iosr-JDMS   Volume-8 ~ Issue-6

Abstract: In children pneumonia is a leading cause of death which is characterized by inflammation of the parenchyma of the lung tissue due to infection. Additional risk factors being continuous exposure of lung epithelium to environmental pollutants, microorganisms, resulting into inflammation and increased oxidative stress .Lung tissue are protected from environmental oxidants by the endogenous antioxidants. A disruption in the fine balance between the antioxidants and oxidants leads to oxidative stress. The present study was conducted to study the oxidative stress in pneumonia by measuring the levels of lipid peroxidation in terms of malondialdehyde, enzymatic and non-enzymatic antioxidants as compared to control group. The study observed significantly lowered levels of antioxidant enzymes glutathione peroxidase, glutathione reductase and paraoxonase 1 along with lowered levels of non enzymatic antioxidants Vitamin C, vitamin E, and β carotene (p< 0.001) and an increased malondialdehyde levels among patients diagnosed with pneumonia when compared with the control group(p <0.001). Our observations are suggestive of an increased oxidative stress in cases of pneumonia in the pediatric age group.

Key words: Antioxidants, Nrf2, Oxidative stress, Pneumonia ,Reactive oxygen species.

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[8] Cemek M , Cakson H, Bayiroglu F. Oxidative stress and enzymatic-non enzymatic antioxidant responses in children with pneumonia. Cell Biochem Function, 2006, 24 (3): 269-273.

[9] Shamir R, Hartman C, Karry R, Pavlotzky E, Eliakim R, Lachter J, Suissa A, Aviram M Paraoxonases (PONs) 1, 2 and 3 are expressed in human and mouse gastrointestinal tract and in Caco-2 cell line: selective secretion of PON1 and PON2. Free Radic. Biol.Med., 2005 39: 336–344.

[10] Aviram M, Rosenblat MParaoxonases 1,2, and 3, oxidative stress and macrophage foam cell formation during atherosclerosis development. Free. Radic. Biol. Med.,2004 37: 1304–1316.

Abstract: Aim: To determine the prevalence of human immunodeficiency virus (HIV) among patients who underwent eye surgery in a tertiary facility. Materials and methods: This was a retrospective study using health records of patients who underwent eye surgery over a 21/2 year period. Demographic information including age, sex, occupation, diagnosis, type of surgery and HIV status were extracted and analyzed with SPSS 17.0. Results: A total of 99 patients were screened, made up of 60 males and 39 females. The age range was between 5 and 83 years with mean age of 49.9 years. Seven patients (7.1%) were sero-positive for human immunodeficiency virus. Of these, five were between 3rd and 5th decade of life while 2 were more than sixty years old. Conclusion: The sero-prevalence of HIV is high in our series. Patients undergoing ophthalmic surgery should be counseled to accept pre-operative HIV screening and ophthalmic surgeons should take precautions to minimize the risks of transmission to self, other health workers and uninfected patients. Keywords: Sero-prevalence, HIV, ophthalmic, surgical, patients.

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Abstract: The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for dental treatment. However, the IAN block does not always result in successful anesthesia. Various other nerve blocks were introduced over the period of time to improve the success rate of anesthesia. The objective of this systematic review was to compare and evaluate the anesthetic efficacy of Inferior alveolar nerve block with various mandibular nerve blocks in dental patients. Electronicdatabases were systematically searched for randomized controlled clinical studies and Clinical trials studies. Studies were selected by predefined inclusion criteria. Methodological quality was appraised and strength of evidence was determined. Seven studies from seven countries were included based on inclusion criteria. Although there is difference in the values comparing the different techniques the data is not significantly different in the anesthetic efficacy of various mandibular nerve block in dental patients. Based on this review, most of the articles included, point towards a better anesthetic efficacy of the classic inferior alveolar nerve block compared to the other inferior alveolar anesthesia techniques. However due to various variables like type of local anesthesia, experience of the operator and familiarity with the individual techniques it is not possible to conclude that classic inferior alveolar nerve block is relatively superior. Hence further research should be aimed at better matching of groups and variables like operator experience and familiarity to validate the findings.

Keywords: anesthetic efficacy,local anesthesia, local anesthetic technique,mandibular anesthesia,pulpal anesthesia

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Abstract: Health workforce includes clinically trained health professionals, health management and support workers. Imbalance in health workforce is a major challenge, as its size and quality positively determine country's ability to meet its goals of organizing and delivering health services, like immunization coverage, outreach of primary care etc. Unfortunately, India has uneven, inequitable and mal-distributed health workforce regarding number, skill, gender mix and type. The perceived gap being more in rural hilly areas, this study in a rural primary health centre (PHC) in Ghayabari, approximately 45 kilometres from Darjeeling was envisaged. The objectives of the study was to assess the status of health workforce in Ghayabari PHC in the hilly terrain of Darjeeling district and find out the associated reasons of any existing imbalance.A cross-sectional study was conducted in Ghayabari PHC, from August to October 2011. Focus–Group-Discussion (FGD) with staff, local leaders, In-Depth- Interview (IDI) of medical officers, nurses and record review was done. There are two doctors, three nurses, ten beds for approx.16,800 population with 8.4 turnover rates. Indian Public Health Standard criteria are incompletely met regarding adequacy and health workforce distribution. 27.27% posts are vacant, 13% left jobs in last 3 yrs. Though emergency and referral services are present, outreach and home visits are irregular, increasing load on the PHC. FGD, IDI identify reasons as staff –shortages, absenteeism, attrition, less capacity building efforts, unskilled staff, intense communication problems in adverse terrain, harsh living and working conditions, absent job satisfaction, irregular supervision and no untied funds. Issues pertaining to staff shortage, skill imbalance and job satisfaction need to be addressed with concern and care to ensure primary health care at doorstep of community.

Keywords- primary health workforce imbalance, hilly terrains

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