Study of Seroprevalence of SARS CoV2 antibodies in children in a diagnostic centre of Central India-a retrospective study

It is said that children are less affected by SARSCoV2 infection because of their young immune system, so they have relatively milder symptoms as compared to adults. So the true incidence of SARSCoV2 is not known in this age group. Serosurveys in the paediatric age group can give a much better estimate of the incidence of SARSCoV2 infection in asymptomatic and symptomatic childrenThe present study was undertaken to study the seroprevalence of SARSCoV2 antibodies in children below 18 years of age, by measuring the S1RBD domain of spike protein neutralizing IgG antibody levels.This was a retrospective study carried out from August 2020 to August 2021 in a private diagnostic centre of Central India. 539 children of both genders from newborn babies upto 18 years of age were included in the study. US FDA Emergency Use Authorized [EUA], Atellica Solution SARS-CoV-2 IgG assay that detects anti S1-RBD antibodies including neutralizing IgG against SARS-CoV-2 was used for antibody estimation. Antibody level ≥1 was termed reactive or seropositive and below 1 were considered to be non reactive or seroneagtive There were 321 males and 218 females with a male to female ratio of 1.47 :1. 57% male children were seropositive while 61.9% female children showed seropositivity with an overall positivity rate of 58.99%.The findings of our study suggest that chidren below 5 years and adolescents exhibit higher antibody responses as compared to children between 5-10 years of age. The results of our study would be of help in formulating surveillance and vaccination strategies for children and in implementing public safety guidelines.

Diagnosis of Primary Ciliary Dyskinesia: Discrepancy according to different algorithms

BackgroundDiagnosis of primary ciliary dyskinesia (PCD) is challenging since there is no gold standard test. The European Respiratory (ERS) and American Thoracic (ATS) Societies developed evidence-based diagnostic guidelines with considerable differences.ObjectiveWe aimed to compare the algorithms published by the ERS and the ATS with each other and with our own PCD-UNIBE algorithm in a clinical setting. Our algorithm is similar to the ERS algorithm with additional immunofluorescence staining. Agreement (Cohen's kappa) and concordance between the three algorithms were assessed in patients with suspicion of PCD referred to our diagnostic centre.ResultsIn 46 out of 54 patients (85%) the final diagnosis was concordant between all three algorithms (30 PCD negative, 16 PCD positive). In eight patients (15%) PCD diagnosis differed between the algorithms. Five patients (9%) were diagnosed as PCD only by the ATS, one (2%) only by the ERS and PCD-UNIBE, one (2%) only by the ATS and PCD-UNIBE, and one (2%) only by the PCD-UNIBE algorithm. Agreement was substantial between the ERS and the ATS (κ=0.72, 95% Confidence Interval (CI) 0.53–0.92) and the ATS and the PCD-UNIBE (κ=0.73, CI 0.53–0.92) and almost perfect between the ERS and the PCD-UNIBE algorithms (κ=0.92, CI 0.80–1.00).ConclusionThe different diagnostic algorithms lead to a contradictory diagnosis in a considerable proportion of patients. Thus, an updated, internationally harmonized and standardised PCD diagnostic algorithm is needed to improve diagnostics for these discordant cases.

Effect of Extender, Storage Time and Temperature on Kinetic Parameters (CASA) on Bull Semen Samples

CASA kinetic parameters are often evaluated in a diagnostic centre. How storage conditions affect ejaculates up to evaluation is unclear. We assessed, in 25 commercial bulls electroejaculated in the field, the impact of time until evaluation (0–2 h, 4–6 h, and 24 h post-ejaculation), holding temperature (5 °C vs. room temperature), and extender (AndroMed®, BIOXcell® or INRA96®) on CASA kinetic parameters. Total and progressive motility, VCL, VAP, VCL, ALH, BCF, STR, LIN, and WOB were assessed. CASA kinetic parameters were preserved for up to 4–6 h post-ejaculation, except for AndroMed®. Regardless of extender or temperature, motility decreased from 4–6 h up to 24 h, with the best values obtained with BIOXcell® at 5 °C. Our results suggest that BIOXcell® can preserve sperm motility for up to 6 h, either at 5 °C or room temperature, and also INRA96® at room temperature, with motility assessments and the percentage of the most rapid sperms being the lowest with INRA96® at 5 °C. The kinetic parameters decreased when analyses were performed at 24 h. Therefore, we suggest evaluating seminal quality as soon as possible, before 6 h after collection. These results help to fix adequate protocols for the short-term storage and shipment of bovine semen collected under field conditions.

Effects of Extender Type, Storage Time, and Temperature on Bull Semen Parameters

Seminal parameters can be evaluated in situ, or samples can be delivered to a diagnostic centre. How storage conditions affect ejaculates up to evaluation is unclear. We assessed, in 25 commercial bulls electroejaculated in the field, the impact of time until evaluation (0–2 h, 4–6 h, and 24 h post-ejaculation), holding temperature (5 °C vs. room temperature), and extender (AndroMed®, BIOXcell® or INRA96®) on semen quality. Acrosome integrity, sperm viability and morphology, CASA-total and progressive motility, pH, and colony-forming units were assessed. Semen quality was preserved for up to 4–6 h post-ejaculation, except for INRA96® at 5 °C. Regardless of extender or temperature, motility decreased from 4 to 6 h up to 24 h, with the best values obtained with BIOXcell® at 5 °C. pH differed from 4 to 6 h up to 24 h, acidifying when stored at room temperature. Microbiological load was stable over time with AndroMed® and BIOXcell®, and increased at room temperature with INRA96®. Our results suggest that AndroMed® and BIOXcell® can preserve semen quality for up to 6 h, either at 5 °C or room temperature, while INRA96® only at room temperature. These results help to fix adequate protocols for short-term storage and shipment of bovine semen collected under field conditions.

Antibacterial Susceptibility Patterns of Common Bacterial Species Associated with Urinary Tract Infections in Patients Attending Kam Medical and Diagnostic Centre, Kampala Uganda.

Background: Urinary tract infection (UTI) is defined as the presence of microbial pathogens within the urinary tract. It is primarily caused by Escherichia coli (E.coli), accounting for 75% of all bacterial UTI cases. Bacteria such Klebsiella pneumonia, Proteus mirabilis, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis have also been reported as causative agents. The study aimed to determine the antibiotic susceptibility patterns of Uropathogenic bacteria in urine samples of patients with suspected UTI in Kam Medical and the diagnostic Centre. Methodology: This was a cross-sectional study where 120 urinary samples from Kam Medical and Diagnostic Centre in 2019. The urine specimens were cultured on CLED (Cysteine Lactose Electrolyte – Deficient) and blood agar media. Kirby-Bauer’s standard disk diffusion method was applied to test the susceptibility of the drug for Mueller-Hinton culture agar plates. Results: All 120 patients suspected of UTI had bacterial pathogen causing UTI. Among the urinary pathogens, Escherichia coli was the most common in 85/120 (70.8%) of the patients followed by S.aureus 13/120 (10.8 %), Klebsiella spp 4/120 (9.2%), Enterococcus spp with 4/120 3.3 %), Pseudomonas aeruginosa with 4/120 (3.3%) and Proteus with 3/120 (2.5%). According to the results of the antibiogram, the highest resistance was observed for Nalidixic acid (64.2%), Ampicillin (61.7%), and Cotrimoxazole (54.2 %). The highest susceptibility (antibiotic sensitivity) was observed with imipenem (97.5%), Nitrofurantoin (49.2 %), Ciprofloxacin (45.8%), and Clotrimazole (44.2 %) Conclusion and recommendations: The bacterial pathogens associated with UTIs in this study were E.coli species, Staphylococcus aureus, Klebsiella, Enterococcus species, Pseudomonas species, and Proteus species. E.coli was the most common isolate followed by S.aureus, Klebsiella spp, Pseudomonas spp, and Enterococcus spp, and lastly Proteus spp. The highest levels of bacterial resistance were recorded against first-generation antibiotic drugs. Bacterial isolates in this study were highly susceptible to broad-spectrum, second/ third generation antibiotics drugs.

Describing the potential of non-specific symptoms-based pathways for diagnosing less common cancers

Background: Although less common cancers account for over half of all cancer diagnoses in England, their relative scarcity and complex presentation, often with non-specific symptoms, means that patients often experience multiple primary care consultations, longer times to diagnosis and poorer clinical outcomes. An urgent referral pathway for non-specific symptoms, the Multidisciplinary Diagnostic Centre (MDC), may address this problem. Aim: To examine the less common cancers identified during the MDC pilots and consider if such an approach improves the diagnosis of these cancers. Design and Setting: A service evaluation of five MDC pilot projects in England to 31st March 2019. Method: Data items were collected by pilot sites in near-real time, based mainly on the English cancer outcomes and services dataset, with additional project specific items. Simple descriptive and comparative statistics were used, including chi-squared tests for proportions and t-tests for means where appropriate. Results: From 5,134 referrals, 378 cancers were diagnosed, of which 218 (58%) were less common. Over 30 different less common tumour types were diagnosed within this cohort. 23% of MDC patients with less common cancers had ≥3 more GP consultations before referral and, at programme level, a median time of 57 days was recorded from GP urgent referral to treatment for these tumour types. Conclusion: A non-specific symptomatic referral route diagnoses a broad range of less common cancers, and can support primary care case management for patients with symptoms of possible cancer that do not qualify for a site-specific urgent referral.

Comparison of a New IgG-EIA for the Detection of Anti-Plasmodium Antibodies with Two Currently Used Assays

<b><i>Background:</i></b> Malaria is a mosquito-borne infectious disease caused by protozoan parasites of the genus <i>Plasmodium.</i> As migration of populations from endemic areas to Europe and overseas recreational travel to endemic regions increase, there is also a growing risk of transfusion-transmitted tropical diseases by blood components. <b><i>Material and Methods:</i></b> In the present study two routine <i>Plasmodium</i> spp. ELISA (CAPTIA™ Malaria EIA, Trinity Biotech, and Malaria EIA, BioRad) were compared with a new commercial ELISA (ELISA IgG, EUROIMMUN). From December 1, 2015 until November 30, 2016, 1,096 plasma samples from blood donors with a potential risk of malaria infection were collected at two blood transfusion centres in Germany and Switzerland. <b><i>Results:</i></b> The samples were tested comparatively with the ELISA from EUROIMMUN and the routine test used at the respective centre. Thirty-four of 595 (5.7%) tested blood samples from centre 1 and 49 of 501 (9.8%) tested blood samples from centre 2 showed reactivity on either or both ELISAs. All 83 reactive samples were sent for confirmation to the Diagnostic Centre of the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel, Switzerland. Sixteen samples, which previously were reactive in the routine <i>Plasmodium</i> spp. EIA assays, were proven positive after confirmation testing (i.e., 4 positive and 12 inconclusive results), indicating an anti-<i>Plasmodium</i> antibody prevalence in blood donations of 1.5%. From these 16 reactive samples, 13 were also detected by the index test, resulting in an assay sensitivity of 81.2%. A specificity of 98.6% was calculated (1,065/1,080 confirmed negative samples). The overall agreement with the reference centre was 95.8% in centre 1 and 94% in centre 2. <b><i>Conclusion:</i></b> The comparison of the new EUROIMMUN ELISA and the established CAPTIA™ Malaria EIA (Trinity Biotech) and Malaria EIA (BioRad) used for routine blood donor screening in two laboratory blood donation centres revealed that all tested ELISAs show comparable sensitivities and are equally suitable for anti-<i>Plasmodium</i> antibody screening in blood banks.

Re-evaluated treatment outcomes of bacteriologically positive TB patients registered at a clinic in Lusaka, Zambia in 2018

SETTING: An urban TB diagnostic centre in Lusaka, Zambia.OBJECTIVE: To re-evaluate treatment outcomes of all bacteriologically confirmed TB patients registered in 2018.DESIGN: This was a retrospective cohort study on TB patients. Treatment outcomes of patients who were transferred out were retrieved.RESULTS: A total of 182 patients were registered, 26 of whom had missing documents; these were excluded from the study. Of the remaining 156 patients who were reviewed, 86 (55.1%) were correctly evaluated by the centre, 35 (22.4%) were incorrectly evaluated and 35 (22.4%) were ‘transferred out’ (not evaluated). As a result of this review, the number of evaluated patients increased from 86 (55.1%) to 150 (96.2%). The cure and treatment success rates rose from 43.6% and 44.2%, respectively, to 57.7% and 73.1%, respectively. Of note, 14 of the 35 patients who were initially declared ‘transferred out’ did not actually reach their treatment facilities and ended up being lost to follow-up.CONCLUSION: This study shows that it is possible to evaluate almost all TB patients. Re-evaluation of treatment outcomes of TB patients revealed the problems in the TB services that need to be improved in the future.