EFFECTIVENESS OF ICE APPLICATION AT SELECTED ACUPOINT (LI-4) PRIOR TO INTRAMUSCULAR INJECTION ON LEVEL OF PAIN AMONG CHILDREN IN A SELECTED HOSPITAL, CHENNAI, TAMIL NADU, INDIA

Immunization is an effective and safest way to prevent vaccine-preventable diseases and thereby reduce morbidity and mortality in children. Injections given for immunization are the most usual ground in order to abstract agony or pain, which is the fifth vital sign leading to long-term physically and psychologically detrimental effects. A basic experimental (control group only for post-test) design using the technique of probability of simple random sampling in order to obtain sample size 105 was conducted in an Immunization Clinic at a selected PHC, Tamil Nadu, India. Ice cube was applied for about 30 seconds that is enfolded with gauze and then injected intramuscularly to administer the IM vaccine. In order to assess the pain level, an observation checklist based on Children's Hospital Eastern Ontario pain scale and Wong Baker's Faces pain scale was used. The study results manifest the higher statistical difference in the level of children's pain between the control groups and the experimental groups at a significance level of p<0.001. In order to reduce the pain level, the application of ice at LI-4 acupoint is effective. The children who are being vaccinated pass through stressful events through the application of an intramuscular injection. The findings revealed that ice application at LI-4 acupoint was very effective in pain reduction, which is a simple, safe, non-invasive, very efficient, easy-to-administer intervention and cost-effective without side effects than any other pharmacological pain intervention.

Effect of Cryo-Treated Cutting Tool End Milling on Custom 450 Stainless Steel

Custom 450 stainless steel is the most desirable material across industries due to its widespread application in the aerospace, defense and marine industries. Stainless-steel materials are challenging to deal with and fall into the list of hard-to-process materials due to their low heat conduction coefficient and high mechanical properties. In this research work, end milling was carried out on Custom 450 stainless steel machined using TiAlN coated with tungsten carbide inserts that have been cryo-treated (CT) for 24 h (24 h) and 36 h (36 h), as well as untreated (UT) inserts. The inserts were evaluated in terms of feed force, feed rate and consistent depth of cut (ap) at various spindle speeds (S). Also examined were the tool morphology, chip anatomy and surface morphology of cryo-treated material compared to untreated inserts at various responses to cutting force (Fx, Fy, Fz), cutting temperature (Tc), vibration and surface abrasion. For inserts that have been cryo-treated for 36 h, the feed force (Fx) value was 44% and 5% less compared to inserts treated for 24 h and in UT inserts, respectively. Furthermore, for 24-h and 36-h CT inserts, feed force (Fx) was 12% and 20% less compared to a UT insert. Using 24-h cryo-treated inserts as opposed to UT inserts significantly reduced the surface roughness by 20%. Cutting inserts that have undergone cryogenic treatment have been observed to exhibit longer cutting tool life due to less wear and friction on the cutting edges.

Larvicidal and ovicidal activities of phenyl acetic acid isolated from Streptomyces collinus against Culex quinquefasciatus Say and Aedes aegypti L. (Diptera: Culicidae)

The bio-efficacy of crude ethyl acetate extract, fractions and a compound phenyl acetic acid from the ethyl acetate extract of Streptomyces collinus was evaluated on Culex quinquefasciatus Say and Aedes aegypti L. mosquitoes (Diptera: Culicidae). The larvae were exposed to concentrations of 2.5, 5.0, 7.5 and 10.0 ppm for fractions and 0.5, 1.0, 1.5 and 2.0 ppm for compound. After 24 h, the larval mortality was assessed and the LC₅₀ and LC₉₀ values were calculated. Similarly, per cent ovicidal activity was calculated for eggs after 120 h post treatment for phenyl acetic acid. Among the eleven fractions screened, fraction 7 from the ethyl acetate extract of Streptomyces collinus exhibited good larvicidal activity against both mosquito species. The LC₅₀ and LC₉₀ values of fraction 7 were 4.42, 6.23 ppm against Cx. quinquefasciatus larvae and 5.13, 14.51 ppm against Ae. aegypti larvae, respectively. Further, the isolated compound, phenyl acetic acid from fraction 7 recorded 100% larvicidal activity at 2 ppm concentration with LC₅₀ and LC₉₀ values of 2.07, 4.87 ppm on Cx. quinquefasciatus larvae and 3.81, 9.87 ppm on Ae. aegypti larvae, respectively. Phenyl acetic acid presented 50.3% and 42.0% ovicidal activity against Cx. quinquefasciatus and Ae. aegypti eggs at 2 ppm concentration after 120 h post treatment. The compound, phenyl acetic acid could be used in mosquito control programme.

Evaluation of IgG Antibody Responseto Severe Acute Respiratory Syndrome Coronavirus-2 in Healthcare Workers in aTertiary Care Centre, Chennai, India

Introduction: Globally, the Coronavirus Disease-2019 (COVID-19) pandemic poses a high risk for Healthcare Workers (HCWs) who are among the population that is most vulnerable of being infected with Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). With a prevailing pandemic such as COVID-19, it becomes important to understand the presence and persistence of antibodies in the serum of HCW, testing positive for COVID-19 on Reverse transcriptase Polymerase Chain Reaction (RT-PCR). An understanding of the prevalence of IgG antibodies against COVID-19 and the duration for which they are present in the serum will help in predicting the immune response of individuals against the disease. Aim: To study the prevalence of COVID-19 IgG antibodies in laboratory confirmed COVID-19 RT-PCR positive symptomatic, asymptomatic and RT-PCR negative subjects. Materials and Methods: The present longitudinal study was conducted from April to December 2020 with a sample size of 90 participants based on a pilot study. Blood sample was collected and serum was separated. Enzyme Linked Immunosorbent Assay (ELISA) was done to detect the presence of COVID-19 IgG antibody in serum. Chi-square test and Pearson correlation were used to find out the statistical significance of COVID-19 IgG antibodies in COVID-19 positive and negative HCWs and the relationship between Cycle threshold values (Ct) and antibody levels, respectively. Results: Fever with sore throat was the most common (33%) symptom. Chi-square test done to compare IgG among RT-PCR positive and negative subjects showed p-value of <0.0001 which was significant. However, statistical significance was not found (p-value 0.9973) with respect to COVID-19 IgG antibodies in RT-PCR positive COVID-19 asymptomatic and symptomatic subjects. Mean antibody index in symptomatic and asymptomatic was 3.7743±1.9834 and 3.571±1.7961, respectively. Average number of days, the antibodies persisted was 25 days-266 days. Conclusion: The prevalence of COVID-19 antibodies among RT-PCR positive symptomatic, asymptomatic and RT-PCR negative subjects was 87.8%, 66.7% and 26.7%, respectively. The maximum number of days antibodies persisted was 266days. Further studies will elucidate whether these antibodies prevent re-infection.

Mucormycosis of the middle ear: a case report with review of literature

Mucor is a saprophytic organism and commonly invades the nose and paranasal sinuses of immunocompromised and diabetic patients involvement of the middle ear and mastoid in a nondiabetic patients is very rare and this may be the first case report clinical presentation of ear pain with reference to the mastoid and upper neck may be the early symptoms unlike the foul smelling ear discharge as seen in atticoantral disease. Radical debridement in the form of M.R.M with or without the use of amphotericin B may suffice in non-diabetic patients this case is reported to highlight the point that mucormycosis can also involve middle ear and mastoid in nondiabetic patients.

Frontal sinus osteoma: a difficult surgical decision in the era of endoscopic sinus surgery

A slow-growing frontal sinus osteoma has been followed up since the year 2001 by clinical, endoscopic, and radiological examination in the Department of Otolaryngology, New Medical Centre Specialty Hospital, Abu Dhabi, for 10 years until the year 2010. The last computed tomography scan of paranasal sinuses was done on April 5, 2010, which revealed increasing size of the osteoma by 38.1 mm; and it has become symptomatic. No specific cause of the sudden change of growth of the osteoma could be evaluated from the history and clinical examination. There was an increase in the frequency of headache and feeling of pressure in the forehead. Choice of surgical approach was difficult in this popular era of endonasal endoscopic sinus approach. A great deal of effort was made after reviewing the literature and consultation with the radiologist and neurosurgeon to accept the bicoronal osteoplastic flap approach. A broad-based posterior frontal sinus is found to be ideal for external approach.