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Background: Thymectomy has been identied as Constructive and active strategy for patients with Myasthenia gravis and thymic masses which have been done classically by Open Sternotomy technique and nowadays new Minimally invasive approaches have also been introduced. In this paper , Subxiphoid Uniportal VATS(Video Assis Method : ted Thoracoscopic Surgery) Thymectomy through a single port technique by utilizing the Subxiphoid approach has been discussed. I have improvised my technique pertaining to the requirements and better recovery and better post operative outcome of the patient .This procedure is indicated for all anterior mediastinal masses and maybe extended to lung cancer.The patient was placed in supine position instead of classical lithotomy position .Carbon dioxide insufation was not used which led to faster recovery after the surgery.After dissection and resection of thymus Bilateral pleural drain were placed which was removed usually on Post Operative day 4 or 5 and patients were discharged afterwards. Several benets of this Results: approach were observed and documented including reduced postoperative pain, Early extubation, better post operative outcome, and better dissection . In the near future ,the Subxiphoid approach has the potential to become Conclusion: GOLD STANDARD for Thymectomy and various other conditions

are found in moist natural environment and hospital settings. In ICU . is the most common cause of Respiratory tract infection. . has evolved from a minor infection to one of the most virulent and multidrug-resistant, pathogens in intensive care units. Overuses of the antibiotics patients drug resistant pattern are increase and immune compromise patient are not recover early. This research will help in better infection control and a better knowledge of antibiotic resistance patterns in our area. The aim and objective of this study is isolation of . and its antimicrobial resistance pattern in all lower respiratory samples from ICU. All lower respiratory samples were collected (Sputum, BAL, ET etc.) samples was inoculated on MacConkey and blood agar. At 37 degrees Celsius, culture plates were incubated aerobically for 24 hours. Gram staining and biochemical test were used to identify the Acinetobacter species. All species was isolate further processed on the basis of AST by automated through vitek2 compact.Among 151 samples, 71 (47.01%) were culture positive. was isolated in 31 (43.66%). The number and percentage of in various clinical sample were sputum 14 (45.20%), ET 12 (38.70%), pleural fluid 3 (9.60%), BAL 2 (6.50%). The strains showed maximum resistance to Ampicillin (100%) and pipracillinetazobactum (94.0%), Ceftazidime (86%) followed by gentamycin (77%), Ciprofloxacin (72%). All the strains were sensitive to colistin and Polymyxin B (100%).The rise of resistant strains has resulted in fewer treatment choices. Because of the limited therapeutic options, infection prevention and control methods, including not only standard measures but also antibiotic management strategies in the ICU, are important.

is a major cause of health care associated infections. It has natural resistance as well as acquired multidrug resistance to various antibiotics leading to increased morbidity and mortality, which lead to problematic condition and increased medical expenses. The main aim of this study was to study the resistance pattern of isolated from samples received from surgical site infections and wound infections.This study was conducted at Microbiology laboratory of Teerthanker Mahaveer Medical College and Research Centre. Pus and wound swab samples were collected from surgical site infections (SSIs) and wound infections. Samples were cultured on MacConkey and Nutrient agar and incubated at 37°C aerobically. Identification of was done by using conventional method and antibiotic sensitivity was determined with automated Vitek2 compact system.From January 2021 to November 2021 during this study period, out of 117 positive samples 32 (27.35%) were isolated. The susceptibility pattern showed the organism to be most commonly susceptible to Colistin, Doripenem, followed by Piperacillin/Tazobactam, Imipenem, Amikacin, and was less susceptible to Ciprofloxacin, Ceftazidime.Presences of multidrug resistance strains have raised significant concern and judicious use of antibiotics is the only option to reduce drug resistance and preventing resistance against reserve antibiotics.

Esophageal candidiasis is often observed in patients for its development and fluconazole is the therapeutic choice for the treatment. To determine its frequency, by performing upper gastrointestinal endoscopy and the frequency of various species isolated from patients with EC. To determine the antifungal susceptibility to fluconazole of isolated various species. From January2020 to December 2020, total 73 patients found eligible for this study from endoscopy unit in Teerthanker Mahaveer medical hospital and research center (Moradabad), who presented whitish plaques consistent with esophageal candidiasis in order to identify species and verify their susceptibility to fluconazole. Total 4256patients referred to UGI endoscopy at the endoscopy unit, 73(1.7%) had found esophageal candidiasis. Most affected age group from this disease was found 41-60 years (48%). Frequent number of species isolated was 50(68.5%). A total of 15(20.6%) isolated species were resistant to fluconazole, while 2(2.7%) had intermediate sensitivity to this drug. Esophageal candidiasis prevalence was low although similar or within the results described by other authors. The common causative species was found for this disease and the resistant to fluconazole were considered high.

Hepatitis E virus causes a self-limiting viral infection, transmitted by feco-oral route. HEV infection is major health problem worldwide, with a higher incidence in developing country.To determine the frequency of HEV infection in patient with acute hepatitis and describe the frequency of HEV in different sex and age groups. From January 2019 to December 2020, Serum samples from clinically suspected acute viral hepatitis cases were collected and sent to the department of microbiology maintaining precautions. These were processed for the detection of HEV- specific Immunoglobulin M antibodies carried out rapid card test which is based on immunochromatography.The seroprevalence of HEV (11.79%), HEV infection is slightly higher in female (52%) as compare to male (48%) and HEV infection was most commonly seen in adults (age group 21-30 years)The best means of reducing the spread of infection is by promoting simple measure of personal and community hygiene. However, these data will be useful for planning of future vaccination and for better sanitation. This study also helps the local organizations for maintaining the proper hygiene condition and supply purified water which can help to reduce the prevalence of Hepatitis E virus.

Introduction: The Group A beta hemolytic streptococcus has remained a major human infective agent for hundreds of years. Group 'A' beta hemolytic streptococcus related ailment and sequelae keep on affecting general public and national economy as they mostly influence kids and youthful grown-ups. Current research aimed to determination of anti-streptolysin –o titer in suspected cases of streptococcal infection. Objectives : Determination of anti-Streptolysin-O (ASO) titer in suspected cases of streptococcal infection. Materials and Methods: The measurement of ASO levels was done by semi-quantitative analyzer analyzer on photometric and colorimetric systems. 107 blood samples were taken in our study. This study was conduct in serological section of microbiology department of Teerthanker Mahaveer Hospital & research centre Moradabad. Results: A total 107 samples were tested in this study. Of these, 23(21.5%) were found to be positive for the presence of ASO having titre of >200IU/mL. Conclusion: This study will be useful to evaluate utility of sero-diagnosis in our catering population and found useful in early diagnosis and treatment of these pathogens. Treatment can be initiated at an early stage leading to reduction in complications and associated mortality. Keywords: Rheumatic fever, Streptococcus, Rheumatic heart disease, Glomerulonephrits

Introduction: It has been recognized that population-based surveys are needed to assess the prevalence of hepatitis C virus, hepatitis B virus and HIV infection. Pregnant women can be considered as outpost populations because they are relatively unselected populations and their prevalence data may be extended to general population. Aim/Objective: Study of viral markers (Human immunodeficiency virus, HBsAg and antiHCV among pregnant woman attending the antenatal clinic. Determination of HIV, HBsAg and HCV in the pregnant females. Result: In this age wise distribution of HCV positive cases, five cases were positive in 17-21, age group of 22-26 twelve patients were positive, age group of 27-31 eleven patients were positive, age group of 32-36 four patients were positive and three were positive in the age above 36 years. In table number two, 7 were positive for HBsAg, 35 were positive for HCV and no one was for HIV. Conclusion: In our study, pregnant women had a higher HCV infection rate. Occurrence of HBsAg infection was low in expectant ladies. In our area, people were very careful because they don’t want to spread HIV in their area. The public has complied with HIV/AIDS regulations. They always used condoms and never shared needles. Hence the mother could not spread HIV to the child. In order tounderstand the reasons and inferences of these findings, and provide more guidance, other research is needed. Keywords : HIV, HBsAg and anti HCV, Pregnant women

Background: Candida species are responsible for causing many health care associated and central line associated infections. They are responsible for causing opportunistic infection in human beings. Genus of Candida is composed of a heterogeneous group of organsims.Invasive infections of Candida mainly caused by Candida albicans, Candida glabrata, Candida parapsilosis & Candida tropicalis. Aim and objective: The main objective of this study was to isolates candida albicans and Non- albicans candida and their antifungal susceptibility testing. Materials and Methods: The study was carried out in the Department of Microbiology, in Tmu Hospital Moradabad. Total numbers of 806 clinical samples were processed in which 206 isolates were taken for candida. Isolation and antifungal susceptibility testing done by Vitek-2 system. Result: Out of 206 samples 77(37%) were C.albicans and 129(63%) were Non-albicans candida (NAC). Maximum isolated species were C.albicans 77(37%), followed by C.tropicalis 70(34%), C. parapsilosis 24(12%), C. glabrata 19(9%), C. dubliniensis 12(6%), C. krusei 3(1%), C.african 1(1%). Conclusion: Infection caused by NAC species have increased. C.tropicalis was the most common isolated species. Candida albicans, C.glabrata and C.krusei were shown high susceptibility to fluconazole and voriconazole. Amphotericin B, Caspofungin, Micafungin and Flucytosine shows high susceptibility towards other candida species. Keywords: Candida species, Non-albicans candida, Antifungal Susceptibility Testing

Dengue virus is a member of arbovirus, family flaviviridae, genus flavivirus. These are found in common tropical areas of the world or the transmitted through bite of the female mosquito Aedes aegypti and chiefly occurs during the rainy season. It is classified into three parts Dengue Fever, Dengue hemorrhagic fever, Dengue shock syndrome. The signs of dengue: fever, headache, retro orbital pain, muscles pain, joints pain or rashes are usually seen on 3-7 days. DF is also called break bone fever.: To study the occurrence of dengue infected patients. To determine the frequency of dengue patients presenting with fever of less than 5 days in NS1 Antigen ELISA. To determine the frequency of dengue infected patient presenting with fever for more than 5 days in IgM ELISA. The study was carried out from period of 2019 to 2021. Blood samples were collected from 161 patients. Serum was separated from blood samples. NS1 Ag detection was done from ELISA method & IgM Ab was detected by using Dengue MAC Capture ELISA test. : A total of the 161 blood samples were tested, 85 (53%) were positive & 76 (47%) were negative for dengue. The dengue infection was commonly found in males than females, the common age groups of patients presenting with dengue was 11-30years.Our study focused on continuous monitoring and community action for individuals and dengue controls. This research will help to improve the ways of surveillance, prevention and control.

Introduction: FUO/ PUO (Fever/Pyrexia of Unknown Origin) is referred to when temperature is observed above 38.30C (1010F) on many occasions over a period of > 3 weeks and unable to diagnose despite 1week of thorough investigations. Different studies reported diagnosis of malaria in 5 to 50% cases; leptospirosis in 3 to 10% cases and influenza in 8 to 12% cases Dengue fever and malaria are arthropod born diseases and endemic in many parts of India during the monsoon season. Leptospirosis and scrub typhus are zoonotic infections and are widely prevalent in areas with heavy monsoon and agrarian way of life. Aim: To evaluate the study of various Rickettsia infections in patients suffering from Fever Of Unknown Origin. Objectives: To understand the occurrence of infections caused by rickettsial species in suspected cases of FUO. To increase awareness and clinical suspicion among doctors for these infections. Materials and Methods: The assay was performed using P.vulgaris OX19, OX2, OXK strains according to manufacture’s instructions by tube method. Serum will be diluted from 1/20 to 1/640 titer. A singleWeil Felix titer of >1:160 or fourfold rise in titers on repeat testing starting from 1:40 will be accepted as a positive result. Result: A total 100 cases were including in my study in which 28 cases were positive. Out of 28 positive rickettsial samples, females were 17 and males were 11. Spotted Fever(9), Endemic Fever(8), Epidemic Fever(7), Scrub Typhus Fever(4). Conclusion: With the growing number of cases detected in India, scrub typhus is fast emerging as a public health threat and also due to limited diagnostics leading to underreporting, Weil Felix test could be used in adjunct with Enzyme-linked immunosorbent assay and blood parameters in the diagnosis of rickettsial diseases. Keywords: Fever/Pyrexia of unknown Origin, (FUO/PUO), Spotted fever, Endemic fever, Epidemic fever, Scrub typhus fever, Weil felix.

Background: Malaria is a protozoan disease transmitted by the bite of infected anopheles mosquitoes. Malaria is one of the most serious parasitic diseases of the world affecting 300-500 million people and causing over 1 million deaths each year. Malaria is caused by Plasmodium species in human. 90% of the death from malaria is caused by P. falciparum and vivax. Complicated malaria is associated with multi organ dysfunction. ARF can be the presence of oliguria and increased serum creatinine and blood urea. Objective: To confirm malaria positive case by peripheral blood smear.To determine association of malaria positive case with kidney function test. Materials and Methods: The study was conducted in the department of microbiology TMMC&RC Moradabad. The study group comprised of 149 malaria positive cases confirmed by PBS & Antigen card test with serum creatinine and blood urea test. The sample venous blood was collected aseptically from the subjects using 5mL disposable syringes. The blood sample was collected and 4mL was transferred into plain vial for the biochemical assays whereas the remaining 1mL was transferred into EDTA vial for malaria parasite tests. Result: Out of 1317 suspected cases in which 149(11.31%) samples were positive for malaria in which 140(93.95%) were infected with P. vivax and 9(6.04) were with P. falciparum. Out of 140 cases of P. vivax, 59(39.59%) had got deranged KFT while out of 9 cases of P. falciparum patients 5(3.35%) had got deranged KFT. Conclusion: It is concluded that kidney function abnormality accounts for 42.18% in malaria positive cases. Keywords: Renal dysfunction, Plasmodium falciparum and, Plasmodium vivax, Mortality.

Introduction: In order to provide an enhanced communication network, the worldwide infrastructure for mobile phones and telecommunication was developed in 1982 in Europe. In the modern-day scenario, Asia has the fastest growing number of mobile phone subscribers in the world. Around 75% of the world’s adults have the access to mobile phones.Mobile phones may act as fomites and may facilitate the transmission of microorganisms from one patient to another in the hospital during their treatments. These mobile phones are now described as technical Petri dishes where they could play a role in health-related infections as they spread through the hands of healthcare staff. Aim: To determine the microbial contamination from mobile phones of healthcare workers (HCWs). Objectives : To study the microbial contamination of mobile phones used by healthcare workers, Identify the isolated organism. Materials and Methods: All specimens were processed for gram staining, Culture was done for those samples which were showing gram positive or gram-negative organisms on gram stain on different culture plates (Nutrient agar, Blood agar, MacConkey agar). Plates were incubated for 24 hours at 370 C, after 24 hours of incubation the culture plates were examined for growth. Result: We had swabbed the 134 mobile phones of health care workers, working in critical areas out of 134 mobile phones, 132 showed the growth of the bacterial pathogen in a significant amount and 2 were negative, so the overall contamination of the mobile phones was found to be 98.50% and no growth was found to be 1.49%. Conclusion: The most predominant bacteria were Staphylococcus aureus MRSA in our study. It may be due to MRSA residue in the nose, when it comes to our hand then individuals get exposed to cross infection. The dominance of clinical phones that could be contaminated by different microorganisms inside the ICUs and OTs has become unacceptable. there are no rules and regulation for staff to

Introduction: Viral hepatitis is a systemic disorder with primary inflammation in the liver. Till now, the hepatitis are of six types i.e. A, B, C, D, E and G in which hepatitis-B is a DNA virus and (A, C, D, E and G) place RNA virus. Hepatitis viruses can cause an acute disease with symptoms including reduced appetite, muscle or joint pain, fever, nausea with yellowish discoloration of human body and eyes (jaundice) and dark urine (bilirubinuria). The most clinically symptoms of HAV infection are dark golden-brown urine, fatigue, malaise, loss of appetite, nausea and vomiting. HAV a positive-strand RNA viruses, is stable at moderate temperature and low pH allowing the virus to survive in the environment and be transmitted by the fecal-oral route. Aim: Occurrence and pattern of hepatitis-A among patients with suggestive symptoms of hepatitis. Objectives: 1. To determines the frequency of Hepatitis-A virus infection. 2. To determine the pattern of Hepatitis-A infection in different Age group. Materials and Methods: 5ml blood was collected from anterior cubital vein by Venipuncture from recruited patient. Samples were collected after proper consent and aseptic precautions. Then every blood sample was transfer overhead a tagged tube plane vial. Result: The study was conducted in Department of Microbiology, Teerthanker Mahaveer Hospital. Blood sample from 87 patients including both male and female were collected from various department of the Hospital for the analysis purpose. Out of them, 10 (11.50%) cases were Hepatitis-A virus positive and 77 (88.50%) cases were Hepatitis-A virus negative. Conclusion: The results of our study put up valuable information and connection in Hepatitis-A positive cases. Females 6 (60%) were more affected by the Hepatitis-A virus infection as compare to Males 4 (40%). An important preventive measure is the screening for Hepatitis-A Virus in blood donors. Hepatitis-A Virus infection can also be prevented by using fresh fo

Background: Brucellosis is the most common bacterial zoonotic disease worldwide.It is mainly occupational disease reported in farmers, slaughter house workers, animal handlers and meat inspectors. This disease is endemic in many parts of Asia, including India. Brucellosis is an important, but neglected major cause of pyrexia of unknown origin(PUO). Diagnosis of brucellosis is difficult. Hence the medical and laboratory staff needs to be alert to recognize this condition. Objective: To assess the possible risk factors associated with human brucellosis.To study frequency of human brucellosis in relation to occupation, age and sex. Materials and Methods: From September (2018) to November (2019) 102 Serum samples of PUO cases were analysed for brucellosis. All serum samples were analysed by slide agglutination method using standard specific brucella antigen. Result: We observed that human brucellosis is present in PUO patients. The total number of brucellosis positive cases were found to be 14 (13.72%) out of 102 PUO cases. Among positive cases, males were 8 (57.14%) and females were 6(42.85%). Highest brucellosis positive cases were seen in age-group between 15-30 years 6(42.85%) followed by 31-45 years 5(35.71%), 46-60 years 2(14.28%) &>60 1(7.14%) in PUO patients. Conclusion: With the growing number of brucellosis cases detected in India. Brucellosis is the fast emerging as a public health threat and also due to limited diagnostics leading to underreporting. The study also highlights the innovative and cost effective methods for rapid and early reporting and ruling out brucellosis in PUO cases. Keywords: PUO, Brucellosis, Agglutination, Prevalence.