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Central line associated blood stream infection (CLABSI) is a device associated infection posing a serious threat among critically ill patients. It also increases the cost of hospital stay, morbidity and mortality. The aim of the study was to implement bundle care approach and identify CLABSI rates post intervention in comparison with the retrospective data. All the patients who were admitted in the ICU with central line (CL) in place were included in our study. The bundle care approach was implemented for all the patients when CL was introduced. We compared the CLABSI rates during the implementation period with the previous year CLABSI rates. The CLABSI rates were compared during the pre-intervention and during the intervention. The pre-intervention rate was 7.48 per 1000 catheter days, whereas the post intervention rates were 1.01 and zero per 1000 catheter days. The etiological agents isolated from CLABSI were Enterobacter aerogenes (30%) followed by Klebsiella pneumonia (20%) and Pseudomonas aeruginosa (20%). Similarly the antibiotic resistance was highest in ceftriaxone (55.5%) and lowest in piperacillin tazobactam (11.1%). A strict adherence to bundle care and proper education of the ICU team members including the doctors and nurses would effectively reduce infection rates. The CLABSI rates were 7.48 per 1000 catheter days in the previous year. However after implementation of bundle care the CLABSI rates reduced to zero.

Introduction: Total knee replacement is a revolutionary procedure aimed at relieving pain improving knee function and the quality of life, Indian women are more prone for osteoarthritis and recent researches have led on to manufacturing implants specific to their anatomy to achieve the above mentioned goals. Aim: The study aimed at analysing whether these modifications in the newly designed gender specific implants translate to any additional significant improvement in functional outcome in comparison to the commonly used traditional knee implants. Materials and Methods: It was a prospective comparative study done in 30 knees of 30 women patients aged between 55-70 years in GV Hospital, Trichy, India between July 2011-January 2013. A total of 15 patients (Group B) had Zimmer Legacy Posterior Stabilized (LPS) knee implant and the other 15 (Group A) had Zimmer gender specific knee implants. Patients were followed up for 24 months post surgery, preoperative and postoperative data were recorded according to the knee society scoring system. All the patients were operated by standard anterior midline incision by a single surgeon and underwent the same postoperative protocol. Results: The average age in Group A was 59.93 and in group B was 59.4. The mean pre op Knee Score (KS) and Functional Score (FS) was 50.2 and 49.3 in Group A and B respectively. The range of motion increased following surgery in all patients but there was no statistically significant difference noted between the two groups. The postoperative KS and FS were assessed at 6 weeks, 3 months, 6 months, 12 months and 24 months and statistical significance using Student's t-test, on SPSS 13.0 (SPSS Inc., Chicago, Illinois) was done during each follow up. There was no statistical significant difference in KS and FS between the groups at the end of 24 months. Conclusion: Based on the results of our study we found no significant advantage of using gender specific implants oriented to female knees. Our study shows the goal of the design of the gender-specific high-flexion knee prosthesis has not been achieved. [ABSTRACT FROM AUTHOR]

During the past three decades, especially in developed countries there are adequate and effective Hospital Acquired Infection (HAI) control programs and implementations are being focused. But in developing countries, due to lack of awareness and effective implementable infection control policies, there is no adequate comparative data to validate the safe healthcare delivery system. Thus this descriptive surveillance study was aimed to find the Incidence rate of Catheter Associated Infections (CA-UTIs) in a tertiary care hospital, Puducherry over a period of three years (2016, 2017 & 2018). From all confirmed CA-UTI cases, demographic details, patient distribution, bacteriological profile and antibiotic resistance pattern was aimed. Strict hand hygiene, aseptic practices and catheter bundle care approaches were meticulously emphasized and monitored regularly. The incidence rate of CA-UTI during 2016, 2017 and 2018 was calculated as 7.9, 4.8 and 2.9 per 1000 catheter days respectively. Male gender preponderance was noticed, with majority of age-group belongs to 61 years and above. E.coli and Klebsiella pneumoniae were found to be the commonest bacterial Uro-pathogens with moderate to high level resistance to various antibiotics tested. This study ensures that strict hand hygiene, appropriate and adequate usage of Personal Protective Equipment’s (PPE), aseptic measures and adherence to infection control bundles will reduce the incidence and burden of CA-UTI.

The research aimed to evaluate the association between heart-type fatty acid binding protein (H-FABP) and cardiovascular events. We systematically reviewed research that has been conducted to assess this relationship, aiming to determine how useful H-FABP could be as a biomarker for cardiovascular diseases, especially in the initial phases of acute myocardial infarction (AMI) and acute coronary syndrome (ACS). Our goal was to validate its diagnostic accuracy and clinical relevance. We systematically searched through PubMed, Web of Science, and Google Scholar databases to find pertinent publications related to cardiovascular diseases and H-FABP, using various permutations, abbreviations, and language variations of MeSH keywords. The final analysis included 12 studies in total. The final study comprised twelve studies, and it was concluded that H-FABP demonstrated high sensitivity (64.3-91.5) and specificity (73-100) for diagnosing Acute Myocardial Infarction (AMI) and Acute Coronary Syndrome (ACS), especially within the first hours of symptom onset. H-FABP demonstrates potential in enhancing the overall diagnostic accuracy during the initial hours following the manifestation of symptoms. However, the existing data do not provide sufficient evidence to recommend the regular utilization of H-FABP as a preliminary risk assessment approach in individuals who present with suspected cardiac events. Additional investigations, with well-defined prospective cohorts, are needed to validate the results observed., Competing Interests: Authors declare no conflict of interests in this study., (© 2024 The Author(s).)

Background/objectives: Mycobacterium tuberculosis, the causative agent of tuberculosis has developed resistance to most of the available antimicrobials. Consequently, it is difficult to cure all the patients with tuberculosis and in future, the incidence of tuberculosis by drug resistant M. tuberculosis is likely to increase, worldwide. Therefore detection and development of new antimicrobials against M. tuberculosis is needed urgently., Methods: Essential oil from the leaves of Ocimum sanctum L (Tulsi/Basil) was obtained by hydro distillation. The anti-mycobacterial effect of essential oil was evaluated against H37Rv and nine clinical isolates of M. tuberculosis in the BD BACTEC MGIT instrument using different volumes of essential oil., Results: The essential oil inhibited the growth of H37Rv and all the nine clinical isolates of M. tuberculosis. The minimal inhibitory concentration of H37Rv was 3 μl (2.931 μg) and those of the clinical isolates of M. tuberculosis ranged from 1.5 μl (1.4655 μg) to 6 μl (5.862 μg)., Conclusion: The Essential oil from the leaves of O. sanctum L.(Tulsi/Basil) has anti-M. tuberculosis effect in the in-vitro BD BACTEC MGIT method., Competing Interests: Conflicts of interest The authors have none to declare., (Copyright © 2021 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Objectives: To compare the BD GeneOhm Methicillin Resistant Staphylococcus aureus (MRSA) Achromopeptidase (ACP) polymerase chain reaction (PCR) assay with the culture method for the detection of MRSA colonization., Methods: One hundred and two patients were admitted to the Intensive Care Unit in King Khalid Hospital, Najran, Kingdom of Saudi Arabia from July 2010 to February 2011. Separate swabs from the nose, axilla, and groin of each patient were processed by the culture method (sheep blood agar plate and mannitol salt agar plate) and BD GeneOhm MRSA ACP assay., Results: Of the 287 samples, 62 (21.6%) were MRSA positive by the PCR assay and 26 (9%) were MRSA positive by the culture method. The PCR method showed 88.4% sensitivity and 98.6% negative predictive value. The number of MRSA-PCR positive groin specimens was nearly the same as nasal specimens. The PCR method gave positive results in 22.5% of patients by nasal specimens, 27.5% of patients by nasal and groin specimens, and 30.4% of patients by nasal, groin, and axilla specimens. The PCR method detected 30.4% of patients as MRSA positive while the culture method detected 19.6% of patients as positive for MRSA., Conclusion: The BD GeneOhm MRSA ACP assay has high sensitivity and NPV and hence is a useful screening method to exclude patients who are not colonized with MRSA.

Antiphospholipid antibody syndrome (APS) is now recognized as an important risk factor for young stroke. Recurrent stroke seems to be common in patients with APS and a first stroke, recurrent stroke and vascular dementia are feared consequences of APS. We are reporting a case of primary APS with recurrent stroke presenting as pseudobulbar palsy in an young man.

IgG antibody to Mycobacterium tuberculosis from the sera of patients with 'definite' pulmonary tuberculosis (PT) was isolated and coupled with Cyanogen bromide-Sepharose 4B. Using an immunoabsorbent affinity chromatography, 14 kDa antigen was recovered from the culture filtrates of M. tuberculosis. With this mycobacterial antigen, a dot immunobinding assay (Dot-Iba) was developed for the detection of specific antibody to M. tuberculosis in the sera of patients with PT and controls. The assay gave positive results in all the 12 sputum-smear positive [acid fast bacilli (AFB)] patients with PT and gave negative results in the 50 sera from control groups. The Dot-Iba as described in this study, is simple, rapid and specific for laboratory diagnosis of PT.

Three antibody assays (anti-PGL-1, anti-35 kDa and anti-LAM) were used to determine the levels of antibodies in the sera of untreated leprosy patients. All the three assays showed higher levels of antibodies in BL/LL patients as compared to I and TT/BT patients, as well as healthy controls. BL/LL patients showed positivity of 100%, 84.2% and 78.9% by anti-PGL-1, anti-35 kDa and anti-LAM assays respectively. All the three assays were negative for leprosy in healthy controls. Anti-PGL-1 assay was positive in 20% of TT/BT patients and 17.9% of I patients. Anti-35 kDa assay was negative in all the TT/BT patients and positive in 7.14% of I patients. Anti-LAM assay was positive in 13.3% of TT/BT patients and in 10.7% of I patients. Hence, while these assays are valuable in diagnosing BL/LL patients, their usefulness in diagnosing I, BT or TT leprosy is limited.

The ability of the fluorescein diacetate and ethidium bromide fluorescent staining method to assess the percentage of viable bacterial cells in suspension was compared with the plate counting method. Mycobacterium smegmatis and Escherichia coli bacterial cell suspensions were incubated at 60 degrees C. At different time intervals samples were taken and the percentage of viable cells in each sample was assessed by the fluorescent staining method and compared with the plate counting method. The fluorescent staining method showed a positive correlation with the plate counting method. However, the viable counts by the plate counting method were lower than the staining method when incubated at 60 degrees C, indicating a lag period in the decay of enzymes after bacterial death. Hence, the fluorescent staining technique can be used to assess the trend of bacterial death rather than to assess to exact number of viable bacilli.

Waldenstrom's macroglobulinaemia is a rare form of monoclonal plasma cell dyscrasia in which there is excess production of immunoglobulin M. Clinically the patient has features of hyperviscosity syndrome and the effects of bone marrow replacement by lympho-plasmacytoid cells. We report here two such cases seen within a period of two months.