Current Trends of Various Candida Coinfection using KB006Hi Candida Kit and CHROM Agar in Pulmonary Tuberculosis Patients at a Tertiary Health Care Center in Patna

Introduction: The various Candida species have long been associated with pulmonary tuberculosis (TB). These Candidahave assumed significance as emerging pathogen in these TB patients with some degree resistance to antifungal therapy thuscomplicating the disease and its treatment. Early identification of Candida species and instituting appropriate treatment therapyis important in reducing the morbidity and mortality in patients with TB.Aim: The aim is to study trends and prevalence of various Candida coinfection using KB006Hi Candida kit and CHROM agarin pulmonary TB patients and evaluating usefulness of these candida identification kit.Material and Methods: This study was done in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences,Patna, Bihar, over a period of 1 year in seventy patients of pulmonary TB. Prior Institutional Ethical Committee approval wasalso obtained for this study.Results: Out of a total of 200 patients, 70 patients (35%) whose sputum samples were positive for acid-fast bacilli were includedin the study. Candida coinfection was observed in 26 (37.14%) patients which included 16 male and 10 female patients. Theratio of male to female in Candida infection group was 1.6:1. Candida albicans was the most common isolate among Candidaspecies in pulmonary TB patients which was isolated in 50% of the patients.Conclusion: Candida coinfection in pulmonary TB patient is common, and synergistic growth between Candida species andTB exists. Along with C. albicans, the prevalence of non-albicans species is also increasing with variable degree of resistance.Prompt measures need to be taken for routine identification and treatment of these opportunistic Candida infections in TB patients.

Aerobic Bacterial Profile Of Aspirated Pus Samples At A Tertiary Care Hospital, Patna, Bihar

Abscess is an accumulation of pus in tissue and it is caused by suppuration deep within a tissue, an organ or confined space. Though the bacterial profile from pus samples remains almost similar in various studies, the irrational use of antibiotics has lead to the emergence of various drug resistant pathogens. In this retrospective study we have taken 290 aspirated pus samples for aerobic culture and sensitivity and found 23 different aerobic bacterial isolates. Most common isolate was Escherichia coli (n-12) followed by Staphylococcus aureus (n-8) and one each was Acinetobacter spp., Klebsiella pneumoniae and Streptococcus spp. Sensitivity of E coli was found to be low for ciprofloxacin, amoxycillin+clavulanic acid, ceftazidime, cefepime and aztreonam; while sensitivity was high for amikacin, imipenem, colistin and tigecycline. Staphylococcus aureus was highly sensitive to most of the antibiotics that had been put for sensitivity testing. A continuous inspection should be carried out to monitor the antimicrobial susceptibility of bacterial isolates from aspirated pus samples to choose appropriate antibiotics for prophylaxis and treatment of infections.

Comparison Of Objective Structured Practical Examination To Conventional Practical Examination In Microbiology.

Background & Objectives: Objective structured practical examination (OSPE) is a good tool to assess skill competency. The objectives of the study was to compare the score of marks obtained by Conventional method of assessment (CPE) with OSPE for assessing skill competency to perform Gram and Zeihl- Neelsen stain and to know the students’ and teachers’ perception about OSPE. Methods: Ninety two MBBS students were included in the study as ‘OSPE’ and ‘CPE’ groups (46+46). The two groups were assessed for their skill competency to perform Gram and Zeihl- Neelsen stain using OSPE and CPE methods respectively. Teachers’ perception was analysed for both the assessment methods with respect to objectivity, reliability, validity, feasibility etc. Feedback was taken from students too. Results: The difference of marks score by OSPE and CPE was found to be extremely statistically significant. The perception (students’ & teachers’ ) assessment reflected the acceptability of the method among students and teachers. Interpretation & Conclusion: OSPE is a tool which would help increase the objectivity while assessing skills in Microbiology and needs to be evaluated further so as to enable teachers to use this valuable tool alone or in combination with CPE.[Namrata K NJIRM 2016; 7(5):87-91]

Introduction Of Case Based Learning In Teaching Of Biochemistry In IGIMS Patna.

Background & Objectives: Biochemistry is the basic science subject of first year MBBS course. It describes all the biochemical reactions occurring in the body, which makes the subject difficult and the student looses interest in it. In our institute, teaching is done mainly by didactic method. We introduced case based learning method (CBL) for teaching. The objective of this study was -1. To compare score of students by two methods of teaching – traditional lectures and case based methodology. 2. To evaluate student’s feedback regarding their perception to case based learning. Methods: After getting written consent from 1st year MBBS students , they were divided into two groups. One group (50 students - case) was taught by case based learning method and another group (50 students control group) was taught by traditional method. Improvement in their performance was assessed by MCQ and statistically compared. Perception of both groups about CBL was taken by a set of questionnaire based on Likert’s scale. Results: Statistically significant increase in performance of student taught by CBL method than student taught by traditional method was seen. Student’s and faculties’s perception about CBL was positive. All students found the CBL as effective method for learning. Conclusion: CBL is a good teaching learning method to increase involvement and interest of student in learning and enhance their academic performance. [Dr. Rekha K NJIRM 2016; 7(5):82-86]

Interdental Papilla Management “Reality or A Myth” - A Review.

Interdental papillary recession has been esthetical as well as an oral hygiene maintenance problem for the patients. Abnormal tooth shape, improper contours of prosthetic restorations, and traumatic oral hygiene procedures may also negatively influence the outline of the interdental soft tissue. There are very fewer surgical techniques to create interdental papilla, which has been very technique sensitive and less predictive in treatment outcome; in this article, a review is attempted to illustrate various causes, classification, and management of interdental papilla.

Is Screening of TORCH Worthwhile in Women with Bad Obstetric History: An Observation from Eastern Nepal.

This pilot case-control study at a tertiary-care hospital over a four-month period was aimed at evaluating the possible usefulness of screening of TORCH (Toxoplasma gondii, rubella virus, cytomegalovirus, and Herpes simplex virus) in females with bad obstetric history. The study included 12 women with bad obstetric history and a similar number of matched controls with previous normal pregnancies. A serological evaluation of TORCH infections was carried out by detecting IgG and IgM antibodies against these infections by ELISA test-kit. Statistical analysis was not done to compare the results relating to the two groups due to a small number of cases and controls included in the study. Ten (83.3%) of the 12 cases with bad obstetric history and two (16.7%) of the 12 healthy controls were serologically positive at least for one of the TORCH agents. The seropositivity rate in women with bad obstetric history was quite high compared to that in the normal healthy controls. The results suggest that a previous history of pregnancy wastage and the serological evaluation of TORCH infections during current pregnancy must be considered while managing cases with bad obstetric history.

Antibiogram pattern of isolates from UTI cases in Eastern part of Nepal.

The present study was conducted to study antibiogram pattern of isolates from urinary tract infection (UTI) cases at a referral hospital in Eastern Nepal. Of the total 2,799 of urine samples studied, 720 (25.7%) were positive for some kinds of bacterial agents. Escherichia coli was most predominant organism (59.0%) followed by Klebsiella sp. (12.6%), Pseudomonas aeruginosa (6.9%), Acinetobacter sp. (5.9%), Enterococcus sp. (4.2%) and others (2.6%). Antimicrobial susceptibility testing was done by Kirby-Bauer's disc diffusion method following National Committee for Clinical Laboratory Services (NCCLS) guidelines. Most strains of Esch. coli and Klebsiella sp. were resistant to Ampicillin and Ciprofloxacin. Ps. aeruginosa and Acinetobacter sp. showed relatively higher resistance to Aminoglycosides. These organisms were often multidrug resistant. Ps. aeruginosa showed 68.0% resistance to even Ceftazidime. For Enterococcus sp. Nitrofurantion and Gentamicin were the drugs of choice. Of the all antimicrobial agents tested, Ciprofloxacin showed most disappointing result.

A study of keratomycosis: our experience.

The aim of the present study was to determine the etiological agents, predisposing factors and important diagnostic tests in keratomycosis in Patna. During period of 2 years, 204 clinically suspected cases of keratomycosis were studied by microscopy (10% KOH smear preparation and Gram's staining) and culture (for bacteria as well as fungus). Out of 204 clinically suspected cases, 76 cases (37.23%) were reported positive for fungus by microscopy and culture. 77% cases were between the age group of 21 to 50 years. Males were more than double the number of females affected. 82% patients were farmers by occupation. 81.58% cases gave a definite history of antecedent corneal trauma. 6.58% cases were known diabetics. Peak incidence was recorded in the months of September-October of the years. Single fungal isolates were present in 63 cases (31%) and multiple were there in 3 cases (1.47%). Mixed isolates of bacteria and fungi were there in 4.90% cases. The predominant isolate was Aspergillus species--42 cases (52.26%) followed by Candida--7 cases (9.21%), Penicillium--6 cases (7.89%) and Fusarium-6 cases (7.89%). Ten (13.15%) of fungal isolates remained unidentified. Therefore mycotic keratitis should be suspected in every patient with a corneal lesion and should be ruled out promptly to save sight and before commencing steroids and antibiotics.