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Human sparganosis is a rare but important food borne zoonosis and could be attributed to increased consumption of raw meat of fish, frogs, snakes etc. Sparganosis may involve varied organ systems but subcutaneous sparganosis remains the one of the commonly reported clinical condition. Rarity of this problem reinforces the necessity of sensitising the treating physicians of the differential possibility of this infection in patients with history of practice of consuming raw meat. Expansion of health communication and provision of safe food and water by the civic agencies can be a part of powerful preventive strategies.

Background As a consequence of growth and advancement in health care, production of health care waste has seen an exponential upward trend. Waste from individual health care facilities can vary based on the nature and scope of health care services they provide. Objectives To analyze the amount of biomedical waste generated by a tertiary care hospital. Methods Biomedical waste generated by the hospital from 2005 to 2019 was quantified and analyzed to calculate the total amount of incinerable waste, recyclable plastic waste, and sharp and glass waste. The amount of waste generated per bed per day and the compound annual growth rate (CAGR) were also calculated. Results The total amount of biomedical waste generated in 2005 was 65,658 kg, which has substantially increased to 374,712 kg in 2019, with a CAGR of 12.5%. The hospital was producing average biomedical waste of 0.179 kg/bed/day in 2005, which has increased four times in 2019 to reach 0.709 kg/bed/day. The overall estimated plastic waste was 31% of the total biomedical waste in 2005 and 53% in 2019. Conclusion The generation of biomedical waste is likely to see significant upward trends unless diligent deliberations are held between different stakeholders in regard to the reintroduction of reusable materials and waste reduction strategies.

Introduction: Being at the forefront, health-care workers (HCWs) have been at an increased risk of developing COVID-19. Objectives: To understand the pattern of the clinical symptoms, transmission dynamics, intake of hydroxychloroquine (HCQ) prophylaxis and outcome in COVID-19 positive HCWs. Methods: One hundred and fifty-one COVID-19 infected HCWs were telephonically followed up to study the exposure details, clinical presentation, comorbidities, HCQ prophylaxis, outcome and further transmission to their families. Results: The most commonly infected were doctors 60 (39.74%), followed by nursing staff (22.52%) and office staff (13.25%). Only 40 (26.49%) of infected staff was posted in COVID area. The most common source of exposure were patients (33.11%), followed by fellow staff members (28.48%) and 13 (8.61%) had contracted the disease from their family. Fever (74.17%) was the most common symptom followed by myalgia (43.71%), anosmia (37.75), sore throat (33.77%), ageusia (31.13%) and dry cough (28.48%). Three (1.99%) HCWs expired due to COVID-19 and 23 (16.31%) transmitted infection to their family members. Conclusions: This study concludes that HCWs are at greater risk of acquiring infection, particularly while working in non COVID areas, contracting the virus mainly from patients and co-workers. They are also a potential source of onward transmission to their colleagues and family.

Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.

Introduction: The burden of Tuberculosis (TB) has managed to remain an age old menace to our society, especially India. The potential impact of Corona Virus Disease-19 (COVID-19) on TB patients continues to be worrisome due to the disruption of the national program and its services. Aim: To compare the TB infection in COVID-19 vs non-COVID-19 patients. Materials and Methods: The study was undertaken at Department of Microbiology, ABVIMS, Dr. RML Hospital Delhi, India. The data was collected, retrospectively from 15thSeptember 2020 to 15th January 2021 from admitted 1094 non-COVID-19 and 150 COVID-19 patients, >18 years of age, either sex. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was done to diagnose COVID-19 and GeneXpert was used to detect Mycobacterium tuberculosis. The data entry was done in the Microsoft Excel spreadsheet and the final analysis was done with the use of Statistical Package for Social Sciences(SPSS) software version 21.0. Two by two contingency table was used for calculating the Odd’s ratio. Results: During the study period, 1094 samples were received from non-COVID-19 ward and 150 from COVID-19 ward. Out of 150 COVID-19 positive patients, 30 (20%) were also positive for Mycobacterium tuberculosis Complex (MTBC) and 120 (80%) were negative for MTBC. Out of 1094 COVID-19 negative patients, 98 (8.96%) were positive for MTBC and 996 (91.04%) were negative for MTBC. The Odd’s ratio/Risk Ratio (RR) of TB infection in COVID-19 infected patients was 3.08 {Confidence Interval (CI) 95%}. The mortality was 10% in the COVID-19 positive group. Conclusion: It was observed that the chances of contracting TBare thrice in COVID-19 patients and thus TB diagnosis should be equally emphasised and further strengthened in this ongoing pandemic.

Background: Fingerprint biometric systems are used to identify personnel, grant authorised access and maintain attendance of staff at most places. Despite their many benefits, biometric devices are potential sources of transmission due to contamination from multiple touches by various users. Due to the COVID-19 pandemic, there have been massive shift in infection control practices specially hand hygiene. This study was conducted to understand the attitude and practices of healthcare workers (HCWs) they are likely to follow when biometric devices come to use again. Materials and Methods: The study was conducted using a self-designed questionnaire given to HCWs in different departments of the hospital in the form of a written form by our infection control nurses. The study was conducted for 5 days. The questionnaire was based on various attitudes and practices before and after the COVID-19 outbreak. Results: Overall 304 participants filled the questionnaire, which comprised 85 (28%) doctors, 117 (38.4%) nurses and 102 (33.6%) other staff. Before the emergence of COVID-19, 114 (37.5%) participants felt touching biometric devices is more dangerous than touching other common items such as doorknobs, elevator buttons, countertops and staircase railings which now increased to 183 (60.2%) after the COVID-19. Earlier 77% of participants felt that hand sanitisers should be installed near biometric devices, but now 95.7% feel the need of hand sanitisers near the biometric devices and want to use them. Conclusion: This improvement in hand hygiene might be a result of increased awareness through educational programmes and mass media during the COVID-19 pandemic. Hand sanitisers should be installed near biometric devices before restarting their use which will reduce the risk of contamination of biometric devices by pathogenic organisms.

Objectives: The aim of this study was to assess the utility of Xpert assay, Ziehl–Neelsen (ZN) staining, and Mycobacteria Growth Indicator Tube (MGIT™) culture for diagnosis of pediatric pulmonary tuberculosis from gastric aspirate (GA) samples and to compare Xpert assay and ZN staining with MGIT rapid liquid culture. Materials and Methods: GA samples from 210 nonexpectorating children, aged between 6 months to 12 years, presenting to the pediatric out-patient department (OPD) with clinical suspicion of tuberculosis (TB) were collected. The samples were tested by GeneXpert, ZN staining, and MGIT liquid culture. Results: GeneXpert is a more sensitive method for rapid and early diagnosis of pediatric TB when compared with microscopy.

Purpose: To describe a newly discovered, previously unreported endemic focus of fasciolopsiasis in the Phulwaria village, under tehsil Sugauli, East Champaran, Bihar. Materials and Methods: A study was conducted at village Phulwaria, following diagnosis of fasciolopsiasis in three children from the village. A total of 120 individuals, including all the children and adults who gave history of recent passage of red fleshy masses in their stool, were included in the study. The cases of fasciolopsiasis were treated with Praziquantel 25 mg/kg, three doses a day. Risk factors for the transmission of the parasite in the village were also studied. Results: Questionnaire revealed majority of the population suffering from abdominal discomfort and passage of red fleshy masses in stool. These fleshy masses were identified as Fasciolopsis buski. One hundred and eighteen individuals were presumably considered as cases of the parasitic infection. After treatment with Praziquantel, all of them passed the parasite in their stool for the next 2-3 days. On investigating, it was observed that all the conditions required for effective continuation of the life cycle of the parasite were present in this village. Conclusion: This study draws attention to a new endemic focus of fasciolopsiasis in Bihar, with a very high prevalence due to poverty, the lack of awareness about the parasite in villagers as well as ignorance among local medical practitioners. There is an urgent need for mass campaign around the region for its effective control.

Objectives Study was conducted to determine the role of procalcitonin (PCT) in the diagnosis of sepsis and guide antibiotic therapy in pediatric intensive care unit. Methods PCT levels were measured from suspected sepsis patients along with a blood culture. Results Out of 52 patients, 30 had initial PCT levels ≥2.0ng/ml, 10 (≥0.5– P =0.006]. Conclusions Measurement of serum PCT levels was found to be helpful in diagnosing sepsis in culture negative patients. Lower PCT values can help in ruling out sepsis and limit antimicrobial use. High initial PCT levels can predict severity of sepsis and mortality.

Background: Staphylococcus aureus is Gram-positive bacterium commonly associated with nosocomial infections. The development of biofilm exhibiting drug resistance especially in foreign body associated infections has enabled the bacterium to draw considerable attention. However, till date, consensus guidelines for in vitro biofilm quantitation and categorization criterion for the bacterial isolates based on biofilm-forming capacity are lacking. Therefore, it was intended to standardize in vitro biofilm formation by clinical isolates of S. aureus and then to classify them on the basis of their biofilm-forming capacity. Materials and Methods: A study was conducted for biofilm quantitation by tissue culture plate (TCP) assay employing 61 strains of S. aureus isolated from clinical samples during May 2015– December 2015 wherein several factors influencing the biofilm formation were optimized. Therefore, it was intended to propose a biofilm classification criteria based on the standard deviation multiples of the control differentiating them into non, low, medium, and high biofilm formers. Results: Brain-heart infusion broth was found to be more effective in biofilm formation compared to trypticase soy broth. Heat fixation was more effective than chemical fixation. Although, individually, glucose, sucrose, and sodium chloride (NaCl) had no significant effect on biofilm formation, a statistically significant increase in absorbance was observed after using the supplement mix consisting of 222.2 mM glucose, 116.9 mM sucrose, and 1000 mM NaCl (P = 0.037). Conclusions: The present study puts forth a standardized in vitro TCP assay for biofilm biomass quantitation and categorization criteria for clinical isolates of S. aureus based on their biofilm-forming capacity. The proposed in vitro technique may be further evaluated for its usefulness in the management of persistent infections caused by the bacterium.

Nocardial brain abscess is a rare central nervous system infection. A 50 year old renal transplant recipient developed a nocardial cerebral abscess. It manifested clinically with pyrexia of unknown origin, recurrent episodes of convulsions and a right sided hemiparesis. The purulent material was drained and sent to the Microbiology Laboratory for culture and sensitivity studies. Direct microscopy and culture confirmed the diagnosis of nocardial infection.