Dr. Dipti Gaikwad

To determine the sensitivity and specicity of three Malaria rapid antigen detection tests(RDTs) .To study the sensitivity of the RDTs in relation to parasitic index. MATERIALS AND METHODS: The study was conducted at a tertiary care hospital. Peripheral smear were prepared and stained.Parasite index was calculated. Three rapid antigen detection tests ; Optimal – IT, Paramax-3 and QDx malaria PAN/PF were tested. RESULTS: Sensitivity for Optimal – IT was highest (98.47%). QDx malaria PAN/Pf gave highest specicity (97%). All the three RDTs gave sensitivity of 100% at a parasitic index of more than 100 parasites per µl. Sensitivity of Optimal – IT and QDx malaria PAN/Pf for P falciparum and P vivax was 100% and 88.88% respectively at a parasitic index of 51- 100 parasites/ µl. CONCLUSION: Malaria RDTs are a good diagnostic tool in health care set ups where quick results are desired and expert microscopy is not available.

BACKGROUND Malaria is a major global health problem. An accurate and rapid clinical and laboratory diagnosis of malaria becomes essential to decrease the morbidity and mortality caused by it. The present study was conducted to study the clinical characteristics and haematological and biochemistry parameters in malaria patients. METHODS The prospective study included 200 patients clinically suspected of malaria and carried out at a tertiary care hospital. A thorough history and clinical details of patients were taken. Blood (2 mL) was collected in EDTA bulb from each patient and peripheral smears prepared and stained with Giemsa stain. Haematological investigations, LFT, and RFT of the patients were noted from the patient’s records. Data was statistically analysed. RESULTS Malarial parasites were detected in 132 of 200 (66%) patients in peripheral smears. Of these, 94 (71%), 33 (25%), and 5 (4%) were P. vivax, P. falciparum, and mixed infections respectively. Maximum number of cases was in age group 11 to 30 years. Male-tofemale ratio was 4.7:1. Constitutional symptoms were seen in both peripheral smear positive and negative cases. CNS involvement was seen both in P. falciparum (24%) and P. vivax infection (4%), although significantly more in P. falciparum infections. Anaemia in P. falciparum (46%) and thrombocytopenia in P. vivax malaria (39%) was of statistical significance. Systemic manifestations and mortality were higher in P. falciparum (33%) than P. vivax (4%) infection. CONCLUSION Clinical signs and symptoms alone cannot be used to diagnose malaria. It has to be confirmed by laboratory diagnosis. Systemic complications and mortality is caused by both P. vivax and P. falciparum, but significantly more by P. falciparum. Haematological abnormalities like anaemia and thrombocytopenia should increase the possibility of malaria. Periodic analysis of the clinical manifestations with haematological and biochemistry parameters can reveal the changing behavioral patterns of the plasmodium species so that appropriate treatment and preventive measures can be taken.

Background: Proper hand hygiene is the single most important, simplest, and least expensive means of reducing the prevalence of Health care associated infections and the spread of antimicrobial resistance. The purpose of this project was to observe compliance of hand hygiene, study factors causing noncompliance and improvement following intervention Materials and Methods: This was a prospective Hand Hygiene Project. It was a 6 month Quality improvement project ( June 2018 to November 2018) designed to improve hand hygiene compliance at Vishwaraj hospital. Data on hand hygiene compliance were collected monthly from June 2018 to November 2018 Results: At baseline, hand hygiene compliance averaged 41.6% in our hospital. Data revealed nine different causes of hand hygiene noncompliance; we developed and implemented specific interventions targeted to causes of hand hygiene noncompliance. The improvements were associated with a increase in compliance from 41.6 % to 54.2 % (p<0.05), a level of performance that was sustained for 4 months through the end of the project period. Conclusion:We targeted the most important causes of hand hygiene failure. Such a targeted approach is an effective improvement strategy.

A 40 day old male infant presented with fever, cough, breathlessness and refusal to feed for two weeks. X-ray chest showed right lung consolidation. Computed Tomography (CT) scan of chest revealed bilateral lung consolidation. Frank pus aspirated from pleural tapping showed Gram positive thin branching filaments. The specimen was processed on Blood agar and Lowenstein – Jensen medium. The colonies grown were identified as Nocardiaasteroides by microbiological techniques. After seven days of admission patient deteriorated. CT scan showed multiple brain abscesses. In spite of extensive medication, patient did not improve and finally succumbed to infection.Nocardiosis is an uncommon infection which occurs infrequently in children. Hence presenting this case due to its rarity.

We report a case of pyogenic liver abscess who presented with fever generalised body weakness, and pain in the abdomen. On examination patient had tenderness in right hypochondriac region . Ultrasonography of the abdomen showed enlargement of the liver with features suggestive of abscess in the right lobe and left lobe. Ultrasound guided liver aspiration was done. Gram stain from the pus sample showed presence of Gram negative coccobacilli. Pan sensitive Acinetobacter lwoffii grew in culture. Patient recovered well after intravenous antimicrobial therapy. Acinetobacter lwoffii is emerging as a pathogen in both hospital and community settings