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Background: Tuberculosis (TB) is the most common presenting illness and leading cause of death among people living with HIV(PLHIV). Diagnosis of TB among PLHIV is challenging as false negative results are common with direct microscopy (DM) and culture takes long time. WHO (2013) recommended Xpert MTB/RIF assay as an initial test for diagnosis of TB in PLHIV. Methods: The present study was conducted on 142 HIV seropositive patients who were clinically suspected to have TB. The sputum specimens obtained from these patients were divided into two parts; one was processed by DM and the other was used for Xpert MTB/RIF assay. Result: Of the 142 HIV seropositive patients, 90(63.3%) were in the age group of 15-40 years and majority 91(64.08%) were males. Out of 142 sputum specimens collected from these patients, only 5(3.52%) were positive by DM and 31(21.83%) by Xpert MTB/RIF assay. Statistically the difference between the two was significant (p value

INTRODUCTION: Resistance to antimicrobial agents is a major concern worldwide and is exemplified by the global spread of the Methicillin resistant Staphylococcus aureus (MRSA). Health care workers (HCWs) and asymptomatically colonized patients are important sources of nosocomial MRSA infections. AIMS AND OBJECTIVES: To determine the prevalence of MRSA colonisation, two hundred HCWs and 200 consecutive outpatients attending our tertiary care hospital were studied. MATERIALS AND METHODS: Two sterile pre-moistened cotton tipped swabs were used to collect specimens from their anterior nares. These were inoculated immediately on Blood agar with oxacillin, Mannitol salt agar with oxacillin and CHROM agar. Resistance to cefoxitin was confirmed by PCR by demonstration of mecA gene. Antibiotic susceptibility was determined by Kirby Bauer’s disc diffusion method and MIC of vancomycin by using broth dilution and Vitek-2 Compact system. RESULTS: The nasal carriage of MRSA among HCWs was found to be 7.5% and in outpatients 3%. All strains of MRSA from HCWs and outpatients grew on three selective media and mecA gene amplified in all of them. All the isolated strains of MRSA showed high degree of resistance to co-trimoxazole (93.3%), ciprofloxacin (80%) and erythromycin (66.66%). However, there was 100% susceptiability to vancomycin, teicoplanin, linezolid and Rifampicin. CONCLUSION: Although a direct casual relationship could not be established, it could be assumed that the transmission from colonised health care worker is responsible atleast in part for MRSA infection among patients. Therefore emphasis should be laid on strict implementation of standard infection control practices which would help in minimizing the carriage and transmission of MRSA in the hospital.

Background: Hepatitis C virus (HCV) infection is high in state of Punjab, however very few studies have been done till date. We all know that pregnant females are a most important section of our community and are usually screened for HCV, HIV, and Hepatitis B at time of presentation. HCV is capable of causing chronic infections and having long-term implications on a person's health. Vertical transmission of HCV can be one of the major route of transmission of this virus to the neonate and there have been various sociodemographic factors like age, literacy, socioeconomic status, occupational status, associated with the disease causation and transmission. Methods: All pregnant females attending Obstetrics and gynecology department of our institute were included in study. All the sociodemographic characters and socioeconomic records were retrieved and analyzed. Results: In our study also a lower socioeconomic status, illiteracy have been significantly associated with the HCV-positive group, thus emphasizing the role of education so as to impart education to the masses as regard to mode of transmission and its effects on the disease. Higher age of conceiving is also significant associated with the increased maternal risk. Conclusions: The more involvement of health care officials and even persons not related to health care set up is required who can educate masses so as to protect the community.

Objective To compare the efficacy of rapid immunochromatographic test (ICT) and ELISA for detection of dengue specific parameters (NS1 antigen and IgM antibodies) and the association of these parameters with thrombocytopenia. Methods A total of 1787 serum samples were obtained from the same number of clinically suspected cases of dengue during an outbreak (2011) of dengue in the Malwa region of Punjab. All the samples were subjected to rapid ICT, dengue early ELISA and dengue IgM-capture ELISA for detection of NS1 antigen and IgM antibodies. Platelet counts of all the cases positive for dengue infection and 150 cases negative for dengue parameters (control group) were recorded. Resutls Rapid ICT for NS1 antigen detection showed same specificity (100%) but lower sensitivity (85.81%) than the dengue early ELISA, while it was 100% and 94.10% respectively for IgM antibody detection. The difference in the platelet counts of cases positive and negative for dengue specific parameters was stastically insignificant (standard error of proportions=0.017, Z value=0.84, P value=0.2). Conclusions The confirmation of serological diagnosis of dengue should always be based on ELISA test and ICT and/or thrombocytopenia should not be used as a stand-alone test.

To determine the current prevalence of four major sexually transmitted infections (STIs: HIV, Hepatitis B, Herpes simplex virus 2, and Syphilis) in asymptomatic pregnant women.This is a prospective study of 500 consecutive, apparently healthy asymptomatic pregnant women who were attending the antenatal clinic. The information regarding their socio-demographic and behavioral characteristics and obstetric performance was recorded. The blood samples was collected after obtaining their informed written consent from those who were tested for the HIV antibodies (NACO guidelines), HBsAg (ELISA test), HSV2-IgM (ELISA test), and Syphilis (VDRL and TPHA tests).The overall prevalence of one or the other four STIs studied was 4.8 % with the highest prevalence of HBV (2.4 %), followed by HSV-2 (2 %), and HIV (0.4 %). No woman tested positive for syphilis and multiple infections. All the infections were more common in illiterate, multigravida, monogamous women of low socio-economic status. High-risk sexual behavior of the husbands, history of STIs in husbands, and blood transfusions were the other factors associated with the prevalence of these infections.The relatively high prevalence of HBV and HSV-2 infections in asymptomatic pregnant women suggests that there is need of screening for HBV and HSV-2 infections along with the pre-existing screening for HIV and Syphilis and universal immunization of HBV high-risk infants.

Ear discharge specimens from 182 clinically diagnosed cases of chronic suppurative otitis media were cultured for isolation of fungi and bacteria. Positive fungal cultures were obtained in 13.7 %; present alone in 7.6% and incombination with various bacteria in 6.1%. Bacteria alone were present in 60.4% cases. The fungal isolates were candida albicans (60%) and Aspergillus (40%). Bacterial isolates showed the predominence of pseudomonas aeriginosa (44.8%) followed by Staphylococcus aureus (20.4%). Newer antibiotics like Cefotaxime, Gentamicin and Ciprofloxacin were found to be more effective against all the gram positive and negative isolates.

Sir, Methicillin resistant Staphylococcus aureus (MRSA) has emerged as a dangerous pathogen of hospital acquired infection and is also spreading in the community1,2. We report here data on this infection from a teaching hospital located in North-West India. During 2012-2013, a total of 248 Staphylococcus aureus isolates obtained from various clinical specimens like pus, blood, urine, body fluids, catheter tips etc. Of the patients visiting Guru Gobind Singh Medical College (GGSMC) and Hospital, Faridkot, Punjab, India, were studied. Of these, 161 (64.9%) were detected as MRSA and 87 (35%) as methicillin sensitive Staphylococcus aureus (MSSA) by observing their resistance to cefoxitin (30 µg) disc3. Further confirmation of methicillin resistance was done by demonstration of mecA gene by PCR4. Overall, MRSA was found in 64.9 per cent (161/248) samples which was higher than the prevalence reported in Indian Network of Surveillance of Antimicrobial Resistance (INSAR) study (41%)1 but was in the range (22 to 68%) observed by various centres participated in the study1. The MRSA increased from 60.5 per cent (92/152) in 2012 to 71.8 per cent (69/96) in 2013, but the difference was not significant. Similar increase has also been reported by six of the 15 tertiary care centres during the two years period (January 2008 to December 2009) of the surveillance1. In our study, the isolation rates of MRSA from non-ICU inpatients (50% in 2012; 69.6% in 2013) were higher than that of outpatients (29.3% in 2012; 18.8% in 2013) and ICU patients (20.7% in 2012; 13% in 2013). This was in contrast to the INSAR study where the isolation rates of MRSA were maximum from ICU followed by non-ICU inpatients and outpatients1. The study of S. aureus isolates from various clinical specimens at our centre showed that maximum isolates were from skin and soft tissue infections followed by blood stream infections and respiratory infections. Susceptibility to various antibiotics is shown in the Table. Similar to the various studies of the INSAR surveillance1, we observed that MRSA isolates were more resistant to antimicrobial agents in comparison to MSSA. However, this difference was not significant for erythromycin, clindamycin, gentamicin and ciprofloxacin. However, for ampicillin and co-trimoxazole the difference was found to be significant (P

Seroprevalence of Rubella was determined in 580 women including 80 women of medical community of district Amritsar, by ELISA test. The overall Rubella IgG seropositivity was 68.8% while in women of medical community it was 80%. Maximum number of women were seropositive (77.2%) in age group 26-35 years. Significantly higher rates were observed in women of urban areas and those belonging to lower socioeconomic class. Although the incidence of seropositivity was more in women with history of adverse pregnancy outcome than those with normal obstetric performance, the difference was statistically not significant (p > 0.05). Serologically, immune status showed poor correlation with history of past Rubella virus like infection.