Journal of Research in Applied and Basic Medical Sciences
Volume:10 Issue: 1, Winter 2024

Leprosy (Hansen's Disease) is a crippling, devastating disease affecting skin, eyes, and nerves; the etiological agent being Mycobacterium leprae. India, Brazil, and Indonesia account for the majority of cases globally. Early diagnosis and prompt treatment by multidrug regimen are the mainstays of management of this chronic infectious disease which is transmitted by respiratory route and skin to skin contact from cases of leprosy. We report a case of leprosy in a 14-year-old boy in Uttar Pradesh, manifesting as hypopigmented hypoesthetic patch with thickened ulnar nerve, emphasizing the fact that the disease is still endemic in states like Uttar Pradesh; hence it is important to do the hawk-eyed examination to avoid missing any hidden case.

An estimated 350 million individuals worldwide suffer from depression, making it a widespread ailment. The mapping of vitamin D receptors in the brain suggests that vitamin D plays a function in psychosomatic illnesses like depression. Limited information exists on vitamin D status and depression in the Nepalese population. The present study aimed to determine the level of vitamin D in patients with depression and compare it with normal individuals. Similarly, it aimed to find out how the level of vitamin D varies with the severity of depression.

The case-control study was conducted at Tribhuvan University Teaching Hospital (TUTH), in Kathmandu, Nepal. In this study, 85 depressive patients and 85 age-sex-matched healthy controls were enrolled. Vitamin D was assessed in the Department of Biochemistry with the Electro-Chemiluminescent Immune Assay (E-CLIA) method. The data were entered into the Microsoft Excel program. Statistical analyses were performed with SPSS software 17.0 version. The mean comparison, group association, and correlation were determined by using t-test, Chi-square test, and Pearson’s correlation, respectively. A probability of < 0.05 was accepted as significant.

The level of vitamin D in patients with depression was found to be significantly lower than that in healthy controls. Likewise, the level of vitamin D was found to vary with the severity of depression; with severe depression, the level of vitamin D was the lowest and the result was found to be statistically significant (P < 0.05). Similarly, the level of vitamin D was found to be significantly lower in subjects having suicidal tendencies (P < 0.05).

The cause-and-effect link between depression and vitamin D deficiency is unclear, but their coexistence in the Nepalese community raises public health concerns. Recognizing those at risk and taking early action is crucial, as severe depression is a potential risk factor for suicidal thoughts.

Wound infection is a major challenge in burn care and is the most common cause of death from burn. Knowledge of the major organisms that are commonly encountered in each unit is essential for effective treatment of infections. The aim of this study was to determine the type of bacterial infections in burn wounds and evaluate the frequency and antibiotic resistance of bacteria isolated from the burn section.

This descriptive study involved 120 burn patients from Imam Khomeini Hospital in Urmia, who were randomly selected from the hospital’s database. We obtained samples from their burn wounds and performed conventional biochemical tests to identify the strains. We applied the disk diffusion method to determine the antibiotic resistance pattern. We used SPSS version 26 for the statistical analysis.

In this study, Acinetobacter baumannii was the most common organism in the burn section. Staphylococcus aureus, Pseudomonas aeruginosa, Coagulase-negative staphylococci, Acinetobacter lwoffi, Escherichia coli, Enterobacter species, and Klebsiella pneumoniae were next in line. According to the antibiogram, %67.7 of the strains had Multiple Drug Resistance. Also, 42.3% of Methicillin-Resistant Staphylococcal isolates were identified.

The high frequency of Multidrug-Resistant strains in the burn ward is a serious warning in the treatment of burn wound infections in this hospital. Therefore, it seems necessary to develop new treatment strategies and follow the correct health and treatment protocols.

Anthropomorphic and parametric features of mothers are associated with placental weight (PW) changes and its function. Anthropomorphic and parametric features can affect neonatal well-being. The aim of this research was to assess the prediction role of maternal body mass index (BMI) and hemoglobin (Hb) in placental weight and neonatal outcome.

This study was a correlational descriptive–analytical study. The data were collected using a demographic-reproductive questionnaire completed by 365 parturient women referred to Valiasr Hospital in Kazeroun, Fars, Iran from May 1 to August 31, 2020. The inclusion criteria were singleton delivery at term (37–42 weeks) and mothers’ consent to attend the study after recovery. The exclusion criteria were retained placenta, multiple pregnancies, and mothers’ discontent to participate in the study. The data were analyzed using Pearson correlation coefficient and multiple regression analysis. All analyses were carried out with SPSS V.21. The significance level was considered less than 0.05.

The findings of the study showed that maternal BMI in early pregnancy (β = 0.20, P < 0.01), and gestational age (β = 0.24, P < 0.01) were the positive predictive factors for placental weight. Also, among the maternal traits, only maternal hemoglobin (β =0.14, P < 0.001) turned out to be a positive predictor for the neonate’s Apgar score. Of all fetal features, only neonatal weight had a significant correlation with placental weight (P < 0.01).

Mother’s BMI and Hb can predict placental weight and neonatal outcome. According to this finding, caregivers can help pregnant women with congruent education about proper nutrition to reach a safe BMI and create a positive outcome for the placenta and the newborn.

 Blistering disorders are acute or chronic autoimmune diseases affecting the skin and the mucous membranes. In mouth or any non-specific lesions like lichen planus, chronic herpesvirus infection, etc., differential diagnosis needs confirmation by biopsies, direct- and indirect- immunofluorescence. This case study is about Gingival Bullae as a rare sign of Mucous Membrane Pemphigoid (MMP), that is a blistering disease.

A 55-year-old woman without any past medical or family history was referred to the Oral Medicine Department of Semnan University of Medical Sciences by an internist with complaints of oral bullae and burning sensation. Intraoral examinations showed gingival erythema and bullae. The histopathology result after biopsy reported that this Gingival Bullae is related to MMP. An oral corticosteroid was administered and no recurrence was observed at 2-year follow-up.

Dentists could be the first healthcare professionals to identify this rare mucocutaneous lesion, ensuring early diagnosis and treatment. This, in turn, determines the prognosis and course of the disease. Multidisciplinary cooperation is recommended.

 Although most countries have long used female staff for prehospital emergency medical services (EMS), this is quite a recent development for the Iranian health system. It is hence necessary to analyze the perspectives of its recipients about the feasibility of assigning female staff to prehospital EMS to improve this service and compare it with other countries. This study aimed to design and evaluate the psychometric properties of a scale for assessing the feasibility of using female staff in prehospital EMS.

This was a methodological study. The literature was reviewed to develop items for the scale. The scale's content validity index (CVI) was then evaluated based on expert opinions, and its face validity was examined by eliciting comments from the target group and experts. Following that, 456 EMS recipients from East Azerbaijan Province, Iran, completed the electronic version of the scale. Finally, the construct validity and reliability of this scale were determined using exploratory factor analysis (EFA) and internal consistency (Cronbach's alpha), respectively.  

 The findings confirmed the scale's high content validity and internal consistency, as well as its acceptable face validity. The EFA findings also revealed three factors, all of which were based on primary domains: the need for engagement (17 items), groundwork (14 items), and staffing (9 items).

 The study's findings suggested that the intended scale's design and psychometric properties were appropriate for Iranian culture. Therefore, it can be used to examine public opinion before, during, and after the inclusion of female personnel in prehospital EMS.

 Accounting for wide variations in clinical manifestations, many variants of the SARS-CoV-2 virus have evolved since the start of the COVID-19 pandemic in 2020. The cause of death in COVID-19 varied from pulmonary involvement to abnormalities in coagulation and thromboembolism. In recent years, the role of lipids and lipoproteins in cardiovascular complications due to thromboembolic disturbances has been brought to light. Hence we conducted a study to evaluate the association between lipid profile and the severity of COVID-19 and their correlation with inflammatory markers.

 The retrospective-observational study included 320 subjects who were confirmed cases of COVID-19. Clinical history including intensive care unit admission, mechanical ventilation requirement, duration of hospital stay, mortality, CT score, CORAD classification scores, along with laboratory investigations comprising of lipid profile and inflammatory markers like C-reactive protein, ferritin, procalcitonin, lactate dehydrogenase, and interleukin-6 were evaluated. Data was analyzed using Mann Whitney U test and Spearman correlation test with R software version 4.1.2, considering p value < 0.05 statistically significant.

 It was observed that 61.56% of the subjects needed intensive care unit admission while only 8.13% required mechanical ventilation and 12.81% were non-survivor patients. A statistically significant association of total cholesterol with mortality (p = 0.0181), low-density lipoprotein-cholesterol (LDL-c) with mortality (p = 0.0237), and mechanical ventilation (p = 0.0211); triglycerides with intensive care unit admission (p = 0.0359) and mechanical ventilation (p = 0.0085) was observed. LDL-c and total cholesterol showed an inverse correlation with duration of hospital stay, while inflammatory markers CRP, ferritin, LDH, and IL 6 had a negative correlation with TC,HDL-c and LDL-c (all p values below 0.05).

 From the present study, it is evident that the lipid profile is linked to both severity and mortality in COVID-19 patients. Primary information from the lipid profile of a COVID-19 patient can help physicians to anticipate the prognosis of the disease and help in instituting preemptive treatment, thereby decreasing complications and any resultant mortality.

 In developing countries, lately dengue has become the most common cause of admission for fever with other infections such as malaria, enteric fever and leptospirosis on the decline. The differential diagnosis is usually sorted by serological investigation such as NS1 antigen; IgG and IgM for Dengue, though are confirmatory are expensive. The diagnosis of dengue is very important considering the sudden decline in the health of a patient due to thrombocytopenia and management of dengue which hinges on hydrating the patients and managing thrombocytopenia.  The aim of this study was to study the correlation between newer parameter high fluorescent lymphocyte count (HFLC) with platelet count and dengue serology (NS1 antigen and IgM antibody).

We conducted a study at R. L. Jalappa Hospital and Research Centre, a rural tertiary and academic teaching hospital attached to Sri Devaraj Urs Medical College with a prospective study period of twelve months and between June 2019 to May 2020. A total of 386 samples were analyzed for complete blood count, Dengue serology, and HFLC count and percentage. The data was entered in excel sheet and analyzed using SPSS 22 software.

 The newer WBC index namely, HFLC Count correlated negatively with platelet count (r = -0.28, p < 0.05) and positively with lymphocyte percentage (r = 0.506, p < 0.05). The parameters that were statistically significant include WBC count, RBC count, hemoglobin, hematocrit, platelet count, RDW, PDW, MPV, PLCR, PCT, Neutrophil %, lymphocyte %, monocyte %, IgG%, HFLC count, HFLC % and Days in hospital including a difference in findings of these parameters between the dengue sero-positive and dengue sero-negative groups who came to the hospital with fever. Thus, highlighting that they can be used as a hint while starting prophylactic treatment until results are available when it is an emergency or when the results are delayed or in resource-limited settings in the periphery due to lack of availability of cost of serological tests.

In resource-limited settings, HFLC percentage and count could be used as a low cost and reliable biomarker for diagnosis and assessing the severity of dengue infection in resource-limited settings.

Staphylococcus aureus is a common bug responsible for infections ranging from minor skin infections to fatal sepsis. Common colonizing sites include anterior nares, hand surfaces. Inadequate use of antibiotics has led to development of resistance giving rise to bugs like MRSA. Nursing staff particularly has a greater duration of patient contact and is thus more likely to become MRSA carrier- hence chosen as study population. This study aimed to study the prevalence and antimicrobial sensitivity profile of MRSA isolated from nasal carriers among nursing staff.

A short-term cross-sectional study done in which nursing staff members were screened for nasal carriage of MRSA by collecting swabs from anterior nares. S.aureus isolates were screened for Methicillin susceptibility using cefoxitin disc. MRSA thus obtained were studied for antibiotic sensitivity profile by using Vitek-2 compact.

Study showed the nasal carriage of MRSA as 13.3%. Maximum carriage was in staff members with >5 years of work experience in hospital. All isolates showed 100% resistance to Ampicillin, Erythromycin, Amoxiclav. Sensitivity reported was 12.5% to Ciprofloxacin; 37.5% to Clindamycin and Amikacin; 87.5% to Cotrimoxazole. All isolates were 100% sensitive to Linezolid, Vancomycin, Teicoplanin and Rifampin.

This study showed a significant carriage of MRSA in the nursing staff. Considering that nurses are more involved in-patient care activity, regular screening should be done. Also, the importance of handwashing should be emphasized. Strict implementation of hospital infection control norms is necessary.

 Non-Fermenting Gram-Negative Bacilli [NFGNB] which are considered as environmental contaminants have emerged as multidrug-resistant bacteria and are of serious concern to the treating physician. The aim of this study was to determine the proportion of metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter species in clinical samples received in the Microbiology Laboratory and to study the antibiotic sensitivity pattern of metallo-beta-lactamase (MBL) producing strains.

 Various samples (pus, sputum, urine, blood and body fluids, etc.) were processed according to standard protocols. P.aeruginosa and Acinetobacter spp were isolated and identified with the help of various culture media, staining methods and biochemical reactions. Antibiotic susceptibility test was done by using Kirby-bauer disc diffusion method. MBL producers were identified using CLSI guidelines.

 Out of 600 positive culture isolates from various samples, 65 (10.8%) were non-fermenting gram-negative bacilli, 40 (61.53%) were Pseudomonas aeruginosa, and 25 (38.47%) were Acinetobacter species. The overall incidence of MBL positive isolates in our study was 12.3% (8 of 65). All the isolates of Pseudomonas aeruginosa and Acinetobacterspecies were 100% sensitive to Colistin and Tigecycline.

 The study helps in understanding the antibiotic resistance pattern of isolates causing nosocomial infections, helping clinicians in making appropriate antibiotic choices as an empirical therapy and the policy-makers to bring out the measures in controlling the superbugs.

Platelet-rich plasma (PRP) has emerged as a treatment for osteoarthritis (OA) and rheumatoid arthritis (RA). The aim of the current study is to assess the effect of PRP injection and its influence on interleukin-6 (IL-6) in the synovial fluid of the knee joint in OA and RA patients.

Clinico-radiologically diagnosed case of OA and RA of 30 each was included during the study period of 2 years. 10 ml of patient blood collected and PRP was prepared by differential centrifugation method, and this freshly prepared PRP was injected to the affected knee joint slowly. IL-6 levels assessed in synovial fluid at pre-PRP injection and 1st, 3rd and 6th month post-PRP Injection. Pain was measured using Visual Analog Scale.

The mean age of the cases was 58.5 years for OA and 47.2 years for RA. Females were predominantly compared to males. Majority were Kellegren Lawrence radiological grade 3 in 15 (50%) cases, following grade 2 in 8 (26.67%) cases, grade 4 in 6(20%) cases and grade 1 in 1(3.33%) case. Mean IL-6 in OA cases was 89.5±24.5 pg/ml at pre PRP, and 66.48±23.1 pg/ml at post PRP (p<0.001, paired t-test). Mean IL-6 in RA was 97.5±18.9 pg/ml at pre-PRP injection, and 89.6±17.9 at post PRP (p<0.001, paired t-test). In OA cases, paired t-test between the mean pain scores (VAS) at follow-up depicts that the mean difference and standard error of difference between 6-month follow-up and one-month follow-up was -1.23 ± 0.20 statistically significant differences (95%CI: -1.71 to -0.73). In RA cases, paired t-test between the mean pain scores (VAS) at followup depicts that the mean difference and standard error of difference between 6-month follow-up and one-month follow-up was -1.38 ± 0.19 statistically significant differences (95% CI: -1.69 to -0.75). There was a positive correlation between levels of IL-6 and pain score (r=0.309, p=0.004).

Study shows that anti-Inflammatory role of PRP, which was evidenced by the statistically significant difference in the IL-6 levels at follow-up. It may be beneficial to halt the progress in arthritic joints. This study successfully established an anti-inflammatory role of PRP in joint pathology by influencing the IL-6 levels.

According to the March of Dimes (MOD) global report on birth defects, 7.9 million births occur annually worldwide with serious birth defects. The prevalence of congenital anomalies in India is 6-7%. Worldwide, NTDs affect 323,904 infants with a prevalence rate of 0.5 to 11 per 1000 births. Although prenatal sonography has been developed in recent years, the definitive diagnosis of fatal fetal malformations is best made by fetal autopsy. An autopsy not only confirms, but also provides additional information and is useful in advising parents about the risks and prevention of similar malformations in future pregnancies. The aim of the study is to study the spectrum of Neural tube defects in foetal autopsies.

This retrospective study was conducted in the Department of Pathology, Hassan Institute of Medical sciences, Hassan, Karnataka, India. 97 fetal autopsies were performed between July 2010 to June 2020, out of which 39 cases had CNS malformations. 36 cases with NTD were included in this study. All the essential clinical data were retrieved from the autopsy forms and case files. In every case, the location and morphology of the NTD and associated morphologic anomalies were noted. The statistical analysis was performed by using frequency and percentage using SPSS version 24.

Out of 36 cases, the majority of the cases were Spina bifida (27.78%) followed by Anencephaly (25%).

Congenital disorders are a great public health issue in developing countries. The multidisciplinary approaches to fetal malformations have ever increasing importance in prenatal medicine. Fetal autopsy has a vital role in diagnosis of congenital malformations and detecting the cause of death.