Yogesh Goswami

Seropositivity of hepatitis B, hepatitis C, syphilis, and HIV in antenatal women in India.

INTRODUCTION The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available. This study was conducted to assess the extent of seropositivity of hepatitis B, hepatitis C, HIV, and syphilis in pregnant women and to re-evaluate the need for routine antenatal care screening. METHODOLOGY All samples were tested to detect HBsAg by enzyme linked immunosorbent assay (ELISA). Samples were tested to detect anti-HCV by ELISA. Samples were also tested for antibodies to Treponema Pallidum by qualitative rapid plasma reagine (RPR); finally, samples were tested for antibodies to HIV by three different methods as per Strategy III of the National AIDS Control Organization by using different systems of testing to establish a diagnosis of HIV. RESULTS Seropositivity of hepatitis B was 2.9%, hepatitis C was 0.19%, syphilis was 0.48%, and HIV was 0.38%. Out of the 1038 samples, no co-infection was found between hepatitis B, hepatitis C, syphilis, or HIV. CONCLUSION The data from this study can help health professionals to treat antenatal patients more effectively. The data also reinforces the need for establishing effective prevention programs, which could lead to a reduction in the prevalence of HBV, HCV, syphilis, and HIV.

To Study the Prevalence of Various Enteric Parasitic Infections Among HIV Infected Individuals in the P.D.U. Medical College and Hospital, Rajkot, Gujarat, India

BACKGROUND AND OBJECTIVES Enteric parasites are a major cause of diarrhoea in HIV infected individuals. The present study was undertaken to detect the enteric parasites in HIV infected patients with diarrhoea, who were at different levels of immunity. METHODS This study was carried out in the P.D.U Medical College and Civil Hospital, Rajkot, India. during the period from June 2009 to June 2010. A total of 100 stool samples from HIV seropositive patients were examined for opportunistic, gastrointestinal parasitic infections. The samples were classified according to the age groups, sex, and occupation, a history of diarrhoea and different categories of the CD4 cell count. The stool samples were collected and examined for enteric parasites by microscopy and by special staining methods. The CD4 cell counts were estimated by using the FACS count system. RESULTS The intestinal parasitic pathogens were detected in 28% patients. Among all, Isospora appeared to have the highest prevalence (18%), followed by Giardia lamblia (5%), Strongyloides stercoralies (3%) and Cryptosporidium parvum (2%). In the HIV infected patients with a CD4 count of < 200 cells/μl, Isospora was the most commonly observed (56%) pathogen. The proportion of the opportunistic pathogens in the patients with CD4 counts of <200 cells/μl was significantly higher as compared to those in the other two groups of patients with CD4 counts of >200 respectively. INTERPRETATION AND CONCLUSIONS Parasitic infections were detected in 28% of the HIV infected patients and a low CD4 count was significantly associated with an opportunistic infection. The detection of the aetiologic pathogens might help the clinicians in deciding the appropriate management strategies.

Epidemiological characteristics of dengue disease in Saurashtra region, India, during year 2015

Background: Dengue is an important vector-borne disease with a spectrum of classical fever to hemorrhagic fever to dengue shock syndrome. The present study was conducted with objective to study epidemiological and demographic characteristics of dengue infections during the year 2015 in Saurashtra region, Gujarat state, India. Materials and Methods: The study was conducted at Tertiary Care Hospital, Rajkot, during the year 2015. A total of 3312 blood samples were collected and tested for dengue NS1 antigen and IgM antibody by capture ELISA testing from various districts of Saurashtra region. A pretested structured data sheet was used as a tool for data collection, and data analysis was done. Results: Out of 3312 tested samples, 33.4% samples were found positive for dengue. Suspected cases were reported from all age groups, including majority from 15 to 24 years (31.1%) and 25 to 44 years (30.0%) and also 8.4% from 0 to 4 years. More than two-third (68.7%) of males were dengue positive than female cases. Significant numbers of cases (P < 0.01) were residing in urban areas (65.7%). Two-third cases (66.8%) diagnosed after 7 days of fever by IgM antibody test. Increasing number of dengue cases reported from July and reached to peak during October 2015. Conclusion: The present study reported that dengue mainly affected males and urban population. Perennial occurrence with seasonal increase during monsoon and postmonsoon months was reported. Effective implementation of vector control measures through efforts toward vector breeding source reduction and with the use of personal prophylactic measures against mosquito bites will help in reducing the dengue prevalence in the community.

A Study of Bacterial Isolates in Diarrhea Infection in Pediatric Patients Under 5 Yrs. of Age Group And Their Antibiotic Susceptibility Pattern, Admitted At P.D.U. Govt. Hospital, Rajkot, Gujarat, India

Background: Diarrhea is a major cause of mortality & morbidity in pediatric age group of patients’ in developing countries. Surveillance for a broad range of enteric pathogens is necessary to accurately predict the frequency of pathogens & potential changes in antibiotic resistance pattern. Methods: The Stool samples were collected between January 2014 to January 2015 from a total of 200 outdoor & indoor patients at P.D.U. Medical College & Govt. hospital. Bacterial pathogens were isolated & antibiotic susceptibility patterns were ascertained. For E.coli isolates genotyping was done at NICED, Kolkata. Result: The bacterial isolates were 54.5%. Isolation rates were higher in male compared to females, & in 2 years of age group. The bacterial isolation rates were EAEC 80%, ETEC 10%, EPEC 10%, S.sonnei 0.5%.Maxium resistance were observed to Cephalothin, Ampicillin, Cefotaxime, Cephazolin. Conclusion: The bacterial pathogens were found to be a significant cause of diarrhea. The study highlights the need for appropriate treatment of children with diarrhea and promotion of its prevention.

An Antibiotic Susceptibility Pattern of Various isolates of Neonatal Septicaemia - Study in tertiary care hospital, Rajkot

Background: Neonatal septicemia is a major cause of Neonatal morbidity & mortality in developing country more commonly due to improper aseptic condition during delivery and postnatal follow up. As in this new era due to use of broad spectrum availabity of newer and more potent antibiotics, resistant strain became a major problem in NICU. It might be possible to reduce these deaths by early diagnosis and proper management. Objectives: To know the antibiotic susceptibility pattern of various isolates. Methods: A hospital based prospective study was carried out in 100 clinically suspected cases of neonatal septicaemia in New Born Intensive Care Unit (NICU) at P.D.U Medical College & Hospital Rajkot. Results: Out of 100 neonates with clinically suspected neonatal septicemia, 62(62%) were blood culture positive. Gram negative bacteria accounted for 50(80.65%) & Gram positive bacteria accounted for 12(19.35%) of all cases. The antibiotic sensitivity of Gram negative isolates in screening test suggested 100% Extended Spectrum Beta Lactamases (ESBLs) producers. Gram Positive Bacteria like staph.aureus is 100%sensitive to linezolid, 75%sensitive to vancomycin, whereas CONS and enterococci shows were sensitive to 100% sensitive to linezolid, vancomycin, Rifampicin. Methicillin resistance was seen in 75% of Staphylococcus aureus and 66.66%of Coagulase negative staphylococcus .Gram Positive cocci were all sensitive to Vancomycin. Conclusion: Organisms isolated from neonatal septicaemia are multidrug resistant. Continued surveillance for various isolates and their susceptibility tests should be done effectively and timely to treat the patients of neonatal septicaemia This study will guide the physician to formulate antibiotic stategy which prevent the mortality & morbidity as well emergence of resistant organisms. Medical Science