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   2015| October-December  | Volume 4 | Issue 4  
    Online since October 20, 2015

 
 
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ORIGINAL ARTICLES
Effectiveness of training community-based rehabilitation workers on multiple disabilities: A pilot study
Vijay Samuel V Raj, Mincy Thomas
October-December 2015, 4(4):259-262
DOI:10.4103/2278-344X.167654  
Context: Community-based rehabilitation (CBR) as a developmental strategy addresses the needs of people with disabilities and their family. CBR personals at remote rural play an important role in early detection and prevention of disabilities. The identification with proper guidance can help to overcome the scarcity in early detection. An effective training for rehabilitation workers should contain training program emphasis on multiple disabilities. Aims: The aim of this study was to assess the effectiveness of training CBR personal with relation to knowledge on multiple disabilities. Settings and Design: An experimental design of 12 month's intervention confined to Chamarajanagar district. Subjects and Methods: A total of 20 subjects of trained CBR personals with the age group of 20–45 years were included in this study. The initial baseline evaluation was performed with a pretest questionnaire to assess their knowledge. The training with practical exposure on multiple disabilities was carried out at an interval of 3 months. The posttest at 12 months was analyzed. Statistical Analysis Used: SPSS version 16 for Windows was used for analysis. The results were statistically analyzed using paired test, Chi-square test, and ANOVA for between and within the groups. Results: The results showed significance on effectiveness of training. There was an improvement in outcome measures reflecting on identification and management of disabilities. Conclusions: The knowledge regarding early identification of disabilities plays an important role. Implementation of training methods on a regular interval and as a part in continuing education plays an important source for better outcome.
  3 1,812 261
Analysis of biofilm formation and antibiotic susceptibility pattern of uropathogens in patients admitted in a tertiary care hospital in India
Ruchi A Tayal, Sujata M Baveja, Anuradha S De
October-December 2015, 4(4):247-252
DOI:10.4103/2278-344X.167648  
Background: Microorganisms attach to surfaces and produce polysaccharides resulting in the formation of biofilms and providing an ideal niche for the exchange of genetic material leading to the emergence of drug-resistant pathogens. Biofilms can develop on anatomical surfaces and implants producing chronic and intractable infections. Aims: Detection of biofilm formation and comparison of antibiotic resistance between biofilm producers and nonproducers. Study Design: Prospective study in which urine specimens from adult patients with urinary tract infection (UTI) during the period of the study were analyzed (1 year). Materials and Methods: Mid-stream clean catch urine from noncatheterized and urine aspirated from in-dwelling urinary catheter in catheterized patients were taken for microbiological processing. Wet mounts, Gram-staining, and urine culture were done. Biofilm formation was detected by tissue culture plate method (TCPM). Statistical Analysis: Chi-square test and mid "P" test were used to analyze the data. A value ofP<0.05 was taken as significant. Results: Gram-negative organisms predominated (89%). Biofilm production was detected in 27% isolates. Maximum biofilm production was seen in Enterococcus spp. (71%), followed by Escherichia coli (26%). Biofilm-producing isolates demonstrated higher antibiotic resistance. All the biofilm-producing Enterococcus spp. showed high-level aminoglycoside resistance. The biofilm-producing isolates of Pseudomonas aeruginosa and Klebsiella pneumoniae demonstrated multi-drug resistance. Conclusions: TCPM is an economical phenotypic method which can be used routinely to detect biofilm formation. Biofilms contribute to an increased resistance to antibiotics used for the treatment of UTIs. Therefore, detection of biofilms is recommended for all patients presenting with chronic or recurrent disease.
  2 1,804 403
LETTERS TO EDITOR
Study of biofilm production and antimicrobial sensitivity pattern of urinary tract infection causing Acinetobacter baumannii and Pseudomonas aeruginosa in a tertiary care hospital
Pragyan Swagatika Panda, Uma Chaudhary, Surya Kumar Dube
October-December 2015, 4(4):272-273
DOI:10.4103/2278-344X.167655  
  1 595 144
ORIGINAL ARTICLES
Effect of integrative naturopathy and yoga therapies in patient with metabolic syndrome
A Mooventhan, Geetha B Shetty
October-December 2015, 4(4):263-266
DOI:10.4103/2278-344X.167658  
A 40-year-married man diagnosed with metabolic syndrome (MS) in 2013 and underwent allopathic medication. In July 2014, he visited our college hospital with the complaint of gradual increasing of body weight since 12 years and generalized weakness and knee pain since 1-year. Our subject received integrative naturopathy and yoga therapies (INYT) for the duration of 60–90 min and 120-min/day, respectively, for the period of 3 weeks along with the human mixed insulin and candesartan. Baseline and post assessment of weight, body mass index, waist circumference, insulin intake, blood glucose level, blood pressure, and lipid profile were assessed before and after the intervention. The result of our study showed a better reduction in all the variables. All the treatments were tolerable, and no adverse event was reported by the subject. It suggests that the INYT with insulin and antihypertensive medication can be considered as an effective treatment modalities in a patient with MS.
  1 1,476 244
Integration of umbilical venous and arterial Doppler flow parameters for prediction of adverse perinatal outcome
Hebbar Shripad, Rubeena Zainab, Adiga Prashant, Rai Lavanya
October-December 2015, 4(4):222-229
DOI:10.4103/2278-344X.167656  
Background: Quantification of umbilical vein (UV) blood flow rate and umbilical artery Doppler indices might be valuable in assessing fetuses at increased risk of perinatal complications as they receive their supply of oxygen and nutrients through this vessel. Previous studies have indicated that UV blood volume flow rate to umbilical artery pulsatility index (UAPI) ratio (venous arterial index [VAI]) evaluates both venous and arterial arm of fetal umbilical circulation and hence, can be adopted as a screening tool in management of high risk pregnancy. Objectives: To compare umbilical VAI with adverse perinatal outcome and also to evaluate its efficacy with other flow indices in determining perinatal outcome. Materials and Methods: Various Doppler indices such as normalized blood flow rate in UV (nUV, ml/kg estimated fetal weight/min), VAI (nUV/UAPI), umbilical artery resistance index (RI), UAPI, and systolic diastolic ratio were determined in 103 pregnant women within 2 weeks of the delivery. A risk score was devised using APGAR at 5 min, birth weight, preterm delivery, fetal distress, Neonatal Intensive Care Unit (NICU) care, and perinatal death and this score was correlated with antenatal Doppler findings. Results: Subjects with low VAI were found to have a greater association with intrauterine growth restricted fetuses (28.5%) and low liquor (35.7%), preterm deliveries (46.4%), lower mean birth weight (2.25 kg), higher NICU admission rates (32.1%). The unfavorable score was noticed in 25.2% of the neonates. They had lower VAI (156 vs. 241), UV diameter (6.2 mm vs. 7.8 mm), UV velocity (16.2 vs. 17.8), nUV (163.7 vs. 206.4), and higher PI (1.3 vs. 0.9). A cut-off of VAI of 105 ml/kg/min had sensitivity of 86.7% and a specificity of 93.5% for predicting poor perinatal outcome. Conclusion: VAI with a cut-off of 105 ml/kg/min can be used as an additional tool along with the other conventional Doppler indices in order to predict adverse fetal outcome.
  1 1,709 195
Impact of educational intervention on knowledge regarding infant feeding practices among medical students at Mysore
GS Vidya, M Renuka, Kulkarni Praveen, BM Shrinivasa
October-December 2015, 4(4):230-233
DOI:10.4103/2278-344X.167657  
Background: Appropriate infant feeding practices is the cost-effective intervention to improve the growth among infants, and it directly contributes to a reduction in the infant morbidity and mortality. Objective: To assess the impact of the educational intervention on knowledge regarding infant feeding practices among medical students. Materials and Methods: This educational interventional study was conducted among 3rd year medical students of a medical college for a period of 3 months. The baseline survey was conducted using a pretested, structured, self-administered questionnaire to assess the knowledge regarding infant feeding practices after obtaining informed consent. This was followed by an educational session regarding correct infant feeding practices. Endline survey was conducted after 1 month using the same questionnaire to assess the impact of educational intervention. Results: The present study revealed that the educational intervention to be the most effective mode for improving the knowledge of medical students regarding infant feeding practices (baseline score vs. endline score: Median [interquartile range] was 21 [19–23] and 28 [24–30], respectively, Z = 7.80, P = 0.001). Conclusion: Educational intervention is an effective tool to influence the knowledge regarding infant feeding practices.
  1 922 183
Development and in vitro characterization of ciprofloxacin loaded polymeric films for wound dressing
Ebere Innocent Okoye, Tobias Azubuike Okolie
October-December 2015, 4(4):234-242
DOI:10.4103/2278-344X.167660  
Background and Aim: Wound treatment is always encumbered with diverse challenges, including inadequacy of dressings. This study was undertaken to fabricate and characterize an antibiotic film useable as a wound dressing. Materials and Methods: Gelatin, sodium carboxymethyl cellulose (Na-CMC), and their blends (at 1:1, 1:2, and 2:1) were loaded with ciprofloxacin at drug: polymer ratios of 1:4, 1:6, 1:8, and 1:10 and fabricated into films using the solvent casting method. In vitro characterization of the films was conducted using standard protocols for wound dressing films. Results: The products displayed uniformity of weight and thickness; sorption capacity was 16–24 times their weights of fluid, with significant differences (P < 0.05), blend of polymers conferred much better sorption capability. Their surface pH lied between 6.33 and 6.74; bending endurance was excellent; photomicroscopy revealed uniform distribution of ciprofloxacin crystals; Fourier transform infrared analysis and differential scanning calorimetry showed that ciprofloxacin interactions with infrared and thermal energies were overshadowed by the polymers. The content uniformity of the formulations was within official limits while the in vitro drug release and antibacterial activities revealed that polymer blends at 1:1 or 1:2 (Na-CMC: gelatin) stood out as the most promising combination for the formulation of ciprofloxacin wound dressing films. Conclusion: Combination of Na-CMC and gelatin in the fabrication of wound dressing film is an attractive choice judging from the outcome of this study. The antibacterial activities and sorption capacities of the drug loaded films are strong indicators to their in vivo functionalities as wound dressing.
  1 1,597 258
Association of BODE index to daily living activities and upper limb strength in chronic obstructive pulmonary disease
Renukadevi Mahadevan, Pradeep Shankar, SK Chaya
October-December 2015, 4(4):243-246
DOI:10.4103/2278-344X.167653  
Context: Chronic obstructive pulmonary disease (COPD) is a progressive disease that reduces the functional capacity and the ability to perform activities of daily living (ADL). Aims: To determine the correlation between the BODE index (B - body mass index; O - airflow obstruction; D - dyspnea; and E - exercise capacity) with ADL and grip strength in COPD patients. Settings and Design: The study was conducted at JSS Hospital, Mysore. It was a correlational study. Subjects and Methods: Sixty-six COPD subjects were recruited by convenience sampling. Forced expiratory volume, body mass index, Six-Minute Walk Test, and Medical Research Council scale were assessed. The BODE index was calculated. The total score of London Chest Activities of Daily Living (LCADL) and grip strength were compared between the patients of the four quartiles of the BODE index. The association between LCADL and grip Strength with BODE index was analyzed. Statistical Analysis: Eta coefficient, Spearman's rank correlation coefficient and the analysis of variance were used. Results: The Eta coefficients showed the strength or the measure of associations of BODE index with age, grip strength, and LCADL. Spearman's correlation coefficient shows that there is an inverse association with grip strength and LCADL, and it was statistically significant as theP<0.05. Conclusions: ADL limitation and hand grip strength test have a strong association with the BODE index in patients with moderate to severe COPD.
  1 780 217
EDITORIAL
Ranking of higher educational institutions in India – Where did we fail?
Prashant Vishwanath, Sunil D Kumar
October-December 2015, 4(4):207-209
DOI:10.4103/2278-344X.167651  
  - 722 1,053
LETTERS TO EDITOR
Posttraumatic spindle cell lesion of the buccal mucosa
Kavita Mardi
October-December 2015, 4(4):271-272
DOI:10.4103/2278-344X.167659  
  - 708 115
ORIGINAL ARTICLES
In vitro anti-cancer activity of ethanolic extract of Momordica charantia on cervical and breast cancer cell lines
CR Shobha, Prashant Vishwanath, MN Suma, Akila Prashant, Chandini Rangaswamy, Basavana H Gowdappa
October-December 2015, 4(4):210-217
DOI:10.4103/2278-344X.167649  
Objectives: To estimate the total phenol content (TPC) of the ethanolic extract of Momordica charantia (EEMC) whole fruit and to study the cytotoxic activity of this extract against cell lines representing carcinomas of cervix and breast. Materials and Methods: Cervical and breast carcinoma cell lines (HeLa and MCF-7) were procured from National Center for Cell Sciences, Pune, and cultured in Dulbecco's modified eagle medium (DMEM) supplemented with 10% fetal bovine serum (FBS) and 1 mM L-glutamine. EEMC was prepared by graded ethanol fractionation method and the TPC determined using Folin–Ciocalteu assay. For cytotoxicity studies, 5000 cells/well in 100 μl DMEM-10% FBS medium were seeded in a 96 well plate; and treated with increasing concentration of EEMC. Efficacy of EEMC was determined by measuring the cell number using sulforhodamine B assay. Percentage inhibition was calculated using dimethyl sulfoxide vehicle control. The IC (50) value was calculated from the plot of inhibition (%) in dose- and time-dependent manner using GraphPad PRISM software. Results: The total phenolic content of EEMC decreased with increasing ethanol concentration from 50% to 100%. Cytotoxicity studies identified 50% ethanolic extract as the most active fraction. A time- and dose-dependent increase in the efficacy of 50% ethanolic extract for inhibiting cervical and breast carcinoma cell growth was noticed. The IC (50) dose was 12.31 μg/ml and 0.769 μg/ml for 50% EEMC at 48 h incubation for HeLa and MCF-7 cell lines, respectively. Conclusion: The presence of high total phenolic acid content in 50% ethanolic extract indicates that the anti-cancer activity of Momordica charantia could be due to the secondary metabolites. Based on the IC (50) value we conclude that the 50% EEMC is more potent against breast cancer cell lines. Further studies are required to know the exact cause for the increase in cell inhibition at 48 h incubation than in 72 h.
  - 2,619 1,249
The simplest technique for cultivation and maintenance of Balantidium coli
Rajesh Bareja, Shinu Pottathil, Prem S Grover, Hazara Singh
October-December 2015, 4(4):218-221
DOI:10.4103/2278-344X.167650  
Introduction: Balantidium coli (B. coli) is considered as the largest protozoon and the only parasitic ciliate known to infect humans. Objective: This study describes the cultivation and maintenance of B. coli isolated from a stool specimen of patient during the routine examination. Materials and Methods: B. coli was identified microscopically and then successfully cultivated and maintained in home-produced culture media. Four media, Water (W), water with fecal matter (WF), WF and blood (WFB), and water with serum (WS) were used to cultivate and maintain the parasite. Inoculated culture media were observed daily and then weekly. Results: WF and WFB exhibited good growth of the parasite as well as maintenance up to 5 months. W and WS showed good maintenance of the parasite up to 7 months and no growth, respectively. Conclusion: The present study depicts the simple and cost-effective techniques that help us in cultivation and maintenance of B. coli for a long time without doing subcultures again and again.
  - 2,415 251
Evaluation of canal stenosis of herniated lumbar disc and its correlation to anterior-posterior diameter with magnetic resonance imaging morphometry
Sitansu Kumar Panda, Geetanjali Arora, Biswa Bhusan Mohanty, Santosh Kumar Sahoo, Dharma Niranjan Mishra, Jami Sagar Prusty
October-December 2015, 4(4):253-258
DOI:10.4103/2278-344X.167652  
Background: The term disc prolapse is defined as extrusion of nucleus pulposus through a rent in annulus fibrosus. This prolapse disc causes impairment of function by nerve root compression compelling the patient to seek medical advice for low backache. A lumbar herniated disc is a common cause of low back pain radiating to the leg. The problem of prolapsed intervertebral disc is of great importance in this part of the world, because of the fact that people are subjected to various physical stress due to their living habits, low socioeconomic status. Ninety percent of lumbar disc extrusions occur at L4- L5or L5-S1. Central lesion may cause no symptoms with the exiting nerve roots unaffected whereas paracentral lesions cause symptoms due to compression of the exiting nerve root. Radio imaging technique has a pivotal role in the diagnosis of vertebral disc herniation. Various radiological procedures are used for the diagnosis, but MRI which is a relatively newer technique is treated as the gold standard in the field. Aim of the Study: In the present study, an attempt is made to establish the anatomy of herniated lumbar disc by the help of MRI technique in the patients of Eastern India & to correlate the occurance of disc herniation with age, sex & vertebral level. Methods and Material: The present study included 120 patients who have lumbar disc herniation syndrome & their MRI findingd are compared with MRI findings of 80 normal persons who are used as control. Results and Conclusions: The different parameters are compared & observed that the maximum number of disc prolapse occurs between 31- 40 age group. Taking the vertebral level into consideration, it is seen maximum number of herniation occurs at the level of L4- L5.
  - 1,459 136
SHORT COMMUNICATION
Cytotoxicity activities of chloroform extract of Cichorium intybus seed against HCT-15 and Vero cell line
Prashant Y Mali
October-December 2015, 4(4):267-270
DOI:10.4103/2278-344X.167647  
Background: Cichorium intybus L., (Asteraceae) is well-known as a coffee substitute but is also widely used medicinally to treat various ailments ranging from wounds to diabetes. Other plant parts are also used for liver and cancer disorder. Objective: The objective was to study the cytotoxic potential of chloroform extract of C. intybus seed against HCT-15 and Vero (normal) cell line. Materials and Methods: Fourier transform infrared spectroscopy (FTIR) analysis of the extract was performed. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay was used for evaluation of the cytotoxic potential of chloroform extract of C. intybus seed. Doxorubicin was considered as standard reference drug. The concentrations 1000–0.05 μg/ml was used in the experiment. Result and Discussion: FTIR spectrum showed 1025.363, 1083.126, 1291.366, 1389.144, and 1569.294 peaks/centers in the wavelength region of 4,000.00–650.00 cm−1. The chloroform extract of C. intybus seed and doxorubicin was showed 1411.37 μg/ml and 460.13 μg/ml 50% cell growth inhibition (IC50) against the HCT-15 cell line. Both extract and doxorubicin were safe against the Vero (normal) cell line. Conclusion: It can be concluded that the chloroform extract of C. intybus seed was not efficient against the HCT-15 cell line at the concentrations used in the experiment. Furthermore, there is no need to explore the said studies by in vivo models.
  - 974 188
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