Gender differences in the clinical diagnosis of tuberculous lymphadenitis—a hospital-based study from Central India

SummaryObjectiveTuberculous lymphadenitis can be difficult to diagnose clinically, and as it is thought to be more common in females, we describe here the clinical characteristics of cervical tuberculous lymphadenitis in men and women and compare this with cytology to assess their diagnostic value.MethodsTwo hundred and nineteen patients with tuberculous lymphadenitis, aged 14 years or more, who presented with a neck mass to the Department of Pathology, Ujjain Hospital, Ujjain, India were included in the study. The presenting clinical symptoms and signs were compared between men and women and with the cytology of fine needle aspirates from the lymph nodes.ResultsSeventy-five percent of the patients were aged between 14 and 35 years, with a male to female ratio of 1:2.1. One or more constitutional symptoms were present in 56.6% of patients on presentation. There were more men with clinical symptoms than women. Fever was the most common manifestation in both gender groups. Fever for more than 30 days, cough, weight loss, and night sweats were significantly more common in men. On cytology, necrotic granulomas were found to be associated with constitutional symptoms.ConclusionsConstitutional symptoms were more frequently reported by men than by women and showed a correlation with necrotic granulomas on cytology

Rapid and Specific Diagnosis of Extrapulmonary Tuberculosis by Immunostaining of Tissues and Aspirates With Anti-MPT64

Background: Extrapulmonary tuberculosis (EPTB) constitutes about 15% to 20% of all cases of tuberculosis (TB). The confirmation of EPTB has always been a challenge to laboratory personnel. We aim to evaluate the diagnostic potential of immunostaining with anti-MPT64 in various EPTB specimens. Materials and Methods: We studied a total of 51 TB cases and 38 non-TB control specimens comprising of fine-needle aspirates and formalin-fixed biopsies. These were investigated using a combination of the Ziehl-Neelsen method, the Lowenstein-Jensen culture, immunostaining with anti-MPT64 and anti-BCG, and nested-polymerase chain reaction (PCR) for IS6110. Results of all the tests were compared using nested-PCR as the gold standard. Results: Diagnostic validation of immunostaining for anti-MPT64 was performed using nested-PCR as the gold standard. The overall sensitivity, specificity, and positive and negative predictive values for immunostaining with anti-MPT64 were 100%, 97%, 97%, and 100%, respectively. Conclusions: Immunostaining using anti-MPT64 is a rapid and sensitive method for establishing an early and specific diagnosis of Mycobacterium tuberculosis infection. The technique is simple to be incorporated into routine pathology laboratories.publishedVersio

Evaluation of safety and tolerability of iron amino acid chelate therapy in pregnant women

Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. It can be associated with increased preterm labor, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths. The aim of the study was to monitor the oral iron therapy [Iron Amino Acid Chelate (IAAC) equivalent to elemental iron 30 mg] administered according to hospital practice and to determine the safety, and tolerability of IAAC in pregnant women.Methods: The data of pregnant women attending the outpatient department of the hospital for antenatal care between March 2020 and February 2021 and prescribed IAAC was retrospectively analyzed. It was of interest to note the changes in the Hemoglobin (Hb) levels and serum ferritin levels. These parameters were considered as the primary efficacy parameter and were analyzed by the paired t-test.Results: The data indicated very well tolerance to IAAC preparation with increase in Hb levels. After 12 week of treatment, there were significant increases in hemoglobin levels with mean rise in Hb level was 7 to 9 gm/dL. A statistically significant difference was observed at the 4th, 8th, and 12th weeks from the baseline value to each evaluation in the Hb level due to the supplementation of oral iron.  The change in the serum ferritin levels was found to be statistically significant at the 12th week from the baseline values. Most of the women tolerated the oral IAAC preparationConclusions: This retrospective analysis showcased a significant improvement in the Hb and serum ferritin levels of pregnant women after 12 weeks

Immunohistochemical diagnosis of abdominal and lymph node tuberculosis by detecting Mycobacterium tuberculosis complex specific antigen MPT64

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to evaluate the diagnostic potential of immunohistochemistry using an antibody to the secreted mycobacterial antigen MPT64, in abdominal and lymph node tuberculosis.</p> <p>Methods</p> <p>We used formalin-fixed histologically diagnosed abdominal tuberculosis (n = 33) and cervical tuberculous lymphadenitis (n = 120) biopsies. These were investigated using a combination of Ziehl-Neelsen method, culture, immunohistochemistry with an antibody to MPT64, a specific antigen for <it>Mycobacterium tuberculosis</it> complex organisms. Abdominal and cervical lymph node biopsies from non-mycobacterial diseases (n = 50) were similarly tested as negative controls. Immunohistochemistry with commercially available anti-BCG and nested PCR for IS6110 were done for comparison. Nested PCR was positive in 86.3% cases and the results of all the tests were compared using nested PCR as the gold standard.</p> <p>Results</p> <p>In lymph node biopsies, immunohistochemistry with anti-MPT64 was positive in 96 (80%) cases and 4 (12.5%) controls and with anti-BCG 92 (76.6%), and 9 (28%) respectively. The results for cases and controls in abdominal biopsies were 25 (75.7%) and 2 (11.1%) for anti-MPT64 and 25 (75.7%) and 4 (22%) for anti-BCG. The overall sensitivity, specificity, positive and negative predictive values of immunohistochemistry with anti-MPT64 was 92%, 97%, 98%, and 85%, respectively while the corresponding values for anti-BCG were 88%, 85%, 92%, and 78%.</p> <p>Conclusion</p> <p>Immunohistochemistry using anti-MPT64 is a simple and sensitive technique for establishing an early and specific diagnosis of <it>M. tuberculosis</it> infection and one that can easily be incorporated into routine histopathology laboratories.</p

Решение обратной задачи кинематики шестизвенного робота

Материалы XX Междунар. науч.-техн. конф. студентов, аспирантов и молодых ученых, Гомель, 23–24 апр. 2020 г

Patient Health Seeking and Diagnostic Delay in Extrapulmonary Tuberculosis: A Hospital Based Study from Central India

Objective. We aimed to investigate the awareness, health care seeking behavior, and diagnostic delay in extrapulmonary tuberculosis (EPTB) in a resource-constrained setting from Central India. Setting and Method. Questionnaire based interview of 1220 EPTB patients ≥14 years of age was conducted between July 2004 and August 2012 at Ujjain charitable Hospital, Ujjain, India. Results. Only 15% of patients had ever heard about EPTB and 2-4% knew about its prevention or treatment. Only 12% patients first sought medical advice while 49% patients practiced self-medication, 28% consulted traditional healers and 11% drug store/pharmacy. The median patient delay was 8 weeks (4.6-21.4 weeks). Majority (78%) of patients visited ≥3 health centers. Thirty-eight percent patients first visited any government health facility. Majority (97%) who first visited district and primary public health center were referred to private sector for investigations and 82% patients changed the consultation to private doctor after initial visit to public hospital. The median health system delay was 7 weeks (0.6-16.4 weeks). Conclusion. Patients had very poor awareness of EPTB. Patients were referred from public to private sector in search of diagnostic facilities. Improvement of public awareness about EPTB and better public-private partnership may contribute towards reduction in diagnostic delay

Mass bathing events in River Kshipra, Central India- influence on the water quality and the antibiotic susceptibility pattern of commensal E.coli.

BACKGROUND:Antibiotic resistance is one of the major global health emergencies. One potential source of dissemination of resistant bacteria is mass gatherings, e.g. mass bathing events. We evaluated the physicochemical parameters of water quality and the antibiotic resistance pattern in commensal Escherichia coli from river-water and river-sediment in pre-, during- and post-mass bathing events in river Kshipra, Central India. METHOD/DESIGN:Water and sediment samples were collected from three selected points during eight mass bathing events during 2014-2016. Water quality parameters (physical, chemical and microbiological) were analyzed using standard methods. In river water and sediment samples, antibiotic susceptibility patterns of isolated E. coli to 17 antibiotics were tested. RESULTS:pH, turbidity and dissolved oxygen were significantly lower and total dissolved solid, free carbon dioxide were higher during mass bathing, whilst TSS, BOD and COD were lowest in pre-bathing and highest in post-bathing period. E.coli with multi drug resistance (MDR) or extended spectrum beta-lactamase (ESBL) production were between 9-44% and 6-24%, respectively in river-water as well as river-sediment. Total coliform count/ml and E. coli count were higher during-and post-bathing in river water than in pre-bathing period. Thus, the percentage of resistance was significantly higher during and post-bathing period (p<.05) than in pre-bathing. Colony forming unit (CFU)/ml in river-sediment was much higher than in river-water. Percentage of resistance was significantly higher in river-water (p<.05) than in river-sediment. CONCLUSIONS:Antibiotic resistance in E.coli isolated from the Kshipra River showed significant variation during mass bathing events. Guidelines and regulatory standards are needed to control environmental dissemination of resistant bacteria

Effectiveness and feasibility of methanol extracted latex of Calotropis procera as larvicide against dengue vectors of western Rajasthan, India

Background & objectives:Identification of novel effective larvicide from natural resources is essential to combat developing resistances, environmental concerns, residue problems and high cost of synthetic insecticides. Results of earlier laboratory findings have shown that Calotropis procera extracts showed larvicidal, ovicidal and refractory properties towards ovipositioning of dengue vectors; further, latex extracted with methanol was found to be more effective compared to crude latex. For testing efficacy and feasibility of extracted latex in field, the present study was undertaken in different settings of Jodhpur City, India against dengue vectors. Methods:Study areas were selected based on surveillance design for the control of dengue vectors. During the study period domestic and peri-domestic breeding containers were treated with methanol extracted latex and mortality was observed after 24 h as per WHO guidelines. Latex was manually collected from internodes of Calotropis procera and extracted using methanol (AR) grade. Results:Methanol extracted latex of C. procera was found effective and feasible larvicide against dengue vectors in the field conditions. Cement tanks, clay pots and coolers (breeding sites) were observed as key containers for the control of dengue transmission. Interpretation & conclusion:Today environmental safety is considered to be very important. Herbal composition prepared by the extraction of latex of C. procera can be used as an alternative approach for the control of dengue vectors. This will reduce the dependence on expensive products and stimulate local efforts to enhance the public involvement

On fractional calculus operator N^{\ni_1,\ni_2} and p-transformation

In this paper, the set {N^{ν1 ν2} } of fractional calculus is discussed. It is shown that the set is an Abelian product group for f(z1 , z2 ) = f ∈ F={ f ; 0 \ne |f_{ ν1ν2} | < ∞, ν1, ν2 ∈ R} with continuous indexes ν1 , ν2 , [1]. A new P-transformation is being introduced for the functions of two variables

Immunocytochemical staining of cervical smears – A comparative study with routine cytology for confirmation of precancerous and cancerous lesions of cervix

Introduction: Carcinoma cervix is one of the leading causes of morbidity and mortality. The most effective method of screening is based on Pap smear study. However, Pap smear has relatively low sensitivity and irreducible false negative &amp; false positive rates. In countries like India, it is not always feasible to follow the patient for confirmation by histology. In the present study, we have tried to fill this gap by staining the cervical smears with, epithelial cell markers including CK17 and CEA expressed by dysplastic squamous cells. Materials &amp; Methods: 50 cervical smears reported as precancerous or cancerous were stained with anti CK17 and anti CEA. The patients were followed for histopathology. Results: Out of 20 cases of ASCUS, three were positive both for anti-CK17 and anti-CEA and six were positive for anti-CK17 only. Out of 18 cases of LSIL, nine were positive for both anti-CK17 and anti-CEA and fifteen were positive for anti-CK17 only. Out of eight cases of HSIL, three were positive for both anti-CK17 and anti-CEA and six were positive for anti-CK17 only. Out of 4 cases of SCC, three were positive for both anti-CK17 and anti-CEA and all four were positive for anti-CK17. Conclusion: Positive result in staining was higher in high grade lesions. CK 17 was found to be better marker than CEA. CK17 and CEA can be used as adjunct to Pap smear screening but its high cost may restrict its use in routine