Laboratory-based Cross-sectional Study Research Articles

Genomic characterization of methicillin-resistant Staphylococcus aureus isolated from patients attending regional referral hospitals in Tanzania

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) colonization increases the risk of subsequent infection by MRSA strain complex interlinking between hospital and community-acquired MRSA which increases the chance of drug resistance and severity of the disease.ObjectiveGenomic characterization of Staphylococcus aures strains isolated from patients attending regional referral hospitals in Tanzania.MethodologyA laboratory-based cross-sectional study using short read-based sequencing technology, (Nextseq550,Illumina, Inc. San diego, California, USA). The samples used were collected from patients attending selected regional referral hospitals in Tanzania under the SeqAfrica project. Sequences were analyzed using tools available in the center for genomic and epidemiology server, and visualization of the phylogenetic tree was performed in ITOL 6.0. SPSS 28.0 was used for statistical analysis.ResultsAmong 103 sequences of S. aureus, 48.5% (50/103) carry the mecA gene for MRSA. High proportions of MRSA were observed among participants aged between 18 and 34 years (52.4%), in females (54.3%), and among outpatients (60.5%). The majority of observed MRSA carried plasmids rep5a (92.0%), rep16 (90.0%), rep7c (90.0%), rep15 (82.0%), rep19 (80.0%) and rep10 (72.0%). Among all plasmids observed rep5a, rep16, rep20, and repUS70 carried the blaZ gene, rep10 carried the erm(C) gene and rep7a carried the tet(K) gene. MLST and phylogeny analysis reveal high diversity among MRSA. Six different clones were observed circulating at selected regional hospitals and MRSA with ST8 was dominant.ConclusionThe study reveals a significant presence of MRSA in Staphylococcus aureus strains from Tanzanian regional hospitals, with nearly half carrying the mecA gene. MRSA is notably prevalent among young adults, females, and outpatients, showing high genetic diversity and dominance of ST8. Various plasmids carrying resistance genes indicate a complex resistance profile, highlighting the need for targeted interventions to manage MRSA infections in Tanzania.

Analysis of heavy metals and minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia

IntroductionNowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries.ObjectiveThis study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.MethodsA laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis.ResultA total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils.ConclusionTo address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.

Effects of Hepatorenal Function on Urinary Alzheimer-Associated Neuronal Thread Protein: A Laboratory-Based Cross-Sectional Study Among the Older Chinese Population.

Urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) is a biomarker for the early diagnosis of Alzheimer's disease (AD). It remains unclear whether hepatorenal function affects the urinary AD7c-NTP level. To evaluate the effects of hepatorenal function on urinary AD7c-NTP level. We enrolled 453 participants aged 60-100 years. An automated chemistry analyzer was used to determine the indicators of serum hepatorenal function. Enzyme-linked immunosorbent assay was used to measure the urinary AD7c-NTP level. Spearman's correlation analysis showed a negative correlation between urinary AD7c-NTP levels and indicators of hepatorenal function, including albumin (r = -0.181, p < 0.001), albumin/globulin ratio (r = -0.224, p < 0.001), cholinesterase (r = -0.094, p = 0.046), total carbon dioxide (r = -0.102, p = 0.030), and glomerular filtration rate (r = -0.260, p < 0.001), as well as a positive correlation with globulin (r = 0.141, p = 0.003), aspartate transaminase (r = 0.186, p < 0.001), blood urine nitrogen (r = 0.210, p < 0.001), creatinine (r = 0.202, p < 0.001), uric acid (r = 0.229, p < 0.001), and cystatin C (r = 0.265, p < 0.001). The least absolute shrinkage and selection operator (LASSO) regression analysis and multiple linear regression model analyses showed that the statistically significant hepatorenal indicators for predicting AD7c-NTP were A/G (p = 0.007), AST (p = 0.002), BUN (p = 0.019), and UA (p = 0.003). The effects of hepatorenal indicators should be considered when using urinary AD7c-NTP levels in clinical settings.

Distribution of Malaria Infection Among Different Genotypes in Three Senatorial Zones of Taraba State Nigeria

Malaria infection is recognized as a severe public health problem linked to most cases of morbidity and mortality in malaria endemic areas. The study was used to determine the distribution of malaria infection among the different genotypes in three senatorial zones in Taraba state. The study employed a community and laboratory based cross sectional study. The electrophoresis machine was used to determine the genotypes of the research subjects while Rapid diagnostic technique and the gold standard microscopy was used to determine the prevalence of malaria infection. The haematology auto-analyzer (Sysmex XTI 2000) was used to determine the haematological parameters of the subjects. A total of 3084 blood samples was obtained by venepuncture. The distribution of the genotypes are AA 1721 (55.8%), AS 966 (31.3%) and SS 397 (12.9%). The overall prevalence of malaria was 620 (20.1%). Malaria infection was highest in the southern senatorial zone (29.1%) than in the north and central zones (p&lt;0.05). Infection was high with the males (21.2%), age-related malaria infection was significant (p&lt;0.05) with age 1-10yrs recording the highest infection (28.0%). No significant difference (p&gt;0.00) was recorded in the marital status of the patient with the widows/widower having 23.4% while degree of infection was significant for education-related infection (p&lt;0.05) with the non-educated subjects recording highest infection (34.4%). Occupational related prevalence was significant (p&lt;0.05) with high infection among traders (162 (28.7%). Significant difference was recorded in the marital status with the widow/widower recording a high prevalence of malaria 112 (23.4%). Our finding in the current study confirm that malaria remains a major challenge and there is need for periodic prophylactic administration of malaria drugs in the treatment regime of sickle cell anaemia patients. Keywords: Malaria infection, genotypes, distribution, senatorial zones, Taraba State, Nigeria

Haematological Derangements Due to Plasmodium falciparum Among Sickle Cell Anaemia Patients in Taraba State Nigeria

Malaria infection is recognized as a severe public health problem linked to most cases of morbidity and mortality in malaria endemic areas. The study was used to determine the hematological derangement of plasmodium falciparum among sickle cell anaemia patients in Taraba state. The study employed a community and laboratory based cross sectional study. The findings shows that malaria infection was highest in the southern senatorial zone (29.1%) than in the north and central zones (p&lt;0.05). Infection was high with the males (21.2%), age-related malaria infection was significant (p&lt;0.05) with age 1-10yrs recording the highest infection (28.0%). No significant difference (p&gt;0.00) was recorded in the marital status of the patient with the widows/widower having 23.4% while degree of infection was significant for education-related infection (p&lt;0.05) with the non-educated subjects recording highest infection (34...4%). Occupational related prevalence was significant (p&lt;0.05) with high infection among traders (162 (28.7%). Significant difference was recorded in the marital status with the widow/widower recording a high prevalence of malaria 112 (23.4%). Haematological parameters show no significant association in malaria parasitized packed cell volume (t=0.284, p&gt;0.05) and monocytes (t=1.361, p&gt;0.05). Significant association was recorded in total white blood count (t=3.647, p&gt;0.05), neutrophil (t=20.794, p&lt;0.05), erythrocyte sedimentation rate (t=30.017, p&lt;0.05), eosinophil (t=4.847, p&lt;0.0.07), basophil (t=11.35, p&lt;0.05), platelet (t=30.378, p&lt;0.05) and lymphocytes (t=21.369, p&lt;0.03).Our finding for this current study confirm that malaria remains a major challenge and there is need for periodic prophylactic administration of malaria drugs in the treatment regime of sickle cell anaemia patients. Keywords: Malaria infection, hematological derangement, plasmodium falciparum, Taraba State, Nigeria.

Magnitude of Metabolic Syndrome and its Associated Factors among Patients with Chronic Kidney Disease: Laboratory-Based Cross-Sectional Study in Northwest Ethiopia

Magnitude of Metabolic Syndrome and its Associated Factors among Patients with Chronic Kidney Disease: Laboratory-Based Cross-Sectional Study in Northwest Ethiopia

Heavy metals in wastewater and fish collected from waste stabilization pond and human health risks in southwestern Ethiopia

IntroductionThis study aimed to measure the concentration of toxic heavy metals in wastewater samples and Nile tilapia (Oreochromis niloticus) species inhabiting wastewater (waste stabilization ponds) and evaluate their safety as a food source in southwestern Ethiopia. For this purpose, toxic metals like lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg) in wastewater samples and fish tissues (muscle, gill, and liver) were independently examined.MethodsA laboratory-based cross-sectional study was performed to ascertain the levels of Pb, Cd, As, and Hg in the fish tissues of O. niloticus and wastewater samples. Heavy metal levels were analyzed by microplasma atomic emission spectrometry (Agilent 4210 MP-AES) and hydrogen-generated atomic absorption spectrometry (HGAAS, novAA 400P, Germany).ResultsHeavy metal concentrations were measured in the following decreasing order (µg L−1): Cd &amp;gt; Pb &amp;gt; As &amp;gt; Hg in facultative and maturation ponds, with Cd (27.66 µg L−1) having the highest concentration and Hg (0.349 µg L−1) having the lowest concentration. Among the heavy metals detected in the wastewater samples, Hg showed a statistically significant difference between the sampling points (p = 0.023). The maximum metal concentration was measured for Pb (0.35 mg kg−1) and Cd (0.24 mg kg−1) in the muscle tissue of O. niloticus. The value of arsenic (0.02 mg kg−1) detected in fish edible muscles exceeded the FAO/WHO maximum permissible limit (MPL = 0.01) for human consumption. The carcinogenic and non-carcinogenic health risks of consuming fish due to trace metals were relatively low and posed fewer potential threats to human health. According to this finding, children were more susceptible to heavy metal exposure than adults.ConclusionDue to the high quantities of these harmful heavy metals, wastewater from oxidation ponds should not be used for fishing to avoid bioaccumulation. The target carcinogenic risk (TR) and target hazard quotient (THQ) indicated that all heavy metals were below the safe threshold. This research will provide a baseline for monitoring trace metals in various edible aquatic creatures and for future research in artificial habitats and regulatory considerations.

Microbiological quality of edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia.

Edible oils are imported and produced in Ethiopia, notably in Gondar, and their production has expanded considerably in recent years. The expansion of locally produced edible vegetable oils with severe quality control, substandard edible oil production, and quality deterioration may contribute to the contamination of microbes, which may cause public health problems. This study determines the microbiological quality of edible vegetable oils being produced and marketed in Gondar City, Northwest Ethiopia, in 2021. A laboratory-based cross-sectional study design was conducted from May to July 2021 in Gondar City. A simple random sampling technique was used to collect 17 edible vegetable oil samples. Aseptically collected samples were analyzed in the microbiology lab room. The microbiological quality of vegetable oil was assessed using standard microbiological procedures and techniques. The collected data were entered into a Microsoft Excel 2016 spreadsheet and Stata Version 14. A non-parametric Kruskal-Wallis test was used to assess significant variation. Seventeen edible vegetable oil samples were examined and found to contain a varying number of bacteria, yeast, and molds. Staphylococcus aureus, Klebsiella Pneumoniae, and Pseudomonas aeruginosa were the identified bacteria, whereas Saccharomyces cerevisiae, Aspergillus niger, Aspergillus flavus, and Aspergillus fumigatus were the identified fungi. Total coliform and fecal coliform isolates were also identified in the oil samples. A level of microbial contamination that has public health importance was observed in some of the oil samples analyzed, and the isolated microorganisms indicate unhygienic handling, processing, and storage practices in the oil production and market sites. The introduction of strict rules, regulations, and updated manufacturing technologies and processes to ensure food safety and quality is needed.

Correlation of HbA1c with Various Hematological Parameters in Patients of Type 2 Diabetes Mellitus in a Tertiary Health Care Centre in North India: A Comparative Cross-Sectional Study

Introduction: Diabetes has become one of the leading Global health Emergencies and is ranked among the top 10 causes of mortality worldwide. Diabetes mellitus causes a wide range of complications including micro and macrovascular complications like microangiopathy, retinopathy, nephropathy, neuropathy and diabetic foot. HbA1c is considered as the Standard of Care for monitoring type 2 Diabetes Mellitus. We aim to evaluate the common hematological parameters along with inflammatory parameters like neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients of type 2 diabetes mellitus. Methods: This was an observational laboratory based cross sectional study in which cases were included from 1st November 2023 to 31st December 2023. Two hundred and thirteen cases were divided into two groups (Diabetic and Non-Diabetic group) based on HbA1c levels and exclusion criteria. All cases were assessed for RBC count, TLC, DLC, Hb, RDW, Hct, NLR and PLR. Data was analysed using IBM SPSS v 29.0.2.0 (20) software and Microsoft Excel. A p value of less than 0.05 was considered statistically significant. Results: The mean age of diabetic and non-diabetic groups were 52.9 years and 50.6 years respectively (p &gt; 0.05) with sex ratio of 1:2.1 and 1:1.7 respectively. There were significant differences in the means of the two groups for hematocrit levels, WBC count, neutrophil count, and NLR with p values of 0.001, 0.018, &lt; 0.001 and &lt; 0.001 respectively. There was no significant difference in the means for other parameters. Conclusion: The study results are consistent with the significant role of inflammation in etiopathogenesis of type 2 diabetes with significant increase in the levels of hematocrit, WBC count, neutrophils and NLR in patients with poor glycemic control. Furthermore, NLR being an easy and cost-effective tool along with its high association with microangiopathic complications, it needs to evaluated meticulously for assessing the prognosis in patients of type 2 diabetes mellitus.

Antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods in selected towns of Ethiopia

BackgroundStreet foods are any foods or drinks prepared or sold by street vendors in an open space. The purpose of this study was to determine the Bacteriological safety and antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods.MethodA laboratory-based cross-sectional study was used from December 2022 to February 2023 on street foods of Addis Ababa, Hawassa, Dire Dawa, and Jimma towns of Ethiopia. 525 street foods and 175 water samples were taken from 175 street food vending stalls. Proportional allocation to the total town population and stratified sampling techniques were used to select vending stalls. Samples were analyzed for the presence of bacteria following the standard microbiological methods used for the isolation, enumeration, and identification of bacteria. Pour plate technique was used to transfer the suspension to MacConkey agar, Mannitol Salt Agar, and Salmonella Shigella Agar. The antibiotic susceptibility test was performed using the Kirby-Bauer disk diffusion method. SPSS software was used to analyze the data.ResultOut of 525 food samples, 279 (53%) were contaminated by bacteria. From 175 water samples, 95 (54.3%) were contaminated with Escherichia coli. From both samples in total, eleven bacterial species were isolated. Staphylococcus aureus was the most frequently isolated species. Shigella, Klebsiella, and Salmonella group A have statistically significant with the type of food. Erythromycin (54%), Streptomycin (17%), and Amoxicillin (14%) were the most resistant antibiotics. Least resistance was observed to Ciprofloxacin (5%).ConclusionStreet foods of the selected towns were highly contaminated with various antibiotic-resistant organisms. Hence, the relevant authorities ought to ensure the proper handling of street food by enforcing safety measures. Additionally, they should initiate a widespread awareness campaign promoting the prudent use of antibiotics among both street food vendors and the broader population.

Physicochemical and bacteriological quality of swimming pools water in Kombolcha Town, Northeastern Ethiopia.

The use of swimming pool water for recreation, rehabilitation, and athletics is widespread around the world, especially in large Cities and Towns. However, poorly managed swimming pool water can facilitate the spread of illnesses connected to recreational water. Despite this, there is no evidence on quality of swimming pools water in Kombolcha Town. Therefore, this study was aimed to evaluate the physicochemical and bacteriological quality of swimming pools water in Kombolcha Town. A laboratory-based cross-sectional study was conducted from February to April, 2021 in Kombolcha Town. A total of 90 water samples were collected from the three outdoor swimming pools. The collected data of both physicochemical and bacteriological parameters were entered into Microsoft Excel 2010 and analyzed using SPSS version 25.0. One-way ANOVA was used to test whether there were statistically significant differences between different swimming pools. The level of significance was declared at a p-value of <0.05. In this study, out of all the pool water samples that were examined, 37.8% had pH values between 7.2 and 7.8, 36.7% had temperatures between 21°C and 32°C, and 26.7% had turbidity values that were within the WHO standard. Furthermore, only 16.7% of the pool water samples showed residual chlorine levels of 2-3 mg/L. In addition, only 27.8, 35.6, and 32.2% of the samples, respectively, met the WHO criterion for total coliform, fecal coliform, and heterotrophic plate count. The result indicates that most pool water samples did not fulfill both the physicochemical and bacteriological quality of the WHO standard limit for swimming pools. Thus, it is crucial to clean and regularly check the pool water, apply pool safety requirements, and raise pool user's awareness about the danger of pool water pollution through training.

Current Status of Drug-resistant Patterns of Gram-positive Clinical Isolates Collected from Renowned Diagnostic Centers of Dhaka, Bangladesh

Background: Antimicrobial resistance is a serious concern and life threat in public health globally. Gram-positive clinical isolates are one of the leading etiological agents showing drug resistance traits. This study aimed to detect the antimicrobial resistance pattern of clinically isolated Gram-positive bacterial isolates collected from various renowned diagnostic centers of Dhaka city, Bangladesh. Methods: A laboratory-based cross-sectional study was conducted at the Microbiological Laboratory of the Department of Microbiology, Stamford University Bangladesh. A total of 104 clinical specimens (wound swab, pus, blood, urine, ear discharge, nasal swab, sputum, nipple discharge, breast milk, catheter tip, umbilical swab, and throat swab) from different age groups were collected from some renowned diagnostic centers of Dhaka city for analyzing the cultural and drug sensitivity patterns from January 2023 to April 2023. According to the study plan, only the Gram-positive bacteria were collected and transported to the laboratory of the Department of Microbiology, Stamford University Bangladesh following WHO guidelines, and the antimicrobial susceptibility tests were carried out by Kirby–Bauer disk diffusion method and the results were interpreted as per CLSI guidelines, 2022. Results: This study highlights the presence of Staphylococcus aureus (65.4%), Streptococcus spp. (23.1%), and Enterococcus spp. (11.5%) as causative agents of Gram-positive bacterial infections from overall 104 clinical specimens. Most of our isolates were found multidrug-resistant. For S. aureus isolates, cefixime (100%); for Streptococcus spp., doxycycline (95.83%); and for Enterococcus spp., amoxicillin (100%), cefixime (100%), colistin (100%), and cotrimoxazole (100%) were found to be the most ineffective drug when compared to other antibiotics. Conclusion: Our study portrayed the remarkable antibiotic resistance feature of Gram-positive bacterial isolates which is a matter of public health concern. It is necessary to carry out a continuous assessment of antibiotic sensitivity patterns of resistant Gram-positive bacteria; otherwise, it will become an uncontrollable problem not only in Bangladesh but also worldwide in the near future.

A laboratory-based cross-sectional study about helicobacter pylori infection and diabetes.

Despite the numerous articles discussing the relationship between diabetes mellitus type 2 (DMT2) and chronic Helicobacter pylori (H. pylori) infection the results have been inconsistent, necessitating further research. This study investigated the coexistence of Helicobacter pylori infection and DMT2. We conducted a study in selected laboratories in Tehran, measuring the H.Pylori stool antigen (HpSA) in individuals referred by physicians for a glycosylated hemoglobin A1c (HbA1c) test. Out of the 2500 patients who were referred to randomly selected laboratories, a total of 2025 (81%) patients had serum HbA1c levels above 6.5%. of 2025 patients with HbA1c levels above 6.5%, 1321 (52.84%) had HpSA in their stool. No significant gender difference was observed, with a mean age ± SD, 48.65 ± 7.55. HpSA was positive in 52.84% of the DM group, while in the non-DM group, HpSA was positive in 37.36% of cases. Fecal antigen titers are not related to gender (P = 0.274) but are related to age (r = 0.213, P=0.034). Long-term infection with Helicobacter pylori may be significantly associated with elevated HgA1c.Testing for H. pylori infection, regular monitoring of blood sugar and HbA1c levels in high-risk people can prevent DMT2.

Insights into the in-vitro Susceptibility and Drug-Drug Interaction Profiles Against Drug-Resistant and Susceptible Mycobacterium tuberculosis Clinical Isolates in Amhara, Ethiopia.

In Ethiopia, tuberculosis (TB) is a major public health problem. The aim of the study was to determine the in vitro susceptibility level of drugs and drug interaction profiles against drug-resistant and susceptible M. tuberculosis clinical isolates. A laboratory-based cross-sectional study was conducted between January 2023 and August 2023. GenoType MTBDRplus v.2.0 was facilitated in genetic mutation detection. Minimum inhibitory concentration (MIC) was determined using resazurin microtitre assay (REMA), while fractional inhibitory concentration index (FICI) using resazurin drug combination microtitre assay (REDCA) for in vitro quantitative susceptibility and drug interaction prediction. Among 32 clinical isolates, a total of 14 (43.8%) RIF, 20 (62.5%) INH, 2 (6.3%) EMB-related resistant and 14 (43.8%) MDR isolates were identified. Five of RIF-resistant isolates (55.6%) carrying rpoB common mutations at codon S450L were associated with high levels of RIF-resistance with MICs of ≥ 2μg/mL, whereas 100% of isolates harboring rpoB substitutions at codons D435V and H445Y were linked with moderate or low-level RIF-resistance in the MIC ranges from 0.5 to 1μg/mL. A proportion of 81.8% of isolates harboring katG S315T mutations were associated with high-level INH resistance (MIC ≥ 1μg/mL), while the 18.2% of isolates with S315T katG mutations and 100% of isolates with inhA C-15T mutations were linked to the low-level of INH resistance with MIC variability from 0.25 to 0.5μg/mL. Our results indicated that most FICIs of the dual drugs INH+RIF and INH+LEV combination for 9 (28.1%) and 4 (12.5%) INH-resistant isolates, respectively, were ≤0.5, whereas triple drugs INH+RIF+EMB, INH+RIF+LEV and INH+EMB+LEV combination for 6 (18.8%), 11 (34.4%) and 8 (25%) INH-resistant isolates were from 0.62 to 0.75, all showed synergistic effect. The study highlights that isolates with rpoB S450L and katG S315T substitutions were associated with high level of RIF and INH resistance. It is concluded that REDCA can quantitatively determine anti-mycobacterial synergy and that LEV being of potential use against INH-resistant isolates including MDR-TB when combined with RIF+INH and INH+EMB.

Impact of BioFire FilmArray Multiplex PCR in the Detection of Microbial Agents causing Severe Acute Respiratory Infection in the COVID-19 Era: A Cross-sectional Study from a Tertiary Care Hospital in Central India

Introduction: Many viral and bacterial respiratory tract infections can present with respiratory signs and progress to complicated pneumonia. In the recent Coronavirus Disease2019 (COVID-19) pandemic, it is crucial to test all Severe Acute Respiratory Infection (SARI) patients for other microbial infections in addition to COVID-19, enabling timely diagnosis and treatment to reduce morbidity and mortality. The automated system, BioFire FilmArray, utilises multiplex Polymerase Chain Reaction (PCR) to rapidly detect and identify multiple respiratory pathogens, including selected Antimicrobial Resistance (AMR) genes, within an hour. Aim: To detect bacterial and/or viral pathogens associated with hospitalised COVID-19-negative SARI patients using the BioFire FilmArray Pneumonia Panel (BFPP). Materials and Methods: This laboratory-based cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India, from June 2020 to February 2021. Respiratory samples, such as sputum, tracheal aspirate, Endotracheal (ET) secretions, and Bronchoalveolar Lavage (BAL), were collected from COVID-19-negative hospitalised SARI cases. A total of 81 patients were included in the study. The samples were tested using the BFPP (multiplex PCR) system and processed using conventional culture techniques. Patient characteristics, clinical and laboratory investigation data, and findings of respiratory viral and bacterial agents, as well as antibiotic resistance genes detected by BioFire FilmArray, were recorded using paper case reports. The data were collected and analysed using Statistical Package for Social Sciences (SPSS) software. Results: Out of the 81 clinical samples processed, the BFPP detected 168 bacterial and 18 viral pathogens. Bacterial-viral codetection was observed in 13 (16%) samples. Atypical bacteria were detected in 3% of cases. Among the bacterial pathogens, the AMR gene for New Delhi Metallo-beta-lactamases (NDM) was detected in 42 (25.9%) cases, followed by CTX-M betalactamases, VIM, and the oxacillinase group of β-lactamases. Conclusion: The BFPP test is a valuable tool for the rapid detection of a wide range of pathogens, including associated AMR genes, with high sensitivity and specificity. This can greatly aid in treatment decisions.

Recommendation to diagnose male factor infertility based on routine semen analysis results

It is apparent that sperm parameters like concentration, motility and morphology are not definitive/adequate fertility measures as sperm is a heterogeneous mixture, and sperm quality is determined by only what is visible in the microscopic field. Objective was to assess the quality variation among different aliquots of an ejaculate and present a concept that may allow interpreting the results in such a way as to determine the clinical usefulness of the semen analysis more accurately.A laboratory-based cross-sectional study was conducted at Teaching Hospital Jaffna’s Semiology laboratory from July to September 2023 after obtaining Institutional Ethical Review committee approval, analysing 102 semen ejaculates collected through masturbation. The sample was analysed using a Makler counting chamber, and Data was analysed using SPSS version 24, with statistical significance set at P&lt; 0.05.The three different aliquots obtained from the same ejaculate revealed no significant difference from each other for all three variables like Concentration (P=0.957), Progressive Motility (P=0.810) and Motility (P=0.832). Similarly, the mean and fifth percentile plus 95% confidence level were not significantly different (P= 0.782, P= 0.328, P= 0.370).When using the Makler counting chamber, the mean value calculated from one aliquot per ejaculate counted on three strips of ten squares should be acceptable, and at least two different ejaculates should be analysed when interpreting the results based on World Health Organization (WHO, 2021) reference limits.

Insights of hematological parameters in dengue virus-infected patients

: Early and accurate diagnosis of dengue is critical for prompt treatment and avoiding severe complications. Thus, the present study aimed to evaluate the serological and hematological parameters for predicting the dengue virus infection. : A laboratory-based cross-sectional study was conducted among the patients who visited Sumeru Hospital, Lalitpur, Nepal, from July 2022 to June 2023. Blood samples were collected from suspected dengue cases and tested using the rapid diagnostic immunochromatography (ICT) method, and hematological parameters were also assessed. The Mann-Whitney U test compared continuous variables between dengue-infected and non-infected groups. A binary logistic regression analysis was done to evaluate the association of variables for dengue positivity.: When compared to dengue-negative cases, dengue-positive cases had thrombocytopenia, leucopenia, erythrocytosis, high hemoconcentration, low mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). However, binary logistic regression predicted platelet count, total leucocyte count, MCH, MCHC, neutrophil count and lymphocyte count as significant predictors of dengue positivity.: This study revealed the characteristics and demographics of dengue-positive cases and their associations with hematological parameters. Furthermore, the identified predictive markers can help healthcare professionals diagnose and manage dengue cases more promptly, potentially reducing the disease's burden.

Virulence And Drug Resistance Pattern Of Escherichia Coli Isolates From Various Clinical Sample

Introduction: E. coli is one of the most common pathogens, and its infection has resulted in a global burden due to its increased medication resistance and virulence factors. The goal of this study was to examine the drug resistance pattern and pathogenicity properties of Escherichia coli isolates. Methods: Over the course of six months (March 2019-August 2019), a laboratory-based cross-sectional study was done among patients visiting Manmohan Memorial Teaching Hospital in Kathmandu, Nepal. Standard microbiological procedures were used to identify bacterial isolates from clinical specimens. The modified Kirby Bauer disk diffusion method was used to determine antibiotic susceptibilities. The combined disk test method was used to confirm the ESBL and MBL. To determine their virulence, serum bactericidal activity and biofilm productions were determined. Results: 59.60 percent (n=81) of the 136 Escherichia coli isolates were multidrug resistant, 25.70 percent (n=35) were ESBL producers, and 11.80 percent (n=16) were MBL producers. Serum resistance was discovered in 22.8 percent (n=31) of the total isolates, while biofilm formation was found in 19.11 percent (n=26). Amoxycillin had the highest level of resistance (87.5%), whereas Chloramphenicol (93.4%) and Imipenem (80.9%) were the most susceptible antibiotics. Polymyxin B and Colistin sulphate were absolutely sensitive. In our investigation, 61.5 percent of biofilm producers were MDR, with non-beta lactamase types being the most common. MBL producers were discovered to be more serum resistant. Amikacin and Imipenem were found to be more sensitive to biofilm makers. Conclusions: The expression of Escherichia coli virulence factors varied depending on the kind of infection. Escherichia coli has a high rate of multidrug resistance. To minimize the emergence and spread of antibiotic resistance in bacteria, proper identification of drug-resistant bacteria, careful use of antibiotics, and effective antibiotic policy are required.

Study Of Thyroid Profile In Different Trimesters Of Pregnancy

Background: Thyroid disorders and dyslipidemia are frequent during pregnancy, which are associated with complications for both the mother and the fetus. Hence, this study aims to evaluate thyroid function test and its association with dyslipidemia in pregnancy. Method: This laboratory-based cross-sectional study was carried out in Manmohan Memorial Teaching Hospital, Kathmandu, Nepal. A total of 200 participants; where 100 pregnant and 100 non pregnant women were included in the study. Pregnant women were further subdivided into 1st, 2nd and 3rd trimester groups. Thyroid Profile and Lipid profile were estimated. Student t-test, one way ANOVA, and Pearson’s correlation were applied. Findings: The findings of the study revealed that the level of TSH was significantly (p&lt;0.001) lower, TG, TC and VLDL were significantly (p&lt;0.001) higher and HDL was significantly (p&lt;0.001) lower in pregnant women as compared to non-pregnant women. In different trimester of pregnancy TG (p&lt;0.001), TC (p&lt;0.05) and VLDL (p&lt;0.001) were found to be significantly increased with increasing trimester of pregnancy. Conclusion: In medical interventions, screening of thyroid hormones, lipid profile and adjustment of TSH level according to trimester specific range in different trimesters should be implemented to improve lipid indices to decrease pregnancy complications outcomes.

The occurrence of fungi from burn wound patients and antifungal susceptibility patterns: a cross-sectional study in Lusaka, Zambia.

Fungal opportunistic infections in burn wound patients are among the leading cause of morbidity and mortality. Attention remains focused on preventing bacterial infection at the expense of increasing fungal infection in burn wound patients. To determine the occurrence of common fungi in admitted burn wound patients and their environment: and their antifungal susceptibility patterns at the University Teaching Hospitals, Lusaka, Zambia. This laboratory-based cross-sectional study enrolled a total 101 participants whose pus swab specimens were collected from their burn wounds as well as 50 environmental swabs collected from strategic points. Wet mount, gram stain, culture on Sabouraud dextrose agar, Corn meal agar and Germ tube were used to identify possible fungal isolates. Agar based disc susceptibility test was carried out using fluconazole. Data was analysed using Excel and STAT version 14. Median age was 3 years and median burn % of TBSA was 18 in participants' who had burn wound fungal infection and consisted of 3 males and 6 females. Organisms isolated included Candida albicans from 8(7.9%) participants and 2(4%) from 50 environmental swabs. 1(1%) Candida spp was isolated from pus swabs. Out of the total 11 Candida isolates, 4 (36.4%) were susceptible to fluconazole and 7 (63.6%) were resistant. The isolation of Candida albicans and Candida spp from burn wound patients and the hospital ward environment suggests presence of fungi in burn wound patients and hospital ward environments. Candida isolated showed varying susceptibility patterns to fluconazole.