BACKGROUND Scrub typhus is a vector borne Rickettsial disease caused by Orientia tsutsugamushi and has been reported from tsutsugamushi triangle which includes India. It is a reemerging pathogen in India including the state of Odisha. This study was conducted to determine seropositivity of scrub typhus in patients attending a tertiary care hospital of Western Odisha. METHODS Fifty febrile patients who were negative for Malaria, Dengue and Leptospira attending a tertiary care hospital of Western Odisha were enrolled in the study. 3 ml of blood was collected, and serum was separated. IgM SD Bioline Tsutsugamushi lateral flow immunochromatography test was performed as per manufacturer instruction. Positive samples were confirmed by PCR method (Geno-Sen's ST Real Time PCR). RESULTS 20% of patients were positive for IgM SD Bioline Tsutsugamushi card test. 60% of positive patients were male. 20% of positive patients were having pathognomonic eschar. 60 % of infected patients were in the age group of 10-30. CONCLUSIONS In this study, 20% of febrile patients were positive for Scrub typhus infection. So, it should be included in the differential diagnosis of a febrile patient in Western Odisha.

A BSTRACT Background and Aim: Throughout the world, many healthcare settings have started using time and motion studies to improve their work pattern and efficiency whose basic purpose is to know the exact time taken in different service delivery points as well as to assess the perception of beneficiaries regarding the total time spent in the Outpatient Department (OPD). The aim of this study is to assess the operational efficiency as well as the satisfaction of patients attending the anti rabies vaccination (ARV) OPD. Materials and Methods: A cross-sectional study was carried out in a referral teaching hospital from 1 st July to 31 st August 2021. The study population comprised of animal bite patients attending the hospital. Data was collected using a pre-designed semi-structured questionnaire and a 5-point Likert scale. Results: The majority of patients were female, i.e., 811 (56.3%), and were between 15 to 30 years of age, i.e., 439 (30.5%). Maximum time was spent by patients in the OPD on Mondays. The mean time spent at Niramaya by new cases was 14.80 ± 6.09 minutes, whereas the same was 0.23 ± 1.89 minutes for follow-up cases. More than half of the respondents, i.e., 56.3% and 55.9%, found the time spent at consultation and the pace of registration to be satisfactory, respectively. Conclusion: Decentralization of registration counters is much needed to provide quality services to the patients.

BACKGROUND Enteric fever is a feco-orally transmitted disease with significant morbidity and mortality in India. Isolation of responsible bacteria from blood or bone marrow is the gold standard method for Enteric fever but it is seldom used now a days due to long turnaround time and higher cost. In developing country like India, relatively cheaper Widal test is used to diagnose Enteric fever. There are two methods of Widal test-slide agglutination test and tube agglutination test. The present study was done to compare efficacy of the slide agglutination test and tube agglutination in diagnosing enteric fever. METHODS An OPD and IPD based cross sectional study was conducted from May 2019 to Oct 2019. A total of 100 patients with clinical suspicion of Enteric fever were included in the study. 15 ml blood was collected. Blood culture of all the samples were also performed by inoculating 10 ml of blood into appropriate blood culture media. Serum was separated from rest of the blood and serum was tested by both slide agglutination test and Widal tube agglutination test. RESULTS Among 100 patients, slide agglutination test demonstrated positive result in 40(40%) samples and Widal tube agglutination test demonstrated positive result in 27 (27%) samples only. Among 40 samples positive by slide test 12 samples were negative by blood culture test. The slide test had a sensitivity of 93.33%, specificity of 82.86%, positive predictive value of 70% and negative predictive value of 96.67% and tube test had a sensitivity of 86.67%, specificity of 98.57% positive predictive value of 96.30% and negative predictive value of 94.52% considering blood culture as gold standard. CONCLUSIONS Due to higher sensitivity but poor specificity, slide Widal test should be used for rapid screening test and positive samples should be confirmed by Widal tube agglutination test.

No abstract