Serological Analysis of Pulmonary and Extra Pulmonary Tuberculosis With Elisa for Anti A60 IgA

Background: Demonstration and evaluation of antituberculous IgA antibodies for rapid diagnosis of bothpulmonary and extra pulmonary tuberculosis.Method: ELISA assay based on mycobacterial antigenA60 (Anda Biologicals, France) was used on the seraobtained from 69 cases of tuberculosis and 136 controls inthe population of Karachi, Pakistan.Result: Of 136 controls only 7.3% were positive for IgA.A very good serological response was observed in caseswith sputum positive active pulmonary tuberculosis,depicting a positivity of 83.3% for IgA antibodies.Relatively low sero positivity was seen in cases of sputumnegative active pulmonary tuberculosis compared to thoseof sputum active pulmonary tuberculosis. A low positivityof 26.3% for IgA was observed in cases of extra pulmonarytuberculosis. In cases of healed tuberculosis 25% werefound positive for IgA. Considering all the cases of activetuberculosis and the controls the global sensitivity of58.4% and specificity of 92.7% were obtained when IgAantibodies were taken into account.Conclusion: The estimation of anti tuberculosisantibody IgA against A60 for the rapid diagnosis is clearlydemonstrated and therefore recommende

Frequency of Functional Gastrointestinal Disorders in Children with Recurrent Abdominal Pain

Background: Functional gastrointestinal disorders (FGIDs) are common disorders characterized by chronic or recurrent gastrointestinal (GI) symptoms, not related to structural or biochemical abnormalities Objective: To determine the frequency of FGIDs in children with complaints of recurrent abdominal pain. Methods: This cross-sectional study was done at the outpatient department of pediatrics, National Institute of Child Health, Karachi, Pakistan from October 2022 to March 2023. Children of either gender aged 1-12 years with complaints of recurrent abdominal pain were analyzed. Socio-demographic characteristics along with presenting complaints and types of FGIDs were noted. Results: In a total of 188 children, the mean age was 7.22±1.96 years while 107 (56.9%) children were boys. The mean duration of symptoms was 2.7±1.8 months. The most frequent presenting complaints were pain during bowel movement, nausea, and epigastric pain reported by 88 (46.8%), 75 (39.9%), and 64 (34.0%) children respectively. Frequency distribution of functional GI disorders revealed that functional abdominal pain was the commonest noted in 72 (38.3%) children while irritable bowel syndrome (IBS) and functional dyspepsia were found among 38 (20.2%) and 37 (19.7%) children respectively. Stratification of functional GI disorders showed a statistically significant relationship (p<0.001) concerning presenting complaints. Conclusion: Among children with FGIDs, the most frequent presenting complaints were pain during bowel movement, nausea, and epigastric pain. Functional abdominal pain, IBS, and functional dyspepsia were the most frequent types of FGID

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Development of Larval Artificial Diet of Chrysoperla carnea (Stephens) (Neuroptera: Chrysopidae)

Abstract. -Green lacewing Chrysoperla carnea (Stephens), is an important predator, its larvae are considered as generalist beneficials. To enhance the larval efficiency for mass rearing of this predator, an artificial diet was standardized. Three different diets were tested. Larval survival, pupation, emergence percentage as well as adults longevity and egg laying potential were recorded. Maximum larval survival (85.75%), pupation percentage (82.67%) and emergence (66.68%) were recorded on the diet in which ground beef and ground beef liver were added instead of beef powder or beef liver powder. It was concluded that brewer&apos;s yeast and vitamin solution effected on fecundity and fertility. Among all diets egg laying was also better in this diet. Artificial larval diet played an important role in whole life cycle of C. carnea for mass production and proved better on all above parameters

Hyperendemic pulmonary tuberculosis in peri-urban areas of Karachi, Pakistan

Abstract Background Currently there are very limited empirical data available on the prevalence of pulmonary tuberculosis among residents of marginalized settings in Pakistan. This study assessed the prevalence of pulmonary tuberculosis through active case detection and evaluated predictors of pulmonary tuberculosis among residents of two peri-urban neighbourhoods of Karachi, Pakistan. Methods A cross-sectional study was conducted in two peri-urban neighbourhoods from May 2002 to November 2002. Systematic sampling design was used to select households for inclusion in the study. Consenting subjects aged 15 years or more from selected households were interviewed and, whenever possible, sputum samples were obtained. Sputum samples were subjected to direct microscopy by Ziehl-Neelson method, bacterial culture and antibiotic sensitivity tests. Results The prevalence (per 100,000) of pulmonary tuberculosis among the subjects aged 15 years or more, who participated in the study was 329 (95% confidence interval (CI): 195 – 519). The prevalence (per 100,000) of pulmonary tuberculosis adjusted for non-sampling was 438 (95% CI: 282 – 651). Other than cough, none of the other clinical variables was significantly associated with pulmonary tuberculosis status. Analysis of drug sensitivity pattern of 15 strains of Mycobacterium tuberculosis revealed that one strain was resistant to isoniazid alone, one to streptomycin alone and one was resistant to isoniazid and streptomycin. The remaining 12 strains were susceptible to all five drugs including streptomycin, isoniazid, rifampicin, ethambutol, and pyrazinamide. Conclusion This study of previously undetected tuberculosis cases in an impoverished peri-urban setting reveals the poor operational performance of Pakistan's current approach to tuberculosis control; it also demonstrates a higher prevalence of pulmonary tuberculosis than current national estimates. Public health authorities may wish to augment health education efforts aimed at prompting health-seeking behaviour to facilitate more complete and earlier case detection. Such efforts to improve passive case-finding, if combined with more accessible DOTS infra-structure for treatment of detected cases, may help to diminish the high tuberculosis-related morbidity and mortality in marginalized populations. The economics of implementing a more active approach to case finding in resource-constrained setting also deserve further study.</p

High resolution melting curve analysis targeting the HBB gene mutational hot-spot offers a reliable screening approach for all common as well as most of the rare beta-globin gene mutations in Bangladesh

Abstract Background Bangladesh lies in the global thalassemia belt, which has a defined mutational hot-spot in the beta-globin gene. The high carrier frequencies of beta-thalassemia trait and hemoglobin E-trait in Bangladesh necessitate a reliable DNA-based carrier screening approach that could supplement the use of hematological and electrophoretic indices to overcome the barriers of carrier screening. With this view in mind, the study aimed to establish a high resolution melting (HRM) curve-based rapid and reliable mutation screening method targeting the mutational hot-spot of South Asian and Southeast Asian countries that encompasses exon-1 (c.1 - c.92), intron-1 (c.92 + 1 - c.92 + 130) and a portion of exon-2 (c.93 - c.217) of the HBB gene which harbors more than 95% of mutant alleles responsible for beta-thalassemia in Bangladesh. Results Our HRM approach could successfully differentiate ten beta-globin gene mutations, namely c.79G > A, c.92 + 5G > C, c.126_129delCTTT, c.27_28insG, c.46delT, c.47G > A, c.92G > C, c.92 + 130G > C, c.126delC and c.135delC in heterozygous states from the wild type alleles, implying the significance of the approach for carrier screening as the first three of these mutations account for ~85% of total mutant alleles in Bangladesh. Moreover, different combinations of compound heterozygous mutations were found to generate melt curves that were distinct from the wild type alleles and from one another. Based on the findings, sixteen reference samples were run in parallel to 41 unknown specimens to perform direct genotyping of the beta-thalassemia specimens using HRM. The HRM-based genotyping of the unknown specimens showed 100% consistency with the sequencing result. Conclusions Targeting the mutational hot-spot, the HRM approach could be successfully applied for screening of beta-thalassemia carriers in Bangladesh as well as in other countries of South Asia and Southeast Asia. The approach could be a useful supplement of hematological and electrophortic indices in order to avoid false positive and false negative results