Cross sectional study of health profile of Interns of 2014 batch of Terna medical college, Nerul.

Background: Health check-up of M.B.B.S. interns is not done routinely. They expose themselves to the hospital environment for a longer time than their student days. It results in a higher rate of contracting and transmitting infectious diseases in a hospital setting than their student days. Objectives: To study the health profile of interns of 2014 batch of Terna Medical College. Materials & Methods: A predesigned pre tested questionnaire was developed to collect the information on identification data, socio economic & demographic data, and current morbidity. Anthropometric measures including height, weight, waist circumference & hip circumference were taken. Accordingly, BMI, Waist/ Hip ratio were calculated. General examination, systemic examination inclusive of refractory error was conducted. Interns were investigated for haemoglobin estimation, random blood sugar examination. Observations & results were tabulated & subjected to statistical analysis. Results: It was found that, 41.38% female interns & 28.57% male interns were anaemic. We observed that 60% of male interns & 27.59% female interns were pre obese & obese. 80% of the male interns & 37.93% of the female interns had increased waist/hip ratio. Out of 22 anaemic interns, 45.45% were pre obese & obese. None of the interns have hypertension, diabetes mellitus. Conclusion: Awareness regarding life style modification habits namely proper & timely diet, exercise should inculcate in the interns.

Oxygen uptake in relation to group size in the juveniles of a climbing perch, Anabas testudineus (Bloch).

The present work reports oxygen uptake in relation to group size in the juveniles (body weight: 0.70 to 1.30 g) of a climbing perch, Anabas testudineus (Bloch). The experiments were conducted at 21.5 +/- 1.0 degrees C using a cylindrical glass respirometer having continuous water flow system. With an increase in the number of fish at an interval of 5 from 5 to 40 in each fourth subsequent experiment, the weight specific aquatic oxygen uptake of a fish decreased from 0.192 +/- 0.030 to 0.800 +/- 0.006 ml O2 x g(-1)x(h(-1). When compared with a controlled fish, there was a reduction of 27.80% in the oxygen uptake in a group of 5 but 58.39% in a group of 40. A negative and significant correlation (r = 0.8411, p < 0.01) was calculated between oxygen uptake and group size of fishes. The investigation showed that probably due to shoaling behaviour, the aquatic oxygen uptake in the juveniles of A. testudineus always remained high in controlled fish or a fish in isolation than when they were in a group.

Profile of bone marrow examination in HIV/AIDS patients to detect opportunistic infections, especially tuberculosis.

Morphological evaluation of 140 bone marrow aspirations received in haematopathology laboratory with serologically established HIV infection, along with other relevant special haematological tests, was done during 1st Jan 1999 - 31st Dec 2002 at state government run tertiary care General Hospital in Maharashtra state, India. Out of 140 cases: 118 (84.28%) patients had anaemia, 25 (17.86%) had leukopenia, while 13 (9.28%) were thrombocytopenic. Dyserythropoiesis was present in 18 (12.86%) cases, dysmyelopoiesis 37 (26.43%) and micromegakaryocytes were noted in 44 (31.43%) cases. Haemophagocytosis was evident in 8 (5.71%) cases. Plasmacytosis encountered in 120 (85.71%) cases was a common feature. Based on clinical profile and results of other investigations 56 (40%) patients were clinically diagnosed to be of Mycobacterium tuberculosis (TB). Of these, 18 (12.86%) bone marrow aspirates were positive for AFB, Mycobacterium tuberculosis. In 4 cases cryptococci were demonstrated (Mucicarmine stain). There was one case each of Histoplasma capsulatum and leishmaniasis. One patient showed dense parasitemia with Plasmodium falciparum. One patient had immunoblastic lymphoma and showed bone marrow infiltration. Findings in this study strongly indicate that in HIV/AIDS, AFB stain should be done on each marrow aspirate to rule out tuberculosis in countries like India; where TB and AIDS are marching together.

Neonatal outbreak of salmonella worthington in a general hospital.

This is a report of an outbreak of Salmonella worthington in neonates at Sassoon General Hospitals, Pune, which occurred during August and September 2000. A total of 148 blood, 4 CSF and 6 stool specimens were received from neonates admitted to the hospital. Salmonella worthington could be isolated from 17 clinical specimens [15 blood (10.8%), 1 CSF (25%) and 1 stool (16.6%) sample]. Environmental swabs were also processed. An attempt was made to detect carriers in health care personnel. However, no source or carrier of Salmonella worthington in the hospital environment could be identified. Intensive cleaning measures and fumigation were undertaken. All these measures succeeded in aborting the outbreak.

A pilot study on CD4 & CD8 cell counts in healthy HIV seronegative pregnant women.

CD4 and CD8 counts are widely used prognostic markers to assess the degree of immune impairment in HIV seropositive individuals and to monitor anti-retroviral therapy (ART). Pregnancy is considered as a physiologically immunocompromised state, hence alterations in T lymphocyte subsets may occur during pregnancy. There is a need to establish base-line values of these counts, especially in healthy pregnant women. One hundred healthy HIV seronegative pregnant women (mean age 22.5 +/- 2.99 yr) in their third trimester of pregnancy and 30 non-pregnant women (mean age 22.7 +/- 3.01 yr) were tested for their CD4 and CDS counts. In pregnant women, the CD4 and CD8 cell counts/microl were 764 +/- 249 and 547 +/- 196 and the CD4 and CD8 per cent were 56.49 +/- 8.3 and 38.03 +/- 7.2 respectively. In the non-pregnant women CD4 and CD8 counts/microl were 965 +/- 267 and 639 +/- 211 whereas the CD4 and CD8 per cent were 55.27 +/- 5.99 and 36.17 +/- 6.44 respectively. Absolute counts were significantly lower (P < 0.05) in the pregnant group as compared to the controls. A wide variation was seen in the CD4 and CD8 counts in both the groups. However, the variations in the mean CD4 and CD8 per cent were much smaller. Thus CD4 and CD8 per cent may be considered as a useful indicator of immune function rather than absolute counts, in pregnant women.

Detection of antibodies to Brucella abortus in animal handlers.

1. Our study showed a prevalence of 5.33% in animal handlers working in an urban city like Pune. The prevalence would definitely be higher in a population from a rural area. 2. All these cases who showed presence of antibodies to B. abortus, had varied clinical manifestations, characteristic of the protean manifestations in brucellosis. Likewise in our study we had cases ranging from arthritis, abortions and genito urinary manifestations. 3. All the antibody positive cases had significant antibody titres. The clinicians miss many cases of brucellosis because it is not considered as an alternative diagnosis. The clinician should keep in mind the possibility of an occupational or environmental exposure in cases of P.U.O. It would also be worthwhile to create awareness of the disease in such professions so that necessary precautions and periodic screening of such occupationally exposed people can be done. Studies are needed to assess the role of brucellosis as a cause of morbidity in India, which had not received the attention it deserved. Prevention of human brucellosis focuses mainly on elimination of infection in cattle along with hygiene, vaccine, and effective heating and pasteurization of dairy products and related foods.

Clinical and morphological variants of cutaneous tuberculosis and its relation to mycobacterium species.

Cutaneous tuberculosis forms a small proportion of extrapulmonary tuberculosis. The incidence of cutaneous tuberculosis has fallen from 2% to 0.15% in India whereas it is rare in developed countries. The present study is an attempt at finding out the Mycobacterium species associated with cutaneous tuberculosis. A total of 51 cases of clinically suspected cutaneous tuberculosis were studied over a period of 18 months from July 1997 to December 1998. Of these, 32 (62.75%) were Scrofuloderma cases, 12 (23.52%) cases of Lupus vulgaris and 7 (13.73%) were Tuberculosis verrucosa cutis (TBVC) cases. Twenty nine mycobacterial isolates from 51 specimens gave an isolation rate of 56.86%. These were subjected to a battery of biochemical tests for identification to species level. Twenty six out of 29 isolates were identified as Mycobacterium tuberculosis, two were identified as Mycobacterium Scrofulaceum and one Mycobacterium avium complex was isolated. Sixteen Mycobacterial isolates were recovered from Scrofuloderma cases, 9 were isolated from Lupus vulgaris and 4 from TBVC cases. The three atypical mycobacterial isolates were recovered from Scrofuloderma cases. Though Mycobacterium tuberculosis was the most common isolate, Mycobacterium scrofulaceum and Mycobacterium avium complex were also isolated in the present study.

Prevalence, identification and distribution of various species of enterococci isolated from clinical specimens with special reference to urinary tract infection in catheterized patients.

Various clinical specimens were processed to find the prevalence rate of enterococci and to identify the species of clinical isolates of enterococci. Screening of various clinical specimens revealed that enterococci were prevalent in 22.19% of the total specimens, with Foley's catheters and burn wounds to be the major site of isolation. High rate of colonization was noted as opposed to infection. Conventional test scheme proposed by Facklam and Collins were successfully used to speciate enterococcal strains. Seven species of enterococci were identified in the study from a set of 202 cultures, with E.faecalis (49.50%) and E. faecium (35.64%) predominating. E. avium (9.40%), E.hirae (2.47%), E.raffinosus (1.98%) and one isolate each of E.gallinarum and E. casseliflavus were the other members of Enterococcus species identified. Urinary tract infection (UTI) by enterococci due to catherisation was found in 8.92% of the patients and is probably the result of high rate of colonization of Foley's catheters and use of broad-spectrum antibiotics.

Comparative pathogenicity of trichomonas vaginalis isolated from symptomatic & asymptomatic cases.

Pathogenicity of 19 isolates of T.vaginalis obtained from vaginal specimens were studied in the murine model by intraperitoneal route. Sixteen isolates were recovered from the females with various clinical conditions and 3 isolates were from normal healthy females. Pathogenicity level of these isolates were studied by inoculating 5 mice per isolates through intraperitoneal route and the animals were sacrificed on tenth day post-inoculation. In general, all the isolates recovered produced infection in mice. On comparison with the reference strain obtained from Hoechst India Ltd., seven isolates recovered from symptomatic cases and one strain from healthy females produced severe infection in mice. Though variation in pathogenicity level was observed among the isolates, a definite correlation between clinical picture in natural host and pathogenicity in mice was not observed.

Prevalence of VDRL sero-positivity in women in reproductive age group in an urban slum community in Bombay.

A cross sectional survey was carried in an Urban Slum Community in Bombay having a population of 60,000. A total of 393 women in reproductive age group were screened for VDRL reactivity. The highest prevalence was in 15 to 29 years of age group. The sero-positivity rate at 1:8 dilution and above was 0.50%. The seropositivity rate can be further brought down by properly planned and implemented STD (Sexually Transmitted Diseases) Control activities at a community level.

Comparative pathogenicity of Trichomonas vaginalis isolated from symptomatic and asymptomatic cases.

Pathogenicity of 19 isolates of Trichomonas vaginalis obtained from vaginal specimens were studied in the murine model by intraperitoneal inoculation. Sixteen isolates were recovered from the females with various clinical conditions and 3 isolates were from normal healthy females. Pathogenicity level of these isolates were studied by inoculating 5 mice per isolate through intraperitoneal route and the animals were sacrificed on the 10th day post-inoculation. In general, all the isolates recovered produced infection in mice. On comparison with the reference strain obtained from Hoechst India Ltd., seven isolates recovered from symptomatic cases and one strain from healthy females produced severe infection in mice. Though variation in the pathogenicity level was observed among the isolates, a definite correlation between the clinical picture in the natural host and pathogenicity in mice was not observed.

Actinomyces species associated with intrauterine contraceptive devices and pelvic inflammatory disease.

Swabs from 112 removed intrauterine contraceptive devices (IUCD), endocervical swabs from these women and from 65 women with pelvic inflammatory disease (PID) were studied for actinomyces, using direct fluorescent antibody test and culture. Endocervical swabs from 50 control subjects were also studied. Actinomyces species could be detected in 23 (20.5 percent) of IUCD wearers and 8 (12.3 percent) of patients with PID. In control cases, no actinomyces were detected. The isolation rate using a selective medium (Actino Blood Agar) was 71.4 percent. Actinomyces israelii, Actinomyces naeslundii and Actinomyces viscosus were isolated.

Mycoplasma hominis in women with bacterial vaginosis.

An association between M. hominis and bacterial vaginosis (BV) was looked for in total 205 women characterized as having BV. Vaginal specimens from these patients were studied for the presence of amines, polymorphonuclear leukocytes, clue cells, and lactobacilli, and were also cultured to isolate Gardnerella vaginalis, M. hominis, Trichomonas vaginalis, Candida albicans and anaerobes. G. vaginalis was found to be the most common isolate from 132 cases (64.3%). M. hominis was isolated from 90 cases (43.9%). 62 per cent of M. hominis isolates were associated with G. vaginalis. 100 age matched control group revealed low prevalence of G. vaginalis and M. hominis whereas the difference in isolation rate of anaerobes was not significant. Anaerobes were found in association with M. hominis in 40 per cent cases. The treatment of these patients was decided after knowing the etiological agent.

Detection of serum antitrichomonal antibodies in urogenital trichomoniasis by immunofluorescence.

Trichomonas vaginalis is a frequently encountered genital pathogen in both males and females. In females, vaginitis due to this parasite is one of the most common manifestation. The indirect fluorescent technique (IFA) test was carried out to detect antitrichomonal antibodies in 370 female patients using whole cell antigen. Seventy one (19.18%) gave positive reaction for either of the class IgG, IgM and IgA antibodies. The level of the IgG class antibodies was found to be higher i.e. 58 (81.69%) than IgM 11 (15.27%) antibodies, which may be suggestive of past infection or a prolonged manifestation by the organisms.

Biotypes of Gardnerella vaginalis isolated from non-specific vaginitis patients in Bombay.

The incidence and prevalent biotypes of G. vaginalis in patients with non-specific vaginitis from Bombay, was studied. Of 300 patients screened, 105 were diagnosed to have nonspecific vaginitis (NSV). G. vaginalis was isolated from 71 per cent patients with NSV; 34.6 and 29.3 per cent G. vaginalis were belonging to biotypes 5 and 1 respectively. In 55 per cent patient, G. vaginalis was associated with anaerobes. None of the isolated strains of G. vaginalis was sensitive to 5 micrograms metronidazole disc whereas 93 per cent of the strains were sensitive to 50 micrograms metronidazole disc.