Deepika Verma

Comparative evaluation of various tests for diagnosis of concurrent malaria and typhoid Fever in a tertiary care hospital of northern India.

BACKGROUND Malaria and Typhoid are two major infectious diseases, still prevalent in most of the tropical countries including India. Millions of individuals residing in these endemic cases contact these diseases either concurrently or as acute infection superimposed on a chronic one. AIM Diagnosis and comparative evaluation of various tests for diagnosis of Typhoid- Malaria co-infection in patients suffering from febrile illness. MATERIALS AND METHODS Around 800 patients of both Out Patient Department (OPD) and In Patient Department (IPD) were referred to microbiology lab for Widal test/ Typhi dot IgG/IgM and Malaria card test between July 2012- September 2012. Patients found to be suffering from co-infection were further confirmed for typhoid by blood culture. Those patients who were found sterile on blood culture were further confirmed by stool culture. Patients positive by Malaria card test (either antibody or antigen or both) were confirmed by peripheral blood smear examination for malaria parasite by both thick and thin smear examination. RESULT 68 (8.5%) patients were found to be suffering from co- infection by the above tests. Blood culture revealed 15 (22%) bacterial pathogens in the widal positive patients out of which 6(8.8%) were Salmonella Typhi and 3 (4.41%) were Salmonella Paratyphi A. Stool culture revealed 8 (11.7%) S.Typhi and 5 (7.35%) S. Paratyphi A cases. Out of 68 patients positive by Malaria card test, only 36 (52.94%) showed Malaria parasite in peripheral blood smear also. Thus the no. of confirmed cases of co-infection was found to be only 1.6%. CONCLUSION The interpretation of Widal test and Malaria card test, when diagnosing concurrent malaria and typhoid fever, must therefore be done with a lot of caution. Negative or positive Widal agglutination test is neither definitive nor completely informative. Similarly erroneous interpretation of Malaria card test (especially Antibody detection card test) result may lead to prolonged treatment and economic burden on patient.

Comparison of In-vitro Activities of Linezolid and Vancomycin against Staphylococcus aureus Isolated from A Tertiary Care Hospital

BACKGROUND Methicillin resistant Staphylococcus aureus (MRSA) has emerged as one of the commonest cause of hospital acquired infections worldwide. Vancomycin is the antibiotic of choice for treatment of MRSA, but due to slow increase in vancomycin minimum inhibitory concentration (MIC) (vancomycin creep),Vancomycin has become a suboptimal therapeutic option in critically ill patients. Linezolid has emerged as an alternative drug in the treatment of such cases. AIM To compare in vitro activities of linezolid and vancomycin against Staphylococcus aureus, in order to help in formulating a better treatment. METHOD 200 strains of Staphylococcus aureus were isolated from different clinical specimens between April 2010 to March 2011. Antibiotic sensitivity testing was performed by Kirby Bauer disc diffusion method and MICs of vancomycin and linezolid were determined for all 200 strains by agar dilution method by following CLSI guidelines. RESULTS Among 200 strains, MIC for linezolid was 4 μg/ml for 3 strains, MIC was 2 μg/ml for 71 strains, and MIC was 1 μg/ml for 126 strains, while for the same 200 strains of Staphylococcus aureus, MIC of vancomycin was 4 μg/ml for 8 strains, it was 2 μg/ml for 103 strains and it was 1 μg/ml for 89 strains. CONCLUSION Linezolid and vancomycin had similar in-vitro efficacies for Staphylococcus aureus in disc diffusion method, but the number of strains with higher ranges of MICs of vancomycin (1-4 μg/ml) were more as compared to those which had higher ranges of MICs for linezolid. So, we suggest that linezolid can be a good alternative for the treatment of multidrug resistant Staphylococcus aureus as compared to vancomycin.

Comparative analysis of prophylactic intramuscular 15 PGF2α 125 μg V/s intravascular methylergometrine for prevention of atonic post-partum haemorrhage (PPH) in high risk cases.

Objectives : To assess, evaluate and compare the safety and efficacy of intramuscular 15 PGF2? 125 ?g and intravenous 0.2mg methylergometrine during active management of third stage of labour in high risk women who are prone to develop atonic postpartum haemorrhage. Methods : 150 women at high risk factors of developing atonic PPH were divided into two groups. Group A received methylergometrine 0.2 mg intravenously and group B received 125mg PGF2a intramuscularly at the time of delivery of anterior shoulder prophylactically. Duration of third stage of labour, amount of blood loss, side effects of drugs used and complications, if any were noted and analyzed. Results : Amount of blood loss was more in group A as compared to group B. Diarrhoea was seen in 3 cases in prostaglandin group, none in methylergometrine group. Nausea, vomiting were seen in 2 women in each group. Conclusions : Prophylactic intramuscular 15 PGF2? 125 ?g is a better alternative to prophylactic intravenous methylergometrine 0.2 mg in high risk women who are more prone to develop atonic PPH.

Lipoma of the penis, a very rare presentation

A lipoma is a common tumor arising from fat cells and can occur anywhere in the body. However, lipoma of the penis is very unusual and rare.

LEVELS OF VANCOMYCIN SUSCEPTIBILITY AMONGST ISOLATED Staphylococcus aureus STRAINS IN A TERTIARY CARE HOSPITAL

Out of 260 strains isolated from the clinical specimens from different wards of hospital, 105 were identified as Methicillin resistant Staphylococcus aureus (MRSA). Minimum inhibitory concentrations (MIC) of vancomycin of these strains were determined by agar dilution method following CLSI guidelines. Sensitivity of different antibiotics was determined by Kirby Bauer disc diffusion method. Eight strains had MIC of vancomycin of 4 microgram /ml (µg/ml), 138 strains had MIC of 2 microgram /ml and 114 had MIC of 1 microgram/ml. All strains having MIC 4µg/ml were MRSA and were resistant to more than five antibiotics. Out of 138 strains having MIC of 2 µg/ml, 88 were MRSA and 50 were MSSA. Significant relation was found between increase in MIC of vancomycin and methicillin resistance. The most common risk factors associated with increased MIC of vancomycin were prior treatment of vancomycin and prolonged hospitalization .