Seroprevalence of transfusion transmissible infections in blood donors: a three year experience

Objective: To determine seroprevalence of transfusion transmissible infections [TTIs] in blood donors and to compare the present results with the data from studies conducted in past

Study Design: Descriptive study

Place and Duration of Study: Armed Forces Institute of Transfusion [AFIT], Rawalpindi from January 2010 to December 2012

Material and Methods: All the blood donors who had donated blood at AFIT during the three year study period were included. Prior to blood donation at the institute, all the donors were subjected to a preset, structured questionnaire to determine their eligibility for donation as per the criteria set by the institute. Donors7 serum samples were screened for hepatitis B virus [HBV], hepatitis C virus [HCV], human immunodeficiency virus [HIV] and syphilis by using HBsAg, anti-HCV, HIV antigen-antibody combination assay and syphilis antibody test, respectively. The repeatedly reactive samples were considered as true reactive

Results: A total 160552 blood donors were screened during the study period. The mean age of the donors was 29 ++/- 10.2 years [Range: 18 - 60 years]. Out of these, 158144 [98.5%] were male donors and 2408 [1.5%] were female donors. 7385 [4.6%] donors were volunteer and 153167 [95.4%] donors the replacement donors. The seroprevalence of TTIs in the donors for HBV, HCV, HIV and syphilis was 2385 [1.48%], 4194 [2.61%] 26 [0.02%] and 1520 [0.95%], respectively. The seroprevalence of HBV was higher and statistically significant [p value<0.05] in Gp-II [31-45 years] and the seroprevalence of both HCV and Syphilis was higher and statistically significant [p value <0.05] in both GP-II [31-45 years] and GP-III [46 years and above] when compared with overall seroprevalence of the respective infections in all age groups

Conclusion: This study highlights that the seroprevalence of HBV and HCV is decreasing in our blood donors, but still it is an important risk factor for spread of these infections. The seroprevalence of HIV is rising gradually in the blood donors

Seroprevalence of human T-Cell Lymphotropic Virus-1/2 in blood donors in Northern Pakistan: implications for blood donor screening

Objective: To determine the seroprevalence of Human T-cell Lymphotropic Virus-1/2 [HTLV-1/2] in blood donors in Northern Pakistan

Study Design: Descriptive study

Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi, from July to August 2013

Methodology: A total of 2100 blood donors were screened for anti-HTLV-1/2 antibodies during the study period, in a pool of six, on a highly sensitive, Chemiluminiscent Microparticle Immunoassay [CMIA] based system. The screening testreactive donors were recalled, counseled and interviewed, and a fresh sample was obtained for confirmatory testing. Confirmation was performed using additional immunoassays including Line Immunoassay [LIA]; with additional testing for HTLV-1 pvDNA PCR. Frequency and percentages were determined

Results: Four donors [0.19%] were repeatedly screening test-reactive and were subsequently confirmed to be HTLV-1 infected by line immunoassay and HTLV-1 pvDNA PCR. All four donors were male with mean age of 27 +/- 6.27 years. Two [50%] of the positive donors gave history of Multiple Sexual Partners [MSP]

Conclusion: HTLV-1 seroprevalence in Northern Pakistan blood donors was determined to be 0.19%. Large scale studies, including the cost effectiveness of screening blood donations for anti-HTLV-1/2 in Pakistan, are recommended

Antibiotic prescription habits of swedish dentists

Antibiotic prescriptions have been on the increase worldwide, leading to increased antibiotic resistance. Inappropriate use of antibiotics has been blamed on lack of education and continuing professional development, and also on patient demand even when they are not required. This study was carried out to find out the pattern of prescriptions by Swedish dentists using data provided by pharmaceutical industry. The data shows that although the number of prescriptions is on the increase in Sweden, dentists still prefer to use conventional antibiotics such as Penicillin Vfor the treatment of oral diseases

Antibiotic prescription habits of dentists in major cities of Pakistan

The aim of this study was to describe the antibiotic prescription habits and trends of dentists of major cities of Pakistan. It was a descriptive study of antibiotic usage by dentists of 7 major cities of Pakistan, using data given by Aventis Pharmaceutical Company, Karachi, Pakistan. The data comprise of the total prescriptions, city wise, gender wise, patient wise and specialty wise breakup of sales of antibiotics. The data constituted dental antibiotics prescriptions which were given in percentage and numbers for all the different cities. The study showed that the antibiotic prescription has increased over the years from 2000 to 2008. Multan 318 to 415 / 1800 showed the most number of prescriptions. Penicillin was the main group prescribed. Most antibiotics were given for pulpal/periapical disease [343000 in 2008] to the age group 11-40 years old [65-70%from 2000-2008], and in general dental practice clinics [65-68%]. Antibiotic prescription habits of dentists vary in different cities of Pakistan. There is a need to develop guidelines to improve knowledge and to prevent antibiotic resistance

Frequency of anti Hepatitis C Virus antibodies amongst sanitary workers in a tertiary care hospital in Pakistan

To determine the frequency of anti Hepatitis C Virus antibodies in sanitary workers at Military Hospital Rawalpindi and to identify additional risk factors in them for hepatitis C infection. Cross sectional study. Department of medicine Military Hospital [M.H.], Rawalpindi Pakistan over six months. All sanitary workers working at Military Hospital Rawalpindi were tested for anti HCV antibodies by third generation ELISA six percent of the study population was found to be positive for anti HCV antibodies. The frequency of anti HCV antibodies is fairly high in sanitary workers working in this tertiary care hospital studied. HCV infection is more frequent in those sanitary workers who have longer duration of service

Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab

To determine the availability and implementation of various hospital infection control measures at tertiary care hospitals. Survery. National Institute of Science and Technology, Islamabad, from June through August 2008. Seven tertiary care very busy hospitals were selected; one from Islamabad, 5 from Rawalpindi, and one from Lahore. A detailed proforma was designed addressing all the issues pertaining to hospital infection control measures. Air sampling was done and growth yielded was identified by standard methods. Analyses revealed that all of the hospitals had an Infection Control Committee. Microbiological diagnostic facilities were adequate at all the hospitals and overall microorganism yield was very high. Antibiotic policy was claimed by most, not available on ground. Majority of the operation theatres were without proper air flow system and autoclaves were not being regularly monitored. There was no proper disposal for sharps and needles. Incineration was not the usual mode for infectious waste. The results of the present study imply availability of proper hospital infection control policies with need of strict implementation of such measures

Rapid detection of methicillin resistant staphylococci from the nasal screening swabs by mannitol salt agar with cefoxitin and oxacillin disks

To assess the reliability of Manitol salt agar [MSA] for directly identifying Methicillin Resistant Staphylococcus aureus [MRSA] and Methicillin Resistant Coagulase negative Staphylococci, [MRCoNS] in nasal swabs for screening purposes using cefoxitin and oxacillin disks. Descriptive and Quasi-experimental. The study was done in the two surgical units of Combined Military Hospital, Rawalpindi and all the samples were processed at the Department of Microbiology, Armed forces Institute of Pathology, Rawalpindi during July 2007. A total of eighty four duplicate swabs were taken from the anterior nares of various staff members of the two surgical units and were directly inoculated on Mannitol salt agar with Cefoxitin disc 30 micro g [MSAFOX] and oxacillin disc 1 micro g [MSAOX]. All the samples were simultaneously inoculated on blood and MacConkey agar for conventional testing, using standard conditions, and confirmed as MRSA or MRCoNS by oxacillin disk diffusion technique. The staphylococcal isolates were later confirmed as MRSA/MRCoNS by polymerase chain reaction [PCR] for mec A gene analysis. There were 45 staphylococci which revealed mec A gene [40 MRCoNS and 5 MRSA] by PCR. Both the disks with MSA effectively identified the methicillin resistance. MSA with cefoxitin could identify 40 methicillin resistant staphylococci [35 MRCoNS and 5 MRSA] where as MSA with oxacillin could identify 39 methicillin resistant staphylococci [34 MRCoNS and 4 MRSA]. There was no significant difference between the two disks in sensitivity, specificity, positive and negative predictive values and overall efficacy of the procedures. MSA with cefoxitin 30 micro g and oxacillin 1 micro g appear to be highly accurate, easy to perform and beneficial for quick and reliable detection of methicillin resistant staphylococci from the nasal carriers in a routine microbiology laboratory

Anterior urethral valves: a rate cause of urethral obstruction in children

Anterior urethral valves are uncommon cause of urethral obstruction in children and diagnosis may be delayed due to rarity of condition. The symptoms mimic those of posterior urethral valves. We are reporting a four years old boy who presented with recurrent urinary tract infections, difficulty in micturition and dribbling of urine. Ultrasound showed bilateral hydronephrosis, hydrouerter and a large bladder with 100 ml of post voiding residual urine. Micturating cystourethrogram showed trabeculated bladder with dilated urethra to the navicular fossa. Cystoscopy revealed fibrous valves just proximal to the navicular fossa. Ablation of valves caused immediate relief of symptoms. Child remained symptoms free at six months follow-up

Seropositivity of hepatitis delta virus in patients with chronic Hepatitis B virus infection

To determine the frequency of hepatitis delta virus [HDV] seropositivity in patients with chronic Hepatitis B Virus [HBV] infection at Armed Forces Institute of Pathology [AFIP], Rawalpindi. Study design: Cross-sectional study. The study was conducted at department of Virology, AFIP, Rawalpindi. A total of 227 serum samples were collected at AFIP, Rawalpindi, from patients with chronic hepatitis B virus [HBV] infection along with a short history regarding the age, sex and socioeconomic status. Enzyme Linked Immundsorbent Assay [ELISA] for detection of HDV Immunoglobulin G [IgG] and Immunoglobulin M [IgM] antibodies was performed on all the collected serum samples. A total of 30 [13.2%] patients out of 227, were found positive for IgG. The mean age of the patients was 35.8 +/- 10.7 years. Seropositivity of HDV-IgG was 12.8% [25/195] in males and 15.6% [5/32] in females. 11.8% [6/51] of patients from higher socioeconomic group and 13.6% [24/176] in lower socioeconomic group were positive for HDV-IgG [p=0.728%]. Our study shows that 13.2% of chronic hepatitis B virus infected patients at AFIP, Rawalpindi, were positive for HDV IgG. HDV seropositivity was not affected by demographic variables-such as age, gender and socioeconomic status of patients

Hepatitis B viral load in various categories of chronic hepatitis B carriers

To determine serum hepatitis B virus [HBV] DNA levels by Real-time Polymerase chain reaction [PCR] in different categories of treatment-naive patients with chronic HBV infection in context with Hepatitis B serology and serum Alanine aminotransferase [ALT] levels. Cross-sectional study. A total of 122 chronic hepatitis B carriers, including 79 low grade carriers [Anti-HBe positive HBeAg negative], 40 high grade carriers [HBeAg positive, Anti-HBe negative] and 3 intermediate grade carriers [Both HBeAg and Anti-HBe negative] were evaluated for HBV DNA levels and serum ALT levels. The serum HBV DNA levels of the low grade carriers with normal ALT levels [<40 IU/L] were significantly lower than the low-grade carriers with raised ALT levels [mean viral load 3x10[3] vs. 1.6x10[6] copies/mL; p=0.0003]. The HBV DNA levels of the high grade carriers were significantly higher than those of the low grade carriers with normal ALT levels [mean viral load 6.4x10[7]vs. 3x10[3] copies/mL; p=0.0007] and than those of low grade carriers with raised ALT levels [mean viral load 6.4x10[7] vs. 1.6x10[6] copies/ mL; p=0.03]. The results show that HBV DNA levels vary in different categories of chronic hepatitis B carriers and when evaluated by a sensitive quantitative PCR assay the HBV DNA levels can be used for differentiation between HBeAg-negative chronic hepatitis B and inactive hepatitis B surface antigen carrier state

In vitro antifungal activity of Rhazya stricta

Rhazya stricta is a small glabrous shrub, widely distributed throughout Western Asia from Yemen to Arabia, to the North West Province of India and abundantly found in various regions of Pakistan.Larvicidal and antifungal studies of polar and non polar aerial parts extracts of Rhazya stricta were performed using brine shrimps larvae for larvicidal study and for antifungal study microorganisms, Trichophyton longifusis, Aspergillus flavus, Candida albicans, Microsporum canis and Fusarium solani were used respectively. The methanol fraction showed significant cytotoxicity with LC[50] 17.809 micro g/ml, having mortality rate 73.33% at highest dose. While pet-ether, chloroform and carbon tetrachloride possessed moderate to low cytotoxicity with their LC[50] values 49.077 micro g/ml, 95.859 micro g/ml and 80.489 micro g/ml respectively, ethyl acetate fraction showed no cytotoxicity .Results of antifungal studies showed that fractionated samples of methanol and chloroform possessed significant antifungal activities against, Trichophyton longifusis, Aspergillusflavus, Candida albicans and Fusarium solani respectively. Due to these promising results, further in vivo studies over R. stricta must be conducted