Objective: To evaluate the diagnostic utility of Typhidot-M and Widal test in the early diagnosis of enteric fever (EF) in terms of sensitivity and specificity. Methods: The study included 270 children in the age group of 1-18 years admitted to the Department of Pediatrics from November 2012 to February 2014, with fever of 5 days or more and with clinical symptoms and signs suggestive of typhoid fever. Detailed history and clinical examination findings were recorded on a standard pro forma. Complete hemogram (hemoglobin, platelet count, and total and differential leukocyte count), Typhidot-M test, Widal tube test, and blood culture weredone on day 1 of admission. For Widal test, a titer of 1 in 160 or more for “O” agglutinins and a titer of 1 in 320 or more for “H” agglutinins were considered as positive results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value  (NPV) were calculated. Results: Of 270 children included in the study, Salmonella typhi was isolated from 82 samples (30.4%) and the remaining 188 (69.6%) were blood culture negative. Widal test was positive in 107 children (39.6%) and Typhidot-M was positive in 136 (50.4%). The sensitivity was 78%, specificity was 79.3%, PPV was 59.8%, and NPV was 91.4% for Widal test. Typhidot-M test had a sensitivity of 81.7%, specificity of 84.6%, PPV of 69.8%, and NPV of 91.4%. Conclusion: Prompt diagnosisof EF is essential for appropriate management and it is, therefore, important to have a satisfactory test to replace conventional tests used for diagnosis. The present study compares newer test (Typhidot-M) against conventional tests such as Widal test and blood culture, and it appears to be a practical alternative to Widal test in the early detection of EF even in the resource-poor laboratories as it neither requires much laboratory equipment nor laboratory expertise to conduct the test. This test can be done within 7 days of illness, but whenever feasible confirmation with blood culture is strongly recommended, especially with the well-documented presence of multidrug-resistant strains of salmonella typhi worldwide. However, both Widal and Typhidot-M appear to correlate less satisfactorily with blood culture, and thus, there is a need for developing a test which allows accurate and early diagnosis of EF to manage a child effectively and limit its morbidity and mortality.

Objective: To evaluate the effectiveness of prophylaxis with coagulation factor concentrates VIII/IX (FVII/IX) in children with severe hemophilia A/B, respectively. Materials and Methods: Retrospective observational study was done on children enrolled in our hemophilia clinic, who initially received “on demand” therapy and were on prophylaxis with factor VIII/IX concentrate at the time of the study. The study group consisted of 8 children. Annual hemarthrosis rate (AHR) over a period of 1-year during on demand therapy was compared with AHR during a period of 1-year on prophylaxis with FVIII/IX. Results: There was reduction in AHR by 87% in hemophilia A and 85% in hemophilia B during prophylaxis compared to on demand therapy. There was a significant reduction in hemarthrosis/patient/year from 2.5 to 0.3 on prophylaxis with factor concentrate compared to on demand therapy. There was also reduction in other bleeding manifestation like psoas muscle bleed, oral bleeds, epistaxis, and number of target joints involved. Conclusion: Prophylaxis with coagulation factor concentrate significantly reduces the AHR, and hence, decreases the disability associated with it compared to “on demand” therapy.

Cervical carcinoma (CaCx) is the second most common gynecological cancers globally. Many authors revealed that low levels of antioxidants induce the overproduction of reactive oxygen species (ROS) that result in oxidative stress. In the present study an attempt was made to evaluate the oxidative stress in 20 women with cervical carcinoma by measuring serum Malondialdehyde (MDA), Glutathione-S-transferase (GST) and Ascorbic acid (Vit-C) levels which was compared with 20 age matched non cancerous women. Signicantly elevated MDA levels (P<0.001) and lowered GST, Vit-C levels (P<0.0001) were observed in women with cervical carcinoma as compared with healthy controls. From our ndings it can be concluded that oxidative stress plays an important role in pathogenesis of cervical carcinoma. Hence supplementation of antioxidants may reduce the oxidative stress and minimize the associated morbidity and mortality

Objective: The objective of this study is to study the current antibiotic sensitivity pattern of Salmonella typhi and paratyphi isolates and the clinical response of children with culture positive enteric fever (EF) to the specific antibiotic used as suggested by the sensitivity pattern. Materials and Methods: This is a retrospective study analyzing the records of 197 children treated for blood culture positive EF during 3 years from January 2013 to December 2015. Antibiogram pattern of S. typhi/paratyphi and response pattern to the antibiotic used as per antibiogram were analyzed. Kirby Bauer’s disc diffusion method was used for antibiotic sensitivity using closed-loop stripping analysis standards. Temperature charts of the patients analyzed for response patternof fever to the antibiotic started. Results: 197 culture positive cases were included in the study (S. typhi=190 and paratyphi=7). Sensitivity pattern to 9 out of 10 antibiotics tested was high and was low only to nalidixic acid (6.3%). There were 184 (93.4%) children whose antibiogram showed high sensitivity to cephalosporins and were treated with intravenous ceftriaxone (Group 1). The majority of children in this group (172/184, 93.5%) became afebrile by 7 days of therapy. 13 (6.6%) children whose antibiogram showed resistance to cephalosporins were treated with intravenous ciprofloxacin (Group 2). 9 of this group became afebrile by 7 days. 12 children from Group 1 and 4 children from Group 2 were considered as either reduced susceptibility or resistance torespective antibiotics and were treated with either azithromycin or piperacillin-tazobactam over the next 5-7 days successfully. Conclusion: Appropriate diagnosis using blood cultures and using 3rd generation cephalosporins as the first line of the drug in treating children with EF can reduce the duration of treatment, promote better compliance, reduce relapse rates, and may help decrease multi-drug resistant S.typhi/partyphi strains in the community..