scholarly journals Assessment of Various Laboratory Diagnostic Methods in Diagnosis of Cutaneous Tuberculosis. A Study from A Tertiary Care Hospital of North India

2021 ◽  
Author(s):  
Shoaib Khan ◽  
Nahid Nahvi ◽  
Umara Amin ◽  
Yousuf Ul Bashir ◽  
Danish Zahoor
Keyword(s):  
Tertiary Care ◽  
Culture Method ◽  
Diagnostic Methods ◽  
North India ◽  
Care Hospital ◽  
Age Group ◽  
Cutaneous Tuberculosis ◽  
Standard Culture ◽  
Lowenstein Jensen ◽  
Culture Positive

Cutaneous tuberculosis (CTB) is the rarest case of extrapulmonary TB comprising 2% of total cases. It’s often a challenge both clinically and diagnostically. 1) To determine prevalence, age & gender-wise distribution of CTB. 2) To assess various diagnostic, microbiological modalities for the diagnosis of CTB. 76 skin biopsy specimens from suspected CTB lesions were analysed using following methods – Acid-fast Bacilli (AFB) staining (Ziehl-Neelsen method), growth of mycobacteria in culture (Lowenstein-Jensen media), and Gene Xpert MTB/RIF, Histopathological (H&E staining). Of the 76 specimens, 44 were males and 32 were females. The most commonly affected age group was 40–59 years. Infections were least common in 0-19 years age group. AFB was not seen in any of the primary smears. 10 were confirmed as CTB by the recovery of Mycobacterium in solid culture. Of the 10 culture positives, 9 were confirmed as MTB, and 1 was found to be NTM. Staining of 10 culture positive specimens revealed acid fast, beaded rods. Detection of MTB by Gene Xpert gave positive result in 9 cases with all RIF sensitive. All 9 PCR confirmed cases were also culture positive, all 9 were slow growers with a minimum of 5 weeks required for growth on the LJ slant. PCR is the test of choice and should be performed on all specimens of suspected CTB. However when coupled with the “gold standard” culture method, the diagnostic accuracy improves. Also, further, culture helps in identification and isolation of NTM’s.

scholarly journals Clinicoepidemiological Profile of Childhood Poisoning in the Pediatric Unit of a Tertiary Care Hospital in North India

2019 ◽  
pp. 1-8
Author(s):  
Rahid Rasool Malla ◽  
Khalid Kawoosa ◽  
Meryem Juwhyreeyeh ◽  
Riyaz Ahmed Malik ◽  
Asif Ahmed ◽  
...  
Keyword(s):  
Parental Education ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Age Groups ◽  
Gastric Lavage ◽  
North India ◽  
Care Hospital ◽  
Age Group ◽  
College Hospital ◽  
Childhood Poisoning

Background: This study was conducted to find out the pattern of poisoning cases among the pediatric population in Srinagar and its Northwestern suburbs and compare it with what occurs elsewhere in India. Thereby we aimed to provide practical knowledge in dealing with these pediatric patients. Methods: The hospital records of children between the ages of 0-19 years admitted to the pediatric emergency ward of SKIMS Medical College Hospital Srinagar with poisoning from July 2016 to June 2018 were evaluated. Results: A total of 154 cases of poisoning were admitted in the study period, of which 89(57%) were males and 69(43%) were females. In the 0-12 year age group the poisonings were mostly in boys (68.26%) and were accidental whereas in the 13-19 year age group poisonings were mostly in girls (64%) and due to suicidal attempts. Organophoshorus poisoning was the most commonly ingested poison across all age groups (44.8%) followed by rodenticides (16.23%), kerosene (13.63%) and medications (11.68%). Interventions mostly commonly done were gastric lavage, induced vomiting. Mortaliy was seen in 2 cases over 2 years (1.29%). Conclusion: Knowledge on epidemiological and clinical features of poisoning in children according to age groups, establishing safety standards for sale and storage of harmful chemicals, and parental education can help to decrease the burden of childhood poisoning.

scholarly journals Determining the Prevalence of Rifampicin Resistant Tuberculosis in A Tertiary Care Centre of North India by using Rapid Culture Method and Gene Xpert

2021 ◽  
Author(s):  
Bipin Chandra Pokhriyal ◽  
Dimple Raina ◽  
Iva Chandola ◽  
Nidhi Negi ◽  
Hitendra Singh ◽  
...  
Keyword(s):  
Predictive Value ◽  
Tertiary Care ◽  
Culture Method ◽  
Drug Susceptibility Testing ◽  
North India ◽  
Reference Laboratory ◽  
Age Group ◽  
Becton Dickinson ◽  
Tertiary Care Centre ◽  
Diagnostic Efficacy

The objective of the present study is to find the prevalence of Mycobacterium tuberculosis from respiratory samples like sputum, BAL and pleural fluid, compare conventional LJ culture with rapid culture method i.e Mycobacterium growth indicator tube (MGIT) and to determine the pattern of drug resistance by automated methods i.e Gene Xpert. Respiratory samples were collected in sterile, wide-mouth, disposable, leak proof containers without any preservatives. Specimens were inoculated into MGIT for primary isolation of Mycobacteria. The specimen was processed according to the SOP manual provided by Becton Dickinson Company. The tubes were read for increasing fluorescence by MGIT reader. Reported results only when a MGIT tube was positive by the MGIT reader and smear made from the positive broth is also positive for AFB. For further identification, TBcID card test was put from MGIT positive tube and the result was given accordingly as mentioned in the procedure for TBcID kit insert. Polymerase chain reaction (PCR) was done in all 17 positive cases. The drug sensitivity test (CB-NAAT) was done at State Intermediate Reference Laboratory, Chandan Nagar, Dehradun, Uttrakhand as per RNTCP laboratory operational guidelines. In our study total number of samples received from the clinically suspected cases of pulmonary tuberculosis were 156, out of which 11% were positive and 89% were negative. The predominant age group involved was 51-60 years 24%, followed by 61-70 years 22%. In young children and adolescent age group very less number of samples were received i.e. 0-5%. Out of 17 positive samples, 94.11% (16/17) were detected as sensitive for Rifampicin and 5.89% (1/17) were resistant. On the statistical analysis of our data for MGIT, Positive Predictive Value (PPV) was 29% against Negative Predictive Value (NPV) of 100%. The specificity of MGIT was 92% against a sensitivity of 100%. Culture is still needed for species identification, confirmation and drug susceptibility testing. The diagnostic superiority of MGIT, both in terms of sensitivity and specificity has been proven better as compared to LJ in previous other studies and supported by our study as well. In our study, the diagnostic efficacy of MGIT culture was found to be superior as compared to the conventional LJ culture. The positivity rate was 10.89% (17/156) in MGIT & 3.2% (5/156) in LJ culture.

scholarly journals Prevalence and antibiotic susceptibility pattern of pathogens in children with urinary tract infection in a tertiary care hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 1513
Author(s):  
Madhu G. N. ◽  
Anjum Aara C. A. ◽  
Shajna Mahamud
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Empiric Therapy ◽  
Current Status ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Local Pattern ◽  
E Coli ◽  
Culture Positive

Background: The changing pattern of antimicrobial susceptibility of bacterial pathogens causing acute UTI is a growing problem. Hence, the knowledge of the local pattern of urinary pathogens and their susceptibility to various antimicrobials is of atmost importance for selection of the appropriate empiric therapy for children with acute UTI.Methods: This retrospective cross-sectional study was conducted in 208 children of 1-18 years age group with suspected UTI infection who were admitted in KIMS hospital, Bangalore from January to December 2018. The data of all samples were collected from medical record.Results: Overall 208 children between 1-18 years with suspected UTI were screened. Out of which 48 were culture positive, with a prevalence of 23%. Culture positive UTI was predominantly found in males in 1-5 years age group as against female predominance in 6-18 years age group. E. coli (45.83%) was the commonest organism isolated in our study, followed by Enterococcus (31.25%), Klebsiella (16.67%), Proteus (4.17%) and Acinetobacter (4.17%).  Antibiotics with highest sensitivity to E-coli are Amikacin (91%) and Gentamicin (77%). Klebsiella is most sensitive to Gentamicin (87.5%) and piperacillin (75%). Enterococcus has highest sensitivity to Vancomycin (67%) and Linezolid (60%).Conclusions: It requires regular monitoring to determine the current status of resistance against antimicrobial agents.  The use of antimicrobials must be restricted in order to decline the resistance and we suggest that empirical antibiotic selection should be based on the knowledge of local pattern of bacterial organisms and their susceptibility to various antimicrobials rather than on universal guidelines.

MOLECULAR DETECTION OF COVID -19 BY TRUENAT RT-PCR IN A TERTIARY CARE HOSPITAL IN DELHI NCR REGION

2021 ◽  
pp. 20-22
Author(s):  
Alosha Sharma ◽  
Maneesh Goyal ◽  
Ritu Agarwal ◽  
Neha Goel ◽  
Divyaansh Shridhar ◽  
...  
Keyword(s):  
Viral Load ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diagnostic Methods ◽  
Therapeutic Interventions ◽  
Nasopharyngeal Swab ◽  
Care Hospital ◽  
Age Group ◽  
Rt Pcr ◽  
Viral Lysis

Introduction: COVID-19 is a severe infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected lives of millions of people , responsible for millions of death affecting health care systems worldwide seriously. To diagnose Aims and Objectives: COVID -19 infection in a tertiary care hospital using TrueNat RTPCR and to categorise and co - relate various Ct values with viral load. Material and Methods: Oropharyngeal and nasopharyngeal swab specimens were collected from the patients following standard protocols and were inserted into the viral lysis medium tube. Specimen is transferred from viral lysis medium to automatic extracted device for extraction of RNA and then into RT-PCR analyser for reaction to start automatically. Test detects the screening E gene and conrmatory RdRp /Orf1a gene and human RNase P. Of the 1025 patients subjected to COVID - 19- RTPCR 630 (61%) were male Results : s and 395 (39%) were females. 26% (269/1025) of patients were conrmed COVID positive and 72% (747/1025) were negative. Age group 21-30 showed maximum positive cases followed by age group 51-60 years. High viral load was seen in 41% cases whereas maximum no. of conrmed positive had low viral loads. Rapid and Conclusion: accurate diagnostic methods are required for early detection along with precautionary measures for timely therapeutic interventions and prophylaxis to control and prevent the Spread of highly contagious COVID-19.

scholarly journals Comparison of MGIT 960 with Lowenstein Jensen Media for Recovery of Mycobacteria from Extrapulmonary Specimens in Southern India

2021 ◽  
Author(s):  
Kalpana Thangavelu ◽  
Imola Jamir ◽  
Kalaiarasan Ellappan ◽  
Krishnapriya Krishnakumariamma ◽  
Pallam Gopichand ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Smear Microscopy ◽  
Care Hospital ◽  
Lowenstein Jensen ◽  
Time To Detection ◽  
Culture Positive ◽  
Indicator Tubes ◽  
Growth Indicator

Introduction: Prevalence of Extrapulmonary Tuberculosis (EPTB) due to Mycobacteriumtuberculosis and Non-Tuberculous Mycobacteria (NTM) are on the rise especially in a developing country like India. Smear Microscopy (SM) is commonly used for detection of mycobacteria. Due to the paucibacillary nature in the extrapulmonary specimens SM pose a problem in detection. Though molecular methods are increasingly used now-a-days but there are possibilities that these reactions may get inhibited due to the presence of inhibitors in the extrapulmonary specimens. Aim: To compare Mycobacterium Growth Indicator Tubes (MGIT 960) with Lowenstein Jensen (LJ) medium for the detection of mycobacteria. Materials and Methods: The current prospective study was conducted on 1879 extrapulmonary specimens collected from a tertiary care hospital during the study period from July 2018 to March 2020. Specimens were subjected to Ziehl Neelsen (ZN) staining and Auramine Phenol (AP) staining. Culture was done in both LJ media and MGIT 960 culture. Positive mycobacterial cultures were subjected to MPT64 Immunochromatographic Test (ICT). Data were analysed using the Statistical Package for Social Sciences (SPSS®) for Windows® release 21.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 129 (6.9%) and 105 (5.6%) mycobacteria was isolated by MGIT 960 and by LJ culture respectively among 1879 extrapulmonary specimens. MGIT 960 identified 118 (91.5%) as Mycobacterium tuberculosis complex and 11 (8.5%) as NTM among the total mycobacteria isolated. Out of 105 mycobacteria grown by LJ culture, 95 (90.5%) and 10 (9.5%) were identified as Mycobacterium tuberculosis and NTM, respectively. The rate of contamination associated with MGIT 960 and LJ culture was 4.6% and 4.3% respectively. The Time to Detection (TTD) was found to be significantly shorter for isolation of Mycobacterium tuberculosis by MGIT 960 culture compared to LJ culture. Conclusion: In the current study, authors compared MGIT 960 with solid LJ culture for recovery of both Mycobacterium tuberculosisComplex and NTM from extrapulmonary specimens and authors found increased recovery by MGIT 960 compared to LJ culture and also shorter duration of detection for Mycobacterium tuberculosis by MGIT 960 with comparable contamination rates.

Profile of First Time Seizure in Infants with 1 to 12 Months of Age Presenting to a Tertiary Care Pediatric Hospital

2017 ◽  
Vol 15 (04) ◽  
pp. 171-174 ◽  
Author(s):  
Abdus Bhat ◽  
Wani Hussain ◽  
Ayaz Kakroo ◽  
Ishtiyaq Qadri
Keyword(s):  
Developmental Delay ◽  
Tertiary Care ◽  
North India ◽  
Pediatric Care ◽  
Care Hospital ◽  
Age Group ◽  
Seizure Recurrence ◽  
Eeg Abnormalities ◽  
First Year Of Life ◽  
First Time

AbstractThe incidence of seizure in first year of life is very high. Considerable research on neonatal seizures has been done; however information regarding the profile of patients with first time seizure in the age group of 1 to 12 months is scarce. Our study was a prospective observational study undertaken at a tertiary pediatric care hospital in north India with objectives of finding the epidemiological, clinical, and aetiological profile of patients in the age group of 1 to 12 months presenting with first time seizure and to ascertain their electroencephalography (EEG) and imaging findings. Seizure recurrence and developmental delay was also studied during the first six months post seizure. Fifty patients were included in the study. There were 31 male patients (62%) and 19 female patients (38%). Mean age at seizure occurrence was 5.3 ±2.1 months. Forty one patients (82%) presented with generalized tonic seizures. Only two patients (4%) had focal seizures. Seizures in 7 patients (14%) could not be classified. Electroencephalography and brain imaging were done in 42 patients as indicated. Among these 42 patients, EEG abnormalities were noted in 15 patients (35.7%), while imaging abnormalities were noted in 10 patients (23%). Fifteen patients (35.7%) were found to have developmental delay on follow-up. 16 (38%) patients developed recurrence of seizures. Statistical analysis revealed significant association between abnormal imaging and developmental delay at six months and seizure recurrence within six months of first seizure, however the association with abnormal EEG was not statistically significant.

scholarly journals Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of bacterial vaginosis in tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 637
Author(s):  
Romi Bansal ◽  
Priyanka Garg ◽  
Aastha Garg
Keyword(s):  
Bacterial Vaginosis ◽  
Predictive Value ◽  
Tertiary Care ◽  
Anaerobic Bacteria ◽  
Diagnostic Methods ◽  
North India ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Vaginal Ph ◽  
Criteria For Diagnosis

Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.

scholarly journals Sociodemographic Profile, Semiology, and Etiology of Patients with Status Epilepticus: A Study from a Tertiary Care Hospital in North India

2018 ◽  
Vol 09 (04) ◽  
pp. 487-491
Author(s):  
Wasim Qadir ◽  
Khurshid Ahmad Wani ◽  
Bilal Ahmad Bhat
Keyword(s):  
Intensive Care ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
North India ◽  
Prior History ◽  
Seizure Type ◽  
Care Hospital ◽  
Age Group ◽  
Sociodemographic Profile

ABSTRACT Background and Objectives: Despite advance in treatment of status epilepticus (SE), a major neurological emergency, it is still associated with mortality and morbidity. The objective of our study was to estimate sociodemographic profile, semiology, and etiology in the children with SE admitted in pediatric intensive care. Materials and Methods: Children between 1 month and 18 years with continuous seizure activity of >5 min or two or more sequential seizures without full recovery of consciousness between seizures, admitted in the Pediatric Intensive Care Unit of the Department of Pediatrics, Government Medical College, Srinagar, were included in the study. A semi-structured tool was designed to record the sociodemographic details. Detailed history, clinical examination, and investigations (including neuroimaging as and when needed) were used to determine the type of seizure and etiology. Results: A total of 51 patients were included in our study. Most of the patients were <5 years with 47.10% in 1–5 years’ age group and 43.10% in >1-year age group. Males (60.80%) outnumbered females. Thirty-nine patients (76.47%) belonged to “known” or “symptomatic” group with 35 (68.60%) of them presenting with SE as their fresh seizure. Thirty-nine (76.47%) of our patients had generalized tonic–clonic seizure (GTCS) type of SE. Conclusion: Most of the children (90%) were below the age of 5 years with male predominance. Most of the patients had SE as their first seizure without prior history of seizures with GTCSs was the most frequent seizure type.

scholarly journals Profile of endoscopic removal of foreign bodies from upper gastrointestinal tract at a tertiary care hospital in North India

2017 ◽  
Vol 5 (9) ◽  
pp. 3935
Author(s):  
Vijant Singh Chandial ◽  
Richu Sharma ◽  
Vinu Jamwal ◽  
Suman Kumar Kotwal
Keyword(s):  
Gastrointestinal Tract ◽  
Tertiary Care ◽  
Upper Gastrointestinal Tract ◽  
North India ◽  
Anatomical Location ◽  
Care Hospital ◽  
Age Group ◽  
Endoscopic Removal ◽  
History Of ◽  
Upper Gastrointestinal

Background: Foreign body (FB) ingestion is a common clinical problem seen in medical practice. Its size can range from a pin head size to coin size. The aim of this study is to report the outcome of patients coming with FBs in their gastro intestinal tracts (GIT) using upper GI endoscopy (UGIE).Methods: The records of all the patients who presented to the department of gastroenterology and who underwent UGIE between May 2015 to May 2017 were reviewed with details on age, sex, type of FBs and its anatomical location and outcome.Results: A total of 31 patients with history of FB ingestion, were subjected to UGIE, over a period of 2 years. The patients were in the age group of 3 years to 100 years. The mean age was 51.27±20.63 years, with males constituting 74.19% of the patients. Most patients were in the age group of 41-60 years (41.9%) followed by 21-40 years age group (22.58%). The majority of FBs found were pieces of bone (n=9) and meat bolus (n=7), making 29.03% and 22.58% respectively. The other FBs included food bolus, coins, dentures, fruit seeds and round worm impaction.Conclusions: It is recommended that all those patients with a history of FB ingestion should be evaluated and if it is located in the upper gastrointestinal tract, should be subjected to UGIE for endoscopic removal.

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