Listeria innocua infection in an old case of total knee replacement - an unusual case report.

Prosthetic implant-associated arthritis due to Listeria is mostly reported for Listeria monocytogenes. Here, we describe a patient who underwent total knee replacement 12 years ago and presented with pain, tenderness, redness and local rise in temperature in the right knee. Purulent fluid was aspirated. Upon microbiological analysis, culture yielded Listeria innocua. L. innocua is rare. Listeria is not reported as a contaminant and routine cultures may be negative. Because of the long interval between surgery and the onset of symptoms, clinical suspicion, radiological investigations and analysing multiple samples are of immense help.

First report of peritonitis caused by the vancomycin-resistant coccus Pediococcus pentosaceus in a patient on continuous ambulatory peritoneal dialysis.

INTRODUCTION: Worldwide, about one-tenth of end-stage renal disease (ESRD) patients are on peritoneal dialysis (PD). Peritonitis is a major cause of PD failure and change of therapy to haemodialysis. An update on peritoneal dialysis-related infections has recommended the use of a first generation cephalosporin or vancomycin as an empirical therapy for Gram-positive organisms. Pediococcus spp. is a Gram-positive environmental cocci that have been increasingly reported from various nosocomial infections but very rarely from peritoneal dialysis infections. It is intrinsically resistant to Vancomycin but sensitive to ampicillin. So, diagnosis of this bacteria is important if isolated from PD infections. CASE PRESENTATION: An elderly female patient of ESRD on continuous ambulatory peritoneal dialysis (CAPD) was admitted with complaints of high fever and cloudy PD effluent for 2 days. She was started with vancomycin and imipenem empirically but did not improve even after 4 days. Pus cells were seen when PD fluid was examined microscopically. BACTEC culture of PD fluid isolated growth of Gram-positive cocci, which was confirmed as Pediococcus pentosaceus . It was resistant to vancomycin. The antibiotic of the patient was changed to ciprofloxacin IV. The patient responded in 2 days and was discharged after 7 days. CONCLUSION: This is the first case report of Pediococcus pentosaceus peritonitis in an ESRD patient on CAPD. Accurate diagnosis and antibiotic sensitivity test of the bacteria is important especially if isolated in critical patients as it is intrinsically resistant to vancomycin.

What affects utilization of malaria control services? A qualitative approach to understanding community perception in highly malarious Gadchiroli district, Maharashtra, India.

National Vector Borne Disease Control Programme (NVBDCP) data have shown that nearly half of all malaria deaths in India occur in tribal-dominated areas. The present study took a qualitative approach to understanding community perceptions and practices related to malarial infection and anti-malarial programmes. Twelve focus group discussions and 26 in-depth interviews of Accredited Social Health Activists (ASHAs) were conducted in nine villages in the district of Gadchiroli, Maharashtra state in India in June 2016. A total of 161 village residents (94 males and 67 females) participated in the focus group discussions and 26 health workers participated in the in-depth interviews. Data were analysed using the content analysis approach. The findings revealed widespread misconceptions about malaria among village residents, and low use of preventive measures and anti-malarial services. Ignorance and treatment by unqualified traditional healers delay effective treatment seeking. Furthermore, failure to maintain drug compliance adds to the gravity of the problem. The study identified the social and behavioural factors affecting treatment uptake and use of treatment facilities in the study area. These should help the development of the behavioural change communication arm of any control strategy for malaria through improving community participation, so improving preventive practices and optimizing utilization of anti-malarial services.

A cost-effective anaerobic culture method & its comparison with a standard method.

Twenty six anaerobes were recovered from 150 deep-seated abscess samples cultured by the proposed two-step combustion-modified candle-jar system and Anoxomat. The degree of growth and colony size were similar in both systems, except for Clostridium difficile. The modified candle-jar system was found to be a sensitive and cost-effective alternative that might be used in resource-limited settings.

Reaching tribal men to improve awareness to sexual morbidities: experience from Baiga tribe of Central India.

BACKGROUND AND OBJECTIVES: Tribal men's reluctance in sharing responsibilities as supportive partners in reproductive and sexual health matters debar women from their sexual rights coupled with their negligence in health care and lesser utilization of reproductive health facilities. As a matter of fact a large proportion of ill health particularly related to sexually transmitted infections (STIs) suffered not only by men but also by their spouses. The present study was planned among one of the primitive tribes of Madhya Pradesh to understand the knowledge of males about reproductive tract infection (RTI)/STI/HIV/AIDS, RTI symptoms suffered, perception on sexual health, utilization of health services and to improve the knowledge by intervention of need based IEC (information, education, communication) strategy. METHOD: The study was conducted among 400 currently married men in the age group of 15-40 yr in one of the primitive tribes, Baigas of Dindori district of Madhya Pradesh. Eighteen villages were explored in the study. The IEC intervention was made by using quasi-experimental before and after with control design. RESULT: The baseline data generated indicated that Baigas male were poorly informed about RTI (18%), STI (21.5%) and HIV/AIDS (10%). Further, men also projected misconception on different aspects of sexuality. Women's views recorded also suggested a disturbing trend regarding male involvement in reproductive health particularly related to STIs. INTERPRETATION & CONCLUSIONS: After intervention of IEC targeting male population in age group 15 - 40 yr by adopting a before and after with controls design the awareness was improved significantly. The utilization of the health services was also improved significantly. The study recommends replication of the IEC strategy designed in other Baiga villages for improving the reproductive health of the tribe.

A trend in women's health in India--what has been achieved and what can be done.

The health of Indian women is intrinsically linked to their status in society. Research into Indian women's status has found that their family contributions are often overlooked and they are likely to be regarded as an economic burden, especially in rural areas. This attitude has a negative impact on their health status. Poor health has repercussions not only for women, but also for their children and other family members. This commentary focuses on the trend in five key women's issues in India: maternal and child health; violence against women; nutritional status; unequal treatment of girls and boys; and care quality. The discussion is based on data extracted from Indian National Family Health Surveys (NFHS-1, NFHS-2 NFHS-3) spanning the period 1993-2006, and data from the Indian Sample Registration System and National Crime Research Bureau.

Male involvement in reproductive health among scheduled tribe: experience from Khairwars of central India.

INTRODUCTION: Indian tribal men's lack of participation in reproductive health not only damages their own health, but also contributes to the reproductive ill health of their female partners and children. In India the involvement of men in such matters is a new concept. There is a paucity of data particularly on Scheduled tribesmen's knowledge and the extent of their participation in reproductive health. This inhibits planning. The present study aims to understand the involvement of Scheduled tribesmen in reproductive health and the barriers to their involvement by generating a database from the Khairwar tribe of Central India. METHODS: A door-to-door survey on knowledge, attitude and practice relating to aspects of reproductive health was conducted by canvassing a pre-designed interview schedule among 15-40 year old, currently married Khairwar males in the Sidhi district of Madhya Pradesh, India. RESULTS: As far as reproductive morbidity is concerned, only 17% of the respondents had heard of HIV/AIDS, and most had no proper knowledge of its transmission. Although 74% of the respondents had heard about reproductive tract infections, the majority of them were unaware of the mechanism of transmission and seriousness of the problem. The duel role of condoms, both as a method of family planning and a protective measure against sexually transmitted infections, was also unknown to them. Approximately 59% of the males were aware of family planning but only 13% were using any method (mostly female sterilization) at the time of survey. Their view on the ideal number of children (3.56) exceeded the actual number of children born and living. High infant and child mortality influenced their preference for higher fertility. Very few among them (29%) had knowledge of antenatal care. They expressed faulty knowledge, myths and unhelpful attitudes towards sexual health matters. CONCLUSION: The study revealed the male Scheduled tribe population's lack of knowledge and misinformation regarding male sexual health issues, the gender inequality in Indian society, and a lack of male-oriented reproductive health services, all of which deter men from sharing the responsibility.

Antihyperalgesic activity of a novel nonpeptide bradykinin B1 receptor antagonist in transgenic mice expressing the human B1 receptor.

We describe the properties of a novel nonpeptide kinin B1 receptor antagonist, NVP-SAA164, and demonstrate its in vivo activity in models of inflammatory pain in transgenic mice expressing the human B1 receptor. NVP-SAA164 showed high affinity for the human B1 receptor expressed in HEK293 cells (K(i) 8 nM), and inhibited increases in intracellular calcium induced by desArg10kallidin (desArg10KD) (IC50 33 nM). While a similar high affinity was observed in monkey fibroblasts (K(i) 7.7 nM), NVP-SAA164 showed no affinity for the rat B1 receptor expressed in Cos-7 cells. In transgenic mice in which the native B1 receptor was deleted and the gene encoding the human B1 receptor was inserted (hB1 knockin, hB1-KI), hB1 receptor mRNA was induced in tissues following LPS treatment. No mRNA encoding the mouse or human B1 receptor was detected in mouse B1 receptor knockout (mB1-KO) mice following LPS treatment. Freund's complete adjuvant-induced mechanical hyperalgesia was similar in wild-type and hB(1)-KI mice, but was significantly reduced in mB1-KO animals. Mechanical hyperalgesia induced by injection of the B1 agonist desArg10KD into the contralateral paw 24 h following FCA injection was similar in wild-type and hB1-KI mice, but was absent in mB1-KO animals. Oral administration of NVP-SAA164 produced a dose-related reversal of FCA-induced mechanical hyperalgesia and desArg10KD-induced hyperalgesia in hB1-KI mice, but was inactive against inflammatory pain in wild-type mice. These data demonstrate the use of transgenic technology to investigate the in vivo efficacy of species selective agents and show that NVP-SAA164 is a novel orally active B1 receptor antagonist, providing further support for the utility of B1 receptor antagonists in inflammatory pain conditions in man.

Can women's childbearing and contraceptive intentions predict contraceptive demand? Findings from a longitudinal study in Central India.

CONTEXT: To predict the need for contraceptive services, family planning program managers often rely on levels of unmet need derived from measures of childbearing intentions. However, women's intention to use a method has not received as much attention as a measure of contraceptive demand. METHODS: A survey was conducted in 1999 in rural Madhya Pradesh, India, among a subsample of women who had participated in the 1992-1993 National Family Health Survey (NFHS). The women's childbearing and contraceptive behaviors were compared with the intentions they had stated in the NFHS, and logistic regression was performed to analyze the association between socioeconomic and demographic variables and inconsistent behavior. RESULTS: Among women who were fecund and married in 1992-1993, 29% of those who intended to have children and 61% of those who intended not to have children failed to adhere to their intentions by 1999. Furthermore, 51% of women who were not practicing contraception at the time of the NFHS but planned to do so acted against their intention by 1999, as did 29% of those who planned not to use a method. NFHS respondents who intended both not to have children and to use a method were more likely than others to have used a method by 1999 (63% vs. 25-41%). Age and history of child death were key factors associated with inconsistency between women's intentions and behavior. CONCLUSIONS: In India, use of both contraceptive and childbearing intentions predicts contraceptive demand better than use of either indicator alone, and may thus help program planners estimate future demand for contraceptive services.