Clinical profile of chikungunya fever in patients in a tertiary care centre in Maharashtra, India.

BACKGROUND & OBJECTIVE: In India a chikungunya fever outbreak started in December 2005 when the country experienced more than 13 lakhs of chikungunya infected cases. We undertook this study to study detailed clinical profile of chikungunya fever in both indoor and outdoor patients in a tertiary care hospital in Nagpur, Maharashtra in 2006. METHODS: Suspected cases of chikungunya fever (n=405) during the period of July to September 2006, having clinical triad of fever, arthralgia and/or rashes were included in the study. Clinical profile was studied in all the cases. Of the 405 samples collected, 166 were tested for serum CHIK IgM antibodies. RESULTS: Of the 166 samples tested for CHIKV IgM antibodies, 87 (52.4%) were positive (confirmed cases). Male: female ratio was 2.3:1. Fever and arthralgia were present in all cases. Rash was present in 27 (31%) confirmed and 38 (12%) suspected cases. Lymphadenopathy was present in 12 (13.8 %) confirmed and 4 of suspected cases. Chronic polyarthritis was seen in 22 (25.3%) confirmed and 75 (23.6%) suspected cases. Neurological manifestations were observed in 08 (9%) confirmed and 10 (3.14%) suspected cases. Mortality was 7 (2.2%) in 318 suspected cases and 3 (3.4%) in 87 confirmed cases. INTERPRETATION & CONCLUSION: Our findings showed that about half of the serum samples for CHIKV IgM antibody tested positive from cases suspected to have chikungunya fever. Fever, joint pain and headache were major symptoms. Certain rare manifestations like lymphodenopathy, oral ulcers and encephalitis were also seen. Mortality in confirmed cases was about 3.4 per cent.

The use of solar energy for powering a portable autoclave.

Climate change and the depletion of fossil fuels have forced the developed world to look for clean energy alternatives. Solar cooking is developing in Asian and African countries blessed with ample sun, but is still at an early stage. A portable autoclave was developed in India using this technology. The Prince-40 Concentrator provided adequate capacity to autoclave culture media and treat biomedical waste in a small laboratory set-up, and could save electricity worth Rs. 15,000 (188.10 GBP)/year or LPG worth Rs. 37,500 (470.25 GBP)/year. This technology would be of immense use in health centres in rural areas with frequent power cuts or no power supply.

Study of metallo-beta-lactamase production in clinical isolates of Pseudomonas aeruginosa.

A study of metallo-beta-lactamase (MBL) production was done in clinical isolates of Pseudomonas aeruginosa. Isolates resistant to ceftazidime and imipenem were screened for MBL production by double disc synergy test (DDST) and minimum inhibitory concentration reduction test. There was complete correlation between two methods for imipenem. For ceftazidime, there was correlation between the two methods in all except four strains. In the screening test for MBL, ceftazidime-EDTA combination was better than imipenem-EDTA combination. 8.05% strains were MBL producers. Presence of MBL producer P. aeruginosa is a cause of concern. Simple DDST can be helpful for monitoring of these emerging resistant determinants.

Bacteriological study of pyogenic meningitis with special reference to C-reactive protein.

Seventy five clinically, biochemically and microscopically diagnosed cases of pyogenic meningitis including 28 adults and 47 paediatric patients were studied. Gram positive isolates in adults and gram negative bacilli in paediatric age group were the predominant organisms. Estimation of C-reactive protein (CRP) in cerebrospinal fluid (CSF) and serum was done in all cases as an early marker for rapid diagnosis of pyogenic meningitis. Simultaneous estimation of CRP levels in serum and CSF was found to have a significant diagnostic utility as compared to culture.