Seroprevalence Of Syphilis And Co-Infections With Hepatitis B Virus, Hepatitis C Virus And Hiv In A Tertiary Care Hospital In Mumbai

Syphilis does not only affect the individual but is also a public health problem. It also increases risk of HIV infection and can cause lifelong morbidity among children born to infected mothers. High risk behaviour like multiple sex partners and unsafe injection practices not only increases chances of acquiring HIV but increase the risk for HBV and HCV transmission. This study was undertaken to study the seroprevalence of Syphilis and co-infection with HIV, HBVand HCVin a tertiary care hospital of Mumbai. Material and Methods: A total of 4160 blood samples received in the Regional STI Training, Research and Reference Laboratory, Department of Microbiology, Mumbai from patients attending the Suraksha clinic, referrals from high risk cases from peripheral hospitals, various STI clinics and ART patients were received from January to December 2016. Syphilis testing was performed using VDRL antigen from Institute of Serology, Kolkata. All the sera reactive in qualitative and quantitative VDRL test were confirmed for antitreponemal antibodies by TPHA test. Biological false positives (BFP) estimated Testing for HIV was done as per National guidelines. Hepatitis B surface Antigen and Hepatitis C virus antibody testing were done using ELISAmethods. Results: The seroprevalence of Syphilis in our study was 3% with BFP of 0.7 %. HIV, HBV and HCV seropositivity in the study was 6.63%, 3.36% and 1.73% respectively. The co-infection rate of HIV, HBV and HCV with Syphilis in the study was 0.21%, 0.16% and 0.07% respectively. Coinfection of HBVand HCVwith HIVwas 0.28% and 0.26% respectively. HBVand HCVco-infection was 0.04%. Conclusion: Public health interventions should be carried out to promote awareness of syphilis among physicians and populations at risk in India. The increased risk of acquiring HBV, HCVand HIVin STI clinic attendees warrants screening the high-risk population for these viral infections.

Prevalence of non A to E hepatitis in Mumbai, India / Prevalencia de la hepatitis no A /E en Mumbai, India

Introduction: Acute viral hepatitis is a common problem in India. World wide data shows that 5 to 20 percent of this is caused by non A-E hepatitis. There is no data in India regarding non A-E hepatitis. We carried out this study to evaluate the epidemiology, clinical features, risk factors and outcome of non A-E hepatitis. Material and methods: In this single centre study, we evaluated all patients admitted with features of acute viral hepatitis at our hospital between the period of February to July 2015. A detailed history about the epidemiology, risk factors and clinical features was done. Patients were evaluated with bilirubin, transaminases and prothrombin time. Each patient was investigated for IgM HAV, IgM HEV, HBsAg and Antibody against hepatitis C. Patients turning out negative were investigated for presence of autoimmune hepatitis or Wilson's disease. All viral markers were repeated a week later to confirm non A-E status. Results: A total 265 patients were included of which 41 (15.4%) patients were non A-E hepatitis. They had higher age (28.55 vs 34.99, p<0.05) but similar gender and sub urban location. Median SEC classification was A2 in hepatitis A/E group as compared to A3 in non A-E group. The duration of symptoms and clinical features between the two groups were similar with Anorexia, Malasie, Nausea/vomiting being most common. The risk factors between the two groups were similar. The bilirubin and transaminases were non significantly lower than hepatitis A/E patients while albumin levels were significantly lower. The outcomes of both groups were similar with no mortality or fulminant hepatitis. Conclusion: Non A-E hepatitis patients tends to be older, lower SEC class and had lower albumin levels as compared to hepatitis A/E

Introdución: La hepatitis viral aguda es un problema común en la India. Los datos mundiales indican que el 5 al 20% es causada por hepatitis no A-E. No hay datos en la India sobre hepatitis no A-E. Objetivo: Se realiza este estudio para evaluar la epidemiología, clínica, factores de riesgo y pronóstico de la hepatitis no A-E. Material y métodos: En este estudio de un solo centro evaluamos a todos los pacientes que se admitieron con clínica de hepatitis viral aguda en nuestro hospital en el periodo de febrero a julio del 2015. Se realizó una historia detallada para evaluar la epidemiología, características clínicas. Se les tomó bilirrubinas, transaminasas y tiempo de protrombina. A cada paciente se le realizó HAV IgM, HEV IgM, HbsAg y anticuerpo anti hepatitis C. Los que fueron negativos se les estudió para hepatitis autoinmune y enfermedad de Wilson. Todos los marcadores virales se repitieron a la semana para confirmar hepatitis no A-E. Resultados: Se incluyeron 256 pacientes, 41 de ellos (15,4%) fueron hepatitis no A-E. Tuvieron más edad (28,55 vs 34,99, p<0,05), pero el mismo género y ubicación urbana. La clasificación media SEC fue A2 en el grupo hepatitis A/E, comparada con 3 en el grupo de no A-E. La duración de los síntomas y el desarrollo clínico fue similar en ambos grupos, siendo la anorexia el malestar general, las náuseas y los vómitos los más frecuentes. El factor de riesgo fue similar, al igual que las transaminasas, mientras que la albúmina fue significativamente menor. El resultado fue similar sin caso alguno de hepatitis fulminante. Conclusión: Los pacientes con hepatitis no A-E tienden a ser mayores, de clase SEC más baja y con valores de albumina más bajos que los pacientes con hepatitis A-E

Subungual hyperkeratosis nail biopsy: A better diagnostic tool for onychomycosis.

Background: Onychomycosis is one of the most common nail disorders. Mycological examination by potassium hydroxide (KOH) mount and fungal culture is the most commonly used diagnostic method. However, it is associated with a low sensitivity. Aims: To evaluate the technique of subungual hyperkeratosis nail biopsy in diagnosing onychomycosis in HIV-infected and immunocompetent adults and compare it with mycological examination. Methods: 34 HIV-positive patients who presented clinically with onychomycosis were recruited in the study from the beginning. There was no screening done for patients with onychomycosis. This has been clarified in manuscript under the heading of methods. Results: All the fungal cultures yielded dermatophytes correlating with the biopsy findings. Only hyphal form of fungus was detected in KOH examination, indicating it was not a contaminant. Clinical types of onychomycosis are stated in discussion. Conclusions: PAS stain of subungual hyperkeratosis nail biopsy was the most sensitive in the diagnosis of onychomycosis in both HIV-infected and non-infected groups.

Salmonella brain abscess in an infant.

Brain abscess is an uncommon and serious life-threatening infection in children. Focal intracranial infections caused by Salmonella spp. in this age group are also rare. We report the case of a 4-month-old male infant with a frontoparietal brain abscess caused by Salmonella typhimurium, the presence of which was not suspected clinically.