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.

Hyperacute Gastric Perforation: A Rare Presentation In The Post-Operative Period

Stress-related gastric ulceration and their perforation have become history because of the research and development of highly effective anti-ulcer drug and their affordability and availability across our country. We present an interesting and thought-provoking case of a 46-year-old female, with stress-related gastric perforation who developed the complication in a span of only 2 days of physiological insult.

Pyloric Stenosis Due To Brunneroma Masquerading As Peptic Ulcer Complication

A 42-year-male presented to the surgical emergency with features of severe gastric outlet obstruction. On investigation, upper gastrointestinal series showed features suggestive of a near complete gastric outlet obstruction. Endoscopy revealed multiple antral ulcers with near complete pyloric stenosis, features suggestive of complications arising out of antral ulcers. Biopsy report revealed Brunner’s gland hyperplasia. A unique aspect about the case is the finding of antral ulcers associated with Brunner’s gland hyperplasia. The patient underwent laparoscopic distal gastrectomy with gastrojejunostomy. A high index of suspicion of Brunner cell hyperplasia in case of the patient presenting with features suggestive of pyloric stenosis is the crux of diagnosis in view of the malignant potential of Brunner cell hyperplasia.

A study on treatment outcome of tuberculosis cases registered under RNTCP in Sonbhadra District: A Medico-Geographical Perspective

Introduction: Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis. It mostly affects the lungs (pulmonary TB) and sometime affect other sites (extra pulmonary TB). The disease is spread when people who are sick with pulmonary TB expel bacteria into the air by coughing. Overall, a relatively small proportion (5–15%) of the estimated 1.7 billion people infected with M. tuberculosis will develop TB disease during their lifetime. Objective: To assess the treatment outcome of tuberculosis patients registered under Revised National Tuberculosis Control Programme (RNTCP) and to find out spatial pattern of tuberculosis patients. Materials and Methods: A retrospective record based study was conducted based on the secondary data pertaining to the patients registered at six different tuberculosis units (TU) and 29 designated microscopic centers (DMC) in Sonbhadra district during the period from 2005 to 2015. Results: Overall 85.8% were new cases and among them 80.0% were as pulmonary cases observed. Sputum conversion rate of new sputum-positive case at 2 or 3 months after treatment was 89.9%. Cure rate for new sputum-positive pulmonary TB cases was 84.9% and out of all smear-positive cases, it was 62.4%. Default among new smear-positive cases was 5.5%. Conclusion: The observed treatment success rate in form of cured and treatment completed (91.5%) reveals that the DOTs as an effective strategy for tuberculosis treatment may be classified as better alternative for area like Sonbhadra.

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]

Diode Laser – A Boon in the Treatment of Mucocele – A Case Report.

A mucous cyst (mucous extravasation cyst, mucocele, ranula, mucous retention cyst) is a thin sac on the inner surface of the lips. They are painless swellings but can be bothersome. The cysts are thought to be caused because of trauma by sucking of the lip membranes between the teeth, if left untreated; they can organize and form a permanent bump on the inner surface of the lip. They are known as ranula when on the floor of the mouth, and epulis when present on the gums. This article highlights the advantages and evaluates the efficacy of treatment of mucocele with the help of diode lasers.

Keratomycosis caused by Exserohilum rostratum.

We report a case of keratomycosis caused by Exserohilum rostratum. A 46-year-old farmer presented with history of pain, watery discharge and redness of the right eye for the past 2 weeks following trauma with vegetable matter. On ocular examination, a central corneal ulcer of about 8 mm with a greyish-white slough, feathery edges and diffuse corneal edema was seen in the right eye. KOH examination of corneal scrapings revealed thick, brown, branched, septate hyphae. Culture of corneal scrapings on Sabouraud dextrose agar showed velvety greenish-black colony with a black pigment on the reverse. The culture was identified as E. rostratum on the basis of microscopic morphology. The patient responded well to treatment with topical natamycin and oral itraconazole.

The 2003 outbreak of Dengue fever in Delhi, India.

Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.