BACKGROUND Osteoarticular tuberculosis(OATB) is a severe form of extrapulmonary TB, which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge,...BACKGROUND Osteoarticular tuberculosis(OATB) is a severe form of extrapulmonary TB, which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge, because of the difficulty of collecting the samples and, secondarily, the paucibacillary nature of lesion, which gives poor sensitivity and reproducibility, with long turnaround time of routine/conventional laboratory tests and the requirement for invasive procedures and expertise. The Xpert MTB/RIF assay has been approved by the World Health Organization as a rapid diagnostic tool for diagnosing pulmonary and extrapulmonary TB.AIM To emphasize the diagnostic efficiency of gene Xpert for OATB in suspected patients in a tertiary care hospital of Eastern India.METHODS This retrospective study was conducted in the Department of Microbiology and Orthopaedics by analyzing the data of the gene Xpert assay over a 3-year duration from January 2018 to February 2021. Demographic and clinical data were recorded. The diagnostic efficiency of gene Xpert was evaluated against the composite reference standard(CRS).RESULTS A total of 37 cases fell into positive, probable, and possible categories of osteoarticular TB out of 112 patients included in the study by CRS;gene Xpert result was positive in 35 out of the 37 different CRS categorized cases. Of the 112 cases, culture was put in 40 cases, and, of these cultures, 5 cases showed the growth of MTB. Of these, 4 cases were included in the 35 cases diagnosed by gene Xpert.Smear microscopy was positive in 6 out of 37 CRS categorized cases. When compared with CRS, the sensitivity of gene Xpert assay, culture, and smear was found to be 94.6%, 13.5%, and 16.2%, respectively, while specificity in all the three types of tests was 100%. When kappa statistics were applied, the percentage of agreement gene Xpert, culture, and microscopy with CRS was found to be 95%, 20%, and 22.6%, respectively. Follow-up of the gene Xpert positive patients after getting anti-tubercular treatment revealed improved conditions.CONCLUSION Gene Xpert could detect 31 extra cases with a low and very low mycobacterial load that were missed by the routine culture methods. Hence, more samples should be processed for molecular diagnostic methods like gene Xpert along with other conventional methods for the validation of the molecular test prospectively for the timely diagnosis of osteoarticular TB.展开更多
Biotechnology plays an important role in mitigation of various pollution in a cost effective manner by using the complex chemistry of living organisms,various cell manipulations and their approaches for environmental ...Biotechnology plays an important role in mitigation of various pollution in a cost effective manner by using the complex chemistry of living organisms,various cell manipulations and their approaches for environmental cleanup along with environmental sustainability.One such technology is phytoremediation technology or green technology which has emerged and evolved as a novel tool for remediation of toxic contaminants from environment.Plants with its diverse range show a remarkable range of their phytoremediation potentiality for establishing a sustainable environment.There is a huge exploitation of natural resources through expanded industrialization,urbanization,modern agricultural development,energy generation to fulfill the never-ending human desires and need.This disturbs the balance in nature where we reside and leads to progressive deterioration of the environment.There are several biotechnological advances which are employed for combating both the biotic and abiotic stress problems caused due to toxic contaminants in the environment.Various biotechnological interventions such as bioinformatics,proteomics,genomics,metallomics and metabolomics play a crucial role and open new avenue in this context.This omics approach is now integrated with bioinformatics to serve as a novel tool in phytoremediation technology.This smart technology provides insights into the complex behavior of enzymes,proteins and metabolites action and their biochemical pathways for degradation of wastes.This leads towards deriving a sustainable solution for environmental pollution.展开更多
文摘BACKGROUND Osteoarticular tuberculosis(OATB) is a severe form of extrapulmonary TB, which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge, because of the difficulty of collecting the samples and, secondarily, the paucibacillary nature of lesion, which gives poor sensitivity and reproducibility, with long turnaround time of routine/conventional laboratory tests and the requirement for invasive procedures and expertise. The Xpert MTB/RIF assay has been approved by the World Health Organization as a rapid diagnostic tool for diagnosing pulmonary and extrapulmonary TB.AIM To emphasize the diagnostic efficiency of gene Xpert for OATB in suspected patients in a tertiary care hospital of Eastern India.METHODS This retrospective study was conducted in the Department of Microbiology and Orthopaedics by analyzing the data of the gene Xpert assay over a 3-year duration from January 2018 to February 2021. Demographic and clinical data were recorded. The diagnostic efficiency of gene Xpert was evaluated against the composite reference standard(CRS).RESULTS A total of 37 cases fell into positive, probable, and possible categories of osteoarticular TB out of 112 patients included in the study by CRS;gene Xpert result was positive in 35 out of the 37 different CRS categorized cases. Of the 112 cases, culture was put in 40 cases, and, of these cultures, 5 cases showed the growth of MTB. Of these, 4 cases were included in the 35 cases diagnosed by gene Xpert.Smear microscopy was positive in 6 out of 37 CRS categorized cases. When compared with CRS, the sensitivity of gene Xpert assay, culture, and smear was found to be 94.6%, 13.5%, and 16.2%, respectively, while specificity in all the three types of tests was 100%. When kappa statistics were applied, the percentage of agreement gene Xpert, culture, and microscopy with CRS was found to be 95%, 20%, and 22.6%, respectively. Follow-up of the gene Xpert positive patients after getting anti-tubercular treatment revealed improved conditions.CONCLUSION Gene Xpert could detect 31 extra cases with a low and very low mycobacterial load that were missed by the routine culture methods. Hence, more samples should be processed for molecular diagnostic methods like gene Xpert along with other conventional methods for the validation of the molecular test prospectively for the timely diagnosis of osteoarticular TB.
文摘Biotechnology plays an important role in mitigation of various pollution in a cost effective manner by using the complex chemistry of living organisms,various cell manipulations and their approaches for environmental cleanup along with environmental sustainability.One such technology is phytoremediation technology or green technology which has emerged and evolved as a novel tool for remediation of toxic contaminants from environment.Plants with its diverse range show a remarkable range of their phytoremediation potentiality for establishing a sustainable environment.There is a huge exploitation of natural resources through expanded industrialization,urbanization,modern agricultural development,energy generation to fulfill the never-ending human desires and need.This disturbs the balance in nature where we reside and leads to progressive deterioration of the environment.There are several biotechnological advances which are employed for combating both the biotic and abiotic stress problems caused due to toxic contaminants in the environment.Various biotechnological interventions such as bioinformatics,proteomics,genomics,metallomics and metabolomics play a crucial role and open new avenue in this context.This omics approach is now integrated with bioinformatics to serve as a novel tool in phytoremediation technology.This smart technology provides insights into the complex behavior of enzymes,proteins and metabolites action and their biochemical pathways for degradation of wastes.This leads towards deriving a sustainable solution for environmental pollution.
