No abstract

BACKGROUNDTimely identification of an epidemic occurrence and appropriate strategies for treatment require accurate diagnosis of viral diseases. However, the data for incidences of viral diseases in the northern parts of India is limited.The aim of the present study was to diagnose the various occurrences and outbreaks of viral diseases mainly chikungunya, cytomegalovirus, dengue, hepatitis A, B, C, E, herpes simplex 1, 2 and rubella in Amritsar and neighbouring districts of Punjab along with the demographic and geographical data of the patients. MATERIALS AND METHODSWhole blood sera samples from a total of 6099 patients suspected of various viral diseases (chikungunya, cytomegalovirus, dengue, hepatitis A, hepatitis B, hepatitis C, hepatitis E, herpes simplex-1, 2 and rubella) were received at VRDL, GMC, Amritsar from May 2016 to December 2016. The diagnosis was based on serological assays. RESULTSOut of total 6099 suspected cases, 3269 were diagnosed with antibodies for at least one of the tested viral diseases. Dengue virus was the highest occurring viral disease (66%). Male patients infected with viruses outnumbered female cases except for chikungunya, herpes simplex-1, 2 and rubella. The 21 -40 years' age group appeared to be the most susceptible age group for nearly all studied viral infections except cytomegalovirus and hepatitis A. Among the total eight reported outbreak investigations, largest encompasses 2795 dengue cases from Amritsar district. CONCLUSIONThe significance of diagnostics is anticipated to increase with advances in interventions and health information technology. Emerging and future diagnostics will have wide-ranging impacts on all aspects of healthcare; further, they will help advance new fundamental concepts of care and improve the quality of health services.

BACKGROUND AND OBJECTIVESMulti-Drug Resistant (MDR) pathogens due to various β-lactamases are major contributors in increasing morbidity and mortality rates in Burn Intensive Care Units, ICU. This study is aimed to apply the various infection control measures and to compare the results of two halves of study and to establish a relation between environment, Health Care Workers (HCWs) and patients regarding manifestation of nosocomial infection. DESIGN AND SETTINGOver a period of three years (June 2010 to June 2013), Clinical, Environment and Health care providers samples from Burn ICU were processed in the Department of Microbiology, Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Organisms were identified by standard microbiological techniques and their antibiotic susceptibility was determined by Kirby Bauer disc diffusion method. The MDR were further tested for various β-lactamases by Clinical Laboratory Standard Institute (CLSI) disc diffusion method using Ceftazidime and Ceftazidime + clavulanate and Cefotaxime and Cefotaxime clavulanate for Extended Spectrum Beta Lactamases (ESBL), Meropenem and meropenem + EDTA for Metallo Beta Lactamases (MBLs) and 3-Dimensional test for AmpC beta lactamases. MATERIAL AND METHODS307 clinical, 210 environmental and 117 HCWs samples in 1 st and 192 clinical, 62 environmental and 92 HCWs samples in 2 nd half of study were processed by standard microbiological techniques. After identification all MDR isolates were first screened for ESBL, AmpC and MBL then confirmed by the respective confirmatory tests. Results of two halves were statistically analyzed. RESULTSInfection rate was reduced from 50.16% to 40.10% in Burn patients. Culture positivity was reduced from 38.0% to 27.41% in environmental and 27.35% to 7.60% in HCWs samples. β-lactamases prevalence in Gram positive was 54.23% and Gram negative was 60.86% before and 37.03% and 54.05% after interventions. CONCLUSIONIn addition to the economic burden for antibiotic treatment, it is important to monitor the bacteriology, resistance pattern, antibiotic susceptibility and β-lactamases production in burn ICU. The development of new agents, strict antibiotic policy and effective infection control measures are paramount in the ongoing battle against multi-resistant organisms.

Background: Intravenous regional anaesthesia (IVRA) is simple, effective technique for upper limb orthopaedic surgeries specifically in developing countries like India because of cost-effectiveness. IVRA is also called Bier's block after the name of its inventor August Bier. Aim: Present study was carried out to evaluate the effects of adding either butorphanol or ketorolac to lignocaine during Bier's block. Materials and Methods: In a prospective randomized double blind study, 60 patients of age group 18-65 years of either sex with weight range of 65-70 kg of ASA grade I-III were randomly allocated into two groups of 30 each. Group I received butorphanol 1mg added to 3mg/kg lignocaine and group II received ketorolac 30 mg added to 3mg/kg lignocaine. Sensory and motor block onset, regression time, intraoperative and postoperative VAS score, duration of analgesia, total analgesic consumption in first 24 hr and side effects were noted. Statistical analysis of data was based on chi square test and post hoc test. Results: Demographic profile in both the groups was same. Duration of analgesia was significantly prolonged in group II(10.8 ±6.42) as compared to group I(3.02±1.52). In both the groups, patients remained haemodynamically stable and side effects and complications were also comparable. Conclusion: Ketorolac with lignocaine in IVRA provides prolonged post-operative analgesia as compared to butorphanol and lesser number of patients require rescue analgesia intraoperatively as well as postoperatively without any significant side effects.