ABSTRACT: Infectious endophthalmitis is the inflammatory involving the ocular cavity and is commonly caused by bacteria and fungi. It can be classified according to the mode of entry, type of etiological agent and location in the eye. Postoperative endophthalmitis occurs after any surgical procedure resulting in a communication between the interior of the eye and the external environment, the source of infection commonly being the periocular flora of the patient. Gram positive bacteria account for largest number of cases followed by Gram negative bacteria and fungi Staphylococcus epidermidis is the predominant causative agent. A chronic, low grade, delayed-onset post-operative endophthalmitis is typical of Propionibacterium acnes endophthalmitis. Post-traumatic endophthalmitis is mainly caused by Bacillus cereus. Endogenous endophthalmitis is most often fungal with Candida albicans being the most common agent. Etiological diagnosis of suspected endophthalmitis is essential to establish appropriate and timely treatment for a successful visual outcome. Culture of intra-ocular specimens is the gold standard but molecular techniques such as PCR have been found to be more sensitive in detection of the infectious agent. Early identification and antimicrobial susceptibility pattern of the agent can help in prompt treatment of endophthalmitis, which consists of intravitreal antimicrobials and vitrectomy.

ABSTRACT: The incidence of fungal infections has increased dramatically over the past few decades due to the increase in the numbers of the population susceptible to such infections. Newer antifungal agents have increased the therapeutic options thereby leading to the demand for in vitro determination of antifungal susceptibility. But the application of in vitro antifungal susceptibility testing in clinical research and to guidance of antifungal therapy has been limited by a lack of reproducibility and uncertain clinical relevance. NCCLS has described a standardized antifungal susceptibility test method M27A which has good inter and intralaboratory reproducibility. A modification of this method for susceptibility testing of filamentous fungi appears promising. Correlation between MICs determined by this method with clinical response to therapy are beginning to emerge, most notably in relation to fluconazole therapy for oropharyngeal candidosis associated with infection with HIV. Although considerable work remains to be done, the available data suggest that routine susceptibility testing of fungi will become meaningful for clinical decision making in the foreseeable future.

ABSTRACT: A prospective study of 3280 surgical wounds was conducted. All the wounds were examined for the presence of infection; those with infection were studied bacteriologically. The overall infection rate was 6.09 percent. The infection rate in wounds following clean surgeries was 4.04 percent while in those following clean contaminated surgeries was 10.06 percent. The increase in the pre-operative hospitalization was associated with a significant rise in the rate of wound infection. There was a significant increase in the rate of infection as the duration of surgery increased. The rate of infection in emergency surgeries was not significantly higher than that in planned, elective surgeries. The infection rate was highest in post-appendicectomy wounds and lowest in the wounds following hydrocele surgeries. The infection rate was less in patients who received pre-operative antibiotics. The most common isolate in clean surgical wounds was Klebsiella pneumoniae followed by Staphylococcus aureus and Pseudomonas aeruginosa, suggesting the emergence of K. pneumoniae as a hospital acquired pathogen. The strains were resistant to the commonly used antibiotics.

ABSTRACT: From 63 clinically suspected cases of gas gangrene confirmation of the3 diagnosis of gas gangrene by laboratory findings was obtained in 8 cases. Of this, Clostridium perfringens was isolated from 4 cases (50 percent); Clostridium septicum from 2 cases (25 percent), while Clostridium oedematiens (12.5 percent) and Clostridium sporogenes (12.5 percent) were isolated from single case each. Three cases were diagnosed as anaerobic streptococcal myositis. From two cases black pigmented Bacteroides were isolated. Polymicrobial flora was observed in one case in which Clostridium perfringens was associated with Klebsiella pneumoniae. No organism (either aerobe or anaerobe) was isolated in 11 cases. In the remaining 39 culture positive cases which did not yield growth of any anaerobe, the common isolates were Proteus sp. K.pneumoniae, Escherichia coli and Staphylococcus aureus in various combinations. Hence it is important to know the aetiological agents to institute specific therapy, to reduce morbidity and mortality.

ABSTRACT: The present study was aimed to assess hepatitis B virus (HBV) carriage in 156 resident doctors. Three hundred and forty three voluntary blood donors acted as control. The carriage of HBV was assessed by testing for hepatitis B surface antigen (HBsAG) by an enzyme immuno-assay (EIA). The carriage rate (6.42 percent) in residents was significantly higher than that in control group. Residents working in surgical units showed a high HBV carriage. The high carriage suggests an additional risk of acquiring patient care in the study group. The study highlights the need to vaccinate health care workers (HCW) with hepatitis B vaccine and strict adherence to the biosafety measures.

ABSTRACT: Helicobacter pylori infection is currently diagnosed by urease test, smear and culture. Many serological tents have been introduced recently. The present study was conducted to evaluate a commercially available ELISA test with standard methods. Significant titres were seen in 53.3 percent cases while urease test, Gram stain and culture were positive in 61.2 percent, 26 percent and 22.5 percent cases respectively. ELISA test was found to be highly sensitive with a good negative predictive value making it a good test for screening.

ABSTRACT: The laboratory performance of a commercially available `rapid' HCV antibody (anti-HCV) assay (MT-HCV/Ulti-Med Anti-HCV, Pharma Health BVBV, Belgium, marketed in India by Rapid Diagnostics Pvt. Ltd, New Delhi) was evaluated. The assay was initially evaluated with a panel of 100 sera comprising 70 negatives and 30 positives. The assay yielded a sensitivity of 100 percent and specificity of 100 percent. However when the assay was subsequently evaluated against another 186 sera, received at the laboratory for routine determination of anti-HCV antibody , the specificity remained at 100 percent while the sensitivity dropped to 95 percent on the cumulative panel. The `gold standard' used for evaluation was a third generation microparticle enzyme immunoassay (IMX)/Axsym, Abbott Laboratories, USA). The fall in sensitivity while using a larger evaluation panel can be explained by (i) chance variation (ii) inadequate representation of antigens on the rapid devices. The study emphasizes the need for testing larger and different kinds of population groups before any rapid assay can be approved for use as a screening test.

ABSTRACT: To provide a base-line data on seroprevalence of Chlamydia trachomatis, serum samples from 114 school going girls (aged 8-15 yrs) were tested for anti-Chlamydia trachomatis IgG and IgA antibodies using commercial enzyme immuno assay kits. The seroprevalence rate in this population was compared with women (n=58) with secondary infertility (group 2) and women with bad obstetric history (BOH) (n=30) (group 3). The results showed that the infection is highly prevalent in young children (28.1 percent) but significantly less than women with secondary infertility in whom it was as high as 48.3 percent (p0.001). Specific IgA antibodies were present in 37.9 percent women as compared to 19.3 percent in girls (p001). Mean OD values of specific IgG and IgA antibodies were also significantly high in women with secondary infertility than women with BOH. Seroprevalence in women with BOH was not significantly higher than girls. Specific IgA antibodies were detected in the vaginal fluids of six married women among 22 serum IgG positive women with BOH was not significantly higher than girls. Specific IgA antibodies were detected in the vaginal fluids of six married women among 22 serum IgG positive women with secondary infertility while only one out of 6 women with BOH was positive for this secretary antibody. This preliminary study indicates that this infection can transmit from person-to-person through non-sexual modes also.

ABSTRACT: A treated case of cerebral aspergilloma recurred after 5 years as orbital aspergillosis. After an apparent cure it again recurred after 7 years. This time the fungus involved ramus of the mandible and adjacent tissue and presented as cervico-racial actinomycosis. As soon as the aetiological agent was identified as Aspergillus flavus the case as considered as a rare example of endogenous eumycetoma with involvement of mandible by Aspergillus sp.(146-147)

ABSTRACT: Filariasis, a mosquito borne parasitic infection is endemic in many parts of India. A 16-year-old female presented with a swollen left eye. Ocular fluid examination from anterior chamber was exudative in nature and showed presence of adult Wuchereria bancrofti.

ABSTRACT: A case of entomophthoromycosis caused by Conidiobolus coronatus was refractory to prolonged treatment with oral potassium iodide and ketoconazole but responded well when antifungal drugs were used along with systemic steroids. Steroid therapy probably helped to remove the barrier for the target action of the drugs.