Background and Objectives: There is a paucity of information available on acute respiratory infection (ARI) among school children in India. This study was aimed to assess the prevalence and certain risk factors associated with ARI among school children. Materials and Methods: This cross-sectional study was conducted among 397 school children age group of 5-14 years in the seven schools of rural Puducherry, India. Data on socio-demographic characteristics and associated risk factors of ARI were collected by interview using pre-tested structured questionnaire. Data was analyzed by univariate and multiple logistic regression analysis. Results: Overall, 51.1% (203) of the subjects had at least one symptom of ARI in the preceding 2 weeks. The manifestations of ARI included allergic rhinitis (183, 46.1%), dry cough (75, 18.9%), throat pain and fever (54, 13.6%), wheezing (39, 9.8%) and ear discharge (28, 7.1%). About half of the subjects with ARI (52.2%) belonged to 5-9 year age group and females (52.3%). Mother's education, family history of allergic disorder and asthma, absence of smoke outlet in kitchen and windows in sleeping room were found to be significantly associated with ARI in univariate analysis (P < 0.05). Multiple logistic regression analysis showed that 5-9 years age group (odds ratio [OR] = 1.7), family history of allergic disorder (OR = 9.6) and asthma (OR = 5.2), presence of smoke outlet in kitchen (OR = 0.5), absence of windows in sleeping room (OR = 3.0) were found to have an independent association with the ARI. About 29.6% (60) of the subjects with ARI had accessed health care facility for treatment. Conclusion: ARI among school children is an important health problem. Interventions like provision of smoke outlets and windows in sleeping room may help in reduction of burden of ARI.

Background: Viral hepatitis is a major public health problem throughout the world. It is the inflammation of the liver due to the infection of any of the five main hepatic viruses A to E and it affects the liver through different modes of transmission. This study mainly aims at the frequency and distribution of viral hepatitis based on age and sex during a time period of 5 years. Materials and Methods: This is a hospital-based retrospective study of 5 years at a tertiary level hospital in Kerala state in India. Medical records department of the hospital follow the guidelines of International Classification of Diseases-10 for coding the diseases. The data on frequency and distribution of viral hepatitis based on age and sex during a period of 5 years from April 2005 to March 2010 were collected and analyzed and 'z' test was used for finding out the difference in proportions. Result: Out of 818 cases, 76.03% were males and 23.96% were females. The preponderance of males was apparent in all types of viral hepatitis infection. The high risk groups were the adults in the age group of 20-39 years. The main cause in the present study was hepatitis E virus (HEV) and followed by hepatitis A virus (HAV). Of total viral hepatitis cases, 31.54% were due to HAV, 6.35% hepatitis B virus, 0.85% hepatitis C virus and 61.24% were due to HEV respectively. In the present study, there was no case of hepatitis D virus has reported. The case fatality rate of viral hepatitis in the present study was minor than 1% (0.98%); whereas males were 0.96%; females of 1.02%. Conclusion: Taking the safety measures including vaccination and proper management of waste materials are the only solution to control or eradicate this infection.

Introduction: Hepatitis B virus (HBV) is a parenterally transmitted viral illness of significant public health importance. The prevalence of HBV related viral hepatitis still remains debatable. Objectives: The objective of the following study is to determine the magnitude and pattern of HBV infection in clinically suspected infectious hepatitis at a tertiary care hospital in urban India. Materials and Methods: This prospective study was conducted in the Department of Microbiology at Lady Hardinge Medical College, New Delhi, over a period of 1 year from January 2008 to December 2008. All the serum samples taken from subjects (600 study and 200 control) were tested for hepatitis B surface antigen (HBsAg) using commercially available enzyme linked immunosorbent assay kit. Serum samples testing positive for HBsAg were tested for hepatitis B e antigen, immunoglobulin M (IgM) capture anti hepatitis D virus (HDV), IgM anti hepatitis B surface and IgM anti hepatitis B core. Results: 24 (4%) serum samples tested positive for HBsAg in the study group while 5 (2.5%) tested positive in the control. Maximum seropositivity of HBsAg was in 20-30 years of age group in the study group (7.6%) followed by 11-20 years (4.5%), 0-10 years (2.8%) and >40 years (2.5%). The difference in seropositivity in study and control group was statistically insignificant in all the age groups (P > 0.05). Out of 24 cases positive for HBsAg, 4 cases (16.6%) were co infected with HDV in study group while there were none in control group. Conclusions: HBV is a common cause of parenterally transmitted viral hepatitis and hence, it is recommended that measures for public awareness regarding safe infection practices and safe sex practices should be undertaken to limit its spread.

Introduction: Dengue is one of the most important arboviral infections caused by one of the four dengue serotypes, 1-4. Objective: To study the applicability of different diagnostic methods in diagnosis of dengue viral infection. Materials and Methods: A total of 2101 blood samples were collected for confirmation of dengue viral infection. All the samples were tested by dengue-specific IgM ELISA, of which 111 were also tested for NS1 antigen detection and 27 acute samples (≤5 days) were further subjected for viral RNA detection by RT-PCR and isolation in C6/36 cell line. To detect the sensitivity of NS1 antigen for different dengue virus serotypes, four dengue serotype 1 and 12 dengue 3 were subjected for the NS1 antigen assay. Results: Most common age group affected was 16-45 years, with male to female ratio of 2.8:1. During first 3 days of illness virus isolation and RT-PCR were the most sensitive (83%) followed by NS1 antigen detection (75%) and IgM detection (37.5%). The positivity of IgM detection was found to be significantly higher as compared to NS1 detection during 4 to 5 days and also after 5 days of illness (P < 0.05). Dengue serotypes 1 and 3 were found to be co-circulated, dengue 1 being the predominant serotype. Conclusion: Virus isolation and RT-PCR were the most sensitive tests during the early period of illness whereas beyond third day, IgM antibody detection was found to be the most sensitive method of dengue diagnosis.

Background and Objective: Mycobacterium tuberculosis has developed resistance to antituberculosis drugs and becoming a major and alarming public health problem in worldwide. This study was aimed to determine antituberculosis drug resistance rate and to identify multidrug resistant tuberculosis (MDR-TB) in West of Iran. Materials and Methods: Of 130 samples were included between December 2011 and July 2012 in the study from that 112 cases were M. tuberculosis. The proportional method was carried out according to the Clinical and Laboratory Standards Institute on Lowenstein-Jensen against isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide, para aminosalicylic acid, ethionamide, cycloserine (CYC). The microdilution method was carried out using 7H9 broth with 96 well-plates. Results: From 112 isolates, resistance was observed to isoniazid 18 (16.07%), rifampicin 16 (14.28%), streptomycin 25 (22.32%), ethambutol 15 (13.39%), pyrazinamide 27 (24.10%), para aminosalicylic acid 19 (16.96%), CYC 4 (3.57%), and ethionamide 14 (12.5%) cases. 16 isolates were MDR. Conclusion: The high prevalence of MDR-TB in our study is assumed to be due to recent transmission of drug-resistant strains. Overall, the rate of drug resistance in our study was high, which is in line with findings of some high-burden countries. Hence that early case detection, rapid drug susceptibility testing, and effective anti-TB treatment is necessary.

Renal transplantation (TX) in human immunodeficiency virus (HIV) infected patients with end stage renal disease (ESRD) is increasingly performed in developed countries in the era of antiretroviral therapy (ART). Management of HIV infected patients during and post-transplant is very complex and challenging due to drug interaction, infection risk and associated co-infections. We described our experience with living related donor renal TX in three HIV infected patients.

Mucormycosis is a rare life-threatening fungal infection mostly affecting immunocompromised hosts. The main categories of human disease with the Mucorales are sinusitis/rhinocerebral, pulmonary, cutaneous/subcutaneous, gastrointestinal and disseminated disease. Other disease states occur with a much lower frequency and include cystitis, vaginitis; external otitis and allergic disease. We report a diabetic patient with comorbidities, who developed gastric perforation clinically indistinguishable from perforated peptic ulcer due to invasive gastric mucormycosis complicated by spleen infarction.

Periorbital soft tissue swelling may result due to primary orbital pathology or from adjacent facio-maxillary or sino-nasal inflammatory causes. Osteomyelitis of maxilla in the pediatric age group is a rare entity in this era of antibiotics. We present an 11-month-old female infant who was brought with peri-orbital selling and purulent nasal discharge. Computed Tomography showed erosions of the walls of maxillary sinus suggestive of osteomyelitis. Culture of sinus scraping showed Staphylococcus aureus growth and the child improved with intravenous cloxacillin therapy. This case is presented due to the rarity of its presentation in this age group and for awareness to consider this entity in children having fever and peri-orbital swelling.

Immune thrombocytopenia is a relatively rare hematological manifestation in tuberculosis. We report two cases of immune thrombocytopemia, one in sputum positive pulmonary tuberculosis and the other in miliary tuberculosis. Antituberculous drugs and immunosuppressive therapy corrected the thrombocytopenia in both patients. Our case reports stress that tuberculosis should be considered during the evaluation of immune thrombocytopenia, and also highlights the safety of immunosuppressive therapy during active tuberculosis along with antituberculous drugs.

Fatal-disseminated Bacillus Calmette Guerin (BCG) disease is well known in infants with severe combined immunodeficiency after BCG vaccination. We report a 7 month male infant delivered as a product of in vitro fertilization and twin gestation that presented with fever, cough and multiple nodular skin lesions. A biopsy of skin lesions revealed the presence of acid fast bacilli. Mycobacterium bovis infection was confirmed by polymerase chain reaction (PCR) and molecular studies. Immunological profile confirmed the diagnosis of severe combined immunodeficiency. Only few reports of similar case exist in the literature.