scholarly journals Cutaneous Leishmaniasis and/or Dermal Leishmanoid in Himachal Pradesh (India)

2020 ◽  
Author(s):  
Suman Lata ◽  
Sandhya kumari ◽  
Ram Das ◽  
Shweta Pasi ◽  
Ramesh C Dhiman
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Culture Media ◽  
Leishmania Species ◽  
Himachal Pradesh ◽  
Leishmania Parasite ◽  
Significant Finding ◽  
Dipstick Test ◽  
Medical College ◽  
Gandhi Medical College ◽  
Species Specific

Abstract Background: Visceral Leishmaniasis (VL) is in elimination phase in India while cases of Cutaneous Leishmaniasis (CL) are spreading to new foci in different parts of the country. In Himachal Pradesh, a foci of CL have been reported along Satluj River, but the causative agent poses a dilemma. To ascertain the Leishmania species from CL cases from Shimla, Kullu and Kinnaur districts of Himachal Pradesh, the present study was undertaken. Methods: A total of 28 CL patients registered in Department of Dermatology, Indira Gandhi Medical College (IGMC) and Hospital Shimla in 2018, were tested by rk39. Barring 16 cases undergoing treatment, 12 fresh cases were subjected to microscopic detection of Leishmania parasite, PCR and sequencing. Skin biopsies of 3-4 mm diameter were taken in culture medium and in formalin under anesthetic and sterile conditions from the border of the lesions. Imprints were prepared for the detection of Leishmania amastigotes. Biopsy samples were inoculated into different culture media (M199, RPMI 1640, and NNN) and were incubated at 22-24°C. Cultures were examined microscopically for the growth of promastigotes up to four weeks. Polymerase chain reaction (PCR) was performed to characterize leishmania parasite species.Results: Of 28 patients, one patient was found positive for by rK39 dipstick test. One imprint was found positive for leishmania amastigotes. Twelve biopsy DNA samples were subjected to PCR for Leishmania kDNA, of which all the 12 were found positive ITS1 Leishmania specific set of primers while eight were found positive with JW11/12 lesihmania species specific set of primers. Identification of Leishmania species was confirmed by PCR-RFLP and sequencing method. Of 12 Leishmania positive samples, six were identified as L. donovani, three L. tropica, two L. major and one remained unidentified.Conclusion: The detection of L. donovani from cutaneous leishmniasis patients is a significant finding leading towards existence of atypical leishmaniasis in Himachal Pradesh.

scholarly journals Clinical profile of snake bite patients in tertiary care hospital in Himachal Pradesh: a prospective study

2018 ◽  
Vol 6 (7) ◽  
pp. 2444 ◽  
Author(s):  
Madan Kaushik ◽  
Vikas Banyal ◽  
Sachin Sondhi ◽  
Manish K. Thakur ◽  
Aseem Kaushik
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Himachal Pradesh ◽  
Snake Bite ◽  
Clinical Profile ◽  
Care Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Gandhi Medical College ◽  
A Prospective Study

Background: To study clinical profile of snake bite patients in tertiary care hospital in Indra Gandhi Medical College at Shimla, Himachal Pradesh of North India.Methods: Hospital based prospective observational study was conducted in the Department of Medicine, for the duration of one year from 1st June2013 to 31st May 2014.Results: A total of 78 patients were admitted with mean age of 38.46 years with male to female ratio of 1:1.6. Seasonal variation with peak incidence during rainy season was seen. Most common snake identified was green coloured and peak timing of snake bite was between 07:00am-04:00pm. There was delay in admission of more than 6 hours in 66.67% of cases. Hemotoxicity was predominant manifestation seen in 62.82% of cases and persistence of coagulopathy was most common complication (51.02%) despite giving optimal ASV. There was paucity in ASV administration seen in only 59.46% of referred patients. Mean ASV vials used were 23.41 vials ±8.72 vials.Conclusions: Mass education is required at both general population and health professional levels to improve snake bite management and monovalent ASV against Green pit viper is more practical option to manage cases in this region.

What makes mucosal and anergic diffuse cutaneous leishmaniases so clinically and immunopathogically different? A review in Brazil

2019 ◽  
Vol 113 (9) ◽  
pp. 505-516 ◽  
Author(s):  
Fernando T Silveira
Keyword(s):  
Latin America ◽  
Cutaneous Leishmaniasis ◽  
Macrophage Activation ◽  
Surface Antigens ◽  
Leishmania Species ◽  
Cutaneous Lesions ◽  
American Cutaneous Leishmaniasis ◽  
Mucosal Tissues ◽  
Species Specific ◽  
Almost All

Abstract American cutaneous leishmaniasis (ACL) is a parasitic protozoan disease caused by different Leishmania species widely distributed throughout Latin America. Fifteen Leishmania species belonging to the subgenera Viannia, Leishmania and Mundinia are known to cause ACL. Seven of these species are found in Brazil, of which Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis have the highest potential to cause mucosal (ML) and anergic diffuse cutaneous leishmaniasis (DCL), respectively, the most severe forms of ACL. The clinical and immunopathological differences between these two clinical forms are reviewed here, taking into account their different physiopathogenic mechanisms of dissemination from cutaneous lesions to mucosal tissues in the case of ML and to almost all body surfaces in the case of anergic DCL. We also discuss some immunopathogenic mechanisms of species-specific Leishmania antigens (from the subgenera Viannia and Leishmania) that are most likely associated with the clinical and immunopathological differences between ML and anergic DCL. Those discussions emphasize the pivotal importance of some surface antigens of L. (V.) braziliensis and L. (L.) amazonensis, such as lipophosphoglycan, phosphatidylserine and CD200 (an immunoregulatory molecule that inhibits macrophage activation), that have been shown to exert strong influences on the clinical and immunopathological differences between ML and anergic DCL.

scholarly journals Outcome comparison study between laparoscopic appendisectomy and conventional open appendisectomy

2019 ◽  
Vol 6 (5) ◽  
pp. 1520
Author(s):  
Mimamaychet B. Sangma ◽  
Selvakumaran Selvaraju ◽  
Pratheeba Natarajan ◽  
Fremingston Marak ◽  
Simon David Dasiah
Keyword(s):  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Meta Analysis ◽  
Operation Time ◽  
Significant Finding ◽  
Medical College ◽  
Early Return ◽  
Outcome Comparison ◽  
Gandhi Medical College

Background: Open appendisectomy (OA) had been the procedure of choice for acute appendisectomy for a century since Mc Burney introduced in 1884. Laprascopic appendisectomy (LA) didn’t gain popularity and many studies had been conducted to see the superiority of one over the other. Recent meta-analysis studies, found overall benefits in favour of LA. So, we have done comparative study with the aim to compare the benefits of LA over OA.Methods: Total of 90 appendisectomies was done, 45 each in OA and LA group and compared over a period of 1-year from October 2016 to October 2017 in Indira Gandhi Medical College and RI, Pondicherry. Outcome parameters were compared between the 2-groups in relation to operative time, analgesia used, length of post-operative hospital stay, return to work, resumption of a regular diet, post-operative scar and post-operative complications.Results: Mean age of LA was 35 years, OA was 30 years. Male preponderance observed in OA (67%), female in LA (60%). Post-operative short hospital stay was 3-days in LA, 5-days in OA. Early return to work was 9-days in LA, 15-days in OA. Operative time was significantly shorter in LA which was 30-minutes and 40-minutes in OA. In laprascopic group, no complications was observed, in open group we had two post-operative infections.Conclusions: LA is an effective and safe option and the procedure of choice for most patients regardless of age, sex and BMI, with a statistically significant finding in regards to operation time in LA compared to conventional OA group.

The Role of CD1a expression in the diagnosis of cutaneous leishmaniasis, its relationship with Leishmania species and clinicopathological features

2021 ◽  
Author(s):  
Yasemin Yuyucu Karabulut ◽  
Funda KuŞ Bozkurt ◽  
Ümit Türsen ◽  
Gül Bayram ◽  
Gülhan Örekeci Temel ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Leishmania Species ◽  
Clinicopathological Features

scholarly journals Film-Forming Systems for the Delivery of DNDI-0690 to Treat Cutaneous Leishmaniasis

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 516
Author(s):  
Katrien Van Bocxlaer ◽  
Kerri-Nicola McArthur ◽  
Andy Harris ◽  
Mo Alavijeh ◽  
Stéphanie Braillard ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Cutaneous Leishmaniasis ◽  
Mouse Skin ◽  
Parasite Load ◽  
Leishmania Species ◽  
Lesion Size ◽  
Drying Time ◽  
Sustained Drug Delivery ◽  
Film Forming ◽  
The Impact

In cutaneous leishmaniasis (CL), parasites reside in the dermis, creating an opportunity for local drug administration potentially reducing adverse effects and improving treatment adherence compared to current therapies. Polymeric film-forming systems (FFSs) are directly applied to the skin and form a thin film as the solvent evaporates. In contrast to conventional topical dosage forms, FFSs strongly adhere to the skin, favouring sustained drug delivery to the affected site, reducing the need for frequent applications, and enhancing patient compliance. This study reports the first investigation of the use of film-forming systems for the delivery of DNDI-0690, a nitroimidazole compound with potent activity against CL-causing Leishmania species. A total of seven polymers with or without plasticiser were evaluated for drying time, stickiness, film-flexibility, and cosmetic attributes; three FFSs yielded a positive evaluation for all test parameters. The impact of each of these FFSs on the permeation of the model skin permeant hydrocortisone (hydrocortisone, 1% (w/v) across the Strat-M membrane was evaluated, and the formulations resulting in the highest and lowest permeation flux (Klucel LF with triethyl citrate and Eudragit RS with dibutyl sebacate, respectively) were selected as the FFS vehicle for DNDI-0690. The release and skin distribution of the drug upon application to Leishmania-infected and uninfected BALB/c mouse skin were examined using Franz diffusion cells followed by an evaluation of the efficacy of both DNDI-0690 FFSs (1% (w/v)) in an experimental CL model. Whereas the Eudragit film resulted in a higher permeation of DNDI-0690, the Klucel film was able to deposit four times more drug into the skin, where the parasite resides. Of the FFSs formulations, only the Eudragit system resulted in a reduced parasite load, but not reduced lesion size, when compared to the vehicle only control. Whereas drug delivery into the skin was successfully modulated using different FFS systems, the FFS systems selected were not effective for the topical application of DNDI-0690. The convenience and aesthetic of FFS systems alongside their ability to modulate drug delivery to and into the skin merit further investigation using other promising antileishmanial drugs.

NSAIDS: A RISK FACTOR AFFECTING PEPTIC ULCER PERFORATION

2021 ◽  
pp. 9-9
Author(s):  
Neelkamal Gupta ◽  
Mangtani Jitendra K ◽  
Khandelwal Dheeraj K
Keyword(s):  
Peptic Ulcer ◽  
Statistical Correlation ◽  
Duodenal Perforation ◽  
Peptic Ulcer Perforation ◽  
Muscularis Mucosa ◽  
Time Duration ◽  
Ulcer Perforation ◽  
Medical College ◽  
Life Threatening ◽  
Gandhi Medical College

INTRODUCTION:Apeptic ulcer is a defect in the upper gastrointestinal mucosa that extends through the muscularis mucosa into deeper layers of the gut wall. Non-steroidal anti-inammatory drugs (NSAIDs) are the major risk factors for peptic ulcer disease.Long-term use of NSAIDs, however, can cause gastrointestinal (GI) ulcers and potentially life-threatening ulcer complications. MATERIALAND METHOD: The present study was conducted on 100 patients of peptic ulcer of either sex in Department of Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. History of any other co morbid illness and any drug being taken with its time duration were recorded in detail. RESULT AND DISCUSSION: From this study, it was observed that among the 69 patients of duodenal perforation, 73.91% were taking NSAID. Similarly among the 31 patients of gastric perforation 80.64% were taking NSAID. Overall total 76% patients were taking these drugs. CONCLUSION: It is concluded from this study that a strong statistical correlation was found between use of NSAIDs and peptic ulcer perforation.

THE EVALUATION OF THE RESULTS OF NEGLECTED CLUBFOOT MANAGED BY PONSETI METHOD

2021 ◽  
pp. 23-25
Author(s):  
Nandram Saryam ◽  
Raja Yadav ◽  
Manish Rajpoot
Keyword(s):  
Ponseti Method ◽  
Effective Technique ◽  
Congenital Talipes Equinovarus ◽  
Medical College ◽  
Relapse Pattern ◽  
Study Results ◽  
Talipes Equinovarus ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Foot Disorder

Background: Congenital talipes equinovarus is the most common congenital foot disorder. neglected of clubfoot deformity occurs after the treatment by Ponseti method .we evaluate the relapse pattern of clubfoot basis of bhasker et al then treat the patient by Ponseti technique. Methods: This is a Prospective study .We are conducting a clubfoot clinic since 2013 in Department of Orthopaedics Gandhi medical college Bhopal . We register all clubfoot patient at our clubfoot clinic on his/her rst visit. All the clubfeet assessed with Pirani scoring system on the initial presentation to our institution and treat by Ponseti method. During this study there were a total of 558 children with 713 idiopathic clubfeet registered at our clinic. A total of 80 neglected clubfeet in 56 children presenting with neglected clubfeet were included in our study. Results: We found that The neglected feet in our study is (80 feet out of 713 feet. The male patient is 38 (67.86%) and female patient is 18 (32.14%). Male were predominantly involved as compared to female.The post treatment Pirani score after relapse treatment is 0.40 Conclusion: Ponseti technique is a simple, effective, inexpensive method for treatment of clubfeet there is, no requirement of special setup with limited resources and less rate of recurrence/complication than the surgical treatment It has been concluded that Ponseti method is a effective technique to treat congenital idiopathic clubfeet with success rate is 94.65% in our study

scholarly journals Causes of stillbirth according to different gestational ages

2018 ◽  
Vol 7 (3) ◽  
pp. 1029
Author(s):  
Aditi Jindal ◽  
Rama Thakur ◽  
Santosh Minhas
Keyword(s):  
Adverse Outcome ◽  
Developed Countries ◽  
Stillbirth Rate ◽  
Socioeconomic Conditions ◽  
Interventional Study ◽  
Common Cause ◽  
Live Births ◽  
Medical College ◽  
Mother And Child ◽  
Gandhi Medical College

Background: Stillbirth is one of the most common yet the most poorly studied adverse outcome of pregnancy. Objective of present study was to determine the risk factors and prevalence of stillbirth at Department of Obstetrics and Gynecology, Kamla Nehru State Hospital, for Mother and Child, Indira Gandhi Medical College, Shimla, Himachal Pradesh.Methods: A prospective non-interventional study was conducted with effect from 1st August 2015 to 31st July 2016, during which all the intrapartum and antepartum stillbirths were enrolled.Results: During the study period total number of stillbirth were 94 and the total number of live births were 6412, giving a stillbirth rate of 14.66/1000 live births. The perinatal mortality was 22.1/1000 births. The most common cause of stillbirth as revealed in the study was hypertensive disorder.Conclusions: The stillbirth rate in the study was higher than the stillbirth rate of developed countries. Improvement of socioeconomic conditions, literacy and health education among women will definitely be important to curb the staggeringly high stillbirth rate, but the need of the hour is to deploy adequate number of dedicated skilled providers.

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