scholarly journals Evaluation of smear microscopy and geneXpert for the rapid diagnosis of pulmonary and extrapulmonary tuberculosis in a tertiary care hospital in North India: a descriptive prospective study

Author(s):  
Danish Zahoor ◽  
Anjum Farhana ◽  
Farhath Kanth ◽  
Munazah Bha

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.

2020 ◽  
Vol 11 (02) ◽  
pp. 237-244
Author(s):  
Sandeep Grover ◽  
Neha Sharma ◽  
Aseem Mehra

Abstract Objective This study aimed to evaluate the prevalence of stigma for mental disorders among nursing staff in a tertiary care hospital, and the secondary objective of the study was to assess the correlation of stigma with the socio-demographic profile and previous experience with mentally ill patients. Methods This cross-sectional study was performed among the 210 nurses working in a tertiary care multispecialty teaching public sector hospital in north India. They were evaluated on community attitudes toward the mentally ill (CAMI) scale. Results About two-thirds of the participants (67.1%) were females and had done graduation (64.2%) in nursing. Nearly 50% of the study participants had an experience of working with mentally ill patients. Female had a more significant positive attitude on the domain of social restrictiveness. Authoritarianism had a significant positive correlation with benevolence and social restrictiveness domains. The benevolence domain had a significant correlation with all other domains. Social restrictiveness domain also had a significant correlation with other domains. Conclusion Nurses have a positive attitude toward mentally ill patients.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.


Author(s):  
Shivani Juneja ◽  
Proteesh Rana ◽  
Parvinder Chawala ◽  
Rekha Katoch ◽  
Kulvir Singh ◽  
...  

Abstract Objectives The use of Hydroxychloroquine (HCQ) prophylaxis has been recommended by the National task force constituted by the Indian Council of Medical Research (ICMR) for the prevention of corona virus disease 2019 (COVID-19) among healthcare workers (HCWs). However, this recommendation was based essentially on the preclinical data and limited clinical experience. The aim of this study was to evaluate the efficacy and safety of HCQ as a pre-exposure prophylaxis for COVID-19 infection among Indian HCWs. Methods A cross-sectional study was conducted among HCWs of a tertiary care hospital in north India. The HCQ prophylaxis was initiated among 996 HCWs and they were followed up to 8 weeks for conversion to COVID-19 positive status and any adverse drug reaction (ADR). Results About 10.3% of the study participants were tested positive for COVID-19 which was comparable to the positivity rate among HCWs not taking HCQ prophylaxis (9.7%). Conclusions HCQ was well tolerated at a weekly dose of 400 mg for 8 weeks but provided no additional benefit in prevention of COVID-19 among HCWs.


2021 ◽  
pp. 16-18
Author(s):  
Shivali Aggarwal ◽  
Seema Goel ◽  
Dimple Chopra

BACKGROUND: Perniosis is a localised inammatory disorder affecting the unprotected skin regions of individuals exposed to damp, nonfreezing cold. The exact pathogenesis has not been elucidated, however, it is thought to be a microvascular disease. AIMS: To study the demographic prole of patients presenting with perniosis and examine the nailfold capillaroscopic (NFC) changes. MATERIAL AND METHODS: This was an observational, cross-sectional study conducted at a Tertiary care hospital of North India over a period of three months (November 2020- January 2021). Patients with idiopathic perniosis were included in the study. After detailed history and clinical examination, proximal nailfold (PNF) video capillaroscopy was performed in the affected digits. RESULTS: A total of 47 patients with idiopathic perniosis were recruited in the study consisting of 35 females and 12 males with female to male ratio of 2.9:1. A majority of individuals belonged to age group 21-35 years (38.29%). Lesions were localized to both hands and feet in 23 patients (48.9%), only hands in 19(40.4%) and only toes in rest 5 (10.6%) patients. Ten (21.2%) patients had family history of similar complaints and history of smoking was present in 2 (4%) patients. The mean BMI 2 recorded in 37 patients aged >20 years was 20.72+4.32kg/m . Finger nail videocapillaroscopy performed in 42 patients showed dilated capillaries in 42.8%, tortuosity in 40.4% and microhaemorrhages in 28.5% patients. CONCLUSION: In the present study, presence of nailfold capillaroscopic changes suggested that an organic damage to the microcirculation is present in perniosis. Low BMI is an important association for development of perniosis. LIMITATIONS: Long term follow up is required for patients with chilblains to assess permanency of nailfold capillaroscopic changes.


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