Diagnosis of asymptomatic bacteriuria and associated risk factors among pregnant women in mangalore, karnataka, India.

BACKGROUND: Asymptomatic bacteriuria (AB) is common inwomen and increases in prevalence with age or sexual activity. Prompt detection and treatment of this condition and associated factors decreases complications like acute pyleonephritis, intrauterine growth retardation and preterm labour. Chromogenic media is a versatile tool in rapid primary screening of the causative organisms considerably reducing daily routine workload. AIM: To determine the prevalence of AB among pregnant women in a tertiary care set-up and analyse the contributory risk factors, its effects on pregnancy and the role of chromogenic media in the laboratory diagnosis of these cases. MATERIALS AND METHODS: Urine samples of all pregnant women attending pre-natal check-ups with no genitourinary complaints, history of fever or antibiotic intake were collected for Gram stain, culture and antibiotic sensitivity tests. A second urine specimen for culture and sensitivity testing was obtained from those with significant bacteriuria. The results were compared with patients showing negative urine cultures. RESULTS: The overall prevalence of this clinical condition in our study was 13.2%. The significant isolates were Klebsiella pneumonia and E.coli and the most common risk factor was a previous history of urinary tract infection. The isolates were easily identified by using chromogenic agar ( HiCrome ) but colonies of uncommon pathogens like Acinetobacter and Streptococcus species appeared white and needed further identification. CONCLUSION: Screening of pregnant women for AB at first prenatal checkup helps analyse the associated factors and prevents its effects on pregnancy. The use of a chromogenic media can enhance reporting accuracy and will be an effective tool to monitor these cases routinely.

Co-Infection: Weil's Syndrome with Hepatitis B Infection- A Diagnostic and Therapeutic Hitch.

Undifferentiated Acute Febrile Illness (AFI) is a common clinical syndrome among patients seeking hospital care. Detection of co-infections at the time of presentation is a diagnostic challenge, especially with limited laboratory support. Even if detected, early treatment and cure of these co-infections can be difficult for the clinicians. We are presenting a rare case of Hepatitis B and leptospirosis co-infection with high titres of Salmonella paratyphi A and scrub typhus. There are a few reports of leptospirosis in Hepatitis -B infected individuals but no generalization can be made due to limited data. Prompt and accurate serological diagnosis of multiple infectious agents have becomes mandatory in a healthcare set-up.

Fusarium Solani: a causative agent of skin and nail infections.

Fusarium spp are non-dermatophytic hyaline moulds found as saprophytes and plant pathogens. Human infections are probably a result of various precipitating predisposing factors of impaired immune status. Immunocompetent individuals of late are also vulnerable to various unassuming saprophytic and plant pathogens. To stress the need to identify correctly and institute appropriate antifungal therapy in newly emerging human fungal infectious agents. Repeated mycological sampling of the skin and nails of the suspected fungal infection were processed as per the standard format including direct microscopy and fungal culture on Sabouraud's dextrose agar. The fungus was isolated as Fusarium solani. Fusarium is an important plant pathogen and soil saprophyte. Infection is acquired by direct inoculation or inhalation of spores. It is associated with a variety of diseases like keratitis, onychomycosis, eumycetoma, skin lesions and disseminated diseases.

Spectrum of melioidosis in the suburbs of Mangalore, S West Coast of India.

Melioidosis is an emerging infection in India. Seventeen cases of culture proven melioidosis are reported in this study. The isolation rate was high during the rainy season. Except one case, all the patients had diabetes mellitus as an underlying disease. Eleven patients improved with ceftazidime or combination therapy and maintenance therapy with doxycycline and Cotrimoxazole. The high prevalence of B. pseudomallei in this region is a matter for serious concern.

Melioidotic pericardial effusion.

Aim is to present a rare case of purulent pericardial effusion caused by Burkholderia pseudomallei. Pericardial sample was inoculated into Bactec Peds Plus/F broth of the Bactec automated system. After the system flagged positive, the broth was subjected to Gram stain, biochemical tests and drug susceptibility. The organism was identified as Burkholderia pseudomallei. Tuberculosis (TB) is the most common cause of pericarditis in countries where it remains a major public health problem, but in the western coastal districts of India, clinicians and microbiologists alike must be aware of Burkholderia pseudomallei a rare cause of pericarditis that can be misdiagnosed as TB pericarditis.

Timing of zero dose of OPV, first dose of hepatitis B and BCG vaccines.

The Indian Academy of Pediatrics has been recommending Hepatitis B vaccination for infants since 1992. This community based cross sectional study carried out in the rural and urban areas of Tamil Nadu found no significant rural urban difference in the proportions of children who had received BCG in 3 days/7 days and OPV-zero dose in 3 days/7 days after birth. The proportion of children who had received first dose of Hepatitis B in 3 days was significantly lower than those who had received BCG and OPV within 3 days after birth. The proportion of children who had received Hepatitis B on the day of birth was significantly lower in the rural area than in the urban area.

Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment.

BACKGROUND: Uncontrolled hypertension (HT) is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. METHOD: We used a 1 in 4 random selection of subjects who were > or = 20 years of age. A questionnaire was administered and the blood pressure (BP) was measured by a doctor. HT was defined as diastolic blood pressure (DBP) > or = 90 mm Hg +/- systolic pressure (SBP) > or = 140 mm Hg. Isolated systolic hypertension (ISH) was defined as SBP > or = 160 mm Hg with DBP < 90 mm Hg. Subsequently, we reanalysed the data using current definition of ISH as SBP > or = 140 mm Hg with DBP < 90 mm Hg. RESULTS: 2879 subjects > or = 20 years of age were randomly selected of which 2415 (84%) participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives > or = 60 years had ISH. CONCLUSION: This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community.

Numerical study of reverse period doubling route from chaos to stability in a two-mode intracavity doubled Nd-YAG laser.

We have numerically studied the behavior of a two-mode Nd-YAG laser with an intracavity KTP crystal. It is found that when the parameter, which is a measure of the relative orientations of the KTP crystal with respect to the Nd-YAG crystal, is varied continuously, the output intensity fluctuations change from chaotic to stable behavior through a sequence of reverse period doubling bifurcations. The graph of the intensity in the X-polarized mode against that in the Y-polarized mode shows a complex pattern in the chaotic regime. The Lyapunov exponent is calculated for the chaotic and periodic regions. (c) 1999 American Institute of Physics.