"Scratch it out": carbon copy based paper devices for microbial assays and liver disease diagnosis.

We present a facile paper-based microfluidic device fabrication technique leveraging off-the-shelf carbon paper for the deposition of hydrophobic barriers using a novel "stencil scratching" method. This exceedingly frugal approach (0.05$) requires practically no technical training to employ. Hydrophobic barriers fabricated using this approach offer a width of 3 mm and a hydrophilic channel width of 849 µm, with an ability to confine major aqueous solvents without leakage. The utility of the device is demonstrated by porting a cell viability assay showing a limit-of-detection (LOD) of 0.6 × 108 CFU mL-1 and bilirubin assay with human serum showing a detection range of 1.76-6.9 mg dL-1 and a limit-of-detection (LOD) of 1.76 mg dL-1. The intuitiveness and economic viability of the fabrication method afford it great potential in the field of point-of-care diagnostics geared towards providing testing infrastructure in resource-scarce regions globally.

Vibrio cholerae O6 gastroenteritis in a patient with lupus nephritis - a report from coastal Karnataka, South India.

INTRODUCTION: Vibrio cholerae O1 strains are responsible for pandemics of cholera and major epidemics in the world. All the remaining V. cholerae non-O1/non-O139 strains are less virulent and are responsible for sporadic cases of gastroenteritis. These non-O1/non-O139 serogroups have more than 200 somatic antigens, and mostly lack cholera toxin and toxin co-regulated pilus encoding genes. Toxigenic and non-toxigenic non-O1/non-O139 V. cholerae have caused several diarrhoeal outbreaks in India and other countries. Acute gastroenteritis is the typical clinical sign and symptom of non-O1/non-O139 V. cholerae infection for both periodical and outbreak cases; in contrast, these V. cholerae are rarely associated with extraintestinal infections. CASE PRESENTATION: Here, we present a case of a 27-year-old female with underlying kidney disease (lupus nephritis) presenting with loose stools, vomiting and fever. V. cholerae O6 was isolated from a faecal sample, which was positive for hlyA and the type III secretion system. The present case is, to the best of our knowledge, the first such case to be reported from South India. CONCLUSION: The V. cholerae O6 associated with autoimmune disease in the present study demonstrates the role of this pathogen in acute gastroenteritis, and if it is left undiagnosed it can lead to septicaemia and other complications. The pathogenic mechanisms of non-O1/non-O139 V. cholerae are multivariate, virulence factors being naturally present in these strains. Therefore, further epidemiological studies are necessary to determine the virulence factors and their pathogenic mechanisms. Non-O1/non-O139 V. cholerae can undoubtedly be the cause of diarrhoea and it would be important to extend bacteriological identification in this line as well as in all cases of gastroenteritis of unknown aetiology.

Role of fetal Doppler and non-stress test in preeclampsia and intrauterine growth restriction.

OBJECTIVES: To study the efficacy of fetal Doppler and non-stress test (NST) in predicting fetal compromise in preeclampsia and growth-restricted fetuses. METHODS: ln a prospective study, 189 pregnant women beyond 32 weeks of gestation with preeclampsia or growth-restricted fetuses confirmed by ultrasound were evaluated by Doppler velocimetry (umbilical and middle cerebral artery) and non-stress testing. The outcome of pregnancy was recorded according to Group I (n = 109, Doppler and NST normal), Group II (n = 48, Doppler abnormal and NST normal), Group III (n = 14, Doppler normal and NST abnormal), and Group IV (n = 18, Doppler and NST both abnormal). The evaluation was done by Chi square testing. RESULTS: Both Doppler and NST had a better specificity and negative predictive value, indicating that these tests were more predictive of a healthy fetus. The fetal compromise in terms of APGAR scores, NICU admissions, birth weight, etc., was greater when both Doppler and NST were abnormal. Doppler detected changes earlier in the disease cascade than NST as evidenced by the lead time of 5.86 days. CONCLUSION: The use of both the tests is necessary as it helps in detecting a spectrum of fetuses compromised at various stages of disease affection.