Worm infection is a public health problem, especially in developing and underdeveloped countries as it has a negative impact on the child’s development. Proper sanitation and personnel hygiene have to be emphasized and monitored to overcome the nutritional deprivement in children. The study is done to evaluate the knowledge and attitude about worm infestation and to assess the deworming practices employed among the caregivers of children aged between 5 – 12 years attending a tertiary care hospital. A cross-sectional descriptive study was conducted among 206 caregivers of pediatric age group after obtaining proper informed consent. The KAP parameters were assessed using a pretested structured questionnaire, and the results were analyzed. Out of 206 caregivers, 61% were mothers, 37% were fathers. Their mean age was 30 years. 41% belong to class III socioeconomic status. 23% were reported to play in the mud, 17% nail-biting and 6% keeping objects in mouth.12% Had open-air defecation practice, which is quite alarming in a developing country.67% were found to have the knowledge and 33% lacked the knowledge about worm infestation. Knowledge was directly proportional to the socioeconomic class. 88% were aware that worm infestation would cause clinical manifestations. 85% preferred allopathy medicines, while 15% preferred homemade remedy. 68% didn’t practice any prophylactic measures, where in 21% of the caregivers dewormed their kid once in 6 months and 11% once a year. The study provides information that most of the caregivers had a good knowledge regarding deworming but failed in practicing necessary measures to control and prevent it. Health education, frequent monitoring, and conducting interventional programs among parents and caregivers would be vital so that the prevalence of the disease can be minimized.

The presence of peripheral vascular disease in chronic kidney disease portends a dismal prognosis due to the increased morbidity and mortality from cardiovascular events. Peripheral vascular disease is asymptomatic in about 40%. The study was designed to identify the prevalence of the peripheral vascular disease in chronic kidney disease, which is a state of accelerated atherosclerosis. A sample of 90 patients of chronic kidney disease attending the outpatient department in medicine and nephrology were assessed for the prevalence of peripheral vascular disease by measuring the Ankle-brachial index and Carotid intima-media thickness. Gender, smoking, hypertension, diabetes and ischemic heart disease profiles of the sample were analyzed for association with peripheral vascular disease. Majority of the patients belonged to the age group 40-50 years. 82 were males, of these 47 were smokers. 6 patients in the sample had symptoms suggestive of peripheral vascular disease. While 21%(n=19) of patients in the sample were diabetics and 21%(n=19) had evidence of ischemic heart disease, hypertension was present in 41%(n=37) of the patients. 50% of the patients belonged to CRF stage 4. The prevalence of the peripheral vascular disease, as determined by ABI<0.9, was 31.1%. CIMT thickness > 0.9mm has a positive correlation with CKD stages and has a statistically significant P value of <0.05. In conclusion, this study revealed that there is an increased prevalence of PVD in smokers, diabetics and in ischemic heart disease compared to those with hypertension.

Acute respiratory distress syndrome (ARDS) is a disease, mainly occurring in critically ill patients. The systemic spread of infections mainly causes ARDS due to the seepage of fluid in the spaces of the lung . Scrub typhus is a infection caused by . The bite of mite transmits it. Scrub typhus is frequently due to its non-specific clinical presentation and relatively low level of suspicion in treating physicians. The clinical presentation of scrub typhus is varied from fever, , rashes, headache, to pneumonia, acute respiratory distress syndrome, sepsis, central nervous system involvement. The disease is usually indistinguishable from other febrile illness like enteric fever, disease, malaria and certain viral hemorrhagic fevers. Identification of an points to the diagnosis without which the diagnosis is based on a high index of clinical suspicion. We report an interesting case of scrub typhus presenting as acute respiratory distress syndrome.

Pitutary adenomas are one of the commonest tumors of seller region of which prolactinomas and non- functioning adenomas predominate. The usual presentation are symptoms of endocrine dysfunction and mass effects. We present a case report of 37 year old male presenting with frontal headache and vomiting. Clinical observations revealed frontal bossing with enlarged hands and feet which arose a suspicion of Acromegaly. Investigations revealed elevated IGF 1 (insulin like growth factor) and growth hormone levels. Magnetic resonance image of the brain were done which showed pituitary adenoma. This case highlights the importance of clinical examination and the treating physician must have high clinical index of suspicion to detect endocrine dysfunction and use the modern techniques like stereotactic radio surgery (SRS).

Hemoglobinopathies are haematalogical disorders that afflict millions of individuals worldwide. HbE is a hemoglobin variation caused by a mutation in the β globin gene that results in the substitution of glutamic acid for lysine at position 26 of the β globin gene. Hemoglobin (Hb) synthesis abnormalities are among the most prevalent inherited disorders. They can be quantitative (thalassemia syndrome) or qualitative (variant HbS). Hemoglobin E (HbE) is the second most common hemoglobin variation after hemoglobin S (HbS).