ABSTRACT
Background: Rapid point-of-care (POC) tests provide an economical alternative for rapid diagnosis and treatment of infl uenza, especially in public health emergency situations. Objectives: To test the performance of a rapid infl uenza diagnostic test, QuickVue (Quidel) as a POC test against a real-time polymerase chain reaction (RT-PCR) assay for detection of infl uenza A and B in a developing country setting. Study Design: In a prospective observational design, 600 patients with infl uenza-like illness (ILI) or with severe acute respiratory illness (SARI) who were referred to the Infl uenza Clinic of a tertiary care hospital in Srinagar, India from September 2012 to April 2013, were enrolled for diagnostic testing for infl uenza using QuickVue or RT-PCR. All infl uenza A-positive patients by RT-PCR were further subtyped using primers and probes for A/H1pdm09 and A/H3. Results: Of the 600 patients, 186 tested positive for infl uenza A or B by RT-PCR (90 A/ H1N1pdm09, 7 A/H3 and 89 infl uenza B), whereas only 43 tested positive for infl uenza (infl uenza A = 22 and infl uenza B = 21) by QuickVue. Thus, the sensitivity of the QuickVue was only 23% (95% confi dence interval, CI: 17.3-29.8) and specifi city was 100% (95% CI: 99.1-100) with a positive predictive value (PPV) of 100% (95% CI 91.8-100) and a negative predictive value (NPV) of 74.3% (95% CI: 70.5-77.9) as compared to RT-PCR. Conclusions: The high specifi city of QuickVue suggest that this POC test can be a useful tool for patient management or triaging during a public health crisis but a low sensitivity suggests that a negative test result need to be further tested using RT-PCR.
ABSTRACT
Out of 210 faecal samples collected from children below 5 years attending different hospitals in Jammu and exhibiting clinical signs of diarrhoea, 41.9% samples were found positive for group A rotavirus by RNA-PAGE. Escherichia coli isolated in the study belonged to nine serogroups, out of which O69 was most frequent, being present in 12.38% samples. E. coli serogroups well recognised as enteropathogens viz. O69, O20 and O153 were present in 27.6% samples. Other bacterial pathogens associated with diarrhoea were present in 8.09% samples, out of which Shigella spp. was found in 4.76% samples followed by Salmonella spp. (2.38%) and Pseudomonas spp. (0.95%).
ABSTRACT
Three hundred and seventy four random patients admitted to the postoperative intensive care unit (lCU) underwent postoperative clinical positioning of endotracheal tube(ET), nasogastric tube, central venous catheter and laboratory arterial blood gas (ABG) assessment. Chest roentgenography was done for all the admitted patients and the findings reviewed. Thirteen (3.47%) patients required intervention because of abnormalities detected on chest roentgenography. None of the pathologic conditions detected was life threatening. Chest roentgenography on admission to the cardiovascular ICU should be done only if the surgery has been performed for cardiac trauma, re-exploration, and also if clinical and laboratory assessment indicate the possibility of underlying pathologic conditions that can only be confirmed by chest roentgenography.
ABSTRACT
Eight two patients operated for congenital cardio vascular disease are presented. All were selected to be managed without chest tube drainage after thoracotomy. However. in 1.4( 17.07%) patients chest tube drainage was necessitated at operation and of the 68(82.93%) patients. 4(5.88%) underwent an uneventful post operative chest tube insertion. Except on two occasions all the patients had uneventful post operative period. To reduce complications post operative hospital stay and unnecessary forgin body in chest we have employed a seleclive use of chest lubes for some common congenital cardiovascular disorders.
ABSTRACT
The main objectives of the study were to find the incidence and risk factors associated with development of hypoglycemia in small for gestational age (SGA) babies, to compare haemoglucotest strips (Boehringer Mannheim) with the standard laboratory method (glucose-hexokinase) for estimation of blood glucose, and to measure the insulin and cortisol responses of SGA babies. This was a prospective longitudinal study. The sample included SGA babies and over a period of six months, 127 consecutively born small for gestational age babies were investigated prospectively for development of hypoglycemia in first 48 hrs of life. Plasma samples were taken during episodes of hypoglycemia for insulin and cortisol estimation and compared with non-hypoglycemic controls. The overall incidence of hypoglycemia was 25.2% in SGA babies and 98% of the episodes occurred within first 24 hrs. Compared to non-hypoglycemics, mothers of hypoglycemic babies had higher incidence of receiving i.v. fluids (5% dextrose) during labour. The hypoglycemic babies were more likely to be sick and oral feeds had been initiated by one hour of life in only 37% of them compared to 63% of non-hypoglycemic babies. Plasma insulin/glucose ratio was significantly higher in hypoglycemic than non-hypoglycemic babies, whereas the cortisol levels were similar. Small for gestational age babies are highly prone to develop hypoglycemia in first 24 hrs of life.