Cu ltu re in liqu id med iu m has re ma ined the go ld standa rd fo r the d iagnos is o f Tricho monas v ag ina lis in fec t ion fo r the past 40 ye ars and has th e h ighe r s ensit iv ity o f 71-100% and spe c ific ity of 100% .  It is ve ry use fu l method when the o rgan is m load is lo w as in asy mpto mat ic wo men and men with chron ic d isease , as it requ ires as fe w as 300-500 Tricho mon ads/ ml o f inocu lu m to in it iat e g ro wth in cu ltu re .  The va rious med ia that have b een used to det ect Tricho monads a re Dia mond (Tript icase , y east and ma ltose ), Mod ified Dia mond, Kup fe rbe rg ’s Trichose l med iu m, Lash, NIH, Fe inbe rg -Wh itt ington med ia and cyste ine pepton e live r med ia (CPLM ). The fo rmu lat ions o f Dia mond med iu m a re supe rio r to that of Kup fe rb erg o r Lash med iu m fo r th e g rowth of Tricho mon as vag ina lis . 
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The prevalence of T. vaginalis infection was highest with ELISA-based antigenic detection method (7.2%). Using the “gold standard” as the reference, the use of ELISA presented with a substantial concordance with the vaginal sample culture method ( κ = 0.710), with vagi- nal sample wet mount and urine culture methods pre- senting with moderate ( κ = 0.487) and slight agreement ( κ = 0.192) respectively. In order to evaluate the per- formance of each test method in diagnosing T. vaginalis infection, we employed the receiver operating character- istics (ROC) curve analysis with reference to the gold standard (vaginal sample culture). The ELISA method performed best compared to the other methods, present- ing with the highest sensitivity [88.9%, 95% CI (54.0 – 99.8)], specificity [97.1%, 95% CI (93.1 – 98.9)], AUC (93.0%), and accuracy (96.7%). This suggest that anti- genic detection using ELISA-based method may be used as a surrogate to HVS culture, for accurate diagnosis of T. vaginalis infection in women in the event where the culture method is unavailable or when rapid diagnosis is required. Nonetheless, it is worthy of note that there is a false-negative and false-positive rate of 1.1% and 2.9% re- spectively when the ELISA method was used compared with the vaginal sample culture method; hence, results from the ELISA method should be interpreted with caution. This incongruity may be partly associated with
Comparative studies such as this one, in which an amplifi- cation test with the potential for high sensitivity is judged against a less-sensitive culture method, produce a now-familiar dilemma: how to estimate specificity when it is likely that some positive results classified as false positives are, in fact, true positives. Discrepant analysis, which subjects discordant results to additional testing and reclassification, has been used in many previous evaluations of new amplification tests. How- ever, discrepant analysis does not provide valid estimates of sensitivity or specificity, and its use has been discouraged (5, 14–16). As an alternative to discrepant analysis, we algebra- ically adjusted specificity estimates for T. vaginalis PCR-ELISA (27). Using reasonable assumptions for the performance of wet mount microscopy and culture, this procedure is unlikely to overestimate the specificity of the new test. We did not adjust the sensitivity estimate, because we assumed the specificity of our combined reference standard to be 1.0. However, our sensitivity may be slightly overestimated due to the potential for concordant false negatives for PCR and the reference stan- dard. The estimated sensitivity of the PCR assay is based upon specimens positive by the combined reference standard. One would predict that the sensitivity would be lower among women with trichomoniasis but a negative combined reference test (16). If these results could be incorporated into the sensi- tivity estimate, the figure would be lowered slightly.
The prevalence of TV infection in this study was 8.6% based on all positive tests. Various studies report differ- ent prevalence values ranging from 13 to 41% based on the methods used, study settings, social-demographics and symptomatology of studied populations [4, 9, 10]. In high-risk populations such as female sex workers in sub- Saharan Africa (SSA), the prevalence of active TV infec- tion can be as high as 47% . However, the relationship between symptoms and presence of active TV infection also varies since the symptoms are not very specific. In this study, less than 10% of symptomatic women were confirmed with TV infection. Thus, it appears that in the studied population, TV infection diagnosis requires diag- nostic algorithms that include highly sensitive laboratory tests. The in-house PCR was highly sensitive and specific for the detection of TV DNA in vaginal swabs, and far out performed the routinely used WMM in the study setting. In our study, the phenol chloroform method was employed for DNA extraction. If costs would allow, it would be better to use extraction columns like silica- membrane-based DNA purification, believed to increase TV detection; consequently the prevalence of tricho- moniasis could probably have been higher in our study. Methodological issues can also affect WMM. Studies elsewhere have shown that the low sensitivity of WMM can further be decreased by 20% with delayed micro- scopic examination for as few as 10 min . In our study, even when the wet preparation was performed at the sample collection site, by the experienced reader who routinely performs the wet preparations at the clinic, its sensitivity (25%) was still poor. Various studies using related but not exactly the same study designs report the sensitivity of WMM to range from around 38 to 65% [4, Table 1 Demographic and clinical characteristics of study
Methods and Materials: A total of 112 clinically suspected cases of meningitis in paediatric age group were included. It was a hospital based Descriptive cross sectional study from January 2017 to November 2017. All the specimens were processed by standard bacteriological techniques that include microscopy (Gram staining, wet mount, India ink), culture in blood agar, Mac Conkey agar, Chocolate Agar plates, Automated culture (BACTEC) method and etc.
Therefore, accurate diagnosis of T. vaginalis infection is an important issue. T. vaginalis infection cannot be accurately diagnosed based on the clinical picture be- cause clinical symptoms of trichomoniasis may be simi- lar to those of other sexually transmitted diseases . Different diagnostic methods that are usually used (wet mount method) for routine field diagnosis of T. vaginalis have low sensitivity [7,8]. Other methods for diagnosis of T. vaginalis, such as culture and polymerase chain re- action (PCR), are time consuming and not available in all field laboratories . Therefore, a simple and rapid diagnostic test with acceptable sensitivity and specificity is required. The latex agglutination test has a high sensi-
Because T. vaginalis infection is linked to serious health outcomes, such as the acquisition and shedding of HIV, our findings suggest that in similar settings, all adolescent women may benefit from additional T. vaginalis testing regardless of other risk factors. In the hands of experienced providers, wet- mount tests yield valuable information on other parameters, such as the presence of WBCs, clue cells, or yeast. Therefore, despite its moderate sensitivity for T. vaginalis, the wet mount is a reasonable first step in the evaluation of women at risk for T. vaginalis and other STIs. Point-of-care tests, such as wet- mount and rapid tests, are important STI diagnostic strategies, since they allow immediate counseling and treatment. There- fore, we propose using a stepwise diagnostic strategy, as fol- lows. (i) Since the wet mount is a useful and inexpensive test, all women at risk for STIs should have a wet mount performed. When the wet-mount swab is obtained, an additional primary vaginal swab can be obtained and held either in saline or as a dry swab. (ii) If the wet mount is negative for trichomonads, a rapid antigen test can be performed using the saved primary swab or the used wet-mount swab with no loss of sensitivity. (iii) If both the wet-mount and rapid antigen tests are negative, the provider should consider inoculating a T. vaginalis culture using the saved primary swab if T. vaginalis is highly suspected or if the prevalence of T. vaginalis is high in the population. Because the NAAT for T. vaginalis is not yet commercially available, we cannot recommend its use as a primary or sec- ondary screening method for T. vaginalis infections.
The data presented here provide evidence that the TVQ assay is a highly sensitive and specific NAAT for detection of T. vaginalis DNA using self-collected vaginal swab specimens. While it is dif- ficult to estimate sensitivity and specificity when only poor refer- ence standards are available, the multiple comparison methods used here clearly demonstrated superior performance versus the wet mount method (P ⬍ 0.001), the most common diagnostic method in use, and equivalence with the ATV assay, the only other FDA-approved NAAT (P ⫽ 0.092). Using the PIS and LCA to model the data obtained in this study, the estimates for sensitivity and specificity were ⬎ 98% and 99.0 to 99.6%, respectively. As expected, NAATs identified more infections than did culture or wet mount testing; 12.9% of all infections were identified only by NAATs. This is a conservative estimate of the increase in sensitiv- ity with NAATs, due to the limitations of PIS analyses based on wet mount and culture results. The use of a nonbiased estimation method such as LCA increases the robustness of the estimates and
color, eye shape, hair texture, religion, and rituals. Amongst all these hidden and visible characteristics there are some key components by which theorists try to categorize cultures. For example, based on values (as a key element in culture) Hofstede (2001cited in Ayman & Korabik, 2010) categorized cultures in five levels: “individualism-collectivism, power distance, uncertainty avoidance, and masculinity-feminity” (p. 158). These levels can be observed in different cultural elements, like language, family relation, values, and social play. Since play is culturally constructed (Pufall & Pufall, 2008), it can be assumed that these levels are embedded in play. Thus, the elements of play (e.g., speed, theme, materials, arena, rules, competition, and simplicity-complexity) can display the values and levels of cultures (Yaoying, 2010). Considering competition as an essential ingredient in play, for instance,
studies have described longitudinal patterns of serological re- sponses in patients with culture-confirmed disease. We aimed to determine which patient characteristics predisposed them to fail to mount a detectable antibody response or predicted sub- sequent changes in IHA titers over time. Previous work from Darwin, Australian Northern Territories, found that female sex, pneumonia, and chronic renal disease correlated with an initially negative IHA (7); these findings were not replicated in our study. However, a robust finding, from both our study and the work from Darwin, appears to be the presence of bactere- mia predicting an initially negative IHA. The rapid progression of disease and the high bacterial load in patients with bacte- remia may have contributed to an inadequate time for devel- opment of an antibody response at the time of presentation. Bacteremia was the only significant factor affecting serial IHA patterns. Most patients who later seroconverted were bactere- mic at presentation and no bacteremic patients seroreverted, indicating that although the rapid onset of disease may provide little time for detectable seroconversion, the stimulus for sub- sequent antibody production is significant and long lasting.
the mechanical stability. To obtain pure chitin, a smooth dissolution of calcium compounds in shrimp shells is pos- sible with lactic acid that forms complexes with Ca 2+ ions. Since lactic acid as such is expensive, in-situ production by lactic acid bacteria LAB from carbohydrates seems to be an elegant method for calcium removal [7-9]. In comparison to chemical treatment with alkali and mineral acids for protein and calcium removal, respectively, bio- logical removal of these compounds proceeds under much less extreme conditions, but requires a longer incubation time [1,2,7,9]. In our study, demineralization of wet or dried shrimp shells was started after deproteination at 68 h or 140 h, respectively, by addition of LAB from a bio yoghurt and glucose as a carbon source (Figures 1a and b). The pH dropped during lactic acid formation from glucose and decalcification apparently proceeded to com- pletion when enough lactic acid for complex formation with Ca 2+ ions was generated by the LAB (Figure 1, M1 and M2). When calcium was not completely removed from shrimp shells by the first glucose feeding, glucose was re-fed, which led to more lactic acid production and
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As found in this study (Table 1) and in previous re- ports [8,34], a wide spectrum of commensal or transi- ently colonizing fungi can be found from healthy nails. These commensal fungi have a potential to overgrow dermatophytes or other real pathogens during culture, even if antibiotics and antifungals are included in select- ive media . In this study, 4 of the 11 array-positive but culture-negative samples were contaminated (growth of bacteria or nondermatophytes) during culture (data not shown). The current array seems to have a better ability to detect fungal pathogens in a complex flora; this advantage was also demonstrated in a study using an array to detect fungal pathogens in patients with cystic fibrosis .
Objective: Intestinal parasites are present throughout the world in varying degrees of prevalence due to many fac- tors. The aim of this study was to determine the 5-year trend prevalence of intestinal prevalence among patients who had been suspected for intestinal parasite infections. A retrospective study was conducted from 2009 to 2013 at Poly Health Center Gondar, Northwest Ethiopia. Samples were examined using direct saline wet mount methods. Statisti- cal analysis was done using SPSS version 20 software and a P-value of < 0.05 was considered statistically significant. The results were presented in tables and graphs.
The accurate diagnosis of VVC is important so that patients do not have to rely on empirical treatment, which may be inappropriate (35). In 2006, Schwiertz et al. reported a rate of misjudgment of VVC by physicians of 77% on the basis of clinical evidence alone (32). Microbiologic testing for episodic VVC is recommended for patients with mild to moderate symptoms and no history of persistent or recurrent infection (41), and women are generally considered to have VVC when vaginal specimens are positive for yeasts by both microscopy and culture. The signs and symptoms of VVC have been re- ported to be more severe in women with yeast counts of ⬎ 10 3
Recently Joy, M.P. et al. (2003) examined toludine blue as an alternative rapid stain. It is an inexpensive stain, and easily available. Although toludine blue has been used in evaluation of touch imprint, frozen sections and in squash preparation of central nervous system tumors (Dusmez et al., 2001), there were no pervious reports using toludine blue for rapid diagnosis of ultrasound guided fine needle aspirates. They studied the reliability of touldine blue stain as a rapid stain for quick diagnosis in ultra round guided aspiration cytology. Here smears were air dried and dipped in a Coplin jar containing freshly filtered staining solution for one minute. Then rinsed in tap water. Wet mounted slides were examined under the microscope. They observed that cytoplasmic, nuclear details were well appreciated in toludine blue stained smear permitting rapid diagnosis. The sensitivity of their study for malignant/suspicious for malignancy was 98.54%. Sensitivity and specificity for an inflammatory condition was 100%. They concluded that toludine blue staining is not only a reliable method for rapid staining and diagnosis, it also permits preservation of cytological material by destaining and restaining with permanent stains.
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Purpose: Dermatophytes are fungi that cause infections affecting hair, nail, and skin; in nails they cause onychomycosis, while in hair they lead to tinea capitis. Detection of dermatophytes using traditional methods, including potassium hydroxide (KOH) and culture on agar-based media leads to high rates of false-negative results. Here, we investigated more accurate diagnostic techniques, including Chicago sky blue staining and Calco ﬂ uor white ﬂ uorescent staining and compared them with traditional KOH and culture methods for the diagnosis of fungi causing onychomycosis and tinea capitis.
Historically, Vietnam was an independent country. During the period from 46 (after the defeat of the Hai Ba Trung uprising) until 938 (Ngo Quyen’s victory on the Bach Dang River), Vietnam was a colony of Chinese feudal dynasties. (Vietnamese people often refer to the Northern domination period). Along with territorial invasions, the feudal armies would inevitably carry with them religious beliefs. Therefore, the spread of Chinese beliefs and religions to Vietnam is evident. According to many researchers of Vietnamese folklore, Tutelary god beliefs can be propagated into Vietnam from the Tang Dynasty, and in particular the time is difficult to determine accurately. However, before foreign cultural factors (including Chinese culture), Vietnam had many folk beliefs with profound indigenous elements.
introduced him to Robert Reid, designate Abbot of Kinloss and future Bishop of Orkney. Ferrerio visited Scotland twice (1528-37 and 1540 45) and was hugely influential in ensuring that Kinloss became a centre of humanist learning. His influence, however, was not confined to the monastic community. He also struck up an acquaintance with the Gordons of Huntly and with the Earl of Moray. Furthermore, he spent a three year period at the Scottish Court (1528-31) where his companions included Sir John Campbell of Lundy, Sir Thomas Scot of Petgorno (a Lord of Session and future Justice Clerk), Laurence Telfer, Sir James Foulis and Sir Walter Lindsay of Torphichen, Knight of Rhodes and kinsman of the poet.12 * Ferrerio's attachment to the Court suggests that the intellectual atmosphere he found there was, to some extent, receptive to his ideas and to humanism in general. While it is wrong to view the court culture of James’s reign as exclusively, or even predominantly, humanistic, it is clear that such influences were making themselves felt. As we shall see, court culture during this period was 11 Whitelaw's Latin oration delivered to Richard III (1484) has been
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Abstract. Enochrus algarum sp. nov. is described from Fujian Province in southern China. Its unusual combination of weakly impressed elytral striae, an entire fi fth abdominal ventrite, and short maxillary palps make subgeneric placement diffi cult, and thus we do not assign it to any subgenus and place it as Enochrus incertae sedis for the time being. All specimens were collected on wet rock surfaces with dense algae or in decaying plants beside wet rock. It is the fi rst species of the genus from East Asia known to occur in hygropetric habitats.
In the study reported here we collected the samples i.e vaginal swabs in 1 ml sterile normal saline squeezed out the swab and stored it till extraction at -20˚C. Pillay et al (2007) has also shown the successful amplification of DNA from vaginal washes with normal saline (80). A total of 10 samples were found positive by the PCR assay used. In our study all the 6 culture positive samples were also positive by the PCR assay. However, one of the culture positive samples became positive only after repeating the PCR with a 1/100 diluted DNA input. This particular sample was also positive by the direct wet mount preparation. This indicated a larger number of parasites in the original sample. Hence, the lack of amplification in the undiluted and 1/10 diluted sample may be due to template DNA excess. The template excess may cause chelation of Mgcl 2 added to suboptimal level for the results for the PCR reactions.
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