ABSTRACT
Health care institutions are generating large amount of Bio-Medical Waste (BMW), which needs to be properly segregated and treated. With this concern, a questionnaire based cross-sectional study was done to determine the current status of awareness and practices regarding BMW Management (BMWM) and areas of deficit amongst the HCWs in a tertiary care teaching hospital in New Delhi, India. The correct responses were graded as satisfactory (more than 80%), intermediate (50–80%) and unsatisfactory (less than 50%). Some major areas of deficit found were about knowledge regarding number of BMW categories (17%), mercury waste disposal (37.56%) and definition of BMW (47%).
ABSTRACT
Plasmodium falciparum infections are frequently fatal if untreated and hence need to be diagnosed and treated early. Malaria diagnosis, with conventional Giemsa staining as a gold standard, has had several limitations. New rapid and accurate methods are needed for diagnosis. In this study, polymerase chain reaction (PCR) analysis specific for diagnosis of P. falciparum was evaluated. For the study, blood samples were collected from 310 patients suspected of having malaria. PCR analysis for P. falciparum from venous blood and at the same time Giemsa staining of thick and thin blood smears was done. A total of 160 (51.6 %) samples were positive for malarial parasite of which 63 (39.4 %) were positive for P. falciparum by Giemsa staining while 61 (38.1 %) were positive for P. falciparum by PCR analysis. Giemsa staining was time consuming, laborious and may give poor results in cases with low parasitaemia. The PCR analysis for P. falciparum was able to detect 3 cases of low parasitaemia missed initially on Giemsa staining, was 96.8 % sensitive, 100% specific but was very costly, needed a lot of practice and standardization and was time consuming. PCR analysis can be used to supplement the conventional Giemsa staining for reliable diagnosis of falciparum malaria especially in cases with low parasitaemia.
Subject(s)
Animals , DNA, Protozoan/chemistry , Humans , India , Malaria, Falciparum/blood , Plasmodium falciparum/genetics , Polymerase Chain Reaction/economics , Sensitivity and SpecificityABSTRACT
Conventional Giemsa stained peripheral blood smear examination for demonstration of malarial parasites remains the gold standard for diagnosis of malaria in developing endemic countries. However this technique is time consuming, requires training and may give poor results in cases with low parasitaemia. To overcome these problems and improve diagnostic accuracy two newer tests have been studied and compared with standard Giemsa staining. These are the wet mount fluorescence microscopy of Acridine Orange stained thin blood films (A.O.) and the Quantitative Buffy Coat technique (Q.B.C) for diagnosis of malaria. A.O. staining was found to be 97.5% sensitive and 100% specific for detection of all stages and species of malarial parasite. The Q.B.C assay was found to be 100% sensitive and 97.5% specific for diagnosis of malaria. A.O. staining was very fast and the species identification was easy once the staining was optimised. The Q.B.C. test required considerable amount of practice, costly equipment, however it was fast and in our study was found to be highly sensitive.
Subject(s)
Acridine Orange/diagnosis , Azure Stains/diagnosis , Coloring Agents/diagnosis , Humans , India , Malaria, Falciparum/blood , Malaria, Vivax/bloodABSTRACT
BACKGROUND: The role of esophageal laboratory testing in predicting response to balloon dilatation in patients with achalasia cardia has been evaluated in the West; data in Indian patients are scant. AIM: To study the predictors of response to pneumatic balloon dilatation in Indian patients with achalasia cardia. METHODS: Twenty-five patients with achalasia cardia who had earlier undergone esophageal manometry before balloon dilatation (Group A) were recalled for clinical evaluation. Another consecutive 25 patients with newly diagnosed achalasia (Group B) underwent esophageal manometry and isotope transit studies before and after dilatation. RESULTS: The overall symptom response to dilatation in the 50 patients at median (range) follow up of 26 (1-60) months was 64%. Pre-dilatation clinical and laboratory parameters did not predict outcome. All patients with 1-week post-dilatation lower esophageal sphincter (LES) basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg were asymptomatic at follow up. CONCLUSION: Post-dilatation LES basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg are predictors of symptom response to balloon dilatation in patients with achalasia cardia.
Subject(s)
Adolescent , Adult , Aged , /methods , Child , Child, Preschool , Esophageal Achalasia/diagnosis , Esophagoscopy , Female , Follow-Up Studies , Humans , Male , Manometry , Middle Aged , Predictive Value of Tests , Probability , Recurrence , Treatment OutcomeABSTRACT
The present study reports results of modified Widal test carried out on 96 cases of acute malaria and 25 healthy controls. Out of the 96 patients studied, 30 had complicated P.falciparum (CPF), 36 had uncomplicated P.falciparum (UPF) and 30 had P.vivax (pv) malaria. Modified widal test was done to know the Widal titers due to Igm type of anti-salmonella antibodies, which is considered very specific for diagnosis of recent enteric fever. This test was positive in 14.58% and 10.41% of malaria patients for salmonella 'o' and 'H' titers respectively. On four weeks follow up most of the positive test become negative. Non-specific polyclonal B lymphocyte stimulation due to malaria was postulated to be responsible for this phenomenon.