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Background: For the management of connective tissue disorders (CTDs), antinuclear antibody (ANA) testing is essential, both from diagnostic and prognostic points of view. Usually, patterns obtained by ANA-IIF testing correlates to specific autoantibodies as obtained from the test for ENA (by LIA/ELISA, etc.). But to apply these data from western studies, we may need validation in the local population like our subjects in sub-Himalayan (Garhwal region) area where CTDs are common. Also, suppose ANA-IFA pattern's correlation is reliably known in our population, it can minimize the cost of managing CTDs by limiting ENA testing, which is 10 times costlier than ANA-IIF. Hence, this study was undertaken to know the specific autoantibody targets (ENA by LIA) against ANA-IIF patterns in our local population. Materials and Methods: In this retrospective cross-sectional work, serum samples of CTDs were tested for ANA by IIF (Euroimmune AG) and ENA by LIA (Euroline ANA-3G) continuously for 36 months. The manufacturer's kit insert was followed, and results were analyzed applying appropriate statistical methods. Results: Major ANA-IIF patterns were found to be associated with specific autoantibodies, for example, Nuclear homogenous with dsDNA, nucleosomes, histones; speckled pattern with nRNP/Sm, Sm, SSA/Ro-52, SSB; nucleolar pattern with Scl-70, Pm-Scl 100 and centromere pattern with CENP-B. Anticytoplasmic (ACA) are found to be linked with some ANA negative (by IIF) samples, emphasizing the need for careful observation for ACA especially where ANA is not found. Conclusions: In most subjects, specific ENA targets correlated well with ANA-IIF patterns, implying effective cost minimization in CTD management. Similar future prospective studies (with clinical data) can provide a database and reference for our population.
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Background: Lack of awareness and poor hygiene practices during menstruation can lead to various gynecological problems in the reproductive life of girls. Menstruation is still considered as unclean in the Indian society. Objectives: The objective of the study is to assess the hygiene practices among adolescent girls with special reference to menstrual hygiene in urban area of Barpeta and to assess the restrictions practiced by them during menstruation. Materials and Methods: It was a community-based cross-sectional study involving 200 adolescent girls of Barpeta conducted from August 2018 to January 2019. The data were collected using predesigned and pretested pro forma. Results: The study revealed that 92% of the respondents knew about menstruation before menarche. As high as 92% of the respondents believed that menstruation occurs due to natural or hormonal cause, whereas 1.5% considered it as a disease process. 81.5% girls used commercially available sanitary pads and 78.5% girls cleaned external genitalia with soap and water. All the participants avoid attending religious occasion, followed by kitchen work (57.5%), marriage party (31.5%), and 30.5% of them were sleeping separately. 46% of the respondent avoid sour food during menstruation. Conclusion: Although awareness regarding menstrual hygiene is quite satisfactory in majority of the respondents, yet false perceptions, ignorance, and unsafe practices are still prevailing in the community. Behavior change communication to bring about safe and hygienic practices during menstruation through different stakeholders will help in solving menstruation-related problems among the adolescent girls.
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Purpose: A study was carried out in an Indian teaching hospital in 2009 to detect the rate of surgical site infections (SSI) and peripheral vascular access site infections. Materials and Methods: The study was a point-prevalence study involving over 300 patients. The presence of infection was determined according to the CDC criteria. Swabs were taken from the infected sites and identification and sensitivity were carried out using VITEK® 2 automated system. Characterisation of β-lactamase was carried out at ARRML, Colindale, London. Results: The rate of SSI was 15% for the clean and clean-contaminated categories while that for the dirty contaminated category was 85% (NNIS risk index 0). Cultures yielded definite or probable pathogens from 64% (9/14) of the patients with SSI. In 1/3 rd of the cultures, Staphylococcus aureus was grown and the rest had Enterobacteriaceae, either extended-spectrum β-lactamase (ESBL) producers or Amp-C hyperproducers and, alarmingly, three isolates were positive for newly recognised New Delhi metallo-β-lactamase-1 (NDM-1). In medicine, 87% (n = 99) of the patients had a peripheral IV access device, 55% developed associated phlebitis/infection and, in seven, probable pathogens were isolated (Candida species and Escherichia coli producing ESBL and NDM-1, respectively, Staphylococcus aureus and Enterococcus faecium). All ESBL and metallo-β-lactamase producers were resistant to multiple classes of antimicrobials, the latter being sensitive only to colistin and tigecycline. The study also found that all post-operative patients were on antibiotics, 92% on IV [213 defined daily doses (DDD)/100 post-op patients] limited mainly to the third-generation cephalosporins (26%) and aminoglycosides (24%) and imidazole derivatives (30%). In medicine, 83% (n = 82) were on IV antibiotics (123 DDD/100 bed-days), limited mainly to the third-generation cephalosporins (74%). Conclusion: Indiscriminate use of antibiotics is a major problem predisposing patients to harm by multi-resistant pathogens. Carbapenems were in little use in this hospital, but the selection pressure exerted by cephalosporins and other unrelated classes was sufficient to select NDM-1-producing strains due to co-selection, suggesting a role of single plasmid carrying resistance genes to multiple classes.
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BACKGROUND & OBJECTIVE: An oedema outbreak occurred in a Guwahati pig farm. Escherichia coli isolates from different necropsy samples collected from the dead piglets with oedema were characterized to confirm the virulence. METHODS: Haemolytic E. coli isolates recovered from liver, lung and intestine of pigs with oedema were examined for presence of genes encoding pathogroups such as enteropathogenic Escherichia coli (EPEC), (eae/bfpA), enteroaggregative Escherichia coli (EAggEC), (eagg), enterotoxigive Escherichia coil (ETEC), (elt/est) and shiga like toxin producing Escherichia coli (STEC), (stx1/ stx2) by PCR and molecular typing by randomly amplified polymorphic DNA-PCR (RAPD-PCR). RESULTS: The three haemolytic E. coli recovered from diseased pigs were STEC because of presence of the stx2 and eae genes. Analysis by RAPD-PCR indicated that two of the three isolates were genetically related. INTERPRETATION & CONCLUSION: The isolation of STEC isolates from pigs with oedema was shown. Although the three isolates were untypable, presence of eae and stx2 genes clearly indicated these as prime cause of pig oedema disease. Further, demonstration of STEC in pigs becomes a public health concern, as pigs are potential reservoir of such agents, which may cause human illness.