Achromobacter: an emerging nosocomial pathogen

Background: Achromobacter is a ubiquitous, non-fermenting, Gram-negative bacterium that lives in soil and aquatic environments. In recent years, many studies have shown its potential as opportunistic pathogen. It can colonize various items used in hospital and can survive various disinfectants. The infections get complicated due to its vast spectrum of intrinsic and extrinsic resistance to antimicrobial agents and disinfectants. Achromobacter spp. is an emerging pathogen and is becoming a reservoir for horizontal genetic transfer elements involved in spreading antibiotic resistance. This study was conducted to assess the extent of the Achromobacter related infection in our hospital setting and to set a baseline for future studies.Methods: This study was conducted over a period of one year (January to December 2018) in our tertiary care hospital. All specimens submitted for aerobic culture and sensitivity were analyzed and the bacterial identification and antibiotic sensitivity of the isolates was carried out using automated method (Vitek 2 Compact, bioMerieux).Results: Achromobacter species was reported from 0.46% (63/13831) specimens, 40% of them were isolated from suction tips. Achromobacter denitrificans amounted for 47/63 (74.6%) while Achromobacter xylosoxidans was identified in 16/63 (25.4%).Conclusions: Studying the organisms in order to observe their changing trend

Bilateral gluteal abscess caused by Kluyvera cryocrescens: a case report

Kluyvera is a relatively new genus, belonging to family Enterobacteriaceae. This organism colonizes mainly respiratory and gastrointestinal tract. It has also been reported from various environmental sources. Due to a rise in immune-compromised states and ease of identification using automated methods rare organisms are now being reported with their role as potential opportunistic pathogens. Meticulous detailed identification and reporting of pathogens like Klyuvera to differentiate it from other members of Enterobacteriaceae can lead to solving the pathogenic importance of such organisms. We report a case of bilateral gluteal abscess due to Kluyvera cryocrescens in an obese diabetic adult male

Sperm penetration assay and its correlation with semen analysis parameters

Background: Aim of current study was to determine whether the Sperm Penetration Assay (SPA) can be used as a test to discriminate the infertile male from fertile one. We have also correlated the SPA with semen analysis.Methods: Sperm characteristics namely Semen analysis and the sperm penetration assay were tested in 44 infertile and 10 fertile men. Sperm penetration assay was determined by using zona free hamster eggs.Results: With decreasing spermatozoa concentration in the semen there was significant decrease in percentage penetration of zona free Hamster eggs (p0.05).  Conclusions: The Sperm penetration assay could discriminate the infertile group from fertile group significantly (p<0.001). The test appeared to be highly reproducible and probably identifies a truly infertile male.

Conjoined Twins with a Single Heart

A case of abdomino-thoracopagus twins with single heart is described. The male twins were delivered in the 15th week of gestation following the desire of the parents to terminate pregnancy. This case is of particular interest because of the rarity of the abdomino-thoracopagus twins with a single heart, in the literature, that too, of male conjoined twins

Emergence of non-albicans Candida among candidal vulvovaginitis cases and study of their potential virulence factors, from a tertiary care center, North India

Purpose: The purpose of this study was to determine the prevalence of various Candida species and study some of their virulence factors among thevulvovaginal candidiasis(VVC)patients. Study Design and Settings: The study was conducted in a Tertiary Care University Hospital in North India. Materials and Methods: This study was carried out prospectively for a period of 1 year. High vaginal swabs (HVSs) were collected from women in childbearing age group attending the gynecology and obstetrics out-patient departments with the complaints suggestive of vulvovaginitis. Samples were plated on Sabouraud′s dextrose agar slope. Candida spp. isolated was further speciated based on microscopy, biochemical tests and culture characteristics on special media. Virulence factors of these strains were determined by biofilm formation and phospholipase activity. Result: A total of 464 HVS from 232 patients with the complaints of vulvovaginitis were included in this study. Following laboratory workup, 71 specimens were positive for genus Candida (30.6%). Further speciation showed 32.4% as Candida albicans, 45.07% Candida parapsilosis and 22.53% of Candida glabrata. Biofilm production was shown by 50 candidal strains (70.4%) and phospholipase activity was given by 41 candidal strains (57.74%). Conclusion: Our study suggests increasing prevalence of non-albicans Candida among the VVC cases along with their virulence factors. Therefore, we recommend that microbiological investigation upto species level should be mandatory to determine the emergence of non-albicans Candida as a major cause of VVC

Psychiatric morbidities in postpartum females: a prospective follow-up during puerperium

Aims and objectives: Postpartum psychiatric disturbances pose a significant mental health problem in community because of their impact on parent-infant and couple relationship. This study was carried out with the aim to find out psychiatric morbidities in postpartum females during puerperium so that a proper assessment of mental health and comprehensive management can be planned. Methodology: Hundred females who had delivered in maternity ward of obstetrics and gynaecology department of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi were evaluated for mental status on day one (i.e. day of delivery), and followed-up till four weeks postpartum period. Psychiatric evaluation was done on the basis of structured proforma containing socio-demographic details and the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria for diagnosis. Brief Psychiatric Rating Scale (BPRS), Hamilton Anxiety Rating Scale (HARS), and Hamilton Rating Scale for Depression (HDRS) were used to assess the severity of the respective conditions. Result: Psychiatric evaluation during postpartum puerperal stage revealed that 16 (16%) females had developed psychiatric morbidity. Twelve (12%) cases fulfilled the criteria for major depressive disorder and four (four per cent) patients had features of anxiety disorder. In 84 (84%) cases, postpartum period was uneventful and no psychiatric disturbance was found.Seventy five per cent females had joint family and good family support. Conclusion: Major depressive disorder is the most common psychiatric morbidity observed in postpartum females during puerperium. The careful observation of females during postpartum puerperal stage may help in identification and proper management of mental state of such females, and also proper care of newborn.perspective

Psychiatric morbidities in patients of carcinoma cervix

Aims and objective: The common psychological and emotional responses to cancer arise from knowledge of life threatening diagnosis, its prognostic uncertainty, and fear about death and dying. Carcinoma cervix (cervical cancer) is one of the major life threatening conditions in females and carries a risk of high mortality. This study was carried out with the aim to find out psychiatric morbidities in patients of carcinoma cervix so that a proper evaluation of their mental health and comprehensive management, and improving their quality of life can be planned. Methodology: One hundred female patients of age range between 31-65 years, recently diagnosed as carcinoma cervix were screened for psychiatric morbidity on a structured proforma containing socio-demographic details. The diagnosis and staging of carcinoma cervix was based on revised FIGO (International Federation of Gynecology and Obstetrics) and psychiatric diagnosis was made as per DSM-IV-TR. Hamilton Anxiety Rating Scale (HARS), Hamilton Rating Scale for Depression (HAM-D), Brief Psychiatric Rating Scale (BPRS), and Yale-Brown Obsessive Compulsive (Y-BOCS) were used to assess the severity of the psychiatric illness. Result: Majority of the patients belonged to age group 51-60 years. Most of them were Hindu, housewives, and belonged to lower socioeconomic status. Psychiatric morbidity was detected in 55% patients; majority of them having duration of cancer for less than six months. Twenty six per cent patients suffered from major depressive disorder, 17% had anxiety disorder, and eight per cent were detected as adjustment disorder with depressed mood while four per cent patients had only insomnia. Patients presenting in late stage of cancer had more severe psychiatric disturbances as compared to patients in early stage of cancer. Conclusion: Significant comorbid psychiatric illness was detected in patients of carcinoma cervix. The proper evaluation, identification, and management of associated psychiatric illness will improve the mental health and quality of life of patients suffering from carcinoma cervix