Food borne diseases are a global public health burden. Food handlers play a major role in the transmission of foodborne diseases. This study was aimed at investigating the presence of intestinal parasites, S. typhi carrier rate and associated risk factors among food handlers in a metropolitan city. MATERIALS AND METHODSA cross-sectional survey was conducted among 200 food handlers working in different food service establishments. A pre-tested structured questionnaire was used to collect data on age, sex, years of service, previous deworming, status of typhoid immunization and hand washing practices. Stool samples were processed for intestinal parasites and S. typhi, as per the standard laboratory methods. RESULTSIn the present study, majority of the food handlers were males 185/200 (92.5%), 90/200 (45%) were aged between 30-50 years, and 72/200 (36%) had less than one year experience. Intestinal parasites were detected in 31/200 (15.5%) and S. typhi in 2 (1%). Of the 31 parasites, 11 (35.5%) were seen by direct saline technique and additional 20 (64.5%) by formol-ether concentration technique. The parasites found in descending order of frequency among the food handlers were: fertilized eggs of Ascaris lumbricoides 8.5% (17/200), cyst of Giardia (3.5%), cyst of Entamoeba histolytica 2% (4/200), eggs of Taenia spp. 1% (2/200) and eggs of Trichuris trichiura 0.5% (1/200). The association of years of work experience was inversely proportional to parasitic infection and directly proportional to history of previous deworming, both of which were statistically significant. CONCLUSIONInexperience and lack of awareness about hygiene in food handlers play a major role in the transmission of food-borne infections. Training on food safety and periodic focused medical check-up can help to control the spread of infection in the community. Laboratory investigation should include formol ether concentration technique to enhance diagnosis.
Bacterial vaginosis characterised by a heavy overgrowth of gram-negative and gram-positive anaerobes with no signs of inflammation has been regarded as a microbiological and immunological enigma. AIMS AND OBJECTIVES1. To identify the causative organisms from clinically suspected cases of bacterial vaginosis. 2. To evaluate the accuracy of Amsel's clinical criteria and Nugent's Gram stain criteria for diagnosis of bacterial vaginosis. 3. To correlate with other associated sexually transmitted infections. MATERIAL AND METHODSThis prospective study involving total 600 non-pregnant women with abnormal vaginal discharge, clinically suspected cases of bacterial vaginosis (BV) attending the Gynaecology OPD at a tertiary care hospital was done over a period of one year. The following samples were collected from each subject: Three vaginal swabs and one blood sample (5 mL). Three vaginal swabs were taken and immediately sent to the microbiology laboratory for processing, by microscopy and culture on appropriate media. For serological diagnosis of Hepatitis B and C, HIV, and VDRL testing, 5 mL blood was collected from cubital vein with aseptic precautions. The following parameters were noted -age, marital status, contraceptive use, presence of abnormal, recurrent, and/or foul-smelling vaginal discharge and clue cells. BV was diagnosed using Amsel's clinical criteria and Nugent's Gram stain criteria. Data was analysed using SPSS version 13, Fischer's exact test, and chi-square test. RESULTSBV occurred in 142/600 (23.7%) women with abnormal vaginal discharge, 55/135 (40.7%) were in age group 36-45 yrs., 140/593 (23.6%) married women and in 92/259 (35.5%) women with recurrent vaginal discharge. Abnormal discharge was most commonly seen (193/600) women who had not used any contraceptives. Foul-smelling discharge was more in BV patients as compared to pain, itching, and burning micturition, which was more common in non-bacterial vaginosis (NBV) and had statistically significant p value (<0.05). Clue cells were seen in total 19/142 (13.3%) patients suffering from BV. Based on Nugent's score, the 600 cases were classified as normal (223), intermediate (161), and BV (142). Based on aetiology, it was noted that mixed infection occurred in 42/600 cases: Vulvovaginal candidiasis (VVC) + intermediate in 24, BV+VVC in 16, and BV+Trichomoniasis in 2. Majority of anaerobes, i.e. 100/136 (73.5%) were found in BV patients. This association of anaerobes in BV was found to be significant with p-value (<0.05). Yeast was grown in 105/600 (17.5%); 16/105 (11.3%) were significantly associated with BV (p<0.05). CONCLUSIONThe Gram stain as interpreted by Nugent's criteria provides an objective, reproducible laboratory based test, and should be used in addition to clinical criteria for diagnosis of BV. KEYWORDS Bacterial Vaginosis (BV).HOW TO CITE THIS ARTICLE: Malpekar K, Vivek K, Shastri J. Clinical correlation and laboratory diagnosis of bacterial vaginosis.
Background: Acute viral hepatitis causes high morbidity in children and young adults. Hepatitis A and E can lead to fulminant hepatitis in 0.1% -2%. Objective: To find prevalence of HAV and HEV among suspected cases of acute viral hepatitis and to co-relate the laboratory findings with clinical presentations, over a one year periodMaterial & Methods:A retrospective analysis of 396 suspected acute viral hepatitis cases, whose samples were received in the laboratory during over a period of 1 year was performed. All sera samples were tested for IgM anti HAV & IgM anti HEV using commercially available solid phase ELISA, in Microbiology laboratory, at our hospital.Results:Majority infected were male (69%) and young adults (98 %). Clinical presentations included fever (92%), jaundice/icterus (74%), nausea/vomiting (60%), hepatomegaly (45%), abdominal pain (40%), darkcoloredurine(15%), itching/rash (8.3%). ELISA revealed overall positivity :21.2% ; HAV: 38% ,HEV:62% and dual infection:5%. Increased serum bilirubin, AST and ALT occured in 68%.Conclusions:Awareness regarding sanitation and hygiene is imperative to curb the spread of acute viral hepatitis, especially in developing countries. Laboratory diagnosis is an essential supplementary tool in confirmation of suspected clinical cases and reduce transmission of this infection.
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