M. Shahid, Hiba Sami, P. Khan, Sanjay Sharma, Ashutosh Kumar Singh, Syed M. Husaini, H. Khan
Background: Electro-chemiluminescence immunoassay (ECLIA), enzyme-linked immunosorbent assay (ELISA), and rapid immunochromatographic test (RICT) are currently commonly used for the detection of hepatitis B surface antigen (HBsAg). Although a few studies have been performed to compare the efficiency of these three different serological assays, but there are still many grey areas where clear guidelines are required to give the reports as reactive or nonreactive. Materials and Methods: We compared three different methods of detecting HBsAg: RICT, ELISA and ECLIA. The aim of this cross-sectional study was to analyze the performance of these tests and evaluate the cut off index (COI) of ECLIA to be considered as positive. Some of the representative samples that showed a discrepancy between ELISA and ECLIA were confirmed by nucleic acid amplification test (NAAT). Results: A total of 3846 samples were included in the study, of which 259 (6.73%) were positive by ECLIA. Of these 259 samples, 68 were positive by both ECLIA and ELISA and had COI of >5 in ECLIA, whereas 191 were positive by ECLIA only (COI between 0.9 and 5). Hence, the concordance rates of the ECLIA and ELISA in detecting serum HBsAg was 26.25% while the same for ELISA and RICT was 31.57%. Four representative samples which were positive by ECLIA and ELISA (i.e., COI >5) were positive with NAAT. However, one sample which was negative by ELISA and positive by ECLIA (i.e., COI <5) was negative by NAAT. Cohen's K showed moderate agreement between ELISA and RICT and fair agreement between ELISA and ECLIA. Conclusions: ECLIA seems a promising and sensitive test to detect HBsAg, however, we suggest, samples with COI between 1 and 5 should be reported cautiously and preferably be combined with NAAT or any other molecular method before considering as positive.
{"title":"Comparative analysis of electro-chemiluminescence immunoassay, enzyme-linked immunosorbent assay and rapid immunochromatographic test for detection of hepatitis B surface antigen","authors":"M. Shahid, Hiba Sami, P. Khan, Sanjay Sharma, Ashutosh Kumar Singh, Syed M. Husaini, H. Khan","doi":"10.4103/cjhr.cjhr_8_21","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_8_21","url":null,"abstract":"Background: Electro-chemiluminescence immunoassay (ECLIA), enzyme-linked immunosorbent assay (ELISA), and rapid immunochromatographic test (RICT) are currently commonly used for the detection of hepatitis B surface antigen (HBsAg). Although a few studies have been performed to compare the efficiency of these three different serological assays, but there are still many grey areas where clear guidelines are required to give the reports as reactive or nonreactive. Materials and Methods: We compared three different methods of detecting HBsAg: RICT, ELISA and ECLIA. The aim of this cross-sectional study was to analyze the performance of these tests and evaluate the cut off index (COI) of ECLIA to be considered as positive. Some of the representative samples that showed a discrepancy between ELISA and ECLIA were confirmed by nucleic acid amplification test (NAAT). Results: A total of 3846 samples were included in the study, of which 259 (6.73%) were positive by ECLIA. Of these 259 samples, 68 were positive by both ECLIA and ELISA and had COI of >5 in ECLIA, whereas 191 were positive by ECLIA only (COI between 0.9 and 5). Hence, the concordance rates of the ECLIA and ELISA in detecting serum HBsAg was 26.25% while the same for ELISA and RICT was 31.57%. Four representative samples which were positive by ECLIA and ELISA (i.e., COI >5) were positive with NAAT. However, one sample which was negative by ELISA and positive by ECLIA (i.e., COI <5) was negative by NAAT. Cohen's K showed moderate agreement between ELISA and RICT and fair agreement between ELISA and ECLIA. Conclusions: ECLIA seems a promising and sensitive test to detect HBsAg, however, we suggest, samples with COI between 1 and 5 should be reported cautiously and preferably be combined with NAAT or any other molecular method before considering as positive.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"110 - 114"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45482602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/cjhr.cjhr_126_21
Deepti Bal, H. Kirubakaran, S. Chacko, J. Muliyil, T. Sudarsanam
Background and Objectives: The study was aimed to evaluate the role of stress, lifestyle as well as traditional risk factors in the development of hypertension among health-care workers (HCWs). Methods: This nested case–control study was done at a tertiary care university teaching hospital in South India. Cases were hospital employees diagnosed with hypertension and who were taking antihypertensive medications. Controls were age- and sex-matched HCWs who were not diagnosed with hypertension. They were identified preferably in the same department where its case was presently working. One hundred and twenty-eight cases and 128 controls were enrolled. We collected data on risk factors for hypertension, physical activity, diet, and stress. Those significant on the bivariate analysis were entered into a logistic regression analysis. Results and Interpretation: In the logistic regression, we found that living in a joint family (2 siblings and their families), family history of hypertension, family history of diabetes mellitus, and family history of ischemic heart disease were independently predictive of hypertension developing in the study HCWs. Occasional or regular walking/cycling to work and milk consumption were independent factors that protected against the development of hypertension. Extra added salt to food and stress more than normal in any domain tested were not associated with the development of hypertension in our cohort. Conclusions: HCWs have some novel and other similar risk factors to general population for developing hypertension. Simple preventive measures seem effective. Neither stress nor self-reported salt consumption seemed to play a role in the development of hypertension.
{"title":"Risk factor for health care workers developing hypertension: A nested case-control study","authors":"Deepti Bal, H. Kirubakaran, S. Chacko, J. Muliyil, T. Sudarsanam","doi":"10.4103/cjhr.cjhr_126_21","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_126_21","url":null,"abstract":"Background and Objectives: The study was aimed to evaluate the role of stress, lifestyle as well as traditional risk factors in the development of hypertension among health-care workers (HCWs). Methods: This nested case–control study was done at a tertiary care university teaching hospital in South India. Cases were hospital employees diagnosed with hypertension and who were taking antihypertensive medications. Controls were age- and sex-matched HCWs who were not diagnosed with hypertension. They were identified preferably in the same department where its case was presently working. One hundred and twenty-eight cases and 128 controls were enrolled. We collected data on risk factors for hypertension, physical activity, diet, and stress. Those significant on the bivariate analysis were entered into a logistic regression analysis. Results and Interpretation: In the logistic regression, we found that living in a joint family (2 siblings and their families), family history of hypertension, family history of diabetes mellitus, and family history of ischemic heart disease were independently predictive of hypertension developing in the study HCWs. Occasional or regular walking/cycling to work and milk consumption were independent factors that protected against the development of hypertension. Extra added salt to food and stress more than normal in any domain tested were not associated with the development of hypertension in our cohort. Conclusions: HCWs have some novel and other similar risk factors to general population for developing hypertension. Simple preventive measures seem effective. Neither stress nor self-reported salt consumption seemed to play a role in the development of hypertension.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"12 2","pages":"16 - 24"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Pradhan, A. Makharia, M. Lakhotia, Kishan Gopal
We report a case of rhabdomyolysis (RM) in a postpercutaneous transluminal coronary angioplasty patient caused by a high dose of rosuvastatin. She was admitted to the hospital with complaints of muscle weakness, myalgia, and passing red-colored urine for the last 7 days. Routine blood investigations showed serum creatinine 1.51 mg/dl, creatinine phosphokinase (CPK) 31,000 U/L, and urine myoglobin 934 ng/ml. The patient was diagnosed with rosuvastatin-induced RM. Rosuvastatin was stopped on the day of admission, and intravenous fluids were started with strict monitoring of clinical and biochemical profile. Consequently, her CPK and urine myoglobin started decreasing and her symptoms improved. The patient was discharged from the hospital on the 10th day without a statin. Rosuvastatin-induced RM is discussed as a potentially preventable life-threatening side effect.
{"title":"Rosuvastatin-Induced reversible rhabdomyolysis","authors":"S. Pradhan, A. Makharia, M. Lakhotia, Kishan Gopal","doi":"10.4103/cjhr.cjhr_52_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_52_22","url":null,"abstract":"We report a case of rhabdomyolysis (RM) in a postpercutaneous transluminal coronary angioplasty patient caused by a high dose of rosuvastatin. She was admitted to the hospital with complaints of muscle weakness, myalgia, and passing red-colored urine for the last 7 days. Routine blood investigations showed serum creatinine 1.51 mg/dl, creatinine phosphokinase (CPK) 31,000 U/L, and urine myoglobin 934 ng/ml. The patient was diagnosed with rosuvastatin-induced RM. Rosuvastatin was stopped on the day of admission, and intravenous fluids were started with strict monitoring of clinical and biochemical profile. Consequently, her CPK and urine myoglobin started decreasing and her symptoms improved. The patient was discharged from the hospital on the 10th day without a statin. Rosuvastatin-induced RM is discussed as a potentially preventable life-threatening side effect.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"122 - 124"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44449648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/cjhr.cjhr_101_21
Senkadhirdasan Dakshinamurthy, V. Saxena, R. Kumari, A. Mirza, Minakshi Dhar, Ashutosh Mishra
Background: Metabolic syndrome (MetS) is rising in Indian population. MetS is less studied in Uttarakhand which has embraced modern culture and lifestyle. Hence, we aimed to study the prevalence and determinants of MetS. Aim and Objectives: (1) To determine the prevalence of MetS in the adult population (19–60 years) in urban areas of Rishikesh. (2) To determine the association of sociodemographic variables and risk factors with MetS. Materials and Methods: A community-based cross-sectional study was conducted in an urban area of Rishikesh. WHO steps instrument and protocol were used for the assessment of risk factors and measurements. Five milliliters of blood sample was collected for estimation of Fasting Blood sugar (FBS), triglycerides, and high-density lipoprotein. Sample size was calculated to be 478 (P = 34.3%, design effect = 2.0, drop out 5%, and relative precision = 18%). Data were analyzed using SPSS Version 20.0. Appropriate statistical tests for bivariate and multivariate analysis were done. P <0.05 was considered significant. Results: The prevalence of MetS in the urban area of Rishikesh is 38.2%. The prevalence of MetS in males and females is 33.9% and 40.5%, respectively. Conclusions: About 442 subjects had either one or more abnormal components of the MetS as classified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. MetS prevalence was found to be higher in females than males. Prevalence was found higher in individuals belonging to the 41–50 years of age group.
背景：代谢综合征（MetS）在印度人群中呈上升趋势。MetS在北阿坎德邦的研究较少，该邦信奉现代文化和生活方式。因此，我们旨在研究代谢综合征的患病率和决定因素。目的和目的：（1）确定里希凯什城市地区成年人群（19-60岁）中MetS的患病率。（2） 确定社会人口统计学变量和风险因素与代谢综合征的关系。材料和方法：在里希凯什的一个城市地区进行了一项基于社区的横断面研究。世界卫生组织的步骤、工具和方案用于评估风险因素和测量。采集5毫升血样，用于评估空腹血糖（FBS）、甘油三酯和高密度脂蛋白。样本量计算为478（P=34.3%，设计效果=2.0，下降5%，相对精密度=18%）。使用SPSS 20.0版对数据进行分析。对双变量和多变量分析进行了适当的统计检验。P＜0.05被认为是显著的。结果：里希凯什市区MetS的患病率为38.2%，男性和女性MetS的发病率分别为33.9%和40.5%。结论：根据国家胆固醇教育计划成人治疗小组III（NCEP ATP III）标准，约442名受试者患有一种或多种MetS异常成分。MetS患病率女性高于男性。41-50岁年龄组的患病率较高。
{"title":"Prevalence of metabolic syndrome in the adult population of urban areas of Rishikesh, Uttarakhand","authors":"Senkadhirdasan Dakshinamurthy, V. Saxena, R. Kumari, A. Mirza, Minakshi Dhar, Ashutosh Mishra","doi":"10.4103/cjhr.cjhr_101_21","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_101_21","url":null,"abstract":"Background: Metabolic syndrome (MetS) is rising in Indian population. MetS is less studied in Uttarakhand which has embraced modern culture and lifestyle. Hence, we aimed to study the prevalence and determinants of MetS. Aim and Objectives: (1) To determine the prevalence of MetS in the adult population (19–60 years) in urban areas of Rishikesh. (2) To determine the association of sociodemographic variables and risk factors with MetS. Materials and Methods: A community-based cross-sectional study was conducted in an urban area of Rishikesh. WHO steps instrument and protocol were used for the assessment of risk factors and measurements. Five milliliters of blood sample was collected for estimation of Fasting Blood sugar (FBS), triglycerides, and high-density lipoprotein. Sample size was calculated to be 478 (P = 34.3%, design effect = 2.0, drop out 5%, and relative precision = 18%). Data were analyzed using SPSS Version 20.0. Appropriate statistical tests for bivariate and multivariate analysis were done. P <0.05 was considered significant. Results: The prevalence of MetS in the urban area of Rishikesh is 38.2%. The prevalence of MetS in males and females is 33.9% and 40.5%, respectively. Conclusions: About 442 subjects had either one or more abnormal components of the MetS as classified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. MetS prevalence was found to be higher in females than males. Prevalence was found higher in individuals belonging to the 41–50 years of age group.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"30 - 36"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47340743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Vitamin D deficiency with a resurgence of rickets and tetany is increasingly being reported in young infants from temperate regions, African Americans, and also from India. The data on Vitamin D status of healthy term breastfed Indian infants and mothers are scant. In fact, the correlation between Vitamin D deficiency and alkaline phosphatase (ALP) is inaccurate in many studies. Aim and Objective: The aim and objective of this study are to determine whether serum Vitamin D levels are correlated with serum levels of ALP or not and to study the point, at which ALP surge occurs in Vitamin D deficiency. Materials and Methods: Ninety-six participants at birth were enrolled and followed up till 9 months of age. Serum 25 (OH) D along with ALP was estimated in cord blood at birth and 14 ± 1 weeks of life. Seventy-seven participants were followed up at 9 months for estimation of serum 25 (OH) D, parathyroid hormone, ALP, calcium, and phosphorus. Vitamin D deficiency was defined as serum 25 (OH) D <15 ng/mL as per the United States Institute of Medicine guidelines. Results: At 9 months out of 96 samples, 16 had mild insufficient (≥15–20 ng/mL) (20.8%), 42 had moderate deficient (<15 ng/mL) (54.5%), and 0 had severe deficient (<5 ng/mL) Vitamin D deficiencies. Serum alkaline phosphate were found to be normal in all the three groups of patients and the receiver operating characteristic curve demonstrated that low Vitamin D level is predicted by a high ALP cutoff of ALP is 190.90 IU/L with reasonable sensitivity and specificity. The correlation coefficient of ALP and serum Vitamin D3 levels was r = 0.501 (P = 0.001). Conclusion: Serum Vitamin D3 levels correlated well with increased serum ALP levels but the level, at which the ALP surge occurs was on the lower side.
{"title":"Prediction of rise in alkaline phosphatase at different vitamin D levels","authors":"M. Gutch, U. Mandal, Sukriti Kumar","doi":"10.4103/cjhr.cjhr_3_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_3_22","url":null,"abstract":"Background: Vitamin D deficiency with a resurgence of rickets and tetany is increasingly being reported in young infants from temperate regions, African Americans, and also from India. The data on Vitamin D status of healthy term breastfed Indian infants and mothers are scant. In fact, the correlation between Vitamin D deficiency and alkaline phosphatase (ALP) is inaccurate in many studies. Aim and Objective: The aim and objective of this study are to determine whether serum Vitamin D levels are correlated with serum levels of ALP or not and to study the point, at which ALP surge occurs in Vitamin D deficiency. Materials and Methods: Ninety-six participants at birth were enrolled and followed up till 9 months of age. Serum 25 (OH) D along with ALP was estimated in cord blood at birth and 14 ± 1 weeks of life. Seventy-seven participants were followed up at 9 months for estimation of serum 25 (OH) D, parathyroid hormone, ALP, calcium, and phosphorus. Vitamin D deficiency was defined as serum 25 (OH) D <15 ng/mL as per the United States Institute of Medicine guidelines. Results: At 9 months out of 96 samples, 16 had mild insufficient (≥15–20 ng/mL) (20.8%), 42 had moderate deficient (<15 ng/mL) (54.5%), and 0 had severe deficient (<5 ng/mL) Vitamin D deficiencies. Serum alkaline phosphate were found to be normal in all the three groups of patients and the receiver operating characteristic curve demonstrated that low Vitamin D level is predicted by a high ALP cutoff of ALP is 190.90 IU/L with reasonable sensitivity and specificity. The correlation coefficient of ALP and serum Vitamin D3 levels was r = 0.501 (P = 0.001). Conclusion: Serum Vitamin D3 levels correlated well with increased serum ALP levels but the level, at which the ALP surge occurs was on the lower side.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"55 - 59"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42908348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: A better diagnosis, early referral, and greater health-care coverage have increased cesarean deliveries at tertiary care hospitals in India. While most cesareans are done in good faith, it does not escape the purview of consumer awareness and protection. Our study aims to audit the awareness, understanding, and adequacy among patients about informed consent (IC) before cesarean sections. Materials and Methods: This was a cross-sectional study. A detailed questionnaire was given to 150 postcesarean patients from July 2016 to July 2017. The questionnaire was then evaluated, and the inference was drawn based on the patients' answers. Results: About 84.6% of patients knew the exact indication. About 79.3% were well explained the procedure. Ninety-six percentage were satisfied with the outcome of the procedure. Eighty-four percentage preferred the same institute for their subsequent delivery. Twelve percentage reported that consent was forcibly taken. Ninety-four percentage were unaware about the intraoperative complications. Only 4.6% were explained about the preferred mode of delivery for the next pregnancy. Ninety-two percentage wanted a vaginal delivery for the subsequent pregnancy. Conclusion: Thus, an adequate IC during antenatal visits brings about awareness about the risks and complications of cesarean section and helps better decision-making.
{"title":"A study of patient's perspectives regarding the adequacy of the informed consent process before a caesarean section","authors":"M. Verma, A. Rajaratnam","doi":"10.4103/cjhr.cjhr_63_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_63_22","url":null,"abstract":"Background: A better diagnosis, early referral, and greater health-care coverage have increased cesarean deliveries at tertiary care hospitals in India. While most cesareans are done in good faith, it does not escape the purview of consumer awareness and protection. Our study aims to audit the awareness, understanding, and adequacy among patients about informed consent (IC) before cesarean sections. Materials and Methods: This was a cross-sectional study. A detailed questionnaire was given to 150 postcesarean patients from July 2016 to July 2017. The questionnaire was then evaluated, and the inference was drawn based on the patients' answers. Results: About 84.6% of patients knew the exact indication. About 79.3% were well explained the procedure. Ninety-six percentage were satisfied with the outcome of the procedure. Eighty-four percentage preferred the same institute for their subsequent delivery. Twelve percentage reported that consent was forcibly taken. Ninety-four percentage were unaware about the intraoperative complications. Only 4.6% were explained about the preferred mode of delivery for the next pregnancy. Ninety-two percentage wanted a vaginal delivery for the subsequent pregnancy. Conclusion: Thus, an adequate IC during antenatal visits brings about awareness about the risks and complications of cesarean section and helps better decision-making.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"8 - 10"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Among Gram-negative bacteria, the presence of beta-lactamases is a defined modality of resistance to antibiotics of the beta-lactam group. Proteus species also has been showing various degrees of resistance to these groups of antibiotics and thereby appearing multidrug resistant. The aim of our study was to know the occurrence of Proteus species from different clinical samples their antibiotic susceptibility, extended-spectrum β-lactamase (ESBL) production, and the associated patient risk factors. Materials and Methods: This observational descriptive study was done from December 2020 to December 2021. All Proteus isolates obtained from various clinical samples, were biochemically identified, antibiogram, and screening for ESBL production was done using a combination of cefotaxime and cefotaxime clavulanic acid antibiotic discs. Results: Seventy-nine Proteus isolates were obtained from hospitalized patients. In that, Proteus mirabilis was the most common isolate followed by Proteus vulgaris. Proteus infections were common in the age groups of 41–60 years and males were affected more than females. Out of the 79 Proteus isolates 12 were ESBL producers. Among these, 25% of ESBL producers were P. mirabilis and 75% of them were P. vulgaris. Conclusion: The most common isolate was P. mirabilis among hospitalized patients and P. vulgaris was the main ESBL producers when compared to P. mirabilis. These pathogens mainly caused wound and urinary tract infections. The patient age groups ranged mainly from 49–60 years. Diabetes mellitus was the most significant risk factor in these Proteus infections.
{"title":"Characterization of genus proteus isolated from various clinical specimens and detection of extended-spectrum β-Lactamase production","authors":"M. Anju, T. Kuruvilla","doi":"10.4103/cjhr.cjhr_13_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_13_22","url":null,"abstract":"Background: Among Gram-negative bacteria, the presence of beta-lactamases is a defined modality of resistance to antibiotics of the beta-lactam group. Proteus species also has been showing various degrees of resistance to these groups of antibiotics and thereby appearing multidrug resistant. The aim of our study was to know the occurrence of Proteus species from different clinical samples their antibiotic susceptibility, extended-spectrum β-lactamase (ESBL) production, and the associated patient risk factors. Materials and Methods: This observational descriptive study was done from December 2020 to December 2021. All Proteus isolates obtained from various clinical samples, were biochemically identified, antibiogram, and screening for ESBL production was done using a combination of cefotaxime and cefotaxime clavulanic acid antibiotic discs. Results: Seventy-nine Proteus isolates were obtained from hospitalized patients. In that, Proteus mirabilis was the most common isolate followed by Proteus vulgaris. Proteus infections were common in the age groups of 41–60 years and males were affected more than females. Out of the 79 Proteus isolates 12 were ESBL producers. Among these, 25% of ESBL producers were P. mirabilis and 75% of them were P. vulgaris. Conclusion: The most common isolate was P. mirabilis among hospitalized patients and P. vulgaris was the main ESBL producers when compared to P. mirabilis. These pathogens mainly caused wound and urinary tract infections. The patient age groups ranged mainly from 49–60 years. Diabetes mellitus was the most significant risk factor in these Proteus infections.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"11 - 15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48685249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amiyabala Sahoo, S. Malhotra, Nirmala Mehta, Shefali Sharma, N. Kaur, A. Kaur, N. Duggal
Introduction: Candida auris is associated with nosocomial outbreaks in intensive care settings, and transmission despite the implementation of enhanced infection prevention and control (IPC) measures is a particular concern. Objective: Isolation and identification of C. auris from suspected cases of fungal septicemia and its surveillance. Materials and Methods: Blood culture samples of all suspected cases of fungal septicemia were taken from the trauma intensive care unit (TICU) of a tertiary care hospital in New Delhi between September 2019 and November 2019 as part of surveillance of device-associated infections. All the samples were obtained by central venous catheter line. Samples were processed in BacT/Alert automated blood culture system. Positive flagged bottles were further subcultured unto blood agar, MacConkey agar, and Sabouraud Dextrose Agar with and without cycloheximide and incubated at 37°C. All suspected Candida isolates were identified by conventional methods and the suspected C. auris isolates were further confirmed by matrix-assisted laser desorption time of flight. Results: Out of 24 suspected fungal septicemia cases from TICU, three patients had C. auris septicemia and all three isolates were resistant to fluconazole and voriconazole. Action Taken: IPC practices were reinforced as per the Centers for Disease Control and Prevention guidelines by the infection control team. Conclusion: This article depicts the emergence of multidrug-resistant C. auris and controlling its spread by appropriate infection control measures.
{"title":"Control of Candida auris septicemia in patients of trauma intensive care unit in a tertiary care hospital","authors":"Amiyabala Sahoo, S. Malhotra, Nirmala Mehta, Shefali Sharma, N. Kaur, A. Kaur, N. Duggal","doi":"10.4103/cjhr.cjhr_22_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_22_22","url":null,"abstract":"Introduction: Candida auris is associated with nosocomial outbreaks in intensive care settings, and transmission despite the implementation of enhanced infection prevention and control (IPC) measures is a particular concern. Objective: Isolation and identification of C. auris from suspected cases of fungal septicemia and its surveillance. Materials and Methods: Blood culture samples of all suspected cases of fungal septicemia were taken from the trauma intensive care unit (TICU) of a tertiary care hospital in New Delhi between September 2019 and November 2019 as part of surveillance of device-associated infections. All the samples were obtained by central venous catheter line. Samples were processed in BacT/Alert automated blood culture system. Positive flagged bottles were further subcultured unto blood agar, MacConkey agar, and Sabouraud Dextrose Agar with and without cycloheximide and incubated at 37°C. All suspected Candida isolates were identified by conventional methods and the suspected C. auris isolates were further confirmed by matrix-assisted laser desorption time of flight. Results: Out of 24 suspected fungal septicemia cases from TICU, three patients had C. auris septicemia and all three isolates were resistant to fluconazole and voriconazole. Action Taken: IPC practices were reinforced as per the Centers for Disease Control and Prevention guidelines by the infection control team. Conclusion: This article depicts the emergence of multidrug-resistant C. auris and controlling its spread by appropriate infection control measures.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"66 - 70"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47087876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/cjhr.cjhr_120_22
O. Jimoh, Hidaayah Jimoh - Abdulghaffaar, T. Bakare, G. Popoola, Waliu Oladosu, E. Grillo, A. Ahmed, A. Adeniran
Background: Combined Oral Contraceptive (COC) pill is associated with atherogenic and cardiovascular changes. Some service providers use individual lipid parameters to assess these changes unlike objective calculation using standard formulae. Objective: To determine and compare the atherogenic changes in women on COCs using six lipid ratios; coronary heart disease risk ratio, atherogenic index of plasma, atherogenic co-efficient, Cholesterol index, Castelli risk index I, and Castelli risk index II. Materials and Methods: A prospective, comparative study among new acceptors of contraceptives at four family planning clinics in Ilorin, North-Central Nigeria. Participants were categorized into COCs acceptors (group I, n=120) and acceptors of non-hormonal contraceptives (group II, n=120). Participants were followed up with serial lipid profiles at 0, 3 and 6 months after uptake. Atherogenic risks were calculated using six standard formulae; statistical analysis was with SPSS version 21.0 and Analysis of variance (ANOVA) was used to compare the differences of more than two means, Bonferroni Post Hoc test was used to test for specific significance within the group and p-value <0.05 was considered significant. Results: A total of 225 participants (111 COC users, 114 non-COC users) aged 19 to 48 years completed the study. Serum levels of Low-Density Lipoprotein showed a statistically significant rise among the COC users over the study period (p=0.038), especially between the third and sixth months. The lipid ratios were statistically increased using all six methods despite apparently normal lipid parameters. Conclusion: Atherogenic changes may occur in the presence of apparently normal lipid parameters among COC users; therefore, serial lipid ratio using standard method formulae is recommended.
背景:复方口服避孕药(COC)与动脉粥样硬化和心血管改变有关。一些服务提供者使用个体脂质参数来评估这些变化，而不像使用标准公式客观计算。目的:利用六种脂质比值测定和比较COCs患者的动脉粥样硬化变化;冠心病危险比、血浆致动脉粥样硬化指数、致动脉粥样硬化系数、胆固醇指数、Castelli风险指数I、Castelli风险指数II。材料和方法:在伊洛林，尼日利亚中北部的四个计划生育诊所避孕药具的新接受者的前瞻性，比较研究。参与者被分为COCs受体(I组，n=120)和非激素避孕药受体(II组，n=120)。在服用后0,3和6个月，对参与者进行了连续的脂质分析。采用6个标准公式计算动脉粥样硬化风险;统计学分析采用SPSS 21.0版本，比较两个以上均值的差异采用方差分析(ANOVA)，组内特定显著性检验采用Bonferroni Post Hoc检验，p值<0.05被认为是显著的。结果:共有225名参与者(111名COC使用者，114名非COC使用者)完成了研究，年龄在19至48岁之间。COC使用者的血清低密度脂蛋白水平在研究期间(p=0.038)有统计学意义的上升，特别是在第3和第6个月之间。尽管脂质参数明显正常，但六种方法的脂质比率均有统计学意义上的升高。结论:COC使用者在脂质参数明显正常的情况下可能发生动脉粥样硬化改变;因此，建议采用标准方法配方进行系列脂质配比。
{"title":"Applicability of lipid ratios in the prediction of atherogenic risks of women on combined oral contraceptives in North-Central Nigeria","authors":"O. Jimoh, Hidaayah Jimoh - Abdulghaffaar, T. Bakare, G. Popoola, Waliu Oladosu, E. Grillo, A. Ahmed, A. Adeniran","doi":"10.4103/cjhr.cjhr_120_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_120_22","url":null,"abstract":"Background: Combined Oral Contraceptive (COC) pill is associated with atherogenic and cardiovascular changes. Some service providers use individual lipid parameters to assess these changes unlike objective calculation using standard formulae. Objective: To determine and compare the atherogenic changes in women on COCs using six lipid ratios; coronary heart disease risk ratio, atherogenic index of plasma, atherogenic co-efficient, Cholesterol index, Castelli risk index I, and Castelli risk index II. Materials and Methods: A prospective, comparative study among new acceptors of contraceptives at four family planning clinics in Ilorin, North-Central Nigeria. Participants were categorized into COCs acceptors (group I, n=120) and acceptors of non-hormonal contraceptives (group II, n=120). Participants were followed up with serial lipid profiles at 0, 3 and 6 months after uptake. Atherogenic risks were calculated using six standard formulae; statistical analysis was with SPSS version 21.0 and Analysis of variance (ANOVA) was used to compare the differences of more than two means, Bonferroni Post Hoc test was used to test for specific significance within the group and p-value <0.05 was considered significant. Results: A total of 225 participants (111 COC users, 114 non-COC users) aged 19 to 48 years completed the study. Serum levels of Low-Density Lipoprotein showed a statistically significant rise among the COC users over the study period (p=0.038), especially between the third and sixth months. The lipid ratios were statistically increased using all six methods despite apparently normal lipid parameters. Conclusion: Atherogenic changes may occur in the presence of apparently normal lipid parameters among COC users; therefore, serial lipid ratio using standard method formulae is recommended.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"99 - 104"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45019460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Mamatha, J. Meena, P. Sulaniya, R. Sehra, S. Verma
Introduction: Birth asphyxia can alter biophysical characteristics of erythrocytes, leukocytes and platelets. Nucleated red blood cell (NRBC) in the umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. NRBCs, platelet count, total leukocyte count, hemoglobin, and hematocrit were taken as hematological parameters. The purpose of this study was to evaluate the various hematological changes following birth asphyxia and their correlation with the severity of birth asphyxia and its outcome. Materials and Methods: It was hospital-based comparative observation study conducted in neonatal units of a tertiary hospital in the northern part of India from May 2019 to May 2020. All term appropriate for gestational age newborns with birth asphyxia were taken as cases and healthy newborns as controls. The sample size of 80 participants in each group was calculated. 2 ml cord blood sample was taken for parameters used in the study. P < 0.05 was taken as statistically significant. Results: There was no statistically significant difference in relation to sex distribution, birth weight, parity of mothers, and mode of delivery between cases and controls. NRBC and total leukocyte count were statistically positively correlated with the severity of hypoxic-ischemic encephalopathy (HIE), whereas hemoglobin, hematocrit, and platelet counts were not statistically significant. Area under the Receiver operating characteristic (ROC) curve of NRBC was 0.812, and the NRBC count cutoff of >20 has a sensitivity of 83% and specificity of 72%. Forty-six percent of total cases with NRBC 20 or more died. Conclusions: NRBC has a significant positive correlation with the severity of HIE and a negative with the Apgar score. NRBCs value more than or equal to 20 can be used as a prognostic marker for assessing the severity and outcome of birth asphyxia.
{"title":"Comparative study to correlate hematological parameters with the severity of birth asphyxia","authors":"R. Mamatha, J. Meena, P. Sulaniya, R. Sehra, S. Verma","doi":"10.4103/cjhr.cjhr_61_22","DOIUrl":"https://doi.org/10.4103/cjhr.cjhr_61_22","url":null,"abstract":"Introduction: Birth asphyxia can alter biophysical characteristics of erythrocytes, leukocytes and platelets. Nucleated red blood cell (NRBC) in the umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. NRBCs, platelet count, total leukocyte count, hemoglobin, and hematocrit were taken as hematological parameters. The purpose of this study was to evaluate the various hematological changes following birth asphyxia and their correlation with the severity of birth asphyxia and its outcome. Materials and Methods: It was hospital-based comparative observation study conducted in neonatal units of a tertiary hospital in the northern part of India from May 2019 to May 2020. All term appropriate for gestational age newborns with birth asphyxia were taken as cases and healthy newborns as controls. The sample size of 80 participants in each group was calculated. 2 ml cord blood sample was taken for parameters used in the study. P < 0.05 was taken as statistically significant. Results: There was no statistically significant difference in relation to sex distribution, birth weight, parity of mothers, and mode of delivery between cases and controls. NRBC and total leukocyte count were statistically positively correlated with the severity of hypoxic-ischemic encephalopathy (HIE), whereas hemoglobin, hematocrit, and platelet counts were not statistically significant. Area under the Receiver operating characteristic (ROC) curve of NRBC was 0.812, and the NRBC count cutoff of >20 has a sensitivity of 83% and specificity of 72%. Forty-six percent of total cases with NRBC 20 or more died. Conclusions: NRBC has a significant positive correlation with the severity of HIE and a negative with the Apgar score. NRBCs value more than or equal to 20 can be used as a prognostic marker for assessing the severity and outcome of birth asphyxia.","PeriodicalId":10321,"journal":{"name":"CHRISMED Journal of Health and Research","volume":"10 1","pages":"60 - 65"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47453048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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