower among FDRs compared to controls. Significant independent determinants of glucose intolerance with odds ratio (OR) and confidence interval (CI) included age (OR = 1.9, CI 1.9–2.0, P = 0.002), body mass index (OR = 1.9, CI 1.8–2.0, P = 0.032), waist circumference (OR = 2.0, CI 1.9–2.0, P = 0.043), waist-to-hip ratio (OR = 1.1, CI 1.0–15.7, P = 0.022), HOMA-IR (OR = 3.0, CI 2.3–3.3, P < 0.001), and HOMA-B (OR = 0.43, CI 0.24–0.65, P < 0.001) which means HOMA-%B is protective against glucose intolerance with inverse OR of 1/0.43 = 2.3. Conclusions: IR was higher and beta cell functions lower among FDRs compared to controls. IR (HOMA-IR) and some obesity indices were significant determinants of glucose intolerance while HOMA-%B was protective against glucose intolerance in this study.
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A comparative study of the hazards management system associated with laundry operations in secondary and Tertiary Health Facilities in Nigeria
Emmanuel Nosa Omoijiade
January-April 2019, 6(1):11-16
Background: Occupational safety and health hazards in health-care facilities (HCFs) can be grouped according to location or service offered. Contaminated laundry, noise, heat, lifting, sharps, slips, trips, falls, and fire hazards are among those located in the laundry department. Aims: This study sought to assess the measures to reduce workplace hazards, thereby providing information on the hazard management system in various HCFs, as this would prove useful to establish appropriate interventions to further ensure the health and safety of workers in hospital laundries. Materials and Methods: The study was conducted in six hospitals with a laundry department in Benin city, composed of one available tertiary HCF and five secondary HCFs. Data were collected through the hazard identification checklist, which was used to determine the safe/unsafe acts and conditions of the workplaces. Results: The percentage rating for the assessment of the hazard management system in the hospital laundry between the health facility types was 39.57% ± 7.12% for the secondary health facilities, while that of the tertiary health facility was 51.85%. A comparison of the means showed that there was no statistically significant difference in the average rating between secondary and tertiary health facility (P = 0.191), (95% confidence interval = −0.339–0.094). Conclusion: Adverse health and safety effects can be avoided or minimized drastically if the associated hazards are properly managed; however, the hazards management system in the health-care laundries was adjudged to be substandard, in both the tertiary and secondary health facilities.
  - 1,384 130
Assessment of plasma iron, transferrin alanine, and aspartate transaminase in amoxicillin overdose supplemented with raw cucumber juice
Mathew Folaranmi Olaniyan, Deborah Bukunmi Adepoju
January-April 2019, 6(1):17-21
Background: Raw cucumber (Cucumis sativus) fruit juice contains substances of health-promoting bioactivities. Elevated plasma alanine transaminase (ALT/serum glutamate-pyruvate transaminase), aspartate transaminase (AST/serum glutamic oxaloacetic transaminase), iron, and decreased transferrin could indicate hepatotoxicity, hepatitis, and kidney and liver damage, which could be drug induced. Aim and Objective: This work was designed to determine the benefits of cucumber fruit juice as a natural antidote in amoxicillin-induced hepatotoxicity by assessing the plasma iron, transferrin alanine, and AST in amoxicillin overdose supplemented with raw cucumber juice. Materials and Methods: Fifteen rabbits of the same sex weighing 0.9–1.4 kg divided into three groups of five rabbits each were used for the study. Group A – five control rabbits; Group B – five rabbits given 30 mg/kg body weight (BW) subcutaneous injection of amoxicillin every 24 h for 7 days which was followed by 30 ml raw cucumber fruit juice supplementation for 14 days; and Group C – five rabbits given 30 mg/kg BW subcutaneous injection of amoxicillin every 24 h and raw cucumber fruit juice supplementation for 14 days simultaneously. Plasma ALT, AST, iron, and transferrin were determined in the rabbits by spectrophotometry and enzyme-linked immunosorbent assay. Results: The results obtained showed a significant increase in plasma ALT, AST, and iron and a significant decrease in plasma transferrin when the rabbits in Group B were given 30 mg/kg BW subcutaneous injection of amoxicillin (B2 samples) compared with the results obtained from their basal samples (B1) and control rabbits (A) and when they were given 30 ml of raw cucumber fruit juice supplementation (B3 samples) (P < 0.05). The results obtained showed a significant decrease in plasma ALT, AST, and iron and a significant increase in plasma transferrin when the Group B rabbits were given 30 ml of raw cucumber fruit juice (B3 sample) than when they were given subcutaneous injection of amoxicillin (B2 samples) (P < 0.05). Conclusion: This work revealed significant biochemical alterations in the values of iron, transferrin, AST, and ALT when given 30 mg/kg BW subcutaneous injection of amoxicillin and supplementation of raw cucumber fruit juice. Cucumber juice is therefore beneficial as a possible antidote to amoxicillin-induced hepatotoxicity.
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Is coconut oil good for oral health? A review
Faizal C Peedikayil
January-April 2019, 6(1):1-4
Oral health is considered to be of prime importance to all individuals in maintaining good health, and the accepted method of oral hygiene maintenance is mechanical method of tooth cleaning. At present, chemotherapeutic agents are also used as adjutants to reduce plaque formation, but they have their own disadvantage. This has paved the way for the use of natural and plant derivatives as alternatives for chemotherapeutics in dentistry. Coconut oil is considered as a tree of life in ancient literature and is used for any ailments. Coconut oil is edible and is consumed as a part of the staple diet in many countries. It also has medicinal and cosmetic properties. Coconut oil differs from most other dietary oils because of the high content of medium chain fatty acid (MCF), whereas in the majority of other oils, the basic building blocks are almost entirely long chain fatty acids. The MCF in coconut oil such as lauric, caproic, caprylic, myristic, and stearic acid influences the physical and chemical properties. Lauric acid, which is predominant in coconut oil, has proved to have antimicrobial, antiviral, and anti-inflammatory action. Of late, few studies have been conducted by researchers regarding the action of coconut oil on oral health. The review of literature shows excellent results on the use of coconut oil on oral health. This short review discusses the studies conducted on coconut oil on oral microorganisms and anti-inflammatory actions.
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