Comparative evaluation of various diagnostic techniques for detection of Cryptosporidium infection from the faecal samples of diarrhoeic bovine calves

BACKGROUND

Cryptosporidium, an opportunistic, zoonotic, apicomplexan parasite, is one of the most common causes of diarrhea in neonatal bovine calves around the globe. Bovine calves act as a major source of infection by excreting huge numbers of highly resistant oocysts in faeces, which can survive for a long time in extreme environmental conditions. As low as ten oocysts can cause disease and mortality, leading to the requirement of an early and accurate diagnosis for proper and favorable prognosis, management, and control.

AIMS

The current study was conducted with the objective to evaluate various diagnostic techniques (acid fast staining, negative staining, fluorescent, ELISA, PCR, nested PCR, and qPCR) for the detection of Cryptosporidium in the faecal samples of diarrheic bovine calves.

METHODS

Two hundred diarrheic faecal samples from bovine calves were collected and subjected to these techniques for Cryptosporidium diagnosis. Results of these were evaluated for diagnostic comparison.

RESULTS

Out of 200 faecal samples evaluated, 24% (48/200) were detected positive for Cryptosporidium using a combination of two techniques as gold standard criteria. Cohen's kappa value indicated moderate to almost perfect agreement (0.616 to 0.986) among all the techniques used in the present study. Leishman staining showed the lowest sensitivity (54.17%), while nested PCR and qPCR showed the highest sensitivity (97.92%). Diagnostic specificity of all these tests ranged from 98.68 to 100%.

CONCLUSION

Auramine stain was used for the first time in the bovine calves in India for the detection and diagnostic comparison of Cryptosporidium. It showed strong agreement with the molecular as well as classical diagnostic techniques, and can be used for primary screening for better diagnosis.

Symptomatology, prognosis, and clinical findings of COVID 19 induced myocarditis: a systematic review

Background

With the advent of the novel coronavirus (COVID-19) in December 2019, numerous case studies have been reported on its impact on cardiac cells, and we purpose to perform a systematic review that explains the symptomatology, prognosis, and clinical findings of COVID-19-related myocarditis patients.

Methods

PRISMA guidelines were employed and peer–reviewed journals in English related to COVID – 19 were included. Exclusion criteria included <50 y, known heart problems. Age criteria was guided by prior systematic report by Kariyanna et al (2020). Search engines included Pubmed, Google scholar, Cochrane Central and Web of Science database using “SARS-CoV-2” or “COVID 19” and “myocarditis”. The data were analyzed and synthesized qualitatively using MS Excel PIVOT and quality was rated using the “Research and Quality Scoring Method” by Sackett and Haynes, the Jadad scale, and the items published by Cho and Bero (Han et al., 2011).

Results

A total of 22 studies on 37 patients were included; 6 were confirmed myocarditis while the rest have possible myocarditis. Among all these 62% were male and showing dominance. The most common presenting symptoms appear to be fever, chest pain, shortness of breath, and cough. Most of the patients have shown elevation in cardiac biomarkers (troponin levels, CRP, CK level, CK-MB, NT-pro BNP). Electrocardiogram changes include sinus rhythm, tachycardia, and non specific ST - segment elevation and T wave changes. Echocardiography results commonly found were left ventricular dysfunction and increased wall thickness. CMR was performed in 8 patients, with features of reduced ejection fraction, myocardial edema, and hypokinesia, whereas biopsy has been performed among 3 patients due to the invasive nature of the procedure and common findings include inflammatory biomarkers were raised. Overall Prognosis appears to be bad in which 25% of patients were not able to survive and 75% of them were recovered.

Conclusions

Myocarditis-related COVID-19 mortality continues to be high and under-estimated. The patient manifestations are identical and difficult to distinguish from COVID-19-related symptoms. Just a limited number of patients undergo confirmatory tests, such as an MRI or an endomyocardial biopsy, which may not be available. Further studies are needed to confirm and quantify the actual prognosis and outcomes of patients with COVID-19 myocarditis. Moreover, available data on the usage of glucocorticoids in the coronavirus infection is controversial to our knowledge. Corticosteroid therapy is unsuccessful in the treatment of viral myocarditis, according to a Cochrane systematic review conducted in 2013. It also allows viral clearance to be overdue. Corticosteroids, on the other hand, reduce the chance of mortality for ICU patients in Wuhan. To concede, more studies, clinical trials, and duration is needed for a thorough understanding of COVID – 19, and its impact on cardiac health

Funding Acknowledgement

Type of funding sources: Other.

Role of whole-body vibration exposure and posture of dumper operators in musculoskeletal disorders: a case study in metalliferous mines

Objectives. The combined role of whole-body vibration (WBV) exposure and awkward posture on musculoskeletal disorders (MSDs) experienced by dumper operators in two metalliferous mines in India was evaluated through a cross-sectional study. Methods. Frequency-weighted root mean square (rms) acceleration was used for WBV exposure assessment. Anthropometry and rapid upper limb assessment (RULA) were used for static and dynamic posture assessment, respectively. Prevalence of MSDs was assessed using the Nordic musculoskeletal questionnaire (NMQ). Logistic regression was used to assess the factors contributing to MSD problems. Results. The rms values revealed that the operators exceeded the lower limit of Standard No. ISO 2631-1:1997. The dynamic posture study revealed that the majority of dumper operators were taking awkward postures and 58-74% of them were subjected to high and medium levels of MSD risk. The adjusted odds ratio (7.96, 95% confidence interval [1.24, 41.35]) for the most awkward postures revealed WBV exposure as the significant risk factor for MSD problems among the operators. Conclusion. WBV exposure and posture of operators should be regularly monitored and corrective actions implemented to reduce their MSD problems. Ergonomic seat design based on the anthropometry of the operators should be assessed at the time of procuring new equipment.

Percutaneous retrieval of fractured intravascular catheters in premature infants

BACKGROUND

Premature infants often require long-term indwelling intravascular catheters. Occasionally, catheters fracture and migrate into cardiovascular structures, risking perforation, infection, thrombosis, and interference with cardiac and valve function. This case series describes our experience with percutaneous retrieval of broken intravascular catheters.

METHODS

A gooseneck micro-snare was used to retrieve fractured catheters in four premature infants, weighing between 840 and 1930 grams.

RESULTS

All procedures were successful without complications.

CONCLUSIONS

Gooseneck-snare retrieval of broken indwelling intravascular catheters can be performed safely and successfully in premature infants even those that weigh less than 1000 grams.

Supervision and Quality Control Measures in Annual Sentinel Surveillance for HIV Infection in India

The National Institute of Health and Family Welfare (NIHFW) has been entrusted by the National AIDS Control Organisation (NACO) to undertake monitoring and supervision of annual Sentinel Surveillance (ASS) activity in India since 1998, to ensure that the data obtained are valid. Earlier Regional coordinating teams cooperated with NIHFW in this task. From 2006 onwards, NACO identified five regional institutes covering all the states and Union Territories and Central team members consisting of experts from various organisations for the monitoring and supervision of the ASS cycle to ensure quality control of both epidemiological data collection and HIV testing (NACO 2006a and b). We describe here the process of quality control and observations of the ASS rounds held from 2005 to 2007. The performance of a majority of sites was satisfactory. The testing laboratories usually adhered to standard operating procedures (SOPs). Lacunae observed during the supervisory visits have been enumerated along with the recommendations for the future surveillance rounds.

Eyelid squamous cell carcinoma in xeroderma pigmentosa: a therapeutic challenge

A 10-year-old male, Muslim child diagnosed with xeroderma pigmentosa with a right upper lid malignancy presented as a therapeutic challenge because of the non-availability of normal facial skin for grafting and lid reconstruction. The lid lesion had been present for the last one month. The disease had been present for past five years with polymorphous, erythematous lesions all over the body. On examination, there was a hard reddish yellow mass in the lower lid with features of secondary infection along with corneal xerosis in both eyes. With a clinical diagnosis of malignancy, the lesion was subjected to a wide excision after the investigations. The resultant large tissue defect in the right lower lid region was managed by a full thickness trans-midline lateral forehead flap based on superficial temporal artery. Post operatively, there was a satisfactory graft uptake. The paucity of surgical options for the plastic reconstruction coupled with the large area to be reconstructed made our case worth reporting.

Depolarization of light in a multiply scattering medium: effect of the refractive index of a scatterer

We report the results of a study carried out to investigate the influence of the refractive index and size parameter of a scatterer on the depolarization of linearly and circularly polarized light in a turbid medium. The results show that for a given refractive index of the surrounding medium, the influence of the refractive index of the scatterer on the depolarization of both linearly and circularly polarized light is rather weak for samples with smaller-sized scatterers (Rayleigh scatterers, radius a<<lambda , anisotropy parameter g < or =0.2 ). For a given value of optical thickness (tau= mu(s) xd , mu(s) being the scattering coefficient, d the physical thickness), the depolarization of circularly polarized light was observed to be higher than that of linearly polarized light for these samples. In contrast, for samples prepared using larger-sized scatterers (Mie scatterers, a > or =lambda , g > or =0.7), linearly polarized light was observed to depolarize much faster than circularly polarized light when the refractive index of scatterers was large (n=1.59) but no appreciable difference in depolarization of linearly and circularly polarized light was observed when the refractive index of scatterers had a lower value (n=1.37) . Further, for scattering samples having Mie scatterers, for comparable values of tau and g , depolarization of polarized light was much higher for samples with scatterers of lower refractive index.

Surgical excision of meningiomas involving the clivus: preoperative and intraoperative features as predictors of postoperative functional deterioration

Neurological deterioration is commonly seen after surgical excision of clival meningiomas; however, an understanding of the risk factors associated with postoperative deterioration can lead to improvements in outcome. In 75 patients with clival meningiomas operated on over a 7-year period, the following data were studied; preoperative variables such as presenting Karnofsky scale score, age, sex, and prior operations or radiation therapy. Radiological findings on magnetic resonance imaging or arteriography, such as the development of the arachnoidal cleavage plane between tumor and the brain stem, brainstem edema, tumor size, extent of compression on the brain stem, vascular encasement, and blood supply from the basilar artery were among other data studied. In addition, intraoperative findings such as development of the arachnoid plane, vascular encasement, and the difficulty of dissection were noted. Finally, each patient's neurological and functional statuses were recorded at 1 week postoperatively and at follow-up examinations. Early postoperative functional deterioration occurred in 45 patients (60%) and ranged from mild (30 patients) to severe (three patients). Significant improvement had occurred by the time of follow-up examination in all but four patients; however, permanent postoperative dysfunction was present in 12 patients. Statistical analysis revealed significant correlations between early functional deterioration and preoperative Karnofsky scale scores, male gender, radiological findings of the absence of an arachnoid plane, edema of the brain stem, and arteriographic supply from the basilar artery. Operative features included difficulty with dissection, an absent arachnoidal cleavage plane, and incomplete tumor resection. Permanent functional deterioration was statistically associated with the following: blood supply from the basilar artery, difficulty of dissection, incomplete tumor resection, and early postoperative dysfunction. Logistical regression analysis revealed that the most important risk factor for early postoperative deterioration was tumor size. Patients with large or giant tumors had a 6.7 to 13 times greater risk of functional deterioration, respectively, than patients with small- or medium-sized tumors. Excluding tumor size, the most important factor for permanent deterioration was blood supply from the basilar artery. Patients in this category had a 4.4 times greater risk of permanent functional deterioration. Three stages of tumor relationship to the brainstem arachnoid and pial membranes are proposed. Based on the results of this clinical study of clival meningiomas, suggestions are made for changes in the management strategy of these difficult lesions.

Cytodiagnosis of rhinosporidiosis

Two clinically suspected cases of nasal rhinosporidiosis were studied cytologically using a wipe out technique. The smears showed the typical spores of the fungus and the cytological diagnosis of rhinosporidiosis was confirmed by excisional biopsy. The smear is recommended as a routine preliminary screening technique in the diagnosis of suspected cases of rhinosporidiosis.

"Shankha prakshalana" (gastrointestinal lavage) in health and disease

Shankha Prakshalana is an easy and effective technique for cleansing the gastrointestinal canal, thereby removing all the autointoxicants present in the alimentary canal. Moreover, it is a very economical procedure which can be performed by the patients at his own residence. The role of Shankha Prakshalana from our own experience is very effective in overcoming the irritable bowel syndrome. Shankha Prakshalana may also be given to the patients of anxiety neurosis with satisfactory results. Its role in the treatment of renal disorder is encouraging in early cases only. However, in the second and third degree chronic renal failure cases its role is yet to be established and needs further investigation. Similarly, in the case of thyrotoxicosis no conclusive evidence could be observed due to very limited number of cases.

Effect of thermal environment and caloric intake on head growth of low birthweight infants during late neonatal period

In order to assess the effects of ambient thermal conditions on postnatal head growth in low birth weight infants, 42 asymtomatic neonates were reared under 4 combinations of caloric intake and thermal environment after the first week of life. Exposure to a subthermoneutral temperature (abdominal skin temperature of 35 degrees C), together with a relatively low caloric intake (120 cal/kg per day), was associated with significant retardation of head growth over a 2-week study period.

Pattern of orbital exenteration at a tertiary eye care centre in North India

Objective: To analyze cases undergoing orbital exenteration in terms of demographic and socioeconomic profile of patients, indications for surgery, histopathological diagnosis and to assess the magnitude of eyelid malignancies as indication of orbital exenteration. Materials and methods: A case record analysis of 25 patients who underwent orbital exenteration at a tertiary care centre in India between October 2002 and October 2007 was undertaken. The case records were reviewed to obtain demographic data, presenting symptoms, duration of symptoms, laterality, best-corrected visual acuity (BCVA), and the clinical and histopathological diagnosis. Results: The age group of patients undergoing exenteration ranged from 1 year to 78 years (Mean 46.92 ± 10 years). Proptosis and/or a palpable mass were the main presenting complaints in 80 % of cases. The duration of symptoms was more than 5 years in 80 % cases. Primary orbital malignancies were the commonest indication for exenteration and were diagnosed in 11cases (44 %), followed by lid malignancies in 8 cases (32 %), retinoblastoma in 4 cases (16 %) and conjunctival malignancies in 2 cases (8 %). Sebaceous gland carcinoma was the commonest lid malignancy followed by basal cell carcinoma and squamous cell carcinoma. Conclusion: Lid malignancies contribute the majority of the patients undergoing orbital exenteration in this part of the world, leading to an extreme sacrifice of eyes with good visual acuity. Increase in awareness, early diagnosis and prompt referral may help to overcome this grim scenario. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5853 NEPJOPH 2012; 4(1): 64-67