A simple, cost-effective quality assurance model for measurement of lipids in a large epidemiological study.

Background. Laboratory measurements are an integral part of epidemiological studies in cardiovascular disease. Standardization and quality assurance is of utmost importance in the context of multicentre studies. Methods. We evaluated a simple and cost-effective method of quality assurance for measurement of total cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides in a study involving 10 centres. Three methods for quality assessment were used for the study that involved measurement of cholesterol, triglycerides and HDL cholesterol and included internal quality control, external quality control and 10% repeat analysis in addition to a uniform standardized protocol developed for the 10 centres. External quality control material was prepared and circulated by the coordinating laboratory. Results. External quality control material was distributed 20 times during the study. The mean variance index suggested a substantial improvement in the performance of participating laboratories over a period of time for cholesterol and triglycerides. This was also evident in the improvement in per cent technical error as a measure of bias and a higher correlation between replicates of samples analysed in the coordinating laboratory and the participating centres for cholesterol, triglycerides and HDL cholesterol. Conclusion. A cost-effective quality assurance model for laboratory measurement using local capacities was developed and implemented in a multicentre epidemiology study. Such a programme would be useful for developing countries where cost-cutting is important.

Ochrobactrum anthropi septicaemia.

Ochrobactrum anthropi is an emerging opportunist pathogen in immunocompromised patients. We report a case of septicaemia due to O. anthropi in an elderly male patient with coronary artery disease with severe left ventricular dysfunction admitted in the Intensive coronary care unit. Following intraaortic balloon pump (IABP) insertion, the patient developed a haematoma at the local site, which led to septicaemia. In spite of intensive treatment, the condition of the patient continued to deteriorate and he died on the seventh day. This infection with the microbiological characteristics useful for identification of the organism is described.

HIV seropositivity among patients with sexually transmitted diseases.

2013 patients with various sexually transmitted diseases were screened for HIV antibodies in voluntary counseling and testing centre (VCTC) attached to Microbiology Lab of Govt. Medical College, Amritsar from Jan. 1998 to Dec. 2001. Sixty-one (3.03%) were found to be positive for HIV. 44 were males and 17 were females. There was a constant rise in the percentage positivity in females from 14.3% in 1998 to 38.09% in 2002. There was also rise in the prevalence of HIV among the STD attenders (1.65% in 1998 to 5.13% in 2001).

Comparative evaluation of conventional methods and elisa based IgG antibodies detection for diagnosis of helicobacter pylori infection in cases of dyspepsia.

Seventy five gastric biopsy specimens and 75 serum samples of same patients complaining of dyspepsia were collected. Biopsy specimens were processed for rapid urease test, gram staining and culture. Serum samples were used for detecting IgG antibodies against 128kDa external protein (Cog A) of H.pylori using a commercially available ELISA kit. Rapid urease test was positive in 54 (72%), culture in 21 (28%) and gram staining in 15 (20%). Significant IgG levels were detected in 57 (76%) cases. It was therefore concluded that for diagnosis of H.pylori infection in cases of dyspepsia, determination of IgG levels can act as an important screening procedure.

Cryptococcal meningitis in aids patients - A report of two cases.

A fiftyfive year old gentleman with HIV infection was investigated for meningitis.Cryptococcus neoformans was isolated.Second case was a lady of 42 years, with HIV infection, was also investigated for meningitis. Cryptococcus neoformans was isolated. Antigen was detected in CSF as well as serum in both the cases.

Correlation of beta-lactamase production/methicillin resistance and phage pattern of Staphylococcus aureus.

Multiple drug resistance is exhibited by coagulase positive staphylococcus aureus isolated from hospitals. Prevalence of MRSA due to prolonged stay in the hospital, instrumentation/invasive procedure, surgical intervention and misuse of antibiotics have been reported. Antibiogram of 200 coagulase staphylococci showed 10% MRSA strains. Predominant phage type 81 belonged to unclassified group followed by phage type 84 belonged to group 3. As the management of MRSA is not easy, efforts should be made to eradicate the MRSA by taking strict aseptic conditions and the severe infections should be treated according to the sensitivity pattern of the strain.

Bacteriology of bronchial secretions in non-tubercular lower respiratory tract infections.

Fifty samples of bronchial secretions collected from patients of non-tubercular lower respiratory tract infections through fiberoptic bronchoscopy (FOB) were cultured both for aerobic and anaerobic organisms. Thirty-three (66%) samples yielded bacteria. Out of these, thirty were isolated in pure culture and from three, a mixed growth of aerobic and anaerobic micro-organisms was obtained. Aerobic bacteria were the predominant isolates. Stephylococcus aureus (10), pseudomonas (9) and streptococcus pneumoniae (8) were the major aerobic isolates. Ciprofloxacin was found to be the most effective drug against aerobes and metronidazole against anaerobes in vitro susceptibility tests.

Predominant phage types of coagulase positive staphylococci in hospital infections.

360 strains of Staphylococcus aureus isolated from various clinical specimens were subjected to bacteriophage typing. 247(68.6%) strains were typable. Among the typable strains 75(20.83%) belonged to phage group I, 45(12.5%) belonged to phage group III, 6(1.67%) belonged to phage group II and 14(3.89%) strains belonged to miscellaneous group. By far, the largest was the mixed group having 107(29.72%) strains. 113 strains (31.4%) were untypable. All the strains were tested for antibiotic sensitivity test. 287 (79.7%) were multiple drug resistant strains.

Microbial profile of pelvic inflammatory disease.

A total of 100 cases were studied. Fallopian tubes removed at operation constituted a very good material to study the infections of upper genital tract. Along with fallopian tubes, HVS from same patients were cultured both for aerobic and anaerobic organisms. Bacteriological analysis of 100 cases of fallopian tubes and same number of HVS showed bacterial growth in 30 cases (30%) whereas in HVS samples growth was obtained in 50 cases (50%). In 66.67% of cases same bacteria were isolated both from HVS and fallopian tubes which strongly favours the theory of ascending infection. Out of all antibiotics ciprofloxacin showed the widest spectrum of activity (94.20%). All anaerobes were sensitive to metronidazole.

Effect of subacute exposure to methyl isocyanate on testicular histomorphology in mice.

Mice exposed to methyl isocyanate (MIC; 134 mg.m-3 for 30 min = 4020 mg.min-1.m-3) showed a marked loss of body weight after 24 hr and the mean body weight of the exposed group was significantly less than the control, even 15 days after the exposure. No significant change was observed on relative testicular weight. Spermatozoa in the seminiferous tubules disappeared 3 days post exposure. Primary and secondary spermatocytes were hypertrophied. Normalization occurred after 15 days.

Toxic effect of mercury on testes in different animal species.

Testicular changes following the administration of mercuric chloride, (HgCl2, ip in various dosages) over one month were studied in rats, mice, guinea pigs and hamsters. HgCl2 (5 mg/kg) caused a testicular degeneration and cellular deformation was observed in both the seminiferous tubules and the Leydig cells in all species: a significant decrease of testicular weight also resulted. There was no cellular deformation at the dose of 2 mg/kg: only spermatogenic inhibition and Leydig cell atrophy were observed in the animals. At the dose of 1 mg/kg, testicular degeneration was observed only in the hamster, only partial degeneration was recorded in the rat and the mouse and no change was noted in the guinea pig.