ABSTRACT: Hepatitis C virus (HCV) is usually transmitted parenterally. It accounts for 75 percent-90 percent of post transfusion non-A, non-B hepatitis (PTNANBH) cases in centres where only Hepatitis B virus-free blood is transfused. Sexual and vertical transmission of HCV also occurs. In nearly 50 percent of patients with acute HCV hepatitis, the mode of transmission is still not known. The identification of HCV was based exclusively on molecular biological techniques. The HCV genome bears similarity to Flaviviridae and shows some heterogeneity. Physico-chemical properties of this virus suggest that it is enveloped and of a size of 30-60 nm. The incubation period if HCV hepatitis infection is 6-12 weeks, with a mode of 7 to 8 weeks. The onset of acute hepatitis is usually insiduous and the course of illness usually mild, but more than 50 percent develop chronic infection. the spectrum of consequences of chronic infection range from no clinical disease to chronic hepatitis (chronic active or chronic persistent), cirrhosis and hepatocellular carcinoma. Early laboratory diagnosis of HCV can be made using the reverse transcriptase polymerase chain reaction to detect HCVRNA in serum. with the onset of clinical illness, these is a moderate elevation of serum amino transferase levels which in chronic disease shows a typical fluctuating profile. Time of HCV seroconversion is variable, but antibodies may be detectable by the currently available second generation Enzyme immunoassay (EIA) 7-8 weeks after infection. the supplemental serological test to EIA is the recombinant immunoblot assay (RIBA). treatment is primarily with alpha-interferon. The HCV carrier rate in our population appears to be low. In a preliminary study screening 2,700 blood bank donors in CMC hospital, Vellore, 0.48 percent were found to be HCV seropositive. HCV seropositivity among multi transfused patients (eg. haemophilias, renal transplant) patients ranges from 7.2 to 37.5 percent; among chronic liver disease patients it is 15 percent -80 percent; coinfection with HBV and HCV are not uncommon.

ABSTRACT: A new enzyme immunoassay (Imzyme M-TP, Fujirebiu, Japan) for detecting IgM antibodies against Treponema pallidum was evaluated. Serum samples from 126 patients, 102 with various stages of untreated syphilis, 12 with treated syphilis and 12 from antenatal cases, were investigated. All sera were also examined by Veneral Disease Research Laboratory (VDRL) test and Treponema Pallidum Haemagglutination Assay (TPHA). In all diagnostic groups of syphilis the reactivity of IgM-EIA was similar to that of VDRL and TPHA except in latent syphilis. False positive IgM-EIA results were not found in 12 antenatal cases who gave false positive VDRL reactions. This indicated that IgM-EIA was very specific. All serum samples from treated patients were non reactive in the IgM-EIA 6 months after treatment. In conclusion, IgM-ELA can be a useful test in early stages of syphilis, for screening of congenital syphilis and for treatment monitoring.

ABSTRACT: Bacteroides fragilis group is the most frequently encountered anaerobic bacteria in human infections. In the present study a total of 1643 specimens yielded 347 strains of B. fragilis group (21.12 percent). Out of 800 anaerobic bacteria isolated in the study, majority were the members of B.fragilis group (347/800 i.e., 43.38 percent). B.fragilis group constituted a significant percentage of anaerobic isolates from cases of diabetic foot ulcer (41.3 percent), various suppurative lesions (35.59 percent), brain abscess (28.33 percent), pulmonary infection (28.24 percent), CSOM (24.17 percent), and chronic bacterial prostatitis (18.07 percent). The identification of B.fragilis group was based on morphology, biochemical and antibiotic sensitivity patterns. Among the species of B.fragilis group, B.fragilis was isolated in 50.79 percent of cases, followed by B. thetaiotamicron 19.02 percent.

ABSTRACT: Microscopic examination of stool samples obtained from 128 residents of South-East Los Angeles showed protozoa in 38 [29.7 percent] and helminths in 44 [34 percent], but this population were asymptomatic. Their ethnic composition included, Hispanics 52.3 percent, African-American, 45.3 percent and 2.3 percent others. The mean prevalence of infections among these populations were: Ascaris lumbricoides 38 [27.5 percent], Giardia lamblia 30 [21.7 percent], Entamoeba histolytica 8 [6.2 percent] and Trichostrongylus 6 [4.7 percent]. Parasitic examination of the stool is recommended seriously in clinical practice of city and community hospitals that cater to the health needs of indigent population.

ABSTRACT: An External Quality assessment Scheme (EQAS) in microbiology was organized for clinical microbiology laboratories in hospitals with departments of medicine, surgery, obstetrics and paediatrics. Currently 29 institutions are EQAS participants. Every 3 months, the laboratories are sent packages containing material for testing and reporting. After 6 rounds of distribution and reporting, the performance of the participating laboratories were reviewed and the results are included in this paper. In the Ziehl-Neelsen staining and reporting and serology the participating laboratories performed very well but many missed identifying cultures of S. typhi, Pneumococci, and E. coli-S. aureus mixture.

ABSTRACT: A total of 19023 blood donors were screened for HIV antibodies by ELISA from 1987 to 1993. One hundred and five donors were found to be positive (0.55 percent). The seropositivity increased from 0.43 percent in 1987 to 1.14 percent in 1993. Most of the donors (15219) were replacement donors (79.5 percent), of whom 90 (0.59 percent) were positive. Among professional donors screened the seropositivity was the highest (0.67 percent).

ABSTRACT: Klebsiella pneumoniae is not an intracellular pathogen and hence iron is not readily accessible to this organism in the body. To circumvent their in vivo iron restriction K.pneumoniae produces siderophores i.e. enterochelin and aerobactin, which are capable of removing iron from host iron-binding proteins. In the present study it was observed that almost all the clinical isolates of K.pneumoniae produced enterochelin (98.6 pre cent) whereas the percentage of aerobactin producers was only 65.78. A large number of urinary isolates elaborated aerobactin (82.9 per cent) which shows that there might be a positive correlation between nephropathogenicity and aerobactin production.

ABSTRACT: Clinically suspected 254 cases of bacteraemia in neonates admitted to Neonatology unit of Niloufer hospital, Hyderabad. were evaluated by blood culture and rapid diagnostic tests viz., total neutrophil count, immature to total neutrophil (I:T) ration, C-reactive protein assay (CRP), nitroblue tetrazolium test (NBT) and acridine orange stained buffy coat smear (AOS) using fluorescent microscope. Blood culture was positive in 119 (47 percent) of cases. Escherichia coli was the commonest organism isolated in 49 (41.2 percent). The rapid diagnostic tests were evaluated in blood culture positive and blood culture negative cases. it was found that CRP had the highest sensitivity; AOS had the highest specificity and the highest positive predictive accuracy. The sensitivity. specificity and positive predictive accuracy of combination of three tests namely (CRP, NBT and AOS) were better compared to the results of each test.

ABSTRACT: A total number of 247 hospital staff working high risk department of the Nizam's Institute of Medical Sciences were vaccinated with recombinant Hepatitis B vaccine (Engerix V, Smith & Kline, Germany). The sero conversion was assessed by testing antibody to HBsAg in 147 subjects after each dose and in another 100 subjects a month after third dose. The antibody positivity was 12 percent, 15 percent and 98 percent after the first, second and third doses, respectively. the range of antibody levels was 14.7-82.5 mlU/ml, 10.4-185.5 mlU/ml and 27.1-807.2 mlU/ml respectively in the 3 doses. In 72 persons the third dose was delayed by 2-8 months due to various reasons, yet the protective antibodies were observed in 97 percent of the subjects. The vaccine was well accepted with minimal reactions. It is concluded that the recombinant HBV vaccine is effective, safe, highly immunogenic and well tolerated.

ABSTRACT: Bacteriologically proved case of brucella arthritis is reported in a child of 12 years. The patient presented with the fever, pain and swelling in the right knee joint. Blood and synovial fluid cultures yielded Brucella melitensis biotype 1. It is the first report of isolation of Br. melitensis from synovial fluid from India.

ABSTRACT: Coccidioides immitis is a well known pulmonary pathogen, but so far, only one human case has been reported from the Indian subcontinent. A young sailor manifested with chest symptoms and haemoptysis. Bronchoscopic lavage revealed septate fungal hyphae and culture led to the isolation of a fungus which mimicked C.immitis in colony character and arthroconidial morphology. Subsequent studies led to its identification as Malbranchea sulfurea. Review of literature revealed that a number of isolates of Malbranchea have been misidentified as C.immitis in different parts of the would. This is the first case of Malbranchea isolation form bronchial aspirate in India. Awareness of similarities between C. immitis and Malbranchea is essential to avoid misdiagnosis.