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Pankaj Saini ¹, Varsha A. Singh ², Kunal Sharma ³, Gunjeet Singh ³, Abhishek Chauhan ⁴, Shailja Sharma ⁵

Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN

Abstract

Non-tuberculous mycobacterium (NTM) has been identified in human pulmonary and extra pulmonary diseases and is of great concern for clinicians and microbiologists because of their increasing global incidence. They are now increasingly recognized as important pathogens in both immunocompromised and immunocompetent population. They should be identified rapidly and should be carefully differentiated as contamination, colonization ordisease. Cultures were made on conventional LJ and LJ with PNB media. Growth was confirmed as AFB (acid fast bacilli) by ZN staining. NTM were identified by growth on LJ with PNB media, colony morphology, rate of growth, pigmentation, catalase activity and confirmed by MPT 64 antigen rapid test (using SD Bioline TB Ag MPT 64 test kit) . Data was analysed statistically using SPSS software. Out of total 500 processed samples (250 pulmonary & 250 extrapulmonary), 12(21.05%) and 7(21.8%) NTM were isolated from pulmonary and extrapulmonary samples respectively. Maximum pulmonary NTM (41.7%) were isolated from > 60 years age of patients in contrast to extrapulmonary NTM isolates which were more in 20-40 years of age group. There was 16.7% previously treated patients in pulmonary while 100% were newly diagnosed patients in extrapulmonary TB cases. This study highlights the importance of early diagnosis and differentiation among Mycobacterium tuberculosisand NTM so that these NTM are not underestimated in routine diagnostic procedures merely as environmental or laboratory contaminants.

Keywords

Non-tuberculous mycobacterium, p-nitrobenzoic acid, Pulmonary TB, extrapulmonary TB, MPT64 antigen.

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Pankaj Saini ¹, Varsha A. Singh ², Pottathil Shinu ³

Affiliations
1 Junior Resident, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, IN
2 Professor,Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, IN
3 Assistant Professor, Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al Ahsa, 31982, SA

Abstract

Background: Culture remains the gold standard for the diagnosis of urinary tract infections (UTIs). However, the diagnosis of UTIs can be potentially enhanced when clinical characteristics of UTI, pyuria and bacteriuria are considered. Methodology: To evaluate the relationship between pyuria, bacteriuria and clinical characteristics with culture, un-centrifuged urine samples (N=817) were subjected to direct wet mount, direct Gram staining and semi-quantitative culture and the results were compared. Results: The direct wet mount and direct gram staining showed an overall sensitivity, specificity, positive predictive value and negative predictive value of 11.08%, 88.88%, 87.96%, 29.28% and 34.21%, 96.55%, 91% and 38.89%, respectively, as compared to semi-quantitative culture. Alternatively, the overall sensitivity, specificity, positive predictive value and negative predictive value of clinical characteristics of both upper and lower UTIs (most sensitive and specific symptoms combined) were found to be 55.14%, 76.06%, 71.29%, 31.47%, respectively. Conclusion: Both the direct wet mount and direct Gram staining could be considered as screening tests for diagnosis of UTI due to its low sensitivity and high specificity. However, integrated approaches wherein clinical characteristics of UTI combined with culture results would be of high diagnostic value in the diagnosis of UTI.

Keywords

Urinary tract infection, significant bacteriuria, pyuria, semi quantitative urine culture.

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Abhishek Chauhan ¹, Jai Kishan ², Sameer Singhal ³, Achchhar Singh ⁴, Aditi Gupta ⁵, Pankaj Saini ¹

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Prof and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Tuberculosis is an infectious disease. It is caused by bacteria Mycobacterium Tuberculosis. It can be diagnosed by demonstrating AFB by either phenotypic method like sputum smear microscopy, culture or by genotypic method like NAAT or LPA. For better results there should be a good quality sputum sample. Induction of sputum is a method for improving the quality of sample. The most commonly used method is induction using 3% saline. It has been seen that during taking throat swab specimen patients usually produce cough. This induced cough can produce better quality of sputum. The following study was done to know about the role of throat swab as a method of sputum induction.

Keywords

AFB, CBNAAT, LPA, Mycobacterium Tuberculosis.

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Gunjeet Singh ¹, ShashankShekhar Gautam ², Anshu Gupta ³, Pankaj Saini ¹

Affiliations
1 Post Graduate Student, Department of Microbiology, MMIMSR, MMDU, Mullana, IN
2 Senior Resident, Department of Microbiology, MMIMSR, MMDU, Mullana, IN
3 Professor, Department of Pharmacology, MMIMSR, MMDU, Mullana, IN

Abstract

The skin is one of the largest organs in the human body. Majority of skin diseases requires lifelong treatments since they are chronic in nature. Thereby, appropriate diagnosis by the physicians and rational prescription of drugs becomes a vital component of drug therapy. ADR monitoring is considered to be mandatory as they become severe and potentially life-threatening. Primarily, in off-label setting, patients are treated with drugs which are not registered for that specific indication. Dermatologists have been at the forefront of the application of azathioprine and have thus been using the immunosuppressant for treating patients over several years.

Keywords

Azathioprine, off-label, adverse drug reaction

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Nikita Jaiswal ¹, Varsha A. Singh ², Ali Ilham K. ³, Pankaj Saini ⁴, Gulnar ⁵

Affiliations
1 Assistant Professor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
3 M.Sc. Student, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN
5 P.G. Tutor, Department of Microbiology, MMIMSR, MMDU, Mullana, Ambala, Haryana, IN

Abstract

Introduction: Tuberculosis is a major health problem faced by mankind since ancient times till date in spite of advances in our knowledge. Recently HIV hastened this & it became the single largest infectious diseasecausing high mortality in humans leading to numerous deaths annually. Early & prompt diagnosis is the only solution to control it. In developing country like India RNTCP depends on chest radiography & smear microscopy but culture is still GOLD standard method. Thus this study was designed to correlate the radiologically suspected tuberculosis cases with Zeihl-Neelsen staining & culture on LJ medium. Method: A cross-sectional study conducted on 60 radiologically suspected cases of pulmonary tuberculosis to compare the efficacy with conventional LJ medium culture and ZN staining. The samples were chosen using simple random sampling method. Results: Out of total 60 cases, 40(66.66%) cases showed positive results by any of the method. ZN staining (100%) rendered highest positivity than LJ media (80%) in far advanced with cavity while in minimal lesion LJ media (25%)was more effective than ZN staining (12.5%). Maximum number of Grading 3+ cases were with far advanced with cavity (100%) followed by moderate lesion with cavity (72.7%). Advanced with cavity showed highest and earliest growth i.e. 60% within 2 weeks while in moderate lesion with cavity it was 18.8% Conclusion: Correlation between radiological and microbiological findings must be the mainstay for the diagnosis in clinical suspected case of pulmonary TB.

Keywords

Tuberculosis, ZN staining, Cavity lesions, LJ media.

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Kunal Sharma ¹, Neha ¹, M.L. Pandey ², Vineet Gupta ³, Pankaj Saini ¹

Affiliations
1 Resident, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
2 Professor, M.M. Institute of Medical Science and Research, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
3 Assistant Professor, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN

Abstract

Purpose: Axenfeld-Rieger syndrome is an ocular anterior segment dysgenesis, autosomal dominantly inherited, commonly associated with glaucoma and systemic anomalies. This study presents various clinical manifestations of Axenfeld-Rieger syndrome within one family. Material and Method: Three members of the family: patient 1--father (54 years old), patient 2--son (12 years old) and patient 3--daughter (8 years old), underwent complete ophthalmic examination, including standard glaucoma diagnostics. It was impossible to perform complete eye examination in one case (patient 1) because of severity of ocular changes. Results: All family members described had iris abnormalities (hypoplastic iris stroma) and advanced glaucoma, however severity of symptoms were different in each case. The most advanced disease was recognized in patient 1. Other findings included: posterior embryotoxon (patients 2 and 3), iridocorneal angle abnormalities (patients 2 and 3), stretch holes and extraocular features (patient 2): dental anomalies (microdontia and hypodontia), maxillary hypoplasia and periumbilical skin fold. All of these symptoms supported the diagnosis of Axenfeld-Rieger syndrome. In addition, we also diagnosed high myopia & strabismus (patient 2) and corneal scar in (patient 1). Conclusion: Reported cases of Axenfeld-Rieger syndrome demonstrate phenotypic variability of the disease among family members, which is characteristic for this disorder and can cause diagnostic problem.

Keywords

Axenfirldreiger syndrome, Glaucoma, Corectopia, Iris Stretch holes, Maxillary hypoplasia, dental abnormalitiies.

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Parashar Mishra ¹, Ahsan Absar ², Archisman Dutta ¹, Vishal V. Sakhare ³, Uday Shankar ², A. P. Thapliyal ⁴, Pankaj Saini ⁵, P. K. Singh ⁴, Joyesh Bagchi ⁴

Affiliations
1 Geological Survey of India, Northern Region, Lucknow 226 024, India; Institute of Science, Banaras Hindu University, Varanasi 221 005, India., IN
2 ONGC Energy Centre, SCOPE Minar, Lakshmi Nagar, Delhi 110 092, India., IN
3 Geological Survey of India, Central Region, Nagpur 440 006, India., IN
4 Geological Survey of India, Northern Region, Lucknow 226 024, India., IN
5 Geological Survey of India, Gangtok 737 101, India., IN

Abstract

In this study, two thermal springs are reported from the Demchok area in Ladakh, India. These are characterized by water having low total dissolved solids (TDS) content (~250 mg/l) as well as high pH (9.5) and surface temperature (75°C). Although these hot springs and their medicinal properties are known to locals, they have not been scientifically studied. Relatively low TDS despite high temperature could be due to sluggish ion-exchange processes in the geothermal reservoir. Such a situation might have developed because of the high water-to-rock ratio and/or smaller residence time of the geothermal fluid in the reaction zone.

Keywords

Geothermal Zone, Hot Springs, Ion-Exchange Process, Medicinal Properties, Water–Rock Ratio.

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