Dipstick Research Articles

Investigation of Visceral Leishmaniasis and Coinfection of Intestinal Parasites in HIV-Positive Patients

Objective: Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaniasis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/Acquired Immune Deficiency Syndrome (AIDS) cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. Materials and Methods: In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. Results: 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. Conclusion: The regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Algorithm for Rapid Exclusion of Clinically Relevant Plasma Levels of Direct Oral Anticoagulants in Patients Using the DOAC Dipstick: An Expert Consensus Paper.

With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (1) determine the potential contribution of the DOAC to spontaneous or trauma-induced hemorrhage; (2) identify appropriate candidates for reversal, or (3) optimize the timing of urgent surgery or intervention. The DOAC Dipstick test uses a disposable strip to identify factor Xa- or thrombin inhibitors in a urine sample. Based on the results of a systematic literature search followed by an analysis of a simple pooling of five retrieved clinical studies, the test strip has a high sensitivity and an acceptably high negative predictive value when compared with levels measured with liquid chromatography tandem mass spectrometry or calibrated chromogenic assays to reliably exclude plasma DOAC concentrations ≥30 ng/mL. Based on these data, a simple algorithm is proposed to enhance medical decision-making in acute care indications useful primarily in hospitals not having readily available quantitative tests and 24/7. This algorithm not only determines DOAC exposure but also differentiates between factor Xa and thrombin inhibitors to better guide clinical management.

Preliminary study of urine analysis in pregnant cows: insights for improved herd management

ABSTRACT This study aimed to establish a standard urine profile for pregnant cows, commonly seen patients in veterinary clinics. Urine samples from 15 pregnant cows (6 Belgian Blue and 9 Holstein) of various ages were analysed, all showing no clinical signs of urinary tract disease. Samples were collected during preventive check-ups, either by spontaneous micturition or catheterisation. Macroscopic evaluation and urine dipstick tests revealed a mean pH of 8.17 ± 0.49. Moderate glycosuria and proteinuria were detected in two animals. No urobilinogen, ketone bodies, haemoglobin, or traces of blood were found. Laboratory urinalysis provided values (with 95% confidence intervals): osmolarity 493–1110.00 mOsm/l, sodium 52.00–122.00 mmol/l, calcium 1.28–3.98 mmol/l, potassium 76–144.00 mmol/l, magnesium 5.00–8.00 mmol/l, chlorine 40.00–80.00 mmol/l, protein 35.00–104.00 mg/l, glucose 0.40–1.27 mmol/l, creatinine 34.00–76.00 mmol/l, and urea 681.00–2086 mmol/l. These findings present the initial descriptive values of urine biochemical parameters in pregnant cows, emphasising their significance in assessing animal health. This research underscores its relevance by providing fundamental insights into animal health, offering a pathway to enhance agricultural sustainability and address food security, echoing the United Nations’ Sustainable Development Goals 1, 2, 8 and 12.

Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery

ObjectiveThe ‘To Dip or Not to Dip’ (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were...

Human Papillomavirus (HPV16 and HPV18) Infection; Pathogenesis, Vaccination, and Detection by Loop-Mediated Isothermal Amplification with Lateral Flow Dipstick Tests: A Review

Context: Human papillomavirus (HPV) infections contribute to the cause of 15% - 20% of all human cancers. This review aims to examine and provide updated information on various aspects, with a particular focus on topics that are of interest to dermatologists. Evidence Acquisition: Using published studies, the pathogenicity of HPV was investigated. Subsequently, the existing vaccines were explored, followed by a review of the loop-mediated isothermal amplification-lateral flow dipstick (LAMP-LFD) method. Results: For HPV detection, the polymerase chain reaction (PCR), self-sustained sequence replication (3SR), strand displacement amplification (SDA), and nucleic acid sequence-based amplification (NASBA) were used. These methods can have good detection but still have problems. In comparison with nested PCR, the detection of HPV16 and HPV18 using LAMP-LFD has higher sensitivity. Conclusions: Loop-mediated isothermal amplification-lateral flow dipstick is a simple and rapid method for the specific and sensitive detection of HPV. Thus, along with the previous HPV16 and HPV18 diagnostic tools, LAMP-LFD might be useful in field studies or local hospitals.

Noninvasive rapid urinary trypsinogen-2 dipstick test for early exclusion of post-endoscopic retrograde cholangiopancreatography pancreatitis within hours after endoscopic retrograde cholangiopancreatography: Clinical diagnosis and considerations.

Few reports have explored the application of urinary trypsinogen-2 measurement in the early diagnosis of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, and none have demonstrated the benefits of noninvasive testing. This study aimed to evaluate the clinical application of the rapid urinary trypsinogen-2 dipstick test (Nipro, Japan) compared with serum amylase and lipase levels for the early diagnosis of post-ERCP pancreatitis (PEP). A total of 100 consecutive patients (54 men and 46 women) who were admitted and underwent ERCP at Tokyo Medical University Hospital from August 2021 to December 2021 were recruited. All patients underwent rapid urinary trypsinogen-2 measurement using the dipstick test before and after ERCP. Measurements were taken 24 h before ERCP for pre-ERCP and 1-4 h after ERCP for post-ERCP. Additionally, serum amylase and lipase levels were measured at 8:00 a.m. of the day after ERCP (at least 8 h after ERCP), and their diagnostic abilities for PEP were compared and evaluated. PEP occurred in 5/100 patients (5%). The sensitivity, specificity, positive predictive value, and negative predictive value of the dipstick test for diagnosing PEP were 100%, 83.2%, 23.8%, and 100%, respectively. These results were comparable to the diagnostic performance of serum amylase and lipase levels at 8:00 a.m. on the day after ERCP (at least 8 h after ERCP). However, false positives must be considered. The dipstick test may be useful in clinical practice as a noninvasive screening test for the early prediction of PEP.

Assessment of the Prevalence and Associated Factors of Chronic Kidney Disease at WURH, West Ethiopia, 2022 G C

for at least three months and are manifested by either kidney damage (most frequently detected as persistent albuminuria or proteinuria) or a decreased glomerular filtration rate (GFR), which is < 60 ml/min per 1.73 m2. (1) . Chronic Kidney Disease (CKD) is a worldwide public health problem. Objective: To determine the prevalence and associated factors of CKD Patients at WURH from November 14-28, 2022. Methods: An institutional-based cross-sectional study of 208 chronic patients was conducted at WURH, which were found in the East Wollega zone, Nekemte town, Ethiopia between December 2021 to November 2022. All analyses and calculations Were performed using SPSS software (SPSS version 20). Data was presented as the means ±SDs for continuous variables and proportions for categorical variables. Demographic and clinical data were described. P values less than 0.05 at a 95% confidence interval were considered statistically significant. Result: The magnitude of chronic kidney disease among the study participants was found that 53 (25.5%) of the participants had hypertension, of whom 60.2 had a follow-up, 22 (10.6%) had diabetes, all of whom were on follow-up, and 46 (22.1%) had cardiac problems. Serum creatinine level was determined for 193(92%) participants and 151(72.6%) had normal level while it was raised (>1.2mg/dl) in 42(20.2%). urine dipstick test for proteinuria was done for 109(52.4%) of the participants and the result showed that 40(36.7%) had +1 proteinuria,32(29.4%) had +2 and 21(19.3%) had +3 and above. Conclusion: The prevalence of CKD in this study concludes that the disease become abundant and needs attention. The magnitude of the disease involves all age categories and is similarly common among males and females. Besides, CKD without any underlying associated factors appears abundant. CKD magnitude among patients with hypertension had statistical significance. Chronic kidney disease is rising at an alarming rate. Therefore, we recommend that relevant prevention, diagnostics, and therapeutic measures must be undertaken in all health facilities.

Utility of urine dipstick in predicting urinary tract infection in pediatric outpatients

Objectives: Children are most frequently affected by urinary tract infections (UTIs). Urine dipsticks along with use in urine routine testing can help in predicting UTI. In this study we aim to evaluate the utility of individual and combination of urine dipstick parameters, including nitrite and leukocyte esterase (LE), against gold standard urine culture for detection of UTI among pediatric outpatients. Materials and Methods: Nine hundred and forty-nine pediatric urine samples from January 2021 to December 2021 were cultured on Cysteine Lactose Electrolyte Deficient Agar and incubated at 37°C overnight. Siemens Multistix 10SG strips were used to perform a urine dipstick for urine markers. Results from the urine dipstick and culture were contrasted. Statistical Analysis: Data obtained in the study was analyzed statistically using stata version 15. Diagnostic performance of urine dipstick parameters was assessed taking urine culture as gold standard. Receiver operating characteristics (ROC) curve was plotted. Results: About 153 of the 949 urine samples received for culture were positive. Males comprised 102 of the 153 positive patients. The most common organism isolated was Escherichia coli, followed by Klebsiella, Pseudomonas, and Proteus. LE, nitrite, red blood cells (RBC), and protein had a sensitivity of 77.1%, 64.7%, 45.1%, and 46.4%, respectively, whereas their specificities were 94.5%, 97.2%, 95.9%, and 93.1%, respectively. When taken together, “LE and Nitrite and RBC and Protein” had a lower area under the curve (AUC) of 0.641, whereas “LE/Nitrite/RBC/Protein” had the highest AUC of 0.914. Conclusions: The urine dipstick test may be utilized as a screening tool and a positive predictor for UTI. When evaluated simultaneously, nitrite and LE can be used as point-of-care tests preceding the culture examination for decision-making. They can aid in the optimized management of children by minimizing UTI-related complications and inappropriate antibiotic use.

Microalbuminuria and Functional Iron Deficiency are Risk Factors for Hearing Loss in Adolescents.

Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10-19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high-frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. 3 (individual cross-sectional study) Laryngoscope, 134:3329-3334, 2024.

Comparison of urine protein-creatinine ratio and urine dipstick test for significant proteinuria in preeclamptic women.

Assessing for significant proteinuria in pregnancy (SPIP) stands as a key indicator for diagnosing preeclampsia. However, the initial method typically employed for this assessment, the urine dipstick test, often yields inaccurate results. While a 24-h urine collection is considered the most reliable test, its implementation can lead to delays in diagnosis, potentially affecting both maternal and fetal well-being. The urine protein-creatinine (P/Cr) ratio can be used as an alternative to 24-h urine protein analysis, but its diagnostic accuracy has remained uncertain. There is a need to compare the diagnostic accuracy of urine P/Cr ratio and dipstick urinalysis for SPIP, especially in resource-poor settings. To determine and compare the diagnostic accuracy of urine P/Cr ratio and dipstick urinalysis in a spot urine specimen for the diagnosis of SPIP among women evaluated for preeclampsia using 24-h urine protein excretions as a gold standard. This is a comparative cross-sectional study. The study involved 82 singleton pregnant women evaluated for preeclampsia from 20 weeks of gestation who underwent dipstick and P/Cr ratio tests in the same urine sample. Women at risk of preeclampsia were given a specimen container for the collection of urine samples on an outpatient basis. Participants were trained and told to collect the urine sample 24 h prior to their next antenatal appointment. However, those on admission and evaluated for preeclampsia had their 24-h urine collected in the hospital. The outcome measures included sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio and accuracy for the two tests. Significant proteinuria was defined as a P/Cr ratio >0.27 or ⩾2+ of proteinuria on the dipstick test. Preeclampsia was confirmed in women with both high blood pressure and SPIP. The mean age of participants was 28.65 ± 5.76 years. Comparatively, the diagnostic accuracy (91.46% (95% CI = 83.29-96.59) vs 59.76% (95% CI = 48.34-70.44), p = 0.001), sensitivity (94.74% vs 70.00%, p = 0.021), specificity (84.00% vs 43.75%, p = 0.001), negative predictive value (87.50% vs 48.28%, p = 0.003) and positive predictive value (93.10% vs 66.04%, p = 0.001), respectively, were higher for the spot urine P/Cr ratio than dipstick test. In addition, the positive likelihood ratio and the negative likelihood ratio for spot urine P/Cr ratio versus dipstick test were (1.93 vs 1.24) and (0.07 vs 0.69), respectively. The spot urine P/Cr has superior diagnostic accuracy in the determination of significant proteinuria in pregnant women being evaluated for preeclampsia than the widely used dipstick test. A more robust multicenter study is needed to compare the diagnostic accuracy of spot urine PCR with the standard 24-h urine protein in low-income settings.

Feline lower urinary tract disease diagnosis in an obese sterile male Persian mixed-breed cat

Feline lower urinary tract disease (FLUTD) occurs because of dysfunction of the urinary bladder and urethra in cats. This study reported that FLUTD occurs in a castrated and obese male cat. The supporting diagnostics used to confirm the diagnosis are the dipstick test, urine microscopic observation, and ultrasound. The examination results showed pyuria, proteinuria, haematuria, struvite crystals, and cystitis. The pathophysiology of FLUTD in this case begins with the condition of castrated males, who tend to have little activity and become obese. Obesity increases the risk of ascending infections, which is one of the causes of crystal formation in the urinary tract.

The diagnostic Accuracy of Visual versus automated dipstick proteinuria testing in Pregnancy: A systematic review and Meta-Analysis

Objective: To evaluate the diagnostic accuracy of point-of-care (POC) tests for detecting proteinuria in pregnant women.Design:Systematic review and meta-analysis.Data Sources:MEDLINE and EMBASE databases were searched from inception to 13 November 2020.Eligibility Criteria and Data Analysis:Included studies measured the sensitivity and specificity ofPOC proteinuria testing compared to laboratory reference standards (protein-creatinine ratio (PCR), 24-hour urine collection). Bivariate meta-analyses determined pooled sensitivity and specificity. Random-effects inverse-variance model determinedheterogeneity.Main Outcome Measures:The primary outcome was overall sensitivity and specificity, stratified by method of POC testing and reference standard. Secondary outcomes were sensitivity and specificity within thesubgroupstest brand, reference standard, and hypertension status.Results: 1078 studies were identified, 17 studies comprising 23 comparisons were included. The meta-analysis included 13 studies with 19 comparisons. Pooled sensitivity and specificity of visual dipsticks against PCR was 72 % (95 % CI: 56 % to 84 %) and 92 % (95 % CI: 76 % to 98 %), respectively. Pooled sensitivity and specificity of visual dipsticks against 24-hour collection was 69 % (55 % to 80 %) and 70 % (51 % to 84 %), respectively. Pooled sensitivity and specificity for automated readers against PCR was 73 % (53 % to 86 %) and 91 % (83 % to 95 %), respectively. Pooled sensitivity and specificity of automated readers against 24-hour collection was 65 % (42 % to 83 %) and 82 % (46 % to 96 %), respectively.Conclusion: Visual dipsticks have comparable accuracy to automated readers, yet are notadequate as a rule-out test for proteinuria. Proteinuria POC testing maybe beneficial inantenatal care when repeatfollow-up tests are performed.PROSPERO Registration Number: CRD42021231914.

Real Clinical Practice Register of Albuminuria Detection in Patients with Previously Undiagnosed Chronic Kidney Disease

Aim. To collect data on the patient phenotype at the highest risk of developing albuminuria, to assess the prevalence of albuminuria in the identified phenotypes, and to collect data on the characteristics, prescribed therapy, and comorbidities of patients with and without identified albuminuria.Materials and methods. Data on presence or absence of albuminuria are collected in this register of real clinical practice instantaneously. All patients seeking medical attention are screened for the presence and extent of albuminuria. All data are collected in anonymized form and entered into an electronic case report form. Inclusion criteria: 1) men and women aged 40 years and older at the time of data collection; 2) the possibility to perform an albuminuria test using dipsticks and/or a test for microalbuminuria or urine albumin/creatinine ratio in a spot urine sample. Exclusion criteria: 1) the patient’s reluctance to participate in the registry; 2) diagnosis of CKD made before screening for the registry; 3) diagnosis of diabetes mellitus type 1 or 2 made before screening for the registry; 4) pregnancy; 5) long distance running or very heavy physical activity in the last 24 hours.Results. At the time of submission of this material, the active phase of patient recruitment for the registry with the specified power has been ongoing. Based on the expected recruitment rate at 45–50 sites, the registry is expected to include data from 12,000–15,000 patients. If fewer than 12,000 patients are recruited and the estimated recruitment rate for the registry is insufficient, the number of study sites or the screening period may be extended.Conclusion. Despite the established prognostic significance of the data on AU, the test is prescribed in routine practice to individuals at risk of developing CKD or to patients with an established nephrological disorder. A local registry that combines diverse patient populations, namely patients not only from established CKD risk groups but also patients with a dipstick test for AU, is of scientific and practical interest and can be used in the development of national clinical guidelines and educational materials and used in clinical practice.

The Value of Negative Urinary Dipstick Tests for Haematuria in Patients Undergoing Surveillance for Low-grade Ta Urothelial Cancer: A Two-stage Prospective Clinical Study in 524 Patients

Background and objectiveThe risk of first recurrence beyond 5 yr for patients with low-grade (LG) Ta non–muscle-invasive bladder cancer (NMIBC) is low enough to consider discontinuing cystoscopic surveillance at that point. However, a positive urinary dipstick test for haematuria (UDH) during and beyond the period of cystoscopic surveillance can disrupt plans to cease surveillance because the association between UDH positivity and recurrence in LG Ta NMIBC is unknown. In a two-stage study, we evaluated this association and explored the role of UDH negativity in predicting the absence of recurrence. MethodsBecause of previously demonstrated changes in recurrence patterns over time, two prospective cohorts were assessed: an “exploratory” cohort (January 2007–March 2008) and a “validation” cohort (November 2017–August 2018). UDH was performed before flexible cystoscopy. Patient, operative, and surveillance data have been recorded prospectively using standard pro forma sheets since 1978 in our institution. Only patients with primary LG Ta pTa NMIBC were included for analysis. Key findings and limitationsWe assessed 231 patients in the exploratory group and 293 in the validation group. The proportion of smokers (67% vs 70%; p = 0.5) and mean follow-up (72.2 vs 79.9 mo; p = 0.2) were similar between the groups. The recurrence rate was higher in the exploratory group (19% vs 11%; p = 0.009), as was the UDH positivity rate (37% vs 11%; p < 0.001). The specificity and negative predictive value were 64% and 83% in the exploratory group, and 90% and 90%, respectively, in the validation group. These values increased further for the subgroup with solitary primary tumours the subgroup without recurrence for 3 yr. Conclusions and clinical implicationsUDH negativity has a high probability of being associated with the absence of recurrence in small LG Ta NMIBC and could be an inexpensive adjunct during surveillance. Ongoing validation, which started in 2019, is being performed in a now-nationalised Scottish protocol in which UDH replaces cystoscopy in years 2 and 4 for patients in the low-risk group. Patient summaryWe investigated the accuracy of a dipstick test for blood in the urine for patients undergoing surveillance for low-grade noninvasive bladder cancer. We found that a negative dipstick test result was highly associated with the absence of tumour recurrence, particularly for patients with the lowest risk. These findings have been introduced into a national protocol designed to reduce the frequency of telescopic inspection of the bladder during surveillance to reduce the burden for patients.

Utility of dipstick urinalysis in the diagnosis of urinary tract infections among outpatients in Mwanza and Dar es Salaam regions in Tanzania

Abstract Background Globally, urinary tract infections (UTIs) are the leading cause of hospital visits, especially among women. In many developing countries, especially in lower health facilities, the dipstick urinalysis is the most commonly requested test, as urine culture is not routinely performed. The dipstick test can potentially reduce the number of patients who could be treated with empirical antibiotics and reduce the burden of antibiotic resistance. The current study determined the utility of dipstick urinalysis in diagnosing UTIs using urine culture as a gold standard method. Methods A cross-sectional study was conducted between July and November 2021. The study involved 1327 outpatients attending lower health centres in Mwanza (n = 678) and Dar es Salaam (n = 649) regions. The samples were subjected to dipstick urinalysis (nitrite and leucocytes) and quantitative bacterial culture. Results Of all 1326 patient samples, 808(60.9%) and 48(3.6%) were positive for urinary leucocyte and nitrite, respectively, while significant urine culture was found in 364(27.4%). leucocyte test correctly diagnosed UTI in 283 (77.75%) and nitrite test in 36 (9.89%). The leucocytes and nitrites, in combination, exhibited a sensitivity of 79.40% and NPV of 85.24% but a lower specificity of 44.96% and a lower PPV of 35.29%. Urinary leucocyte test had a higher discrimination ability to detect urinary tract infection than urinary nitrite test (AUC = 0.073, 95% CI 0.043–0.103, p &lt; 0.001); likewise, combined results of urinary nitrite and leucocytes tests had higher discrimination ability to detect UTI than nitrite only (AUC = − 0.079, 95% CI − 0.107–0.050, p &lt; 0.001). Conclusions In settings where culture is available, dipstick urinalysis can be a helpful screening method for reducing unnecessary urine cultures and related expenses because of its higher negative predictive value. In most low-resource settings where patients' diagnosis solely depends on clinical diagnosis and culture is not easily available, urine dipstick can decrease the risk of overuse of antibiotics. However, the combined (leucocytes and nitrites) dipstick urinalysis has a rather low positive predictive value, with approximately one-third of cases giving positive test results being truly UTI, subjecting over 65% of cases to unnecessary antibiotic treatment.

Can the urine dipstick test be used as a proteinuria screening test?

Can the urine dipstick test be used as a proteinuria screening test?

Pregnancy-associated asymptomatic bacteriuria and antibiotic resistance in the Maternity and Children's Hospital, Arar, Saudi Arabia.

The Ministry of Health in Saudi Arabia provides comprehensive antenatal care for all pregnant women with all required investigations. However, it does not include urine culture for diagnosis of asymptomatic bacteriuria (ASB). This is the first study to evaluate the prevalence of ASB among pregnant females, identify the causative organisms and determine their antibiotic susceptibility patterns in the Maternity and Children's Hospital, Arar, Saudi Arabia. This cross-sectional study included 400 pregnant women attending an antenatal clinic. Two midstream urine samples were aseptically collected and screened using standard microbiological techniques including microscopic examination, dipstick testing, and urine culture. In order to interpret the urine culture results, ≥ 105 CFUs/mL was considered significant bacteriuria. Identification of the isolates and their antibiotic sensitivity testing was performed using the Vitek 2 system (BioMérieux, Marcy l'Etoile, France) with the available test kits. The prevalence of ASB was 8.25% (35/400). Significant positive correlations (p ˂ 0.05) were detected between positive urine culture results and random blood sugar, leucocytes, nitrites, pus cells, urine red blood cells, epithelial cells, and mucus. Escherichia coli was the most common causative organism (45.7%), followed by Staphylococcus aureus (22.9%). Klebsiella pneumoniae represented 11.4% of the isolates. Most of the isolated Gram-positive organisms were sensitive to many of the tested antibiotics; most of the detected Gram-negative isolates were resistant. ASB caused by antibiotic resistant organisms is alarming. Screening for ASB during pregnancy using urine culture and sensitivity testing is of vital importance to improve the maternal and neonatal outcome.

Urine-based point-of-care testing for factor-Xa-inhibitors in acute ischemic stroke patients: a feasibility study.

Direct oral anticoagulants (DOACs) have become widely used in clinical practice for preventing thromboembolic events. Point-of-care testing methods, particularly those based on urine samples, offer a promising approach for rapid and accurate assessment of DOAC presence. This pilot study aims to evaluate the utility of a urine-based DOAC dipstick test as a point-of-care tool for identifying DOAB presence in acute ischemic stroke (AIS) or transient ischemic attack (TIA) patients. This prospective pilot study included patients with AIS/TIA eligible for DOAC-measurement. After exclusion of 3 patients, 23 patients with DOAC-intake (DOAC group; factor-Xa-inhibitors; n = 23) and 21 patients without DOAC-intake (control-group) remained for analyses. The urine-based DOAC dipstick test and parallel blood-based specific DOAC-level assessment were performed in all patients. Time-intervals of sampling urine/blood sampling and result of DOAC-test were recorded to analyze a potential time benefit based on dipstick evaluation. The urine-based DOAC dipstick test demonstrated high sensitivity (100%) and specificity (100%), correctly identifying all patients with anticoagulatory activity due to DOAC intake (i.e., anti-Xalevel ≥30 ng/mL). Moreover, the visual readout of the test provided semiquantitative information on drug-specific anti-Xa levels, showing a sensitivity of 83% and specificity of 93% to detect anti-Xa levels ≥120 ng/mL. The dipstick test exhibited a median time-benefit of 2:25 h compared to standard blood-based DOAC-level testing. The results of this pilot study underline the efficacy of urine-based point-of-care testing as a rapid and reliable method for assessing DOAC presence in patients with acute ischemic stroke. The value of this tool for clinical decision-making in stroke management needs to be established in future trials.Clinical Trial Registration: Clinicaltrails.org identifier [NCT06037200].

Barriers, enablers, benefits, and drawbacks to point-of-care testing: a survey of the general practice out-of-hours service in Scotland.

The general practice out-of-hours (GPOOH) service is under pressure to treat more patients in less time, while reducing referrals and minimising diagnostic errors. Point-of-care (POC) testing involves rapid clinical tests that can be used to generate results during the consultation, and has the potential to facilitate managing these competing demands safely. To describe current availability of POC tests in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to its use. Cross-sectional mixed-methods study, which surveyed opinions of clinicians working in the GPOOH service in NHS Scotland. An electronic questionnaire was developed, designed, piloted, and distributed to clinicians, which had closed questions and areas for free text. In total, 142 responses were received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%), and blood glucose testing (93.9%), were the only POC tests commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POC tests, particularly C-reactive protein (CRP; 79.4%), strep A (76.0%), and D-dimer (75.2%). Responders felt that POC tests would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POC test use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%), and time to do the test (62.0%). Few POC tests are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POC testing. They identified a number of benefits to its use, with very few drawbacks. Increased provision of POC testing in GPOOH in NHS Scotland should be considered urgently.

Prevalence of Schistosomiasis and Soil-Transmitted Helminthiasis and Their Risk Factors: A Cross-Sectional Study in Itilima District, North-Western Tanzania.

Schistosomiasis and soil-transmitted helminthiasis remain a public health concern in Tanzania. This study investigated the prevalence and intensities of Schistosoma haematobium, S. mansoni, and soil-transmitted helminths and associated factors in Itilima district, north-western Tanzania. A cross-sectional survey was conducted between August and September 2020 among 3779 primary schoolchildren in 62 primary schools and 1122 adults in 19 villages. Urine samples were obtained from each participant and examined visually for the presence of macrohaematuria, microhaematuria, and S. haematobium eggs using a urine dipstick and urine filtration test. A single stool sample was obtained from each participant and screened for S. mansoni and soil-transmitted helminths using the Kato Katz and formalin-ether concentration techniques. A questionnaire was administered to schoolchildren to elucidate the risk factors for schistosomiasis. The overall prevalence of S. haematobium in adults was 8.1% (95% confidence interval (CI), 6.6-9.8%). In total, 3779 schoolchildren had complete results from urine testing, and the overall prevalence of S. haematobium was 10.1% (95% CI, 9.1-11.1%). The prevalence of S. mansoni and soil-transmitted helminths was relatively low among both children and adults compared to S. haematobium. Factors associated with S. haematobium infection among schoolchildren were the mother's occupation, children aged 11-15 years, and water contact behaviour. The odds of having schistosomiasis infection among children aged 11-15 are 40% higher than those aged 5-10 (95% confidence interval (CI), 10-80%, p = 0.04). Children of parents who are livestock keepers have 12.3 times higher odds of having infection compared to those who have small-scale businesses (95% CI, 1.0-5.4, p = 0.03). Children who are in contact with infested water more than three times a week have 2.1 times higher odds of having an infection compared to those who do not (95% CI, 2.1; 1.6-2.8, p < 0.001). The findings provide updated geographical information on prevalence, yielding insights into the planning and implementation of mass drug administration in rural Tanzania.