ABSTRACT
Background: The aim was to determine utility of Cartridge based nucleic acid amplification test (CBNAAT) in diagnosis of mycobacterium tuberculosis in children with neurotuberculosis diagnosed on the basis of clinical evaluation, CSF findings and neuroimaging.Methods: A prospective randomized controlled trial was conducted in Pediatric Department of RNT Medical College, Udaipur, Rajasthan, India from July 2017 to June 2018. Total 110 children of age group of 6 months to 18 years with the diagnosis of tubercular meningoencephalitis (TBME) on the basis of clinical evaluation, CSF examination and neuroimaging were included in the study.Results: A total 110 children were enrolled. Maximum number of cases admitted with TBME were among 1-5 years of age group (60.91%). CSF and gastric aspirate were examined by CBNAAT for MTB. 5 (4.55%) children had CBNAAT positivity in CSF. Gastric aspirate was positive among 16 (14.55%) children. None of the patient had CBNAAT positive result both in CSF and gastric aspirate.Conclusions: TBME is a major health problem in children below 5 years. Gene Xpert assay has the potential to significantly improve and escalate the diagnosis of smear-negative body fluid specimens. CBNAAT for mycobacterium tuberculosis was positive in 5 (4.55%) children from CSF and 16 (14.55%) from gastric aspirate. Negative CBNAAT should not prevent any patient with suspected features of TBME from starting anti tubercular treatment (ATT) as sensitivity of this test remains low. Final judgement to start ATT should be based on clinical, biochemical and radiological profile especially in CNS tuberculosis.
ABSTRACT
In the present study, performance of the trickle bed air biofilter (TBAB) for treating mono-chlorobenzene (MCB) was evaluated for various influent volatile organic compound (VOC) loadings using coal and mixed consortium of activated sludge as the packing material. Microbial acclimation to MCB was achieved by exposing the system continuously for 31 d to an average inlet MCB concentration of 0.688 g m-3 at an empty bed residence time (EBRT) of 188 s. The TBAB achieved maximum removal efficiency of 87% at an EBRT of 188 s for an inlet concentration of 0.681 g m-3, which is quite significance than the values reported in the literature. Elimination capacities of MCB increased with an increase of the influent VOC loading, but an opposite trend was observed for the removal efficiency. The maximum elimination capacity of the biofilter was 110.75 g m-3 hr -1 at an inlet MCB concentration of 1.47 g m-3. The effect of starvation on the TBAB was also studied. After starvation, the TBAB lost its ability to degrade MCB initially. However, the biofilter recovered very quickly. Evaluation of the concentration profile along the bed height indicated that the bottom section of TBAB has the best performance for all concentrations. By using Wani’s method of macrokinetic determination based on simple Monod kinetics, the maximum removal rate of MCB, rmax and saturation constant Km was to be found as 1.304 g m-3 s-1 and 113.446 g m-3, respectively.
ABSTRACT
A case of myxoma of mandible in a 23 years old female patient is described. The case was treated with enbloc resection and bone graft from iliac crest. No recurrence is reported after 4 years follow up.