The clinician, the lab and the patient: Understanding lab diagnostics to eradicate tuberculosis.

BACKGROUND: Diagnostic modalities for diagnosing Tuberculosis caused by Mycobacterium group of organisms include mainly AFB smear by Ziehl Neelsen carbol fuchsin smear microscopy, GeneXpert (CB NAAT) molecular method, Line probe assay (Molecular method) and AFB culture (Liquid automated systems and solid media) methods. METHODS: This study was initiated to understand and prioritize TB lab diagnosis, with reference to selection of lab diagnostic tests and its order of preference for MTC and NTM/MOTT closely associating it with the TB irradication program initiated by the Government of India. RESULT AND CONCLUSION: The results and discussion bring to light the importance of each test and the purpose of their requisition. When diagnosis is handled half heartedly eradication of TB becomes a challenge. All the efforts including planning, resources in the form of manpower, infrastructure, finances, education, time etc., would be hampered. This challenge is not only for India but the globe. For countries harboring TB, Correct diagnostic request and timely diagnosis and treatment is the key to eradication of tuberculosis.

Investigating the impact of climate change on the lake ecosystem during the late Holocene using a sedimentary record from the southern Arabian Desert, Yemen.

Lake systems respond physically, chemically, and biologically to hydro-climatic change and variability, and these responses are documented in the sediments. Individual proxies and lacustrine environments may respond to climate variations in a nonlinear way, making it difficult to determine the direction and extent of a climatic shift. Here we investigate the response of lake ecosystem to climatic and environmental changes using a suite of paleo-proxies including ostracods, chironomids, and n-alkanes distribution from paleolake 'Gayal el Bazal (Yemen)'. A previous study from this site has provided a continuous, and high-resolution dataset providing an understanding of precipitation during the last ca 1200 years, particularly during Medieval Climate Anomaly (MCA) and Little Ice Age (LIA). However, the response of the lake ecosystem to these changing hydro-climate conditions, including water-level, salinity, and productivity, remains unknown. The n-alkanes dataset shows that during pluvial interval such as the MCA, the lake experienced an increase in nutrient input resulting in enhanced aquatic productivity. Concurrently, ostracods assemblage displays an increased abundance of swimmer species (like Bradleytriebella lineata and Fabaeomiscandona cf. breuili), suggesting an indirect response between ostracods and climate shifts. The chironomid community during the MCA interval is dominated by taxa belonging to the subfamilies of Chironomini, suggesting a warm, shallow, productive environment with macrophyte vegetation. The LIA interval is marked by increased abundance of higher-chain length n-alkanes, suggesting increased contribution from higher plants. Furthermore, ostracod distribution revealed increased abundance of non-swimmer species like Vestalenula cylindrica., which thrive under saline conditions in the lake. Changes in abundances of Tanytarsini during the LIA interval, which are associated with higher oxygen levels, suggest changes in lake productivity. As a result, the overall patterns in biological indicators reveal that their individual abundance and species/tribe distribution fluctuates in response to changes in the climate and hydrological conditions.