Microbial Profiles of Hands, Foods, Easy Contact Surfaces and Food Contact Surfaces: A Case Study of a University Campus

Human hands usually harbour microbes both as part of body normal flora as well as transient microbes acquired from the environment. One common way by which transient organisms of hand are picked up is by contact with food and surfaces. A total of 130 samples consisting of 40 hand swabs, 20 each of food samples and food contact surfaces and 10 each of swabs from banisters, table top, door handles, taps handles and toilet flushers were collected from different locations of the University campus. Samples were analyzed for total aerobic plate count, fungal count, coliform count and for specific organisms. About 98% of hand swabs, food contact and the easy contact surfaces were contaminated with diverse organisms. Hand swabs from the halls of residence and Library had higher levels of contaminations 2.1x105 and 1.9x105 cfu respectively. Toilet flushers and Banisters had TAPC of 8.3x106 and 4.8x106. Moin-moin, Fried rice and Coleslaw had counts of 3.2x107, 1.6x106 and 1.1x106 cfu/g. The predominant microorganisms isolated were Bacillus spp., Staphylococcus spp., Streptococcus spp., Aspergillus spp., Fusarium spp., Penicillium spp. and Actinomycetes. Also present in the food samples and contact surfaces are Klebsiella spp., Escherichia coli and Salmonella spp. Different types of organisms can be picked up from the environment specifically the easy contact surfaces and the hand can be the most important means by which enteric pathogens are transmitted. Likewise, the rate of food borne illness can be greatly reduced by effective HACCP, GMP and hand washing

Reproductive tract disorders among Afghan refugee women attending health clinics in Haripur, Pakistan

Afghans comprise one of the largest groups of refugees in the world, with the majority living in Pakistan. The objective of this study was to identify commonly-occurring reproductive tract infections (RTIs), des-cribe knowledge of women about RTIs, and assess physical and behavioural factors contributing to the de-velopment of RTIs. Afghan women presenting at Basic Health Units in refugee camps in Haripur, Pakistan, with reproductive health-related complaints, were included in the study (n= 634). Data collection included implementation of an interviewer-administered questionnaire, along with a physical examination and laboratory tests. A descriptive analysis was conducted first. Qualitative data were coded and analyzed us-ing predetermined themes. Chi-square test was used for determining the possible relationships between a binary outcome and categorical risk factors. Over three-fourths ( 76. 7%) of those who reported to the health clinics with reproductive complaints had an RTI. Nearly half ( 49. 5%) of these women were diagnosed with some form of vaginitis, and 14. 7% were diagnosed with clinical suspicion of pelvic inflammatory disease (PID). Women with cervical prolapse (p= 0. 033) or who cleansed after intercourse (p= 0. 002) were more likely to have vaginitis. There was a significant difference (p= 0. 017) in the prevalence of suspected PID among women who used mud only ( 11. 1%), any water ( 18. 8%), and an old cloth or toilet paper ( 9. 8%) for cleansing after defaecation. Specific physical and behavioural contributors to the high prevalence of RTIs in this population were identified, and recommendations to ameliorate these factors are offered

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society