Validity of quantitative unspun urine microscopy, dipstick test leucocyte esterase and nitrite tests in rapidly diagnosing urinary tract infections

OBJECTIVES

Rapid diagnostic tests can screen out negative samples and can save valuable time and money. The study was conducted to assess the usefulness of leukocyte esterase, nitrate reductase and quantitative microscopic unspun urine wet mount examination in rapidly diagnosing urinary tract infections (UTI).

METHODS

Four hundred and fifty samples were tested by semi-quantitative culture on cysteine lactose electrolyte deficient medium, microscopic examination of unspun urine for significant pyuria, dipstick leucocyte esterase test (LET) and nitrite test (NT). Culture was used as gold standard to evaluate the performance of direct microscopy and dipstick tests.

RESULTS

Urine culture examination revealed significant bacteriuria (>10(5) cfu/ml) 98 (21.8%), in urine samples. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic odds ratio (DOR) of the dip-stick LET were 73.5%, 58.5%, 33.0%, 88.8%, and 3.9 respectively; those of the dip-stick NT were 57.1%, 78.7%, 42.7%, 86.8%, and 4.9 respectively; and those for microscopic significant pyuria detection were 68.4%, 60.8%, 32.7%, 87.3%, and 3.4 respectively. Highest sensitivity (95.9%), NPV (97.9%) and DOR (25.7) was obtained on combining microscopy and dip-stick LET and NT (either of them positive). This can potentially cut costs by 79%.

CONCLUSION

Quantitative unspun urine wet mount microscopy and dipstick tests for leucocyte esterase and nitrite test should be added into routine laboratory practices for faster diagnosis of UTI.

The efficacy of Echinacea in a 3-D tissue model of human airway epithelium

We evaluated the antirhinovirus efficacy of a standardized preparation of Echinacea purpurea (Echinaforce) in a 3-dimensional organotypic model of normal human airway epithelium (EpiAirway tissue). Individual replicate tissue samples, maintained as inserts in culture for 3 days or 3 weeks, were infected with rhinovirus type 1A (RV1A), Echinacea alone, a combination of the two, or medium only. None of the treatments affected the histological appearance or integrity of the tissues, all of which maintained a high level of cell viability and preservation of cilia. RV infection resulted in increased mucopolysaccharide inclusions in the goblet cells, but this feature was reversed by Echinacea treatment. This result was confirmed by measurements of mucin secretion, which was stimulated by RV but reversed by Echinacea, suggesting that mucus production during colds could be ameliorated by Echinacea. We did not find evidence of virus replication, although the RV-infected tissues secreted substantial amounts of the pro-inflammatory cytokines IL-6 and IL-8 (CXCL8), and this response was reversed by Echinacea treatment. These results confirmed previous findings derived from studies of bronchial and lung epithelial cell lines, namely, that RV infection results in a substantial inflammatory response in the absence of virus replication.

Higher moments of net proton multiplicity distributions at RHIC

We report the first measurements of the kurtosis (κ), skewness (S), and variance (σ2) of net-proton multiplicity (Np-Np) distributions at midrapidity for Au+Au collisions at square root of s(NN)=19.6, 62.4, and 200 GeV corresponding to baryon chemical potentials (μB) between 200 and 20 MeV. Our measurements of the products κσ2 and Sσ, which can be related to theoretical calculations sensitive to baryon number susceptibilities and long-range correlations, are constant as functions of collision centrality. We compare these products with results from lattice QCD and various models without a critical point and study the square root of s(NN) dependence of κσ2. From the measurements at the three beam energies, we find no evidence for a critical point in the QCD phase diagram for μB below 200 MeV.

Three-particle coincidence of the long range pseudorapidity correlation in high energy nucleus-nucleus collisions

We report the first three-particle coincidence measurement in pseudorapidity (Δη) between a high transverse momentum (p⊥) trigger particle and two lower p⊥ associated particles within azimuth |Δϕ|<0.7 in square root of s(NN)=200 GeV d+Au and Au+Au collisions. Charge ordering properties are exploited to separate the jetlike component and the ridge (long range Δη correlation). The results indicate that the correlation of ridge particles are uniform not only with respect to the trigger particle but also between themselves event by event in our measured Δη. In addition, the production of the ridge appears to be uncorrelated to the presence of the narrow jetlike component.

A new marker of carotid atherosclerosis in middle aged adults: cystatin C or microalbuminuria

OBJECTIVE

Cystatin C and microalbuminuria, the new markers of atherosclerosis, have been shown to predict cardiovascular outcome in older individuals. However there is limited data regarding their role in middle aged individuals with preserved renal functions. Hence this study.

METHODS

Patients aged 45 to 65 years irrespective of presence or absence of diabetes, hypertension or coronary artery disease were subjected to high resolution B mode ultrasonography for carotid artery intimal-medial complex thickness (IMT). Patients with maximal intimal-medial complex thickness greater than 800 microm at the far wall of the common carotid artery, excluding raised lesions and plaques, were selected for the study. Study participants were subjected to biochemical tests for serum cystatin-C, serum creatinine, glomerular filtration rate (GFR) and for presence of microalbuminuria. The relationship of carotid artery intimal-medial complex thickness with serum cystatin C and microalbuminuria was compared.

RESULTS

The mean carotid IMT of the study group was 928 +/- 117 microm. Carotid IMT was significantly associated with advancing age, raised systolic blood pressure, ESR, GFR, LDL cholesterol and microalbuminuria but not with cystatin C. Carotid IMT has significant association with systolic blood pressure but not with diastolic blood pressure. There was a statistically significant difference in ESR across tertiles (p < 0.05). There was a statistically significant difference in GFR across tertiles (p < 0.05) and an inverse relationship was found between GFR and IMT. Carotid IMT was positively and significantly correlated with microalbuminuria but there was no significant correlation of carotid IMT with serum cystatin C.

CONCLUSION

Microalbuminuria was found to be associated with carotid atherosclerosis in middle aged individuals. However cystatin C was not associated with carotid atherosclerosis in patients with preserved renal functions.

Group dynamics and social interaction in a South Asian online learning forum for faculty development of medical teachers

BACKGROUND

Group dynamics of online medical faculty development programs have not been analyzed and reported in literature. Knowledge of the types of content of posted messages will help to understand group dynamics and promote participation in an asynchronous learning environment. This paper assesses group dynamics and social interactivity in an online learning environment for medical teachers in the South Asian context.

METHODS

Participants of a medical education fellowship program conducted by the Foundation for Advancement of International Medical Education and Research (FAIMER) Regional Institute at Christian Medical College, Ludhiana (CMCL) in India interact on a listserv called the Mentoring-Learning Web (ML-Web). Monthly topics for online discussion are chosen by fellows through a standard tool called "multi-voting". Fellows volunteer to moderate sessions and direct the pace of the discussion. We analyzed the content and process of the discussion of one particular month. The emails were categorized as those that reflected cognitive presence (dealing with construction and exploration of knowledge), teacher presence (dealing with instructional material and learning resources), and social presence, or were administrative in nature. Social emails were further classified as: affective, cohesive and interactive.

RESULTS

Social emails constituted one-third of the total emails. Another one-quarter of the emails dealt with sharing of resources and teacher presence, while cognitive emails comprised 36.2% of the total. More than half of the social emails were affective, while a little less than one-third were cohesive.

CONCLUSION

Social posts are an inevitable part of online learning. These posts promote bonding between learners and contribute to better interaction and collaboration in online learning. Moderators should be aware of their presence and use them as tools to promote interactivity.

Functional hierarchy and reversibility within the murine spermatogenic stem cell compartment

Stem cells support tissue maintenance by balancing self-renewal and differentiation. In mice, it is believed that a homogeneous stem cell population of single spermatogonia supports spermatogenesis, and that differentiation, which is accompanied by the formation of connected cells (cysts) of increasing length, is linear and nonreversible. We evaluated this model with the use of lineage analysis and live imaging, and found that this putative stem cell population is not homogeneous. Instead, the stem cell pool that supports steady-state spermatogenesis is contained within a subpopulation of single spermatogonia. We also found that cysts are not committed to differentiation and appear to recover stem cell potential by fragmentation, and that the fate of individual spermatogonial populations was markedly altered during regeneration after damage. Thus, there are multiple and reversible paths from stem cells to differentiation, and these may also occur in other systems.

Bidirectional modulation of isoflurane potency by intrathecal tetrodotoxin and veratridine in rats

BACKGROUND AND PURPOSE

Results from several studies point to voltage-gated Na(+) channels as potential mediators of the immobility produced by inhaled anaesthetics. We hypothesized that the intrathecal administration of tetrodotoxin, a drug that blocks Na(+) channels, should enhance anaesthetic potency, and that concurrent administration of veratridine, a drug that augments Na(+) channel opening, should reverse the increase in potency.

EXPERIMENTAL APPROACH

We measured the change in isoflurane potency for reducing movement in response to a painful stimulus as defined by MAC (minimum alveolar concentration of anaesthetic required to abolish movement in 50% of subjects) caused by intrathecal infusion of various concentrations of tetrodotoxin into the lumbothoracic subarachnoid space of rats, and the change in MAC caused by the administration of a fixed dose of tetrodotoxin plus various doses of intrathecal veratridine.

KEY RESULTS

Intrathecal infusion of tetrodotoxin (0.078-0.63 microM) produced a reversible dose-related decrease in MAC, of more than 50% at the highest concentration. Intrathecal co-administration of veratridine (1.6-6.4 microM) reversed this decrease in a dose-related manner, with nearly complete reversal at the highest veratridine dose tested.

CONCLUSIONS AND IMPLICATIONS

Intrathecal administration of tetrodotoxin increases isoflurane potency (decreases isoflurane MAC), and intrathecal administration of veratridine counteracts this effect in vivo. These findings are consistent with a role for voltage-gated Na(+) channel blockade in the immobility produced by inhaled anaesthetics.

Standardized cannabis in multiple sclerosis: a case report

A 52 year old female suffering from severe progressive multiple sclerosis was administered quantifiable amounts of standardized cannabis and monitored over the period of one year, while providing daily pain charts and records of her condition. An average daily intake of 500 mg of Tetrahydrocannabinol as cannabis was required to achieve a desired quality of life.