Shyamal Kumar Bhattacharya

Effect of Urogenital Cleaning with Paper Soap on Bacterial Contamination Rate While Collecting Midstream Urine Specimens

Context: Urinary tract infection (UTI) is one of the major health problems. Urine culture is considered as a gold standard method for the diagnosis of UTI. But, improper sample collection can lead to contamination with normal urogenital flora. Use of any portable disinfectant that can reduce contamination rate would be the significant help in urine culture interpretation. Aims: To observe the effect of urogenital cleaning with paper soap on bacterial contamination rate while collecting specimens. Materials and Methods: A cross-sectional comparative study was done in 600 patients aged 15-45 years, equally divided into three groups. The first group was given sterile container and instructed to collect midstream clean catch urine (MSU) after urogenital cleaning with provided piece of paper soap. The second group was given sterile container and strictly instructed to collect the MSU sample after urogenital cleansing by tap water only. The third group was given the sterile container and asked for midstream urine. Collected specimens were inoculated in CLED media, incubated aerobically for overnight at 37°C. Reporting of culture was done according to the guideline of American Society of Microbiology. Results: The contamination rate in the three groups were 6.0%, 13.0%, and 27.5%, respectively (P value < 0.05), which was statistically significant. Conclusions: Contamination rate was significantly lower in group who provided urine specimen after urogenital cleaning with paper soap. Thus, cleaning the urogenital area may reduce the need of the repeat sample to rule out actual contamination and prevent from the unnecessary antibiotic treatment.

Extra-pulmonary tuberculosis - A retrospective study

Background: Tuberculosis can occur in various organ systems of human body. In the recent years, there has been an increase in the occurrence of extra-pulmonary tuberculosis (EPTB) worldwide. As very little data is available regarding the situation of EPTB in Eastern Nepal, this study was conducted to assess its frequency in various organ systems of the body and to evaluate the role of demographic factors like sex and age in its causation. Aim : To see the prevalence of EPTB among the patient attending a tertiary care hospital, BPKIHS. Methods: Extrapulmonary specimens received for Acid Fast Bacilli (AFB) microscopy in the TB Laboratory, BP Koirala Institute of Health Sciences, Dharan from 1 st July 2010–30 th June 2011 were included in the study. Age, sex and origin of specimens were retrieved and analyzed. Results: High male prevalence was noted with Male: Female ratio of 1.6:1. Maximum specimens were received from age group 0-15 years followed by 16-30years. Body fluids were the most common specimen submitted for EPTB examination. Out of 1823 suspected cases of EPTB, 11 cases were found to be positive by microscopic method, out of the positives cases eight were male and remaining were female. Conclusion: EPTB is high amongst male in their productive age. Tubercular lymphadenitis is the most common form of EPTB. Introduction of newer and rapid method for the diagnosis of EPTB is utmost necessary for country like ours where diagnosis of Extrapulmonary Tuberculosis is still a challenge.