Comparison of diagnostic accuracy of bactec culture, gene-xpert and histopathology in the diagnosis of genital tuberculosis in women with infertility

Background: Female genital tuberculosis (FGTB) is often a silent disease sparing no age group but majority of patients are in the reproductive age. In infertility patient’s incidence of FGTB varies from 3-16% in India but the actual incidence of genital tuberculosis may be under reported due to asymptomatic presentation and paucity of investigations.Methods: Prospective case control study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut. A total 100 Endometrial samples were collected during diagnostic laparoscopy from all suspected case of genital TB, presented with either primary or secondary infertility and samples sent for histopathology, Gene-xpert and Bactec culture.Results: Out of 100 samples Bactec culture was positive in 2 samples, Gene-xpert positive in 3 samples. On histopathology out of 100 cases, non-specific endometritis was found in 1 case, tubercular-endometritis in 1 case, proliferative enometrium (anovulatory) in 40 cases and secretory endometrium found in 58 cases.Conclusions: Female genital TB poses a diagnostic dilemma because of its varied presentation and lack of sensitive and specific method of diagnosis. Culture though remains the gold standard of diagnosis of female genital TB, gene-xpert, histopathology, Bactec culture or laparoscopy can be used for starting treatment. Endometrial biopsy on histopathology shows not only Tubercular endometritis but also gives hormone response on endometrium, local factors of endometrium concerning non-specific and specific infections and anovulatory cycles.

Assessment of nutritional status of school going adolescent girls in a rural block of Haryana, India

Background: Good nutrition during adolescence is critical to cover the deficits suffered during childhood and should include nutrients required to meet the demands of physical and cognitive growth and development, provide adequate stores of energy for illnesses and pregnancy and prevent adult onset of nutrition-related diseases. Poorly nourished adolescent mothers are more likely to give birth to low birth weight babies, perpetuating a cycle of health problems which pass from one generation to the next. Therefore, this study was aimed to assess the nutritional status of school going adolescent girls of Agroha block of Haryana.Methods: Study area was two senior secondary and two high schools (randomly selected) of Agroha block of district Hisar (Haryana). Study design was school based cross-sectional study. Study participants were three hundred and forty-four adolescent girls studying in class 9th, 10th, 11th and 12th. Study tool was pre-designed and pre-tested questionnaire. Percentages and Chi- Square. Statistical Package for Social Sciences (SPSS) software version 20.0 was used.Results: Out of total girls, 8.72% were found to be thin followed by severely thin (0.58%). Thirteen (3.78%) girls were found to be overweight followed by obese (0.58%).Conclusions: Nutritional status of adolescent girls was found to be satisfactory.

A Retrospective Study to Estimate the Prevalence of Anemia and Associated Factors among First Year MBBS Students of Maharaja Agrasen Medical College, Agroha, Hisar.

Introduction: Anemia is a most common public healthproblem affecting around 1.9 billion population of the world.It is a severe public health problem in India. Medical studentsare vulnerable to develop anemia due to irregular eatinghabits due to hectic study schedule. Anemia among this agegroup has significant health consequences resulting in poorcognition, decreased attention span and memory affectingthe performance, depressed immunity, repeated infections,increased fatigue, and shortness of breath, dizziness, blurredvision, low endurance and irregular menstruation.Material and Methods: This study is conducted among 100students of both gender taking admission in MBBS first yearat MAMC, Agroha. Hemoglobin values and other relevantdetails of the students were taken from academic sectionsubmitted at time of admission. World Health Organizationcriteria were taken to determine the severity of anemia.Modified B.G. Prasad scale was used to assess the socioeconomic status of the family. Data was first entered into MSexcel sheet and then was exported to SPSS version 20.0 forappropriate analysis.Results: Prevalence of anemia came out to be 54% amongstudy subjects. Difference between the mean levels ofhemoglobin across the genders came out be statisticallysignificant (P=<0.001).Conclusion: Prevalence of anemia is high among the studysubjects with more prevalence among females study subjects.There is a need to accelerate efforts for achieving control ofanemia by strengthening multi-sectoral partnership involvinggovernment departments, academic institutions, bilateralagencies and food industry.

Thyroid Stimulatory Hormone (tsh) Reference Ranges In The Normal Pregnant Women Of Lucknow

Maternal hypothyroidism is known to be associated with adverse perinatal outcomes. This study was done to evaluate the normal reference range of TSH in pregnant women. 483 pregnant women on their first visit to Obstetrics OPD in Era's Lucknow Medical College and hospital were tested for TSH and TPO antibody using ELISA method. 25 out of 483 were positive for TPO Antibody. Of the remaining 458 patients, 142 were in first trimester, 222 were in second trimester and 94 were in third trimester. The TSH values ranged from 0.043 mIU/L to 10.1 mIU/L (mean = 2.34 mIU/L). The reference range of TSH values in all the trimesters are, 0.35 to 5.82(1st trimester), 0.28 to 5.82(2nd trimester) and 0.11 to 6.8(3rd trimester). The reference range of TSH values among the normal pregnant women of Lucknow and its surrounding areas were found to be higher than those recommended by the test kit

Fabrication and Characterization of chitosan based polymeric Escitalopram nanoparticles.

Objective: Escitalopram (ETP), an SSRI (selective serotonin reuptake inhibitor), and s-enantiomer of citalopram is exclusively used as an antidepressant. The drug shows extensive hepatic metabolism, reduced drug efficacy and potential side effects, which reduces its therapeutic index. The present study is focused on developing and characterizing chitosan based nanoparticles of Escitalopram oxalate (ETP). Materials and Methods: The nanoparticles were prepared by ionic gelation method using chitosan and tripolyphosphate (TPP). The formulated nanoparticles were optimized and further characterized by various techniques like particle size, zeta potential analysis, TEM, SEM, EDX, rheological parameters and FT-IR techniques. Also, in vitro drug diffusion was studied to evaluate its pattern of drug release. Result and Discussion: The optimized ETP loaded nanoparticles were made with chitosan: tripolyphosphate (1:1.5) ratio, showing particle size range of 60 – 115nm, with polydispersity index of 0.117, which was further confirmed by TEM analysis whereas; zeta potential was estimated to be -1.89mV. The SEM EDX scans showed almost smooth morphology of the same. The FT – IR results confirmed that there is no interaction between the polymers and drug molecules. The in vitro drug release study using dialysis membrane showed sustained drug release pattern of ETP nanoparticles. Conclusion: ETP loaded chitosan nanoparticles were prepared successfully from ionic gelation method, suggesting a comparatively suitable option for treatment of disease with fewer side effects and increased affinity of drug.

Helicobacter pylori-induced apoptosis in pathogenesis of gastric carcinoma.

BACKGROUND: Despite a possible role of Helicobacter pylori in gastric carcinoma (GC), its pathogenesis is not clear. There is scanty data on apoptosis in GC in relation to H. pylori and CagA antibody. Therefore, we studied gastric epithelial apoptosis in GC and non-ulcer dyspepsia (NUD) with or without H. pylori infection, and the degree of apoptosis in relation to CagA antibody status. METHODS: 20 patients each with GC and NUD were investigated for H. pylori using rapid urease test (RUT), IgG anti-H. pylori and anti-CagA antibodies, histology of endoscopically normal-looking mucosa for H. pylori, intestinal metaplasia (IM), and apoptosis using TUNEL assay. Positivity to one tissue-based (RUT or histology) and one serology based (anti-H. pylori or CagA IgG) test was taken as diagnostic of active H. pylori infection, and negative result in both tissue-based tests suggested its absence. RESULTS: Patients with GC more often had anti-H. pylori IgG (16 of 20 vs. 8 of 20; p=0.02) and a trend towards higher apoptotic index (AI) (48.6 [19.2 to 71.7] vs. 41.4 [11.7 to 63.6]; p=0.06) than NUD. AI was higher in GC (66.7 [57.5 to 71.7] vs. 32.6 [19.2 to 39.8]; p<0.0001) and NUD (58.6 [50.7 to 63.6] vs. 24.4 [11.7 to 32.2]; p<0.0001) infected with H. pylori than in those without infection. AI was also higher in GC than in NUD with H. pylori infection (66.7 [57.5 to 71.7] vs. 58.6 [50.7 to 63.6]; p=0.01). Four of the 20 patients with GC and none with NUD had IM (p=ns). There was no difference in AI in relation to CagA antibody. AI positively correlated with patients' age in presence of H. pylori infection (correlation coefficient=0.5, p=0.03) but not in its absence. CONCLUSION: Exaggerated apoptosis may play a role in H. pylori-mediated gastric diseases including carcinogenesis. AI increases with aging in patients infected with H. pylori.

Candidaemia in patients of a tertiary health care hospital from north India.

BACKGROUND & OBJECTIVES: Candidaemia is an important cause of mortality in hospital settings. Limited information is available from India on nosocomial candidaemia. The objective of the present study was to isolate and identify yeasts from patients suspected to have nosocomial bloodstream infection (BSI) and to determine the carriage rate of Candida species, risk factors for acquisition of infection and mortality in this group of patients. METHODS: Blood samples from 4871 patients suspected to have BSI at least 48 h after admission were cultured following standard protocol to isolate and identify the pathogens. Clinical details, possible risk factors and outcome of all candidaemic patients were recorded and analysed. Samples of hand washings and throat gargles from these patients were also cultured to determine the carriage rate. Candida albicans isolated from patients and their carriage sites were genotyped by randomly amplified polymorphic DNA (RAPD) analysis to study strain relatedness. RESULTS: Twenty one patients with candidaemia were detected with mortality of 55 per cent. Candidaemia per 1000 admissions was 1.61. Isolation of non-C. albicans Candida species was significantly higher than C. albicans (14/21 vs 7/21: P < 0.05). Use of broad-spectrum antibiotics (43%), gastrointestinal surgery (23%), immunosuppressive therapy (23%), protein calorie malnutrition with parenteral hyperalimentation (23%) and neutropaenia (14%) were identified as probable risk factors. The seven C. albicans strains isolated from patients with BSI were typed into 6 genotypes. Yeast carriage rate among the patients was 71.4 per cent. C. albicans isolated from the hand, throat and blood of two patients had identical genotype. INTERPRETATION & CONCLUSION: BSI due to non-C. albicans Candida species is more common than C. albicans in our patients and candidaemia is associated with high mortality. RAPD appears to be a simple method to study strain relatedness for C. albicans. There is a need for early diagnosis and systematic surveillance to meet the challenges of nosocomial candidaemia.