Prevalence of soil-transmitted helminth infestations among children attending Integrated Child Development Service centers in a tea garden area in Darjeeling.

INTRODUCTION: Helminths infestations are common in children in the tea garden areas of Darjeeling, which present unique social, cultural, and environmental conditions. The present study was conducted to determine the proportion of soil-transmitted helminth (STH) infestations and association of STH to sociodemographic variables among children attending Integrated Child Development Services centers of a tea garden area in Darjeeling. METHODOLOGY: A cross-sectional descriptive study was conducted at Kiran Chandra Tea Estate, a tea garden in Naxalbari, Darjeeling, between August and September 2016. Stool samples were collected from children attending ICDS centers in the area and examined using the direct and concentration methods. A pretested and predesigned questionnaire was used to collect data on the sociodemographic profile of the children's families. RESULTS: Stool samples could be collected from 52 (45%) of the 115 eligible children. The children were predominantly male (61.5%), from families with an income between Rs. 2000 and 4000 per month, had mothers with no formal education (75.0%) and came from households with no sanitary toilets (33.5). The proportion of children with STHs was 9.6%; with Ascaris found in 7.7% and Trichuris in 1.9%. No statistically significant differences were found in selected variables between the worm-positive and worm-negative children. CONCLUSIONS: The proportion of STH infestation is low among children <6 years of age attending ICDS in the study area probably because of the mass de-worming strategy of the government of India. Some differences in infestations among groups might suggest a clustering effect.

A large outbreak of Japanese encephalitis predominantly among adults in northern region of West Bengal, India.

Unusual rise of acute encephalitis syndrome cases (AES) were reported in July 2014 in the northern region of West Bengal, India. Investigations were carried out to characterize the outbreak and to identify the associated virus etiology. This observational study is based on 398 line listed AES cases, mostly (70.8%, 282/398) adults, with case fatality ratio of 28.9% (115/398). Japanese encephalitis virus infection was detected in 134 (49.4%) among 271 AES cases tested and most of them (79.1%, 106/134) were adults. The study reports a large outbreak of genotype III Japanese encephalitis among adults in northern region of West Bengal, India. J. Med. Virol. 88:2004-2011, 2016. © 2016 Wiley Periodicals, Inc.

Unusual presentation of Enterobius vermicularis in conjunctival sac.

We report an unusual case of extraintestinal infection with adult Enterobius vermicularis worms in the conjunctival sac of a two-and-a-half year old boy from Alipurduar, West Bengal, India. Only two other similar cases have been reported in the English literature, one from Assam, India in 1976, and the other from Illinois and California in 2011.

Detection of Blastocystis hominis: a controversial human pathogen.

Blastocystis hominis has been reclassified as a protozoan parasite. Its role as a human pathogen is somewhat controversial. There has been a dramatic increase in the frequency of B. hominis infection in association with diarrhea especially in immunocompromised hosts like AIDS patients, travelers, homosexuals, day care children, animal handlers especially zoo keepers, etc. Recent reports suggest that B. hominis is an emerging pathogen; hence, we have undertaken this study to detect B. hominis from stool samples of patients attending our hospital. About 200 stool samples were tested by light microscopic examination, for observing wet mounts with saline and Lugol's iodine. Permanent staining of fecal smear by Gram's staining and modified acid fast staining was done. The stool sample which was microscopically positive for B. hominis was cultured on Lowenstein-Jensen's (LJ) medium. In one patient, the vacuolated form of B. hominis was observed in wet mount with saline preparation of stool sample. This was very clearly seen in wet mount with Lugol's iodine. In Gram's stained preparation, also the vacuolated form was observed. Detection of B. hominis was not possible by modified acid fast staining. B. hominis was also grown on LJ medium which is an egg-containing medium. Clinical microbiology laboratories should start screening of stool samples for B. hominis as it is an emerging pathogen.

Yolk sac tumour of the cryptorchid testis, with an unusual presentation - diagnosed by fine needle aspiration cytology.

Yolk sac tumour is the most common germ cell tumour in infants and children, with a majority of them arising in the gonads. Rare cases of extra - gonadal germ cell tumours have been described in the literature. We are presenting here, a case of a yolk sac tumour of the cryptorchid testis in a 2 year old child, who initially presented with a mass in the left lobe of the liver, with huge ascites and which posed diagnostic difficulties. The mass was diagnosed as hepatoblastoma on Computed Tomography (CT). Subsequently, CT guided Fine Needle Aspiration Cytology (FNAC) of the liver mass showed the features of a yolk sac tumour. The raised serum Alfa Foetoprotein (AFP) levels corroborated with the cytological diagnosis.

A simple method for demonstrating the giardia lamblia trophozoite.

INTRODUCTION: Giardia lamblia is a flagellated protozoan parasite of man. Only 2 stages i.e. the trophozoite and the cyst forms are observed in the life cycle of Giardia. The Giardia infection is acquired from drinking water or by eating food which is contaminated with cysts. The symptoms of the Giardia infection are foul smelling diarrhoea, flatulence, steatorrhoea, etc. Stool samples from the patients are examined for the detection of the motile trophozoites and cysts. As the trophozoites disintegrate rapidly, the stool sample should be observed within 15 minutes of its passage. Hence, we developed a staining method to stain the Giardia trophozoite permanently. MATERIALS AND METHODS: Smears of the stool samples were prepared and they were fixed with methanol. The staining was done by using a 1% methylene blue solution. RESULTS: All the 15 known Giardia lamblia trophozoite positive samples were also found to be positive by the Methylene blue staining. The Giardia lamblia cysts could not be stained by this method. 20 stool samples were used as negative controls. CONCLUSION: We developed the methylene blue staining for demonstrating the trophozoite of Giardia, which is a very simple permanent staining method. The slides can be kept for a permanent record.

Accurate detection of methicillin-resistant Staphylococcus aureus in day to day practice: a great help to clinicians.

Methicillin-resistant Staphylococcus aureus (MRSA) infections are difficult and expensive to treat, therefore early detection is essential to avoid treatment failure. Several phenotypic and genotypic methods are used to detect MRSA; however, the method of choice remains problematic. For detection of MRSA we have evaluated 3 different phenotypic methods with the genotypic method ie, polymerase chain reaction (PCR). Detection of mecA gene by PCR is a gold standard for detection of MRSA strains. Methicillin resistance was detected in 280 clinical Staphylococcus aureus isolates by PCR, oxacillin (1 microg) disc diffusion (ODD), oxacillin screen agar (OSA), and cefoxitin (30 microg) disc diffusion (CDD) methods. Out of 280 Staphylococcus aureus strains 145 (51.8%) were mecA gene positive PCR. Sensitivity and specificity of the ODD, OSA and CDD methods were detected as follows: 97.2% and 95.9%, 100% and 94.8%, and 97.8% and 100%, respectively, when compared to PCR for mecA gene. Amongst all 3 phenotypic methods, cefoxitin disc diffusion (CDD) method was best correlated with mecA-PCR. CDD methods could be a good choice for detecting methicillin resistance in S aureus strains in day to day practice where mecA PCR cannot be performed.

MRSA--too many hurdles to overcome: a study from Central India.

Methicillin-resistant Staphylococcus aureus (MRSA) are commonly associated with nosocomial infections and are usually resistant to many antibiotics. This study describes the prevalence of MRSA strains and their antibiogram in a tertiary care hospital in Central India. The detection of MRSA was done by a cefoxitin (30 microg) disc diffusion test. Antibiotic sensitivity tests were done as per the Clinical and Laboratory Standards Institute guidelines 2006. Of the 280 S. aureus strains studied: 145 (51.8%) strains were MRSA; 51 (35.2%) MRSA strains were inducible clindamycin resistant; and all (100%) MRSA strains were resistant to penicillin and sensitive to vancomycin and linezolid. In order to detect the MRSA strains, cefoxitin disc diffusion tests should be used routinely in any microbiology laboratory to enable prompt treatment for the patient.

In vitro evaluation of folic acid modified carboxymethyl chitosan nanoparticles loaded with doxorubicin for targeted delivery.

The development of smart targeted nanoparticle that can deliver drugs to direct cancer cells, introduces better efficacy and lower toxicity for treatment. We report the development and characterizations of pH-sensitive carboxymethyl chitosan modified folic acid nanoparticles and manifest their feasibility as an effective targeted drug delivery vehicle. The nanoparticles have been synthesized from carboxymethyl chitosan with covalently bonded bifunctional 2,2'-(ethylenedioxy)-bis-(ethylamine) (EDBE) through the conjugation with folic acid. The conjugation has been analyzed by Fourier transform infrared spectroscopy and nuclear magnetic resonance spectroscopy. The resultant nanoparticles with an average size less then 200 nm measured by dynamic light scattering and transmission electron microscopy. Confocal microscopy and flow cytometric analysis have revealed that folate-mediated targeting significantly enhances the cellular uptake of the nanoparticle and thus facilitates apoptosis of cancer cells (HeLa, B16F1). For the application of the nanoparticles as a drug carrier, Doxorubicin a potent anticancer drug has been loaded into the nanoparticles, with the drug loading amount and the drug release pattern observed.

Extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae isolated in a rural hospital.

Extended spectrum beta-lactamase (ESBL) producing strains pose greatest therapeutic challenge and have been reported as emerging pathogens causing nosocomial infection. The present study was undertaken to detect the ESBL producing Esch coli and Klebsiella pneumoniae strains, which were screened to detect ESBL production. A total number of 320 E. coli and Klebsiella pneumoniae strains were processed in the microbiology department. Antibiotic sensitivity test with ciprofloxacin, amikacin, cefotaxime, ceftazidime, imipenem, etc, was put by Kirby Bauer method. ESBL producing strains were detected by double disc synergy test (DDST) using cefotaxime (30 microg) and amoxicillin/clavulanic acid (20/10 microg) disc. ESBL production was confirmed by minimum inhibitory concentration (MIC) reduction test in presence of clavulanic acid and fractional inhibitory concentration (FIC) index. MIC of cefotaxime was done by broth dilution technique. One hundred and thirty-seven strains (42.8%) were ESBL positive; 41.3% E. coli and 44.7% Klebsiella pneumoniae were ESBL producers; One E. coli strain and 4 Klebsiella pneumoniae strains had MIC of cefotaxime 256 microg/ml. To conclude, DDST method for screening of ESBL producing strains is quite simple, cost effective and yet reliable test which can be adopted by any clinical microbiology laboratory.