An overview on urinary tract infection in pregnancy

Urinary tract infections (UTI) include a wide range of symptoms, such as urethritis, cystitis, prostatitis, and pyelonephritis. The most frequent bacterial infections are UTIs. Lower and upper UTI’s are used to categories UTI’s. While pyelonephritis is an upper tract infection, cystitis is a lower tract infection. Significant physiologic changes to the entire urinary system occur during pregnancy and drastically influence the prevalence of UTI’s and pyelonephritis. Both symptomatic and asymptomatic forms are possible. Gram-negative bacteria are the most frequent causes of both symptomatic and acute UTI, including E. coli, K. pneumonia, P. areuginosa, Enterobacter, and Serratia. The gold standard for the diagnosis of a urinary tract infection is quantitative culture methods. Untreated UTIs have been linked to severe morbidity and mortality in pregnant women and their babies. According to Edward Kass's groundbreaking research, 6% of pregnant women reported asymptomatic bacteriuria (ASB), which was linked to higher preterm and perinatal death than those with sterile urine. According to the urine culture and sensitivity results, correct treatment is therefore of utmost importance. An agent with a seven-day dosage schedule that is safe for both the mother and the fetus should be used as the therapy. To prevent a recurrence of UTI, confirmation of the pathogenic organism's full eradication is required. Precautions and good cleanliness can also aid in preventing recurrence.

Histological and Ultrastructural Changes in Lungs One Year Post Asymptomatic or Mild SARS-CoV-2 Infection: Evaluating the Potential for Active Virus Presence / Cambios Histológicos y Ultraestructurales en los Pulmones un Año Después de una Infección Asintomática o Leve por SARS-CoV-2: Evaluación del Potencial de Presencia Activa del Virus

SUMMARY: Prior research on post-COVID-19 or long COVID primarily focused on the presence of SARS-CoV-2 mostly in symptomatic patients. This study aimed to investigate the persistence of SARS-CoV-2 after 1 year of asymptomatic or mild COVID-19. SARS-CoV-2 infected and control K18-hACE2 transgenic mice (n=25) were studied. Moderate and severe symptomatic subjects were sacrificed after eight days, while mild or asymptomatic mice were kept in BSL-III for twelve months. Analyses included general condition, histochemistry, immunohistochemistry, transmission electron microscopy, and qRT-PCR. Lungs from the twelve-month group showed thickening of alveolar walls, with some lungs exhibiting the recruitment of inflammatory cells, the presence of SARS- CoV-2 mRNA, immunopositivity for the SARS-CoV-2 spike protein, and TEM showed viruses (60-125 nm) within vesicles, indicating continued replication. Certain lung samples showed persistent SARS-CoV-2 presence in Club cells, endothelial cells, and macrophages. The eight-day group exhibited viral interstitial pneumonitis, SARS-CoV-2 immunopositivity, and mRNA. The eight-day hearts displayed viral mRNA, while the twelve-month hearts tested negative. Some asymptomatic twelve-month subjects presented reduced surfactant, basal membrane thickening, fibrosis, and mild autonomic nerve degeneration. In this study conducted on mice, findings indicate the potential for chronic persistence of SARS-CoV-2 in the lungs one year post initial mild or asymptomatic infection, which could suggest the possibility of recurrent episodes in similar human conditions. The observed thickening of alveolar walls and potential fibrotic areas in these mice may imply an increased risk of post-COVID fibrosis in humans. Furthermore, the presence of SARS-CoV-2-positive inflammatory cells in some asymptomatic murine cases could herald a progression toward ongoing inflammation and chronic lung disease in humans. Therefore, the necessity for further studies in human subjects and vigilant monitoring of high-risk human populations is underscored.

Investigaciones anteriores sobre COVID-19 o COVID prolongado se centraron principalmente en la presencia de SARS-CoV-2 principalmente en pacientes sintomáticos. Este estudio tuvo como objetivo investigar la persistencia del SARS-CoV-2 después de 1 año de COVID-19 asintomático o leve. Se estudiaron ratones transgénicos K18-hACE2 infectados con SARS-CoV-2 y de control (n=25). Los animales con síntomas moderados y graves se sacrificaron después de ocho días, mientras que los ratones con síntomas leves o asintomáticos se mantuvieron en BSL-III durante doce meses. Los análisis incluyeron estado general, histoquímica, inmunohistoquímica, microscopía electrónica de transmisión y qRT- PCR. Los pulmones del grupo de doce meses mostraron engrosamiento de las paredes alveolares, y algunos pulmones exhibieron reclutamiento de células inflamatorias, presencia de ARNm del SARS-CoV-2, inmunopositividad para la proteína de la espícula del SARS-CoV-2 y TEM mostró virus (60 -125 nm) dentro de las vesículas, lo que indica una replicación continua. Ciertas muestras de pulmón mostraron una presencia persistente de SARS- CoV-2 en exocrinocitos bronquiolares, células endoteliales y macrófagos. El grupo de ocho días presentó neumonitis intersticial viral, inmunopositividad al SARS-CoV-2 y ARNm. Los corazones de ocho días mostraron ARNm viral, mientras que los corazones de doce meses dieron negativo. Algunos animales asintomáticos de doce meses presentaron disminución del surfactante, engrosamiento de la membrana basal, fibrosis y degeneración leve del nervio autónomo. En este estudio realizado en ratones, los hallazgos indican la posibilidad de persistencia crónica del SARS-CoV-2 en los pulmones un año después de la infección inicial leve o asintomática, lo que podría sugerir la posibilidad de episodios recurrentes en condiciones humanas similares. El engrosamiento observado de las paredes alveolares y las posibles áreas fibróticas en estos ratones puede implicar un mayor riesgo de fibrosis post-COVID en humanos. Además, la presencia de células inflamatorias positivas para SARS- CoV-2 en algunos casos murinos asintomáticos podría presagiar una progresión hacia una inflamación continua y una enfermedad pulmonar crónica en humanos. Por lo tanto, se subraya la necesidad de realizar más estudios en seres humanos y realizar un seguimiento atento de las poblaciones humanas de alto riesgo.

Corelation of Significant Asymptomatic Bacteriuria in Pregnancy with Preterm Labour

Introduction: There is a correlation between asymptomatic bacteriuria and adverse pregnancy outcomes like increased risk of preterm labour. As asymptomatic bacteriuria is detectable and treatable, screening during pregnancy may be justified. It provides obstetrician an opportunity to prevent a significant complication of pregnancy. Objective to study the risk of preterm labour in pregnant women with significant asymptomatic bacteriuria and prevalence of asymptomatic bacteriuria in antenatal women. Material and methods: A total of one thousand pregnant patients were screened for symptomatic bacteriuria by using two rapid reagent strip tests and urine culture. One hundred twenty six screened positive for asymptomatic bacteriuria among whom one hundred patients with single positive urine culture were taken as cases. Out of those screened negative, one hundred patients were randomly selected and followed as controls. Results: Our study reflects a definite corelation of asymptomatic bacteriuria with preterm labour. The prevalence of asymptomatic bacteriuria was 12.6%. There is a positive corelation of asymptomatic bacteriuria with lower socioeconomic status and lower hemoglobin levels.

Detection of plasma anti-lipopolysaccharide (LPS)antibodies against enterohemorrhagic Escherichia coli(EHEC) in asymptomatic kindergarten teachers fromBuenos Aires province

Resumen En Argentina, el síndrome urémico hemolítico causado por Escherichia coli enterohemorrágica (EHEC) tiene la más alta incidencia del mundo. Las infecciones por EHEC tienen un comportamiento endemoepidémico y causan del 20 al 30% de los síndromes de diarrea sanguinolenta en niños menores de 5 años. En el período 2016-2020, se notificaron 272 nuevos casos por año al Sistema de Vigilancia de Salud Nacional. Múltiples factores son responsables de la alta incidencia de SUH en Argentina, incluyendo la transmisión persona-persona. Con el objetivo de detectar posibles portadores asintomáticos de EHEC, realizamos un estudio preliminar de la frecuencia de anticuerpos antilipopolisacáridos contra los serotipos de EHEC más prevalentes en Argentina. El estudio se realizó con muestras de plasma obtenidas de 61 maestras y maestros de jardines de infantes de 26 instituciones del distrito de José C. Paz, localizado en el área suburbana de la provincia de Buenos Aires, Argentina. El 51% de las muestras presentaron anticuerpos contra los serotipos de lipopolisacáridos O157, O145, O121 y O103; el 6,4% de las muestras positivas tuvieron el isotipo IgM (n=2), el 61,3% el isotipo IgG (n=19) y el 32,3% los isotipos IgM e IgG (n=10). Dado que los anticuerpos antilipopolisacáridos presentan usualmente una duración corta, la detección de IgM específica podría indicar una infección reciente. Además, el alto porcentaje de muestras positivas hallado podría indicar una exposición frecuente a las cepas de EHEC en la cohorte estudiada. Asimismo, la gran población de adultos portadores asintomáticos de estas cepas patógenas podría contribuir al comportamiento endémico, a través de la transmisión persona-persona. El perfeccionamiento de programas educacionales continuos en jardines de infantes podría constituir una medida importante para reducir los casos de síndrome urémico hemolítico, no solo en Argentina, sino también en el mundo.

Abstract In Argentina, hemolytic uremic syndrome (HUS) caused by EHEC has the highest incidence in the world. EHEC infection has an endemo-epidemic behavior, causing 20-30% of acute bloody diarrhea syndrome in children under 5 years old. In the period 2016-2020, 272 new cases per year were notified to the National Health Surveillance System. Multiple factors are responsible for HUS incidence in Argentina including person-to-person transmission. In order to detect possible EHEC carriers, we carried out a preliminary study of the frequency of kindergarten teachers with anti-LPS antibodies against the most prevalent EHEC serotypes in Argentina. We analyzed 61 kindergarten teachers from 26 institutions from José C. Paz district, located in the suburban area of Buenos Aires province, Argentina. Fifty-one percent of the plasma samples had antibodies against O157, O145, O121 and O103 LPS: 6.4% of the positive samples had IgM isotype (n=2), 61.3% IgG isotype (n=19) and 32.3% IgM and IgG (n=10). Given that antibodies against LPS antigens are usually short-lived specific IgM detection may indicate a recent infection. In addition, the high percentage of positive samples may indicate a frequent exposure to EHEC strains in the cohort studied, as well as the existence of a large non-symptomatic population of adults carrying pathogenic strains that could contribute to the endemic behavior through person-to-person transmission. The improvement of continuous educational programs in kindergarten institutions could be a mandatory measure to reduce HUS cases not only in Argentina but also globally.

Asymptomatic carriage of pneumococcus in children under 2 years of age in Libreville: prevalence and associated factors

Background: The morbidity and mortality attributed to pneumococcus are impressive even in the absence of any problem of antibiotic resistance. The objectives of this study were to determine the prevalence of asymptomatic pneumococcal carriage in children aged between 2 months and 2 years in Libreville and to identify the socio-demographic factors associated with carriage.Methods: Cross-sectional, descriptive, and analytical study from September 2019 to February 2020, including infants aged 2 months to 2 years, randomly selected, in 8 health centres in Libreville. We collected sociodemographic data from children and parents. Nasopharyngeal swabs were taken from each child and analyzed in the laboratory of institut de recherche en ecologie tropicale (IRET). Categorical data were expressed as frequencies. Univariate analyses (odd ratio-OR) were performed to measure the relationship between the relevant variables and pneumococcal carriage, followed by a multivariate analysis using logistic regression. The threshold of statistical significance was set at p<0.05 for a two-tailed chi-square test.Results: Of the 434 children included, 51.2% (n=222) were girls, with a mean age of 5.4�2 months. Streptococcus pneumoniae was found in 53 children, giving a prevalence of 12.6% (95% CI [9.5-15.6%]). The prevalence was the same for both sexes. Carriage was associated with more than 2 siblings (OR=2.1; p=0.01); an age greater than 6 months (OR=3.6; p=0.001); a child's rank higher than the median (OR=2.3; p=0.006); a mother's low level of education (OR=4.5; p=0.001); a father working in the informal sector (OR=2.4; p=0.01). The mother's level of education was the factor found in the multivariate analysis (p=0.043).Conclusions: The data from this survey encourage the serotyping of strains to guide the vaccination strategy.

Mycoplasma and Neisseria Prevalence in Asymptomatic Women and Investigation of their Susceptibility to Tamarindus indica and Syzygium aromaticum Aqueous Extracts

Neisseria and Mycoplasma are two prevalent bacteria in the female urogenital tract leading to gynecological infections and infertility. The aim of this study was to assess the antibacterial activity of Tamarindus indica and Syzygium aromaticum extracts against Neisseria and Mycoplasma isolates. It was a cross cectional study on 60 asymptomatic women at the Protestant and Regional Hospital of Ngaoundere. For this reason, a large consecutive sample of patients with several well-defined characteristics was assembled and urine and cervical-vaginal swab were collected using standard procedures. After being isolated on a specific medium, several strains of Neisseria and Mycoplasma were identified based on their morphological and biochemical characteristics. The antibacterial activity of the plant extracts was tested using the agar-well diffusion method. It was discovered that 70% of asymptomatic women had overall infection, with varying prevalence rates. The prevalence rates of Neisseria and Mycoplasma were 14.29% and 85.71% respectively. The aqueous extracts of Syzygium aromaticum against Neisseria produced inhibitory diameters of 43 mm, 40 mm and 32 mm at doses of 20 mg/mL, 10 mg/mL, and 5 mg/mL, respectively while, at the same doses, the aqueous extract of Tamarindus indica produced inhibitory diameters of 16 mm, 14 mm and 13 mm, respectively. The combined extract of Syzygium aromaticum and Tamarindus indica exhibits inhibitory diameters of 25, 23, and 30 mm at 20 mg/mL, 10 mg/mL, and 5 mg/mL, respectively. Syzygium aromaticum extract alone showed efficacy against Mycoplasma, with diameters of 16.5 mm, 13 mm and 10.5 mm at concentrations of 20 mg/mL, 10 mg/mL, and 5 mg/mL respectively. Inhibition diameters of 18 mm (for fosfomycin and ofloxacin), 22 mm (for chloramphenicol and ceftriaxone) and 26 mm (for levofloxacin) were found using Neisseria isolates. The only drugs that demonstrated efficacy against Mycoplasma were Minocycline and Josamycin. Given these findings, extracts of Syzygium aromaticum and Tamarindus indica can be investigated and used to treat infections caused by Niesseria and Mycoplasma.

Relationship between IL-1Ra gene polymorphism and the natural outcome of asymptomatic bacterial vaginosis / 安徽医科大学学报

Objective To investigate the relationship between interleukin 1 receptor a(IL-1Ra)gene polymorphism and different outcomes in asymptomatic bacterial vaginosis(aBV)patients with the aim of grouping and managing aBV patients.Methods In study on the natural attribution of aBV patients,all patients were enrolled and a sam-ple of venous blood and vaginal lavage fluid were separately frozen.After 4 months at the end of the clinical study,patients who completed the study were divided into three groups based on clinical outcomes:self-healing,progres-sive,and unchanged.The IL-1Ra gene polymorphism,the concentration of IL-1 β and IL-1Ra were tested,and the differences in the above indicators among three groups of patients with different outcomes were compared.Results 1 014 Chinese Han female patients were enrolled,and 984 patients completed clinical follow-up and obtained clini-cal outcome data.13 specimens were unusable during testing,with a total of 971 specimens completed the test.IL-1Ra gene was detected in all patients,with three genotypes:A1/A1,A1/A2,and A2/A2.Most population had a genotype of A1/A1,with the rarest genotype being A2/A2.No rare genotype of female was found.The frequency of A2 alleles in the progression group was significantly higher than that in the self-healing group(P＜0.05).IL-1 βand IL-1Ra were detected in all vaginal lavage fluid samples.Compared with the progression group,IL-1 β in the self-healing group was significantly lower(P＜0.05).When carrying the A2 allele,IL-1 β in progression group was relatively low,while the level of IL-1Ra was relatively high.The values of the unchanged group were middle.Con-clusion The polymorphism characteristics of the IL-1Ra gene in aBV patients are related to the IL-1Ra content in vaginal secretions.Carrying allele A2 is related to the elevation of IL-1Ra,the decrease of IL-1 β in vaginal secre-tions.Carrying allele A2 may affect the clinical outcome of aBV by some potential mechanism.

Study on the TCM Medication Law of Asymptomatic Hyperuricemia Based on Data Mining / 中国中医药信息杂志

Objective To explore the characteristics of TCM in the treatment of asymptomatic hyperuricemia based on data mining.Methods Clinical literature on the TCM treatment of asymptomatic hyperuricemia in CNKI,Wanfang Data,VIP and SinoMed was retrieved.After screening,the prescriptions obtained were input into Excel 2019 database,and SPSS Modeler 18.0,SPSS Statistics 26.0 and Cytoscape 3.9.1 were used for frequency analysis,association rule analysis,clustering analysis and factor analysis.Results A total of 133 articles meeting the criteria were included,and 140 prescriptions were included,involving 202 kinds of Chinese materia medica,with a total frequency of 1 387 times.22 drugs,such as Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,were frequently used in the treatment of asymptomatic hyperuricemia.The commonly used drugs were drugs for urine excretion to strain off dampness,tonics,clearing heat,promoting blood circulation and removing blood stasis.The medicinal property was mainly warm,the medicinal taste was mainly sweet,and the meridians were mainly liver,spleen,stomach and kidney meridians.21 groups of medicinal combinations were obtained by high frequency drug association rule analysis,among which the core drug pairs were Coicis Semen-Astrctylodis Rhizoma,Smilacis Glabrae Rhizoma-Dioscoreae Spongiosae Rhizoma-Coicis Semen,Coicis Semen-Astrctylodis Rhizoma-Smilacis Glabrae Rhizoma,etc.Clustering analysis obtained 5 clustering methods,and factor analysis obtained 7 common factors.Conclusion In the TCM treatment of asymptomatic hyperuricemia,the main methods are urine excretion to strain off dampness,strengthening spleen and tonifying qi,and the main drugs are Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,which can provide reference for clinical treatment of asymptomatic hyperuricemia.

Clinical significance of detecting group B Streptococcus from midstream urine culture / 中国感染控制杂志

Objective To explore the clinical significance and antimicrobial resistance of group B Streptococcus(GBS)isolated from midstream urine culture,aiming to provide a basis for the diagnosis and treatment of clinical urinary tract infection(UTI).Methods Information about GBS strains isolated from midstream urine culture of in-patients and outpatient in a hospital in Nanjing from February 2020 to December 2022 were retrieved through labora-tory information system,strains with complete data were screened out.Case data,urine routine,and antimicrobial susceptibility testing results were reviewed.Results A total of 9 081 non-repetitive bacterial strains were detected from midstream urine culture,including 425 GBS strains,accounting for 4.7％,ranking sixth.Strains with incom-plete data were excluded,a total of 365 patients were included in the study.169(46.3％)were males and 196(53.7％)were females,with an average age of(55.4±15.2)years.365 patients who were detected GBS were from 17 de-partments,with the highest proportion being department of urology(n=237,64.9％).The underlying diseases of patients mainly included hypertension(n=136),diabetes(n=95),urolithiasis(n=120)and urinary tumors(n=98).211 patients underwent urological surgery,all were treated with antimicrobial agents before surgery,and 205 patients underwent indwelling urinary catheters after surgery;9 patients were detected GBS from urine during the middle and advanced stage of pregnancy.36.4％(n=133),38.9％(n=142)and 24.7％(n=90)patients had GBS colony count ≤104 CFU/mL,104-105 CFU/mL,and ≥105 CFU/mL,respectively.Patients with symptoms of UTI accounted for 24.9％(n=91),and asymptomatic bacteriuria accounted for 75.1％(n=274).The incidence of UTI symptoms in males was lower than that in females(19.5％vs 29.6％,P＜0.05).As the GBS colony count in urine culture increased,the proportion of patients with symptoms of UTI showed an upward trend(P＜0.05).On the day of urine culture,the positive rates of urine routine white blood cells,leukocyte esterase,and nitrite were 53.2％,50.1％,and 3.8％,respectively.The positive rates of urine occult blood,leukocyte esterase,white blood cells,and urine protein in patients with symptomatic UTI were all higher than those with asymptomatic bacteriuria patients(all P＜0.05).No GBS were found to be resistant to penicillin,ampicillin,vancomycin,linezolid,and tigecycline.The resistance rate to levofloxacin and moxifloxacin was about 40％,and resistance rate to tetracycline and clindamycin was over 60％.Conclusion GBS isolated from urine is more common in non-pregnant adults,and only a small percentage have symptoms of UTI.The results of urine culture and urine routine should be comprehen-sively judged based on patient's clinical symptoms and signs.GBS in urine is susceptible to multiple antimicrobial agents,and clinical medication should be adopted rationally based on antimicrobial susceptibility testing result.

Comparative analysis of asymptomatic infection prevalence in Beta, Delta, and Omicron surges of COVID-19

Abstract Background The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a devastating impact on the global population, with an estimated 650 million people infected and more than 6.6 million lives lost. Asymptomatic individuals have been shown to play a significant role in the transmission of the virus. Therefore, this study aims to investigate and compare the prevalence of asymptomatic individuals across three waves associated with the Beta, Delta, and Omicron variants of the virus. Methods This retrospective study was conducted between December 2020 and March 2022. The study population consisted of passengers on international flights who were referred to the Gerash Clinical and Molecular Diagnosis Laboratory. Real-time PCR was employed for the diagnosis of SARS-CoV-2. Results Out of a total of 8592 foreign travelers referred to our laboratory, 139 (1.16 %) tested positive for SARS-CoV-2 infection and were asymptomatic. During the Beta surge, 35 (1.49 %) out of 2335 passengers tested positive for SARS-CoV-2. In the Delta surge, 31 (0.6 %) out of 5127 passengers tested positive. However, during the Omicron surge, a significantly higher number of passengers, specifically 73 (6.46 %) out of 1130, had a positive result for the SARS-CoV-2 test. Conclusion Considering the significant role of asymptomatic transmission in the spread of COVID-19, it is imperative to reconsider health policies when dealing with future surges of the Omicron subvariants. Additionally, we strongly recommend that the World Health Organization prioritize the development and distribution of second-generation vaccines that target not only disease but also infection prevention.

Viable Leishmania parasites in the absence of an in vitro IFN-γ response in asymptomatic carriers

ABSTRACT Asymptomatic infection (the absence or inapparent signs and symptoms) has been observed in many endemic areas of leishmaniasis, however, little is known about the parasitological and immunological factors associated with this type of infection. This study aimed to identify the in vitro expression of IFN-γ in asymptomatic carriers of viable Leishmania parasites. Asymptomatic infection was identified using the Montenegro skin test in an at-risk population from Yucatan, Mexico. Parasite viability was evinced in the blood by 7SL RNA transcripts amplification. The expression of mRNA IFN-γ was analyzed in peripheral blood mononuclear cells stimulated with soluble Leishmania antigen, using RT-qPCR. Parasite viability was observed in 33.3 % (5/15) of asymptomatic subjects. No differences were found in the expression of IFN-γ between asymptomatic and healthy subjects, and no correlation was found between the presence of viable parasites and the expression of IFN-γ. This study demonstrates the persistence of Leishmania parasites in the absence of an in vitro IFN-γ response in asymptomatic carriers from Mexico.

Prevalence of SARS-CoV-2 infection in asymptomatic preoperative patients

Background: Surgeries were performed on emergency and trauma patients as well as oncology patients in many centres during the pandemic period. Screening of asymptomatic preoperative patients is very important not only in protecting healthcare personnel but also in preventing nosocomial infections and in protecting patients with deficient or suppressed immune systems. The aim of the current study was to retrospectively evaluate the prevalence of SARS-CoV-2 infection in asymptomatic preoperative patients during the pandemic period. Methods: A total of 3773 asymptomatic preoperative patients among the 23385 patients were evaluated retrospectively with Rt-qPCR test. The DS CORONEX COVID-19 PCR test (Ver.2.0, DS Bio and nano technology, Turkiye) kit used for the RT-qPCR. PCR test targets the N and Orf1ab gene region specific for SARS-CoV-2. Results: SARS-CoV-2 positivity was significantly lower in the preoperative patient group than in COVID-19 positive patients whose routine test results were positive for other reasons (2.3% vs 23.1%; p<0.0005). Distribution of preoperative SARS-CoV-2 positive patients according to clinics were 7.1% thoracic surgery, 3.7% neurosurgery, 3.5% otolaryngology, 2.6% general surgery and 2.4% urology clinic, respectively. Conclusions: SARS-CoV-2 positivity was lower in the preoperative patients but this rate never excludes pre-screening of asymptomatic preoperative patients. Applying pre-screening tests to asymptomatic preoperative patients is significant in protecting healthcare personnel and patients with deficient or suppressed immune systems and also preventing nosocomial infections.

Clinico-pathological study of vaginitis in peri and post-menopausal women

Background: Menopause is universal phenomena which has adverse effect on health of women. The vaginal cytology by maturation value is an inexpensive mean to evaluate hormonal influence in women. Objective was to diagnose atrophic by vaginal pH and vaginal maturation value in peri and post-menopausal women symptomatic as well as asymptomatic.Methods: This study conducted on 100 peri and post-menopausal women who attended in Department of Obstetrics & Gynaecology, Kamla Raja Hospital, and G.R. Medical College Gwalior from August 2015 to August 2016. They were divided into three groups: Group A (Cases) - subjects having VMV < 64 with or without symptoms, Group B (Suspects) - Symptomatic subjects with VMV > 64 and Group C (Controls) - Asymptomatic subjects with VMV > 64.Results: The detection rate of vaginitis in total 100 peri and post-menopausal women in this study was 36% while detection rate in symptomatic peri and postmenopausal women was 36/65 i.e., 55.38%. To our surprise 13/35 (37.14%) had VMV < 64 (mild estrogen deficiency) in control group (asymptomatic postmenopausal women). They became true cases as VMV was taken as gold standard for diagnosis of vaginitis. It means that detection rate of vaginitis in asymptomatic peri and post-menopausal women were 37.14%.Conclusions: There is a lack of awareness of symptoms and signs among both in population and physicians for early detection of vaginitis.

Clinico-pathological study of vaginitis in peri and post-menopausal women

Background: Menopause is universal phenomena which has adverse effect on health of women. The vaginal cytology by maturation value is an inexpensive mean to evaluate hormonal influence in women. Objective was to diagnose atrophic by vaginal pH and vaginal maturation value in peri and post-menopausal women symptomatic as well as asymptomatic.Methods: This study conducted on 100 peri and post-menopausal women who attended in Department of Obstetrics & Gynaecology, Kamla Raja Hospital, and G.R. Medical College Gwalior from August 2015 to August 2016. They were divided into three groups: Group A (Cases) - subjects having VMV < 64 with or without symptoms, Group B (Suspects) - Symptomatic subjects with VMV > 64 and Group C (Controls) - Asymptomatic subjects with VMV > 64.Results: The detection rate of vaginitis in total 100 peri and post-menopausal women in this study was 36% while detection rate in symptomatic peri and postmenopausal women was 36/65 i.e., 55.38%. To our surprise 13/35 (37.14%) had VMV < 64 (mild estrogen deficiency) in control group (asymptomatic postmenopausal women). They became true cases as VMV was taken as gold standard for diagnosis of vaginitis. It means that detection rate of vaginitis in asymptomatic peri and post-menopausal women were 37.14%.Conclusions: There is a lack of awareness of symptoms and signs among both in population and physicians for early detection of vaginitis.

Vaginal delivery in a patient with asymptomatic severe aortic stenosis: a case report

Heart disease complicates about 1-4% of all pregnancies of which valvular heart disease is the commonest cause. In developing countries, congenital heart diseases are commonly first detected during pregnancy. Most women do well during pregnancy but severe mitral stenosis or severe aortic stenosis are high-risk conditions that can cause significant morbidity and mortality. Unlike asymptomatic severe mitral stenosis, asymptomatic severe aortic stenosis is mWHO category 3. There is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis. Here we describe a case of successful vaginal delivery in a woman with severe aortic stenosis. As the patient was asymptomatic and ejection fraction was preserved, a joint decision for vaginal delivery was taken along with the cardiology team. The patient was induced and delivered with operative vaginal delivery. This case shows that vaginal delivery could be a viable option in patients with asymptomatic severe aortic stenosis given continuous haemodynamic monitoring can be provided.

Vaginal delivery in a patient with asymptomatic severe aortic stenosis: a case report

Heart disease complicates about 1-4% of all pregnancies of which valvular heart disease is the commonest cause. In developing countries, congenital heart diseases are commonly first detected during pregnancy. Most women do well during pregnancy but severe mitral stenosis or severe aortic stenosis are high-risk conditions that can cause significant morbidity and mortality. Unlike asymptomatic severe mitral stenosis, asymptomatic severe aortic stenosis is mWHO category 3. There is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis. Here we describe a case of successful vaginal delivery in a woman with severe aortic stenosis. As the patient was asymptomatic and ejection fraction was preserved, a joint decision for vaginal delivery was taken along with the cardiology team. The patient was induced and delivered with operative vaginal delivery. This case shows that vaginal delivery could be a viable option in patients with asymptomatic severe aortic stenosis given continuous haemodynamic monitoring can be provided.

PREVALENCE OF ASYMPTOMATIC MALARIA AND ANEMIA AMONG PRIMARY SCHOOL CHILDREN IN ENUGU STATE, NIGERIA

Objective: The objective of the study was to determine the prevalence of asymptomatic malaria and anaemia among primary school children in Enugu State, Nigeria.Methods: This research was a quantitative cross-sectional survey conducted among children in 8 primary schools in Nsukka, Enugu State, Nigeria. Asymptomatic children aged 5 to 13 were randomly selected and screened for malaria parasitemia and anaemia. The presence of malaria parasites in the blood sample was detected using the rapid diagnostic test (RDT) kit. At the same time, haemoglobin concentration was measured using a portable Mission® Plus Hemoglobin (Hb) Testing kit. The clinical status of the children was obtained from a self-administered questionnaire completed by their parents or guardians. Descriptive statistics and the Chi-square test were used for data analysis.Results: The prevalence of asymptomatic malaria and anaemia was 24.1% and 45.8%, respectively. The school-age children with both asymptomatic malaria and anaemia were 13.7%. The prevalence of asymptomatic malaria was significantly associated with asymptomatic anaemia (p = 0.013). Sleeping under insecticide-treated nets was significantly associated with a lower prevalence of asymptomatic malaria (p = 0.024) and anaemia (p = 0.015).Conclusion: The study revealed a high burden of asymptomatic malaria and anaemia among primary school children in Nsukka. This study, thus, underscores the need for robust implementation of malaria and anaemia screening, prevention, and treatment programmes in this population.

Asymptomatic bacteriuria in pregnancy screening, risk factors, diagnosis and treatment

Background: Asymptomatic bacteriuria is a frequent pregnancy issue that, if left untreated, increases the risk of premature birth and pyelonephritis. Urine culture is the basis for the diagnosis. In the current study, 200 pregnant women are examined for severe asymptomatic bacteriuria to gain insight into its frequency in emerging nations, to re-evaluate some predisposing factors, and to test for the susceptibility of specific aetiological agents. The purpose of this study was to assess the prevalence of asymptomatic bacteriuria in pregnant women as well as to isolate, characterise, and establish the pathogens antibiotic susceptibility patterns. Methods: 200 pregnant women with asymptomatic bacteriuria are included in the study. By using traditional techniques, isolates were located, and their antibiotic susceptibility patterns were established. Results: Significant bacteriuria was detected in 102 individuals (51%) in total. The three most efficient antibiotics against the urine isolates were determined to be Piperacillin-Tazobactam, Amikacin, and Nitrofurantion. Escherichia coli was the most prevalent bacterium, followed by Klebsiella pneumoniae. Conclusions: In the group under study, prenatal patients frequently have asymptomatic bacteriuria. All prenatal patients should have routine urine cultural testing to detect any undetected infections. This action will significantly lessen pregnancy-related maternal and obstetric problems.

Severe acute respiratory syndrome for COVID-19 by RT-PCR test during its intensifying phase, Gujarat, India

Background: The COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) originated from Wuhan, China, a pandemic. By knowing different demographic and clinical data, one can have a better idea about the progress and fate of disease, which will help others to plan accordingly to manage patients in terms of decreasing morbidity and mortality caused by it. Aims and Objectives: The study was done to describe the RT-PCR diagnostic profiles of SARS-CoV-2 patients in Gujarat from three districts (Arvalli, Sabarkantha, and Gandhinagar) and their correlation with respect to age, sex, travel history, symptoms, and underlying conditions. Materials and Methods: This was a retrospective cohort study of patients with COVID-19, who were screened for SARS-CoV-2 from April 16 to May 25, 2020, from three districts of Gujarat (Arvalli, Sabarkantha, and Gandhinagar). Positive cases were confirmed by qRT-PCR and analyzed for epidemiological, demographic, and clinical characterization among different groups. Results: Of 4000 suspects screened, a total of 199 patients were confirmed with SARS-CoV-2 infection. Among them, middle-aged group (5.4%) and young adult patients (4.3%) were infected with SARS-CoV-2. The median age was 33 years, including 143 males and 56 females. The positivity rate from breathlessness was 8 (28.5%), nasal discharge 2 (25%), and nausea/vomiting 2 (25%) followed by fever 28 (20%) among total cases in respective categories. Among asymptomatic 3536 patients, 146 patients were confirmed for SARS-CoV. Among 256 patients with comorbidities, 14 patients were confirmed for SARS-CoV. Conclusion: Clinical investigation in initial SARS-CoV-2 patients in the western Indian region revealed that young adult male was more susceptible than female. Symptoms such as fever, cough, and sore throat reports are useful for screening the SARS-CoV-2.

Shedding of infectious SARS-COV-2 in two asymptomatic children / Excreción de SARS-CoV-2 infeccioso en dos niños asin tomáticos

Abstract Asymptomatic infections with SARS-CoV-2 are associ ated with viral transmission and have a key role in the propagation of the pandemic. Understanding viral shed ding during asymptomatic infections is critical. Unfor tunately, data on asymptomatic SARS-CoV-2 infection in children is extremely limited. To determine the presence of viral viable shedding, we prospectively followed two healthy children of a family where both parents devel oped mild COVID-19 (April 2021). SARS-CoV-2 detection was made by RT-PCR and virus isolation by cell culture from saliva samples. Positive samples were sequenced to identify variants of SARS-CoV-2. Serum samples were evaluated to determine the presence of antibodies using a single enzyme-linked immunosorbent assay (ELISA, COVIDAR IgG). Both children were SARS-CoV-2 positive and asymptomatic. In addition, the virus grew in cell cul ture from saliva samples. Furthermore, one child showed viable SARS-CoV-2 for at least 17 days after the onset symptoms from his father. The recommended isolation period for asymptomatic contacts during the acquisition of data had been established for 10 days; however, this child remained with viable virus beyond that period. The positive samples from both children were consistent with B.1.1.28.1 lineage (Gamma). In both asymptomatic children, anti-Spike IgG was detected. Asymptomatic children may represent a source of infection that should not be underestimated during this pandemic.

Resumen Las infecciones asintomáticas por SARS-CoV-2 están asociadas a la transmisión viral y tienen un papel cla ve en la propagación de la pandemia. Comprender la excreción viral durante las infecciones asintomáticas es fundamental. Desafortunadamente, los datos sobre la infección asintomática por SARS-CoV-2 en niños son extremadamente limitados. Para determinar la presencia de excreción de virus viable, se siguió prospectivamente a dos niños sanos de una familia en la que ambos padres desarrollaron COVID-19 leve (abril 2021). La detección de SARS-CoV-2 se realizó por RT-PCR y el aislamiento del virus por cultivo celular a partir de muestras de saliva. Las muestras positivas se secuenciaron para identificar variantes de SARS-CoV-2. En las muestras de suero se determinó la presencia de anticuerpos utilizando un ensayo de ELISA (COVIDAR IgG). Ambos niños fueron positivos para SARS-CoV-2 y asintomáticos. Además, el virus creció en cultivos celulares a partir de muestras de saliva. Uno de los niños mantuvo SARS-CoV-2 via bles durante al menos 17 días después de la aparición de los síntomas de su padre. El período de aislamiento recomendado para contactos asintomáticos durante la adquisición de datos se había establecido en 10 días, sin embargo, este niño permaneció con virus viable más allá de ese período. Las muestras positivas de estos niños correspondieron al linaje B.1.1.28.1 (Gamma). En ambos niños asintomáticos se detectó anticuerpos IgG anti-Spike. Concluimos que los niños asintomáticos pueden representar una fuente de infección que no debe subestimarse durante esta pandemia.