ABSTRACT
Background: HIV infection / AIDS is a global pandemic with cases reported from every part of the globe. India currently harbours 20.89 Lakh of HIV infected patients. Opportunistic infections (OI’s) and cancers have been recognized as common complications of HIV infection. The present study has been taken up with an aim to know the incidence of various opportunistic infections in HIV positive patients attending our hospital for either medical / surgical treatment. Methods: One hundred patients who were known to be infected with HIV having pulmonary symptoms, who were clinically diagnosed to have lower respiratory tract infections are included in the study. Early morning sputum samples were obtained from the patients and are sent to the Department of Microbiology for isolation and identification of infectious agents. All the samples were processed as per standard guidelines for Bacterial, Mycobacterial and Fungal cultures. Results: All the sputum samples were subjected to bacteriological, Mycobacterial and fungal cultures. Most of the samples grew either monomicorbial or polymicrobial bacterial cultures associated with either Mycobacterial or fungal pathogens. Out of 100 samples, 32 were positive for single pathogenic organisms and 68 were positive for polymicrobial organisms. The bacterial flora isolated in the present study includes Staphylococcus aureus (32.38%) followed by Streptococcus pneumoniae (17.14%), Coagulase Negative Staphylococci (CONS) (15.23%), Streptococcus spp (12.38%), Klebsiella pneumoniae (8.57%), Pseudomonas aeruginosa (5.7%), Acinetobater spp (3.8%) and Escherichia coli (3.8%). Antibiotic sensitivity for all the bacterial isolates were performed where Linezolid was the most sensitive drug in case of Gram Positive Organisms and Imipenem in case of Gram Negative Organisms. Conclusion: Education, counseling and behavior modification are important issues which are the need of the hour and concerted effort from every organization and individual is requested to save us from the brink of this inevitable disastrous pandemic called AIDS, which will be undoubtedly the scourge of this century.
ABSTRACT
Background: Infections caused by Toxoplasma gondii, Rubella virus and Cytomegalovirus are major causes of Bad Obstetric History (BOH). Cause of BOH may be genetic, hormonal, abnormal maternal immune response, and maternal infection. Women affected with any of these diseases during pregnancy are at high risk for miscarriage, stillbirth, or for a child with serious birth defects and/or illness and also a hazard to attending staff nurses. Methods: A total 96 serum samples were collected from antenatal women with BOH attending the out-patient services of department of gynaecology at NRI general hospital, Chinakakani, Guntur district, Andhra Pradesh. Serum samples were obtained and were subjected to screening for Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies of Toxopalsma gondii, Rubella Virus and CMV infections by VIDAS (bioMerieux, France) and Nanoplex ToRCH Screen kit [Lilac Medicare (P) Ltd, Maharastra, India]. Results: Majority of cases with BOH were found in females aged 18-23 years (25, 52.08%) followed by 24-29 years (18, 37.5%). Congenital anomalies and other complications were found to be more in age group 18-23 years followed by 24-29 years. The disease prevalence as studied with respect to IgM antibodies was found to be 31.25% for Cytomegalovirus Infections, 23.96% for Toxoplasma gondii, 21.88% for Rubella virus infections. The overall agreement in the Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) between VIDAS and Nanoplex ToRCH Screen kit for the detection of specific IgM and IgG antibodies in our study was excellent with sensitivity ranging from 90.91%-96.00% and specificity ranging from 89.47%-95.59% for the detection of IgM& IgG antibodies. The discrepancies were relatively less with 8.3% for CMV IgM, 6.2% for CMV IgG, 5.20% for Rubella IgM, 6.25% for Rubella IgG, 6.25% for Toxo IgM and 5.20% for Toxo IgG. Conclusion: Nanoplex ToRCH Screen Kit is a cheap, cost effective, efficient and innovative alternate for the diagnosis of ToRCH infections. As the technology is new, it needs to be further explored bring out various multiplex kits for diagnosing other infectious diseases.
ABSTRACT
Background: Dengue is one of the most serious mosquito borne arboviral infections affecting tropical and subtropical countries in the world. Since there is no immune prophylactic or specific anti-viral therapy available, timely and rapid diagnosis plays a vital role in patients management and implementation of control measures. This work has been taken up 1. To study the incidence of dengue cases in our rural hospital, Chinakakani, South India. 2. To compare the performances of Pan Bio capture ELISA [PanBio], J Mitra Microlisa [J Mitra] and SD BIO dengue duo rapid test [SD RT]. Methods: A total of 1180 serum samples from clinically suspected dengue cases were collected over a period of seven months. All the samples were subjected to NS1 antigen and IgM antibody Pan Bio ELISA. The same were tested for J Mitra Microlisa and SDRT and were compared with Pan Bio. Measure of discrimination i.e. sensitivity and specificity was calculated for each observed test value and an receiver operating characteristic [ROC] curve was constructed to compare the area under curve‟s [AUC] of different test kits thereby identifying the test with the best discriminative value. Results: Out of 1180 samples tested, Pan Bio has shown an incidence rate of 284 [24.06%] (NS1 156+IgM 128), J Mitra 280 [23.72%] (NS1 156 + IgM 124) and SDRT 292 [24.74%] (NS1 156+IgM 136). As far as NS1 is concerned the same 156 samples were positive in all the three tests giving the sensitivity, specificity, positive and negative predictive values 100%. Remaining 1024 samples were negative for NS1. But this was not the case with IgM. AUC of IgM Pan Bio is 0.944 with sensitivity 90.32% and specificity 98.48%. AUC of IgM J Mitra is 0.932 with sensitivity 81.62% and specificity 98.75%. AUC of IgM SD RT is 0.992 with sensitivity 99.2% and specificity 99.1%. „Z‟ test revealed that there is statistically significant difference between AUC‟s of SD RT when compared to Pan Bio (p value: 0.05) and J Mitra (p value 0.0001) The p values explain that SD RT is superior to Pan Bio and J Mitra in classifying between diseased and non-diseased. Conclusion: High incidence rate was noticed in our region during monsoon and post-monsoon season which calls for timely preventive and control measures. SDRT is a valuable screening test in laboratories with minimal resources.