Medicine, merit, money and caste: the complexity of medical education in India.

Private medical colleges in India are under the scanner. There is a longstanding debate about the selection methodology that should be followed for admissions in medical colleges. A significant proportion of aspirants are able to afford medical education in private colleges despite not clearing entrance examinations. Others gain entry purely on the basis of caste. Medicine deals with human life and, consequently, there is a widespread feeling that admission criteria in medical schools should be based only on merit as assessed in entrance examinations. This article examines some of these contentious issues.

Microbiological evaluation of various parameters in ophthalmic operating rooms. The need to establish guidelines.

PURPOSE: Postoperative infections can be caused by a contaminated environment, unsterile equipment, contaminated surfaces, and infected personnel as well as contaminated disinfectants. In order to establish guidelines for microbiological monitoring, a detailed microbiological surveillance was carried out in an ophthalmic hospital. METHOD: Over a period of 21 months, we assessed environmental Bacteria Carrying Particle(BCP) load and surface samples weekly (n = 276); the autoclaving system once a month and repeated whenever the process failed (n = 24); the air conditioning filters for fungal growth once in four months (n = 15), and the disinfectant solution for contamination once in two months (n = 10). Additionally, the personnel involved directly in surgery were screened for potential pathogens such as Staphylococcus aureus and beta haemolytic streptococci. RESULT: On 14 (5.07%) occasions the environment in the operating rooms had a significant risk of airborne infections. Sterilisation of instruments in the autoclaves was unsatisfactory on 4 (16.66%) occasions. Samples from the filters of the air-conditioning units yielded potentially pathogenic fungi on 3 (20%) occasions. Personnel sampling revealed that 5 (8.77%) individuals harboured beta haemolytic Streptococci in the throat and 4 (7.01%) harboured S. aureus in the nasal cavity. The samples of disinfectant in use were not contaminated. CONCLUSION: There is a need to standardise microbiological evaluation protocols for operating rooms.

Outbreak of neonatal meningitis caused by Salmonella enterica serotype Worthington.

We report an outbreak of Salmonella meningitis in a nursery unit due to serotype Worthington. The organism was isolated from blood and CSF samples of five babies. The isolates were found to be resistant to commonly used antibiotics such as ampicillin, cefotaxime, cefiriaxone and amikacin but were sensitive to ciprofloxacin. Serotype Worthington appears to be an emerging pathogen in neonatal units.

Role of IgM specific indirect immunofluorescence assay in diagnosing an outbreak of leptospirosis.

The study was conducted during a suspected epidemic of leptospirosis in Maharashtra. A total of 13 acute phase blood samples, collected at 5-6 days from the onset of symptoms, and 10 convalescent phase samples, colected at around 20 days from the onset of symptoms were obtained from 13 patients. Sera were separated and the samples were subjected to Microagglutination Test (MAT) and IgM-Indirect Immunofluorescence assay (IFA) to detect antibodies against leptospira. In the acute phase sera, only one sample was positive by MAT while seven were positive by IFA. In the convalescent samples, six were positive by MAT and seven were positive by IFA. IFA is a rapid test and can be used for early diagnosis of leptospirosis.