Prevalence of urinary tract infection in febrile children of less than five years of age

To determine the prevalence of urinary tract infection in febrile children, less than 5 years of age. To assess the validity of microscopic urine analysis and urine culture in the diagnosis of urinary tract infection.Prospective study. Children attending the department of paediatrics, Dr.V.R.K. Women’s Medical College, Teaching Hospital & Research Centre, with febrile illness during June 2019-June 2020.370 children between 1 month to 5 years of age.Data related to age, sex, nutritional status, socioeconomic status and predisposing risk factors like urethral instrumentation, bowel habits etc, were noted. A thorough physical examination with relevant investigations were carried out in all these patients. Routine urinary microscopy was done in all patients and urine culture was done in those who showed pyuria of >5 pus cells/HPF in centrifuged urine sample.In our study, overall prevalence of UTI was 3.5% in children between 1 month to 5 yrs and 4.1% in children <2yrs and 7% in Children <1 year of age with M:F ratio of 1:1in children <2yrs. Prevalence of culture positivity was 44% in those who showed >10 pus cells/HPF in centrifuged sample of urine and 2.5% in those who showed >5pus cells/HPF.The presence of obvious source of fever such as upper respiratory tract infection or otitis media is not reliable in excluding urinary tract infection. Overall prevalence of UTI in our study was low (3.5%) and prevalence among children <2yrs was 4.1% and <1 year of age was 7%. Pyuria of >5pus cells/HPF (centrifuged urine sample) should be considered as significant and further evaluation should be done to initiate prompt treatment.

DEVELOPMENT OF PAPER-BASED ANALYTICAL DEVICE FOR DETECTING DIAZEPAM IN URINE

Objective: The aim of this study was to develop Paper-based Analytical Devices (PADs) with colorimetric method as a presumptive test for detecting diazepam in urine Methods: Colorimetric method was used as a principle of this study. PADs were fabricated with wax-printing methods. Chosen colorimetric reagent was tested for selectivity with hydromorphone and codeine; and sensitivity by measuring the absorbance with UV-Vis spectrophotometer. PADs were tested for its sensitivity and stability. The intensity of color developed on PADs are measured with ImageJ. The ability of PADs to detect diazepam in urine was simulated with testing spiked urine sample to the PADs Results: Zimmermann gave the most obvious prominent color change from colorless to purple-red color out of the four reagents. PAD is selective to diazepam when tested with hydromorphone and codeine. PAD is sensitive with a cut-off concentration at 100 ppm. PAD can detect diazepam in urine with the highest recovery percent at 92.8%±4,6 Conclusion: It can be concluded that PAD is quite selective and sensitive to detect diazepam in urine and can be done easily and fast for onsite analysis

Quick-Wee method Versus Standard method for urine collection in infants 1-12 month old

BACKGROUND: Urinary Tract infections [UTI] often presents with fever and nonspecific findings in infants less than one year. So urine sample collection is mandatory for diagnosis or exclusion. Collecting Urine sample is very challenging in infants and choosing the method of collection must balance the reliability, speed and contamination. Clinical guidelines have different recommendations so there is a need for reliable collection method. Therefore this study was conducted to determine if a simple stimulation method (Quick–wee Method) increases the rate of clean catch voiding of urine within five minutes. METHODS: A prospective age and sex matched case control study in 1-12 months children conducted from June 2017 – June 2018 in Pediatric ward of Manipal college of medical sciences, Pokhara, after Ethical clearance from Institutional review Board [IRB]. The study population was randomized to either clean catch midstream urine with stimulation [Quick–Wee method] or without stimulation [Standard method]. The primary outcome was voiding of urine within 5 minute. Secondary outcome were waiting time for voiding, successful collection, parental satisfaction, and contamination. The analysis was done using SPSS version 20 and a ‘p’value <0.05 was considered statistically significant. RESULTS: Waiting time for voiding in Quick wee group was less and statistically significant compared to standard group. There was 10% increment in voiding within 5 minutes in Quick wee group . It had higher successful urine collection rate (91.4%), slightly higher contamination rate (14.28%) but better parental satisfaction. CONCLUSIONS: Quick wee method is easy, reliable, successful method of urine collection in infants with better parental satisfaction and slightly higher contamination rate.

Measuring adherence to antihypertensive medication using an objective test in older adults attending primary care: cross-sectional study

Analysis of urine samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) has previously revealed high rates of non-adherence to antihypertensive medication. It is unclear whether these rates represent those in the general population. This study aimed to investigate whether it is feasible to collect urine samples in a primary care setting and analyse them using LC-MS/MS to detect non-adherence to antihypertensive medication. This study used a prospective, observational cohort design. Consecutive patients were recruited opportunistically from five general practices in UK primary care. They were aged ≥65 years with hypertension and had at least one antihypertensive prescription. Participants were asked to provide a urine sample for analysis of medication adherence. Samples were sent to a laboratory via post and analysed using LC-MS/MS. Predictors of adherence to medication were explored with multivariable logistic regression. Of 349 consecutive patients approached for the study, 214 (61.3%) gave informed consent and 191 (54.7%) provided a valid urine sample for analysis. Participants were aged 76.2 ± 6.6 years and taking a median of 2 antihypertensive medications (IQR 1–3). A total of 27/191 participants (14.2%) reported not taking all of their medications on the day of urine sample collection. However, LC-MS/MS analysis of samples revealed only 4/27 (9/191 in total; 4.7%) were non-adherent to some of their medications. Patients prescribed more antihypertensive medications were less likely to be adherent (OR 0.24, 95%CI 0.09–0.65). Biochemical testing for antihypertensive medication adherence is feasible in routine primary care, although non-adherence to medication is generally low, and therefore widespread testing is not indicated.

Laboratory Evidence of the Presence of Demodex in Urine La-boratory: A Case Report

Folliculorum mites (Demodex folliculorum, and D. brevis) are part of the common external parasites in humans as the exclusive host of them. The highest focus of these mites is on those parts of the body that have fat glands and fatty products in the skin. This is proven by the dermal – epidermal separation method. In the present study, the presence of Demodex is reported in a urine sample containing hematuria, which has not been observed so far according to the previous investigations. The case was related to a 44-yr-old woman with symptoms of headache, chills, and joint pain referring to the medical diagnostic laboratory of Sanandaj, Kurdistan Province, northwest of Iran. After historiography and collecting the urine sample as middle, the live parasite of Demodex was observed. The presence or migration of mite in the atypical areas of the body (genital, urinary, eye, etc.), which are close to hairy tissues (especially in women), may be one of the causes of allergic reactions and clinical symptoms in people.

Determination of nitrogen mustard metabolites in urine using high-performance liquid chromatography and high-resolution mass spectrometry

Detection of biologically active components in mixtures of complex composition which include biological fluids (blood, urine, etc.) is the most difficult problem of the analytical chemistry and requires the use of modern highly informative research methods. One of the most effective and universal ways to study the structure of unknown substances is the method of liquid chromatography- high resolution mass spectrometry that combines the possibility of highly selective separation of the mixtures under study, the reliable detection of unknown substances and high sensitivity of the procedure. We propose a method for the simultaneous extraction of highly polar biomarkers of nitrogen mustard — N-triethanolamine (TEA), N-ethyl diethanolamine (EDEA) and N-methyldiethanolamine (MDEA) — from urine with subsequent determination by HPLC and detection by high resolution tandem mass spectrometry. The mass spectra of fragmentation of protonated molecular ions of TEA, EDEA, and MDEA have been studied and possible structural formulas of the fragment ions are given. The sample preparation of urine and mass spectrometric detection in the multiple reaction monitoring mode were optimized. The five-fold dilution with deionized water was chosen as a method of urine sample preparation for analysis. Separation of the components was performed in the reversed-phase chromatography mode with retention times for TEA, EDEA, and MDEA of 2.00, 2.05, and 1.92 min, respectively. The time required to complete all steps of the urine sample analysis did not exceed 25 min. The detection limits in urine were 1 ng/ml for TEA and 2 ng/ml for EDEA and MDEA. The developed approach provides determination of the fact of application of specific nitrogen mustard in enquiry of possible exposure of living organism to the blister agents.