Background:We recently described the utility of the "TB Concentration & Transport" kit for biosafe, ambient temperature transport of dried sputum on Trans-Filter, and the "TB DNA Extraction" kit for DNA extraction from Trans-Filter for the early diagnosis of drug-resistant tuberculosis (TB). This study aimed to assess the feasibility and compatibility of these kits with line probe assay (LPA) under National Tuberculosis Elimination Programme (NTEP) settings. Methods:Patients with presumptive pulmonary TB, multidrug-resistant (MDR) TB, or extensively drug-resistant TB (N = 8491) who attended Designated Microscopy Centers (DMCs, n = 13) under National Reference Laboratories (NRLs) at Bhopal, New Delhi, Chennai, and Bhubaneswar were screened by smear microscopy. The performance of Trans-Filter extracted DNA-based LPA (Kit-LPA) was assessed against Direct-LPA on smear-positive sputum (n = 681), and feedback was obtained from scientists (n = 10) and laboratory technicians (n = 42) regarding logistics, kit usage, training, and troubleshooting. A scoring questionnaire was used to assess (i) the TB Concentration & Transport kit versus conventional sputum transport and (ii) the TB DNA Extraction kit versus Hain GenoLyse kit (statistical significance of the scores was calculated using paired t test). Results:Kit-LPA showed a sensitivity and specificity in the range of 89%-96% and 99%-100%, respectively, for rifampicin and isoniazid resistance detection and was comparable to Direct-LPA (concordance = 99%-100%; κ = 0.94-0.97). Overall scores indicated that (i) sputum transport on Trans-Filters was more convenient as compared to conventional sputum transport (P < .0001) and (ii) Trans-Filter extracted DNA was easily amalgamated with LPA testing for MDR-TB detection. Conclusions:These findings provide evidence for incorporation of these kits into the NTEP. Their use can facilitate sputum transport from DMCs to NRLs and provide universal drug susceptibility testing to people with TB residing in remote areas.
Background Sepsis is a severe condition resulting from a dysregulated immune response to infection, often leading to organ failure and high mortality rates. Septic shock, the most severe form, has a mortality rate of 25–40% despite standard treatments. Aim To evaluate the impact of intravenous vitamin C on improving clinical outcomes in septic shock patients. This study aims to assess the effectiveness of high-dose intravenous vitamin C as a supplementary therapy in patients with septic shock. Methods A prospective, interventional study was conducted on 50 septic shock patients in the critical care unit (CCU) of a multispecialty hospital in Hyderabad, India. Patients were randomly assigned to two groups: the test group received intravenous vitamin C, while the control group received standard care. Data collected included demographics, comorbidities, infection source, blood culture results, vasopressor use, length of CCU stay, and MAP levels. SOFA and APACHE II scores were calculated before and after treatment. Data analysis was done using Microsoft Excel and SPSS version 26. Results The test group showed improvement in clinical outcomes, including reduced 30-day mortality, better APACHE II and SOFA scores, shorter ICU stays, and decreased vasopressor duration compared to the control group. Conclusion Intravenous vitamin C may help resolve septic shock more rapidly. However, due to the study’s small sample size and short duration, further research is needed to confirm the benefits of vitamin C in managing septic shock.
BACKGROUND:Worldwide, Acinetobacter species is a multidrug-resistant (MDR) nosocomial pathogen capable of acquiring or upregulating resistant determinants thereby effecting drug efficacy. Resistance to Carbapenems causes high morbidity and mortality. The study aims to know prevalence of carbapenemase producing genes in Acinetobacter spp., and understand the local epidemiology of carbapenem-resistant Acinetobacter spp. in a tertiary care hospital in India. METHODS:Carbapenem-resistant Acinetobacter isolates from clinical samples were analysed to identify the resistance mechanism to carbapenem drugs viz. ertapenem, meropenem and doripenem. The Multiple antibiotic resistance (MAR) index with reference to Carbapenems was calculated. Quantitative PCR was performed to investigate prevalence of antimicrobial resistance encoding bla genes (NDM, VIM, KPC, OXA-23, OXA-48, OXA-58, OXA-51). The frequency and prevalence of the different genes in various health care area of the hospital was identified. RESULTS:Seventeen (41.46 %) Acinetobacter isolates were multidrug-resistant (MDR) isolates and nine (21.95 %) were extensively drug-resistant (XDR) to carbapenem drugs. Twenty-two (53.65 %) isolates were from the intensive care unit. Majority of the Acinetobacter isolates with Multiple Antibiotic Resistance (MAR) indices greater than 0.2 were isolated from patients admitted to the intensive care unit. The frequencies of distribution of antimicrobial resistance genes for blaNDM and blaOXA-23 like were 84.62 % respectively; blaOXA-51 like was 76.92 %; blaVIM 73.08 % and blaOXA-48 like was 61.54 %. Many antibiotic-resistant genes were found co-existent in multiple isolates. No pan drug resistant strain was detected. CONCLUSION:The major carbapenemase genetic determinants circulating especially in the hospital intensive care unit during the period of the study were blaNDM, blaOXA-23 like, blaOXA-51 like and blaVIM.
Purpose:Clinical evidence suggests that patients with chronic hepatitis B (CHB) have an increased risk of renal impairment due to inflammation induced by virus-host interaction. We aimed to evaluate and validate a set of protein biomarkers singularly and in combination for the early detection of subclinical kidney injury in patients with CHB naive to antiretroviral therapy. Methods:This work is part of a prospective cross-sectional study for which 69 HBsAg-positive, treatment-naive patients with CHB with an equal number of age-matched healthy volunteers were considered. At diagnosis, serum creatinine (sCr), urea, alanine transaminase, aspartate transaminase, serum cystatin-C (sCys-C), serum neutrophil gelatinase-associated lipocalin (sNGAL), serum Fetuin-A (sFet-A), urinary interleukin-18 binding protein (uIL-18BP), and urinary kidney injury molecule-1 (uKIM-1) levels were determined. Results:There was a significant elevation in the concentrations of three proteins in our CHB cohort (sCys-C, sNGAL, and uIL-18BP; p < 0.0001) while sFet-A was down-regulated (p<0.01) as compared to the control group. A receiver operating characteristic curve analysis revealed an Area under the curve of 0.935 for sCys-C and 0.811 for sNGAL, which improved to 0.984 when all four indicators were combined in a panel to discriminate the onset of renal injury incited by inflammatory response in CHB with 97.1% sensitivity at 91.3% specificity. Additionally, only sCys-C and sNGAL differed significantly among the phases of CHB infection (p<0.05). Conclusions:This novel noninvasive diagnostic screen is expedient in detecting inflammation and early kidney injury before a rise in sCr and can aid in predicting renal outcomes in patients with CHB.
Amaranthus is considered a superfood with high nutraceutical value. It is a functional food composed of bioactive compounds crucial for sports nutrition including secondary metabolites, tocopherols, sterols, squalene, trace elements, polyphenols, peptides, polyunsaturated fatty acids, antioxidants, proteins, fat, carbohydrates, fibers, minerals, and vitamins making it a versatile supplement source. Notably, it is rich in amino acids, including branched-chain amino acids (BCAAs), natural enhancer of nitric oxide levels for improved circulation, endurance, strength, and stamina in athletes. It has been found to improve aerobic capacity, muscle recovery, and improved body composition. It is rich in fiber making it a beneficial prebiotic for athletes to maintain gastrointestinal health after intense training. Being rich in antioxidants and gluten-free, it’s ideal for special diets to reduce fat and increase muscle mass. A comprehensive overview of the ergogenic potential of Amaranthus and further research promises insights into developing Amaranthus-based dietary supplements for enhancing sports performance..
