Clinical profile of patients with vernal keratoconjunctivitis

Background: Ocular allergy is a common disorder, which can be debilitating for patients and at times challenging physicians to diagnose and treat. Allergic disease affects 30-50% of the population. Vernal keratoconjunctivitis (VKC) has predilection for young age group and the diagnosis is generally based on signs and symptoms of the disease. This study was undertaken to stress upon the disease and those secondary to its long-term medication.Methods: 74 patients with VKC detected at random, who attended the Department of Ophthalmology KIMS, Hubli from December 2012 to May 2014. The relevant details of history and clinical examination of the patients were recorded on a specifically designed Proforma. The type and severity of VKC was noted. Clinical observation and evaluation of clinical signs and symptoms were performed before and after drug therapy at first visit, weekly interval for 2 weeks and at the end of 3 months.Results: 22 out of 74 (29.72%) were in the 6-10 years of age. The male: female ratio was 2.7:1.13. Majority of the patients presented in the month of May. Family history of allergy was present in 4 (5.04%) of patients. 59 (72.72%) patients showed seasonal symptoms and 15 (20.27%) patients showed perennial symptoms. Mixed type was found in 60.81%. Itching was present in 59 (79.72%). 72 (97.29%) had papillae on the upper tarsal conjunctiva.Conclusions: VKC was common in males, during hot climate. Mixed type of VKC was more commonly present.

The sensitivity of real-time PCR amplification targeting invasive Salmonella serovars in biological specimens

Background: PCR amplification for the detection of pathogens in biological material is generally considered a rapid and informative diagnostic technique. Invasive Salmonella serovars, which cause enteric fever, can be commonly cultured from the blood of infected patients. Yet, the isolation of invasive Salmonella serovars from blood is protracted and potentially insensitive. Methods: We developed and optimised a novel multiplex three colour real-time PCR assay to detect specific target sequences in the genomes of Salmonella serovars Typhi and Paratyphi A. We performed the assay on DNA extracted from blood and bone marrow samples from culture positive and negative enteric fever patients. Results: The assay was validated and demonstrated a high level of specificity and reproducibility under experimental conditions. All bone marrow samples tested positive for Salmonella, however, the sensitivity on blood samples was limited. The assay demonstrated an overall specificity of 100% (75/75) and sensitivity of 53.9% (69/128) on all biological samples. We then tested the PCR detection limit by performing bacterial counts after inoculation into blood culture bottles. Conclusions: Our findings corroborate previous clinical findings, whereby the bacterial load of S. Typhi in peripheral blood is low, often below detection by culture and, consequently, below detection by PCR. Whilst the assay may be utilised for environmental sampling or on differing biological samples, our data suggest that PCR performed directly on blood samples may be an unsuitable methodology and a potentially unachievable target for the routine diagnosis of enteric fever. </p