Bone marrow smear VS Blood smear in diagnosis of Kala-azar

Background  and Objectives:  Bone marrow specimen is considered as superior to the blood in the laboratory diagnosis of Kala-azar. The  main objective of this study is to compare these two methods of diagnosis and determine the usefulness of the diagnostic techniques.Material and Methods:  This  prospective  cross sectional  study  was  conducted at Janakpur Zonal Hospital, Janakpur which was  aimed  to  determine  the usefulness of the bone marrow specimen and blood specimen in the  laboratory diagnosis of Kala-azar. Bone marrow aspirate and venous blood  was  collected  aseptically  from  the  cases  were  processed  simultaneously.  The  results  of these two cultures were compared. Results:  Total 60 cases  of Kala-azar were included in the study of which 32 were male  and 28 were  female.   Amastigote  form  of  Leishmania  donovani  were  detected  in  56  (93.33%)  samples with  high  titre  of  parasitemiae  and  119  (18%)  in  the  blood  sample  with  low  parasitemiae. Sensitivity and Specificity of the test was calculated of the bone marrow sample test have more sensitivity (98%) and specificity (100%) over the sensitivity (90%) and specificity (96%) of blood smear test.Conclusion:  Bone marrow specimens were  found to be more useful than the blood sample in the  laboratory diagnosis of Kala-azar.

Multi-Drug Resistance of Bacterial Isolates among Dental Caries Patients

Background and Objectives: Dental caries is a well known major oral health problem in most developing countries which has multifactorial etiology caused by many facultatively anaerobes. S. mutans is the main pathogen associated with this disease. Recently Multi-Drug Resistant (MDR) species of S. mutans were identified from the dental caries patients against many commercial antibiotics. MDR is a natural phenomenon, posing a serious worldwide threat to public health. Several therapeutic agents are available to treat or prevent tooth decay, but still global burden of the disease with MDR are emerging. Therefore, the present study was designed for assessing the antibiotic sensitivity pattern of commercially available antibiotics.Material and Methods: This cross-sectional study was carried out by following Standard protocols of Bergey’s Manual of Systematic Bacteriology to isolate and identify the organism and further followed by antibiotic susceptibility test of bacterial isolates by disc diffusion method.Results: Streptococcus mutans (40%) was the most predominant to cause dental caries followed by S. aureus with 28.92. Gram positive isolates were found to be frequently resistant towards penicillin and tetracycline whereas Gram negative isolates were found to be Cotrimoxazole resistant.Conclusion: A high frequency of penicillin resistance in oral isolates and its co-resistance to erythromycin, tetracycline, gentamycin and amipicillin among the pateints was observed. The various awareness programmes should be facilitating the appropriate use of antibiotic to re-establish dominance over diseases must be implemented.

Cryptosporidium infection in school children in Dhanusha district, Nepal

Background and Objectives: Gastro-intestinal water-borne infections are among the most emerging and re-emerging infectious diseases throughout the world. Most water-borne diseases are caused by organism ranging from microscopic viruses of less than 30 nm in diameter to parasites of 10cm in length culminate into diarrhea and cause approximately 5million reported deaths annually. The purpose of the present study was to evaluate the prevalence of intestinal parasites, Cryptosporidium parvum among school children. Material and Methods: The study was carried out between Februry to July 2012. Cases of diarrhea reported in 23 students were linked to water handling practices. A total 500 of child of age less than 15 years old was included in the study. A total five hundred soft, loose or watery stool specimens collected from student of less than fifteen years from different school in Janakpur. The sample was collected randomly from randomly selected five schools. The collected stool samples were screened for the presence of Cryptosporidium oocysts. A modified Ziehl Neelsen with DMSO staining method was used for detecting Cryptosporidium oocysts in the stool samples. Results: The oocysts of Cryptosporidium were identified in 64 (6.8%) of the samples, while 242 samples (13%) showed mixed infections. Children aged between 3 and 10 years were mostly infected by this parasite, while infection was more prevalent in females than in males for all the age groups. Conclusion: The study suggests that Cryptosporidium is one of the important intestinal parasites of children as etiologic agents of diarrhea in immune-compromised population.