Screening for lower genital tract infections in women of reproductive age group attending a tertiary care hospital

Background: Lower genital tract infections are the major cause of gynecological morbidity and a great public health concern in India. Inadequate laboratory diagnostic facilities in all the levels of health care, limited resources in material and manpower, stigma and discrimination associated with RTI services are some of the reasons of lack of exact incidence/prevalence rate of RTI in India. Hence this study was conducted to provide a reliable laboratory based data on the occurrence of lower genital tract infections.Methods: A prospective study was conducted on 110 women attending Gynecology OPD at a tertiary care teaching hospital over a period of one year (June 2014 to May 2015). After getting informed consent and brief history, vaginal swab and endocervical sample was collected and used for microscopic examination and culture. All the endocervical samples were subjected to Real Time PCR for detection of Chlamydia trachomatis.Results: Among 110 samples, laboratory diagnosis of lower genital tract infections was positive in 43 subjects (39.09%). By Real time PCR assay among the 110 samples, 9 (8.8%) of the samples were positive for Chlamydia trachomatis infection. Candida sp., (17, 35.42%) was the most common organism identified followed by Escherichia coli (10, 20.83%).Conclusions: Laboratory screening is must in all the symptomatic women in order to avoid the unnecessary treatment, which warrants the patients’ reliability. Chlamydia trachomatis screening is mandatory for all the child bearing age group women to avoid consequences like PID and infertility

Predictors of mortality among hospitalized COVID-19 patients and risk score formulation for prioritizing tertiary care—An experience from South India

BACKGROUND: We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. METHODS AND FINDINGS: Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among ‘survivors’ and ‘non-survivors’. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 “survivors” and 259 “non-survivors” (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40–70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO(2)3; 3.01 (1.61–5.83), Age ≥50 years;2.52 (1.45–4.43), Pulse Rate ≥100/min: 2.02 (1.19–3.47) and coexisting Diabetes Mellitus; 1.73 (1.02–2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO(2)3–11, Age ≥50 years-9, Pulse Rate ≥100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as ‘OUR-ARDs score’ showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. CONCLUSIONS: The ‘OUR ARDs’ risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system

A biochemical study on the level of lipids and glycoproteins in the serum and platelets of liver cirrhotic bleeders

Bleeding complication and abnormal platelet functions are associated with liver cirrhosis. The aim of the present investigation was to assess the functional integrity of platelets in terms of lipids like cholesterol and phospholipids, glycoproteins and membrane-bound enzymes. Liver cirrhotic patients with bleeding complications were studied. Age and sex matched normal healthy volunteers were also involved in this study as a control group. Levels of cholesterol, phospholipids, glycoproteins and adenosine triphosphatases were assessed in isolated platelet membrane fraction. The level of glycoproteins and the activity of adenosine triphosphatases were found to be decreased significantly in cirrhotic patients. The cholesterol/phospholipid ratio was found to be altered significantly, indicating an alteration in the fluidity of platelet membrane. The results of this study reveal that the functional impairment of platelets in liver cirrhotic patients which is responsible for their bleeding tendency might also be due to altered lipid and enzyme levels in platelet membrane

Screening for lower genital tract infections in women of reproductive age group attending a tertiary care hospital

Background: Lower genital tract infections are the major cause of gynecological morbidity and a great public health concern in India. Inadequate laboratory diagnostic facilities in all the levels of health care, limited resources in material and manpower, stigma and discrimination associated with RTI services are some of the reasons of lack of exact incidence/prevalence rate of RTI in India. Hence this study was conducted to provide a reliable laboratory based data on the occurrence of lower genital tract infections.Methods: A prospective study was conducted on 110 women attending Gynecology OPD at a tertiary care teaching hospital over a period of one year (June 2014 to May 2015). After getting informed consent and brief history, vaginal swab and endocervical sample was collected and used for microscopic examination and culture. All the endocervical samples were subjected to Real Time PCR for detection of Chlamydia trachomatis.Results: Among 110 samples, laboratory diagnosis of lower genital tract infections was positive in 43 subjects (39.09%). By Real time PCR assay among the 110 samples, 9 (8.8%) of the samples were positive for Chlamydia trachomatis infection. Candida sp., (17, 35.42%) was the most common organism identified followed by Escherichia coli (10, 20.83%).Conclusions: Laboratory screening is must in all the symptomatic women in order to avoid the unnecessary treatment, which warrants the patients’ reliability. Chlamydia trachomatis screening is mandatory for all the child bearing age group women to avoid consequences like PID and infertility

Comparison of analgesic efficacy of transversus abdominis plane block with direct infiltration of local anesthetic into surgical incision in lower abdominal gynecological surgeries

Background: Transversus abdominis plane block is a safe, simple and effective technique of providing analgesia for lower abdominal surgeries with easily identifiable landmarks. Aims: To compare the analgesic efficacy of transversus abdominis plane block with that of direct infiltration of local anesthetic into surgical incision in lower abdominal procedures. Settings and Design: Prospective randomized controlled trial in lower abdominal surgeries done under general anesthesia. Materials and Methods: 52 ASA I-II patients undergoing lower abdominal gynecological procedures under general anesthesia were divided randomly into two groups each after written informed consent. A bilateral TAP block was performed on Group T with 0.25% bupivacaine 0.6 ml/kg with half the volume on either side intra-operatively after skin closure before extubation using a short bevelled needle, whereas Group I received local infiltration intra-operatively after skin closure with the same amount of drug. The time taken for the first rescue analgesic and visual analog score (VAS) was noted, following which, the patient was administered intravenous morphine 0.1 mg/kg and connected to an intravenous patient controlled analgesia system with morphine for 24 hrs from the time of block administration. 24 h morphine requirement was noted. VAS and sedation scores were noted at 2, 4, 6 and 24 h postoperatively. Statistical Analysis Used: The results were analyzed with SPSS 16. A P value < 0.05 was considered significant. Duration of analgesia and 24 h morphine requirement was analysed by Student′s t-test. VAS scores, with paired comparisons at each time interval, were performed using the t-test or Mann-Whitney U-test, as appropriate. Categorical data were analyzed using Chi square or Fisher′s exact test. Results: In Group T, the time to rescue analgesic was significantly more and the VAS scores were lower ( P = 0.001 and 0.003 respectively). The 24 hr morphine requirement and VAS at 2, 4, 6 and 24 h were less in the Group T ( P = 0.001). Incidence of PONV was significant in Group I ( P = 0.043), whereas Group T were less sedated at 2 and 4 h ( P = 0.001 and 0.014). Conclusions: Transversus abdominis plane block proved to be an effective means of analgesia for lower abdominal surgeries with minimal side-effects

Detection of embryonic stem cell markers in adult human adipose tissue-derived stem cells

Background: Bone marrow transplantation is already an established therapy, which is now widely used in medicine to treat leukemia, lymphoma, and several inherited blood disorders. The culture of multilineage cells from easily available adipose tissue is another source of multipotent mesenchymal stem cells, and is referred to as adipose tissue-derived stem cells (ADSCs). While ADSCs are being used to treat various conditions, some lacuna exists regarding the specific proteins in these. It was therefore decided to analyze the specific proteins of embryonic cells in ADSCs. Aims: To analyze the specific protein of embryonic stem cells (ESCs) in ADSCs. Materials and Methods: Adult human adipose tissue-derived stem cells (ADSCs) were harvested from 13 patients after obtaining patients′ consent. The specific markers of ESCs included surface proteins CD10, CD13, CD44, CD59, CD105, and CD166, and further nucleostemin,(NS) NANOG, peroxisome proliferator-activated receptor-gγ, collagen type 1 (Coll1), alkaline phosphate, (ALP) osteocalcin (OC), and core binding factor 1 (Cbfa1) were analyzed using by reverse transcription-polymerase chain reaction, (RT-PCR) immunofluorescence (IF), and western blot. Results: All the proteins were expressed distinctly, except CD13 and OC. CD13 was found individually with different expressions, and OC expression was discernable. Conclusions: Although the ESC with its proven self-renewal capacity and pluripotency seems appropriate for clinical use, the recent work on ADSCs suggests that these adult stem cells would be a valuable source for future biotechnology, especially since there is a relative ease of procurement

Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147)

Background & objectives: Despite the rising prevalence of non-communicable diseases (NCDs) in rural India, data on the dietary profile of the rural Indian population in relation to the recommendations for prevention of NCDs are scarce. This study was conducted to assess the dietary intake of a rural south Indian population in relation to the current dietary recommendations for the prevention of NCDs. Methods: The dietary profiles of 6907 adults aged ≥ 20 yr, from a cluster of 42 villages in Kancheepuram district of Tamil Nadu State in southern India, were assessed using a validated food frequency questionnaire. Results: The prevalence of general obesity was 27.4 per cent and that of abdominal obesity, 14.0 per cent among this rural population. The median daily energy intake of the population was 2034 (IQR 543) kcals. More than 3/4 th of the calories (78.1%) were provided by carbohydrates. Refined cereals, mainly polished rice, was the major contributor to total calories. About 45 per cent of the population did not meet WHO recommendation for protein due to low intake of pulses, flesh foods and dairy products and more than half (57.1%) exceeded the limit of salt intake; 99 per cent of the population did not meet WHO recommendations for fruits and vegetables and 100 per cent did not meet the requirement of n-3 poly unsaturated fatty acids. Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action