Prevalence of Candiduria in Infants from a Tertiary Care Hospital.

Yeast related urinary tract infections are rare in healthy newborns. Study was conducted in the department of microbiology in a tertiary care hospital, New Delhi from June 2012 to June 2013. Only infants were included in the study. A total of three hundred and thirty three urine samples were received for fungal culture and microscopy. The isolation rate of Candida species amongst the 333 samples was found to be 21.62%. Amongst 333 samples received 37 (11.11%) were positive for Candida albicans while 35 (10.51%) were positive for non albicans Candida species. So, in this study among 72 isolates of Candida, Candida albicans was found in 51.39% while non-albicans Candida species was found to be in 48.61% of the Candida isloates. It is important that the specific species responsible for symptomatic infection is identified, given the differences in antimicrobial susceptibility among Candida species.

The Potential Role of Infections in Attention- Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder ADHD is a behavioral disorder which mostly affects children in the age group of six to eleven years. The disorder affects boys more than girls. Although difficult to assess in infancy and toddlerhood, signs of ADHD may begin to appear as early as age of two or three, but the symptom picture changes as adolescence approaches. Many symptoms, particularly hyperactivity, diminish in early adulthood. However, impulsivity and inattention problems remain with upto 50% of ADHD individuals through their adult life. Recently there have been studies on correlation between ADHD and bacterial and viral infections in brain. This review focuses on possible role of various viruses and certain bacterias in development of ADHD in children.

Multicenter evaluation of individual donor nucleic acid testing (NAT) for simultaneous detection of human immunodeficiency virus -1 & hepatitis B & C viruses in Indian blood donors.

BACKGROUND & OBJECTIVE: India has a high prevalence of HIV-1, hapatitis C and B virus (HCV and HBV) in the blood donors but has yet to implement nucleic acid testing (NAT) in blood screening. We undertook a multicentre evaluation of blood donor testing by NAT for simultaneous detection of HIV-1, HBV and HCV in a single tube and also to determine the feasibility of NAT implementation in India's low volume setting. METHODS: A total of 12,224 unlinked samples along with their serological results were obtained from representative eight blood banks in India and were individually manually tested by the Procleix Ultrio Assay (Chiron Corp. Emeryville, CA) for simultaneous detection of HIV-1, HCV, and HBV. RESULTS: Of the 12,224 samples tested, 209 (1.71%) were seroreactive. One hundred thirty three samples (1.09%) were reactive by Ultrio assay, 84 samples were seroreactive but NAT non reactive. There were eight NAT yield cases: 1 HIV, 1 HIV-HCV co-infection, and 6 HBV. INTERPRETATION & CONCLUSION: Our observed NAT yield for all three viruses was 1 in 1528 (0.065%). We estimate NAT could interdict 3272 infectious donations a year among our approximate 5 million annual donations.

Identification of amastigote-specific antigens of Leishmania donovani using kala-azar patient sera.

Antigenic characterization of the soluble fraction of axenic amastigotes of Leishmania donovani ( strain Dd8, causative agent of Indian kala-azar) and their comparison with promastigotes is reported. The axenic amastigotes were assessed for their immunological status employing anti-A2 monoclonal antibody which is extremely specific for L. donovani amastigotes. SDS-PAGE of 35[S] methionine labeled proteins of the two parasite stages exhibited few stage specific and some conserved antigens in both the stages. An increased synthesis of heat shock proteins was observed in axenic amastigotes. Western blot experiments employing sera of kala azar positive patients identified immunodominent antigens of 116,83,26 and 12 kDa in axenic amastigotes which were not present in promastigotes. These amastigote stage specific antigens may have immense potential in immunodiagnosis and prophylaxis of kala-azar.

Aerodigestive foreign bodies.

Accidents with foreign bodies (FBs) are most common within the first two years of life. The airway FBs present a diagnostic dilemma as both the history and the investigations can be misleading. The persistent hypoxia presents a threat to life as does extraction. Moreover, the chemical pneumonitis induced by vegetative FB makes the situation even more worse. The FB of digestive tract are comparatively benign unless long standing. It is neither necessary for the airway FB to present with respiratory symptoms and signs nor for the FB of digestive tract to complain of dysphagia/throat pain. Oesophagoscopy may have to be done if an esophageal FB is causing only recurrent respiratory infections without dysphagia. The situation in dealing with FB varies from site to site in the aerodigestive tract. This article stresses the various dubious factors including the history, examination and investigation which can lead to misdiagnosis and also those problems which are encountered during planned extraction as well as post-operatively.

Aural foreign bodies.

At KGMC Lucknow, 168 pediatric cases with aural foreign bodies (FB) were reviewed. Most of the FB were self-inflicted and seen in children under 5 years of age (69.64%), within 24 hours (91.66%) of impaction. 86.30% of FB were seen to impact in external auditory canal (EAC) and their nature revealed predominance of nonvegetative inanimate FBs (43.45%). The TM perforation was encountered in only 6.54% of cases. If the FB is a living insect, it should be drowned before being manipulated. Syringing is the method of choice for a nonimpacted relatively small FB, even if it is vegetative. It is to be avoided in the 'potential' cases of external otitis or in cases with severely impacted wax. For a tightly wedged smooth rounded FB the hook and forceps are preferred in superficially and deep lying FBs respectively. A dissociate anaesthesia (ketamine) appears to be a better choice than general anaesthesia. An end-aural incision should be preferred over post-aural one and canalplasty for access of FB should be carried out wherever necessary. The presence of otorrhoea in cases of penetrating FB or aural myasis should be dealt on the lines of otitis media after removing the FB concerned.

'NESTROFT'--an effective screening test for beta thalassemia trait.

OBJECTIVE: To evaluate the efficacy of NESTROFT (Naked Eye Single Tube Red Cell Osmotic Fragility Test) as a screening tool for detection of beta thalassemia trait. DESIGN: Prospective study. SETTING: Field camps in various parts of Gujarat and Maharashtra States. METHODS: A total of 2525 subjects were screened. NESTROFT, complete hemogram including red cell indices and calculation of Mentzer's Fraction (MF) and discriminant functions (DF1-4) were done in all subjects. HbA2 was performed in 830 initial subjects to compute sensitivity, specificity and predictive values for various parameters. RESULTS: NESTROFT (sensitivity 94.4%), as a single screening parameter was superior to any of the other evaluated parameters individually, besides being cost effective. Mean corpuscular volume (MCV) < 80 fl followed NESTROFT closely (sensitivity 93.7; p > 0.05). MCV < 75 fl had a significantly (p < 0.001) lower sensitivity (87.3%) in comparison to both of these parameters. In contrast, MF, DF1, DF2, DF3 and DF4 did not meet the requirements of a good screening test with sensitivity values of 66.2%, 54.9%, 47.2%, 64.1% and 55.6%, respectively. NESTROFT in combination with MCV < 80 fl proved 100% sensitive. However, the combination was not cost effective. CONCLUSION: NESTROFT is a sensitive, cost effective, rapid and reliable screening test for detection of beta thalassemia trait in a population.