Annals of International Medical and Dental Research

47-8

Authors: Varshney R

Mosquitoes are the greatest threat in the rainy season, blameable for several millions of deaths due to cases of malaria, dengue and yellow fever worldwide. These devils also transmit other fatal diseases like lymphatic filariasis and Japanese encephalitis. Malaria is endemic in 91 countries, endangering the life of 40% world's population. By destabilisation of the health conditions and working capability of hundreds of millions, it is closely allied to poverty and low social and economic development. Dengue is the world's second utmost significant mosquito-borne virus disease, with 2500 million people globally at risk and 20 million cases a year in more than 100 countries. Plasmodium’s ability to alternate its host’s behaviour help to elucidate its ability to infect so many individuals. Investigators have found that these alterations in insects contribute to differential attractiveness for the host. Infected mosquitoes take longer duration blood meals which are responsible for transmission of infection to human beings. It has been indicated that, while selecting a human host, mosquitoes have inclination for certain individuals.[1] For example, Anopheles gambiae which is principal malaria vector in Africa, prefers pregnant woman. Another example of host-parasite manipulation is seen in malaria infected people which becomes desired host for A. gambiae during the contagious phase of infection. Individuals with a greater body mass and high body temperature do appear to be more attractive to mosquitoes and bugs. Some researchers also claim that dietary consumption of garlic, vitamin B or beer have repellent action on mosquitoes.[2] Host preference and host-seeking ability play crucial roles in disease transmission and are targets for intervention. Female mosquitoes use two volatile signs to select and traverse toward hosts: exhaled CO2 and human skin odorants. Odours such as lactic acid, ammonia, carboxylic acids, 1-octen-3-ol, and nonanal, increase mosquito attraction when combined with CO2. Since mosquitoes use odour to find their prey scientists have wondered whether this factor is responsible for endemicity of diseases and has some genetic basis behind it. In 2007 a study was piloted in Netherlands to understand how the parasite affects mosquitoes’ magnetism to people. They establish that a species of Plasmodium parasite that causes malaria in rodents can amend mosquitoes’ olfactory proteins. Foot sweat from a volunteer who wore nylon stockings for 20 hours was placed in a cage with two groups of Anopheles gambiae. One group was infected with Plasmodium falciparum; the other wasn’t. Infected mosquitoes landed on the fabric three times as frequently as did non-infected mosquitoes.[3] Recently genetic basis behind the odour of individual which attracts the mosquito has become the subject of interest among the researchers. It is seen that the CO2-sensitive, Gr-expressing cpA olfactory neurons on the maxillary palps of mosquitoes are sensitive sensors of human skin odours in A. aegypti and A. gambiae. Only known ORN class in mosquitoes is the CO2 receptor neuron cpA whose activity closely correlates with behavioural attraction, it is assumed that volatiles from human skin may activate cpA. Various studies prove that the Gr1-, Gr2-, and Gr3-expressing cpA neurons on the maxillary palps of mosquitoes play a critical role in attraction toward humans by detecting both exhaled CO2 and odorants from skin. [4] Understanding genetically-determined mechanisms that underlie disparity in the odour of human body and thus variation in frequency and duration of mosquito bites lead to the development of innovative methods to enhance the production of natural repellents, thus generating a novel repellent technology that could curtail the need for topical application.[5] The researchers still don’t know the actual mechanism, how the parasite manipulates mosquitoes’ sense of smell. It’s also indistinct which constituent of human odour is the most attractive to the mosquitoes. That facts could help researchers improve traps to catch infected mosquitoes. “We're at the tip of the iceberg, really, of understanding all the strategies the parasite is using in the mosquitoes,” says parasitologist Hilary Hurd of Keele University in England, who collaborates with some of the study’s authors. “That's Editorial Annals of International Medical and Dental Research, Vol (1), Issue (2) Page 48 remarkable, given that this is a single-celled organism we're talking about.”[6]

53-6

Authors: Kataria P, Malhotra G, Shukla P, Malgotra R, Dangi P, Gupta V.

The oral cavity present itself as a home to a rich flora of bacteria; more than 500 distinct microbial species are found in dental plaque. Mycoplasma, yeast, protozoa and viruses are found in the plaque as the non-bacterial microorganism. Viruses are known to be immunosuppressive and facilitate establishment of subgingival pathogens and have been detected in the gingival crevicular fluid. Viruses infect the inflammatory cells of the periodontium; they are present more frequently in diseased sites than in healthy sites. Traditional methods such as in vitro cultivation presents difficulty in detecting viruses. The field of virology has advanced greatly over the past two decades because of the introduction of sophisticated molecular tools, such as monoclonal antibodies, polymerase chain reaction based amplification, DNA sequencing, DNA and protein micro array chip assays, rapid diagnostic tests. These technologies identify the viral bodies, proteins and nucleic acids in body fluids and tissue samples.

61-5

Authors: Agarwal C, Srivastava I, Bhati M, Sharma P, Swami N.

Background: Cardio-vascular disease is a major contributor to the global burden of disease among the non-communicable diseases. Obesity- the condition of excess of body fat has been known to be associated with increase in cardio vascular disease. To obtain a reasonable estimation of body-fat distribution, several anthropometric parameters have been proposed, such as subcutaneous skinfolds and body circumferences. Therefore, the aim of the present study was to examine the relationship of skin fold measurements and CVD and thus to predict and facilitate screening of the disease risk in study population. Methods: A total of 100 male patients, with recently diagnosed cardio vascular disease, in age group of 35-55 years were included as subjects for the study. Four skin fold measurements (over Biceps, Triceps, Subscapular and Suprailiacal) were taken using skin fold measuring calipers. Results: Values of central skin folds i.e. Subscapular and Suprailiacal were found to be higher than the peripheral skin folds i.e. Biceps and Triceps in each group, thus showing Subscapular and Supra-iliacal are positively linked to cardiovascular disease whereas Biceps and Triceps have negative relation with cardiovascular disease. Conclusion: Central fat mass can be recognized as an independent risk factor for cardiovascular disease and metabolic disease as well as overall mortality. Skinfold measurement is sensitive marker of cardiovascular risk. Measurement of these parameters may help to identify individuals with adverse concentrations of lipids and other risk factors. These persons could then targeted for weight reduction and risk-factor surveillance.

72-81.

Authors: Yadav M, Rastogi P

Background: Patient safety and security extends beyond due to medical error alone i.e. due to administrative carelessness. This aspect has been neglected or low priority area in India. Many instances if overlooked can be source of potential litigations for which court can award compensation against the hospital. Courts in India have recognized civil rights of right to safety of the patients and awarded compensation. Methods: A descriptive study has been conducted. This paper deals with administrative aspect on patient safety. A critical review of court cases in India and abroad along with review of relevant literature to make the situation understandable and clear for the safety and security of patients in India scenario. Results: Further study (KAP) needed to draw impact on the Health Administrators. Conclusion: An attempt has been made to sensitize the healthcare administrators/managers in both private and public sector hospitals.

88-91

Authors: Tripathi SK, Nanda SN, Warrier S, Pradhan P, Shiraz SM, Agarwal SK.

Background: A retrospective study was conducted in the department of orthopaedic surgery in a tertiary care hospital of western Maharashtra. Methods: Data of all the patients with fracture of distal end radius with or without ulna fracture who were admitted in our centre over a period of 4 years were recorded from case files, casuality admission register and operative records. A total of 204 patients were included in our study and mode of treatment was compared among the various available treatment modality such as cast/slab; percutation fixation with k-wire, external fixation & plate osteosynthesis. Results: Out of the total number of cases (n=204) for fracture distal end radius, nearly 10% case were managed with cast (n=21), 22% with percutaneous fixation with k-wire (n=45), 23.5% with external fixature (n=48), 19% with both external fixator and k-wire (n=38) and 25% with plate osteosynthesis (n=52). Hence when we assess the modality of treatment of distal end radius year wise from 2011 to 2014, the incidence of surgery by plate osteosynthesis has increased over a span of period. Conclusion: Retrospective study conducted at our tertiary care hospital concludes that incidence of plating for distal end radius fracture has increased over a period of time as compared to cast, percutaneous k -wire fixation and external fixator.

95-6.

Authors: Shukla A, Bharti R, Chaudhary R, Devra V.

Acute intestinal obstruction is a frequently encountered surgical emergency but cases arising from internal herniation through the broad ligament are very rare. We report a case of a middle aged lady with intestinal obstruction due to internal herniation of small bowel through the right side of broad ligament and managing her successfully by timely and immediate surgical intervention.

100-1.

Authors: Kumar S

The four pulmonary veins carry oxygen-rich blood from the lungs to the left atrium of the heart. They are the only veins in the post-fetal human body that carry oxygenated blood. They commence in a capillary network upon the walls of the air sacs, and join together form one vessel for each lobule. These vessels unite successively and form a single trunk for each lobe (three for right and two for left lung). The vein from middle lobe of the right lung generally unites with that from the upper lobe, so that ultimately two trunks from each lung are formed. They open separately into the upper and back part of the left atrium. Occasionally, three veins on the right side remain separate, and not infrequently the two left pulmonary veins end by a common opening into the left atrium. The number of pulmonary veins opening into the left atrium can vary between three and five in the healthy population. Here we are discussing single anomalous pulmonary vein opening in the left atrium.

104-7

Authors: Khurmi MS, Mathur N, Kaur P, Nichale A, Patle A, Khera A.

The National Health Mission (NHM, previously called National Rural Health Mission) was launched by Government of India in 2005 to make architectural correction of the Health system. One of the primary Goals of the Mission was to reduce Under five Mortality rate (U5MR) vis a vis Global commitment made under Millennium development Goals especially Goal numbering 4. Although, India still contributes to about one fifth of U5MR and Maternal Mortality rate but unfortunately it contributes to one third of Global Neonatal Mortality Rate. In sheer numbers alone, these rates are alarming. However, India has achieved a faster pace of reduction in U5MR by 46.5% in comparison to 41% for the entire world. In this article, data from Sample Registration System of the Registrar General of India which is available for most of the States/UTs has been analyzed for child health indicators in the country. In the next NHM phase, focused efforts need to be made with state specific Goals so as that the desired targets could be achieved.