ABSTRACT
Background: Dengue is the most common arboviral infection that spreads by Aedes aegypti and Aedes albopictus mosquitoes, and is quickly gaining prominence as a major mosquito-borne viral disease. One of the major public health issues is dengue fever (DF), which can also cause dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Therefore, this study focused on comparison of dengue antigen non-structural protein (NS1) and immunoglobulin M (IgM) using enzyme-linked immunosorbent assay (ELISA) and immunochromatography test (ICT) for detection of dengue. Method: In a Tertiary Care Hospital (TCH), sociodemographic status of probable dengue cases from February 2021 to February 2022 was studied. The results of the Dengue Antigen NS1 and IgM ICT, Dengue NS1 Microlisa, and Dengue IgM Microlisa were compared in order to determine the effective one at managing patients and preventing complications like DHF and DSS. Results: In distribution of 100 ICT reactive samples, 50% were NS1 reactive and 50% were IgM reactive. One hundred ICT reactive samples were further processed for IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) for both NS1 and IgM. Sensitivity and specificity of NS1 ICT were 89.3% and 71.4% and that of IgM ICT was 88% and 64.5%. As a result of antigenic cross-reactivity, false positive cases were reported. Platelet count of the patients was correlated with an optical density (OD) value of ELISA for both NS1 and IgM. In the present study, patients having low platelet count showed high OD value. Conclusion: In cases of severe thrombocytopenia (platelet count <50000), early diagnosis by screening ICT and confirmation by ELISA (NS1 and IgM) would reduce the complications like DHF and DSS.
ABSTRACT
Introduction Psidium guajava (guava) is a fruit plant of the Myrtaceae family. Guava roots, leaves, and fruits have traditionally been used to prevent and treat various infections. In the last few decades, there has been exponential growth in herbal medicine. Therefore, the present study was conducted to determine the susceptibility and synergistic properties of the antimicrobial activity of the aqueous leaf extract of guava and other antimicrobial drugs against Escherichia coli (E. coli). Methodology A prospective observational study was conducted at the Department of Microbiology, MGM Medical College and Hospital, Navi Mumbai, India, involving 180 urine samples collected from patients who exhibited symptoms of urinary tract infection (UTI). The aim was to evaluate in vitro synergism between leaf extracts of guava and antimicrobial drugs on uropathogenic E. coli, using minimal inhibitory concentration (MIC) and the Kirby-Bauer method. The Kirby-Bauer disc diffusion method was employed to determine the synergistic activity using Muller-Hinton agar (MHA), and the zone of inhibition was measured in millimeters. Results The study found that, of the 180 urine samples collected from patients with UTI, significant growth was observed in 93 samples, with the most notable increase seen in E. coli. The antibiotics tobramycin, ofloxacin, and amikacin, each showing a sensitivity of 76% and 70% respectively, were found to be the most sensitive. Conversely, cefuroxime and cephalothin, both at 76%, were the most resistant. Furthermore, the antibiotic sensitivity pattern of E. coli without guava extract demonstrated tobramycin (TOB) at 76.66%, followed by ofloxacin (OF) and amikacin (AK) at 70% each, levofloxacin (LE) at 63.33%, nitrofurantoin (NIT) at 53.33%, trimethoprim (TR) at 43.33%, cefotaxime (CTX) at 36.66%, ceftizoxime (CZX) at 30%, norfloxacin (NR) at 26.66%, cephalothin (CEP) at 23.33%, amoxicillin-clavulanate (AMC) at 20%, and cefuroxime (CXM) at 10%. In contrast, when the antibiotic sensitivity pattern of E. coli with guava extract was examined, the highest sensitivity was noted for OF (100%), followed by LE (96.66%), TOB (93.33%), AK (90%), NIT (76.66%), AMC and TR (66.66% each), CTX (60%), CZX (53.33%), CEP (50%), NX (43.33%), and CXM (26.66%). Therefore, Psidium guajava (guava) extract exhibited a synergistic effect when combined with antibiotics, most notably with ofloxacin. Conclusion The study revealed that the highest synergistic activity of guava plant leaf extract was with the antibiotic ofloxacin. This finding indicates that guava extract enhances the effectiveness of commonly used antibiotics for treating UTI, an effect mainly attributed to the flavonoid compounds and their derivatives in the guava leaf extract, which inhibit bacterial growth. This study demonstrated the antibacterial properties of guava, suggesting that combining antibiotics with guava extract can help delay the emergence of bacterial resistance.
ABSTRACT
INTRODUCTION: India is one of the countries in the world which contribute to the global burden of multidrug-resistant tuberculosis (MDR-TB). GeneXpert is a method recommended by the World Health Organization (WHO) that uses five overlapping probes (Probe A to E) to detect mutation in the beta subunit of ribonucleic acid (RNA) polymerase gene (Rpoß) responsible for rifampicin resistance in Mycobacterium tuberculosis (MTB). METHOD: All the pulmonary and extrapulmonary samples received in tuberculosis (TB) laboratory for testing of MTB from January 2018 to December 2020 were analyzed for bacillary load and rifampicin resistance was identified by analyzing the number of missing probes. RESULTS: During the study period, a total of 10,021 samples were tested for MDR-TB. Out of those samples, 2674 samples were positive for MTB of which 2321 were pulmonary samples and 353 were extra-pulmonary samples. Rifampicin resistance was detected in 385 pulmonary samples and 63 extrapulmonary samples. These samples were further differentiated according to the bacillary load. The highest number of mutations was observed in Probe E followed by Probe B, Probe A, and Probe D, and the lowest was observed in Probe C. Also, mutations were associated when all probes were present or a few combinations of probes were missing. CONCLUSION: GeneXpert assay is a rapid molecular method that detected MTB and rifampicin resistance with a two-hour turnaround. It uses molecular beacons to detect mutation in the Rpoß gene. This study can be useful in analyzing the prevalence and epidemiology of MTB in a particular demographic area and also the addition of a few more probes can enhance the identification of the mutation in other codons and therefore better therapeutic interventions can be developed accordingly.