ABSTRACT
Background: High levels of stress and psychological morbidity occur in health-care professional students. Objective: The objective of this study was to estimate psychological well-being, perceived stress level, and coping abilities among medical and paramedical students. Materials and Methods: A cross-sectional analytical study carried out in a tertiary care hospital, West Uttar Pradesh, India. The total study period was from September 2019 to November 2019 with a sample of 145 medical students aged 17–25 years and 81 paramedical students aged 19–33 years. Ethical clearance was obtained from the College Ethical Committee. We used self-administered, three different types of validated tools for data collection. Data were analyzed using SPSS Version 20. Results: The median age of paramedical and medical trainees was 22 and 21 years, respectively. Family history of mental illness was 21% and 5.5%, respectively. On general health questionnaire-12 scale, 9% of paramedical trainees reported evidence of distress and 91% of severe problem and psychological distress while 19% of medical trainees having evidence of distress and 81% of severe problem and psychological distress. On perceived stress scale-10 (PSS-10) scale, 15% of paramedical trainees reported average level, 27% moderate level, and 55% high level of perceived stress while 2% of medical trainees having average, 19% moderate level, and 79% high level of perceived stress, respectively. The difference in mean score on PSS-10 and Brief COPE scale between paramedics and medical trainees group was found statistically significant (P < 0.05). Conclusion: We concluded the higher level of severe problem and psychological distress in the paramedical and high level of perceived stress in medical trainees. Paramedical trainees practice a better coping mechanism than medical trainees.
ABSTRACT
Background: Unhealthy food handlers have been implicated in occurrence of various foodborne illnesses (FBIs). The benefits acquired by routine medical examination of food handlers are as a strong preventive tool in hands of public health experts in reducing the episodes of FBI. Medical examination of handlers is complementary toward the World Health Day theme of the WHO 2015 “food safety” and Swachh Bharat Abhiyan. Objective: The objective of this study was as follows: (i) To study the sociodemographic profile of the food handlers working in food establishment of tertiary care hospital and (ii) to estimate the parasite load among food handlers working in food establishments of a tertiary care hospital. Materials and Methods: It was a cross-sectional study carried over a period of 3 months. Sampling method employed was Simple Random Sampling. The total number of subjects was 86. The Institutional Ethics Committee approval was obtained. They were interviewed face to face using a semi-structured questionnaire and were assessed clinically for personal hygiene and head-to-toe examination. Stool examination was done for all using simple floatation technique. Results: Mean age of food handlers was 29 ± 2 years. Two-thirds (75%) of food handlers were educated <12th standard. Majority (61%) of them had up to 5 years of experience. The overall personal hygiene of subjects was good except for long hair. At the time of study, 59% had symptoms of infectious disease and had not reported. They had not received typhoid vaccination. The prevalence of Ascariasis, Giardia, and Taenia was 22.5%, 2.5%, and 2.5%, respectively. Conclusion: The overall health and personal hygiene of food handlers was good. However, the prevalence of enteropathogenic infections was high. Hence, periodic medical examination of food handlers should be taken seriously.
ABSTRACT
Background: Integrons are the main contributors to the development of multidrug resistance (MDR) among Gram‑negative bacilli. There is a lack of knowledge about the molecular relation between gene cassettes and antibiotic resistance in India. Objective: In this study, we have investigated the occurrence of Class II integron and their cassette array among Enterobacteriaceae. Materials and Methods: A total of 268 MDR non‑duplicate strains of Enterobacteriaceae were collected from Silchar Medical College and Hospital, Silchar, Assam, India, during June 2012 to May 2013. Polymerase chain reaction was performed for detection of the integrase genes and gene cassettes within the Class II integron which were further analysed by sequencing. Results: Class II integron was observed in 47 isolates. Four different gene cassette arrangements were detected: dfrA1‑sat2‑aadA1; dfrA1‑sat2‑aadA1‑orfX‑ybeA‑ybfA‑ybfB‑ybgA; dfrA12‑sat2‑aadA1; and dfrA1‑linF‑aadA1. The most prevalent cassette combination was dfrA1‑sat2‑aadA1. This study has also identified a set of gene cassette associated with linF gene instead of sat2 gene. Conclusion: Further investigation is required to determine the current situation and important reservoir of Class II integron for the transmission of drug resistance among Enterobacteriaceae and their contribution to antimicrobial resistance in hospital environment.
ABSTRACT
Background: Pseudomonas aeruginosa is one of the leading opportunistic pathogen and its ability to acquire resistance against series of antimicrobial agents confi ne treatment option for nosocomial infections. Increasing resistance to fl uroquinolone (FQ) agents has further worsened the scenario. The major mechanism of resistance to FQs includes mutation in FQs target genes in bacteria (DNA gyrase and/or topoisomerases) and overexpression of antibiotic effl ux pumps. Objective: We have investigated the role of effl ux pump mediated FQ resistance in nosocomial isolates of P. aeruginosa from a tertiary referral hospital in north eastern part of India. Materials and Methods: A total of 234 non-duplicate, consecutive clinical isolates of P. aeruginosa were obtained from a tertiary referral hospital of north-east India. An effl ux pump inhibitor (EPI), carbonyl cyanide m-chlorophenylhydrazone (CCCP) based method was used for determination of effl ux pump activity and multiplex polymerase chain reaction (PCR) was performed for molecular characterisation of effl ux pump. Minimum inhibitory concentration (MIC) reduction assay was also performed for all the isolates. Results and Conclusion: A total number of 56 (23%) have shown effl ux mediated FQ resistance. MexAB-OprM effl ux system was predominant type. This is the fi rst report of effl ux pump mediated FQ resistance from this part of the world and the continued emergence of these mutants with such high MIC range from this part of the world demands serious awareness, diagnostic intervention, and proper therapeutic option.
ABSTRACT
Purpose: The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The diagnosis of MDR-TB is of paramount importance in establishing appropriate clinical management and infection control measures. The aim of this study was to evaluate drug resistance and mutational patterns in clinical isolates MDR-TB by GenoType® MTBDRplus assay. Material and Methods: A total of 350 non-repeated sputum specimens were collected from highly suspected drug-resistant pulmonary tuberculosis (PTB) cases; which were processed by microscopy, culture, differentiation and first line drug susceptibility testing (DST) using BacT/ALERT 3D system. Results: Among a total of 125 mycobacterium tuberculosis complex (MTBC) strains, readable results were obtained from 120 (96%) strains by GenoType® MTBDRplus assay. Only 45 MDR-TB isolates were analysed for the performance, frequency and mutational patterns by GenoType® MTBDRplus assay. The sensitivity of the GenoType® MDRTBplus assay for detecting individual resistance to rifampicin (RIF), isoniazid (INH) and multidrug resistance was found to be 95.8%, 96.3% and 97.7%, respectively. Mutation in codon S531L of the rpoB gene and codon S315T1 of katG genes were dominated in MDR-TB strains, respectively (P < 0.05). Conclusions: The GenoType® MTBDRplus assay is highly sensitive with short turnaround times and a rapid test for the detection of the most common mutations conferring resistance in MDR-TB strains that can readily be included in a routine laboratory workflow.
ABSTRACT
Purpose: India has a high burden of drug-resistant tuberculosis (TB), although there is little data on multidrug-resistant tuberculosis (MDR-TB). Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years. Materials and Methods: This was a prospective study from July 2007 to December 2010. Microscopy, culture by Bactec460 and p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP) test was performed to isolate and identify Mycobacterium tuberculosis (M. tb) complex (MTBC). Drug sensitivity testing (DST) was performed by 1% proportional method (Bactec460) for four drugs: Rifampicin, isoniazid, ethambutol and streptomycin. Various clinical and demographical profiles were evaluated to analyse risk factors for development of drug resistance. Results: We found the overall prevalence rate of MDR-TB to be 38.8%, increasing from 36.4% in 2007 to 40.8% in 2010. we found that the prevalence of MDR-TB in new and previously treated cases was 29.1% and 43.3% ( P < 0.05; CI 95%). The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB ( P < 0.05; CI 95%). Conclusions: we found a high prevalence (38.8%) of MDR-TB both in new cases (29.1%) and previously treated cases (43.3%).This study strongly highlights the need to make strategies for testing, surveillance, monitoring and management of such drug-resistant cases.
ABSTRACT
Purpose: Extrapulmonary tuberculosis (EPTB) is emerging problem in developing and developed countries. The diagnosis of EPTB in its different clinical presentations remains a true challenge. IS6110-based polymerase chain reaction (PCR) is used for rapid identification and positivity rate of the Mycobacterium tuberculosis complex in clinical isolates of different sites of EPTB. The present study was carried out to study the prevalence of M. tuberculosis complex in clinical isolates of EPTB at tertiary care centres in Lucknow. Materials and Methods: Seven hundred fifty-six specimens were collected from the suspected cases of EPTB which were processed for Mycobacteria by Ziehl Neelson (ZN) staining and BACTEC culture. All the specimens were also processed for IS6110-based PCR amplification with primers targeting 123 bp fragment of insertion element IS6110 of the M. tuberculosis complex. Results: Of these 756 specimens, 71(9.3%) were positive for acid fast bacilli (AFB) by ZN staining, 227(30.1%) were positive for mycobacteria by BACTEC culture and IS6110 PCR were positive for M. tuberculosis complex in 165 (20.7%) isolates. We found a significant difference in sensitivities of different tests (P<0.05). Conclusions: This study reveals the positivity of M. tuberculosis complex in clinical isolates of EPTB case in tertiary care hospitals in Northern India. 72.7% of M. tuberculosis complex was confirmed by IS6110-PCR in culture isolates from different sites of EPTB. The high prevalence of the M. tuberculosis complex was seen in lymph node aspirate and synovial fluid. However, utility of PCR may play a potentially significant role in strengthening the diagnosis of EPTB especially targeting IS6110.