ABSTRACT
GeneXpert is a novel, automated diagnostic test that can identify Mycobacterium tuberculosis (MTB) DNA and resistance to rifampicin (RIF) rapidly for Extrapulmonary tuberculosis (EPTB). Incidence of EPTB is increasing in low burden settings in comparison to pulmonary tuberculosis (PTB) & EPTB is relatively neglected. Aim: This study is aimed at knowing the incidence of EPTB and rifampicin sensitivity using an automated rapid detection method, GeneXpert. Methods: 271 EPTB positive patients were included in this retrospective study during a period from January to July 2018. Details regarding TB diagnosis, rifampicin sensitivity, nature of the sample and patient details including age, sex, occupation, address, habits, past history of TB, HIV status and other clinically relevant information was obtained from hospital and laboratory registers. Results: Out of 1290 tuberculosis positive patients, 1019 were of pulmonary tuberculosis (PTB) i.e., 78.9% and remaining 271 were of extrapulmonary tuberculosis (EPTB) i.e., 21.1%. 42.4% (115 out of 271) patients were in the age group of 31-40 years. Female predominance was observed in EPTB patients. Among 271 EPTB patients, 122 (45%) were diagnosed as pleural TB, 95 (35%) patients affected by tuberculosis at lymphnodes, 3(1.1%) had meningeal TB, 9(3.3%) EPTB cases were diagnosed from pus samples of various clinical conditions and remaining 42(15.4%) EPTB cases identified from various samples including tissues, genitourinary, synovial fluid, bones & joints. 247 (91.1%) out of 271 EPTB patients clinical samples showed rifampicin sensitive. 12 (9.8%) out of 122 pleural tuberculosis cases and 5 (5.2%) out of 95 TB lymphadenitis cases showed resistant rifampicin. Conclusion: TB can be diagnosed by various methods, among which GeneXpert is a rapid, reliable, easy to operate, automated system. GeneXpert helps physicians by providing rapid diagnosis within 90 minutes, in turn aid to initiate prompt treatment at the earliest.
ABSTRACT
To assess the pre-test level of quality of life (QOL) and blood glucose among the patients with type -2 diabetes mellitus and to compare and find out the effectiveness of Pranayama and selected yoga asanas on blood sugar and quality of life among patients with type-2 diabetes mellitus. The post-test values of blood sugar and QOL of patients with type-2 diabetes mellitus in experimental group had shown statistically significant improvement at P<0.001 level. It inferred that Pranayama and selected yoga asanas were effective in the management of type-2 diabetes mellitus. Hence, yoga asanas and Pranayama were effective complementary method to improve the health of the patients with type-2 diabetes mellitus.
ABSTRACT
Background: Extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-Kp) has recently become an important nosocomial pathogen. Intensive care units infections are predominant hospital acquired infections especially in tertiary health care. It is essential to know about ESBL prevalence in tertiary health care to take necessary actions by curbing resistant microorganisms. We aimed to study ESBL prevalence in Klebsiella species among respiratory samples from ICU patients. Methods: Respiratory samples collected from Intensive care unit patients, were processed under aseptic precautions. All Klebsiella isolates were subjected to routine antibiotic susceptibility testing by modified Kirby Bauer’s disc diffusion method and also for ESBL testing along with control. The results were interpreted as per CLSI (Clinical Laboratory Standards Institute) guidelines. Results: 153 (47.2%) Klebsiella species were isolated from 324 culture positive respiratory samples. Out of the 153 isolates which were screened for ESBL production, 90 (58.8%) isolates were found to be ESBL positive by CLSI disc diffusion. On performing confirmatory tests on the 90 isolates which were ESBL positive by screening tests, 84 (54.9%) were found to be ESBL producers on CLSI phenotypic confirmatory test (PCT) and 88 (57.5%) were found to be ESBL producers on Double Disc Synergy Test (DDST). Conclusion: Discussing with clinical microbiologist about antibiotic therapy helps clinicians to tackle with these resistant pathogens; also prevents transmission of resistant bugs and indirectly aid to increase life expectancy of patients.