Purpose: To assess and compare the diagnostic accuracy of the GenBody COVID-19 Antigen kit (GenBody Inc., Cheonan, South Korea) available in the market with the gold standard reverse transcription-polymerase chain reaction (RT-PCR) assay to detect severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).Methods: Nasopharyngeal and oropharyngeal swabs were collected from suspected coronavirus disease 2019 (COVID-19) patients and tested by RT-PCR and GenBody Rapid antigen kit. Performance characteristic of the antigen kit was calculated.Results: We tested nasopharyngeal swabs and oropharyngeal swabs (n=240). Amongst the 102 positive RT-PCR samples, the rapid antigen test detected 36 as positive, showing an overall sensitivity of 35.3%. All the samples detected positive with the antigen rapid test were also detected positive by RT-PCR. Conclusion:The performance of the rapid antigen kit was good with respect to high viral load samples, whereas those with lower levels were missed. Unfortunately, the overall low sensitivity of the antigen kit does not allow using it alone as the frontline testing kit for COVID-19 diagnosis.

Background: An intestinal parasitic infection is a serious public health problem in the world, especially in developing countries, and accounts for a major cause of morbidity and mortality among different high-risk groups.[1] Aims: To find out the prevalence of intestinal parasitic infections in Moradabad district in Western Uttar Pradesh and compare and correlate it with gender, age group and area (rural or urban). Methods: The stool samples from suspected patients were collected and subjected to routine stool investigations during the study, i.e. Macroscopic examination was carried out for the presence adult worms or their body segments and microscopic examination such as stool wet mounts (both saline and iodine mounts) after Formol-ether concentration technique. Results: Out of total 643 patients, 102 (15.86%) had parasitic infection. Maximum numbers of patients were in the age group of 0-10yrs (277, 43.08%) whereas out of these, 36 patients were found positive (13%). Total 112 parasites were isolated from 102 positive patients. Mixed infection with two parasites was most commonly seen in the 0-10yrs age group (7 out of 10 cases), combination of Giardia lamblia and Hymenolepis nana were most commonly isolated (3 out of 10 mixed infections). Parasite most commonly isolated was Hookworm 35 (31.25%), followed by Hymenolepis nana 25 (22.32%) and Giardia lamblia 19(16.96%). Enterobius vermicularis was the least common isolate 2(1.78%) followed by Taenia species, 3(2.68%). Mostly male patients were affected by parasitic infections (59.57%).and most of the positive patients were from rural area, 72(64.28%). Conclusion: Prevalence of intestinal parasites is 15.86% in Moradabad district in Western Uttar Pradesh.

Background: Urinary tract infection (UTI) is common infection in the world caused by uropathogens, to make a proper treatment of UTI should be a proper diagnosis of the cause and therefore a proper application of drugs. Keeping in mind the causes of urinary tract infections and the sensitivity pattern of uropathogens towards the antibiotic, the present study was proposed to study the uropathogens. An empiric treatment of UTI is find out by the antibiotic sensitivity patterns of uropathogens in a population. There is an resistance increased to the first line empirical drugs used in the treatment of UTI. This study was conducted in Garhwal Uttrakhand (India) to determine the resistance patterns of amongst uropathogens, to help in the establishment of local guidelines on the treatment of UTI. Methods: This is a retrospective study on 338 urine cultures from July 2013 to June 2014. Antibiotic susceptibility test (AST) method was done by Kirby-Bauer disc diffusion method and compared. Data Analysis was done by using simple percentage method. Results: Out of the 338 samples subjected to culture, 166(49.11%) were positive for growth. Out of the 166 culture isolates, Escherichia coli was the most common 67 (19.8%) followed by CoNS 30(8.8%), Staphylococcus 14(4.1%), Enterococcus 11(3.3%), Acinetobacter spp. 10(2.9%), Klebsiella 8(2.4%), and Candida albicans 7(2.1%). The antibiotic sensitivity pattern was analyzed for all the bacterial isolates together and drugs are sort in order of their sensitivity. On the basis of antibiotic sensitivity pattern it is found that all bacterial isolates were 24.6 % sensitive to Amikacin, 23.1 % sensitive to Gentamicin, 18 % sensitive to Nitrofurantoin Acid, 15.1 % sensitive to Ciprofloxacin, 13.3 % sensitive to Meropenem and Cefoperazone-sulbactam, 13% sensitive to Piperacillin-tazobactam and Co-trimoxazole, 10.7 % sensitive to Amoxicillin-clavulanic acid, 10.4 % sensitive to Aztreonam and 10.1% sensitive to Chloramphenicol. All the isolates were 16.9% resistant to Ciprofloxacin and Co-trimoxazole, 12.7% resistant to Amoxicillin-clavulanic acid, 12.4% resistant to Ampicillin, 10.7% resistant to Cefotaxime, Cefazolin &Ticarcillin-Clavulanic acid and 10.4 % resistant to Cefuroxime. Conclusion: The alarming rate of resistance to Ciprofloxacin, Co-trimoxazole, Amoxicillin-clavulanic acid, Ampicillin, Cefotaxime, Cefazolin &Ticarcillin-Clavulanic acid of urinary isolates, precludes the use of these commonly used antibiotics for empiric treatment of urinary tract infections (UTI) in India. Therefore, urine culture is necessarily recommended for screening and diagnosis.

Objective: Toxoplasma gondii (T. Gondii) infects 30-50% of the world human population with high diversity in geo-epidemiological data on its seroprevalence. Data on burden of toxoplasmosis and its determinants from remote and vulnerable regions of India are scarce. This study aimed to evaluate the prevalence of toxoplasma antibodies and factors associated with seropositivity among people from Uttarakhand and adjoining areas. Methods: Serum samples from 442 cases were tested for anti-Toxoplasma IgG and IgM antibodies by Enzyme-linked Immunosorbent Assay. Correlation of seropositivity with age, sex, place of residence, dietary habits, and co-morbidity were analyzed by binary logistic regression. Results: An overall Toxoplasma seropositivity of 36.88% [95% Confidence Interval (CI)=30.40–39.28] was observed. While anti-T. gondii IgG was present in 36.84% [95% CI=30.40–39.28], anti- T. gondii IgM was detected in 6.33% [95% CI=4.06–8.61]. The overall and IgG seroprevalence increased with age in both the genders and the slope was steeper after the age of 40 years [Adjusted Odds Ratio (AOR)=2.98, p-value=0.030]. The probability of seropositivity tended to be significantly higher in people from Uttarakhand in both the hilly region (AOR=5.61; 95%CI:[2.14-14.68]) and plains (AOR=5.14; 95%CI:[2.2-12.02]). Multivariable logistic regression analysis also showed that being rural residents (AOR=3.23; 95%CI:[1.67-6.23]) and presence of co-morbidity (AOR=8.64; 95%CI:[4.62-16.18]) were potential risk factors of Toxoplasmosis. Consumption of vegetarian diet was found to have a protective effect (AOR=0.46; 95%CI: [0.28-0.75]). Conclusion: Seroprevalence of T. gondii antibodies was relatively high in Uttarakhand, particularly in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.

IntroductionToxoplasma gondii (TG), rubella virus (RV), cytomegalovirus (CMV), and herpes simplex virus type 1 and 2 (HSV 1 and 2) cause mild maternal morbidity but have serious fetal consequences. The prevalence of these infections varies widely by country and population subgroup, and the paucity of data from the hilly state of Uttarakhand prompted us to undertake this study on their seroprevalence and association with potential risk factors. MethodsSerum samples received from pregnant women attending the antenatal clinic of All India Institute of Medical Sciences, Rishikesh, between January 2016 to December 2019 were tested for TG-, RV-, CMV, and HSV-specific IgM and IgG by capture enzyme-linked immunoassay (ELISA). The data were then analyzed to determine the seroprevalence of the major ToRCH infections (toxoplasmosis, other (syphilis, varicellazoster, parvovirus B19), rubella, cytomegalovirus, and herpes), and Fisher's exact test was applied to check association with potential risk factors. ResultsOut of 165 pregnant women who were screened for the four major ToRCH pathogens, overall seroprevalence was 41.2% for TG (IgM=13.3%; IgG=38.2%), 80.0% for RV (IgM=3.0%; IgG=80.0%), 61.8% for CMV (IgM=1.8%; IgG=61.8%), and 42.4% for HSV (IgM=4.3%; IgG=40.6). TG was significantly associated with increasing maternal age (p-value=0.007). The seropositivity of RV was maximum in the drier and windy months of January-March (p-value=0.004), while that of TG in the warmer months of April-June (p-value=0.03). HSV prevalence was comparatively more common in Muslim women (p-value=0.05). Women presenting with bad obstetric history (BOH) and multiparous women were at higher risk for TG-RV-HSV and TG-RV-CMV, respectively. ConclusionConsidering the high prevalence and risk of ToRCH infections in this region, we suggest disease-specific screening based on maternal history. Recognition of the burden of ToRCH infections in pregnant women is vital in clinicians' decisions and implementing control measures.

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Mucormycosis is a fatal opportunistic fungal infection most commonly seen in immunocompromised individuals. The mortality can vary depending on the extent of the disease, starting in the paranasal sinuses, reaching the orbit, and eventually spreading intracranially. The sudden surge of Mucormycosis along with COVID-19 infections has rightfully been described as an epidemic amidst a pandemic. While the exact etiological factor is still being investigated, uncontrolled diabetes seems to be the most common inciting factor. Mucormycosis being angioinvasive, often leads to thrombus formation in the vessels, which leads to the necrosis of the tissues and bones, most commonly the maxilla. This necrotic tissue forms an ideal culture for various organisms and is a potential source for maggots' infestation. The presence of nasal myiasis further worsens the clinical status of the patients, making them prone to life-threatening complications. Thus, nasal myiasis seems to be an independent prognosticating factor in such cases. Here, we have described two such cases, our approach to management and mortality despite the best possible management.Two cases are being presented of elderly patients with comorbidities of type 2 diabetes mellitus and coronary artery disease. Both patients had a recent onset of COVID-19 and presented with intraorbital and intracranial disease extension along with nasal myiasis. Both patients succumbed to the fulminant pathology despite aggressive management.Mucormycosis, COVID-19 and nasal myiasis combine together to form a fatal triad, which despite early identification and aggressive management, carries a poor prognosis.

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