This study examined stool samples from 207 patients with diarrhea attending an HIV testing center in India, 115 of whom were HIV-infected. Intestinal parasites were found in 46.1% of HIV-infected patients compared to 17.4% of non-infected patients. The most common parasites identified among HIV-infected patients were Isospora belli (16.5%) and Cryptosporidium parvum (12.2%). Opportunistic protozoans were detected in 32.2% of HIV-infected patients but only 1.1% of non-infected patients, showing a significant association between opportunistic protozoan infection and HIV status. Higher rates of opportunistic protozoans
ABSTRACT- Urinary Tract Infections (UTI) is a major threat to human health. It is caused due to various physiological changes of the urinary tract by the activity of microorganisms. Urinary Tract infections has also been a major type of hospital acquired infection. Hospital acquired infections (HAI) are of various types: Respiratory Tract Infection (RTI), Urinary Tract Infection (UTI), Blood Stream Infection (BSI), and Surgical Site Infection (SSI) and the most common are Urinary Tract (39%) and Respiratory Tract (20-22%) infection. The main aim of this study was to assess various urine samples collected from patients of the ICU of a tertiary care hospital for microbial growth and create a statistical picture on the contribution of UTI to nosocomial infections. Certain governing factors for UTI like presence of pus cells, epithelial cells, and diabetes mellitus were also kept under consideration along with various patient details like age, sex, primary illness and prior antibiotic treatment. The key findings of the study were: the
mean age of patients with symptomatic and asymptomatic UTI was 51 years and people from both genders within the age group of 41-60 were equally susceptible. E. coli was the most common causative organism (35.7%) followed by Citrobacter (21.42%) and Klebsiella (14.28%). Other organisms included Pseudomonas, Enterococcus and Candida. The rate of UTI was 56.22/1000 days of catheterization. Most of the organisms isolated were found to be multi drug resistant. UTI has been hence concluded to play a major contribution in nosocomial infections which needs to be controlled by integrating proper monitoring of hospital data and surveillance of hospital acquired urinary tract infection.
Key-words- ICU, Urinary Tract Infection, Center for Disease Control, Multi drug resistant, antibiotics, Microorganism
Determination of baseline Widal titre among apparently healthy population in ...IOSR Journals
Present study was conducted to determine the baseline widal titer of healthy population of Dehradun city. A total of 300 serum samples were collected from healthy individual with no history of fever and who had not received any vaccination for enteric fever. Tube agglutination test was done with commercially available antigens which contained the Salmonella enterica serovar typhi O and H antigens, the Salmonella enterica serovar paratyphi AH antigen and paratyphi BH antigen. In the present study an agglutination titer for TO – 1:20 is 28%, for 1:40 is 24%, followed by 1:80 and 1: 160 which is 10%, 4% respectively. The highest sample with an anti-H titre found with 1:20 (22%) followed by 1:40(17%). Based upon the results of the study it has been recommended that a single Widal can be significant in an endemic region when higher titre (1:160) is obtained.
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
A comparative study of various diagnostic techniques for CryptosporidiosisIOSR Journals
Diarrhoeal disease is a common complication of infection with HIV. Cryptosporidium has gained importance as an AIDS indicator disease and a cause of intractable diarrhoea in immunosuppressed individuals. This warranted a study of stool specimens of HIV positive patients with (n=60) and without (n=60) diarrhoea along with their HIV negative counterparts (n=200). Microscopic examination for ova and cysts were done using wet mount and Lugol’s iodine preparation. Smears were stained with Kinyoun Cold Acid Fast (KCAF) and Auramine ‘O’ fluorochrome (AOF) staining methods to identify Cryptosporidium oocysts. ELISA using Cryptosporidium microplate assay (alexon Inc) for detection of Cryptosporidium antigen was conducted on all stool specimens. By KCAF staining detection of Cryptosporidium in HIV positive subjects with diarrhoea was 20%, by AOF it was 7.5% and by ELISA the detection rate went up to 30%. All the detailed result were statistically compared taking KCAF staining as gold standard which revealed AOF staining to have sensitivity of 36.67% and specificity of 99.31% while ELISA was found to have sensitivity of 83.88% and specificity of 96.55%. Keeping in mind the present scenario of HIV infection in India and more so in Goa, it is recommended to include detection of Cryptosporidium oocysts in routine parasitological examination of stool specimens and an urgent need to standardize a gold standard for various diagnostic tests presently available
Post Endodontic Restoration: Are You Serious?IOSR Journals
After root canal obturation of sound posterior teeth, dentists are always in hurry of giving full
crown. They are not serious in giving proper post endodontic restoration which results in fracture of tooth or
restoration, if patient delays the full crown treatment. The inherent causes of failures are rarely evaluated.
Thus, it was the purpose of this study to analyze the opinion of practicing dentist and after 24 months of clinical
observation to present a logical approach to this subject as the final success of endodontic treatment is depend
on the proper and timely coronal restoration.
ABSTRACT- Urinary Tract Infections (UTI) is a major threat to human health. It is caused due to various physiological changes of the urinary tract by the activity of microorganisms. Urinary Tract infections has also been a major type of hospital acquired infection. Hospital acquired infections (HAI) are of various types: Respiratory Tract Infection (RTI), Urinary Tract Infection (UTI), Blood Stream Infection (BSI), and Surgical Site Infection (SSI) and the most common are Urinary Tract (39%) and Respiratory Tract (20-22%) infection. The main aim of this study was to assess various urine samples collected from patients of the ICU of a tertiary care hospital for microbial growth and create a statistical picture on the contribution of UTI to nosocomial infections. Certain governing factors for UTI like presence of pus cells, epithelial cells, and diabetes mellitus were also kept under consideration along with various patient details like age, sex, primary illness and prior antibiotic treatment. The key findings of the study were: the
mean age of patients with symptomatic and asymptomatic UTI was 51 years and people from both genders within the age group of 41-60 were equally susceptible. E. coli was the most common causative organism (35.7%) followed by Citrobacter (21.42%) and Klebsiella (14.28%). Other organisms included Pseudomonas, Enterococcus and Candida. The rate of UTI was 56.22/1000 days of catheterization. Most of the organisms isolated were found to be multi drug resistant. UTI has been hence concluded to play a major contribution in nosocomial infections which needs to be controlled by integrating proper monitoring of hospital data and surveillance of hospital acquired urinary tract infection.
Key-words- ICU, Urinary Tract Infection, Center for Disease Control, Multi drug resistant, antibiotics, Microorganism
Determination of baseline Widal titre among apparently healthy population in ...IOSR Journals
Present study was conducted to determine the baseline widal titer of healthy population of Dehradun city. A total of 300 serum samples were collected from healthy individual with no history of fever and who had not received any vaccination for enteric fever. Tube agglutination test was done with commercially available antigens which contained the Salmonella enterica serovar typhi O and H antigens, the Salmonella enterica serovar paratyphi AH antigen and paratyphi BH antigen. In the present study an agglutination titer for TO – 1:20 is 28%, for 1:40 is 24%, followed by 1:80 and 1: 160 which is 10%, 4% respectively. The highest sample with an anti-H titre found with 1:20 (22%) followed by 1:40(17%). Based upon the results of the study it has been recommended that a single Widal can be significant in an endemic region when higher titre (1:160) is obtained.
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
A comparative study of various diagnostic techniques for CryptosporidiosisIOSR Journals
Diarrhoeal disease is a common complication of infection with HIV. Cryptosporidium has gained importance as an AIDS indicator disease and a cause of intractable diarrhoea in immunosuppressed individuals. This warranted a study of stool specimens of HIV positive patients with (n=60) and without (n=60) diarrhoea along with their HIV negative counterparts (n=200). Microscopic examination for ova and cysts were done using wet mount and Lugol’s iodine preparation. Smears were stained with Kinyoun Cold Acid Fast (KCAF) and Auramine ‘O’ fluorochrome (AOF) staining methods to identify Cryptosporidium oocysts. ELISA using Cryptosporidium microplate assay (alexon Inc) for detection of Cryptosporidium antigen was conducted on all stool specimens. By KCAF staining detection of Cryptosporidium in HIV positive subjects with diarrhoea was 20%, by AOF it was 7.5% and by ELISA the detection rate went up to 30%. All the detailed result were statistically compared taking KCAF staining as gold standard which revealed AOF staining to have sensitivity of 36.67% and specificity of 99.31% while ELISA was found to have sensitivity of 83.88% and specificity of 96.55%. Keeping in mind the present scenario of HIV infection in India and more so in Goa, it is recommended to include detection of Cryptosporidium oocysts in routine parasitological examination of stool specimens and an urgent need to standardize a gold standard for various diagnostic tests presently available
Post Endodontic Restoration: Are You Serious?IOSR Journals
After root canal obturation of sound posterior teeth, dentists are always in hurry of giving full
crown. They are not serious in giving proper post endodontic restoration which results in fracture of tooth or
restoration, if patient delays the full crown treatment. The inherent causes of failures are rarely evaluated.
Thus, it was the purpose of this study to analyze the opinion of practicing dentist and after 24 months of clinical
observation to present a logical approach to this subject as the final success of endodontic treatment is depend
on the proper and timely coronal restoration.
A Study to Assess the Effectiveness of Planned Teaching Program on the Knowle...ijtsrd
Malnutrition and Tuberculosis chronic infectious disease are both problems of considerable magnitude in the most underdeveloped regions of the world. Malnutrition can leads to secondary immunodeficiency that increase the host susceptibility to infection. The aim of the study was to assess the effectiveness of planned teaching program on the knowledge and practice regarding dietary pattern among mothers of children with tuberculosis admitted in pediatric ward. Quasi experimental with two groups pre test post test design was used for 60 mothers at IPD and OPD of pediatric department and purposive sampling technique was used. Self structured questionnaire was used to assess knowledge and checklist for practice. In post test experimental group mothers have 63.3 average knowledge, 26.6 poor knowledge and 10 good knowledge while in the control group, 53.3 poor knowledge, 46.6 average knowledge and non hove good knowledge. In experimental group mean score was 17.9 1.96 while in control group mean score was 11.8 2.99. At the “p” value 0.05, the calculated t value 3.21 was compared with the tabulated value 2.01 . In post test experimental group, mothers have 53.3 good practice, 46.6 average practice and none have poor practice while in the control group, 63.33 average practice, 23.3 poor practice and 13.3 good practice. In experimental group mean score was 19.13 1.99 while in the control group, mean score was 14.06 2.85.At the “p” value 0.05, the calculated t value 3.28 was compared with the tabulated value 2.01 . These finding reveals that the planned teaching program on dietary pattern was effective. Mrs. Anchal Tiwari | Mrs. Anugrah Charan | Dr. Sarika Gupta "A Study to Assess the Effectiveness of Planned Teaching Program on the Knowledge and Practice Regarding Dietary Pattern among Mothers of Children with Tuberculosis Admitted in Pediatric Ward at KGMU Hospital, Lucknowv" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38591.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/38591/a-study-to-assess-the-effectiveness-of-planned-teaching-program-on-the-knowledge-and-practice-regarding-dietary-pattern-among-mothers-of-children-with-tuberculosis-admitted-in-pediatric-ward-at-kgmu-hospital-lucknowv/mrs-anchal-tiwari
Study of Bacterial Isolates and their Susceptibility Pattern in Chronic Suppu...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Etiology and Antimicrobial Sensitivity Profile of the Microorganism Associate...inventionjournals
This study proposes to meet the most common aetiologic agents in urinary tract infection and the antimicrobial susceptibility pattern. We analyzed all bacteriological examinations of urine recorded in Central Laboratory do Piauí-LACEN situated in the municipality of Teresina-PI of patients seen in December 2013 period through April 2014. It was observed that were filed during the designated period urine, 1647. Of these, 109 were positive cultural examination. Escherichia coli was the most isolated microorganism (71.6%), followed by the genus Klebsiella (14.7%), by Pseudomonas aeruginosa (2.8) and Proteus mirabilis (1.8%). In relation to antimicrobial susceptibility, Escherichia coli and Klebsiella spp feature high resistance to antimicrobials Amoxicillin, Piperacilina, Cephalotin, Ceftazidime and Quinolones. To the Enterobacteria in study, Imipeneme, Netilmicin and Amikacin were the antimicrobials with higher degree of susceptibility. In respect of Pseudomonas aeruginosa isolates, antimicrobials were more effective, the Imipeneme and Amikacin. In this way, the need to periodically reviews the ITU for being a promising environment for bacterial infection and to understand the evolution of antimicrobial susceptibilities, for part of the main etiological agents, over time.
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alri...CrimsonpublishersCJMI
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alribat University hospital, Khartoum State, Sudan, 2017 by Mohammed HMN in Cohesive Journal of Microbiology & Infectious Disease
Helicobacter pylori Frequency in Polycythemia Vera Patients without Dyspeptic...asclepiuspdfs
Introduction: In polycythemia vera (PV) patients, peptic ulcer and gastroduodenal erosions are more common than the general population, but there are insufficient data on the frequency of Helicobacter pylori (HP) and its role in etiopathogenesis. In this study, we aimed to compare the prevalence of HP infection in PV patients without dyspeptic complaints with a healthy control group without dyspeptic complaints. Materials and Methods: Fifty patients with PV without dyspeptic complaints and 50 controls without dyspeptic complaints were enrolled in this study after informed consent obtained. Stool samples of selected patients were analyzed using HP stool antigen test (True Line®). Results: There was surprisingly striking difference between HP prevalence in PV patients without dyspeptic complaints and asymptomatic healthy controls (64% vs. 2%) (P < 0.05). There was no significant relationship found between HP presence and age, gender, treatment modalities, complete blood count, positivity of JAK2 V617F, serum erythropoietin level, and splenomegaly in PV patients (P > 0.05). Conclusion: As the susceptibility of HP infections in PV patients are higher, it is recommended to have close surveillance of these patients by screening HP presence. In addition, when HP positivity is determined, the eradication of HP is essential to prevent possible future gastrointestinal lesions in patients with PV.
SPORADIC OUTBREAK CASES OF DIPHTHERIA: A THREE YEARS’ STUDY IN A TERTIARY CAR...Earthjournal Publisher
SPORADIC OUTBREAK CASES OF DIPHTHERIA: A THREE YEARS’ STUDY IN A TERTIARY CARE CENTRE OF NORTHEAST INDIA.
Daiji Gogoi Mohan, Mayuri Gogoi,Naba Kumar Hazarika
IRO INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES 2018, 1(1):1-5.
The title is the main advertisement for an article and enables the reader to decide whether they want to read the article or not. The title should be simple, specific and reflect the article's content clearly and precisely in 10 - 15 words. The abstract summarizes the whole article in 200 to 250 words and should be structured for a research article. It includes the problem or the study objectives, the methods used, the main results obtained and the conclusion reached. Most authors write the abstract last, so that it accurately reflects the content of the article. Keywords are placed below the abstract and are usually 3 - 7 in number. Choosing right keywords will enhance the article being found by other researchers as these are used by abstracting and indexing services. Ultimately, a well-cited research article depends on how well the title, abstract and keywords are written.
A Study to Assess the Effectiveness of Planned Teaching Program on the Knowle...ijtsrd
Malnutrition and Tuberculosis chronic infectious disease are both problems of considerable magnitude in the most underdeveloped regions of the world. Malnutrition can leads to secondary immunodeficiency that increase the host susceptibility to infection. The aim of the study was to assess the effectiveness of planned teaching program on the knowledge and practice regarding dietary pattern among mothers of children with tuberculosis admitted in pediatric ward. Quasi experimental with two groups pre test post test design was used for 60 mothers at IPD and OPD of pediatric department and purposive sampling technique was used. Self structured questionnaire was used to assess knowledge and checklist for practice. In post test experimental group mothers have 63.3 average knowledge, 26.6 poor knowledge and 10 good knowledge while in the control group, 53.3 poor knowledge, 46.6 average knowledge and non hove good knowledge. In experimental group mean score was 17.9 1.96 while in control group mean score was 11.8 2.99. At the “p” value 0.05, the calculated t value 3.21 was compared with the tabulated value 2.01 . In post test experimental group, mothers have 53.3 good practice, 46.6 average practice and none have poor practice while in the control group, 63.33 average practice, 23.3 poor practice and 13.3 good practice. In experimental group mean score was 19.13 1.99 while in the control group, mean score was 14.06 2.85.At the “p” value 0.05, the calculated t value 3.28 was compared with the tabulated value 2.01 . These finding reveals that the planned teaching program on dietary pattern was effective. Mrs. Anchal Tiwari | Mrs. Anugrah Charan | Dr. Sarika Gupta "A Study to Assess the Effectiveness of Planned Teaching Program on the Knowledge and Practice Regarding Dietary Pattern among Mothers of Children with Tuberculosis Admitted in Pediatric Ward at KGMU Hospital, Lucknowv" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-2 , February 2021, URL: https://www.ijtsrd.com/papers/ijtsrd38591.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/38591/a-study-to-assess-the-effectiveness-of-planned-teaching-program-on-the-knowledge-and-practice-regarding-dietary-pattern-among-mothers-of-children-with-tuberculosis-admitted-in-pediatric-ward-at-kgmu-hospital-lucknowv/mrs-anchal-tiwari
Study of Bacterial Isolates and their Susceptibility Pattern in Chronic Suppu...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Etiology and Antimicrobial Sensitivity Profile of the Microorganism Associate...inventionjournals
This study proposes to meet the most common aetiologic agents in urinary tract infection and the antimicrobial susceptibility pattern. We analyzed all bacteriological examinations of urine recorded in Central Laboratory do Piauí-LACEN situated in the municipality of Teresina-PI of patients seen in December 2013 period through April 2014. It was observed that were filed during the designated period urine, 1647. Of these, 109 were positive cultural examination. Escherichia coli was the most isolated microorganism (71.6%), followed by the genus Klebsiella (14.7%), by Pseudomonas aeruginosa (2.8) and Proteus mirabilis (1.8%). In relation to antimicrobial susceptibility, Escherichia coli and Klebsiella spp feature high resistance to antimicrobials Amoxicillin, Piperacilina, Cephalotin, Ceftazidime and Quinolones. To the Enterobacteria in study, Imipeneme, Netilmicin and Amikacin were the antimicrobials with higher degree of susceptibility. In respect of Pseudomonas aeruginosa isolates, antimicrobials were more effective, the Imipeneme and Amikacin. In this way, the need to periodically reviews the ITU for being a promising environment for bacterial infection and to understand the evolution of antimicrobial susceptibilities, for part of the main etiological agents, over time.
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alri...CrimsonpublishersCJMI
Prevalence of Intestinal Parasitic Infections among Patients Attended to Alribat University hospital, Khartoum State, Sudan, 2017 by Mohammed HMN in Cohesive Journal of Microbiology & Infectious Disease
Helicobacter pylori Frequency in Polycythemia Vera Patients without Dyspeptic...asclepiuspdfs
Introduction: In polycythemia vera (PV) patients, peptic ulcer and gastroduodenal erosions are more common than the general population, but there are insufficient data on the frequency of Helicobacter pylori (HP) and its role in etiopathogenesis. In this study, we aimed to compare the prevalence of HP infection in PV patients without dyspeptic complaints with a healthy control group without dyspeptic complaints. Materials and Methods: Fifty patients with PV without dyspeptic complaints and 50 controls without dyspeptic complaints were enrolled in this study after informed consent obtained. Stool samples of selected patients were analyzed using HP stool antigen test (True Line®). Results: There was surprisingly striking difference between HP prevalence in PV patients without dyspeptic complaints and asymptomatic healthy controls (64% vs. 2%) (P < 0.05). There was no significant relationship found between HP presence and age, gender, treatment modalities, complete blood count, positivity of JAK2 V617F, serum erythropoietin level, and splenomegaly in PV patients (P > 0.05). Conclusion: As the susceptibility of HP infections in PV patients are higher, it is recommended to have close surveillance of these patients by screening HP presence. In addition, when HP positivity is determined, the eradication of HP is essential to prevent possible future gastrointestinal lesions in patients with PV.
SPORADIC OUTBREAK CASES OF DIPHTHERIA: A THREE YEARS’ STUDY IN A TERTIARY CAR...Earthjournal Publisher
SPORADIC OUTBREAK CASES OF DIPHTHERIA: A THREE YEARS’ STUDY IN A TERTIARY CARE CENTRE OF NORTHEAST INDIA.
Daiji Gogoi Mohan, Mayuri Gogoi,Naba Kumar Hazarika
IRO INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES 2018, 1(1):1-5.
The title is the main advertisement for an article and enables the reader to decide whether they want to read the article or not. The title should be simple, specific and reflect the article's content clearly and precisely in 10 - 15 words. The abstract summarizes the whole article in 200 to 250 words and should be structured for a research article. It includes the problem or the study objectives, the methods used, the main results obtained and the conclusion reached. Most authors write the abstract last, so that it accurately reflects the content of the article. Keywords are placed below the abstract and are usually 3 - 7 in number. Choosing right keywords will enhance the article being found by other researchers as these are used by abstracting and indexing services. Ultimately, a well-cited research article depends on how well the title, abstract and keywords are written.
Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India.
Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification.
Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes.
Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.
Key words Dengue virus - IgM antibody - seroprevalence - serotype - vector control
Background and study aim: During last two decades, there has been a world-wide trend in increasing occurrence of enterococcal infections in the hospitals. The aim of present study was to determine the spectrum of enterococcal infections, species prevalence, antimicrobial and characteristics of vancomycin resistant enterococci (VRE) in a tertiary care hospital, Eastern India.
Patients and Methods: Between January 2013 and July 2014, 152 Enterococcus species were obtained from clinical samples. Enterococci were identified using standard biochemical tests. Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion according to Clinical resistance
& Laboratory Standards Institute (CLSI) guidelines.VRE agar base was used to screen VRE isolates. Minimum inhibitory concentration (MIC) values of VRE isolates were determined using Epsilometer-test. VRE isolates were also examined by PCR to detect vanA gene.
Results: From 1602 clinical samples, 961 (60%) were culture positive and 152 (15.8%) enterococcal isolates were obtained. Most common species isolated was E. faecalis (63.8%) followed by E. faecium (35.5%). Majority of enterococcal infections were detected from ICUs and surgical wards and clinically presented as UTIs. Disk diffusion method showed 67.1% were resistant to penicillin, 61.2% ampicillin, 58.5% ciprofloxacin, 46.7% high-level gentamicin, 42. 8% high-level streptomycin, 7.9% teicoplanin and none to linezolid. Twenty (13.2%) enterococcal isolates were vancomycin resistant in VRE screen and disk diffusion method. Epsilometer-test of VRE isolates showed 8 (40%) isolates were resistant and 9 (45%) were intermediately resistant. From 20 VRE isolates, six showed VanA and two VanB phenotypes and all six VanA phenotypes had vanA gene cluster.
Conclusion: More accurate and reliable MIC determination tests should be performed in all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster.
Key words: Enterococci, E. faecalis, E. faecium, VRE, vanA gene
Introduction: Bloodstream infections (BSIs) are associated with a high mortality rate of 20%-50%. Blood culture is paramount to identify causative agents of BSIs to choose an appropriate antimicrobial therapy. Objectives: The present study was undertaken to analyze the various microorganisms causing BSIs and study their antimicrobial resistance patterns in a tertiary care hospital, Eastern India. Materials and Methods: A total of 239 blood specimens from clinically suspected cases of BSIs were studied for 6 months from July 2015 to December 2015. Blood specimens were incubated in BacT/ALERT ® 3D system (bioMerieux, Durham, NC, USA) a fully automated blood culture system for detection of aerobic growth. Identification and antimicrobial susceptibility testing were conducted on VITEK ® 2 (bioMerieux, Durham, NC, USA) as per Clinical Laboratory Standards Institute guidelines. Results: Out of 239 specimens, 41 (17.2%) yielded growth of different microorganisms. From these isolates, 20 (48.8%) were Gram-negative bacilli, 18 (43.9%) were Gram-positive cocci and rest 3 (7.3%) were yeasts. Among Gram-negative bacilli, Klebsiella pneumoniae sub spp. pneumoniae (70%) was most commonly isolated. Coagulase-negative staphylococci (88.9%) were the most common isolate among Gram-positive cocci. All three Candida spp. isolated were nonalbicans Candida (two Candida tropicalis and one Candida krusei). Gram-negative isolates were least resistant to tigecycline and colistin. All Gram-positive cocci were sensitive to linezolid. Conclusion: Monitoring of data regarding the prevalence of microorganisms and its resistance patterns would help in currently prescribing antimicrobial regimens and improving the infection control practices by formulating policies for empirical antimicrobial therapy.
POLIEDROS EXPLICACIÓN DE POLIEDROS COMO CUERPOS REDONDOS INCLUYENDO UNA ACTIVIDAD PARA PODER DESARROLLAR EN EL AULA CONSISTENTE EN REALIZAR UNA CIUDAD, MEDIANTE EDIFICACIONES FORMADAS POR CUBOS, PRISMAS, PIRÁMIDES O CUERPOS REDONDOS. FINALMENTE SE PUEDEN AÑADIR MOBILIARIO Y VEGETACIÓN.
Introduction: Clindamycin is an excellent drug for skin and soft tissue Staphylococcus aureus infections, but resistance mediated by inducible macrolide-lincosamide-streptogramin B (iMLS B ) phenotype leads to in vivo therapeutic failure even though they may be in vitro susceptible in Kirby-Bauer disk diffusion method. Objective: The study was aimed to detect the prevalence of iMLS B phenotype among S. aureus isolates by double disk approximation test (D-test) in a tertiary care hospital, Eastern India. Materials and Methods: A total of 209 consecutive S. aureus isolates were identified by conventional methods and subjected to antimicrobial susceptibility testing by Kirby-Bauer disk diffusion method. Erythromycin-resistant isolates were tested for D-test. Results: From 1282 clinical specimens, 209 nonrepeated S. aureus isolates were obtained. Majority of isolates 129 (61.7%) were methicillin-resistant S. aureus (MRSA). There was statistically significant difference between outpatients 60.1% and inpatients 39.9% (P < 0.0001). From 209 S. aureus isolates, 46 (22%) were D-test positive (iMLS B phenotype), 41 (19.6%) were D-test negative (methicillin sensitive [MS] phenotype), and 37 (17.7%) were constitutively resistant (constitutive macrolide-lincosamide-streptogramin B phenotype). The incidence of inducible, constitutive, and MS phenotype was higher in MRSA isolates compared to MS S. aureus (MSSA). The constitutive clindamycin resistance difference between MSSA and MRSA isolates were found to be statistically significant (P = 0.0086). Conclusion: The study revealed 22% of S. aureus isolates were inducible clindamycin resistant, which could be easily misidentified as clindamycin susceptible in Kirby-Bauer disk diffusion method. Therefore, clinical microbiology laboratory should routinely perform D-test in all clinically isolated S. aureus to guide clinicians for the appropriate use of clindamycin.
ABSTRACT
Background: With the advances in medical care, invasive fungal
infections possess a significant health problem especially in
immunocompromised patients. These infections have varied aetiological
agents which are commonly found in soil, water, plant debris and organic
substrates. Aim: The overview of different fungal aetiological agents,
newer and rapid diagnostic modalities and overall treatment and
prevention options available is presented in this article. Methods:
Literature search was performed in PubMed by using MeSH terms
‘mycoses’ and ‘immunocompromised host’. Only relevant review articles
published within the last five years were considered. Google Scholar
search engine was also used. Results: Common invasive fungi include
Candida spp., Cryptococcus spp., Aspergillus spp., Trichosporon spp.,
Rhodotorula spp., Fusarium spp., Mucormycotina, Pheohyphomycosis
spp., Pneumocystis jirovecii, Scedosporium spp., and endemic mycoses
such as Penicillium, Histoplasma and Blastomyces. A high degree of
suspicion is required for early diagnosis and optimal management of these
infections. Conclusion: Early and rapid diagnosis of causative fungal
agents is required so that appropriate treatment can be initiated. Adequate
preventive measures must be applied in an immunocompromised host that
can prevent development of drug resistant super-infections.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Prevalence of Cryptosporidiosis Among Selected Group of Sudanese Patients by Mosab Nouraldein Mohammed Hamad in Advancements in Bioequivalence & Bioavailability
Shigellosis and Socio-Demography of hospitalized Patients in Kano, North-West...inventionjournals
Aim: The aim of the study was to determine the prevalent of Shigellosis in relation to socio-demographic characteristics of hospitalized patients in Kano metropolis. Study design: The study is a descriptive cross-sectional study. Place and duration of study: One milliliter of venous blood was collected from each patient with some or all clinical features of Shigellosis that sign a consent form and transfer into EDTA bottles. If daily is unavoidable blood samples were stored at 4 0C. Samples were analyzed at the both laboratories of the authors. This work was carried out between May, 2012 and March, 2014. Methodology: The blood specimens were cultured in thioglycollate broth and sub-cultured onto deoxycholate citrate agar (DCA), Salmonella-Shigella agar (SSA) and brilliant Green agar (BGA) followed by confirmation of presumptive colonies using different biochemical tests and analytical profile index 20E. Serologic identification of Shigella was performed by slide agglutination test using polyvalent O and H Shigella antisera. Results: Although, the relationship between different age groups was not significantly associated (P < 0.05), patients under age bracket of 21-30 years were found to be more susceptible to Shigella infections with 13 representing 2.6% followed in that order by 11-20 years (6), , ≤10 -years (4) 31-40 years (3) and >40 years (2) age groups, representing 1.2%, 0.8%, 0.6% and 0.4% respectively. The frequency of shigellosis was highest in other patients (without occupation), patients with informal level of education, using tap water as sources of drinking water, with more than one of all clinical manifestations of Salmonella infections and patients on treatment. However, there was a significant difference between the rate of Salmonella infections and sociodemographic characteristics of patients studied (p<0.05).> 0.05) in males than the females’ patients. However, Shigella flexneri was the most common among patients followed by Shigella dysenteriae, Shigella boydii and Shigella sonnei in decreasing order. The frequency of shigellosis was highest in other patients (without occupation), patients with informal level of education, using tap water as sources of drinking water, with more than one of all clinical manifestations of Salmonella infections and patients on treatment.
Bacteriological profile of childhood sepsis at a tertiary health centre in so...QUESTJOURNAL
Introduction: Sepsis is a leading cause of morbidity and mortality in children worldwide, even more so in developing countries. Knowledge of common pathogens and their antibiotic susceptibility pattern is useful for guiding initial treatment while awaiting blood culture results. Objective:To determine the major causative organisms and their antibiotic sensitivity pattern of childhood sepsis at the Niger Delta University TeachingHospital (NDUTH), with the aim of revising existing treatment protocols. Methods: Within a 2 year period (1st January 2014 to 31st December 2015) blood culture results of children with clinical suspicion of sepsis were retrospectively studied. Results:During the study period, 116 (12.11%) of the 958 children admitted into the Children Emergency Ward had blood culture tests. Thirty one (26.72%) had positive blood cultures.Eighteen (58.06%) of the organisms were gram positive while thirteen (41.93%) were gram negative. The predominant organism was Staphylococcus aureus in 16 (51.61%) followed by Klebsiella pneumoniae in 5 (16.13%) patients. The bacterial isolates demonstrated the highest sensitivity to the quinolones. Conclusion:There is need for periodic surveillance of the causative organisms and antibiotic susceptibility pattern of childhood sepsis to guide effective management of patients.
Abdominal Tuberculosis Revisited–A single institutional experience of 72 case...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinical Features and Patterns of CD4+ T Lymphocyte Counts Among HIV/AIDS Pat...IjcmsdrJournal
Background:The use of CD4+ T Lymphocyte count as a vital component to ascertain the stage of HIV/AIDS disease as well as monitor the progress of the disease continues to take centre stage in the management of HIV/AIDS in Africa and beyond. Most health centres in Sub-saharan Africa rely on cut off reference values from different races and distant parts of the world.
Aim:This study was designed to establish the range of CD4+ T Lymphocyte counts among the HIV-negative individuals and also HIV-positive patients at initial booking in the anti-retroviral clinic of our hospital where clinical diagnosis was established.
Methods:Patients were recruited into the study as they report to the hospital on daily basis; structured questionnaires were administered where socio-demograhic and relevant clinical information were obtained. Blood samples (3-5mls) were collected using aseptic techniqueand processed where HIV screening was conducted, and CD4+ T Lymphocyte cell count was carried out using Cyflow (Partec, Germany). Results were fed into Microsoft excel 2007 version and analysed using SPSS 14.
Results:A total of 386 HIV-positive and 145 HIV-negative individuals were recruited into the study. The average CD4+ T Lymphocytes count among the HIV negative individuals was 850 cells /μL and ranged from 200 to 1950 cells/μL with CD4+ T Lymphocyte counts of less than 300 cells/μL being 5 (3.4%). The CD4+ T Lymphocyte counts of less than 500 cells/μL among the HIV-negative individuals was 19(13.1%). However, the CD4+ T Lymphocyte counts among HIV-infected individuals ranged from 50 to 1450 cells/μL, 0.8% (n=3) while 45.9% (n=177) presented with CD4+ T Lymhocyte counts of 50 or less and less than 250 cells/μL respectively. The fact that 75.9% (n=293) of the patients had a CD4+ T Lymphocyte counts of less than 500 cells/μL shows the general late presentation of patients with HIV infection at our health settings, and as much as 50% of these were aware of their HIV status the very first time.
ILRI and ACIAR One Health related research activities in Lao PDRILRI
Presentation by P. Inthavong, B. Khamlome, B. Somoulay, K. Blaszak, A. Okello, H. Holt, K. Graham, J. Allen, P. Durr and J. Gilbert at a One Health symposium conference, Luang Prabang, Laos, 5-6 September 2013.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
How to Give Better Lectures: Some Tips for Doctors
Intestinal protozoans in adults with diarrhoea
1.
2. Intestinal Protozoans in Adults with Diarrhea
Muktikesh Dash, Sanghamitra Padhi, Pritilata Panda, Banojini Parida
Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur University,
Abstract
Background: Diarrhea is one of the most common presenting complaints in human immunodefi ciency virus-infected individuals.
Aims: The study was designed to determine the magnitude of opportunistic and nonopportunistic intestinal parasitic infections among
diarrheal patients and association between CD4+ T-cell counts and human immunodefi ciency virus (HIV)-infected intestinal parasites.
Materials and Methods: A cross-sectional study was conducted among 207 enrolled diarrheal patients attending HIV integrated
counseling and testing center from January 2012 to December 2012. Stool samples were subjected to special modifi ed Ziehl-Neelsen
and chromotrope staining method for detection of opportunistic protozoans. Blood samples were also collected from all study subjects
for HIV testing and CD4+ T-cell counts were estimated by only in HIV-infected patients. Results: Intestinal parasitic pathogens were
detected in 46.1% HIV-infected patients and the major pathogens were opportunistic protozoans 32.2% (37/115), most common being
Isospora belli 16.5% (19/115) followed by Cryptosporidium parvum 12.2% (14/115). In HIV noninfected diarrheal patients, major pathogens
detected were Entamoeba histolytica/Entamoeba dispar 8.7% (8/92) and Ascaris lumbricoides 3.3% (3/92). Conclusions: The opportunistic
intestinal protozoans especially I. belli and C. parvum were most commonly isolated in HIV-infected patients with diarrhea. Majority of the
infections occurred in patients when a CD4+ T-cell counts were less than 200 cells/l.
Keywords: Cryptosporidium parvum, human immunodefi ciency virus, intestinal protozoans, isospora belli, opportunistic
Address for correspondence: Dr. Muktikesh Dash, Department of Microbiology, Maharaja Krushna Chandra Gajapati Medical College and Hospital,
Berhampur, Odisha - 760 004, India. E-mail: mukti_mic@yahoo.co.in
Introduction
Odisha, India
The global pandemic of human immunodeficiency
v i r u s / a c q u i r e d i m m u n o d e f i c i e n c y
syndrome (HIV/AIDS) in its third decade has shown
public health concerns especially infections by
opportunistic pathogens including various forms
of intestinal parasitosis. Diarrhea is one of the most
common presenting complaints in HIV-infected
individuals, reaching a rate up to 60% in developed
countries and 90% in developing countries.[1] The
infectious etiological agents include both opportunistic
agents that consistently cause severe, often frequent
or chronic diarrhea and nonopportunistic agents
that usually cause acute, treatable gastro-intestinal
illness.[2] Many self-limiting and sporadic intestinal
parasites have now become opportunistic parasites
causing uncontrollable life threatening diarrhea among
people living with HIV/AIDS.[3] Opportunistic intestinal
protozoan parasites such as Cryptosporidium parvum,
Isospora belli, Cyclospora cayetanensis and Microsporidia
including Enterocytozoon bieneusi and Encephalitozoon
intestinalis have been reported in HIV infection.[4] Recent
studies have also opined that mucosa dwelling parasites
may benefi t from HIV-induced pathological changes and
reduced immune response due to HIV infection, which
creates suitable environment for opportunistic intestinal
parasites in HIV/AIDS patients.[3,4]
Intestinal parasites are frequently transmitted by low level
of environmental and personal hygiene, contamination
of food and drinking water and poor sanitary conditions
in developing countries.[5] Proper investigation of the
parasitic etiology of diarrhea leading to prompt and
effective management can help in decreasing the morbidity
and mortality in such patients.[6]
Only a few studies have been reported regarding
the prevalence of intestinal parasites from eastern
North American Journal of Medical Sciences | December 2013 | Volume 5 | Issue 12 | 707
Original Article
Access this article online
Quick Response Code:
Website:
www.najms.org
DOI:
10.4103/1947-2714.123261
3. Dash, et al.: Intestinal protozoans in adults
part of India. Against the above background as
well as the generated data that will improve the
management of opportunistic infections in HIV/AIDS
patients, this study is aimed to determine the prevalence
of intestinal parasitic infections with special emphasis on
opportunistic coccidian parasites among HIV-infected
and HIV noninfected patients presenting with diarrhea
as well as effect of CD4+ (cluster of differentiation 4) T-cell
counts on prevalence of the disease among HIV-infected
patients.
Materials and Methods
Study design and subjects
A cross-sectional study was carried out between January
2012 and December 2012 in a 900-bedded tertiary
health institution, Odisha state with antiretroviral
therapy (ART) facilities for HIV/AIDS management.
This study was conducted after due approval of
institutional ethical committee.
A total of 5973 subjects who attended integrated
counseling and testing center (ICTC) were enrolled for
HIV testing during study period and among them 372
suffered from diarrhea. Stool samples were collected
from 207 consenting HIV-infected and HIV noninfected
patients suffered from diarrhea were included in
this study in order to determine the magnitude and
prevalence of intestinal parasites among HIV-infected
patients. Study patients were interviewed using a
structured questionnaire and information was obtained
on demographic characteristics, present and past
history of diarrhea and antibiotic treatment. Diarrhea
was defi ned as two or more liquid or three or more soft
stools per day. Patients already received antiparasitics
and antibiotics treatment and less than 18 years were
excluded from the study. Verbal informed consent was
obtained from all patients prior to collection of stool
sample.
Blood sample collection and processing, HIV
serology, and CD4 + T cell count
All the ICTC attendees received relevant pretest
counseling and written informed consent was obtained
from each of them before HIV testing was carried out.
Five milliliters venous blood sample was collected in a
sterile plain container from all patients suffering from
diarrhea who attended ICTC. Blood was allowed to clot
for 30 minutes at room temperature (25–30 C) and serum
was separated after centrifugation at low speed. The
serum samples were then stored at 4 C and were tested
within 48 hours.
HIV antibodies were tested by the three rapid tests protocol
as per the guidelines laid down by the World Health
Organization (WHO Testing strategy III) and National
AIDS Control Organization, Government of India.[7] All
positive test results were disclosed only after post test
counseling of the patients. Antibodies to HIV (1 and 2)
were tested initially with a SD BIOLINE HIV-1/2 3.0
rapid test [Standard Diagnostics, Inc. Korea]. The samples
tested positive in the fi rst method were subjected to tests
with two different rapid tests, that is, PAREEKSHAK
HIV 1/2 Triline Card Test [Bhat Bio-Tech India (P) Ltd.,
Bangalore, India] and PAREEKSHAK HIV 1/2 Rapid Test
Kit (TRISPOT) [Bhat Bio-Tech India (P) Ltd., Bangalore,
India]. The samples were considered as positive when
found reactive by all three different methods. All tests
were done according to manufacturer’s instructions.
CD4+ T-lymphocytes count was carried out in
HIV-infected patients by using BD FACS™ Calibour
system (Becton Dickinson, Singapore). In brief,
a three-color direct immunofluorescence reagent,
that is, CD3 fluorescein isothiocyanate (FITC)/CD4
phycoerythrin (PE)/CD45 peridinin chlorophyll
protein (PerCP) was used to identify and determine the
absolute counts of helper T-lymphocyte (CD4+) subsets
in erythrocyte-lysed whole-blood.[8]
Stool sample collection and examination
From consenting ICTC diarrheal attendees, single stool
sample was collected for this study. All stool specimens
were subjected to fresh direct wet mounts, formol-ether
concentration technique, modified Ziehl–Neelsen
stain and chromotrope stain for detection of intestinal
parasites.
Direct wet mount
A direct saline and iodine wet mount of each sample
was used to detect intestinal parasites microscopically.
The wet mounts were examined under light microscope
at ×100 and ×400 magnifi cations. A small portion of the
stool samples were also preserved in 10% formalin for
repeating the tests whenever required.
Formol ether concentration method
A portion of each fresh stool sample was taken and
processed. Briefl y, 1 g of stool was placed in a clear 15 ml
conical centrifuge tube containing 7 ml formalin saline
by using applicator stick. The resulting suspension was
fi ltered through a sieve into another conical tube. After
adding 3 ml of diethyl ether to the formalin solution,
the content was centrifuged at 3200 rpm for 3 minutes.
The supernatant was poured away and the tube was
replaced in its rack. Finally smear was prepared from
the sediment and observed under light microscope
with a magnification of ×100 and ×400. Fresh stool
specimens were used as saline wet mounts to detect
motile trophozoites and concentrated stool specimens
708 North American Journal of Medical Sciences | December 2013 | Volume 5 | Issue 12 |
4. Dash, et al.: Intestinal protozoans in adults
were used as iodine wet mounts to detect ova, larva,
and cysts.
Modifi ed Ziehl-Neelsen staining method
Thin smear was prepared directly from sediment of
formol-ether concentrated stool and allowed to air dry.
The slides were then fi xed with methanol for 5 minutes
and stained with carbol fuchsin for 30 minutes. After
washing the slides in tap water, they were decolorized
with acid alcohol (99 ml of 96% ethanol and 1 ml HCL)
for 3 minutes and counterstained in methylene blue for
1 minute. The slides were then washed in tap water and
observed for Cryptosporidium parvum, Isospora belli, and
Cyclospora cayetanensis under light microscope with a
magnifi cation of 1000×.[9]
Chromotrope staining method
A small part of 10% formalin fi xed unconcentrated stool
suspension was smeared on a glass slide. The thin smear
was heat fi xed on a slide warmer at 60 C until completely
dry (5-10 minutes) followed by absolute methanol
fi xation for 5 minutes. The slides were stained with
chromotrope for 90 minutes. After washing in tap water,
they were destained with acid alcohol (995.5 ml of 90%
ethanol and 4.5 ml glacial acetic acid) only for 1-3 seconds,
then immediately rinsed with 95% ethanol by dipping.
Subsequently the slides were changed twice in 100%
ethanol for 3 minutes each and changed twice in xylene
for 10 minutes each. The slides were then drained and
mounted and observed for Microsporidia under light
microscope with a magnifi cation of 1000×.[9]
Quality control
A control slide of Cryptosporidium parvum, Isospora
belli, Cyclospora cayetanensis, and Microsporidia from a
10% preserved specimen were included along with each
staining run.
Statistical analysis
GraphPad Inc. statistical software (2236 Avenida de la
Playa La Jolla, CA 92037 USA) was used for calculation
of mean, median, standard deviation, range, and P value
using Fisher’s exact test. Statistical signifi cance was
defi ned when P value is less than 0.05.
Results
A total of 207 diarrheal stool samples were examined
for presence of intestinal parasites, 115 (55.6%)
were collected from HIV-infected patients and the
rest 92 (44.4%) were from HIV negative patients.
The mean age of HIV-infected patients was
37.7 (9.7) (median 38, range 20-62 years) and HIV
noninfected was 34.6 (12.8) (median 32, range 18–67 years).
Intestinal parasites were detected in 53 (46.1%) out of
115 samples from HIV-infected patients, whereas only
16 (17.4%) parasites were found from 92 HIV negative
samples. Among HIV-infected patients, majority
32.2% (37 out of 115) had infected with opportunistic
protozoans (Coccidia and Microsporidia) and the rest
16 (13.9%) suffered from nonopportunistic protozoans
and nematodes [Table 1]. From 92 HIV negative stool
samples, 16 (17.4%) were positive for intestinal parasites
and only 1 (1.1%) had revealed opportunistic protozoan
infection. The association of opportunistic protozoans
with HIV-infected patients had shown statistically
signifi cant P value (P < 0.01).
Among HIV-infected patients, I. belli 16.5% (19/115) was
most commonly detected parasites followed by C. parvum
12.2%, E. histolytica/E. dispar 7.8%, Microsporidia (2.6%),
S. stercoralis (2.6%), and 0.9% each of C. cayetanensis,
A. duodenale, and G. lamblia, respectively. From 16 (17.4%)
parasite positive stool samples of 92 HIV-negative
patients, E. histolytica/E. dispar was the common
parasite (8.7%), followed by A. lumbricoides (3.3%),
A. duodenale (2.2%), and 1.1% each of E. vermicularis,
T. trichiura, and C. parvum respectively [Table 1].
CD4+ T-cell count was performed in all 115 HIV-infected
patients. The prevalence of opportunistic intestinal
protozoans among HIV-infected patients with CD4
counts <200 cells/l and ≥ 200 cells/l were 61.9% (26/42)
and 15.1% (11/73), respectively. The CD4+ T-cell count
was signifi cantly associated with an increased prevalence
of opportunistic intestinal protozoans in HIV-infected
diarrheal patients (P < 0.001) [Table 2]. The mean
CD4+ T-cell count among HIV-infected opportunistic
protozoans was 135.2 (80.7) cells/l (median 112, range
37–389 cells/l).
The HIV-seropositive subjects were grouped by
18-27, 28-37, 38-47, and ≥ 48 years. The percentage
of HIV-infected study participants who were males
with diarrhea was more (61.7%, 71/115) than that of
females (38.3%, 44/115). Similarly, the occurrence of
opportunistic protozoans was higher in ≥ 48 years of age
group followed by 38-47 years [Table 3].
Discussion
HIV-infected individuals become susceptible to a variety
of opportunistic parasite infections that occur with
greater frequency and severity due to down regulation of
immune system. Almost 80% of AIDS patients die from
AIDS-related infections including intestinal parasites
rather than HIV infection itself.[10] The Coccidian
parasites (C. parvum, I. belli and C. cayetanensis) and
Microsporidia (Enterocytozoon bieneusi and Encephalitozoon
intestinalis) are the foremost among enteric parasites in
North American Journal of Medical Sciences | December 2013 | Volume 5 | Issue 12 | 709
5. Dash, et al.: Intestinal protozoans in adults
Table 1: Distribution of diff erent intestinal parasites detected from HIV-infected and HIV-negative diarrheal patients
Parasitic divisions Parasites Diarrheal patients (n=207) (%) Total P value
Intestinal Protozoa (Amoebas,
Flagellates, Coccidia and Microsporidia)
Entamoeba histolytica/
Entamoeba dispar
Giardia lamblia 1 (0.9) 0 1 0.37 (NS)
Cryptosporidium parvum 14 (12.2) 1 (1.1) 15 <0.01 (S)
Isospora belli 19 (16.5) 0 19 <0.001 (S)
Cyclospora cayetanensis 1 (0.9) 0 1 0.37 (NS)
Microsporidia 3 (2.6) 0 3 0.34 (NS)
Total Protozoa 47 (40.9) 9 (9.8) 56 <0.001 (S)
Intestinal nematodes Ascaris lumbricoides 2 (1.7) 3 (3.3) 5 0.81 (NS)
Ancylostoma duodenale 1 (0.9) 2 (2.2) 3 0.85 (NS)
Strongyloides stercoralis 3 (2.6) 0 3 0.34 (NS)
Trichuris trichiura 0 1 (1.1) 1 0.92 (NS)
Enterobius vermicularis 0 1 (1.1) 1 0.92 (NS)
Total Nematodes 6 (5.2) 7 (7.6) 13
Total (Protozoa and nematodes) 53 (46.1) 16 (17.4) 69 0.71 (NS)
P<0.05 (statistically signifi cant); S: Statistically signifi cant; NS: Not signifi cant, HIV: human immunodefi ciency virus
Table 2: Correlation of CD4+ T-cell counts with
opportunistic intestinal protozoans among
HIV-infected diarrheal patients
CD4+T-lymphocytes
(cells/μl)
Total no.
of HIV-infected
(n=115)
Total no. of
HIV-infected
positive with
opportunistic
protozoa
(Coccidia and
Microsporidia)
(n=37) (%)
P value
<200 42 26 (61.9) <0.001
(statistically
signifi cant)
≥200 73 11 (15.1)
HIV: Human immunodefi ciency virus; CD4: Cluster of differentiation 4
these patients.[2] Gastrointestinal parasitic infections
largely present with diarrhea leading to life threatening
complications.[11]
In this present study, enteric parasites were detected
in 46.1% of HIV-infected patients with diarrhea.
Various studies from India and other countries
have reported low, similar, or higher prevalence of
intestinal parasites, ranging from 15.3% to 77.14%.[12-17]
The opportunistic protozoans (69.8%) predominated
among all intestinal parasites with I. belli (51.3%)
being the most commonly detected parasite followed
by C. parvum (37.8%), Microsporidia (8.1%), and
C. cayetanensis (2.8%). The overall high prevalence of
16.5% was shown by I. belli followed by C. parvum (12.2%),
E. histolytica/dispar (7.8%), Microsporidia (2.6%),
S. stercoralis (2.6%), A. lumbricoides (1.7%), and 0.9%
each by G. lamblia, C. cayetanensis and A. duodenale in
HIV-infected diarrheal patients. This present study
No. of HIV-infected
(n=115)
No. of HIV
noninfected (n=92)
09 (7.8) 08 (8.7) 17 0.83 (NS)
differed from most of the studies within and outside
India where they have found out C. parvum was the most
commonly prevalent protozoan.[12,13,15-28] Few studies
within India have reported I. belli was the predominant
opportunistic intestinal protozoan.[14,29] The reason for
these large difference in prevalence of opportunistic
intestinal infections that tend to vary from one locality to
the other and from one country to the other depending
on the level of contamination of water, foodstuff, and
contact with animals, which are important factors in the
dissemination of the parasites.[30] The variation in the
prevalence of opportunistic intestinal protozoans in HIV
diarrheal patients could also be related to the immune
status of the HIV patients examined, the sensitivity of
the diagnostic techniques used and the experience of the
microscopist.[23]
H I V - s e r o n e g a t i v e s w e r e p r e d o m i n a n t l y
infected by common intestinal parasites
such as E. histolytica/E.dispar (8.7%) followed by
A. lumbricoides (3.3%) and A. duodenale (2.2%). Single (1.1%)
case of C. parvum was found in HIV noninfected diarrheal
patient, which is in agreement with studies conducted
by Ramakrishnan et al. and Mohandas et al. in India
where they found out C. parvum in 3.7% and 2% cases,
respectively.[5,18] Our study differed from the Gupta et al.
study in India, the Akinbo et al. study in Nigeria, and the
Alemu et al. study in Ethiopia where they did not fi nd
any opportunistic protozoans in control groups.[12,14,23]
The findings of Coccidia and Microsporidia among
HIV-infected patients indicate that opportunistic
parasites readily cause infection in immune-defi cient
individuals. In this present study, HIV-infected
710 North American Journal of Medical Sciences | December 2013 | Volume 5 | Issue 12 |
6. Dash, et al.: Intestinal protozoans in adults
Table 3: Age and sex wise distribution of HIV-infected diarrheal patients
Age groups in
years
patients with CD4+ T-cell count <200 cells/l are at an
increased risk of acquiring opportunistic infections,
which is similar to all previous studies.[5,12,14,15] Indeed,
an immune-defi cient state has been reported by other
authors as risk factor for opportunistic protozoan
infections.
Majority, that is, 67.7% of opportunistic intestinal
parasites were detected in males in comparison to
females (32.3%). This may be due to males utilizing more
integrated counseling and testing services. They usually
go undiagnosed for long periods and present late in the
course of disease with severe persistent infections and
low CD4+ T-cell counts.[14]
There were few limitations in this present study. The
study was done on a small sample size as majority of
the patients were referred from general practitioners
and from secondary care centers, therefore they have
already received some amount of antiparasitics and
antibiotics. Also the single stool specimen processing
might underestimate the actual parasite prevalence.
As the etiology of diarrhea could not be determined
in 53.9% of HIV-infected patients and 82.6% of HIV
noninfected patients, comprehensive etiological
studies are needed to cover bacterial, fungal, viral, and
noninfective causes of diarrhea among patients.
Conclusion
In conclusion, intestinal parasitic infections caused
diarrhea in 46.1% of HIV-infected individuals. The
opportunistic intestinal protozoans especially I. belli and
C. parvum were most commonly isolated in HIV-infected
patients with diarrhea. Majority of the infections
occurred in patients when CD4+ T-cell counts were less
than 200 cells/l.
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HIV: Human immunodefi ciency virus
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How to cite this article: Dash M, Padhi S, Panda P, Parida B. Intestinal
protozoans in adults with diarrhea. North Am J Med Sci 2013;5:707-12.
Source of Support: Nil. Confl ict of Interest: None declared.
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