Role of mobile phone in spreading hospital acquired infection: A study in different group of health care workers.

Background: Use of mobile phones by Health Care Workers (HCWs) in the operation theatre (OT), Intensive Care Unit (ICU) and Critical Care Unit (CCU) may have serious hygiene consequences as these patients are more vulnerable to hospital acquired infection. This study will assess possibility of spreading hospital acquired infection due to usage of mobile phone by HCWs working in OT, ICU and CCU, their causative microorganisms and antibiotic sensitivity pattern. Methods: After institutional ethics committee approval, this observational study was carried out in government teaching hospital. After written informed consent, three groups (doctors, nurses and other health care personnel) each of 50 participants were selected. From each participant two samples were collected, one from the dominant hand and another from the mobile phone. The samples were tested for the identification of microorganism and antibiotic sensitivity.Results: It was found that 58.66% of hands and 46.66% mobile phones were contaminated by bacteria. Staphylococcus epidermidis was isolated as most common causative organism with infection rate of 42% in hand and 32.66% in the mobile phone. Contaminations with other organisms were 16.66% in hand and 14% in mobile phone. We found that 50% isolated Staphylococcus aureus were methicillin resistant Staphylococcus aureus (MRSA). Pseudomonas and Acinetobactor species isolated in the study showed multi drug resistance to commonly used antibiotics.Conclusion: We recommend simple measures like hand washing, cleaning of mobile phones with 70% isopropyl alcohol, using hand free mobile phone while working hours and well practiced infection control plan to bring down the rate of hospital acquired Infection.

Transforming growth factor-β-1 polymorphisms are infrequent but exist at selected loci in oral submucous fibrosis.

Background : Oral submucous fibrosis (OSF) may be considered a collagen metabolic disorder resulting from areca-nut alkaloid exposure and individual variation in collagen metabolism. Due to the complexity of OSF pathogenesis, it is important to elucidate independent and interactive effects of polymorphisms of collagen-related genes on OSF risk. Materials and Methods : This study is focused on seven polymorphisms (SNPs) of transforming growth factor-beta-1 (TGF-beta-1) gene in patients with oral submucous fibrosis (OSF), belonging to south Indian ethnic extraction. The mean age at presentation was 43.9 years, range 23-72 years (n=50, M:F ratio, 2.6:1). DNA samples from 50 subjects of the same ethnic group and comparable demographic features who have had practiced the habit of areca-chewing of almost equal duration, but remained free of disease constituted the controls. All DNA samples were collected progressively and purified from peripheral blood employing standard protocols and tested for SNPs. They included two polymorphisms in the promoter region (C-509T and G-800A), three polymorphisms in exon-1 (Arg25Pro(G915C), Leu10Pro(T869C), Glu47Gly(A979G) and two in 5 ͲUTR regions (C→T(rs13306708) and G→A (rs9282871). The extracted DNA samples along with the primers underwent PCR amplification and the genotypic and allelic frequencies were calculated. All calculations were performed using the SPSS software. The PCR products were purified and subsequently sequenced using Flour S™ multi-imager system (Biorad). The sequenced data were analyzed using the BioEdit sequence analysis software. Results : Out of the seven polymorphisms analyzed, six such as two in the promoter region, three in exon-1 and one in 5¢UTR were found to have a " P" value above 0.05 and hence were not significant. The C→T transition (rs13306708) in the 5¢UTR region recorded a " P" value of 0.03 on comparison and hence was found to be significant. The allelic frequencies for this C→T transition in patients were 68.7% C and 31.2% T (27CC, 15CT, 8TT) and that in controls were 89.5% C and 10.4% T (42CC, 6CT, 2TT). Conclusions : The polymorphism in 5¢UTR C-T in TGF beta 1 gene has a significant association with OSF, being a prime determinant in the pro-angiogenic pathway which has got direct bearing with the pathophysiology of the disease. The proximity of this polymorphism to the transcription site and the associated risk involved is discussed.

Primary cardiac sarcoma.

Primary cardiac sarcomas are uncommon entities. The diagnosis of sarcoma is not made preoperatively because of the rarity of the lesion and the nonspecific nature of the signs and symptoms. This is a report of a case of primary sarcoma arising from the left atrium, in a patient who presented with acute dyspnoea; the sarcoma resembled an atrial myxoma on echocardiography.

Aerobic bacterial isolates from choledochal bile at a tertiary hospital.

We studied the aerobic bacterial isolates from bile and their susceptibilty pattern in patients with biliary tract disease. Samples of bile collected during endoscopic retrograde cholangio pancreatography (ERCP) and surgery, were inoculated on standard media. Bacterial identification and susceptibility were done by standard techniques. A total of 209 samples were cultured, out of which 128 samples showed growth. Total number of isolates obtained was 221. Poly-microbial infection was detected in 67 patients. Predominant aerobic bacterial isolates obtained were Escherichia coli 30% (67), Klebsiella species 23.98% (53), Enterococcus species 12.21% (27). Multi-drug resistance was noted in 57%. Higher resistance rate was noted among Gram negative bacilli for ampicillin (92.4%), cephalexin (82.46%), ciprofloxacin (68.42%), piperacillin (64.33%). Sensitivity to meropenem was 90.64% and amikacin was 76.61%. Gram positive bacteria showed high resistance to gentamicin (39.53%). Sensitivity to ampicillin was 86.05% and penicillin was 81.4%. Vancomycin and teicoplanin showed 100% sensitivity. From our study we conclude that E. coli, Klebsiella species and Enterococcus species are common pathogens infecting biliary tract. Poly-microbial infection and multi-drug resistance warrants culture and sensitivity to guide antimicrobial therapy. We recommend combination of amikacin and ampicillin for empirical therapy at our institution.

Video-assisted thoracoscopic surgery for closure of patent ductus arteriosus in children.

Video-assisted thoracoscopic surgery (VATS) was recently described as an approach to clip the patent ductus arteriosus (PDA). Between May 1994 and May 1996, we performed this procedure on 34 children below 12 years of age (mean 7 years). Thirty-two had an isolated PDA and two had associated small perimembranous ventricular septal defect (VSD), diagnosed on echocardiography and colour flow mapping. None had pulmonary arterial hypertension. The procedure was successful in 33 (97%) children confirmed by absence of residual shunt on serial echocardiography. Complications in the form of pneumothorax (1) and vocal card paralysis (2) were encountered in three children. The overall hospital stay was reduced to five days. In conclusion, the technique of PDA clipping using VATS is easy to learn and highly successful with acceptable risk of complications.

Goodwin's high risk score and neonatal outcome: an evaluation.

Goodwin's high risk scoring system was applied to a total of 725 expectant mothers at the onset of labor. The risk score ranges from 0-10, the quantum of risk increasing with the higher scores. Their newborns were assessed at birth in terms of Apgar score, birth weight, gestation age and occurrence of morbidity and/or mortality during the hospital stay. Twenty one were stillborn and out of 700 singleton liveborn, 92 developed some significant illness, of which 28 expired. The incidence of preterms, low birth weights and asphyxiated babies increased with increasing risk score. The mean risk score for alive and dead babies in perinatal period was 1.55 and 5.06, respectively. The scoring system can be easily applied at the District hospital level and CHCs but not at the level of dispensaries and PHC where the facilities for even the baseline investigations are not available and one has to decide about a home or hospital delivery.